Brain and nerve = Shinkei kenkyū no shinpo
-
Central nervous system hyperexcitability disorders, known as stiff-man/person syndrome (SPS), are thought to be related to the regulatory disturbance of inhibitory synaptic transmission of motor neurons in the brainstem and spinal cord. SPS is characterized by stiffness and spasms of the axis and limbs and is divided into two clinical subgroups: classic SPS, which affects the lumbar, trunk, and proximal limb muscles, and SPS-plus syndrome. The latter comprises (1) the stiff-limb subtype, in which symptom is limited to the lower limbs; (2) jerking stiff-man syndrome, characterized by chronically progressive stiffness and myoclonus; and (3) acute-onset and progressive encephalomyelitis with rigidity and myoclonus. ⋯ In paraneoplastic SPS, anti-amphiphysin antibodies have been shown in patients with breast cancer or small cell lung cancer. One case of mediastinal tumor with anti-gephyrin antibodies has also been reported. However, the roles of these autoantibodies in the pathomechanisms of SPS have not yet been elucidated.
-
Alzheimer's disease (AD) is the most common type of dementia in the elderly and has multiple causes. The amyloid precursor protein (APP), presenilin1 (PSEN1), and presenilin2 (PSEN2) genes were identified as causative genes in a small number of families with autosomal dominant early-onset forms of AD (ADEOAD). However, many AD cases are sporadic and the late-onset type, which develops after 65 years of age. ⋯ Mutations in the causative genes of ADEOAD have been also observed in both familial LOAD and sporadic EOAD. Furthermore, new causative genes have been identifies in some families by whole genome or exome analyses. Considering the new common disease-rare variants hypothesis, personal genome sequence analysis is a potential strategy for identifying AD risk or protective genes.
-
Compared to young people, elderly people are more likely to develop cognitive impairments associated with medications. Dementia and delirium (acute confusional state) are known to be associated with drug toxicity. ⋯ In addition, non-psychoactive drugs such as histamine H2 receptor antagonists, cardiac medications, and antibiotics may cause acute and chronic cognitive impairments. Early diagnosis and withdrawal of the offending agent is essential for treating drug-induced dementia and delirium.
-
Different surgical procedures are available for the treatment of many neuropathic pain syndromes. These surgical procedures can be divided into 2 main sections: non-destructive and destructive procedures. In recent years, the non-destructive neurostimulation method has undergone rapid development. ⋯ Currently, destructive surgical procedures have a limited range of indications for pain control. However, the advantages of destructive procedures over non-destructive ones include continuous pain reduction without implantation of a stimulation system. Each of the surgical procedures has great potential for providing patients with significant relief from neuropathic pain.
-
Musculoskeletal disorders are the most common causes of severe long-term pain and physical disability, affecting hundreds of millions of people around the world. In industrialized countries, which have increasingly aging populations, chronic musculoskeletal pain has become a significant health care burden and major issue in the 1980s and 1990s. On January 13, 2000, The Bone and Joint Decade was formally launched at the headquarters of the World Health Organization in Geneva, Switzerland. ⋯ Chronic pain had a significant impact on the occupational and social relationships, and it seriously affected their psychological conditions and quality of life. Such disabling chronic pain is regarded as the result of interrelated physical, psychological, and social or occupational factors requiring multidisciplinary intervention. We introduce a multidisciplinary clinical approach and report on novel multimodal methodologies -- for patients with chronic musculoskeletal pain.