Diffusion Tensor Imaging in a Case of Pontine Bleeding Showing Hypertrophic Olivary Degeneration and Cerebellar Ataxia

We present diffusion tensor tractography (DTT) findings in a case of hypertrophic olivary degeneration (HOD) and cerebellar ataxia. A 56-year-old man presented with abnormal ataxic gait and dysarthria. MRI 5 months after onset showed chronic pontine hematoma and enlarged bilateral inferior olivary nuclei. DTT showed decreased volume of the bilateral central tegmental tract, in accordance with the conventional hypothesis that HOD is associated with neurologic insult to the Guillain-Mollaret triangle. The patient’s cerebellar ataxia was speculated to be due to decreased decussating fibers of the superior cerebellar peduncle, and this was confirmed by DTT

Associations between non-motor symptoms and patient characteristics in Parkinson’s disease: a multicenter cross-sectional study

ObjectiveParkinson’s disease (PD) is characterized by various non-motor symptoms (NMS), such as constipation, olfactory disturbance, sleep disturbance, mental disorders, and motor symptoms. This study aimed to investigate factors associated with NMS in patients with PD.MethodsSymptoms of PD were evaluated using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Parts I–IV. NMS was assessed using the MDS-UPDRS Part I (self-assessment of NMS) and rapid eye movement sleep behavior disorder (RBD) questionnaires. Patients were categorized by age into <70 years and ≥ 70 years (older adults) groups, according to disease duration into early-stage and advanced-stage groups with a cut-off value of 5 years for motor symptoms, and by sex into male and female groups.ResultsA total of 431 patients with PD (202 males and 229 females) with a mean age of 67.7 years, a mean disease duration of 6.4 years, and a mean Part I total score of 9.9 participated in this study. The Part I total score was significantly positively correlated (p < 0.01) with disease duration and Part II, III, and IV scores. For Part I sub-item scores, the older group had significantly higher scores for cognitive impairment, hallucinations, sleep problems, urinary problems, and constipation than the <70 years group, whereas the advanced-stage group had significantly higher scores for hallucinations, sleep problems, daytime sleepiness, pain, urinary problems, and constipation (p < 0.05) than the early-stage group. Anxiety was higher in female patients than in male patients, whereas daytime sleepiness, urinary problems, and RBD were higher in male patients than in female patients (p < 0.05). Factors affecting Part I included disease duration, Part II total scores, Part IV total scores, and RBD.ConclusionAccording to the self-questionnaire assessment, NMS was highly severe in older adult patients, those with longer illness duration, subjective and objective motor function impairments, and RBD. Sex-based differences were also observed

Noncoherent Maximum Likelihood Detection for Differential Spatial Multiplexing MIMO Systems

In this paper, we propose a novel noncoherent maximum likelihood detection (NMLD) method for differential spatial multiplexing (SM) multiple-input multiple-output (MIMO) systems. Unlike the conventional maximum likelihood detection (MLD) method which needs the knowledge of channel state information (CSI) at the receiver, WILD method has no need of CSI at either the transmitter or receiver. After repartitioning the observation block of multiple-symbol differential detection (MSDD) and following a decision feedback process, the decision metric of NMLD is derived by reforming that of MSDD. Since the maximum Doppler frequency and noise power are included in the derived decision metric, estimations of both maximum Doppler frequency and noise power are needed at the receiver for NMLD. A fast calculation algorithm (FCA) is applied to reduce the computational complexity of NMLD. The feasibility of the proposed WILD is demonstrated by computer simulations in both slow and fast fading environments. Simulation results show that the proposed NMLD has good bit error rate (BER) performance, approaching that of the conventional coherent MILD with the extension of reference symbols interval. It is also proved that the BER performance is not sensitive to the estimation errors in maximum Doppler frequency and noise power.ArticleIEICE TRANSACTIONS ON COMMUNICATIONS. E93B(2):361-368 (2010)journal articl

MRI Signal Abnormalities of the Inferior Olivary Nuclei in Spinocerebellar Ataxia Type 2

Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant spinocerebellar degeneration, associated with extended repeats of the trinucleotide CAG in the ATXN2 gene on the long arm of chromosome 12. Magnetic resonance imaging (MRI) of SCA2 showed significant atrophies of the brainstem, middle cerebellar peduncles, and cerebellum. We report two genetically proven SCA2 patients who showed hypertrophy of the inferior olivary nuclei on proton density- and T2-weighted MRI. This pattern has never been reported in patients with SCA1, SCA3, or SCA6, and may make it possible to differentiate SCA2 from other hereditary spinocerebellar ataxias

Early Motor Fluctuations in a Patient with Striatonigral Degeneration

We report a 44-year-old female with striatonigral degeneration (SND) who showed wearing-off oscillations after 4 months of levodopa treatment. The patient presented with asymmetric left-side dominant rigidity, and levodopa was effective at first. However, she began to show wearing-off oscillations of motor symptoms, which gradually worsened thereafter. Fluid-attenuated inversion recovery sequence magnetic resonance imaging (MRI) showed linear lateral putamen hyperintensities, and positron emission tomography (PET) studies using 18F-fluorodopa (FD) and 11C-N-methylspiperon (NMSP) showed a marked decrease of radioactivity in the right putamen, especially in the posterior putamen. The results of MRI and 2 PET studies with FD and NMSP were well consistent with the diagnosis of SND

A Patient with Intravenous Immunoglobulin-Responsive Lower Motor Neuron Syndrome

ABSTRACT We report a 50-year-old woman who developed localized proximal muscle weakness, in addition to transient elevation of antibodies to GM1 ganglioside, without multifocal conduction block. She was treated with intravenous immunoglobulin (IVIg) and steroid pulse therapy, which were effective for over 10 years. Her clinical course and laboratory tests were consistent with lower motor neuron syndrome (LMNS) with localized proximal muscle weakness. We suggest that some patients diagnosed as LMNS may remain responsive to IVIg or steroid pulse therapy for a long time