Episodic obsessive-compulsive disorder and bipolar spectrum disorder: new evidence from a large Italian OCD sample.

OBJECTIVES: Obsessive-Compulsive Disorder (OCD) has been considered to be a chronic illness; however, some authors described a subtype of OCD characterised by symptom-free periods of time: Episodic-OCD (E-OCD). Only few studies focussed on this subtype of the disorder. The objectives of this research were to study the association between the episodic course of the disorder and lifetime psychiatric comorbidities and to investigate socio-demographic and other clinical features correlated to the episodic course. METHODS: The sample is composed of adult OCD patients. The course was defined episodic when at least one circumscribed symptom-free interval of at least 6 months was present. The sample was divided into two subgroups: Episodic-OCD and Chronic-OCD. Differences between groups were analysed with Student's t-test, χ2 tests, Fisher test and multivariate logistic regression. RESULTS: Data regarding 585 individuals were collected. 14.2% (N = 83) of our sample had an episodic course. Bipolar I comorbid disorder, abrupt onset, lower severity of illness and lower rates of repeating compulsions were associated with the likelihood of having an E-OCD. CONCLUSIONS: Our findings confirm that a significant proportion of OCD patients have an episodic course and that E-OCD could represent a specific endophenotype.

A significant proportion of OCD patients has an episodic course;Episodic OCD was related to comorbid Bipolar I Disorder;Episodic course was associated with an abrupt onset of OCD;Lower rates of repeating compulsions were associated with Episodic OCD.

Attention modulates the contextual similarity effect in negative priming: evidence from task demand and attentional capture.

Negative priming refers to the delayed response to a probe target that was previously a prime distractor. Memory retrieval has been proposed as one critical mechanism for the manifestation of negative priming. This perspective perpetuates that the contextual similarity between prime and probe trials should modulate memory retrieval, and therefore, affect negative priming. However, evidence for the contextual similarity effect in negative priming is mixed. The present study tested the hypothesis that attended contextual cues are more likely to be encoded into a distractor representation, and thus, are more likely to modulate the negative priming effect. By manipulating whether the contextual cues were relevant to the task demand in Section 1, and by manipulating whether cues had an abrupt or simultaneous onset, and by analysing reaction time (RT) distributions of the data in Section 2, our results demonstrated that attended cues produced the contextual similarity effect in negative priming, especially when RTs were long.

Acute presentation of Chiari 1 malformation in children.

PURPOSE: To review the literature about the acute presentation of Chiari 1 malformation in children, with a focus on acute cervical cord syndromes with impairment of the cortico-spinal tract. To analyze the possible precipitating factors and the pathophysiology of the acute onset. METHOD: Illustrative case presentation with literature review. RESULTS: The literature includes just a few dozens of children with acute presentation of Chiari 1 malformation. The more frequent presentations consist of oropharyngeal dysfunction, cranial nerve impairment, high intracranial pressure, peripheral motor deficit. Acute impairment of cervical long tracts is very rare and we could find only 16 previously reported cases of cervical cord impairment with quadriparesis or hemiparesis. CONCLUSIONS: Nowadays, a lot of asymptomatic Chiari 1 malformations are frequently observed owing to the wide diffusion of magnetic resonance imaging. This raised the question about the management of these patients. Despite severe and even lethal manifestations being reported in previously asymptomatic patients, the absolute rarity of acute deterioration does not justify prophylactic surgery. The diagnosis of Chiari malformation may be initially difficult in patients with isolated, acute, and unusual presentations but physicians should bear in mind its possibility, because prompt cranio-cervical decompression may be decisive.

The eyes like their targets on a stable background.

In normal human visual behavior, our visual system is continuously exposed to abrupt changes in the local contrast and mean luminance in various parts of the visual field, as caused by actual changes in the environment, as well as by movements of our body, head, and eyes. Previous research has shown that both threshold and suprathreshold contrast percepts are attenuated by a co-occurring change in the mean luminance at the location of the target stimulus. In the current study, we tested the hypothesis that contrast targets presented with a co-occurring change in local mean luminance receive fewer fixations than targets presented in a region with a steady mean luminance. To that end we performed an eye-tracking experiment involving eight observers. On each trial, after a 4 s adaptation period, an observer's task was to make a saccade to one of two target gratings, presented simultaneously at 7° eccentricity, separated by 30° in polar angle. When both targets were presented with a steady mean luminance, saccades landed mostly in the area between the two targets, signifying the classic global effect. However, when one of the targets was presented with a change in luminance, the saccade distribution was biased towards the target with the steady luminance. The results show that the attenuation of contrast signals by co-occurring, ecologically typical changes in mean luminance affects fixation selection and is therefore likely to affect eye movements in natural visual behavior.

Children With PANS May Manifest POTS.

Objectives: Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by an abrupt-onset of severe psychiatric symptoms including OCD, anxiety, cognitive difficulties, and sleep issues which is thought to be a post-infection brain inflammatory disorder. We observed postural orthostatic tachycardia syndrome (POTS) which resolved with immunomodulation in a patient with Pediatric acute-onset neuropsychiatric syndrome (PANS). Here, we aim to present a case of POTS and to examine the prevalence of (POTS) in our PANS cohort, and compare the clinical characteristics of patients with and without POTS. Study Design: We conducted this cohort study of patients meeting PANS criteria who had at least three clinic visits during the study period. We included data from prospectively collected questionnaires and medical record review. We present a case followed by statistical comparisons within our cohort and a Kaplan-Meier analysis to determine the time-dependent risk of a POTS diagnosis. Results: Our study included 204 patients: mean age of PANS onset was 8.6 years, male sex (60%), non-Hispanic White (78%). Evidence of POTS was observed in 19/204 patients (9%) with 5/19 having persistent POTS defined as persistent abnormal orthostatic vitals, persistent POTS symptoms, and/or continued need for pharmacotherapy for POTS symptoms for at least 6 months). In this PANS cohort, patients with POTS were more likely to have comorbid joint hypermobility (63 vs 37%, p = 0.04), chronic fatigue (42 vs 18%, p = 0.03), and a family history of chronic fatigue, POTS, palpitations and syncope. An unadjusted logistic regression model showed that a PANS flare (abrupt neuropsychiatric deterioration) was significantly associated with an exacerbation of POTS symptoms (OR 3.3, 95% CI 1.4-7.6, p < 0.01). Conclusions: Our study describes a high prevalence of POTS in patients with PANS (compared to the general population) and supports an association between POTS presentation and PANS flare within our cohort.

To look or not to look: Subliminal abruptonset cues influence constrained free-choice saccades.

Subliminal cues have been shown to capture attention and modulate manual response behaviour but their impact on eye movement behaviour is not well-studied. In two experiments, we examined if subliminal cues influence constrained free-choice saccades and if this influence is under strategic control as a function of task-relevancy of the cues. On each trial, a display containing four filled circles at the centre of each quadrant was shown. A central coloured circle indicated the relevant visual field on each trial (Up or Down in Experiment 1; Left or Right in Experiment 2). Next, abrupt-onset cues were presented for 16 ms at one of the four locations. Participants were then asked to freely choose and make a saccade to one of the two target circles in the relevant visual field. The analysis of the frequency of saccades, saccade endpoint deviation and saccade latency revealed a significant influence of the relevant subliminal cues on saccadic decisions. Latency data showed reduced capture by spatiallyirrelevant cues under some conditions. These results indicate that spatial attentional control settings as defined in our study could modulate the influence of subliminal abrupt-onset cues on eye movement behaviour. We situate the findings of this study in the attention-capture debate and discuss the implications for the subliminal cueing literature.

Effects of driver age and experience in abrupt-onset hazards.

Novice drivers and older drivers are found to have the highest crash risk among all drivers and this has motivated many research studies into various aspects of novice and older drivers. Although age-related declines were expected, studies did not find older drivers to respond slower to hazards. This study examined the hazard detection and response latencies of 14 young novice drivers, 14 young experienced drivers, and 12 older experienced drivers, to abrupt-onset hazards. Older drivers were found to take longer times before fixating on an abrupt-onset road hazard but appeared to have insignificantly faster reaction times after the initial fixation. Hence, the overall response latency did not suggest any age effects. Older drivers also scanned the roadway less as compared to their younger counterparts. No effects of experience were found. The findings provided insight on age-related declines in hazard detection whose effects have been masked by other components of hazard response.

Abrupt Onset of Palisaded Neutrophilic and Granulomatous Dermatitis in a Patient with Rheumatoid Arthritis / 대한피부과학회지

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is characterized histopathologically by the presence of granulomatous inflammation with or without leukocytoclastic vasculitis. It has been associated with multiple systemic diseases, particularly autoimmune conditions like rheumatoid arthritis and Behcet's disease. We report a 52-year-old woman with rheumatoid arthritis who presented with a single, non-tender, rapidly growing nodule on her right elbow. Histologic examination of the nodule revealed degenerated collagen, neutrophils, neutrophilic dust, fibrin, and mucin present in the centers of the palisades of histiocytes throughout the dermis. Herein, we report the abrupt onset of PNGD in a patient with rheumatoid arthritis.