Motor and language resting state functional magnetic resonance imaging in brain tumor patients

Background and purpose: Resting state functional magnetic resonance (RS-fMRI) correlation with pre-surgical functional status in patients with brain tumors is scarcely documented in the present literature. Aim of the present study was to investigate the validity of RS-fMRI as potential preoperative functional mapping tool in tumor brain surgery by exploring the association of motor and language RS-fMRI networks with subjects’ preoperative performance on motor and language clinical assessment respectively in patients with brain tumor. Materials and methods: 85 patients presented with brain tumor entities and 27 healthy controls were prospectively recruited for the present study. Clinical sample was subdivided into two groups according to mass localization: patients with tumors in proximity to motor cortex (n=59) underwent clinical examination for gross (paresis- muscle weakness) and fine (finger tapping) motor deficits. Patients harboring tumors in proximity to the left inferior frontal gyrus (n=35) were clinically assessed for apparent (expressive aphasia) and subtle language function (phonological verbal fluency) disturbances. All patients and healthy subjects underwent RS-fMRI with motor and language resting networks being derived by Independent Component Analysis (ICA). Results: In the motor group, patients with paresis demonstrated significantly (p=<0.01) reduced resting state BOLD-signal intensity in ipsilesional motor cortex in comparison to the respective one in contralesional-intact motor cortex. Significantly (p<0.01) decreased BOLD-signal intensity was additionally noticed in ipsilesional motor cortex of patients with paresis in comparison to patients with normal muscle strength. Furthermore, in patients with intact muscle strength, a strong positive correlation (r=0.70, p<0.01) between ipsilesional pre-central gyrus BOLD-signal and performance on finger tapping task was demonstrated. Compared to the healthy group, clinical motor group showed reduced resting state network activity, with patients’ ipsilesional pre- central gyrus BOLD-signal intensity to be significantly (p<0.01) lower than normals’ left and right pre-central gyri BOLD-signal intensities. Concerning language group, patients presented with expressive aphasia exhibited significantly (p=<0.01) reduced RS-fMRI BOLD-signal intensity in left inferior frontal gyrus (Broadmann area 44) when compared with patients without aphasia. In non-aphasic patients, a strong positive correlation (r=0.70, P<0.01) between left inferior frontal gyrus’ BOLD-signal intensity and phonological fluency scoring was demonstrated. Similarly with the motor group, language group also showed significantly (p=<0.01) reduced left inferior gyrus RS- fMRI BOLD-signal when compared to healthy controls. Finally, RS-fMRI BOLD signal was not observed to have an association with demographic parameters (age, gender) for both clinical and healthy groups and with tumor histopathological grading for both motor and language clinical groups. Conclusions: Our findings show a significant affection of motor and language RS-fMRI networks’ BOLD-signal intensity by the presence of a tumor and a correlation with clinical performance of patients providing thus evidence for the functional validity of RS-fMRI in brain tumor patients; our results indicate therefore, that RS-fMRI may be a valuable complementary tool for preoperative mapping of eloquent areas, at least in patients who cannot cooperate satisfactory in a traditional task-based motor and language fMRI

Prognostic value of preoperative dynamic contrast-enhanced MRI perfusion parameters for high-grade glioma patients

INTRODUCTION: The prognostic value of the dynamic contrast-enhanced (DCE) MRI perfusion and its histogram analysis-derived metrics is not well established for high-grade glioma (HGG) patients. The aim of this prospective study was to investigate DCE perfusion transfer coefficient (Ktrans), vascular plasma volume fraction (vp), extracellular volume fraction (ve), reverse transfer constant (kep), and initial area under gadolinium concentration time curve (IAUGC) as predictors of progression-free (PFS) and overall survival (OS) in HGG patients. METHODS: Sixty-nine patients with suspected anaplastic astrocytoma or glioblastoma underwent preoperative DCE-MRI scans. DCE perfusion whole tumor region histogram parameters, clinical details, and PFS and OS data were obtained. Univariate, multivariate, and Kaplan–Meier survival analyses were conducted. Receiver operating characteristic (ROC) curve analysis was employed to identify perfusion parameters with the best differentiation performance. RESULTS: On univariate analysis, ve and skewness of vp had significant negative impacts, while kep had significant positive impact on OS (P < 0.05). ve was also a negative predictor of PFS (P < 0.05). Patients with lower ve and IAUGC had longer median PFS and OS on Kaplan–Meier analysis (P < 0.05). Ktrans and ve could also differentiate grade III from IV gliomas (area under the curve 0.819 and 0.791, respectively). CONCLUSIONS: High ve is a consistent predictor of worse PFS and OS in HGG glioma patients. vp skewness and kep are also predictive for OS. Ktrans and ve demonstrated the best diagnostic performance for differentiating grade III from IV gliomas

Idiopathic Intracranial Hypertension: Epidemiology, pathophysiology, clinical features and contemporary management.

Idiopathic Intracranial Hypertension (IIH) is a syndrome of increased intracranial pressure (ICP) without evident cause. The exact pathogenesis of IIH remains elusive but it is also plausible that the syndrome represents the common final pathway of several different mechanisms. IIH has an estimated incidence of 1-3 per 100 000 and a predilection for obese women of childbearing age.  Presentation involves symptomatology and semiology of elevated intracranial pressure with headache being the most common. Visual disturbances can be devastating, progressive and may result in permanent visual loss. Moreover, pulsatile tinnitus is frequently encountered. However, asymptomatic presentations are also not uncommon with patients diagnosed after routine ophthalmological examination illustrates papilledema. Diagnosis is based upon the Friedman’s criteria. Absence of hydrocephalus or mass lesion and normal cerebrospinal fluid (CSF) composition need to be confirmed. Several treatment modalities have been suggested, varying from non-surgical (weight loss, drugs such as acetazolamide, serial lumbar puncture) to interventional and surgical (CSF diversion procedures, optic nerve sheath fenestration (ONSF), endovascular venous sinus stenting, or even bariatric surgery). There are very few RCTs to critically assess these therapies and, consequently, no consensus on the optimal management of IIH.

THE AFTERCARE SURVEY:Assessment and intervention practices after brain tumour surgery in Europe

Introduction People with gliomas need specialized neurosurgical, neuro-oncological, psycho-oncological, and neuropsychological care. The role of language and cognitive recovery and rehabilitation in patients’ well-being and resumption of work is crucial, but there are no clear guidelines for the ideal timing and character of assessments and interventions. The goal of the present work was to describe representative (neuro)psychological practices implemented after brain surgery in Europe. Methods An online survey was addressed to professionals working with individuals after brain surgery. We inquired about the assessments and interventions and the involvement of caregivers. Additionally, we asked about recommendations for an ideal assessment and intervention plan. Results Thirty-eight European centres completed the survey. Thirty of them offered at least one post-surgical (neuro)psychological assessment, mainly for language and cognition, especially during the early recovery stage and at long-term. Twenty-eight of the participating centres offered post-surgical therapies. Patients who stand the highest chances of being included in evaluation and therapy post-surgically are those who underwent awake brain surgery, harboured a low-grade glioma, or showed poor recovery. Nearly half of the respondents offer support programs to caregivers, and all teams recommend them. Treatments differed between these offered to individuals with low-grade glioma versus those with high-grade glioma. The figure of caregiver is not yet fully recognized in the recovery phase. Conclusion We stress the need for more complete rehabilitation plans, including the emotional and health-related aspects of recovery. In respondents´ opinions, assessment and rehabilitation plans should also be individually tailored and goal-directed (e.g., professional reinsertion)

Motifs de régulation impliqués dans le trafic de LRRRTM2 et stabilisation des récepteurs AMPA par LRRTM2 au niveau des synapses excitatrices

Synapses are the main site of communication between neurons in the central nervous system. These specialised cell-cell contacts are initiated by cell adhesion molecules at the pre- and post-synapse, that interact with one another to form trans-synaptic complexes, and recruit molecules regulating synapse maturation, specificity and function.Leucine Rich Repeat Transmembrane Protein 2 (LRRTM2) is a synaptic adhesion molecule that binds to pre-synaptic neurexin and is exclusively localised and enriched at excitatory synapses where it exhibits low membrane dynamics. Interestingly, LRRTM2 is involved in synaptic transmission and plasticity and regulates the surface levels of AMPARs, the main glutamatergic receptors responsible for fast neurotransmission in the brain.In my PhD, I investigated the molecular mechanisms underlying LRRTM2 stabilisation and trafficking at excitatory synapses, as well as the interplay between LRRTM2 and AMPARs.We demonstrated that the C-terminal domain of LRRTM2 controls its compartmentalisation in dendrites as well as its enrichment and compaction at synapses. Surprisingly, LRRTM2 synaptic confinement was found to be independent of its PDZ-like binding domain and was instead regulated by a recently identified YxxC intracellular sequence. We further confirmed that this sequence was critical for LRRTM2 trafficking and exocytosis and observed the existence of intracellular LRRTM2-containing vesicles inside spines. Regarding the interplay between LRRTM2 and AMPARs, we showed for the first time, that the recently identified neurexin-binding site in LRRTM2 (E348) is responsible for membrane stabilisation of synaptic AMPARs.These results demonstrate that the intracellular region of LRRTM2 controls its synaptic clustering, membrane dynamics, and confinement, while extracellular binding interfaces are involved in stabilising AMPARs at the plasma membrane.Les synapses constituent le principal site de communication entre les neurones du système nerveux central. Ces contacts cellule-cellule spécialisés sont initiés par des molécules d'adhésion cellulaire au niveau de pré- et post-synapses, qui interagissent entre elles pour former des complexes trans-synaptiques, recrutant à leur tour des molécules régulant la maturation, la spécificité et la fonction des synapses.Leucine Rich Repeat Transmembrane Protein 2 (LRRTM2) est une molécule d'adhésion synaptique qui se lie à la neurexine pré-synaptique et elle est exclusivement localisée et enrichie au niveau des synapses excitatrices où elle présente une faible dynamique membranaire. LRRTM2 est impliquée dans la transmission et la plasticité synaptique et régule les niveaux de surface des récepteurs AMPA, les principaux récepteurs glutamatergiques responsables de la neurotransmission rapide dans le cerveau.Au cours de ma thèse, j'ai étudié les mécanismes qui sous-tendent la stabilisation et le trafic membranaire de LRRTM2 au niveau des synapses excitatrices, ainsi que l'interaction entre LRRTM2 et les récepteurs AMPA.Nous avons démontré que le domaine C-terminal de LRRTM2 contrôle sa compartimentation dans les dendrites ainsi que son enrichissement et sa compaction au niveau des synapses. De manière surprenante, le confinement synaptique de LRRTM2 s'est avéré être indépendant de son domaine de liaison PDZ-like, mais régulé par une séquence intracellulaire récemment identifiée, YxxC. Nous avons observé que cette séquence était également essentielle au trafic membranaire et à l'exocytose de LRRTM2 et caractérisé l'existence de vésicules intracellulaires contenant LRRTM2 à l'intérieur des épines. En ce qui concerne l'interaction entre LRRTM2 et les récepteurs AMPA, nous avons montré pour la première fois que le site nouvellement identifié de liaison à la neurexine (E348), est impliqué dans la stabilisation membranaire des récepteurs AMPA synaptiques.Ces résultats démontrent que la région intracellulaire de LRRTM2 contrôle son enrichissement synaptique, sa dynamique membranaire, et son confinement aux synapses excitatrices, tandis que les domaines extracellulaires sont impliqués dans la stabilisation des récepteurs AMPA à la membrane plasmique

Regulatory motifs involved in LRRTM2 trafficking and LRRTM2-dependent stabilisation of AMPARs at excitatory synapses

Les synapses constituent le principal site de communication entre les neurones du système nerveux central. Ces contacts cellule-cellule spécialisés sont initiés par des molécules d'adhésion cellulaire au niveau de pré- et post-synapses, qui interagissent entre elles pour former des complexes trans-synaptiques, recrutant à leur tour des molécules régulant la maturation, la spécificité et la fonction des synapses.Leucine Rich Repeat Transmembrane Protein 2 (LRRTM2) est une molécule d'adhésion synaptique qui se lie à la neurexine pré-synaptique et elle est exclusivement localisée et enrichie au niveau des synapses excitatrices où elle présente une faible dynamique membranaire. LRRTM2 est impliquée dans la transmission et la plasticité synaptique et régule les niveaux de surface des récepteurs AMPA, les principaux récepteurs glutamatergiques responsables de la neurotransmission rapide dans le cerveau.Au cours de ma thèse, j'ai étudié les mécanismes qui sous-tendent la stabilisation et le trafic membranaire de LRRTM2 au niveau des synapses excitatrices, ainsi que l'interaction entre LRRTM2 et les récepteurs AMPA.Nous avons démontré que le domaine C-terminal de LRRTM2 contrôle sa compartimentation dans les dendrites ainsi que son enrichissement et sa compaction au niveau des synapses. De manière surprenante, le confinement synaptique de LRRTM2 s'est avéré être indépendant de son domaine de liaison PDZ-like, mais régulé par une séquence intracellulaire récemment identifiée, YxxC. Nous avons observé que cette séquence était également essentielle au trafic membranaire et à l'exocytose de LRRTM2 et caractérisé l'existence de vésicules intracellulaires contenant LRRTM2 à l'intérieur des épines. En ce qui concerne l'interaction entre LRRTM2 et les récepteurs AMPA, nous avons montré pour la première fois que le site nouvellement identifié de liaison à la neurexine (E348), est impliqué dans la stabilisation membranaire des récepteurs AMPA synaptiques.Ces résultats démontrent que la région intracellulaire de LRRTM2 contrôle son enrichissement synaptique, sa dynamique membranaire, et son confinement aux synapses excitatrices, tandis que les domaines extracellulaires sont impliqués dans la stabilisation des récepteurs AMPA à la membrane plasmique.Synapses are the main site of communication between neurons in the central nervous system. These specialised cell-cell contacts are initiated by cell adhesion molecules at the pre- and post-synapse, that interact with one another to form trans-synaptic complexes, and recruit molecules regulating synapse maturation, specificity and function.Leucine Rich Repeat Transmembrane Protein 2 (LRRTM2) is a synaptic adhesion molecule that binds to pre-synaptic neurexin and is exclusively localised and enriched at excitatory synapses where it exhibits low membrane dynamics. Interestingly, LRRTM2 is involved in synaptic transmission and plasticity and regulates the surface levels of AMPARs, the main glutamatergic receptors responsible for fast neurotransmission in the brain.In my PhD, I investigated the molecular mechanisms underlying LRRTM2 stabilisation and trafficking at excitatory synapses, as well as the interplay between LRRTM2 and AMPARs.We demonstrated that the C-terminal domain of LRRTM2 controls its compartmentalisation in dendrites as well as its enrichment and compaction at synapses. Surprisingly, LRRTM2 synaptic confinement was found to be independent of its PDZ-like binding domain and was instead regulated by a recently identified YxxC intracellular sequence. We further confirmed that this sequence was critical for LRRTM2 trafficking and exocytosis and observed the existence of intracellular LRRTM2-containing vesicles inside spines. Regarding the interplay between LRRTM2 and AMPARs, we showed for the first time, that the recently identified neurexin-binding site in LRRTM2 (E348) is responsible for membrane stabilisation of synaptic AMPARs.These results demonstrate that the intracellular region of LRRTM2 controls its synaptic clustering, membrane dynamics, and confinement, while extracellular binding interfaces are involved in stabilising AMPARs at the plasma membrane

Motifs de régulation impliqués dans le trafic de LRRRTM2 et stabilisation des récepteurs AMPA par LRRTM2 au niveau des synapses excitatrices

Les synapses constituent le principal site de communication entre les neurones du système nerveux central. Ces contacts cellule-cellule spécialisés sont initiés par des molécules d'adhésion cellulaire au niveau de pré- et post-synapses, qui interagissent entre elles pour former des complexes trans-synaptiques, recrutant à leur tour des molécules régulant la maturation, la spécificité et la fonction des synapses.Leucine Rich Repeat Transmembrane Protein 2 (LRRTM2) est une molécule d'adhésion synaptique qui se lie à la neurexine pré-synaptique et elle est exclusivement localisée et enrichie au niveau des synapses excitatrices où elle présente une faible dynamique membranaire. LRRTM2 est impliquée dans la transmission et la plasticité synaptique et régule les niveaux de surface des récepteurs AMPA, les principaux récepteurs glutamatergiques responsables de la neurotransmission rapide dans le cerveau.Au cours de ma thèse, j'ai étudié les mécanismes qui sous-tendent la stabilisation et le trafic membranaire de LRRTM2 au niveau des synapses excitatrices, ainsi que l'interaction entre LRRTM2 et les récepteurs AMPA.Nous avons démontré que le domaine C-terminal de LRRTM2 contrôle sa compartimentation dans les dendrites ainsi que son enrichissement et sa compaction au niveau des synapses. De manière surprenante, le confinement synaptique de LRRTM2 s'est avéré être indépendant de son domaine de liaison PDZ-like, mais régulé par une séquence intracellulaire récemment identifiée, YxxC. Nous avons observé que cette séquence était également essentielle au trafic membranaire et à l'exocytose de LRRTM2 et caractérisé l'existence de vésicules intracellulaires contenant LRRTM2 à l'intérieur des épines. En ce qui concerne l'interaction entre LRRTM2 et les récepteurs AMPA, nous avons montré pour la première fois que le site nouvellement identifié de liaison à la neurexine (E348), est impliqué dans la stabilisation membranaire des récepteurs AMPA synaptiques.Ces résultats démontrent que la région intracellulaire de LRRTM2 contrôle son enrichissement synaptique, sa dynamique membranaire, et son confinement aux synapses excitatrices, tandis que les domaines extracellulaires sont impliqués dans la stabilisation des récepteurs AMPA à la membrane plasmique.Synapses are the main site of communication between neurons in the central nervous system. These specialised cell-cell contacts are initiated by cell adhesion molecules at the pre- and post-synapse, that interact with one another to form trans-synaptic complexes, and recruit molecules regulating synapse maturation, specificity and function.Leucine Rich Repeat Transmembrane Protein 2 (LRRTM2) is a synaptic adhesion molecule that binds to pre-synaptic neurexin and is exclusively localised and enriched at excitatory synapses where it exhibits low membrane dynamics. Interestingly, LRRTM2 is involved in synaptic transmission and plasticity and regulates the surface levels of AMPARs, the main glutamatergic receptors responsible for fast neurotransmission in the brain.In my PhD, I investigated the molecular mechanisms underlying LRRTM2 stabilisation and trafficking at excitatory synapses, as well as the interplay between LRRTM2 and AMPARs.We demonstrated that the C-terminal domain of LRRTM2 controls its compartmentalisation in dendrites as well as its enrichment and compaction at synapses. Surprisingly, LRRTM2 synaptic confinement was found to be independent of its PDZ-like binding domain and was instead regulated by a recently identified YxxC intracellular sequence. We further confirmed that this sequence was critical for LRRTM2 trafficking and exocytosis and observed the existence of intracellular LRRTM2-containing vesicles inside spines. Regarding the interplay between LRRTM2 and AMPARs, we showed for the first time, that the recently identified neurexin-binding site in LRRTM2 (E348) is responsible for membrane stabilisation of synaptic AMPARs.These results demonstrate that the intracellular region of LRRTM2 controls its synaptic clustering, membrane dynamics, and confinement, while extracellular binding interfaces are involved in stabilising AMPARs at the plasma membrane

Shared Mobility to Compensate for Public Transport Demand under the impacts of a pandemic crisis: The Case of Bike Sharing System in Milan during COVID–19 pandemic

The COVID-19 pandemic poses an unprecedented challenge for the public transport system. The capacity of the transport system has been significantly reduced due to the imposition of social distancing measures to reduce the spread of the coronavirus. People remain skeptical about the use of public transport and prefer alternatives for their transportation as the likelihood of the virus spreading through public transport is high. Therefore, new avenues to increase the resilience of public urban mobility need to be explored. This research proposes the integration of the bike sharing system into the existing public transport system to compensate for public transport demand under the disruptive impacts of the COVID-19 pandemic. To achieve this, a two-part methodology is developed. The first part concerns the development of a mathematical model for the demand integration of the two systems. The demand for the public transport system, which cannot be serviced by the system due to the distancing measures (distance of 1.5 meters between passengers), is considered as unsatisfied demand and is the new additional demand for the bike sharing system. The second part concerns the development of an optimization model for the design and operation of a bike sharing system with features that can cope with the mobility needs of the pandemic. These features of the bike sharing system are the mixed fleet, i.e., the system will provide the mode options of bike and e-bike, and the hybrid in its design, i.e., the bike system will be a free-floating system while the e-bike system will be docked. The developed methodology is applied in the case study of the Milan city in Italy. The two studied systems are the subway system and the public bike sharing system of Milan. For the implementation of the developed methodology, three demand scenarios and fifteen designs that reflect the needs of the bike sharing system are created. The parameters that differ in the designs are the number and location of the new (virtual) stations, the number of the maximum number of available bikes in the virtual stations of the bike system and the capacity specifications (number of docks) in the e-bikes stations. The selected locations of the new (virtual) stations in the designs are close to subway stations with unsatisfied demand. The obtained results show that 30% of the demand for the evening peak hour of the subway system in Milan cannot be satisfied due to distancing measures and that the current public bike sharing system can only compensate for 6% of the new demand (unsatisfied demand of public transport system and its own demand). However, the mobility capacity increases based on the system’s features. The separation of the bike sharing system into a free-floating bike system and a docked e-bike system increases the covered demand at least twice (2.1-2.4 times). Moreover, an increase of the capacity specifications of the e-stations and the available bikes in virtual stations by 60% brings an additional increase of the covered demand by 6.5-7.5%. Despite the increased mobility capacity of the system with the incorporation of the mentioned features, to fully cover the bike system demand it is needed 30959 bikes, while 20445 e-bikes are needed for 70% coverage of e-bikes demand. In addition, there is no limit to the available bikes per station and the maximum number of docks per e-station is 200. It is concluded that the bike sharing system cannot fully counterbalance for limited capacity in the public transport system. These findings contribute worthwhile insights into the mobility capacity of the integrated public transport system during the pandemic and where the operators of both systems should give emphasis.Transport, Infrastructure and Logistic

Η μη ζητηθείσα εμπορική επικοινωνία

Στην παρούσα μελέτη επιχειρήθηκε η εξέταση ενός σύγχρονου νομικού ζητήματος, αυτού της «μη ζητηθείσας εμπορικής επικοινωνίας», το οποίο αποτελεί σήμερα πεδίο εκτενών συζητήσεων και αναλύσεων μεταξύ των θεωρητικών ως προς τις νομικές πτυχές και τις συνέπειες του για τα εμπλεκόμενα μέρη (διαφημιζόμενους – ανταγωνιστές – καταναλωτές). Ιδιαίτερη έμφαση δόθηκε στην προστασία των καταναλωτών – αποδεκτών της μη ζητηθείσας εμπορικής επικοινωνίας, καθώς οι κίνδυνοι προσβολής των συνταγματικών δικαιωμάτων τους, και ιδίως της παραβίασης της ιδιωτικής τους ζωής, του δικαιώματος τους στον «πληροφοριακό αυτοκαθορισμό» αλλά και της οικονομικής ελευθερίας τους, είναι κάτι παραπάνω από ορατοί στα πλαίσια της σύγχρονης και ραγδαίως μεταβαλλόμενης – λόγω της τεχνολογικής προόδου – νέας κοινωνικής πραγματικότητας. Στο πλαίσιο αυτό, εξετάστηκαν κυρίως: α) οι διατάξεις του άρθρου 11 του Ν. 3471/2006 (που ενσωμάτωσε στην Ελληνική έννομη τάξη την Οδηγία ePrivacy), με τις οποίες επιτυγχάνεται η προστασία της ιδιωτικής ζωής και των προσωπικών δεδομένων των ατόμων από τις μη ζητηθείσες ηλεκτρονικές επικοινωνίες, αυτές δηλαδή που πραγματοποιούνται με τη χρήση ηλεκτρονικών μέσων, β) οι σχετικές με την απευθείας εμπορική προώθηση ρυθμίσεις του ΓΚΠΔ, οι οποίες τελούν υπό την επιφύλαξη των ρυθμίσεων του άρθρου 11 του Ν. 3471/2006, βρίσκουν, ωστόσο, οπωσδήποτε εφαρμογή στις περιπτώσεις των μη ζητηθεισών εμπορικών επικοινωνιών που τελούνται με άλλα μέσα, όπως λχ. μέσω του παραδοσιακού ταχυδρομείου και των προσωπικών επισκέψεων στα σπίτια των καταναλωτών και β) οι εφαρμοστέες διατάξεις του Ν. 2251/1994 για την προστασία του καταναλωτή, όπως αυτός ισχύει μετά την τροποποίηση του με τον Ν. 3587/2007 και την ενσωμάτωση της Οδηγίας 2005/29/ΕΚ «για τις αθέμιτες εμπορικές πρακτικές».Στην παρούσα μελέτη επιχειρήθηκε η εξέταση ενός σύγχρονου νομικού ζητήματος, αυτού της «μη ζητηθείσας εμπορικής επικοινωνίας», το οποίο αποτελεί σήμερα πεδίο εκτενών συζητήσεων και αναλύσεων μεταξύ των θεωρητικών ως προς τις νομικές πτυχές και τις συνέπειες του για τα εμπλεκόμενα μέρη (διαφημιζόμενους – ανταγωνιστές – καταναλωτές). Ιδιαίτερη έμφαση δόθηκε στην προστασία των καταναλωτών – αποδεκτών της μη ζητηθείσας εμπορικής επικοινωνίας, καθώς οι κίνδυνοι προσβολής των συνταγματικών δικαιωμάτων τους, και ιδίως της παραβίασης της ιδιωτικής τους ζωής, του δικαιώματος τους στον «πληροφοριακό αυτοκαθορισμό» αλλά και της οικονομικής ελευθερίας τους, είναι κάτι παραπάνω από ορατοί στα πλαίσια της σύγχρονης και ραγδαίως μεταβαλλόμενης – λόγω της τεχνολογικής προόδου – νέας κοινωνικής πραγματικότητας. Στο πλαίσιο αυτό, εξετάστηκαν κυρίως: α) οι διατάξεις του άρθρου 11 του Ν. 3471/2006 (που ενσωμάτωσε στην Ελληνική έννομη τάξη την Οδηγία ePrivacy), με τις οποίες επιτυγχάνεται η προστασία της ιδιωτικής ζωής και των προσωπικών δεδομένων των ατόμων από τις μη ζητηθείσες ηλεκτρονικές επικοινωνίες, αυτές δηλαδή που πραγματοποιούνται με τη χρήση ηλεκτρονικών μέσων, β) οι σχετικές με την απευθείας εμπορική προώθηση ρυθμίσεις του ΓΚΠΔ, οι οποίες τελούν υπό την επιφύλαξη των ρυθμίσεων του άρθρου 11 του Ν. 3471/2006, βρίσκουν, ωστόσο, οπωσδήποτε εφαρμογή στις περιπτώσεις των μη ζητηθεισών εμπορικών επικοινωνιών που τελούνται με άλλα μέσα, όπως λχ. μέσω του παραδοσιακού ταχυδρομείου και των προσωπικών επισκέψεων στα σπίτια των καταναλωτών και β) οι εφαρμοστέες διατάξεις του Ν. 2251/1994 για την προστασία του καταναλωτή, όπως αυτός ισχύει μετά την τροποποίηση του με τον Ν. 3587/2007 και την ενσωμάτωση της Οδηγίας 2005/29/ΕΚ «για τις αθέμιτες εμπορικές πρακτικές»

Transcranial Electrical Stimulation: Methodology and Applications

Low-intensity transcranial current stimulation is a rapidly growing field of research. Transcranial direct current stimulation (tDCS) is the dominant paradigm of this new field, with transcranial alternating current stimulation (tACS) just emerging. Anodal stimulation with tDCS has excitatory effects on the underlying cortex, whereas cathodal stimulation has inhibitory effects. Because both electrodes have significant brain effects when placed at cephalic areas, the term &quot;reference&quot; electrode should be avoided. Most studies have applied tDCS to the motor cortex, the prefrontal cortex, and the occipital cortex. Applications of tDCS include modulation of electrophysiological and hemodynamic brain activity, symptom reduction in neurological and psychiatric pathology, and cognitive improvement in healthy volunteers or clinical populations. There is evidence of motor improvement in patients with stroke, pain reduction in fibromyalgia, improved mood in patients with unipolar or bipolar depression, and reduced craving. Healthy volunteers are shown to improve their verbal fluency, working memory, and implicit learning. Moreover, there are interactions of tDCS with various pharmacological substances. There are no significant side effects, apart from minor skin lesions when tap water is used instead of saline solution in the sponge electrodes. Further research is required to reveal the potential of tACS. © 2011 Copyright Taylor and Francis Group, LLC