L. Murri

Impaired ascendant central pathways conduction in impotent diabetic subjects.

Objectives – Diabetic impotence is generally due to peripheral neuropathy, but a central pathway impairment has also been suggested. We evaluated somatosensory transmission in a group of impotent diabetic men to assess the role of central nervous system (CNS) involvement. Materials and methods – Somatosensory evoked potentials (SEPs) of pudendal (pdn) and posterior tibial (ptn) nerves were recorded in 74 patients. Type and duration of diabetes, severity of sexual dysfunction, medium term metabolic control, occurrence of microangiopathic chronic complications and autonomic neuropathy were evaluated. Results – Our data show an impairment of central conduction times in pdn (25.7%) and ptn (39.2%) greater than peripheral nervous impairment (pdn 12.2%, ptn 8.1%), in impotent diabetic patients without any further major complication. Central nervous conduction delay resulted to be correlated with poor glycemic control. Significant evident autonomic dysfunction was found only in a minority of cases. Conclusion – Our data might suggest that altered conduction along CNS and somatic peripheral neuropathy might develop independently. We confirm the hypothesis of a “central diabetic neuropathy” and suggest that central sensory pathways involvement, not related to peripheral impairment, could play a role in the pathogenesis of erectile dysfunction in diabetic patients.

Motor unit number estimation (mune) as a quantitative measure of disease progression and motor unit reorganization in amyotrophic lateral sclerosis.

Motor Unit Number Estimation (MUNE), a technique allowing to estimate the number of functioning Motor Units (MU) in single muscles, was used to score the diseases severity and progression rate in a group of 58 patients with Amyotrophic Lateral Sclerosis (ALS). All patients underwent MUNE in the abductor digiti minimi (ADM) muscle during the diagnostic work-up (T0), after three (T1) and six (T2) months. A significant loss [p < .001] of MU and a decrease [p < .001] of the maximal M wave area at T0 was found, whereas mean step area was increased [p < .001]. During the follow-up (T1 and T2), MU loss continued, maximal M wave decreased, and mean step area increased significantly. The results confirm that MUNE is a suitable tool to quantify the pathological changes in MU in patients with ALS.

A study of the interhemispheric correlation during sleep in elderly subjects.

The interhemispheric relationship during sleep in elderly subjects was studied throughout the night by a minute-by-minute computation of two linear correlation coefficients between right and left EEG activities. One of these coefficients (Xδ) related to the 1–4-Hz band activity, and the other (Xσ) to the 12.5–14.5-Hz band activity. For five of the six subjects examined, it was found that the rapid-eyemovement (REM) mean values of both coefficients were significantly different from the nonrapid-eye-movement (NREM) values. A comparison between this elderly group and a control group of young subjects, examined previously, did not reveal any significant shift, either for the REM or for the NREM mean values of the coefficients.

Almotriptan: Review of Efficacy in Treating Migraine in Adolescents

Migraine is a common disabling neurological disorder, often starting in children and adolescents. Triptans, a class of selective 5HT1b/d receptor agonists, have been shown to be effective and well-tolerated as acute therapy in adult migraineurs. Data examining efficacy and tolerability of triptans in adolescents are limited compared with adults. Almotriptan has recently been approved by the USA regulatory authorities (FDA) for the acute treatment of migraine headache in adolescent patients (age 12 to 17 years). A double-blind placebo-controlled, parallel group, multicenter trial demonstrated that oral almotriptan in effective and well tolerated in adolescents, with the 12,5 mg dose associated with the most favourable profile. The aim of this review is to give an overview of clinical data about efficacy and safety of oral Almotriptan in adolescents.