Neurological Disorders

Parkinson's disease is a heterogeneous, multifactorial and often complex disease characterized by motor impairment due to the presence of Lewy bodies and prominent degeneration of dopaminergic neurons in the substantia nigra. Although the specific pathogenesis involving PD remains under investigation, mitochondrial dysfunction has been widely accepted as one of the major pathogenic pathways underlying the development of PD. Based on the hypothesis that depiction of HtrA2 (serine protease gene, mitochondrial precursor) might contribute to an increase in mitochondrial stress and transcriptional up regulation of the nuclear stress response CHOP gene. The present study aimed to analyze through laboratory based research the role of HtrA2 and CHOP in the transmission of stress signaling and the consequent activation of mitochondrial quality control in Parkinson's disease using ATP and Bradford assays.

Introduction: Educational Environment (EE) is of paramount importance in Medical Education, but can be intangible and hard to clearly determine. There is a consistent evidence for a link between burnout and postgraduate EE, with negatively perceived learning environments associated with increased burnout. We aimed to measure the EE of a Psychiatry postgraduate training programme in Ireland, comparing the EE perceptions among trainees of different grade, gender and levels of working experience and identify specific areas of weaknesses for intervention in hopes of reducing trainees’ dissatisfaction of their EE.

Methods: This study took place between April and June 2021. A mixed methods approach was adopted, using the Postgraduate Hospital Educational Environment Measure (PHEEM) and semi-structured one to one interviews.

Results: Response rate was 88% (n=22). The total PHEEM score was 105.64 ± 23.52, indicating a postgraduate EE with more positive than negative aspects, with room for improvement. There were no differences in overall PHEEM and subscale scores between trainees’ gender, grades or years of working experience. Three themes were identified that contribute to trainees’ perception of EE: the commitment of the trainees’ supervisors to the role they play in trainees’ overall development, the clinical workload of the trainee, and the day to day working conditions of the trainee.

Conclusion: Although the training program had an overall positive EE, specific answers and interview themes indicated some areas of weakness that may contribute to trainee dissatisfaction and possible burnout. Planned interventions targeting these areas and tracking changes in EE and burnout rates over time may be useful measures going forward.

Background and aims: Disorganized speech (DS) refers to the failure to communicate coherently. Children with autism spectrum disorder (ASD) show disorganized speech, such as abrupt topic changes. Disorganized speech can be explained by 1 social pragmatic communication difficulties (SPCD) or 2 social cognition problems (SCP).

Methods: We tested whether children with ASD and severe disorganized speech differed from those with mild or no disorganized speech, using parent’s report on SPCD and tested SCP (i.e., Theory of Mind; ToM). A total of 62 children with ASD (aged 7-12 years) were included, 12 with severe disorganized speech, 32 with mild, and 18 with no disorganized speech. The disorganized speech was assessed using the Kiddie Formal Thought Disorder Rating Scale (KFTDS). SPCD was measured using the parent reported Children’s Communication Checklist (CCC). SCP was measured using a first order false belief task.

Results: Children with severely disorganized speech showed significantly more inappropriate initiations and less coherence. No significant group differences were found in the false belief task, even after included verbal IQ as a covariate in multivariate analysis.

Conclusion: These findings may contribute to the conceptualization of autistic communication difficulties which may guide intervention optimizations. Implications: Furthermore, we may consider offering children with ASD and disorganized speech interventions that stimulate and train broader social pragmatic communication skills, social cognition, and verbal ability (i.e., conversational skills).

We report the case of a young woman who presented with chronic relapsing inflammatory optic neuritis (CRION) in association with HLA-B27 and silent brain lesions. The attacks were refractory to steroids but no further attacks occurred on treatment with mycophenolate mofetil. This is one of the few HLA-B27- associated optic neuritis cases reported in the literature, emphasizing the relation of HLA-B27 and inflammation of the brain and optic nerve, as well as the role mycophenolate mofetil might offer in stabilizing the disease.