Brain and nerve = Shinkei kenkyū no shinpo
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Human actions, emotions, and decision making are products of complex interactions between explicit and implicit processes at various levels of spatial and temporal scales. Although it may not be possible to obtain to experimental data for all the complexity of human behavioral and emotional processes in our everyday life, recent studies have investigated the effects of social contexts on actions, emotions, and decision making; these studies include those in the fields of experimental psychology, cognitive science, and neuroscience. In this paper, we review several empirical studies that exemplify how our actions, social emotions, and decision making are influenced by the presence of implicit external, rather than internal factors, particularly by presence of other individuals. ⋯ This tendency occurs unconsciously even when the observed and the to-be-executed movements are unrelated at various levels and aspects of behaviors (e. g., behavioral tempo and speed). (2) Neural substrates of social emotions: Various social emotions, including admiration, compassion, envy, and schadenfreude, are represented in neuronal networks that are similar to those of basic emotional processes. (3) Evasive nature of human decision making: Individuals tend to overrate their own subjective impression of and emotional reaction in forecasting affective reaction to events in the future, even though the predictive power of information from peer group is much larger in this regard. Individuals are seldom aware of the dissociation between their intended choice and excuted actions and are willing to give elaborate explanations for the choices they, in fact, did not make. Using these empirical examples, I will illustrate the considerable influences of implicit, unconscious processes on human actions, emotions, and decision making.
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Review
[Magnetic resonance imaging in patients of amyotrophic lateral sclerosis with and without dementia].
Classic magnetic resonance imaging (MRI) findings in patients with amyotrophic lateral sclerosis (ALS) are subtle, but some findings have been reported such as signal changes in the primary motor cortex and the corticospinal tract (CST). Only a few reports have discussed MRI findings of ALS with dementia (ALS-D), in which frontotemporal atrophy and hyperintensity in subcortical white matter of bilateral temporal tips have been reported. Recent development of diffusion tensor imaging (DTI) techniques allows us to extract specific white matter tracts and to analyze them quantitatively, i.e. we can visualize the CST and can also measure its integrity using DTI parameters such as fractional anisotropy (FA) or apparent diffusion coefficient (ADC). ⋯ Voxel based morphometry or statistical analysis of imaging are the newly developed methods which enable to make objective and reliable imaging analysis based on automated procedure using standardized database. We also presented several researches using these techniques. In this article, we reviewed classic imaging findings and recent development of MRI including DTI and statistical imaging analysis in patients with ALS/ALS-D.
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Review Case Reports
[Case of ruptured middle cerebral artery bifurcation aneurysm presenting as putaminal hemorrhage without subarachnoid hemorrhage].
Ruptured aneurysms typically present as subarachnoid hemorrhage (SAH); however, they can also cause intracerebral hemorrhage (ICH) that can be mistaken for hypertensive hemorrhage. We report a rare case of a ruptured middle cerebral artery bifurcation aneurysm presenting as putaminal hemorrhage without subarachnoid hemorrhage (SAH). A 47-year-old man, with a past history of hypertension, presented with a decreased level of consciousness. ⋯ We performed aneurysmal clipping and hematoma evacuation. The postoperative course was uneventful. This case suggested that ruptured aneurysms situated on the middle cerebral artery can present as putaminal hemorrhage without SAH.
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Beta blockers (beta-adrenoceptor blockers) are known to be used for the prophylactic treatment of migraine. The improvement of migraine in the patients who recieved propranolol for angina pectoris revealed the effectiveness of propranolol in migraine prophylaxis. Many clinical trials have confirmed that propranolol is effective in the prophylactic treatment of migraine. ⋯ In contrast, several beta blockers with intrinsic sympathetic activity (ISA), such as alprenolol, oxprenolol, pindolol and acebutolol, have not been demonstrated to be effective in migraine prophylaxis. In this review, we have descrived the pharmacologic background and pharmacokinetics of the beta blockers that demonstrated a prophylactic effect for migraine will be described. We have also reviewed the results of clinical trials of beta-blocking drugs for migraine.
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The US Food and Drug Administration (FDA) approved the use of intravenous (IV) recombinant tissue plasminogen activator (rt-PA) in 1996, on the basis of the results of the National Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Study. IV rt-PA therapy at a dose of 0.9 mg/kg has been approved internationally for the treatment of hyperacute ischemic stroke. After a dose comparison study using duteplase and a multicenter study using a single dose of alteplase (Japan Alteplase Clinical Trial: J-ACT), the administration of IV rt-PA therapy at a dose of 0.6 mg/kg was approved in Japan in 2005. ⋯ A combination of reperfusion therapies, IV rt-PA and sonothrombolysis, neuroprotective agents or antiplatelet agents may be effective. However, currently available data do not provide conclusive evidence for the safety or efficacy of these combination therapies. Patients having ICA occlusion may require alternatives including a higher dose of alteplase, combined IV/IA thrombolysis, or possibly mechanical thrombectomy by using a thrombus-removal device.