1,720,984 research outputs found
Noninvasive neurostimulation methods for migraine therapy: The available evidence
No full textpeer reviewedAbstract
Background: Migraine is one of the most disabling neurological disorders. The current pharmacological armamentarium
is not satisfying for a large proportion of patients because the responder rate does not exceed 50% on average and
the most effective drugs often induce intolerable side effects. During recent years, noninvasive central and peripheral
neuromodulation methods have been explored for migraine treatment.
Overview: A review of the available evidence suggests that noninvasive neuromodulation techniques could be beneficial
for migraine patients. The transcranial stimulation methods allow modulating selectively cortical activity and can thus be
curtailed to the patient’s pathophysiological profile, while transcutaneous stimulation of pericranial nerves likely modulates
central pain control centers. Occipital single-pulse transcranial magnetic stimulation and transcutaneous supraorbital
stimulation have the strongest evidence respectively for acute and preventive treatment. Transcranial direct
current stimulation and repetitive magnetic stimulation are promising in pilot studies, but large sham-controlled trials
are not yet available.
Conclusions: The noninvasive neurostimulation methods are promising for migraine treatment and devoid of serious
adverse effects allowing their combination with drug therapies. Their application in clinical practice will depend on the
industry’s capacity to develop portable and user-friendly devices, and on the scientists’ capacity to prove their efficacy in randomized sham-controlled trials
Internal carotid artery dissection in a patient with hemophilia A: a case report and literature review
No full textSpontaneous cervical artery dissection (sCeAD) is the most common cause of ischemic stroke at a young age, but its pathogenetic mechanism and risk factors are not fully elucidated. It is reasonable to think that bleeding propensity, vascular risk factors such as hypertension and head or neck trauma, and constitutional weakness of the arterial wall together play a role in the pathogenesis of sCeAD. Hemophilia A is known to be an X-linked condition that leads to spontaneous bleeding in various tissues and organs. To date, a few cases of acute arterial dissection in patients with hemophilia have been reported, but the relationship between these two diseases has not been studied so far. In addition, there are no guidelines indicating the best antithrombotic treatment option in these patients. We report the case of a man with hemophilia A who developed sCeAD and transient oculo-pyramidal syndrome and was treated with acetylsalicylic acid. We also review previous published cases of arterial dissection in patients with hemophilia, discussing the potential pathogenetic mechanism underlying this rare association and potential antithrombotic therapeutic options
Oral Health Status in Subjects with Amnestic Mild Cognitive Impairment and Alzheimer's Disease: Data from the Zabút Aging Project
Full text linkBackground: The relationship between Alzheimer's disease (AD) and periodontitis has been recently investigated with heterogenous results.
Objective: This study aims to evaluate the oral health status and its relationship with cognitive impairment of participants, enrolled in the Zabút Aging Project, a community-based cohort study performed in rural community in Sicily, Italy.
Methods: A case-control study (20 subjects with AD, 20 with amnestic mild cognitive impairment (aMCI), and 20 controls) was conducted. The protocol included a comprehensive medical and cognitive-behavioral examination. Full-mouth evaluation, microbial analysis of subgingival plaque samples (by RT-PCR analysis), and oral health-related quality of life (OHR-QoL) were evaluated.
Results: The decayed, missing, and filled teeth (DMFT) total score of AD subjects was significantly higher than for aMCI (p = 0.009) and controls (p = 0.001). Furthermore, the "M" component of DMFT (i.e., the number of missing teeth) was significantly higher in AD than in aMCI (p < 0.001) and controls (p < 0.001). A Poisson regression model revealed that age (p < 0.001), male gender (p = 0.001), and AD (p = 0.001) were positively correlated with DMFT. Concerning oral microbial load, the presence of Fusobacterium nucleatum was significantly higher in AD than in controls (p = 0.02), and a higher load of Treponema denticola was found in aMCI than with AD (p = 0.004). OHR-QoL scores did not differ among the groups.
Conclusion: The current research suggests that AD is associated with chronic periodontitis, which is capable of determining tooth loss due to the pathogenicity of Fusobacterium nucleatum. These data remain to be confirmed in larger population-based cohorts
Multisensorial Perception in Chronic Migraine and the Role of Medication Overuse
No full textMultisensory processing can be assessed by measuring susceptibility to crossmodal illusions such as the Sound-Induced Flash Illusion (SIFI). When a single flash is accompanied by 2 or more beeps, it is perceived as multiple flashes (fission illusion); conversely, a fusion illusion is experienced when more flashes are matched with a single beep, leading to the perception of a single flash. Such illusory perceptions are associated to crossmodal changes in visual cortical excitability. Indeed, increasing occipital cortical excitability, by means of transcranial electrical currents, disrupts the SIFI (ie, fission illusion). Similarly, a reduced fission illusion was shown in patients with episodic migraine, especially during the attack, in agreement with the pathophysiological model of cortical hyperexcitability of this disease. If episodic migraine patients present with reduced SIFI especially during the attack, we hypothesize that chronic migraine (CM) patients should consistently report less illusory effects than healthy controls; drugs intake could also affect SIFI. On such a basis, we studied the proneness to SIFI in CM patients (n = 63), including 52 patients with Medication Overuse Headache (MOH), compared to 24 healthy controls. All migraine patients showed reduced fission phenomena than controls (P < .0001). Triptan MOH patients (n = 23) presented significantly less fission effects than other CM groups (P= .008). This exploratory study suggests that CM - both with and without medication overuse - is associated to a higher visual cortical responsiveness which causes deficit of multisensorial processing, as assessed by the SIFI.Perspective: This observational study shows reduced susceptibility to the SIFI in CM, confirming and extending previous results in episodic migraine. MOH contributes to this phenomenon, especially in case of triptans. (C) 2020 by United States Association for the Study of Pain, Inc
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Cortical excitability in episodic cluster headache
Full text linkBackground: Cluster headache (CH) is a severe primary headache
disorder, whose pathophysiological processes remain largely unknown.
Along with central disinhibition of the trigeminal nociceptive system and
hypothalamic impairment, a cortical involvement has been supposed.
Aim: To evaluate cortical excitability in episodic CH patients by using
different paradigms of transcranial magnetic stimulation (TMS).
Methods: Twenty-five patients with episodic CH and thirteen healthy
subjects underwent an experimental session where we evaluated, in both
hemispheres, motor-cortical response to: 1) single-pulse TMS: i.e. motor
threshold (MT); input-output (IO) curves and cortical silent period (CSP) and
2) paired-pulse TMS: i.e. intracortical facilitation (ICF) and short intracortical
inhibition (SICI). Thirteen patients were evaluated outside bout, while the
remaining twelve patients were inside bout at the time of recording.
Results: We showed increased ICF values in the hemisphere ipsilateral to
the side of pain in patients evaluated both outside and inside bout.
Differently, IO curves showed increased slope in both hemispheres in
patients examined outside bout, but only in the hemisphere contralateral
to the affected side in those evaluated during bout.
Conclusions: Our results show a condition of increased cortical excitability
in episodic CH both outside and inside bout. Interestingly, cortical
excitability was greater in the hemisphere ipsilateral to the side of pain in
patients outside bout, but decreased in patients inside bout possibly due to
activation of compensatory inhibitory mechanisms of cortical excitability.
Along with subcortical and peripheral mechanisms, changes in cortical
excitability could also play an important role in the pathophysiology of CH.
No conflict of interest
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
- …
