Examining the effects of adjuvant chemotherapy on cognition and the impact of any cognitive impairment on quality of life in colorectal cancer patients: study protocol

Background: Research suggests that chemotherapy can cause deficits in both patients’ objectively measured and self-reported cognitive abilities which can in turn affect their quality of life (QoL). The majority of research studies have used post-treatment retrospective designs or have not included a control group in prospective cohorts. This has limited the conclusions that can be drawn from the results. There have also been a disproportionate number of studies focussed on women with breast cancer, which has limited the generalisability of the results to other cancer populations. Aim: This study aims to identify the extent and impact of chemotherapy-induced cognitive decline in colorectal cancer patients. Possible associations with poorer QoL will also be explored. Design: This will be a longitudinal controlled cohort study. Questionnaires measuring subjective cognitive functioning, QoL, fatigue and mood, and neuropsychological assessments of objective cognitive function will be collected pre-, mid- and post- chemotherapy treatment from a consecutive sample of 78 colorectal cancer patients from five London NHS Trusts. A further 78 colorectal cancer surgery only patients will be assessed at equivalent time points; this will allow the researchers to compare the results of patients undergoing surgery, but not chemotherapy against those receiving both treatments. Pre- and post-chemotherapy difference scores will be calculated to detect subtle changes in cognitive function as measured by the objective neuropsychological assessments and the self-reported questionnaires. A standardised zscore will be computed for every patient on each neuropsychological test, and for each test at each time point. The post-chemotherapy score will then be subtracted from the pre-chemotherapy score to produce a relative difference score for each patient. ANCOVA will be used to compare mean difference z-scores between the chemotherapy and surgery-only groups while controlling for the effects of gender, age, depression, anxiety, fatigue and education. Discussion: The result from this study will indicate whether a decline in cognitive functioning can be attributed to chemotherapy or to disease, surgical or some other confounding factor. Identification of risk factors for cognitive deficits may be used to inform targeted interventions, in order to improve QoL and help patients’ cope

The development and general morphology of the telencephalon of actinopterygian fishes: synopsis, documentation and commentary

The Actinopterygii or ray-finned fishes comprise, in addition to the large superorder of teleosts, four other superorders, namely the cladistians, the chondrosteans, the ginglymodes, and the halecomorphs, each with a limited number of species. The telencephalon of actinopterygian fishes differs from that in all other vertebrates in that it consists of a pair of solid lobes. Lateral ventricles surrounded by nervous tissue are entirely lacking. At the end of the nineteenth century, the theory was advanced that the unusual configuration of the forebrain in actinopterygians results from an outward bending or eversion of its lateral walls. This theory was accepted by some authors, rejected or neglected by others, and modified by some other authors. The present paper is based on the data derived from the literature, complemented by new observations on a large collection of histological material comprising specimens of all five actinopterygian superorders. The paper consists of three parts. In the first, a survey of the development of the telencephalon in actinopterygian fishes is presented. The data collected show clearly that an outward bending or eversion of the pallial parts of the solid hemispheres is the principal morphogenetic event in all five actinopterygian superorders. In all of these superorders, except for the cladistians, eversion is coupled with a marked thickening of the pallial walls. In the second part, some aspects of the general morphology of the telencephalon in mature actinopterygians are highlighted. It is pointed out that (1) the degree of eversion varies considerably among the various actinopterygian groups; (2) eversion leads to the transformation of the telencephalic roof plate into a wide membrane or tela choroidea, which is bilaterally attached to the lateral or ventrolateral aspect of the solid hemispheres; (3) the lines of attachment or taeniae of the tela choroidea form the most important landmarks in the telencephalon of actinopterygians, indicating the sites where the greatly enlarged ventricular surface of the hemispheres ends and its reduced meningeal surface begins; (4) the meningeal surface of the telencephalon shows in most actinopterygians bilaterally a longitudinally oriented sulcus externus, the depth of which is generally positively correlated with the degree of eversion; (5) a distinct lateral olfactory tract, occupying a constant topological position close to the taenia, is present in all actinopterygians studied; and (6) this tract is not homologous to the tract of the same name in the evaginated and inverted forebrains of other groups of vertebrates. In the third and final section, the concept that the structural organization of the pallium in actinopterygians can be fully explained by a simple eversion of its walls, and the various theories, according to which the eversion is complicated by extensive shifts of its constituent cell groups, are discussed and evaluated. It is concluded that there are no reasons to doubt that the pallium of actinopterygian fishes is the product of a simple and complete eversion

The alterations of tonus and movements through the interplay between the cerebral hemispheres and the cerebellum

This paper deals with the experimental production of involuntary movenients and abnormal tonus in macaques ( Macacu mulatta ) and their alterations in these animals and in children with cerebral palsy and other cerebral lesions. The first major subdivision of the paper has three parts. The first part describes the effects of lesions in the macaque cerebral hemispheres, ranging from a small destructive lesion in area 4 to an essentially complete bicortectomy. The case histories of a few patients document some of the results. The second part reports the effects of lesions in the macaque cerebellum ranging from small vermal injuries to complete cerebellectomies. The third part is concerned with successive lesions in the cerebellum and cerebral hemispheres of macaques and with planned cerebellar lesions in a few children with grave hypertonicity and marked involuntary movements. This subdivision is illustrated with photographs of the monkeys and the children at various stages of the procedures, photographs of many monkey brains at postmortem, and some photomicrographs showing lesions. The second major subdivision has a discussion of the anatomic and the physiologic bases for the experimental results obtained and for the operations on the children. It correlates the material presented with data from the literature and is illustrated with photomicrographs of degenerated tracts and with diagrams. The paper stresses the balancing of cerebral hemisphere and cerebellar discharges in the regulation of tonus and in the stabilizing of movements. It discusses the possibility of producing more effective tonus by making carefully planned lesions in cerebellar areas of animals or of children with highly handicapping hypertonicity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/49991/1/901270502_ftp.pd

Narcolepsy. Aspects of the psychiatric phenotype

Contains fulltext : 90831.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 31 augustus 2011Promotores : Buitelaar, J.K., Renier, W.O. Co-promotor : Overeem, S.175 p

Treatment of delirium with phototherapy: a case report

Contains fulltext : 22439.pdf (publisher's version ) (Open Access

Perifere benzodiazepinereceptoren. Spelen perifere benzodiazepinereceptoren een rol bij menselijke stressreacties?

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Diurnal increase in lower frequencies in narcoleptic EEG

Contains fulltext : 64199.pdf (publisher's version ) (Open Access