Emotional processing in RRMS patients: Dissociation between behavioural and neurophysiological response.

BACKGROUNG: Multiple sclerosis (MS) results in a broad range of symptoms, including motor, visual, cognitive, and neuropsychiatric deficits. Some studies, considering affective facial expressions to study emotion processing, demonstrated emotion recognition difficulties in MS patients. OBJECTIVE: We investigated the impact of MS on the emotional-behaviour rating and neurophysiological response (Event Related Potentials-ERP) through a battery of affective visual stimuli selected from the International Affective Picture System (IAPS). METHODS: Twenty patients with diagnosis of Relapsing Remitting MS (RRMS) and 20 Healthy Controls (HC) matched by age, gender and education were enrolled. Each of them, after a neuropsychological assessment, were asked to evaluate arousal and valence of affective visual stimuli. RESULTS: Our results showed higher P300 amplitudes in RRMS patients than HC group for pleasant and unpleasant images. Moreover, RRMS patients showed lower Reaction Time (RT) respect HC in valence rating. No other effect did emerge between groups. CONCLUSION: Our study shows early compensatory cerebral mechanisms in RRMS patients throughout emotional information processing, particularly for unpleasant and pleasant stimuli. We hypothesize that this compensatory cerebral mechanism reduces the behavioural dissimilarity between patients and HC.

Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability.

Cognitive dysfunction affects 40-65% of multiple sclerosis (MS) patients and can occur in the early stages of the disease. This study aimed to explore cognitive functions by means of the Italian version of the minimal assessment of cognitive function in MS (MACFIMS) in relapsing-remitting MS (RRMS) patients with very mild clinical disability to identify the primarily involved cognitive functions. Ninety-two consecutive RRMS patients with Expanded Disability Status Scale (EDSS) scores ≤ 2.5 and forty-two healthy controls (HC) were investigated. Our results show that 51.1% of MS patients have cognitive dysfunction compared to HC. An impairment of verbal and visual memory, working memory, and executive functions was found in the RRMS group. After subgrouping RRMS by EDSS, group 1 (EDSS ≤ 1.5) showed involvement of verbal memory and executive functions; moreover, group 2 (2 ≤ EDSS ≤ 2.5) patients were also impaired in information processing speed and visual memory. Our results show that utilizing a comprehensive neuropsychological assessment, approximately half of MS patients with very mild physical disability exhibit cognitive impairment with a primary involvement of prefrontal cognitive functions. Detecting impairment of executive functions at an early clinical stage of disease could be useful to promptly enroll MS patients in targeted rehabilitation.

From illness narratives to social commentary: a Pirandellian approach to "nerves".

The concept of "nerves" is an integral component of the language of distress found in a number of societies. Individuals, however, often extend its meaning well beyond the realm of suffering. In this article, I examine some Sicilian-Canadian uses of "nerves" from a Pirandellian perspective. This, I believe, gives us an insight into how people (1) make use of illness narratives to give meaning to their life experiences, and (2) attempt to influence the thought and behavior of significant others. In the process, I address the question how do we move away from anthropological definitions and explanations that tend to simplify or mask some of the rich complexities surrounding the meaning(s) of "folk" concepts?

Alloplastic augmentation of the mandibular angle.

PURPOSE: This article describes the use of a large-pore polyethylene implant for mandibular angle augmentation. PATIENTS AND METHODS: Patients with severe facial deformities who had previously undergone multiple surgical procedures and were now seeking esthetic improvement were included in this series. Their deficient mandibular angles and reduced ramus height were corrected with polyethylene implants appropriately sculptured and fixed to the mandible through extraoral incisions that preexisted in most patients. The surgical technique is described, and four representative cases are presented that illustrate the changes in facial contour and esthetics. RESULTS: Postoperative appearance was considered very satisfactory, and the patients' esthetic expectations were met to a great extent. The mandibular angle was well outlined, and facial contour and proportions were enhanced. CONCLUSION: This surgical procedure is recommended for mandibular angle augmentation when proper indications are strictly observed and surgical steps are accurately followed.

Gender, emotion, and physical distress: the Sicilian-Canadian "nerves" complex.

Researchers identify "nerves" as an idiom of distress, an illness category, a metaphorical device capable of communicating social distress, and a technique for impression management. Much of the literature, however, links "nerves" to women. In this paper, I address two aspects of the phenomenon which have received limited attention. First, I discuss "nerves" within the context of Sicilian-Canadian conceptions of anatomy and physiology. Sicilian-Canadians regard "nerves" as essential components of the human anatomy which, in some cases, may be linked to both physical and psychic distress. Second, I build on this discussion to examine how Sicilian-Canadian males make use of the "nerves" idiom. The implications of my work include the need to: (1) modify our definition of "nerves" to recognize formally that we are dealing with a dynamic complex consisting of multiple, variable, and ambiguous meanings--meanings that enable people to confront or cope with a variety of situations; (2) direct greater attention to "nerves" as an idiom of physical distress; and, (3) examine further the role of physical "nerves" in the social construction of gender.

Punctuality, pain and time-orientation among Sicilian-Canadians.

Southern Italians, including immigrants residing in North America, are often labeled as having a present time-orientation. This notion, in turn, has been used as an explanation for diverse phenomena commonly attributed to southern Italians--such as 'arriving late for appointments'; 'seeking immediate relief from the sensation of pain'; and, generally displaying 'a high degree of emotion and expression in their illness behavior'. Labeling an entire group of people as having a particular time-orientation, however, may generate stereotypes that affect negatively the type of medical treatment patients receive. In this paper, I challenge the unsubstantiated notion that southern Italians are present time-oriented. The data I have collected among Sicilian-Canadians indicates that there are alternative explanations for the phenomena people commonly attribute to southern Italians. I will support my contention by examining: (1) Sicilian-Canadian conceptions of punctuality; and, (2) the communicative dimension of the pain experience.