Acupuncture : a promising approach for Comorbid depression and insomnia in perimenopause
- Authors: Zhao, Fei , Fu, Qiang-Aiang , Spencer, Sarah , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article
- Relation: Nature and Science of Sleep Vol. 13, no. (2021), p. 1823-1863
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- Description: Comorbid depression and insomnia are ubiquitous mental complaints among women going through the perimenopausal stage of life and can result in major decline in quality of life. Antidepressive agents combined with/without hypnotics, and/or hormone therapy are currently the most common treatment for perimenopausal depression (PMD) and insomnia (PMI). Balancing the benefits of these pharmacotherapies against the risk of adverse events (AEs) is a difficult task for both clinicians and women. There has been a growing body of research regarding the utilization of acupuncture for treatment of PMD or PMI, whereas no studies of acupuncture for comorbid PMD and PMI have appeared. In this review, we summarize the clinical and preclinical evidence of acupuncture as a treatment for PMD or PMI, and then discuss the potential mechanisms involved and the role of acupuncture in helping women during this transition. Most clinical trials indicate that acupuncture ameliorates not only PMD/PMI but also climacteric symptoms with minimal AEs. It also regulates serum hormone levels. The reliability of trials is however limited due to methodological flaws in most studies. Rodent studies suggest that acupuncture prolongs total sleep time and reduces depression-like behavior in PMI and PMD models, respectively. These effects are possibly mediated through multiple mechanisms of action, including modulating sex hormones, neurotransmitters, hypothalamic-pituitary-adrenal axis/hypothalamic-pituitary-ovary axis, oxidative stress, signaling pathways, and other cellular events. In conclusion, acupuncture is a promising therapeutic strategy for comorbid depression and insomnia during perimenopause. Neuroendocrine modulation is likely to play a major role in mediating those effects. High-quality trials are required to further validate acupuncture’s effectiveness. © 2021 Zhao et al.
Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- Authors: Feigin, Valery , Stark, Benjamin , Johnson, Catherine , Roth, Gregory , Rahman, Muhammad Aziz
- Date: 2021
- Type: Text , Journal article
- Relation: The Lancet Neurology Vol. 20, no. 10 (2021), p. 1-26
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- Description: Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
Quantifying psychopathology in rapid readmissions
- Authors: Suhail, Sam , Sandhu, Harpinder , Mellacheruvu, Sandeep
- Date: 2021
- Type: Text , Journal article
- Relation: CNS spectrums Vol. 26, no. 2 (2021), p. 165-166
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- Description: Psychiatric readmissions contribute to a significant cost and healthcare burden to physicians, hospitals, and the healthcare system as an entity. Furthermore, as part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) began to reduce financial coverage to hospitals with overwhelming rehospitalization rates. The purpose of this study was to do a systematic analysis on inpatient psychiatric readmission data and identify co-morbidities and risk factors that lead to high readmission rates. The data collection includes 163 patients with a total of 348 readmissions over the span of 90 days at one inner-city hospital in the Chicagoland area. Study findings suggest that higher rates of readmission are linked to cocaine abuse in both male and female populations. Diagnosis of bipolar in females and schizoaffective disorder in male populations were the among the highest for readmission. Key social factors such as homelessness and low socioeconomic status were identified to contribute to a large proportion of psychiatric readmission burden. However, an overwhelming amount of information was missing due to unobtained labs and lack of current patient social history. By using this data as well as data from electronic medical records (EMRs) to further investigate and identify other features of at-risk patients, hospitals can potentially address these markers to lower readmission rates. Ultimately, a higher understanding of the patients' needs can be understood and can help develop standardized plans of care for prevalent psychiatric illnesses in these populations.
Comparative effectiveness of three exercise types to treat clinical depression in older adults : a systematic review and network meta-analysis of randomised controlled trials
- Authors: Miller, Kyle , Gonçalves-Bradley, Daniela , Areerob, Pinyadapat , Hennessy, Declan , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Ageing Research Reviews Vol. 58 (2020).
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- Description: Background: Few studies have directly compared the effects of different exercise therapies on clinical depression in older adults. Thus, we conducted a systematic review and network meta-analysis of current evidence from randomised controlled trials (RCTs) to compare the effectiveness of three major exercise types (aerobic, resistance, and mind-body exercise) in clinically depressed older adults. Methods: We followed PRISMA-NMA guidelines and searched databases for eligible RCTs (inception – September 12th, 2019). RCTs were eligible if they included clinically depressed adults aged >65 years, implemented one or more exercise therapy arms using aerobic, resistance, or mind-body exercise, and assessed depressive symptoms at baseline and follow-up using a validated clinical questionnaire. Results: A network meta-analysis was performed on 15 eligible RCTs comprising 596 participants (321 treatment and 275 controls), including aerobic (n = 6), resistance (n = 5), and mind-body (n = 4) exercise trials. Compared with controls, mind-body exercise showed the largest improvement on depressive symptoms (g = −0.87 to −1.38), followed by aerobic exercise (g = −0.51 to −1.02), and resistance exercise (g = −0.41 to −0.92). Notably, there were no statistically significant differences between exercise types: aerobic versus resistance (g = −0.10, PrI = −2.23, 2.03), mind-body versus aerobic (g = −0.36, PrI = −2.69, 1.97), or mind-body versus resistance (g = −0.46, PrI = −2.75, 1.83). Conclusions: These findings should guide optimal exercise prescription for allied health professionals and stakeholders in clinical geriatrics. Notably, clinically depressed older adults may be encouraged to self-select their preferred exercise type in order to achieve therapeutic benefit on symptoms of depression. In coalition with high levels of compliance, these data provide encouraging evidence for the antidepressant effect of either aerobic, resistance, or mind-body exercise as effective treatment adjucts for older adults presenting with clinical depression. © 2019
High CD26 and low CD94 expression identifies an IL-23 responsive Vδ2+ T Cell subset with a MAIT cell-like transcriptional profile
- Authors: Wragg, Kathleen , Tan, Hyon , Kristensen, Anne , Nguyen-Robertson, Catriona , Kelleher, Anthony , Parsons, Matthew , Wheatley, Adam , Berzins, Stuart , Pellicci, Daniel , Kent, Stephen , Juno, Jennifer
- Date: 2020
- Type: Text , Journal article
- Relation: Cell Reports Vol. 31, no. 11 (2020), p.
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- Description: Vδ2+ T cells play a critical role in immunity to micro-organisms and cancer but exhibit substantial heterogeneity in humans. Here, we demonstrate that CD26 and CD94 define transcriptionally, phenotypically, and functionally distinct Vδ2+ T cell subsets. Despite distinct antigen specificities, CD26hiCD94lo Vδ2+ cells exhibit substantial similarities to CD26hi mucosal-associated invariant T (MAIT) cells, although CD26− Vδ2+ cells exhibit cytotoxic, effector-like profiles. At birth, the Vδ2+Vγ9+ population is dominated by CD26hiCD94lo cells; during adolescence and adulthood, Vδ2+ cells acquire CD94/NKG2A expression and the relative frequency of the CD26hiCD94lo subset declines. Critically, exposure of the CD26hiCD94lo subset to phosphoantigen in the context of interleukin-23 (IL-23) and CD26 engagement drives the acquisition of a cytotoxic program and concurrent loss of the MAIT cell-like phenotype. The ability to modulate the cytotoxic potential of CD26hiCD94lo Vδ2+ cells, combined with their adenosine-binding capacity, may make them ideal targets for immunotherapeutic expansion and adoptive transfer. Wragg et al. identify a population of human gd T cells with striking similarities to MAIT cells. These cells dominate the cord blood Vd2 population and upregulate an effector-like program upon antigen and IL-23 stimulation, providing a potential mechanism by which cytotoxic Vd2 cells may accumulate during adolescence and adulthood. © 2020
- Description: National Health and Medical Research Council, NHMRC
Repeated long-term sub-concussion impacts induce motor dysfunction in rats : a potential rodent model
- Authors: Lavender, Andrew , Rawlings, Samuel , Warnock, Andrew , McGonigle, Terry , Hiles-Murison, Bailey , Nesbit, Michael , Lam, Virginie , Hackett, Mark , Fitzgerald, Melinda , Takechi, Ryusuke
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Neurology Vol. 11, no. (2020), p.
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- Description: Whilst detrimental effects of repeated sub-concussive impacts on neurophysiological and behavioral function are increasingly reported, the underlying mechanisms are largely unknown. Here, we report that repeated sub-concussion with a light weight drop (25 g) in wild-type PVG rats for 2 weeks does not induce detectable neuromotor dysfunction assessed by beamwalk and rotarod tests. However, after 12 weeks of repeated sub-concussion, the rats exhibited moderate neuromotor dysfunction. This is the first study to demonstrate development of neuromotor dysfunction following multiple long-term sub-concussive impacts in rats. The outcomes may offer significant opportunity for future studies to understand the mechanisms of sub-concussion-induced neuropsychological changes. © Copyright © 2020 Lavender, Rawlings, Warnock, McGonigle, Hiles-Murison, Nesbit, Lam, Hackett, Fitzgerald and Takechi.
A randomized controlled trial of MoodSwings 2.0 : An internet-based self-management program for bipolar disorder
- Authors: Gliddon, Emma , Cosgrove, Victoria , Berk, Lesley , Lauder, Sue , Mohebbi, Mohammadreza , Grimm, David , Dodd, Seetal , Coulson, Carolyn , Raju, Karishma , Suppes, Trisha , Berk, Michael
- Date: 2019
- Type: Text , Journal article
- Relation: Bipolar Disorders Vol. 21, no. 1 (2019), p. 28-39
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- Description: Objectives MoodSwings 2.0 is an online self-guided intervention for bipolar disorder that includes educational modules, interactive tools, and discussion forums. The primary aim of the study was to determine if participation in MoodSwings 2.0 would result in decreased symptoms of depression and mania compared to the control condition. Secondary aims were to identify improvements in core depression symptoms, quality of life, medication adherence, functioning, and time to relapse. Methods This was a three-arm randomized controlled trial that compared two intervention arms against a peer support control group (forum). A total of 304 adults aged 21 to 65 years with a diagnosis of bipolar disorder were assigned to a forum-only control group (Group 1; n = 102), a forum plus modules treatment group (Group 2; n = 102), or a forum, modules, and tools treatment group (Group 3; n = 100), in addition to usual care. Results There was a significant intervention impact showing improvement on the primary outcome of depression for Group 2 compared to Group 1 (P = .05) with effect sizes (Cohen's d) ranging from 0.17 to 0.43. There was also a significant intervention impact showing improvement on the secondary outcome of core depression for Group 2 (P = .02) and Group 3 (P = .05), but worse physical functioning for Group 3 (P = .01), compared to Group 1. Conclusions This study provides evidence of the efficacy of internet-based psychoeducation interventions for bipolar disorder in reducing depressive symptoms. Further investigation is needed to assess effectiveness in a public program.
Binge eating in patients with polycystic ovary syndrome : Prevalence, causes, and management strategies
- Authors: Krug, Isabel , Giles, Sarah , Paganini, Chiara
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Neuropsychiatric Disease and Treatment Vol. 15, no. (2019), p. 1273-1285
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- Description: Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh
- Authors: Kader, Manzur , Perera, Nirmala , Hossain, Mohammad , Islam, Redwanul
- Date: 2018
- Type: Text , Journal article
- Relation: Spinal Cord Vol. 56, no. 3 (2018), p. 239-246
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- Description: Study design: Cross-sectional study. Objectives: To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. Setting: Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. Methods: This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25-43) years and 5 (2-10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-Administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0-100; a high score indicates greater activity limitations and participation restrictions). Independent variables included socio-demographic factors (i.e., age, sex, marital status, educational level, monthly household income, employment status, and place of residence) and injury-related factors (i.e., injury duration, cause of injury, injury severity, and type of paralysis). Multivariable linear regression analyses were performed to identify the factors that independently contributed to activity limitations and participation restrictions. Results: Three significant independent variables explained 20.7% of the variance in activity limitations and participation restrictions (WHODAS 2.0 score), in which tetraplegia was the strongest significant contributing factor, followed by rural residence and complete injury. Conclusions: This study would indicate that tetraplegia, complete injury, and residing in a rural area are the major contributions in limiting the activity and participation following SCI in Bangladesh.
Factor structure of parent and teacher ratings of the ODD symptoms for Malaysian primary school children
- Authors: Gomez, Rapson
- Date: 2017
- Type: Text , Journal article
- Relation: Asian Journal of Psychiatry Vol. 25, no. (2017), p. 22-26
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- Description: This present study used confirmatory factor analysis (CFA) to examine the applicability of one-, two- three- and second order Oppositional Defiant Disorder (ODD) factor models, proposed in previous studies, in a group of Malaysian primary school children. These models were primarily based on parent reports. In the current study, parent and teacher ratings of the ODD symptoms were obtained for 934 children. For both groups of respondents, the findings showing some support for all models examined, with most support for a second order model with Burke et al. (2010) three factors (oppositional, antagonistic, and negative affect) as the primary factors. The diagnostic implications of the findings are discussed. © 2016 Elsevier B.V.
Clinical significance of individual GAD symptoms in later life
- Authors: Miloyan, Beyon , Pachana, Nancy
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Geriatric Psychiatry and Neurology Vol. 29, no. 2 (2016), p. 92-98
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- Description: Background: There are age-related differences in the manifestation of generalized anxiety disorder (GAD) symptoms and their associated impact on psychosocial and functional status. However, it remains unclear whether specific symptoms (or symptom patterns) are of comparable clinical significance across different functional domains. Methods: A sample of 865 self-reported worriers (aged 60 years and older) who endorsed GAD screening questions in the Alcohol Use Disorder and Associated Disabilities Interview Schedule, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were derived from Wave 1 of the National Epidemiological Survey of Alcohol and Related Conditions. Results: Being easily fatigued was significantly associated with occupational disability and a functional disability variable (restricting usual activity in any way). Irritability was significantly associated with social friction (arguments with friends, family, or colleagues) and a functional disability variable (found was unable to do something wanted to do), and poor self-perceived health was also associated with the same functional disability variable. Excessive worry, despite being among the least reported symptoms, was significantly associated with distress. Conclusions: These findings suggest that individual GAD symptoms are differentially associated with aspects of clinical significance relevant to daily life, such as social, occupational, and functional ability. The differential impact of individual symptoms on functional status may be diluted when using symptom sum scores. A nuanced approach to assessing the clinical significance of individual GAD symptoms in older adults may be fruitful for efforts aimed at early detection and treatment. © 2015 SAGE Publications.
ADHD bifactor model based on parent and teacher ratings of Malaysian children
- Authors: Gomez, Rapson
- Date: 2014
- Type: Text , Journal article
- Relation: Asian Journal of Psychiatry Vol. 8, no. 1 (2014), p. 47-51
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Malaysian parent and teacher ratings of the oppositional defiant disorder symptoms : Measurement invariance and parent-teacher agreement
- Authors: Gomez, Rapson
- Date: 2014
- Type: Text , Journal article
- Relation: Asian Journal of Psychiatry Vol. 11, no. (2014), p. 35-38
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- Description: BACKGROUND: This study evaluated the measurement invariance and agreement across parent and teacher ratings of the DSM-IV-TR oppositional defiant disorder (ODD) symptoms. METHOD: Malaysian parents and teachers of 934 children (between 6 and 11 years of age) completed rating scales comprising the ODD symptoms. RESULTS: Findings showed support for full measurement invariance (configural, metric and thresholds). Additional results indicated low parent-teacher agreement for all symptoms. DISCUSSION: The theoretical and clinical and implications of these findings are discussed.
Mouse models of intracranial aneurysm
- Authors: Wang, Yutang , Emeto, Theophilus , Lee, James , Marshman, Laurence , Moran, Corey , Seto, Sai-wang , Golledge, Jonathan
- Date: 2014
- Type: Text , Journal article
- Relation: Brain Pathology Vol. 25, no. (2014), p. 237-247
- Relation: http://purl.org/au-research/grants/nhmrc/1062671
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- Description: Subarachnoid hemorrhage secondary to rupture of an intracranial aneurysm is a highly lethal medical condition. Current management strategies for unruptured intracranial aneurysms involve radiological surveillance and neurosurgical or endovascular interventions. There is no pharmacological treatment available to decrease the risk of aneurysm rupture and subsequent subarachnoid hemorrhage. There is growing interest in the pathogenesis of intracranial aneurysm focused on the development of drug therapies to decrease the incidence of aneurysm rupture. The study of rodent models of intracranial aneurysms has the potential to improve our understanding of intracranial aneurysm development and progression. This review summarizes current mouse models of intact and ruptured intracranial aneurysms and discusses the relevance of these models to human intracranial aneurysms. The article also reviews the importance of these models in investigating the molecular mechanisms involved in the disease. Finally, potential pharmaceutical targets for intracranial aneurysm suggested by previous studies are discussed. Examples of potential drug targets include matrix metalloproteinases, stromal cell-derived factor-1, tumor necrosis factor-α, the renin-angiotensin system and the β-estrogen receptor. An agreed clear, precise and reproducible definition of what constitutes an aneurysm in the models would assist in their use to better understand the pathology of intracranial aneurysm and applying findings to patients
- Description: Subarachnoid hemorrhage secondary to rupture of an intracranial aneurysm is a highly lethal medical condition. Current management strategies for unruptured intracranial aneurysms involve radiological surveillance and neurosurgical or endovascular interventions. There is no pharmacological treatment available to decrease the risk of aneurysm rupture and subsequent subarachnoid hemorrhage. There is growing interest in the pathogenesis of intracranial aneurysm focused on the development of drug therapies to decrease the incidence of aneurysm rupture. The study of rodent models of intracranial aneurysms has the potential to improve our understanding of intracranial aneurysm development and progression. This review summarizes current mouse models of intact and ruptured intracranial aneurysms and discusses the relevance of these models to human intracranial aneurysms. The article also reviews the importance of these models in investigating the molecular mechanisms involved in the disease. Finally, potential pharmaceutical targets for intracranial aneurysm suggested by previous studies are discussed. Examples of potential drug targets include matrix metalloproteinases, stromal cell-derived factor-1, tumor necrosis factor-
Teacher ratings of ODD symptoms: Measurement equivalence across Malaysian Malay, Chinese and Indian children
- Authors: Gomez, Rapson
- Date: 2014
- Type: Text , Journal article
- Relation: Asian Journal of Psychiatry Vol. 8, no. 1 (2014), p. 52-55
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- Description: Background The study examined the measurement equivalence for teacher ratings across Malaysian Malay, Chinese and Indian children. Methods Malaysian teachers completed ratings of the ODD symptoms for 574 Malay, 247 Chinese and 98 Indian children. Results The results supported the equivalences for the configural, metric, and error variances models, and the equivalences for ODD latent variances and mean scores. Discussion Together, these findings suggest good support for measurement and structural equivalences of the ODD symptoms across these ethnic groups. The theoretical and clinical implications of the findings for cross-cultural equivalence of the ODD symptoms are discussed.
Sustained activation of microglia in the hypothalamic PVN following myocardial infarction
- Authors: Dworak, Melissa , Stebbing, Martin , Kompa, Andrew , Rana, Indrajeetsinh , Krum, Henry , Badoer, Emilio
- Date: 2012
- Type: Text , Journal article
- Relation: Autonomic Neuroscience Vol. 169, no. 2 (August 2012 2012), p. 70-76
- Full Text: false
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- Description: Microglia are the immune cells in the central nervous system and can produce cytokines when they are activated by an insult or injury. In the present study, we investigated in detail the time frame of the activation of microglia in the hypothalamic paraventricular nucleus (PVN) following myocardial infarction in rats. Morphological changes and immunohistochemistry to detect CD11b (clone OX-42) were used to identify activated microglia. Compared to rats that had undergone sham surgical procedures, there was a significant increase of between 40 and 50% in the proportion of activated microglia in the PVN 4–16 weeks following myocardial infarction (P < 0.001, One way ANOVA). At 24 h or 1 week post myocardial infarction, however, there was no significant increase in the proportion of activated microglia. Echocardiography and haemodynamic parameters after myocardial infarction indicated significantly reduced left ventricular function. In conclusion, following myocardial infarction, activation of microglia in the PVN does not occur immediately but once manifested, activation is sustained. Thus, activated microglia may contribute to the chronic elevation in cytokine levels observed following myocardial infarction. Since cytokines elicit sympatho-excitatory effects when locally microinjected into the PVN, activated microglia may contribute to the mechanisms mediating the chronic increase in sympathetic nerve activity in animals with reduced left ventricular function induced following myocardial infarction.
- Description: C1
Vestibular evoked myogenic potentials to sound and vibration : Characteristics in vestibular migraine that enable separation from Meniere's disease
- Authors: Taylor, Rachael , Zagami, Alessandro , Gibson, William , Black, Deborah , Watson, Shaun , Halmagyi, Michael G. , Welgampola, Miriam
- Date: 2012
- Type: Text , Journal article
- Relation: Cephalalgia Vol. 32, no. 3 (2012), p. 213-225
- Full Text: false
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- Description: OBJECTIVES: It can be difficult to distinguish vestibular migraine (VM) from Meniere's disease (MD) in its early stages. Using vestibular-evoked myogenic potentials (VEMPs), we sought to identify test parameters that would help discriminate between these two vestibular disorders. METHODS: We first recorded ocular and cervical VEMPs (oVEMP/cVEMP) to air-conducted clicks and bone-conducted vibration in 30 control participants, 30 participants with clinically definite VM and 30 participants with clinically probable VM. Results were compared with a group of 60 MD patients from a previous study. oVEMPs and cVEMPs were then recorded at octave frequencies of 250 Hz to 2000 Hz in 20 controls and 20 participants each with clinically definite VM and MD. Inter-aural amplitude asymmetry ratios and amplitude frequency ratios were compared between groups. RESULTS: For click, tendon-hammer-tap and minishaker-tap VEMPs, there were no significant differences in reflex amplitudes or symmetry between controls, definite VM and probable VM. Compared with MD patients, participants with VM had significantly fewer reflex abnormalities for click-cVEMP, click-oVEMPs and minitap-cVEMPs. The ratio of cVEMP amplitude generated by tone bursts at a frequency of 0.5 kHz to that generated by 1 kHz was significantly lower for MD affected ears than for VM or controls ears. cVEMP asymmetry ratios for 0.5 kHz tone bursts were significantly higher for MD than VM. CONCLUSIONS: The 0.5/1 kHz frequency ratio, 0.5 kHz asymmetry ratio and caloric test combined, separated MD from VM with a sensitivity of 90.0% and specificity of 70.0%.
Can the severity of dependence scale be usefully applied to 'ecstasy'?
- Authors: Bruno, Raimondo , Matthews, Allison , Topp, Libby , Degenhardt, Louisa , Gomez, Rapson , Dunn, Matthew
- Date: 2009
- Type: Text , Journal article
- Relation: Neuropsychobiology Vol. 60, no. 3-4 (2009), p. 137-147
- Full Text: false
- Reviewed:
- Description: Background/Aims: Although use of 'ecstasy' (drugs sold as containing 3,4-methylenedioxymethamphetamine) is prevalent, it is typically infrequent, and treatment presentations involving ecstasy as a principal problem drug are relatively rare. Human case reports and animal literature suggest dependence potential, although there may be some unique aspects to this syndrome for ecstasy in comparison to other substances. The Severity of Dependence Scale (SDS) was examined to determine whether this could usefully identify 'dependent' ecstasy consumers. Methods: We conducted a cross-sectional survey of 1,658 frequent (at least monthly) ecstasy consumers across Australia, assessing drug use, associated harms and risk behaviours. Dependence was evaluated with the SDS, using a cut-off of ≥4 to identify potential 'dependence'. Results: One fifth of the participants were screened as potentially dependent. These individuals used ecstasy more frequently, in greater amounts, engaged more extensively in risk behaviours and reported greater role interference than other participants. These findings were independent of methamphetamine use or dependence. The underlying structure of the ecstasy SDS was bifactorial. Conclusions: The SDS has demonstrated construct validity as a screening tool to identify ecstasy users at elevated risk of experiencing adverse consequences, including features of dependence. The underlying structure of dependence symptoms differs for ecstasy compared to other drug classes, and some dependent consumers use the drug infrequently. The unique neurotoxic potential and entactogenic effects of ecstasy may require a distinct nosological classification for the experience of dependence associated with the drug. Copyright © 2009 S. Karger AG, Basel.
Axonal function in a family with episodic ataxia type 2 due to a novel mutation
- Authors: Krishnan, Arun V , Bostock, Hugh , Ip, Jerome , Hayes, Michael , Watson, Shaun , Kiernan, Matthew C
- Date: 2008
- Type: Text , Journal article
- Relation: Journal of Neurology Vol. 255, no. 5 (2008), p. 750-755
- Full Text: false
- Reviewed:
- Description: Episodic ataxia type 2(EA-2) is a rare, autosomal dominant disorder characterised by recurrent episodes of ataxia and dysarthria,due to mutations in the CACNA1A gene on chromosome 19 encoding voltage-dependent Ca2+ channels. The aim of the present study was to explore whether axonal membrane properties, assessed using nerve excitability techniques, were abnormal in patients with EA-2 . Nerve excitability techniques were applied to the median nerve of three individuals from three generations of a single family, all of whom had typical features of EA-2. This family was found to have a novel mutation at codon 1451 of the Ca2+ channel alpha 1A subunit. Nerve excitability testing demonstrated significant abnormalities,with all patients outside the normal 95 % confidence limits in having a high rheobase and reduced early hyperpolarizing threshold electrotonus. On average there were also significant reductions in refractoriness,late sub excitability and early depolarizing threshold electrotonus. Mathematical modelling indicated that a similar pattern of abnormalities may result from a reduced voltage dependence of slow K+ channels (KCNQ channels). There are significant and distinctive changes in peripheral nerve excitability in EA-2 patients,which are presumably induced indirectly. These findings raise the possibility that excitability testing may prove a convenient screening test for patients with this suspected channelopathy.