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Background: Outcomes from neuro-behavioural wards can be overlooked due to the complex and varied presentations and difficulty in establishing the ingredients contributing to functional improvements. Methods: A service evaluation was conducted on an adult Neuro-behavioural Rehabilitation Unit (NRU) at the Royal Hospital for Neuro-disability (RHN) (2015-2022). Primary aims were to examine demographic characteristics and assess the functional benefits of admission to a setting that utilises a positive behaviour support (PBS) approach as indicated by the Functional Independence Measure and Functional Assessment Measure (FIM+FAM) and Swansea Neurobehavioural Outcome Scale (SASNOS) scores. Results: The FIM+FAMs of 53 patients (38% female; mean age 44) were included. The majority of patients were White British (60%). Most patients were admitted to the NRU following a traumatic brain injury (TBI; 41%), and admission was, on average, seven months after their injury. The results show that the mean FIM+FAM score revealed significant statistical improvement from admission to discharge. Improvement is also seen in all domains and almost all sub-domains of the SASNOS. Conclusion: The findings support an association between admission to a neuro-behavioural rehabilitation setting providing PBS and improvements over time. Careful selection of outcome measures and consistent completion is necessary to support successful funding applications for neuro-behavioural rehabilitation services. [ABSTRACT FROM AUTHOR]

Introduction: Palatable foods have potent reinforcing effects that are mediated, partly, by an abrupt augmentation of dopaminergic neurotransmitters in the brain’s reward pathways. Food addiction to highly palatable foods contributes to the increasing prevalence of obesity. Aim: To evaluate the effect of food addiction on neurobehavioural parameters and the Behavioral Satiety Sequence (BSS) during restriction to a highly palatable diet in a food addiction rat model. Materials and Methods: The experimental study was conducted in the Pharmacology Department at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India from April 2018 to January 2019. The study included six animals out of 28 female Sprague Dawley rats aged approximately 10 weeks and weighing 180-220 g were allocated to the control group and were fed a Standard Chow diet (SC) throughout the study. Twenty-two animals (induction group) were exposed to free choice between SC and a highly palatable Cafeteria Diet (CD), a mix of equal amounts of Bounty®, Snickers®, Mars®, and Milka® chocolate made into homogenous food pellets. After six weeks, 12 animals were randomly selected to have restricted access to the CD diet with free access to SC, while the rest continued to receive a free choice between the two diets for two weeks. Central Nervous System (CNS) parameters, BSS, 24-hour food intake, and body weight were recorded. Results: A significant decrease of 25.4 seconds (18.27%) in the mean time the CD restricted group stayed on the rotarod (113.6±8.31) seconds. and a reduced locomotor activity score of 46.92 (20.94%) in the CD access group in the actophotometer (177.08±5.29) compared to SC was noted. In the open field test, the CD restricted group demonstrated a 47.33% increase in grooming (12.0±1.11) and a 30% lower number of central squares crossed (2.80±0.57). In the Elevated Plus Maze (EPM), the time spent in the open arm (15.00±8.10) was statistically lower (p=0.045). No statistically significant difference between groups was recorded in the forced swim or tail suspension tests. Disruption of the BSS in varying dimensions was apparent in both CD groups. Conclusion: The study has shown that anxiety and altered feeding behaviour were evident in the CD restricted rats in the food addiction model.

Antioxidant-rich supplementation plays an essential role in the function of mammals’ central nervous system. However, no research has documented the effect of berberine (BER) supplementation on the cerebrocerebellar function of prepubertal rats. The present study was designed to investigate the impact of BER supplementation on neurochemical and behavioural changes in prepubertal male rats. Five groups (90 ± 5 g, n = 7 each) of experimental rats were orally treated with corn oil or different doses of BER (25, 50, 100, and 200 mg/kg bw) from the 28th at 68 post-natal days. On the 69 days of life, animals underwent behavioural assessment in the open field, hanging wire, and negative geotaxis tests. The result revealed that BER administration improved locomotive and motor behaviour by increasing distance travelled, line crossings, average speed, time mobile, and absolute turn angle in open field test and decrease in time to re-orient on an incline plane, a decrease in immobility time relative to the untreated control. Furthermore, BER supplementation increased (p < 0.05) antioxidant enzyme activities such as SOD, CAT, GPx, GSH, and TSH and prevented increases (p < 0.05) in oxidative and inflammatory levels as indicated by decreases in RONS, LPO, XO, carbonyl protein, NO, MPO, and TNF-α compared to the untreated control. BER-treated animals a lessened number of dark-stained Nissl cells compared to the untreated control rats. Our findings revealed that BER minimised neuronal degeneration and lesions, improved animal behaviour, and suppressed oxidative and inflammatory mediators, which may probably occur through its agonistic effect on PPAR-α, PPAR-δ, and PPAR-γ – essential proteins known to resolve inflammation and modulate redox signalling towards antioxidant function. [ABSTRACT FROM AUTHOR]

Introduction: Palatable foods have potent reinforcing effects that are mediated, partly, by an abrupt augmentation of dopaminergic neurotransmitters in the brain’s reward pathways. Food addiction to highly palatable foods contributes to the increasing prevalence of obesity. Aim: To evaluate the effect of food addiction on neurobehavioural parameters and the Behavioral Satiety Sequence (BSS) during restriction to a highly palatable diet in a food addiction rat model. Materials and Methods: The experimental study was conducted in the Pharmacology Department at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India from April 2018 to January 2019. The study included six animals out of 28 female Sprague Dawley rats aged approximately 10 weeks and weighing 180-220 g were allocated to the control group and were fed a Standard Chow diet (SC) throughout the study. Twenty-two animals (induction group) were exposed to free choice between SC and a highly palatable Cafeteria Diet (CD), a mix of equal amounts of Bounty®, Snickers®, Mars®, and Milka® chocolate made into homogenous food pellets. After six weeks, 12 animals were randomly selected to have restricted access to the CD diet with free access to SC, while the rest continued to receive a free choice between the two diets for two weeks. Central Nervous System (CNS) parameters, BSS, 24-hour food intake, and body weight were recorded. Results: A significant decrease of 25.4 seconds (18.27%) in the mean time the CD restricted group stayed on the rotarod (113.6±8.31) seconds. and a reduced locomotor activity score of 46.92 (20.94%) in the CD access group in the actophotometer (177.08±5.29) compared to SC was noted. In the open field test, the CD restricted group demonstrated a 47.33% increase in grooming (12.0±1.11) and a 30% lower number of central squares crossed (2.80±0.57). In the Elevated Plus Maze (EPM), the time spent in the open arm (15.00±8.10) was statistically lower (p=0.045). No statistically significant difference between groups was recorded in the forced swim or tail suspension tests. Disruption of the BSS in varying dimensions was apparent in both CD groups. Conclusion: The study has shown that anxiety and altered feeding behaviour were evident in the CD restricted rats in the food addiction model. [ABSTRACT FROM AUTHOR]

Background: Understanding the specific neurobehavioural profile of rare genetic diseases enables clinicians to provide the best possible care for patients and families, including prognostic and treatment advisement. Previous studies suggested that a subset of individuals with Kabuki syndrome (KS), a genetic disorder causing intellectual disability and other neurodevelopmental phenotypes, have attentional deficits. However, these studies looked at relatively small numbers of molecularly confirmed cases and often used retrospective clinical data instead of standardised assessments. Methods: Fifty‐five individuals or caregivers of individuals with molecularly confirmed KS completed assessments to investigate behaviour and adaptive function. Additionally, information was collected on 23 unaffected biological siblings as controls. Results: Attention Problems in children was the only behavioural category that, when averaged, was clinically significant, with the individual scores of nearly 50% of the children with KS falling in the problematic range. Children with KS scored significantly higher than their unaffected sibling on nearly all behavioural categories. A significant correlation was found between Attention Problems scores and adaptive function scores (P = 0.032), which was not explained by lower general cognitive ability. Conclusions: We found that the rates of children with attentional deficits are much more elevated than would be expected in the general population, and that attention challenges are negatively correlated with adaptive function. When averaged across KS participants, none of the behavioural categories were in the clinically significant range except Attention Problems for children, which underscores the importance of clinicians screening for attention deficit hyperactivity disorder (ADHD) in children with KS. [ABSTRACT FROM AUTHOR]

In those who survive tuberculous meningitis (TBM), the long-term outcome is uncertain; individuals may suffer neurocognitive, functional and psychiatric impairment, which may significantly affect their ability to lead their lives as they did prior to their diagnosis of TBM. In children who survive, severe illness has occurred at a crucial timepoint in their development, which can lead to behavioural and cognitive delay. The extent and nature of this impairment is poorly understood, particularly in adults. This is in part due to a lack of observational studies in this area but also inconsistent inclusion of outcome measures which can quantify these deficits in clinical studies. This leads to a paucity of appropriate rehabilitative therapies available for these individuals and their caregivers, as well as burden at a socioeconomic level. In this review, we discuss what is known about neurocognitive impairment in TBM, draw on lessons learnt from other neurological infections and discuss currently available and emerging tools to evaluate function and cognition and their value in TBM. We make recommendations on which measures should be used at what timepoints to assess for impairment, with a view to optimising and standardising assessment of neurocognitive and functional impairment in TBM research.

Caralluma dalzielii (Asclepiadiaceae) is a shrub used in folkloric medicine to treat epilepsy, pain and infertility in sub-Saharan Africa. Previous studies demonstrated its analgesic, antiulcer, anticonvulsant, and anti-inflammatory activities. This study aimed to determine the neurobehavioural properties of Caralluma dalzielii aqueous aerial parts extract (CDAE) in mice using standard experimental models. Neurobehavioural activities of CDAE were evaluated (100, 200, and 400 mg/kg) in Swiss Albino mice using the beam walk, staircase, hole board, object recognition, open field assay, Y-maze and forced swimming tests. Phytochemical constituents were analysed using GC-MS. CDAE significantly increased the mean number of head dips, recognition index and spontaneous alternation in hole board (14.03 at 400 mg/kg and 6.01 in distilled water group; p < 0.05), object recognition (68.16% at 400 mg/kg compared with 51.66% of distilled water group) and Y maze (9.16 at 400 mg/kg as against 4.66 of distilled water group; p < 0.05) tests respectively. It decreased the rearing counts as well as the peripheral and central square crossing in the staircase (4.2 at 400 mg/kg as against 7.87 of the distilled water group; p < 0.05) and open field tests (central, 0.81; peripheral, 1.66 at 400 mg/kg as against central, 5.23; peripheral 11.83 of the distilled water control group; p < 0.05), respectively. There were no significant effects on beam walk assays and forced swim tests. The GC-MS analysis identified a hundred compounds in CDAE. Some compounds which have been reported to possess neurobehavioural activity that were identified include 3,5-Dimethylpyrazole, 2-Amino-5-methylbenzoic acid, Acetophenone, and Tetrahydropyran. CDAE demonstrated anxiolytic, anti-hyperactivity, and memory-improving effects in mice. The extract may possess GABAergic and glutamatergic properties. More studies are needed to confirm this. Isolation of the bioactive compounds is currently ongoing to unravel the bioactive constituents present in C. dalzielii extract. [Display omitted] • Caralluma dalzielii extract increases the number of head dips in Hole Board test. • It reduces the number of central and peripheral crosses in the open-field test. • It increases the object recognition index in mice. • It induces anxiolytic, anti-hyperactivity, and memory-improving effects. • It contains bioactive compounds which may be implicated in the activities observed. [ABSTRACT FROM AUTHOR]

Objective: To synthesise the current best evidence on both pharmacological and non-pharmacological behaviour management interventions for adult patients in the acute hospital setting with traumatic brain injury (TBI) or post-traumatic amnesia (PTA). Data Sources: A comprehensive search of 10 electronic databases was completed. Study Selection: Systematic reviews (SRs) published in English before September 2018 were included. Initial search resulted in 4604 citations, 2916 for title and abstract screening with duplicates removed, and 2909 articles failed to meet the inclusion criteria leaving seven reviews for inclusion. Five reporting pharmacological management approaches, two reporting non-pharmacological management approaches, and one reporting both pharmacological and non-pharmacological management approaches. Data Extraction: Methodological quality was assessed independently by two reviewers using the Critical Appraisal Skills Programme Tool for SRs. Data were extracted from the studies based on the recommendations of the Joanna Briggs Institute (JBI) Methodology for JBI Umbrella Reviews. Data Synthesis: The SRs were of low-to-moderate quality overall. High-quality SRs were characterised by low numbers of studies and significant biases. The evidence relating to pharmacological interventions demonstrates low level and variable quality. The evidence relating to non-pharmacological interventions was limited and of low quality. Conclusions: The current evidence for the management of challenging behaviours in patients with acute TBI/PTA is generally equivocal, potentially reflecting the heterogeneity of patients with TBI and their clinical behaviours. More studies with rigorous methodologies are required to investigate the most suitable pharmacological and non-pharmacological behavioural interventions for the acute phase of TBI or PTA. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate pharmacotherapeutic potential of Naringenin and its brain targeted nanoformulations in Autism Spectrum Disorders (ASD).ASD like phenotype was induced by infusion of 1 M Propanoic acid into anterior portion of lateral ventricle in rats. Naringenin (25, 50 and 100 mg/kg), uncoated and coated (glutathione & tween 80) naringenin loaded poly (lactic-co-glycolic acid) (PLGA) nanoparticles (25 mg/kg) and minocycline (50 mg/kg) were administered orally for 29 days. Neurobehavioural, biochemical, blood-brain barrier permeability, TNF-α, MMP-9, HSP-70 and P-glycoprotein tests were performed.Naringenin and its nanoparticles significantly restored behavioural and biochemical deficits in ASD phenotype. Glutathione and tween 80 coated nanoparticles enhanced brain delivery of NGN by inhibition of P-glycoprotein. Naringenin (100 mg/kg) and its nanocarriers (25 mg/kg) demonstrated pharmacological efficacy comparable to minocycline (50 mg/kg).Naringenin and its coated nanocarriers have strong clinical potential as an adjunct neurotherapeutic moiety in attenuating neuropsychopathology associated with ASD.

Background: Neurobehavioural screening measures specific to foetal alcohol spectrum disorders (FASD) are warranted to inform treatment and care. This study determined basic psychometric properties of the Fetal Alcohol Spectrum Consultation, Education, and Training Services (FASCETS) Neurobehavioural Screening Tool (NBST) to measure neurobehavioural deficits and understand the potential for adjunctive use with the FASD 4-Digit Diagnostic Code. Method: Caregivers of 86 children, adolescents, and young adults voluntarily completed surveys as part of a medical evaluation for FASD. Exploratory factor analyses were conducted to evaluate internal reliability and to describe the relationship between variables. Results: The NBST demonstrated adequate factor structure and internal consistency reliability. Two of the NBST subscales (Executive Function 1 and Learning) were significantly correlated with clinical rankings for central nervous system structural/functional abnormalities of the FASD 4-Digit Diagnostic Code. Conclusions: Results provide preliminary evidence that the NBST has adequate psychometric properties and may be a useful adjunctive screening tool for the medical diagnosis of FASD. [ABSTRACT FROM AUTHOR]

Purpose: Patients who suffer acquired brain injury (ABI) require a great variety of drugs. Furthermore, the lack of evidence on the medication effects in this type of patient increases off-label prescription. The aim of this study was to describe the pattern of medication use and the practice of prescribing off-label drugs in these patients. Methods: A cross-sectional study was conducted in patients with ABI, of either traumatic or non-traumatic cause, admitted to a neurorehabilitation hospital for rehabilitation. Demographic and clinical data and prevalence of medication use and off-label prescription were collected. Results: The majority of the studied patients (85.2%) were considered polymedicated since they were prescribed ≥ 6 drugs concomitantly. In traumatic brain injury (TBI) patients, antidepressants (81.5%) were the Anatomical Therapeutic Chemical (ATC) group's most prescribed versus antithrombotic agents (80.5%) in non-traumatic brain injury (N-TBI) patients. Up to 37.3% of all active substances prescribed in TBI patients were off-label compared with 24.9% in N-TBI patients. The most prescribed off-label active substances in both groups were those related to the Nervous System (N) ATC group to treat neurobehavioural problems. Conclusion: A multidisciplinary pharmacotherapeutic follow-up of these patients would be essential to address the high prescription rate of medications and the off-label prescription practice. In this way, medication problems related to polypharmacy could be minimised and the benefit-risk ratio of prescribed off-label drugs could be ensured according to the available medical evidence. [ABSTRACT FROM AUTHOR]

• Manganese exposure from drinking water is associated with cognitive, and neurodevelopmental effects. • Manganese exposure resulted in poor neurobehavioural performance. • School-aged children were adversely affected by exposure to manganese. • Only few studies on the subject were available and there was no consistency in the results of the studies considered. The aim of this study was to analyse the published literature on the potential effects of manganese exposure from drinking water on school-age children, with emphasis on cognitive, and neurodevelopment and behavioural effects. A systematic review of up-to-date scientific evidence published from 2006 to 2017 was conducted using Science Direct. A further search was carried out using PubMed and Web of Science. A total of 21 studies were reviewed and categorised into 12 cognitive and 9 neurodevelopment and behavioural effects. The most utilised cognitive test was the Wechsler Intelligence Scale for Children (WISC) or some subtests from it. 10 of the 12 studies on cognitive effects reported an adverse effect of manganese exposure from drinking water on children. 3 out of the 9 studies on neurodevelopment and behavioural effects reported that manganese exposure from drinking water was associated with poorer neurobehavioural performances in school children. 4 others implied the presence of some sex-specific associations with manganese exposure. 1 study suggested that children suffering from attention deficit hyperactivity disorder (ADHD) may be more susceptible to manganese exposure. Another study suggested that manganese was a beneficial nutrient as well as a neurotoxicant. Regardless of the limitations of the studies analysed, the adverse effects of manganese exposure from drinking water on school-aged children is sufficiently demonstrated. Further investigation into the subject to address inconsistencies in existing studies is recommended. [ABSTRACT FROM AUTHOR]

The Human Health Assessment Group has over the past decade recommended that effect studies be conducted in the circumpolar area. Such studies examine the association between contaminant exposure in the Arctic populations and health effects. Because foetuses and young children are the most vulnerable, effect studies are often prospective child cohort studies. The emphasis in this article is on a description of the effects associated with contaminant exposure in the Arctic. The main topics addressed are neurobehavioural, immunological, reproductive, cardiovascular, endocrine and carcinogenic effect. For each topic, the association between exposure and effects is described, and some results are reported for similar studies outside the Arctic.

The aim of the study was to investigate pharmacotherapeutic potential of Naringenin and its brain targeted nanoformulations in Autism Spectrum Disorders (ASD). ASD like phenotype was induced by infusion of 1 M Propanoic acid into anterior portion of lateral ventricle in rats. Naringenin (25, 50 and 100 mg/kg), uncoated and coated (glutathione & tween 80) naringenin loaded poly (lactic-co-glycolic acid) (PLGA) nanoparticles (25 mg/kg) and minocycline (50 mg/kg) were administered orally for 29 days. Neurobehavioural, biochemical, blood-brain barrier permeability, TNF-α, MMP-9, HSP-70 and P-glycoprotein tests were performed. Naringenin and its nanoparticles significantly restored behavioural and biochemical deficits in ASD phenotype. Glutathione and tween 80 coated nanoparticles enhanced brain delivery of NGN by inhibition of P-glycoprotein. Naringenin (100 mg/kg) and its nanocarriers (25 mg/kg) demonstrated pharmacological efficacy comparable to minocycline (50 mg/kg). Naringenin and its coated nanocarriers have strong clinical potential as an adjunct neurotherapeutic moiety in attenuating neuropsychopathology associated with ASD. [ABSTRACT FROM AUTHOR]

Aggression is a frequently cited outcome of acquired brain injury (ABI). Paradoxically, evidence suggests that ABI clinicians underestimate the risk of violence, and aggression in neurobehavioural services appears more frequent than in forensic/secure psychiatric settings. Risk assessment tools are endemic in the latter and highly beneficial in managing harm. However, none has been validated for ABI. This study examines the predictive validity of ABI violence using one established tool, the Short-Term Assessment of Risk and Treatability (START). It is argued that successful management of aggression in neurobehavioural rehabilitation is partly attributable to ongoing programme calibration following regular review of measures conceptualised for ABI. The predictive ability of START and ABI measures was determined through correlational, receiver operating characteristic and hierarchical multiple regression analyses, using 4559 aggression recordings concerning 76 patients over 4 weeks. The START risk of violence was classed “low” for 50% of the sample and “high” for 13.7%. Significant relationships between individual measures and aggression were evident. However, multivariate analysis confirmed that the best fitting model comprised ABI measures of neurobehavioural disability and functional abilities: START data did not increase explained variance. ABI risk prediction may benefit from development of specific tools. However, these should be conceptualised for ABI to incorporate the diverse range of variables underpinning neurobehavioural disability. [ABSTRACT FROM PUBLISHER]

Primary objective: Context is critical to the interpretation of measurement instruments that capture acquired brain injury (ABI) outcomes. Ratings reflect behaviours and abilities observed in a particular setting; it cannot be assumed that results are generalizable beyond these. This study explored the utility of a method to convey the impact of context-dependent support given on ratings of neurobehavioural disability (NBD) using the St Andrews-Swansea Neurobehavioural Outcome Scale (SASNOS). Methods and procedures: A supplementary SASNOS scoring system was developed using a mixed-methods approach. Dependency ratings were used to recalibrate standardised SASNOS scores to reflect support received. To aid interpretation, an expert panel reviewed SASNOS ratings for 50 ABI cases participating in residential neurobehavioural rehabilitation programmes. An end-user survey was undertaken to explore some of its psychometric properties. Finally, a representative case study was employed to illustrate its clinical utility. Main outcomes: The expert panel identified three dependency profiles: (1)Normal/Independent; (2)Normal/Dependent; and (3)Abnormal/Review. Survey results supported face and construct validity of the supplementary system; the case study demonstrated benefits of discriminating between dependency profiles. Conclusions: The supplementary scoring system enables SASNOS to convey the impact of support received on ratings of NBD, solidifying its usefulness for measuring outcomes in rehabilitation. [ABSTRACT FROM AUTHOR]

Background Neuronal dysfunction caused by neuroinflammation triggered by the stimulation of matrix metalloproteinases and the subsequent release of pro-inflammatory cytokines, as a result of oxidative stress and mitochondrial dysfunction, is one of the probable mechanisms involved in the pathogenesis of autism spectrum disorders (ASD). The aim of the present study was to explore the ameliorative potential of resveratrol on neuroinflammation in the experimental paradigm of neuroinflammatory model of ASD in rats. Method 1M Propanoic acid (PPA) (4 μl) was infused over 10 min into the anterior portion of the lateral ventricle to induce ASD like symptoms in rats. Resveratrol (5, 10 and 15 mg/kg) was administered starting from the 2nd day of the surgery and continued upto 28th day. Rats were tested for various behavioural paradigms such as social interaction, stereotypy, locomotor activity, anxiety, novelty, depression, spatial learning, memory, repetitive and pervasive behaviour between the 7th day and 28th day. In addition, biochemical tests for oxidative stress, mitochondrial complexes, TNF-α and MMP-9 were also assessed. Results Treatment with resveratrol for four weeks restored, significantly and dose dependently, all the neurological, sensory, behavioural, biochemical and molecular deficits in PPA induced autistic phenotype in rats. Conclusion The major finding of the study is that resveratrol restored the core and associated symptoms of autistic phenotype by suppressing oxidative-nitrosative stress, mitochondrial dysfunction, TNF-α and MMP-9 expression in PPA induced ASD in rats. Therefore, resveratrol might serve as an adjunct potential therapeutic agent for amelioration of neurobehavioural and biochemical deficits associated with autism spectrum disorders. [ABSTRACT FROM AUTHOR]

Objectives To assess whether solvent use and workplace practices in the vehicle collision repair industry are associated with symptoms of neurotoxicity in spray painters and panel beaters (auto body repair workers). Methods Neurobehavioural symptoms were assessed using a cross-sectional study design in 370 vehicle collision repair and 211 reference workers using the EUROQUEST questionnaire. Full-shift airborne solvent levels were measured in a subset (n = 92) of collision repair workers. Results Solvent exposures were higher in spray painters than in panel beaters, but levels were below current international exposure standards. Collision repair workers were more likely to report symptoms of neurotoxicity than reference workers with ORs of 2.0, 2.4 and 6.4 (all p < 0.05) for reporting ≥5, ≥10 and ≥15 symptoms respectively. This trend was generally strongest for panel beaters (ORs of 2.1, 3.3 and 8.2 for ≥5, ≥10 and ≥15 symptoms respectively). Associations with specific symptom domains showed increased risks for neurological (OR 4.2), psychosomatic (OR 3.2), mood (OR 2.1), memory (OR 2.9) and memory and concentration symptoms combined (OR 2.4; all p < 0.05). Workers who had worked for 10–19 years or 20+ years in the collision repair industry reported consistently more symptoms than those who had only worked less than 10 years even after adjusting for age. However, those who worked more than 20 years generally reported fewer symptoms than those who worked 10–19 years, suggesting a possible healthy worker survivor bias. Conclusions Despite low airborne solvent exposures, vehicle collision repair spray painters and panel beaters continue to be at risk of symptoms of neurotoxicity. [ABSTRACT FROM AUTHOR]

Background & objectives: Though newer antiepileptic drugs are considered safer than conventional antiepileptics, the effects of lamotrigine, levetiracetam and topiramate on neurobehavioural functions are yet to be established. This study evaluated neurobehavioural parameters and oxidative stress markers in brain tissue of rats treated with lamotrigine, levetiracetam and topiramate compared to sodium valproate . Methods: Five groups of male Wistar rats were treated respectively with normal saline (control), sodium valproate (370 mg/kg), lamotrigine (50 mg/kg), levetiracetam (310 mg/kg) and topiramate (100 mg/kg) for 45 days. Neurobehavioural parameters were assessed using elevated plus maze (EPM), actophotometer, rotarod, passive avoidance and Morris water maze (MWM) at baseline and at the end of treatment. Oxidative stress parameters [malondialdehyde (MDA), reduced glutathione (GSH) and superoxide dismutase (SOD)] were estimated in rat brain at the end of treatment. Results: Valproate and lamotrigine showed no significant effect on learning and memory in passive avoidance and MWM tests. However, levetiracetam and topiramate reduced retention memory significantly as compared to control (P<0.01) and lamotrigine (P<0.05) groups. Performances on EPM, rotarod and actophotometer were not significantly different between the groups. In comparison to control group, MDA was higher in the levetiracetam and topiramate (360.9 and 345.9 nmol/g of homogenized brain tissue, respectively) groups. GSH and SOD activity were significantly reduced by valproate and levetiracetam treatment. Lamotrigine did not induce significant oxidative stress. Interpretation & conclusions: Long-term and therapeutic dose treatment with levetiracetam and topiramate significantly impaired learning and memory, which was not seen with valproate and lamotrigine in rats. Levetiracetam, topiramate and valproate augmented oxidative stress, whereas lamotrigine has little effect on it. These antiepileptic drugs are used in clinical practice, hence pharmacovigilance studies are required to evaluate their safety profile. [ABSTRACT FROM AUTHOR]

The Human Health Assessment Group has over the past decade recommended that effect studies be conducted in the circumpolar area. Such studies examine the association between contaminant exposure in the Arctic populations and health effects. Because foetuses and young children are the most vulnerable, effect studies are often prospective child cohort studies. The emphasis in this article is on a description of the effects associated with contaminant exposure in the Arctic. The main topics addressed are neurobehavioural, immunological, reproductive, cardiovascular, endocrine and carcinogenic effect. For each topic, the association between exposure and effects is described, and some results are reported for similar studies outside the Arctic. [ABSTRACT FROM AUTHOR]

The RFX7 gene is one of eight genes within the regulatory factor X family. RFX7 is highly expressed in the brain and plays an important role in cell maturation and differentiation. It has only recently been implicated in disease in humans. Reports from 15 individuals have described RFX-associated phenotype as a neurobehavioural disease, manifesting primarily with global developmental delay and intellectual disability. Autism spectrum disorder and attention deficit hyperactivity disorder have also been described in some children. Here we report a case of a 19-month-old with a de novo missense variant in RFX7 resulting in severe global developmental delay including significant speech delay, microcephaly, dyskinetic movements, and failure to thrive. This is the first association between variants in RFX7 and failure to thrive, expanding the phenotype of this newly described gene. In this report we will also show RFX7 associated progressive central nervous system involvement through serial brain imaging., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare. MK is a full-time employee of Blueprint Genetics, a Quest Diagnostics Company, which offers diagnostic genetic testing., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Aim Neuroinflammatory response triggered by the stimulation of matrix metalloproteinases plays a pivotal role in the development of autistic phenotype. MMPs stimulate inflammatory cytokines release along with mitochondrial deficits that ultimately lead to neuronal dysfunction and precipitate autistic symptoms. The aim of the present study was to explore the neuropsychopharmacotherapeutic efficacy of curcumin in the experimental paradigm of autism spectrum disorders. Materials and methods 1 M propanoic acid (4 μl) was infused over 10 min into the anterior portion of the caudoputamen to induce autistic behavior in rats. Curcumin (50, 100 and 200 mg/kg) was administered per orally starting from 2nd day of surgery and continued up to 28th day. Rats were tested for various neurobehavioural paradigms like social interaction, stereotypy, locomotor activity, anxiety, novelty, depression, spatial learning and memory as well as for repetitive and pervasive behavior. In addition, biochemical tests for oxidative stress, mitochondrial complexes, TNF-α and MMP-9 were also carried out. Key findings Intracerebroventricular injection of propanoic acid produced neurological, sensory, behavioral, biochemical and molecular deficits which were assessed as endophenotype of autism spectrum disorders. Regular treatment with curcumin for four weeks significantly and dose dependently restored neurological, behavioral, biochemical and molecular changes associated with autistic phenotype in rats. Significance The major finding of the study is that curcumin restored the core and associated symptoms of autistic phenotype by suppressing oxidative-nitrosative stress, mitochondrial dysfunction, TNF-α and MMP-9 in PPA-induced autism in rats. Therefore, curcumin can be developed as a potential neuropsychopharmacotherapeutic adjunct for autism spectrum disorders (ASD). [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the level of exposure to polychlorinated biphenyls (PCBs) and selected heavy metals among fishermen via dietary intake of fish and other seafood from the eastern coast along the Straits of Malacca. This study determined the neurobehavioural performances (based on neurobehavioural core test battery scores) of the fishermen and evaluated the correlations between scores of neurobehavioural core test battery and exposure factors. Ninety fishermen participated in the study. The total fish intakes of the fishermen were measured using a set of food frequency questionnaires. The PCBs contents in the seafood samples ranged between 0.2 and 0.6 pg/g fresh sample. The concentrations of mercury (Hg), arsenic (As), cadmium (Cd), and lead (Pb) in the seafood samples were 1.1-5.4, 0.3-4.4, 0.6-36.1, and 0.02-0.3 μg/g fresh sample, respectively. The PCBs, Hg, As, Cd, and Pb exposures of the fishermen was estimated to be 2.8, 0.02, 4.5, 0.09, and 0.5 pg/kg body weight/day, respectively. PCB and heavy metal exposures through dietary intake of fish and seafood were within the tolerable daily limits. The results of neurobehavioural core test battery revealed that the neurobehavioural performances of the fishermen were not affected due to PCB and heavy metal intoxication. No correlations were found between the exposure and neurobehavioural performance among the fishermen. These data are useful for policy makers to assure the safety and quality of seafood in relation to sea pollution. Although the levels of exposure were low, periodic assessment of the quality of fish and fish products is required due to the polluted seawater. [ABSTRACT FROM AUTHOR]

Sleep inertia, sleep homeostatic and circadian processes modulate cognition, including reaction time, memory, mood and alertness. How these processes influence higher-order cognitive functions is not well known. Six participants completed a 73-day-long study that included two 14-day-long 28-h forced desynchrony protocols to examine separate and interacting influences of sleep inertia, sleep homeostasis and circadian phase on higher-order cognitive functions of inhibitory control and selective visual attention. Cognitive performance for most measures was impaired immediately after scheduled awakening and improved during the first ~2-4 h of wakefulness (decreasing sleep inertia); worsened thereafter until scheduled bedtime (increasing sleep homeostasis); and was worst at ~60° and best at ~240° (circadian modulation, with worst and best phases corresponding to ~09:00 and ~21:00 hours, respectively, in individuals with a habitual wake time of 07:00 hours). The relative influences of sleep inertia, sleep homeostasis and circadian phase depended on the specific higher-order cognitive function task examined. Inhibitory control appeared to be modulated most strongly by circadian phase, whereas selective visual attention for a spatial-configuration search task was modulated most strongly by sleep inertia. These findings demonstrate that some higher-order cognitive processes are differentially sensitive to different sleep-wake regulatory processes. Differential modulation of cognitive functions by different sleep-wake regulatory processes has important implications for understanding mechanisms contributing to performance impairments during adverse circadian phases, sleep deprivation and/or upon awakening from sleep. [ABSTRACT FROM AUTHOR]

Primary objective: To evaluate excitability and inhibition of the motor cortex acutely and longitudinally following mild traumatic brain injury (mTBI). Research design: A longitudinal paired case-control design was used to examine cortical excitability and inhibition in 15 adults who had sustained an mTBI (mean age = 20.8 ± 1.2 years) and 15 matched control participants (mean age = 21.1 ± 1.3 years). Methods and procedures: Participants visited the lab within 72 hours of injury and again at 1, 2, 4 and 8 weeks post-injury. During each visit, transcranial magnetic stimulation was used to examine resting motor threshold (RMT), motor evoked potential peak-to-peak amplitude (MEPamp) and cortical silent period (CSP) duration of the first dorsal interosseous muscle. Main outcomes and results: There were no differences between groups in RMT ( p = 0.10) or MEPamp ( p = 0.22) at 72 hours post-injury or across the 2-month testing period ( p ≥ 0.68), indicating similar cortical excitability. However, the CSP duration was higher in individuals with mTBI, indicating greater intra-cortical inhibition compared with the control group at 72 hours post-injury ( p = 0.03) and throughout the 2 months of recovery ( p = 0.009). Conclusions: mTBI appeared to have little effect on cortical excitability, but an acute and long-lasting effect on intra-cortical inhibition. [ABSTRACT FROM AUTHOR]

Abstract: Various potential molecules with putative positive role in stroke pathology have failed to confer neuro-protection in animal models due to their insufficient bioavailability in brain. Efflux of these molecules by P-glycoprotein (P-gp), on blood brain barrier (BBB) is one of the reasons of their poor bioavailability. Berberine, have anti-inflammatory, antioxidant, anti-apoptotic properties, but also having low oral bioavailabilty. Verapamil, which increased the central nervous system uptake of few drugs, when concomitantly administered with berberine was evaluated in this animal model. Wistar rats were subjected to bilateral common carotid artery occlusion to induce acute cerebral ischemia for 15min followed by reperfusion resulting in transient global cerebral ischemia. For 19 days berberine (5, 10, 20mg/kg, p.o.) alone and in similar doses concomitantly with verapamil (2mg/kg, p.o.) was evaluated employing various neuro-behavioral test, biochemical parameters and molecular estimations. The adjunction of berberine with verapamil improved the neurological outcome in a battery of behavioral paradigms, improved spatial memory in Morris water maze task, ameliorated the oxidative-nitrosative stress, increased acetylcholinesterase (AChE) activity, as well as improved mitochondrial complex (I, II, and IV) activity, reducing tumor necrosis factor-alpha, interleukin-1 beta and caspase-3 levels in brain tissues as compared to berberine alone group in ischemic rats. There is a strong possibility of improved brain bioavailabity of berberine when combined with verapamil. The findings suggested that the combination of berberine with verapamil, which could enhance its brain uptake, will surely provide a greater impact in neroprotection drug discovery for search of such combination. [Copyright &y& Elsevier]

BACKGROUND: The evidence base on neurobehavioural disorders and their rehabilitation has been growing for four decades. Over that time understanding of the need for effective interventions for a range of handicaps in personal, interpersonal and employment spheres has developed. There is a continuing need to demonstrate whether interventions, are effective and cost-sensitive. Moreover, in pursuing effectiveness, clinicians need to be able to predict which individuals are likely to benefit from a programme and here, clinical experience needs to be informed by research evidence. OBJECTIVE: To review the outcome of rehabilitation for neurobehavioural disorders. METHODS: This review initially considers the background to neurobehavioural rehabilitation and discusses methodological issues. It reviews the evidence for neurobehavioural interventions for severe head injury with emphasis on holistic models of care, behavioural treatments, interventions in non-specialist settings and for emotion perception and self-awareness. RESULTS: In general, there is a need for further high quality studies with longer follow-ups and evidence for generalisation in the community. However, there is a growing consensus that intensive holistic rehabilitation programmes can improve community reintegration and self-efficacy. For behaviour disturbance the evidence base largely comprises studies with weaker (single group or single case) designs. Overall studies here provide limited evidence in support of behavioural approaches for externalised behaviour such as aggression. Further RCT or group comparison studies are needed. In terms of negative behaviours such as apathy, there are few studies on head injury and conclusions cannot be made with confidence. Self awareness is a key issue associated with good outcome in general and research to date supports use of interventions that focus in on-task behaviour and education. The correct perception of emotions in others is a precursor to successful social interaction, and here there is very little evidence although early studies are encouraging. CONCLUSION: There is mounting evidence to support the effectiveness of non-pharmacological interventions for neurobehavioural disorders. Successful outcomes are often associated with intensive and prolonged interventions involving multidisciplinary working. [ABSTRACT FROM AUTHOR]

BACKGROUND: Neurobehavioural disability often leads to serious social handicap. Many individuals never recover full social independence and will remain largely dependent upon family support, imposing a significant and potentially life-long psychological burden on those who care for injured relatives. Close relationships are at risk and many partnerships break down, increasing the risk of social isolation and subsequent psychological distress to the survivor. OBJECTIVES: The aim of this paper is to examine the nature of some cardinal features of neurobehavioural disability that contribute to poor psychosocial outcome; consider their organic origins, and problems associated with standardised methods of assessment. METHODS: A review of clinical literature addressing neurobehavioural disability after TBI. RESULTS: Many forms of neurobehavioural disability are subtle but have a pervasive impact on psychosocial outcome in general and relationships in particular. CONCLUSIONS: Caution is recommended when employing standardised tests to identify the complex and often subtle nature of neurobehavioural disorders. More work is needed to define the nature and impact of different forms of neurobehavioural disorders that comprise this complex form of disability. [ABSTRACT FROM AUTHOR]

Aim To study the neurobehavioural development and somatic growth of children at preschool-age born to opioid-addicted mothers given opiate maintenance treatment ( OMT) with buprenorphine during pregnancy. Methods Twenty-eight children, whose 21 opiate-addicted mothers were treated with OMT during pregnancy and accepted participation to the study, went through a battery of neurobehavioural tests ( WPPSI- R, Mc Carthy, BROWN and SDQ). Twenty-five children fulfilled the tests at an age of 5-6 years. Results The children showed evidence of serious visual motor and attention problems in the field of performance ( WPPSI- R scales) and major problems in the field of motor skills and memory abilities ( Mc Carthy Scales). The results of behavioural tests also showed significantly elevated levels of hyperactivity, impulsivity and attention problems on the attention deficit hyperactivity disorder ( ADHD) scale in BROWN and in SDQ tests estimated by the teachers, while the parents estimated no problems for their children. Regarding the outcomes, there were no significant differences in terms of neonatal abstinence syndrome, gender or socio-economic factors. The somatic growth of the children corresponded to the mean values of the normal population in weight, length and head circumference at birth and at preschool-age, respectively. Conclusion Children to opiate-addicted mothers with buprenorphine maintenance treatment during pregnancy constitute a risk population, which should be recognized before start of the school. Whether the effects are associated with buprenorphine exposition during foetal life or not are discussed and need further investigation. [ABSTRACT FROM AUTHOR]

Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson’s disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson’s disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease has been developed specifically for Parkinson’s disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine. [ABSTRACT FROM PUBLISHER]

Abstract: Recently the psychological effects of space flight have gained in attention. In uncovering the psychological challenges that individuals and teams can face, we need research options that integrate psychosocial aspects with behavioral, performance, technical and environmental issues. Future perspectives in Space Psychology and Human Spaceflight are reviewed in this paper. The topics covered include psychosocial and neurobehavioural aspects, neurocognitive testing tools, decision making, autonomy and delayed communications, well being, mental health, situational awareness, and methodology. Authors were members of a European Space Agency (ESA) Research Topical Team on Psychosocial and Behavioral Aspects of Human Spaceflight. They discuss the different topics under a common perspective of a theoretical and practical framework, showing interactions, relationships and possible solutions for the different aspects and variables in play. Recommendations for every topic are offered and summarized for future research in the field. The different proposed research ideas can be accomplished using analogs and simulation experiments, short- and long-duration bed rest, and in-flight microgravity studies. These topics are especially important for future Moon and Mars mission design and training. [Copyright &y& Elsevier]

Abstract: Prenatal exposure to alcohol may exert a significant detrimental effect on the functioning of the individual''s brain, however few studies have examined this before birth. This longitudinal study examined the effect of maternal alcohol consumption on the elicited startle response of the fetus. Two groups of fetuses were examined: one whose mothers drank alcohol (approximately 10 units per week); the other whose mothers did not drink alcohol. Fetuses were examined at 29, 32 and 35weeks gestation and their startle response observed using ultrasound in response to 2 presentations of a pink noise (70–250Hz) at 90dB(A) separated by 30s. Fetuses exposed to alcohol exhibited a weaker startle response at 29weeks gestation than did fetuses not exposed to alcohol. There was no difference in the response at 32 and 35weeks gestation. To ensure that the effects were not due to a more general effect of alcohol on fetal movement, a second experiment compared the spontaneous movements (observed on ultrasound for 45min) of fetuses whose mothers drank alcohol and fetuses of mothers who didn''t drink alcohol. There were no differences in movements exhibited by the fetuses. The results suggest that exposure to alcohol delays the emergence of the elicited startle response at 29weeks gestation but this delay has disappeared by 32weeks gestation. The possible role of altered neural development, acute exposure to alcohol and disruptions to the fetus''s behavioural repertoire, in mediating these effects are discussed. [Copyright &y& Elsevier]

Primary objective: The present study investigated the effect of upper limb skilled reach training in the intracerebral haemorrhage (ICH) model of rats. Methods: Forty-five male Sprague-Dawley rats with body weights of 200-250 g were divided randomly into the control (CON), ipsilateral (IST) and contralateral (CST) groups. All groups had induced ICH injury and were then rested to recover. Skilled reach training was applied on the left anterior paw in the ISP group and on the right paw in the CST group for 4 weeks. Behavioural testing, immunohistochemistry, western blotting and histological analysis were performed to confirm the expressions of neurotrophic factors and apoptosis-related proteins and brain recovery in the ICH rat model. Results: The increased neurotrophic factors expression in the IST and CST groups decreased the expressions of Bax and Caspase-3, which was enhanced by CST. Moreover, decreased ischemic volume and progressive neurobehavioural outcome were observed in both the IST and CST groups. Conclusion: Skilled reach training promotes brain recovery and motor function through an increase of neurotrophic factors expression and a decrease of apoptosis-related protein expression. [ABSTRACT FROM AUTHOR]

Objective: To describe behavioural and health-related quality-of-life (HRQoL) outcomes in survivors of childhood meningitis and identify variables predictive of psychosocial outcome. Methods: Psychosocial outcomes were measured via parent and teacher report using the Strengths and Difficulties Questionnaire (SDQ) and the Paediatric Quality of Life Inventory (PedsQL Core & Fatigue versions). Participants were 334 consecutive survivors admitted to a regional children's hospital (1991-2007). One hundred and twelve of 346 (34%%) returned postal questionnaires and file review confirmed diagnosis in 100 cases. Results: At a mean of 8 years post-illness 32%% of parents and 19%% of teachers reported clinically significant behavioural difficulties on the SDQ; along with significantly lowered HRQoL on PedsQL measures. Later sequelae such as learning disability and hearing/visual impairment, along with socioeconomic status, independently predicted behavioural and HRQoL outcome on regression analysis. Acute disease complications were associated with later occurrence of epilepsy, learning disability and visual impairment, but not directly with psychosocial outcomes at time of follow-up. Conclusions: Survivors with these sequelae should be screened for emotional and behavioural difficulties during key developmental transitions such as school entry. These findings strongly support recent UK clinical guidelines (NICE and SIGN) proposing that parents be made aware of possible psychological complications on discharge. [ABSTRACT FROM AUTHOR]

Primary objective: To evaluate the effectiveness of a brief acute neurobehavioural intervention, the First Steps Acute Neurobehavioural and Cognitive Intervention (FANCI), with persons who have traumatic brain injury (TBI). Research design: Prospective, controlled, repeated measures design. Methods and procedures: Seventy-two patients in acute TBI rehabilitation participated either as FANCI subjects or as control participants who watched videos to control for time and attention. Outcome measures included the Neurobehavioural Rating Scale-Revised (NRS-R), Functional Independence Measure (FIM™™), a FANCI Learning Assessment (LA) and the Satisfaction with Life Scale (SWLS). Main outcomes and results: In comparison with controls, FANCI participants had significantly greater neurobehavioural (cognitive, emotional and behavioural) as well as FIM motor improvements. Significantly greater learning occurred and persisted over time for FANCI subjects as compared to controls. Pre-treatment cognitive and neurobehavioural status, length of coma and number of sessions completed were moderating variables for functional and cognitive outcomes. Conclusions: Persons with TBI can benefit from comprehensive, manualized neurobehavioural interventions, over and above standard rehabilitation care, even during the acute phase of recovery. [ABSTRACT FROM AUTHOR]

Abstract: The study aim was to determine whether low level exposure to organophosphate pesticides (OPs) causes neuropsychological or psychiatric impairment. Methodological weaknesses of earlier studies were addressed by: recruiting participants who had retired on ill health grounds; excluding participants with a history of acute poisoning, medical or psychiatric conditions that might account for ill health; and exploring factors which may render some individuals more vulnerable to the effects of OPs than others. Performance on tests of cognition and mood of 127 exposed sheep farmers (67 working, 60 retired) was compared with 78 unexposed controls (38 working, 40 retired) and published test norms derived from a cross section of several thousand adults in the general population. Over 40% of the exposed cohort reported clinically significant levels of anxiety and depression compared to less than 23% of controls. Exposed subjects performed significantly worse than controls and standardisation samples on tests of memory, response speed, fine motor control, mental flexibility and strategy making, even after controlling for the effects of mood. The pattern was similar for both working and retired groups. The cognitive deficits identified cannot be attributed to mood disorder, malingering, a history of acute exposure or genetic vulnerability in terms of PON1192 polymorphisms. Results suggest a relationship may exist between low level exposure to organophosphates and impaired neurobehavioural functioning and these findings have implications for working practice and for other occupational groups exposed to OPs such as aviation workers and Gulf War veterans. [Copyright &y& Elsevier]

Objective: To investigate the effects of electroacupuncture (EA) on the activation of astrocytes (AST) in the periinfarct region after cerebral ischemia, as well as to evaluate potential behavioural improvement after EA treatment. Methods: Male Wistar rats were randomly divided into normal, model and EA groups. Rats in each group were further divided into 7, 14 and 28 days sub-groups. A model of middle cerebral artery occlusion was established, followed by 7, 14 or 28 days of EA on ‘Bai hui’ and ‘Da zhui’ acupoints. The number of GFAP-immunoreactive cells was determined and behavioural tests were performed. Results: Many more GFAP-immunoreactive cells were detected in the EA group on day 14 than on day 7 after ischemia and a slightly decreased number of immunoreactive cells were observed on day 28. The results of behavioural tests of animals in the EA group on the beam balance performance and prehensile traction performance were superior to that of animals in the model group. Conclusion: These findings indicate that EA has the potential to activate AST in the periinfarct region and to avoid excess reactive gliosis and also can facilitate the recovery of post-ischemic behavioural dysfunction. [ABSTRACT FROM AUTHOR]

Summary: Primary insomnia is a sleep disorder where the subjective complaint of initiating or maintaining sleep, or the experience of sleep that is non-refreshing, cannot be directly attributed to a comorbid medical or psychiatric disorder. For a diagnosis of primary insomnia, a patient must also report that the nighttime sleep disturbance is impacting upon daytime functioning. Yet, while subjective complaints of impaired wake-time functioning are well documented, consistent objective evidence of these impairments has proved elusive, particularly with regard to cognitive functioning. We aimed to review the body of literature examining neurobehavioural impairments in primary insomnia to identify which cognitive domains appear to be most consistently impaired in this group. The relatively few studies that have investigated neurobehavioural performance deficits in patients with primary insomnia have produced inconsistent and sometimes conflicting findings. It is suggested that methodological limitations, including heterogeneous test populations, variable testing protocols and conditions as well as unsuitable cognitive tasks have contributed to our inability to describe unequivocally the daytime impairments associated with insomnia. Based on our review, it appears that the deficits associated with insomnia are relatively subtle and may be qualitatively different to those that result from other sleep disorders and from imposed sleep deprivation. Attention tasks, which have a high cognitive load, and working memory tasks appear to show performance deficits more often than not in insomnia patients. It is important to more definitively characterise the daytime impairments associated with primary insomnia so that the efficacy of treatments to remedy the wake-time consequences of the disorder, in addition to the nighttime symptoms, can be investigated. [Copyright &y& Elsevier]

Background: Traumatic brain injury (TBI) can result in serious and disabling neuropsychiatric disorders. Method: The authors report a case of a 51-year old male, admitted to the psychiatric ward for acute psychosis and suicidal ideation, probably associated with TBI. After a temporal head trauma he initiated auditory/verbal hallucinations and subsequently developed paranoid delusions. The electroencephalography showed slow bilateral temporal activity and the neuropsychological testing showed several impairments. The patient improved with olanzapine at a dosage of 20 mg daily. Results: This case shows the difficulty of differential diagnosis between schizophrenia and psychotic disorder due to traumatic brain injury. Conclusions: The authors conducted a revision of literature about the diagnosis, epidemiology, clinical aspects, laboratory and structural investigations and the treatment of this condition. Based on this revision work, the authors sketch some recommendations about the work-up that should be done when faced with this diagnostic hypothesis. [ABSTRACT FROM AUTHOR]

Primary objective: The aim of the present study was to explore the concurrent validity, inter-rater agreement and diagnostic sensitivity of a French adaptation of the Coma Recovery Scale-Revised (CRS-R) as compared to other coma scales such as the Glasgow Coma Scale (GCS), the Full Outline of UnResponsiveness scale (FOUR) and the Wessex Head Injury Matrix (WHIM). Research design: Multi-centric prospective study. Method and procedures: To test concurrent validity and diagnostic sensitivity, the four behavioural scales were administered in a randomized order in 77 vegetative and minimally conscious patients. Twenty-four clinicians with different professional backgrounds, levels of expertise and CRS-R experience were recruited to assess inter-rater agreement. Main outcomes and results: Good concurrent validity was obtained between the CRS-R and the three other standardized behavioural scales. Inter-rater reliability for the CRS-R total score and sub-scores was good, indicating that the scale yields reproducible findings across examiners and does not appear to be systematically biased by profession, level of expertise or CRS-R experience. Finally, the CRS-R demonstrated a significantly higher sensitivity to detect MCS patients, as compared to the GCS, the FOUR and the WHIM. Conclusion: The results show that the French version of the CRS-R is a valid and sensitive scale which can be used in severely brain damaged patients by all members of the medical staff. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness of a residential community reintegration programme for participants with chronic sequelae of severe acquired brain injury that hamper community functioning. Design: Prospective cohort study. Subjects: Twenty-four participants with acquired brain injury (traumatic n = 18; stroke n = 3, tumour n = 2, encephalitis n = 1). Participants had impaired illness awareness, alcohol and drug problems and/or behavioural problems. Intervention: A skills-oriented programme with modules related to independent living, work, social and emotional well-being. Methods: The Community Integration Questionnaire, CES-Depression, EuroQOL, Employability Rating Scale, living situation and work status were scored at the start (T0), end of treatment (T1) and 1-year follow-up (T2). Results: Significant effects on the majority of outcome measures were present at T1. Employability significantly improved at T2 and living independently rose from 42% to over 70%. Participants working increased from 38% to 58% and the hours of work per week increased from 8 to 15. Conclusion: The Brain Integration Programme led to a sustained reduction in experienced problems and improved community integration. It is concluded that even participants with complex problems due to severe brain injury who got stuck in life could improve their social participation and emotional well-being through a residential community reintegration programme. [ABSTRACT FROM AUTHOR]

Abstract: Maternal alcohol consumption during pregnancy may delay the development of spontaneous fetal startle behaviour. Previous study indicated that fetuses exposed to alcohol exhibited a significantly higher incidence of spontaneous startles compared to fetuses not exposed at 20 weeks gestation. This study examined startle behaviour longitudinally from 20 to 35 weeks gestation to determine whether the previous results were due to ‘developmental delay’ or a ‘permanent effect’. The number of spontaneous startles exhibited by fetuses of mothers who drank during pregnancy and fetuses whose mothers did not drink was recorded at 20, 25, 30 and 35 weeks gestation during a 45-min observation. The results indicate that exposure to alcohol during pregnancy significantly increases the exhibition of spontaneous startles by the fetus but across gestation there is significant catch-up in startle behaviour. The results suggest exposure to alcohol delays the natural maturation of spontaneous startle behaviour of the fetus but also has a smaller ‘permanent’ effect. It is suggested that these effects are mediated by alcohol exerting an effect on the inhibitory pathways controlling startle behaviour. [Copyright &y& Elsevier]

Objectives. The objective was to investigate potential nervous system effects of manganese (Mn) exposure in workers employed in manganese-alloy-producing plants. Methods. One hundred male Mn alloy plant workers were compared with 100 age-matched referents. The subjects were examined with a comprehensive neuropsychological test battery. Exposure was assessed by measurement of Mn concentrations in the workroom air, blood and urine. Results. The geometric mean (GM) concentration of inhalable Mn in workroom air was 301 μg/m3. The GM concentration of Mn in whole blood (181 nmol/l vs 160 nmol/l) (P=0.002) and urine (0.9 nmol/mmol creatinine vs 0.4 nmol/mmol creatinine) (P<0.001) was higher among the exposed subjects than among the referents. The Mn-exposed subjects had increased postural tremor while conducting a visually guided tremor test (static steadiness test) compared with the referents (mean number of contacts 94 vs 59 (P= 0.001); duration of contacts (in seconds) 5.1 vs 3.5 (P=0.003)). The tremor had larger frequency dispersion, indicating that the tremor included a wider variety of frequencies, among the exposed subjects than among the referents, assessed by the “TREMOR” test system. Smoking habits (self-reported) influenced the tremor parameters significantly, the Mn-exposed smokers having more tremor than the non-smoking Mn-exposed subjects. No differences between the groups were found in tests for cognitive functions, reaction time or in symptom reporting. Conclusion. The Mn-exposed subjects had increased hand tremor compared with their referents. The tremor was related to exposure parameters. Smoking habits (self-reported) influenced the tremor parameters. [ABSTRACT FROM AUTHOR]

Five hundred and nine production workers at a manganese (Mn) smelting works comprising eight production facilities and 67 external controls were studied cross-sectionally for Mn related neuroehavioural effects. Exposure measures from personal sampling included Mn in inhalable dust as cumulative exposure indices (CEI) and average intensity (INT). Biological exposure and biological effect measures included blood (MnB), urine (MnU) manganese and serum prolactin. Endpoints included items from the Swedish nervous system questionnaire (Q16), World Health Organisation neurobehavioural core test battery (WHO NCTB), Swedish performance evaluation system (SPES), Luria–Nebraska (LN), and Danish product development (DPD) test batteries, and a brief clinical examination. Potential confounders and effect modifiers included age, educational level, alcohol and tobacco consumption, neurotoxic exposures in previous work, past medical history, previous head injury and home language. Associations were evaluated by multiple linear and logistic regression modelling. Modelling assumptions were tested. Average exposure intensity across all jobs ranged from near 0 (0.06 μg/m3) for external controls to 5.08 mg/m3 for inhalable Mn, and was greater than the ACGIH TLV for 69% of subjects. Results from the large number of tests performed resolved into three groups. Group 1 shows differences between external unexposed referents and all the exposed and/or differences between internal low exposed referents and the rest of the exposed but no further exposure–response relationships. It includes the Santa Ana, Benton and digit-span tests from the WHO NCTB; the hand tapping and endurance tapping tests from the SPES; Luria–Nebraska item 2L; questionnaire items tired, depressed, irritated, having to take notes in order to remember things, and subjects’ perception that they had sex less often than normal; a test of clinical abnormality; and increased sway under two conditions (eyes open without foot insulation, eyes open with foot insulation). Group 2 shows the presence of a more substantive exposure–response relationship. It consists of only two tests: and includes the WHO digit-symbol test (although the major impact is at low exposure and therefore counterintuitive, arguably placing this test in group 3) and the LN item 1R which has a step to a poorer score at high exposure. Group 3 contains the overwhelming majority of test results (almost all the questionnaire items, almost all the DPD tests including tremor, sway and diadochokinesia, and serum prolactin) which were either null or counterintuitive (did not make sense). The CEI was the strongest predictor of test abnormalities, except for the clinical test which was more strongly associated with blood manganese. Despite a comprehensive range of endpoints, and levels of exposure ranging from environmental to industrial, this large study of Mn workers found little convincing evidence for a continuum of effects, contributing further questions to current debates about the adequacy of the current ACGIH TLV. [Copyright &y& Elsevier]

The startle behaviour of the fetus (both spontaneous and elicited) was examined in fetuses of mothers who drank alcohol and mothers who did not. Fetuses exposed to alcohol showed a higher frequency of spontaneous startles and were less likely to exhibit a normal startle in response to a vibroacoustic stimulus. These differences illustrate a teratogenic effect of alcohol on CNS functioning in utero, possibly associated with brainstem damage. [Copyright &y& Elsevier]

VK Mah, EL Ford-Jones. Spotlight on middle childhood: Rejuvenating the 'forgotten years'. Paediatr Child Health 2012;17(2):81-83. Middle childhood, from six to 12 years of age, is often known as the 'forgotten years' of development because most research is focused on early childhood development or adolescent growth. However, middle childhood is rich in potential for cognitive, social, emotional and physical advancements. During this period, the brain is actively undergoing synaptic pruning and, as such, is constantly becoming more refined, a process that is heavily dependent on a child's environment. This discovery opens the door to optimizing the experiences a child needs to provide themselves with a strong foundation for adulthood. The present article reviews the neurological changes that occur in middle childhood, their impact on overall development and how to implement this knowledge to augment a child's capabilities. Pleins feux sur la période intermédiaire de l'enfance: redonner un coup de jeunesse aux « annees oubliees » La période intermédiaire de l'enfance, de six à 12 ans, est souvent connue comme « les années oubliées » du développement, car une bonne partie de la recherche est axée sur le développement de la petite enfance ou la croissance à l'adolescence. Cependant, cette période est riche en potentiel sur le plan du progrès cognitif, social, affectif et physique. Le cerveau subit activement un élagage synaptique et devient done de plus en plus raffiné, un processus qui dépend lourdement de l'environnement de l'enfant. Cette découverte ouvre la porte à l'optimisation des expériences que vit l'enfant afin d'établir des assises solides pour l'âge adulte. Le présent article aborde les changements neurologiques qui se produisent pendant la période intermédiaire de l'enfance, leurs répercussions sur le développement global et la mise en œuvre de ces connaissances pour accroître les capacités de l'enfant. [ABSTRACT FROM AUTHOR]