Neurodevelopmental testing of mice in the neonatal period does not affect their locomotor activity, depressive- and anxiety-like behaviour in adolescence.

Neonatal life is a sensitive period of brain plasticity. There are concerns that pre-weaning handling may therefore alter behavioural phenotype in adolescence or adulthood. Since neurodevelopment tests require daily manipulation with pups, later behavioural outcomes might be biased by repeated handling during suckling period. The aim of our study was to assess whether daily neurodevelopmental testing would cause alterations in behavioural phenotype. Sixty-four CD1 mice were randomized to tested and not tested group. In the tested group, maturation of physical features and neurodevelopment were monitored daily from postnatal day 1-21 between 9 and 11 AM. After weaning, battery of behavioural tests to monitor anxiety-like, depressive, or repetitive behaviour was performed in all mice. We revealed no significant between-group differences in performance of these tests. Our data did not confirm the assumption that early neurodevelopment testing during suckling period affects behavioural phenotype in adolescence.

Programa Antiestrés de Sincronización Cerebral mediante estimulación visual / Anti-stress software of synchronization of brain wave by visual stimulation

Se presenta un programa computarizado que permite la sincronización de las ondas cerebrales mediante una estimulación visual, a una frecuencia similar a la actividad eléctrica del cerebro en estado de sedación, lo cual favorece la disminución de los niveles de estrés en los pacientes que acuden al Centro de Histoterapia Placentaria para tratar las patologías de Vitiligo, Psoriasis y Alopecia Areata. La aplicación informática fue programada en lenguaje Delphi 7.0 y cuenta con dos módulos para su ejecución. El efecto antiestrés se determinó a través de criterios observacionales y mediante la cuantificación de los niveles de concentración de adrenalina y cortisol en suero sanguíneo(AU)

A computer program that allows synchronization of brain waves by visual stimulation, similar to the electrical activity of the brain in a state of sedation frequently, which helps to reduce stress levels in patients who come to Placental Histotherapy Center to treat Vitiligo, Psoriasis and Alopecia Areata is presented. The computer application was programmed in the language Borland Delphi 7.0 and has two modules for its execution. The anti-stress effect was determined by observational criteria and the cuantification of levels of epinephrine and cortisol concentration in the blood serum(AU)

The Sensory Gating Inventory as a potential diagnostic tool for attention-deficit hyperactivity disorder.

Diagnoses of attention-deficit hyperactivity disorder (ADHD) are often made rapidly in physicians' offices without thorough assessment. We examined whether adults diagnosed with ADHD would score differently from controls on a modified Sensory Gating Inventory (SGI: Hetrick et al. in Schizophr Bull 38:178-191, 2012; Kisley et al. in Psychophysiol 41:604-612, 2004), which would facilitate rapid and easy preliminary assessment of ADHD status. The modified SGI was administered to 22 controls and 22 adults with physician diagnoses of ADHD. Analysis was performed on the 17 SGI items and the three categories to which they belong (Perceptual Modulation, Distractibility, and Over-Inclusion). The Distractibility category, and its individual items, showed large group differences. In spite of a relatively small sample size, we found large effect sizes between those with and without ADHD diagnoses. The SGI is a simple, quick, paper/pencil method that may be used to facilitate accurate diagnosis of individuals experiencing ADHD symptoms, which may be especially useful when evaluations are made in settings such as physicians' offices.

Anxiety and depression in multiple sclerosis patients around diagnosis.

OBJECTIVES: To prospectively identify anxiety and depressive symptoms, and their predictors, during the multiple sclerosis (MS) peridiagnostic period. METHODS: The Hospital Anxiety and Depression Scale (HADS) was administered during diagnostic workup (baseline), and one and six months after diagnosis disclosure, to SIMS-Trial participants (ISRCTN81072971). RESULTS: Of 197 screened patients, 120 (61%) were diagnosed with MS. At baseline, median HADS anxiety (HADS-A) score was 7.0 (interquartile range [IQR] 5.0-9.5), ≥8 (anxiety cut-off) in 43% (95% confidence interval [CI] 34%-52%). Median HADS depression (HADS-D) was 3.0 (IQR 1.0-5.0), ≥8 (depression cut-off) in 11% (95% CI 5%-16%). Independent predictors of anxiety were female sex (odds ratio [OR] 2.8, 95% CI 1.1-7.2) and HADS-D score (OR 20.8, 95% CI 2.5-175.5). The only predictor of depressive symptoms was HADS-A score (OR 20.0, 95% CI 2.8-260.9). Anxiety symptoms had decreased slightly but significantly (p<0.001) at six months. Depressive symptoms remained low. CONCLUSIONS: Anxiety was prominent in the period surrounding MS diagnosis disclosure, particularly in women. A slight but significant reduction occurred six months after diagnosis disclosure. Depressive symptoms were less common and stable over time. In addition to sex, depressive symptoms were the only variable independently associated with anxiety.

[What happens in the brain of my patients? Neuroimaging and neurogenetics as ethical challenges in medicine]. / Was passiert im Gehirn meines Patienten? Neuroimaging und Neurogenetik als ethische Herausforderungen in der Medizin.

Precise diagnosis of many neurological or psychiatric diseases has for long been one of the main problems in medicine. New diagnostic procedures like neuroimaging or neurogenetics seem now able to change thi situation but evoke new ethical questions. How should we cope with the fact that we may be able to diagnose and even predict diseases like schizophrenia or Alzheimer's Disease? How should we deal with incidental findings in neuroimaging? Can and should we use neuroimaging or neurogenetic procedures to detect certain behavioral dispositions? A new interdisciplinary research programme, called "neuroethics", can provide an ethical orientation for such questions.

Methods for diagnosing hepatic encephalopathy in patients with cirrhosis: a multidimensional approach.

There is no "gold standard" for diagnosing hepatic encephalopathy in patients with cirrhosis. In consequence, the presence of this condition, unless floridly overt, is often missed. As a result, the majority of patients are denied the benefits of treatment. There are a number of individual techniques, which access different aspects of cerebral function that can be used, singly or in combination, to provide diagnostic information in this condition, including mental state assessment, psychometric testing, electroencephalography, sensory and cognitive evoked potentials, and neuroimaging. These have been variously applied to the study of hepatic encephalopathy but fundamental differences in the essential aims of the studies, as well as differences in the patient populations and the acquisition and analysis of the data, have made comparisons difficult. Thus, there is no clear consensus as to the sensitivity, specificity, or validity of these tests when used alone or in combination. There are, however, a number of additional methods that could be used to analyze the electrophysiological data, and a number of alternative evoked potentials that could be measured to provide better diagnostic information. In addition, there are a number of techniques, such as critical flicker frequency and smooth pursuit eye movements, which have not yet been applied systematically in this condition and which may provide useful diagnostic information. Clearly the methods for assessing hepatic encephalopathy need to be reviewed, newer methods for analyzing the electrophysiological data and newer techniques for assessing alternative aspects of cerebral function need to be explored for their diagnostic utility. This process should aim at developing a multidimensional diagnostic tool.

Serial administration of clinical concussion assessments and learning effects in healthy young athletes.

OBJECTIVE: To determine if serial administration of the Standardized Assessment of Concussion (SAC) and Balance Error Scoring System (BESS) would elicit a learning effect in young athletes and to determine the intratester reliability of scoring the BESS. DESIGN: A prospective study of 50 healthy young athletes who were assigned to either the control or practice group. All subjects were administered the assessments on 2 occasions, 60 days apart. In addition, subjects in the practice group received serial administration of the assessments on 3 occasions in the week following the initial assessment. SETTING: University Sports Medicine/Athletic Training Research Laboratory. SUBJECTS: Fifty uninjured young athletes between 9 and 14 years of age. MAIN OUTCOME MEASURED: Scores on 2 clinical concussion assessments, the SAC and the BESS. RESULTS: We found a significant learning effect upon serial BESS testing in the practice group. BESS error scores were significantly lower than baseline (15.0 +/- 4.6) on days 5 (11.3 +/- 5.33), 7 (12.4 +/- 6.2), and 60 (12.6 +/- 6.2). We also found a significant learning effect upon the day 60 BESS administration across all subjects. We did not find a practice or learning effect with serial SAC test administration. The intratester reliability of the investigator's ability to score repeated observations of the same BESS test ranged from 0.87 to 0.98. CONCLUSIONS: Our results demonstrated that serial administration of the BESS elicited a learning effect, which was more prominent during the tandem conditions. Clinicians utilizing the BESS as a measure of postural stability should be aware of the potential for improvement with repeated testing. Clinicians should not expect improvement with the SAC, as scores remained relatively stable across all trials.

Neurology, technology, and the diagnostic imperative.

Advancements in diagnostic technologies have revolutionized the field of neurology. The use of these tools in the course of neurological evaluations is driven by a strong version of the diagnostic imperative, with the goal of precisely identifying the locus and extent of disease processes. Because of the discrepancy between the sophistication of these technologies and the availability of therapeutic interventions, there is active debate regarding the appropriate use of these tools when the diagnosis is clear, or when no change is made to the therapeutic management. A narrow view of management that is bounded by the availability of pharmacological or surgical interventions results in a more rigid dichotomy between the needs of doctors and patients. A broader view that relaxes the constraint between diagnostic procedures and interventions is more in keeping with the observation that many acts are performed for the benefit of doctors and patients alike. An historical and ethical analysis of the diagnostic imperative, with attention to the rise of innovative medical technologies and current concepts of therapeutic intervention, can help clarify the principles of medical paternalism and beneficence that guide current models of decision making in the neurological sciences.