Zika virus congenital microcephaly severity classification and the association of severity with neuropsychomotor development.

BACKGROUND: Zika virus infection during pregnancy is linked to birth defects, most notably microcephaly, which is associated with neurodevelopmental delays. OBJECTIVE: The goals of the study were to propose a method for severity classification of congenital microcephaly based on neuroradiologic findings of MRI scans, and to investigate the association of severity with neuropsychomotor developmental scores. We also propose a semi-automated method for MRI-based severity classification of microcephaly. MATERIALS AND METHODS: We conducted a cross-sectional investigation of 42 infants born with congenital Zika infection. Bayley Scales of Infant and Toddler Development III (Bayley-III) developmental evaluations and MRI scans were carried out at ages 13-39 months (mean: 24.8 months; standard deviation [SD]: 5.8 months). The severity score was generated based on neuroradiologist evaluations of brain malformations. Next, we established a distribution of Zika virus-microcephaly severity score including mild, moderate and severe and investigated the association of severity with neuropsychomotor developmental scores. Finally, we propose a simplified semi-automated procedure for estimating the severity score based only on volumetric measures. RESULTS: The results showed a correlation of r=0.89 (P<0.001) between the Zika virus-microcephaly severity score and the semi-automated method. The trimester of infection did not correlate with the semi-automated method. Neuropsychomotor development correlated with the severity classification based on the radiologic readings and semi-automated method; the more severe the imaging scores, the lower the neuropsychomotor developmental scores. CONCLUSION: These severity classification methods can be used to evaluate severity of microcephaly and possible association with developmental consequences. The semi-automated methods thus provide an alternative for predicting severity of microcephaly based on only one MRI sequence.

Onde termina o uso recreativo e inicia a dependência de jogos eletrônicos: uma revisão da literatura / Where recreational use ends and addiction to electronic games starts: a literature review

Os videogames ganharam destaque desde os anos 1970 e com a popularização da internet, originaram-se diversos relatos de que jovens vêm exagerando nos jogos fazendo com que em muitas vezes o uso deixe de ser recreativo. Esta pesquisa objetiva investigar, por meio da literatura, quando o uso de jogos eletrônicos é caracterizado como uma atividade recreativa e quando começa a ser considerado uma dependência. Foi realizada uma revisão na literatura na qual foram selecionados artigos científicos relacionados ao tema. Os resultados apontam que os jogos eletrônicos são a atividade de lazer mais praticada pelos adolescentes e por proporcionar um ambiente seguro e controlado permitem uma fuga da realidade para evitação dos problemas sociais. Concluindo, o uso abusivo dos jogos eletrônicos está associado a diversas comorbidades, interferindo de forma significativa na vida social, familiar, acadêmica e afetiva do sujeito, sendo que os adolescentes são os mais vulneráveis a desenvolver uma dependência.

Video games have gained prominence since the 1970s and with the popularization of the internet, several reports have originated that young people have been exaggerating in games, often making their use stop being recreational. This research aims to investigate, through the literature, when the use of electronic games is characterized as a recreational activity and when it starts to be considered a dependency. A literature review was carried out in which scientific articles related to the topic were selected. The results show that electronic games are the leisure activity most practiced by teenagers and, by providing a safe and controlled environment, they allow an escape from reality to avoid social problems. In conclusion, the abusive use of electronic games is associated with several comorbidities, significantly interfering in the subject's social, family, academic and affective life, with adolescents being the most vulnerable to developing addiction.

Correlation between the corpus callosum index and brain atrophy, lesion load, and cognitive dysfunction in multiple sclerosis.

BACKGROUND: The corpus callosum index (CCI) can be easily and reliably obtained from conventional magnetic resonance imaging (MRI) and has been proposed as a possible marker of brain atrophy in MS. However, further validation of its correlation with volumetric measurements is still warranted. OBJECTIVE: To assess the correlation of the CCI with the corpus callosum volume (CCV), brain and lesion volumes, and level of disability in MS. METHODS: Cross-sectional, exploratory study including patients with relapsing-remitting MS. Clinical assessment comprised of physical and cognitive disability scales. MRI parameters included conventional volumetric measurements, the CCI (manual), and the CCV (automated). RESULTS: Twenty-four patients were included. There was a strong correlation between the CCI and CCV. The CCI correlated strongly with the white matter and lesion volumes, and moderately with the whole brain volume and scores on the Paced Auditory Serial Addition Test and MS Functional Composite. There were no correlations between the CCI and either gray matter volume or scores on the Expanded Disability Status Scale, the 9-Hole Peg Test, or the Timed 25-Foot Walk test. CONCLUSION: The findings support the validity of the CCI as an easy-to-obtain marker of brain atrophy, lesion load, and cognitive dysfunction in patients with MS.

Route learning performance: is it a hippocampus function?

INTRODUCTION: In temporal lobe epilepsy (TLE), about 30% of the patients do not achieve adequate pharmacologic control of refractory crises, and surgery becomes an alternative. In ablative interventions, neuropsychologic testing of memory is a crucial step. However, evaluations of the right hippocampal functions have not been consistent. AIM: To assess the hippocampal function in remote orientation and visuospatial memory in patients with refractory temporal epilepsy. METHODS: A controlled study of patients with left (LTLE) or right (RTLE) TLE. The subjects were submitted to a neuropsychologic evaluation through the Route Learning Test and the Childhood Home Test in the preoperative period. The statistical analysis was performed using the Kruskal-Wallis, analysis of variance, χ, and Mann-Whitney U tests. RESULTS: There was no significant difference in performance in the remote visuospatial memory (as measured by the Childhood Home Test) across the groups (LTLE, RTLE, and control). Concerning the spatial orientation memory, however, there was a significant difference between the LTLE and controls as compared with the RTLE group (P<0.001), the latter showing a poorer performance. CONCLUSIONS: The study suggests that spatial orientation memory relies on the integrity of the right hippocampus. Nevertheless, further studies are necessary to confirm this hypothesis.