Paraneoplastic Ataxia: Antibodies at the Forefront Have Become Routine Biomarkers.

Paraneoplastic cerebellopathies are immune-mediated disorders targeting primarily the cerebellar circuitry, often presenting in a subacute course. The syndrome often develops before the cancer. Therefore, its identification often leads secondarily to a diagnosis of cancer, a critical step to stabilize symptoms. Two categories of antibodies have been identified these last 30 years: (a) onconeuronal antibodies which are directed against intracellular antigens, and (b) antibodies which are directed against synaptic and cell surface proteins. These latter impact on the location and function of the antigens, causing a genuine neuronal dysfunction. Appropriate and fast tumor screening has emerged as a recommendation facing a subacute cerebellar syndrome suspected to be paraneoplastic. Search for antibodies is now a milestone for the diagnosis.

Nothnagel Syndrome.

The internist Hermann Nothnagel (1841-1905) took a special interest in the cerebellum. In an early experimental study on rabbits conducted in 1876, he demonstrated the involvement of the vermis in the pathophysiology of motor ataxia. Between 1879 and 1889, he reported four cases of tectal tumors that clinically manifested with bilateral ophthalmoplegia and unilateral gait ataxia, culminating in the Cerebellar Classic highlighted here. Nothnagel attributed this clinical syndrome to lesions of the colliculi ("quadrigeminal bodies") and compression of the nuclei of the third cranial nerves, but also left open the possibility of the involvement of neighboring structures, such as the cerebellar vermis. Today, the ataxic component of Nothnagel syndrome is explained by a dorsal midbrain abnormality of either neoplastic or vascular origin, involving the superior cerebellar peduncles, besides the oculomotor nerves.

The Pioneer Neuropharmacologist Alfred Fröhlich (1871-1953) and the Origins of Neuroendocrinology: A Sesquicentennial Remembrance.

The birth of neuroendocrinology as a scientific discipline is traced back to 1900-1901, when Joseph Babinski, Alfred Fröhlich, and Harvey Cushing independently identified adiposogenital dystrophy (Fröhlich syndrome), and related gonadal underdevelopment and obesity to a tumor near the pituitary gland. This discovery prompted decades of research into the brain mechanisms responsible for the control of peripheral metabolism and endocrine functions. On the occasion of the 150th anniversary of Fröhlich's birth, this study traces the origins of his intellectual formation and his association with renowned contemporaries in Austria, England, Italy, and finally Cincinnati, Ohio, where he sought refuge after Austria's annexation by Nazi Germany. Fröhlich interacted with seminal figures in biomedicine, including Lothar von Frankl-Hochwart, Hans Horst Meyer, Ernst Peter Pick, Harvey Cushing, John Newport Langley, and the Nobel laureates Charles Scott Sherrington and Otto Loewi. Alfred Fröhlich, one of the 20th century's most emblematic physicians, left his mark on neurophysiology and neuropharmacology with important works, and published authoritative manuals of drug dispensing and clinical therapy. He confronted the calamities of two World Wars with remarkable resilience like many of his Viennese colleagues who, overcoming the constraints of National Socialism, settled overseas to fulfil their calling as physicians, researchers, and teachers.

From Cerebellar Apoplexy in 1849 to Cerebellar Stroke in the 2020s: Robert Dunn's Contribution.

Stroke of the cerebellum represents about 10% of strokes of the brain. Both infarction and hemorrhage manifest with symptoms related to the location and extent of the lesion(s). Bilateral cerebellar infarcts constitute up to one third of all cerebellar infarctions. The leading cause of cerebellar infarcts is emboli of cardiac origin or from intra-arterial sources. Potential complications include brainstem compression and hydrocephalus. Malignant cerebellar edema is a life-threatening complication of ischemic posterior circulation stroke requiring urgent management. The advent of MRI has revolutionized the early diagnosis in vivo, showing small and large territorial infarcts, hemorrhages, and venous infarcts. Endovascular procedures are growingly applied and are impacting on the prognosis of stroke, although cerebellar stroke from occlusion of small cerebellar arteries is currently not accessible to thrombectomy. Surgical procedures of space-occupying stroke include external ventricular drainage, suboccipital craniotomy, or combined procedures. In 1849, Robert Dunn (1799-1877), an English surgeon, reported the details of a case of apoplexy of the cerebellum in a 52-year-old man, pointing to the importance of post-mortem studies of patients followed meticulously during lifetime. Dunn discussed inflammation surrounding hemorrhage as a source of cerebral degeneration, linking for the first time cerebellar stroke, neuroinflammation, and atherosclerosis.

Vicente Dimitri (1885-1955).

The pioneer neuropathologist Vicente Dimitri (1885-1955) was professor and chairman of neurology at the Medical School of the University of Buenos Aires. He founded the Revista Neurológica de Buenos Aires, the first Spanish-language journal of neurology (currently, Neurología Argentina), and is eponymously remembered in 'Sturge-Weber-Dimitri syndrome' or encephalotrigeminal angiomatosis.

Soul, butterfly, mythological nymph: psyche in philosophy and neuroscience / Alma, borboleta, ninfa mitológica: psique em filosofia e neurociência

ABSTRACT The term “psyche” and its derivatives – including “Psychology” and “Psychiatry” – are rooted in classical philosophy and in mythology. Over the centuries, psyche has been the subject of discourse and contemplation, and of fable; it has also come to signify, in entomology, the order of Lepidoptera. In the current surge of research on brain and mind, there is a gradual transition from the psyche (or the “soul”) to the specified descriptors defined by the fields of Behavioral, Cognitive and Integrative Neuroscience.

RESUMO O termo “psique” e seus derivados - incluindo “Psicologia” e “Psiquiatria” - estão enraizados na filosofia clássica e na mitologia. Ao longo dos séculos, a psique tem sido objeto do discurso, da contemplação, e de fábula; Também veio a significar, em entomologia, a ordem dos lepidópteros. Na atual onda de pesquisa sobre cérebro e mente, há uma transição gradual da psique (ou da “alma”) para os descritores especificados definidos pelos campos da Neurociência Comportamental, Cognitiva e Integrativa.

Neuromusicology or Musiconeurology? "Omni-art" in Alexander Scriabin as a Fount of Ideas.

Science can uncover neural mechanisms by looking at the work of artists. The ingenuity of a titan of classical music, the Russian composer Alexander Scriabin (1872-1915), in combining all the sensory modalities into a polyphony of aesthetical experience, and his creation of a chord based on fourths rather than the conventional thirds are proposed as putative points of departure for insight, in future studies, into the neural processes that underlie the perception of beauty, individually or universally. Scriabin's "Omni-art" was a new synthesis of music, philosophy and religion, and a new aesthetic language, a unification of music, vision, olfaction, drama, poetry, dance, image, and conceptualization, all governed by logic, in the quest for the integrative action of the human mind toward a "higher reality" of which music is only a component.

Professor Bernhard Pollack (1865-1928) of Friedrich Wilhelm University, Berlin: neurohistologist, ophthalmologist, pianist.

This article highlights the life and work of Bernhard Pollack (1865-1928), a pioneer neurohistologist, ophthalmologist, and world-class pianist. In 1897, Pollack published the first standard manual on staining methods for the nervous system. Born into a Prussian-Jewish family, he received his piano education from the composer Moritz Moszkowski and his pathology education from Carl Weigert. Pollack worked in the Institutes of Wilhelm Waldeyer (anatomy), Emanuel Mendel (neuropsychiatry), the later Nobel laureate Robert Koch (infectious diseases), and the Eye Policlinic of Paul Silex (ophthalmology), becoming a Professor of Ophthalmology at Berlin's Friedrich-Wilhelms-Universität in 1919. The study also chronicles the founding by Pollack of the Berlin Doctors' Orchestra in 1911.

Challenging the supremacy of the frontal lobe: early views (1906-1909) of Christfried Jakob on the human cerebral cortex.

This article focuses on a series of six studies that address functional localization in the frontal lobe; they were published in Argentina between 1906 and 1909 by Christfried Jakob (1866-1956), one of the great thinkers in early 20th century neuropathology and neurophilosophy. At that time, the localization-holism controversy was at a peak, having been triggered by the historic Marie-Déjerine aphasiology debate. Jakob held the view that constitutive physiological elements of cognition are localized. Nonetheless, he cast doubt on phrenological approaches that considered the frontal lobe as 'superior' to the other cortical regions. Jakob studied the human frontal lobe from fetal life through senility, in normality and pathology, including tumors, injuries, softening, general paralysis and dementia. Based on those finds, he considered strict localization theories a dead-end. Taking a critical look at Flechsig's ideas on the parallel ontogenies of frontal association centers and intellect, Jakob argued that the frontal lobe does not carry any selective advantage over the remaining human cerebral lobes or even over the frontal lobe in non-human primates. Regarding lesion experiments in laboratory animals, he pointed to methodological caveats, such as insufficient recovery time, that may lead to disorientating conclusions, and rejected élite brain research, calling it superficial and inexact. Jakob was convinced that the verification of the anatomical connections of the frontal lobe would elucidate its functions. Thus, he viewed the frontal lobe as a central station receiving input via olfactory pathways and thalamic radiations, pertinent to muscular and cutaneous senses, and attributed a perceptive character to a brain region traditionally associated with productive functions. Modern neuroscience seems to support Jakob's rejection of distinguishable motor and sensory regions and to adopt a cautious stance concerning oversimplified localization views.