ఇంటర్నేషనల్ జర్నల్ ఆఫ్ న్యూరో రిహాబిలిటేషన్

Psychologists and other clinical professionals struggle with the problem of understanding and modifying noncongruent conversational styles of individuals with Autism Spectrum Disorders (ASD). More recent studies have attempted to identify relevant acoustical parameters of speech, including volume, pitch, rhythm and lengths of utterances, in an attempt to better explain errors in social communication and interaction. While a complex set of biological, behavioral and developmental factors lead to disruptions in social and communication abilities there is both theoretical and empirical support for focused intervention. In our lab we have utilized a software platform called speechmatch that provides children and adults with ASD real time feedback about their success in matching critical acoustic parameters that contribute to effective social interaction. A neuro-behavioral rehabilitation model focuses on early chain intervention, operant/reward-based shaping of sound matching, and neuroplasticity.

Introduction: Myasthenia Gravis (MG) is characterized by muscle weakness that may be exacerbated with exercise. Research on safety of exercise in MG is scarce. Patients are frequently discouraged from participation. At the same time, exercise-based cardiac rehabilitation is a class I recommendation for patients recovering from Myocardial Infarction (MI) and Percutaneous Coronary Intervention (PCI). Rehabilitation of cardiac patients suffering from MG presents a unique challenge for clinicians.

Methods: We describe a cardiac rehabilitation (CR) program in a patient status post STEMI (ST-Elevation Myocardial Infarction) and PCI with a fifteen-year history of MG.

Results: The patient was able to successfully complete a 36-session program consisting of aerobic, strength and flexibility training, showing marked improvements in aerobic capacity, endurance, and field exercise tests results. No significant adverse events were noted.

Conclusion: aerobic and resistance exercise programs are feasible and may be beneficial in cardiac patients with comorbid MG.

Objective: To assess the controversies about the surgical treatment of high malignancy degree lobar gliomas in adults.

Acquisition of evidences: They used the published research in PubMed and Scielo search engines in the last 5 years (2013-2018). Those documents containing contradictory information were taken into account.

Results: Multimodal treatment is the alternative that has shown the best results in the survival of patients with high malignancy grade gliomas. In most patients, surgery is the most important procedure in the treatment. There are three controversies regarding the surgical behavior of high malignancy degree gliomas: craniotomy versus a single trephine; assessment of the degree of tumor resection, and surgery versus observational medical treatment. A maximum tumor resection should be indicated, with no neurological defects addition. The use of new technologies is recommended to achieve wide and safe resections. The biopsy is indicated in well selected patients and tumors.

Conclusions: Multimodal treatment is the general guideline for patients with high malignancy grade gliomas. However, in the molecular era, personalized treatment is necessary.

Our study experimentally provides promising opportunities for further clinical use of a combination of the essential amino acid L-arginine with a thiotriazoline in placental insufficiency (PI). The biological functions of L-arginine are substantiated by the fact that it is a precursor to the synthesis of nitric oxide (NO). Tiotriazolin is able to act as a tansport molecule NO, forming nitrosothiols. The pharmacological effect of the combination is due to the mutual potentiality of thiotriazoline and arginine on the synthesis, transport and bioavailability of NO and the physiological functions of this molecular messenger.

White matter hyperintensities (WMH) are areas of hyperintense signal within cerebral white matter which can be identified on T2-weighted fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) scans. WMH are common in older individuals and in patients with small vessel disease-related ischemic brain injury. Increased WMH were also reported in patients with Alzheimer’s disease (AD). Whether WMH can be a sign of early AD or the result of the pathophysiological mechanisms of AD is yet unclear. By its localization, all the white matter abnormalities can be divided into periventricular and deep WMH. Here we review the differences between periventricular and deep WMH in terms of pathophysiology, etiology and the neuroimaging characteristics in normal subjects and AD patients. Neuroimaging studies distinguish regional patterns in the WMH distribution between healthy aging controls and AD patients. Previous studies using different approaches have reported the prevalence of periventricular WMH in AD. Similar results were demonstrated in our recent study using lesion probability mapping in AD patients and age-matched controls. These results highlight the important etiological role of periventricular white matter damage in the pathogenesis of AD. It has been suggested that white matter lesions may disrupt cholinergic long projection fibers, thus confirming the possible contribution of WMH to the pathogenesis of cognitive decline in AD. It is possible that the effect of periventricular white matter abnormalities on cognitive function is typical for the early AD stages before cortical neurodegeneration begins to prevail over the relatively subtle effects of periventricular white matter damage in patients with dementia. The pathogenesis of the WMH spatial distribution in AD and their connection with cognitive impairment requires further research using new imaging techniques.

Stroke is a disabling global health-care problem, and rehabilitation is a major part of patient care. By 4 years after the event, more than 30% of stroke survivors report participation restrictions. Up to 70% of patients present fall during the first 6 months, the reason may be due to impairments in balance, gait, motor control, perception and vision contribute to an increment in fear of falling. This can lead to reduced levels of activity and loss of independence. Some of the affected areas include the balance, because of alteration of sensory and motor networks; this contributes to difficulty in activity daily living (ADLs). This is the reason of balance training must be performed. Another sequelae are loss or difficulty with ambulation, and restoration of gait is one of the primary goals in rehabilitation; limitation in gait is another factor that contributes to an increase in fall risk. Recurrence of stroke has been found to vary by sex: 24% of women and 42% of men experience a recurrence within 5 years of onset.

Dystrophin, the pathogenic variants of which can cause muscular diseases, is a protein mainly distributed under the sarcolemma. However, the protein also exists in the central nervous system and many reports have described neural comorbidities in patients with dystrophinopathy. Duchenne muscular dystrophy (DMD) has been described as being associated with neurodevelopmental disorders, including intellectual developmental disorders, communication disorders, autism spectrum disorders, and attention deficit/hyperactivity disorders. Patients with dystrophinopathy have also been reported to have depression, anxiety, or obsessive-compulsive disorders. Female carriers of DMD mutations exhibit a wide variety of clinical features from asymptomatic high serum creatine kinase level to severe muscle weakness or dilated cardiomyopathy, and mental disorders including cognitive impairment. Since the mental disorders in female carriers of DMD mutations can be easily overlooked, it is necessary to pay close attention for correct diagnosis

A patient with schizophrenia was admitted to an acute inpatient psychiatric ward due to discontinued medication use and the presentation of schizophrenia symptoms. The patient had poor understanding of the disease and corresponding medication use. During the course of hospitalization and occupational therapy intervention, it was discovered that pottery was a meaningful occupation for the patient in the past. Upon engaging in pottery during hospitalization, the patient’s attitude toward the disease and medication use changed. In continuing to engage in pottery, the patient regained self-recognition and self-compassion and came to recognize the importance of continuing medication use and maintaining physical and mental health. Study suggests that approaching schizophrenia patients by focusing on “healthy parts” centering on the meaningful occupation of the subject can be an effective mental health rehabilitation approach. This approach based on a meaningful occupation has commonality with two frameworks for mental health recovery: the 'Recovery Model' and the 'Strengths Model'. Therefore, the use of meaningful occupational therapy should be considered be part of the framework for acute phase occupational therapy of schizophrenia and mental health rehabilitation in general.