Search

Changes in the structure and function of dendritic spines contribute to numerous physiological processes such as synaptic transmission and plasticity, as well as behavior, including learning and memory. Moreover, altered dendritic spine morphogenesis and plasticity is an endophenotype of many neurodevelopmental and neuropsychiatric disorders. Hence, the molecular mechanisms that control spine plasticity and pathology have been under intense investigation over the past few years. A series of recent studies has improved our understanding of spine dynamics by establishing kalirin-7 as an important regulator of dendritic spine development as well as structural and functional plasticity, providing a model for the molecular control of structural plasticity and implicating kalirin-7 in synaptic pathology in several disorders including schizophrenia and Alzheimer's disease.

Byline: N. Miyakoshi (1), E. Itoi (1), M. Kobayashi (1), H. Kodama (2) Keywords: Osteoporosis; Postural deformity; Quality of life; Spinal mobility Abstract: The objective of the study was to evaluate the impact of postural deformities and spinal mobility on quality of life (QOL) in patients with spinal osteoporosis. A total of 157 postmenopausal women aged over 60 years with osteoporosis were divided into five groups according to their postural deformities: round back (RB, n=41), hollow round back (HRB, n=33), whole kyphosis (WK, n=40), lower acute kyphosis (LAK, n=18), and normal posture (NP, n=25). QOL was evaluated using the Japanese Osteoporosis QOL Questionnaire (JOQOL) proposed by the Japanese Society for Bone and Mineral Research. This questionnaire contains six domains, with higher scores indicating higher levels of QOL. The number of vertebral fractures, thoracic kyphosis and lumbar lordosis angles, and spinal range of motion (ROM) during maximum flexion and extension were also measured with radiographs. Total QOL scores in RB, HRB, WK, and LAK groups were significantly lower than those in the NP group, and those in WK group were even lower compared with the other groups (P&lt 0.05). All the groups with postural deformities, but not the NP group, showed significant positive correlations between total QOL score and spinal ROM (0.521a$?ra$?0.747, P&lt 0.05). Total QOL score showed a significant correlation with age, number of vertebral fractures, lumbar lordosis angle, and spinal ROM in a total of 157 patients. However, multiple regression analysis revealed that spinal ROM best correlated with total QOL score. We concluded that QOL in patients with osteoporosis was impaired by postural deformities, especially by whole kyphosis, and that spinal mobility has a strong effect on QOL in these patients. Author Affiliation: (1) Department of Orthopedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, 010-8543, Akita, Japan (2) South Akita Orthopedic Clinic, Akita, Japan Article History: Received Date: 02/02/2003 Accepted Date: 29/08/2003 Online Date: 14/10/2003

Byline: Andrea Giorgetti (1), Maria Vittoria Calloni (1), Roberto Freschi (1), Giuseppe Mariani (1), Patrizia Perrone (1), Patrizia Secchi (1), Adriana Sermoni (1) Keywords: Key words Cerebral venous thrombosis; Lumbar puncture; Headache Abstract: The present case report underlies the importance of modifications in the characteristics of post-lumbar puncture headache, which led us to diagnose cerebral venous thrombosis in a 34-year-old woman affected by multiple sclerosis. The patient underwent a lumbar puncture for diagnostic purposes and successively was treated with megadoses of methylprednisolone (1 g intravenously for 6 days). After lumbar puncture, the patient developed an orthostatic headache sue to cerebrospinal fluid (CSF) hypotension. Eight days later, and two days after finishing the cycle of methylprednisolone, the headache worsened, became diffuse and persisting, and was longer modified by postural changes. This was associated with psychomotor slowing and, the day after, a partial epileptic status. Magnetic resonance imaging showed an alteration in the signal corresponding to the sagittal superior, transverse and sigmoid sinuses, indicative of venous thrombosis. The potential role of lumbar puncture, steroid treatment and other associated risk factors, and the importance of considering modifications in post-puncture headache as a condition which needs specific neuroradiological examinations are discussed. Author Affiliation: (1) Neurology Department, Civil Hospital of Legnano, Via Candiani 2, I-20025 Legnano (MI), Italy, e-mail: neurologia@ao-legnano.it, Tel.: +39-0331-449551, Fax: +39-0331-449558, IT Article note: Received: 19 October 2000 / Accepted in revised form: 9 January 2001

Byline: J. Adelson-Mitty (1), M. P. Fink (1), A. Lisbon (1) Keywords: Key words Lumbar puncture; Surgical intensive care unit; Meningitis; Cerebrospinal fluid; Cardiac surgery; General surgery Abstract: Objective: To evaluate the diagnostic value of lumbar puncture (LP) in surgical intensive care unit (SICU) patients. Design: Retrospective chart review. Setting: Surgical intensive care unit at a major tertiary care medical center. Patients: All patients admitted to the SICU during the period 1987--1995 who had a lumbar puncture, excluding those with a history of recent head trauma or a neurosurgical procedure. Measurements: Cerebral spinal fluid (CSF) results, indication for lumbar puncture, admitting service, length of ICU stay, presence of fever and use of antibiotics. Results: Of 7,555 admissions to the SICU over the period 1987--1995, 204 patients underwent LP during the hospital admission. Four charts could not be located and 75 patients underwent LP in locations other than the SICU. Of the remaining 125 cases, 55 carried a neurosurgical diagnosis and 70 had non-neurosurgical problems. Fifty-three (75 %) of the patients had received antibiotics prior to the procedure. Among the 70 cases without a primary neurosurgical diagnosis, LP was performed to rule out infective meningitis suggested by fever and mental status changes (30 patients), mental status changes alone (7 patients), systemic illness with fever and/or mental status changes (10 patients), seizures (10 patients), meningismus (+/- fever, 4 patients), or a combination of neurological findings (8 patients). There were no cases in which meningitis was positively diagnosed. Medical management was altered in only two patients based upon the results obtained by LP. Conclusions: We conclude that LP in SICU patients without a recent history of head trauma or a neurosurgical operation is a low yield procedure, especially for the diagnosis of bacterial meningitis. Author Affiliation: (1) Department of Anesthesia, Beth Israel Hospital, 330 Brookline Avenue, Boston, MA 02215, USA FAX: +1 (617) 667 5013 e-mail: alisbon@bih.harvard.edu, IL Article note: Received: 10 September 1996 Accepted: 6 May 1997

Byline: N. Morelli (1,2), S. Gallerini (1), S. Gori (1), A. Chiti (1), M. Cosottini (1), G. Orlandi (1), L. Murri (1) Keywords: Chiropractic; Intracranial hypotension syndrome; Headache Abstract: Cervical spine manipulation has been associated with several disorders such as cervical arteries dissection, but rarely has a relationship with intracranial hypotension been reported. We describe a patient showing intracranial hypotension syndrome following chiropractic cervical spine treatment. Magnetic resonance showed the presence of dural leakage at cervical level, suggesting the pathogenesis of the syndrome. We state that cervical spine manipulation should be considered a treatment with risk of neurological complications, including the occurrence of intracranial hypotension. Author Affiliation: (1) University Centre for Adaptive Disorders and Headache (UCADH), Section of Pisa I - Institute of Neurology, Department of Neurosciences, University of Pisa, Via Roma 67, I-56126, Pisa, Italy (2) Department of Neuroscience, Institute of Neurology, Via Roma 67, I-56126, Pisa, Italy Article History: Registration Date: 01/01/2006 Received Date: 28/04/2006 Accepted Date: 01/06/2006 Online Date: 11/08/2006

Background. One area of research that requires further elaboration is the relationship between impairments and functional limitations. By identifying specific contributors to functional limitations, it may be possible to establish intervention strategies, including exercise approaches, that can delay or ameliorate decline in function. The association between impaired spinal flexibility and functional limitations has not been studied in depth. The purposes of this study were to determine (a) the associations between spinal flexibility and functional limitations; (b) the relative contribution of spinal flexibility to specific functional limitations; and (c) how disease state (Parkinson's disease [PD] vs no PD) modified these relationships. Methods. Participants included 251 community-dwelling adults, 56 of whom were with diagnosed PD and 195 were without PD or other specific disorders. Measures included spinal flexibility (i.e., functional axial rotation [FAR]) and configuration (i.e., thoracic kyphosis and lumbar lordosis), functional limitations (i.e., functional reach, supine-to-stand time, 10-m walk, and 360 [degrees] turn). Results. Canonical correlation (Can R) demonstrated significant associations between spinal measures and functional limitations (Can R = .488, p = .0001). After controlling for age, gender, race, body mass index, comorbidity, confidence, and depression, a multivariate regression model demonstrated that spinal flexibility contributed significantly to functional reach ([R.sup.2] = .334 for the overall model, p = .000l). Based on the parameter estimate of 0.026, the results predict that FAR accounts for a 4.6-inch difference in reach distance between the least and most flexible of the participants. In addition, there were significant differences between almost all measurements for the PD compared with the non-PD participants. Conclusion. Results clearly implicate spinal flexibility as a contributor to functional reach, a measure of functional limitation and an established measure of balance control. Further work is needed to determine the extent to which spinal flexibility can be improved and the effect of that improvement on balance.

In the early 1990s, spine specialists began to perform fluoroscopically guided structure-specific injections in patients who have known focal spine pathology and corroborative clinical presentations that have possible biochemical mechanisms [...]