Cerebellar Plasticity in Health and Disease

The cerebellum helps fine-tuning movements by evaluating disparities between intention and action, in order to adjust the execution of movements ‘online’, and to keep movements calibrated in the long term. The cerebellar capacity to store information, which provides the ‘memory’ needed for the recalibration of movements, the learning of new motor skills, and associative learning, is provided by modifications in the strength of synaptic couplings between neurons in the cerebellar circuitry (‘synaptic plasticity’). Cerebellar coordination and motor learning can be affected by degenerative processes, such as paraneoplastic cerebellar ataxia (PCA). This is a severe side effect of certain forms of cancer, usually characterized by the degeneration of Purkinje cells, which provide the sole output of the cerebellar cortex. PCA is associated with the expression of antineuronal autoantibodies. In chapters 2 and 3 we describe two patients with Hodgkin’s disease and PCA associated with a previously undescribed autoantibody against the metabotropic glutamate receptor type 1 (mGluR1). This autoantibody directly interferes with receptor function in vitro, affecting synaptic transmission and spontaneous Purkinje neuronal firing behavior, as well as inhibiting the induction of long-term depression of the parallel fiber to Purkinje cell synapse (PF-LTD), a form of synaptic plasticity widely associated with motor learning. Infusion of these anti-mGluR1 autoantibodies into the cerebellum of mice causes severe, reversible ataxia, indicating that PCA autoantibodies can directly affect Purkinje neuronal function by blocking receptors. Post-mortem analysis of one mGluR1-PCA patient’s cerebellum reveals a reduction in the number of Purkinje cells after chronic exposition to anti-mGluR1 autoantibodies. Together these results indicate that the anti-mGluR1 autoantibodies can cause ataxia by acutely interfering with neuronal function and synaptic plasticity, as well as through a chronic degenerative effect on cerebellar Purkinje cells. The block of PF-LTD by the anti-mGluR1 autoantibodies was also shown to affect the patients’ ability to recalibrate motor output. Cerebellar motor learning in the patients was assessed using a saccade adaptation paradigm, in which the amplitude of voluntary fast eye movements (‘saccades’) is gradually changed by systematically displacing a target during a series of consecutive saccades. Although their saccade performance was within the normal range, the capability to gradually adapt saccade amplitude was impaired in the patients with anti-mGluR1 autoantibodies, adding to the body of evidence that PF-LTD underlies forms of motor learning. In chapter 4, further analysis of saccade adaptation characteristics in humans indicates that this form of motor learning conforms to learning rules similar to those of cerebellar synaptic plasticity processes. The time course of induction and the error-based character of saccade adaptation are in line with the properties of cerebellar synaptic plasticity forms, such as PF-LTD. In chapters 5 and 6, the cellular mechanisms putatively underlying cerebellar motor learning were further explored by studying synaptic plasticity in vitro. PF-LTD can be induced by coactivation of parallel fiber (PF) and climbing fiber (CF) input at low frequencies, and is expressed as a reduction in AMPA glutamate receptors on the postsynaptic membrane. This selectively decreases the effect of glutamate released by the PFs that were concurrently active with the CF. In order to prevent synapse saturation and to allow reversal of motor learning, this reduction of PF-Purkinje cell synaptic strength must be counterbalanced by a form of potentiation that is also expressed postsynaptically. This modification, called long-term potentiation of the PF – Purkinje cell synapse (PF-LTP), can be induced by tetanizing only the PF at low frequencies. CF¬evoked calcium transients into the Purkinje cell are shown to be the polarity switch factor making the difference between PF-LTD and PF-LTP induction. Long-term depression of synaptic strength can also be induced at the CF – Purkinje cell synapse (CF-LTD), by high-frequent CF activity. CF-LTD reduces the amplitude of the CF¬evoked calcium transient, which is shown to inhibit the induction of PF-LTD. The concept arises that the cerebellar circuitry uses multiple interacting mechanisms to calibrate its output

Faktor-Faktor yang Mempengaruhi Keaktifan Lansia Mengikuti Kegiatan Berorganisasi PWRI Kecamatan Sambungmacan Sragen

Advanced age is the last phase of human life during which their general human will experience a period of decline in terms of both physical and psychological, Seniors generally have the advantage of experience in life that can be useful in society, so that the elderly still have an important role in people's lives one social activity among full duty or retired civil servants. Goals forknow the characteristics of the elderly and the factors that affect the activity of the elderly participated in PWRI organized Sambungmacan District of Sragen. Methods descriptive study using cross sectional approach. The study population is numbering 47 people, the study sample as many as 47 elderly with a total sampling technique. Data collection research using questionnaires and documentation attendance attendance, while data analysis using logistic regression. The results showed that there was no significant effect of work before retirement (p 0.430) terdadap liveliness. While the physical status shows the results (p 0.019), which means there is an influence on the activity of the elderly. The conclusion of this study the physical status factor strongly influencing the activity of the elderly participated in PWRI organized Sragen. There needs to be an examination of the elderly to get the specific physical health

Depression and Poverty II. Strategies for Intervention

In Part I of this paper, I reviewed the recent findings in psychosocial causes of depression among the poor, and questions raised by them. In this paper, I will suggest certain strategies for intervention for treatment of this population

Depression and Poverty I. Psychosocial and Cultural Determinants

The WorldHealth Organization estimates that over 100 million people worldwide suffer from depression, that three times as many may be affected (1). While major advances have occurred in our understanding of the biological aspects of depression, the understanding of psychosocial causes of depression is still largely sketchy. Thus adequate intervention in dealing with this aspect of treatment of depression is scarce. This paper, divided into two parts, will review recent findings in psychosocial causes of depression and suggest certain strategies.for intervention, speculate on the roles of poverty and the issues raised by poverty on the rates of depression and suggest certain strategies.for intervention in the treatment of depression amongst the poor

Hubungan Tingkat Dukungan Keluarga dengan Kesejahteraan Psikologis Lanjut Usia Anggota PWRI Kecamatan Sambungmacan Bagian Barat Sragen

Proses alamiah yang akan dialami sebagian orang yang mencapai umur panjang adalah proses menua dengan disertai konsekuensi perubahan pada tubuhnya. Keluarga merupakan support system utama bagi lansia dalam mempertahankan kesehatannya. Peranan keluarga dalam perawatan lansia yaitu menjaga atau merawat lansia, mempertahankan dan meningkatkan status mental, mengantisipasi perubahan sosial ekonomi serta memberikan motivasi dan memfasilitasi kebutuhan spritual bagi lansia. Penelitian ini bertujuan untuk mengetahui ada tidaknya hubungan dukungan keluarga dengan kesejahteraan psikologis lanjut usia anggota PWRI Kecamatan Sambungmacan bagian Barat Sragen. Penelitian ini merupakan kuantitatif deskriptif korelasi dengan pendekatan cross sectional. Populasi penelitian adalah seluruh anggota PWRI Kecamatan Sambungmacan bagian Barat Sragen sebanyak 47 orang. Sampel penelitian sebanyak 47 orang anggota PWRI yang ditentukan menggunakan teknik total sampling. Pengumpulan data penelitian menggunakan kuesioner, sedangkan analisis data menggunakan uji Spearman Rank. Hasil penelitian diperoleh nilai signifikansi uji (p-value) lebih rendah dari 0,05 (0,001<0,05) sehingga H0 ditolak. Kesimpulan penelitian adalah terdapat hubungan dukungan keluarga dengan kesejahteraan psikologis lansia anggota PWRI Kecamatan Sambungmacan bagian Barat Sragen, yaitu semakin tinggi tingkat dukungan keluarga, maka tingkat kesejahteraan lansia semakin meningkat. Kata kunci: lansia, dukungan keluarga, kesejahteraan psikologi

Hubungan Aktivitas Mendongeng dengan Konsep Diri Lansia di Paguyuban Purna Bakti Praja Desa Kepuh

Background: Aging is a situation that occurs in human life. Aging process can cause problems both physically, biologically, mentally and socially economically. The decline that occurs in almost all functions that exist in the elderly will result in disruption of self-concept. The declining self-concept will affect the thinking of the elderly in judging him either positively or negatively. This also applies to retirees, since the elderly after retirement will generally lose a role in social society, prestige, power, social contact, economics and even self-esteem. these conditions can trigger stress or even depression in the elderly. Therefore, it should be given support to the elderly by involving the elderly on light activities such as storytelling. Purpose: This study aims to determine the relationship activity of storytelling with the concept of elderly self in Paguyuban Purna Bakti Praja Desa Kepuh. Objects and Methods: The object of this research is the elderly pensioners who joined in Paguyuban Purna Bakti Praja with a total sample of 40 respondents. The research design used descriptive correlation with cross sectional study approach. Data analysis to know correlation on this research using Chi Square test. Result: The value of Chi Square test obtained (p-value) equal to 0.435 so that (p-value) is greater than 0,05. The storytelling activity of the elderly in Paguyuban Purna Bakti Praja is active. The concept of elderly self in Paguyuban Purna Bakti Praja is negative. Conclusion: There is no relationship of storytelling activity with elderly self concept in Paguyuban Purna Bakti Praja Desa Kepuh. Keywords: elderly, storytelling, self concep

The Other Drug War: Societal Attitudes and the Pharmacologic Treatment of Anxiety Disorders

Societal attitudes with respect to mood altering agents have undergone cyclical changes through American history. Cycles of relative tolerance and intolerance affect the perception of psychotropic drugs for illicit use, as well as legitimate medical therapy, often creating confusion between these two realms. This article examines the relationship between the prevailing social climate and the subsequent restrictions placed on the use of opiates. Historical attitudes toward opiate use serve as a model to explore the current social climate as it pertains to the pharmacologic treatment of anxiety. The under treatment of anxiety disorders is hypothesized to result largely from social myths concerning both the nature and treatment of these conditions

Stevens-Johnson Syndrome Following Treatment With Carbamazepine for a Mood Disorder

A case of Stevens-Johnson Syndrome (SJS) induced by carbamazepine in a psychiatric patient with schizo-affective disorder is reported. The patient also had diabetes mellitus and was on glyburide which posed an initial dilemma at the onset of SJS as to the causative drug. In view of the expanding use of carbamazepine in psychiatric patients and the potentially lethal consequences of SJS, the authors suggest a risk management approach when initiating Carbamazepine therapy to reduce the incidence and morbidity of the syndrome