Neurological Control Research Articles

Decreased arylesterase activity of paraoxonase-1 (PON-1) might be a common denominator of neuroinflammatory and neurodegenerative diseases

High-density lipoprotein (HDL)-bound paraoxonase-1 (PON-1) is mechanistically related to oxidative stress, inflammation and atherosclerosis and this multirole nature positions the enzyme as potential pathogenic player and candidate biomarker for many diseases. Our previous work suggests that decline in serum PON-1 activities, i.e. arylesterase and paraoxonase, might be associated with the occurrence of mild cognitive impairment (MCI) to late onset Alzheimer’s disease (LOAD) or vascular dementia (VAD). The present study aimed to: (1) expand our previous findings in a larger and different population, including patients with LOAD-VAD mixed dementia (MD); (2) explore a possible association between PON-1 and multiple sclerosis (MS); (3) evaluate if cerebrospinal fluid (CSF) levels of PON-1 activities might be useful biomarkers for MS. We found that serum arylesterase, but not paraoxonase, levels of PON-1 were significantly lower in patients affected by MCI (n=232), VAD (n=65), LOAD (n=175), MD (n=88) as well as those with MS (n=104) as compared to healthy controls. Notably, the most pronounced decline in this activity was shown by MD (−18%, p<0.01) and MS (−23%, p<0.001), while the lowest changes were detected in the MCI group (11%, p<0.05). Only arylesterase was detectable in the CSF of MS patients and the levels were not significantly different from those detected in the other two neurological control groups. Overall our data suggest that a depressed arylesterase activity could be a common denominator of different neurological diseases which, independently of their peculiar ethiopathogenesis and pathophysiology, appear to be all characterized by an altered systemic redox balance.

Microsurgical resectability, outcomes, and tumor control in meningiomas occupying the cavernous sinus.

OBJECTIVE Cavernous sinus meningiomas (CSMs) represent a cohort of challenging skull base tumors. Proper management requires achieving a balance between optimal resection, restoration of cranial nerve (CN) function, and maintaining or improving quality of life. The objective of this study was to assess the pre-, intra-, and postoperative factors related to clinical and neurological outcomes, morbidity, mortality, and tumor control in patients with CSM. METHODS A retrospective review of a single surgeon's experience with microsurgical removal of CSM in 65 patients between January 1996 and August 2013 was done. Sekhar's classification, modified Kobayashi grading, and the Karnofsky Performance Scale were used to define tumor extension, tumor removal, and clinical outcomes, respectively. RESULTS Preoperative CN dysfunction was evident in 64.6% of patients. CN II deficits were most common. The greatest improvement was seen for CN V deficits, whereas CN II and CN IV deficits showed the smallest degree of recovery. Complete resection was achieved in 41.5% of cases and was not significantly associated with functional CN recovery. Internal carotid artery encasement significantly limited the complete microscopic resection of CSM (p < 0.0001). Overall, 18.5% of patients showed symptomatic recurrence after their initial surgery (mean follow-up 60.8 months [range 3-199 months]). The use of adjuvant stereotactic radiosurgery (SRS) after microsurgery independently decreased the recurrence rate (p = 0.009; OR 0.036; 95% CI 0.003-0.430). CONCLUSIONS Modified Kobayashi tumor resection (Grades I-IIIB) was possible in 41.5% of patients. CN recovery and tumor control were independent of extent of tumor removal. The combination of resection and adjuvant SRS can achieve excellent tumor control. Furthermore, the use of adjuvant SRS independently decreases the recurrence rates of CSM.

Reflexes in Immunity

Simple reflex circuits provide crucial infrastructure for the neurological control of organ systems--even the immune system. Now, Gabanyi et al. reveal a reflex mechanism in gut activated by the presence of pathogens that forces macrophages into a tissue protective phenotype.

Surgical Treatment Options for Metastatic Spinal Tumors

Introduction Metastatic spinal tumors are surgically challenging lesions. Around 10 to 20% of all cancer patients develop symptoms of bone metastases that are most common in spine and pelvis. The metastatic tumors can involve any part of the spinal column, invade the spinal canal, and spread to the neighboring tissue and to the mediastinal or retroperitoneal space. The indication for surgery is usually rapidly progressive spinal cord compression as an initial manifestation of a malignant disease. Methods Most of the patients with spinal metastatic disease present with the local pain and/or neurological deterioration. The patients are assessed regarding the severity of the pain and neurological deficit, and there are several systems that are helping us classify the patients (Karnofsky performance score, Tomita and Tokuhashi predicting survival scores, etc.). The main goals of surgical treatment of metastases are preservation and improvement of neurological functions, pain control, and stabilization of the spine. The surgery usually involves a multidisciplinary approach. The type of operative and postoperative treatment depends on the histological nature of the tumor, extension of the tumor, and integrity of the bony elements of the spine. The prognosis and extension of the primary disease and other comorbidities is also to be considered. Variety of surgical options include: microsurgical decompression of the neural structures, posterior, anterior, or lateral fusion, corpectomy, vertebroplasty, or kyphoplasty, and combination of those options. Results In the last years in our department, a single-step posterolateral approach was increasingly utilized, consisting of maximal tumor resection, combined with stabilization. Favorable clinical results and good palliation were achieved in most patients. The additional oncological therapy is usually necessary. Conclusion The prognosis for most patients with metastatic spinal tumors is still very unpredictable. Individual treatment strategy is mandatory for each patient and usually consists of multidisciplinary approach. The surgery has moved from multiple-steps to one-step surgery in the last years and with this a favorable clinical results could be achieved.

THORACOLUMBER VERTEBRAL FRACTURES

For spinal injuries, thoracolumbar junction is common site in our population.Surgical management of unstable fractures and fracture dislocations of thoracolumbar spineis still controversial. This study was conducted to document efficacy of short segment fixationof thoracolumbar verterbral fractures. Objectives: To determine the outcome of short segmenttranspedicular fixation of thoracolumbar fractures. Study design: Descriptive cross-sectionalstudy. Sampling technique: Non-probability purposive sampling. Material and Methods: Atotal of 103 study cases with thoracolumbar vertebral fractures were taken in this descriptivecase series study which was conducted at department of Neurosurgery, Nishtar HospitalMultan from February 2014 to June 2015. Informed verbal consent was taken from eachpatient before participation in this study ensuring them confidentiality of the information andexplaining them objectives and procedure of our study. Once registered, detailed history andclinical examination was done by a Neurosurgeon, investigations like X-ray dorsolumbar spine,CT scan and Magnetic resonance imaging (MRI) dorsolumbar spine were also done. Shortsegment transpedicular fixation was done and outcome of surgical management was assessedin terms of improvement in power, hardware failure and infection by consultant neurosurgeon.All the study cases were called for follow up visits after every month till 6 months to record finaloutcome of management. All the information were recorded in the study proforma. Data wereentered and analyzed by SPSS version 22. Results: Out of these 103 study cases, 66 (64.1 %)were male patients and 37 (35.9 %) were female patients and male to female ratio was 1.85:1.Mean age of our study cases 33.92 ± 9.72 years ranging from 20 years to 54 years. Meanages of male patients was 36.68 ± 10.37 years while in female patients it was 29.00 ± 5.89years (p=0.000).Post-surgical management improvement in power was seen in 55 (53.4%)of our study cases, hardware failure in 11 (10.7%) and infection was observed in 20 (19.4%).Conclusion: According to our study short segment transpedicular fixation is safe &amp; effectiveprocedure providing efficient spinal stability. Short segment fixation is associated with minimumblood loss and trauma and leads to early mobilization of the patient and ease in physiotherapy.Transpedicular screw fixation is a useful choice for achieving better neurological recovery andgood pain control in post-traumatic thoracolumbar fractures.

Runs of homozygosity reveal signatures of positive selection for reproduction traits in breed and non-breed horses.

BackgroundModern horses represent heterogeneous populations specifically selected for appearance and performance. Genomic regions under high selective pressure show characteristic runs of homozygosity (ROH) which represent a low genetic diversity. This study aims at detecting the number and functional distribution of ROHs in different horse populations using next generation sequencing data.MethodsNext generation sequencing was performed for two Sorraia, one Dülmen Horse, one Arabian, one Saxon-Thuringian Heavy Warmblood, one Thoroughbred and four Hanoverian. After quality control reads were mapped to the reference genome EquCab2.70. ROH detection was performed using PLINK, version 1.07 for a trimmed dataset with 11,325,777 SNPs and a mean read depth of 12. Stretches with homozygous genotypes of >40 kb as well as >400 kb were defined as ROHs. SNPs within consensus ROHs were tested for neutrality. Functional classification was done for genes annotated within ROHs using PANTHER gene list analysis and functional variants were tested for their distribution among breed or non-breed groups.ResultsROH detection was performed using whole genome sequences of ten horses of six populations representing various breed types and non-breed horses. In total, an average number of 3492 ROHs were detected in windows of a minimum of 50 consecutive homozygous SNPs and an average number of 292 ROHs in windows of 500 consecutive homozygous SNPs. Functional analyses of private ROHs in each horse revealed a high frequency of genes affecting cellular, metabolic, developmental, immune system and reproduction processes. In non-breed horses, 198 ROHs in 50-SNP windows and seven ROHs in 500-SNP windows showed an enrichment of genes involved in reproduction, embryonic development, energy metabolism, muscle and cardiac development whereas all seven breed horses revealed only three common ROHs in 50-SNP windows harboring the fertility-related gene YES1. In the Hanoverian, a total of 18 private ROHs could be shown to be located in the region of genes potentially involved in neurologic control, signaling, glycogen balance and reproduction. Comparative analysis of homozygous stretches common in all ten horses displayed three ROHs which were all located in the region of KITLG, the ligand of KIT known to be involved in melanogenesis, haematopoiesis and gametogenesis.ConclusionsThe results of this study give a comprehensive insight into the frequency and number of ROHs in various horses and their potential influence on population diversity and selection pressures. Comparisons of breed and non-breed horses suggest a significant artificial as well as natural selection pressure on reproduction performance in all types of horse populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12864-015-1977-3) contains supplementary material, which is available to authorized users.

English

For spinal injuries, thoracolumbar junction is common site in our population.Surgical management of unstable fractures and fracture dislocations of thoracolumbar spineis still controversial. This study was conducted to document efficacy of short segment fixationof thoracolumbar verterbral fractures. Objectives: To determine the outcome of short segmenttranspedicular fixation of thoracolumbar fractures. Study design: Descriptive cross-sectionalstudy. Sampling technique: Non-probability purposive sampling. Material and Methods: Atotal of 103 study cases with thoracolumbar vertebral fractures were taken in this descriptivecase series study which was conducted at department of Neurosurgery, Nishtar HospitalMultan from February 2014 to June 2015. Informed verbal consent was taken from eachpatient before participation in this study ensuring them confidentiality of the information andexplaining them objectives and procedure of our study. Once registered, detailed history andclinical examination was done by a Neurosurgeon, investigations like X-ray dorsolumbar spine,CT scan and Magnetic resonance imaging (MRI) dorsolumbar spine were also done. Shortsegment transpedicular fixation was done and outcome of surgical management was assessedin terms of improvement in power, hardware failure and infection by consultant neurosurgeon.All the study cases were called for follow up visits after every month till 6 months to record finaloutcome of management. All the information were recorded in the study proforma. Data wereentered and analyzed by SPSS version 22. Results: Out of these 103 study cases, 66 (64.1 %)were male patients and 37 (35.9 %) were female patients and male to female ratio was 1.85:1.Mean age of our study cases 33.92 ± 9.72 years ranging from 20 years to 54 years. Meanages of male patients was 36.68 ± 10.37 years while in female patients it was 29.00 ± 5.89years (p=0.000).Post-surgical management improvement in power was seen in 55 (53.4%)of our study cases, hardware failure in 11 (10.7%) and infection was observed in 20 (19.4%).Conclusion: According to our study short segment transpedicular fixation is safe &amp; effectiveprocedure providing efficient spinal stability. Short segment fixation is associated with minimumblood loss and trauma and leads to early mobilization of the patient and ease in physiotherapy.Transpedicular screw fixation is a useful choice for achieving better neurological recovery andgood pain control in post-traumatic thoracolumbar fractures.

CD4(+)CD25(High) Treg cells in HIV/HTLV co-infected patients with neuropathy: high expression of Alpha4 integrin and lower expression of Foxp3 transcription factor.

BackgroundRegulatory CD4 T cells (Tregs) are critical in maintaining the homeostasis of the immune system. Quantitative or phenotypic alterations and functional impairment of Tregs have been associated with the development of pathologies including those of the central nervous system. Individuals with HIV-1/HTLV-1 co-infection are more prone to develop neurological complications. The aim of this study was to characterize phenotypically Treg cells in HIV-1/HTLV-1 co-infected Mozambican individuals presenting neurological symptoms.MethodsA cross-sectional study was conducted among HIV-infected individuals presentingneurological symptoms, with and without HTLV co-infection, and blood donors. Peripheral bloodmononuclear cells were stained with monoclonal antibodies conjugated with fluorochromes to quantifyTregs and activated T cells by four colors flow cytometry.ResultsHigher Treg cell frequency (10.6 %) was noted in HIV-1/HTLV-1 co-infected group with neurological symptoms when compared to HIV-1 mono-infected group with neurological symptoms (0.38 %, p = 0.003) and control group (0.9 %, p = 0.0105). An inverse correlation between Foxp3 and CD49d expression was observed in all study groups (rh = −0.71, p = 0.001). In addition, increased levels of Treg cells in co-infected patients were strongly associated with total activated CD4 T cells (rh = 0.8, p = 0.01).ConclusionTreg cells in co-infected patients present phenotypic alterations and might have dysfunction marked by low expression of Foxp3 and increased expression of molecules not frequently seen on Treg cells, such as CD49d. These alterations may be related to (1) changes in Treg cell trafficking and migration, possibly making those cells susceptible to HIV infection, and (2) inability to control the activation and proliferation of effector T lymphocytes.

Pós-operatório de implante de bioprótese aórtica por cateter: intervenções de enfermagem

Aortic stenosis (AS) is the most common valvular heart disease; affects approximately 3% of the elderly population, underwent implantation of aortic bioprosthesis catheter. Nurses need to improve knowledge, to develop treatment protocols and care. Objective: Propose nursing interventions for postoperative patients treated for AS catheter. Method: Retrospective, quantitative research; composite sample of the Registro Brasileiro de Implantepor Cateter de Bioprotese Valvar Aortica, with 418 patients between January 2008 and February 2013. Results: The mean age was 81.5 years, 348 were in functional class III or IV cardiac arrest; complications with the highest incidence: left bundle branch block (129 patients), atrioventricular block (110) and the need for pacemaker implantation (83). Conclusion: We propose the nursing interventions for evaluation of neurological function, vascular, hematologic, renal, cardiac, vital signs, and pain control.

Orthostatic Blood Pressure Behavior in People with Mild Cognitive Impairment Predicts Conversion to Dementia.

To compare the patterns of blood pressure (BP) behavior during orthostasis in individuals with mild cognitive impairment (MCI) with those of controls and to investigate whether orthostatic BP behavior differs between individuals with MCI who convert to dementia and those who do not. Longitudinal study with 3 years of follow-up. Memory clinic in Dublin, Ireland, between 2007 and 2012. Community-dwelling individuals with MCI (n = 150) and controls (n = 75). Orthostatic BP was examined using the active standing test with a beat-to-beat continuous BP monitoring device in addition to neuropsychological testing. Hazard ratios (HRs) from parametric survival models were used to determine whether conversion to dementia was independently associated with baseline orthostatic BP variables. Individuals with MCI were more likely than controls to have a systolic BP (SBP) deficit of greater than 30% 30 seconds after standing (P = .01). Thirty percent of participants with MCI (n = 43) converted to dementia within the 3-year follow-up period. Individuals with MCI with a SBP deficit greater than 30% 30 seconds after standing were twice as likely to convert to dementia as those without the deficit (HR = 2.77, 95% confidence interval = 1.02-7.50). Human beings have evolved an elaborate neurological control system to maintain cerebral perfusion during orthostatic challenge. In people with MCI, this response is impaired and renders them twice as likely to convert to dementia.

Neurofilaments in the diagnosis of motoneuron diseases: a prospective study on 455 patients

ObjectivesBiomarkers for the diagnosis of motoneuron diseases (MND) are urgently needed to improve the diagnostic pathway, patient stratification and monitoring. The aim of this study was to validate candidate markers...

Home Mechanical Ventilation in Children.

The number of children dependent on home mechanical ventilation has been reported to be increasing in many countries around the world. Home mechanical ventilation has been well accepted as a standard treatment of children with chronic respiratory failure. Some children may need mechanical ventilation as a lifelong therapy. To send mechanically ventilated children back home may be more difficult than adults. However, relatively better outcomes have been demonstrated in children. Children could be safely ventilated at home if they are selected and managed properly. Conditions requiring home ventilation include increased respiratory load from airway or lung pathologies, ventilatory muscle weakness and failure of neurologic control of ventilation. Home mechanical ventilation should be considered when the patient develops progressive respiratory failure or intractable failure to wean mechanical ventilation. Polysomnography or overnight pulse oximetry plus capnometry are used to detect nocturnal hypoventilation in early stage of respiratory failure. Ventilator strategy including non-invasive and invasive approach should be individualized for each patient. The author strongly believes that parents and family members are able to take care of their child at home if they are trained and educated effectively. A good team work with dedicated members is the key factor of success.

Uroneurology

The function of the pelvic organs, including the lower urinary tract (LUT), is controlled by a complex network of nerves. This leaves patients with neurologic disease vulnerable to LUT and pelvic organ dysfunction. Physicians often come across urogenital complaints in their patients with neurologic disease, the symptoms of which can result in significant distress and loss of dignity and quality of life. Due to the health and economic burden that accompanies neurogenic pelvic organ dysfunction, it is important for clinicians to understand the common forms of dysfunction, essential investigations, and modes of management. This chapter covers bladder dysfunction from a physician’s perspective. Topics include neurologic control of the LUT, large bowel, and sexual functions; male and female sexual response; neurogenic bladder dysfunction and its management; diagnostic evaluation; management of neurogenic sexual dysfunction; management of erectile dysfunction; ejaculatory dysfunction; sexual dysfunction in women; and fecal incontinence. Figures illustrate efferent innervation of the LUT, neurologic detrusor overactivity, a urethral pressure profile in a patient with Fowler syndrome, an example bladder diary, an example bladder scan, and normal and obstructed flow patterns. Tables list common causes of injury at the suprapontine, suprasacral, and infrasacral levels and storage and voiding systems. This chapter contains 6 highly rendered figures, 2 tables, 53 references, 1 teaching slide set, and 5 MCQs.

Decision-making under explicit risk is impaired in multiple sclerosis: relationships with ventricular width and disease disability.

BackgroundDecision-making is an essential function of everyday life. Decision-making under explicit risk requires developing advantageous decision strategies based on fixed outcomes (e.g., probabilities of winning or losing a bet). Decision-making and its neural substrates have been rarely studied in MS. We expected performance in decision-making under risk to be lowered in MS patients, and negatively correlated with disease-related disability, cognition, and ventricular width.MethodsThree groups were included: 32 MS patients and 20 healthy controls were examined with conventional neuropsychological tests and the Game-of-Dice Task (GDT) assessing decision-making under explicit risk. Linear 2-D ventricular width was assessed on MS patients’ clinical MRIs and compared to a third group, 20 non-MS neurological control patients.ResultsCompared to healthy controls, MS patients showed impaired GDT and neuropsychological performance, depending on the MS-subtype (relapsing-remitting (RR), n = 22; secondary progressive, n = 10) and disability severity among RR-MS patients. In MS patients, GDT performance correlated with processing speed, intercaudate ratio, and third ventricle ratio (p’s < 0.05). Mediation analysis showed that the link between GDT performance and processing speed was fully explained by ventricular size.ConclusionDecision-making under explicit risk was reduced in MS patients, but only those with more pronounced disability. Independent of processing speed, decision-making under explicit risk correlates inversely with central atrophy in MS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0318-0) contains supplementary material, which is available to authorized users.

Coelomic Transport and Clearance of Durable Foreign Bodies by Starfish (Asterias rubens).

Echinoderms have excellent healing and regeneration abilities, but little is known about how they deal with the related challenge of durable foreign bodies that become lodged within their bodies. Here we report a novel mechanism for foreign body elimination in starfish. When injected into the arm of a starfish, passive integrated transponder tags and magnets of similar dimensions are eliminated at a rate approximating 10% per day. These objects are forcefully ejected through the body wall at the distal tip of an arm. Ultrasound images reveal that foreign bodies are moved within the body cavity, and tracking of magnets injected into starfish suggests that the movements are haphazard rather than directed. Constrictions of the body wall near the foreign object are the likely mechanism for this transport process. Open questions include the ecological relevance of this behavior, why clearance occurs through the distal tips of the arms, the neurological and muscular control of this behavior, what other animals use this mechanism, and the range of objects starfish can eliminate in this way.

Transorbital Ultrasonographic Measurement of Optic Nerve Sheath Diameter in Brain Death.

Ultrasonographic measurement of optic nerve sheath diameter (ONSD) can successfully be used to estimate intracranial pressure (ICP) elevation. Its utility in corroboration of brain death (BD) was herein studied. ONSD was measured in 29 subjects with BD; in 19 comatose patients (with raised ICP in 11), 20 patients with various neurological diseases, and 40 healthy control subjects. The distance between the inner and outer edges of the echolucent lines around hyperechoic area surrounding the optic nerve (ON) was identified as ONSD external (ONSDe) and ONSD internal (ONSDi). Compared to patients with neurological diseases (5.75 ± .79 mm) or healthy controls (5.98 ± .63 mm), ONSDe was significantly higher in comatose patients (7.61 ± .97 and 6.71 ± 1.07 mm in those with and without raised ICP) and BD subjects (8.34 ± .66 mm). ONSDi showed similar trends across the groups: 6.09 ± .71 mm in BD; 5.89 ± .37 mm in comatose control with elevated ICP; 5.16 ± .49 mm in comatose control with normal ICP; 4.36 ± .68 mm in neurological control; 4.69 ± .67 mm in healthy control. The accuracy of ONSDe measurements in differentiating patients with ICP elevation (n = 40) was .965 as determined by area under the curve (AUC) of receiver-operator characteristics curves. Similarly, accuracy in discrimination of BD was .952. However, ONSDe showed limited yield to identify BD cases among comatose patients with Glasgow coma scale score of 3, where accuracy was .803 (95% CI: .709-.816) and decreased further to .722 (95% CI: .610-.816) when analyses were restricted to comatose patients with ICP elevation. AUC values for ONSDi was similar or lower. ONSD is significantly greater in subjects with BD. However, quantification of ONSD cannot discriminate BD subjects from comatose ones with raised ICP with 100% certainty.

Stereotactic radiosurgery for spinal metastases with or without separation surgery.

In patients with significant epidural spinal cord compression, initial surgical decompression and stabilization of spinal metastases, as opposed to radical oncological resection, provides a margin around the spinal cord that facilitates subsequent treatment with high-dose adjuvant stereotactic radiosurgery (SRS). If a safe margin exists between tumor and spinal cord on initial imaging, then high-dose SRS may be used as the primary therapy, eliminating the need for surgery. Selecting the appropriate approach has shown greater efficacy of tumor control, neurological outcome, and duration of response when compared with external beam radiotherapy, regardless of tumor histology. This study evaluates the efficacy of this treatment approach in a series of 57 consecutive patients. Patients treated for spinal metastases between 2007 and 2011 using the Varian Trilogy Linear Accelerator were identified retrospectively. Each received SRS, with or without initial surgical decompression and instrumentation. Medical records were reviewed to assess neurological outcome and surgical or radiation-induced complications. Magnetic resonance images were obtained for each patient at 3-month intervals posttreatment, and radiographic response was assessed as stability/regression or progression. End points were neurological outcome and local radiographic disease control at death or latest follow-up. Fifty-seven patients with 69 lesions were treated with SRS for spinal metastases. Forty-eight cases (70%) were treated with SRS alone, and 21 (30%) were treated with surgery prior to SRS. A single fraction was delivered in 38 cases (55%), while a hypofractionated scheme was used in 31 (45%). The most common histological entities were renal cell, breast, and lung carcinomas. Radiographically, local disease was unchanged or regressed in 63 of 69 tumors (91.3%). Frankel score improved or remained stable in 68 of 69 cases (98.6%). SRS, alone or as an adjunct following surgical decompression, provides durable local radiographic disease control while preserving or improving neurological function. This less-invasive alternative to radical spinal oncological resection appears to be effective regardless of tumor histology without sacrificing durability of radiographic or clinical response.

Amino acid supplementation in l-dopa treated Parkinson's disease patients

The correlation between Parkinson disease and malnutrition is well established, however a protein-restricted diet is usually prescribed because of potentially negative interactions between dietary amino acids and l-dopa pharmacokinetics. This strategy could increase the risk of further nutritional deficits. A monocentric, prospective, randomized, double-blind pilot study was performed on two groups of Parkinson-affected, protein-restricted, patients: Intervention (n = 7; amino acid supplementation twice daily) and Placebo (n = 7; placebo supplementation twice daily). At enrolment, after 3- and 6-month supplementation, neurological evaluations (UPDRS III, Hoenh-Yahr scale, l-dopa equivalent dose assessment) were performed and blood sample was collected to define insulin sensitivity (QUICKI index) and oxidative stress (oxidized and reduced glutathione). Repeated measure ANCOVA was applied to define time effect and time × treatment interaction. Participants were comparable at baseline for all assessed parameters. Neurological outcomes and l-dopa requirement were comparable in both group after 6-month of supplementation, without time × treatment interaction. The decrease in insulin sensitivity, as assessed by QUICKI index, observed after 6 months in both groups, was greater in Placebo than in Intervention (time effect p < 0.001; time × treatment interaction p = 0.01). Moreover, despite no changes in total erythrocyte glutathione concentrations, oxidized glutathione levels decreased by 28 ± 17% in the Intervention while increased by 55 ± 38% in Placebo (time effect p = 0.05; time × treatment interaction p = 0.05), after 6-month supplementation. Amino acid supplementation, assumed with shrewd temporal distribution, did not show detrimental effects on neurological and pharmacological control in protein-restricted Parkinson-affected patients, chronically treated with l-dopa. Furthermore, daily amino acid supplementation partially counteracted insulin resistance development and the loss in antioxidant availability.

Robust tracking and quantification of C. elegans body shape and locomotion through coiling, entanglement, and omega bends.

The behavior of the well-characterized nematode, Caenorhabditis elegans (C. elegans), is often used to study the neurologic control of sensory and motor systems in models of health and neurodegenerative disease. To advance the quantification of behaviors to match the progress made in the breakthroughs of genetics, RNA, proteins, and neuronal circuitry, analysis must be able to extract subtle changes in worm locomotion across a population. The analysis of worm crawling motion is complex due to self-overlap, coiling, and entanglement. Using current techniques, the scope of the analysis is typically restricted to worms to their non-occluded, uncoiled state which is incomplete and fundamentally biased. Using a model describing the worm shape and crawling motion, we designed a deformable shape estimation algorithm that is robust to coiling and entanglement. This model-based shape estimation algorithm has been incorporated into a framework where multiple worms can be automatically detected and tracked simultaneously throughout the entire video sequence, thereby increasing throughput as well as data validity. The newly developed algorithms were validated against 10 manually labeled datasets obtained from video sequences comprised of various image resolutions and video frame rates. The data presented demonstrate that tracking methods incorporated in WormLab enable stable and accurate detection of these worms through coiling and entanglement. Such challenging tracking scenarios are common occurrences during normal worm locomotion. The ability for the described approach to provide stable and accurate detection of C. elegans is critical to achieve unbiased locomotory analysis of worm motion.

A model to investigate the mechanisms underlying the emergence and development of independent sitting.

When infants first begin to sit independently, they are highly unstable and unable to maintain upright sitting posture for more than a few seconds. Over the course of 3 months, the sitting ability of infants drastically improves. To investigate the mechanisms controlling the development of sitting posture, a single-degree-of-freedom inverted pendulum model was developed. Passive muscle properties were modeled with a stiffness and damping term, while active neurological control was modeled with a time-delayed proportional-integral-derivative (PID) controller. The findings of the simulations suggest that infants primarily utilize passive muscle stiffness to remain upright when they first begin to sit. This passive control mechanism allows the infant to remain upright so that active feedback control mechanisms can develop. The emergence of active control mechanisms allows infants to integrate sensory information into their movements so that they can exhibit more adaptive sitting.