Non-Functional Jaw Muscular Activity in Patients with Disorders of Consciousness Revealed by A Long-Lasting Polygraphy

The presence of involuntary, non-functional jaw muscle activity (NFJMA) has not yet been assessed in patients with disorders of consciousness (DOC), although the presence of bruxism and other forms of movement disorders involving facial muscles is probably more frequent than believed. In this work, we evaluated twenty-two prolonged or chronic DOC patients with a long-lasting polygraphic recording to verify NFJMA occurrence and assess its neurophysiological patterns in this group of patients. A total of 5 out of 22 patients showed the presence of significant NFJMA with electromyographic patterns similar to what can be observed in non-DOC patients with bruxism, thus suggesting a disinhibition of masticatory motor nuclei from the cortical control. On the other hand, in two DOC patients, electromyographic patterns advised for the presence of myorhythmia, thus suggesting a brainstem/diencephalic involvement. Functional, non-invasive tools such as long-lasting polygraphic recordings should be extended to a larger sample of patients, since they are increasingly important in revealing disorders potentially severe and impacting the quality of life of DOC patients

Grasping the semantic of actions: a combined behavioral and MEG study

There is experimental evidence that the brain systems involved in action execution also play a role in action observation and understanding. Recently, it has been suggested that the sensorimotor system is also involved in language processing. Supporting results are slower response times and weaker motor-related MEG Beta band power suppression in semantic decision tasks on single action verbs labels when the stimulus and the motor response involve the same effector. Attenuated power suppression indicates decreased cortical excitability and consequent decreased readiness to act. The embodied approach forwards that the simultaneous involvement of the sensorimotor system in the processing of the linguistic content and in the planning of the response determines this language-motor interference effect. Here, in a combined behavioral and MEG study we investigated to what extent the processing of actions visually presented (i.e., pictures of actions) and verbally described (i.e., verbs in written words) share common neural mechanisms. The findings demonstrated that, whether an action is experienced visually or verbally, its processing engages the sensorimotor system in a comparable way. These results provide further support to the embodied view of semantic processing, suggesting that this process is independent from the modality of presentation of the stimulus, including language

Concomitant radiotherapy and TKI in metastatic EGFR- or ALK-mutated non-small cell lung cancer: a multicentric analysis on behalf of AIRO lung cancer study group

PurposeTo investigate the role of radiotherapy (RT) in the management of EGFR- or ALK-mutated metastatic non-small cell lung cancer (NSCLC) treated with TKI.Materials and methodsClinical data of 106 patients (pts) from five Institutions treated with RT concomitant to TKI were retrospectively revised. Overall survival (OS) and toxicities were analyzed as endpoints of the study.ResultsMedian age of pts was 65years. TKIs were given for EGFR (81%)- or ALK (19%)-mutated metastatic NSCLC. Stereotactic RT (SRT) was delivered to 49 pts (46%). Patients with four or less metastasis were defined as oligometastatic/oligoprogressive (OM/OP); sites of RT were brain, bone, lung or others in 46%, 27%, 14% and 13%, respectively. Median OS was 23months. At univariate analysis SRT, ECOG PS 0-1, OM/OP disease, lung sites and a TKI duration longer than median favorably affected OS (all p14months (HR 0.17, 95% CI 0.10-0.30; p<0.001) as independent factors related to better OS. Toxicities were rare.ConclusionsSRT seems to positively affect OS with limited toxicity in selected patients

Gene expression profile predicts response to the combination of tosedostat and low-dose cytarabine in elderly AML

Tosedostat is an orally administered metalloenzyme inhibitor with antiproliferative and antiangiogenic activity against hematological and solid human cancers. Clinical activity has been demonstrated in relapsed acute myeloid leukemia (AML). Thirty-three elderly patients with AML (median age, 75 years) received 120 mg tosedostat orally once daily combined with subcutaneous low-dose cytarabine (20 mg twice per day for 10 days, up to 8 cycles), until disease progression. Induction mortality was 12%. According to an intention-to-treat analysis, the complete remission (CR) rate was 48.5%, and thus the primary end point of the study was reached (expected CR, 25%). The partial remission rate was 6.1%, with an overall response rate of 54.5%. Furthermore, 4 of 33 patients had stable disease (median: 286 days). The median progression-free survival and overall survival (OS) were 203 days and 222 days, respectively. Responding patients had a longer median OS than nonresponding patients (P = .001). A microarray analysis performed in 29 of 33 patients identified 188 genes associated with clinical response (CR vs no CR). Three of them (CD93, GORASP1, CXCL16) were validated by quantitative polymerase chain reaction, which correctly classified 83% of the patients. Specifically, CR achievement was efficiently predicted by the gene expression patterns, with an overall accuracy exceeding 90%. Finally, a negative predictive value of 100% was validated in an independent series, thus representing the first molecular predictor for clinical response to a specific combination drug treatment for AML. This trial has been registered at the European Medicines Agency and on the European Clinical Trials Database (https://www.clinicaltrialsregister.eu) as #2012-000334-19

Early cortico-muscular coherence and cortical network changes in Parkinson’s patients treated with MRgFUS

IntroductionTo investigate cortical network changes using Magnetoencephalography (MEG) signals in Parkinson’s disease (PD) patients undergoing Magnetic Resonance-guided Focused Ultrasound (MRgFUS) thalamotomy.MethodsWe evaluated the MEG signals in 16 PD patients with drug-refractory tremor before and after 12-month from MRgFUS unilateral lesion of the ventralis intermediate nucleus (Vim) of the thalamus contralateral to the most affected body side. We recorded patients 24 h before (T0) and 24 h after MRgFUS (T1). We analyzed signal epochs recorded at rest and during the isometric extension of the hand contralateral to thalamotomy. We evaluated cortico-muscular coherence (CMC), the out-strength index from non-primary motor areas to the pre-central area and connectivity indexes, using generalized partial directed coherence. Statistical analysis was performed using RMANOVA and post hoct-tests.ResultsMost changes found at T1 compared to T0 occurred in the beta band and included: (1) a re-adjustment of CMC distribution; (2) a reduced out-strength from non-primary motor areas toward the precentral area; (3) strongly reduced clustering coefficient values. These differences mainly occurred during motor activation and with few statistically significant changes at rest. Correlation analysis showed significant relationships between changes of out-strength and clustering coefficient in non-primary motor areas and the changes in clinical scores.DiscussionOne day after MRgFUS thalamotomy, PD patients showed a topographically reordered CMC and decreased cortico-cortical flow, together with a reduced local connection between different nodes. These findings suggest that the reordered cortico-muscular and cortical-networks in the beta band may represent an early physiological readjustment related to MRgFUS Vim lesion

Performance evaluation of IR-UWB in short-range fiber communication using linear combination of monocycles

Abstract-We present the performance evaluation of impulse radio ultrawideband (IR-UWB) over fiber using a simple pulse design technique with a high fractional bandwidth. The technique, based on the linear combination of the first-order Gaussian derivatives with different pulse-shaping factors, shows full compliance with Federal Communications Commission mask requirements even in the most severely power-restricted GPS band. We validated our approach with experiments employing an intensity-modulation direct-detection scheme. The experimental setup uses a directly modulated DFB laser at 1302.56 nm and a multimode fiber-coupled photodetector with 24 m diameter photosensitive area. The transmission link consists of 25 km single-mode fiber or 4.4 km multimode fiber. Error-free transmission at 2 Gb/s is achieved over both fiber links. The result shows the proposed pulse-generation technique to be simple and cost-effective compared to higher order Gaussian derivative schemes. This can be implemented successfully to distribute UWB signals over optical links for access and in-building networks. Index Terms-Impulse radio (IR), in-building network, signal processing, ultrawideband (UWB) communications