Theories of developmental dyslexia: Insights from a multiple case study of dyslexic adults

A multiple case study was conducted in order to assess three leading theories of developmental dyslexia: the phonological, the magnocellular (auditory and visual) and the cerebellar theories. Sixteen dyslexic and 16 control university students were administered a full battery of psychometric, phonological, auditory, visual and cerebellar tests. Individual data reveal that all 16 dyslexics suffer from a phonological deficit, 10 from an auditory deficit, 4 from a motor deficit, and 2 from a visual magnocellular deficit. Results suggest that a phonological deficit can appear in the absence of any other sensory or motor disorder, and is sufficient to cause a literacy impairment, as demonstrated by 5 of the dyslexics. Auditory disorders, when present, aggravate the phonological deficit, hence the literacy impairment. However, auditory deficits cannot be characterised simply as rapid auditory processing problems, as would be predicted by the magnocellular theory. Nor are they restricted to speech. Contrary to the cerebellar theory, we find little support for the notion that motor impairments, when found, have a cerebellar origin, or reflect an automaticity deficit. Overall, the present data support the phonological theory of dyslexia, while acknowledging the presence of additional sensory and motor disorders in certain individuals

Kinematic and kinetic patterns related to free-walking in Parkinson's disease

The aim of this study is to compare the properties of free-walking at a natural pace between mild Parkinson’s disease (PD) patients during the ON-clinical status and two control groups. In-shoe pressure-sensitive insoles were used to quantify the temporal and force characteristics of a 5-min free-walking in 11 PD patients, in 16 young healthy controls, and in 12 age-matched healthy controls. Inferential statistics analyses were performed on the kinematic and kinetic parameters to compare groups’ performances, whereas feature selection analyses and automatic classification were used to identify the signature of parkinsonian gait and to assess the performance of group classification, respectively. Compared to healthy subjects, the PD patients’ gait pattern presented significant differences in kinematic parameters associated with bilateral coordination but not in kinetics. Specifically, patients showed an increased variability in double support time, greater gait asymmetry and phase deviation, and also poorer phase coordination. Feature selection analyses based on the ReliefF algorithm on the differential parameters in PD patients revealed an effect of the clinical status, especially true in double support time variability and gait asymmetry. Automatic classification of PD patients, young and senior subjects confirmed that kinematic predictors produced a slightly better classification performance than kinetic predictors. Overall, classification accuracy of groups with a linear discriminant model which included the whole set of features (i.e., demographics and parameters extracted from the sensors) was 64.1

A scoping review of biopsychosocial risk factors and co-morbidities for common spinal disorders

OBJECTIVE: The purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders. METHODS: A scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities. RESULTS: Of 3,453 candidate papers, 145 met study criteria and were included in this review. Risk factors were reported for group 1: non-specific low back pain (smoking, overweight/obesity, negative recovery expectations), non-specific neck pain (high job demands, monotonous work); group 2: degenerative spinal disease (workers\u27 compensation claim, degenerative scoliosis), and group 3: spinal tuberculosis (age, imprisonment, previous history of tuberculosis), spinal cord injury (age, accidental injury), vertebral fracture from osteoporosis (type 1 diabetes, certain medications, smoking), and neural tube defects (folic acid deficit, anti-convulsant medications, chlorine, influenza, maternal obesity). A range of comorbidities was identified for spinal disorders. CONCLUSION: Many associated factors for common spinal disorders identified in this study are modifiable. The most common spinal disorders are co-morbid with general health conditions, but there is a lack of clarity in the literature differentiating which conditions are merely comorbid versus ones that are risk factors. Modifiable risk factors present opportunities for policy, research, and public health prevention efforts on both the individual patient and community levels. Further research into prevention interventions for spinal disorders is needed to address this gap in the literature

High efficacy of Sofosbuvir plus Simeprevir in a large cohort of Spanish cirrhotic patients infected with genotypes 1 and 4

[Abstract] Background and Aims. Hepatitis C (HCV) therapy with Sofosbuvir (SOF)/Simeprevir (SMV) in clinical trials and real‐world clinical practice, showed high rates of sustained virological response (SVR) in non‐cirrhotic genotype (GT)‐1 and GT‐4 patients. These results were slightly lower in cirrhotic patients. We investigated real‐life effectiveness and safety of SOF/SMV with or without ribavirin (RBV) in a large cohort of cirrhotic patients. Methods. This collaborative multicentre study included data from 968 patients with cirrhosis infected with HCV‐GT1 or 4, treated with SOF/SMV±RBV in 30 centres across Spain between January‐2014 and December‐2015. Demographic, clinical, virological and safety data were analysed. Results. Overall SVR was 92.3%; the majority of patients were treated with RBV (62%) for 12 weeks (92.4%). No significant differences in SVR were observed between genotypes (GT1a:94.3%; GT1b:91.7%; GT4:91.1%). Those patients with more advanced liver disease (Child B/C, MELD≥10) or portal hypertension (platelet count≤100×109/L, transient elastography≥21 Kpa) showed significantly lower SVR rates (84.4%‐91.9%) than patients with less advanced liver disease (93.8%‐95.9%, P<.01 in all cases). In the multivariate analysis, the use of RBV, female gender, baseline albumin≥35 g/L, MELD<10 and lack of exposure to a triple therapy regimen were independent predictors of SVR (P<.05). Serious adverse events (SAEs) and SAE‐associated discontinuation events occurred in 5.9% and 2.6%. Conclusions. In this large cohort of cirrhotic patients managed in the real‐world setting in Spain, SOF/SMV±RBV yielded to excellent SVR rates, especially in patients with compensated liver cirrhosis. In addition, this combination showed to be safe, with low rates of SAEs and early discontinuations.Instituto de Salud Carlos III; PI15/0015

Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639

StartReact effects in first dorsal interosseous muscle are absent in a pinch task, but present when combined with elbow flexion.

OBJECTIVE:To provide a neurophysiological tool for assessing sensorimotor pathways, which may differ for those involving distal muscles in simple tasks from those involving distal muscles in a kinetic chain task, or proximal muscles in both. METHODS:We compared latencies and magnitudes of motor responses in a reaction time paradigm in a proximal (biceps brachii, BB) and a distal (first dorsal interosseous, FDI) muscle following electrical stimuli used as imperative signal (IS) delivered to the index finger. These stimuli were applied during different motor tasks: simple tasks involving either one muscle, e.g. flexing the elbow for BB (FLEX), or pinching a pen for FDI (PINCH); combined tasks engaging both muscles by pinching and flexing simultaneously (PINCH-FLEX). Stimuli were of varying intensity and occasionally elicited a startle response, and a StartReact effect. RESULTS:In BB, response latencies decreased gradually and response amplitudes increased progressively with increasing IS intensities for non-startling trials, while for trials containing startle responses, latencies were uniformly shortened and response amplitudes similarly augmented across all IS intensities in both FLEX and PINCH-FLEX. In FDI, response latencies decreased gradually and response amplitudes increased progressively with increasing IS intensities in both PINCH and PINCH-FLEX for non-startling trials, but, unlike in BB for the simple task, in PINCH for trials containing startle responses as well. In PINCH-FLEX, FDI latencies were uniformly shortened and amplitudes similarly increased across all stimulus intensities whenever startle signs were present. CONCLUSIONS:Our results suggest the presence of different sensorimotor pathways supporting a dissociation between simple tasks that involve distal upper limb muscles (FDI in PINCH) from simple tasks involving proximal muscles (BB in FLEX), and combined tasks that engage both muscles (FDI and BB in PINCH-FLEX), all in accordance with differential importance in the control of movements by cortical and subcortical structures. SIGNIFICANCE:Simple assessment tools may provide useful information regarding the differential involvement of sensorimotor pathways in the control of both simple and combined tasks that engage proximal and distal muscles

First dorsal interosseous response latencies for trials with startle signs (S+), and trials without startle signs (S-) in PINCH and PINCH-FLEX tasks for the four analyzed stimulus intensities (multiples of sensory threshold, ST: 8×ST, 13×ST, 18×ST, 23×ST).

<p>Bars correspond to mean (± SD) values for all subjects. Asterisks above the bars define the level of significance for group comparisons: * = <i>P</i> < 0.05, ** = <i>P</i> < 0.01, *** = <i>P</i> < 0.001.</p

Biceps brachii response amplitudes for trials with startle signs (S+), and trials without startle signs (S-) in FLEX and PINCH-FLEX tasks for the four analyzed stimulus intensities (multiples of sensory threshold, ST: 8×ST, 13×ST, 18×ST, 23×ST).

<p>Bars correspond to mean (± SD) values for all subjects. Asterisks above the bars define the level of significance for group comparisons: * = <i>P</i> < 0.05, ** = <i>P</i> < 0.01, *** = <i>P</i> < 0.001.</p

Biceps brachii (BB) and first dorsal interosseous (FDI) response amplitudes for trials with startle signs (S+), and trials without startle signs (S-).

<p>Dark square boxes represent the mean value corresponding to PINCH-FLEX task for both muscles. White square boxes represent the mean value corresponding to FLEX task for BB, and PINCH task for FDI. Data are mean (± SD) values for all subjects and intensities.</p