How the cognitive reserve interacts with β-amyloid deposition in mitigating FDG metabolism: An observational study

This observational study had the aim to assess the interaction between cognitive reserve (CR) and cerebrospinal fluid β-amyloid1-42 (Aβ1-42) in modulating brain [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) metabolism in patients with moderate Alzheimer disease (AD).Twenty-seven patients with probable AD and 25 neurological normal subjects (NNS) entered the study. All participants had an FDG-PET scan, and AD patients also received a lumbar puncture to measure Aβ1-42, 181p-tau, and Tau concentrations. Based on years of formal education, AD patients were classified as highly educated-AD (years of formal education >5) or less educated-AD (years of formal education <5). By using a voxel-wise approach, we first investigated differences in the cerebral glucose uptake between AD and NNS, then we assessed the interaction between level of education (a proxy of CR) and cerebrospinal fluid biomarkers on FDG-PET metabolism in the patient groups.Significantly lower glucose uptake was observed in the posterior cingulate gyrus, in the precuneus, in the inferior and medial temporal gyrus, and in the inferior parietal lobule of AD patients compared with NNS. A significant interaction was found between CR and Aβ1-42 values on brain metabolism in the inferior and medial temporal gyrus bilaterally.The AD patients with higher CR level and marked signs of neuropathology showed glucose hypometabolism in regions typically targeted by AD pathology. This finding supports the hypothesis that CR partially compensates for the effect of Aβ plaques on cognitive impairment, helps in patients' clinical staging, and opens new possibilities for the development of nonpharmacological interventions

Towards sustainability in European agricultural firms

Agricultural activity plays an important role in all 28 Member States (MS) of the European Union (EU) in terms of: -Economics, -Environmental, -Social, and -Political activity. The sector also provides: -agricultural goods and services to support food security; -exports and imports at European and World level; -creation of direct and indirect jobs; and -the maintenance of population living in rural and regional areas.N/

Successful treatment of hypnic headache with topiramate: a case report.

Hypnic headache is a rare cause of benign headache in the elderly. This is a clinical report of a 67-year-old housewife, suffering from hypnic headache, in which topiramate yielded a successful prophylactic effect at 100 mg/da

Pathological gambling plus hypersexuality in restless legs syndrome: a new case.

Emerging clinical data indicate that dopaminergic agonists used to treat restless legs syndrome may be associated with dopamine dysregulation syndrome, particularly pathological gambling. We report a new case with pathological gambling plus hypersexuality and impotence in an old patient treated with a small dose (0.18 mg daily at bedtime) of pramipexole for restless legs syndrome for 5 months. The time relationship and the resolution upon discontinuation of dopaminergic agonists suggest a causative association. Our new case confirms that restless legs syndrome patients should be cautioned about potential dopamine dysregulation syndrome coinciding with dopaminergic agonists, as it can be reversed by drug withdrawa

Indagine epidemiologica sulla Corea di huntington in Puglia nel periodo 1970-79. Dati preliminari

Studio epidemiologico sulla prevalenza della corea di Huntington in Puglia nel periodo 1970-79. La prevalenza è stata calcolata nella misura del 2.94 x 100000, mentre la prevalenza stimata era di 3.42 x 100000 abitanti

Bilateral putaminal necrosis and bronopol toxicity

Among alcohols, methanol intoxication is the most frequently associated with cerebral toxicity, causing retinal damage and putaminal necrosis. This consequence is believed to be due to the transformation of methanol into formic acid. We describe the case of a patient who presented with acute impairment of consciousness and tetraparesis after she had been drinking several bottles of a topical antiseptic solution (Lysoform Medical) containing 2-bromo-2-nitro-1,3-propandiol (bronopol) among excipients, in order to lose weight during previous months. Moreover, she had been on a strict slimming diet. Soon after admission, a severe respiratory and metabolic impairment became rapidly evident, requiring an intensive care unit admission. Cerebral MRI showed the presence of bilateral putaminal necrosis. She recovered in 10 days, surprisingly, without any evident clinical neurological signs. Methanol, also bronopol, when diluted in aqueous solution, at warm temperature and/or higher pH, may release formaldehyde, which is converted into formic acid, a basal ganglia toxic compound

I riflessi vestibolo-oculomotori in rapporto al livello di vigilanza. I. Nistagmo patologico e sonno notturno.

E' stato studiato il comportamento del nistagmo spontaneo da lesioni cerebrali nel corso delle fasi di sonno in 8 pazienti. Il nistagmo, ampio e continuo nelle registrazioni durante la veglia scomparve fin dalla prime fasi dell'addormentamento, nè è stato evidenziato nelle fasi di sonno sincrono. In 3 casi è ricomparso nella fase di sonno REM. La depressione del nistagmo osservato durante il sonno era riferibile all'azione di influenze inibitorie esercitate sui meccanismi del sonno sulle strutture del tronco intercalate sulle vie del riflesso vestibolo-oculare

Early prognosis of epilepsy. Effects of treatment in the first follow-up year

A multicenter prospective investigation was conducted in 17 teaching and general hospital in Italy to assess the efficacy of the care delivered to previously untreated patients with epilepsy: 175 cases were included and allocated to monotherapy. Only 112 cases completed the first year of follow-up. Of these, 59 (52.7%) were completely controlled and 53 (47.3%) had one or more seizure relapses. Controlled and uncontrolled patients were compared with respect to the main variables believed to influence non-responsiveness to standard therapy. The proportion of cases with relapses was significantly associated with the number of seizures reported before treatment was started. Selected seizure patterns (absences, myoclonic seizures) and prolonged disease duration were also reported more frequently among patients with recurrences. The implication of these findings are discussed with respect to drug response and prognosis of epilepsy

Interrelation between stages of sleep and nystagmus due to CNS lesions: polygraphic study

Electropolygraphic reconrding during night sleep were carried out in ten patients with spontaneous nystagmus due to CNS lesions of various etiology. NREM sleep was found to be normal, REM sleep was diminished, while the intermediate stage eas abundantly represented. In some patients with bilateral lesions of the brainstem, REMs were few in number and never clustered; phasin activity of chin muscles during REMs episodesappeared as usual. The nystagmus, which was coarse and sustained during wakefulness with eyes open, and which was only slightly diminished with eyes closed, disappeared at the very onset of sleep and was never seen during NREM sleep. Usaually the nystagmus was also absent during REM sleep with the exception of three cases where nystagmoid jerks were observed during REMs