Applause sign: is it really specific for Parkinsonian disorders? Evidence from cortical dementias.

Objective: The applause sign, originally reported as a specific sign of progressive supranuclear palsy (PSP), has recently been found in several parkinsonian disorders. Its nature is still uncertain. It has been interpreted as a motor perseveration or a form of apraxia.

Early activation of intracranial collateral vessels influences the outcome of spontaneous internal carotid artery dissection.

Background And Purpose: the effectiveness of different treatments for internal carotid artery (ICA) dissection has not been well defined. Lack of early prognostic indicators may represent a major problem in adequately identifying the most appropriate option for treatment. This study aimed at evaluating the influence of patients' vascular risk profiles and of early cerebral hemodynamic changes in determining the clinical evolution after ICA dissection.

Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery.

The application of continuous positive airway pressure (CPAP) produces important hemodynamic alterations, which can influence breathing pattern (BP) and heart rate variability (HRV). The aim of this study was to evaluate the effects of different levels of CPAP on postoperative BP and HRV after coronary artery bypass grafting (CABG) surgery and the impact of CABG surgery on these variables. Eighteen patients undergoing CABG were evaluated postoperatively during spontaneous breathing (SB) and application of four levels of CPAP applied in random order: sham (3 cmH₂O), 5 cmH₂O, 8 cmH₂O, and 12 cmH₂O.

Time delay from onset to diagnosis of migraine.

Objective: To investigate the factors involved in the delayed diagnosis of migraine without aura among patients attending a tertiary center for headache diagnosis and management.

Methods: Two hundred consecutive patients were divided into 3 groups according to the time elapsed from the first clinical manifestations and the diagnosis of migraine at our center.

Results: The interval was <1 year in 16.

Extracranial aneurysms of the posterior inferior cerebellar artery. Literature review and report of a new case.

Aneurysms arising from the extracranial portion of the posterior-inferior cerebellar artery (PICA) are considered extremely rare. To date, only ten cases have been reported in the literature. The authors report a case of a 29 year-old male patient admitted comatose in Hunt-Hess grade IV because of an subarachnoid haemorrhage predominantly involving the left cranio-vertebral junction up to C2 rather than the posterior fossa and the fourth ventricle.

Atherosclerosis in the evolution of Alzheimer's disease: can treatment reduce cognitive decline?

The relationship between cerebrovascular impairment and Alzheimer's disease is a controversial debate. An important and topical aspect in clinical research is the attempt to define the role of atherosclerosis and its determinants in the presentation and evolution of dementia. In this article, we discuss the evidence of the interaction between degenerative and vascular mechanisms in the pathogenesis of dementia.

Short-term supervised inpatient physiotherapy exercise protocol improves cardiac autonomic function after coronary artery bypass graft surgery--a randomised controlled trial.

Objective: Coronary artery bypass grafting (CABG) is accompanied by severe impairment of cardiac autonomous regulation (CAR). This study aimed to determine whether a short-term physiotherapy exercise protocol post-CABG, during inpatient cardiac rehabilitation (CR), might improve CAR.

Design: Seventy-four patients eligible for CABG were recruited and randomised into physiotherapy exercise group (EG) or physiotherapy usual care group (UCG).

Dissociation apraxia secondary to right premotor stroke.

Apraxia is usually associated with damage to the dominant parietal cortex, but several other areas, including the left dorsolateral frontal cortex and subcortical structures, have also been implicated, suggesting that the praxis system is mediated by an anatomically distributed network. The right premotor frontal cortex is commonly assumed to play a secondary role in this system. We describe a patient who developed left upper limb apraxia after a right premotor ischaemic stroke.

Jugular tubercle and vertebral artery/posterior inferior cerebellar artery anatomic relationship: a 3-dimensional angiography computed tomography anthropometric study.

Objective: To evaluate structural variations of the jugular tubercles (JTs) and their relationships with the vertebral artery, the posterior inferior cerebellar artery (PICA), and the vertebrobasilar junction (VBJ).

Methods: The depth, height, and width of the JTs were measured using 30 cadaveric basicranial specimens and 50 three-dimensional angiography computed tomographic (angio-CT) scans evaluating morphological variations between the 2 sides. Angio-CT analysis evaluated the relationships of the JTs with the vertebral arteries and the PICAs.

Short-term memory binding deficits in Alzheimer's disease.

Alzheimer's disease impairs long term memories for related events (e.g. faces with names) more than for single events (e.

Cystic dilation of the ventriculus terminalis in adults.

The ventriculus terminalis (VT) is a small ependyma-lined cavity within the conus medullaris that is in direct continuity with the central canal of the anterior portion of the spinal cord. Normally, such a cavity is identifiable only histologically in children and adults and can be visualized using common neuroradiological techniques only after dilation. Currently, the mechanisms of isolated dilation are not documented.

Evolution of a prolactin-secreting pituitary microadenoma into a fatal carcinoma: a case report.

Pituitary carcinomas are very rare tumors, nearly always presenting as widely invasive masses, although the hallmark of these lesions is the finding of distant metastases. One third of reported cases are prolactin (PRL)-secreting tumors. We report the case of a fatal pituitary carcinoma evolving within 4 years from a PRL-secreting microadenoma.

Foreign accent syndrome as the initial sign of primary progressive aphasia.

Foreign accent syndrome (FAS) is a rare speech disorder characterised by the emergence of a new accent, perceived by listeners as foreign. FAS has usually been described following focal brain insults, such as stroke. We describe the unusual case of a woman presenting with FAS as the earliest symptom of progressive degenerative brain disease.

A polycystic variant of a primary intracranial leptomeningeal astrocytoma: case report and literature review.

Background: Primary leptomeningeal astrocytomas are rare intracranial tumors. These tumors are believed to originate from cellular nests which migrate by means of aberration, ultimately settling in the leptomeningeal structure. They may occur in both solitary and diffuse forms.

Perception of emotions on happy/sad chimeric faces in Alzheimer disease: relationship with cognitive functions.

Aims: To investigate the ability to recognize facial emotions in patients with Alzheimer disease (AD). Happiness and sadness, fundamental emotions that are easily recognized across cultures, were evaluated. Results were further analyzed in relation to demographic, clinical, and neuropsychologic characteristics.

Distinct patterns of olfactory impairment in Alzheimer's disease, semantic dementia, frontotemporal dementia, and corticobasal degeneration.

Performance on tests of odour discrimination, naming, and matching was compared in patients with four distinct forms of neurodegenerative disease: Alzheimer's disease (AD), semantic dementia (SD), frontotemporal dementia (FTD), and corticobasal degeneration (CBD). The SD patients were found to have a severe impairment of identification from olfaction despite having normal discrimination, consistent with the multimodal semantic impairment characteristic of this patient group. The AD patients' poor odour discrimination suggests that a perceptual impairment is the root of their poor odour identification.

Emergency surgery in a severe penetrating skull base injury by a screwdriver: case report and literature review.

Background: Very few cases of severe penetrating injuries to the skull base with a seemingly innocuous object have been described in the literature. Of the cases reported, only ten involve a penetrating screwdriver. However, the choice of therapeutic management, whether it be emergency surgical or non-surgical removal of the penetrating object as well as the selected surgical approach remain quite controversial.

Modifications of platelet from Alzheimer disease patients: a possible relation between membrane properties and NO metabolites.

Alzheimer disease (AD) is a chronic neurodegenerative disorder characterised by a progressive loss of memory and cognitive functions. The formation of nitric oxide (NO), by astrocytes, has been suggested to contribute to the neurodegnerative process. Some studies have described the participation of different isoforms of NOS in the progression of AD.

The influences of positive end expiratory pressure (PEEP) associated with physiotherapy intervention in phase I cardiac rehabilitation.

Purpose: To evaluate the effects of positive end expiratory pressure and physiotherapy intervention during Phase I of cardiac rehabilitation on the behavior of pulmonary function and inspiratory muscle strength in postoperative cardiac surgery.

Methods: A prospective randomized study, in which 24 patients were divided in 2 groups: a group that performed respiratory exercises with positive airway expiratory pressure associated with physiotherapy intervention (GEP, n = 8) and a group that received only the physiotherapy intervention (GPI, n = 16). Pulmonary function was evaluated by spirometry on the preoperative and on the fifth postoperative days; inspiratory muscle strength was measured by maximal inspiratory pressure on the same days.

Peroxynitrite production and NOS expression in astrocytes U373MG incubated with lipoproteins from Alzheimer patients.

Apolipoprotein E (apo E), a plasma protein involved both in the metabolism of cholesterol and triglycerides, particularly in nervous tissue, has been associated with a higher risk of Alzheimer's disease. It has been shown that apo E increased the production of nitric oxide (NO) from human monocyte-derived macrophages (MDM); this effect could represent an important link between tissue redox balance and inflammation, since inflammation and oxidative stress are involved in chronic neurodegenerative disorders. Moreover, it has been evidenced that an overproduction of NO in the central nervous system (CNS) may play a key role in aging and that the glial cells (microglials cells and probably astrocytes) are able to form consistent amounts of NO through the induction of a nitric oxide synthase (iNOS) isoform so-called inducible or inflammatory.

L-arginine analogs as alternate substrates for nitric oxide synthase.

The L-arginine analogs, N(delta)-methyl-L-arginine (deltaMA) and L-canavanine, were used to probe the role of the N delta nitrogen of L-arginine in the reaction catalyzed by nitric oxide synthase (NOS). deltaMA was synthesized and found to be a partial alternate substrate and a weak, reversible inhibitor of NOS with a Ki equal to 1.4 mM.

Lateralization of ventral and dorsal auditory-language pathways in the human brain.

Recent electrophysiological investigations of the auditory system in primates along with functional neuroimaging studies of auditory perception in humans have suggested there are two pathways arising from the primary auditory cortex. In the primate brain, a 'ventral' pathway is thought to project anteriorly from the primary auditory cortex to prefrontal areas along the superior temporal gyrus while a separate 'dorsal' route connects these areas posteriorly via the inferior parietal lobe. We use diffusion MRI tractography, a noninvasive technique based on diffusion-weighted MRI, to investigate the possibility of a similar pattern of connectivity in the human brain for the first time.

Motivational symptoms of depression mask preclinical Alzheimer's disease in elderly subjects.

Background: Althoughthe relationship between depressive disorders and Alzheimer's disease (AD) is debated, there is evidence that depression may be an early symptom of dementia.

Objective: To evaluate depression features prospectively in elderly subjects with a view to identifying a subgroup affected by preclinical AD.

Methods: We performed a cohort study on cognitive performances with a 12-month follow-up in out-patients referred to the local Neuropsychology Clinic complaining of memory problems.