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Proceedings of the Scientific Meeting of the Christchurch
Medical Research Society, Friday 1 November 2002
Recovery of oculomotor,
visuomotor and neuropsychological deficits following mild closed head injury. M
H Heitger1,2, T J
Anderson1,2,3, R D
Jones1,2,4, M
Ardagh1,5. 1
Christchurch Movement Disorders and Brain Research Group (CMDBRG);
2 Department of Medicine, Christchurch School
of Medicine and Health Sciences; 3 Department
of Neurology, Christchurch Hospital; 4
Department of Medical Physics and Bioengineering, Christchurch Hospital;
5 Emergency Department, Christchurch Hospital,
Christchurch.
We have earlier found that motor deficits and
neuropsychological impairment immediately following mild closed head injury
(CHI) are largely independent phenomena. In this study, we compared 37 patients
with mainly mild closed head injury (36 mild and 1 moderate) and 37 controls
(matched for age, gender, years of education) at 1 week, 3 months and 6 months
post injury on measures of oculomotor function (saccades, smooth pursuit),
upper-limb visuomotor function (visual perception, basic arm motor function,
eye-arm tracking tasks), neuropsychological performance (Paced Auditory Serial
Addition, PASAT; California Verbal Learning, CVLT; Symbol Digit Modalities,
SDMT; Trail Making A+B, Wechsler Abbreviated Scale of Intelligence, WASI), and
several outcome measures (SF-36 health survey, ‘Rivermead Postconcussion
Symptoms’ and ‘Rivermead Head Injury Follow-up’
questionnaires).
At one week, the CHI group reported high rates of
postconcussion symptoms and demonstrated prolonged saccade latencies, increased
directional errors and decreased saccade accuracy, in combination with increased
arm movement reaction time, decreased arm movement speed, and decreased motor
accuracy on the tracking tests. Fast oculomotor smooth pursuit was mildly
impaired. SF-36 was impaired on all 8 scales, while neuropsychological testing
showed deficits on the CVLT and SDMT only.
At three months, several oculomotor and visuomotor deficits
remained, in combination with some deficits on the CVLT, despite decreased rates
of postconcussion symptoms and normalisation of the SF-36 scores. At six months,
the CHI group showed no deficits on our tests, while still reporting abnormal
levels of postconcussion symptoms.
These results indicate that multiple motor systems can be
impaired following mild CHI and that this can occur in the absence of widespread
neuropsychological impairments. Our study also indicates that quantitative tests
of oculomotor and upper-limb visuomotor function can provide sensitive markers
of cerebral dysfunction and supports the possible use of such tests to
supplement patient assessment.
Trinucleotide expansion in
the human androgen receptor gene is not associated with poor semen quality in
men. T Erasmuson1, I L
Sin2, F Y T
Sin1. 1
Department of Zoology, University of Canterbury, Christchurch;
2
New Zealand Centre for
Reproductive Medicine, Hiatt Chambers and Department of Obstetrics and
Gynaecology, University of Otago, Dunedin.
Spermatogenesis is thought to be regulated by numerous genes
including those on the Y chromosome and the androgen receptor on the X
chromosome.
Previous studies have shown that CAG repeat expansion is
associated with infertility. Further, there is accumulating evidence for the
involvement of Y chromosome-linked genes, such as AZF. However, there have been
no concurrent studies investigating mutations in these genes.
We aimed to investigate the possible relationship between
semen quality and AR-CAG repeat number and microdeletions of the AZFc region in
a New Zealand Caucasian sample population. A total of 105 subfertile men and 93
fertile men were analysed by PCR and sequenced to determine CAG repeat number.
The majority of samples were analysed for microdeletions using two multiplex PCR
reactions and confirmed using Southern blotting. Mean CAG repeat number for each
group of men was compared using two-sample one- and two-tailed t-tests and
considered significant if p <0.05. Subfertile men did not have significantly
different AR-CAG repeat numbers to fertile men (21.46 ± 0.30 vs 20.99
± 0.28, p = 0.126), arguing against the hypothesis that higher CAG repeats
are associated with male infertility. Y chromosome microdeletions were detected
in 7.4% of subfertile men and not fertile men. There was no correlation between
the presence of a microdeletion in AZFc and CAG repeat number.
Comparison with other studies of Caucasian men suggested
that different populations might show variation in repeat number in addition to
the previously noted racial variation. The number of microdeletions in the AZFc
region is consistent with previous studies.
Using signal decomposition
and dipole modelling to detect focal activity in the EEG. B
Vanrumste1,2, R D
Jones1,3, P J
Bones2, G J
Carroll4. 1
Department of Medical Physics and Bioengineering, Christchurch Hospital;
2 Department of Electrical and Computer
Engineering, University of Canterbury, Christchurch; 3
Department of Medicine, Christchurch School of Medicine and Health
Sciences, Christchurch; 4 Department of
Neurology, Christchurch Hospital, Christchurch.
Detection of focal EEG activity is important in the
diagnosis of epilepsy. We have developed an algorithm for the detection of focal
activity in multi-channel EEG recordings. The EEG is divided into overlapping
epochs, which are processed in two steps. The first is singular value
decomposition (SVD), which gives the most dominant potential distribution with
respect to energy. When the fraction of the energy in the epoch associated with
this distribution is high, we can assume this has arisen from a single primary
active source in the brain. In the second step, EEG dipole source analysis
(assuming a single dipole and 3-layer spherical model of the head) is applied to
that dominant potential distribution. This aims to find the focal neural sources
represented by a dipole that generate scalp potentials corresponding as closely
as possible to the given potentials. This is accomplished by changing the dipole
parameters until a minimum is found in the cost-function given by the relative
residual energy (RRE). The smaller the RRE, the better the dominant potentials
obtained from the SVD represent a focal source. It was found that dipoles
located on the inner-shell representing the brain-skull boundary are typically
attributed to EEG artifacts. The detection algorithm flags an EEG epoch when SVD
indicates a dominant source, the RRE is low and the dipole is not located too
close to the inner-shell. The algorithm has been applied to real EEG containing
multiple spikes and artifacts (eye-blinks, electrode artifacts). The SVD
indicated a dominant source active for both spikes and artifacts and no dominant
activity for background EEG. The RRE was also low for both types of events.
These preliminary results indicate that the method can be used to detect
seizures and spikes with a focal origin. In addition, the dipole parameters can
provide valuable information on the location of the epileptogenic
source.
Social
class and the determinants of smoking among young people: an analysis of causal
pathways using data from the Christchurch Health and Development Study. G
Jenkin. Department of Public Health and General Practice, Christchurch School of
Medicine and Health Sciences, University of Otago,
Christchurch.
This study examined whether the social class gradient in
parental smoking – of increasing rates of smoking with decreasing social
class – was replicated amongst their children at age 21, and examined
causal mechanisms accounting for this phenomenon. Drawing on data collected by
the Christchurch Health and Development Study (CHDS) – a longitudinal
study of a birth cohort of 1265 children born in Christchurch during 1977
– this research tested a hypothetical model of potential pathways between
parental social class and the rates of smoking of their offspring.
Initial analyses revealed the presence of a statistically
significant (p = 0.0002) social class gradient in smoking amongst the CHDS
cohort. A series of linear logistic regression analyses revealed that of six
potential pathways identified from the literature (parental smoking, parental
attitudes to smoking, early smoking experimentation, deviant behaviour,
educational achievement, and affiliations with smoking peers), only four were
found to mediate the association between parental social class and offspring
smoking (p = 0.05). These were: parental smoking, deviant behaviour, educational
achievement, and affiliations with smoking peers. A log-linear model fitted to
the data revealed that the association between parental socioeconomic status and
young adult smoking was explained by three pathways: directly by way of parental
smoking and educational achievement, and indirectly via the effect of parental
smoking on affiliations with smoking peers.
This analysis of the CHDS data highlighted how parental
smoking and educational achievement, and to a lesser extent, affiliations with
smoking peers, are potential points for intervention in reducing the
socioeconomic gradient in young adult smoking.
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