Brain and nerve = Shinkei kenkyū no shinpo
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Restless legs syndrome (RLS) is a sensorimotor disorder, characterized by an irresistible urge to move the legs and usually accompanied or caused by uncomfortable and unpleasant sensations. It begins or worsens during periods of rest or inactivity, is partially or totally relieved by movement and is exacerbated or occurs mainly in the evening or night. People suffering from RLS are estimated to represent 2-3% of the general Japanese population, which is relatively lower than the estimated prevalence in western countries. ⋯ Small fiber neuropathy can trigger RLS or mimic its symptoms. RLS is associated with many neurological disorders, including Parkinson disease and multiple system atrophy; althoughit does not predispose to these diseases. A symptom rating scale for RLS authorized by the International RLS Study Group (IRLS) would facilitate accurate diagnosis of this condition.
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Restless legs syndrome (RLS) is a sensorimotor disorder characterized by an irresistible urge to move the legs, accompanied by uncomfortable and unpleasant sensations that diminish with motor activity and worsen at rest. The symptoms of this syndrome worsen in the evening and at night, leading to difficulty in sleeping. Treatment of RLS includes non-pharmacological intervention and drug therapy. ⋯ More recently, studies on the use of anticonvulsants for the treatment of RLS have focused on gabapentin. Benzodiazepines, including clonazepam and nitrazepam, are widely prescribed, but their therapeutic effects on RLS symptoms were rather modest. Therefore, benzodiazepines are mostly used to improve the sleep quality in patients with RLS.
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Case Reports
[Deficits of mnemonic rhyme for the multiplication table (Kuku) after right putaminal hemorrhage].
In Japan, the multiplication table is learned predominantly by rote learning of reciting multiplication table (which is named Kuku) with a standardized mnemonic rhymes. The Kuku is memorized intensively by oral repetitions. Therefore, it is not clear whether the neuropsychological features of the deficit of the Kuku and that of the multiplication table in Western countries after brain injury are the same or not. ⋯ Moreover, our patient did not make any errors when the first operand of the Kuku was 5. Sparing of multiplication errors when the first operand is 5 has been reported in another Japanese case study on acalculia as well as in studies of healthy Japanese children; however, this has never been reported in Western studies. Therefore, it was suggested that there were similarities as well as differences between the deficits of multiplication table in Western and Japanese patients after brain injury.
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Review
[Cortico-basal ganglia circuits--parallel closed loops and convergent/divergent connections].
The basal ganglia play important roles not only in motor control but also in higher cognitive functions such as reinforcement learning and procedural memory. Anatomical studies on the neuronal connections between the basal ganglia, cerebral cortex, and thalamus have demonstrated that these nuclei and cortical areas are interconnected via independent parallel loop circuits. The association, motor, and limbic cortices project to specific domains in the striatum, which, in turn, project back to the corresponding cortical areas via the substantia nigra/globus pallidus and the thalamus. ⋯ It has also been suggested that the location of the substantia nigra is in such that it can transmit information from the 'limbic loop' to the 'association loop', and from the 'association loop' to the 'motor loop'. Furthermore, a recent transsynaptic neuronal tracing study conducted at our laboratory demonstrated that the ventral (limbic) striatum sends divergent outputs to multiple regions in the frontal cortex. These 'inter-loop' connections would be important for the integration of information to achieve goal-directed behaviors.