Development of a novel gripping test for the evaluation of the finger fine motor ability in MPTP-treated monkeys.

Assessing the finger fine motor ability is extremely important. However, conventional behavioral tests in monkeys are complicated and costly. We attempted to develop a new task to assess the precise finger grip in Parkinson's disease monkeys based on the principles of objectification, multipurpose, and simplification. This study involved seven adult male cynomolgus monkeys. A gripping test based on the previous food reaching test was developed. Parallel experiments of food reaching test and gripping test affected by the treatments of levodopa and deep brain stimulation of the subthalamic nucleus were performed to verify the utility of the gripping test. We found that gross motor ability (measured by food reaching test) could be significantly improved by both the subthalamic nucleus and levodopa administration, which reproduced the results of our previous study. The finger fine motor ability (measured by the gripping test) could be significantly improved by levodopa administration, but not by the subthalamic nucleus. Our results verified the utility and reliability of the gripping test, which is a simple, convenient, and objective task for evaluating the finger fine motor skill in Parkinson's disease monkeys. Mechanisms of the efficacy of deep brain stimulation on fine motor ability require further investigation.

Scalp Nerve Block Alleviates Headaches Associated With Sonication During Transcranial Magnetic Resonance-Guided Focused Ultrasound.

BACKGROUND AND OBJECTIVES: In magnetic resonance-guided focused ultrasound (MRgFUS) procedures, headache is a frequent symptom and cause of treatment discontinuation. Herein, we assessed the efficacy of scalp nerve block (SNB) for alleviating headache during MRgFUS procedures. METHODS: The effect of SNB on intraprocedural headache was examined by retrospectively comparing 2 patient cohorts at a single institution. During the study period from April 2020 to February 2022, an SNB protocol for all patients with a skull density ratio ≤0.55 was instituted on October 6, 2021. The number of patients with a skull density ratio ≤0.55 was 34 before the protocol and 36 afterward. Headache intensity was evaluated using a numerical rating scale (NRS) after each sonication. To evaluate the effect of SNB on headache intensity, multiple regression analysis was performed per patient and per sonication. In the per-patient analysis, the effect of SNB was evaluated using the maximum NRS, mean NRS, and NRS at the first ultrasound exposure that reached 52.5°C. In the per-sonication analysis, the effect of SNB was evaluated not only for the entire sonication but also for sonications classified into ≤9999 J, 10 000 to 29 999 J, and ≥30 000 J energy doses. RESULTS: With SNB, headache alleviation was observed in the NRS after the first sonication that reached 52.5°C in each patient (ß = -2.40, 95% CI -4.05 to -0.758, P = .00499), in the NRS when all sonications were evaluated (ß = -0.647, 95% CI -1.19 to -0.106, P = .0201), and in the NRS when all sonications were classified into 10 000 to 29 999 J (ß = -1.83, 95% CI -3.17 to -0.485, P = .00889). CONCLUSION: SNB significantly reduced headache intensity during MRgFUS, especially that caused by sonication with a moderate-energy dose. These findings suggest that scalp nerves play a role in headache mechanisms during MRgFUS.

The genus Pseudostenophylax Martynov (Trichoptera, Limnephilidae) in Japan.

I revise the Japanese species of the genus Pseudostenophylax Martynov (Trichoptera, Limnephilidae), and recognize 8 species including five new species, P. tohokuensis, P. kuharai, P. itoae, P. tanidai and P. befui, and three previously described species, P tochigiensis Schmid, P ondakensis (Iwata) and P. dentilus (Kobayashi). Pseudostenophylax takaoensis Schmid is synonymized with P. ondakenis. Adults and larvae of all species are described or redescribed except for the larval stage of P befui sp. nov.

DNA barcoding facilitates discovery and description of two new species of the Mystacides azureus Species Group (Trichoptera: Leptoceridae) in Japan.

We examined adult specimens of the Mystacides azureus Species Group (Trichoptera: Leptoceridae) collected in Japan and confirm three species including M. azureus Linnaeus 1761 and two new species, M. rivularis and M. moritai. Males and females of the new species are described. Mystacides azureus in Japan is shown to have a considerable variation in morphology of the male tergum X. We analyzed mitochondrial COI barcodes of the genus Mystacides including these three species to confirm their species status. A maximum likelihood phylogeny based on COI barcodes shows monophyly of the new species. It also supports the hypothesis that morphological variation of the male tergum X in Japanese populations is intraspecific in only M. azureus.

The genus Diplectrona Westwood (Trichoptera: Hydropsychidae) in the Japanese main islands.

The genus Diplectrona Westwood (Trichoptera: Hydropsychidae) is revised for the Japanese main islands, and four species are recognized, the three species D. aiensis Kobayashi, D. burha Schmid, and D. kibuneana Tsuda, and one new species, D. takaii sp. nov. Diplectrona difficultata (Kobayashi) is synonymized with D. kibuneana. Diplectrona japonica Banks and D. albomarginata Ulmer are transferred to the genus Homoplectra Ross.

Two new species of the genus Rhyacophila Pictet (Trichoptera, Rhyacophilidae) from Korea and Japan.

Two new species of the genus Rhyacophila Pictet, R. kangae Park Nozaki sp. nov. and R. yamamotoi Nozaki sp. nov., are described from Korea and Japan, respectively. Both species belong to the Rhyacophila nigrocephala Species Group, and their genitalic morphology is very similar to those of R. confissa Botosaneanu 1970 and R. vicina Botosaneanu 1970 described from the Korean Peninsula. These four species can be distinguished from each other by the shape of the complex of preanal appendages and apicodorsal lobe of segment IX in males, and by the shape of the vaginal apparatus in females. Males of the two new species bear larger compound eyes in proportion to the head widths than those of R. confissa and R. vicina.

Increased anteroventral striatal dopamine transporter and motor recovery after subthalamic deep brain stimulation in Parkinson's disease.

OBJECTIVE: Subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease is effective; however, its mechanism is unclear. To investigate the degree of neuronal terminal survival after STN-DBS, the authors examined the striatal dopamine transporter levels before and after treatment in association with clinical improvement using PET with [11C]2ß-carbomethoxy-3ß-(4-fluorophenyl)tropane ([11C]CFT). METHODS: Ten patients with Parkinson's disease who had undergone bilateral STN-DBS were scanned twice with [11C]CFT PET just before and 1 year after surgery. Correlation analysis was conducted between [11C]CFT binding and off-period Unified Parkinson's Disease Rating Scale (UPDRS) scores assessed preoperatively and postoperatively. RESULTS: [11C]CFT uptake reduced significantly in the posterodorsal putamen contralateral to the parkinsonism-dominant side after 1 year; however, an increase was noted in the contralateral anteroventral putamen and ipsilateral ventral caudate postoperatively (p < 0.05). The percentage increase in [11C]CFT binding was inversely correlated with the preoperative binding level in the bilateral anteroventral putamen, ipsilateral ventral caudate, contralateral anterodorsal putamen, contralateral posteroventral putamen, and contralateral nucleus accumbens. The percentage reduction in UPDRS-II score was significantly correlated with the percentage increase in [11C]CFT binding in the ipsilateral anteroventral putamen (p < 0.05). The percentage reduction in UPDRS-III score was significantly correlated with the percentage increase in [11C]CFT binding in the ipsilateral anteroventral putamen, ventral caudate, and nucleus accumbens (p < 0.05). CONCLUSIONS: STN-DBS increases dopamine transporter levels in the anteroventral striatum, which is correlated with the motor recovery and possibly suggests the neuromodulatory effect of STN-DBS on dopaminergic terminals in Parkinson's disease patients. A preoperative level of anterior striatal dopamine transporter may predict reserve capacity of STN-DBS on motor recovery.

A new species of the genus Goera Stephens (Trichoptera, Goeridae) found in madicolous habitats in Amami-Oshima, southwestern Japan.

A new species of the genus Goera, G. rupicola, is described based on adult and immature stages from Amami-Oshima, southwestern Japan. The larvae of this species inhabit wet cliff faces where water trickles over the surface. This is the first madicolous species reported in the genus Goera.

Descriptions of five new species of Homoplectra Ross (Trichoptera, Hydropsychidae) from Japan with reassignment of Homoplectra tohokuensis (Kobayashi).

Five new species of the genus Homoplectra Ross 1938 (Trichoptera: Hydropsychidae) are described from Japan: H. crassa, H. ise, H. hattorii, H. occidens, and H. gracilis. Diplectrona tohokuensis Kobayashi 1973 is transferred to the genus Homoplectra. Geographic variations in the male genitalia are reported for four new species. Descriptions of the immature stages of H. crassa sp. nov. and H. tohokuensis are provided. Larvae of these species were found in small seeps and flows in hill or mountain areas.

Fluid-Blood Level and Hematoma Expansion in a Cerebral Amyloid Angiopathy-Associated Intracerebral Hematoma.

BACKGROUND Cerebral amyloid angiopathy (CAA) results from progressive deposition of amyloid-ß in the walls of cortical and leptomeningeal vessels, leading to CAA-associated intracerebral hemorrhage (ICH). Hematoma expansion is a common early complication of spontaneous ICH, and is a strong independent predictor of poor outcome. However, there are limited reports of hematoma expansion related to CAA-associated ICH. Herein, we describe a novel case of hematoma expansion with a fluid-blood level in the cystic cavity of CAA-associated ICH. CASE REPORT A 76-year-old male was initially diagnosed with probable CAA according to the modified Boston criteria, and presented with lobar ICH in the left frontal lobe 4 months later. Admission computed tomography scans showed an ICH including a high-density hematoma within a cystic cavity, revealing a clearly lower-density fluid component. Serial computed tomography scans showed no evidence of an expansion of the high-density clot, but obvious expansion of the fluid component containing a fluid-blood level. We recognized a bleeding site with no enhancement on preoperative magnetic resonance imaging. Left frontal craniotomy revealed a liquefied hematoma, which was removed by suction. We subsequently evacuated the blood clot extending into the left frontal sulcus, and confirmed and cauterized the bleeding site, leading to successful hemostasis. CONCLUSIONS We report a CAA-associated ICH case showing hematoma expansion with a fluid-blood level. Intraparenchymal fluid-blood level suggests extravasation of blood into pre-existing cystic cavities because of hematoma liquefaction. Thus, fluid-blood levels are an important finding of hematoma expansion in acute CAA-associated ICH, and early treatment should be considered.

Can the Latest Computerized Technologies Revolutionize Conventional Assessment Tools and Therapies for a Neurological Disease? The Example of Parkinson's Disease.

Dramatic breakthroughs in the treatment and assessment of neurological diseases are lacking. We believe that conventional methods have several limitations. Computerized technologies, including virtual reality, augmented reality, and robot assistant systems, are advancing at a rapid pace. In this study, we used Parkinson's disease (PD) as an example to elucidate how the latest computerized technologies can improve the diagnosis and treatment of neurological diseases. Dopaminergic medication and deep brain stimulation remain the most effective interventions for treating PD. Subjective scales, such as the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr stage, are still the most widely used assessments. Wearable sensors, virtual reality, augmented reality, and robot assistant systems are increasingly being used for evaluation of patients with PD. The use of such computerized technologies can result in safe, objective, real-time behavioral assessments. Our experiences and understanding of PD have led us to believe that such technologies can provide real-time assessment, which will revolutionize the traditional assessment and treatment of PD. New technologies are desired that can revolutionize PD treatment and facilitate real-time adjustment of treatment based on motor fluctuations, such as telediagnosis systems and "smart treatment systems." The use of these technologies will substantially improve both the assessment and the treatment of neurological diseases before next-generation treatments, such as stem cell and genetic therapy, and next-generation assessments, can be clinically practiced, although the current level of artificial intelligence cannot replace the role of clinicians.

Origin of the transition from aquatic to terrestrial habits in Nothopsyche caddisflies (Trichoptera: Limnephilidae) based on molecular phylogeny.

The larvae and pupae of most caddisflies (Trichoptera) are aquatic, whereas the adults are terrestrial. However, the trichopteran genus Nothopsyche includes species with terrestrial pre-pupal and pupal stages and with an entirely terrestrial life cycle. The phylogenetic relationships within this genus, inferred from sequences of mitochondrial 16S and nuclear 18S ribosomal RNA genes, suggest that Nothopsyche species were originally aquatic and that a single lineage acquired tolerance to terrestrial habitats at the pre-pupal and pupal stages. In this lineage, N. montivaga became completely terrestrial. In addition, the larval case materials changed from plant matter to sand at one point in the phylogeny of this genus.

The family Hydropsychidae Curtis (Trichoptera) in the Ryukyu Archipelago, southwestern Japan.

The caddisfly family Hydropsychidae Curtis is revised for the Ryukyu Archipelago, southwestern Japan. Four new species are described based on adults: Diplectrona uken Ito and Nozaki sp. nov., Homoplectra crassicornea Nozaki and Ito sp. nov., Homoplectra trifurcata Nozaki and Ito sp. nov. and Cheumatopsyche aira Ito and Nozaki sp. nov. Based on examination of type specimens of species described from Taiwan in 1910-1930's: Cheumatopsyche uchidai Kobayashi 1987 and Hydropsyche yaeyamensis Tanida 1986 are synonymized with C. clavalis Martynov 1930 and H. orbiculata Ulmer 1911, respectively. Five East Asian species: Diplectrona burha Schmid 1961, Diplectrona albofasciata (Ulmer 1913), Cheumatopsyche clavalis Martynov 1930, Hydropsyche verrucosa (Ulmer 1911), and Macrostemum formosicolum (Matsumura 1931) are recorded from Japan for the first time and re-described. Adults of two known species, Cheumatopsyche okinawa Oláh and Johanson 2008 and Macrostemum okinawanum (Matsumura 1931) are re-described. Females of five species, previously known only as males, are described for the first time.

Effect of Subthalamic Deep Brain Stimulation on Upper Limb Dexterity in Patients with Parkinson Disease.

OBJECTIVE: The efficacy of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on dexterity remains controversial despite its recognition as an effective strategy for Parkinson disease. The present study investigated the efficacy of STN-DBS for ameliorating bradykinesia and dexterity compared with dopaminergic medications. METHODS: Part III of the Unified Parkinson's Disease Rating Scale was used for the evaluation of bradykinesia, whereas the Purdue Pegboard Test and the Box and Block test were selected for dexterity. RESULTS: Our findings indicate that bradykinesia is significantly improved with both DBS and dopaminergic medication, whereas dexterity is improved only with DBS. Dopaminergic medication did not show a satisfactory efficacy on dexterity, and there was little synergistic effect of dopaminergic medication and STN-DBS for improving dexterity associated with Parkinson disease. CONCLUSIONS: Our results suggest that DBS is potentially more effective than dopaminergic medications for improving dexterity. The disparities in efficacy for bradykinesia and dexterity between DBS and dopaminergic medication hint at the potential mechanisms of STN-DBS. We speculate that DBS follows at least 2 different mechanisms for improving parkinsonian symptoms: 1) the dopaminergic system, primarily for the improvement of bradykinesia and 2) the nondopaminergic system, for the improvement of dexterity. This hypothesis requires further verification and investigation.

Deep Brain Stimulation for Intractable Obsessive-compulsive Disorder: The International and Japanese Situation/Scenario.

Deep brain stimulation (DBS) is used to treat symptoms by modulating the cortico-striato-thalamo-cortical (CSTC) loop in the central nervous system (CNS), and attempts to research loop circuit disorders have been globally initiated among the intractable neurological and psychiatric disorders. DBS treatment has been evaluated for all these newly found CNS loop circuit disorders. In 2011, neurosurgical treatments for psychiatric disorders were renamed from "psychosurgery" to "neurosurgery for psychiatric disorders (NPD)" by the World Society for Stereotactic and Functional Neurosurgery (WSSFN). Moreover, in 2014, "Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders" was published by the WSSFN to address the differences in correspondence of stereotactic NPD. Globally, two multicenter prospective randomized control trials regarding DBS of the subcallosal cingulated gyrus and ventral anterior internal capsule/ventral striatum for intractable depression have been terminated after futility analysis. However, DBS for intractable obsessive-compulsive disorder (OCD), unlike for intractable depression, is showing steady development. In Japan, NPDs have not been performed since 1975 following the adoption of "Resolution of total denial for psychosurgery" by the Japanese Society of Psychiatry and Neurology. Nevertheless, a trend to adopt new neuro-modulation techniques for psychiatric disorders, including DBS, are emerging. We have created a clinical research protocol for the use of DBS in intractable OCD, which has been approved by the ethical committee of Hamamatsu University School of Medicine, with the hope of commencing DBS treatment for intractable OCD patients in the near future.

Current behavioral assessments of movement disorders in children.

Pediatric movement disorders (PMDs) are common and have recently received increasing attention. As these disorders have special clinical features, the selection of appropriate behavioral assessment tools that can clearly distinguish movement disorders from other diseases (eg, epilepsy and neuromuscular disorders) is crucial for achieving an accurate diagnosis and treatment. However, few studies have focused on behavioral assessments in children. The present report attempts to provide a critical review of the available subjective and objective assessment tests for common PMDs. We believe that the principles of objectification, multi-purpose use, and simplification are also applicable to the selection and development of satisfactory pediatric behavioral assessment tools. We expect that the development of wearable sensors, virtual reality, and augmented reality will lead to the establishment of more reliable and simple tests. In addition, more rigorous randomized controlled trials that have been specifically designed to evaluate behavioral testing in children are also expected in the future.

Discovery in Japan of the second species of the genus Dolichocentrus Martynov (Trichoptera: Brachycentridae).

A new species Dolichocentrus sakura is described from western Honshu, Japan. This is the second species of the genus Dolichocentrus Martynov. Descriptions of female and immature stages of this genus are provided for the first time.

Psychometric evaluation of the Chinese version of the revised American Pain Society Patient Outcome Questionnaire concerning pain management in Chinese orthopedic patients.

The present study tested the clinical efficiency (item grouping, internal consistency of the subscales, construct validity, and clinical feasibility) of a widely used pain assessment system, the Mandarin version of the American Pain Society Patient Outcome Questionnaire (APS-POQ-R-C), in Chinese patients. We also attempted to investigate the current quality of pain management provided in orthopedic inpatient units in China and provide baseline data. First, we investigated the test-retest reliability of APS-POQ-R-C. In total, 236 orthopedic patients were evaluated. Our results showed that APS-POQ-R-C has satisfactory internal consistency and construct validity, although some items are not appropriate for orthopedic patients. Test-retest reliability outcomes indicated that APS-POQ-R-C is a satisfactory battery with acceptable validity and reliability, and is therefore recommended for pain management in future studies.

Multifaceted interventions for improving spontaneous reporting of adverse drug reactions in a general hospital in China.

BACKGROUND: The present study investigates changes in spontaneous reporting (SR) compliance and ADR patterns following adoption of a new hospital SR system, and multiple interventions designed for its improvement use under modified drug administration guidelines. METHODS: In total, 1389 ADR cases were reviewed. Cases were divided into two groups, cases from period 1 (n = 557, from January 2006 to June 2011) under the old SR system and cases in period 2 (n = 832, from July 2011 to December 2016) under the new SR system with multiple interventions to improve physician SR compliance. General information, drug information, and clinical manifestations were investigated and compared between periods. RESULTS: Interventions for improved clinician training, education on knowledge, attitudes, and practices (KAP), and economic incentives substantially improved SR adherence. We also found that changing drug usage patterns (based on the new drug administration guidelines) greatly influenced ADR occurrence and type. CONCLUSIONS: We found the SR compliance can be improved by multifaceted interventions. Drug usage patterns also influence ADR occurrence, so programs tailored for rational use are essential. These results could lead to further improvements in the SR system for ADRs in China, and provide guidance for establishing better methods of pharmacovigilance.

Larvae and females of two Stenopsyche species in Taiwan with redescription of the male of S. formosana (Insecta: Trichoptera).

Larvae and females of two Stenopsyche species, S. formosana Kobayashi and S. drakon Weaver, are described for the first time. They were associated with the adult male through mitochondrial DNA sequence comparisons. The male of S. formosana, which has been recorded as Stenopsyche banksi Mosely from Taiwan, is redescribed. The males of S. formosana and S. banksi can be distinguished from each other by the shape of segments IX and X, and endothecal spines. In larvae, S. formosana and S. drakon are distinguishable from each other and from other known species by the combination of different dark marking patterns and shapes of no. 18 setae of the head, and by the shapes of forecoxae. The larval morphology of S. formosana and S. drakon suggests that the phylogenetic relationships based mainly on male genitalia in the genus Stenopsyche should be reconsidered.