Converging perspectives in vestibular neurology.

This paper discusses the human postural control as a system engineering approach problem. Two main perspectives are considered: neurological and engineering. From the neurological perspective, the problem is described, main sensory systems are identified, sensor fusion is suggested, and control system architecture and details are presented. Experimental results on both human subjects and on a special-purpose humanoid agree with the presented architecture. On the other hand, the humanoid parameters are identified, the humanoid dynamic model is derived, external-disturbance estimation methods are presented, a control method for stabilizing the body motion and then for robust tracking of voluntary motion in the presence of external disturbances is shown. This constitutes an engineering approach to this problem. Simulation results are given and it is shown that the presented method is capable of estimating the disturbances and for controlling the motion

This paper discusses the human postural control as a system engineering approach problem. Two main perspectives are considered: neurological and engineering. From the neurological perspective, the problem is described, main sensory systems are identified, sensor fusion is suggested, and control system architecture and details are presented. Experimental results on both human subjects and on a special-purpose humanoid agree with the presented architecture. On the other hand, the humanoid parameters are identified, the humanoid dynamic model is derived, external-disturbance estimation methods are presented, a control method for stabilizing the body motion and then for robust tracking of voluntary motion in the presence of external disturbances is shown. This constitutes an engineering approach to this problem. Simulation results are given and it is shown that the presented method is capable of estimating the disturbances and for controlling the motion.

The traumatic events of the past decades have touched each of us in either primary or secondary ways. The effects of trauma are experienced physically, mentally, emotionally, socially and spiritually. Many who have been touched by natural disasters or human atrocities view their spiritual distress as the most intense of these responses. While many of the therapeutic models used today all but fail to address this important aspect of humanness, a growing number of psychotherapists are exploring alternate methods of healing in an effort to address the spiritual distress experienced by their traumatized clients. As they being their study of spirituality and spiritual interventions as different from religion and religious models, some of these therapists are revisiting ancient methods of soul healing, including the time- honored teachings and practices of Shamanism. In this discussion article, the relationship between triggers, flashbacks and dissociation are explored from both a neurological perspective and a spiritual (rooted in Shamanic knowledge) perspective. These two worldviews are compared and contrasted. Questions are presented which invite psychotherapists to ponder the need for an increased understanding of spiritual distress and spiritual interventions in order to provide to their trauma clients a more balanced and holistic approach

This article is a discourse analysis of two historical inquiries into what clinici‐ans today call attention deficit hyperactivity disorder (ADHD). Of primary con‐cern in this regard are psychodynamic perspectives towards ADHD symptoms, championed by psychoanalysts and psychologists, and neurological perspectives towards ADHD, which continue to favor a purely physiological approach to understanding the disorder. Those within the psychodynamic camp are inclined to view ADHD as an interactional difficulty between self and social environment ‐ a condition best remedied by psychotherapy. Those within the neurological camp see ADHD as a specific brain process, whose effective treatment depends upon adequate psychopharmacology. This essay argues that both psychodynamic and neurological perspectives towards ADHD have strategized to legitimate one perspective through the expulsion of the other. Within the current era of ADHD nomenclature and treatment it is clear that neurological perspectives dominate the debate. However, neurological perspectives continue to be haunted by a considerable amount of skepticism, both nationally and internationally. Because of this it would be difficult to assert that neurological perspectives, though winning the “legitimation race” in contemporary understandings of ADHD, are entirely monolithic sources of ADHD knowledge.

Review for "Acute porphyrias – A neurological perspective"

Rare neurological complications can occur after COVID-19 vaccination, but recent studies show that such complications are much more common after SARS-CoV-2 infection. Novel approaches to risk–benefit analysis such as Bayesian network models can integrate the latest global evidence with local factors to inform decision-making and support the global vaccination effort.

Decision letter for "Acute porphyrias – A neurological perspective"

Vertebroplasty (VP) and balloon kyphoplasty (KP) are minimally invasive stabilization procedures for pathologic vertebral compression fractures (VCF). Concurrent administration of photodynamic therapy (PDT) as a tumor-ablative modality has yet to be studied in humans as a potential complement to improved mechanical stability that is afforded by vertebral cement augmentation (VCA). This first-in-human trial used a single 6 mg/m2 dose of the clinical photosensitizer Visudyne with escalating laser light doses. Following a cohort of light-only controls (n = 6), the drug and light treatment groups (n = 6 each) were 50, 100, 150, and 200 J/cm. VCA was performed within 15 minutes following PDT. Patients were clinically reviewed at 1 and 6 weeks. The primary outcome measure was safety from a neurologic perspective. Thirty patients comprising a variety of primary tumors were treated with PDT and either KP or VP. Vertebral PDT was technically feasible and delivered in all study patients. No dose groups showed significant increases in pain as defined by the generic SF-36 as well as disease-specific EORTC-QLQ-BM22 and EORTC-QLQ-C15-PAL questionnaires. The 50 and 100 J/cm groups showed the most significant pain reduction (P < 0.05). Twelve (40%) patients experienced complications during the study including 3 patients with further vertebral fracture progression by 6 weeks despite VCA. No complications were directly attributed to PDT. Using the parameters described, vertebral PDT as an adjunct to VCA is safe from a pharmaceutical and neurologic perspective. The results of this trial motivate scale-up study evaluating potential PDT efficacy in vertebral metastatic treatment.

Even though severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system, the nervous system is not spared either. SARS-CoV-2 has been isolated from the brain, olfactory bulb and cerebrospinal fluid. During the SARS (SARS-CoV-1) outbreak in 2002 to 2003, neurons had been found to be highly susceptible for infection and the virus could cause extensive neuronal damage. Similar to SARS-CoV-1,SARS-CoV-2 exploits the angiotensin-converting enzyme 2 (ACE-2) receptor to gain entry and infect both glial and neuronal cells which express ACE-2 receptors.[1] SARS-CoV-2 affects the central as well as peripheral nervous system presenting with diverse manifestations like myelitis, cerebrovascular events (CVE) and encephalitis to mention a few.[2,3] Indepth understanding of neurotropic potential of this virus will be helpful to individualize the treatment protocol from a neurological perspective.

&lt;div&gt;AbstractPurpose:&lt;p&gt;Vertebroplasty (VP) and balloon kyphoplasty (KP) are minimally invasive stabilization procedures for pathologic vertebral compression fractures (VCF). Concurrent administration of photodynamic therapy (PDT) as a tumor-ablative modality has yet to be studied in humans as a potential complement to improved mechanical stability that is afforded by vertebral cement augmentation (VCA).&lt;/p&gt;Patients and Methods:&lt;p&gt;This first-in-human trial used a single 6 mg/m&lt;sup&gt;2&lt;/sup&gt; dose of the clinical photosensitizer Visudyne with escalating laser light doses. Following a cohort of light-only controls (&lt;i&gt;n&lt;/i&gt; = 6), the drug and light treatment groups (&lt;i&gt;n&lt;/i&gt; = 6 each) were 50, 100, 150, and 200 J/cm. VCA was performed within 15 minutes following PDT. Patients were clinically reviewed at 1 and 6 weeks. The primary outcome measure was safety from a neurologic perspective.&lt;/p&gt;Results:&lt;p&gt;Thirty patients comprising a variety of primary tumors were treated with PDT and either KP or VP. Vertebral PDT was technically feasible and delivered in all study patients. No dose groups showed significant increases in pain as defined by the generic SF-36 as well as disease-specific EORTC-QLQ-BM22 and EORTC-QLQ-C15-PAL questionnaires. The 50 and 100 J/cm groups showed the most significant pain reduction (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Twelve (40%) patients experienced complications during the study including 3 patients with further vertebral fracture progression by 6 weeks despite VCA. No complications were directly attributed to PDT.&lt;/p&gt;Conclusions:&lt;p&gt;Using the parameters described, vertebral PDT as an adjunct to VCA is safe from a pharmaceutical and neurologic perspective. The results of this trial motivate scale-up study evaluating potential PDT efficacy in vertebral metastatic treatment.&lt;/p&gt;&lt;/div&gt;

Post-traumatic stress disorder (PTSD) is a chronic condition characterized by symptoms of physiological and psychosocial burden. While growing research demonstrated signs of inflammation in PTSD, specific biomarkers that may be representative of PTSD such as the detailed neural correlates underlying the inflammatory responses in relation to trauma exposure are seldom discussed. Here, we review recent studies that explored alterations in key inflammatory markers in PTSD, as well as neuroimaging-based studies that further investigated signs of inflammation within the brain in PTSD, as to provide a comprehensive summary of recent literature with a neurological perspective. A search was conducted on studies published from 2009 through 2019 in PubMed and Web of Science. Fifty original articles were selected. Major findings included elevated levels of serum proinflammatory cytokines in individuals with PTSD across various trauma types, as compared with those without PTSD. Furthermore, neuroimaging-based studies demonstrated that altered inflammatory markers are associated with structural and functional alterations in brain regions that are responsible for the regulation of stress and emotion, including the amygdala, hippocampus, and frontal cortex. Future studies that utilize both central and peripheral inflammatory markers are warranted to elucidate the underlying neurological pathway of the pathophysiology of PTSD.

Chapter 9 - Neurological perspectives on aging

Author response for "Acute porphyrias – A neurological perspective"

This paper explores the relationship between memory, language, and embodied cognition by analyzing how sign languages encode the concept of memory through bodily referents. While memory is often associated with the brain from a neurological perspective (Baddeley [1974]; Cann &amp; Ross [1989]; Ackerman [1992]), different languages metaphorically locate memory in various parts of the body, such as the heart, muscles, or even the environment. Sentences like “This is etched on my heart” (English) refer to something that has made a big impression on me, making it easy for me to remember. Other languages refer to memory as residing in various places in the body, such as the ventral area of the body or the environment itself (in Japanese culture, for instance). Sign languages provide an opportunity to examine this phenomenon visually and spatially, offering insights into how bodily experience influences linguistic representation. Drawing on theories of embodiment, including work from neuroscience, psycholinguistics, and sign linguistics, this study investigates the bodily locations used to express memory across five sign languages: Italian Sign Language (LIS), Brazilian Sign Language (LIBRAS), American Sign Language (ASL), British Sign Language (BSL), and Japanese Sign Language (JSL). Using data from Spreadthesign and other linguistic resources, the study identifies commonalities in how these languages position memory-related signs primarily around the head, supporting the idea that cognitive and linguistic structures align with physical and cultural perceptions of memory storage. The research is grounded in conceptual metaphor theory (Lakoff &amp; Johnson [1981]), which posits that abstract concepts are understood through embodied experiences and incorporates reflections on the semantic approach to sign language studies (Cuxac [2004]). Findings suggest that while spoken languages may metaphorically associate memory with different body parts, sign languages provide a more direct visual and spatial representation of these associations. By analyzing the lexicon of “memory” across different sign languages, the study offers evidence of a shared cognitive and bodily foundation in language structure, supporting the hypothesis that linguistic meaning is deeply embedded in human perception and bodily experience. Furthermore, this work contributes to ongoing discussions about the relationship between sign and spoken languages. While sign languages have often been studied in relation to their spoken counterparts, they offer unique insights into how language interacts with cognition and physicality. This study also aligns with previous research on iconicity in sign language (Cuxac [2000a, 2000b]; Wilcox [2000]; Taub [2001]), emphasizing the role of the body in structuring linguistic meaning. The findings challenge traditional distinctions between phonology and morphology in linguistic theory, reinforcing the need for models that account for the multimodal and spatial dimensions of sign language. By bridging linguistic, cognitive, and neurological perspectives, this paper underscores the importance of embodied cognition in understanding language development and meaning construction. The analysis of memory-related lexicon in sign languages not only highlights the influence of bodily experience in linguistic representation but also opens new avenues for exploring how language reflects fundamental cognitive processes across different modalities.

&lt;div&gt;AbstractPurpose:&lt;p&gt;Vertebroplasty (VP) and balloon kyphoplasty (KP) are minimally invasive stabilization procedures for pathologic vertebral compression fractures (VCF). Concurrent administration of photodynamic therapy (PDT) as a tumor-ablative modality has yet to be studied in humans as a potential complement to improved mechanical stability that is afforded by vertebral cement augmentation (VCA).&lt;/p&gt;Patients and Methods:&lt;p&gt;This first-in-human trial used a single 6 mg/m&lt;sup&gt;2&lt;/sup&gt; dose of the clinical photosensitizer Visudyne with escalating laser light doses. Following a cohort of light-only controls (&lt;i&gt;n&lt;/i&gt; = 6), the drug and light treatment groups (&lt;i&gt;n&lt;/i&gt; = 6 each) were 50, 100, 150, and 200 J/cm. VCA was performed within 15 minutes following PDT. Patients were clinically reviewed at 1 and 6 weeks. The primary outcome measure was safety from a neurologic perspective.&lt;/p&gt;Results:&lt;p&gt;Thirty patients comprising a variety of primary tumors were treated with PDT and either KP or VP. Vertebral PDT was technically feasible and delivered in all study patients. No dose groups showed significant increases in pain as defined by the generic SF-36 as well as disease-specific EORTC-QLQ-BM22 and EORTC-QLQ-C15-PAL questionnaires. The 50 and 100 J/cm groups showed the most significant pain reduction (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Twelve (40%) patients experienced complications during the study including 3 patients with further vertebral fracture progression by 6 weeks despite VCA. No complications were directly attributed to PDT.&lt;/p&gt;Conclusions:&lt;p&gt;Using the parameters described, vertebral PDT as an adjunct to VCA is safe from a pharmaceutical and neurologic perspective. The results of this trial motivate scale-up study evaluating potential PDT efficacy in vertebral metastatic treatment.&lt;/p&gt;&lt;/div&gt;