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Anlotinib followed by transarterial chemoembolization and radiofrequency ablation is a effective and safe first answer to hepatocellular carcinoma sufferers together with web site vein tumor thrombus: A retrospective circumstance series examine.
Today, there is a broad consensus on the boundaries of what we call the prefrontal cortex, but this has not always been the case. The purpose of this historical review is to examine in greater depth the topographical origins of the term «prefrontal» and analyse its conceptual evolution.

The article is structured according to the main criteria that have been proposed successively over time in order to define the limits of the prefrontal cortex, namely, morphological, cytoarchitectural and hodological. RMC-6236 cost During the second half of the 19th century, the criteria were essentially of a morphological nature. David Ferrier popularised the term «prefrontal» in this period. In the early years of the 20th century, criteria based on the architectural organisation of the cerebral cortex (or cytoarchitecture) predominated, and their main representative was Korbinian Brodmann. At the end of the 1940s, Jerzy E. Rose and Clinton N. Woolsey considered that the study of brain connections (hodology) was the way to define the boundaries of the prefrontal cortex and proposed that this frontal region was the main area of projection of the dorsomedial nucleus of the thalamus.

Historically, the limits of the so-called «prefrontal» region of the brain has been blurred and changing, as a result of the different criteria used at different times.
Historically, the limits of the so-called «prefrontal» region of the brain has been blurred and changing, as a result of the different criteria used at different times.
Motor fluctuations are one of the most common complications of Parkinson's disease and their treatment is still a complex matter. Therefore, from the Neurology Movement Disorders Group we present our clinical experience in the treatment of these complications, with the intention of it being useful in decision-making in daily clinical practice.

Nineteen questions were developed based on a literature review and an open survey answered by members of this group. These issues were discussed in two phases, using the Delphi methodology. Considering the results of the survey, levodopa dose adjustment and dopamine agonists are the option with the best efficacy/tolerability ratio in the treatment of motor fluctuations. Rotigotine is useful in the motor fluctuations associated with gastroparesis, and intermittent subcutaneous apomorphine has positive effects in patients with unpredictable off periods. The most relevant adverse effect associated with dopamine agonists is impulse control disorder. Catechol-O-methyltransferase inhibitors are useful in the initial stages of motor fluctuations, especially in wearing off. Monoamine oxidase inhibitors are generally drugs that are well-tolerated and useful in motor fluctuations. If these measures are not effective, second-line treatments should be indicated on a case-by-case basis.

The clinical profile of patients with Parkinson's disease is paramount in deciding the most appropriate therapy for the treatment of motor fluctuations.
The clinical profile of patients with Parkinson's disease is paramount in deciding the most appropriate therapy for the treatment of motor fluctuations.
Topiramate is the only oral preventative with level of evidence I for the treatment of chronic migraine.

To evaluate gray matter parameters, obtained with magnetic resonance imaging (MRI), as biomarkers of the response to topiramate in chronic migraine patients.

The sample was composed by 57 chronic migraine patients, screened for first time in a Headache Unit due to chronic migraine. MRI acquisitions were performed at a 3 T unit. Afterwards, topiramate preventive treatment began. Response and tolerability were evaluated after three months, defining response as at least 50% reduction in headache days per month. We included patients that tolerated topiramate. T1- and diffusion-weighted MRI were processed to obtain gray matter (68 cortical and 16 subcortical regions) descriptive parameters. A logistic regression model was employed for the predictive assessment.

Forty-two patients tolerated the treatment and were analyzed, responding 23 of them (54.7%). The final prediction model was built with gray matter parameters with significant results. In this model, higher left cuneus curvature and right insula area values were associated with a higher probability of response, while higher right inferior parietal cortex volume and left superior temporal gyrus area values were associated with a lower probability. The accuracy of the predictive model was 95%.

The gray matter parameters may be useful biomarkers of preventive treatment response with topiramate in chronic migraine.
The gray matter parameters may be useful biomarkers of preventive treatment response with topiramate in chronic migraine.
The current evidence collected consistent results about morphological and functional brain changes produced by psychological treatment. Exposure cognitive-behavioral therapy (CBT) is currently the most effective psychological treatment for phobias.

To explore the brain activation and self-reported changes in patients with specific phobias to small animals who underwent a CBT exposure program and to prove if the CBT program made phobic patients process feared stimuli similarly to non-phobic persons.

The sample consisted of 32 adults, of which 16 (5 males and 11 females; mean age 38.08) had specific phobia to small animals and 16 (4 males and 12 females; mean age 21.81) had no phobias. A univariate before-and-after treatment design were used. In addition, the scores of the non-phobic group in self-reports and brain activity were compared with the post-treatment scores of the phobic group.

Data show significant changes in brain activity, and improvements in self-reported measures because of applying CBT to specific phobias. As a highlight, participants showed a greater activation in points of the precuneus after receiving CBT. Also, when compared with non-phobic participants, phobic patients still remain with both fear and defensive responses to phobic stimuli.

The precuneus seems to be a regulator that reorganizes the processing of phobic stimuli. It can imply as CBT/ exposure also active acceptance, self-awareness, and self-efficacy mechanisms.
The precuneus seems to be a regulator that reorganizes the processing of phobic stimuli. It can imply as CBT/ exposure also active acceptance, self-awareness, and self-efficacy mechanisms.
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