Frontostriatal deficit in Motor Neuron Disease/Amyotrophic Lateral Sclerosis (MND/ALS)

So far, cognitive derangements in MND/ALS have not been widely studied. Nevertheless, it seems that in subgroups of patients cognitive functions are impaired in different degree, so that often at least two sub-types of the syndrome are reported: Motor Neuron Disease/Amyotrophic Lateral Sclerosis/Dementia Syndrome (MND/ALS/DS) and Motor Neuron Disease/Amyotrophic Lateral Sclerosis/ Aphasia Syndrome (MND/ALS/AS. A third subtype showing both symptoms of cognitive impairment may be identified in subgroups of patients and denominated Motor Neuron Disease/Amyotrophic Lateral Sclerosis/Dementia-Aphasia Syndrome (MND/ALS/DAS). Frontostriatal system is reported as a network heavily damaged in MND/ALS/DS, MND/ALS/AS, MND/ALS/DAS. The system is plausibly responsible of motor skills and verbs production, hence to become aware of a possible frontostriatal deficit in subgroup of MND/ALS patients might consent us to link at the brain level (motor) action and verbs and possibly ideomotor praxia and verbs. We have used Goal-Oriented Perception Task (GOPT) and Action Fluency Task (AFT) in order to detect with some accuracy impairments related to gestaltic analysis directed toward a goal, and verb retrieval deficits possibly underlying executive system dysfunction that destabilizes the ability to mentally coordinate the information associated with a verb. These tests should consent to detect possible frontostriatal derangements. We have tested 10 MND/ALS patients and 10 healthy subjects matched fore age, sex and laterality. AFT showed that 3 out of 6 patients are heavily impaired in this test (6.3 (mean) verbs generated vs 13.3 of the control group). GOPT detected a remarkable impairment in all patients: p=0.0021 (grammatical side), p=0.0002 (perceptual side). Reported frontostriatal deficit in MND/ALS seems confirmed by this study, and probably it is more easily detected by GOPT than by AFT

Migraine mediates the influence of C677T MTHFR genotypes on ischemic stroke risk with a stroke-subtype effect.

BACKGROUND AND PURPOSE: The objective was to investigate the role of C677T MTHFR polymorphism in migraine pathogenesis and in the migraine-ischemic stroke pathway. METHODS: A first genotype-migraine association study was conducted on 100 patients with migraine with aura (MA), 106 with migraine without aura (MO), and 105 subjects without migraine, which provided evidence in favor of association of the TT677 MTHFR genotype with increased risk of MA compared with both control subjects (OR, 2.48; 95% CI, 1.11 to 5.58) and patients with MO (OR, 2.21; 95% CI, 1.01 to 4.82). Based on these findings, mediational models of the genotype-migraine-stroke pathway were fitted on a group of 106 patients with spontaneous cervical artery dissection, 227 young patients whose ischemic stroke was unrelated to a spontaneous cervical artery dissection (noncervical artery dissection), and 187 control subjects, and a genotype-migraine partial mediation model was selected. RESULTS: Both migraine and the TT genotype were more strongly associated to the subgroup of patients with spontaneous cervical artery dissection (OR, 4.06; 95% CI, 1.63 to 10.02 for MA; OR, 5.45; 95% CI, 3.03 to 9.79 for MO; OR, 2.87; 95% CI, 1.45 to 5.68 for TT genotype) than to the subgroup of patients with noncervical artery dissection ischemic stroke (OR, 2.22; 95% CI, 1.00 to 4.96 for MA; OR, 1.81; 95% CI, 1.02 to 3.22 for TT genotype) as compared with controls. CONCLUSIONS: Migraine may act as mediator in the methylenetetrahydrofolate reductase-ischemic stroke pathway with a more prominent effect in the subgroup of patients with spontaneous artery dissection

Enhanced dynamic functional connectivity (whole-brain chronnectome) in chess experts

Multidisciplinary approaches have demonstrated that the brain is potentially modulated by the long-term acquisition and practice of specific skills. Chess playing can be considered a paradigm for shaping brain function, with complex interactions among brain networks possibly enhancing cognitive processing. Dynamic network analysis based on resting-state magnetic resonance imaging (rs-fMRI) can be useful to explore the effect of chess playing on whole-brain fluidity/dynamism (the chronnectome). Dynamic connectivity parameters of 18 professional chess players and 20 beginner chess players were evaluated applying spatial independent component analysis (sICA), sliding-time window correlation, and meta-state approaches to rs-fMRI data. Four indexes of meta-state dynamic fluidity were studied: i) the number of distinct meta-states a subject pass through, ii) the number of switches from one meta-state to another, iii) the span of the realized meta-states (the largest distance between two meta-states that subjects occupied), and iv) the total distance travelled in the state space. Professional chess players exhibited an increased dynamic fluidity, expressed as a higher number of occupied meta-states (meta-state numbers, 75.8 ± 7.9 vs 68.8 ± 12.0, p = 0.043 FDR-corrected) and changes from one meta-state to another (meta-state changes, 77.1 ± 7.3 vs 71.2 ± 11.0, p = 0.043 FDR-corrected) than beginner chess players. Furthermore, professional chess players exhibited an increased dynamic range, with increased traveling between successive meta-states (meta-state total distance, 131.7 ± 17.8 vs 108.7 ± 19.7, p = 0.0004 FDR-corrected). Chess playing may induce changes in brain activity through the modulation of the chronnectome. Future studies are warranted to evaluate if these potential effects lead to enhanced cognitive processing and if "gaming" might be used as a treatment in clinical practice

Nocardiosis in a Kidney-Pancreas Transplant

34-year-old man with chronic renal and pancreas failure in complicated diabetic disease received a kidney-pancreas transplantation. On the 32nd postoperative day, an acute kidney rejection occurred and resolved with OKT3 therapy. The patient also presented refractory urinary infection by E. Fecalis and M. Morganii, and a focal bronchopneumonia in the right-basal lobe resolved with elective chemotherapy. During the 50th post-operative day, an intense soft tissue inflammation localized in the first left metatarsal-phalangeal articulation occurred (Figure 1) followed by an abscess with a cutaneous fistula and extension to the almost totality of foot area. The radiological exam revealed a small osteo-lacunar image localized in the proximal phalanx head of the first finger foot. From the cultural examination of the purulent material, N. Asteroides was identified. An amoxicillin-based treatment was started and continued for three months, with the complete resolution of infection This case is reported for its rarity in our casuistry, and for its difficult differential diagnosis with other potentially serious infections

Bioprospecting on invasive plant species to prevent seed dispersal

The most anthropized regions of the world are characterized by an impressive abundance of invasive plants, which alter local biodiversity and ecosystem services. An alternative strategy to manage these species could be based on the exploitation of their fruits in a framework of bioprospecting to obtain high-added value compounds or phytocomplexes that are useful for humans. Here we tested this hypothesis on three invasive plants (Lonicera japonica Thunb., Phytolacca americana L., and Prunus serotina Ehrh.) in the Po plain (northern Italy) which bear fruits that are highly consumed by frugivorous birds and therefore dispersed over large distances. Our biochemical analyses revealed that unripe fruit shows high antioxidant properties due to the presence of several classes of polyphenols, which have a high benchmark value on the market. Fruit collection for phytochemical extraction could really prevent seed dispersal mediated by frugivorous animals and produce economic gains to support local management actions

Long-Term Risk of Arterial Thrombosis after Intracerebral Hemorrhage: MUCH-Italy

BACKGROUND: The identification of patients surviving an acute intracerebral hemorrhage who are at a long-term risk of arterial thrombosis is a poorly defined, crucial issue for clinicians. METHODS: In the setting of the MUCH-Italy (Multicenter Study on Cerebral Haemorrhage in Italy) prospective observational cohort, we enrolled and followed up consecutive 30-day intracerebral hemorrhage survivors to assess the long-term incidence of arterial thrombotic events, to assess the impact of clinical and radiological variables on the risk of these events, and to develop a tool for estimating such a risk at the individual level. Primary end point was a composite of ischemic stroke, myocardial infarction, or other arterial thrombotic events. A point-scoring system was generated by the β-coefficients of the variables independently associated with the long-term risk of arterial thrombosis, and the predictive MUCH score was calculated as the sum of the weighted scores. RESULTS: Overall, 1729 patients (median follow-up time, 43 months [25th to 75th percentile, 69.0]) qualified for inclusion. Arterial thrombotic events occurred in 169 (9.7%) patients. Male sex, diabetes, hypercholesterolemia, atrial fibrillation, and personal history of coronary artery disease were associated with increased long-term risk of arterial thrombosis, whereas the use of statins and antithrombotic medications after the acute intracerebral hemorrhage was associated with a reduced risk. The area under the receiver operating characteristic curve of the MUCH score predictive validity was 0.716 (95% CI, 0.56-0.81) for the 0- to 1-year score, 0.672 (95% CI, 0.58-0.73) for the 0- to 5-year score, and 0.744 (95% CI, 0.65-0.81) for the 0- to 10-year score. C statistic for the prediction of events that occur from 0 to 10 years was 0.69 (95% CI, 0.64-0.74). CONCLUSIONS: Intracerebral hemorrhage survivors are at high long-term risk of arterial thrombosis. The MUCH score may serve as a simple tool for risk estimation