Thalamic metabolic abnormalities in patients with Huntington's disease measured by magnetic resonance spectroscopy

Huntington's disease (HD) is a neurologic disorder that is not completely understood; its fundamental physiological mechanisms and chemical effects remain somewhat unclear. Among these uncertainties, we can highlight information about the concentrations of brain metabolites, which have been widely discussed. Concentration differences in affected, compared to healthy, individuals could lead to the development of useful tools for evaluating the progression of disease, or to the advance of investigations of different/alternative treatments. The aim of this study was to compare the thalamic concentration of metabolites in HD patients and healthy individuals using magnetic resonance spectroscopy. We used a 2.0-Tesla magnetic field, repetition time of 1500 ms, and echo time of 135 ms. Spectra from 40 adult HD patients and 26 control subjects were compared. Quantitative analysis was performed using the LCModel method. There were statistically significant differences between HD patients and controls in the concentrations of N-acetylaspartate+N-acetylaspartylglutamate (NAA+NAAG; t-test, P<0.001), and glycerophosphocholine+phosphocholine (GPC+PCh; t-test, P=0.001) relative to creatine+phosphocreatine (Cr+PCr). The NAA+NAAG/Cr+PCr ratio was decreased by 9% and GPC+PCh/Cr+PCr increased by 17% in patients compared with controls. There were no correlations between the concentration ratios and clinical features. Although these results could be caused by T1 and T2 changes, rather than variations in metabolite concentrations given the short repetition time and long echo time values used, our findings point to thalamic dysfunction, corroborating prior evidence.72272

Temporomandibular disorders in patients with craniocervical dystonia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Temporomandibular disorders are a set of musculoskeletal dysfunctions within the masticatory system, with multiple etiologies. Objective: Since craniocervical dystonia can involye the same neuromuscular structure as the temporomandibular joint, we sought to assess the correlation between temporomandibular disorders and craniocervical dystonia. Method: We applied the Research Diagnostic Criteria for Temporomandibular Disorders to 42 patients with craniocervical dystonia, in order to identify orofacial pain and temporomandibular characteristics on the day of botulinum toxin injection. Results: Twenty-two patients (52.3%) reported temporomandibular joint pain; 24 (57.1%), joint sounds; 20 (47.6%), masticatory muscle pain; and 21(50%), diminished jaw mobility. The patients with oromandibular dystonia presented temporomandibular disorders more frequently than did patients with other types of craniocervical dystonia (p<0.001). Conclusion: Temporomandibular disorders occur frequently in patients with oromandibular dystonia. Further studies should address the proper treatment of temporomandibular disorders associated with dystonia. Key words: botulinum toxin, cervical dystonia, cranial dystonia, temporomandibular disorders.696896899Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Boehringer IngelheimRocheIpsenFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Família, dificuldades no aprendizado e problemas de comportamento em escolares

Resumo Nos anos escolares, família e escola são contextos em que se engendram mecanismos de risco e proteção para trajetórias favoráveis ou não de desenvolvimento das crianças. Dificuldades adaptativas precoces, expressas em altos níveis de problemas emocionais e/ou comportamentais, têm sido associadas a trajetórias desfavoráveis. O presente estudo objetivou testar um modelo de predição de problemas de comportamento em escolares, tendo como preditores variáveis de apoio ao desenvolvimento e adversidade no contexto familiar, bem como a presença da queixa escolar, sinalizando adversidade no contexto escolar. Participaram 60 crianças, de 7 a 11 anos, e suas mães, recrutadas em escola pública de Ensino Fundamental e em clínica-escola de psicologia. Os instrumentos utilizados foram Matrizes Progressivas Coloridas de Raven, Inventário de Comportamento da Infância e Adolescência (CBCL), Inventário de Recursos do Ambiente Familiar (RAF), subescala Vida Familiar, da Escala de Eventos Adversos (EEA). A coleta ocorreu na clínica e na escola. Os dados foram analisados por meio de regressão linear múltipla, verificando-se o poder explicativo das variáveis ambientais sobre os desfechos comportamentais. Os resultados apontaram a adversidade escolar como principal preditor de problemas de atenção, problemas sociais e comportamento agressivo. A adversidade familiar foi associada a problemas internalizantes e externalizantes. Duas modalidades de apoio familiar (rotina regular no dia a dia e atividades de lazer no tempo livre) parecem implicadas na atenuação dos problemas de comportamento. Destaca-se que esses são recursos passíveis de intervenção