Iodized Salt May Not Be Sufficient to Guarantee an Adequate Iodine Intake in Pregnant Women.

Adequate iodine intake is of crucial importance in pregnancy to meet the thyroid hormone needs of both mother and fetus. In the present study, undertaken as a part of the surveillance actions following the introduction in Italy of a national salt iodination program in 2005, the iodine intake was investigated in 123 pregnant women and 49 control women living in the same area of central Italy. All the participants were screened for urinary iodine concentration (UIC), serum level of thyrotropin, free-thyroxine, free-triiodothyronine, and thyroid volume. Moreover, they were provided with a questionnaire on the use of iodine-containing salt or supplements. Control women had a median UIC of 102 µg/L, consistent with an iodine sufficiency, while in pregnant women the median UIC value was 108 µg/L, lower than the endorsed UIC of 150 µg/L. In addition, pregnant women showed a significantly increased median thyroid volume compared to controls. Interestingly, the median UIC did not differ between pregnant women not using iodine-containing salt or supplements and those regularly consuming iodized salt alone, while pregnant women with a daily intake of iodine-containing supplements had an adequate median UIC (168 µg/L). In conclusion, the data reported here showed that pregnant women and their fetuses are still exposed to the detrimental effects of iodine deficiency and that the consumption of iodine-containing supplements should be recommended in pregnancy.

Is hypnotic assessment relevant to neurology?

Studies conducted in healthy subjects have clearly shown that different hypnotic susceptibility, which is measured by scales, is associated with different functional equivalence between imagery and perception/action (FE), cortical excitability, and information processing. Of note, physiological differences among individuals with high (highs), medium (mediums), and low hypnotizability scores (lows) have been observed in the ordinary state of consciousness, thus independently from the induction of the hypnotic state, and in the absence of specific suggestions. The potential role of hypnotic assessment and its relevance to neurological diseases have not been fully explored. While current knowledge and therapies allow a better survival rate, there is a constant need to optimize rehabilitation treatments and quality of life. The aim of this paper is to provide an overview of hypnotizability-related features and, specifically, to discuss the hypothesis that the stronger FE, the different mode of information processing, and the greater proneness to control pain and the activity of the immune system observed in individuals with medium-to-high hypnotizability scores have potential applications to neurology. Current evidence of the outcome of treatments based on hypnotic induction and suggestions administration is not consistent, mainly owing to the small sample size in clinical trials and inadequate control groups. We propose that hypnotic assessment may be feasible in clinical routine and give additional cues into the treatment and rehabilitation of neurological diseases.

High Motor Cortex Excitability in Highly Hypnotizable Individuals: A Favourable Factor for Neuroplasticity?

Hypnotizability is a psychophysiological trait associated with morphofunctional brain peculiarities and with several cognitive, sensorimotor and cardiovascular correlates. Behavioral and EEG studies indicate stronger functional equivalence (FE) between motor imagery and action in the individuals with high hypnotizability scores (Highs). We hypothesized that stronger FE leading to greater proneness to ideomotor behavior could be due to greater cortical excitability of the motor cortex. The aim of the study was to evaluate the motor cortical excitability through measurements of the muscle potentials (MEPs) evoked in the left abductor pollicis brevis by transcranial magnetic stimulation (TMS) of the right motor cortex in 10 Highs, 10 medium (Mediums) and 10 low hypnotizable individuals (Lows) classified according to the Stanford Hypnotic Susceptibility Scale, form A (SHSS). They were studied in basal conditions (B) and during motor imagery (MI). Results showed significant, negative correlations (i) between hypnotizability and MEPs Resting Motor Threshold (RMT) in basal conditions, and (ii) between hypnotizability and both MEPs RMT and suprathreshold (I1mv) stimulation intensities during MI. ANOVA revealed significantly lower stimulation intensities in Highs than in Lows, with Mediums exhibiting intermediate values. Thus, the Highs' greater cortical excitability could sustain their greater FE and proneness to ideomotor behavior. In cognitive neuroscience these findings are relevant to the physiological interpretation of the response to sensorimotor suggestions by participants in the ordinary state of consciousness. In the clinical field they can predict the efficacy of mental training based on motor imagery and, possibly, the degree of imagery-induced cortical plasticity.

A Case of Carbon Monoxide-Induced Delayed Neurological Sequelae Successfully Treated with Hyperbaric Oxygen Therapy, N-Acetylcysteine, and Glucocorticoids: Clinical and Neuroimaging Follow-Up.

Carbon monoxide (CO) poisoning is a leading cause of intentional and unintentional poisoning worldwide, associated with mortality and severe morbidity. Some survivors of CO poisoning develop, after a lucid interval, a potentially permanent encephalopathy in the form of cognitive impairment and movement disorders, such as Parkinsonism. One of the most frequent neuroimaging findings is a cerebral white matter damage, but so far its precise cause and specific therapy are still debated. We here report the case of a 33-year-old woman with severe carbon monoxide poisoning who, after a period of lucid interval, presented symptoms of declining motor and cognitive functions. She was treated with 40 sessions of Hyperbaric Oxygen Therapy (HBOT). The therapeutic use of oxygen at supraphysiological pressures might either increase systemic oxidative stress or cause an overproduction of oxygen free radicals as drawbacks. Concurrent use of antioxidants and anti-inflammatory drugs may prevent the side effects of oxygen therapy at supraphysiological pressure due to oxidative stress. For this reason, the patient was also treated with high-dose N-Acetylcysteine and glucocorticoids. Here, we describe the longitudinal monitoring of patient's cognitive abilities and leukoencephalopathy associated with her positive clinical outcome.