Brain activity pattern changes after adaptive working memory training in multiple sclerosis

Cognitive impairment and related abnormal brain activity are common in people with multiple sclerosis (PwMS). Adaptive training based on working memory (WM) has been shown to ameliorate cognitive symptoms, although the effects at a neural level are unclear. The aim of this study was to expand the existing research on the effects of an adaptive WM rehabilitative intervention on brain functional activity in PwMS. A sample of eighteen PwMS performed an 8-week home-based cognitive rehabilitation treatment based on adaptive WM training. PwMS were assessed before and after treatment using a validated neuropsychological battery and undergoing an fMRI session while carrying out a cognitive task (i.e., Paced Visual Serial Addition Test - PVSAT). fMRI activations were compared to the activation pattern elicited by eighteen matched healthy subjects performing the same task. At baseline, we found abnormal brain activity during PVSAT in PwMS when compared to healthy subjects, with a pattern including several bilateral activation clusters. Following rehabilitation, PwMS improved cognitive performance, as evaluated by the neuropsychological battery, and showed a different activation map with clusters mainly located in the right cerebellum and in the left hemisphere. The only significant cluster in the right hemisphere was located in the inferior parietal lobule, and the BOLD signal extracted in this area significantly correlated with cognitive performance both before and after the treatment. We suggest that WM training can improve the cognitive performance and reduce the abnormal activation of PwMS by partially maintaining or even restoring brain cognitive function

Stato di male non convulsivo. Analisi di 124 casi

Nonconvulsive status epilepticus (NCSE) is defined as a mental status change from baseline during at least 30 minutes associated with continuous or nearly continuous ictal EEG discharges, categorized into complex partial status epilepticus, and generalized nonconvulsive status epilepticus. Despite being often regarded as a benign condition, NCSE is accompanied by serious morbidity and mortality. The clinical signs of NCSE may be subtle or misleading, so that diagnosis and treatment are often delayed. The object of this study is to determinate the natural history of NCSE in a series of 124 adults patients evaluated in a teaching hospital of Genova. Diagnosis was based on EEG and clinical manifestation. Lesional aetiology and consequently the type of NCSE and the absence of clinical and EEG response to BZD administration are associated with poor prognosis

Mechanical properties and metallurgical features of new and ex vivo used reciproc blue and reciproc

AIM: To compare the mechanical properties and metallurgic features of new and used Reciproc Blue and Reciproc instruments. METHODOLOGY: A total of 120 R25Reciproc Blue and R25 Reciproc instruments were used. The morphological, chemical, mechanical, thermal and phase composition characteristics of new and ex vivo used files were investigated by scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDS), focused ions beam analysis (FIB), micro-Raman spectroscopy, optical and SEM metallography, X-ray diffraction (XRD), differential scanning calorimetry (DSC) and indentation tests. Usage-induce degradation was evaluated. Ten new and ten used instruments per type were run until fracture occurred in a stainless-steel artificial canal (60\ub0 angle of curvature, 4-mm radius). Time to fracture and the length of the fractured fragment were recorded. Torque and angle of rotation at failure of ten new and ten used instruments for each type were measured according to ISO 3630-1. The fracture surface of each fragment was examined. Analyses of variance and Bonferroni post hoc tests were used to analyse the data statistically (\u3b1-level 0.05). RESULTS: SEM analysis revealed microcracks near the tip on both files after ex vivo usage tests. FIB imaging and micro-Raman spectroscopy confirmed the presence of an oxide layer on the Reciproc Blue surface. There was no thinning of the coating after use. The area of grains of Reciproc detected by metallographic analysis was significantly wider than Reciproc Blue (P<0.05). XRD revealed a reduction of martensite and R-phase in Reciproc Blue after use. DSC analysis revealed different transformation temperatures for the instruments analysed. Reciproc Blue was significantly more flexible than Reciproc for both new and used samples (P<0.05) and they were significantly more resistant to cyclic fatigue than Reciproc (P<0.05). Ex vivo usage reduced the fatigue resistance of both files. Torsional resistance of Reciproc and Reciproc blue was not reduced by the simulated use (P>0.05). CONCLUSIONS: The thermal treatment of Reciproc Blue produced a finer structure with smaller grains than Reciproc, which increased its fracture resistance and was also responsible for its reduced hardness and lower elastic modulus. Both files were safe during ex vivo usage in severely curved canal

When \u201cExtraneous\u201d Becomes \u201cMine\u201d. Neurophysiological Evidence of Sensorimotor Integration During Observation of Suboptimal Movement Patterns Performed by People with Multiple Sclerosis

Action observation is known to enhance sensorimotor system activation, and such effect has been linked to neural priming and response facilitation mechanisms. This facilitation effect, however, has been primarily studied by focusing on high-level motor proficiency, whereas evidence on the effect of observing poorly performed actions is still lacking. We then devised a study to investigate neural correlates of the observation of suboptimal motor acts as mirrored by corticospinal activation (via transcranial magnetic stimulation (TMS), Experiment 1) and by modulation of cortical oscillatory activity (via electroencephalography (EEG), Experiment 2). 40 participants were presented with four randomly reiterated videos. Videos depicted a healthy confederate, a minimally impaired multiple sclerosis (MS) patient, a mildly impaired MS patient, or a confederate trying to simulate mild motor difficulties performing a test concerning fine motor abilities. In Experiment 1 we analyzed TMS-induced motor-evoked potentials during the observation of videos. In Experiment 2 EEG data were analyzed in the frequency-domain. Analyses highlighted both increased corticospinal excitability and desynchronized alpha-beta oscillations during the observation of poorly performed motor acts performed by the mildly impaired MS patient. Further, we observed gradually increasing beta activity across videos reiterations, specifically for the minimally impaired patient's video. Reported findings corroborate the hypotheses that the action-observation network and the motor system might be involved in processes evoked in the attempt to understand and predict observed actions which do not belong to the onlookers\u2019 motor repertoire, reflecting in an increased sensorimotor activity

Atopy as a risk factor for thyroid autoimmunity in children

Recently, there has been considerable interest in the relationship between allergic and autoimmune diseases. We evaluated the prevalence of thyroid autoimmunity in 566 children affected by atopic dermatitis (AD), urticaria, rhinitis, chronic cough, and asthma. Our results suggest that allergy and autoimmunity can be two potential outcomes of dysregulated immunity. It is tempting to speculate that NK Th2 cells can favour asthma onset and at the same time improve thyroid autoimmunity

Il governo dell'emergenza. Poteri straordinari e di guerra in Europa tra XVI e XX secolo

Nel corso degli ultimi anni, l\u2019universo della politica ha sperimentato una profonda mutazione, in conseguenza del conflitto scatenato contro un nemico in s\ue9 enigmatico e sfuggente come il terrorismo internazionale. La retorica stessa della guerra al terrore sembra infatti aver riportato all\u2019interno dei sistemi di governo occidentali imperativi e logiche di relazione caratteristici dell\u2019universo militare, aprendo la strada al riproporsi di una forma di assolutezz del potere, difficilmente conciliabile con i principi e i valori dello Stato democratico di diritto. Nella storia dell\u2019Europa moderna, non \ue8 certo la prima volta che la logica dell\u2019emergenza si propone come il fondamentale nucleo propulsivo e legittimatorio di una radicale trasformazione delle pratiche politico-istituzionali di governo della societ\ue0. Obiettivo di questo volume \ue8 proprio quello di offrire un contributo ad una pi\uf9 consapevole e problematica comprensione del nostro presente, attraverso la costruzione delle peculiari modalit\ue0 con cui in momenti e luoghi diversi ha potuto concretamente imporsi una concezione drasticamente \u201cesecutiva\u201d della politica, caratterizzata dalla centralit\ue0 di dispositivi di comando assolut