Acquired equivalence and related memory processes in migraine without aura.

Introduction Interictal deficits of elementary visuo-cognitive functions are well documented in patients with migraine and are mostly explained in terms of neocortical hyperexcitability. It has been suggested that the basal ganglia and the hippocampi might also be affected in migraine. If so, a deterioration of learning and memory processes related to these structures is expected. Methods A visual learning paradigm thought to be capable of dissociating learning/memory processes mediated by the basal ganglia from processes mediated by the hippocampus (the Rutgers Acquired Equivalence Test) was applied to a group of patients with migraine without aura and to age- and sex-matched controls. Results Patients with migraine showed a significantly poorer performance in both main phases of the test and the deficit in the phase considered to be dependent on the hippocampi was especially marked. Conclusions These results can be interpreted as behavioural support for findings that have suggested the involvement of the basal ganglia and the hippocampi in migraine, but further research is needed to clarify these findings.

Further Evidence for the Utility of Electrophysiological Methods for the Detection of Subclinical Stage Retinal and Optic Nerve Involvement in Diabetes.

OBJECTIVE: To assess the utility of visual electrophysiological methods, visual evoked potentials (VEPs) and pattern electroretinograms (PERGs) were recorded for the detection of subclinical optic nerve and retinal involvement in patients with diabetes mellitus. SUBJECTS AND METHODS: The data of 63 patients (126 eyes) with no vascular retinopathy or optic neuropathy were retrospectively analyzed. The patients were divided into polyneuropathic/nonpolyneuropathic groups to differentiate between early and late subclinical stages. The recorded parameters were compared with local reference values. RESULTS: 116 eyes (92%) had VEP and 76 (60%) had PERG abnormalities. The most frequent alteration was latency delay, but waveform and amplitude irregularities were also observed. The simultaneous use of the two methods allowed us to differentiate abnormal VEPs of purely optic nerve origin from those reflecting retinal involvement. CONCLUSIONS: We suggest that regular electrophysiological screening should receive more attention in the ophthalmological care of diabetic patients.

Achromatic luminance contrast sensitivity in X-linked color-deficient observers: an addition to the debate.

It is a matter of debate whether X-linked dichromacy is accompanied by enhanced achromatic processing. In the present study, we used sinusoidally modulated achromatic gratings under photopic conditions to compare the contrast sensitivity (CS) of protanopes, deuteranopes, and normal trichromats. 36 male volunteers were examined. CS was tested in static and dynamic conditions at nine different spatial frequencies. The results support the assumption that X-linked color-defective observers are at an advantage in terms of achromatic processing. Both protanopes and deuteranopes had significantly better CS than controls in both the static and the dynamic conditions. In the static condition, the advantage was observed especially at higher spatial frequencies, whereas in the dynamic condition, it was seen also at lower frequencies. The results are interpreted in terms of decreased chromatic modulation of the luminance channel and the early plasticity of the parvocellular system.

Interocular amplitude and latency differences of pattern ERG and pattern VEP parameters.

PURPOSE: To determine the normal interocular differences in amplitudes and peak times of the pattern electroretinograms (PERGs) and pattern visual evoked potentials (PVEPs) and to investigate whether the PERG and PVEP parameters correspond in lateral dominance or whether the eye-side distributions of the functional parameters are similar. METHODS: The PERGs and PVEPs were recorded in healthy subjects (N = 77) according to the standards of the International Society for Clinical Electrophysiology of Vision, with the modification of the check size of the PERG to 0.5 degrees. This allows stimulation of the macular ganglion cells and their corresponding visual pathways in healthy subjects. RESULTS: Comparison of the averaged higher and lower response amplitudes and the shorter and longer response peak times showed significant differences (p < 0.001) in both the PERG and the PVEP parameters (median [5 to 95%]): the P50 (1.92% [0 to 5.48%]) and N95 (2.06% [0 to 13.95%]) peak times and the P50 (11.82% [1.32 to 29.93%) and N95 (9.45% [1.17 to 30.38%]) amplitudes of the PERGs and the P100 (1.04% [0 to 4.15%]) and N135 (1.96% [0 to 12.36%]) peak times and the P100 (9.86% [1.26 to 29.76%]) and N135 (11.19% [1.18 to 29.99%]) amplitudes of the PVEPs. No significant correlation was found concerning the eye dominance of the PERG and PVEP parameters. CONCLUSIONS: Our results reveal a significant interocular difference on PERG and PVEP recording, but this could not be ascribed to the anatomy of the retina and related visual pathways. If the difference between the eyes is not taken into account, misinterpretation may occur in a pathological process.

{alpha}-Synuclein gene duplication impairs reward learning.

alpha-Synuclein (SNCA) plays an important role in the regulation of dopaminergic neurotransmission and neurodegeneration in Parkinson disease. We investigated reward and punishment learning in asymptomatic carriers of a rare SNCA gene duplication who were healthy siblings of patients with Parkinson disease. Results revealed that healthy SNCA duplication carriers displayed impaired reward and intact punishment learning compared with noncarriers. These results demonstrate that a copy number variation of the SNCA gene is associated with selective impairments on reinforcement learning in asymptomatic carriers without the motor symptoms of Parkinson disease.

Long-Term Follow-Up of a Family with Retinal Dystrophy Caused by RPE65 Mutation.

We present here the case histories of two siblings, a boy and a girl, with Leber's congenital amaurosis (LCA). The diagnosis was based on non-recordable full-field electroretinogram (ffERG). The long-term ophthalmologic follow-up included kinetic perimetry (Goldmann), visual evoked potentials with flash stimulation, optical coherence tomography (OCT: B-scan images at the area of fovea), and multifocal ERG. The boy (sibling 1, born in 1986) was sent for electrophysiological examination at the age of four because he had nystagmus from birth. The diagnosis would be LCA based on non-recordable ffERG. Four years later, his visual acuity decreased rapidly due to vitreous opacification, caused by the autoimmune reaction of the retinal pigment epithelial cells. This was treated successfully with steroid injections, administered parabulbarly. Retinal autoimmune panel was not performed. Genetic testing became available only in 2019, and it revealed a RPE65 gene mutation: (NM_000329.2) c.{442G>A};{442G>A} (p.{Glu148Lys}; {Glu148Lys}). His sister (sibling 2, born in 1993) showed similar symptoms, caused by the same genetic mutation. Even though their parents were free of symptoms, it appeared that they were heterozygous carriers of the same mutation. Research of the family tree revealed a consanguineous marriage four generations before. Both siblings received successful gene therapy relatively late in their age: sibling 1 was 35 and sibling 2 was 28 years old, meaning that they were at an advanced stage of the disease. Nevertheless, follow-up examinations showed measurable improvements in their retinal function. The study shows that electrophysiological examinations, including flash-evoked responses, are useful in the objective evaluation of the progression in the central photoreceptor loss during the follow-up of LCA. The results also show that gene therapy can have beneficial effects even at an advanced stage of the disease.

Delayed development of visual motion processing in childhood migraine.

INTRODUCTION: Altered visual processing has been observed in adult migraineurs. But because visual processing has not been studied in paediatric cases, it is not known whether such visual system alterations are already present in early development. We therefore used a dynamic visual task to investigate motion detection threshold in paediatric migraine. METHODS: Fourteen migraineurs and 21 controls participated in the study (age range: 8-17 years). The minimal percentage of coherently moving dot stimuli at which subjects were still able to detect coherent movement (absolute threshold) was determined using a random dot kinematogram paradigm. RESULTS: Motion coherence detection threshold was higher in migraineurs (p < 0.05). This difference between groups was more pronounced at younger ages, but migraineurs seem to catch up with healthy controls over the years. CONCLUSIONS: Children with migraine exhibit a delayed development of visual motion processing. This might be a useful supplementary biomarker in paediatric migraine.

The effects of peptide and lipid endocannabinoids on arthritic pain at the spinal level.

BACKGROUND: Hemopressin, a nonapeptide (PVNFKFLSH: HP) derived from the α chain of hemoglobin was shown to interact specifically with brain cannabinoid CB(1) receptors. Therefore, it seems to be the only peptide structure with cannabinoid activities. Our goal in this study was to further characterize this peptide and to clarify the antinociceptive potency of the polyunsaturated fatty acid derivates, 2-arachidonoyl-glycerol (2-AG) and anandamide, by investigating their effects on mechanical allodynia at the spinal level. METHODS: HP was prepared on solid phase by in situ neutralization. After chronic intrathecal catheterization, mechanical hypersensitivity was produced in male Wistar rats by injection of carrageenan (300 µg/30 µL) into the tibiotarsal joint of one of the hind legs. Three hours after carrageenan administration, the ligands were administered intrathecally. The mechanical threshold was assessed using a dynamic aesthesiometer. RESULTS: 2-AG (1-200 µg) and anandamide (10-200 µg) decreased carrageenan-induced mechanical allodynia in a dose-dependent manner, whereas HP had no antinociceptive effect in a wide dose range (0.3-30 µg). The effect of 2-AG was prevented by the CB(1) receptor antagonist AM 251, but not by the CB(2) antagonist SSR144528-2. HP (3 and 30 µg) also inhibited the effect of 2-AG. None of the ligands influenced the degree of edema. CONCLUSIONS: HP posttreatment had no effect on mechanical allodynia, whereas spinally injected 2-AG and anandamide were potent drugs.

[Laparoscopic subtotal gastrectomy -- our experience]. / Laparoscopos technikával végzett subtotalis gyomorresectióinkról.

Laparoscopic surgery gained significant popularity in the last two decades. In our department, laparoscopic gall bladder, hernia and large bowel surgeries are the most frequent ones. Recently we started to do laparoscopic surgery for early gastric cancer, too. Initially, wedge resections, distal gastrectomy and laparoscopically asssisted periventricular lymphadenectomies were carried out. Later on, laparoscopic subtotal gastrectomy was also done. Therefore, we can provide three different ways of surgical treatment for gastric malignancies by now: wedge resection, intramucosal resection as well as subtotal gastrectomy. Four laparoscopic gastrectomies were carried out with D1 or D2 lypmhadenectomy - in case it was needed - in our department by the end of 2010. All patients' gastric cancer was less than 3 cm in size, and it was verified by preoperative histology (adenocarcinoma, T1b/N0/M0 or T2/N0/M0). The cancers were localized in the antrum or distally in the peripyloric region, and were ulcerated frequently. Subtotal gastrectomy with retrocolic gastroentero anastomosis was carried out in every case.Patient's age was not considered in patient selection. Surgical time was between two and four hours. We discuss our experience with laparoscopic gastric surgery and recommend its incorporation into practice.

Development of visual contour integration in children with migraine without aura.

INTRODUCTION: As migraine attacks pose insult to cerebral circulation and ion homeostasis, migraine has the potential to interfere with the development of different brain structures, producing functional deficits. It is known that visual contour integration (CI) is a function with a protracted development. Therefore, we sought to establish whether migraine interferes with its development. METHODS: Forty-eight migraineurs (without aura) and 48 age- and sex-matched controls participated in the study, divided into three cohorts by age. Stimuli were presented on cards with a contour consisting of Gabor patches embedded in random noise. Difficulty was varied by the manipulation of relative noise density. The task was to identify and show the contour. RESULTS: A significant difference was found between the performance of migraineurs and controls in the 10-14-year-old and 15-18-year-old cohorts (p < 0.05). Development between all three cohorts was significant in the control group (p < 0.017), while it was not significant in migraineurs between 6 and 14 years. Correlation between age and CI threshold was stronger in controls than in migraineurs. CONCLUSION: Children with paediatric migraine exhibited a less marked development in the Gabor patch-based CI task.

Is the development of visual contrast sensitivity impaired in children with migraine? An exploratory study.

INTRODUCTION: Impairment of visual contrast sensitivity is a well-known phenomenon in adult migraineurs. Little is known, however, about whether contrast sensitivity deficits are already present in children with migraine. METHODS: We conducted an exploratory study with 18 children with migraine without aura, in which we tested our subjects' visual contrast sensitivity. Eighteen age- and sex-matched healthy children served as controls. RESULTS: Among the youngest subjects (6-10 years) we found no significant differences at any of the spatial frequencies tested, as compared to the controls, whereas from the age of 10 on, migraineurs exhibited significantly poorer contrast sensitivity, especially at the lower spatial frequencies. CONCLUSION: To our knowledge, we are the first to report on such a deficit in children, and we conclude that our findings might be interpreted as reflecting an increased vulnerability of the visual system to migraine attacks as part of the migrainous endophenotype.

The perception of biological and mechanical motion in female fragile X premutation carriers.

Previous studies reported impaired visual information processing in patients with fragile X syndrome and in premutation carriers. In this study, we assessed the perception of biological motion (a walking point-light character) and mechanical motion (a rotating shape) in 25 female fragile X premutation carriers and in 20 healthy non-carrier controls. Stimuli were moving stimulus dots embedded among a cloud of noise dots. Sensitivity (d') for motion detection was determined. Emotional symptoms were assessed by Hamilton's depression and anxiety rating scales. Results revealed that the premutation carriers displayed lower sensitivities for biological and mechanical motion relative to the non-carriers. This deficit was more pronounced in the case of biological stimuli. The premutation carriers displayed higher depression and anxiety scores relative to the non-carriers. Higher depression, but not anxiety, scores were associated with decreased sensitivity for biological, but not mechanical, motion in the carrier group. These results suggest that motion perception deficits are detectable in fragile X premutation carriers, and that the impairment of biological motion perception is associated with depressive symptoms.

Peripheral antinociceptive effect of 2-arachidonoyl-glycerol and its interaction with endomorphin-1 in arthritic rat ankle joints.

1. Both cannabinoid and opioid receptors are localized at the peripheral level, and drugs acting on these receptors may produce antinociception after topical administration; however, the effect of endogenous ligands at these receptors is poorly understood. Our goal was to determine the antinociceptive potency of the endogenous cannabinoid 2-arachidonoyl-glycerol (2-AG), and its interaction with endomorphin-1 (EM1) at joint level in the rat inflammation model. 2. Mechanical hypersensitivity was produced by injection of carrageenan (300 microg/30 microL) into the tibiotarsal joint of the right hind leg. The mechanical threshold was assessed by von Frey filaments. 2-AG (3-200 microg), EM1 (100-300 microg) and their combinations in a fixed-dose ratio (1 : 10) were given into the inflamed joint, and the threshold was determined repeatedly for 105 min after the drug administrations. 3. Both ligands produced dose-dependent anti-hyperalgesia, and the highest doses caused prolonged effects, but they did not influence the degree of oedema and the withdrawal threshold at the non-inflamed side. EM1 had lower potency compared to 2-AG (ED(25): 233 (CI: 198-268) microg and 126 (CI: 88-162) microg, respectively; P < 0.05). The effects of EM1 and 2-AG were prevented by mu-opioid and cannabinoid 1 receptor antagonists, respectively. The ED(25) value for the combination (98 (CI: 80-112) microg) did not differ significantly from the value of 2-AG; however, the largest dose combination produced a significantly higher effect than the ligands by themselves. 4. Our data showed that 2-AG was an effective antinociceptive ligand at joint level, and its combination with EM1 produced long-lasting, effective antinociception.

Visual pathways serving motion detection in the mammalian brain.

Motion perception is the process through which one gathers information on the dynamic visual world, in terms of the speed and movement direction of its elements. Motion sensation takes place from the retinal light sensitive elements, through the visual thalamus, the primary and higher visual cortices. In the present review we aim to focus on the extrageniculo-extrastriate cortical and subcortical visual structures of the feline and macaque brain and discuss their functional role in visual motion perception. Special attention is paid to the ascending tectofugal system that may serve for detection of the visual environment during self-motion.

Immunohistochemical Analysis of a Vitreous Membrane Removed from a Patient with Incontinentia Pigmenti-Related Retinal Detachment.

This is a case history of a 23-year-old woman suffering from incontinentia pigmenti (IP). The patient's vision in the left eye started to deteriorate due to cataract progression at the age of 22, and by the age of 23, it dropped from 0.9 to 0.04. Ultrasound examination confirmed tractional vitreoretinal membranes. Vitrectomy was performed, therefore, on her left eye. The histological evaluation of vitreous membrane revealed a complex immunophenotype (positivity for glial fibrillary acidic protein (GFAP), vimentin, S-100, anti-pan cytokeratin antibody (AE/AE3), and smooth muscle-specific actin (SMA) to various extents). The right eye remained unsymptomatic throughout this course. Besides being the first to analyze the tractional vitreoretinal membrane in IP with immunohistochemical methods, this case study points out that extreme cases of asymmetric side involvement in IP do exist, even to the point of one eye being completely unsymptomatic.

Oxytocin enhances the perception of biological motion in humans.

Evidence suggests that intranasally administered oxytocin modulates several social cognitive and emotional processes in humans. In this study, we investigated the effect of oxytocin on the perception of biological motion (a walking character) and nonbiological motion (a rotating shape). The participants were 20 healthy volunteers who observed moving dots embedded among a cloud of noise (mask) dots. Sensitivity (d') for motion detection was determined after the administration of oxytocin and placebo. The results showed that oxytocin (relative to placebo) administration increased sensitivity to biological motion but not to nonbiological motion. These results suggest that oxytocin specifically modulates the perception of socially relevant stimuli.

Selective disturbance of pain sensitivity after social isolation.

The effects of social isolation or NMDA-receptor antagonists on pain sensitivity have repeatedly been described. However, the mechanisms underlying the alterations of pain perception in these models still remain a matter of debate. Thus, we aimed to determine the long-lasting effects of subchronic ketamine treatment and social isolation on the C- and Adelta-fiber-mediated nociception. Wistar rats after weaning (21-23 days old) were either housed individually or grouped for 21 days. The animals were treated daily for 14 days with either ketamine (30 mg/kg) or saline. On the 21st day, tail-flick latency was determined at 48 degrees C (C-fiber activation) and 52 degrees C (affects mainly Adelta-fibers), and rats were rehoused. Tail-flick test was repeated 2 and 4 weeks later. On the 5th week, carrageenan-induced heat hyperalgesia was determined on paw-withdrawal test before and after morphine treatment (1, 2 or 3 mg/kg). Regarding tail-flick latencies at 48 degrees C, juvenile isolation, but not ketamine resulted in a significantly enhanced pain threshold (p<0.001) throughout the investigation period, while the changes at 52 degrees C were not significant. In addition, both isolation and ketamine treatments enhanced the antihyperalgesic effect of 2 mg/kg morphine. In summary, juvenile isolation exerts a long-lasting effect on acute heat pain sensitivity, disturbing primarily the C-fiber-linked pain pathways, suggesting a selective disruption in the parallel sensory pathways. Since both social isolation and NMDA treatment are well-known animal models of schizophrenia, our results showed that juvenile isolation but not ketamine administration can simulate hypoalgesia associated with this disease.

Visual pathway deficit in female fragile X premutation carriers: a potential endophenotype.

Previous studies indicated impaired magnocellular (M) and relatively spared parvocellular (P) visual pathway functioning in patients with fragile X syndrome. In this study, we assessed M and P pathways in 22 female fragile X premutation carriers with normal intelligence and in 20 healthy non-carrier controls. Testing procedure included visual contrast sensitivity and vernier threshold measurements. Results revealed that carriers were selectively impaired on tests of M pathways (low spatial/high temporal frequency contrast sensitivity and frequency-doubling vernier), whereas they showed intact performance on P pathway tests. These results suggest that the deficit of the M pathway is an endophenotype of fragile X syndrome.

The antinociceptive interaction of anandamide and adenosine at the spinal level.

Both anandamide and adenosine have significant roles in pain mechanisms, but no data are available concerning their interaction at the spinal level. The goal of this study was to determine how adenosine and the adenosine receptor antagonist caffeine affect the antinociceptive effect of anandamide. The pain sensitivity was assessed by the acute tail-flick test and by paw withdrawal test after carrageenan-induced inflammation. The substances were administered intrathecally to male Wistar rats. Anandamide alone (1, 30 and 100 microg) dose-dependently decreased the hyperalgesia, however it had low potency in the tail-flick test. Neither adenosine (100 microg) nor caffeine (400 microg) alone changed the pain sensitivity markedly. Their combination caused a short-lasting antihyperalgesia, but it did not influence the tail-flick latency. Both adenosine and caffeine decreased the antihyperalgesic potential of 100 microg anandamide, while adenosine-caffeine pretreatment temporarily enhanced its effect. As regards acute heat pain sensitivity, no combination with anandamide influenced the effect of anandamide. These findings provide new data concerning the interaction between two endogenous ligands and caffeine. Since these substances may exert effects on several receptors and/or systems, their interaction in vivo must be very complex and the net outcome after their coadministration could not been predicted from the in vitro results.

The peripheral antinociceptive effects of endomorphin-1 and kynurenic acid in the rat inflamed joint model.

BACKGROUND: Several data suggest that both opioid and N-methyl-d-aspartate (NMDA) receptors are localized at the peripheral level, and drugs acting on these receptors may produce antinociception after topical administration; however, the antinociceptive effect of endogenous ligands at these receptors is poorly clarified. Our goal in this study was to determine the antinociceptive potency of the endogenous opioid peptide, endomorphin-1 (EM1), and the endogenous NMDA receptor antagonist, kynurenic acid (KYNA), and their interaction at the peripheral level in the rat inflamed joint model. METHODS: Mechanical hypersensitivity was produced by injection of carrageenan (300 microg/20 microL) into the tibiotarsal joint of the right hind leg. The mechanical pain threshold was assessed by von Frey filaments (0.064-110 g). EM1 (30, 100, and 200 microg), KYNA (30, 100, 200, and 400 microg), and their combinations in a fixed-dose ratio (1:1) were injected into the inflamed joint, and the pain threshold was determined repeatedly for 75 min after the drug administrations. RESULTS: Neither EM1 nor KYNA administered to the inflamed joint influenced the pain threshold at the noninflamed side. Both ligands produced dose-dependent antihyperalgesia, and the highest doses caused a prolonged effect. EM1 had higher potency (30% effective dose [ED(30)] and 50% effective dose [ED(50)] values were 112 microg [confidence interval {CI}: 80-146] and 167 microg [CI: 135-220], respectively) compared with KYNA (ED(30) and ED(50) values were 204 microg [CI: 160-251] and 330 microg [CI: 280-407], respectively). The antinociceptive effect of EM1 was prevented by subcutaneous naltrexone pretreatment. The coadministration of EM1 with KYNA caused an enhanced and/or prolonged antinociceptive effect. The ED(30) and ED(50) values of the combination were 141 microg [CI: 83-182] and 231 microg [CI: 190-293], respectively, which did not differ significantly from the theoretically additive values (ED(30) and ED(50) values were 145 microg [CI: 68-237] and 220 microg [CI: 144-230], respectively), thus the interaction between these ligands is additive. None of the treatments caused any sign of side effects. CONCLUSION: Peripherally administered endogenous opioid agonist and NMDA receptor antagonist ligands might be beneficial in inflammatory pain. Because both drugs barely cross the blood-brain barrier, their local administration causes no central side effects.