Krisztina Horváth

MRI-assessed volume of left and right hippocampi in females correlates with the relative length of the second and fourth fingers (the 2D: 4D ratio)

Atrophy of the left or right side of the hippocampus has been related to cognitive deficits and psychiatric disease. In this study, we examined the correlation between the hippocampal volume laterality index and the relative lengths of the second (index finger) and fourth (ring finger) digits (2D:4D) in healthy female subjects. The 2D:4D ratio is fixed in utero, and the ratio is higher in women than in men. There is evidence that this ratio is an indicator of the intrauterine concentration of testosterone, which influences the development of different regions of the brain. Assessing the volume of different parts of the brain of 40 healthy adult female students by magnetic resonance imaging (MRI), we found that the 2D:4D ratio was associated with an asymmetry in the hippocampal sub-regions. Smaller volume on the left side was found in the posterior part of the hippocampus in females with a low (masculine type) 2D:4D ratio. On the other hand, smaller volume on the left side was found in the middle part of the hippocampus in females with a high (female type) 2D:4D ratio. Thus, the development of the middle and posterior regions of the hippocampal formation may respond in opposite ways to prenatal levels of testosterone. Other brain regions such as the amygdala, the cerebral cortex, the total volume hippocampus, and the head of the hippocampus did not show such a difference.

Plasma carnitine ester profiles in Crohn's disease patients characterized for SLC22A4 C1672T and SLC22A5 G-207C genotypes.

Crohns disease (CD) is a chronic inflammatory bowel disorder caused by environmental and genetic factors. The purpose of this study was to analyse the possible influence of functional variants of genes of OCTN cation transporters on the carnitine ester profile of patients with CD. Genotyping for SLC22A4 1672C --> T, SLC22A5-207G --> C mutations and three common NOD2 variants (R702W, G908R and 1007finsC) were performed in 100 adult CD patients and in ninety-four healthy controls by direct sequencing. The carnitine ester profile was determined using ESI triple quadrupole tandem MS. Contrary to the NOD2/CARD15 mutations, none of the SLC variants showed increased prevalence in the CD group, the prevalence of TC haplotype did not differ between the patients and the controls. In the mixed group of CD patients the fasting propionyl- (0.243 (sem 0.008) v. 0.283 (sem 0.014) micromol/l), butyryl- (0.274 (sem 0.009) v. 0.301 (sem 0.013)) and isovalerylcarnitine (0.147 (sem 0.006) v. 0.185 (sem 0.009)) levels were decreased; while the level of octenoyl- (0.086 (sem 0.006) v. 0.069 (sem 0.005)), myristoleyl- (0.048 (sem 0.003) v. 0.037 (sem 0.003)), palmitoyl- (0.140 (sem 0.005) v. 0.122 (sem 0.004)) and oleylcarnitine (0.172 (sem 0.006) v. 0.156 (sem 0.008); P < 0.05 in all comparisons) were increased. After sorting the patients into SLC22A genotype-specific subgroups, no significant differences could be observed between them. The carnitine ester profile data suggest selective involvement of the carnitine esters in CD patients, probably due to their altered metabolism.

Is the MDS-UPDRS a Good Screening Tool for Detecting Sleep Problems and Daytime Sleepiness in Parkinson’s Disease?

Movement Disorder Society-sponsored Unified Parkinsons Disease Rating Scale (MDS-UPDRS) has separate items for measuring sleep problems (item 1.7) and daytime sleepiness (1.8). The aim of our study was to evaluate the screening sensitivity and specificity of these items to the PD Sleep Scale 2nd version (PDSS-2) and Epworth Sleepiness Scale (ESS). In this nationwide, cross-sectional study 460 PD patients were enrolled. Spearmans rank correlation coefficients were calculated between the individual items, domains, and the total score of PDSS-2 and item 1.7 of MDS-UPDRS. Similarly, the items and the total score of ESS were contrasted to item 1.8 of MDS-UPDRS. After developing generalized ordinal logistic regression models, the transformed and observed scores were compared by Lins Concordance Correlation Coefficient. Only item 3 difficulties staying asleep and the “disturbed sleep” domain of PDSS-2 showed high correlation with “sleep problems” item 1.7 of the MDS-UPDRS. Total score of PDSS-2 had moderate correlation with this MDS-UPRDS item. The total score of ESS showed the strongest, but still moderate, correlation with “daytime sleepiness” item 1.8 of MDS-UPDRS. As intended, the MDS-UPDRS serves as an effective screening tool for both sleep problems and daytime sleepiness and identifies subjects whose disabilities need further investigation.

Neuroimaging and cognitive changes during deja vu.

OBJECTIVE The cause or the physiological role of déjà vu (DV) in healthy people is unknown. The pathophysiology of DV-type epileptic aura is also unresolved. Here we describe a 22-year-old woman treated with deep brain stimulation (DBS) of the left internal globus pallidus for hemidystonia. At certain stimulation settings, DBS elicited reproducible episodes of DV. METHODS Neuropsychological tests and single-photon-emission computed tomography (SPECT) were performed during DBS-evoked DV and during normal DBS stimulation without DV. RESULTS SPECT during DBS-evoked DV revealed hyperperfusion of the right (contralateral to the electrode) hippocampus and other limbic structures. Neuropsychological examinations performed during several evoked DV episodes revealed disturbances in nonverbal memory. CONCLUSION Our results confirm the role of mesiotemporal structures in the pathogenesis of DV. We hypothesize that individual neuroanatomy and disturbances in gamma oscillations or in the dopaminergic system played a role in DBS-elicited DV in our patient.

Minimal clinically important differences for the experiences of daily living parts of movement disorder society–sponsored unified Parkinson's disease rating scale

Background: The minimal clinically important difference is the smallest change of scores clinically meaningful to patients.

Test-retest validity of Parkinson's disease sleep scale 2nd version (PDSS-2).

BACKGROUND AND AIMS The aim of the present study was to measure the test-retest validity of Parkinsons Disease Sleep Scale 2nd version (PDSS-2) on PD patients with stable medication and motor symptoms over the period of 4 weeks. METHODS The subject population consisted of 92 PD patients. Besides PDSS-2, Unified PD rating scale, Montgomery-Asberg Depression Rating Scale and EQ-5D were assessed at baseline and 4 weeks later. RESULTS The total score of PDSS-2 decreased from 19.06 ± 10.78 points to 18.00 ± 9.34 points (p > 0.05). For the total score of PDSS-2 the Intra-class and Lins Concordance Correlation Coefficients were 0.782 and 0.799. The average difference between the baseline and follow-up total PDSS-2 scores was -1.06 points with the 95% confidence interval of -7.96 and +5.84 points. CONCLUSIONS Our data supports that the items and the total score of PDSS-2 have acceptable test-retest reliability over a four week period on patients with stable PD symptoms and pharmacological therapy.

Plasma carnitine ester profiles in Crohn's disease and ulcerative colitis patients with different IGR2230a_1 genotypes.

An association has been repeatedly demonstrated between inflammatory bowel disease (IBD) and the IBD5 locus in the 5q31 chromosomal region. The aim of the present study was to examine the prevalence of the IGR2230a_1 intronic nucleotide polymorphism of the slc22a5 gene (coding for the OCTN2 carnitine transporter protein) lying within this region, and its possible relationship with the carnitine metabolism in Hungarian IBD patients and controls. We genotyped by restriction fragment length polymorphism 200 Crohns disease (CD) and 246 ulcerative colitis (UC) patients, as well as 187 healthy controls. From plasma samples we determined detailed carnitine ester profiles of 76 CD, 43 UC patients and 45 control persons using electrospray ionization triple quadruple tandem mass spectrometry. The distribution of the genotypes was not significantly different in the CD or the UC group compared with the controls. We found no significant alterations of the carnitine profile in the carrier/non‐carrier or the homozygote/non‐homozygote comparisons in both the CD and the UC groups, stratified by IGR2230a_1 genotype. Our data suggest that this polymorphism alone is not associated with CD and UC in the Hungarian population, and has no effect on the carnitine metabolism.

Changes in Quality of Life in Parkinson's Disease: How Large Must They Be to Be Relevant

Background: Minimal clinically important difference (MCID) is the smallest change in an outcome, which a patient identifies as meaningful. Although the 2 most frequently applied Parkinsons disease (PD) “quality of life” questionnaires (the PDQ-39 and PDQ-8) provide encouragingly similar results, their MCID thresholds appear to be vastly different. Our aim was to calculate the MCID estimates for both PDQ-39 and PDQ-8 Summary Indices (PDQ-39-SI and PDQ-8-SI) by the utilization of both anchor- and distribution-based techniques. Methods: Nine hundred eighty-five paired investigations of 365 patients were included. Three different techniques were used simultaneously to calculate the MCID values. Results: First, we replicated the previously published results demonstrating how both PDQ-39-SI and PDQ-8-SI provide similar values and respond in a similar way to changes. Subsequently, we calculated the MCID thresholds. The most optimal estimates for MCID thresholds for PDQ-39-SI were -4.72 and +4.22 for detecting minimal clinically important improvement and worsening. For PDQ-8-SI, these estimates were -5.94 and +4.91 points for detecting minimal clinically important improvement and worsening respectively. Conclusions: Our study is the first one that directly compared the MCID estimates for both PDQ-39-SI and PDQ-8-SI on a large pool of patients including all disease severity stages. These MICD estimates varied across PD severity.

Knowledge-intensive territorial servitization: regional driving forces and the role of the entrepreneurial ecosystem

ABSTRACT This study analyzes how regional manufacturing characteristics, i.e., specialization and the size of new manufacturers, and the entrepreneurial ecosystem, i.e., contextual factors driving entrepreneurial actions, impact the rate of new knowledge-intensive business service (KIBS) firms. Its spatial analysis of 121 European regions reveals that the entrepreneurial ecosystem plays a decisive role in supporting KIBS formation rates in territories with a solid industrial fabric. The economic potential of more attractive neighbouring regions can be detrimental to regional KIBS formation rates. The study offers valuable implications on how the entrepreneurial ecosystem can facilitate the interaction between manufacturing and KIBS firms.

The Relevance of Quantity and Quality Entrepreneurship for Regional Performance: The Moderating Role of the Entrepreneurial Ecosystem

This study analyses how the entrepreneurial ecosystem and different types of entrepreneurship — i.e., quantity (Kirznerian) and quality (Schumpeterian) entrepreneurship — impact regional performance, in terms of gross value added per worker and employment growth. By analysing 121 European Union regions between 2012 and 2014, we find that an enhanced entrepreneurial ecosystem yields to superior regional performance. The results reveal a heterogeneous effect of quantity- and quality-based entrepreneurship on regional performance: quantity (Kirznerian) entrepreneurship negatively impacts regional performance, while this effect turns positive in case of quality (Schumpeterian) entrepreneurship. The findings also suggest that regions with a healthy entrepreneurial ecosystem have a greater capacity to materialize the effects of high regional business formation rates, regardless of their quality level (Kirznerian entrepreneurship), while regions with weak entrepreneurial ecosystem may rely on Schumpeterian entrepreneurs — who channel new and more innovative resources to the economy — to compensate the absence of entrepreneurship policy-support instruments and increase their economic outcomes.