Chronic intermittent bipolar electrical stimulation of the left nucleus reticulatus polaris thalami was performed in a patient in a state of subcoma due to ischaemic infarction of wide medial parts of the midbrain, mainly the tegmentum, and the right-sided mediobasal parts of the forebrain. Stimulation immediately resulted in autonomic reactions and behavioural arousal reactions during the periods of stimulation. Longterm effect consisted of a rise in the level of clinical responsiveness for a period of seven weeks. A preexistent severe pneumonia disappeared completely after one week of stimulation and returned after seven weeks. The results are discussed on the basis of the pathoanatomical findings and of the physiological functions of the damaged as well as of the stimulated areas.
The synthesis of a series of nine large macrocyclic ligands with two N(2)S(2) (thioether and Schiff-base imine) binding sites each, with different bridges between the donor atoms of each site (ethylene, o-xylylene, propylene, butylene) and different spacer groups between the two binding sites (p-xylylene, 2,5-dimethyl-p-xylylene, 2,5-dimethoxy-p-xylylene), and the synthesis of a similar ligand with a preorganized double-helical geometry, based on a paracyclophane spacer group, are reported, together with the syntheses and characterizations of the corresponding dicopper(I) compounds. The solid state structures of the dicopper(I) complexes have two tetrahedral copper(I) sites, separated by ca. 8 Å, and a figure-of-eight loop configuration of the ligand with a parallel arrangement of the two substituted benzene spacer groups (benzene.benzene distance of ca. 3.5 Å). All the dicopper(I) compounds have the same double-helical configuration ("twisted ring figure-of-eight loop"). NMR spectroscopy indicates that the monocyclic metal-free ligands have an open, cyclic structure in solution, while the dicopper(I) compounds are folded as in the solid. In acetonitrile there is a fast dynamic equilibrium between two enantiomeric forms of the double-helical dicopper(I) compounds. The fact that copper(I)-donor atom bond breaking is involved in this process is supported by (1)H NMR data and by the X-ray crystal structure analysis of a putative intermediate with each of the two copper(I) centers coordinated to one acetonitrile and three donors of the macrocycle. A second fast dynamic, solvent independent process (epimerization) has been identified in nitromethane and acetonitrile, involving helix inversion with full conservation of the copper(I) coordination.
BackgroundObjective assessments of Parkinson’s disease (PD) patients’ motor state using motion capture techniques are still rarely used in clinical practice, even though they may improve clinical management. One major obstacle relates to the large dimensionality of motor abnormalities in PD. We aimed to extract global motor performance measures covering different everyday motor tasks, as a function of a clinical intervention, i.e., deep brain stimulation (DBS) of the subthalamic nucleus.MethodsWe followed a data-driven, machine-learning approach and propose performance measures that employ Random Forests with probability distributions. We applied this method to 14 PD patients with DBS switched-off or -on, and 26 healthy control subjects performing the Timed Up and Go Test (TUG), the Functional Reach Test (FRT), a hand coordination task, walking 10-m straight, and a 90° curve.ResultsFor each motor task, a Random Forest identified a specific set of metrics that optimally separated PD off DBS from healthy subjects. We noted the highest accuracy (94.6%) for standing up. This corresponded to a sensitivity of 91.5% to detect a PD patient off DBS, and a specificity of 97.2% representing the rate of correctly identified healthy subjects. We then calculated performance measures based on these sets of metrics and applied those results to characterize symptom severity in different motor tasks. Task-specific symptom severity measures correlated significantly with each other and with the Unified Parkinson’s Disease Rating Scale (UPDRS, part III, correlation of r2 = 0.79). Agreement rates between different measures ranged from 79.8 to 89.3%.ConclusionThe close correlation of PD patients’ various motor abnormalities quantified by different, task-specific severity measures suggests that these abnormalities are only facets of the underlying one-dimensional severity of motor deficits. The identification and characterization of this underlying motor deficit may help to optimize therapeutic interventions, e.g., to “automatically” adapt DBS settings in PD patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.