Clinical Core Symptoms of Posterior Spinal Artery Ischemia

2011 ◽  
Vol 65 (4) ◽  
pp. 183-186 ◽  
Author(s):  
Walter Struhal ◽  
Thomas Seifert-Held ◽  
Heinz Lahrmann ◽  
Franz Fazekas ◽  
Wolfgang Grisold
Keyword(s):  
Posterior Spinal Artery ◽  
Core Symptoms

Disorder-specific alterations of tactile sensitivity in neurodevelopmental disorders

2020 ◽  
Author(s):  
Jason He ◽  
Ericka Wodka ◽  
Mark Tommerdahl ◽  
Richard Edden ◽  
Mark Mikkelsen ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Autism Spectrum ◽  
Typically Developing ◽  
Hyperactivity Disorder ◽  
The Core ◽  
Children With Asd ◽  
Tactile Detection ◽  
Spectrum Disorders ◽  
Sensory Processes ◽  
Core Symptoms

Alterations of tactile processing have long been identified in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, the extent to which these alterations are disorder-specific, rather than disorder-general, and how they relate to the core symptoms of each disorder, remains unclear. We measured and compared tactile detection, discrimination and order judgment thresholds between a large sample of children with ASD, ADHD, ASD + ADHD combined and typically developing controls. The pattern of results suggested that while difficulties with tactile detection and order judgement were more common in children with ADHD, difficulties with tactile discrimination were more common in children with ASD. Strikingly, subsequent correlation analyses found that the disorder-specific alterations suggested by the group comparisons were also exclusively related to the core symptoms of each respective disorder. These results suggest that disorder-specific alterations of lower-level sensory processes exist and are specifically related to higher-level clinical symptoms of each disorder.

scholarly journals Correction to: Identifying Subgroups of Toddlers with DSM‑5 Autism Spectrum Disorder Based on Core Symptoms

2021 ◽  
Author(s):  
Holly K. Harris ◽  
Collin Lee ◽  
Georgios D. Sideridis ◽  
William J. Barbaresi ◽  
Elizabeth Harstad
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Dsm 5 ◽  
Core Symptoms

Dopaminergic loss of cyclin-dependent kinase-like 5 recapitulates methylphenidate-remediable hyperlocomotion in mouse model of CDKL5 deficiency disorder

2020 ◽  
Vol 29 (14) ◽  
pp. 2408-2419
Author(s):  
Cian-Ling Jhang ◽  
Hom-Yi Lee ◽  
Jin-Chung Chen ◽  
Wenlin Liao
Keyword(s):  
Movement Control ◽  
Motor Dysfunction ◽  
Signaling Proteins ◽  
Cyclin Dependent Kinase ◽  
Serine Threonine Kinase ◽  
Hyperactivity Disorder ◽  
Dopamine Content ◽  
Therapeutic Development ◽  
Dopamine Signaling ◽  
Core Symptoms

Abstract Cyclin-dependent kinase-like 5 (CDKL5), a serine-threonine kinase encoded by an X-linked gene, is highly expressed in the mammalian forebrain. Mutations in this gene cause CDKL5 deficiency disorder, a neurodevelopmental encephalopathy characterized by early-onset seizures, motor dysfunction, and intellectual disability. We previously found that mice lacking CDKL5 exhibit hyperlocomotion and increased impulsivity, resembling the core symptoms in attention-deficit hyperactivity disorder (ADHD). Here, we report the potential neural mechanisms and treatment for hyperlocomotion induced by CDKL5 deficiency. Our results showed that loss of CDKL5 decreases the proportion of phosphorylated dopamine transporter (DAT) in the rostral striatum, leading to increased levels of extracellular dopamine and hyperlocomotion. Administration of methylphenidate (MPH), a DAT inhibitor clinically effective to improve symptoms in ADHD, significantly alleviated the hyperlocomotion phenotype in Cdkl5 null mice. In addition, the improved behavioral effects of MPH were accompanied by a region-specific restoration of phosphorylated dopamine- and cAMP-regulated phosphoprotein Mr 32 kDa, a key signaling protein for striatal motor output. Finally, mice carrying a Cdkl5 deletion selectively in DAT-expressing dopaminergic neurons, but not dopamine receptive neurons, recapitulated the hyperlocomotion phenotype found in Cdkl5 null mice. Our findings suggest that CDKL5 is essential to control locomotor behavior by regulating region-specific dopamine content and phosphorylation of dopamine signaling proteins in the striatum. The direct, as well as indirect, target proteins regulated by CDKL5 may play a key role in movement control and the therapeutic development for hyperactivity disorders.

scholarly journals Response (minimum clinically relevant change) in ASD symptoms after an intervention according to CARS-2: consensus from an expert elicitation procedure

2021 ◽  
Author(s):  
Lucie Jurek ◽  
Matias Balthazar ◽  
Sheffali Gulati ◽  
Neda Novakovic ◽  
María Núñez ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Rating Scale ◽  
Expert Knowledge ◽  
Scientific Evidence ◽  
Autism Spectrum ◽  
Expert Elicitation ◽  
Spectrum Disorder ◽  
Initial Finding ◽  
Elicitation Process ◽  
Core Symptoms

AbstractThe lack of consensual measures to monitor core change in Autism Spectrum Disorder (ASD) or response to interventions leads to difficulty to prove intervention efficacy on ASD core symptoms. There are no universally accepted outcome measures developed for measuring changes in core symptoms. However, the CARS (Childhood Autism Rating Scale) is one of the outcomes recommended in the EMA Guideline on the clinical development of medicinal products for the treatment of ASD. Unfortunately, there is currently no consensus on the response definition for CARS among individuals with ASD. The aim of this elicitation process was to determine an appropriate definition of a response on the CARS2 scale for interventions in patients with Autism Spectrum Disorder (ASD). An elicitation process was conducted following the Sheffield Elicitation Framework (SHELF). Five experts in the field of ASD and two experts in expert knowledge elicitation participated in an 1-day elicitation workshop. Experts in ASD were previously trained in the SHELF elicitation process and received a dossier of scientific evidence concerning the topic. The response definition was set as the mean clinically relevant improvement averaged over all patients, levels of functioning, age groups ***and clinicians. Based on the scientific evidence and expert judgment, a normal probability distribution was agreed to represent the state of knowledge of this response with expected value 4.03 and standard deviation 0.664. Considering the remaining uncertainty of the estimation and the available literature, a CARS-2 improvement of 4.5 points has been defined as a threshold to conclude to a response after an intervention. A CARS-2 improvement of 4.5 points could be used to evaluate interventions' meaningfulness in indivudals. This initial finding represents an important new benchmark and may aid decision makers in evaluating the efficacy of interventions in ASD.

Forty years of methylphenidate treatment in Attention-Deficit/Hyperactivity Disorder

2002 ◽  
Vol 6 (1_suppl) ◽  
pp. 17-30 ◽  
Author(s):  
C. K. Conners
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Drug Effects ◽  
Long Term Effects ◽  
Stimulant Treatment ◽  
Hyperactivity Disorder ◽  
Subject Selection ◽  
Methodological Rigor ◽  
Adolescents And Adults ◽  
Core Symptoms

This paper reviews approximately 40 years of stimulant drug treatment of children with behavior and learning problems. These patients generally fall under the rubric of Attention-Deficit/Hyperactivity Disorder (ADHD), with core symptoms of hyperactivity, impulsivity, and inattention being the most studied and most robust of the targets for stimulant treatment. In addition, the drug effects on other targets, such as cognitive and academic function, are included. The largest selection of studies involves methylphenidate. Both qualitative studies and meta-analytic studies from major reviews are examined. Variations in the methodology of the reviews are described and some of the discrepancies in interpretation examined. Despite wide variations in subject selection, types of trials, degree of methodological rigor, and the decade in which the studies took place, the evidence is remarkably consistent. The overall results suggest significant clinical impact upon the core features of ADHD. More studies of long-term effects and special populations such as older adolescents and adults will be necessary, though existing evidence strongly supports similar findings as for the younger patients with a diagnosis of ADHD.

Cholinesterase-inhibitor Therapy for Dementia: Novel Clinical Substrates and Mechanisms for Treatment Response

CNS Spectrums ◽  
2002 ◽  
Vol 7 (10) ◽  
pp. 742-750 ◽  
Author(s):  
Daniel I. Kaufer
Keyword(s):  
Cholinesterase Inhibitors ◽  
Therapeutic Potential ◽  
Neuropsychiatric Symptoms ◽  
Lewy Bodies ◽  
Integrative Model ◽  
Complementary Interactions ◽  
Central Monoamine ◽  
Unexpected Findings ◽  
Core Symptoms ◽  
Disease Stages

ABSTRACTHistorically, drugs that increase central cholinergic transmission have primarily been investigated for relieving cognitive symptoms in mild-to-moderate Alzheimer's disease. These efforts have led to the somewhat unexpected findings that cholinergic therapy has a beneficial effect on selected neuropsychiatric symptoms in AD across disease stages. In Parkinson's disease with dementia and dementia with Lewy bodies, cholinergic deficits are more severe than in AD, and there is emerging evidence that cholinesterase inhibitors are efficacious in treating core symptoms of attentional disturbance and psychosis. Recent data also suggest a rational basis for cholinergic therapy in vascular dementia. The cognitive and neuropsychiatric effects of cholinergic therapy observed in AD and other dementias form the crux of an integrative model of cholinergic therapeutic efficacy that encompasses the diverse central nervous system actions of acetylcholine and its complementary interactions with central monoamine transmitters. This heuristic framework highlights the broader therapeutic potential of cholinergic therapy for symptom-based indications in other neuropsychiatric disorders.

Self-monitoring in patients with schizophrenia

2004 ◽  
Vol 34 (8) ◽  
pp. 1561-1569 ◽  
Author(s):  
GÜNTHER KNOBLICH ◽  
FRANK STOTTMEISTER ◽  
TILO KIRCHER
Keyword(s):  
Hand Movements ◽  
Control Group ◽  
Formal Thought Disorder ◽  
Self Monitoring ◽  
The Core ◽  
Matched Healthy Control ◽  
Healthy Control ◽  
Dsm Iv ◽  
Core Symptoms ◽  
The Relationship

Background. The present study investigated whether a failure of self-monitoring contributes to core syndromes of schizophrenia.Method. Three groups of patients with a DSM-IV diagnosis of schizophrenia (n=27), with either prominent paranoid hallucinatory or disorganization syndrome, or without these symptoms, and a matched healthy control group (n=23) drew circles on a writing pad connected to a PC monitor. Subjects were instructed to continuously monitor the relationship between their hand movements and their visual consequences. They were asked to detect gain changes in the mapping. Self-monitoring ability and the ability to automatically correct movements were assessed.Results. Patients with either paranoid-hallucinatory syndrome or formal thought disorder were selectively impaired in their ability to detect a mismatch between a self-generated movement and its consequences, but not impaired in their ability to automatically compensate for the gain change.Conclusions. These results support the claim that a failure of self-monitoring may underlie the core symptoms of schizophrenia.

Concomitant origin of the anterior or posterior spinal artery with the feeder of a spinal dural arteriovenous fistula (SDAVF)

2016 ◽  
Vol 9 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Yudhi Adrianto ◽  
Ku Hyun Yang ◽  
Hae-Won Koo ◽  
Wonhyoung Park ◽  
Sung Chul Jung ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Arteriovenous Fistula ◽  
Open Surgery ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula ◽  
Posterior Spinal Artery ◽  
Lumbar Level ◽  
Scale Scores ◽  
Complete Obliteration ◽  
Endovascular Approach

Background/objectiveThe concomitant origin of the anterior spinal artery (ASA) or the posterior spinal artery (PSA) from the feeder of a spinal dural arteriovenous fistula (SDAVF) is rare and the exact incidence is not known. We present our experience with the management of SDAVFs in such cases.MethodsIn 63 patients with SDAVF between 1993 and 2015, the feeder origin of the SDAVF was evaluated to determine whether it was concomitant with the origin of the ASA or PSA. Embolization was attempted when the patient did not want open surgery and an endovascular approach was regarded as safe and possible. The outcome of the procedure was evaluated as complete, partial, or no obliteration. The clinical outcome was evaluated by Aminoff–Logue (ALS) gait and micturition scale scores.ResultsNine patients (14%) had a concomitant origin of the ASA or PSA with the feeder. There were two cervical, five thoracic, and two lumbar level SDAVFs. A concomitant origin of the feeder was identified with the ASA (n=7) and PSA (n=2). Embolization was performed in four patients and open surgery was performed in five. Embolization resulted in complete obliteration in three patients and partial obliteration in one. Using the ALS gait and micturition scale, the final outcome improved in six while three cases remained in an unchanged condition over 2–148 months.ConclusionsThe concomitant origin of the ASA or PSA with the feeder occurs occasionally. Complete obliteration of the fistula can be achieved either by embolization or open surgery. Embolization can be carefully performed in selected patients who are in a poor condition and do not want to undergo open surgery.

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