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BackgroundScreening and intervention for alcohol use disorders (AUDs) are recommended to improve the prognosis of patients with alcohol-related liver disease (ALD). Most patients’ smartphone app diaries record drinking behavior for self-monitoring. A smartphone app can be expected to also be helpful for physicians because it can provide rich patient information to hepatologists, leading to suitable feedback. We conducted this prospective pilot study to assess the use of a smartphone app as a journaling tool and as a self-report–based feedback source for patients with ALD. ObjectiveThe aims of this study were assessment of whether journaling (self-report) and self-report–based feedback can help patients maintain abstinence and improve liver function data. MethodsThis pilot study used a newly developed smartphone journaling app for patients, with input data that physicians can review. After patients with ALD were screened for harmful alcohol use, some were invited to use the smartphone journaling app for 8 weeks. Their self-reported alcohol intake, symptoms, and laboratory data were recorded at entry, week 4, and week 8. Biomarkers for alcohol use included gamma glutamyl transferase (GGT), percentage of carbohydrate-deficient transferrin to transferrin (%CDT), and GGT-CDT (GGT-CDT= 0.8 × ln[GGT] + 1.3 × ln[%CDT]). At each visit, their recorded data were reviewed by a hepatologist to evaluate changes in alcohol consumption and laboratory data. The relation between those outcomes and app usage was also investigated. ResultsOf 14 patients agreeing to participate, 10 completed an 8-week follow-up, with diary input rates between 44% and 100% of the expected days. Of the 14 patients, 2 withdrew from clinical follow-up, and 2 additional patients never used the smartphone journaling app. Using the physician’s view, a treating hepatologist gave feedback via comments to patients at each visit. Mean self-reported alcohol consumption dropped from baseline (100, SD 70 g) to week 4 (13, SD 25 g; P=.002) and remained lower at week 8 (13, SD 23 g; P=.007). During the study, 5 patients reported complete abstinence. No significant changes were found in mean GGT and mean %CDT alone, but the mean GGT-CDT combination dropped significantly from entry (5.2, SD 1.2) to the week 4 visit (4.8, SD 1.1; P=.02) and at week 8 (4.8, SD 1.0; P=.01). During the study period, decreases in mean total bilirubin (3.0, SD 2.4 mg/dL to 2.4, SD 1.9 mg/dL; P=.01) and increases in mean serum albumin (3.0, SD 0.9 g/dL to 3.3, SD 0.8 g/dL; P=.009) were recorded. ConclusionsThese pilot study findings revealed that a short-term intervention with a smartphone journaling app used by both patients and treatment-administering hepatologists was associated with reduced drinking and improved liver function. Trial RegistrationUMIN CTR UMIN000045285; http://tinyurl.com/yvvk38tj

Abstract Aims The use of new psychoactive substances (NPS) has become increasingly widespread over the last decade, in Japan and internationally. NPS are associated with a range of increasingly serious clinical, public, and social issues. Political measures to ameliorate the effects of NPS in Japan have focused on tightening regulation rather than establishing treatment methods. The current study sought to compare the neuropsychiatric symptoms of patients with NPS‐related disorders across several years. We examined patients who attended specialized hospitals for treating addiction, to elucidate the impacts of legal measures to control NPS. Methods Subjects (n = 864) were patients with NPS‐related disorders who received medical treatment at eight specialized hospitals for treating addiction in Japan between April 2012 and March 2015. Clinical information was collected retrospectively from medical records. Results Among psychiatric symptoms, the ratio of hallucinations/delusions decreased over time across 3 years of study (first year vs second year vs third year: 40.1% vs 30.9% vs 31.7%, P = 0.037). Among neurological symptoms, the ratio of coma/syncope increased over the 3‐year period (7.8% vs 11.0% vs 17.0%, P = 0.002), as did the ratio of convulsions (2.8% vs 4.3% vs 9.7%, P = 0.001). Conclusion The symptoms associated with NPS were primarily psychiatric in the first year, while the prevalence of neurological symptoms increased each year. The risk of death and the severity of symptoms were greater in the third year compared with the first year, as regulation of NPS increased.

Objective: Neurophysiological changes related to meditation have recently attracted scientific attention. We aimed to detect changes in electroencephalography (EEG) parameters induced by a meditative intervention in subjects with post-traumatic residual disability (PTRD), which has been confirmed for effectiveness and safety in a previous study. This will allow us to estimate the objective effect of this intervention at the neurophysiological level. Methods: Ten subjects with PTRD were recruited and underwent psychological assessment and EEG recordings before and after the meditative intervention. Furthermore, 10 additional subjects were recruited as normal controls. Source current density as an EEG parameter was estimated by exact Low Resolution Electromagnetic Tomography (eLORETA). Comparisons of source current density in PTRD subjects after the meditative intervention with normal controls were investigated. Additionally, we compared source current density in PTRD subjects between before and after meditative intervention. Correlations between psychological assessments and source current density were also explored. Results: After meditative intervention, PTRD subjects exhibited increased gamma activity in the left inferior parietal lobule relative to normal controls. In addition, changes of delta activity in the right precuneus correlated with changes in the psychological score on role physical item, one of the quality of life scales reflecting the work or daily difficulty due to physical problems. Conclusions: These results show that the meditative intervention used in this study produces neurophysiological changes, in particular the modulation of oscillatory activity of the brain. Significance: Our meditative interventions might induce the neurophysiological changes associated with the improvement of psychological symptoms in the PTRD subjects. Keywords: EEG, Meditation, eLORETA, PTRD, Gamma band, Delta band

Objectives: The aim of this paper is to investigate cortical electric neuronal activity as an indicator of brain function, in a mental arithmetic task that requires sustained attention, as compared to the resting state condition. The two questions of interest are the cortical localization of different oscillatory activities, and the directional effective flow of oscillatory activity between regions of interest, in the task condition compared to resting state. In particular, theta and alpha activity are of interest here, due to their important role in attention processing. Methods: We adapted mental arithmetic as an attention ask in this study. Eyes closed 61-channel EEG was recorded in 14 participants during resting and in a mental arithmetic task (“serial sevens subtraction”). Functional localization and connectivity analyses were based on cortical signals of electric neuronal activity estimated with sLORETA (standardized low resolution electromagnetic tomography). Functional localization was based on the comparison of the cortical distributions of the generators of oscillatory activity between task and resting conditions. Assessment of effective connectivity was based on the iCoh (isolated effective coherence) method, which provides an appropriate frequency decomposition of the directional flow of oscillatory activity between brain regions. Nine regions of interest comprising nodes from the dorsal and ventral attention networks were selected for the connectivity analysis. Results: Cortical spectral density distribution comparing task minus rest showed significant activity increase in medial prefrontal areas and decreased activity in left parietal lobe for the theta band, and decreased activity in parietal-occipital regions for the alpha1 band. At a global level, connections among right hemispheric nodes were predominantly decreased during the task condition, while connections among left hemispheric nodes were predominantly increased. At more detailed level, decreased flow from right inferior frontal gyrus to anterior cingulate cortex for theta, and low and high alpha oscillations, and increased feedback (bidirectional flow) between left superior temporal gyrus and left inferior frontal gyrus, were observed during the arithmetic task. Conclusions: Task related medial prefrontal increase in theta oscillations possibly corresponds to frontal midline theta, while parietal decreased alpha1 activity indicates the active role of this region in the numerical task. Task related decrease of intracortical right hemispheric connectivity support the notion that these nodes need to disengage from one another in order to not interfere with the ongoing numerical processing. The bidirectional feedback between left frontal-temporal-parietal regions in the arithmetic task is very likely to be related to attention network working memory function. Significance: The methods of analysis and the results presented here will hopefully contribute to clarify the roles of the different EEG oscillations during sustained attention, both in terms of their functional localization and in terms of how they integrate brain function by supporting information flow between different cortical regions. The methodology presented here might be clinically relevant in evaluating abnormal attention function. Keywords: Quantitative EEG, sLORETA, iCoh, Directional connectivity, Frontal midline theta, Attention network, Mental arithmetic, Fronto-parietal network, Directional flow, Attention task, Granger causality

Transcranial direct current stimulation is a promising neuromodulation method for treating depression. However, compared with pharmacological treatment, previous studies have reported that a relatively limited proportion of patients respond to tDCS treatment. In addition, the neurophysiological mechanisms underlying tDCS treatment remain unclear, making it difficult to identify response predictors for tDCS treatment based on neurophysiological function. Because treatment effects are achieved by repetitive application of tDCS, studying the immediate effects of tDCS in depressive patients could extend understanding of its treatment mechanisms. However, immediate changes in a single session of tDCS are not well documented. Thus, in the current study, we focused on the immediate impact of tDCS and its association with pre-stimulus brain activity. To address this question, we applied anodal tDCS to the left dorsolateral prefrontal cortex (DLPFC) or dorsomedial prefrontal cortex (DMPFC) in 14 patients with major depressive disorder (MDD) and 19 healthy controls (HCs), at an intensity of 1.0 mA for 20 min in a single session. To evaluate anxiety, the state trait anxiety inventory was completed before and after tDCS. We recorded resting electroencephalography before tDCS, and calculated electrical neuronal activity in the theta and alpha frequency bands using standardized low-resolution electromagnetic tomography. We found that, during application of left DLPFC tDCS to patients with MDD, the anxiety reduction effect of tDCS was related to higher baseline theta-band activity in the rostral anterior cingulate cortex (rACC) and no medication with benzodiazepine used as hypnotic. For DMPFC stimulation in MDD, the anxiety reduction effect was associated with lower baseline alpha-band activity in the left inferior parietal lobule. In contrast, in HCs, the anxiety reduction effect was associated with higher baseline alpha activity in the precuneus during DMPFC stimulation. The current results suggest that the association between pre-tDCS brain activity and the anxiety reduction effect of tDCS depends on psychopathology (depressed or non-depressed) as well as the site of stimulation (DMPFC or left DLPFC) and insomnia. Furthermore, the results suggest that tDCS response might be associated with baseline resting state electrophysiological neural activity.

Liver regeneration (LR) involves an early inductive phase characterized by the proliferation of hepatocytes, and a delayed angiogenic phase distinguished by the expansion of non-parenchymal compartment. The interest in understanding the mechanism of LR has lately shifted from the proliferation and growth of parenchymal cells to vascular remodeling during LR. Angiogenesis accompanied by LR exerts a pivotal role to accomplish the process. Vascular endothelial growth factor (VEGF) has been elucidated as the most dynamic regulator of angiogenesis. From this perspective, platelet derived/Intra-platelet (IP) VEGF-A should be associated with LR.Thirty-seven patients diagnosed with hepatocellular carcinoma and undergoing partial hepatectomy (PH) were enrolled in the study. Serum and IP VEGF-A was monitored preoperatively and at four weeks of PH. Liver volumetry was determined on computer models derived from computed tomography (CT) scan.Serum and IP VEGF-A was significantly elevated at four weeks of PH. Preoperative IP VEGF-A was higher in patients with advanced cancer and vascular invasion. Postoperative IP VEGF-A was higher after major liver resection. There was a statistically significant correlation between postoperative IP VEGF-A and the future remnant liver volume. Moreover, the soluble vascular endothelial growth factor receptor-1 (sVEGFR1) was distinctly down-regulated suggesting a fine-tuned angiogenesis at the later phase of LR.IP VEGF-A is overexpressed during later phase of LR suggesting its implications in inducing angiogenesis during LR.

BACKGROUND: It is unclear whether, like in schizophrenia, psychosis-related disruption in connectivity between certain regions, as an index of intrinsic functional disintegration, occurs in schizophrenia-like psychosis of epilepsy (SLPE). In this study, we sought to determine abnormal patterns of resting-state EEG oscillations and functional connectivity in patients with SLPE, compared with nonpsychotic epilepsy patients, and to assess correlations with psychopathological deficits. METHODOLOGY/PRINCIPAL FINDINGS: Resting EEG was recorded in 21 patients with focal epilepsy and SLPE and in 21 clinically-matched non-psychotic epilepsy controls. Source current density and functional connectivity were determined using eLORETA software. For connectivity analysis, a novel nonlinear connectivity measure called "lagged phase synchronization" was used. We found increased theta oscillations in regions involved in the default mode network (DMN), namely the medial and lateral parietal cortex bilaterally in the psychotic patients relative to their nonpsychotic counterparts. In addition, patients with psychosis had increased beta temporo-prefrontal connectivity in the hemisphere with predominant seizure focus. This functional connectivity in temporo-prefrontal circuits correlated with positive symptoms. Additionally, there was increased interhemispheric phase synchronization between the auditory cortex of the affected temporal lobe and the Broca's area correlating with auditory hallucination scores. CONCLUSIONS/SIGNIFICANCE: In addition to dysfunction of parietal regions that are part of the DMN, resting-state disrupted connectivity of the medial temporal cortex with prefrontal areas that are either involved in the DMN or implicated in psychopathological dysfunction may be critical to schizophrenia-like psychosis, especially in individuals with temporal lobe epilepsy. This suggests that DMN deficits might be a core neurobiological feature of the disorder, and that abnormalities in theta oscillations and beta phase synchronization represent the underlying neural activity.

Purpose: To elucidate the prognostic factors in the spontaneous rupture of hepatocellular carcinoma (HCC) and to determine whether transcatheter arterial embolisation (TAE) is associated with better prognosis compared to conservative treatment. Material and methods: A retrospective multicentre study was conducted involving 71 patients with spontaneous rupture of HCC. A conservative treatment group (Cons T group) included 20 patients, while a transcatheter arterial embolisation group (TAE group) included 51 patients. Results: The median survival time (MST) in the Cons T group was only 16 days and the survival rate was 39% at one month, whereas the MST in the TAE group was 28 days and the one month survival rate was 63%. However, there is no statistically significant difference in the overall survival between Cons T and TAE groups (p = 0.213). Multivariable analysis identified only the presence of distant metastasis as an independent prognostic factor (p = 0.023). A subanalysis including patients without distant metastasis showed that the presence of portal vein tumour thrombosis was a significant prognostic factor (p = 0.015). Conclusions: Distant metastasis appears to be a prognostic factor in spontaneous rupture of HCC. In cases without distant metastasis, portal vein tumour thrombosis could influence the prognosis. Our data failed to prove any benefit of TAE as the primary management. [ABSTRACT FROM AUTHOR]

Recent functional magnetic resonance imaging (fMRI) studies have shown that functional networks can be extracted even from resting state data, the so called "Resting State independent Networks" (RS-independent-Ns) by applying independent component analysis (ICA). However, compared to fMRI, electroencephalography (EEG) and magnetoencephalography (MEG) have much higher temporal resolution and provide a direct estimation of cortical activity. To date, MEG studies have applied ICA for separate frequency bands only, disregarding cross-frequency couplings. In this study, we aimed to detect EEG-RS-independent-Ns and their interactions in all frequency bands. We applied exact low resolution brain electromagnetic tomography-ICA (eLORETA-ICA) to resting-state EEG data in 80 healthy subjects using five frequency bands (delta, theta, alpha, beta and gamma band) and found five RS-independent-Ns in alpha, beta and gamma frequency bands. Next, taking into account previous neuroimaging findings, five RS-independent-Ns were identified: (1) the visual network in alpha frequency band, (2) dual-process of visual perception network, characterized by a negative correlation between the right ventral visual pathway (VVP) in alpha and beta frequency bands and left posterior dorsal visual pathway (DVP) in alpha frequency band, (3) self-referential processing network, characterized by a negative correlation between the medial prefrontal cortex (mPFC) in beta frequency band and right temporoparietal junction (TPJ) in alpha frequency band, (4) dual-process of memory perception network, functionally related to a negative correlation between the left VVP and the precuneus in alpha frequency band; and (5) sensorimotor network in beta and gamma frequency bands. We selected eLORETA-ICA which has many advantages over the other network visualization methods and overall findings indicate that eLORETA-ICA with EEG data can identify five RS-independent-Ns in their intrinsic frequency bands, and correct correlations within RS-independent-Ns. [ABSTRACT FROM AUTHOR]

Exact low-resolution brain electromagnetic tomography (eLORETA) is a technique for three-dimensional representation of the distribution of sources of electrical activity in the brain. Kurtosis analysis allows for identification of spiky activity in the brain. To evaluate the reliability of eLORETA kurtosis analysis, the results of the analysis were compared with those of equivalent current dipole (ECD) and synthetic aperture magnetometry (SAM) kurtosis analysis of magnetoencephalography (MEG) data in a patient with epilepsy with elementary visual seizures in a 6-year follow-up. The results of electroencephalography (EEG) eLORETA kurtosis analysis indicative of a right superior temporal spike source partially overlapped with MEG ECD/SAM kurtosis results in all recordings, with a total overlapping at the end of the follow-up period. Overall findings suggest that eLORETA kurtosis analysis of EEG data may aid in the localisation of spike activity sources in patients with epilepsy. [ABSTRACT FROM AUTHOR]

Frontal midline theta rhythm (Fmϴ) appears widely distributed over medial prefrontal areas in EEG recordings, indicating focused attention. Although mental calculation is often used as an attention-demanding task, little has been reported on calculation-related activation in Fmϴ experiments. In this study we used spatially filtered MEG and permutation analysis to precisely localize cortical generators of the magnetic counterpart of Fmϴ, as well as other sources of oscillatory activity associated with mental calculation processing (i.e., arithmetic subtraction). Our results confirmed and extended earlier EEG/MEG studies indicating that Fmϴ during mental calculation is generated in the dorsal anterior cingulate and adjacent medial prefrontal cortex. Mental subtraction was also associated with gamma event-related synchronization, as an index of activation, in right parietal regions subserving basic numerical processing and number-based spatial attention. Gamma eventrelated desynchronization appeared in the right lateral prefrontal cortex, likely representing a mechanism to interrupt neural activity that can interfere with the ongoing cognitive task. [ABSTRACT FROM AUTHOR]

Frontal midline theta rhythm (Fmθ) appears widely distributed over medial prefrontal areas in EEG recordings, indicating focused attention. Although mental calculation is often used as an attention-demanding task, little has been reported on calculation-related activation in Fmθ experiments. In this study we used spatially filtered MEG and permutation analysis to precisely localize cortical generators of the magnetic counterpart of Fmθ, as well as other sources of oscillatory activity associated with mental calculation processing (i.e., arithmetic subtraction). Our results confirmed and extended earlier EEG/MEG studies indicating that Fmθ during mental calculation is generated in the dorsal anterior cingulate and adjacent medial prefrontal cortex. Mental subtraction was also associated with gamma event-related synchronization, as an index of activation, in right parietal regions subserving basic numerical processing and number-based spatial attention. Gamma event-related desynchronization appeared in the right lateral prefrontal cortex, likely representing a mechanism to interrupt neural activity that can interfere with the ongoing cognitive task. [ABSTRACT FROM AUTHOR]

The posterior EEG alpha rhythm is a distinctive feature of the normal brain in the waking state, consisting of oscillations within the 8-15 Hz frequency range over posterior cortical regions. This activity appears in resting, eyes-closed condition and is typically suppressed by eyes-opening. Other physiological rhythms in the alpha band, in particular the Rolandic mu rhythm, are proposed to include a fast component in the beta range. In this study we used spatial filtering techniques and permutation analysis to explore cortical source-power changes related to the magnetoencephalography (MEG) counterpart of the posterior alpha rhythm. We also aimed at determining a possible implication of components outside the alpha frequency range in the posterior rhythm reactivity to eye closure. We recorded resting brain activity using a whole-head MEG system in fifteen normal subjects. We applied an eyes-open! eyes-closed paradigm. A significant increase in alpha oscillations after eyes closing, representing the posterior alpha rhythm, was observed bilaterally in the occipital and parietal cortex, 'including the calcarine fissure and the parieto-occipital stilcus. We also found signifi- cant increase in beta (15-30 Hz) and low gamma (30-60 Hz) oscillations. This fast components and the classical alpha rhythm had similar topographic distribution in posterior brain regions, although with different strength and spatial extension. These features were highest for alpha synchronized oscillations, intermediate for beta, and lowest for gamma activity. These results suggest that, like the Rolandic mu rhythm, the MEG posterior dominant rhythm may be impure, with a mixture of predominant alpha oscillations and high-frequency components. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the potentiality of atelocollagen, a new embolic agent which is collagen type I in a porcine experimental model., Materials and Methods: Three pigs underwent transcatheter embolization of lower interlobular arteries of the renal artery (n=6) and one branch of the hepatic artery (n=3) with collagen type I. Angiography was performed prearterial, during, and postarterial embolization. After the procedure, samples from the embolized organs were evaluated by histological analysis., Results: Six lower interlobular renal arteries and three hepatic arteries were successfully embolized by administration of 0.8±0.3 mL and 2.9±1.2 mL, respectively, of the collagen type I. Histological findings of the embolized kidney specimens showed that the collagenous materials filled the arterial lumen, whose size ranged from 2.02 to 839.82 μm and reached the level of afferent arteries of glomerular tufts. Although the area of occluded arteries of the liver was smaller than the kidney, histological findings of the liver specimens showed that the collagenous materials filled small arterial lumens from 2.81 to 187.86 μm in diameter., Conclusion: Atelocollagen, a collagen type I, has the potential to be used to embolize the distal vessels of both renal and hepatic arteries.