Quantifying changes over 1 year in motor and cognitive skill after transient ischemic attack (TIA) using robotics

Recent work has highlighted that people who have had TIA may have abnormal motor and cognitive function. We aimed to quantify deficits in a cohort of individuals who had TIA and measured changes in their abilities to perform behavioural tasks over 1 year of follow-up using the Kinarm Exoskeleton robot. We additionally considered performance and change over time in an active control cohort of migraineurs. Individuals who had TIA or migraine completed 8 behavioural tasks that assessed cognition as well as motor and sensory functionality in the arm. Participants in the TIA cohort were assessed at 2, 6, 12, and 52 weeks after symptom resolution. Migraineurs were assessed at 2 and 52 weeks after symptom resolution. We measured overall performance on each task using an aggregate metric called Task Score and quantified any significant change in performance including the potential influence of learning. We recruited 48 individuals to the TIA cohort and 28 individuals to the migraine cohort. Individuals in both groups displayed impairments on robotic tasks within 2 weeks of symptom cessation and also at approximately 1 year after symptom cessation, most commonly in tests of cognitive-motor integration. Up to 51.3% of people in the TIA cohort demonstrated an impairment on a given task within 2-weeks of symptom resolution, and up to 27.3% had an impairment after 1 year. In the migraine group, these numbers were 37.5% and 31.6%, respectively. We identified that up to 18% of participants in the TIA group, and up to 10% in the migraine group, displayed impairments that persisted for up to 1 year after symptom resolution. Finally, we determined that a subset of both cohorts (25–30%) experienced statistically significant deteriorations in performance after 1 year. People who have experienced transient neurological symptoms, such as those that arise from TIA or migraine, may continue to experience lasting neurological impairments. Most individuals had relatively stable task performance over time, with some impairments persisting for up to 1 year. However, some individuals demonstrated substantial changes in performance, which highlights the heterogeneity of these neurological disorders. These findings demonstrate the need to consider factors that contribute to lasting neurological impairment, approaches that could be developed to alleviate the lasting effects of TIA or migraine, and the need to consider individual neurological status, even following transient neurological symptoms.

Gamma band alterations and REM-like traits underpin the acute effect of the atypical psychedelic ibogaine

Ibogaine is a psychedelic alkaloid that has attracted scientific interest because of its important antiaddictive properties evidenced in observational studies in humans, and in models for substance-use-disorders in rodents. Its subjective effect has been described as intense vivid dream-like experiences occurring while awake; hence, ibogaine is often referred to as an oneirogenic psychedelic. While this unique dream-like profile has been hypothesized to aid the antiaddictive effects in the past, the electrophysiological signatures of the ibogaine psychedelic state remain unknown. In our previous work, we showed in rats that ibogaine administration promotes a waking state with abnormal motor behavior, accompanied by a decrease in NREM and REM sleep. Here, we performed an in-depth analysis of the intracranial electroencephalogram during “ibogaine wakefulness”. Ibogaine induced gamma oscillations with larger power than control levels but less coherent and less complex; i.e., this state shows clear REM sleep traits within the gamma frequency band. Thus, our results provide novel biological evidence for the association between the psychedelic state and REM sleep, and an empirical basis for the oneirogenic conjecture of ibogaine.

THE RELATIONSHIP OF NUTRITIONAL STATUS WITH CRUDE MOTOR DEVELOPMENT IN CHILDREN AGED 2-3 YEARS IN POSYANDU WORK AREA SITU UDIK PUSKESMAS

According to UNICEF in 2011,dataofthe high number ofgrowth and development disorderinchildren under fivewas obtained,especially motor development disorder where (27.5%) or 3 million children had disorder. This research aims to determine theCorrelation ofNutritional StatusandGross Motor Developmentin 2-3 Year OldChildren atMaternal and Child Health Servicein Situ UdikCommunity Health Center Working Area. This is an analytic researchwith cross-sectional research design. This research was conducted atMaternal and Child Health Service atSitu UdikCommunity Health CenterinOctober 2017-October 2018 with total sample of 114 2-3 year oldchildrenby implementingSlovin formula for the sampling. The instruments used weredemographic questionnaire, DDST IIobservation sheet, and weight scale that had been provided. Furthermore,univariate and bivariate analysis were applied in analyzing the data. Based on nutritional status,children who hadmalnutrition were 22 children (29.7%) with normal motor development, 43 children (58.1%) were suspected abnormal motor development, and 9 children (12.2%) who could not be tested. Children who hadgood nutrition were 21 children (56.8%) with normal gross motor development, 10 children (27.0%) were suspected, and 6 children (16.2%) who could not be tested. Children who hadovernutrition were 2 children (66.7%) with normal gross motor development, 1 (33.3%) child were suspected abnormal motor development. In addition, the statistical test value = 0.026 obtained meaning thatnutritional status has significant correlation withgross motor development in 2-3 year oldchildren atMaternal and Child Health Service in Situ Udik Community Health Center Working Area.

Clinical Manifestation Differences of Schizophrenia Patients Based on Gender

Background: Schizophrenia is yet to be deeply understood, despite being one of the most common mental illnesses in the world. Male and female schizophrenic patients may show different clinical presentations. The differences have been studied extensively globally, but there has yet many reports in regards of this in Indonesia.Aims: Knowing the differences of clinical manifestation on schizophrenia patients based on gender.Method: This research is analytic study in retrospective design. The data is taken from medical records of male and female schizophrenic inpatients of Psychiatric Ward of Dr. Soetomo General Hospital Surabaya on January 1st to December 31st, 2018, in total of 75 samples included. Data is processed with ANOVA statistic method.Result: The prevalence of male schizophrenic inpatients is 65,3% and 34,7% for female inpatients, with the ratio of 1,88:1. The differences of clinical presentations are not significant for the following clinical manifestations; abnormal motor behaviour (P=0,281), delusion (P=0,240), disorganized thinking (P=0,306), diminished emotional expression (P=0,295), and avolition (P=0,633) clinical manifestations. There is a significant difference in hallucination clinical manifestation between male and female inpatients (P=0,037).Conclusion: There is a significant difference in schizophrenia’s clinical manifestation of hallucination between male and female inpatients.

0003 LGI1 and CASPR2 Autoimmunity: Sleep Symptoms, Polysomnography, and Quantitative REM Sleep without Atonia

Introduction Sleep disturbances, including rapid eye movement (REM) behavior disorder (RBD), are known manifestations of voltage-gated-potassium-channel-complex VGKC-IgG seropositivity (VGKC+). Discovery of leucine-rich, glioma inactivated protein 1 (LGI1) and contactin-associated protein 2 (CASPR2) have refined our understanding of VGKC+. VGKC+ without LGI1/CASPR2-IgG (“double-negative”) has lost its clinical significance. Previous detailed sleep analysis of these subtypes has been limited. Methods We performed a retrospective study to characterize clinical and polysomnographic features of LGI1/CASPR2 seropositive (LGI1+/CASPR2+) and VGKC double-negative patients, including quantitative REM sleep without atonia (RSWA). Quantified RSWA was compared to matched controls and normative RSWA percentiles. Results Eleven LGI1+/CASPR2+ (LGI1+, 9) and twelve VGKC double-negative patients were analyzed. Insomnia was seen in 55% of LGI1+/CASPR2+ and 8% of VGKC double-negative patients (p=0.05). The LGI1+/CASPR2+ group had reduced slow wave sleep compared to the VGKC double-negative group. Five LGI1+ patients had clinical dream enactment behavior (DEB). Eight LGI1+ patients met quantitative diagnostic levels of RSWA. Higher RSWA levels were seen in the LGI1+/CASPR2+ group. Ten LGI1+/CASPR2+ patients received immunotherapy; all ten neurologically benefited with sleep benefits in 6/10. Conclusion Sleep disorders such as insomnia and RBD are part of the LGI1/CASPR2 autoimmune phenotype. Objective sleep manifestations can be seen on polysomnogram in the form of reduced N3 and elevated RSWA as compared to controls. Quantitative RSWA analysis identified RBD in more LGI1+ patients than clinical report or qualitative RSWA. In this study, RBD was only seen with LGI1+, not CASPR2+. The intermediate RSWA levels of the VGKC double-negative patients may suggest a spectrum of abnormal motor activity in these related antibodies. Additional studies are needed to further explore the biomarker potential of quantitative RSWA in autoimmune neurological conditions. Support This project was supported by the National Center forResearch Resources, National Institutes of Health, through Grant Number 1 UL1 RR024150- 01.