Frontotemporal Dementias: A Review

Dementia is a clinical state characterized by loss of function in multiple cognitive domains. It is a costly disease in terms of both personal suffering and economic loss. Frontotemporal dementia (FTD) is the term now preferred over Picks disease to describe the spectrum of non-Alzheimers dementias characterized by focal atrophy of the frontal and anterior temporal regions of the brain. The prevalence of FTD is considerable, though specific figures vary among different studies. It occurs usually in an age range of 35–75 and it is more common in individuals with a positive family history of dementia. The risk factors associated with this disorder include head injury and family history of FTD. Although there is some controversy regarding the further syndromatic subdivision of the different types of FTD, the three major clinical presentations of FTD include: 1) a frontal or behavioral variant (FvFTD), 2) a temporal, aphasic variant, also called Semantic dementia (SD), and 3) a progressive aphasia (PA). These different variants differ in their clinical presentation, cognitive deficits, and affected brain regions. Patients with FTD should have a neuropsychiatric assessment, neuropsychological testing and neuroimaging studies to confirm and clarify the diagnosis. Treatment for this entity consists of behavioral and pharmacological approaches. Medications such as serotonin reuptake inhibitors, antipsychotics, mood stabilizer and other novel treatments have been used in FTD with different rates of success. Further research should be directed at understanding and developing new diagnostic and therapeutic modalities to improve the patients' prognosis and quality of life

The catatonic dilemma expanded

Catatonia is a common syndrome that was first described in the literature by Karl Kahlbaum in 1874. The literature is still developing and remains unclear on many issues, especially classification, diagnosis, and pathophysiology. Clinicians caring for psychiatric patients with catatonic syndromes continue to face many dilemmas in diagnosis and treatment. We discuss many of the common problems encountered in the care of a catatonic patient, and discuss each problem with a review of the literature. Focus is on practical aspects of classification, epidemiology, differential diagnosis, treatment, medical comorbidity, cognition, emotion, prognosis, and areas for future research in catatonic syndromes

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Comprehensive Review of Psychiatry

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MR Imaging by Using Very Short Echo Time Sequences after Syngeneic Lung Transplantation in Mice

Purpose:To test the in vivo feasibility of magnetic resonance (MR) imaging of ischemia reperfusion injury after syngeneic lung transplantation in mice and to characterize tissue relaxation properties by using very short echo-time (TE) sequences at 4.7 T.Materials and Methods:The experimental protocol was approved by the institutional animal committee. MR imaging was performed in six C57BL/6 mice 24 hours after the animals underwent syngeneic orthotopic left lung transplantation. A small-animal MR imager was equipped with a linear polarized hydrogen birdcage mouse coil. In addition to conventional T1-weighted spoiled gradient-echo and T2-weighted fast spin-echo sequences, three-dimensional very short TE sequences (50-5000 μsec) were performed. Color-encoded parametric maps of T2* transverse relaxation times were calculated on a pixel-by-pixel basis. Quantitative T2* values of the parenchyma of the transplanted lungs and relative spin density were compared by using region-of-interest analysis with the two-sided paired Student t test. After MR imaging, transplanted lungs were processed for histologic examination.Results:Transplanted ventilated lungs in all the mice showed similar low signal intensity with the conventional T1- and T2-weighted sequences. The very short TE sequence exhibited signal yield in the lungs that was higher than that of the noise level. Increased spin density (50.8% ± 26.9 [standard deviation], P = .006) and longer T2* relaxation time (1041 μsec ± 424, P = .016) were found in the transplanted lungs. Best visualization was possible using color-encoded log-transformed parametric T2* maps. Conventional T2-weighted sequences revealed small pleural effusions. Histologic examination demonstrated ischemia reperfusion injury with a predominance of either cell influx or edema.Conclusion:Ischemia reperfusion injury after syngeneic lung transplantation can be visualized and characterized using very short TE sequences showing different MR imaging relaxation properties when compared with normal lung parenchyma.© RSNA, 2012