The candidate neuroprotective agent artemin induces autonomic neural dysplasia without preventing peripheral nerve dysfunction.

Artemin (ART) signals through the GFR alpha-3/RET receptor complex to support sympathetic neuron development. Here we show that ART also influences autonomic elements in adrenal medulla and enteric and pelvic ganglia. Transgenic mice over-expressing Art throughout development exhibited systemic autonomic neural lesions including fusion of adrenal medullae with adjacent paraganglia, adrenal medullary dysplasia, and marked enlargement of sympathetic (superior cervical and sympathetic chain ganglia) and parasympathetic (enteric, pelvic) ganglia. Changes began by gestational day 12.5 and formed progressively larger masses during adulthood. Art supplementation in wild type adult mice by administering recombinant protein or an Art-bearing retroviral vector resulted in hyperplasia or neuronal metaplasia at the adrenal corticomedullary junction. Expression data revealed that Gfr alpha-3 is expressed during development in the adrenal medulla, sensory and autonomic ganglia and their projections, while Art is found in contiguous mesenchymal domains (especially skeleton) and in certain nerves. Intrathecal Art therapy did not reduce hypalgesia in rats following nerve ligation. These data (1) confirm that ART acts as a differentiation factor for autonomic (chiefly sympathoadrenal but also parasympathetic) neurons, (2) suggest a role for ART overexpression in the genesis of pheochromocytomas and paragangliomas, and (3) indicate that ART is not a suitable therapy for peripheral neuropathy.

Neuropsychological tests in the elderly: methods and sample characteristics of a GRECC study.

This report describes the methods and sample characteristics of a neuropsychological study of the elderly conducted by the Geriatric Research, Education and Clinical Center of the Department of Veterans Affairs Medical Center in Minneapolis, Minnesota. The goal of the study was to provide normative data, internal consistency and 1-year reliability estimates, and validated methods of estimating expected performance level. Thirty-one cognitive measures and a demographic questionnaire were administered to an age-, education-, and gender-stratified sample ( N = 349) and a validation sample (N = 70). After 1 year, 104 of the participants were retested. Relative to published, nationally based normative data, the stratified sample showed performance levels that ranged from average to high average across the five tests examined.

Facial recognition test in the elderly: norms, reliability and premorbid estimation.

The Facial Recognition Test (Benton, Hamsher, Varney, & Spreen, 1983; Benton, Sivan, Hamsher, Varney, & Spreen, 1994) was examined in an age-, education- and gender-stratified sample of 346 healthy older adults. Internal consistency reliability estimates were.72 for the Long Form (FRLF),.53 for the Short Form, and.69 for a new short form. Mean FRLF scores did not change over a 1-year interval (p >.5), and the stability estimate was.71 (n = 100). The first of the methods below yielded the highest correlation between estimated and obtained FRLF scores in cross-validation (n = 67): (1) multiple regression based on oral reading and demographics, (2) multiple regression based on age, education and gender, and (3) mean scores by age group.

Neuropsychological Tests for Monitoring Delirium Severity in Elderly Patients.

The authors identified neuropsychological tests appropriate for use in monitoring delirium severity in elderly patients. Ten elderly patients were administered a battery of tests while they were delirious and later during their recovery. All of the measures showed significant improvement across the two occasions (P < 0.05). Examination of components of variance suggests that modified versions of the Forward Digit Span, Similarities, or Oral Sentence Spelling tests or a combination of Forward Digit Span and Similarities or Oral Sentence Spelling are likely to be most effective in monitoring delirium severity.