Brain Sciences

14 pages, 258 KiB

Open AccessReview

The Efficacy of Transcranial Current Stimulation Techniques to Modulate Resting-State EEG, to Affect Vigilance and to Promote Sleepiness

by Ludovica Annarumma, Aurora D’Atri, Valentina Alfonsi and Luigi De Gennaro

Brain Sci. 2018, 8(7), 137; https://doi.org/10.3390/brainsci8070137 - 20 Jul 2018

Cited by 37 | Viewed by 7010

Abstract

Transcranial Current Stimulations (tCSs) are non-invasive brain stimulation techniques which modulate cortical excitability and spontaneous brain activity by the application of weak electric currents through the scalp, in a safe, economic, and well-tolerated manner. The direction of the cortical effects mainly depend on [...] Read more.

Transcranial Current Stimulations (tCSs) are non-invasive brain stimulation techniques which modulate cortical excitability and spontaneous brain activity by the application of weak electric currents through the scalp, in a safe, economic, and well-tolerated manner. The direction of the cortical effects mainly depend on the polarity and the waveform of the applied current. The aim of the present work is to provide a broad overview of recent studies in which tCS has been applied to modulate sleepiness, sleep, and vigilance, evaluating the efficacy of different stimulation techniques and protocols. In recent years, there has been renewed interest in these stimulations and their ability to affect arousal and sleep dynamics. Furthermore, we critically review works that, by means of stimulating sleep/vigilance patterns, in the sense of enhancing or disrupting them, intended to ameliorate several clinical conditions. The examined literature shows the efficacy of tCSs in modulating sleep and arousal pattern, likely acting on the top-down pathway of sleep regulation. Finally, we discuss the potential application in clinical settings of this neuromodulatory technique as a therapeutic tool for pathological conditions characterized by alterations in sleep and arousal domains and for sleep disorders per se. Full article

(This article belongs to the Special Issue Non-Invasive Brain Stimulation Applications)

8 pages, 815 KiB

Open AccessArticle

Novel Type of Complicated Autosomal Dominant Hereditary Spastic Paraplegia Associated with Congenital Distal Arthrogryposis Type I

by Peter Hedera, Paolo Moretti, Jane Howard and Jiali Zhao

Brain Sci. 2018, 8(7), 136; https://doi.org/10.3390/brainsci8070136 - 19 Jul 2018

Cited by 3 | Viewed by 4342

Abstract

Hereditary spastic paraplegia (HSP) is one of the most genetically heterogeneous neurological disorders. HSP is classified as pure when only a spastic weakness of the lower extremities is present. Complex HSP comes with additional neurological or systemic abnormalities. Complex HSP with skeletal abnormalities [...] Read more.

Hereditary spastic paraplegia (HSP) is one of the most genetically heterogeneous neurological disorders. HSP is classified as pure when only a spastic weakness of the lower extremities is present. Complex HSP comes with additional neurological or systemic abnormalities. Complex HSP with skeletal abnormalities is rare and mostly seen in autosomal recessive HSP. Autosomal dominant (AD) complex HSP with skeletal abnormalities are consistently seen only in SPG9 (spastic gait type 9). In this paper, we report a kindred condition with AD HSP among four living affected individuals who had progressive, adult onset spastic paraparesis that was associated with a distal arthrogryposis (DA) in every affected individual. They also had episodes of rhabdomyolysis without any clinical signs of myopathy. Exhaustive genetic analysis including targeted sequencing of known HSP and DA genes and whole exome sequencing did not identify the disease-causing gene. It excluded all known HSP and DA genes. We propose that this is a novel genetic type of complex AD HSP. Elucidation of a genetic cause of this type of HSP will further contribute to our understanding of axonal degeneration and skeletal abnormalities. Full article

(This article belongs to the Special Issue Advances in Genetics of Hereditary Spastic Paraplegia)

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12 pages, 2045 KiB

Open AccessArticle

Pediatric Deep Brain Stimulation Using Awake Recording and Stimulation for Target Selection in an Inpatient Neuromodulation Monitoring Unit

by Terence D. Sanger, Mark Liker, Enrique Arguelles, Ruta Deshpande, Arash Maskooki, Diana Ferman, Aprille Tongol and Aaron Robison

Brain Sci. 2018, 8(7), 135; https://doi.org/10.3390/brainsci8070135 - 17 Jul 2018

Cited by 36 | Viewed by 5994

Abstract

Deep brain stimulation (DBS) for secondary (acquired, combined) dystonia does not reach the high degree of efficacy achieved in primary (genetic, isolated) dystonia. We hypothesize that this may be due to variability in the underlying injury, so that different children may require placement [...] Read more.

Deep brain stimulation (DBS) for secondary (acquired, combined) dystonia does not reach the high degree of efficacy achieved in primary (genetic, isolated) dystonia. We hypothesize that this may be due to variability in the underlying injury, so that different children may require placement of electrodes in different regions of basal ganglia and thalamus. We describe a new targeting procedure in which temporary depth electrodes are placed at multiple possible targets in basal ganglia and thalamus, and probing for efficacy is performed using test stimulation and recording while children remain for one week in an inpatient Neuromodulation Monitoring Unit (NMU). Nine Children with severe secondary dystonia underwent the NMU targeting procedure. In all cases, 4 electrodes were implanted. We compared the results to 6 children who had previously had 4 electrodes implanted using standard intraoperative microelectrode targeting techniques. Results showed a significant benefit, with 80% of children with NMU targeting achieving greater than 5-point improvement on the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS), compared with 50% of children using intraoperative targeting. NMU targeting improved BFMDRS by an average of 17.1 whereas intraoperative targeting improved by an average of 10.3. These preliminary results support the use of test stimulation and recording in a Neuromodulation Monitoring Unit (NMU) as a new technique with the potential to improve outcomes following DBS in children with secondary (acquired) dystonia. A larger sample size will be needed to confirm these results. Full article

(This article belongs to the Special Issue Update on Deep Brain Stimulation: Technical Nuances and New Indications)

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19 pages, 2737 KiB

Open AccessArticle

A Pilot Study Investigating a Novel Non-Linear Measure of Eyes Open versus Eyes Closed EEG Synchronization in People with Alzheimer’s Disease and Healthy Controls

by Daniel J. Blackburn, Yifan Zhao, Matteo De Marco, Simon M. Bell, Fei He, Hua-Liang Wei, Sarah Lawrence, Zoe C. Unwin, Michelle Blyth, Jenna Angel, Kathleen Baster, Thomas F. D. Farrow, Iain D. Wilkinson, Stephen A. Billings, Annalena Venneri and Ptolemaios G. Sarrigiannis

Brain Sci. 2018, 8(7), 134; https://doi.org/10.3390/brainsci8070134 - 17 Jul 2018

Cited by 24 | Viewed by 6339

Abstract

Background: The incidence of Alzheimer disease (AD) is increasing with the ageing population. The development of low cost non-invasive diagnostic aids for AD is a research priority. This pilot study investigated whether an approach based on a novel dynamic quantitative parametric EEG method [...] Read more.

Background: The incidence of Alzheimer disease (AD) is increasing with the ageing population. The development of low cost non-invasive diagnostic aids for AD is a research priority. This pilot study investigated whether an approach based on a novel dynamic quantitative parametric EEG method could detect abnormalities in people with AD. Methods: 20 patients with probable AD, 20 matched healthy controls (HC) and 4 patients with probable fronto temporal dementia (FTD) were included. All had detailed neuropsychology along with structural, resting state fMRI and EEG. EEG data were analyzed using the Error Reduction Ratio-causality (ERR-causality) test that can capture both linear and nonlinear interactions between different EEG recording areas. The 95% confidence intervals of EEG levels of bi-centroparietal synchronization were estimated for eyes open (EO) and eyes closed (EC) states. Results: In the EC state, AD patients and HC had very similar levels of bi-centro parietal synchronization; but in the EO resting state, patients with AD had significantly higher levels of synchronization (AD = 0.44; interquartile range (IQR) 0.41 vs. HC = 0.15; IQR 0.17, p < 0.0001). The EO/EC synchronization ratio, a measure of the dynamic changes between the two states, also showed significant differences between these two groups (AD ratio 0.78 versus HC ratio 0.37 p < 0.0001). EO synchronization was also significantly different between AD and FTD (FTD = 0.075; IQR 0.03, p < 0.0001). However, the EO/EC ratio was not informative in the FTD group due to very low levels of synchronization in both states (EO and EC). Conclusion: In this pilot work, resting state quantitative EEG shows significant differences between healthy controls and patients with AD. This approach has the potential to develop into a useful non-invasive and economical diagnostic aid in AD. Full article

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10 pages, 245 KiB

Open AccessArticle

Synthetic Cannabinoid use in a Case Series of Patients with Psychosis Presenting to Acute Psychiatric Settings: Clinical Presentation and Management Issues

by Stefania Bonaccorso, Antonio Metastasio, Angelo Ricciardi, Neil Stewart, Leila Jamal, Naasir-Ud-Dinn Rujully, Christos Theleritis, Stefano Ferracuti, Giuseppe Ducci and Fabrizio Schifano

Brain Sci. 2018, 8(7), 133; https://doi.org/10.3390/brainsci8070133 - 14 Jul 2018

Cited by 17 | Viewed by 5677

Abstract

Background: Novel Psychoactive Substances (NPS) are a heterogeneous class of synthetic molecules including synthetic cannabinoid receptor agonists (SCRAs). Psychosis is associated with SCRAs use. There is limited knowledge regarding the structured assessment and psychometric evaluation of clinical presentations, analytical toxicology and clinical management [...] Read more.

Background: Novel Psychoactive Substances (NPS) are a heterogeneous class of synthetic molecules including synthetic cannabinoid receptor agonists (SCRAs). Psychosis is associated with SCRAs use. There is limited knowledge regarding the structured assessment and psychometric evaluation of clinical presentations, analytical toxicology and clinical management plans of patients presenting with psychosis and SCRAs misuse. Methods: We gathered information regarding the clinical presentations, toxicology and care plans of patients with psychosis and SCRAs misuse admitted to inpatients services. Clinical presentations were assessed using the PANSS scale. Vital signs data were collected using the National Early Warning Signs tool. Analytic chemistry data were collected using urine drug screening tests for traditional psychoactive substances and NPS. Results: We described the clinical presentation and management plan of four patients with psychosis and misuse of SCRAs. Conclusion: The formulation of an informed clinical management plan requires a structured assessment, identification of the index NPS, pharmacological interventions, increases in nursing observations, changes to leave status and monitoring of the vital signs. The objective from using these interventions is to maintain stable physical health whilst rapidly improving the altered mental state. Full article

(This article belongs to the Special Issue Recent Changes in Drug Abuse Scenario: The Novel Psychoactive Substances (NPS) Phenomenon)

16 pages, 1789 KiB

Open AccessArticle

A Multidisciplinary Approach Reveals an Age-Dependent Expression of a Novel Bioactive Peptide, Already Involved in Neurodegeneration, in the Postnatal Rat Forebrain

by Giovanni Ferrati, Emanuele Brai, Skye Stuart, Celia Marino and Susan A. Greenfield

Brain Sci. 2018, 8(7), 132; https://doi.org/10.3390/brainsci8070132 - 10 Jul 2018

Cited by 5 | Viewed by 4829

Abstract

The basal forebrain has received much attention due to its involvement in multiple cognitive functions, but little is known about the basic neuronal mechanisms underlying its development, nor those mediating its primary role in Alzheimer’s disease. We have previously suggested that a novel [...] Read more.

The basal forebrain has received much attention due to its involvement in multiple cognitive functions, but little is known about the basic neuronal mechanisms underlying its development, nor those mediating its primary role in Alzheimer’s disease. We have previously suggested that a novel 14-mer peptide, ‘T14’, could play a pivotal role in Alzheimer’s disease, via reactivation of a developmental signaling pathway. In this study, we have characterized T14 in the context of post-natal rat brain development, using a combination of different techniques. Ex-vivo rat brain slices containing the basal forebrain, at different stages of development, were used to investigate large-scale neuronal network activity in real time with voltage-sensitive dye imaging. Subsequent Western blot analysis revealed the expression profile of endogenous T14, its target alpha7 nicotinic receptor and the familiar markers of Alzheimer’s: amyloid beta and phosphorylated Tau. Results indicated maximal neuronal activity at the earliest ages during development, reflected in a concomitant profile of T14 peptide levels and related proteins. In conclusion, these findings show that the peptide, already implicated in neurodegenerative events, has an age-dependent expression, suggesting a possible contribution to the physiological mechanisms underlying brain maturation. Full article

(This article belongs to the Special Issue Mechanistic and Therapeutic Crosstalk across Neurodegenerative Diseases: What Can We Learn from Each Other?)

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17 pages, 272 KiB

Open AccessArticle

Perceived Discrimination and Substance Use among Caribbean Black Youth; Gender Differences

by Shervin Assari, Ritesh Mistry and Cleopatra Howard Caldwell

Brain Sci. 2018, 8(7), 131; https://doi.org/10.3390/brainsci8070131 - 9 Jul 2018

Cited by 28 | Viewed by 8686

Abstract

Although perceived discrimination in Black youth is a risk factor for a wide range of negative mental health outcomes, recent research has suggested some gender differences in these associations. Gender differences in vulnerability to perceived discrimination among Caribbean Black youth is, however, still [...] Read more.

Although perceived discrimination in Black youth is a risk factor for a wide range of negative mental health outcomes, recent research has suggested some gender differences in these associations. Gender differences in vulnerability to perceived discrimination among Caribbean Black youth is, however, still unknown. The current cross-sectional study investigated gender variations in the association between perceived discrimination and substance use (SU) in a national sample of Caribbean Black youth. Data came from the National Survey of American Life-Adolescents (NSAL-A), 2003–2004. This analysis included 360 Caribbean Black youth (165 males and 195 females) who were between 13 and 17 years old. Sociodemographic factors, perceived discrimination, and SU were measured. Logistic regressions were used for data analysis. Among Caribbean Black youth, a positive association was found between perceived discrimination and SU (odds ratio (OR) = 1.15 (95% confidence interval (CI) = 1.02–1.29)). A significant interaction was found between gender and perceived discrimination on smoking (OR = 1.23 (95% CI = 1.07–1.41)) suggesting that the association between perceived discrimination and smoking is larger for male than female Caribbean Black youth. The interaction between gender and perceived discrimination on SU was not statistically significant (OR = 1.32 (95% CI = 0.94–1.86)). While perceived discrimination increases SU in Caribbean Black youth, this effect is stronger for males than females, especially for smoking. While discrimination should be reduced at all levels and for all populations, clinicians may specifically address discrimination for SU prevention and treatment among male Caribbean Black youth. Full article

18 pages, 638 KiB

Open AccessArticle

Code-VEP vs. Eye Tracking: A Comparison Study

by Hooman Nezamfar, Seyed Sadegh Mohseni Salehi, Matt Higger and Deniz Erdogmus

Brain Sci. 2018, 8(7), 130; https://doi.org/10.3390/brainsci8070130 - 7 Jul 2018

Cited by 8 | Viewed by 4818

Abstract

Even with state-of-the-art techniques there are individuals whose paralysis prevents them from communicating with others. Brain–Computer-Interfaces (BCI) aim to utilize brain waves to construct a voice for those whose needs remain unmet. In this paper we compare the efficacy of a BCI input [...] Read more.

Even with state-of-the-art techniques there are individuals whose paralysis prevents them from communicating with others. Brain–Computer-Interfaces (BCI) aim to utilize brain waves to construct a voice for those whose needs remain unmet. In this paper we compare the efficacy of a BCI input signal, code-VEP via Electroencephalography, against eye gaze tracking, among the most popular modalities used. These results, on healthy individuals without paralysis, suggest that while eye tracking works well for some, it does not work well or at all for others; the latter group includes individuals with corrected vision or those who squint their eyes unintentionally while focusing on a task. It is also evident that the performance of the interface is more sensitive to head/body movements when eye tracking is used as the input modality, compared to using c-VEP. Sensitivity to head/body movement could be better in eye tracking systems which are tracking the head or mounted on the face and are designed specifically as assistive devices. The sample interface developed for this assessment has the same reaction time when driven with c-VEP or with eye tracking; approximately 0.5–1 second is needed to make a selection among the four options simultaneously presented. Factors, such as system reaction time and robustness play a crucial role in participant preferences. Full article

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12 pages, 254 KiB

Open AccessReview

Transcranial Magnetic Stimulation in Tourette Syndrome: A Historical Perspective, Its Current Use and the Influence of Comorbidities in Treatment Response

by Marco Grados, Rachel Huselid and Laura Duque-Serrano

Brain Sci. 2018, 8(7), 129; https://doi.org/10.3390/brainsci8070129 - 6 Jul 2018

Cited by 27 | Viewed by 6438

Abstract

Background. Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder consisting of impairing motor and vocal tics which often persists adolescent and adult years. In this older refractory group, standard treatments such as pharmacotherapy and psychotherapeutic interventions may only have limited effects. Based on [...] Read more.

Background. Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder consisting of impairing motor and vocal tics which often persists adolescent and adult years. In this older refractory group, standard treatments such as pharmacotherapy and psychotherapeutic interventions may only have limited effects. Based on electrical cortical dysregulation in individuals with TS, a novel approach has employed brain stimulation strategies to modulate the putative aberrant neural electrical activity in pathways that may underlie tics, such as insula-supplementary motor area (SMA) connectivity. Methods. This review will examine all published clinical trials employing transcranial magnetic stimulation (TMS) to ameliorate tics, and discuss a framework for the pathophysiology of TS in relation to electrical brain activity. A framework for future research in tic disorders using TMS and imaging targeting neuroplasticity will be discussed. Results. Therapeutic electrical brain activity modulation with TMS has been carried out in stroke neuro-rehabilitation and neuropsychiatry, including trials in TS. Eleven trials document the use of TMS in TS targeting several brain areas, a positive effect is seen for those trials targeting the SMA. In particular, it appears that younger individuals with concurrent attention-deficit hyperactivity disorder (ADHD) benefit the most. Conclusions. TMS can be used as an effective tool to explore the psychophysiology of TS and potentially provide a therapeutic option. Ultimately, translational research using TMS in TS needs to explore connectivity differences pre- and post-treatment in individuals with TS that are linked to improvement in tic symptoms, with an emphasis on approaches using functional neuroimaging as well as other probes of neuroplasticity. Full article

(This article belongs to the Special Issue Cerebral Etiology and Treatment of the Gilles de la Tourette Syndrome)

11 pages, 421 KiB

Open AccessArticle

Trait Emotional Empathy and Resting State Functional Connectivity in Default Mode, Salience, and Central Executive Networks

by Elena Bilevicius, Tiffany A. Kolesar, Stephen D. Smith, Paul D. Trapnell and Jennifer Kornelsen

Brain Sci. 2018, 8(7), 128; https://doi.org/10.3390/brainsci8070128 - 6 Jul 2018

Cited by 27 | Viewed by 6275

Abstract

Emotional empathy is the ability to experience and/or share another person’s emotional states and responses. Although some research has examined the neural correlates of emotional empathy, there has been little research investigating whether this component of empathy is related to the functional connectivity [...] Read more.

Emotional empathy is the ability to experience and/or share another person’s emotional states and responses. Although some research has examined the neural correlates of emotional empathy, there has been little research investigating whether this component of empathy is related to the functional connectivity of resting state networks in the brain. In the current study, 32 participants answered a trait emotional empathy questionnaire in a session previous to their functional magnetic resonance imaging scan. Results indicate that emotional empathy scores were correlated with different patterns of functional connectivity in the default mode network (DMN), salience network (SN), and left and right central executive networks. For example, within the DMN, emotional empathy scores positively correlated with connectivity in the premotor cortex. Within the SN, empathy scores were positively correlated with the fusiform gyrus and cuneus. These findings demonstrate that emotional empathy is associated with unique patterns of functional connectivity in four of the brain’s resting state networks. Full article

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15 pages, 1857 KiB

Open AccessArticle

Maternal Biomarkers of Acetaminophen Use and Offspring Attention Deficit Hyperactivity Disorder

by Yuelong Ji, Anne W. Riley, Li-Ching Lee, Xiumei Hong, Guoying Wang, Hui-Ju Tsai, Noel T. Mueller, Colleen Pearson, Jessica Thermitus, Anita Panjwani, Hongkai Ji, Tami R. Bartell, Irina Burd, M. Daniele Fallin and Xiaobin Wang

Brain Sci. 2018, 8(7), 127; https://doi.org/10.3390/brainsci8070127 - 3 Jul 2018

Cited by 26 | Viewed by 7939

Abstract

Previous studies have suggested a positive association between self-reported maternal acetaminophen use during pregnancy and risk of attention deficit hyperactivity disorder (ADHD) in offspring. We sought to examine the prospective association between maternal plasma biomarkers of acetaminophen intake and ADHD diagnosis in the [...] Read more.

Previous studies have suggested a positive association between self-reported maternal acetaminophen use during pregnancy and risk of attention deficit hyperactivity disorder (ADHD) in offspring. We sought to examine the prospective association between maternal plasma biomarkers of acetaminophen intake and ADHD diagnosis in the offspring. This report analyzed 1180 children enrolled at birth and followed prospectively as part of the Boston Birth Cohort, including 188 with ADHD diagnosis based on electronic medical record review. Maternal biomarkers of acetaminophen intake were measured in plasma samples obtained within 1–3 days postpartum. Odds ratios for having ADHD diagnosis or other developmental disorders were estimated using multinomial logistic regression models, adjusting for pertinent covariables. Compared to neurotypical children, we observed significant positive dose-responsive associations with ADHD diagnosis for each maternal acetaminophen biomarker. These dose–responsive associations persisted after adjusting for indication of acetaminophen use and other pertinent covariates; and were specific to ADHD, rather than other neurodevelopmental disorders. In the stratified analyses, differential point estimates of the associations were observed across some strata of covariates. However, these differences were not statistically significant. Maternal acetaminophen biomarkers were specifically associated with increased risk of ADHD diagnosis in offspring. Additional clinical and mechanistic investigations are warranted. Full article

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14 pages, 2024 KiB

Open AccessArticle

A 20-Questions-Based Binary Spelling Interface for Communication Systems

by Alessandro Tonin, Niels Birbaumer and Ujwal Chaudhary

Brain Sci. 2018, 8(7), 126; https://doi.org/10.3390/brainsci8070126 - 2 Jul 2018

Cited by 4 | Viewed by 4900

Abstract

Brain computer interfaces (BCIs) enables people with motor impairments to communicate using their brain signals by selecting letters and words from a screen. However, these spellers do not work for people in a complete locked-in state (CLIS). For these patients, a near infrared [...] Read more.

Brain computer interfaces (BCIs) enables people with motor impairments to communicate using their brain signals by selecting letters and words from a screen. However, these spellers do not work for people in a complete locked-in state (CLIS). For these patients, a near infrared spectroscopy-based BCI has been developed, allowing them to reply to “yes”/”no” questions with a classification accuracy of 70%. Because of the non-optimal accuracy, a usual character-based speller for selecting letters or words cannot be used. In this paper, a novel spelling interface based on the popular 20-questions-game has been presented, which will allow patients to communicate using only “yes”/”no” answers, even in the presence of poor classification accuracy. The communication system is based on an artificial neural network (ANN) that estimates a statement thought by the patient asking less than 20 questions. The ANN has been tested in a web-based version with healthy participants and in offline simulations. Both results indicate that the proposed system can estimate a patient’s imagined sentence with an accuracy that varies from 40%, in the case of a “yes”/”no” classification accuracy of 70%, and up to 100% in the best case. These results show that the proposed spelling interface could allow patients in CLIS to express their own thoughts, instead of only answer to “yes”/”no” questions. Full article

(This article belongs to the Special Issue Brain-Computer Interfaces for Human Augmentation)

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10 pages, 244 KiB

Open AccessReview

End-of-Life Care in High-Grade Glioma Patients. The Palliative and Supportive Perspective

by Giuseppe Roberto Giammalva, Domenico Gerardo Iacopino, Giorgio Azzarello, Claudia Gaggiotti, Francesca Graziano, Carlo Gulì, Maria Angela Pino and Rosario Maugeri

Brain Sci. 2018, 8(7), 125; https://doi.org/10.3390/brainsci8070125 - 30 Jun 2018

Cited by 46 | Viewed by 10686

Abstract

High-grade gliomas (HGGs) are the most frequently diagnosed primary brain tumors. Even though it has been demonstrated that combined surgical therapy, chemotherapy, and radiotherapy improve survival, HGGs still harbor a very poor prognosis and limited overall survival. Differently from other types of primary [...] Read more.

High-grade gliomas (HGGs) are the most frequently diagnosed primary brain tumors. Even though it has been demonstrated that combined surgical therapy, chemotherapy, and radiotherapy improve survival, HGGs still harbor a very poor prognosis and limited overall survival. Differently from other types of primary neoplasm, HGG manifests also as a neurological disease. According to this, palliative care of HGG patients represents a peculiar challenge for healthcare providers and caregivers since it has to be directed to both general and neurological cancer symptoms. In this way, the end-of-life (EOL) phase of HGG patients appears to be like a journey through medical issues, progressive neurological deterioration, and psychological, social, and affective concerns. EOL is intended as the time prior to death when symptoms increase and antitumoral therapy is no longer effective. In this phase, palliative care is intended as an integrated support aimed to reduce the symptoms burden and improve the Quality Of Life (QOL). Palliative care is represented by medical, physical, psychological, spiritual, and social interventions which are primarily aimed to sustain patients’ functions during the disease time, while maintaining an acceptable quality of life and ensuring a dignified death. Since HGGs represent also a family concern, due to the profound emotional and relational issues that the progression of the disease poses, palliative care may also relieve the distress of the caregivers and increase the satisfaction of patients’ relatives. We present the results of a literature review addressed to enlighten and classify the best medical, psychological, rehabilitative, and social interventions that are addressed both to patients and to their caregivers, which are currently adopted as palliative care during the EOL phase of HGG patients in order to orientate the best medical practice in HGG management. Full article

(This article belongs to the Special Issue Optimizing Management of High Grade Glioma)

11 pages, 261 KiB

Open AccessArticle

Suicide Attempts in Michigan HealthCare System; Racial Differences

by Shervin Assari

Brain Sci. 2018, 8(7), 124; https://doi.org/10.3390/brainsci8070124 - 30 Jun 2018

Cited by 15 | Viewed by 5176

Abstract

Background. Community-based studies have documented racial differences in social, psychiatric, and medical determinants of suicidal ideation; however, less is known about racial differences in the profile of suicide attempts in clinical settings. Aim. The current study aimed to compare Blacks and Whites who [...] Read more.

Background. Community-based studies have documented racial differences in social, psychiatric, and medical determinants of suicidal ideation; however, less is known about racial differences in the profile of suicide attempts in clinical settings. Aim. The current study aimed to compare Blacks and Whites who attempted suicide for demographic factors, socioeconomic status, medical history, psychiatric disorders, and outcomes. Methods. This retrospective study was a retrospective chart review of DataDirect, which is an electronic data repository of the Michigan Health Care System, 2014 to 2017. This analysis included 6147 suicide attempts (5388 Whites and 759 Blacks). Race, sociodemographic factors, medical history, psychiatric disorders, and outcomes were measured. Results. Blacks and Whites with suicide attempt did not differ in age or gender, but varied by insurance type. Blacks were more commonly under Medicare and Medicaid, while Whites were more commonly under private insurance or self-pay (p < 0.05). Blacks with suicide attempt were more likely to be obese, while Whites with suicide attempt were more likely to be underweight. Frequency of psychiatric disorders, including depression, alcohol abuse, drug abuse, and psychosis, were not different between Whites and Blacks with suicide attempt; however, medical conditions showed a different profile across racial groups. When compared to Whites, Blacks had higher prevalence of uncomplicated hypertension, renal failure, chronic obstructive pulmonary disease, coagulopathy, and obesity (p < 0.05 for all comparisons). In contrast, Whites had higher prevalence of other neurological disorders than Blacks. There were no differences in in-patient survival rate between Whites and Blacks who attempted suicide. Conclusion. There are considerable differences between Blacks and Whites with at least one suicide attempt. Although their psychiatric diagnoses seem to be similar, Blacks who have attempted suicide attempt have more medical comorbidities than their White counterparts. Lack of racial disparities in in-patient mortality rate of suicide attempts in the Michigan Health Care System is promising news given the higher physical health needs of Blacks when compared to Whites. Full article

9 pages, 623 KiB

Open AccessReview

Sales and Advertising Channels of New Psychoactive Substances (NPS): Internet, Social Networks, and Smartphone Apps

by Cristina Miliano, Giulia Margiani, Liana Fattore and Maria Antonietta De Luca

Brain Sci. 2018, 8(7), 123; https://doi.org/10.3390/brainsci8070123 - 29 Jun 2018

Cited by 53 | Viewed by 9017

Abstract

In the last decade, the trend of drug consumption has completely changed, and several new psychoactive substances (NPS) have appeared on the drug market as legal alternatives to common drugs of abuse. Designed to reproduce the effects of illegal substances like cannabis, ecstasy, [...] Read more.

In the last decade, the trend of drug consumption has completely changed, and several new psychoactive substances (NPS) have appeared on the drug market as legal alternatives to common drugs of abuse. Designed to reproduce the effects of illegal substances like cannabis, ecstasy, cocaine, or ketamine, NPS are only in part controlled by UN conventions and represent an emerging threat to global public health. The effects of NPS greatly differ from drug to drug and relatively scarce information is available at present about their pharmacology and potential toxic effects. Yet, compared to more traditional drugs, more dangerous short- and long-term effects have been associated with their use, and hospitalizations and fatal intoxications have also been reported after NPS use. In the era of cyberculture, the Internet acts as an ideal platform to promote and market these compounds, leading to a global phenomenon. Hidden by several aliases, these substances are sold across the web, and information about consumption is shared by online communities through drug fora, YouTube channels, social networks, and smartphone applications (apps). This review intends to provide an overview and analysis of social media that contribute to the popularity of NPS especially among young people. The possibility of using the same channels responsible for their growing diffusion to make users aware of the risks associated with NPS use is proposed. Full article

(This article belongs to the Special Issue Recent Changes in Drug Abuse Scenario: The Novel Psychoactive Substances (NPS) Phenomenon)

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13 pages, 702 KiB

Open AccessArticle

Education and Income Predict Future Emotional Well-Being of Whites but Not Blacks: A Ten-Year Cohort

by Shervin Assari, Brianna Preiser and Marisa Kelly

Brain Sci. 2018, 8(7), 122; https://doi.org/10.3390/brainsci8070122 - 29 Jun 2018

Cited by 67 | Viewed by 8368

Abstract

Background: The Minorities’ Diminished Return (MDR) theory is defined as systematically smaller effects of socioeconomic status (SES) on the health and well-being of minority groups when compared to Whites. To extend the existing literature on the MDR theory as applied to the change [...] Read more.

Background: The Minorities’ Diminished Return (MDR) theory is defined as systematically smaller effects of socioeconomic status (SES) on the health and well-being of minority groups when compared to Whites. To extend the existing literature on the MDR theory as applied to the change of mental well-being over time, we investigated Black-White differences in the effects of baseline education and income on subsequent changes in positive and negative affect over a ten-year period. Methods: The Midlife in the United States (MIDUS) is a 10-year longitudinal study of American adults. This analysis followed 3731 adults who were either Whites (n = 3596) or Blacks (n = 135) for 10 years. Education and income, as measured at baseline and 10 years later, were the independent variables. Negative and positive affect, measured at baseline and over ten years of follow up, were the dependent variables. Covariates were age, gender, and physical health (body mass index, self-rated health, and chronic medical conditions), measured at baseline. Race was the focal moderator. We ran multi-group structural equation modeling in the overall sample, with race defining the groups. Results: High education at baseline was associated with an increase in income over the 10-year follow up period for Whites but not Blacks. An increase in income during the follow up period was associated with an increase in the positive affect over time for Whites but not Blacks. Conclusion: The MDR theory is also relevant to the effects of baseline education attainment on subsequent changes in income and then in turn on positive affect over time. The relative disadvantage of Blacks in comparison to Whites in receiving mental health gains from SES may reflect structural racism and discrimination in the United States. There is a need for additional research on specific societal barriers that minimize Blacks’ mental health gains from their SES resources, such as education and income. There is also a need for policies and programs that help Blacks to leverage their SES resources. Full article

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29 pages, 738 KiB

Open AccessReview

On the Developmental Timing of Stress: Delineating Sex-Specific Effects of Stress across Development on Adult Behavior

by Anna Schroeder, Michael Notaras, Xin Du and Rachel A. Hill

Brain Sci. 2018, 8(7), 121; https://doi.org/10.3390/brainsci8070121 - 29 Jun 2018

Cited by 39 | Viewed by 6894

Abstract

Stress, and the chronic overactivation of major stress hormones, is associated with several neuropsychiatric disorders. However, clinical literature on the exact role of stress either as a causative, triggering, or modulatory factor to mental illness remains unclear. We suggest that the impact of [...] Read more.

Stress, and the chronic overactivation of major stress hormones, is associated with several neuropsychiatric disorders. However, clinical literature on the exact role of stress either as a causative, triggering, or modulatory factor to mental illness remains unclear. We suggest that the impact of stress on the brain and behavior is heavily dependent on the developmental timing at which the stress has occurred, and as such, this may contribute to the overall variability reported on the association of stress and mental illness. Here, animal models provide a way to comprehensively assess the temporal impact of stress on behavior in a controlled manner. This review particularly focuses on the long-term impact of stress on behavior in various rodent stress models at three major developmental time points: early life, adolescence, and adulthood. We characterize the various stressor paradigms into physical, social, and pharmacological, and discuss commonalities and differences observed across these various stress-inducing methods. In addition, we discuss here how sex can influence the impact of stress at various developmental time points. We conclude here that early postnatal life and adolescence represent particular periods of vulnerability, but that stress exposure during early life can sometimes lead to resilience, particularly to fear-potentiated memories. In the adult brain, while shorter periods of stress tended to enhance spatial memory, longer periods caused impairments. Overall, males tended to be more vulnerable to the long-term effects of early life and adolescent stress, albeit very few studies incorporate both sexes, and further well-powered sex comparisons are needed. Full article

(This article belongs to the Special Issue Sex Differences in the Healthy and Diseased Brain)

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13 pages, 1717 KiB

Open AccessArticle

Neuroprotective Role of N-acetylcysteine against Learning Deficits and Altered Brain Neurotransmitters in Rat Pups Subjected to Prenatal Stress

by Liegelin Kavitha Bernhardt, K. Lakshminarayana Bairy and Sampath Madhyastha

Brain Sci. 2018, 8(7), 120; https://doi.org/10.3390/brainsci8070120 - 28 Jun 2018

Cited by 5 | Viewed by 4660

Abstract

Prenatal adversaries like stress are known to harm the progeny and oxidative stress, which is known to be one of the causative factors. N-acetyl cysteine (NAC), which is a potent antioxidant, has been shown to play a neuroprotective role in humans and [...] Read more.

Prenatal adversaries like stress are known to harm the progeny and oxidative stress, which is known to be one of the causative factors. N-acetyl cysteine (NAC), which is a potent antioxidant, has been shown to play a neuroprotective role in humans and experimental animals. This study examines the benefits of NAC on the prenatal stress-induced learning and memory deficits and alteration in brain neurotransmitter in rat pups. Pregnant dams were restrained (45 min; 3 times/day) during the early or late gestational period. Other groups received early or late gestational restrain stress combined with NAC treatment throughout the gestational period. At postnatal day (PND) 28, offspring were tested in a shuttle box for assessing learning and memory, which was followed by a brain neurotransmitter (dopamine, norepinephrine, and serotonin) estimation on PND 36. Late gestational stress resulted in learning deficits, the inability to retain the memory, and reduced brain dopamine content while not affecting norepinephrine and serotonin. NAC treatment in prenatally stressed rats reversed learning and memory deficits as well as brain dopamine content in offspring. These findings suggest that NAC protect the progeny from an undesirable cognitive sequel associated with prenatal stress. Full article

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19 pages, 2349 KiB

Open AccessArticle

Ethanol Reinforcement Elicits Novel Response Inhibition Behavior in a Rat Model of Ethanol Dependence

by Sucharita S. Somkuwar, Leon W. Quach, Jacqueline A. Quigley, Dvijen C. Purohit, McKenzie J. Fannon, George F. Koob and Chitra D. Mandyam

Brain Sci. 2018, 8(7), 119; https://doi.org/10.3390/brainsci8070119 - 26 Jun 2018

Cited by 4 | Viewed by 4086

Abstract

Lower impulse control is a known risk factor for drug abuse vulnerability. Chronic experience with illicit drugs is suggested to enhance impulsivity and thereby perpetuate addiction. However, the nature of this relationship (directionality, causality) with regard to alcohol use disorder is unclear. The [...] Read more.

Lower impulse control is a known risk factor for drug abuse vulnerability. Chronic experience with illicit drugs is suggested to enhance impulsivity and thereby perpetuate addiction. However, the nature of this relationship (directionality, causality) with regard to alcohol use disorder is unclear. The present study tested the hypothesis that higher impulsivity is observed during chronic intermittent ethanol vapor inhalation (CIE; a model of ethanol dependence) and subsequent abstinence from CIE in adult Wistar rats. Impulsivity was tested using a differential reinforcement of low rates 15 s (DRL15) schedule using either nondrug reward (palatable modified sucrose pellets) or sweetened ethanol. A decrease in the efficiency of earning reinforcers (expressed as % reinforcers/responses) is indicative of a decrease in response inhibition or an increase in impulsivity. The efficiency of reinforcement and amount of reinforcers earned were unaltered in CIE and control animals when the reinforcer was sucrose. When the reinforcer was sweetened ethanol, the efficiency of reinforcement increased in CIE rats compared with controls only during protracted abstinence. Responding for sweetened ethanol under a progressive-ratio schedule was more rapid in CIE rats during protracted abstinence. Contrary to the initial hypothesis, impulsivity did not increase in rats with a history of CIE; instead, it decreased when ethanol was used as the reinforcer. Furthermore, although the efficiency of ethanol reinforcement did not differ between CIE and control animals during CIE, CIE rats escalated the amount of sweetened ethanol consumed, suggesting that behavioral adaptations that are induced by CIE in rats that are tested under a DRL15 schedule appear to be targeted toward the maximization of ethanol intake and thus may contribute to escalation and relapse. Full article

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15 pages, 938 KiB

Open AccessArticle

Reelin Haploinsufficiency and Late-Adolescent Corticosterone Treatment Induce Long-Lasting and Female-Specific Molecular Changes in the Dorsal Hippocampus

by Anna Schroeder, Maarten Van den Buuse and Rachel A. Hill

Brain Sci. 2018, 8(7), 118; https://doi.org/10.3390/brainsci8070118 - 25 Jun 2018

Cited by 6 | Viewed by 4924

Abstract

Reelin depletion and stress seem to affect similar pathways including GABAergic and glutamatergic signaling and both are implicated in psychiatric disorders in late adolescence/early adulthood. The interaction between reelin depletion and stress, however, remains unclear. To investigate this, male and female heterozygous reelin [...] Read more.

Reelin depletion and stress seem to affect similar pathways including GABAergic and glutamatergic signaling and both are implicated in psychiatric disorders in late adolescence/early adulthood. The interaction between reelin depletion and stress, however, remains unclear. To investigate this, male and female heterozygous reelin mice (HRM) and wildtype (WT) controls were treated with the stress hormone, corticosterone (CORT), during late adolescence to simulate chronic stress. Glucocorticoid receptors (GR), N-methyl-d-aspartate receptor (NMDAr) subunits, glutamic acid decarboxylase (GAD₆₇) and parvalbumin (PV) were measured in the hippocampus and the prefrontal cortex (PFC) in adulthood. While no changes were seen in male mice, female HRM showed a significant reduction in GR expression in the dorsal hippocampus. In addition, CORT reduced GR levels as well as GluN2B and GluN2C subunits of NMDAr in the dorsal hippocampus in female mice only. CORT furthermore reduced GluN1 levels in the PFC of female mice. The combined effect of HRM and CORT treatment appeared to be additive in terms of GR expression in the dorsal hippocampus. Female-specific CORT-induced changes were associated with overall higher circulating CORT levels in female compared to male mice. This study shows differential effects of reelin depletion and CORT treatment on GR and NMDAr protein expression in male and female mice, suggesting that females are more susceptible to reelin haploinsufficiency as well as late-adolescent stress. These findings shed more light on female-specific vulnerability to stress and have implications for stress-associated mental illnesses with a female bias including anxiety and major depression. Full article

(This article belongs to the Special Issue Sex Differences in the Healthy and Diseased Brain)

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12 pages, 1984 KiB

Open AccessArticle

Pallidal Stimulation Modulates Pedunculopontine Nuclei in Parkinson’s Disease

by Imke Galazky, Christian Kluge, Friedhelm C. Schmitt, Klaus Kopitzki, Tino Zaehle, Jürgen Voges, Lars Büntjen, Andreas Kupsch and Hermann Hinrichs

Brain Sci. 2018, 8(7), 117; https://doi.org/10.3390/brainsci8070117 - 25 Jun 2018

Cited by 1 | Viewed by 4438

Abstract

Background: In advanced Parkinson’s disease, the pedunculopontine nucleus region is thought to be abnormally inhibited by gamma-aminobutyric acid (GABA) ergic inputs from the over-active globus pallidus internus. Recent attempts to boost pedunculopontine nucleus function through deep brain stimulation are promising, but suffer from [...] Read more.

Background: In advanced Parkinson’s disease, the pedunculopontine nucleus region is thought to be abnormally inhibited by gamma-aminobutyric acid (GABA) ergic inputs from the over-active globus pallidus internus. Recent attempts to boost pedunculopontine nucleus function through deep brain stimulation are promising, but suffer from the incomplete understanding of the physiology of the pedunculopontine nucleus region. Methods: Local field potentials of the pedunculopontine nucleus region and the globus pallidus internus were recorded and quantitatively analyzed in a patient with Parkinson’s disease. In particular, we compared the local field potentials from the pedunculopontine nucleus region at rest and during deep brain stimulation of the globus pallidus internus. Results: At rest, the spectrum of local field potentials in the globus pallidus internus was mainly characterized by delta-theta and beta frequency activity whereas the spectrum of the pedunculopontine nucleus region was dominated by activity only in the delta and theta band. High-frequency deep brain stimulation of the globus pallidus internus led to increased theta activity in the pedunculopontine nucleus region and enabled information exchange between the left and right pedunculopontine nuclei. Therefore, Conclusions: When applying deep brain stimulation in the globus pallidus internus, its modulatory effect on pedunculopontine nucleus physiology should be taken into account. Full article

(This article belongs to the Special Issue Update on Deep Brain Stimulation: Technical Nuances and New Indications)

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24 pages, 3678 KiB

Open AccessArticle

High and Low Levels of an NTRK2-Driven Genetic Profile Affect Motor- and Cognition-Associated Frontal Gray Matter in Prodromal Huntington’s Disease

by Jennifer A. Ciarochi, Jingyu Liu, Vince Calhoun, Hans Johnson, Maria Misiura, H. Jeremy Bockholt, Flor A. Espinoza, Arvind Caprihan, Sergey Plis, Jessica A. Turner, Jane S. Paulsen and The PREDICT-HD Investigators and Coordinators of the Huntington Study Group

Brain Sci. 2018, 8(7), 116; https://doi.org/10.3390/brainsci8070116 - 22 Jun 2018

Cited by 4 | Viewed by 5052

Abstract

This study assessed how BDNF (brain-derived neurotrophic factor) and other genes involved in its signaling influence brain structure and clinical functioning in pre-diagnosis Huntington’s disease (HD). Parallel independent component analysis (pICA), a multivariate method for identifying correlated patterns in multimodal datasets, was applied [...] Read more.

This study assessed how BDNF (brain-derived neurotrophic factor) and other genes involved in its signaling influence brain structure and clinical functioning in pre-diagnosis Huntington’s disease (HD). Parallel independent component analysis (pICA), a multivariate method for identifying correlated patterns in multimodal datasets, was applied to gray matter concentration (GMC) and genomic data from a sizeable PREDICT-HD prodromal cohort (N = 715). pICA identified a genetic component highlighting NTRK2, which encodes BDNF’s TrkB receptor, that correlated with a GMC component including supplementary motor, precentral/premotor cortex, and other frontal areas (p < 0.001); this association appeared to be driven by participants with high or low levels of the genetic profile. The frontal GMC profile correlated with cognitive and motor variables (Trail Making Test A (p = 0.03); Stroop Color (p = 0.017); Stroop Interference (p = 0.04); Symbol Digit Modalities Test (p = 0.031); Total Motor Score (p = 0.01)). A top-weighted NTRK2 variant (rs2277193) was protectively associated with Trail Making Test B (p = 0.007); greater minor allele numbers were linked to a better performance. These results support the idea of a protective role of NTRK2 in prodromal HD, particularly in individuals with certain genotypes, and suggest that this gene may influence the preservation of frontal gray matter that is important for clinical functioning. Full article

(This article belongs to the Special Issue New Insights in Huntington's Disease)

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