Hypothalamic Hamartomas: Evolving Understanding and Management

Hypothalamic hamartomas (HH) are rare, basilar developmental lesions with widespread comorbidities often associated with refractory epilepsy and encephalopathy. Imaging advances allow for early, even prenatal, detection. Genetic studies suggest mutations in GLI3 and other patterning genes are involved in HH pathogenesis. About 50-80% of children with HH suffer from severe rage and aggression and a majority of cases exhibit externalizing disorders. Behavioral disruption and intellectual disability may predate epilepsy. Neuropsychological, sleep and endocrine disorders are typical. The purpose of this paper is to provide a summary of the current understanding of HH, and to highlight opportunities for future research.

Is PTSD-Phenotype Associated with HPA-Axis Sensitivity?: The Endocannabinoid System in Modulating Stress Response in Rats

Endocannabinoids play a role in adaptation to stress and regulate the release of glucocorticoids in stressed and unstressed conditions. We recently found that basal corticosterone pulsatility may significantly impact the vulnerability for developing post-traumatic-stress-disorder (PTSD), suggesting that the endocannabinoid system may contribute to its development. To examine this, we exposed rats to predator scent stress (PSS). Behavioral reactions were recorded seven days post-PSS. Cerebrospinal fluid (CSF) was collected from anesthetized rats shortly after PSS exposure to determine the levels of 2-arachidonoyl glycerol (2-AG) and anandamide (AEA). To correlate between endocannabinoids and corticosterone levels, rats were placed in metabolic cages for urine collection. To assess the levels of endocannabinoids in specific brain regions, rats’ brains were harvested one day after behavioral analysis for staining and fluorescence quantification. Moreover, 2-AG was elevated in the CSF of PTSD-phenotype rats as compared with other groups and was inversely correlated with corticosterone urinary secretion. Eight days post-PSS exposure, hippocampal and hypothalamic 2-AG levels and hippocampal AEA levels were significantly more reduced in the PTSD-phenotype group compared to other groups. We posit that maladaptation to stress, which is propagated by an abnormal activation of endocannabinoids, mediates the subsequent stress-induced behavioral disruption, which, later, reduces neuronal the expression of endocannabinoids, contributing to PTSD symptomology.

Changing Technology or Behavior? The Impacts of a Behavioral Disruption

Transportation is a key factor in the fight against climate change. Consumer behavior changes in transportation are underrepresented in energy policies, even if they could be essential to achieve the fixed GHG emission reduction targets. To help quantify the role of behaviors in energy transition and their implications on the dynamics of an energy system, this study is conducted using the North American TIMES Energy Model, adapted to Quebec (Canada). A behavioral disruption scenario (an increase in carpooling) is introduced in the model’s transportation sector and is compared to a massive electrification scenario. Our results highlight the fact that a behavioral disruption can lead to the same GHG emission reductions (65%) by 2050 as an electrification policy, while alleviating different efforts (such as additional electrical capacity and additional costs) associated with massive electrification. Moreover, the results are sensitive to behavior-related parameters, such as social discount rates and car lifetimes.

Tax Enforcement in the Black Economy

The black economy—also called the hidden, covert, underground, grey, illicit, or cash economy—is used to describe the aspect of a country's economy that is not visibly subject to taxation. However, it is also a useful measure of behavioral disruption to the taxation system, as the scale and tactics of black economy participants vary over time. The purpose of this chapter is to suggest that existing tax policy (where legal constraints alone are used) is insufficient to affect black economy behaviour. It suggests that by adopting responses that are “more than law,” revenue administrations can deploy a more advanced and effective approach to improve tax compliance and can decrease the negative impacts of the black economy.

Psychoeducation

This chapter explains the tripartite model of anxiety: physiological arousal, behavioral disruption and avoidance, and distorted cognition. The interaction of these three components underlies the cognitive–behavioral therapy (CBT) model for this treatment. The material begins laying the groundwork for cognition as the precipitating event in a downward spiral and for avoidance as key in maintaining the problem. These concepts are important for helping clients understand the rationale for the primary components of treatment (cognitive restructuring and exposure both in and out of session). One goal of this chapter is to develop a common language to understand anxiety, which is helped by spending some time on each of the three components of anxiety to ensure that the client understands each component before moving on to their interaction.

C-21 Emotional Predictors of Self-Reported Frontal Behavior Disruption in Older Adults

Objective Behavioral manifestations of executive dysfunction (e.g., apathy) include internal experiences subject to informant misinterpretation. Self-reports of these functions, however, may be influenced by subjective cognitive concerns (SCC). The purpose of this study was to assess emotional distress and SCC as predictors of self-reported frontal behavior disruption. Method Twenty-one women and 18 men aged 55 to 83 (M = 66), completed measures of emotional functioning and SCC. The Frontal Systems Behavior Scale (FrSBe) measured frontal behavior concerns, which provided three subscales (Apathy, Disinhibition, Executive Function) and a total score. Emotional functioning was measured with the Patient Health Questionnaire, 9-item (PHQ-9), Generalized Anxiety Disorder, 7-item (GAD-7), and the Dementia Worry Scale (DWS). SCCs were measured using the Cognitive Function- Short-Form 6a (CFSF). Results FrSBe scores were regressed on PHQ-9, GAD-7, CFSF, and DWS. Apathy was predicted by PHQ (B = 1.02, CI: .49 to 1.55, sr2 = .151), CFSF (B = -.42, CI: -.75 to -.10, sr2 = .071), and DWS (B = .14, CI: .02 to .26, sr2 = .052). Disinhibition was predicted by CFSF (B = -.61, CI: -1.06 to -.15, sr2 = .134). Executive dysfunction was predicted by DWS (B = .22, CI: .02 to .41, sr2 = .080). Trends were found for PHQ and CFSF to predict Executive Dysfunction. Conclusions Depression, dementia worry, and SCC predicted aspects of perceived frontal behavior disruption, particularly apathy. Subjective cognitive concern predicted perceived apathy ad disinhibition; dementia worry predicted perceived apathy and executive dysfunction. Depression was only predictive of perceived apathy. These findings support the relationship between depression, dementia worry, SCC, and self-reported behavioral disruption emphasizing the importance of emotions and SCC in self-reported behavioral functioning.