The habit hypothesis of compulsive behavior / 中华行为医学与脑科学杂志

Compulsive behavior is a trans-diagnostic symptom.However, researchers' understanding of compulsive behavior is still argumentative.Most conventional understanding of compulsive behavior is that this symptom may be related to abnormalities in the brain goal-direct and habitual learning systems.Nevertheless, majority of studies only explore the role of goal-direct system in compulsive behavior, and they pay less attention to how the habit system affects compulsive behavior.However, individuals with compulsive behaviors will show more habitual behaviors and their abnormal brain neural circuits overlap with the brain neural structures activated by habits.Besides, starting from habit system can also explain some genetic risk factors of compulsive behavior.On top of this, habit hypothesis can bring new insights in understanding compulsive behavior from a pharmacological aspect.Therefore, in this review, the evidences from behavioral, neurobiological, genetic and pharmacological aspects were combined to explore the new insights brought by the habit hypothesis in understanding compulsive behavior, and propose the urgent problems need to be solved in current compulsive behavior habit studies.

Methanol related death in National Institute of Forensic Medicine, Hospital Kuala Lumpur: A case series

@#Introduction: Methanol is a widely available chemical with a range of uses including as solvent, as a fuel, in chemical synthesis and anti-freeze preparations. Most of the cases are accidental exposures to drinking beverages contaminated with methanol. Materials and Methods: In mid-September 2018, there was a single outbreak of methanol poisoning in Malaysia especially involving the state of Federal Territory Kuala Lumpur and Selangor. There were 33 reported deaths suspected due to methanol poisoning in this current outbreak where 11 of them were brought in to the Institute of Forensic Medicine (NIFM), Kuala Lumpur. The last outbreak was in the year 2013 with 29 deaths reported out of 44 cases. Results: There were 3 cases (27.2%) died in hospital and the remaining 8 cases (72.8%) were found dead at home and were later brought in dead to the hospital. A full autopsy was carried out for each case. Autopsy findings, as well as lab results pertaining to cases that survived and directly brought in dead, were of a different spectrum. Conclusion: Methanol related deaths are almost always as a result of greed. The running truism is ‘methanol poisoning is a result of deliberate addition/adulteration with industrial methanol’. Prevention of the illegal production of methanol and methylated spirits should be established to curb this matter in the future.

Subcortical Volume Changes in Migraine with Aura

BACKGROUND AND PURPOSE: Various features of the cerebral cortex and white matter have been extensively investigated in migraine with aura (MwA), but the morphological characteristics of subcortical structures have been largely neglected. The aim of this study was to identify possible differences in subcortical structures between MwA patients and healthy subjects (HS), and also to determine the correlations between the characteristics of migraine aura and the volumes of subcortical structures. METHODS: Thirty-two MwA patients and 32 HS matched by sex and age were analyzed in this study. Regional subcortical brain volumes were automatically calculated using the FSL/FMRIB Image Registration and Segmentation Tool software (https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/Glossary). A general linear model analysis was used to investigate differences in the volume of subcortical structures between the MwA patients and HS. A partial correlation test was used to assess correlations between the volume of subcortical structures and characteristics of MwA. RESULTS: The volumes of the right globus pallidus, left globus pallidus, and left putamen were significantly smaller in MwA patients than in HS (mean±SD): 1,427±135 mm³ vs. 1,557±136 mm³ (p<0.001), 1,436±126 mm³ vs. 1,550±139 mm³ (p=0.001), and 4,235±437 mm³ vs. 4,522±412 mm³ (p=0.006), respectively. There were no significant relationships between subcortical structures and clinical parameters. CONCLUSIONS: These findings suggest that both the globus pallidi and left putamen play significant roles in the pathophysiology of the MwA. Future studies should determine the cause-and-effect relationships, since these could not be discriminated in this study due to its cross-sectional design.

Neuro Wilson’s – An Alien Presentation.

Wilson’s disease is an Autosomal recessive disorder of inborn error of copper metabolism in liver which results in accumulation of copper in the liver, brain, kidneys, eye and other organs affecting commonly children and young adults. Its incidence varied from 33 to 68 per 100,000 in India and 1 in 30,000– 40,000 in worldwide population. Mainstay of diagnosis primarily depends on clinical features, biochemical parameters, presence of Kayser-Fleischer (KF) ring. A middle aged man referred as spinocerebellar ataxia was incidentally found to be an exclusive case of Neuro Wilson’s without involvement of the liver and hence we intend to report this case for its rarity.

The Putamen and Caudate Nucleus Volume in Korean Youth by MRI Volumetry / 체질인류학회지

Corpus striatum is subcortical nuclei composed of caudate nucleus and putamen. It has been considered to be associated with motor control and learning. Dysfunction of the striatum is related to Huntington's disease, Tourette's syndrome, obsessive-compulsive disorder and schizophrenia. Nevertheless, standard Korean striatum volume was not set yet. Here, we report the striatum volume in healthy Korean youths. The subjects were composed of 57 youths (male, 28; female, 29). The MRI study was undertaken after a brief history taking and neurological examination. The DICOM files were imported into V-Works program. Volume models of the intracranial cavity, whole brain, caudate nucleus, and putamen were made and their volumes were calculated by the program. The average caudate volume was 7.23±1.18 cm³ in male group and 6.23±0.96 cm³ in female group. The average volume of putamen was 7.19±1.25 cm³ in male group and 6.38±0.86 cm³ in female group. Interestingly the right caudate volume is significantly larger in both group, although there is no difference in putamen volume. This study reports Korean corpus striatum volume in healthy volunteers. These results would provide an important standard reference for further study.

Effect of baicalein on brain injury induced by 6-hydroxydopamine at different sites in rats / 中国药理学通报

Aim To explore the therapeutical effect and mechanism of baicalein on two 6-hydroxydopamine (6-OHDA ) induced Parkinson′s disease (PD ) rat models,which received unilateral lesions of the left medial forebrain bundle (MFB ) or caudate putamen (CPu ) made by stereotaxic injection of 6-OHDA (MFB-M,CPu-M).Methods PD rat models were established by microinjection of 6-OHDA into MFB or CPu.The anti-tremor effect of baicalein on PD rat models was examined.Spontaneous activity was recor-ded. Dopamine (DA ), dihydroxyphenylacetic acid (DOPAC)and homovanilic acid (HVA)in striatum were quantified by HPLC-ECD.The tyrosine hydroxy-lase (TH)and OX-42 positive cells were detected by immunohistochemical method.The morphological vari-ation of the neurons was confirmed by analysis at an ul-trastructural level.Results Baicalein significantly in-creased the spontaneous activity in CPu-M.The elec-tromyography (EMG ) recordings revealed that com-pared with 6-OHDA group,the tremor frequency in ba-icalein group was decreased by 55% in MFB-M,and by 60% in CPu-M.6-OHDA treatment decreased DA levels in the striatum,while treatment with baicalein attenuated the DA decreases in CPu-M.Moreover,ba-icalein treatment could increase TH-positive neurons and decrease OX-42-postive microglia compared with 6-OHDA group in both MFB-M and CPu-M.Conclu-sions In the present study,it is illustrated that ①microinjection of 6-OHDA into the MFB and the CPu could cause different pathological changes of PD, which is important for efficacy evaluation;②baicalein showed the ability to alleviate the behavior symptoms in PD-rats at different stages by improving motor function and attenuating muscle tremor;③therapeutic effect of baicalein was produced by inhibiting the inflammatory medium production and release,anti-apoptosis,chan-ging dopamine catabolism, and inhibiting dopamine turnover.

A rare case of toxic optic neuropathy secondary to consumption of neem oil.

A 35-year-old female was referred to our hospital with bilateral loss of vision of two days duration. She gave history of consumption of about 150 ml of neem oil five days back. Examination revealed no perception of light in both eyes. Both pupils were dilated and sluggishly reacting to light. Her fundus examination showed bilateral hyperemic, edematous discs and also edema extending along the superior and inferior temporal vascular arcade. Magnetic resonance imaging (MRI) scan showed bilateral putaminal regions with altered signal, hypointensities in T1-weighted images, hyperintensities on T2-weighted, images and hyperintense on Fluid Attenuation Inversion Recovery (FLAIR) images suggestive of cytotoxic edema due to tissue hypoxia. Her vision improved to 20/200 in both eyes with treatment after two months. This is the first case report of such nature in the literature to the best of our knowledge.

H-magnetic resonance spectrum of putaman of Tourette' s syndrome / 中华神经科杂志

Objective To study the changes of the putamen metabolites with magnetic resonance spectrum(MRS),and to explore possible underlying unrecongnised aetiological factor and pathophysiology mechanism in the central nervous system of the patients with Tourette' s syndrome.Methods Twenty-two cases of Tourette' s syndrome,and twenty-two gender and age-matched subjects ( the control subjects ) were performed on a clinical 3.0 T MRI system.Proton prob-voxel spectroscopy imaging (1H-MRS) was obtained from two sides of the putamen.The metabolites included N-acetylaspartate (NAA),creatine and phosphocreatine ( Cr),choline-containing compounds (Cho),and myoinositol ( MI ).The value of the NAA,Cr,Cho,and MI were calculated by integration of their peaks.The ratios of NAA/Cr,Cho/Cr,ML/Cr were calculated respectively.Repeated measures analysis of variance ( ANOVA ) was used to test both the value of NAA/Cr,Cho/Cr,MI/Cr of the putamen for group difference,with group as between-subjects factor and side as within-subjects factor.Results The NAA/Cr ratio in patients ( left:1.29 ± 0.13 ; right:1.34 + 0.15 ) was significantly lower than that in the control subjects ( left:1.50 ± 0.08,T =1.962,P ＜0.05 ; right:1.52 ± 0.11,T =1.865,P ＜ 0.05 ).There was no significant difference in the Cho/Cr and MI/Cr ratio between both groups.Conclusion The abnormalities of the structure and(or) function in the putamens of patients may be the one of the underlying anaetiological factors and pathophysiology mechanisms of the Tourette' s syndrome.

A Case of Transient Memory Impairment after Acute Left Focal Lateral Putamen ICH with Old Caudate Nucleus Infarction

Transient memory impairment can be occurred by many causes. One of them is acute focal brain lesion in strategic site. Caudate nucleus and medial basal ganglia (globus pallidus) are lesion of strategic site. They play its role in cognitive processing. But lateral basal ganglia (putamen) is known as a structure involving movement, not cognitive function. We report a interesting case of transient memory dysfunction with acute focal putamen ICH with old caudate nucleus infarction.

Interactions of Dopamine D1 and N-methyl-D-Aspartate Receptors are Required for Acute Cocaine-Evoked Nitric Oxide Efflux in the Dorsal Striatum

Alterations in nitric oxide (NO) release in response to psychostimulants in the striatum cause a plastic change contributing to the development and expression of addiction. In this study, regulation of NO efflux evoked by acute cocaine in the dorsal striatum was investigated using real-time detection of NO in vivo. We found that acute systemic injection of cocaine (20 mg/kg) increased NO efflux, which was reduced by the intrastriatal infusion of the dopamine D1 receptor antagonist, SCH23390 (7.5 nmol), and the dopamine D2 receptor agonist, quinpirole (5 nmol). Increased levels of NO efflux by acute cocaine were also reduced by the intrastriatal infusion of the N-methyl-D-aspartate (NMDA) receptor antagonists, MK801 (2 nmol) and AP5 (2 nmol). These findings suggest that interactions of dopamine D1 receptors and NMDA receptors after acute exposure to cocaine participate in the upregulation of NO efflux in the dorsal striatum.

Prospect of cell therapy for Parkinson's disease / 대한해부학회지

The hallmark of Parkinson's disease is on-going degeneration of dopaminergic neurons in the substantia nigra, which may be due to various etiologies. Various approaches to alleviate symptoms are available, such as life-long pharmacological intervention, deep brain stimulation, and transplantation of dopaminergic neuron-containing fetal tissue. However, each of these approaches has a disadvantage. Several studies have shown that various kinds of stem cells, induced pluripotent stem cells, and other cells can differentiate into dopaminergic neurons and may be promising for treating Parkinson's disease in the future. Therefore, this review addresses those cells in terms of their prospects in cell therapy for Parkinson's disease. In addition, the need for safety and efficacy studies, various cell delivery modes and sites, and possible side effects will be discussed.

Estudio anátomo-radiológico mediante segmentación de los núcleos cerebrales caudado, putamen y pálido / Anatomoradiologic study of cerebral nuclei caudate, putamen and pallidum by means of segmentation

Introducción: En la fisiopatología de algunas entidades neurológicas y psiquiátricas se involucran determinadas estructuras encefálicas. Las pruebas diagnósticas por imagen y la segmentación informática brindan la oportunidad de estudiar posibles relaciones entre ellas. Objetivo: Realizar un atlas anatómico mediante imágenes de resonancia magnética (RM) encefálica, definiendo los valores de normalidad en sujetos sanos de diversas estructuras para aplicarlos en el estudio de pacientes con patologías neurológicas y/o psiquiátricas, determinando posibles relaciones. Materiales y métodos: Diez estudios de RM de individuos sanos, analizados por dos radiólogos independientes. Se estudiaron los núcleos caudado, putamen y pálido de ambos hemisferios cerebrales, mediante la herramienta de segmentación ITK-SNAP. Se determinaron los volúmenes máximo, mínimo y medio de los núcleos, comparando ambos lados y la concordancia interobservador. Resultados: Los resultados volumétricos del caudado reflejaron una media de 4032 mm3 (+/-719'72), 4626'42 mm3 (+/-653'87) para el putamen y 1251'25 mm3 (+/- 277'3) para el pálido. Los índices de correlación entre los núcleos de ambos lados fueron de 0'974 para el caudado, 0'946 para el putamen y 0´76 para el pálido. Los índices de correlación interobservador fueron de 0'737, 0'919 y 0'082, respectivamente. Conclusiones: La segmentación en imágenes médicas -en este caso, RM- tiene un futuro prometedor para analizar patologías cerebrales con alteraciones morfológicas y/o morfométricas. Los resultados obtenidos para los núcleos putamen y caudado representan una directriz inicial para establecer la morfología y morfometría normales.

Introduction: Some encephalic structures are involved into the physiopathology of some neurologic and psychiatric entities. The different imaging modalities and the computer segmentation allow the opportunity of studying the possible relationship among them. Objective: To elaborate an anatomic atlas of the encephalic structures by means of MR images, evaluating in healthy patients the normal values of these structures, in order to apply them in the study of patients with neurologic or psychiatric pathologies to determine a possible relationship. Material and methods: Ten MR studies of healthy patients, analysed by two independents radiologists. Caudate, putamen and pallidum nuclei of both hemispheres were evaluated by means of the segmentation tool ITKSNAP. The maximum, minimum and medium volumes of the nuclei were determined, comparing both sides and the interobserver correlation. Results: The volumetric results for caudate nucleus (media) were: 4032 mm3 (+/-719'72), 4626'42 mm3 (+/-653'87) for the putamen and 1251'25 mm3 (+/-277'3) for the pallidum. The correlation index between the nucleus of both sides were of 0,974 for caudate, 0,946 for the putamen and 0,76 for the pallidum. The interobserver correlation indexes were 0,737, 0,919 and 0,082 respectively. Conclusions: Medical imaging segmentation, in this case MR, has a very promising future in order to analyse brain entities with morphometric or morphologic alterations. The obtained results in case of caudate, putamen and pallidum nuclei represent an initial key in order to establish the normal morphology and morphometry of these structures.

A Case of Marchiafava-Bignami Disease with Symmetrical Lesions of the Putamen in a Patient with Chronic Alcohol Dependence

Marchiafava-Bignami disease(MBD) is a rare complication of chronic alcoholism characterized by symmetrical demyelination of the corpus callosum. We report a case of MBD in a Korean patient having chronic alcohol dependence. The patient exhibited mental depression, weakness of all four limbs and dysarthria. Laboratory data showed mild hyponatremia. Magnetic resonance imaging(MRI) revealed unusual symmetrical resolving lesions of the putamen in addition to the typically observed lesion of the corpus callosum. The neurologic disturbances were gradually improved with the normalization of low plasma sodium levels. Marked improvement of abnormal MRI findings was noted after thiamine supplement, though the patient still exhibited severe cognitive impairment.

The Volumetric MRI Analysis of the Basal Ganglia in Boys with Tourette's Disorder / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the regional differences of the basal ganglia volume between the boy subjects who have Tourette's disorder and the control group who don't have this disorder by using Brain MRI. METHODS: Sixteen subjects who were diagnosed as Tourette's disorder using DSM-IV criteria, and sixteen healthy subjects were selected. For analysis the coronal slice images of the basal ganglia were collected and collected MR images were analyzed with NIH Image (version 6.1 ppc). RESULTS: The total brain volume in the subjects with Tourette's disorder were smaller than control group by 6.2% (F=6.2, d.f.=1, p=0.019). The right putamen volume in boys with Tourette's disorder were significant smaller than control group statistically (F=3.2, d.f.=3, p=0.040). The asymmetry (left>right) in the globus pallidus decreased significantly in the boys with Tourette's disorder (p=0.06) were found from this experiment. CONCLUSION: These findings suggest that boys with Tourette's disorder may have neuropathological abnormalities in the basal ganglia. Moreover, the present findings point out the important role of basal ganglia, especially putamen, in pathophysiology of Tourette's disorder. More studies about the structural and functional analysis of the basal ganglia in Tourette's disorder are highly required.

Use of the Putamen/Caudate Volume Ratio for Early Differentiation between Parkinsonian Variant of Multiple System Atrophy and Parkinson Disease

BACKGROUND AND PURPOSE: Neuropathological studies have demonstrated that multiple system atrophy (MSA) produces selective atrophy of the putamen with sparing of the caudate nucleus, while both structures are spared in idiopathic Parkinson's disease (PD). In this study we evaluated the clinical efficacy of using putaminal atrophy in brain MRI to differentiate MSA and PD. METHODS: We measured the putamen/caudate volume ratio on brain MRI in 24 patients with MSA and 21 patients with PD. Two clinicians who were blinded to the patients' diagnoses and to each other's assessments measured the volume ratio using a computer program. RESULTS: The measured volume ratios of the two investigators were highly correlated (r=0.72, p<0.0001). The volume ratio was significantly lower in MSA (1.29+/-0.28) than PD (1.91+/-0.29, p<0.0001). Setting an arbitrary cutoff ratio of 1.6 resulted in about 90% of patients with MSA falling into the group with a lower ratio, whereas more than 80% of patients with PD belonged to the other group. CONCLUSIONS: The present results demonstrate that putaminal atrophy in MSA as measured on brain MRI represents an effective tool for differentiating MSA from PD.

Imaging Evidence of Basal Ganglia Pathology in Hemi choreoballistic Movement of the Patient with Nonketotic Hyperglycemia: Case Report with Serial Follow Up of Neuroimages

The mechanism of chorea underlying nonketotic hyperglycemia was controversial. Serial follow up of brain MRI, 99mTc-ECD SPECT, and 18F-FDG PET in conjunction with clinical observation was done to clarify the pathologic localization. From the functional neuroimages, according to the clinical improvement, the relevant pathology was localized on the lentiform nucleus, mainly on the putamen. In caudate, the mismatch between glucose metabolism and blood flow was observed during and after choreoballistic movement which suggested an important cue to understand the pathogenesis of chorea.

Seizure Induced Alteration of Microtubule Associated Proteins Immunoreactivities in the Mongolian Gerbil Striatum / 대한해부학회지

The present study involves a chronological and comparative analysis of both microtubule-associated protein 1A (MAP1A) and microtubule-associated protein 2 (MAP2) immunoreactivities in the striatum of both seizure resistant (SR) and seizure sensitive (SS) gerbil. The MAP1A immunoreactivity is weakly detected in perikarya of SR gerbils. However, MAP1A immunoreactivity is more accumulated in perikarya and dendrites in the pre-seizure group. At 30 min postictal, MAP1A immunoreactivity in the perikarya is decreased. At 3 hr postictal, MAP1A immunoreactivity in perikarya and dendrites is similarly decreased to the level of SR gerbils. The MAP2 immunoreactivity is weakly detected in the perikarya and dendrites of SR gerbils. However, MAP2 immunoreactivity is more accumulated in perikarya and dendrites. In particular, the neuropil between unstained fiber tracts obviously contains strong MAP2 immunoreactivity. At 30 min postictal, MAP2 immunoreactivity isn't almost observed in striatum. At 3 hr postictal, the MAP2 immunoreactivity is not different in the 30 min post -seizure groups but is only observed in the neuropil. However, at 12 hr postictal, the decrease of both MAP1A and MAP2 immunoreactivities had recovered to the pre -seizure level of SS gerbils. These results suggest that MAPs immunoreactivity in the striatum is different in SR and SS gerbils, and that this difference may be the results of seizure activity in this animal.

Clinical and Neuropsychological Characteristics of Patients with Stroke of the Basal Ganglia

The experimental evidences suggest that the roles of basal ganglia are cognition and emotion through the corticostriatothalamocortical relationship. The patients with lesions in the caudate nucleus have high incidences of cognitive and behavioral abnormalities accompanied with the motor paralysis. In these patients, the accurate assessment of neuropsychologic dysfunctions and the prompt application of cognitive rehabilitation programs are important for the functional restoration. We evaluated the patients with stroke of basal ganglia for the clinical and neuropsychological characteristics in relation to the involved substructures of basal ganglia. Fourteen patients were evaluated for the clinical neurologic examinations, functional assessment by functional independence measure(FIM), speech assessment, and various neuropsychological tests for the assessment of attention and memory functions. The results were analysed a ccording to their lesion sites. Of the nine patients with stroke at the right basal ganglia, five patients had neglect of the contralateral hemispace and one had dysarthria. On the other hand, of the five patients with stroke at the left basal ganglia, none had hemispatial neglect and three had aphasia or dysarthria. Of the six patients with caudate lesions, three had aphasia or dysarthria, whereas of the eight patients without caudate lesion, one had dysarthria. The scores of Wechsler memory test were significantly lower in the patients with caudate lesions(P<0.05). Among the FIM subscales, the scores of communication and social cognition were significantly lower in the patients with caudate lesions(P<0.05). The Motor Score was significantly lower in the patients with putamen lesions(P<0.05). Among the FIM subscales, the scores of self care and locomotion were significantly lower in the patients with putamen lesions(P<0.05).

Effects of morphine dependence and withdrawl on SNAPs expression in different brain regions of rats / 中国药理学通报

Aim To investigate the effects of chronic morphine treatment and withdrawal on the level of SNAPs in different brain regions of rats,including nucleus accumbens(NAc),caudate putamen(CPu) and hippocampus(Hip).Methods Adult male Wistar rats were randomly assigned into control,morphine and spontaneous withdrawal group.The morphine dependent rat model was established by subcutaneous morphine injection with increasing doses for 8 d,three times a day(8:00,12:00,and 18:00).The control group was injected with the same volume of normal saline.Rats in morphine group were killed 4 h after the last injection,and rats in withdrawl group were killed at indicated time.Control groups were paralleled with all treatment groups.The brains were removed and the NAc,CPu and Hip were separated.The expression of SNAPs mRNA and protein were determined by RT-PCR and Western blot.Results The expression of ?SNAP in CPu of morphine dependent rats was up-regulated by about 25%(P

ANALGESIC ACTION OF LITHIUM SALT IN RAT CAUDATE-PUTAMEN NUCLEUS / 重庆医科大学学报

Effect of lithium salt(Li)administnation to caudate-putamen nucleus (CPN) on pain response in the rat was studied by chronic cannula implantation and direct injection of drugs into the brain structurementioned above. The results were as follows:( 1 ) The injection of Li into anterior part of the head of CPN of rats produced significantly the analgesic effect that could be antagonized by naloxone, atropine,phento-lamine.propranolol, lysergic acid diethylamide and bicuculline, but not by haloperidol.(2) The injection of Li into central part of the head of CPN of rats did not produce analgesic effect.The results above showed that microinjection of Li into different parts of the head of CPN could give rise to different effects on pain response and the analgesic effect of Li could be related to metabolic changes of endogenous opioid peptides, acetylcholine, noradrenaline, gama aminobutyric acid and 5-hydroXytryptamin aad mediated by their receptors respectively