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eLetter zum Artikel "Condiciones neuropsi-quiátricas y probable causa de muerte de Maurice Ravel" von Gómez-Carvajal AM, Botero-Meneses JS, Palacios-Espinosa X und Palacios-Sánchez L., veröffentlicht in Iatreia 35(3), Seite 341-8 (DOI: https://doi.org/10.17533/udea.iatreia.154).
This book, now in its third, completely revised and updated edition, offers a critical approach to the challenging interpretation of the latest research data obtained using functional neuroimaging in whiplash injury. Such a comprehensive guide to recent and current international research in the field is more necessary than ever, given that the confusion regarding the condition and the medicolegal discussions surrounding it have increased further despite the publication of much literature on the subject. In recent decades especially the functional imaging methods – such as single-photon emission tomography, positron emission tomography, functional MRI, and hybrid techniques – have demonstrated a variety of significant brain alterations. Functional Neuroimaging in Whiplash Injury - New Approaches covers all aspects, including the imaging tools themselves and the various methods of image analysis. Details on biomechanics, including the finite element method and facts on historical whiplash experiments and crash tests have now been added to this new edition. The book will continue to help physicians, patients and their relatives and friends, and others to understand this condition as a disease.
eLetter: "The ancient Capua leg from 300 BC and the 1941 air raid on the Royal College of Surgeons"
(2021)
eLetter zum Artikel "The College of Surgeons, London", veröffentlicht in Science, Vol. 93, Issue 2425, Seite 587 (DOI: 10.1126/science.93.2425.587).
eLetter zum Artikel "Plague Through History" von Nils Chr. Stenseth, veröffentlicht in Science, Vol. 321, Issue 5890, Seite 773-774 (doi.org/10.1126/science.1161496)
eLetter zum Artikel "The Hannes hand prosthesis replicates the key biological properties of the human hand" von Matteo Laffranchi et al., veröffentlicht in Science Robotics, Vol. 5, Issue 46, eabb0467 (doi.org/10.1126/scirobotics.abb0467)
Method for controlling a device, in particular, a prosthetic hand or a robotic arm (US20200327705A1)
(2020)
A method for controlling a device, in particular a prosthetic hand or a robotic arm, includes using an operator-mounted camera to detect at least one marker positioned on or in relation to the device. Starting from the detection of the at least one marker, a predefined movement of the operator together with the camera is detected and is used to trigger a corresponding action of the device. The predefined movement of the operator is detected in the form of a line of sight by means of camera tracking. A system for controlling a device, in particular a prosthetic hand or a robotic arm, includes a pair of AR glasses adapted to detect the at least one marker and to detect the predefined movement of the operator.
Restoring hand motion to people experiencing amputation, paralysis, and stroke is a critical area of research and development. While electrode-based systems that use input from the brain or muscle have proven successful, these systems tend to be expensive and di¨cult to learn. One group of researchers is exploring the use of augmented reality (AR) as a new way of controlling hand prostheses. A camera mounted on eyeglasses tracks LEDs on a prosthetic to execute opening and closing commands using one of two different AR systems. One system uses a rectangular command window to control motion: crossing horizontally signals “open” along one direction and “close” in the opposite direction. The second system uses a circular command window: once control is enabled, gripping strength can be controlled by the direction of head motion. While the visual system remains to be tested with patients, its low cost, ease of use, and lack of electrodes make the device a promising solution for restoring hand motion.
In this entry, the 3D CAD reconstructions and 3D multi-material polymer replica printings of knight Götz von Berlichingen´s first „Iron Hand,“ which were developed in the last few years at Offenburg University, are presented. Even by today's standards, the first “Iron Hand”–as could be shown in the replicas–demonstrates sophisticated mechanics and well thought-out functionality and still offers inspiration and food for discussion when it comes to the question of an artificial prosthetic replacement for a hand.
Dementia is a clinical diagnosis reflecting many possible underlying pathologies, for example, vascular dementia and neurodegenerative disorders such as frontotemporal dementia, Lewy body-type disorder or Alzheimer’s disease (AD). The breakthrough of 99mtechnetium-labelled perfusion tracers in the 1990s resulted in many SPECT studies of flow changes in AD. In the first decade of 2000, the role of perfusion SPECT was shifted from diagnosis towards differential diagnosis, parallel to the growing attention for diagnosing early stages of dementia. Previously a diagnosis based largely on a process of exclusion, new guidelines have emerged increasingly employing positive criteria to establish the diagnosis, including neuroimaging biomarkers. Nowadays, FDG PET has largely limited the role of perfusion SPECT, although it is still considered a valuable and cost-effective alternative when PET is not available.
(1) Background: Little is known about the baroque composer Domenico Scarlatti (1685-1757), whose life was centred behind closed doors at the royal court in Spain. There are no reports about his illnesses. From his compositions, mainly for harpsichord, an outstanding virtuosity can be read. (2) Case Presentation: In this case report, the only known oil painting of Domenico Scarlatti is presented, on which he is about 50 years old. In it one recognizes conspicuous hands with hints of watch glass nails and drumstick fingers. (3) Discussion: Whether Scarlatti had chronic hypoxia of peripheral body regions as a sign of, e.g., bronchial cancer or a severe heart disease, is not known. (4) Conclusions: The above-mentioned signs recorded in the oil painting, even if they were not interpretable at that time, are clearly represented and recorded for us and are open to diagnostic discussion from today's point of view.
Kommentar zu "Intracortical microstimulation of human somatosensory cortex" von Sharlene N. Flesher et al., veröffentlicht in Science Translational Medicine, Vol. 8, No. 361, Seite 361ra141 (DOI: 10.1126/scitranslmed.aaf8083)
Kommentar zum Artikel "Arthur Willis Goodspeed" von Otto Glasser, veröffentlicht in Science Vol. 98, Issue 2540, Seite 219 (doi.org/10.1126/science.98.2536.125).
Neuroprosthetics 2.0
(2019)
The study from Mehrazin et al. in HJNM 2011; 14(3): 243-50 on the neuropsychology, morphological computerized tomography (CT) and functional neuroimaging with 99mTc-labelled ethylene cystein-ate dimer single-photon emission tomography (SPET) in mild trau-matic brain injury (MTBI) is an interesting new approach to a disease condition which is often neglected or denied. Related to the above, we may note that the French composer Maurice Ravel (1875-1937), who suffered from Pick ́s disease with primary progressive apha-sia, had a taxi accident in 1932, with a mild concussion, perhaps an MTBI. Apart from the dysphasia and beginning apraxia, which Rav-el had already 5 years prior to the taxi accident, these symptoms exacerbated-the dysphasia became a progressive aphasia-and he developed additional severe deficits in concentration and atten-tion after the accident. It has also been suspected that this accident may have triggered Ravel ́s agraphia the unability to write down any new composition beyond the date of the taxi accident, a condi-tion that Ravel himself described as unacceptable and which made him feel very sad as his mind was full of ideas. Due to the deterio-ration of his health, which can also be seen in his appearance on late photographs, Ravel consulted the famous neurosurgeon Prof. Clovis Vincent. Vincent, who suspected a hydrocephalus, opened Ravel ́s skull on December 19, 1937, showing a normal brain. Soon after surgery Ravel died. In conclusion, a SPET/CT approach com-bined with a brain perfusion analysis using statistical parametric mapping might be the recommendable approach today for mild traumatic brain injury.
A survey in 2000 revealed that only about 30% of the prescriptions in the European pediatric population were on the basis of evidence-based medicine (EbM). Less for radiopharmaceuticals and principally for diagnostics, radiologists throughout Europe are referred to the pediatric guidelines of the European Association of Nuclear Medicine (EANM), as none of the frequently used tracers have been evaluated in clinical trials in the different pediatric subgroups. Following a resolution to address the lack of EbM in children, the European Commission published the Pediatric Regulation EC 1901/2006 and its amendment EC 1902/2006, effective from 2007. This regulation foresees the development of evidence-based medicine in the pediatric population. This is effected through a set of principles like the mandatory pediatric investigation plan (PIP) to be included with the market authorization application (MAA), and the pediatric use market authorization (PUMA) for off-patent pharmaceuticals, and to a very small part radiopharmaceuticals with funding possibilities for pediatric-specific research through the 7th Framework Programme (7FP) of the European Union.
Routine nuclear cardiology examinations indicate heart rate, cardiac rhythm, the height of cardiac pulse and respiration rhythm. It would be of interest to study whether these data, especially if the same tests are repeated, can indicate patients’ well being in the future and perhaps patients’ life span, other factors being equal. Related old theories and suggestions are mentioned. Furthermore, some drugs like I-f channel antagonists and stress tests testing cardiac reserves could support such a study.
The Baroque composer Johann Sebastian Bach (1685–1750) has left us with many puzzles. The well-known oil painting by Elias Gottlob Haußmann is the only painting for which Bach actually posed in person. According to this portrait, Bach must have been quite obese. The cheeks and nose are flushed – possibly as signs of hypertension – and the eye lids are narrow – a sign of myopia. Furthermore, there is a thinning of the lateral third of the right eyebrow, which is known as Hertoghe’s sign, and indicated periorbital edema. Both signs are compatible with hypothyroidism. Bach might have been suffering from type-2 diabetes as the origin of his final illness, and the obituary reports two cataract surgeries by oculist John Taylor in March/April 1750, and, four months later, “apoplexy” followed by a high fever, of which Bach died. It may be speculated, however, that Bach’s entire illness was the result of his presumed obesity, possibly in combination with hypothyroidism.
In this paper pathophysiological interrelated deactivation/activation phenomena are set out in the example of whiplash injury. These phenomena could have been underestimated in previous positron emission tomography studies as their focus was on hypoperfusion rather than hyperperfusion. In addition, statistical parametric mapping analysis of cerebral studies is normally not fine-tuned to special interesting areas rather than to obvious clusters of difference.
This book, now in its second, completely revised and updated edition, offers a critical approach to the challenging interpretation of the latest research data obtained using functional neuroimaging in whiplash injury. Such a comprehensive guide to recent and current international research in the field is more necessary than ever, given that the confusion regarding the condition and the medicolegal discussions surrounding it have increased further despite the publication of much literature on the subject. In recent decades especially the functional imaging methods – such as single-photon emission tomography, positron emission tomography, functional MRI, and hybrid techniques – have demonstrated a variety of significant brain alterations. Functional Neuroimaging in Whiplash Injury - New Approaches covers all aspects, including the imaging tools themselves, the various methods of image analysis, different atlas systems, and diagnostic and clinical aspects. The book will help physicians, patients and their relatives and friends, and others to understand this condition as a disease.
Online comment on: "Printing ferromagnetic domains for untethered fast-transforming soft materials"
(2018)
Chronic insomnia is defined by difficulties in falling asleep, maintaining sleep, and early morning awakening, and is coupled with daytime consequences such as fatigue, attention deficits, and mood instability. These symptoms persist over a period of at least 3 months (Diagnostic and Statistical Manual 5 criteria). Chronic insomnia can be a symptom of many medical, neurological, and mental disorders. As a disorder, it incurs substantial health-care and occupational costs, and poses substantial risks for the development of cardiovascular and mental disorders, including cognitive deficits. Family and twin studies confirm that chronic insomnia can have a genetic component (heritability coefficients between 42% and 57%), whereas the investigation of autonomous and central nervous system parameters has identified hyperarousal as a final common pathway of the pathophysiology, implicating an imbalance of sleep–wake regulation consisting of either overactivity of the arousal systems, hypoactivity of the sleep-inducing systems, or both. Insomnia treatments include benzodiazepines, benzodiazepine-receptor agonists, and cognitive behavioural therapy. Treatments currently under investigation include transcranial magnetic or electrical brain stimulation, and novel methods to deliver psychological interventions.
eLetter zu "Illusory movement perception improves motor control for prosthetic hands" von Paul D. Marasco et al., veröffentlicht in Science Translational Medicine, Vol. 10, No. 432 (DOI: 10.1126/scitranslmed.aao6990)
Concussions in sports and during recreational activities are a major source of traumatic brain injury in our society. This is mainly relevant in adolescence and young adulthood, where the annual rate of diagnosed concussions is increasing from year to year. Contact sports (e.g., ice hockey, American football, or boxing) are especially exposed to repeated concussions. While most of the athletes recover fully from the trauma, some experience a variety of symptoms including headache, fatigue, dizziness, anxiety, abnormal balance and postural instability, impaired memory, or other cognitive deficits. Moreover, there is growing evidence regarding clinical and neuropathological consequences of repetitive concussions, which are also linked to an increased risk for depression and Alzheimer’s disease or the development of chronic traumatic encephalopathy. With little contribution of conventional structural imaging (computed tomography (CT) or magnetic resonance imaging (MRI)) to the evaluation of concussion, nuclear imaging techniques (i.e., positron emission tomography (PET) and single-photon emission computed tomography (SPECT)) are in a favorable position to provide reliable tools for a better understanding of the pathophysiology and the clinical evaluation of athletes suffering a concussion.
This is a commentary note on the situation of functional neuroimaging in psychiatry. With this we would like to encourage psychiatrists and the journal editors of psychiatric and related journals to at least rethink the role of functional neuroimaging in this discipline and use these imaging techniques in their various aspects of clinical diagnosis and therapy regimens,respectively.
eLetter zum Artikel "How hair can reveal a history" von Hanae Armitage & Nala Rogers, veröffentlicht in Science, Vol. 351, Issue 6278, Seite 1134 (doi.org/10.1126/science.351.6278.1134)
eLetter zum Artikel "How hair can reveal a history" von Hanae Armitage & Nala Rogers, veröffentlicht in Science, Vol. 351, Issue 6278, Seite 1134 (doi.org/10.1126/science.351.6278.1134)
eLetter zum Artikel "Hybrid EEG/EOG-based brain/neural hand exoskeleton restores fully independent daily living activities after quadriplegia" von Surjo R. Soekadar et al., veröffentlicht in Science Robotics, Vol. 1, No. 1 (DOI: 10.1126/scirobotics.aag3296)
The aim of this data collection is to enforce evidence of SCS effectiveness in treating neuropathic chronic pain and the very low percentage of undesired side effects of complications reported in our case series suggests that all implants should be performed by similarly well-trained and experienced professionals.
All you need is sleep
(2016)
In 21st century, the century when the humanity hopes to embark on interplanetary travel, we are yet to fully reach an understanding of our very own idiosyncratic terra incognita – the human sleep. Sleep is a highly conserved evolutionary process that constitutes approximately one third of our life, and the lack or inadequate sleep may lead to impairment across multiple cognitive domains (Tononi and Cirelli, 2014; Lim and Dinges, 2010). Sleep deprivation also leads to aberrant brain functioning, immunological and metabolic collapse, and if it is sufficiently prolonged it will ultimately lead to death (Tononi and Cirelli, 2014).
There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing alterations of regional cerebral blood flow (rCBF) in cWAD, (2) to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3) to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H215O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing.
In the past two decades much has been published on whiplash injury, yet both the confusion regarding the condition, and the medicolegal discussion about it have increased. In this paper, functional imaging research results are summarized using MRIcroGL3D visualization software and assembled in an image comprising regions of cerebral activation and deactivation.
Hybrid SPECT/US
(2014)
In the brain-cell microenvironment, diffusion plays an important role: apart from delivering glucose and oxygen from the vascular system to brain cells, it also moves informational substances between cells. The brain is an extremely complex structure of interwoven, intercommunicating cells, but recent theoretical and experimental works showed that the classical laws of diffusion, cast in the framework of porous media theory, can deliver an accurate quantitative description of the way molecules are transported through this tissue. The mathematical modeling and the numerical simulations are successfully applied in the investigation of diffusion processes in tissues, replacing the costly laboratory investigations. Nevertheless, modeling must rely on highly accurate information regarding the main parameters (tortuosity, volume fraction) which characterize the tissue, obtained by structural and functional imaging. The usual techniques to measure the diffusion mechanism in brain tissue are the radiotracer method, the real time iontophoretic method and integrative optical imaging using fluorescence microscopy. A promising technique for obtaining the values for characteristic parameters of the transport equation is the direct optical investigation using optical fibers. The analysis of these parameters also reveals how the local geometry of the brain changes with time or under pathological conditions. This paper presents a set of computations concerning the mass transport inside the brain tissue, for different types of cells. By measuring the time evolution of the concentration profile of an injected substance and using suitable fitting procedures, the main parameters characterizing the tissue can be determined. This type of analysis could be an important tool in understanding the functional mechanisms of effective drug delivery in complex structures such as the brain tissue. It also offers possibilities to realize optical imaging methods for in vitro and in vivo measurements using optical fibers. The model also may help in radiotracer biomarker models for the understanding of the mechanism of action of new chemical entities.
Whiplash injury
(2012)