Successful Cognitive Aging in Rats: A Role for mGluR5 Glutamate Receptors, Homer 1 Proteins and Downstream Signaling Pathways

Normal aging is associated with impairments in cognition, especially learning and memory. However, major individual differences are known to exist. Using the classical Morris Water Maze (MWM) task, we discriminated a population of 24-months old Long Evans aged rats in two groups - memory-impaired (AI) and memory-unimpaired (AU) in comparison with 6-months old adult animals. AI rats presented deficits in learning, reverse memory and retention. At the molecular level, an increase in metabotropic glutamate receptors 5 (mGluR5) was observed in post-synaptic densities (PSD) in the hippocampus of AU rats after training. Scaffolding Homer 1b/c proteins binding to group 1 mGluR facilitate coupling with its signaling effectors while Homer 1a reduces it. Both Homer 1a and 1b/c levels were up-regulated in the hippocampus PSD of AU animals following MWM task. Using immunohistochemistry we further demonstrated that mGluR5 as well as Homer 1b/c stainings were enhanced in the CA1 hippocampus sub-field of AU animals. In fact mGluR5 and Homer 1 isoforms were more abundant and co-localized in the hippocampal dendrites in AU rats. However, the ratio of Homer 1a/Homer 1b/c bound to mGluR5 in the PSD was four times lower for AU animals compared to AI rats. Consequently, AU animals presented higher PKCγ, ERK, p70S6K, mTOR and CREB activation. Finally the expression of immediate early gene Arc/Arg3.1 was shown to be higher in AU rats in accordance with its role in spatial memory consolidation. On the basis of these results, a model of successful cognitive aging with a critical role for mGluR5, Homer 1 proteins and downstream signalling pathways is proposed here

Sports medicine in The Netherlands: consultation with a sports physician without referral by a general practitioner

Matthijs C de Bruijn,1 Boudewijn J Kollen,2 Frank Baarveld21Center for Sports Medicine, 2Department of General Practice, University Medical Center Groningen, University of Groningen, The NetherlandsBackground: In The Netherlands, sports medicine physicians are involved in the care of about 8% of all sports injuries that occur each year. Some patients consult a sports physician directly, without being referred by a general practitioner. This study aims to determine how many patients consult a sports physician directly, and to explore differences in the profiles of these patients compared with those who are referred.Methods: This was an exploratory cross-sectional study in which all new patients presenting with an injury to a regional sports medical center during September 2010 were identified. The characteristics of patients who self-referred and those who were referred by other medical professionals were compared.Results: A total of 234 patients were included (mean age 33.7 years, 59.1% male). Most of the injuries occurred during soccer and running, particularly injuries of the knee and ankle. In this cohort, 39.3% of patients consulted a sports physician directly. These patients were significantly more often involved in individual sports, consulted a sports physician relatively rapidly after the onset of injury, and had received significantly less care before this new event from medical professionals compared with patients who were referred.Conclusion: In this study, 39.3% of patients with sports injuries consulted a sports physician directly without being referred by another medical professional. The profile of this group of patients differed from that of patients who were referred. The specific roles of general practitioners and sports physicians in medical sports care in The Netherlands needs to be defined further.Keywords: sports injuries, sports medicine physician, primary care, secondary car

Probability of regaining dexterity in the flaccid upper limb - Impact of severity of paresis and time since onset in acute stroke

Background and Purpose-To improve the accuracy of early postonset prediction of motor recovery in the flaccid hemiplegic arm, the effects of change in motor function over time on the accuracy of prediction were evaluated, and a prediction model for the probability of regaining dexterity at 6 months was developed. Methods-In 102 stroke patients, dexterity and paresis were measured with the Action Research Arm Test, Motricity Index, and Fugl-Meyer motor evaluation. For model development, 23 candidate determinants were selected. Logistic regression analysis was used for prognostic factors and model development. Results-At 6 months, some dexterity in the paretic arm was found in 38%, and complete functional recovery was seen in 11.6% of the patients. Total anterior circulation infarcts, right hemisphere strokes, homonymous hemianopia, visual gaze deficit, visual inattention, and paresis were statistically significant related to a poor arm function. Motricity Index leg scores of at least 25 points in the first week and Fugl-Meyer arm scores of 11 points in the second week increasing to 19 points in the fourth week raised the probability of developing some dexterity ( Action Research Arm Test greater than or equal to 10 points) from 74% ( positive predictive value [PPV], 0.74; 95% confidence interval [CI], 0.63 to 0.86) to 94% ( PPV, 0.83; 95% CI, 0.76 to 0.91) at 6 months. No change in probabilities of prediction dexterity was found after 4 weeks. Conclusions-Based on the Fugl-Meyer scores of the flaccid arm, optimal prediction of arm function outcome at 6 months can be made within 4 weeks after onset. Lack of voluntary motor control of the leg in the first week with no emergence of arm synergies at 4 weeks is associated with poor outcome at 6 months

Predictors for a positive outcome of adapted clinical dry bed training in adolescents and adults with enuresis

Item does not contain fulltextAIMS: Adapted Dry Bed Training (Adapted DBT) has been shown to be effective in therapy-resistant adolescents and adults with enuresis. Given the substantial impact of enuresis and the time-consuming nature of Adapted DBT, we investigated which patients benefited most from Adapted DBT. Therefore, we identified predictors for a successful treatment response to Adapted DBT in this population. METHODS: Retrospective cohort study in 907 consecutive patients, aged 11-42 years, subjected to in-hospital Adapted DBT in our Dry Bed Center between January 2003 and July 2013. Outcome was defined as treatment success after six months (primary outcome) and six weeks. Results of logistic regression analyses are presented in odds ratios and 95% confidence intervals. Results : Predictors for a successful treatment response to Adapted DBT in adolescents and adults with enuresis after six months are: gender (female), initial degree of enuresis (mild: 0-3 nights/week), current diaper use, never used anticholinergics in the past, and degree of enuresis six weeks after training. Predictors for successful treatment response after six weeks are: gender and initial degree of enuresis only. LIMITATION: The low explained variance of our model, showing that many other factors, not included in our study, could be of interest in the prediction of success. CONCLUSIONS: Several factors that predicted a successful treatment response of Adapted DBT after six weeks and six months were identified. However, the low explained variance of our model suggests that other non-identified factors are also important in predicting outcome. Neurourol. Urodynam. 35:1006-1010, 2016. (c) 2015 Wiley Periodicals, Inc