Clin Med
-
We all know people with tone deafness: these are the people who get thrown out of the choir at school. Although tone deafness is recognised as an output disorder, recent studies have characterised it as one of music perception in the absence of deafness or any associated cognitive disorder. The disorder can therefore be characterised as a form of auditory agnosia. ⋯ Studies of multiply affected families are underway to see if the disruption of this network can be caused by single genes. This disorder therefore offers the opportunity to study how a complex phenotype can be characterised as a cortical perceptual disorder potentially explained by a single gene or molecule. Although tone deafness is not pernicious, the underlying abnormality may prove to be a disorder of cortical connectivity that provides a model for disorders that are more so, such as schizophrenia.
-
Decisions about the use of therapeutic interventions, whether for individuals or entire healthcare systems, should be based on the totality of the available evidence. The notion that evidence can be reliably or usefully placed in 'hierarchies' is illusory. Rather, decision makers need to exercise judgement about whether (and when) evidence gathered from experimental or observational sources is fit for purpose.
-
Movement impairment affects the independence and lifestyle of a significant number of people worldwide. A MDT approach towards the problem is needed for optimal restoration of mobility. ⋯ Assessment of the patient is critical to ensure successful outcomes of technological interventions. Novel technologies such as targeted reinnervation prosthesis and implantable technologies, although at a very early stage in their development, have huge potential to help people with movement impairments due to disorders of neuromuscular control or limb loss.