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Aim: To compare safety and functional outcomes of intravenous thrombolysis (IVT) between females and males with acute ischaemic stroke (AIS) in relation to preadmission use of antiplatelets. Methods: Multicentre cohort study of patients admitted from 1 January 2014 to 31 January 2020 to hospitals participating in the Swiss Stroke Registry, presenting with AIS and receiving IVT. Primary safety outcome was in-hospital symptomatic intracerebral haemorrhage (sICH). Primary functional outcome was functional independence at 3 months after discharge. Multivariable logistic regression models were fitted to assess the association between sex and each outcome according to preadmission use of antiplatelets. Results: The study included 4996 patients (42.51 % females, older than males, median age 79 vs 71 years, p < 0.0001). Comparable proportions of females (39.92 %) and males (40.39 %) used antiplatelets before admission (p = 0.74). In total, 3.06 % females and 2.47 % males developed in-hospital sICH (p = 0.19), with similar odds (adjusted odds ratio, [AOR] 0.93, 95 % confidence interval, [CI] 0.63–1.39). No interaction was found between sex and preadmission use of either single or dual antiplatelets in relation to in-hospital sICH (p = 0.94 and p = 0.23). Males had higher odds of functional independence at 3 months (AOR 1.34, 95 % CI 1.09–1.65), regardless of preadmission use of antiplatelets (interaction between sex and preadmission use of either single or dual antiplatelets p = 0.41 and p = 0.58). Conclusion: No sex differences were observed in the safety of IVT regarding preadmission use of antiplatelets. Males showed more favourable 3-month functional independence than females; however, this sex difference was apparently not explained by a sex-specific mechanism related to preadmission use of antiplatelets.

Pareidolias, the illusory perception of patterns like faces or animals in backgrounds or textures (e.g., clouds), may be a potentially interesting paradigm to assess creativity. The present study investigates the relationship between production of pareidolias, divergent thinking, and associative thinking. To analyze creative aspects of pareidolias a tablet-based task was devised, the Divergent Pareidolias Task (DPT), where participants were presented with photographs of natural landscapes and they were asked to produce pareidolias. Pareidolic outputs were analyzed in terms of fluency, flexibility, and originality. Creativityrelated cognitive tasks (i.e., tasks assessing alertness, cognitive inhibition, and verbal intelligence) and a short interview assessing creative interests in everyday life were additionally administered. Regression analyses revealed that divergent thinking, in terms of fluency of the Alternative Uses Task significantly predicted fluency and originality of pareidolias produced in the DPT. Moreover, fluent and rarer associations in an Associative Fluency Task were predictive of fluent and original aspects of pareidolias in the DPT, respectively. Taken together, the results of this pilot study indicate the involvement of creative processes in the production of pareidolias and suggest that the DPT could represent a possible future way to investigate divergent aspects of creative cognition.

The analysis of eye movement parameters in visual neglect such as cumulative fixation duration, saccade amplitude, or the numbers of saccades has been used to probe attention deficits in neglect patients, since the pattern of exploratory eye movements has been taken as a strong index of attention distribution. The current overview of the literature of visual neglect has its emphasis on studies dealing with eye movement and exploration analysis. We present our own results in 15 neglect patients. The free exploration behavior was analyzed in these patients presenting 32 naturalistic color photographs of everyday scenes. Cumulative fixation duration, spatial distribution of fixations in the horizontal and vertical plane, the number and amplitude of exploratory saccades was analyzed and compared with the results of an age-matched control group. A main result of our study was that in neglect patients, fixation distribution of free exploration of natural scenes is not only influenced by the left-right bias in the horizontal direction but also by the vertical direction

Zusammenfassung: Das Kernsymptom des Ganser-Syndroms besteht im "Vorbeiantworten" auf einfache Fragen. Die Ursache dieses seltenen Syndroms ist unklar. Aktuelle Klassifikationssysteme zählen es zu den dissoziativen Störungen, wobei eine psychogene Ursache der Symptome angenommen wird. Anhand einer Literaturrecherche (n=151) wird jedoch gezeigt, dass das Ganser-Syndrom sehr häufig mit Hirnverletzungen assoziiert ist, wobei detaillierte bildgebende, neuropsychologische und neurologische Untersuchungen weitgehend fehlen. Wir stellen eine rechtshändige Patientin mit einem Ganser-Syndrom nach einem großen linkshemisphärischen Mediainfarkt vor. Die detaillierte neuropsychologische Untersuchung zeigte eine untypische Lateralisierung kognitiver Funktionen mit einer sog. gekreuzten Nichtaphasie und ausgeprägten frontal-exekutiven Funktionsstörungen. Unter Berücksichtigung sowohl der psychiatrischen als auch der neuropsychologischen Aspekte wird diskutiert, in welchem Zusammenhang das psychopathologische Symptom des "Vorbeiantwortens" mit spezifischen frontal-exekutiven Hirnfunktionsstörungen stehen könnte

One of the leading approaches to non-invasively treat a variety of brain disorders is transcranial magnetic stimulation (TMS). However, despite its clinical prevalence, very little is known about the action of TMS at the cellular level let alone what effect it might have at the subcellular level (e.g. dendrites). Here, we examine the effect of single-pulse TMS on dendritic activity in layer 5 pyramidal neurons of the somatosensory cortex using an optical fiber imaging approach. We find that TMS causes GABAB-mediated inhibition of sensory-evoked dendritic Ca(2+) activity. We conclude that TMS directly activates fibers within the upper cortical layers that leads to the activation of dendrite-targeting inhibitory neurons which in turn suppress dendritic Ca(2+) activity. This result implies a specificity of TMS at the dendritic level that could in principle be exploited for investigating these structures non-invasively.

A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy, consciousness disorders, tinnitus, depression, anxiety disorders, obsessive-compulsive disorder, schizophrenia, craving/addiction, and conversion. Despite unavoidable inhomogeneities, there is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC). A Level B recommendation (probable efficacy) is proposed for the antidepressant effect of low-frequency (LF) rTMS of the right DLPFC, HF-rTMS of the left DLPFC for the negative symptoms of schizophrenia, and LF-rTMS of contralesional M1 in chronic motor stroke. The effects of rTMS in a number of indications reach level C (possible efficacy), including LF-rTMS of the left temporoparietal cortex in tinnitus and auditory hallucinations. It remains to determine how to optimize rTMS protocols and techniques to give them relevance in routine clinical practice. In addition, professionals carrying out rTMS protocols should undergo rigorous training to ensure the quality of the technical realization, guarantee the proper care of patients, and maximize the chances of success. Under these conditions, the therapeutic use of rTMS should be able to develop in the coming years.