Left or right carotid endarterectomy in patients with atherosclerotic disease: ipsilateral effects on cognition?

We evaluated hemispheric functions ipsilateral to the side of carotid endarterectomy (CEA) in patients with a severe stenosis in the left or right carotid artery. Assessments took place 1 day before and 3 months after CEA. Only right-handed males were included. Nineteen patients underwent surgery of the left carotid artery and 17 of the right. Valid instruments for hemispheric function were included, such as verbal dichotic listening, finger tapping, and a lateralised test for motor planning. Results showed that, preoperatively, patients had lower scores compared to norms on the laterality tests, and on a visuoconstructive test. There was no evidence of ipsilateral improvement related to side of surgery. Left ear dichotic listening improved, which was seen in both left and right surgery groups. Also in both groups, left- and right-hand movement speed in the motor planning test decreased. Conclusion is that beneficial ipsilateral cognitive change after CEA in patients with severe stenosis in one of the carotid arteries may not be demonstrated, even if valid instruments for hemispheric function are included.     

Crying Without Tears: Dimensions of Crying and Relations With Ocular Dryness and Mental Well-Being in Patients With Sjögren’s Syndrome

This study examined dimensions of crying and its relations with ocular dryness and mental well-being in patients with Sjögren’s syndrome, a systemic autoimmune disease with dryness as primary symptom. Three-hundred patients with Sjögren’s syndrome completed questionnaires on crying, dryness, and well-being. The crying questionnaire revealed four dimensions: “Cryability” (comprising both crying sensibility and ability to cry), Somatic consequences, Frustration, and Suppression. Compared to 100 demographically-matched control participants from the general population, patients scored low on Cryability and high on Somatic consequences and Frustration. The crying dimensions generally showed significant but weak associations with ocular dryness and mental well-being in patients. This is the first quantitative study indicating that crying problems are more common in patients with Sjögren’s syndrome than in the general population. Perhaps, patients who experience problems with crying could be helped to rely on other ways of expressing emotions than crying in tear-inducing situations.     

Discovering New Ways of Moving: Observational Analysis of Motor Creativity While Dancing Contact Improvisation and the Influence of the Partner

Contact improvisation (CI) is a form of dance based on motor creativity, improvisation and the physical contact between different improvisers dancing together. This will generate different ways of moving and a varied use of motor creativity depending on the dancers involved. This study aims to observe the differences in movement generation depending on the partner by using OSMOS (Observational System of Motor Skills; Castañer & Camerino 2006; Castañer et al., 2009). Four contact improvisers were video‐recorded while dancing in duets. Data were analysed by three observers using Theme Coder software (Magnusson, 1996) for the detection of T‐patterns and the production of event frequency charts. The results show that (1) the motor skills that appear most frequently are the conduction of partners, elevations, spatial level changes and turns; (2) motor creativity is affected by the partner, as there is a reciprocal influence in the dance; and (3) motor creativity is enhanced by interaction with a partner.     

Why Dexamethasone Poorly Penetrates in Brain

Dexamethasone poorly penetrates in brain. A tracer amount of [3H]-dexamethasone administered to adrenalectomized rats or mice is poorly retained by glucocorticoid receptors in brain, while pituitary corticotrophs containing equivalent amounts of these receptors accumulate and retain large amounts of this synthetic steroid. However, adrenalectomized mice with a genetic disruption of the multiple drug resistance (mrd1a) gene have a tenfold increase of [3H]-dexamethasone uptake in brain glucocorticoid target sites reaching levels observed in the pituitary. These data demonstrate that dexamethasone is extruded from brain by the mrd1a-encoded P-glycoproteins. The data support the concept of a pituitary site of action of dexamethasone in blockade of stress-induced ACTH release, which implies that chronic dexamethasone treatment does not replace the endogenous corticosteroids depleted from brain mineralocorticoid (MRs) and glucocorticoid receptors (GRs). Dexamethasone, therefore, causes a profound disturbance in the balance of these two receptor types in hippocampus, which is an unfavourable condition threatening the neuronal integrity of this brain structure through the expression of noxious genes.     

Dexamethasone Does Not Prevent Seven-Day ADX-Induced Apoptosis in the Dentate Gyrus of the Rat Hippocampus

Long-term adrenalectomy (ADX) is known to result in apoptosis within the dentate gyrus of the rat hippocampus. While the underlying mechanism is still unclear, adrenal steroids appear to play a pivotal role in granule cell survival, as administration of the mineralocorticoid receptor (MR) agonists, corticosterone and aldosterone, to ADX rats results in protection against the ADX-induced effect. The consequence of administration of the glucocorticoid receptor (GR) agonists, dexamethasone and RU28362, however, is less clear, and either complete or only partial protection for the ADX animal has been reported. This study investigated further the role played by GR in the degenerative process. After establishing the characteristics of seven-day ADX-induced apoptosis in the young male Wistar rat, the effect of chronically-implanted, subcutaneous pellets containing various doses of dexamethasone and corticosterone, on ADX-induced apoptosis was studied. Both high and low doses of corticosterone were found to be protective. In contrast to some other studies, however, neither dose of dexamethasone had any obvious protective effect and rather seemed to increase apoptosis in dentate gyrus of intact animals. Intracerebroventricular infusion of dexamethasone for seven days was also found to be ineffective in preventing apoptosis, demonstrating that it is occupation of MR, rather than GR, which is crucial to dentate gyrus granule cell survival.