Microstructural abnormalities in deep and superficial white matter in youths with mild traumatic brain injury

BACKGROUND: Diffusion Tensor Imaging (DTI) studies of traumatic brain injury (TBI) have focused on alterations in microstructural features of deep white matter fibers (DWM), though post-mortem studies have demonstrated that injured axons are often observed at the gray-white matter interface where superficial white matter fibers (SWM) mediate local connectivity. OBJECTIVES: To examine microstructural alterations in SWM and DWM in youths with a history of mild TBI and examine the relationship between white matter alterations and attention. METHODS: Using DTIDWM fractional anisotropy (FA) and SWM FA in youths with mild TBI (TBI, n=63) were compared to typically developing and psychopathology matched control groups (n=63 each). Following tract-based spatial statistics, SWM FA was assessed by applying a probabilistic tractography derived SWM mask, and DWM FA was captured with a white matter fiber tract mask. Voxel-wise z-score calculations were used to derive a count of voxels with abnormally high and low FA for each participant. Analyses examined DWM and SWM FA differences between TBI and control groups, the relationship between attention and DWM and SWM FA and the relative susceptibility of SWM compared to DWM FA to alterations associated with mild TBI. RESULTS: Case-based comparisons revealed more voxels with low FA and fewer voxels with high FA in SWM in youths with mild TBI compared to both control groups. Equivalent comparisons in DWM revealed a similar pattern of results, however, no group differences for low FA in DWM were found between mild TBI and the control group with matched psychopathology. Slower processing speed on the attention task was correlated with the number of voxels with low FA in SWM in youths with mild TBI. CONCLUSIONS: Within a sample of youths with a history of mild TBI, this study identified abnormalities in SWM microstructure associated with processing speed. The majority of DTI studies of TBI have focused on long-range DWM fiber tracts, often overlooking the SWM fiber type

Imaging-Genetics in Autism Spectrum Disorder: Advances, Translational Impact, and Future Directions

Autism Spectrum Disorder (ASD) refers to a group of heterogeneous neurodevelopmental disorders that are unified by impairments in reciprocal social communication and a pattern of inflexible behaviors. Recent genetic advances have resolved some of the complexity of the genetic architecture underlying ASD by identifying several genetic variants that contribute to the disorder. Different etiological pathways associated with ASD may converge through effects on common molecular mechanisms, such as synaptogenesis, neuronal motility, and axonal guidance. Recently, with more sophisticated techniques, neuroimaging, and neuropathological studies have provided some consistency of evidence that altered structure, activity, and connectivity within complex neural networks is present in ASD, compared to typically developing children. The imaging-genetics approach promises to help bridge the gap between genetic variation, resultant biological effects on the brain, and production of complex neuropsychiatric symptoms. Here, we review recent findings from the developing field of imaging-genetics applied to ASD. Studies to date have indicated that relevant risk genes are associated with alterations in circuits that mediate socio-emotional, visuo-spatial, and language processing. Longitudinal studies ideally focused on early development, in conjunction with investigation for gene–gene, and gene–environment interactions may move the promise of imaging-genetics in ASD closer to the clinical domain

Aspekte der protestantischen Spiritualität Felix Mendelssohn Bartholdys, eruiert unter dem Schwerpunkt der Genese seines Paulus-Librettos

Felix Mendelssohn Bartholdys christliches Selbstbild steht heute gemeinhin außer Frage. Jedoch ist nach wie vor von Interesse, auf welche Weise er seine protestantische Spiritualität ganz konkret auslebte und welcherart seine Glaubensüberzeugungen waren. Diesen Fragen widmet sich diese Staatsexamensarbeit, wobei neben dem Konfirmationsbekenntnis aus dem Jahr 1825 und weiteren schriftlichen Quellen (vornehmlich die Korrespondenz mit Julius Schubring) insbesondere der Entstehungsprozess des mendelssohnschen Oratoriums Paulus Beachtung findet. Die Forschungsfrage lautet: Inwiefern lassen sich aus der Analyse des Konfirmationsbekenntnisses sowie des Entstehungsprozesses des Oratoriums Paulus von Felix Mendelssohn Bartholdy Schlüsse auf dessen protestantische Spiritualität ziehen? Es werden folgende Hypothesen überprüft: 1. Das Konfirmationsbekenntnis sowie der Entstehungsprozess des Oratoriums Paulus legen nahe, dass Mendelssohns protestantische Spiritualität weniger in der schlichten Bibelgläubigkeit des Pietismus als vielmehr in einem aufgeklärten, eher rationalistischen Protestantismus bestand. 2. Im Libretto des Paulus können Anhaltspunkte der Theologie Friedrich Daniel Ernst Schleiermachers nachgewiesen werden, die darauf schließen lassen, dass Mendelssohn diese teilte und infolgedessen als ein Anhänger Schleiermachers bezeichnet werden darf.:1. Einleitung 1.1 Relevanz der Thematik 1.2 Forschungsfrage und Hypothesen 2. Mendelssohns religiöse Prägung in der Kindheit 2.1 Der Einfluss der Eltern 2.2 Das Konfirmationsbekenntnis 2.2.1 Vorbemerkungen und Forschungsstand 2.2.2 Erkenntnisse aus dem Dokument 2.2.3 Resümee 3. Die Genese des Paulus-Librettos 3.1 Umstände der Entstehung 3.2 Theologen, die bzgl. der Genese Einfluss auf Mendelssohn nahmen 3.2.1 Friedrich Daniel Ernst Schleiermacher (1768-1834) 3.2.2 Julius Schubring (1806-1889) 3.3 Die Zusammenarbeit mit Schubring 3.3.1 Theologische Erwägungen zu zwei werkgenetischen Aspekten 3.3.1.1 Die Choralfrage 3.3.1.2 Die biblische Grundlage 3.3.2 Erfahrungen mit dem Pietismus 1830 3.3.3 Erfahrungen mit dem Pietismus 1834 3.4 Theologische Dimensionen des Librettos 3.4.1 Die Theologie Schleiermachers im Paulus 3.4.1.1 Vergleich mit einer Predigt Schleiermachers vom 19.08.1810 4.4.1.2 Zwei weitere Aspekte 3.4.2 Schlussfolgerungen aus der Verwendung der Choräle 3.4.3 Schlussfolgerungen aus der Auswahl der biblischen Textgrundlage 4. Diskussion der Ergebnisse unter Einbezug des Elias und Christus 5. Quellenverzeichnis 5.1 Notenausgabe 5.2 Primärliteratur 5.3 Sekundärliteratur 5.3.1 Monografien 5.3.2 Beiträge aus Sammelbänden und Periodika 6. Selbstständigkeitserklärun

„What makes us happy“ - Internationale Begegnungen im virtuellen Raum: Zu Erfahrungen der virtuellen Summer School im Projekt „Data Literacy in Context – DaLiCo“

Im Rahmen des dreijährigen internationalen Hochschulprojektes „Data Literacy in Context – DaLiCo“ fand Ende September die erste Summer School statt mit internationalen studentischen Teilnehmern, bestehend aus PhD-, Bachelor- und Masterstudierenden aus den Partnerländern des Projektes. Dabei brachte der thematische Fokus Open Governmental Data den Teilnehmenden einen Wissensgewinn und vertieften gemeinsamen Diskurs. Die Möglichkeit an einem gemeinsamen Forschungsprojekten zu arbeiten sowie der Austausch mit internationalen Studierenden und Lehrenden wurde von allen Studierenden als wertvolle Erfahrung geschätzt

Morbidität und Mortalität in der Ösophagus-Chirurgie : Risikostratifizierung anhand einer retrospektiven Analyse

Ein wichtiger ärztlicher Aufgabenbereich ist die Aufklärung der Patienten über die vorliegende Diagnose und die damit verbundenen Therapieoptionen. Eine für den medizinischen Laien verständliche Sprache ist ebenso wichtig wie die Darstellung der einzelnen Behandlungsoptionen und deren Effektivität. Aber auch das mit der Behandlung verbundene Risiko in Form von Nebenwirkungen oder denkbaren Komplikationen während Operation und/oder der Folgebehandlung und der Stellenwert der möglichen Vorerkrankungen der Patienten müssen deutlich dargestellt werden. In der vorliegenden Arbeit wurden retrospektiv die Daten von insgesamt 109 Patienten ausgewertet, die sich im Zeitraum zwischen 2012 und 2015 an der Klinik für Allgemein- und Viszeralchirurgie an den Helios Dr. Horst Schmidt Kliniken Wiesbaden einer Ösophagusresektion aufgrund eines Tumors unterziehen mussten. Unterschieden wurde zwischen dem Auftreten eines Plattenepithel- und eines Adenokarzinoms der Speiseröhre, deren Lage, histopathologischen Ergebnissen, der neoadjuvanten und adjuvanten Behandlung, sowie intra- und postoperativen Aspekten. Besonderes Augenmerk wurde dabei auf die Risiken während der Ösophagektomie und mögliche Folgekomplikationen in der postoperativen Phase gerichtet. Ziel dieser Arbeit war es, die einzelnen Risiken der Ösophagusresektion zu ermitteln, um den Patienten mit Ösophaguskarzinom eine bestmögliche Aufklärung unter Berücksichtigung der Nebendiagnosen und möglicher Komplikationen anbieten zu können. Die vorliegenden Ergebnisse verdeutlichen die Relevanz des ärztlichen Aufklärungsgesprächs. Es wird deutlich, welch wichtige Rolle die individuelle Therapieplanung unter Berücksichtigung des präoperativen Gesundheitszustandes des Patienten (Komorbiditäten, Ernährungszustand, Risikofaktoren wie Alkohol und Nikotin, und andere.), Informationen zum Tumor, Präferenzen des operierenden Chirurgen und Wahl des geeigneten Krankenhauses für diesen Eingriff einnimmt. Dazu wurden die Daten der Patienten ausgewertet und mit der aktuellen Literatur verglichen, vor dem Hintergrund, Informationen über präoperative Optimierungsmöglichkeiten, optimale operative Versorgung und komplikationsarme postoperative Nachsorge zu erhalten. Schlussfolgernd soll damit nicht nur das perioperative Setting, sondern auch die Prognose des Patienten in Hinblick auf das Langzeitüberleben und das rezidivfreie Intervall des Patienten verbessert werden. Diese sollen dann im Aufklärungsgespräch genutzt werden, um gemeinsam mit dem Patienten die für ihn bestmöglichen Therapiemaßnahmen in die Wege leiten zu können.An important medical task is to educate patients about the present diagnosis and the associated treatment options. A language that can be understood by the medical layperson is just as important as the presentation of the individual treatment options and their effectiveness. The risk associated with the treatment in the form of side effects or conceivable complications during surgery and/or follow-up treatment and the significance of the possible pre-existing conditions of the patients must also be clearly described. The present study retrospectively evaluated the data of 109 patients who underwent an esophageal resection due to a tumor at the Clinic for General and Visceral Surgery at the Helios Dr. Horst Schmidt Kliniken Wiesbaden between 2012 and 2015. Distinction was made between the occurrence of squamous cell carcinoma and adenocarcinoma of the esophagus, their location, histopathological findings, neoadjuvant and adjuvant treatment, as well as intraoperative and postoperative aspects. Particular attention was paid to the risks during esophagectomy and possible complications in the postoperative period. The aim of this work was to identify individual risk profiles for patients undergoing esophageal resection due to carcinoma for best possible preoperative education, taking into account the secondary diagnoses and possible complications. The present results clarify the relevance of the medical information discussion. It becomes clear what an important role the individual therapy planning takes, taking into account the preoperative health status of the patient (comorbidities, nutritional status, risk factors such as alcohol and nicotine and more), information on the tumor, preferences of the operating surgeon and choice of the appropriate hospital for this procedure. For this purpose, the data of the patients were evaluated and compared with the current literature in order to obtain information about preoperative optimization possibilities, optimal operative care and postoperative follow-up without complications. Thus, not only the perioperative setting, but also the prognosis of the patient with regard to the long-term survival and the recurrence-free interval of the patient should be improved. These should then be used in the educational discussion in order to be able to launch the best possible therapeutic options together with the patient

Cortical gyrification morphology in individuals with ASD and ADHD across the lifespan: a systematic review and meta-analysis

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are common neurodevelopmental disorders (NDDs) that may impact brain maturation. A number of studies have examined cortical gyrification morphology in both NDDs. Here we review and when possible pool their results to better understand the shared and potentially disorder-specific gyrification features. We searched MEDLINE, PsycINFO, and EMBASE databases, and 24 and 10 studies met the criteria to be included in the systematic review and meta-analysis portions, respectively. Meta-analysis of local Gyrification Index (lGI) findings across ASD studies was conducted with SDM software adapted for surface-based morphometry studies. Meta-regressions were used to explore effects of age, sex, and sample size on gyrification differences. There were no significant differences in gyrification across groups. Qualitative synthesis of remaining ASD studies highlighted heterogeneity in findings. Large-scale ADHD studies reported no differences in gyrification between cases and controls suggesting that, similar to ASD, there is currently no evidence of differences in gyrification morphology compared with controls. Larger, longitudinal studies are needed to further clarify the effects of age, sex, and IQ on cortical gyrification in these NDDs.info:eu-repo/semantics/publishedVersio

Physical health of autistic girls and women: a scoping review.

BACKGROUND: There is a growing recognition of sex and gender influences in autism. Increasingly, studies include comparisons between sexes or genders, but few have focused on clarifying the characteristics of autistic girls'/women's physical health. METHODS: A scoping review was conducted to determine what is currently known about the physical health of autistic girls/women. We screened 1112 unique articles, with 40 studies meeting the inclusion criteria. We used a convergent iterative process to synthesize this content into broad thematic areas. RESULTS: Autistic girls/women experience more overall physical health challenges compared to non-autistic girls/women and to autistic boys/men. Emerging evidence suggests increased prevalence of epilepsy in autistic girls/women compared to non-autistic girls/women and to autistic boys/men. The literature also suggests increased endocrine and reproductive health conditions in autistic girls/women compared to non-autistic girls/women. Findings regarding gastrointestinal, metabolic, nutritional, and immune-related conditions are preliminary and inconsistent. LIMITATIONS: The literature has substantial heterogeneity in how physical health conditions were assessed and reported. Further, our explicit focus on physical health may have constrained the ability to examine interactions between mental and physical health. The widely differing research aims and methodologies make it difficult to reach definitive conclusions. Nevertheless, in keeping with the goals of a scoping review, we were able to identify key themes to guide future research. CONCLUSIONS: The emerging literature suggests that autistic girls/women have heightened rates of physical health challenges compared to non-autistic girls/women and to autistic boys/men. Clinicians should seek to provide holistic care that includes a focus on physical health and develop a women's health lens when providing clinical care to autistic girls/women

Paired-Associative Stimulation-Induced Long-term Potentiation-Like Motor Cortex Plasticity in Healthy Adolescents

ObjectiveThe objective of this study was to evaluate the feasibility of using paired-associative stimulation (PAS) to study excitatory and inhibitory plasticity in adolescents while examining variables that may moderate plasticity (such as sex and environment).MethodsWe recruited 34 healthy adolescents (aged 13–19, 13 males, 21 females). To evaluate excitatory plasticity, we compared mean motor-evoked potentials (MEPs) elicited by single-pulse transcranial magnetic stimulation (TMS) before and after PAS at 0, 15, and 30 min. To evaluate inhibitory plasticity, we evaluated the cortical silent period (CSP) elicited by single-pulse TMS in the contracted hand before and after PAS at 0, 15, and 30 min.ResultsAll participants completed PAS procedures. No adverse events occurred. PAS was well tolerated. PAS-induced significant increases in the ratio of post-PAS MEP to pre-PAS MEP amplitudes (p < 0.01) at all post-PAS intervals. Neither socioeconomic status nor sex was associated with post-PAS MEP changes. PAS induced significant CSP lengthening in males but not females.ConclusionPAS is a feasible, safe, and well-tolerated index of adolescent motor cortical plasticity. Gender may influence PAS-induced changes in cortical inhibition. PAS is safe and well tolerated by healthy adolescents and may be a novel tool with which to study adolescent neuroplasticity

Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond

Abstract: The new coronavirus disease (COVID-19) pandemic is changing how society operates. Environmental changes, disrupted routines, and reduced access to services and social networks will have a unique impact on autistic individuals and their families and will contribute to significant deterioration in some. Access to support is crucial to address vulnerability factors, guide adjustments in home environments, and apply mitigation strategies to improve coping. The current crisis highlights that our regular care systems are not sufficient to meet the needs of the autism communities. In many parts of the world, people have shifted to online school and increased use of remote delivery of healthcare and autism supports. Access to these services needs to be increased to mitigate the negative impact of COVID-19 and future epidemics/pandemics. The rapid expansion in the use of telehealth platforms can have a positive impact on both care and research. It can help to address key priorities for the autism communities including long waitlists for assessment and care, access to services in remote locations, and restricted hours of service. However, system-level changes are urgently needed to ensure equitable access and flexible care models, especially for families and individuals who are socioeconomically disadvantaged. COVID-19 mandates the use of technology to support a broader range of care options and better meet the diverse needs of autistic people and their families. It behooves us to use this crisis as an opportunity to foster resilience not only for a given individual or their family, but also the system: to drive enduring and autism-friendly changes in healthcare, social systems, and the broader socio-ecological contexts