Search

Peroxisome proliferator-activated receptors (PPARs), including PPAR-α, PPAR-β/δ, and PPAR-γ, are involved in various cellular responses, including metabolism and cell proliferation. Increasing evidence suggests that PPARs are closely associated with tumorigenesis and metastasis. However, the exact role of PPARs in energy metabolism and cancer stem cell (CSC) proliferation remains unclear. This study investigated the role of PPARs in energy metabolism and tumorigenesis in ovarian CSCs. The expression of PPARs and fatty acid consumption as an energy source increased in spheroids derived from A2780 ovarian cancer cells (A2780-SP) compared with their parental cells. GW6471, a PPARα inhibitor, induced apoptosis in A2780-SP. PPARα silencing mediated by small hairpin RNA reduced A2780-SP cell proliferation. Treatment with GW6471 significantly inhibited the respiratory oxygen consumption of A2780-SP cells, with reduced dependency on fatty acids, glucose, and glutamine. In a xenograft tumor transplantation mouse model, intraperitoneal injection of GW6471 inhibited in vivo tumor growth of A2780-SP cells. These results suggest that PPARα plays a vital role in regulating the proliferation and energy metabolism of CSCs by altering mitochondrial activity and that it offers a promising therapeutic target to eradicate CSCs. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) patients are at risk for developing bone health problems, and freezing of gait (FOG) in PD is associated with a high risk of falling and fracture. This study aimed to determine the association between FOG and bone mineral density (BMD) in patients with PD. We included 148 PD patients. FOG was assessed using the FOG Questionnaire (FOG-Q), and BMD was measured by dual-energy X-ray absorptiometry. Of 148 PD patients, 102 (68.9%) had FOG. PD patients with FOG were older and had longer disease duration, higher levodopa equivalent dose, higher modified Hoehn and Yahr stage, higher Unified PD Rating Scale motor score, higher FOG-Q score, higher total Non-Motor Symptom Scale score, and lower BMD scores in the femoral neck area than those without FOG. Pearson correlation analysis revealed that age, sex, body mass index, and age at onset were significantly correlated with areal BMDs in all areas. FOG-Q scores correlated negatively with areal BMDs in the total hip area and femoral neck, but not with areal BMD in the lumbar spine. Multivariate regression analysis showed that FOG-Q score was significantly correlated with areal BMD in the femoral neck, but not with areal BMDs in the lumbar spine or total hip. FOG in PD patients correlates significantly with BMD in the femoral neck area. Therefore, PD patients with FOG should be screened for osteoporosis. [ABSTRACT FROM AUTHOR]

Objective: The current study examined the relationship between learning and auditory processing (AP) ability in a clinical sample of children with and without learning difficulties (LD). Design: A non-randomised, cross-sectional, single measure research design was used. Study sample: The participants consisted of 50 children (7.7–10.8 years) who had been referred for a clinical AP assessment based on having been referred from a school-based AP screening. These children had previously been identified as having (n = 14) or not having (n = 36) LD. Results: Children with LD performed significantly worse than children without LD on frequency patterns with linguistic reports (FPlinR and FPlinL), dichotic digits (DD) and Auditory Word Memory – Forward (ANMF) tests, with significant correlations being observed between these variables and the learning score. The multiple linear regression showed that FPlinR, DDR and ANMF scores explained 50% of the variance in the learning score. Conclusion: The present study's results are most consistent with risk factor models linking AP to learning abilities in children where reduced AP abilities could put children at greater risk for LD. Further investigations into the potential relationships between AP, cognition, speech and language development, and learning ability in children are warranted. [ABSTRACT FROM AUTHOR]

Introduction: Prediction of the dementia progression is important for patient management. We aimed to investigate the cognitive trajectories of Alzheimer's disease dementia (ADD) and dementia with Lewy bodies (DLB) according to the initial structural change measured by comprehensive visual rating scales (CVRS). Methods: We retrospectively included the patients who initially visited the Dementia Clinic of Chonnam National University Hospital between 2010 and 2012. All patients underwent dementia workup including neuropsychological battery (Seoul Neuropsychological Screening Battery, SNSB). We recruited the participant who underwent SNSB annually for 3 years successively. A total of 136 patients of ADD and 63 patients of DLB were included for analysis. We analyzed the decline pattern of the cognitive profile according to the initial brain structural changes. Results: The general cognitive trajectories between ADD and DLB patients were not different. However, DLB patients showed more rapid decline of cognitive function in language and related function, visual memory function, and frontal executive function. The scores were lower in participants with DLB with the lesser atrophy group in attention, visuospatial function, and frontal executive function. In analysis of the cognitive trajectories, the visual memory domain declined rapidly in the DLB with lesser atrophy group compared with the ADD with lesser atrophy group. Conclusion: We founded that the differences in the visual cognitive profile in ADD and DLB patients in serial follow-up of neuropsychological tests. It is prominent in the mild structural change group of ADD and DLB. [ABSTRACT FROM AUTHOR]

Patients with Parkinson's disease (PD) are liable to experience impairment in their activities of daily living (ADL), which include ambulating, eating, dressing, bathing, and personal hygiene. The aim of this study is to assess which clinical characteristics contribute significantly to instrumental ADL (IADL) in PD patients without dementia. We included 106 PD patients in our study, and each patient's motor and non-motor status and basic and instrumental ADL were assessed using the appropriate scales. Of the 106 PD patients, 31 (29.2%) had abnormal Korean IADL (K-IADL) scores. These patients were older and had higher scores in terms of the modified Hoehn and Yahr (mHY) staging scale, Unified Parkinson's Disease Rating Scale (UPDRS) parts II and III, UPDRS part IV motor fluctuation, Beck Depression Inventory (BDI), and total Non-Motor Symptoms assessment scale for PD (NMSS), as well as lower scores in the Mini-Mental State Examination (MMSE). Pearson's correlation analysis showed significant associations between the scores of K-IADL and each of the following characteristics of the patients: age, mHY stage, UPDRS parts II and III, UPDRS part IV motor fluctuation, BDI, total NMSS, and MMSE. Multivariate linear regression analysis showed that the significant clinical characteristics associated with the K-IADL scores were determined to be the UPDRS part II, MMSE, and BDI scores. The results of our study revealed that the cognitive, depression, and motor symptoms were the significant predictors of IADL in PD patients without dementia. [ABSTRACT FROM AUTHOR]

Background: Freezing of gait (FOG) is a common and debilitating problem in patients with Parkinson's disease (PD). The aim of this study was to estimate the prevalence of FOG, and to identify factors that independently contribute to FOG in patients with PD.Method: We included 157 PD patients. FOG was assessed using the FOG Questionnaire (FOG-Q). Patients with or without FOG were defined as item 3 in the FOG-Q.Results: One hundred eleven (70.7%) out of 157 PD patients presented with FOG. Patients with FOG were older, had long disease duration, were taking higher doses of dopaminergic agents, and had higher motor and non-motor scores than those without FOG. Multivariate linear regression analysis showed that high modified Hoehn and Yahr (mHY) stage, Unified PD Rating Scale (UPDRS) part II score, and non-motor symptom assessment scale for PD (NMSS) total score were significant predictors of a high FOG-Q score. Patients with FOG had significantly higher scores for cardiovascular, gastrointestinal tract, urinary, and miscellaneous NMSS domains than those without FOG.Conclusions: FOG in PD was associated with higher mHY stage, UPDRS part II score, and total NMSS score. Therefore, clinicians should consider non-motor, motor features and activities of daily living states for the proper management of FOG. [ABSTRACT FROM AUTHOR]

Objective: Coffee consumption has an inverse association with the risk of Parkinson's disease (PD). The aim of this study was to investigate the association between coffee consumption and non-motor symptoms (NMSs) in patients with PD.Methods: In this cross-sectional study, we included 196 early-stage, treatment-naïve PD patients. Coffee consumption history was obtained via semi-structured interviews. NMSs were assessed using the Non-Motor Symptom assessment scale (NMSS).Results: Of the 196 patients with PD, 136 (69.3%) were categorized as coffee drinkers and 60 (30.6%) were non-drinkers. Coffee drinkers were younger, predominantly male, were younger in age at symptom onset, had lower Unified Parkinson's Disease Rating Scale motor and Beck Depression Inventory scores, and higher Mini-Mental State Examination scores than non-coffee drinkers. After adjustment, coffee drinking was significantly inversely associated with the prevalence of lack of motivation, anhedonia, and lack of pleasure, which were less frequent in coffee drinkers. Total NMSS scores were lower in coffee drinkers than in non-drinkers (p = 0.047). In particular, coffee drinking was significantly associated with a reduced severity of the mood/cognition domain of NMSS (p = 0.003). After correcting for multiple testing, there were no significant differences in the prevalence of NMSs, but there were significant differences in the severity of NMSs between coffee drinkers and non-drinkers.Conclusion: There is a negative association between coffee consumption and the severity of the mood/cognition domain of NMSS in patients with PD. Clinicians should consider the history of coffee consumption in the assessment of NMSs in PD. [ABSTRACT FROM AUTHOR]

Magnetic resonance (MR) measurements of brainstem structures have been reported to be useful in differentiating patients with progressive supranuclear palsy (PSP) from those with Parkinson's disease (PD). The aim of this study was to determine whether quantitative measurements of brainstem structures on MR images can help differentiate vascular parkinsonism (VaP) from degenerative parkinsonism (PD and PSP). Areas of the midbrain and pons, and widths of the superior cerebellar peduncle (SCP) and middle cerebellar peduncle (MCP) were measured in 62 patients with PD, 25 patients with PSP (11 probable and 14 possible), and 24 patients with VaP on T 1-weighted MR images. The midbrain-to-pons area ratio (M/P ratio), MCP-to-SCP width ratio (MCP/SCP ratio), and MR parkinsonism index (MRPI; P/M × MCP/SCP) were calculated. The midbrain area and M/P ratio of patients with VaP (104 and 0.22 mm2, respectively) were smaller than those in patients with PD (121 and 0.24 mm2, respectively) and larger than those in patients with PSP (90 and 0.19 mm2, respectively). The MRPI was significantly larger in patients with PSP (13.6) in comparison with those with PD (10.1) and VaP (10.7). However, the MRPI of patients with VaP was not significantly different from patients with PD. Our study showed that MRPI was useful in differentiating PSP from VaP or PD. Thus, MR imaging measurements of brainstem structures may help differentiate patients with VaP from those with PD and PSP. [ABSTRACT FROM AUTHOR]

Background: Pain and osteoporosis are common in Parkinson's disease (PD), and lower bone mineral density (BMD) or osteoporosis may be associated with an increased risk of reporting to have pain in the general population. The aim of this study was to determine whether there is an association between the pain subtypes and the BMD in patients with PD. Methods: We included 162 PD patients. Pain was assessed using the patients' descriptions, a structured interview, a detailed neurologic examination, and the Visual Analogue Scale. BMD was measured using dual energy X-ray absorptiometry scans. Results: Of the 162 PD patients, 120 had chronic pain, while 42 reported no pain. The most prevalent type of pain was musculoskeletal, followed by radicular/ neuropathic, dystonic, and central. PD patients with musculoskeletal pain had a lower BMD than PD patients without pain. Multivariate regression analysis showed that the low BMD of the lumbar spine, hip, and femoral neck were related to old age, female gender, low MBI, and the presence of musculoskeletal pain. Conclusion: PD patients with musculoskeletal pain have low BMD and are at risk for developing osteoporosis. If a PD patient has musculoskeletal pain and other risk factors related to low BMD, clinicians should consider screening for osteoporosis. [ABSTRACT FROM AUTHOR]

Dysfunctions in the perirhinal cortex (PRh) are associated with visual recognition memory deficit, which is frequently detected in the early stage of Alzheimer’s disease. Muscarinic acetylcholine receptor–dependent long-term depression (mAChR-LTD) of synaptic transmission is known as a key pathway in eliciting this type of memory, and Tg2576 mice expressing enhanced levels of Aβ oligomers are found to have impaired mAChR-LTD in this brain area at as early as 3 months of age. We found that the administration of Aβ oligomers in young normal mice also induced visual recognition memory impairment and perturbed mAChR-LTD in mouse PRh slices. In addition, when mice were treated with infliximab, a monoclonal antibody against TNF-α, visual recognition memory impaired by pre-administered Aβ oligomers dramatically improved and the detrimental Aβ effect on mAChR-LTD was annulled. Taken together, these findings suggest that Aβ-induced inflammation is mediated through TNF-α signaling cascades, disturbing synaptic transmission in the PRh, and leading to visual recognition memory deficits. [ABSTRACT FROM AUTHOR]

Background: Essential tremor (ET) and Parkinson's disease (PD) are common neurological disorders in elderly people, and some features of ET and PD may overlap. Quantitative analysis of brain atrophy may be useful in differentiating neurodegenerative disorders. The aim of this study was to identify the volumetric differences of subcortical structures in patients with ET and PD tremor using an automated segmentation method. Methods: Volumetric MRIs were obtained in 45 patients with ET, 45 patients with PD tremor, and 45 age- and sex-matched control subjects. The volume of the different brain structures was measured by the automated segmentation method (FreeSurfer). Results: Volumetric data obtained with automated segmentation of cerebral regions showed a significant atrophy of the cerebellum in patients with ET. Cerebellar atrophy of ET patients was more significant in the white matter than in the grey matter, and it was noted only in patients with ET having a head tremor. No volumetric differences were found between the PD group and the control group. Conclusion: Our study suggests that volumetric differences in subcortical structures using whole brain segmentation method may help to differentiate ET from PD tremor. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The diagnosis of spinocerebellar ataxia (SCA) currently depends upon genetic testing. Although genetic testing for SCA is highly specific, clinical parameters for the differentiation of SCAs are still insufficient. We aimed to assess the vestibulo-ocular reflex (VOR) parameters of various SCA subtypes to determine whether they have substantial value in differential diagnosis. We consecutively enrolled 33 genetically confirmed SCA patients (SCA2 = 8, SCA3 = 6, SCA6 = 10, SCA7 = 9). Normative data were obtained from 36 age- and gender-matched healthy controls. Quantitative indicators of VOR were measured using video head impulse test (HIT) and combined ocular motor dysfunctions were investigated using video-oculography. Compared with the control group, the VOR gains in SCA2 were relatively spared, but were markedly decreased for all six canals in SCA3. The VOR gains for the posterior canals (PCs) were significantly decreased in SCA6, and for both vertical canals were decreased in SCA7. The VOR gains for the horizontal canals in SCA3 were negatively correlated with disease severity (R = -0.900, p = 0.037). Abnormal catch-up saccades were common in SCA3 and SCA6, rare in SCA7 and absent in SCA2. Spontaneous, headshaking-induced, and positional nystagmus were only documented in SCA6. SCA3 and SCA6 commonly showed horizontal gaze-evoked nystagmus, but SCA2 and SCA7 had characteristic saccadic slowing without gaze-evoked nystagmus. VOR impairments are common in SCAs, but their patterns vary depending on subtype. In addition to ocular motor characteristics, distinctive VOR performance for each subtype using video HIT may aid the differential diagnosis of the SCA genotypes. [ABSTRACT FROM AUTHOR]

Background: Alterations in thyroid hormone (TH) levels may be related to the pathogenesis of mild cognitive impairment (MCI) and dementia. Cognitive deficits are common in Parkinson's disease (PD) patients. The aim of this study was to investigate whether variations within the normal ranges of thyroid function are related to cognitive function in early PD without dementia. Methods: Eighty-four euthyroid patients with early PD underwent evaluation of their thyroid status, including measures of thyroid-stimulating hormone (TSH), total triiodothyronine (tT3) and free thyroxine (fT4), and comprehensive neuropsychological tests. Results: The 46 patients of the PD-MCI group did not differ in the serum levels of TH compared to the 38 patients of the PD-normal cognition group. fT4 levels were inversely associated with the Mini-Mental State Examination (MMSE) score and neuropsychological tests of attention and visuospatial and executive function. TSH and tT3 levels were not related to cognitive performances. After controlling for demographic and clinical variables, multiple regression analyses indicated statistically significant associations between fT4 concentrations and MMSE score and neuropsychological tests of executive function. Conclusions: This study supports a relationship between the thyroid status and cognitive function in euthyroid early PD patients, with higher concentrations of fT4 being associated with a poor performance of executive function. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Saccade may be abnormal in Parkinson's disease (PD), but there have been no systematic studies on directional asymmetries of horizontal saccades in early PD. The aims of this study were to determine the saccadic abnormalities and their directional asymmetries. Methods: We recorded visually guided horizontal prosaccades with random (random amplitudes and irregular time intervals) and regular (fixed amplitude and regular time interval) paradigms using video-oculography in 44 patients with unilateral symptoms and signs from early PD and in 26 controls. Results: PD patients showed decreased saccadic amplitude compared to the controls, especially during regular paradigm while the saccadic latency did not differ between the groups. Patients with unilateral PD tended to show more severe saccadic hypometria toward the symptomatic side during the regu- lar paradigm, compared to normal control. Conclusion: Even in early PD patients, saccadic accuracy may be abnormal. Asymmetries in saccadic hypometria are more likely to be detected during the anticipatable saccadic paradigm, which could be a useful adjunct in the diagnosis of early-stage PD. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Ceramic-based nanocomposites were reviewed, emphasizing the newly developed concept of material design for ceramics. First, characteristics of the nanocomposites observed by previous researchers were summarized as, significant or moderate improvement in strength, drastic change of the fracture mode from intergranular fracture of monolithic ceramics to transgranular fracture of nanocomposites, moderate enhancement of fracture toughness, improvement of other mechanical properties, and observations of dislocations. Second, several mechanisms proposed previously to explain these characteristics were reviewed. Third, our strengthening and toughening mechanisms of nanocomposites on the basis of dislocation activities were explained. In nanocomposites, the highly localized residual stresses in the matrix grains are generated by the mismatch of thermal expansion coefficients between the matrix and the dispersed particles, and the dislocations are yielded during the cooling process after sintering. These dislocations then release the tensile residual stresses intrinsically existing in the matrix grains of sintered ceramics and improve the strength of the materials. In addition, as these dislocations cannot move at room temperature the sessile dislocations in the matrix operate as nano-crack nuclei in a frontal process zone (FPZ) ahead of the crack tip when the tip of a propagating crack approaches this area. Therefore, the size of the FPZ is expanded and as a result the fracture toughness is improved. Finally, estimation of the critical FPZ size was explained in order to clarify its toughening mechanism in nanocomposites. [Copyright &y& Elsevier]

Toughening and strengthening mechanisms in ceramic-based nanocomposites were explained based on Griffith''s energy equilibrium and residual stresses around second-phase nanoparticles dispersed in matrix grains. The residual thermal stresses around a spherical dispersed particle within a concentric sphere of a matrix grain were specifically analyzed to clarify the effects of residual stresses on the toughening mechanism in the frontal process zone involving nanocracking and on the strengthening mechanism caused by nucleation of dislocations. The analytical results revealed that the ratio of the thermal expansion coefficients of the particle and matrix has a marked effect on residual stresses and the estimated residual stresses were of sufficient magnitude to generate lattice defects such as dislocations around the particle even in ceramics, and that the nanosize particle within a matrix can only create dislocations around the particle. The toughening and strengthening mechanisms for nanocomposites were also discussed based on the analytical results and explained schematically. [Copyright &y& Elsevier]

Abstract: Disappearance of resting tremor was observed in a 76-year-old patient with Parkinson''s disease after a contralateral thalamic infarct involving the territory of the tuberothalamic artery. Based on the analysis of surgical data of Parkinson''s disease patients, this might be explained by the lesion of the ventral lateral nucleus, which is supplied by the inferolateral and tuberothalamic arteries. Thalamic infarction in the territory of the tuberothalamic artery as well as the inferolateral artery can produce amelioration of tremor. [Copyright &y& Elsevier]

Background: Coffee consumption represents a negative risk factor for Parkinson's disease (PD) and seems to affect PD motor symptoms. We aimed to investigate the association between coffee consumption and motor symptoms in de novo PD patients.Methods: In total, 284 patients with de novo PD were included in the current study. Motor and non-motor symptoms were evaluated using various scales. History of coffee consumption was obtained via a semi-structured interview.Results: In total, 204 patients were categorized as coffee drinkers and 80 as non-coffee drinkers. Coffee drinkers were predominantly male and had early symptom onset; in addition, they were younger, reported more years in formal education, and had better motor and non-motor scores than did non-coffee drinkers. After adjustments, coffee drinkers had lower tremor scores than did non-coffee drinkers, and coffee consumption was related to tremors in a dose-dependent manner. These relationships were statistically significant in case of rest tremor but not in case of action tremor. The dose-dependent relationship between coffee consumption and tremor severity was significant only in men. Non-motor symptom scores were not significantly different between coffee drinkers and non-coffee drinkers.Conclusions: Coffee consumption and tremor severity are inversely related in male patients with de novo PD. [ABSTRACT FROM AUTHOR]

We investigated the association between retinal changes measured using optical coherence tomography (OCT) and diverse clinical grading scales in patients with Parkinson's disease (PD). Seventy-four eyes of 74 patients with de novo PD and 53 eyes of age-matched control subjects were included. The thickness of the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) were measured. We analyzed the correlations between the clinical PD grading scales and OCT parameters, and between the OCT parameters and volumetric data in the cerebral cortical and subcortical structures. The area under the receiver operating characteristic curve (AUC) was calculated for diagnosing cognitive impairment in patients with PD. Statistically significant reductions in the thickness of average, temporal, and inferior pRNFL and overall mGCIPL were observed in patients with PD. The Montreal Cognitive Assessment score was significantly associated with mGCIPL thinning. The AUC of the mGCIPL parameters for diagnosing cognitive impairment in patients with PD ranged from 0.651 to 0.760. Moreover, thinning of the mGCIPL was significantly associated with the volumetric parameters of associated brain structures. Our findings highlight the clinical implications of OCT measurements as a potential biomarker for early detection of cognitive impairment in patients with PD. [ABSTRACT FROM AUTHOR]

Background: Increasing levodopa (L‐dopa)/dopa decarboxylase inhibitor (DDCI) daily dose or adding a catechol‐O‐methyltransferase (COMT) inhibitor to levodopa/DDCI therapy are strategies used to manage wearing‐off symptoms in Parkinson's disease (PD) patients. Objectives: To evaluate the COMT inhibitor opicapone versus an additional dose of levodopa to treat early wearing‐off in PD patients. Methods: ADOPTION was a randomized, parallel‐group, open‐label, Phase 4 study conducted in Korea. At baseline, eligible patients were randomized (1:1) to opicapone 50 mg (n = 87) or L‐dopa 100 mg (n = 81) (added to current L‐dopa/DDCI therapy) for 4 weeks. The main efficacy endpoint was change from baseline to end of study in absolute off time. Other endpoints included changes in on time, in Movement Disorder Society‐Unified Parkinson's Disease Rating Scale and 8‐item PD Questionnaire scores, and the Clinical and Patient Global Impression of Improvement/Change. Results: The adjusted mean in absolute off time was significantly greater for opicapone 50 mg than for L‐dopa 100 mg (−62.1 vs. −16.7 minutes; P = 0.0015). Opicapone‐treated patients also reported a greater reduction in the percentage of off time (P = 0.0015), a greater increase in absolute on time (P = 0.0338) and a greater increase in the percentage of on time (P = 0.0015). There were no significant differences in other secondary endpoints. The L‐dopa equivalent daily dose was significantly higher in the opicapone group (750.9 vs. 690.0 mg; P = 0.0247), when a 0.5 conversion factor is applied. Conclusions: Opicapone 50 mg was more effective than an additional 100 mg L‐dopa dose at decreasing off time in patients with PD and early wearing‐off. [ABSTRACT FROM AUTHOR]

Background: We previously demonstrated the validity of a regression model that included ethnicity as a novel predictor for predicting normative brain volumes in old age. The model was optimized using brain volumes measured with a standard tool FreeSurfer. Objective: Here we further verified the prediction model using newly estimated brain volumes from Neuro I, a quantitative brain analysis system developed for Korean populations. Methods: Lobar and subcortical volumes were estimated from MRI images of 1,629 normal Korean and 786 Caucasian subjects (age range 59–89) and were predicted in linear regression from ethnicity, age, sex, intracranial volume, magnetic field strength, and scanner manufacturers. Results: In the regression model predicting the new volumes, ethnicity was again a substantial predictor in most regions. Additionally, the model-based z-scores of regions were calculated for 428 AD patients and the matched controls, and then employed for diagnostic classification. When the AD classifier adopted the z-scores adjusted for ethnicity, the diagnostic accuracy has noticeably improved (AUC = 0.85, ΔAUC = + 0.04, D = 4.10, p < 0.001). Conclusions: Our results suggest that the prediction model remains robust across different measurement tool, and ethnicity significantly contributes to the establishment of norms for brain volumes and the development of a diagnostic system for neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

Background: Freezing of gait (FOG) is a common and debilitating problem in patients with Parkinson's disease (PD). The aim of this study was to estimate the prevalence of FOG, and to identify factors that independently contribute to FOG in patients with PD.Method: We included 157 PD patients. FOG was assessed using the FOG Questionnaire (FOG-Q). Patients with or without FOG were defined as item 3 in the FOG-Q.Results: One hundred eleven (70.7%) out of 157 PD patients presented with FOG. Patients with FOG were older, had long disease duration, were taking higher doses of dopaminergic agents, and had higher motor and non-motor scores than those without FOG. Multivariate linear regression analysis showed that high modified Hoehn and Yahr (mHY) stage, Unified PD Rating Scale (UPDRS) part II score, and non-motor symptom assessment scale for PD (NMSS) total score were significant predictors of a high FOG-Q score. Patients with FOG had significantly higher scores for cardiovascular, gastrointestinal tract, urinary, and miscellaneous NMSS domains than those without FOG.Conclusions: FOG in PD was associated with higher mHY stage, UPDRS part II score, and total NMSS score. Therefore, clinicians should consider non-motor, motor features and activities of daily living states for the proper management of FOG. [ABSTRACT FROM AUTHOR]

Network coding is becoming essential part of network systems since it enhances system performance in various ways. To take full advantage of network coding, however, it is vital to guarantee low latency in the decoding process and thus parallelization of random network coding has drawn broad attention from the network coding community. In this paper, we investigate the problem of parallelizing random network coding for embedded sensor systems with multicore processors. Recently, general purpose graphics processing unit (GPGPU) technology has paved the way for parallelizing random network coding; however, it is not an option on embedded sensor nodes without GPUs and thus it is indispensable to leverage multicore processors which are becoming more common in embedded sensor nodes. We propose a novel random network coding parallelization technique that can fully exploit multicore processors. In our experiments, our parallel method exhibits over 150% throughput enhancement compared to existing state-of-the-art implementations on an embedded system. [ABSTRACT FROM AUTHOR]

This multicentre, prospective, single-arm study evaluated safinamide as add-on therapy to levodopa in Korean patients with Parkinson’s disease (PD) with motor fluctuations with ≥ 1.5 h of “off” time daily, who took levodopa ≥ 3 times/day (n = 199). Baseline levodopa and dopamine agonist doses were maintained without escalation during the 18-week treatment period. Participants received safinamide 50 mg/day for 2 weeks and 100 mg/day thereafter. PD diaries and questionnaires (Parkinson’s Disease Questionnaire, PDQ-39; Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale, MDS–UPDRS part 3 and part 4; King’s Parkinson’s Disease Pain Scale, KPPS; Mini-Mental State Examination, MMSE) were assessed at baseline and at week 18. Treatment-emergent adverse events (TEAEs) were recorded. Mean disease duration was 6.6 years, and mean levodopa equivalent daily dose was 721.1 mg/day. At week 18, significant improvements from baseline were seen for the co-primary endpoints, mean daily “off” time (− 1.3 ± 2.4 h, p < 0.001) and quality of life (QoL) based on PDQ-39 summary index (− 2.7 ± 10.3, p < 0.001), Moreover, significant improvements were seen in motor symptoms and motor complications (MDS-UPDRS part 3 and 4), daily “on” time without dyskinesia (all p < 0.001) and pain (KPPS; p = 0.013). TEAEs occurred in 40.2% of patients, with most being mild in severity. In conclusion, safinamide at a dosage of 100 mg/day significantly improved motor symptoms, QoL, and pain, and demonstrated a favourable safety profile without levodopa dosage escalation during the 18-week treatment period in Korean patients with PD.Trial registration number and date: NCT05312632, First Posted: April 5, 2022 [ABSTRACT FROM AUTHOR]

The diagnosis of Alzheimer's disease (AD) needs to be improved. We investigated if hippocampal subfield volume measured by structural imaging, could supply information, so that the diagnosis of AD could be improved. In this study, subjects were classified based on clinical, neuropsychological, and amyloid positivity or negativity using PET scans. Data from 478 elderly Korean subjects grouped as cognitively unimpaired β-amyloid-negative (NC), cognitively unimpaired β-amyloid-positive (aAD), mild cognitively impaired β-amyloid-positive (pAD), mild cognitively impaired—specific variations not due to dementia β-amyloid-negative (CIND), severe cognitive impairment β-amyloid-positive (ADD+) and severe cognitive impairment β-amyloid-negative (ADD-) were used. NC and aAD groups did not show significant volume differences in any subfields. The CIND did not show significant volume differences when compared with either the NC or the aAD (except L-HATA). However, pAD showed significant volume differences in Sub, PrS, ML, Tail, GCMLDG, CA1, CA4, HATA, and CA3 when compared with the NC and aAD. The pAD group also showed significant differences in the hippocampal tail, CA1, CA4, molecular layer, granule cells/molecular layer/dentate gyrus, and CA3 when compared with the CIND group. The ADD- group had significantly larger volumes than the ADD+ group in the bilateral tail, SUB, PrS, and left ML. The results suggest that early amyloid depositions in cognitive normal stages are not accompanied by significant bilateral subfield volume atrophy. There might be intense and accelerated subfield volume atrophy in the later stages associated with the cognitive impairment in the pAD stage, which subsequently could drive the progression to AD dementia. Early subfield volume atrophy associated with the β-amyloid burden may be characterized by more symmetrical atrophy in CA regions than in other subfields. We conclude that the hippocampal subfield volumetric differences from structural imaging show promise for improving the diagnosis of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

The present study reports two novel genome-wide significant loci for late-onset Alzheimer's disease (LOAD) identified from APOE ε4 non-carrier subjects of East Asian origin. A genome-wide association study of Alzheimer's disease was performed in 2,291 Korean seniors in the discovery phase, from the Gwangju Alzheimer' and Related Dementias (GARD) cohort study. The study was replicated in a Japanese cohort of 1,956 subjects that suggested two novel susceptible SNPs in two genes: LRIG1 and CACNA1A. This study demonstrates that the discovery of AD-associated variants is feasible in non-European ethnic groups using samples comprising fewer subjects from the more homogeneous genetic background. [ABSTRACT FROM AUTHOR]

α-Fe2O3, which is an attractive material for supercapacitor electrodes, has been studied to address the issue of low capacitance through structural development and complexation to maximize the use of surface pseudocapacitance. In this study, the limited performance of α-Fe2O3 was greatly improved by optimizing the nanotube structure of α-Fe2O3 and its combination with polyaniline (PANI). α-Fe2O3 nanotubes (α-NT) were fabricated in a form in which the thickness and inner diameter of the tube were controlled by Fe(CO)5 vapor deposition using anodized aluminum oxide as a template. PANI was combined with the prepared α-NT in two forms: PANI@α-NT-a enclosed inside and outside with PANI and PANI@α-NT-b containing PANI only on the inside. In contrast to α-NT, which showed a very low specific capacitance, these two composites showed significantly improved capacitances of 185 Fg−1 for PANI@α-NT-a and 62 Fg−1 for PANI@α-NT-b. In the electrochemical impedance spectroscopy analysis, it was observed that the resistance of charge transfer was minimized in PANI@α-NT-a, and the pseudocapacitance on the entire surface of the α-Fe2O3 nanotubes was utilized with high efficiency through binding and conductivity improvements by PANI. PANI@α-NT-a exhibited a capacitance retention of 36% even when the current density was increased 10-fold, and showed excellent stability of 90.1% over 3000 charge–discharge cycles. This approach of incorporating conducting polymers through well-controlled nanostructures suggests a solution to overcome the limitations of α-Fe2O3 electrode materials and improve performance. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by a rapid accumulation of amyloid β (Aβ) protein in the hippocampus, which impairs synaptic structures and neuronal signal transmission, induces neuronal loss, and diminishes memory and cognitive functions. The present study investigated the impact of neuregulin 1 (NRG1)-ErbB4 signaling on the impairment of neural networks underlying hippocampal long-term potentiation (LTP) in 5xFAD mice, a model of AD with greater symptom severity than that of TG2576 mice. Specifically, we observed parvalbumin (PV)-containing hippocampal interneurons, the effect of NRG1 on hippocampal LTP, and the functioning of learning and memory. We found a significant decrease in the number of PV interneurons in 11-month-old 5xFAD mice. Moreover, synaptic transmission in the 5xFAD mice decreased at 6 months of age. The 11-month-old transgenic AD mice showed fewer inhibitory PV neurons and impaired NRG1-ErbB4 signaling than did wild-type mice, indicating that the former exhibit the impairment of neuronal networks underlying LTP in the hippocampal Schaffer-collateral pathway. In conclusion, this study confirmed the impaired LTP in 5xFAD mice and its association with aberrant NRG1-ErbB signaling in the neuronal network. [ABSTRACT FROM AUTHOR]

Background: Isolated central positional vertigo (CPV) due to cerebellar infarction is often difficult to differentiate from benign paroxysmal positional vertigo (BPPV). Here, we aimed to evaluate whether vascular risk factors and serum vitamin D level can differentiate between positional vertigo types. Methods: A total of 78 consecutive patients were consecutively enrolled from January 2017. All CPV patients had a National Institutes of Health Stroke Scale score of 0 and cerebellar infarctions confirmed by brain MR imaging. Vascular risk factors and serum 25-hydroxyvitamin D levels were compared between the two groups of patients. Results: The proportion of men was higher in the CPV than in the BPPV group (p = 0.004). Atrial fibrillation was common in the CPV group on univariate analysis (p = 0.046). However, there were no independent differentiating factors between the two groups. The proportion of patients according to the number of risk factors was significantly different between the two groups (linear by linear association test, p = 0.02). The mean serum 25-hydroxyvitamin D level did not differ. Also, the proportions of vitamin D insufficiency and deficiency did not differ significantly between the two groups. Conclusions: Increased number of vascular risk factors including male sex suggested more CPV than BPPV. However, the serum vitamin D level was below the normal range in both groups. Our results demonstrate that serum vitamin D level has little value in the differential diagnosis of positional vertigo. Efforts to identify differentiating factors are warranted, and accumulating evidences including our research may lead to a diagnostic algorithm for isolated positional vertigo. [ABSTRACT FROM AUTHOR]

Background: Cerebrospinal fluid (CSF) amyloid-β1-42 (Aβ1-42), total tau protein (t-Tau), and phosphorylated Tau (p-Tau) are ATN biomarkers for Alzheimer's disease (AD) and reflect pathogenic changes in the brain. CSF biomarkers of AD are considered for inclusion in the diagnostic criteria for research and clinical purposes to reduce the uncertainty of clinical diagnosis and to distinguish among AD stages.Objective: This study aims to compare two commercially available analytical platforms with respect to accuracy and the potential for early diagnosis of AD.Methods: A total of 211 CSF samples from healthy control (HC) and AD subjects were analyzed using two analytical platforms, INNOTEST ELISA and INNOBIA AlzBio3 xMAP kits. The accuracy of diagnosis and AUC values distinguishing study groups were compared between the two analytical platforms.Results: The absolute values for Aβ1-42, t-Tau, and p-Tau181 levels differed between the two platforms. The Aβ1-42 levels decreased, while t-Tau and p-Tau levels increased according to the AD stages. The AUC of Aβ1-42 and t-Tau, which distinguish the early stages of AD (preclinical and prodromal AD), were similar between the two platforms, whereas there were significant differences in p-Tau AUC values. CSF p-Tau using the INNOBIA was highly accurate for distinguishing both preclinical AD (AUC = 0.826, cut-off score≥38.89) and prodromal AD (AUC = 0.862, cut-off score≥41.88) from HC.Conclusion: The accuracy of CSF p-Tau levels in the preclinical and prodromal AD is higher for the INNOBIA than the INNOTEST, and the early stage AD can be accurately distinguished from HC. [ABSTRACT FROM AUTHOR]

Background: Clinical subtypes of Parkinson's disease (PD) have been empirically defined based on the prominent motor symptoms. The aim of this study was to compare the prevalence of non-motor symptoms across PD motor subtypes in patients with PD.Methods: A total of 192 patients with de novo PD were included. The patients were classified into the tremor-dominant/mixed/akinetic-rigid (TD/mixed/AR) and tremor-dominant/mixed/postural instability and gait disturbance (TD/mixed/PIGD) subtypes, according to previous reports.Results: In the TD/mixed/AR classification, scores for scales related to motor symptoms and activities of daily living (ADL) were significantly different among the groups, and patients with the AR subtype demonstrated more severe scores than patients with the TD subtype. In the TD/mixed/PIGD classification, age, age at symptom onset, scores on motor-related scales, ADL, and non-motor symptoms were significantly different among the groups. Scores including the modified Hoehn and Yahr stages, the motor and ADL subscores of the Unified Parkinson's Disease Rating Scale, the Beck Depression Inventory, and the Non-Motor Symptom Assessment Scale were significantly different after adjustments for age and age at symptom onset, and patients with the PIGD subtype obtained more severe scores than patients with the TD subtype.Conclusion: The TD/mixed/PIGD classification seems to be more suitable for identifying non-motor abnormalities than the TD/mixed/AR classification. [ABSTRACT FROM AUTHOR]

Parkinson’s disease (PD) is characterized by the formation of Lewy bodies (LBs) in dopaminergic neurons. α-Synuclein (α-syn), a major protein component of LBs, is known to regulate synaptic plasticity, with a crucial role in memory and motor function in the central nervous system. Levodopa (L-3,4-dihydroxyphenylalanine; also known as L-DOPA) is considered the most effective medication for controlling the symptoms of PD. However, it is unclear whether L-DOPA improves the neuropathology of PD. In the present study, we investigated the effect of L-DOPA on SH-SY5Y neuronal cells under α-syn-induced toxicity. We assessed the protein and mRNA levels of endoplasmic reticulum (ER) stress and cell death markers using western blot analysis and reverse transcription–PCR. Our data showed that L-DOPA could attenuate ER stress markers, including the levels of activating transcription factor 4 (ATF4), C/EBP homologous protein expression (CHOP), immunoglobulin-heavy-chain-binding protein (BiP), sliced X-box-binding protein 1 (XBP-1), and reduce nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling through dopamine receptor D2 (DRD2) in SH-SY5Y neuronal cells under α-syn-induced toxicity. In conclusion, we suggest that L-DOPA may attenuate the neuropathology of PD by regulating signaling related to DRD2 in neuronal cells under α-syn-induced toxicity. Our study, therefore, indicates an additional role for L-DOPA in the treatment of PD. [ABSTRACT FROM AUTHOR]

Background: Alpha-lipoic acid (aLA) is a strong antioxidant commonly used for treating diabetic polyneuropathy. Previously, we demonstrated the neurorestorative effects of aLA after cerebral ischemia in rats. However, its effects on patients with stroke remain unknown. We investigated whether patients treated with aLA have better functional outcomes after acute ischemic stroke (AIS) and reperfusion therapy than patients not receiving aLA. Methods: In this retrospective study of 172 prospectively registered patients with diabetes and AIS treated with tissue plasminogen activator (tPA), we investigated the relationship between aLA use and functional outcome both after 3 months and after 1 year. The functional outcomes included occurrence of hemorrhagic transformation (HT), early neurological deterioration (END), and early clinical improvement (ECI). Favorable outcomes were defined as modified Rankin Scale (mRS) scores of 0–2. Results: Of the 172 patients with AIS and diabetes, 47 (27.3%) used aLA. In the entire cohort, favorable outcomes occurred at significantly higher rates both at 3 months and at 1 year in those treated with aLA. The risks for END and HT were lower and the occurrence of ECI was higher in patients treated with aLA. In multivariable analysis, aLA use was associated with favorable outcomes both at 3 months and at 1 year. Age, HT, and increased National Institutes of Health Stroke Scale scores were negative predictors of a favorable outcome. Conclusions: The use of aLA in patients with AIS and diabetes who are treated with tPA is associated with favorable outcomes. These results indicate that aLA could be a useful intervention for the treatment of AIS after reperfusion therapy. [ABSTRACT FROM AUTHOR]

Despite the clinical impact of non-motor symptoms (NMS) in Parkinson’s disease (PD), the characteristic NMS in relation to the motor subtypes of PD is not well elucidated. In this study, we enrolled drug-naïve PD patients and compared NMS between PD subtypes. We enrolled 136 drug-naïve, early PD patients and 50 normal controls. All the enrolled PD patients were divided into tremor dominant (TD) and non-tremor dominant (NTD) subtypes. The Non-Motor Symptom Scale and scales for each NMS were completed. We compared NMS and the relationship of NMS with quality of life between normal controls and PD patients, and between the PD subtypes. Comparing with normal controls, PD patients complained of more NMS, especially mood/cognitive symptoms, gastrointestinal symptoms, unexplained pain, weight change, and change in taste or smell. Between the PD subtypes, the NTD subtype showed higher total NMS scale score and sub-score about weight change. Weight change was the characteristic NMS related to NTD subtype even after controlled other variables with logistic regression analysis. Even from the early stage, PD patients suffer from various NMS regardless of dopaminergic medication. Among the various NMS, weight change is the characteristic NMS associated with NTD subtype in PD patients. [ABSTRACT FROM AUTHOR]

Objectives: There has been controversy regarding whether or not people affected by leprosy have more cognitive dysfunction than healthy individuals. The purpose of this study was to assess cognitive functions and activities of daily living (ADL) in people affected by leprosy relative to a control population living in rural areas.Materials and Methods: We assessed cognitive functions and ADL using the Korean Mini-Mental State Examination (K-MMSE), Korean Dementia Screening Questionnaire (KDSQ), and Seoul-Instrumental ADL (S-IADL). Higher scores of K-MMSE and lower scores of both KDSQ and S-IADL are indicative of better functioning. We assessed 224 persons living in Sorokdo who were affected by leprosy and 448 age- and gender-matched control subjects living in Namwon of the Chonbuk province.Results: After adjusting for age, gender, and educational status, the K-MMSE score was found to be significantly higher in people affected by leprosy than in control subjects (23.14 ± 4.89 vs. 22.25 ± 4.62, respectively, P = 0.022). Items related to memory in the KDSQ showed no differences between the groups, but people affected by leprosy had a better score in division for other cognitive functions than controls. On items related to ADL in the KDSQ and S-IADL, people affected by leprosy performed significantly worse compared with controls.Conclusions: Our results suggest that although people affected by leprosy have a lower capacity of ADL, they may have better cognitive functions than normal controls. [ABSTRACT FROM AUTHOR]

Background: The “drip and ship” approach can facilitate an early initiation of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) at community hospitals. New endovascular treatment modalities, such as stent retrieval, have further improved the rate of safe and successful recanalization. We assessed the clinical outcomes of on-demand endovascular therapy in patients with AIS who were transported to a comprehensive stroke center under the “drip and ship” paradigm. Methods: This retrospective study evaluated prospectively registered patients with acute large vessel occlusions in the anterior circulation who underwent endovascular recanalization after IVT at our regional comprehensive stroke center between January 2011 and April 2014. Clinical outcomes and neuroradiological findings were compared between patients who received IVT at the center (direct visit, DV) and at a community hospital (drip and ship, DS). Results: Baseline characteristics such as age, initial National Institutes of Health Stroke Scale (NIHSS) score, and risk factors for stroke were similar, and most patients underwent endovascular therapy with a Solitaire stent (81.9% vs. 89.3% for DV and DS, respectively, P = 0.55). The average initial NIHSS score was 12.15±4.1 (12.06 vs. 12.39 for DV and DS, respectively, P = 0.719). The proportions of long-term favorable outcomes (modified Rankin Scale score ≤2 at 90 days) and successful recanalization (Thrombolysis in Cerebral Ischemia score ≥2b) were not significantly different (P = 0.828 and 0.158, respectively). The mortality rates and occurrences of symptomatic intracerebral hemorrhage were not significantly different (P = 0.999 and 0.267, respectively). Conclusions: The “drip and ship” approach with subsequent endovascular therapy is a feasible treatment concept for patients with acute large vessel occlusion in the anterior circulation that could help improve clinical outcomes in patients with AIS. [ABSTRACT FROM AUTHOR]

It remains controversial whether APOE E4 polymorphism is related to cognitive function in general population. We aimed to evaluate an association between the APOE E4 genotype and cognitive function, and whether this association may differ by age. Cognitive function was assessed using the Korean version of modified Mini-Mental State Examination (K-mMMSE) in 10,371 Koreans aged 45-74 years in Namwon City. According to the APOE E4 status, all participants were classified as non-carriers, heterozygotes, or homozygotes. Multiple linear and logistic regression models were used to evaluate the association between APOE genotypes and cognition. The frequency of APOE genotypes in the study population was 0.4, 10.1, 1.1, 72.9, 14.7 and 0.8 % for E2 E2, E2 E3, E2 E4, E3 E3, E3 E4, and E4 E4, respectively. Compared to the APOE E4 non-carriers, the heterozygotes and homozygotes showed 1.3 and 7.3 % lower K-mMMSE scores at 65-74 years and 0.8 and 4.6 % higher scores at 45-55 years, respectively. Educational attainment modified the effect of APOE E4 on cognitive function in the 45-54 age group ( p for interaction =0.003), showing that the E4 carriers with no-formal education showed significantly higher cognitive function than those with formal education. The present study demonstrates that the effect of APOE E4 on cognitive function depends on age and education. [ABSTRACT FROM AUTHOR]

Abstract: Background: Some recent studies have shown that poor outcomes after acute ischemic stroke (AIS) were closely related to lower serum triglyceride (TG) levels, not hypertriglyceridemia. However, hypertriglyceridemia has been shown to be an independent predictor for poor outcome in patients with coronary artery disease. This study attempted to evaluate the association between serum TG levels and early prognosis of AIS. Methods: We enrolled 736 consecutive patients with AIS. Based on the TG level, patients were divided into 5 groups based on the guidelines of the National Cholesterol Education Program (NCEP). We defined early neurological deterioration (END) as a 4-point or greater deterioration of the NIH stroke scale (NIHSS) score and early clinical improvement (ECI) as a 4-point reduction of NIHSS within a week after symptom onset. We compared patients with END, ECI, and neither END nor ECI. Results: The risk of END was significantly higher in the hyperTG and hypoTG groups compared with the normal group. The percentages of ECI were significantly lower in the hypoTG, borderline, and hyperTG groups compared with the normal group. For END, the multivariable adjusted odds ratios were significantly higher in the hypoTG, borderline, and hyperTG groups compared with the low normal group (50 to 100mg/dl). Conclusions: TG had a nonlinear, J-shaped association with poor outcome and a reverse J-shaped association with good outcome in AIS. This study suggests that both hyperTG and hypoTG can be risk factors for poor early outcome in AIS. [Copyright &y& Elsevier]

Non-contrast enhanced computed tomography (NCCT) is usually performed to estimate bleeding complications immediately after procedures. However, hyperdense areas on NCCT have not yet been understood; different interpretations have been reported in the literature. It remains unclear whether NCCT performed immediately after intra-arterial revascularization (IAR) could be useful for predicting hemorrhagic transformation (HT) or clinical outcomes. Therefore, we investigated the diagnostic values of hyperdense areas on NCCT images obtained immediately after IAR. This was a retrospective study of acute ischemic stroke patients who underwent IAR between October 2007 and December 2010. NCCT scans were routinely obtained immediately after IAR and additional follow-up imaging protocols included diffusion weighted imaging (DWI)/gradient echo imaging (GRE) 24 h after IAR. HT was assessed by means of GRE obtained 24 h after IAR. Hounsfield Unit (HU) of the hyperdensity was measured in the manually drawn regions of interest. A total of 68 patients were analyzed in this study. Twenty-nine patients (42.6%) developed HT on follow-up images. Thirty-eight patients had hyperdense areas on NCCT immediately after IAR. Hyperdensity on NCCT performed immediately after IAR revealed 23 (60.5%) of the 38 patients with six false negative areas. NCCT performed immediately after IAR showed a sensitivity of 79.3%, a specificity of 61.5%, a positive predictive value of 60.5% and a negative predictive value of 80% for HT. The HU value was a predictor of HT without statistical significance (area under curve of 0.629; 95% CI: 0.49-0.76; p = 0.068). In addition, an HU of >90 poorly predicted HT with a low sensitivity (23%) and a high specificity (94%). In conclusion, our results showed that although hyperdensity on NCCT images obtained immediately after IAR had a moderate predictive value for HT, there were limitations to the prediction of subsequent parenchymal hematoma and symptomatic intracranial hemorrhage, with a low specificity and a low positive predictive value. [ABSTRACT FROM AUTHOR]

Background: Mood disorder is a frequent complication of stroke. Comorbid depressive and anxiety disorders are very common, indicating that it is advisable to assess both disorders at the same time. The aim of the present study was to examine the prevalence of post-stroke depression (PSD) and poststroke anxiety (PSA) at baseline and to evaluate factors related to delayed PSD and PSA at 3 months after stroke onset. Methods: This was a prospectively registered and retrospectively analyzed study of patients with acute ischemic stroke between January 2009 and March 2010. Patients included in this study were interviewed in order to evaluate their Hospital Anxiety and Depression Scale (HADS) scores. In this study, each depression and anxiety score was dichotomized into 'nondepressive and nonanxious' (HADS-D and HADS-A ≤7) and 'depressive and anxious' (HADS-D and HADS-A >7). Multiple logistic regression analysis was used to evaluate the independent factors of depressive and anxious symptoms 3 months after stroke onset. Results: Of the 133 patients, 47.4% were 'depressive' and 56.4% were 'anxious' at baseline. The depressive and anxious groups had a significantly higher frequency of severe white matter hyperintensity (WMH) than the nondepressive and nonanxious groups (p < 0.05). The independent factors of PSD and PSA at 3 months were deep white matter hyperintensities (DWMH) and modified Rankin scale 0 to 1 at 3 months. Conclusion: In conclusions, the results of our study demonstrated that delayed depression and anxiety after ischemic stroke were related to the severity of DWMH and unfavorable outcomes at 3 months, regardless of anti-anxiety treatment. Our results suggested that WMH might be associated with pathomechanism of delayed depression and anxiety. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Catechol-O-methyltransferase (COMT) inhibitors are used to increase the bioavailability of therapeutic L-dopa. We examined the efficacy of entacapone in Parkinson's disease patients who had daily "off" duration of ≤2 hours, and carried different COMT polymorphisms. A total of 168 PD patients were recruited from 19 centers. Subjects were administered with 100-200 mg of entacapone in combination with each dose of L-dopa for 2 months. The clinical efficacy was evaluated based on the activities of daily living (ADL), score on the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr (H&Y) stage, and Clinical Global Impression (CGI). COMT polymorphisms were genotyped. 3-O-methyldopa (3-OMD) levels were measured before and after the administration of entacapone. Entacapone administration produced significant improvements in the total daily "on" duration, ADL, UPDRS score, and H&Y stage. Nineteen patients (11.3%) had the low-activity COMT genotype, 68 patients (40.5%) had the intermediate-activity COMT genotype, and 81patients (48.2%) had the high-activity COMT genotype. The efficacy, and adverse effects of entacapone therapy did not differ between the three groups. There was a significant reduction in 3-OMD, but this did not differ among the three genotypes. Entacapone provided an increased "on" duration and improved motor function in all COMT genotypes. [ABSTRACT FROM AUTHOR]

Although high-density lipoprotein (HDL) infusion therapy now seems to be a promising therapy for the treatment of several diseases, including atherosclerosis, myocardial infarction, sepsis, and diabetes, there is a real need for more information on the production, quality, and safety of reconstituted HDL (rHDL). In this context, we described a production-scale preparation of rHDL and examined the reproducibility of the process and product, and its shelf stability over a 24-month period. Apolipoprotein A-I (apoA-I) was isolated from precipitates IV (by plasma fractionation) using polyethylene glycol, ethanol, pH precipitation, and ion-exchange chromatography. This manufacturing process included 3 virus-elimination steps consisting of ethanol precipitation, pasteurization, and nanofiltration. HDLs were then reconstituted through cholate dialysis using soybean phosphatidylcholine. The product released data from 3 separate rHDL production were adequate to fulfill the required specification and admitted range. Following lyophilization, the products were stable in the presence of sucrose for at least 24 months. Redissolved rHDLs were disc-shaped and had sizes ranging from 10 to 20 nm. Studies on structure-function relationships provided evidence that these rHDLs could be used as potential therapeutic agents for acute coronary syndrome and inflammatory diseases. [ABSTRACT FROM AUTHOR]

Background: The mechanisms underlying small deep infarcts in the subcortical area are unknown. This study used coronal diffusion-weighted imaging (DWI) to investigate clinical and radiological findings in patients with small deep infarcts. Methods: This was a retrospective study of consecutively admitted patients with small deep infarcts in the subcortical area. We divided the patients into two groups as follows: (1) those with isolated lesion (IL) defined as an IL in the parenchyma by coronal DWI (group A), and (2) those with linear lesion (LL), defined as a LL extending to the basal surface on coronal DWI (group B). Results: A total of 86 patients were included in this study, with 43 patients in each group. Neurological decline and ipsilateral MCA stenosis were observed more frequently in group B than in group A. Fluid-attenuated inversion recovery (FLAIR) signals showed that white-matter hyperintensity was more severe in group A than in group B (p = 0.015). Conclusions: This study suggests that LL patterns of small deep infarcts may result in a higher rate of neurological decline and ipsilateral MCA stenosis than IL patterns. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Many parameters of multimodal computed tomography (CT) have been assessed to predict clinical outcome and recanalization after thrombolysis. However, an early predictor of fatal stroke has not been clearly identified. Therefore, this study was conducted to identify early predictors related to fatal stroke. Methods: We retrospectively analyzed subjects with acute ischemic stroke within 6 h of onset between March 2007 and January 2009. Early fatal stroke was defined as death or coma within 1 week of the initial ischemic stroke. Multimodal CT images were scored according to previous studies, such as the Alberta Stroke Program Early CT Score (ASPECTS), collateral score (CS) and clot burden score (CBS). Results: A total of 68 patients were analyzed in this study. Twenty-two patients (32.4%) fell into a coma or died within 1 week of the initial stroke. Patients with fatal stroke had a lower CS, CBS and ASPECTS in the cerebral blood volume (CBV) and time-to-peak maps than those with nonfatal stroke. The initial NIHSS score, CBV-ASPECTS, age and diabetes mellitus were associated with fatal infarct in multivariate logistic regression analysis. Conclusions: Our study demonstrated that initially low CBV-ASPECTS on perfusion CT could predict early fatal stroke and that a CBV-ASPECTS threshold of <4 with a modest sensitivity and specificity could be considered as an early predictor of fatal stroke. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Previously published research proposed strengthening and toughening mechanisms of nanocomposites based on dislocation activities even in brittle ceramics. We reported that an intra-type nano-structure could only have the potential to improve strength and fracture toughness due to dislocations formed around the dispersed particles. In this research, nickel dispersed alumina nanocompsoites were fabricated using a novel soaking method, based on the developed strengthening and toughening mechanisms. Commercially available γ-alumina powder with high porosity was used as the starting materials. Secondary, particles were introduced into the nano-pores of the porous γ-alumina powder using a soaking method, where the alumina powder was soaked in a nickel nitrate solution under vacuum. During pre-calcination, nickel oxide particles were generated inside the nano-pores. The alumina powders were then reduced under hydrogen atmosphere to obtain nano-sized metallic nickel inside the γ-alumina grains. The alumina–nickel composite powders were sintered by pulse electric current sintering (PECS) technique with α-alumina seeds. The mechanical properties of specimens were investigated, such as density, three-point strength, and fracture toughness. The maximum strength of the alumina–nickel nanocomposites was 984MPa after being sintered at 1450°C with α-alumina seeds, where the specimen size was 2mm×2mm×10mm. The maximum fracture toughness was 5.5MPam1/2 after being sintered at 1350°C with seeds measured by the single edge V-notched beam method. [Copyright &y& Elsevier]

Kikuchi's disease (KD) is a histiocytic necrotizing lymphadenopathy. KD is an enigmatic, benign, and self-limiting disease characterized by regional lymphadenopathy. It usually affects young Asian women and an involvement of central nervous system is rare in KD and only few cases of aseptic meningitis associated with KD have been reported. Aseptic meningitis in KD might have very close clinical and laboratory findings with other etiologies of meningitis such as viral and tuberculous meningitis and it should be differentiated from those meningitis. Here, we report a case of KD manifested as meningitis with elevated cerebrospinal fluid and serum adenosine deaminase that is common and suggestive feature of tuberculous meningitis. A close observation of the different clinical course and excisional biopsy of regional lymphadenopathy might be critical points for distinguishing meningitis associated with KD from tuberculous meningitis. [ABSTRACT FROM AUTHOR]

The article provides information on the association of cerebral microbleeds (CMBs) with neurological symptoms causing intracerebral hemorrhage (ICH). It states that deposition of amyloid in cerebral blood vessels increases the susceptibility of patient to cerebral infraction, CMB and ICH. MRI study reveals that the CMBs are associated with neurological symptoms which increase during the acute period of ischemic stroke.

A letter to the editor is presented regarding the association of ophthalmic artery stenosis in a patient with recurrent transient monocular blindness.