Neurophysiological Features Research Articles

Electroencephalographic differences in patients with paranoid schizophrenia with or without a history of suicide attempts

To identify differences in electroencephalographic parameters in schizophrenia patients with and without a history of suicide attempts. Eighty-seven inpatients (50 men and 37 women) with paranoid schizophrenia were examined. Suicidal attempts in the anamnesis of patients were verified by a psychiatrist on the basis of clinical interviewing. The severity of psychopathological symptoms was assessed using The Positive and Negative Syndrome Scale (PANSS) based on a five-factor model. Electroencephalogram (EEG) parameters were recorded and evaluated using a 16-channel encephalograph. A clinical and quantitative analysis of the recordings was carried out with the calculation of absolute spectral power indicators for theta, alpha and beta rhythms, as well as the severity of the activation reaction (Berger effect). Significantly higher rates of the PANSS depression factor were revealed in patients with a history of suicide attempts (p=0.016). Clinical analysis of EEG changes did not reveal any significant differences between the groups (p>0.05). The spectral analysis of the EEG showed significant differences only in the spectral power of the beta rhythm in the central (p=0.048) and occipital (p=0.021) leads with closed eyes, which was lower in the group with a history of suicide attempts. The degree of alpha rhythm depression in the occipital leads was also significantly lower in this group (p=0.016). The regression analysis showed that significant correlates of suicidal attempts in patients with paranoid schizophrenia are the PANSS depressive factor (t=2.784; p=0.016) and a deficiency in the activation response to EEG (t=-2.035; p=0.045). The results complement previous studies on the relationship between suicidal attempts, clinical symptoms and neurophysiological features of the functioning of the brain of patients with paranoid schizophrenia.

Возможности и перспективы технологии функциональной ближней инфракрасной спектроскопии у пациентов, нуждающихся в высокотехнологичном слухопротезировании

One of the most notable features of auditory prosthetics at the present stage of development is the close interdisciplinary interaction of related medical, scientific, and social specialties. The solution of practical problems in audiology has long gone beyond the range of selecting a method of acoustic or electrical amplification. The priorities in decision making have increasingly shifted from purely engineering efficiency toward improving the quality of life in general. A personalized approach to choosing optimal solutions for each specific case inevitably led specialists to study the cognitive potential and neurophysiological characteristics of the patient. That is why various methods of functional neuroimaging are increasingly being introduced into the scientific and practical activities of an audiologist. Functional near infrared spectroscopy (fNIRS) is considered one of the youngest and most promising technologies. It allows us to research the metabolic activity of the cerebral cortex, which is an important source of feedback when working with sensory functions of the body. The potential of its use can vary from evaluating the effectiveness of measures already taken to solving complex controversial issues of selecting patients for high-tech treatment methods, which do not always remain regulated in methodological documents: the choice of prosthetics, the expediency of performing cochlear implantation in patients with ambiguous indications and contraindications, assessment of rehabilitation potential in neurological comorbidity, etc. In this article, we have tried to systematize and reflect the relevant aspects of the use of fNIRS for audiology patients with a description of the essence of the method, its comparison with alternative methods of functional imaging such as functional magnetic resonance imaging, electroencephalography, magnetoencephalography, positron emission tomography.

The effect of transcutaneous spinal cord stimulation on the balance and neurophysiological characteristics of young healthy adults.

Transcutaneous spinal cord stimulation (TSCS) is gaining popularity as a noninvasive alternative to epidural stimulation. However, there is still much to learn about its effects and utility in assisting recovery of motor control. In this study, we applied TSCS to healthy subjects concurrently performing a functional training task to study its effects during a training intervention. We first carried out neurophysiological tests to characterize the H-reflex, H-reflex recovery, and posterior root muscle reflex thresholds, and then conducted balance tests, first without TSCS and then with TSCS. Balance tests included trunk perturbations in forward, backward, left, and right directions, and subjects' balance was characterized by their response to force perturbations. A balance training task involved the subjects playing a catch-and-throw game in virtual reality (VR) while receiving trunk perturbations and TSCS. Balance tests with and without TSCS were conducted after the VR training to measure subjects' post-training balance characteristics and then neurophysiological tests were carried out again. Statistical comparisons using t-tests between the balance and neurophysiological data collected before and after the VR training intervention found that the immediate effect of TSCS was to increase muscle activity during forward perturbations and to reduce balance performance in that direction. Muscle activity decreased after training and even more once TSCS was turned off. We thus observed an interaction of effects where TSCS increased muscle activity while the physical training decreased it.

Personalized Alpha-Motoneuron Pool Models Driven by Neural Data Encode the Mechanisms Controlling Rate of Force Development.

The central nervous system employs distinct motor control strategies depending on task demands. Accordingly, the activity of alpha-motoneuron (MN) pools innervating skeletal muscle fibers is modulated based on muscle force and rate of force development (RFD). In human subjects, biophysical MN models enable inferring in vivo the neural processes (e.g., synaptic input, activity of the entire MN pool, etc.) underlying this modulation, which are otherwise challenging to measure experimentally. Due to unique neurophysiological characteristics of individuals, personalizing these models is essential to study motor control in humans. Therefore, this work studied the mechanisms involved in the modulation of RFD using person-specific MN pool models driven by in vivo common synaptic input estimates (i.e., derived from surface high-density electromyography). Specifically, we assessed how in vivo MN activity changed across RFD and muscle force. This included modulation of recruitment and rate coding in the complete MN pool, as well as model-based estimates of excitatory synaptic gains ( ∆ IF). We found RFD-specific changes in MN activity associated to changes in ∆ IF. Moreover, we showed that MN pool models driven by RFD-specific ∆ IFs reproduced in vivo MN firing features and associated force profiles at different RFDs. Altogether, this work represents a step towards modelling the mechanisms of force generation in humans and creating person-specific models of the spinal circuitry. This will open a window for studying in vivo human neuromechanics and motor restoring interventions.

Neurophysiological features in patients with psychopathological disorders in the right hemisphere stroke

Neurophysiological changes and functional activity of the brain on the electroencephalogram after a cerebral infarction reflect the direct electromagnetic activity of neurons that can be measured in the affected areas of the brain. EEG signals provide a non-invasive and sensitive indicator of brain function during mental processes. Its main use is in the assessment of cerebral function, and not in the detection of structural abnormalities. There is a lot of evidence that the analysis of the electrical fields of the brain can detect changes in the behavior of brain signals in neurological patients. The aim of the study was to establish correlational relationships between the development of psychopathological disorders and neurophysiological changes using EEG in right hemisphere stroke. The subject of the study was neglect and its relationship with neurophysiological changes and functional activity of the brain. Twenty-three patients with a right-hemisphere stroke who were undergoing inpatient treatment in the medical and diagnostic department No. 1 of the LORITOM PE. The correlation of the reduced α-index in patients with manifestations of unilateral neglect on the background curve was determined in the cohort of subjects. Moderate irritation phenomena was noted closer to the center in the parietal and to the right in the temporal and parietal leads in patients with neglect syndrome. While without manifestations of hemineglect, moderate phenomena of irritation was noted mainly parasagittal and on the left. A trend of slow-wave activity in the frontal areas in patients with neglect syndrome has been demonstrated. The prospect of further research in the field of psychopathological disorders is shown which will significantly increase the efficiency of diagnosis and treatment and as a result increase the degree of restoration of impaired functions of post-stroke patients, the level of their social and everyday adaptation and accordingly the quality of life. Keywords: electroencephalography, unilateral neglect, hemineglect.

An electroencephalographic signature predicts craving for methamphetamine

Craving is central to methamphetamine use disorder (MUD) and both characterizes the disease and predicts relapse. However, there is currently a lack of robust and reliable biomarkers for monitoring craving and diagnosing MUD. Here, we seek to identify a neurobiological signature of craving based on individual-level functional connectivity pattern differences between healthy control and MUD subjects. We train high-density electroencephalography (EEG)-based models using data recorded during the resting state and then calculate imaginary coherence features between the band-limited time series across different brain regions of interest. Our prediction model demonstrates that eyes-open beta functional connectivity networks have significant predictive value for craving at the individual level and can also identify individuals with MUD. These findings advance the neurobiological understanding of craving through an EEG-tailored computational model of the brain connectome. Dissecting neurophysiological features provides a clinical avenue for personalized treatment of MUD.

Neurophysiological and behavioral synchronization in group-living and sleeping mice

Social interactions profoundly influence animal development, physiology, and behavior. Yet, how sleep-a central behavioral and neurophysiological process-is modulated by social interactions is poorly understood. Here, we characterized sleep behavior and neurophysiology in freely moving and co-living mice under different social conditions. We utilized wireless neurophysiological devices to simultaneously record multiple individuals within a group for 24 h, alongside video acquisition. We first demonstrated that mice seek physical contact before sleep initiation and sleep while in close proximity to each other (hereafter, "huddling"). To determine whether huddling during sleep is a motivated behavior, we devised a novel behavioral apparatus allowing mice to choose whether to sleep in close proximity to a conspecific or in solitude, under different environmental conditions. We also applied a deep-learning-based approach to classify huddling behavior. We demonstrate that mice are willing to forgo their preferred sleep location, even under thermoneutral conditions, to gain access to social contact during sleep. This strongly suggests that the motivation for prolonged physical contact-which we term somatolonging-drives huddling behavior. We then characterized sleep architecture under different social conditions and uncovered a social-dependent modulation of sleep. We also revealed coordination in multiple neurophysiological features among co-sleeping individuals, including in the timing of falling asleep and waking up and non-rapid eye movement sleep (NREMS) intensity. Notably, the timing of rapid eye movement sleep (REMS) was synchronized among co-sleeping male siblings but not co-sleeping female or unfamiliar mice. Our findings provide novel insights into the motivation for physical contact and the extent of social-dependent plasticity in sleep.

Neurophysiological markers in community-dwelling older adults with mild cognitive impairment: an EEG study

BackgroundNeurodegeneration and structural changes in the brain due to amyloid deposition have been observed even in individuals with mild cognitive impairment (MCI). EEG measurement is considered an effective tool because it is noninvasive, has few restrictions on the measurement environment, and is simple and easy to use. In this study, we investigated the neurophysiological characteristics of community-dwelling older adults with MCI using EEG.MethodsDemographic characteristics, cognitive function, physical function, resting-state MRI and electroencephalogram (rs-EEG), event-related potentials (ERPs) during Simon tasks, and task proportion of correct responses and reaction times (RTs) were obtained from 402 healthy controls (HC) and 47 MCI participants. We introduced exact low-resolution brain electromagnetic tomography-independent component analysis (eLORETA-ICA) to assess the rs-EEG network in community-dwelling older adults with MCI.ResultsA lower proportion of correct responses to the Simon task and slower RTs were observed in the MCI group (p < 0.01). Despite no difference in brain volume between the HC and MCI groups, significant decreases in dorsal attention network (DAN) activity (p < 0.05) and N2 amplitude of ERP (p < 0.001) were observed in the MCI group. Moreover, DAN activity demonstrated a correlation with education (Rs = 0.32, p = 0.027), global cognitive function (Rs = 0.32, p = 0.030), and processing speed (Rs = 0.37, p = 0.010) in the MCI group. The discrimination accuracy for MCI with the addition of the eLORETA-ICA network ranged from 0.7817 to 0.7929, and the area under the curve ranged from 0.8492 to 0.8495.ConclusionsThe eLORETA-ICA approach of rs-EEG using noninvasive and relatively inexpensive EEG demonstrates specific changes in elders with MCI. It may provide a simple and valid assessment method with few restrictions on the measurement environment and may be useful for early detection of MCI in community-dwelling older adults.

Prevention of emotional burnout syndrome in various occupational groups (analytical review)

Introduction. Timely detection and prevention of burnout syndrome in various occupational groups is an urgent task of occupational health, since this condition directly affects the health, working capacity, and quality of life in workers.&#x0D; The purpose of the study. an analytical review of Russian literature on the prevalence, risk factors, and prevention of burnout syndrome in various occupational groups and the definition of criteria for the formation of risk groups.&#x0D; The search for articles was carried out using information portals including eLibrary.ru, CyberLeninka, PubMed, Medscape, Google Scholar, Scopus, Web of Science. Inclusion criteria: search depth of eleven years (2012–2022), Russian original full-text articles in open access. Initially, one thousand eight hundred sixty five publications were identified, of which 38 cohort selected that met the inclusion criteria. &#x0D; A high prevalence of burnout was revealed among health workers, educators, IT-specialists and law enforcement officials, slightly less among aviation service specialists, employees of the Ministry of Emergency Situations, media workers, bank employees, and miners. There are discussed leading risk factors for the development of burnout among employees in various fields of activity. A number of studies have studied the neurophysiological characteristics of patients with burnout syndrome, showing the relationship between burnout and affective disorders. Many studies discuss various approaches to the prevention and treatment of burnout syndrome, but the effectiveness of the proposed methods is evaluated only in a few studies. In modern conditions, there is a need for further research, conceptualization and systematization in managing job burnout.

Identifying Individualized Neurophysiological Causal Features for Working Memory Performance: Implications for Non‐Invasive Brain Stimulation

AbstractBackgroundNon‐invasive brain stimulation (NIBS) has been extensively used to target specific neural oscillations with the aim of improving working memory performance. However, current NIBS paradigms have two main limitations: first, lack of personalization and second, a need for a randomized controlled trial (RCT) to infer causality between targets of NIBS and subsequent performance. RCT is a powerful measure to infer causality, but its implementation is expensive, time consuming, and sometimes simply not possible. Therefore, our aim was to use computational models and observational data to discover causal relations between neural oscillations and working memory performance to identify potential targets and stimulation parameters for personalized NIBS paradigms.MethodWe used electroencephalography (EEG) data of 66 young healthy participants collected while performing a 3‐back working memory task. Using graphical causal modeling, we extracted individualized causal brain oscillations of 3‐back performance and compared the causal features between two groups: high and low performers.ResultTotal number of causal features in high performers was higher than low performers. Among the causal features, right temporal gamma oscillation was ∼5 times (z‐score = 3.87, p = 0.003) more frequently a causal feature among high performers than low performers. However, the power of causal temporal gamma oscillation was not different between the two groups.ConclusionOur findings suggest that a potential approach to improve working memory performance using NIBS is to induce more causal gamma oscillations by, for example, generating more local gamma entrainment over the right temporal cortex and not necessarily by increasing gamma power.

Electrophysiological correlates of the emotional response on brain activity in adolescents

Many studies have attempted to analyze the main neurophysiological characteristics of emotional response, but few have been carried out at early ages, including adolescence or early adulthood. The main objective of the present study is to assess the electrophysiological correlates of emotional response in adolescents and young adults through electroencephalography (EEG) measures. Sample, composed of 25 subjects (18.44 ± 0.71 years old), were exposed to different sequences of images belonging to the IAPS, which were selected following the dimensional model, based on their valence and arousal, while their neural activity was evaluated through EEG. Results indicated differences in cortical neural activity in response to the valence of the images and the level of arousal. Specifically, we observed that exposure to positive images (high valence) with high arousal produced an increase in alpha, beta, and delta wave activity but not in theta activity. In the case of positive images with low arousal, however, the results indicated an increase in beta waves only and a decrease in alpha, delta, and theta activity. For negative images (low valence) with high arousal, an increase in alpha, beta, and delta waves but not in theta was observed, while negative images with low arousal induced an increase in beta, delta, and theta wave response. This study demonstrates that activated cortical areas indicated significant differences based on the different emotional responses in adolescents and young adults.

Alleviation of neuropathic pain with neuropeptide Y requires spinal Npy1r interneurons that coexpress Grp.

Neuropeptide Y targets the Y1 receptor (Y1) in the spinal dorsal horn (DH) to produce endogenous and exogenous analgesia. DH interneurons that express Y1 (Y1-INs; encoded by Npy1r) are necessary and sufficient for neuropathic hypersensitivity after peripheral nerve injury. However, as Y1-INs are heterogenous in composition in terms of morphology, neurophysiological characteristics, and gene expression, we hypothesized that a more precisely defined subpopulation mediates neuropathic hypersensitivity. Using fluorescence in situ hybridization, we found that Y1-INs segregate into 3 largely nonoverlapping subpopulations defined by the coexpression of Npy1r with gastrin-releasing peptide (Grp/Npy1r), neuropeptide FF (Npff/Npy1r), and cholecystokinin (Cck/Npy1r) in the superficial DH of mice, nonhuman primates, and humans. Next, we analyzed the functional significance of Grp/Npy1r, Npff/Npy1r, and Cck/Npy1r INs to neuropathic pain using a mouse model of peripheral nerve injury. We found that chemogenetic inhibition of Npff/Npy1r-INs did not change the behavioral signs of neuropathic pain. Further, inhibition of Y1-INs with an intrathecal Y1 agonist, [Leu31, Pro34]-NPY, reduced neuropathic hypersensitivity in mice with conditional deletion of Npy1r from CCK-INs and NPFF-INs but not from GRP-INs. We conclude that Grp/Npy1r-INs are conserved in higher order mammalian species and represent a promising and precise pharmacotherapeutic target for the treatment of neuropathic pain.

Psychophysiological and Neurophysiological Correlates of Dropping Objects from Hands in Carpal Tunnel Syndrome.

Dropping objects from hands (DOH) is a common symptom of carpal tunnel syndrome (CTS). We evaluated the clinical, neurophysiological, and psychophysiological features of 120 CTS patients to elucidate the DOH pathophysiology. Forty-nine healthy controls were included. In the patients, the Boston Carpal Tunnel Questionnaire (BCTQ), the Douleur Neuropathique 4 questions (DN4), and a numeric rating scale for pain (NRS) were evaluated. In patients and controls, we evaluated bilateral median and ulnar motor and sensory nerve conduction studies, cutaneous silent period and cutaneomuscular reflexes (CMR) of the abductor pollicis brevis, cold-detection threshold (CDT) and heat-pain detection threshold (HPT) at the index, little finger, and dorsum of the hand, and vibratory detection threshold at the index and little finger by quantitative sensory testing. CTS with DOH had higher BCTQ, DN4 and NRS, lower median sensory action potential, longer CMR duration, lower CDT and higher HPT at all tested sites than controls and CTS without DOH. Predictive features for DOH were abnormal CDT and HPT at the right index and dorsum (OR: 3.88, p: 0.03) or at the little finger (OR: 3.27, p: 0.04) and a DN4 higher than 4 (OR: 2.16, p < 0.0001). Thermal hypoesthesia in median and extra-median innervated territories and neuropathic pain are predictive of DOH in CTS.

Comorbid mental disorders with epilepsy in childhood

The clinical and anamnestic method analyzed 496 outpatient records of children and adolescents suffering from epilepsy in order to identify data contributing to the development and influencing the nature and severity of comorbid mental disorder. The presence of cognitive and affective disorders of varying severity was noted in 415 (83.6%) patients. As an addition to the neurological diagnosis was revealed: 171 patients (61.3%) had anxiety-depressive syndrome, 245 patients (87.8%) had emotional-volitional instability syndrome, and 101 patients (36.2%) had autism spectrum disorder (ASD). But further psychiatric verification of these syndromes in accordance with ICD-10 was not carried out. Clinical, neurophysiological and morphological characteristics of comorbid mental symptoms in epilepsy in childhood and adolescence were revealed.

Clinical Symptoms of Carpal Tunnel Syndrome and Its Correlation With Vitamin D Level

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the peripheral nerves in the upper extremities that is often found in workers. Nerve conduction disorders occur due to compression of the carpal tunnel, resulting in motor and sensory symptoms in the hands and wrists. This causes clinical symptoms and characteristic neurophysiological examinations. Vitamin D is an intrinsic factor that causes CTS which is now widely studied and is expected to play a role in the choice of CTS management. Vitamin D is important for maintaining health and has been found to have neuroprotective function. Several studies have proven the association between vitamin D deficiency and the incidence of CTS. Supplementation can improve clinical symptoms and neurophysiological features of mild to moderate CTS patients.

Limited clinical validity of univariate resting-state EEG markers for classifying seizure disorders.

Differentiating between epilepsy and psychogenic non-epileptic seizures presents a considerable challenge in clinical practice, resulting in frequent misdiagnosis, unnecessary treatment and long diagnostic delays. Quantitative markers extracted from resting-state EEG may reveal subtle neurophysiological differences that are diagnostically relevant. Two observational, retrospective diagnostic accuracy studies were performed to test the clinical validity of univariate resting-state EEG markers for the differential diagnosis of epilepsy and psychogenic non-epileptic seizures. Clinical EEG data were collected for 179 quasi-consecutive patients (age > 18) with a suspected diagnosis of epilepsy or psychogenic non-epileptic seizures who were medication-naïve at the time of EEG; 148 age- and gender-matched patients subsequently received a diagnosis from specialist clinicians and were included in the analyses. Study 1 is a hypothesis-driven study testing the ability of theta power and peak alpha frequency to classify people with epilepsy and people with psychogenic non-epileptic seizures, with an advanced machine learning pipeline. The next study (Study 2) is data-driven; a high number of quantitative EEG features are extracted and a similar machine learning approach as Study 1 assesses whether previously unexplored univariate EEG measures show promise as diagnostic markers. The results of Study 1 suggest that EEG markers that were previously identified as promising diagnostic indicators (i.e. theta power and peak alpha frequency) have limited clinical validity for the classification of epilepsy and psychogenic non-epileptic seizures (mean accuracy: 48%). The results of Study 2 indicate that identifying univariate markers that show good correlation with a categorical diagnostic label is challenging (mean accuracy: 45-60%). This is due to a considerable overlap in neurophysiological features between the diagnostic classes considered in this study, and to the presence of more dominant EEG dynamics such as alterations due to temporal proximity to epileptiform discharges. Markers that were identified in the context of previous epilepsy research using visually normal resting-state EEG were found to have limited clinical validity for the classification task of distinguishing between people with epilepsy and people with psychogenic non-epileptic seizures. A search for alternative diagnostic markers uncovered the challenges involved and generated recommendations for further research.

FMRI fluctuations within the language network are correlated with severity of hallucinatory symptoms in schizophrenia

Although schizophrenia (SZ) represents a complex multiform psychiatric disorder, one of its most striking symptoms are auditory verbal hallucinations (AVH). While the neurophysiological origin of this pervasive symptom has been extensively studied, there is so far no consensus conclusion on the neural correlates of the vulnerability to hallucinate. With a network-based fMRI approach, following the hypothesis of altered hemispheric dominance (Crow, 1997), we expected that LN alterations might result in self-other distinction impairments in SZ patients, and lead to the distressing subjective experiences of hearing voices. We used the independent component analysis of resting-state fMRI data, to first analyze LN connectivity in three groups of participants: SZ patients with and without hallucinations (AVH/D+ and AVH/D–, respectively), and a matched healthy control (HC) group. Then, we assessed the fMRI fluctuations using additional analyses based on fractional Amplitude of Low Frequency-Fluctuations (fALFF), both at the network- and region of interest (ROI)-level. Specific LN nodes were recruited in the right hemisphere (insula and Broca homologous area) for AVH/D+ , but not for HC and AVH/D–, consistent with a left hemisphere deficit in AVH patients. The fALFF analysis at the ROI level showed a negative correlation between fALFF Slow-4 and P1 Delusions PANSS subscale and a positive correlation between the fALFF Slow-5 and P3 Hallucination PANSS subscale for AVH/D+ only. These effects were not a consequence of structural differences between groups, as morphometric analysis did not evidence any group differences. Given the role of language as an emerging property resulting from the integration of many high-level cognitive processes and the underlying cortical areas, our results suggest that LN features from fMRI connectivity and fluctuations can be a marker of neurophysiological features characterizing SZ patients depending on their vulnerability to hallucinate.

Art Therapy as an Effective Means of Overcoming Stress: Neurophysiological Features

The article presents the results of research into the use of the most effective means to overcome stress in children and adults, in particular, the use of art therapy. The relevance of the study is determined by the need to build stress resistance in crisis situations, which are a fairly common phenomenon in the context of modern problems. The study defined the essence of the concepts of "fear", "anxiety" and "art therapy". Aspects related to the impact of stress on children, its causes, and the main trends in overcoming it were formed. The work describes art therapy as one of the most effective methods of preventing stress and building stress resistance. The results of the study confirm the hypothesis regarding the use of art therapy as a method of overcoming stress and at the same time as prevention. The most effective means of overcoming stress have been determined, in particular fairy-tale therapy, art therapy, etc. The causes of stress as neurophysiological features in a child were also investigated. The prerequisites and factors of stressful situations are characterized. Methods of synthesis, analysis, research, scientific and descriptive methods were used to ensure an effective research result. The research became the basis for determining ways to overcome stress, for the formation of effective means of diagnosis and psychocorrection. To determine effective approaches to overcoming stress, scientific research on the problem was analyzed and features were determined. The results of the study became the basis for establishing the features of stress in crisis conditions, analyzing the most effective methods of overcoming stress, describing neurophysiological factors that cause stress, and characterizing art therapy as the most effective method of overcoming stress. The article is the result of research and analysis of scientific intelligence on the specified problem.

Mutations in alpha-B-crystallin cause autosomal dominant axonal Charcot-Marie-Tooth disease with congenital cataracts.

Mutations in the alpha-B-crystallin (CRYAB) gene have initially been associated with myofibrillar myopathy, dilated cardiomyopathy and cataracts. For the first time, peripheral neuropathy is reported here as a novel phenotype associated with CRYAB. Whole-exome sequencing was performed in two unrelated families with genetically unsolved axonal Charcot-Marie-Tooth disease (CMT2), assessing clinical, neurophysiological and radiological features. The pathogenic CRYAB variant c.358A>G;p.Arg120Gly was segregated in all affected patients from two unrelated families. The disease presented as late onset CMT2 (onset over 40 years) with distal sensory and motor impairment and congenital cataracts. Muscle involvement was probably associated in cases showing mild axial and diaphragmatic weakness. In all cases, nerve conduction studies demonstrated the presence of an axonal sensorimotor neuropathy along with chronic neurogenic changes on needle examination. In cases with late onset autosomal dominant CMT2 and congenital cataracts, it is recommended that CRYAB is considered for genetic testing. The identification of CRYAB mutations causing CMT2 further supports a continuous spectrum of expressivity, from myopathic to neuropathic and mixed forms, of a growing number of genes involved in protein degradation and chaperone-assisted autophagy.

Is it safe to control the car pedal with the lower limb of the unaffected side in patients with stroke?

Objectives Few studies have examined motor function in determining the suitability of patients with stroke to resume driving a car. Patients with hemiplegia usually control car pedals with the unaffected lower limb. However, motor control on the unaffected side is also impaired in patients with stroke. This study aimed to clarify the neurophysiological characteristics of pedal switching control during emergency braking in patients with hemiplegia. Methods The study participants consisted of 10 drivers with left hemiplegia and 10 age-matched healthy drivers. An experimental pedal was used to measure muscle activity and kinematic data during braking, triggered by the light from a light-emitting diode placed in front of the drivers. Results The patient group took the same reaction time as the healthy group. However, from the visual stimulus to the release of the accelerator pedal, the patient group had higher muscle activity in the tibialis anterior and rectus femoris and had faster angular velocities of hip and knee flexion than the healthy group. In addition, the patient group had higher co-contraction activities between flexors and extensors. From the accelerator pedal release to brake contact, the patient group had slower angular velocities of hip adduction, internal rotation, ankle dorsiflexion, internal return, and internal rotation than the healthy group. Conclusions Patients with hemiplegia exhibited poor control of pedal switching using their unaffected side throughout the pedal-switching task. These results indicate that the safety related to car-pedal control should be carefully evaluated while deciding whether a patient can resume driving a car after a stroke.