13 resultados para Disorders of consciousness

em Aston University Research Archive


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In spite of the inherent difficulties in achieving a biologically meaningful definition of consciousness, recent neurophysiological studies are starting to provide some insight in fundamental mechanisms associated with impaired consciousness in neurological disorders. Generalised seizures are associated with disruption of the default state network, a functional network of discrete brain areas, which include the fronto-parietal cortices. Subcortical contribution through activation of thalamocortical structures, as well as striate nuclei are also crucial to produce impaired consciousness in generalised seizures.

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Objective: Early life experiences are associated with severe and long-lasting effects on behavioural and emotional functioning, which in turn are thought to increase the risk for unipolar depression and other disorders of affect regulation. The neurobiological and psychological mechanisms through which adverse early life experiences confer risk are poorly understood. Method: Alterations in brain structure and function in limbic and prefrontal cortical regions have been linked to early negative experiences and to mood disorders. Results: There are a number of psychological domains that may be dysfunctional in people with mood disorders, and which, if the dysfunction occurs prior to onset of mood symptoms, may signify a risk factor for depression. Cognitive dysfunction has been examined in patients with mood disorders, with some suggestion that changes in cognitive function may antedate the onset of mood symptoms, and may be exacerbated in those who experienced early negative trauma. Social cognition, including emotion comprehension, theory of mind and empathy, represent under-studied domains of psychological function that may be negatively influenced by early adverse experience. Temperament and personality factors may also leave people vulnerable to mood instability. Conclusion: This review summarizes the evidence for dysfunction in each of these domains for people with mood disorders.

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In vivo, neurons of the globus pallidus (GP) and subthalamic nucleus (STN) resonate independently around 70 Hz. However, on the loss of dopamine as in Parkinson's disease, there is a switch to a lower frequency of firing with increased bursting and synchronization of activity. In vitro, type A neurons of the GP, identified by the presence of Ih and rebound depolarizations, fire at frequencies (≤80 Hz) in response to glutamate pressure ejection, designed to mimic STN input. The profile of this frequency response was unaltered by bath application of the GABAA antagonist bicuculline (10 μM), indicating the lack of involvement of a local GABA neuronal network, while cross-correlations of neuronal pairs revealed uncorrelated activity or phase-locked activity with a variable phase delay, consistent with each GP neuron acting as an independent oscillator. This autonomy of firing appears to arise due to the presence of intrinsic voltage- and sodium-dependent subthreshold membrane oscillations. GABAA inhibitory postsynaptic potentials are able to disrupt this tonic activity while promoting a rebound depolarization and action potential firing. This rebound is able to reset the phase of the intrinsic oscillation and provides a mechanism for promoting coherent firing activity in ensembles of GP neurons that may ultimately lead to abnormal and pathological disorders of movement.

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The revolution in the foundations of physics at the beginning of the twentieth century suggested to several of its most prominent workers that biology was ripe for something similar. In consequence, a number of physicists moved into biology. They were highly influential in initiating a molecular biology in the 1950s. Two decades later it seemed to several of these migrants, and those they had influenced, that the major problems in molecular biology had been solved, and that it was time to move on to what seemed to them the final problem: the nervous system, consciousness, and the age-old mind-body problem. This paper reviews this "double migration" and shows how the hopes of the first generation of physicist-biologists were both realized and dashed. No new physical principles were discovered at work in the foundations of biology or neuroscience. On the other hand, the mind-set of those trained in physics proved immensely valuable in analyzing fundamental issues in both biology and neuroscience. It has been argued that the outcome of the molecular biology of the 1950s was a change in the concept of the gene from that of "a mysterious entity into that of a real molecular object" (Watson, 1965, p.6); the gates and channels which play such crucial roles in the functioning of nervous systems have been transformed in a similar way. Studies on highly simplified systems have also opened the prospect of finding the neural correlatives of numerous behaviors and neuropathologies. This increasing understanding at the molecular level is invaluable not only in devising rational therapies but also, by defining the material substrate of consciousness, in bringing the mind-body problem into sharper focus. Copyright © Taylor & Francis Inc.

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This survey collected information on aspects of health amongst an employed population, employees in 14 different organisations in the West Midlands Regional Health Authority; and was a stratified sample of senior managers, middle managers and operatives. Nine hundred and sixty questionnaires were distributed asking for both quantitative and qualitative information on 58 questions covering health, work, family, leisure activities and life-style. A response rate of 48% (459 returned questionnaires) came from 290 men (63%), 165 women (36%) and four people (1%) who did not answer the gender question. The initial findings from this study are unique in that there has not been a specific review of the health of people at work. In answer to the main research questions, 92% felt they were healthy. Compared to others of a similar age, 34% felt their health was `above average', 58% `average', and 7&37 `below average'. Thirty two percent of respondents had visited their GP in the past 1-2 months; the highest reason given was disorders of the respiratory system, 20%. People's perceptions on the effects of work on their health were: good effect, 13% fair effect, 20% no effect, 27% poor effect, 27% and bad effect, 7%. The effects of leisure activities on health were thought to be more positive: good effect, 46% fair effect, 20% no effect, 21% poor effect, 3% and bad effect, 2%. The perceptions of effects of life-style on health were considered to be: good effect, 32% fair effect, 32% no effect, 20% poor effect, 9% and bad effect, 1%.  In this survey, leisure and life-style were seen by employees to have more beneficial effects on health than work. Future implications include a review of occupational health as a major policy development area within primary care. There is a need to influence the education and training of health care practitioners in order to affect their ability to practise effectively in this new and challenging area of work.

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This research examines the relationship between 'race' and class in Britain. This is achieved by considering how these two concepts articulate in the overall structuring of class relationships in a society which is typified by the incorporatation of black labour into a majority white society, This relationship is examined through an investigation of those black workers who occupy a position in the objectively defined middle class. The basic theme underlying this research is that 'race, in the form of structural racism, plays a significant role at two levels. Firstly, it serves to structure the class position of black labour in Britain. Secondly, it serves to determine the type of race, class and political consciousness generated by black labour. The study was carried out in the London area. Occupation was used as an indicator of 'objective' class position when selecting respondents to be included in the two survey populations required for the research. A 'network' approach was used to actually locate the respondents. In-depth interviews were carried out with all the respondents. The study concludes that the concepts of 'race' and class are not independent of each other in the overall structuring of class relationships between black and white labour. It is argued that the inter-relationship identified between these two concepts serves to highlight the fact that the structural position of black labour, the type of consciousness generated and the type of decisions taken by those who took part in the research are to a large extent a result of the structural constraints deriving from the effects of structural racism in Britain.

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The limbal vascular response to extended contact lens wear was examined in a group comparative study initially intended to last eighteen months. After six months all patients wearing contact lenses had presented with micro-epithelial cysts. This unanticipated occurrence of the micro-epithelial-cysts necessitated termination of the study, and limited the quantity of data collected. However, sufficient results were available to allow a limited description of •the vascular response to this form of contact lens wear. Interpretations of the date collected ore discussed in relation to suggested vasostimulating factors in the cornea. The micro-epithelial cysts observed after extended wear were classified and their rate of recovery recorded. A further clinical study was undertaken to observe cysts in both contact lens - and non contact lens-wearing eyes. Cysts were observed in every category of patient, although the characteristic patterns varied. These observations of micro-epithelial cysts are discussed with respect to the aetiopathogeneses of corneal epithelial cystic disorders. Subsequently, attempts were made to induce cysts in rabbit corneae by extended contact lens wear. Clinical observations revealed cyst-like appearances. Histological sections did not contain cysts but did exhibit signs characteristic •of cystic disorders of the corneal epithelium. In general, the results from the study indicate that extended wear is subjectively acceptable to contact lens wearers. However, the objective findings of significant vascular changes, micro-epithelial cysts and cases of acute red eye response cast considerable doubt on the recommendation of extended wear contact lenses for purely cosmetic applications.

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Visual sensitivity, defined as the “susceptibility toward experiencing seizures, which are triggered by the physical characteristics of visual stimuli and not by their perceptual properties,”1 can manifest in the context of various forms of generalized or focal, idiopathic or symptomatic epilepsies.2 We report a patient with no family or personal history of epilepsy who presented episodes of loss of consciousness exclusively triggered by visual stimuli unrelated to their emotional content, in which we have documented EEG-EKG characteristics suggestive of a neurally mediated syncope.

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It is estimated that 69-75 million people worldwide will suffer a traumatic brain injury (TBI) or stroke each year. Brain oedema caused by TBI or following a stroke, together with other disorders of the brain cost Europe €770 billion in 2014. Aquaporins (AQP) are transmembrane water channels involved in many physiologies and are responsible for the maintenance of water homeostasis. They react rapidly to changes in osmolarity by transporting water through their highly selective central pore to maintain tonicity and aid in cell volume regulation. We have previously shown that recombinant AQP1-GFP trafficking occurs in a proteinkinase C-microtubule dependant manner in HEK-293 cells in response to hypotonicity. This trafficking mechanism is also reliant on the presence of calcium and its messenger-binding protein calmodulin and results in increased cell surface expression of AQP1 in a time-scale of ~30 seconds. There is currently very little research into the trafficking mechanisms of endogenous AQPs in primary cells. AQP4 is the most abundantly expressed AQP within the brain, it is localised to the astrocytic end-feet, in contact with the blood vessels at the blood-brain-barrier. In situations where the exquisitely-tuned osmotic balance is disturbed, high water permeability can become detrimental. AQP4-mediated water influx causes rapid brain swelling, resulting in death or long term brain damage. Previous research has shown that AQP4 knock-out mice were protected from the formation of cytotoxic brain oedema in a stroke model, highlighting AQP4 as a key drug target for this pathology. As there are currently no treatments available to restrict the flow of water through AQP4 as all known inhibitors are either cytotoxic or non-specific, controlling the mechanisms involved in the regulation of AQP4 in the brain could provide a therapeutic solution to such diseases. Using cell surface biontinylation of endogenous AQP4 in primary rat astrocytes followed by neutraavidin based ELISA we have shown that AQP4 cell surface localisation increases by 2.7 fold after 5 minutes hypotonic treatment at around 85 mOsm/kg H2O. We have also shown that this rapid relocalisation of AQP4 is regulated by PKA, calmodulin, extra-cellular calcium and actin. In summary we have shown that rapid translocation of endogenous AQP4 occurs in primary rat astrocytes in response to hypotonic stimuli; this mechanism is PKA, calcium, actin and calmodulin dependant. AQP4 has the potential to provide a treatment for the development of brain oedema.

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The introduction situates the ‘hard problem’ in its historical context and argues that the problem has two sides: the output side (the Kant-Eccles problem of the freedom of the Will) and the input side (the problem of qualia). The output side ultimately reduces to whether quantum mechanics can affect the operation of synapses. A discussion of the detailed molecular biology of synaptic transmission as presently understood suggests that such affects are unlikely. Instead an evolutionary argument is presented which suggests that our conviction of free agency is an evolutionarily induced illusion and hence that the Kant-Eccles problem is itself illusory. This conclusion is supported by well-known neurophysiology. The input side, the problem of qualia, of subjectivity, is not so easily outflanked. After a brief review of the neurophysiological correlates of consciousness (NCC) and of the Penrose-Hameroff microtubular neuroquantology it is again concluded that the molecular neurobiology makes quantum wave-mechanics an unlikely explanation. Instead recourse is made to an evolutionarily- and neurobiologically-informed panpsychism. The notion of an ‘emergent’ property is carefully distinguished from that of the more usual ‘system’ property used by most dual-aspect theorists (and the majority of neuroscientists) and used to support Llinas’ concept of an ‘oneiric’ consciousness continuously modified by sensory input. I conclude that a panpsychist theory, such as this, coupled with the non-classical understanding of matter flowing from quantum physics (both epistemological and scientific) may be the default and only solution to the problem posed by the presence of mind in a world of things.

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This is the second part of a review of the work of quantum physicists on the ‘hard part’ of the problem of mind. After an introduction which sets the scene and a brief review of contemporary work on the neural correlates of consciousness (NCC) the work of four prominent modern investigators is examined: J.C. Eccles/Friedrich Beck; Henry Stapp; Stuart Hameroff/Roger Penrose; David Bohm. With the exception of David Bohm, all attempt to show where in the brain’s microstructure quantum affects could make themselves felt. It is reluctantly concluded that none have neurobiological plausibility. They are all instances, to paraphrase T.H. Huxley, of a beautiful hypothesis destroyed by ugly facts. David Bohm does not attempt to fit his new quantum physics to contemporary neurobiology but instead asks for a radical rethink of our conventional scientific paradigm. He suggests that we should look towards developing a ‘pan-experientialism’ or ‘dual-aspect monism’ where consciousness goes ‘all the way down’ and that the ‘hard problem’ is not soluble within the framework of ideas provided by ‘classical’ natural science.

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Reactive oxygen species (ROS) and the sphingolipid ceramide are each partly responsible for the intracellular signal transduction of a variety of physiological, pharmacological or environmental agents. Furthermore, the enhanced production of many of these agents, that utilise ROS and ceramide as signalling intermediates, is associated with the aetiologies of several vascular diseases (e.g. atherosclerosis) or disorders of inflammatory origin (e.g. rheumatoid arthritis; RA). Excessive monocyte recruitment and uncontrolled T cell activation are both strongly implicated in the chronic inflammatory responses that are associated with these pathologies. Therefore the aims of this thesis are (1) to further elucidate the cellular responses to modulations in intracellular ceramide/ROS levels in monocytes and T cells, in order to help resolve the mechanisms of progression of these diseases and (2) to examine both existing agents (methotrexate) and novel targets for possible therapeutic manipulation. Utilising synthetic, short chain ceramide to mimic the cellular responses to fluctuations in natural endogenous ceramide or, stimulation of CD95 to induce ceramide formation, it is described here that ceramide targets and manipulates two discrete sites responsible for ROS generation, preceding the cellular responses of growth arrest in U937 monocytes and apoptosis in Jurkat T-cells. In both cell types, transient elevations in mitochondrial ROS generation were observed. However, the prominent redox altering effects appear to be the ceramide-mediated reduction in cytosolic peroxide, the magnitude of which dictates in part the cellular response in U937 monocytes, Jurkat T-cells and primary human peripheral blood resting or PHA-activated T-cells in vitro. The application of synthetic ceramides to U937 monocytes for short (2 hours) or long (16 hours) treatment periods reduced the membrane expression of proteins associated with cell-cell interaction. Furthermore, ceramide treated U937 monocytes demonstrated reduced adhesion to 5 or 24 hour LPS activated human umbilical vein endothelial cells (HUVEC) but not resting HUVEC. Consequently it is hypothesised that the targeted treatment of monocytes from patients with cardiovascular diseases with short chain synthetic ceramide may reduce disease progression. Herein, the anti-inflammatory and immunosuppressant drug, methotrexate, is described to require ROS production for the induction of cytostasis or cytotoxicity in U937 monocytes and Jurkat T-cells respectively. Further, ROS are critical for methotrexate to abrogate monocyte interaction with activated HUVEC in vitro. The histological feature of RA of enhanced infiltration, survivability and hyporesponsiveness of T-cells within the diseased synovium has been suggested to arise from aberrant signalling. No difference in the concentrations of endogenous T-cell ceramide, the related lipid diacylglycerol (DAG) and cytosolic peroxide ex vivo was observed. TCR activation following PHA exposure in vitro for 72 hours did not induced maintained perturbations in DAG or ceramide in T-cells from RA patients or healthy individuals. However, T-cells from RA patients failed to upregulate cytosolic peroxide in response to PHA, unlike those from normals, despite expressing identical levels of the activation marker CD25. This inability to upregulate cytosolic peroxide may contribute to the T-cell pathology associated with RA by affecting the signalling capacity of redox sensitive biomolecules. These data highlight the importance of two distinctive cellular pools of ROS in mediating complex biological events associated with inflammatory disease and suggest that modulation of cellular ceramides represents a novel therapeutic strategy to minimise monocyte recruitment.