Presurgical thalamic hubness predicts surgical outcome in temporal lobe epilepsy.

OBJECTIVE: To characterize the presurgical brain functional architecture presented in patients with temporal lobe epilepsy (TLE) using graph theoretical measures of resting-state fMRI data and to test its association with surgical outcome. METHODS: Fifty-six unilateral patients with TLE, who subsequently underwent anterior temporal lobectomy and were classified as obtaining a seizure-free (Engel class I, n = 35) vs not seizure-free (Engel classes II-IV, n = 21) outcome at 1 year after surgery, and 28 matched healthy controls were enrolled. On the basis of their presurgical resting-state functional connectivity, network properties, including nodal hubness (importance of a node to the network; degree, betweenness, and eigenvector centralities) and integration (global efficiency), were estimated and compared across our experimental groups. Cross-validations with support vector machine (SVM) were used to examine whether selective nodal hubness exceeded standard clinical characteristics in outcome prediction. RESULTS: Compared to the seizure-free patients and healthy controls, the not seizure-free patients displayed a specific increase in nodal hubness (degree and eigenvector centralities) involving both the ipsilateral and contralateral thalami, contributed by an increase in the number of connections to regions distributed mostly in the contralateral hemisphere. Simulating removal of thalamus reduced network integration more dramatically in not seizure-free patients. Lastly, SVM models built on these thalamic hubness measures produced 76% prediction accuracy, while models built with standard clinical variables yielded only 58% accuracy (both were cross-validated). CONCLUSIONS: A thalamic network associated with seizure recurrence may already be established presurgically. Thalamic hubness can serve as a potential biomarker of surgical outcome, outperforming the clinical characteristics commonly used in epilepsy surgery centers

Application of Principal Components Analysis in Kinetics Study for Isometric Squat

Abstract available in the 10th Annual Coaches and Sport Science College

A new noninvasive method for the accurate and precise assessment of varicose vein diameters

The feasibility and reproducibility of a new ultrasonic method for the direct assessment of maximal varicose vein diameter (VVD) were evaluated. A study was also performed to demonstrate the capacity of the method to detect changes in venous diameter induced by a pharmacologic treatment. Patients with varicose vein disease were recruited. A method that allows the precise positioning of patient and transducer and performance of scans in a gel-bath was developed. Maximal VVD was recorded both in the standing and supine positions. The intraassay reproducibility was determined by replicate scans made within 15 minutes in both positions. The interobserver variability was assessed by comparing VVDs measured during the first phase baseline examination with those obtained during baseline examinations in the second phase of the study. The error in reproducibility of VVD determinations was 5.3% when diameters were evaluated in the standing position and 6.4% when assessed in the supine position. The intramethod agreement was high, with a bias between readings of 0.06 ±0.18 mm and of –0.02 ±0.19 mm, respectively, in standing and supine positions. Correlation coefficients were better than 0.99 in both positions. The method appears to be sensitive enough to detect small changes in VVDs induced by treatments. The proposed technique provides a tool of potential valid use in the detection and in vivo monitoring of VVD changes in patients with varicose vein disease. The method offers an innovative approach to obtain a quantitative assessment of varicose vein progression and of treatment effects, thus providing a basis for epidemiologic survey

Establishing a Duration Standard for the Calculation of Session Rating of Perceived Exertion in Ncaa Division I Men’s Soccer

Objectives: The purpose of this study was to determine the best predictor of training and/or match load using session RPE. Design and Methods: 20 NCAA DI male soccer players participated in the study during the 2014 and 2015 competitive seasons. Players completed 15.20 ± 1.05 matches for a total of 304 individual data points and 29.90 ± 1.89. training sessions for a total of 598 individual data points. GPS variables (total distance, High-intensity running distance, and Player load) were analyzed with session RPE using Pearson product-moment correlations. To evaluate various methods of session RPE, “match duration” was recorded using eight different definitions: total match duration including warm-up and half-time, total match duration and warm-up, total match duration and half-time, total match duration only, minutes played including warm-up and half-time, minutes played and warm-up, minutes played and half-time, and minutes played only. A one-way ANOVA with repeated measures was used to determine if differences existed between the eight session RPE calculations. Results: Results from the ANOVA showed that all session RPE measures were significantly different from one another (P \u3c 0.05). Very large correlations were reported between session RPE calculated using minutes played and total distance (0.81), while session RPE calculated using match duration showed less magnitude (0.57). Conclusions: Minutes played should be used to calculate session RPE as it was found to most closely reflect the actual workloads incurred during competitive matches

Time course of forearm arterial compliance changes during reactive hyperemia

Ultrasonic studies have shown that arterial compliance increases after prolonged ischemia. The objective of the present study was to develop an alternative plethysmographic method to investigate compliance, exploring validity and clinical applicability. Forearm pulse volume (FPV) and blood pressure (BP) were used to establish the FPV-BP relationship. Forearm arterial compliance (FAC) was measured, and the area under the FAC-BP curve (FAC(AUC)) was determined. The time course curve of compliance changes during reactive hyperemia was obtained by continuous measurements of FAC(AUC) for 20 s before and for 300 s after arterial occlusion. This technique allows us to effectively assess compliance changes during reactive hyperemia. Furthermore, the selected measurement protocol indicated the necessity for continuous measurements to detect "true" maximal FAC(AUC) changes. On multivariate analysis, preischemic FAC(AUC) was mainly affected by sex, peak FAC(AUC) was affected by sex and systolic BP, percent changes were affected by plasma high-density and low-density lipoprotein cholesterol, peak time was affected by age and body mass index, and descent time was affected by plasma triglyceride levels. The proposed technique is highly sensitive and well comparable with the generally accepted echotracking system. It may thus be considered as an alternative tool to detect and monitor compliance changes induced by arterial occlusion

Increased carotid artery intima-media thickness in subjects with primary hypoalphalipoproteinemia

The plasma concentration of high-density lipoprotein cholesterol (HDL-C) is inversely correlated with the incidence of atherosclerotic vascular events. In the present study we evaluated preintrusive atherosclerosis in subjects with plasma HDL-C at the extremities of normal distribution. Fifty-five subjects with primary hypoalphalipoproteinemia (HypoALP) or hyperalphalipoproteinemia (HyperALP) were compared with fifty-five control subjects with average HDL-C levels, matched for sex, age and plasma cholesterol. The average and maximal intima-media thickness (Avg-IMT and Max-IMT) of 48 carotid segments for each subject were approximately 40% greater in HypoALP than control subjects (0.94\ub10.06 vs. 0.69\ub10.04 mm, p=0.004; and 1.86\ub10.16 vs. 1.35\ub10.10 mm, p=0.025). The IMT values in HyperALP subjects (Avg-IMT: 0.71\ub10.04 and 1.38\ub10.14 mm) were the same as controls. In a large cohort of hyperlipidemic subjects (n=559), significantly greater Avg-IMT and Max-IMT were found in subjects belonging to the first HDL-C quintile (< 42 mg/dl) than all the others. The measurement of carotid IMT in cases with HypoALP and HyperALP, and in a large series of hyperlipidemic patients, thus indicates that a low HDL-C is associated with significant preintrusive atherosclerosis, while a HDL-C above average values does not lead to a further reduction of arterial wall thickening

Assessing and mapping language, attention and executive multidimensional deficits in stroke aphasia.

There is growing awareness that aphasia following a stroke can include deficits in other cognitive functions and that these are predictive of certain aspects of language function, recovery and rehabilitation. However, data on attentional and executive (dys)functions in individuals with stroke aphasia are still scarce and the relationship to underlying lesions is rarely explored. Accordingly in this investigation, an extensive selection of standardized non-verbal neuropsychological tests was administered to 38 individuals with chronic post-stroke aphasia, in addition to detailed language testing and MRI. To establish the core components underlying the variable patients' performance, behavioural data were explored with rotated principal component analyses, first separately for the non-verbal and language tests, then in a combined analysis including all tests. Three orthogonal components for the non-verbal tests were extracted, which were interpreted as shift-update, inhibit-generate and speed. Three components were also extracted for the language tests, representing phonology, semantics and speech quanta. Individual continuous scores on each component were then included in a voxel-based correlational methodology analysis, yielding significant clusters for all components. The shift-update component was associated with a posterior left temporo-occipital and bilateral medial parietal cluster, the inhibit-generate component was mainly associated with left frontal and bilateral medial frontal regions, and the speed component with several small right-sided fronto-parieto-occipital clusters. Two complementary multivariate brain-behaviour mapping methods were also used, which showed converging results. Together the results suggest that a range of brain regions are involved in attention and executive functioning, and that these non-language domains play a role in the abilities of patients with chronic aphasia. In conclusion, our findings confirm and extend our understanding of the multidimensionality of stroke aphasia, emphasize the importance of assessing non-verbal cognition in this patient group and provide directions for future research and clinical practice. We also briefly compare and discuss univariate and multivariate methods for brain-behaviour mapping

Effetto della atorvastatina sulle propriet&#224; funzionali delle arterie dell&#8217;avambraccio in pazienti ipercolesterolemici

Studi sulla funzionalit\ue0 vascolare effettuati in pazienti non aterosclerotici ma dislipidemici, diabetici, o ipertesi, indicano che un adeguato trattamento farmacologico pu\uf2 migliorare le propriet\ue0 funzionali e l\u2019emodinamica delle grandi arterie. Obiettivo del presente studio \ue8 stato quello di valutare se un trattamento ipocolesterolemizzante con atorvastatina (10 mg/die; per sei mesi), fosse in grado di migliorare le caratteristiche di flusso e di compliance arteriosa delle arterie dell\u2019avambraccio in un gruppo di pazienti ipercolesterolemici asintomatici. La funzionalit\ue0 delle arterie dell\u2019avambraccio \ue8 stata valutata sia a livello basale, che dopo somministrazione di vasodilatatori endotelio-dipendenti (infusione diretta intra-arteriosa di acetilcolina), o endotelio-indipendenti (somministrazione sublinguale di nitroglicerina). La terapia con atorvastatina ha indotto una riduzione significativa dei livelli plasmatici di colesterolo totale (-19%), di colesterolo LDL (-25.8%), di trigliceridi (-23.5%) e di ApoB (-18.6%) ed ha aumentato del 10.8% i livelli di colesterolo HDL. Il trattamento non ha invece avuto alcun effetto sull\u2019indice di massa corporea sulla pressione arteriosa o sulla frequenza cardiaca. Per quanto riguarda le variabili emodinamiche di flusso non \ue8 stata osservata alcuna variazione significativa indotta dal trattamento farmacologico. L\u2019atorvastatina non ha influenzato, infatti, n\ue9 i livelli di flusso a riposo n\ue9 le resistenze vascolari basali e tanto meno le corrispondenti variabili post-ischemiche come il flusso durante iperemia o le resistenze minime. Anche per quanto riguarda le variabili di compliance arteriosa dell\u2019avambraccio, non \ue8 stato rilevato alcun effetto del trattamento ipocolesterolemizzante. Non sono state osservate infatti variazioni di compliance arteriosa basale o post ischemica, n\ue9 variazioni nel tempo necessario per raggiungere il picco, nel tempo di mantenimento del picco, nel tempo di discesa o nell\u2019area sotto la curva di variazione di compliance arteriosa post-ischemica. Anche le variazioni di compliance arteriosa indotte da GTN o da ACh non erano influenzate significativamente dal trattamento ipocolesterolemizzante. Infatti, sebbene la somministrazione di questi vasodilatatori abbia indotto un significativo aumento della compliance arteriosa dell\u2019avambraccio a tutti i tempi osservati, non sono osservate differenze n\ue9 nel valore assoluto n\ue9 nella variazione percentuale tra basale, terzo e sesto mese di trattamento con atorvastatina. I dati emersi da questo studio suggeriscono che un trattamento ipocolesterolemizzante a breve termine con 10 mg/die di atorvastatina, sebbene in grado di migliorare significativamente il profilo lipidico, non \ue8 in grado di modificare le propriet\ue0 funzionali delle grandi arterie di pazienti con leggera o moderata ipercolesterolemia primaria