Vol 2-3 Mini Review

Comorbidity of Depression and Pain: a review of shared contributing mechanisms

Ai-Ling Li1,2,3*, Yuan Bo Peng1

1Department of Psychology, The University of Texas at Arlington, 501 South Nedderman Drive, Arlington, Texas 76019, USA
2Department of Psychological & Brain Sciences, Indiana University Bloomington, 1101 E. 10th St., Bloomington, IN 47405, USA.
3Gill Center for Biomolecular Science, Indianan University Bloomington, 702 N. Walnut Grove Ave., Bloomington, IN 47405, USA.

 Pain and depression are two major health issues that we are currently facing. Chronic pain is the main reason that people seek medical care; and numerous people commit suicide each year because of depression. These two pathological conditions often coexist. Chronic pain patients are more likely to develop major depressive symptoms, while depressed patients reported more pain symptoms than normal healthy population. Understanding the common mechanisms associated with depression and pain is important for developing the effective strategy to treat this comorbidity. In this review, the potential mechanisms that contribute to both depression and pain are discussed from four perspectives, the morphological changes in the brain, monoamine deficiency, brain-derived neurotrophic factor (BDNF) reduction in the hippocampus, and the hypothalamic-pituitary-adrenocortical (HPA) axis dysfunction.

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Vol 2-3 Commentary

Commentary: Early Secondary Prevention of Cardioembolic Stroke with Direct Oral Anticoagulants (DOAC)

Kosmas Macha, Bastian Volbers, Bernd Kallmünzer

Department of Neurology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany

 Direct Oral Anticoagulants (DOAC) are highly effective for the prevention of systemic embolism and ischemic stroke in non-valvular atrial fibrillation, but the optimal time point of treatment initiation after stroke has not been defined yet. The very early period after stroke bears a particular high risk of stroke recurrence and the timely initiation of secondary prevention at that early stage could therefore be most beneficial for the patient. Contrarily the use of DOAC in the hyperacute phase of stroke might increase the risk of bleeding complications. The prospective trials investigating the use of DOAC versus vitamin K antagonists did not include patients during the first weeks after stroke due to safety concerns. However, preliminary results from smaller cohorts suggest that the use of DOACs in this early time frame is feasible and safe. Larger prospective trials are warranted to confirm these results and investigate the efficacy of early treatment initiation.

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Vol 2-3 Mini Review

Basilar Invagination: cranio-cervical kyphosis rather than prolapse from the upper cervical spine

Ricardo Vieira Botelho1, Juliete Melo Diniz1

Post-graduation program-IAMSPE; Neurosurgical department-Hospital do Servidor Público Estadual and Conjunto Hospitalar do Mandaqui-São Paulo, Capital, Brazil.

 Background: Adult craniocervical junction malformations have been described as Chiari malformation (CM) and Basilar invagination (BI). Recently, angular craniometric studies have identified differences among subtypes of malformations and reveled new relationships between skull and spine. Objective: The scope of this study is to summarize the knowledge related to craniometric relationship in pathophysiology of these diseases. Results: In CM, angular craniometric measures are not different from normal controls. In BI type I and II there is an increased craniocervical Kyphosis associated to cervical spine lordosis. Chamberlain’s line violation evaluation reveals that there is a downward angulation of the skull towards the upper cervical spine in BI. Conclusion: BI should be considered a craniometrical kyphosis rather than a prolapse of the cervical spine to the skull base.

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Vol 2-3 Commentary
Vol 2-3 Mini Review

Mobile team reintegration-rehabilitation: An activity outside. Results of 3 years of functioning to the Pole Saint-Helier

A Duruflé1, C Le Meur1, P Gallien1, C Lozach1, MP Reillon1, N Clerc1, M Jambou1, B Nicolas1

1Pôle Saint Hélier, 54 rue Saint Hélier, 35 043 Rennes cedex, France

 Many mobile teams were created over the past decade in various medical specialties including physical medicine and rehabilitation.

The Pole Saint Helier has created a mobile team of reintegration - rehabilitation (EM2R) in December 2012 with support from the Regional Health Agency of Brittany. It operates on the health territory No. 5 of Brittany near people experiencing neurological disability. Its main mission is to implement the necessary devices to facilitate the home return of people hospitalized after a neurological event or maintaining to home people with neurological disorders.

The number of supported annual is about 200. People with brain lesions account for 2/3 of the population, mean age 60 years, with a high degree of dependence. The complexity of the patients become clearer with a minimum of two professionals involved by patient. Occupational therapy represents the majority of requests for intervention. New activities have emerged: supported to people with brain tumor, collaborations with palliative mobile teams and home hospital, formation and education of caregivers.

This activity outside is an alternative to the PMR care offer in link especially with the recommendations of the French Society of Physical Medicine and Rehabilitation and High Autority of Health on the organization of care pathway of stroke.

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Vol 2-3 Mini Review

Axonal Transport: A Constrained System

Clare C. Yu1, Babu J. N. Reddy2, Juliana C. Wortman1, Steven P. Gross1,2

1Department of Physics and Astronomy, University of California, Irvine, Irvine, California, USA
2Department of Developmental and Cell Biology, University of California, Irvine, Irvine, California, USA

Long-distance intracellular axonal transport is predominantly microtubulebased, and its impairment is linked to neurodegeneration. Here we review recent theoretical and experimental evidence that suggest that near the axon boundaries (walls), the effective viscosity can become large enough to impede cargo transport in small (but not large) caliber axons. Theoretical work suggests that this opposition to motion increases rapidly as the cargo approaches the wall. However, having parallel microtubules close enough together to enable a cargo to simultaneously engage motors on more than one microtubule dramatically enhances motor activity, and thus decreases the effects due to such opposition. Experimental evidence supports this hypothesis: in small caliber axons, microtubule density is higher, increasing the probability of having parallel microtubules close enough that they can be used simultaneously by motors on a cargo. For transport toward the minus-end of microtubules, e.g., toward the cell body in an axon, a recently discovered forceadaptation system can also contribute to overcoming such opposition to motion.

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