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Brain Sci., Volume 8, Issue 11 (November 2018)

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Cover Story (view full-size image) Movement disorders are common features of metal storage disorders. The current study investigates [...] Read more.
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Open AccessReview New Hope in Brain Glioma Surgery: The Role of Intraoperative Ultrasound. A Review
Brain Sci. 2018, 8(11), 202; https://doi.org/10.3390/brainsci8110202
Received: 17 October 2018 / Revised: 7 November 2018 / Accepted: 16 November 2018 / Published: 19 November 2018
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Abstract
Maximal safe resection represents the gold standard for surgery of malignant brain tumors. As regards gross-total resection, accurate localization and precise delineation of the tumor margins are required. Intraoperative diagnostic imaging (Intra-Operative Magnetic Resonance-IOMR, Intra-Operative Computed Tomography-IOCT, Intra-Operative Ultrasound-IOUS) and dyes (fluorescence) have
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Maximal safe resection represents the gold standard for surgery of malignant brain tumors. As regards gross-total resection, accurate localization and precise delineation of the tumor margins are required. Intraoperative diagnostic imaging (Intra-Operative Magnetic Resonance-IOMR, Intra-Operative Computed Tomography-IOCT, Intra-Operative Ultrasound-IOUS) and dyes (fluorescence) have become relevant in brain tumor surgery, allowing for a more radical and safer tumor resection. IOUS guidance for brain tumor surgery is accurate in distinguishing tumor from normal parenchyma, and it allows a real-time intraoperative visualization. We aim to evaluate the role of IOUS in gliomas surgery and to outline specific strategies to maximize its efficacy. We performed a literature research through the Pubmed database by selecting each article which was focused on the use of IOUS in brain tumor surgery, and in particular in glioma surgery, published in the last 15 years (from 2003 to 2018). We selected 39 papers concerning the use of IOUS in brain tumor surgery, including gliomas. IOUS exerts a notable attraction due to its low cost, minimal interruption of the operational flow, and lack of radiation exposure. Our literature review shows that increasing the use of ultrasound in brain tumors allows more radical resections, thus giving rise to increases in survival. Full article
(This article belongs to the Special Issue Optimizing Management of High Grade Glioma)
Open AccessReview Borderline Personality Disorder (BPD): In the Midst of Vulnerability, Chaos, and Awe
Brain Sci. 2018, 8(11), 201; https://doi.org/10.3390/brainsci8110201
Received: 5 October 2018 / Revised: 7 November 2018 / Accepted: 7 November 2018 / Published: 18 November 2018
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Abstract
Borderline personality disorder (BPD) is a chronic psychiatric disorder characterized by pervasive affective instability, self-image disturbances, impulsivity, marked suicidality, and unstable interpersonal relationships as the core dimensions of psychopathology underlying the disorder. Across a wide range of situations, BPD causes significant impairments. Patients
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Borderline personality disorder (BPD) is a chronic psychiatric disorder characterized by pervasive affective instability, self-image disturbances, impulsivity, marked suicidality, and unstable interpersonal relationships as the core dimensions of psychopathology underlying the disorder. Across a wide range of situations, BPD causes significant impairments. Patients with BPD suffer considerable morbidity and mortality compared with other populations. Although BPD is more widely studied than any other personality disorder, it is not understood sufficiently. This paper briefly reviews the recent evidence on the prevalence, etiology, comorbidity, and treatment approaches of borderline personality disorder (BPD) by examining published studies, and aims to offer a more coherent framework for the understanding and management of borderline personality disorder. Full article
Open AccessReview Intersection of Brain Development and Paediatric Diffuse Midline Gliomas: Potential Role of Microenvironment in Tumour Growth
Brain Sci. 2018, 8(11), 200; https://doi.org/10.3390/brainsci8110200
Received: 16 October 2018 / Revised: 3 November 2018 / Accepted: 15 November 2018 / Published: 16 November 2018
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Abstract
Diffuse intrinsic pontine glioma (DIPG) is a devastating and incurable paediatric brain tumour with a median overall survival of 9 months. Until recently, DIPGs were treated similarly to adult gliomas, but due to the advancement in molecular and imaging technologies, our understanding of
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Diffuse intrinsic pontine glioma (DIPG) is a devastating and incurable paediatric brain tumour with a median overall survival of 9 months. Until recently, DIPGs were treated similarly to adult gliomas, but due to the advancement in molecular and imaging technologies, our understanding of these tumours has increased dramatically. While extensive research is being undertaken to determine the function of the molecular aberrations in DIPG, there are significant gaps in understanding the biology and the influence of the tumour microenvironment on DIPG growth, specifically in regards to the developing pons. The precise orchestration and co-ordination of the development of the brain, the most complex organ in the body, is still not fully understood. Herein, we present a brief overview of brainstem development, discuss the developing microenvironment in terms of DIPG growth, and provide a basis for the need for studies focused on bridging pontine development and DIPG microenvironment. Conducting investigations in the context of a developing brain will lead to a better understanding of the role of the tumour microenvironment and will help lead to identification of drivers of tumour growth and therapeutic resistance. Full article
(This article belongs to the Special Issue Tumour Microenvironment in Paediatric Brain Tumour)
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Open AccessArticle EEG Waveform Analysis of P300 ERP with Applications to Brain Computer Interfaces
Brain Sci. 2018, 8(11), 199; https://doi.org/10.3390/brainsci8110199
Received: 27 September 2018 / Revised: 9 November 2018 / Accepted: 13 November 2018 / Published: 16 November 2018
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Abstract
The Electroencephalography (EEG) is not just a mere clinical tool anymore. It has become the de-facto mobile, portable, non-invasive brain imaging sensor to harness brain information in real time. It is now being used to translate or decode brain signals, to diagnose diseases
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The Electroencephalography (EEG) is not just a mere clinical tool anymore. It has become the de-facto mobile, portable, non-invasive brain imaging sensor to harness brain information in real time. It is now being used to translate or decode brain signals, to diagnose diseases or to implement Brain Computer Interface (BCI) devices. The automatic decoding is mainly implemented by using quantitative algorithms to detect the cloaked information buried in the signal. However, clinical EEG is based intensively on waveforms and the structure of signal plots. Hence, the purpose of this work is to establish a bridge to fill this gap by reviewing and describing the procedures that have been used to detect patterns in the electroencephalographic waveforms, benchmarking them on a controlled pseudo-real dataset of a P300-Based BCI Speller and verifying their performance on a public dataset of a BCI Competition. Full article
(This article belongs to the Special Issue Brain-Computer Interfaces for Human Augmentation)
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Open AccessArticle The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury
Brain Sci. 2018, 8(11), 198; https://doi.org/10.3390/brainsci8110198
Received: 15 October 2018 / Revised: 11 November 2018 / Accepted: 12 November 2018 / Published: 13 November 2018
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Abstract
The Gulf War Illness Consortium (GWIC) was designed to identify objective biomarkers of Gulf War Illness (GWI) in 1991 Gulf War veterans. The symptoms of GWI include fatigue, pain, cognitive problems, gastrointestinal, respiratory, and skin problems. Neurotoxicant exposures during deployment, such as pesticides,
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The Gulf War Illness Consortium (GWIC) was designed to identify objective biomarkers of Gulf War Illness (GWI) in 1991 Gulf War veterans. The symptoms of GWI include fatigue, pain, cognitive problems, gastrointestinal, respiratory, and skin problems. Neurotoxicant exposures during deployment, such as pesticides, sarin, and pyridostigmine bromide pills have been identified as contributors to GWI. We have also found an association between mild traumatic brain injury (mTBI) and increased rates of GWI. However, the combined impact of these physical and chemical exposures has not yet been explored in GWI. The objective of this study was to examine both self-reported mTBI and exposure to chemical/biological weapons (CBW) as a multiple or two hit model for increased risk of GWI and other chronic health conditions. The study population included 125 Gulf War (GW) veterans from the Boston GWIC. Exposure to CBW was reported in 47.2% of the study population, and 35.2% reported sustaining a mTBI during the war. Results confirmed that those with both exposures (mTBI and CBW) had higher rates of comorbid chronic health conditions while rates of GWI were equivalent for mTBI and CBW or mTBI alone. The timing of exposure to mTBI was found to be strikingly different between those with GWI and those without it. Correspondingly, 42.3% of GWI cases reported experiencing a mTBI during military service while none of the controls did (p = 0.0002). Rates of mTBI before and after the war did not differ between the cases and controls. In addition, 54% of cases compared to 14.3% of controls (p = <0.001) reported being exposed to CBW during military service. The current study examined the relation of the separate and combined effects of exposure to mTBI and CBW in 1991 GW veterans. The findings from this study suggest that both exposure to mTBI and CBW are associated with the development of GWI and multiple chronic health conditions and that combined exposure appears to lead to higher risk of chronic health effects. Full article
(This article belongs to the Section Clinical Neuroscience)
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Open AccessArticle Use and Propensity to Use Substances as Cognitive Enhancers in Italian Medical Students
Brain Sci. 2018, 8(11), 197; https://doi.org/10.3390/brainsci8110197
Received: 17 October 2018 / Revised: 31 October 2018 / Accepted: 6 November 2018 / Published: 9 November 2018
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Abstract
International media has paid attention to the use of substances by healthy subjects to enhance cognitive performance. Medical students are liable to use cognitive enhancers (CE) with the aim of improving academic performance. The study explored use and attitudes toward the use of
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International media has paid attention to the use of substances by healthy subjects to enhance cognitive performance. Medical students are liable to use cognitive enhancers (CE) with the aim of improving academic performance. The study explored use and attitudes toward the use of CE in Italian medical students. The authors anonymously surveyed 433 medical students of the University of Modena and Reggio Emilia with an ad hoc 36-items questionnaire. CE were broadly defined as any substance taken with the purpose of improving cognitive functions, from readily available beverages and substances, such as coffee, tea, energy drinks, and supplements to prescription only medication, such as psychostimulants and modafinil. Response rate was 83.8% (n = 363). While the majority of the students (74.7%; n = 271) said that they had used substances to improve cognitive functions, only 2 students (0.6%) reported the use of prescription-only medications in the last 30 days. Main reasons for not taking prescription-only drugs were concerns about safety and side effects, reported by 83.3% of students (n = 295). A positive attitude toward use was held by 60.3% (n = 219) subjects. The surveyed Italian medical students used many substances as CE, but this did not seem to apply significantly to psychostimulants. A multivariable analysis showed that the following variables were related to the propensity to use substances as CE: male gender, self-reported memory impairment, concerns about worsening of cognitive performance, lifetime use of at least one illegal substance, use of any substance (both legal or illegal) in the last 30 days. Full article
(This article belongs to the Section Clinical Neuroscience)
Open AccessArticle Opposing Morphogenetic Defects on Dendrites and Mossy Fibers of Dentate Granular Neurons in CRMP3-Deficient Mice
Brain Sci. 2018, 8(11), 196; https://doi.org/10.3390/brainsci8110196
Received: 17 October 2018 / Revised: 30 October 2018 / Accepted: 31 October 2018 / Published: 3 November 2018
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Abstract
Collapsin response mediator proteins (CRMPs) are highly expressed in the brain during early postnatal development and continue to be present in specific regions into adulthood, especially in areas with extensive neuronal plasticity including the hippocampus. They are found in the axons and dendrites
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Collapsin response mediator proteins (CRMPs) are highly expressed in the brain during early postnatal development and continue to be present in specific regions into adulthood, especially in areas with extensive neuronal plasticity including the hippocampus. They are found in the axons and dendrites of neurons wherein they contribute to specific signaling mechanisms involved in the regulation of axonal and dendritic development/maintenance. We previously identified CRMP3’s role on the morphology of hippocampal CA1 pyramidal dendrites and hippocampus-dependent functions. Our focus here was to further analyze its role in the dentate gyrus where it is highly expressed during development and in adults. On the basis of our new findings, it appears that CRMP3 has critical roles both in axonal and dendritic morphogenesis of dentate granular neurons. In CRMP3-deficient mice, the dendrites become dystrophic while the infrapyramidal bundle of the mossy fiber shows aberrant extension into the stratum oriens of CA3. This axonal misguided projection of granular neurons suggests that the mossy fiber-CA3 synaptic transmission, important for the evoked propagation of the activity of the hippocampal trisynaptic circuitry, may be altered, whereas the dystrophic dendrites may impair the dynamic interactions with the entorhinal cortex, both expected to affect hippocampal function. Full article
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Open AccessArticle The Duration of Emotional Image Exposure Does Not Impact Anticipatory Postural Adjustments during Gait Initiation
Brain Sci. 2018, 8(11), 195; https://doi.org/10.3390/brainsci8110195
Received: 17 October 2018 / Revised: 29 October 2018 / Accepted: 30 October 2018 / Published: 1 November 2018
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Abstract
Previous studies have reported that anticipatory postural adjustments (APAs) associated with gait initiation are affected by emotion-eliciting images. This study examined the effect of the duration of exposure to emotional images on the APAs along the progression axis. From a standing posture, 39
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Previous studies have reported that anticipatory postural adjustments (APAs) associated with gait initiation are affected by emotion-eliciting images. This study examined the effect of the duration of exposure to emotional images on the APAs along the progression axis. From a standing posture, 39 young adults had to reach a table by walking (several steps) toward pleasant or unpleasant images, under two sets of conditions. In the short condition, the word “go” appeared on the image 500 ms after image onset and participants were instructed to initiate gait as soon as possible after the word go appeared. In the long condition, the same procedure was used but the word “go” appeared 3000 ms after image onset. Results demonstrated that the APAs were longer and larger for pleasant images than unpleasant ones, regardless of the condition (i.e., the duration of exposure to the images). In the same way, the peak of forward velocity of the centre of body mass (reached at the end of the first step) followed the same tendency. These results emphasized that APAs depended on image valence but not on the duration of images exposure and were consistent with those of previous studies and the motivational direction hypothesis. Full article
(This article belongs to the Section Cognitive Neuroscience)
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Open AccessReview Parkinson’s Disease and Metal Storage Disorders: A Systematic Review
Brain Sci. 2018, 8(11), 194; https://doi.org/10.3390/brainsci8110194
Received: 9 October 2018 / Revised: 29 October 2018 / Accepted: 30 October 2018 / Published: 31 October 2018
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Abstract
Metal storage disorders (MSDs) are a set of rare inherited conditions with variable clinical pictures including neurological dysfunction. The objective of this study was, through a systematic review, to identify the prevalence of Parkinsonism in patients with MSDs in order to uncover novel
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Metal storage disorders (MSDs) are a set of rare inherited conditions with variable clinical pictures including neurological dysfunction. The objective of this study was, through a systematic review, to identify the prevalence of Parkinsonism in patients with MSDs in order to uncover novel pathways implemented in Parkinson’s disease. Human studies describing patients of any age with an MSD diagnosis were analysed. Foreign language publications as well as animal and cellular studies were excluded. Searches were conducted through PubMed and Ovid between April and September 2018. A total of 53 publications were identified including 43 case reports, nine cross-sectional studies, and one cohort study. The publication year ranged from 1981 to 2018. The most frequently identified MSDs were Pantothenate kinase-associated neurodegeneration (PKAN) with 11 papers describing Parkinsonism, Hereditary hemochromatosis (HH) (7 papers), and Wilson’s disease (6 papers). The mean ages of onset of Parkinsonism for these MSDs were 33, 53, and 48 years old, respectively. The Parkinsonian features described in the PKAN and HH patients were invariably atypical while the majority (4/6) of the Wilson’s disease papers had a typical picture. This paper has highlighted a relationship between MSDs and Parkinsonism. However, due to the low-level evidence identified, further research is required to better define what the relationship is. Full article
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Open AccessArticle Parental Educational Attainment and Mental Well-Being of College Students: Diminished Returns of Blacks
Brain Sci. 2018, 8(11), 193; https://doi.org/10.3390/brainsci8110193
Received: 5 October 2018 / Revised: 17 October 2018 / Accepted: 18 October 2018 / Published: 29 October 2018
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Abstract
Background. According to the Minorities’ Diminished Returns (MDR) theory, the health returns of socioeconomic status (SES) are systemically smaller for Blacks compared to Whites. Less is known, however, about trans-generational aspects of such diminished gains. For example, the differential impact of parental educational
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Background. According to the Minorities’ Diminished Returns (MDR) theory, the health returns of socioeconomic status (SES) are systemically smaller for Blacks compared to Whites. Less is known, however, about trans-generational aspects of such diminished gains. For example, the differential impact of parental educational attainment on differences in mental well-being between White versus Black college students remains unknown. Aims. With a national scope, this study explored racial differences in the effect of parental educational attainment on the mental well-being of college students in the United States. Methods. The Healthy Mind Study (HMS), 2016–2017, is a national telephone survey that included 41,898 college students. The sample was composed of Whites (n = 38,544; 92.0%) and Blacks (n = 3354; 8.0%). The independent variable was highest parental educational attainment. The dependent variable was mental well-being (mentally healthy days in the past month) which was measured using a single item. Age and gender were covariates. Race was the moderator. Logistic regression was used for data analysis. Results. In the pooled sample, high parental educational attainment was associated with better mental wellbeing, independent of race, age, and gender. Race, however, showed a significant interaction with parental educational attainment on students’ mental wellbeing, indicating a smaller effect of parent education on the mental wellbeing of Black compared to White college students. Conclusions. The returns of parental educational attainment in terms of mental well-being is smaller for Black college students compared to their White counterparts. To minimize the diminished returns of parental education in Black families, policies should go beyond equalizing SES and reduce the structural barriers that are common in the lives of Black families. Policies should also aim to reduce extra costs of upward social mobility, prevent discrimination, and enhance the quality of education for Blacks. As the mechanisms that are involved in MDR are multi-level, multi-level solutions are needed to minimize the racial gaps in gaining mental health benefits from higher socioeconomic levels. Full article
Open AccessArticle Brain Mapping as Helpful Tool in Brain Glioma Surgical Treatment—Toward the “Perfect Surgery”?
Brain Sci. 2018, 8(11), 192; https://doi.org/10.3390/brainsci8110192
Received: 4 September 2018 / Revised: 28 September 2018 / Accepted: 24 October 2018 / Published: 26 October 2018
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Abstract
Gliomas are the most common primary malignant brain tumours in adults, representing nearly 80%, with poor prognosis in their high-grade forms. Several variables positively affect the prognosis of patients with high-grade glioma: young age, tumour location, radiological features, recurrence, and the opportunity to
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Gliomas are the most common primary malignant brain tumours in adults, representing nearly 80%, with poor prognosis in their high-grade forms. Several variables positively affect the prognosis of patients with high-grade glioma: young age, tumour location, radiological features, recurrence, and the opportunity to perform post-operative adjuvant therapy. Low-grade gliomas are slow-growing brain neoplasms of adolescence and young-adulthood, preferentially involving functional areas, particularly the eloquent ones. It has been demonstrated that early surgery and higher extent rate ensure overall longer survival time regardless of tumour grading, but nowadays, functional preservation that is as complete as possible is imperative. To achieve the best surgical results, along with the best functional results, intraoperative mapping and monitoring of brain functions, as well as different anaesthesiology protocols for awake surgery are nowadays being widely adopted. We report on our experience at our institution with 28 patients affected by malignant brain tumours who underwent brain mapping-aided surgical resection of neoplasm: 20 patients underwent awake surgical resection and 8 patients underwent asleep surgical resection. An analysis of the results and a review of the literature has been performed. Full article
(This article belongs to the Special Issue Optimizing Management of High Grade Glioma)
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Open AccessArticle Effect of Eye-Object Distance on Body Sway during Galvanic Vestibular Stimulation
Brain Sci. 2018, 8(11), 191; https://doi.org/10.3390/brainsci8110191
Received: 13 September 2018 / Revised: 17 October 2018 / Accepted: 18 October 2018 / Published: 23 October 2018
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Abstract
Gazing at objects at a near distance (small eye-object distance) can reduce body sway. However, whether body sway is regulated by movement in the mediolateral or anteroposterior direction remains unclear. Galvanic vestibular stimulation (GVS) can induce body tilting in the mediolateral or anteroposterior
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Gazing at objects at a near distance (small eye-object distance) can reduce body sway. However, whether body sway is regulated by movement in the mediolateral or anteroposterior direction remains unclear. Galvanic vestibular stimulation (GVS) can induce body tilting in the mediolateral or anteroposterior direction. This study examined the directionality of the eye-object distance effect, using body-tilting GVS manipulations. Ten healthy subjects (aged 21.1 ± 0.3 years) stood on a force plate covered with a piece of foamed rubber and either closed their eyes or gazed at a marker located 0.5 m, 1.0 m, or 1.5 m in front of them. The GVS polarities were set to evoke rightward, forward, and backward body tilts. To compare the effects of eye-object distance in the mediolateral and anteroposterior directions, the root mean square (RMS) of the center of pressure (COP) without GVS was subtracted from the COP RMS during GVS. For swaying in the mediolateral direction, significant visual condition-related differences were found during rightward and forward GVS (p < 0.05). Thus, reductions in mediolateral body sway are more evident for smaller eye-object distances during rightward GVS. It would be appropriate to use body-tilting GVS to detect the directionality of the eye-object distance effect. Full article
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