Lateralization of Neurobiological Response in Adolescents with Post-Traumatic Stress Disorder Related to Severe Childhood Sexual Abuse: the Tri-Modal Reaction (T-MR) Model of Protection.

This study inquires into neurobiological response to stress and its clinical correlates among adolescents with post-traumatic stress disorder (PTSD). Structural magnetic resonance imaging (MRI) measures of cerebral anatomy were carried out on 23 female adolescents with PTSD related to severe childhood sexual abuse and 21 matched healthy controls. Clinician Administered PTSD Scale for Children and Adolescents, Adolescent Dissociative Experiences Scale, Childhood Trauma Questionnaire, Schedule for Affective Disorders and Schizophrenia for School Age Children, Beck Depression Scale, and a set of neuro-cognitive tests were administered to all participants. Compared to controls, PTSD group bilaterally had smaller amygdala, hippocampus, anterior cingulate, and thinner prefrontal cortex but normal thalamus. Further analyses within the PTSD group suggested an association between symptoms of PTSD and sizes of right brain structures including smaller amygdala but larger hippocampus and anterior cingulate. Thinner right prefrontal cortex and larger right thalamus seemed to be related to denial and response prevention, respectively. Being related to both hemispheres, dissociative amnesia was negatively associated with proportion of the right amygdala to right thalamus and to both left and right prefrontal cortex. Suggesting a neuro-protective effect against traumatic stress at least through adolescence, depersonalization-derealization and identity alteration were correlated with thicker left prefrontal cortex. Unlike the lateralization within PTSD group, correlations between regions of interest were rather symmetrical in controls. The graded response to stress seemed to be aimed at mental protection by lateralization of brain functions and possibly diminished connection between two hemispheres. A Tri-Modal Reaction (T-MR) Model of protection is proposed.

The TREAT-NMD Duchenne muscular dystrophy registries: conception, design, and utilization by industry and academia.

Duchenne muscular dystrophy (DMD) is an X-linked genetic disease, caused by the absence of the dystrophin protein. Although many novel therapies are under development for DMD, there is currently no cure and affected individuals are often confined to a wheelchair by their teens and die in their twenties/thirties. DMD is a rare disease (prevalence <5/10,000). Even the largest countries do not have enough affected patients to rigorously assess novel therapies, unravel genetic complexities, and determine patient outcomes. TREAT-NMD is a worldwide network for neuromuscular diseases that provides an infrastructure to support the delivery of promising new therapies for patients. The harmonized implementation of national and ultimately global patient registries has been central to the success of TREAT-NMD. For the DMD registries within TREAT-NMD, individual countries have chosen to collect patient information in the form of standardized patient registries to increase the overall patient population on which clinical outcomes and new technologies can be assessed. The registries comprise more than 13,500 patients from 31 different countries. Here, we describe how the TREAT-NMD national patient registries for DMD were established. We look at their continued growth and assess how successful they have been at fostering collaboration between academia, patient organizations, and industry.

The links between health-related behaviors and life satisfaction in elderly individuals who prefer institutional living.

BACKGROUND: Life satisfaction among residents of institutions is becoming an important issue in a rapidly aging population. The aim of this cross-sectional study was to investigate the links between life satisfaction and health-related behaviors amongst functionally independent elderly people who prefer institutional living in Istanbul, Turkey. METHODS: The socio-demographic characteristics, health-related behaviors, leisure-time activities and fall histories of 133 residents of an institution in Istanbul were assessed by a structured questionnaire during face-to-face interviews. A validated life-satisfaction index questionnaire (LSI-A) was completed. RESULTS: The mean age of the study group was 73.9 +/- 8.0 (range 60-90 years). Within the group, 22.6% had never married and 14.3% had university degrees. The majority (71.4%) were in the low income bracket. The overall mean LSI-A score was 20.3 +/- 5.9. Participants who declared moderate/high income levels had a significantly higher mean LSI-A score than those in the low-income bracket (p = 0.009). Multivariate analysis of the data suggested that leisure-time activities and participation in regular physical activities are significant predictors of LSI-A scores (R2: 0.112; p = 0.005 and p = 0.02, respectively). CONCLUSION: The findings imply that regular physical activity and leisure-time activities are significantly related to life satisfaction among residents in institutions. Participation in physical activity and leisure-time activity programs may help to improve the life satisfaction of elderly people living in institutions.

Evaluation of elbow joint proprioception with RehabRoby: a pilot study.

OBJECTIVE: The aim of this study was to evaluate the proprioceptive sense of elbow flexion through a robot-assisted rehabilitation system, RehabRoby, and to understand the usability of RehabRoby as a robotic system in physiotherapy. METHODS: The study included 20 volunteer, healthy students studying either physiotherapy (PT) (5 females and 5 males) or electrical and electronics engineering (EEE) (5 females and 5 males). Using the RehabRoby, they were asked to flex their elbow joints in pronation actively and then against a comfortable resistance to the target angles (20°, 45° and 90°), with eyes open and closed. Angle of movement and applied torque for each target angle and error of movement with respect to the target angle (error of matching) were recorded as absolute values. Participants' socio-demographic and physical features were also evaluated. RESULTS: Physiotherapy students had less matching error at 45° with eyes opened than EEE students. A negative correlation was found between resistive elbow flexion and applied torque while eyes closed at 20° (p<0.05). Biceps brachii strength and being female were significant predictive factors for the least matching error in active elbow flexion at 20° with eyes closed. Error of matching at 45° without vision was lower in the PT group (-0.31) than in the EEE group (0.77). In addition, it was noticed that biceps brachii muscle strength played an important role in the proprioceptive sense of the motion at 20°. CONCLUSION: The RehabRoby can be considered a usable system for the evaluation of joint proprioception sense. With future validity studies, the RehabRoby may be used to assess, diagnose and improve the proprioceptive sense of patients.

Evaluation of proprioceptive sense of the elbow joint with RehabRoby.

In recent years, robot-assisted rehabilitation systems have been an active research area that can quantitatively monitor and adapt to patient progress, and ensure consistency during rehabilitation. In this work, an exoskeleton type robot-assisted rehabilitation system called RehabRoby is developed. A control architecture, which contains a high level controller and a low level controller, is designed for RehabRoby. Proprioceptive sense of healthy subjects has been evaluated during the execution of a task with RehabRoby. Additionally, usability of RehabRoby has been evaluated using a questionnaire.