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Pardo B, Herrada-Soler E, Satrústegui J, Contreras L, del Arco A. AGC1 Deficiency: Pathology and Molecular and Cellular Mechanisms of the Disease. Int J Mol Sci 2022; 23:528. [PMID: 35008954 PMCID: PMC8745132 DOI: 10.3390/ijms23010528] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 02/01/2023] Open
Abstract
AGC1/Aralar/Slc25a12 is the mitochondrial carrier of aspartate-glutamate, the regulatory component of the NADH malate-aspartate shuttle (MAS) that transfers cytosolic redox power to neuronal mitochondria. The deficiency in AGC1/Aralar leads to the human rare disease named "early infantile epileptic encephalopathy 39" (EIEE 39, OMIM # 612949) characterized by epilepsy, hypotonia, arrested psychomotor neurodevelopment, hypo myelination and a drastic drop in brain aspartate (Asp) and N-acetylaspartate (NAA). Current evidence suggest that neurons are the main brain cell type expressing Aralar. However, paradoxically, glial functions such as myelin and Glutamine (Gln) synthesis are markedly impaired in AGC1 deficiency. Herein, we discuss the role of the AGC1/Aralar-MAS pathway in neuronal functions such as Asp and NAA synthesis, lactate use, respiration on glucose, glutamate (Glu) oxidation and other neurometabolic aspects. The possible mechanism triggering the pathophysiological findings in AGC1 deficiency, such as epilepsy and postnatal hypomyelination observed in humans and mice, are also included. Many of these mechanisms arise from findings in the aralar-KO mice model that extensively recapitulate the human disease including the astroglial failure to synthesize Gln and the dopamine (DA) mishandling in the nigrostriatal system. Epilepsy and DA mishandling are a direct consequence of the metabolic defect in neurons due to AGC1/Aralar deficiency. However, the deficits in myelin and Gln synthesis may be a consequence of neuronal affectation or a direct effect of AGC1/Aralar deficiency in glial cells. Further research is needed to clarify this question and delineate the transcellular metabolic fluxes that control brain functions. Finally, we discuss therapeutic approaches successfully used in AGC1-deficient patients and mice.
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Affiliation(s)
- Beatriz Pardo
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (E.H.-S.); (J.S.); (L.C.)
- Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid (UAM)-Consejo Superior de Investigaciones Científicas (CSIC), 28049 Madrid, Spain;
- Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Eduardo Herrada-Soler
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (E.H.-S.); (J.S.); (L.C.)
- Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid (UAM)-Consejo Superior de Investigaciones Científicas (CSIC), 28049 Madrid, Spain;
- Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Jorgina Satrústegui
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (E.H.-S.); (J.S.); (L.C.)
- Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid (UAM)-Consejo Superior de Investigaciones Científicas (CSIC), 28049 Madrid, Spain;
- Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Laura Contreras
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (E.H.-S.); (J.S.); (L.C.)
- Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid (UAM)-Consejo Superior de Investigaciones Científicas (CSIC), 28049 Madrid, Spain;
- Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Araceli del Arco
- Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid (UAM)-Consejo Superior de Investigaciones Científicas (CSIC), 28049 Madrid, Spain;
- Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Centro Regional de Investigaciones Biomédicas, Facultad de Ciencias Ambientales y Bioquímica, Universidad de Castilla La Mancha, 45071 Toledo, Spain
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Fajardo TCG, Gazeta RE, Catalan DT, Mello AS, da Silva ACB, Bertozzi APAP, Santos GRD, Pinto CAL, Monteiro CO, Machado RRG, Oliveira DBL, Durigon EL, Passos SD. Neonatal consequences of maternal exposure to the chikungunya virus: Case reports. Medicine (Baltimore) 2021; 100:e25695. [PMID: 33907147 PMCID: PMC8084008 DOI: 10.1097/md.0000000000025695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
RATIONALE The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV. PATIENT CONCERNS In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth. DIAGNOSIS In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children. INTERVENTIONS The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection. OUTCOMES There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth. LESSONS Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Cairo Oliveira Monteiro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Saulo Duarte Passos
- Laboratory of Paediatric Infectology, Jundiaí School of Medicine
- Department of Paediatric, Jundiaí School of Medicine
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Taczała J, Latalski M, Aftyka A, Dmoszyńska-Graniczka M, Chrościńska-Krawczyk M, Majcher P. The predictive value of 'red flags' as milestones of psychomotor development of premature babies - preliminary study. Ann Agric Environ Med 2021; 28:183-188. [PMID: 33775086 DOI: 10.26444/aaem/126746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Premature babies are a special group at risk of persistent brain damage caused by diseases, the most serious of which are cerebral palsy(CP), autism spectrum disorders (ASD) and mental retardation, among others. These conditions may occur concurrently, but appear more often as separate disease syndromes in the same group of at-risk children. Long-term observation of psychomotor development by an interdisciplinary medical team closely cooperating with parents is necessary. It is important to detect the risk of developing these diseases as soon as possible in all development spheres. MATERIAL AND METHODS The research was conducted to demonstrate the prognostic value of 'red flags' of developmental milestones and the ability to detect early signs of risk of developing CP and ASD in extremely premature babies. In this preliminary study, 42 preterm babies, born after less than 32 weeks pregnancy participated. RESULTS The occurrence of 'red flags'in the spheres: gross motor, fine motor and cognitive at 9 months was strongly associated with their presence at 24 months. The sensitivity and specificity were: gross motor - 0.91 (95% CI: 0.59, 1.00) and 0.94 (95% CI: 0.79, 0.99); fine motor - 0.83 (95% CI 0.36-1.00) and 1.00 (95% CI: 0.90-1.00); cognitive - 1.00 (0.40, 1.00) and 0.97 (0.86, 1.00). Other spheres had lower sensitivity but high specificity. CONCLUSIONS The conclusion is that the 'red flags'at the 9 months milestones already predict the normal or developmental delay of premature babies, and predict the risk of CP and ASD. Due to the availability and lack of the need for specialized and costly training, it is worth considering their use in everyday life medical practice.
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Affiliation(s)
- Jolanta Taczała
- Department of Rehabilitation, Physiotherapy and Balneotherapy, Faculty of Health Sciences, Medical University, Lublin, Poland
| | - Michał Latalski
- Department of Children Orthopedics, Medical University, Lublin, Poland
| | - Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Medical University, Lublin, Poland
| | | | | | - Piotr Majcher
- Department of Rehabilitation, Physiotherapy and Balneotherapy, Faculty of Health Sciences, Medical University, Lublin, Poland
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Abstract
OBJECTIVE To explore the genetic basis for a child with ocular anomaly, microcephaly, growth retardation and intrauterine growth restriction. METHODS The patient underwent ophthalmologic examinations including anterior segment photography, fundus color photography, and fundus fluorescein angiography. The patient and her parents were subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing and bioinformatic analysis. RESULTS The patient was found to have bilateral persistent pupillary membrane and coloboma of inferior iris, in addition with macular dysplasia and radial pigmentation near the hemal arch of the temporal retina. She was found to have carried compound heterozygous missense variants of the PHGDH gene, namely c.196G>A and c.1177G>A, which were respectively inherited from her father and mother. Bioinformatic analysis suggested both variants to be pathogenic. CONCLUSION The patient was diagnosed with phosphoglycerate dehydrogenase deficiency. Above finding has enriched the phenotypic spectrum of the disease with ocular manifestations.
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Affiliation(s)
- Zhiyan Tao
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan 640041, China. lufang@wchscu. cn
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Mishra S, Girisha KM, Shukla A. Expanding the phenotype of PURA-related neurodevelopmental disorder: a close differential diagnosis of infantile hypotonia with psychomotor retardation and characteristic facies. Clin Dysmorphol 2021; 30:1-5. [PMID: 33229923 PMCID: PMC9944571 DOI: 10.1097/mcd.0000000000000360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purine-rich element-binding protein A (PURA) encodes Pur-alpha, a transcriptional activator protein is crucial for normal brain development. Pathogenic variants in PURA are known to cause mental retardation, autosomal dominant 31, characterized by psychomotor delay, absent or poor speech, hypotonia, feeding difficulties, seizures or 'seizure-like' movements, and dysmorphism. PURA-related neurodevelopmental disorder (PURA-related NDD) result either from heterozygous pathogenic sequence variants in PURA or microdeletions spanning PURA. Singleton whole-exome sequencing (WES) was performed for the proband after a clinical diagnosis of infantile hypotonia with psychomotor retardation and characteristic facies (IHPRF) was made. The pathogenic variant was validated by Sanger sequencing in the proband and parents. Comparison of PURA-related NDD and IHPRF was carried out. WES identified a novel, de-novo stop-gain variant c.178G>T in PURA. In addition to typical phenotype, subject also had hypersensitivity to various stimuli which was not reported in PURA-related NDD. Significant phenotypic overlap was observed in subjects with PURA-related NDD and IHPRF especially with IHPRF2, caused by biallelic pathogenic variants in UNC80. This study expands the phenotypic and mutational spectrum of PURA-related NDD. We propose PURA-related NDD to be considered as a close differential diagnosis of IHPRF.
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Affiliation(s)
- Shivani Mishra
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
| | - Katta Mohan Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
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Alsaif HS, Khashab HYEL, Alkuraya FS. Two further cases of polyhydramnios, megalencephaly, and symptomatic epilepsy syndrome, caused by a truncating variant in STRADA. Am J Med Genet A 2020; 185:604-607. [PMID: 33247513 DOI: 10.1002/ajmg.a.61990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/27/2020] [Accepted: 10/31/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Hessa S Alsaif
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Heba Youssef E L Khashab
- Department of Pediatrics, Dr. Sulaiman Al-Habib Hospital, Riyadh, Saudi Arabia
- Department of Pediatrics, Division of Pediatric Neurology, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Labbé M, Young M, Mascarella M, Husein M, Doyle PC, Nguyen LHP. How Consistent Is Competent? Examining Variance in Psychomotor Skills Assessment. Acad Med 2020; 95:771-776. [PMID: 31517685 DOI: 10.1097/acm.0000000000002985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Direct assessment of trainee performance across time is a core tenet of competency-based medical education. Unlike variability of psychomotor skills across levels of expertise, performance variability exhibited by a particular trainee across time remains unexplored. The goal of this study was to document the consistency of individual surgeons' technical skill performance. METHOD A secondary analysis of assessment data (collected in 2010-2012, originally published in 2015) generated by a prospective cohort of participants at Montreal Children's Hospital with differing levels of expertise was conducted in 2017. Trained raters scored blinded recordings of a myringotomy and tube insertion performed 4 times by junior and senior residents and attending surgeons over a 6-month period using a previously reported assessment tool. Descriptive exploratory analyses and univariate comparison of standard deviations (SDs) were conducted to document variability within individuals across time and across training levels. RESULTS Thirty-six assessments from 9 participants were analyzed. The SD of scores for junior residents was highly variable (5.8 out of a scale of 30 compared with 1.8 for both senior residents and attendings [F(2,19) = 5.68, P < 0.05]). For a given individual, the range of scores was twice as large for junior residents than for senior residents and attendings. CONCLUSIONS Surgical residents may display highly variable performances across time, and individual variability appears to decrease with increasing expertise. Operative skill variability could be underrepresented in direct observation assessment; emphasis on an adequate amount of repetitive evaluations for junior residents may be needed to support judgments of competence or entrustment.
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Affiliation(s)
- Mathilde Labbé
- M. Labbé is a resident, Department of Family Medicine, McGill University, Montreal, Quebec, Canada. M. Young is associate professor, Faculty of Medicine, McGill University, and research scientist, Centre for Medical Education, McGill University, Montreal, Quebec, Canada. M. Mascarella is a resident, Department of Otolaryngology-Head and Neck Surgery, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. M. Husein is associate professor, Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada. P.C. Doyle is professor, Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada. L.H.P. Nguyen is associate professor, Department of Otolaryngology-Head and Neck Surgery, McGill University, and member, Centre for Medical Education, McGill University, Montreal, Quebec, Canada
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Karakosta P, Margetaki K, Fthenou E, Kampouri M, Kyriklaki A, Koutra K, Chalkiadaki G, Roumeliotaki T, Vafeiadi M, Kogevinas M, Mantzoros C, Chatzi L. Cord Leptin is Associated with Neuropsychomotor Development in Childhood. Obesity (Silver Spring) 2019; 27:1693-1702. [PMID: 31479200 PMCID: PMC6756960 DOI: 10.1002/oby.22571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/06/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Leptin is critical for central nervous system development and maturation. This study aimed to evaluate the potential regulatory role of cord leptin in the neuropsychomotor development of children ages 18 months to 6 years. METHODS This study included 424 children from a prospective mother-child cohort (Rhea Study; Crete, Greece) with available cord leptin levels and data on neurodevelopmental outcomes at 18 months (Bayley Scales of Infant and Toddler Development, Third Edition), 4 years (McCarthy Scales of Children's Abilities), and 6 years (Raven's Coloured Progressive Matrices and Trail Making Test). Multivariable linear regression models were used to explore the associations. RESULTS Each 10-ng/mL increase in the cord leptin level was associated with increased scores on the gross motor scale at 18 months (β coefficient: 3.8; 95% CI: 0.0-7.5), with decreased scores in the general cognitive performance (β coefficient: -3.0; 95% CI: -5.5 to -0.4), perceptual performance (β coefficient: -3.4; 95% CI: -6.0 to -9.9), working memory (β coefficient: -3.1; 95% CI: -5.7 to -0.4), executive function (β coefficient -3.1; 95% CI: -5.7 to -0.5), and functions of the posterior cortex (β coefficient: -2.7; 95% CI: -5.2 to -0.1) scales at 4 years, and with a 3.7-unit decrease in the Raven's Coloured Progressive Matrices score at 6 years (β coefficient: -3.7; 95% CI: -6.9 to -0.5). CONCLUSIONS Increased cord leptin levels are associated with enhanced gross motor development at 18 months but decreased cognitive performance in early and middle childhood.
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Affiliation(s)
- Polyxeni Karakosta
- Department of Social Medicine, School of Medicine,
University of Crete, Heraklion, Greece
- Clinical Microbiology Laboratory, Attikon University
Hospital, National and Kapodistrian University of Athens, Greece
| | - Katerina Margetaki
- Department of Social Medicine, School of Medicine,
University of Crete, Heraklion, Greece
| | - Eleni Fthenou
- Qatar Biobank for Medical Research, Qatar Foundation for
Education, Science and Community, Doha, Doha, Qatar
| | - Mariza Kampouri
- Department of Social Medicine, School of Medicine,
University of Crete, Heraklion, Greece
| | - Andriani Kyriklaki
- Department of Social Medicine, School of Medicine,
University of Crete, Heraklion, Greece
| | - Katerina Koutra
- Department of Psychology, School of Social Sciences,
University of Crete, Rethymnon, Greece
| | - Georgia Chalkiadaki
- Department of Social Medicine, School of Medicine,
University of Crete, Heraklion, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, School of Medicine,
University of Crete, Heraklion, Greece
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine,
University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- ISGlobal, Centre for Research in Environmental
Epidemiology (CREAL), Barcelona, Spain
| | - Christos Mantzoros
- Division of Endocrinology, Diabetes, and Metabolism,
Department of Medicine, Beth Israel, Deaconess Medical Center, Harvard Medical
School, Boston, Massachusetts, United States
| | - Lida Chatzi
- Department of Preventive Medicine, University of Southern
California, Los Angeles, CA, United States
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Kim BR, Han JH, Shin JE, Park MS, Park KI, Namgung R, Lee HJ, Lee JS, Eun HS. Genitopatellar Syndrome Secondary to De Novo KAT6B Mutation: The First Genetically Confirmed Case in South Korea. Yonsei Med J 2019; 60:395-398. [PMID: 30900427 PMCID: PMC6433568 DOI: 10.3349/ymj.2019.60.4.395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/21/2019] [Accepted: 02/23/2019] [Indexed: 01/13/2023] Open
Abstract
Genitopatellar syndrome (GPS) is a rare disorder characterized by patellar hypoplasia, flexion contractures of the lower limbs, psychomotor retardation and genital and renal anomalies. We report the case of a female infant diagnosed with GPS to a KAT6B gene mutation, which was identified using whole exome sequencing.
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Affiliation(s)
- Byuh Ree Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Ho Han
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Eun Shin
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Soo Park
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kook In Park
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ran Namgung
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Joo Lee
- Division of Clinical Genetics, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Sung Lee
- Division of Clinical Genetics, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Sun Eun
- Division of Neonatology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Johansson GM, Häger CK. A modified standardized nine hole peg test for valid and reliable kinematic assessment of dexterity post-stroke. J Neuroeng Rehabil 2019; 16:8. [PMID: 30642350 PMCID: PMC6332630 DOI: 10.1186/s12984-019-0479-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 01/02/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Impairments in dexterity after stroke are commonly assessed by the Nine Hole Peg Test (NHPT), where the only outcome variable is the time taken to complete the test. We aimed to kinematically quantify and to compare the motor performance of the NHPT in persons post-stroke and controls (discriminant validity), to compare kinematics to clinical assessments of upper extremity function (convergent validity), and to establish the within-session reliability. METHODS The NHPT was modified and standardized (S-NHPT) by 1) replacing the original peg container with an additional identical nine hole pegboard, 2) adding a specific order of which peg to pick, and 3) specifying to insert the peg taken from the original pegboard into the corresponding hole of the target pegboard. Eight optical cameras registered upper body kinematics of 30 persons post-stroke and 41 controls during the S-NHPT. Four sequential phases of the task were identified and analyzed for kinematic group differences. Clinical assessments were performed. RESULTS The stroke group performed the S-NHPT slower (total movement time; mean diff 9.8 s, SE diff 1.4), less smoothly (number of movement units; mean diff 0.4, SE diff 0.1) and less efficiently (path ratio; mean diff 0.05, SE diff 0.02), and used increased scapular/trunk movements (acromion displacement; mean diff 15.7 mm, SE diff 3.5) than controls (P < 0.000, r ≥ 0.32), indicating discriminant validity. The stroke group also spent a significantly longer time grasping and releasing pegs relative to the transfer phases of the task compared to controls. Within the stroke group, kinematics correlated with time to complete the S-NHPT and the Fugl-Meyer Assessment (rs 0.38-0.70), suggesting convergent validity. Within-session reliability for the S-NHPT was generally high to very high for both groups (ICCs 0.71-0.94). CONCLUSIONS The S-NHPT shows adequate discriminant validity, convergent validity and within-session reliability. Standardization of the test facilitates kinematic analysis of movement performance, which in turn enables identification of differences in movement control between persons post-stroke and controls that may otherwise not be captured through the traditional time-based NHPT. Future research should ascertain further psychometric properties, e.g. sensitivity, of the S-NHPT.
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Affiliation(s)
- Gudrun M Johansson
- Department of Community Medicine and Rehabilitation; Physiotherapy, Umeå University, Umeå, Building 15, Umeå University, SE-901 87 Umeå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation; Physiotherapy, Umeå University, Umeå, Building 15, Umeå University, SE-901 87 Umeå, Sweden
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Metzger A, Pisella L, Vighetto A, Joubert B, Honnorat J, Tilikete C, Desestret V. Balint syndrome in anti-NMDA receptor encephalitis. Neurol Neuroimmunol Neuroinflamm 2019; 6:e532. [PMID: 30588484 PMCID: PMC6299677 DOI: 10.1212/nxi.0000000000000532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/08/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Aude Metzger
- Service de neuro-ophtalmologie et neuro-cognition (A.M., A.V., C.T., V.D.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; IMPACT-Integrative, Multisensory (L.P., A.V., C.T.), Perception, Action and Cognition Team, Centre de recherche des Neurosciences de Lyon (CRNL); Université Claude Bernard Lyon 1 (A.V., B.J., J.H., C.T., V.D.); Centre de référence français des syndromes paranéoplasiques (B.J., J.H.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310 (B.J., J.H., V.D.), équipe synaptopathies et anticorps (SYNATAC), Lyon, France
| | - Laure Pisella
- Service de neuro-ophtalmologie et neuro-cognition (A.M., A.V., C.T., V.D.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; IMPACT-Integrative, Multisensory (L.P., A.V., C.T.), Perception, Action and Cognition Team, Centre de recherche des Neurosciences de Lyon (CRNL); Université Claude Bernard Lyon 1 (A.V., B.J., J.H., C.T., V.D.); Centre de référence français des syndromes paranéoplasiques (B.J., J.H.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310 (B.J., J.H., V.D.), équipe synaptopathies et anticorps (SYNATAC), Lyon, France
| | - Alain Vighetto
- Service de neuro-ophtalmologie et neuro-cognition (A.M., A.V., C.T., V.D.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; IMPACT-Integrative, Multisensory (L.P., A.V., C.T.), Perception, Action and Cognition Team, Centre de recherche des Neurosciences de Lyon (CRNL); Université Claude Bernard Lyon 1 (A.V., B.J., J.H., C.T., V.D.); Centre de référence français des syndromes paranéoplasiques (B.J., J.H.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310 (B.J., J.H., V.D.), équipe synaptopathies et anticorps (SYNATAC), Lyon, France
| | - Bastien Joubert
- Service de neuro-ophtalmologie et neuro-cognition (A.M., A.V., C.T., V.D.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; IMPACT-Integrative, Multisensory (L.P., A.V., C.T.), Perception, Action and Cognition Team, Centre de recherche des Neurosciences de Lyon (CRNL); Université Claude Bernard Lyon 1 (A.V., B.J., J.H., C.T., V.D.); Centre de référence français des syndromes paranéoplasiques (B.J., J.H.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310 (B.J., J.H., V.D.), équipe synaptopathies et anticorps (SYNATAC), Lyon, France
| | - Jérôme Honnorat
- Service de neuro-ophtalmologie et neuro-cognition (A.M., A.V., C.T., V.D.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; IMPACT-Integrative, Multisensory (L.P., A.V., C.T.), Perception, Action and Cognition Team, Centre de recherche des Neurosciences de Lyon (CRNL); Université Claude Bernard Lyon 1 (A.V., B.J., J.H., C.T., V.D.); Centre de référence français des syndromes paranéoplasiques (B.J., J.H.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310 (B.J., J.H., V.D.), équipe synaptopathies et anticorps (SYNATAC), Lyon, France
| | - Caroline Tilikete
- Service de neuro-ophtalmologie et neuro-cognition (A.M., A.V., C.T., V.D.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; IMPACT-Integrative, Multisensory (L.P., A.V., C.T.), Perception, Action and Cognition Team, Centre de recherche des Neurosciences de Lyon (CRNL); Université Claude Bernard Lyon 1 (A.V., B.J., J.H., C.T., V.D.); Centre de référence français des syndromes paranéoplasiques (B.J., J.H.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310 (B.J., J.H., V.D.), équipe synaptopathies et anticorps (SYNATAC), Lyon, France
| | - Virginie Desestret
- Service de neuro-ophtalmologie et neuro-cognition (A.M., A.V., C.T., V.D.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; IMPACT-Integrative, Multisensory (L.P., A.V., C.T.), Perception, Action and Cognition Team, Centre de recherche des Neurosciences de Lyon (CRNL); Université Claude Bernard Lyon 1 (A.V., B.J., J.H., C.T., V.D.); Centre de référence français des syndromes paranéoplasiques (B.J., J.H.), Hospices Civils de Lyon, hôpital neurologique Pierre Wertheimer; and Institut NeuroMyoGene INSERM U1217/CNRS UMR 5310 (B.J., J.H., V.D.), équipe synaptopathies et anticorps (SYNATAC), Lyon, France
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Natovich R, Gayus N, Azmon M, Michal H, Twito OG, Yair T, Achiron RN, Kraviz N, Mordenfeld N, Cukierman-Yaffe T. Supporting a comprehensive and coordinated evaluation of the elderly with diabetes by integrating cognitive and physical assessment in the evaluation process. Diabetes Metab Res Rev 2018; 34:e3030. [PMID: 29896891 DOI: 10.1002/dmrr.3030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 04/25/2018] [Accepted: 05/29/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Successful ageing with diabetes is challenged by co-morbidities, which may present barriers to self-care. Currently, measurement of physical and cognitive status is not part of routine care of the older person with diabetes, and these are not taken into account when devising the treatment plan. OBJECTIVE To describe a novel approach that integrates cognitive and physical assessment into the routine evaluation of the older person with diabetes and the tailor-made treatment plan devised accordingly. To provide estimates of the relative contribution of cognitive and physical disabilities in this population. METHODS Cognitive and physical assessments were added to the standard evaluation. A composite measure of cognitive and of physical status categorizing each individual to intact, mild, or severe impairment was generated. In addition, all recommendations provided were categorized and tabulated. RESULTS Of 119 individuals, over the age of 60 with type 2 diabetes who were referred because of difficulties in managing their disease, 16% and 3% of individuals met the criteria for severe cognitive/physical impairment, respectively, and 42% and 21% met the criteria for mild cognitive/physical impairment; 72%, 12.5%, 61% received recommendations related to intensification of physical activity, cognitive treatment, change in pharmacological agents, respectively. 25% were referred for further emotional treatment. CONCLUSIONS These data suggest that a substantial proportion of individuals with diabetes over the age of 60 may have cognitive/physical impairment. It highlights the importance of measuring these as part of the multidisciplinary evaluation and being able to provide a tailor made treatment plan.
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Affiliation(s)
- Rachel Natovich
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Noa Gayus
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Michal Azmon
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
- The Physiotherapy Department, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Hila Michal
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Omri Gury Twito
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Tomer Yair
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Romi Noy Achiron
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Neta Kraviz
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Nadia Mordenfeld
- The Epidemiology Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Cukierman-Yaffe
- The "Segal" Center for Successful Aging with Diabetes, Endocrinology Institute, Sheba Medical Center, Ramat Gan, Israel
- The Epidemiology Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Salamanca-Zarzuela B, Morales-Luego F, Alcalde-Martin C, Centeno-Malfaz F. [Psychomotor development in patients with severe congenital heart disease]. Rev Neurol 2018; 66:409-414. [PMID: 29897608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM Retrospective analysis of the neurodevelopment in the first two years of life in patients with severe congenital heart disease. PATIENTS AND METHODS Out of 89 patients with severe congenital heart disease 19 were excluded due to a history of prematurity and/or chromosomopathy, four due to a history of ischemic stroke and two due to lack of medical history. Denver Test (DT) results at 2, 6, 12, 15 and 18 months, and results in motor, language and social interaction fields were achieved. RESULTS 59.4% were male and 40.6% female. The mean age of patients undergoing extracorporeal membrane oxygenation with pathological DT at 18 months was 3 months, compared to 11.88 months in those with normal DT. DT at 2 months was normal in 98.4% of patients, 87.5% at 6 and 12 months, 81.3% at 15 months and 85% at 18 months. Two patients with abnormal neurodevelopment normalized the DT before 24 months. The field of neurodevelopment most affected was language (15.6%), followed by motor (10.9%) and social interaction (8%). CONCLUSIONS Psychomotor development delay, especially in the area of language, is more frequent in patients with severe congenital heart disease. The presence of cyanosis and the need for extracorporeal membrane oxygenation were the variables that are most associated with this type of pathology.
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Affiliation(s)
| | - F Morales-Luego
- Hospital Universitario Rio Hortega, 47010 Valladolid, Espana
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14
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Zhang F, Shi XY, Liu LY, Liu YT, Zou LP. [Psychomotor retardation with neutropenia for more than one year in a toddler]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:497-500. [PMID: 29972126 PMCID: PMC7389942 DOI: 10.7499/j.issn.1008-8830.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
A boy was admitted at the age of 17 months. He had psychomotor retardation in early infancy. Physical examination revealed microcephalus, unusual facies, and a single palmar crease on his right hand, as well as muscle hypotonia in the extremities and hyperextension of the bilateral shoulder and hip joints. Genetic detection identified two pathogenic compound heterozygous mutations, c.8868-1G>A (splicing) and c.11624_11625del (p.V3875Afs*10), in the VPS13B gene, and thus the boy was diagnosed with Cohen syndrome. Cohen syndrome is a rare autosomal recessive disorder caused by the VPS13B gene mutations and has complex clinical manifestations. Its clinical features include microcephalus, unusual facies, neutropenia, and joint hyperextension. VPS13B gene detection helps to make a confirmed diagnosis.
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Affiliation(s)
- Fan Zhang
- Department of Pediatrics, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
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Evliyaoğlu O, Ercan O, Ataloğlu E, Zübarioğlu Ü, Özcabı B, Dağdeviren A, Erdoğan H, De Franco E, Ellard S. Neonatal Diabetes: Two Cases with Isolated Pancreas Agenesis due to Homozygous PTF1A Enhancer Mutations and One with Developmental Delay, Epilepsy, and Neonatal Diabetes Syndrome due to KCNJ11 Mutation. J Clin Res Pediatr Endocrinol 2018; 10:168-174. [PMID: 28943513 PMCID: PMC5985387 DOI: 10.4274/jcrpe.5162] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/23/2017] [Indexed: 12/01/2022] Open
Abstract
Neonatal diabetes mellitus is a rare form of monogenic diabetes which is diagnosed in the first six months of life. Here we report three patients with neonatal diabetes; two with isolated pancreas agenesis due to mutations in the pancreas-specific transcription factor 1A (PTF1A) enhancer and one with developmental delay, epilepsy, and neonatal diabetes (DEND) syndrome, due to a KCNJ11 mutation. The two cases with mutations in the distal enhancer of PTF1A had a homozygous g.23508363A>G and a homozygous g.23508437A>G mutation respectively. Previous functional analyses showed that these mutations can decrease expression of PTF1A which is involved in pancreas development. Both patients were born small for gestational age to consanguineous parents. Both were treated with insulin and pancreatic enzymes. One of these patients’ fathers was also homozygous for the PTF1A mutation, whilst his partner and the parents of the other patient were heterozygous carriers. In the case with DEND sydrome, a previosly reported heterozygous KCNJ11 mutation, p.Cys166Tyr (c.497G>A), was identified. This patient was born to nonconsanguineous parents with normal birth weight. The majority of neonatal diabetes patients with KCNJ11 mutations will respond to sulphonylurea treatment. Therefore Glibenclamide, an oral antidiabetic of the sulphonylurea group, was started. This treatment regimen relatively improved blood glucose levels and neurological symptoms in the short term. Because we could not follow the patient in the long term, we are not able to draw conclusions about the efficacy of the treatment. Although neonatal diabetes mellitus can be diagnosed clinically, genetic analysis is important since it is a guide for the treatment and for prognosis.
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Affiliation(s)
- Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Emel Ataloğlu
- University of Health Science, Haseki Training and Research Hospital, Newborn Intensive Unit, İstanbul, Turkey
| | - Ümit Zübarioğlu
- Şişli Hamidiye Etfal Training and Research Hospital, Newborn Intensive Unit, İstanbul, Turkey
| | - Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Aydilek Dağdeviren
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Hande Erdoğan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Elisa De Franco
- University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, United Kingdom
| | - Sian Ellard
- University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, United Kingdom
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Abstract
RATIONALE Reversible splenial lesion syndrome (RESLES) is a reversible condition with an excellent prognosis in most patients. The clinical features include altered states of consciousness, delirium, headache, and seizures, but no callosal disconnection syndromes have been described in RESLES. PATIENT CONCERNS We presented a 57-year-old patient with alien hand syndrome, autotopagnosia, gait disorders, and left ideomotor apraxia after blood transfusion. The brain magnetic resonance imaging (MRI) showed a few regions with high signal intensity in the genu, body, and splenium of the right corpus callosum on diffusion weighted images. Cerebrovascular examination was unremarkable. DIAGNOSES He was diagnosed with RESLES and callosal disconnection syndrome. INTERVENTIONS The patient received symptomatic and supportive treatment in our hospital. OUTCOMES He recovered to baseline on following up of 6 months and abnormalities on brain MRI completely disappeared. LESSONS Neurologists should be aware of the symptoms of callosal disconnection syndrome in RESLES. In addition, caution should be taken when transfusing blood products in patients with gastrointestinal bleeding.
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Abstract
A 61-year-old woman was admitted to our hospital due to memory difficulties, visual hallucinations, and slowly progressing motor difficulties in the limbs. A clinical examination revealed bradykinesia, gait disturbance, left-side-dominant rigidity, ideomotor apraxia, dressing apraxia, left-sided spatial agnosia, impaired visuospatial ability, and executive dysfunction. Her symptoms were unresponsive to levodopa, and corticobasal syndrome (CBS) was diagnosed. One year later, amyloid positron emission tomography revealed amyloid beta accumulation in the bilateral cerebral cortices; at this point, CBS with underlying Alzheimer's disease pathology (CBS-AD) was diagnosed. Visual hallucinations may help differentiate CBS with corticobasal degeneration (CBS-CBD) from other pathologies, including CBS-AD.
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Affiliation(s)
- Hiroshi Nishida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Yuichi Hayashi
- Departments of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Japan
| | - Naoko Harada
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Takeo Sakurai
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Kenji Wakida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
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Loganovsky K, Kuts K. Evoked bioelectrical brain activity following exposure to ionizing radiation. Probl Radiac Med Radiobiol 2017; 22:38-68. [PMID: 29286496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Indexed: 06/07/2023]
Abstract
The article provides an overview of modern physiological evidence to support the hypothesis on cortico limbic sys tem dysfunction due to the hippocampal neurogenesis impairment as a basis of the brain interhemispheric asym metry and neurocognitive deficit after radiation exposure. The importance of the research of both evoked poten tials and fields as a highly sensitive and informative method is emphasized.Particular attention is paid to cerebral sensor systems dysfunction as a typical effect of ionizing radiation. Changes in functioning of the central parts of sensory analyzers of different modalities as well as the violation of brain integrative information processes under the influence of small doses of ionizing radiation can be critical when determining the radiation risks of space flight. The possible long term prospects for manned flights into space, including to Mars, given the effects identified are discussed. Potential risks to the central nervous system during space travel comprise cognitive functions impairment, including the volume of short term memory short ening, impaired motor functions, behavioral changes that could affect human performance and health. The remote risks for CNS are considered to be the following possible neuropsychiatric disorders: accelerated brain aging, Alzheimer's disease and other types of dementia. The new radiocerebral dose dependent effect, when applied cog nitive auditory evoked potentials P300 technique with a possible threshold dose of 0.05 Gy, manifesting in a form of disruption of information processing in the Wernicke's area is under discussion. In order to identify neurophys iological biological markers of ionizing radiation further international researches with adequate dosimetry support are necessary.
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Affiliation(s)
- K Loganovsky
- tate Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - K Kuts
- tate Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
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19
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Frith E, Addoh O, Mann JR, Windham BG, Loprinzi PD. Individual and Combined Associations of Cognitive and Mobility Limitations on Mortality Risk in Older Adults. Mayo Clin Proc 2017; 92:1494-1501. [PMID: 28982485 DOI: 10.1016/j.mayocp.2017.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/26/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate the potential independent and combined associations of cognitive and mobility limitations on risk of all-cause mortality in a representative sample of the US older adult population who, at baseline, were free of cardiovascular and cerebrovascular disease. PATIENTS AND METHODS Data from the 1999 to 2002 National Health and Nutrition Examination Survey were used to identify 1852 adults (age, 60-85 years) with and without mobility and/or cognitive limitations. Hazard ratios (HRs) for mortality risk were calculated for 4 mutually exclusive groups: no limitation (group 1 as reference), mobility limitation only (group 2), cognitive limitation only (group 3), both cognitive and mobility limitations (group 4). RESULTS Compared with group 1, the adjusted HRs (95% CI) for groups 2, 3, and 4 were 1.72 (1.24-2.38), 2.00 (1.37-2.91), and 2.18 (1.57-3.02), respectively. The mortality risk when comparing group 4 (HR, 2.18) with group 3 (HR, 2.00), however, was not statistically significant (P=.65). Similarly, the mortality risk when comparing group 4 (HR, 2.18) with group 2 (HR, 1.72) was not statistically significant (P=.16). CONCLUSION Although the highest mortality risk occurred in those with both limitations (group 4), this point estimate was not statistically significantly different when compared with those with cognitive or mobility limitations alone.
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Affiliation(s)
- Emily Frith
- Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, Jackson
| | - Ovuokerie Addoh
- Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, Jackson
| | - Joshua R Mann
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson
| | - B Gwen Windham
- Department of Medicine, Division of Geriatrics, Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson
| | - Paul D Loprinzi
- Jackson Heart Study Vanguard Center of Oxford, Jackson; and the Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University.
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20
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Cho JH, Kang E, Lee BH, Kim GH, Choi JH, Yoo HW. DEND Syndrome with Heterozygous KCNJ11 Mutation Successfully Treated with Sulfonylurea. J Korean Med Sci 2017; 32:1042-1045. [PMID: 28480665 PMCID: PMC5426229 DOI: 10.3346/jkms.2017.32.6.1042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 04/04/2016] [Indexed: 12/27/2022] Open
Abstract
Permanent neonatal diabetes mellitus (PNDM) is caused by mutations in the ATP-sensitive potassium channel (KATP channel) subunits. Developmental delay, epilepsy, and neonatal diabetes (DEND) syndrome is the most severe form of PNDM and is characterized by various neurologic features. We report on a patient with DEND syndrome following initial misdiagnosis with type 1 DM, who was successfully switched from insulin to sulfonylurea therapy. A 50-day-old male presented with fever and seizure, complicated by persistent hyperglycemia. Insulin therapy was initiated. At 10 months of age, the patient was unable to hold his head up and make eye contact with others. At 17.9 years of age, direct sequencing of KCNJ11 identified a heterozygous mutation of c.602G>A (p.R201H). Since then, treatment with gliclazide was initiated and the insulin dose was gradually reduced. Following 3 months, insulin was discontinued with a gliclazide dose of 2.4 mg/kg. The patient continued to have excellent glycemic control with a glycated hemoglobin (HbA1c) level of 5.8% after 5 months. However, the patient's psychomotor retardation did not improve. This study reports the first case of DEND syndrome in Korea caused by a KCNJ11 mutation and emphasizes the necessity to screen mutations in KATP channel genes in patients with neonatal diabetes.
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MESH Headings
- Base Sequence
- Brain/diagnostic imaging
- DNA/chemistry
- DNA/isolation & purification
- DNA/metabolism
- Diabetes Mellitus/diagnosis
- Diabetes Mellitus/drug therapy
- Diabetes Mellitus/genetics
- Epilepsy/diagnosis
- Epilepsy/drug therapy
- Epilepsy/genetics
- Gliclazide/therapeutic use
- Glycated Hemoglobin/analysis
- Heterozygote
- Humans
- Hypoglycemic Agents/therapeutic use
- Infant
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/drug therapy
- Infant, Newborn, Diseases/genetics
- Insulin/therapeutic use
- Magnetic Resonance Imaging
- Male
- Polymorphism, Single Nucleotide
- Potassium Channels, Inwardly Rectifying/genetics
- Psychometrics
- Psychomotor Disorders/diagnosis
- Psychomotor Disorders/drug therapy
- Psychomotor Disorders/genetics
- Sequence Analysis, DNA
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Affiliation(s)
- Ja Hyang Cho
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Eungu Kang
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Beom Hee Lee
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Gu Hwan Kim
- Medical Genetics Center, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Jin Ho Choi
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
| | - Han Wook Yoo
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea
- Medical Genetics Center, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Korea.
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21
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Ahmed J, Dwyer DM, Farr TD, Harrison DJ, Dunnett SB, Trueman RC. Lickometry: A novel and sensitive method for assessing functional deficits in rats after stroke. J Cereb Blood Flow Metab 2017; 37:755-761. [PMID: 28056584 PMCID: PMC5305038 DOI: 10.1177/0271678x16684141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/14/2016] [Accepted: 10/21/2016] [Indexed: 12/30/2022]
Abstract
The need for sensitive, easy to administer assessments of long-term functional deficits is crucial in pre-clinical stroke research. In the present study, we introduce lickometry (lick microstructure analysis) as a precise method to assess sensorimotor deficits up to 40 days after middle cerebral artery occlusion in rats. Impairments in drinking efficiency compared to controls, and a compensatory increase in the number of drinking clusters were observed. This highlights the utility of this easy to administer task in assessing subtle, long-term deficits, which could be likened to oral deficits in patients.
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Affiliation(s)
- Jewel Ahmed
- School of Life Sciences, University of Nottingham, UK
| | | | - Tracy D Farr
- School of Life Sciences, University of Nottingham, UK
| | - David J Harrison
- Brain Repair Group, School of Biosciences, Cardiff University, UK
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Chen W, Hammond-Bennett A, Hypnar A. Examination of motor skill competency in students: evidence-based physical education curriculum. BMC Public Health 2017; 17:222. [PMID: 28228116 PMCID: PMC5322665 DOI: 10.1186/s12889-017-4105-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 02/03/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Researchers found that children with a competent level of motor skill performance are more likely to be physically active. This study examined how well K-1 students demonstrated motor skill competency in relation to Physical Education Content Standard 1. METHODS Participants were K-1 grade students (N = 1,223-1,588; boys = 568-857; girls = 526-695; Mean age = 5.5 yrs old) who were enrolled in nine elementary schools. The K-1 students' motor skill competency in running, weight transferring, hand dribbling, and underhand catching skills was assessed using four PE Metrics skill assessment rubrics in the intervention year 1 and year 2, respectively. Data were analyzed by means of descriptive statistics and independent sample t-tests. RESULTS The students in the intervention year 1 and year 2 cohorts performed at the Competent Level or higher in the four skill assessments. The prevalence of the students' demonstration of skill competency across the four skills was high in the two intervention years. The intervention year 2 cohort scored significantly higher than the intervention year 1 cohort in the four skill assessments. The boys significantly outperformed than the girls in the two manipulative skills in the intervention year 1 and in the two manipulative skills and the weight transferring skill in the intervention year 2. No gender differences in the running skill in either year were found. CONCLUSIONS The evidence-based CATCH PE play a critical role in developing and building K-1 students' ability to demonstrate motor skill competency in four fundamental skills. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT03015337 , registered date: 1/09/2017, as "retrospectively registered".
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Affiliation(s)
- Weiyun Chen
- School of Kinesiology, University of Michigan, 1402 Washington Heights, Ann Arbor, MI 48109 USA
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Abstract
BACKGROUND The CORE measure was designed to assess a central feature of melancholia - signs of psychomotor disturbance (PMD) - and so provide an alternate non-symptom based measure of melancholia or of its probability. This review evaluates development and application studies undertaken over the last 25 years to consider how well it has met its original objectives. METHODS All studies published using the CORE measure as either the only or an adjunctive measure of melancholia were obtained and are considered in this review. RESULTS Findings suggest high reliability in quantifying CORE scores can be achieved and that it has construct validity as a measure of PMD. A number of application studies assessing socio-demographic factors, cognitive and motor impairment, dexamethasone suppression and thyrotropin-releasing hormone, response to psychotherapy and to electroconvulsive therapy support its validity as a measure of melancholia, while functional brain imaging studies suggest that the measure identifies regions of decreased connectivity. LIMITATIONS Use of the CORE benefits from rater training and for subjects to be assessed at or near nadir of their depressive episode. There have been insufficient studies evaluating genetic factors, and the treatment response of CORE-defined melancholic patients to antidepressant drugs of differing classes. CONCLUSIONS The CORE, either as a proxy or direct measure of melancholia, provides a strategy for assigning depressed subjects a diagnosis or melancholic or non-melancholic depression or for estimating the probability of melancholia.
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Affiliation(s)
- Gordon Parker
- School of Psychiatry, the University of New South Wales, Sydney, NSW, Australia; The Black Dog Institute, Sydney, NSW, Australia.
| | - Stacey McCraw
- School of Psychiatry, the University of New South Wales, Sydney, NSW, Australia; The Black Dog Institute, Sydney, NSW, Australia
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Abstract
In a large sample of 722 community residents, scores on the Frontal Systems Behavior Scale were significantly associated with age, sex, and education, indicating that scores were higher for men, younger participants, and less educated participants.
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Affiliation(s)
- Marcello Spinella
- Psychology Program, The Richard Stockton College of New Jersey, P.O. Box 195, Jimmie Leeds Road, Pomona, NJ 08240-0195, USA
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Kanioglou A, Tsorbatzoudis H, Barkoukis V. Socialization and Behavioral Problems of Elementary School Pupils with Developmental Coordination Disorder. Percept Mot Skills 2016; 101:163-73. [PMID: 16350619 DOI: 10.2466/pms.101.1.163-173] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study examined the role of the developmental coordination disorder in 154 children's socialization and the expression of deviant behaviors in the context of Greek primary education. For assessment of their motor coordination, the Movement Assessment Battery for Children of Henderson and Sugden was used. The peer nomination method (sociogram) was used for the estimation of children's social status, and the expression of deviant behaviors was assessed via Conners' Teacher Questionnaire. Analyses showed that developmental coordination disorder was associated with poor socialization and the expression of deviant behaviors. These findings support the development of educational programs to include children with poor motor coordination.
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Affiliation(s)
- Aggelos Kanioglou
- Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Greece
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Abstract
The present purpose is to provide clinicians, occupational and physical therapists, and educators with a comparative analysis of three tests of motor proficiency. The Bruininks-Oseretsky Test of Motor Proficiency, Movement Assessment Battery for Children, and Tufts Assessment of Motor Performance were developed to assess the motor skills of children with developmental delays. The selection criteria, interrater reliability, reproducibility, and recommended use of each test are reported here. Recommendations for use of each test include standardization of the sample population to ensure its appropriateness.
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Affiliation(s)
- Dustin Y Yoon
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA
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Abstract
While motor clumsiness is frequently described as an associated feature of Asperger's Disorder, little research has examined specific motor skills and the relation among aspects of motor performance in this population. The present purpose was to present preliminary findings for three aspects of Asperger's: the presence and magnitude of gross motor and fine motor deficits, the presence and magnitude of visuomotor deficits, and the relation between motor functioning and visuomotor skills. 17 boys, 6 to 13 years old, with Asperger's were tested using standardized measures of gross, fine, and visuomotor skills. Statistically significant deficits were found for the sample's scores compared with values for the general population (using one-sample t tests), but none for fine motor vs gross motor skills (using a dependent sample t test). Significant positive correlations were found for gross motor skills with visuomotor skills (.73) and for fine motor skills with visuomotor skills (.71). Tentative suggestions for clinical assessment were proposed.
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Affiliation(s)
- Christopher Lopata
- Department of Counseling, School and Educational Psychology, University at Buffalo, State University of New York, 14260-1000, USA.
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Domizio S, Barbante E, Puglielli C, Clementini E, Domizio R, Sabatino GMD, Albanese A, Colosimo C, Sabatino G. Excessively High Magnetic Resonance Signal in Preterm Infants and Neuropsychobehavioural Follow-up at 2 Years. Int J Immunopathol Pharmacol 2016; 18:365-75. [PMID: 15888258 DOI: 10.1177/039463200501800218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The diffuse excessive high-signal intensity (DEHSI) findings in the T2 weighted scans of white matter (WM), besides the corresponding low signal in the T1 weighted images, are usually more evident around the periventricular regions. It is not clear whether the DEHSI should be considered as a diffuse WM injury rather than a sign of delayed maturation of the WM. Eighty nine preterm infants at the full-term equivalent age (FEA) were studied using conventional Magnetic Resonance (MR) imaging of the brain. Based on the MR findings, the infants studied were divided into three groups: the control group presenting normal WM, the DEHSI group and the group with other WM lesions. Ten newborns were not included in the statistical analysis because they presented evidence of precedent germinal matrix hemorrhage (GMH-IVH) which cannot be considered as WM lesions. Seventy nine infants were enrolled in a program of neuropsychobehavioural study follow-up until 24 months of age. Each infant was evaluated for those variables which mostly affect the occurrence of neuropsychomotor disability. In the DEHSI infant group, significantly lower mean pH and mean base excess (BE) values were found in comparison to controls, while the mean birth weight (BW) was significantly higher. No significant difference was observed between the mean 1st minute Apgar Score, mean birth gestational age (GA) and assisted ventilation mean duration of controls and DEHSI groups. Finally, no significant difference between the parameters studied was found by comparing the WM lesion infants group to the DEHSI infants one. Our observations, together with follow-up studies, even up to school age, confirm that DEHSI has a clinical significance and cannot be considered as a simple indicator of delayed WM maturation.
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Affiliation(s)
- S Domizio
- Neonatal Intensive Care Unit, University G. D'Annunzio, Chieti, Italy
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Moreno-Medinilla EE, Mora-Ramirez MD, Calvo-Medina R, Martinez-Anton J. [Autosomal recessive GTPCH 1 deficiency: the importance of the analysis of neurotransmitters in cerebrospinal fluid]. Rev Neurol 2016; 62:502-6. [PMID: 27222084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION A deficiency of the enzyme guanosine triphosphate cyclohydrolase I (GTPCH 1) causes a reduction in the synthesis of tetrahydrobiopterin (BH4), a cofactor that is essential in the synthesis of tyrosine, dopamine and serotonin. It is an infrequent disease that produces psychomotor delay or regression and movement disorders, although treatment can improve or even correct the clinical signs and symptoms. CASE REPORT We report the case of a girl with autosomal recessive GTPCH deficiency, who was diagnosed at 14 months by means of an analysis of the cerebrospinal fluid with pterin, HVA and 5-HIAA deficiency, and positive phenylalanine overload test and genetic study. The clinical features began at the age of 5 months with intermittent upper limb and brain tremors, both at rest and intentional, that disappeared after a month. Psychomotor development was normal, mild axial hypotonia being found in the examination while the complementary tests that were performed were normal. The patient later presented psychomotor regression with loss of head control, diminished active movements, difficulty in bimanual manipulation, hypomimia and severe global hypotonia, which was the reason for the study of a progressive encephalopathy. Following the diagnosis of GTPCH deficiency, replacement therapy was established with levodopa/carbidopa, OH tryptophan and BH4, with excellent progress made in motor and cognitive functioning. Today, the patient is 5 years old, has an adequate psychomotor development for her age, is in the third year of preschool education and has caught up with the level of the rest of her classmates. CONCLUSION In this case attention must be drawn to the extremely satisfactory motor and cognitive improvement of the patient after starting replacement therapy, as in many cases the cognitive level is usually affected on a permanent basis.
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Affiliation(s)
| | | | - R Calvo-Medina
- Hospital Regional Universitario de Malaga, Malaga, Espana
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Przybylska-Kruszewska A, Kutkowska-Kaźmierczak A, Krzywdzińska A, Smyk M, Nowakowska B, Gryglicka H, Obersztyn E, Hozyasz KK. [17p13.3 duplication as a cause of psychomotor developmental delay in an infant - a further case of a new syndrome]. Pol Merkur Lekarski 2016; 40:255-259. [PMID: 27137828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
17p13.3 duplication is a rare and heterogeneous genetic syndrome. Microdeletions of this region are responsible for the symptoms of Miller-Dieker syndrome. We present a case of 17p13.3 duplication consisting of about 730kb in a patient with psychomotor developmental delay, concerning eye-hand coordination, posture, locomotion and speech. Among other symptoms, we found excessive physical development in relation to age, hypotonia, dysmorphic facial features (high and prominent forehead, low-set ears, hypertelorism, short nose, small upturned nose, narrow lips and pointed chin) and discrete changes in the CNS - enhanced frontal horns of the lateral ventricles and quite narrow corpus callosum. These symptoms overlap with phenotype of previously described patients with 17p13.3 duplication. The aberration has been identified by array comparative genomic hybridization (aCGH) and confirmed by fluorescence in situ hybridization (FISH). This publication presents a detailed, comparative characteristic of clinical fetures expression in discussed patient with 17p13.3 duplication and patients previously described in medical literature. Further cases with different variants of 17p13.3 duplication may contribute to characterise the specific genotypephenotype correlation.
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Affiliation(s)
| | | | | | - Marta Smyk
- Institute of Mother and Child in Warsaw, Poland: Department of Medical Genetics
| | - Beata Nowakowska
- Institute of Mother and Child in Warsaw, Poland: Department of Medical Genetics
| | - Halina Gryglicka
- Institute of Mother and Child in Warsaw, Poland: Department of Pediatrics
| | - Ewa Obersztyn
- Institute of Mother and Child in Warsaw, Poland: Department of Medical Genetics
| | - Kamil K Hozyasz
- Institute of Mother and Child in Warsaw, Poland: Department of Pediatrics
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Downey LA, Hayley AC, Porath-Waller AJ, Boorman M, Stough C. The Standardized Field Sobriety Tests (SFST) and measures of cognitive functioning. Accid Anal Prev 2016; 86:90-98. [PMID: 26528800 DOI: 10.1016/j.aap.2015.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/29/2015] [Accepted: 10/19/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The Standardized Field Sobriety Tests (SFST) are utilised widely to assess fitness to drive when law enforcement suspects a driver's ability to drive is impaired, whether by drugs or alcohol. The SFST ostensibly achieve this through assessment of the level of drivers' cognitive and psychomotor impairment, although no studies have explicitly assessed the relatedness of cognitive ability and performance on the SFST. The current study aimed to assess the relationship between the three components of the SFST with a well validated computerised cognitive battery. METHOD A sub-set of 61 placebo condition participants comprised the sample, with 33 females and 28 males (mean age 25.45 years). Correlations between the individual SFST subscales 'Horizontal Gaze Nystagmus' (HGN), the 'One Leg Stand' (OLS) and the 'Walk and Turn' test (WAT) and Cognitive Drug Research (CDR) sub-scales of 'Quality of Working Memory', 'Power of Attention' and 'Continuity of Attention' were analysed using point-biserial correlation. RESULTS Sixty participants were included for analyses. A weak-moderate positive (five subscales) and a moderate-strong negative (two subscales) association was noted between seven of the nine individual CDR subscales and the SFST subscale of the WAT test (all p<0.05). Individually, a moderate positive association was noted between the sub-scale 'Nystagmus lack of smooth pursuit' and 'digit vigilance reaction time' and 'choice reaction time; reaction time' (both p<0.05) and 'Nystagmus head move and/or jerk' and 'simple reaction time' (p<0.001). When assessed as a partially composite factor, a comparable association was also noted between the composite score of the SFST subscale 'Nystagmus head move and/or jerk' and both (a) simple and (b) digit vigilance reaction time (both p<0.05). No association was noted between any of the individual cognitive variables and the SFST subscale 'OLS', or between composite cognitive scores 'Quality of Working Memory', 'Power of Attention' and 'Continuity of Attention' and total SFST scores. DISCUSSION Variation in some aspects of cognitive performance was found to be moderately and positively correlated with some individual aspects of the SFST; particularly among tasks which assess reaction time. Impairment of these cognitive processes can also contribute to the completion of complex tasks such as driving or the SFST. Complex behavioural tasks such as driving are often severely impaired due to intoxication, and thus in a practical sense, the SFST can still be considered a useful screening tool to identify drug or alcohol impaired drivers.
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Affiliation(s)
- Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia; Cambridge Health Alliance, Cambridge, MA, United States.
| | - Amie C Hayley
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia
| | | | - Martin Boorman
- Road Policing Command, Victoria Police, Melbourne, Australia
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia
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Onofrj M, Bonanni L, Delli Pizzi S, Caulo M, Onofrj V, Thomas A, Tartaro A, Franciotti R. Cortical Activation During Levitation and Tentacular Movements of Corticobasal Syndrome. Medicine (Baltimore) 2015; 94:e1977. [PMID: 26559277 PMCID: PMC4912271 DOI: 10.1097/md.0000000000001977] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Levitation and tentacular movements (LTM) are considered specific, yet rare (30%), features of Corticobasal Syndrome (CBS), and are erroneously classified as alien hand. Our study focuses on these typical involuntary movements and aims to highlight possible neural correlates.LTM were recognizable during functional magnetic resonance imaging (fMRI) in 4 of 19 CBS patients. FMRI activity was evaluated with an activation recognition program for movements, during LTM, consisting of levitaton and finger writhing, and compared with the absence of movement (rest) and voluntary movements (VM), similar to LTM, of affected and unaffected arm-hand. FMRI acquisition blocks were balanced in order to match LTM blocks with rest and VM conditions. In 1 of the 4 patients, fMRI was acquired only during LTM and with a different equipment.Despite variable intensity and range of involuntary movements, evidenced by videos, fMRI showed, during LTM, a significant (P<0.05-0.001) activation only of the contralateral primary motor cortex (M1). Voluntary movements of the affected and unaffected arm elicited the known network including frontal, supplementary, sensory-motor cortex, and cerebellum. Willed movements of the LTM-affected arm induced higher and wider activation of contralateral M1 compared with the unaffected arm.The isolated activation of M1 suggests that LTM is a cortical disinhibition symptom, not involving a network. Higher activation of M1 during VM confirms that M1 excitability changes occur in CBS. Our study calls, finally, attention to the necessity to separate LTM from other alien hand phenomena.
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Affiliation(s)
- Marco Onofrj
- From the Department of Neuroscience, Imaging and Clinical Sciences "G. d'Annunzio" University (MO, LB, SDP, MC, AT, AT, RF); Aging Research Centre, Ce.S.I. (MO, LB, SD, AT, RF); ITAB, "G. d'Annunzio" University Foundation, Chieti (SDP, MC, AT, RF); and Dipartimento Di BioImmagini, Università Cattolica SC, Roma, Italy (VO)
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Carducci C, Santagata S, Friedman J, Pasquini E, Carducci C, Tolve M, Angeloni A, Leuzzi V. Urine sepiapterin excretion as a new diagnostic marker for sepiapterin reductase deficiency. Mol Genet Metab 2015; 115:157-60. [PMID: 26123188 DOI: 10.1016/j.ymgme.2015.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 06/22/2015] [Accepted: 06/22/2015] [Indexed: 11/24/2022]
Abstract
Sepiapterin reductase deficiency (SRD) causes depletion of biogenic amines in the brain, early onset motor disorder, and intellectual disability. The diagnostic marker for this rare disease is increased sepiapterin and biopterin in CSF. Through a new analytic methodology we demonstrated accumulation of sepiapterin in urine of four SRD patients several times greater than that found in healthy controls and carriers, regardless of age or treatment. Our findings suggest a new interpretation of current theories of peripheral pterin metabolism and provide a new noninvasive diagnostic tool for children with early onset cryptogenetic developmental delay and/or movement disorder.
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Affiliation(s)
- Claudia Carducci
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
| | - Silvia Santagata
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
| | - Jennifer Friedman
- Department of Neurosciences and Pediatrics, University of CA San Diego and Rady Children's Hospital, San Diego, USA; Department of Pediatrics, University of CA San Diego and Rady Children's Hospital, San Diego, USA.
| | | | - Carla Carducci
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
| | - Manuela Tolve
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
| | - Antonio Angeloni
- Department of Molecular Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome Italy.
| | - Vincenzo Leuzzi
- Department of Pediatrics, Child Neurology and Psychiatry, Sapienza University of Rome, Via dei Sabelli 108, 00185 Rome, Italy.
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Ben-Salem S, Gleeson JG, Al-Shamsi AM, Islam B, Hertecant J, Ali BR, Al-Gazali L. Asparagine synthetase deficiency detected by whole exome sequencing causes congenital microcephaly, epileptic encephalopathy and psychomotor delay. Metab Brain Dis 2015; 30:687-94. [PMID: 25227173 PMCID: PMC4915861 DOI: 10.1007/s11011-014-9618-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 09/08/2014] [Indexed: 02/05/2023]
Abstract
Deficiency of Asparagine Synthetase (ASNSD, MIM 615574) is a very rare autosomal recessive disorder presenting with some brain abnormalities. Affected individuals have congenital microcephaly and progressive encephalopathy associated with severe intellectual disability and intractable seizures. The loss of function of the asparagine synthetase (ASNS, EC 6.3.5.4), particularly in the brain, is the major cause of this particular congenital microcephaly. In this study, we clinically evaluated an affected child from a consanguineous Emirati family presenting with congenital microcephaly and epileptic encephalopathy. In addition, whole-exome sequencing revealed a novel homozygous substitution mutation (c.1193A > C) in the ASNS gene. This mutation resulted in the substitution of highly conserved tyrosine residue by cysteine (p.Y398C). Molecular modeling analysis predicts hypomorphic and damaging effects of this mutation on the protein structure and altering its enzymatic activity. Therefore, we conclude that the loss of ASNS function is most likely the cause of this condition in the studied family. This report brings the number of reported families with this very rare disorder to five and the number of pathogenic mutations in the ASNS gene to four. This finding extends the ASNS pathogenic mutations spectrum and highlights the utility of whole-exome sequencing in elucidation the causes of rare recessive disorders that are heterogeneous and/or overlap with other conditions.
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Affiliation(s)
- Salma Ben-Salem
- Department of Pathology, College of Medicine and Heath Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Joseph G. Gleeson
- Department of Neuroscience and Pediatrics, Neurogenetics Laboratory, Howard Hughes Medical Institute, University of California, San Diego, CA, USA
| | - Aisha M. Al-Shamsi
- Department of Pediatrics, Tawam Hospital, Al-Ain, United Arab Emirates, Al-Ain, United Arab Emirates
| | - Barira Islam
- Department of Pediatrics, College of Medicine and Heath Sciences, United Arab Emirates University, P.O. Box 17666, Al-Ain, United Arab Emirates
| | - Jozef Hertecant
- Department of Pediatrics, Tawam Hospital, Al-Ain, United Arab Emirates, Al-Ain, United Arab Emirates
- Department of Pediatrics, College of Medicine and Heath Sciences, United Arab Emirates University, P.O. Box 17666, Al-Ain, United Arab Emirates
| | - Bassam R. Ali
- Department of Pathology, College of Medicine and Heath Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Lihadh Al-Gazali
- Department of Pediatrics, College of Medicine and Heath Sciences, United Arab Emirates University, P.O. Box 17666, Al-Ain, United Arab Emirates
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Couceiro R, Fonseca A, Campos F. Toddler with retinal defects. . .psychomotor regression. Sandhoff disease. J Pediatr Ophthalmol Strabismus 2015; 52:138-9, 176. [PMID: 26020229 DOI: 10.3928/01913913-20150427-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Flanagan JD, Reuter S, Crotwell PL, Myers A, De Berg K. A Hutterite condition that mimics Bowen-Conradi syndrome. S D Med 2015; 68:101-103. [PMID: 25906497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Bowen-Conradi syndrome (BCS) is a common autosomal recessive condition in the Hutterite population. In 2012, when BCS clinical testing was not available, we reported two babies believed to have BCS based upon their clinical features. Diagnostic molecular testing is now available for this condition. We describe here a brother born to the parents of one of the infants in our previous report. Although clinically both babies in the 2012 report appeared to have the same condition, this current infant was found to have a normal EMG1 gene sequence, and thus, lacks the Hutterite mutation for BCS. We discuss the importance of molecular testing in the Hutterite population.
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Torbert N, Reuter S, Myers A, De Berg K, Crotwell PL, Flanagan JD. Bowen-Conradi Syndrome: a trisomy 18-like autosomal recessive disorder common in Hutterites. S D Med 2015; 68:65-69. [PMID: 25799636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Bowen-Conradi syndrome (BCS) is a common lethal condition amongst infants of Hutterite ancestry. We describe a newborn infant with features of BCS, which may mimic trisomy 18 and other conditions such as cerebro-oculo-facial syndrome (COFS) and CHARGE syndrome. We describe the constellation of clinical findings in BCS. We believe this is the first case of BCS clinically confirmed by molecular testing for mutation in the EMG1 gene.
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Docx L, Sabbe BGC, Koning J, Mentzel TQ, van Harten PN, Morrens M. [Instrumental registration of psychomotor symptoms in schizophrenia: has the time come to use the technique in clinical practice?]. Tijdschr Psychiatr 2015; 57:148-153. [PMID: 25669955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND In clinical practice, psychomotor deficits are currently assessed by means of observation scales. However, instrumental (including mechanical and electronic) measurement techniques might also be valuable in clinical practice. AIM To discuss the added value of using instrumental registration of psychomotor functioning into clinical practice. METHOD We investigated the main pros and cons of instrumental registration by searching the literature systematically and we discuss our findings using concrete examples. RESULTS Compared to observation scales, instrumental registration yields more reliable and sensitive information about the psychomotor functioning of patients. Another advantage of instrumental registration is that it gives us an opportunity to study affected sub-processes and underlying mechanisms. However, the validity of these measurements depends on whether instrumental registration can adequately reflect aspects of a movement that can be observed clinically. CONCLUSION Clinical practice could benefit substantially from using instrumental registration of psychomotor disturbances in schizophrenia. However, more time and money needs to be invested in research before the new technique is fully validated and ready for use in clinical practice.
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Gudkov AB, Dyomin AV, Gribanov AV. [Postural control characteristics in elderly women with fallers]. Adv Gerontol 2015; 28:513-520. [PMID: 28509490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Using computer posturografic (stabilometric) complex a study of postural control peculiarities was carried out in 108 women aged 65-74 years who had experienced two or more falls during the year (fallers). These tests were: Sensory Organization Test, Motor Control Test, Rhythmic Weight Shift. It was found that elderly women with fallers had a decrease of sensory information (somatosensory - by 1,8 %, of the visual - by 6 %, and of the vestibular - by 10,1 %), the neurophysiological mechanisms of postural control (by 5,7 points), violation of adaptation possibilities of sensory and motor components of the legs to respond quickly to changes in the center of gravity within the support base of its footing (7,3 ms), as well as reducing balance control in the frontal (by 7,2 %) and sagittal (by 23,2 % ) planes compared with the women of the same age without fallers.
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Affiliation(s)
- A B Gudkov
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation;
- M. V. Lomonosov Institute of Biomedical Research of the Northern (Arctic) Federal University, Arkhangelsk, 163045, Russian Federation;
| | - A V Dyomin
- M. V. Lomonosov Institute of Biomedical Research of the Northern (Arctic) Federal University, Arkhangelsk, 163045, Russian Federation;
| | - A V Gribanov
- M. V. Lomonosov Institute of Biomedical Research of the Northern (Arctic) Federal University, Arkhangelsk, 163045, Russian Federation;
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Rhebergen D, Sienaert P. [Do psychomotor symptoms predict the treatment response of patients with depressive disorders?]. Tijdschr Psychiatr 2015; 57:83-88. [PMID: 25669943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Patients with depressive disorders may present with typical psychomotor symptoms such as retardation and/or agitation. So far, however,the prognostic significance of these symptoms is unclear. AIM To present an overview in which we assess to what extent psychomotor symptoms can predict the effect of the type of treatment that patients with depressive disorders receive. METHOD We searched the literature using Medline. RESULTS Psychomotor symptoms might predict that the patient will respond more favourably to treatment with dopaminergic antidepressants and broad-spectrum antidepressants (TCAs) and particularly to electroconvulsive therapy than to 'single-acting serotonergic antidepressants' - but, so far, the scientific evidence for the foregoing is limited. CONCLUSION In our view psychomotor symptoms do have a predictive value with regard to treatment response, but further research is needed.
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41
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Schqnhaut B L, Armijo R I. [Applicability of the Ages & Stages Questionnaires (ASQ) as a developmental screening tool for psychomotor delay]. ACTA ACUST UNITED AC 2014; 85:12-21. [PMID: 25079179 DOI: 10.4067/s0370-41062014000100002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 02/03/2014] [Indexed: 11/17/2022]
Abstract
The screening and timely intervention of developmental psychomotor delay (DSM) has proven benefits for the child, families and society. In order to improve the efficiency in the identification of these disorders, many scientific groups recommend performing clinical monitoring during health controls and the use of standard evaluations at specific patient age or when delays are suspected. In recent years, screening instruments have been developed based on the report of parents or primary caregivers, which have the advantage of being inexpensive, require little application and interpretation time and involve the adults who are responsible for the care and stimulation of the child. One of these tools is the Ages and Stages Questionnaires (ASQ), which has been widely used in the US and validated by several countries. This study describes the DSM assessment practices used in Chile and backs up the use of monitoring systems based on the report of parents/caregivers. ASQ validation experiences in other countries are discussed along with their psychometric characteristics for the Chilean population and consequent applicability.
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Leonard MM, Agar M, Spiller JA, Davis B, Mohamad MM, Meagher DJ, Lawlor PG. Delirium diagnostic and classification challenges in palliative care: subsyndromal delirium, comorbid delirium-dementia, and psychomotor subtypes. J Pain Symptom Manage 2014; 48:199-214. [PMID: 24879995 DOI: 10.1016/j.jpainsymman.2014.03.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/17/2014] [Accepted: 04/02/2014] [Indexed: 12/19/2022]
Abstract
CONTEXT Delirium often presents difficult diagnostic and classification challenges in palliative care settings. OBJECTIVES To review three major areas that create diagnostic and classification challenges in relation to delirium in palliative care: subsyndromal delirium (SSD), delirium in the context of comorbid dementia, and classification of psychomotor subtypes, and to identify knowledge gaps and research priorities in relation to these three areas of focus. METHODS We combined multidisciplinary input from delirium researchers and knowledge users at an international delirium study planning meeting and relevant PubMed literature searches as the knowledge synthesis strategy in this review. RESULTS We identified six (SSD), 33 (dementia), and 44 (psychomotor subtypes) articles of relevance in relation to the focus of our review. Recent literature data highlight the frequency and impact of SSD, the relevance of comorbid dementia, and the propensity for a hypoactive presentation of delirium in the palliative population. The differential diagnoses to consider are wide and include pain, fatigue, mood disturbance, psychoactive medication effects, and other causes for altered consciousness. CONCLUSION Challenges in the diagnosis and classification of delirium in people with advanced disease are compounded by the generalized disturbance of central nervous system function that occurs in the seriously ill, often with comorbid illness, including dementia. Further research is needed to delineate the pathophysiological and clinical associations of these presentations and thus inform therapeutic strategies. The expanding aged population and growing focus on dementia care in palliative care highlight the need to conduct this research.
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Affiliation(s)
- Maeve M Leonard
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Meera Agar
- Discipline, Palliative & Supportive Services, Flinders University, Adelaide, South Australia, Australia; South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Department of Palliative Care, Braeside Hospital, HammondCare, Sydney, New South Wales, Australia
| | - Juliet A Spiller
- Palliative Medicine, Marie Curie Hospice, Edinburgh and West Lothian Palliative Care Service, Edinburgh, United Kingdom
| | - Brid Davis
- Milford Care Centre, University of Limerick, Limerick, Ireland
| | - Mas M Mohamad
- Milford Care Centre, University of Limerick, Limerick, Ireland
| | - David J Meagher
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Peter G Lawlor
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada; Division of Palliative Care, Department of Medicine, Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
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Abstract
The monoamine neurotransmitter disorders are increasingly recognized as an expanding group of inherited neurometabolic syndromes caused by disturbances in the synthesis, transport and metabolism of the biogenic amines, including the catecholamines (dopamine, norepinephrine, and epinephrine) and serotonin. Disturbances in monoamine metabolism lead to neurological syndromes that frequently mimic other conditions, such as hypoxic ischemic encephalopathy, cerebral palsy, parkinsonism-dystonia syndromes, primary genetic dystonia and paroxysmal disorders. As a consequence, neurotransmitter disorders are frequently misdiagnosed. Early and accurate diagnosis of these neurotransmitter disorders is important, as many are highly amenable to, and some even cured by, therapeutic intervention. In this review, we highlight recent advances in the field, particularly the recent extensive characterization of known neurotransmitter disorders and identification of novel neurotransmitter disorders. We also provide an overview of current and future research in the field focused on developing novel treatment strategies.
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Affiliation(s)
- Clara Marecos
- Department of Neurology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Jover M, Ayoun C, Berton C, Carlier M. Development of motor planning for dexterity tasks in trisomy 21. Res Dev Disabil 2014; 35:1562-1570. [PMID: 24769429 DOI: 10.1016/j.ridd.2014.03.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 03/15/2014] [Accepted: 03/16/2014] [Indexed: 06/03/2023]
Abstract
We examined the macroscopic aspects of motor planning in two manual dexterity tasks, comparing children, adolescents, and young adults with trisomy 21 (T21) with typically developing controls from a developmental perspective. We analyzed the order in which objects were picked up from a table during two manual tasks of the Movement Assessment Battery for Children (M-ABC). Participants with T21 were always slower than controls. Task completion times depended on the strategy used by participants to gather up the pegs or coins. A structured strategy, in which the participants picked the items up moving methodically along each row/column, contributed to rapid task completion by younger children and participants with T21. This study highlights the ability of children with T21 to select and maintain an efficient strategy that takes account of their motor difficulties. Developmental trajectories help to explain T21 functioning in these dexterity tasks.
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Affiliation(s)
- Marianne Jover
- Aix Marseille Université, PsyCLE EA 3273, 13621 Aix en Provence, France.
| | | | | | - Michèle Carlier
- Aix Marseille Université, CNRS, LPC UMR 7290, 1331 Marseille, France.
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Ben-Sasson A, Gill SV. Motor and language abilities from early to late toddlerhood: using formalized assessments to capture continuity and discontinuity in development. Res Dev Disabil 2014; 35:1425-1432. [PMID: 24751905 DOI: 10.1016/j.ridd.2014.03.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 03/15/2014] [Accepted: 03/16/2014] [Indexed: 06/03/2023]
Abstract
Developmental tests reflect the premise that decreases in skills over time should be a sign of atypical development. In contrast, from a psychological perspective, discontinuity may be viewed as a normal part of typical development. This study sought to describe the variability in patterns of continuity and discontinuity in developmental scores over time. Seventy-six toddlers (55% boys) from a larger screening study were evaluated at 13 and 30 months using the Mullen Scales of Early Development (MSEL) in five areas: gross motor, fine motor, visual perception, receptive language, and expressive language. Parents completed the First Year Inventory (FYI) at 12 months as well. At 30 months, 23.68% of the sample received a clinical diagnosis (e.g., developmental delay, autism spectrum disorder [ASD]). Toddlers were classified as stable, increasing, or decreasing by at least 1.5 standard deviations (SD) on their scores in each of the five MSEL areas from 13 to 30 months. Between 3.9% and 51.3% of the sample was classified as increasing and 0-23.7% as decreasing across areas. Decreases in motor areas were associated with increases in language areas. None of the toddlers showed decreases greater than 1.5 SD on their MSEL composite scores. There was no single pattern that characterized a certain diagnosis. Higher FYI sensory-regulatory risk was associated with decreases in gross motor. Lower FYI risk was linked with increases in receptive language. Developmental discontinuity in specific developmental areas was the rule rather than the exception. Interpretations of decreases in developmental levels must consider concurrent increases in skill during this emerging period.
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Affiliation(s)
- Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel.
| | - Simone V Gill
- Department of Occupational Therapy, Boston University College of Health & Rehabilitation Sciences, Sargent College, Boston, MA, 02215 United States
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Shin D, Bohn D, Cronquist S, Lindstrom K, Agel J, Van Heest A. Quantitative assessment of pediatric hand function using touchscreen technology. Minn Med 2014; 97:45. [PMID: 24941594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Bouati N, Sagne A. [The aged and the test of folding a rhombus Psychometric and chronopsychological aspects]. Geriatr Psychol Neuropsychiatr Vieil 2013; 11:433-442. [PMID: 24333823 DOI: 10.1684/pnv.2013.0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study highlights the incongruence of geriatric institutions to set up activities for elderly people without taking into account the circadian fluctuations of cognitive processes related to circadian rhythms. By example, rehabilitation for falls is based on the indication given by the therapist (instruction), its integration and assimilation by the patient (comprehension), and the resulting action (execution). However, the recorded information and the execution may present a shift of phase and even an opposition of phase. The Test of Folding a Rhombus (TFR) was conceived to assess the fluctuation and articulation of these processes. It was proposed to 60 elderly individuals divided into 2 groups (30 subjects with cognitive disorders - case group - and 30 subjects without cognitive disturbance - control group -), and was applied at different time schedules of the day (8:00, 11:00, 15:00 and 18:00 h) once a week during 4 weeks. Its purpose was to quantify the relationship between automatic and controlled processes. Statistical analysis indicates significant circadian differences during the evolution of the two processes between the case and control groups. Simple, fast and easy to use, the TFR can also help professionals to choose the best automatic or controlled processes activity according to the need of patients.
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Affiliation(s)
- Noureddine Bouati
- Clinique universitaire de médecine gériatrique, CHU de Grenoble, France, Laboratoire SIS « Santé, individu, société », EAM 4128, Université Lyon 2, France
| | - Alain Sagne
- Département de psychologie de la santé, de l'éducation et du développement (PSED), parcours « Psychologie Clinique du Vieillissement », Université Lyon 2, France, Laboratoire SIS « Santé, individu, société », EAM 4128, Université Lyon 2, France
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Opladen T, Hoffmann GF, Kühn AA, Blau N. Pitfalls in phenylalanine loading test in the diagnosis of dopa-responsive dystonia. Mol Genet Metab 2013; 108:195-7. [PMID: 23375473 DOI: 10.1016/j.ymgme.2013.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 01/05/2013] [Accepted: 01/05/2013] [Indexed: 12/01/2022]
Abstract
Phenylalanine (Phe) loading test is a useful tool in the differential diagnosis of dopa-responsive dystonia due to autosomal dominant or recessive GTP cyclohydrolase I (GTPCH) deficiency or autosomal recessive sepiapterin reductase (SR) deficiency. In these patients hepatic phenylalanine hydroxylase system is compromised due to subnormal tetrahydrobiopterin (BH(4)) levels and hydroxylation of phenylalanine (Phe) to tyrosine (Tyr) is reduced with elevated Phe/Tyr ratio 1-2 h after oral Phe administration (100 mg/kg bw) administration. In healthy persons there is only a modest increase in Tyr production and blood Phe normalizes after 4 h. We report on a challenge with Phe (100 mg/kg bw) in a patient with dopa-responsive dystonia while on therapy with BH(4) and l-dopa. During Phe challenge Phe concentration remained below the normal range while a transient mild hypertyrosinemia was observed, leading to an extremely low Phe/Tyr ratio. A repeated test, after BH(4) withdrawal, reversed the findings and resulted normal. These data suggest activation of hepatic phenylalanine hydroxylase by BH(4). Thus, the Phe loading test should not be performed during substitution with BH(4).
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Affiliation(s)
- Thomas Opladen
- Division of Inborn Metabolic Diseases, University Children's Hospital, Heidelberg, Germany
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Seitz DP, Gill SS, Herrmann N, Brisbin S, Rapoport MJ, Rines J, Wilson K, Le Clair K, Conn DK. Pharmacological treatments for neuropsychiatric symptoms of dementia in long-term care: a systematic review. Int Psychogeriatr 2013; 25:185-203. [PMID: 23083438 PMCID: PMC3544545 DOI: 10.1017/s1041610212001627] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 05/10/2012] [Accepted: 08/30/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Medications are frequently prescribed for neuropsychiatric symptoms (NPS) associated with dementia, although information on the efficacy and safety of medications for NPS specifically in long-term care (LTC) settings is limited. The objective of this study was to provide a current review of the efficacy and safety of pharmacological treatments for NPS in LTC. METHODS We searched MEDLINE, EMBASE, PsychINFO, and the Cochrane Library for randomized controlled trials comparing medications with either placebo or other interventions in LTC. Study quality was described using the Cochrane collaboration risk of bias tool. The efficacy of medications was evaluated using NPS symptom rating scales. Safety was evaluated through rates of trial withdrawals, trial withdrawals due to adverse events, and mortality. RESULTS A total of 29 studies met inclusion criteria. The most common medications evaluated in studies were atypical antipsychotics (N = 15), typical antipsychotics (N = 7), anticonvulsants (N = 4), and cholinesterase inhibitors (N = 3). Statistically significant improvements in NPS were noted in some studies evaluating risperidone, olanzapine, and single studies of aripiprazole, carbamazepine, estrogen, cyproterone, propranolol, and prazosin. Study quality was difficult to rate in many cases due to incomplete reporting of details. Some studies reported higher rates of trial withdrawals, adverse events, and mortality associated with medications. CONCLUSIONS We conclude that there is limited evidence to support the use of some atypical antipsychotics and other medications for NPS in LTC populations. However, the generally modest efficacy and risks of adverse events highlight the need for the development of safe and effective pharmacological and non-pharmacological interventions for this population.
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Affiliation(s)
- Dallas P Seitz
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
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Hsu JF, Tsai MH, Chu SM, Fu RH, Chiang MC, Hwang FM, Kuan MJ, Huang YS. Early detection of minor neurodevelopmental dysfunctions at age 6 months in prematurely born neonates. Early Hum Dev 2013; 89:87-93. [PMID: 23084697 DOI: 10.1016/j.earlhumdev.2012.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 07/12/2012] [Accepted: 08/11/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the 6-month neurodevelopmental outcomes of prematurely born neonates and find the determining neonatal factors of minor neurological dysfunctions (MNDs). STUDY DESIGN We examined data collected prospectively on 151 infants born before 37th week of gestation in 2009-2010 who were assessed at 6 months corrected age with the Bayley Scales of Infant Development-2nd Edition (BSID-II) and the Denver Developmental Screening Test (DDST). RESULTS Of 151 neonates born before 37 weeks, 20 (13.2%) had MNDs at 6 months corrected age. These proportions were 21.6%, 13.2%, and 8.2% for neonates born before 28 weeks, 29 weeks to 32 weeks, and 33 weeks to 36 weeks, respectively. Half of neonates with MNDs have a birth body weight of less than 1000g. BSID-II and DDST are highly correlated in assessing the MNDs of premature neonates at 6 months corrected age. MND was independently associated with postnatal corticosteroid use (odds ratio [OR], 11.2; 95% confidence interval [CI], 1.9-66.0, P=0.008) and cholestasis (OR, 6.2; 95% CI, 1.16-33.1, P=0.033). CONCLUSIONS Premature neonates, even those born at 33 to 36 weeks, are found to have MNDs as early as 6 months corrected age by BSID-II and DDST, with risk increasing as gestation decreases.
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Affiliation(s)
- Jen-Fu Hsu
- Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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