It demonstrated a clear benefit when compared to placebo on reducing the frequency of different seizure types and exerting a higher effect in younger children. In conclusion, mTOR cascade can be a potentially major cause of TSC-associated epilepsy and neurodevelopmental disability, and additional research should investigate if early suppression of abnormal mTOR signal with mTOR inhibitors before seizure onset can be a more efficient approach and an effective antiepileptogenic and disease-modifying strategy in infants with TSC.Three types of reconstruction are possible following total laryngopharyngectomy (TLP) for advanced hypopharyngeal cancer locoregional tubularized island flaps, gastric pull-up and free flaps. Gastro-omental free flap (GOFF) is rarely used in this setting. learn more However, because of its composite nature, this flap has the advantage of being able to restore digestive continuity and reconstruct part of the skin of the neck when it needs to be sacrificed because of tumour invasion or poor trophicity. The GOFF is a reliable and robust flap particularly indicated in hostile environments repeated neck surgery, atrophic and devascularized skin after radiotherapy, sepsis in the context of fistula and/or pharyngostomy. It requires the collaboration of two or even three surgical teams. In this article, we describe the flap harvesting technique and the complications and functional outcome.
Impairment in cognitive control is one of the most significant cognitive deficits in schizophrenia. Although it has generally been associated with altered engagement of lateral and medial prefrontal cortices, how attention fluctuations affect this engagement is still not known. In this context, we explored sustained (orproactive) and transient (or reactive) control engagement by investigating frontal theta-band oscillations during periods of low- and high-performance instability, assumed to represent intraindividual attentional fluctuations.
A total of 25 patients with schizophrenia (16 males) and 25 healthy matched control subjects (18 males) performed a long-sustained Go/NoGo task coupled with electroencephalographic recording. Proactive control was explored through frontal lateral theta during trial-by-trial conflict (Go N-1/Go N+1), whereas reactive control was explored through frontal midline theta and the N2 component during current-trial conflict (Go/NoGo). Variance in the time course of reaction ts was state dependent. The findings highlight the importance of accounting for attentional fluctuations when investigating cognitive control impairment in schizophrenia.
Secure attachment is important in maintaining an individual's health and well-being. Attachment disturbances increase the risk for developing psychiatric disorders such as affective disorders. Yet, the neurobiological correlates of human attachment are poorly understood at the neurotransmitter level. We investigated whether adult attachment style is linked to functioning of the opioid and serotonergic systems in the human brain.
We used positron emission tomography with radioligands [
C]carfentanil and [
C]MADAM to quantify mu opioid receptor (n= 39) and serotonin transporter (n= 37) availability in volunteers with no current psychiatric disorders. Attachment style was determined according to the Dynamic-Maturational Model of Attachment and Adaptation with the structured Adult Attachment Interview.
Secure attachment was associated with higher mu opioid receptor availability in the hippocampus, amygdala, thalamus, and prefrontal cortex when compared with insecure (i.e., avoidant or ambivalent groups combined) attachment. In contrast, attachment style was not associated with serotonin transporter availability.
Our results provide preliminary invivo evidence that the opioid system may be involved in the neurocircuits associated with individual differences in adult attachment behavior. The results suggest that variation in mu opioid receptor availability may be linked with the individuals' social relationships and psychosocial well-being and thus contributes to risk for psychiatric morbidity.
Our results provide preliminary in vivo evidence that the opioid system may be involved in the neurocircuits associated with individual differences in adult attachment behavior. The results suggest that variation in mu opioid receptor availability may be linked with the individuals' social relationships and psychosocial well-being and thus contributes to risk for psychiatric morbidity.Clinical outcomes vary for individuals at clinical high risk (CHR) for psychosis, ranging from conversion to a psychotic disorder to full remission from the risk syndrome. Given that most CHR individuals do not convert to psychosis, recent research efforts have turned toward identifying specific predictors of CHR remission, a task that is conceptually and empirically dissociable from the identification of predictors of conversion to psychosis, and one that may reveal specific biological characteristics that confer resilience to psychosis and provide further insights into the mechanisms associated with the pathogenesis of schizophrenia and those underlying a transient CHR syndrome. Such biomarkers may ultimately facilitate the development of novel early interventions and support the optimization of individualized care. In this review, we focus on two event-related brain potential measures, mismatch negativity and P300, that have attracted interest as predictors of future psychosis among CHR individuals. We describe several recent studies examining whether mismatch negativity and P300 predict subsequent CHR remission and suggest that intact mismatch negativity and P300 may reflect the integrity of specific neurocognitive processes that confer resilience against the persistence of the CHR syndrome and its associated risk for future transition to psychosis. We also highlight several major methodological concerns associated with these studies that apply to the broader literature examining predictors of CHR remission. Among them is the concern that studies that predict dichotomous remission versus nonremission and/or dichotomous conversion versus nonconversion outcomes potentially confound remission and conversion effects, a phenomenon we demonstrate with a data simulation.learn more
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