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No diagnostic or predictive instruments to help with early diagnosis and timely therapeutic intervention are available as yet for most neuro-psychiatric disorders. A quantum potential mean and variability score (qpmvs), to identify neuropsychiatric and neurocognitive disorders with high accuracy, based on routine EEG recordings, was developed. Information processing in the brain is assumed to involve integration of neuronal activity in various areas of the brain. Thus, the presumed quantum-like structure allows quantification of connectivity as a function of space and time (locality) as well as of instantaneous quantum-like effects in information space (non-locality). EEG signals reflect the holistic (nonseparable) function of the brain, including the highly ordered hierarchy of the brain, expressed by the quantum potential according to Bohmian mechanics, combined with dendrogram representation of data and p-adic numbers. Participants consisted of 230 participants including 28 with major depression, 42 with schizophrenia, 65 with cognitive impairment, and 95 controls. Routine EEG recordings were used for the calculation of qpmvs based on ultrametric analyses, closely coupled with p-adic numbers and quantum theory. Based on area under the curve, high accuracy was obtained in separating healthy controls from those diagnosed with schizophrenia (p

Early-onset Alzheimer's disease (EOAD) accounts for 1-5% of Alzheimer's disease cases and is associated with specific ethnicities. It has been our impression that non-Ashkenazi Jews have a higher rate of EOAD and we therefore explored this hypothesis. We performed a retrospective case control study of EOAD cases referred to our cognitive neurology clinic between January 1999 and December 2016. Patients (n = 129) were compared to age- and geographically-matched controls generated from the Second Israeli National Health Survey (n = 1,811). Data on country of origin, education, dementia family history, depression, and vascular risk factors were compared between the groups. The association of non-Ashkenazi Jewish heritage and country of origin with EOAD was calculated using a logistic multivariate regression model. The EOAD group's mean age was 59.6±4.1 years, with a female predominance (64.3%). The EOAD group had a higher percentage of individuals of non-Ashkenazi Jewish origin (64.3% versus 51.4%, p = 0.003) and of Yemenite descent in particular (16.28% versus 6.24%, p < 0.001). On multiple logistic regression analysis, Yemenite Jewish origin was an independently associated with EOAD (OR 2.54, 95% CI 1.4-4.8). There were no significant differences in parameters between non-Ashkenazi and Ashkenazi Jews. Only 4.6% of EOAD cases had a positive EOAD family history. In conclusion, EOAD is over-represented among non-Ashkenazi Jews. Yemenite origin is independently associated with EOAD and the majority of patients with EOAD have no family history of Alzheimer's disease. Further evaluation with genetic studies is warranted.

A growing body of evidence shows that epileptic activity is frequent but often undiagnosed in patients with Alzheimer's disease (AD) and has major therapeutic implications. Here, we analyzed electroencephalogram (EEG) data from patients with AD and found an EEG signature of transient slowing of the cortical network that we termed paroxysmal slow wave events (PSWEs). The occurrence per minute of the PSWEs was correlated with level of cognitive impairment. Interictal (between seizures) PSWEs were also found in patients with epilepsy, localized to cortical regions displaying blood-brain barrier (BBB) dysfunction, and in three rodent models with BBB pathology: aged mice, young 5x familial AD model, and status epilepticus-induced epilepsy in young rats. To investigate the potential causative role of BBB dysfunction in network modifications underlying PSWEs, we infused the serum protein albumin directly into the cerebral ventricles of naive young rats. Infusion of albumin, but not artificial cerebrospinal fluid control, resulted in high incidence of PSWEs. Our results identify PSWEs as an EEG manifestation of nonconvulsive seizures in patients with AD and suggest BBB pathology as an underlying mechanism and as a promising therapeutic target.

BACKGROUND AND PURPOSE Intracranial hypertension develops in only some patients with lateral sinus thrombosis (LST), for reasons that are unclear. The purpose of this study was to evaluate a possible association between patency of the unaffected sinus and clinical presentation of unilateral LST. METHODS A computerized search identified patients with LST, hospitalized in Soroka Medical Center. Patients with signs of increased intracranial pressure (iICP) and those with normal intracranial pressure (nICP) were compared. CT venography or MR venography confirmed the diagnosis, located the thrombosis, and determined the dominant lateral sinus (LS). Diameters of the right and left LSs (the occluded and unaffected) were compared to the diameter of the distal superior sagittal sinus (SSS). RESULTS Of the 50 patients identified, 30 had iICP and 20 nICP. The dominant LS was the right one in 39 (78%) and the left one in 8 (16%); 3 (6%) had equal LS dominance. The dominant sinus was affected in 32 (70%) and the non-dominant in 15 (30%) patients. iICP was detected in 28/32 (81%) of patients with the dominant side affected, and 3/15 (20%) of those with non-dominant thrombotic sinus (P = .002). The unaffected sinus was narrower in iICP patients (size relative to SSS diameter = 43% in iICP vs. 86% in nICP [P = .0002]; size grading, according to Farb's method was 1.86 in the iICP vs. 3.57 in the nICP group [P = .0001]). CONCLUSIONS Thrombosis was more common in the dominant LS. Unaffected LS patency appears to be associated with the development of increased ICP.

Essential tremor (ET) is much more prevalent than Parkinson's disease (PD) in Western countries. We estimated ET and PD prevalence in Wadi Ara Arabic villages in Northern Israel. In this door-to-door survey, all consenting residents aged >or=65 years were systematically examined by an Arabic speaking team. No prescreening questionnaires were used. A random sample of 900 subjects [437 males, mean age (SD) = 72.6 years (6.6)] of the 2,163 eligible residents were evaluated. Sixteen subjects had an action, intentional tremor. Tremor prevalence was estimated as 1.78% (95% CI 1.1-2.87). Nine of these had another likely cause of tremor. Only 7 patients were diagnosed as ET [prevalence 0.78% (95% CI 0.38-1.6)]. PD was diagnosed in 13 subjects. PD prevalence was 1.44% (95% CI 0.84-2.45). ET is unusually uncommon in this population and possibly even less frequent than PD. The PD prevalence in Wadi Ara is similar to that reported in Western countries.

Benign hereditary chorea (BHC) is a rare autosomal dominant nonprogressive movement disorder. In some cases the phenotype includes, besides choreoathetosis, thyroid dysfunction and pulmonary infections in infancy, as expressed by the name "Brain-Thyroid-Lung syndrome". Mutations in the thyroid transcription factor-1 (TITF-1) gene have been identified in some BHC families. We present the phenotypic features of a family with chorea, hypothyroidism, and lung dysfunction. All affected individuals suffered from a nonprogressive chorea with infancy onset. All showed short stature and some webbed neck. One patient suffered from psychosis at the age of 27 years another from lung carcinoma. In all affected individuals, a novel mutation consisting of heterozygous C to A substitution at position 650 of the coding sequence of the TITF-1 gene, exon 3 was detected, leading to a premature stop at codon 217 (S217X). We describe the unique phenotypic features and intrafamilial variability expressing this novel mutation.

Intracranial hypertension develops in only some patients with lateral sinus thrombosis (LST), for reasons that are unclear. The purpose of this study was to evaluate a possible association between patency of the unaffected sinus and clinical presentation of unilateral LST.A computerized search identified patients with LST, hospitalized in Soroka Medical Center. Patients with signs of increased intracranial pressure (iICP) and those with normal intracranial pressure (nICP) were compared. CT venography or MR venography confirmed the diagnosis, located the thrombosis, and determined the dominant lateral sinus (LS). Diameters of the right and left LSs (the occluded and unaffected) were compared to the diameter of the distal superior sagittal sinus (SSS).Of the 50 patients identified, 30 had iICP and 20 nICP. The dominant LS was the right one in 39 (78%) and the left one in 8 (16%); 3 (6%) had equal LS dominance. The dominant sinus was affected in 32 (70%) and the non-dominant in 15 (30%) patients. iICP was detected in 28/32 (81%) of patients with the dominant side affected, and 3/15 (20%) of those with non-dominant thrombotic sinus (P = .002). The unaffected sinus was narrower in iICP patients (size relative to SSS diameter = 43% in iICP vs. 86% in nICP [P = .0002]; size grading, according to Farb's method was 1.86 in the iICP vs. 3.57 in the nICP group [P = .0001]).Thrombosis was more common in the dominant LS. Unaffected LS patency appears to be associated with the development of increased ICP.

Friedreich ataxia is an inherited disorder characterized by degeneration of the peripheral and central nervous system and hypertrophic cardiomyopathy. Homozygous mutations in the frataxine (FXN) gene reduce expression of frataxin and cause accumulation of iron in the mitochondria. Deferiprone, an oral iron chelator, has been shown effective in cell and animal models of Friedreich ataxia. The results of a 6-month randomized, double blind placebo-controlled study suggested that deferiprone 20 mg/kg/day may reduce disease progression. The authors present their experience of 5 Friedreich ataxia patients treated with deferiprone (20 mg/kg/day), in addition to idebenone treatment, followed over a period of 10-24 months, under off-label authorization. The patients were monitored for laboratory parameters, cardiac assessment, neurological evaluations, and quality of life. The authors conclude that combined therapy of a low dose of deferiprone with idebenone is relatively safe, might improve neurological function, and seems to improve heart hypertrophy, warranting further studies.

T cells are an important part of the acquired immune response and target specific antigen with their T cell receptor. The peritoneum is a special milieu within which T cells react. We describe briefly the anatomy important for T cell function. T cell biology including antigen presentation, T cell activation, and the different T cell subpopulations are reviewed. We also define innate and acquired immunity and describe the role of polymorphonuclear cells and peritoneal mesothelial cells in the regulation of leukocyte population recruitment during peritonitis. We focus particularly on peritoneal lymphocytes and compare them to the regular lymphocyte populations in the circulation. We illustrate the role of PMCs in antigen presentation and discuss the changes of CD4+ helper T cell subtypes (Th1 and Th2) during peritoneal dialysis. The role of CD8+ cytotoxic T lymphocytes and their possible destructive role for the peritoneal membrane modified by advanced glycation end products are discussed. Polymorphonuclear cells play an important role in the regulation of inflammation and immunity. We describe their possible role in supporting T cells and particularly for generating memory CD8+ T cells by secretion of interleukin-15, a potent T cell growth factor. Light is shed on γδ T cells, a special T cell population that is able to recognize antigens without the restriction of antigen presentation. We end our review with a description of regulatory T cells. This cell population is extremely important in preventing autoimmunity and in the regulation of acquired immunity.

Background CD40 belongs to the tumor necrosis factor receptor family and its ligation is a central event in major inflammatory and immune reactions. We have previously demonstrated that CD40 ligation upregulates the secretion of mononuclear chemokines from peritoneal mesothelial cells (PMC), and that blocking the CD40 ligand (CD154) reduced the mononuclear infiltrate in a model of peritonitis. Objective To characterize the kinetics of CD154 expression on peritoneal leukocytes and examine the correlation of this occurrence with the mononuclear transition at the resolution phase of peritonitis. Methods Leukocytes were collected from the effluent of 11 patients during episodes of peritonitis while undergoing peritoneal dialysis (PD). The effluent was then analyzed by flow cytometry to characterize CD154 expression. Results CD154 expression on peritoneal mononuclear cells gradually increased during the resolution phase of peritonitis, peaking first on T cells (CD4+ and CD8+ cells at 20 – 45 hours) and then on macrophages (CD14+ at 20 – 50 hours). The maximal expression of CD154 on macrophages, CD4+ cells, and CD8+ cells during peak hours reached values of 33% ± 23%, 4% ± 3%, and 24% ± 17%, respectively. The increase in CD154 expression was in negative correlation ( r=–0.44, p = 0.032) with total leukocyte numbers and in positive correlation ( r = 0.52, p = 0.009) with the increase of mononuclear cells. Deterioration of peritonitis was associated with a decrease in CD154 levels, while recurrence of peritonitis was related to high CD154 levels. Conclusion Our data, which show a positive correlation between CD154 levels and mononuclear dominance, suggest that CD40–CD154 ligation plays an important role in the transition to mononuclear predominance in the late phase of peritonitis.