Monitoring Local Regional Hemodynamic Signal Changes during Motor Execution and Motor Imagery Using Near-Infrared Spectroscopy.

The aim of this study was to clarify the topographical localization of motor-related regional hemodynamic signal changes during motor execution (ME) and motor imagery (MI) by using near-infrared spectroscopy (NIRS), as this technique is more clinically expedient than established methods (e.g., fMRI). Twenty right-handed healthy subjects participated in this study. The experimental protocol was a blocked design consisting of 3 cycles of 20 s of task performance and 30 s of rest. The tapping sequence task was performed with their fingers under 4 conditions: ME and MI with the right or left hand. Hemodynamic brain activity was measured with NIRS to monitor changes in oxygenated hemoglobin (oxy-Hb) concentration. Oxy-Hb in the somatosensory motor cortex (SMC) increased significantly only during contralateral ME and showed a significant interaction between task and hand. There was a main effect of hand in the left SMC. Although there were no significant main effects or interactions in the supplemental motor area (SMA) and premotor area (PMA), oxy-Hb increased substantially under all conditions. These results clarified the topographical localization by motor-related regional hemodynamic signal changes during ME and MI by using NIRS.

Carvedilol can prevent cardiac events in Duchenne muscular dystrophy.

OBJECTIVE: Heart failure is one of the most serious complications in Duchenne muscular dystrophy (DMD). Beta-blocker medication is known to improve the prognosis of chronic heart failure of adults, but its efficacy and safety for DMD patients has not been fully assessed. Thus we conducted a multicenter open trial. METHODS: Fifty-four DMD patients participated; 41 received carvedilol (BB group) and 13 did not (non BB group). All patients with an ejection fraction of less than 50% received angiotensin-converting enzyme inhibitor. Then, patients in BB group were started on carvedilol. The mean maintenance dose of carvedilol in BB group was 7.85+/-2.80 mg/day. Clinical signs and cardiac function were monitored regularly and statistical analysis was done. RESULTS: The survival rate free from primary endpoints (death, deterioration of heart failure and severe arrhythmia) was higher in the BB group. The survival rate free from all-cause death was also higher in the BB group, although not significantly higher. Patients with primary endpoints received lower maintenance doses of carvedilol and presented higher mean heart rates (HR) during the observation period. In the BB group, mean HR at enrollment and the reduction of mean HR were correlated with the change of ejection fraction. Although serious adverse events were rare during the introduction of carvedilol, patients with advanced cardiac dysfunction required a longer period for up-titration and frequently presented with minor complaints. CONCLUSION: The present study suggests that carvedilol is relatively safe and can prevent cardiac events even in patients with DMD.

Evaluating community attitudes to people with schizophrenia and mental disorders using a case vignette method.

Utilizing the case vignette method, community attitudes about people with schizophrenia and mental disorders, and perceived causes of and images regarding schizophrenia were investigated. Participants comprised 1596 respondents living in the area covered by the K health center in N prefecture. The survey utilized the Mental Disorder Prejudice Scale, a case vignette, and other basic attributes. The case vignette survey yielded the following results: when asked about a landlord refusing to rent an apartment to the vignette subject, approximately 80% of respondents agreed with the landlord's decision. However, when asked about necessary conditions for the vignette subject to live in an apartment independently, only 2.4% of respondents chose 'difficult under any circumstance'. Approximately half of the respondents chose the following conditions: 'periodic visits to the hospital', 'availability of a system where people can discuss and address any problems that might arise' and 'attending a sheltered workshop or making attempts to rehabilitate'. Regarding acceptance as a neighbor after meeting the listed conditions, most respondents stated they would 'treat him just like any other neighbor' (47.3%), followed by 'help as much as possible in times of need' (36.3%). In other words, approximately 80.0% of respondents were willing to have the vignette subject as their neighbor. In addition, many respondents thought that schizophrenia is caused by problems in interpersonal relationships (64.8%) and represents an unstable disease (69.9%). When asked about having the subject as a neighbor, respondents were more willing to accept him as a neighbor after clarifying conditions for living arrangements.

Evaluating stigma against mental disorder and related factors.

This study attempted to identify forms of stigma against individuals with mental disorders and related factors. The subjects comprised 2632 people living in the area covered by the K health center in N prefecture. Factor analysis of the Mental Disorder Prejudice Scale (1211 valid responses) identified three factors: 'rejection', 'peculiarity' and 'human rights alienation'. Regression analysis revealed that age, welfare activities, an active problem-solving attitude, lecture attendance, and previous contact, exerted independent effects with respect to 'rejection'. These results suggest the importance of disseminating accurate information and creating more opportunities for people to have meaningful interactions with people with mental disorders in order to dispell the stigma.

Effects of an educational program on public attitudes towards mental illness.

The World Psychiatric Association promotes global anti-stigma programs. However, evaluation research is crucial to developing effective programs. The present study examined the effects of a lecture on mental health on public attitudes towards mental illness. Subjects were recruited from individuals employed by private companies and the government. Attitudes towards mental illness were measured using the Mental Illness and Disorder Understanding Scale developed by the authors and the Scale of Negative Attitudes Towards the Independence of People with Mental Disorders. Test scores obtained before and after the lecture were compared. The results demonstrated that scores on both scales improved significantly. The present study suggests the effectiveness of this type of educational program in reducing stigma attached to mental illness and disorder.