Breakfast Staple Types Affect Brain Gray Matter Volume and Cognitive Function in Healthy Children

Childhood diet is important for brain development. Furthermore, the quality of breakfast is thought to affect the cognitive functioning of well-nourished children. To analyze the relationship among breakfast staple type, gray matter volume, and intelligence quotient (IQ) in 290 healthy children, we used magnetic resonance images and applied voxel-based morphometry. We divided subjects into rice, bread, and both groups according to their breakfast staple. We showed that the rice group had a significantly larger gray matter ratio (gray matter volume percentage divided by intracranial volume) and significantly larger regional gray matter volumes of several regions, including the left superior temporal gyrus. The bread group had significantly larger regional gray and white matter volumes of several regions, including the right frontoparietal region. The perceptual organization index (POI; IQ subcomponent) of the rice group was significantly higher than that of the bread group. All analyses were adjusted for age, gender, intracranial volume, socioeconomic status, average weekly frequency of having breakfast, and number of side dishes eaten for breakfast. Although several factors may have affected the results, one possible mechanism underlying the difference between the bread and the rice groups may be the difference in the glycemic index (GI) of these two substances; foods with a low GI are associated with less blood-glucose fluctuation than are those with a high GI. Our study suggests that breakfast staple type affects brain gray and white matter volumes and cognitive function in healthy children; therefore, a diet of optimal nutrition is important for brain maturation during childhood and adolescence

Knowledge of and attitudes to influenza vaccination among community pharmacists in Catalonia (Spain). 2013-2014 season: a cross sectional study

Annual recommendations on influenza seasonal vaccination include community pharmacists, who have low vaccination coverage. The aim of this study was to investigate the relationship between influenza vaccination in community pharmacists and their knowledge of and attitudes to vaccination. An online cross-sectional survey of community pharmacists in Catalonia, Spain, was conducted between September and November 2014. Sociodemographic, professional and clinical variables, the history of influenza vaccination and knowledge of and attitudes to influenza and seasonal influenza vaccination were collected. The survey response rate was 7.33% (506 out of 6906); responses from 463 community pharmacists were included in the final analyses. Analyses were performed using multivariable logistic regression models and stepwise backward selection method for variable selection. The influenza vaccination coverage in season 2013-2014 was 25.1%. There was an association between vaccination and correct knowledge of the virus responsible for epidemics (adjusted Odds Ratio (aOR) = 1.74; 95% CI 1.03-2.95), recommending vaccination in the postpartum (aOR = 3.63; 95% CI 2.01-6.55) and concern about infecting their clients (aOR = 5.27; 95% CI 1.88-14.76). In conclusion, community pharmacists have a very low influenza vaccination coverage, are not very willing to recommend vaccination to all their customers but they are concerned about infecting their clients

Anatomical connectivity of the subgenual cingulate region targeted with deep brain stimulation for treatment-resistant depression.

Chronic deep brain stimulation (DBS) of subgenual cingulate white matter results in dramatic remission of symptoms in some previously treatment-resistant depression patients. The effects of stimulation may be mediated locally or via corticocortical or corticosubcortical connections. We use tractography to define the likely connectivity of cingulate regions stimulated in DBS-responsive patients using diffusion imaging data acquired in healthy control subjects. We defined 2 distinct regions within anterior cingulate cortex based on anatomical connectivity: a pregenual region strongly connected to medial prefrontal and anterior midcingulate cortex and a subgenual region with strongest connections to nucleus accumbens, amygdala, hypothalamus, and orbitofrontal cortex. The location of electrode contact points from 9 patients successfully treated with DBS lies within this subgenual region. The anatomical connectivity of the subgenual cingulate region targeted with DBS for depression supports the hypothesis that treatment efficacy is mediated via effects on a distributed network of frontal, limbic, and visceromotor brain regions. At present, targeting of DBS for depression is based on landmarks visible in conventional magnetic resonance imaging. Preoperatively acquired diffusion imaging for connectivity-based cortical mapping could improve neurosurgical targeting. We hypothesize that the subgenual region with greatest connectivity across the distributed network described here may prove most effective

Long-term results of Deep Brain Stimulation of the Anterior Cingulate Cortex for Neuropathic Pain.

BACKGROUND: Deep Brain Stimulation of the Anterior Cingulate Cortex is a recent technique that has shown some promising short-term results in patients with chronic refractory neuropathic pain. Three years after the first case-series, we assessed its efficacy on a larger cohort, with longer follow-up. METHODS: 24 patients (19 males; 49.1 years) with neuropathic pain underwent bilateral ACC DBS. Patient reported outcome measures were collected pre- and post-surgery, using the Numerical Rating Scale (NRS), Short-Form 36 quality of life (SF-36), McGill pain (MPQ) and EuroQol-5D questionnaires. RESULTS: 22 patients after a trial week were fully internalized and 12 had a mean follow-up of 38.9 months. Six months post-surgery the mean NRS score dropped from 8.0 to 4.27 (P=.004). There was a significant improvement in the MPQ (mean -36%; P=.021) and EQ-5D score significantly decreased (mean -21%; P=.036). The PF domain of SF-36 was significantly improved (mean +54.2%; P=.01). Furthermore, in 83% of these patients: at 6 months NRS was improved by 60% (P<.001) and MPQ decreased by 47% (P<.01). After 1 year, NRS decreased by 43% (P< .01), EQ-5D was significantly reduced (mean -30.8; P=.05) and significant improvements were also observed for different domains of the SF-36. At longer follow-ups, efficacy was sustained up to 42 months in some patients, with a NRS as low as 3. CONCLUSIONS: Follow-up results confirm that ACC DBS alleviates chronic neuropathic pain refractory to pharmacotherapy and improves quality of life in a significant number of patients