Different types of abstract concepts: evidence from two neurodegenerative patients.

The observation of neurological patients showing selective impairments for specific conceptual categories contributed in the development of semantic memory theories. Here, we studied two patients (P01, P02), affected, respectively, by the semantic variant of Primary Progressive Aphasia (sv-PPA) and Cortico-Basal Syndrome (CBS). An implicit lexical decision task, including concrete (animals, tools) and abstract (emotions, social, quantity) concepts, was administered to patients and healthy controls.P01 and P02 showed an abolished priming effect for social and quantity-related concepts, respectively. This double dissociation suggests a role of different brain areas in representing specific abstract categories, giving insights for current semantic memory theories.

Complications of oral piercing: a review of the literature and two case reports.

The practice of piercing has been used since ancient times, and nowadays is coming back in fashion among adolescents and young adults. Teenagers wearing oral piercings are frequently observed during routine examination, and there are, also, recurrent harmful consequences attributed to the devices. Unfortunately, piercings are usually placed by unlicensed individuals, lacking the appropriate anatomical knowledge, and therefore unable to provide sufficient information regarding the potential risks, especially when compared to the ones known by the patients. In this regard, the relevant legislation is frayed both vertically (that is within the framework of State and Regional competences), and horizontally (within the competences between the various regions). With the present study, through an accurate review of the literature and the description of two case reports, we underline the importance of informing both the patients and the dental professionals about the dental consequences undergoing the application of piercing. Both patients examined presented the common complications related to the application of piercing. The aim of this study is to underline the importance of being informed for both the dental professional and the person who undergoes piercing about its consequences for the whole oral system as well as the possible risks of infections and complications. We want to underline the key role of the dentist as a promoter of prevention of oral disorders as well as being able to deal with the possible complications which may occur.

Early childhood caries in Tirana, Albania.

Early Childhood Caries (ECC) is a destructive form of caries that affects the temporary teeth and may be present in children of very young age as early as teeth erupt. The distinctive characteristic of caries in this age is that it affects initially a limited number of teeth which if not treated in time spread rapidly across all deciduous teeth. The purpose of this study is to determine the prevalence and severity of early childhood caries in children 3-5 years old in the public kindergartens in Tirana.

Qualitative and quantitative analysis of the CTX in relation to the period of intake of bisphosphonates: A systematic review.

The aim of this systematic review was to determinate the true value of C-terminal crosslinking telopeptide test (CTX) in patient who takes Bisphosphonate. A comprehensive search of studies published up to March 2020 and listed in the PubMed/MEDLINE and Cochrane Library databases, was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines. The search identified 99 publications; 6 studies were finally deemed eligible for inclusion according to the study criteria. These studies included a total 104 patients and was selected 101. The CTX value in the various study groups is less than 150 pg/ml. There is a difference between the age of the patient and the period of taking the drug. This systematic review indicates that the CTX test has diffent predictive value in determining the risk of osteonecrosis in patients taking bisphosphonate compared to previus standard.

Fibre post cementation: instrumental analysis.

The loss of dental substance due to the presence of decay, to wide conservative repairs, to the preparation of prosthetics or to enamel-dentine fractures, often causes an important structural weakening in the element that is endodontically treated (1-15). It is therefore necessary to use endocanal posts in the coronal reconstruction. Mineral fibre posts and epoxy resins that are available at present, fixed with resinous cements, thanks to their excellent integration, exceed the concept of reconstruction, meant as assembly of heterogeneous materials, arranging homogeneous materials according to a similar flexibility module (16-18). This allows to get a "post dentine cement monobloc", which is ideal for the morphofunctional tooth resetting (19-35). The aim of our experimental study was to analyse and compare the surface characteristics of same posts that are available at present by observing them in their relationship with cement and dental materials (36-44).

The relationship between TMJ symptoms and orthodontic treatments: a survey on 236 orthodontic patients.

The study analyzes how and if temporomandibular joint symptoms are influenced by different types of orthodontic therapy. Two-hundred-and-thirty-six adult orthodontic patients treated by different clinicians, were asked to complete a survey in which factors as the age, the gender and the type of device were considered. The questions were about the typical symptoms of temporomandibular disorders, in particular headache, bruxism, clenching, pain while opening the mouth and joint's noise. It was highlighted if these symptoms changed during the therapy and if they increased or decreased. The answers to our questionnaire revealed that the only statistically significative difference was related to bruxism, because we found a higher rate in patients treated with aligners than patients treated with metal braces, so we can suggest the fixed technique in the orthodontic patient who suffers of bruxism, even if further studies are required.

Evaluating human basal metabolism: the erroneous and misleading use of so-called "prediction equations".

Prediction (regression) equations are widely used, but their reliability as predictive tools is questionable as they provide contradicting results. The key point is that values calculated by regression equations are not precisely defined numbers but lie within a range of possible values in the standard deviation interval, none of which can be considered as the most probable. Ignoring this point leads to illicit/improper calculations, generating wrong results, which may have adverse consequences for human health. To demonstrate this, we applied the equations of Harris and Benedict in a reverse method, i.e. calculating (predicting) the daily energy expenditure in the same subjects used to obtain the equations and comparing values with the original measured data. We used the Bland-Altman and frequency distribution analyses. We found large differences in both individual data and population characteristics, showing that prediction equations are not predictive tools.

Modulating risky decision-making in Parkinson's disease by transcranial direct current stimulation.

BACKGROUND AND PURPOSE: Performance on gambling tasks in Parkinson's disease (PD) is of particular interest, as pathological gambling is often associated with dopamine replacement therapy in these patients. We aimed to evaluate the effects of transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex (DLPFC) in modulating gambling behaviour in PD. METHODS: We assessed the effects of cathodal tDCS over the right DLPFC during the Iowa Gambling Task in 20 patients with PD, compared with sham stimulation. We then conducted a second experimental design, assessing the effects of anodal tDCS over the right DLPFC. RESULTS: We observed that cathodal tDCS over the right DLPFC increased Iowa Gambling Task scores compared with sham stimulation. In the second experimental design, we did not find significant differences between anodal and sham tDCS. CONCLUSIONS: Cathodal tDCS over the right DLPFC possibly reduces the pathological overdrive in frontostriatal networks in patients with PD on dopaminergic medication, thus modulating impulsive and risky decision-making.

Left parietal cortex transcranial direct current stimulation enhances gesture processing in corticobasal syndrome.

BACKGROUND AND PURPOSE: Corticobasal syndrome (CBS) is a clinical entity characterized by higher cortical dysfunctions associated with asymmetric onset of levodopa-resistant parkinsonism, dystonia and myoclonus. One of the most typical and distressful features of CBS is limb apraxia, which affects patients in their everyday life. Transcranial direct current stimulation (tDCS) is a non-invasive procedure of cortical stimulation, which represents a promising tool for cognitive enhancement and neurorehabilitation. The present study investigated whether anodal tDCS over the parietal cortex (PARC), would improve ideomotor upper limb apraxia in CBS patients. METHODS: Fourteen patients with possible CBS and upper limb apraxia were enrolled. Each patient underwent two sessions of anodal tDCS (left and right PARC) and one session of placebo tDCS. Ideomotor upper limb apraxia was assessed using the De Renzi ideomotor apraxia test that is performed only on imitation. RESULTS: A significant improvement of the De Renzi ideomotor apraxia test scores (post-stimulation versus pre-stimulation) after active anodal stimulation over the left PARC was observed (χ(2) = 17.6, P = 0.0005), whilst no significant effect was noticed after active anodal stimulation over the right PARC (χ(2) = 7.2, P = 0.07). A post hoc analysis revealed a selective improvement in the De Renzi ideomotor apraxia score after active anodal stimulation over the left PARC compared with placebo stimulation considering both right (P = 0.03) and left upper limbs (P = 0.01). CONCLUSIONS: These findings indicate that tDCS to the PARC improves the performance of an ideomotor apraxia test in CBS patients and might represent a promising tool for future rehabilitation approaches.

Prefrontal cortex rTMS enhances action naming in progressive non-fluent aphasia.

BACKGROUND AND PURPOSE: Progressive non-fluent aphasia (PNFA) is a neurodegenerative disorder that is characterized by non-fluent speech with naming impairment and grammatical errors. It has been recently demonstrated that repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) improves action naming in healthy subjects and in subjects with Alzheimer's disease. PURPOSE: To investigate whether the modulation of DLPFC circuits by rTMS modifies naming performance in patients with PNFA. METHODS: Ten patients with a diagnosis of PNFA were enrolled. High-frequency rTMS was applied to the left and right DLPFC and the sham (i.e. placebo) condition during object and action naming. A subgroup of patients with semantic dementia was enrolled as a comparison group. RESULTS: A repeated-measure anova with stimulus site (sham, left and right rTMS) showed significant effects. Action-naming performances during stimulation of both the left and right DLPFC were better than during placebo stimulation. No facilitating effect of rTMS to the DLPFC on object naming was observed. In patients with a diagnosis of semantic dementia, no effect of stimulation was reported. CONCLUSIONS: Our study demonstrated that rTMS improved action naming in subjects with PNFA, possibly due to the modulation of DLPFC pathways and a facilitation effect on lexical retrieval processes. Future studies on the potential of a rehabilitative protocol using rTMS applied to the DLPFC in this orphan disorder are required.

The neural bases of word encoding and retrieval: A fMRI-guided transcranial magnetic stimulation study.

There is evidence that the human prefrontal cortex is asymmetrically involved in long-term episodic memory processing. Moreover, abstract and concrete words processing has been reported to differentially involve prefrontal and parietal areas. We implemented a two-stages functional magnetic resonance imaging (fMRI)-repetitive transcranial magnetic stimulation (rTMS) paradigm to investigate the role of the dorsolateral prefrontal cortices (DLPFCs) and parietal cortices (PARCs) in encoding and retrieval of abstract and concrete words. Using this paradigm we could select areas to be stimulated on the basis of single-subject (SS) anatomical and functional data, investigating the usefulness of this integration approach. With respect to fMRI, abstract and concrete words differed only for a greater left fusiform gyrus activation for concrete words. In turn, significant rTMS effects were found, but only for the retrieval of abstract words. Consistent with previous findings, repetitive stimulation of the right DLPFC had a specific impact on episodic retrieval. Memory retrieval performance was also disrupted when rTMS was applied to the left PARC. Finally, we found a significant positive correlation between the effect sizes of SS right PARC activations for abstract word retrieval and the consequent rTMS interference effects. Taken together these data provide for the first time evidence that also the PARC has a necessary role in episodic retrieval of abstract words. Importantly, from a methodological perspective, our data demonstrate that fMRI-guided rTMS with a SS approach provides a powerful tool to investigate the neural underpinnings of cognitive functions.

Transcranial magnetic stimulation improves naming in Alzheimer disease patients at different stages of cognitive decline.

OBJECTIVE: Word-finding difficulty (anomia) is commonly observed in Alzheimer's dementia (AD). The aim of this study was to assess the effect of repetitive transcranial magnetic stimulation (rTMS) applied to the dorso-lateral prefrontal cortex (dlPFC) on picture naming in 24 probable AD patients with different degrees of cognitive decline. METHODS: High-frequency rTMS was applied to the left and right dlPFC during object and action naming in AD patients. A sham stimulation was used as a control condition. RESULTS: Whilst, as previously reported, stimulation to both the left and the right dlPFC improved action, but not object naming in the mild AD group; an improved naming accuracy for both classes of stimuli was found in the moderate to severe group. CONCLUSIONS: Repetitive transcranial magnetic stimulation applied to the dlPFC improves naming performance also in the advanced stages of AD. Moreover, in the severe group the effect is not specific for action naming, as in the case of the mild AD group. These findings suggest that rTMS can affect the intrinsic ability of the brain to restore or compensate for damaged function and may represent an useful new tool for cognitive rehabilitation.

Action and object naming in Parkinson's disease without dementia.

The present study aimed to assess the ability in objects and actions naming in Parkinson's disease (PD) patients. Further, we wished to assess the effect of a particular conceptual dimension, i.e. manipulability, on the naming of object and actions. Patients were recruited from the Department of Neurology, University of Brescia. Thirty-two were diagnosed as PD, according to published criteria, and 15 healthy volunteers matched in age and education to patients' sample. All patients underwent a detailed clinical and neurological evaluation. The stimuli used in the action-object picture naming task were taken from the Center for Research in Language-International Picture Naming Project corpus. To assess the effect of manipulability (or the involvement of fine hand movements) the noun-verb stimuli were re-categorized into manipulable and non-manipulable items (i.e. objects which can or cannot be manipulated and actions which do or do not involve fine hand movements). Patients showed a deficit both in action and object naming, compared with controls. In addition, patients with PD but not controls were significantly more impaired in action than in object naming. The current study supports the view that action naming is affected in patients with PD, possibly reflecting the presence of prefrontal dysfunction.

Persistent autobiographical amnesia: a case report.

We describe a 47-year-old man who referred to the Emergency Department for sudden global amnesia and left mild motor impairment in the setting of increased arterial blood pressure. The acute episode resolved within 24 hours. Despite general recovery and the apparent transitory nature of the event, a persistent selective impairment in recollecting events from some specific topics of his personal life became apparent. Complete neuropsychological tests one week after the acute onset and 2 months later demonstrated a clear retrograde memory deficit contrasting with the preservation of anterograde memory and learning abilities. One year later, the autobiographical memory deficit was unmodified, except for what had been re-learnt. Brain MRI was normal while H20 brain PET scans demonstrated hypometabolism in the right globus pallidus and putamen after 2 weeks from onset, which was no longer present one year later. The absence of a clear pathomechanism underlying focal amnesia lead us to consider this case as an example of functional retrograde amnesia.

Action and object naming in frontotemporal dementia, progressive supranuclear palsy, and corticobasal degeneration.

Action naming has been reported to be disproportionately impaired in comparison to object naming in patients with frontotemporal dementia (FTD). This finding has been attributed to the crucial role of frontal cortex in action naming. The investigation of object and action naming in the different subtypes of FTD, as well as in the related conditions of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), may thus contribute to the elucidation of the cerebral correlates of the action-object discrepancy as well as provide clues to the underlying cognitive mechanisms. The results indicated that, with the exception of semantic dementia, action naming was more impaired than object naming in all patient groups. The discrepancy was similar in frontal variant of FTD and Alzheimer's disease patients, whereas patients with nonfluent primary progressive aphasia, PSP, and CBD were significantly more impaired in the oral production of actions than of objects. These findings indicate that action naming impairment is not a general feature of FTD, but rather is associated with conditions that affect the frontoparietal-subcortical circuits involved in action knowledge and action representation.

Chemical analysis and biological activity of airborne particulate matter.

We examined the chemical composition of the suspended particulate matter in a typical, middle-sized, nonindustrial Italian town in terms of total carcinogenic PAH, heavy metal, and polynuclear azo-aromatic compounds. The chemical data relate to the biological activity of the organic extract of the particulate matter (mutagenicity and mice alveolar macrophage phagocytosis inhibition). The concentration values of benz(a)pyrene, the concentration ratios of selected PAH's, and the GC-MS profile of some typical samples indicate that motor vehicle traffic is the main pollution source. PAH concentration is significantly correlated with mutagenicity and a phagocytosis inhibition of up to 75% was observed at the highest PAH concentration. As far as the effect of meteorological variables on PAH concentration and mutagen-icity is concerned, a statistically significant inverse correlation with temperature was found.

The role of the dorsolateral prefrontal cortex in retrieval from long-term memory depends on strategies: a repetitive transcranial magnetic stimulation study.

The ability to associate a name to a face is a crucially relevant task in daily life. In this study, we investigated the neuronal basis of face-name retrieval in young subjects using repetitive transcranial magnetic stimulation (rTMS) over the left or right dorsolateral prefrontal cortex (DLPFC). The experimental task was composed of two study phases: an encoding phase and a retrieval phase. During the encoding phase, subjects saw a face (familiar or unfamiliar) followed by a name. During the retrieval phase, they saw the face together with two names and had to choose the name that was correctly associated with the face. rTMS was delivered only during retrieval. In addition, we evaluated the use of memory strategies during the task. Accordingly, subjects were subdivided into two groups: strategy users (SU) and no-strategy users (NSU). No rTMS effects were present for familiar face-name pairs, probably due to a ceiling effect. However, for unfamiliar face-name pairs, the different use of memory strategies resulted in different rTMS effects. The SU group showed a selective interference effect after right DLPFC stimulation, whereas the NSU group showed an effect after left DLPFC stimulation. Importantly, the overall performance of the two groups was comparable. We suggest that during memory retrieval the left DLPFC might be recruited when the subject does not apply deliberately a retrieval strategy whereas there is a shift to the right DLPFC if cognitive control processes that are engaged by strategies are needed to guide episodic retrieval.