Sensory impairment, loneliness, and the discordance between subjective and objective cognitive function among older adults: A multi-cohort study.

OBJECTIVES: This study aimed to examine the association between sensory impairment and the discordance between subjective/objective cognitive function among older adults and test the mediating effect of loneliness. METHODS: We used data from four cohort studies conducted in 16 countries (N = 19,119). Sensory impairment and subjective cognitive impairment were self-reported. Objective cognitive impairment was measured in three dimensions. Generalized estimating equations were conducted to examine the association between sensory impairment and discordance in subjective/objective cognitive function. Cross-lagged panel model and a bootstrap method with 2,000 samples were employed to verify the mediating effect. RESULTS: Sensory impairment was related to an increased risk of subjective cognitive impairment (OR = 4.70, 95 % CI 4.33-5.10), objective impairment (OR = 1.51, 95 %CI 1.31-1.74), as well as the discordance in subjective/objective cognitive function (OR = 1.35, 95 %CI 1.06-1.71 for older adults with normal subjective cognitive function). In contrast, sensory impairment was associated with a decreased risk of discordant subjective/objective cognitive function among those with subjective cognitive impairment (OR = 0.79, 95 %CI 0.66-0.94). Moreover, loneliness mediated the association between sensory impairment and subjective cognitive impairment (standardized indirect effect = 0.002, 95 %CI 0.001-0.004), objective cognitive impairment (standardized indirect effect = 0.005, 95 %CI 0.003-0.007) as well as the discordance in subjective/objective cognitive function (standardized indirect effect = 0.001, 95 %CI 0.001-0.003 for older adults with normal subjective cognitive function). CONCLUSIONS: Significant association between sensory impairment and discordance in subjective/objective cognitive function and the mediating role of loneliness were revealed, varying by subjective cognitive function. Early screening on sensory impairment and targeted interventions on loneliness should be considered in future policies on cognitive impairment.

Disentangling the relationship between sensory processing, alexithymia and broad autism spectrum: A study in parents' of children with autism spectrum disorders and sensory processing disorders.

BACKGROUND: Autistic features and sensory processing difficulties and their phenotypic co-expression with alexithymia share a transdiagnostic vulnerability. In this work, we explored whether the current concept of broad autism phenotype rather translates altered sensory processing (non-specific to autism), meaning that the characteristics of altered sensory processing should be overexpressed among individuals with heightened vulnerability to sensory processing atypicalities (parents of children with sensorial processing disorder, or SPD parents) and individuals with heightened vulnerability to autistic traits (parents of children with autism spectrum disorders, or ASD parents). In addition, the association between altered sensory processing and alexithymia was inspected. METHOD: The Adolescent/Adult Sensory Profile, Autism Spectrum Quotient, and Toronto Alexithymia Scale were completed by 31 parents of children with ASD, 32 parents of children with SPD, and 52 parents of typically developed (TD) children. RESULTS: Extreme sensory patterns were overexpressed both in parents of children with SPD and parents of children with ASD when compared to parents of TD children. In addition, extreme sensory patterns were significantly associated with alexithymia scores. Specifically, sensory avoidance, low registration, and sensory sensitivity were positively correlated with alexithymia. No significant differences were found regarding the proportion of autistic traits and alexithymia between ASD and SPD groups of parents. CONCLUSIONS: These results challenge the specificity of broad autism phenotype and suggest a neurodevelopmental atypicity with roots in altered sensory and emotional processing.

Prevalence and severity-based classification of sensory processing issues. An exploratory study with neuropsychological implications.

Sensory processing issues, mainly known as sensory processing disorder or SPD, are frequent in children with neurodevelopmental disorders and are associated with learning and behavioral difficulties. However, previous studies suggest that these disturbances might also be present in typically developing children, reaching prevalence rates of 10-20%. Nevertheless, published studies have been primary been conducted in non-European countries. Therefore, we aim, as first objective, to explore the frequency of sensory processing difficulties in a random sample of school-age children from Spain to contribute to the study of its prevalence. The Sensory Profile-2 (SP2) assessment tool was administered to 369 participants to study their sensory processing patterns, the absence or presence of sensory processing issues, the affected sensory systems, as well as their socioemotional, attentional, and behavioral impact. Furthermore, as second objective, we have developed a novel strategy to classify SPD by severity ranges using SP2 yielded results; accordingly, the sample was classified as follows: no alteration, mild, moderate, and severe sensory processing alteration. The results show prevalence rates consistent with previous findings: 15.9% of participants met the severe alteration criteria and 10.5%, 11.1% and 62.5% were classified as moderate, mild and no alteration, respectively. Finally, we hypothesize about SPD and underlying neuropsychological processes that might be associated with this condition. Our results highlight the necessity of further research efforts to establish whether high-frequency and severity rates of sensory processing alterations are linked to neuropsychological variables. The provided classification system might be useful to determine such associations.

Postural and gait symptoms in de novo Parkinson's disease patients correlate with cholinergic white matter pathology.

INTRODUCTION: The postural instability gait difficulty motor subtype of patients with Parkinson's disease (PIGD-PD) has been associated with more severe cognitive pathology and a higher risk on dementia compared to the tremor-dominant subtype (TD-PD). Here, we investigated whether the microstructural integrity of the cholinergic projections from the nucleus basalis of Meynert (NBM) was different between these clinical subtypes. METHODS: Diffusion-weighted imaging data of 98 newly-diagnosed unmedicated PD patients (44 TD-PD and 54 PIGD-PD subjects) and 10 healthy controls, were analysed using diffusion tensor imaging, focusing on the white matter tracts associated with cholinergic projections from the NBM (NBM-WM) as the tract-of-interest. Quantitative tract-based and voxel-based analyses were performed using FA and MD as the estimates of white matter integrity. RESULTS: Voxel-based analyses indicated significantly lower FA in the frontal part of the medial and lateral NBM-WM tract of both hemispheres of PIGD-PD compared to TD-PD. Relative to healthy control, several clusters with significantly lower FA were observed in the frontolateral NBM-WM tract of both disease groups. Furthermore, significant correlations between the severity of the axial and gait impairment and NBM-WM FA and MD were found, which were partially mediated by NBM-WM state on subjects' attentional performance. CONCLUSIONS: The PIGD-PD subtype shows a loss of microstructural integrity of the NBM-WM tract, which suggests that a loss of cholinergic projections in this PD subtype already presents in de novo PD patients.

Self-reported dual sensory impairment, dementia, and functional limitations in Medicare beneficiaries.

BACKGROUND: Vision and hearing impairments often co-exist with dementia, and all are independently associated with limitations in daily activities. Our aim was to examine the association of dual sensory impairment with functional limitations, and further examine the combined estimated association of sensory impairment and dementia with these functional limitations. METHODS: Cross-sectional analysis of the National Health and Aging Trends Study (NHATS), a population-based cohort of Medicare beneficiaries, was performed. Participants were selected from the 2015 round. Survey weighted Poisson regression models adjusted for dementia, demographics, and health status variables examined the association of self-reported dual sensory impairment (no sensory impairment, single sensory impairment, dual sensory impairment) with scores of limitations in mobility, self-care, and household activities. Models were repeated to take into account the combined effects of dual sensory impairment and dementia. RESULTS: Overall, 7124 participants representative of Medicare beneficiaries 65 years or older were included. Of them, 43.9% were 75 years or older and 55.3% were female. Older adults with dual sensory impairment had greater limitations with mobility (prevalence rate ratio [PRR] = 1.45, 95% CI = 1.28-1.63), self-care (PRR = 1.41, 95% CI = 1.25-1.59), and household activities (PRR = 1.54, 95% CI = 1.37-1.72) compared with those without sensory impairment. They also had greater limitations than those with a single sensory impairment across the different activity categories. In models taking into account the combined estimated effect of both sensory impairment and dementia, those with dual sensory impairment and dementia had greater limitations than those without sensory impairment or dementia in each category (mobility: PRR = 1.85, 95% CI = 1.59-2.14, self-care: PRR = 1.86, 95% CI = 1.59-2.18, household: PRR = 2.41, 95% CI = 2.09-2.77). CONCLUSIONS: Older adults with dual sensory impairment had greater functional limitations compared with those without sensory impairment and those with a single sensory impairment. Strategies to improve visual and/or hearing function (e.g., sensory aids, rehabilitation) could potentially help prevent or minimize disability, even among those with dementia.

Ear fullness characteristics and prognosis in patients with all-frequency sudden sensorineural hearing loss.

OBJECTIVE: This study investigated the characteristics and prognosis of the feeling of ear fullness in patients with unilateral all-frequency sudden sensorineural hearing loss. METHODS: Our study included 56 patients with a diagnosis of unilateral all-frequency sudden sensorineural hearing loss accompanied by a feeling of ear fullness and 48 patients without a feeling of ear fullness. The condition of these patients was prospectively observed. RESULTS: Positive correlations were observed between grading of feeling of ear fullness and hearing loss in patients with a feeling of ear fullness (r = 0.599, p < 0.001). No significant differences were observed in the total effective rate of hearing recovery between patients with and without a feeling of ear fullness after one month of treatment (Z = -0.641, p = 0.521). Eighty-six per cent of patients (48 out of 56) showed complete recovery from the feeling of ear fullness. There was no correlation between feeling of ear fullness recovery and hearing recovery (r = 0.040, p = 0.769). CONCLUSION: The prognosis of feeling of ear fullness is good. There was no correlation between feeling of ear fullness recovery and hearing recovery for all-frequency sudden sensorineural hearing loss patients.

Inhibition of TLR4 signaling protects mice from sensory and motor dysfunction in an animal model of autoimmune peripheral neuropathy.

BACKGROUND: While the etiology remains elusive, macrophages and T cells in peripheral nerves are considered as effector cells mediating autoimmune peripheral neuropathy (APN), such as Guillain-Barre syndrome. By recognizing both pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs) signals, TLRs play a central role in the initiation of both innate and adaptive immune responses. In this study, we aimed to understand the involvement of TLR4 in the pathogenesis of APN and explore the potential of TLR4 as a drug target for therapeutic use. METHODS: APN was induced by a partial ligation on one of the sciatic nerves in B7.2 (L31) transgenic mice which possess a predisposed inflammatory background. APN pathology and neurological function were evaluated on the other non-injured sciatic nerve. RESULTS: TLR4 and its endogenous ligand HMGB1 were highly expressed in L31 mice, in circulating immune cells and in peripheral nerves. Enhanced TLR4 signaling was blocked with TAK 242, a selective TLR4 inhibitor, before and after disease onset. Intraperitoneal administration of TAK 242 not only inhibited monocyte, macrophage and CD8+ T cell activation, but also reduced the release of pro-inflammatory cytokines. TAK 242 protected mice from severe myelin and axonal loss, resulting in a remarkable improvement in mouse motor and sensory functions. TAK 242 was effective in alleviating the disease in both preventive and reversal paradigms. CONCLUSION: The study identified the critical contribution of TLR4-mediated macrophage activation in disease course and provided strong evidence to support TLR4 as a useful drug target for treating inflammatory autoimmune neuropathy.

Chronic Pharmacological Increase of Neuronal Activity Improves Sensory-Motor Dysfunction in Spinal Muscular Atrophy Mice.

Dysfunction of neuronal circuits is an important determinant of neurodegenerative diseases. Synaptic dysfunction, death, and intrinsic activity of neurons are thought to contribute to the demise of normal behavior in the disease state. However, the interplay between these major pathogenic events during disease progression is poorly understood. Spinal muscular atrophy (SMA) is a neurodegenerative disease caused by a deficiency in the ubiquitously expressed protein SMN and is characterized by motor neuron death, skeletal muscle atrophy, as well as dysfunction and loss of both central and peripheral excitatory synapses. These disease hallmarks result in an overall reduction of neuronal activity in the spinal sensory-motor circuit. Here, we show that increasing neuronal activity by chronic treatment with the FDA-approved potassium channel blocker 4-aminopyridine (4-AP) improves motor behavior in both sexes of a severe mouse model of SMA. 4-AP restores neurotransmission and number of proprioceptive synapses and neuromuscular junctions (NMJs), while having no effects on motor neuron death. In addition, 4-AP treatment with pharmacological inhibition of p53-dependent motor neuron death results in additive effects, leading to full correction of sensory-motor circuit pathology and enhanced phenotypic benefit in SMA mice. Our in vivo study reveals that 4-AP-induced increase of neuronal activity restores synaptic connectivity and function in the sensory-motor circuit to improve the SMA motor phenotype.SIGNIFICANCE STATEMENT Spinal muscular atrophy (SMA) is a neurodegenerative disease, characterized by synaptic loss, motor neuron death, and reduced neuronal activity in spinal sensory-motor circuits. However, whether these are parallel or dependent events is unclear. We show here that long-term increase of neuronal activity by the FDA-approved drug 4-aminopyridine (4-AP) rescues the number and function of central and peripheral synapses in a SMA mouse model, resulting in an improvement of the sensory-motor circuit and motor behavior. Combinatorial treatment of pharmacological inhibition of p53, which is responsible for motor neuron death and 4-AP, results in additive beneficial effects on the sensory-motor circuit in SMA. Thus, neuronal activity restores synaptic connections and improves significantly the severe SMA phenotype.

The relationship between sensory processing sensitivity and attention deficit hyperactivity disorder traits: A spectrum approach.

The aim of the present study was to examine the relationship between sensory processing sensitivity (SPS) and symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in adults. The Highly Sensitive Person Scale (HSPS) scale and the Adult ADHD Self-Report Scale (ASRS) were administered to a non-clinical group of 274 participants recruited from a university volunteers list. We found a highly significant positive correlation between number of self-reported ADHD traits and sensory sensitivity. Furthermore, ADHD traits and age were predictors of SPS and exploratory factor analysis revealed a factor that combined ADHD traits and items from the HSPS. The psychometric properties of the HSPS were also examined supporting the unidimensional nature of the concept. To our knowledge, this is the first study to identify a positive relationship between HSPS and ADHD traits in the general population. Our results further support recent findings suggesting abnormal sensory processing in ADHD.

Exploration of life satisfaction of Korean people with sensory impairments across the lifespan.

BACKGROUND: Approximately, 600,000 people in South Korea have registered as people with either visual or hearing impairment or both. Individuals with sensory impairments are more likely to have limited physical and social functioning, which consequently affected their health, well-being and life satisfaction. While diverse elements were considered as critical determinants of life satisfaction among individuals with sensory impairments, only few studies examined the relationships between life domains and life satisfaction of the population. OBJECTIVES: This study investigated the relationships between life domains and life satisfactions among Korean individuals with sensory impairments. METHODS: This study used 2015 national data from Korea to explore the relationships across different age groups. A total of 965 participants were selected, and they were divided into three groups: (a) middle aged group (MAG; 54 and below, 35.2%), (b) late-middle aged group (L-MAG; 55-64; 35.2%), and (c) older adult group (OAG; 65 and older; 29.5%). Demographic variables (e.g., perceived socioeconomic status, the severity of disabilities), the satisfaction of seven life domains, and the overall life satisfaction were measured. RESULTS: Although most of the life domains were significant predictors of overall life satisfaction, the leisure domain was the strongest determinant of the overall life satisfaction to MAG and OAG and the second strongest predictor to L-MAG. CONCLUSION: This study highlights the importance of leisure for quality of life of individuals with sensory impairments and suggests an implication to researchers and practitioners to increase accessibility for individuals with sensory impairments to leisure facilities and programs.

Cross-Sectional Investigation of Self-Reported Concussions and Reporting Behaviors in 866 Adolescent Rugby Union Players: Implications for Educational Strategies.

OBJECTIVE: To examine the self-recalled concussion and bell ringer (BR) prevalence, reporting rates, and reporting behaviors in adolescent rugby players. DESIGN: Cross-sectional survey. SETTING: School classroom. PARTICIPANTS: Adolescent male rugby players aged 12 to 18 years (n = 866). MAIN OUTCOME MEASURES: Concussion and BR prevalence, reporting rates, and reporting behaviors. RESULTS: The sample reported a concussion and BR prevalence rate of 40% and 69.9%, respectively. Of these athletes with a history, 38.4% and 86.4% suffered recurrent concussions and BRs, respectively. The total reporting rates per 1000 suspected concussions and BRs were 474.8 [95% confidence interval (CI), 415.4-534.3] and 238.7 (95% CI, 217.8-259.5), respectively. The athletes highlighted several barriers which hindered their truthful reporting of concussion, including "not thinking the injury is serious enough to report" (70%), "wanting to win the game" (38%), and "not wanting to miss future games or training" (48%). CONCLUSIONS: Educational interventions are an invaluable component within a socioecological framework aimed at improving the concussion reporting rates of adolescent athletes. The self-recalled prevalence, underreporting rates, and behaviors of the sample are alarming, which prompts the need to further explore their motivational beliefs behind their decision to underreport a potential concussion. The information obtained can be used to tailor personalized interventions for specific athlete samples.

[Intolerance to uncertainty in autism]. / La intolerancia a la incertidumbre en el autismo.

We start from the evidence that confirms a greater vulnerability to anxiety in people with autism and to wonder to what extent the intolerance to the uncertainty mediates in that anxiety. In addition, the alterations of the predictive abilities in autism could explain the coherence between greater intolerance to uncertainty and some peculiarities inherent in autism such as patterns of restrictive and stereotyped behaviors, interests and activities, and particularities in the processing of sensory information. This information will allow us to develop interventions specifically focused on this construct for the prevention and improvement of anxiety symptoms in autism in cases that the severity of intolerance to uncertainty constitutes a significant risk factor.

Partimos de las evidencias que confirman una mayor vulnerabilidad a la ansiedad de las personas con autismo para preguntarnos en qué medida la intolerancia a la incertidumbre media en dicha ansiedad. Además, las alteraciones de las habilidades predictivas en el autismo podrían explicar la coherencia existente entre mayor intolerancia a la incertidumbre y algunas particularidades inherentes al autismo como los patrones de comportamientos, intereses y actividades restrictivos y estereotipados, y las particularidades en el procesamiento de la información sensorial. Esta información nos permitirá desarrollar intervenciones centradas específicamente en este constructo para la prevención y mejora de la sintomatología ansiosa en el autismo en los casos en los que la severidad de la intolerancia a la incer tidumbre constituya un factor de riesgo significativo.

Sensory Reactivity at 1 and 2 Years Old is Associated with ASD Severity During the Preschool Years.

Children with Autism Spectrum Disorder (ASD) often display atypical sensory reactivity within the first years of life, prior to a diagnosis. This study examined sensory reactivity patterns at 14 months, changes from 14 to 23 months, and later ASD severity at 3 to 5 years of age in children (n = 87) at elevated likelihood of ASD. Results indicated that observed hyporeactivity at 14 months and increases from 14 to 23 months were related to higher ASD severity during the preschool years. Parent report of hyperreactivity at 14 months was associated with higher ASD severity in the RRB domain during the preschool years. Early hypo and hyperreactivity may predict later severity of ASD and aid in subtyping and developing individualized treatments.

La intolerancia a la incertidumbre en el autismo / Intolerance to uncertainty in autism

Partimos de las evidencias que confirman una mayor vulnerabilidad a la ansiedad de las personas con autismo para preguntarnos en qué medida la intolerancia a la incertidumbre media en dicha ansiedad. Además, las alteraciones de las habilidades predictivas en el autismo podrían explicar la coherencia existente entre mayor intolerancia a la incertidumbre y algunas particularidades inherentes al autismo como los patrones de comportamientos, intereses y actividades restrictivos y estereotipados, y las particularidades en el procesamiento de la información sensorial. Esta información nos permitirá desarrollar intervenciones centradas específicamente en este constructo para la prevención y mejora de la sintomatología ansiosa en el autismo en los casos en los que la severidad de la intolerancia a la incer tidumbre constituya un factor de riesgo significativo.

We start from the evidence that confirms a greater vulnerability to anxiety in people with autism and to wonder to what extent the intolerance to the uncertainty mediates in that anxiety. In addition, the alterations of the predictive abilities in autism could explain the coherence between greater intolerance to uncertainty and some peculiarities inherent in autism such as patterns of restrictive and stereotyped behaviors, interests and activities, and particularities in the processing of sensory information. This information will allow us to develop interventions specifically focused on this construct for the prevention and improvement of anxiety symptoms in autism in cases that the severity of intolerance to uncertainty constitutes a significant risk factor.

The relationship between sensory sensitivity, food fussiness and food preferences in children with neurodevelopmental disorders.

Heightened sensitivity to sensory information has been associated with food fussiness in both atypical and typical development. Despite food fussiness and sensory dysfunction being reported as common concerns for children with neurodevelopmental disorders, the relationship that exists between them, and whether they differ between disorders, has yet to be established. The current study aimed to examine sensory sensitivity as a predictor of food fussiness in three different neurodevelopmental disorders, whilst controlling for comorbidity amongst these disorders. Ninety-eight caregivers of children with Attention Deficit Hyperactivity Disorder (ADHD; n = 17), Tourette Syndrome (TS; n = 27), Autism Spectrum Disorder (ASD; n = 27), and typical development (TD; n = 27) were compared using parental reports of child food fussiness, food preferences and sensory sensitivity. Children with neurodevelopmental disorders were reported to have significantly higher levels of both food fussiness and sensory sensitivity, with children with ASD and TS also showing significantly less preference for fruit than children with TD. Importantly, higher levels of taste/smell sensitivity predicted food fussiness for all four groups of children. In addition, taste/smell sensitivity fully mediated the differences in food fussiness between each group of neurodevelopmental disorders compared to the TD group. The findings highlight that food fussiness is similar across these neurodevelopmental disorders despite accounting for comorbidity, and that greater sensitivity to taste/smell may explain why children with neurodevelopmental disorders are more likely to be fussy eaters.

Association of Multisensory Impairment With Quality of Life and Depression in English Older Adults.

Importance: Sensory acuity tends to decrease with age, but little is known about the relationship between having multiple sensory impairments and well-being in later life. Objective: To examine associations between concurrent multisensory impairments and aspects of well-being and mental health, namely quality of life and depressive symptoms. Design, Setting, and Participants: Cross-sectional analysis of participants in the English Longitudinal Study of Aging wave 8 (May 2016 to June 2017). This is a representative sample of free-living English individuals 52 years and older. Analysis began April 2018. Main Outcomes and Measures: Linear and logistic regression models were used to assess the association of self-reported concurrent impairments in hearing, vision, smell, and taste with quality of life (0-57 on the 19-item CASP-19 scale; Control, Autonomy, Self-realization and Pleasure) and depressive symptoms (≥4 items on the 8-item Centre for Epidemiologic Study Depression Scale). Results: Using a representative sample of 6147 individuals, 52% (weighted) were women (n = 3455; unweighted, 56%) and the mean (95% CI) age was 66.6 (66.2-67.0) years. Multiple sensory impairments were associated with poorer quality of life and greater odds of depressive symptoms after adjustment for sociodemographic characteristics, lifestyle factors, chronic conditions, and cognitive function. Compared with no sensory impairment, quality of life decreased linearly as the number of senses impaired increased, with individuals reporting 3 to 4 sensory impairments displaying the poorest quality of life (-4.68; 95% CI, -6.13 to -3.23 points on the CASP-19 scale). Similarly, odds of depressive symptoms increased linearly as the number of impairments increased. Individuals with 3 to 4 senses impaired had more than a 3-fold risk of depressive symptoms (odds ratio, 3.36; 95% CI, 2.28-4.96). Conclusions and Relevance: In this cross-sectional study, concurrent sensory impairments were associated with poorer quality of life and increased risks of depressive symptoms. Therefore, assessing and managing sensory impairments could help improve older adults' well-being.

Demographic characteristics and delayed neurological sequelae risk factors in carbon monoxide poisoning.

AIM: Carbon monoxide (CO) is a colorless, odorless gas and tasteless. CO poisoning (COP) is one of the most frequently encountered inhalation poisonings. The most common cause of morbidity in COP is delayed neurological sequelae (DNS). DNS is the occurrence of neuropsychiatric findings within 2-240 days after discharge of patients with COP and there are no definitive diagnostic criteria. The aim of our study is; to determine the risk factors and incidence of DNS. METHOD: Our study is a retrospective, observational study. Patients with the diagnosis of COP in the emergency department between 2015 and 2016 were included in the study. Patients age, gender, findings in the initial physical examination (PE) and neurological examination (NE), blood carboxyhemoglobin (COHb) level, relation between hyperbaric oxygen (HBO) treatment and DNS were assessed. RESULTS: Total of 72 patients were included in the study. Mean age was 33.43 ±â€¯20.89. It was determined that pathological findings in the initial NE are a significant predictive factor for DNS (Odds ratio 18.600, p:0.004). Significant relation between NE and HBO treatment was present (p:00.1). There was no statistically significant relationship between initial COHb level and receiving HBO treatment (p:0.9). Median COHb level of patients with DNS was 30 (min:10, max: 43), median COHb level of patients without DNS was 25 (min:10, max:44) and there was no statistically significant relationship between the two groups according to COHb levels (p:0.7). CONCLUSION: Pathological findings in the initial neurological examination had a predictive value for delayed neurological sequelae in patients with carbon monoxide poisoning.

Adaptation of tape removal test for measurement of sensitivity in perineal area of rat.

Regeneration after spinal cord injury is a goal of many studies. Although the most obvious target is to recover motor function, restoration of sensation can also improve the quality of life after spinal cord injury. For many patients, recovery of sensation in the perineal and genital area is a high priority. Currently there is no experimental test in rodents for measuring changes in sensation in the perineal and genital area after spinal cord injury. The aim of our study was to develop a behavioural test for measuring the sensitivity of the perineal and genital area in rats. We have modified the tape removal test used routinely to test sensorimotor deficits after stroke and spinal cord injury to test the perineal area with several variations. A small piece of tape (approximately 1 cm2) was attached to the perineal area. Time to first contact and to the removal of the tape was measured. Each rat was trained for 5 consecutive days and then tested weekly. We compared different rat strains (Wistar, Sprague-Dawley, Long-Evans and Lewis), both genders, shaving and non-shaving and different types of tape. We found that the test was suitable for all tested strains, however, Lewis rats achieved the lowest contact times, but this difference was significant only for the first few days of learning the task. There were no significant differences between gender and different types of tape or shaving. After training the animals underwent dorsal column lesion at T10 and were tested at day 3, 8, 14 and 21. The test detected a sensory deficit, the average time across all animals to sense the stimulus increased from 1'32 up to 3'20. There was a strong relationship between lesion size and tape detection time, and only lesions that extended laterally to the dorsal root entry zone produced significant sensory deficits. Other standard behavioural tests (BBB, von Frey, ladder and Plantar test) were performed in the same animals. There was a correlation between lesion size and deficit for the ladder and BBB tests, but not for the von Frey and Plantar tests. We conclude that the tape removal test is suitable for testing perineal sensation in rats, can be used in different strains and is appropriate for monitoring changes in sensation after spinal cord injury.

Prospective study of anxiety, post-traumatic stress and depression on postural control, gait, otolith and visuospatial function in military service members with persistent post-concussive symptoms.

PURPOSE: Military service members often report both affective and vestibular complaints after mild traumatic brain injury (mTBI), but associations between symptoms and vestibular deficits can be subtle and inconsistent. METHODS: From two complementary studies, one of military service members with persistent post-concussive symptoms after mTBI (NCT01611194) and the other of adult volunteers with no history of brain injury (NCT01925963), affective symptoms were compared to postural control, gait, otolith and visuospatial function. RESULTS: The studies enrolled 71 participants with mTBI and 75 normative controls. Participants with mTBI had significantly reduced postural equilibrium on the sensory organization test (SOT), and more so in those with high anxiety or post-traumatic stress. Cervical and ocular vestibular evoked myogenic potentials (cVEMP; oVEMP) showed prolonged latencies in mTBI participants compared to controls; oVEMPs were significantly delayed in mTBI participants with high anxiety, post-traumatic stress or depression. A subset of the mTBI group had abnormal tandem gait and high anxiety. Anxiety, post-traumatic stress, and depression did not correlate with performance on the 6-Minute Walk Test, visuospatial neuropsychological measures, and the Satisfaction with Life Scale in the mTBI group. CONCLUSION: In this study military service members with mTBI reported affective symptoms, concurrently with vestibular-balance concerns. Worse scores on affective measures were associated with abnormal findings on measures of postural control, gait and otolith function.

Sensory loss enhances multisensory integration performance.

Auditory and visual sensory loss has repeatedly been shown to alter abilities in remaining sensory modalities. It is, however, unclear whether sensory loss also impacts multisensory integration; an ability that is fundamental for the perception of the world around us. We determined effects of olfactory sensory deprivation on multisensory perception by assessing temporal as well as semantic aspects of audio-visual integration in 37 individuals with anosmia (complete olfactory sensory loss) and 37 healthy, matched controls. Participants performed a simultaneity judgement task to determine the temporal binding window, and a multisensory object identification task with individually degraded, dynamic visual, auditory, and audio-visual stimuli. Individuals with anosmia demonstrated an increased ability to detect multisensory temporal asynchronies, represented by a narrowing of the audio-visual temporal binding window. Furthermore, individuals with congenital, but not acquired, anosmia demonstrated indications of greater benefits from bimodal, as compared to unimodal, stimulus presentation when faced with degraded, semantic information. This suggests that the absence of the olfactory sense alters multisensory integration of remaining senses by sharpening the perception of cross-modal temporal violations, independent of sensory loss etiology. In addition, congenital sensory loss may further lead to increased gain from multisensory, compared to unisensory, information. Taken together, multisensory compensatory mechanisms at different levels of perceptual complexity are present in individuals with anosmia.