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Typical users of 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy") are polydrug users, combining MDMA with alcohol or cannabis [most active compound: delta-9-tetrahydrocannabinol (THC)].The aim of the present study was to investigate whether co-administration of alcohol or THC with MDMA differentially affects ongoing electroencephalogram (EEG) oscillations compared to the administration of each drug alone.In two separate experiments, 16 volunteers received four different drug conditions: (1) MDMA (100 mg); (2) alcohol clamp (blood alcohol concentration = 0.6‰) or THC (inhalation of 4, 6 and 6 mg, interval of 1.5 h); (3) MDMA in combination with alcohol or THC; and (4) placebo. Before and after drug administration, electroencephalography was recorded during an eyes closed resting state.Theta and alpha power increased after alcohol intake compared to placebo and reduced after MDMA intake. No interaction between alcohol and MDMA was found. Significant MDMA x THC effects for theta and lower-1-alpha power indicated that the power attenuation after the combined intake of MDMA and THC was less than the sum of each drug alone. For the lower-2-alpha band, the intake of MDMA or THC alone did not significantly affect power, but the intake of combined MDMA and THC significantly decreased lower-2-alpha power.The present findings indicate that the combined intake of MDMA and THC, but not of MDMA and alcohol, affects ongoing EEG oscillations differently than the sum of either one drug alone. Changes in ongoing EEG oscillations may be related to the impaired task performance that has often been reported after drug intake.

The purpose of this work was to show that the overall peak power of RF pulses for CAIPIRINHA excitation can be substantially reduced by applying interslice phase relaxation. The optimal phases are scan dependent and can be quickly calculated by the proposed method.The multi‐band RF pulse design is implemented as the minimization of a linear objective function with quadratic constraints. The interslice phase is considered to be a variable for optimization. In the case of a phase cycling scheme (CAIPIRINHA), the peak power is considered over all pulses.The computation time (about 1 s) is compatible with online RF pulse design. It is shown that the optimal interslice phases depend on the CAIPIRINHA scheme used and that RF peak power is reduced when the CAIPIRINHA phase cycling is taken into account in the optimization.The proposed method is extremely fast and results in RF pulses with low peak power for CAIPIRINHA excitation. The MATLAB implementation is given in the appendix; it allows for online determination of scan‐dependent phase parameters. Furthermore, the method can be easily extended to pTx shimming systems in the context of multi‐slice excitations, and this possibility is included in the software. Copyright © 2015 John Wiley & Sons, Ltd.

Based on musculoskeletal anatomy of the lower back, abdominal wall, pelvis and upper legs, a biomechanical model has been developed on forces in the load transfer through the pelvis. The aim of this model is to obtain a tool for analyzing the relations between forces in muscles, ligaments and joints in the transfer of gravitational and external load from the upper body via the sacroiliac joints to the legs in normal situations and pathology. The study of the relation between muscle coordination patterns and forces in pelvic structures, in particular the sacroiliac joints, is relevant for a better understanding of the aetiology of low back pain and pelvic pain. The model comprises 94 muscle parts, 6 ligaments and 6 joints. It enables the calculation of forces in pelvic structures in various postures. The calculations are based on a linear/non-linear optimization scheme. To gain a better understanding of the function of individual muscles and ligaments, deviant properties of these structures can be preset. The model is validated by comparing calculations with EMG data from the literature. For agonistic muscles, good agreement is found between model calculations and EMG data. Antagonistic muscle activity is underestimated by the model. Imposed activity of modelled antagonistic muscles has a minor effect on the mutual proportions of agonistic muscle activities. Simulation of asymmetric muscle weakness shows higher activity of especially abdominal muscles.

Objective: Weight loss in amyotrophic lateral sclerosis (ALS) is associated with faster disease progression and shorter survival. It has different possible causes, including loss of appetite. Our objective is to determine the prevalence and impact of loss of appetite on change in body weight and composition in patients with ALS. Methods: We conducted a prospective case-control study, comparing demographic, clinical, appetite and prognostic features between 62 patients with ALS and 45 healthy non-neurodegenerative disease (NND) controls. To determine the impact of loss of appetite on weight throughout disease course, we conducted serial assessments at ∼three to four-month intervals. Results: Loss of appetite is more prevalent in patients with ALS than NND controls (29 vs. 11.1%, odds ratio = 3.27 (1.1-9.6); p < 0.01). In patients with ALS, loss of appetite is associated with greater weight loss and greater loss of fat mass. Appetite scores in patients with ALS worsens as disease progresses and are correlated with worsening ALS Functional Rating Scale-Revised scores. Conclusion: We confirm that loss of appetite is prevalent in patients with ALS and is significantly associated with weight loss and loss of fat mass. Appetite worsens with disease progression. Identification and early interventions to address loss of appetite in patients with ALS may prevent or slow weight loss; this could improve disease outcome.

In a recent series of papers, Caramazza and Miozzo [Caramazza, A., 1997. How many levels of processing are there in lexical access? Cognitive Neuropsychology 14, 177-208; Caramazza, A., Miozzo, M., 1997. The relation between syntactic and phonological knowledge in lexical access: evidence from the 'tip-of-the-tongue' phenomenon. Cognition 64, 309-343; Miozzo, M., Caramazza, A., 1997. On knowing the auxiliary of a verb that cannot be named: evidence for the independence of grammatical and phonological aspects of lexical knowledge. Journal of Cognitive Neuropsychology 9, 160-166] argued against the lemma/lexeme distinction made in many models of lexical access in speaking, including our network model [Roelofs, A., 1992. A spreading-activation theory of lemma retrieval in speaking. Cognition 42, 107-142; Levelt, W.J.M., Roelofs, A., Meyer, A.S., 1998. A theory of lexical access in speech production. Behavioral and Brain Sciences, (in press)]. Their case was based on the observations that grammatical class deficits of brain-damaged patients and semantic errors may be restricted to either spoken or written forms and that the grammatical gender of a word and information about its form can be independently available in tip-of-the-tongue states (TOTs). In this paper, we argue that though our model is about speaking, not taking position on writing, extensions to writing are possible that are compatible with the evidence from aphasia and speech errors. Furthermore, our model does not predict a dependency between gender and form retrieval in TOTs. Finally, we argue that Caramazza and Miozzo have not accounted for important parts of the evidence motivating the lemma/lexeme distinction, such as word frequency effects in homophone production, the strict ordering of gender and phoneme access in LRP data, and the chronometric and speech error evidence for the production of complex morphology.

Recent interest in NK1 receptor antagonists has focused on a potential role in the treatment of drug addiction and substance abuse. In the present study, the potential for interactions between the NK1 receptor antagonist aprepitant and alcohol, given as an infusion at a target level of 0.65 g/L, was evaluated. Amitriptyline was included as positive control to provide an impression of the profile of central nervous system (CNS) effects. In a double-blind, randomized, placebo- and amitriptyline-controlled study, the pharmacokinetics and CNS effects of aprepitant and alcohol were investigated in 16 healthy volunteers. Cognitive and psychomotor function tests included the visual verbal learning test (VVLT), Bond and Lader visual analogue scales (VAS), digit symbol substitution test (DSST), visual pattern recognition, binary choice reaction time, critical flicker fusion (CFF), body sway, finger tapping, and adaptive tracking. Alcohol impaired finger tapping and body sway. Amitriptyline impaired DSST performance, VAS alertness, CFF, body sway, finger tapping, and adaptive tracking. No impairments were found after administration of aprepitant. Co-administration of aprepitant with alcohol was generally well tolerated and did not cause significant additive CNS effects, compared with alcohol alone. Therefore, our study found no indications for clinically relevant interactions between aprepitant and alcohol.

Objectives: To evaluate the effectiveness of an energy conservation management (ECM) intervention versus an MS-nurse control intervention for treating fatigue in persons with multiple sclerosis (MS). Design: Single-blind, two-parallel-arms randomized clinical trial (RCT). Setting: Two outpatient rehabilitation departments. Subjects: Adult persons with definite MS, severe fatigued, and being ambulatory. Interventions: The individual-based ECM intervention (12 sessions in 4 months) is based on the Packer group program and was given by occupational therapists. The control intervention (3 sessions in 4 months) consisted of MS-nurse consultations. Method: Primary outcome measures were Fatigue (Checklist Individual Strength-CIS20r domain subjective experience of fatigue) and participation (Impact on Participation and Autonomy- IPA). Additional secondary outcome measures on fatigue, activity and participation were done. Measurements, evaluated by blinded assessors, were at baseline and 8, 16, 26 and 52 weeks after randomization. Linear Mixed Models analyses with a three level structure (repeated measures, patients and therapists) were performed. Results: Intention to treat analysis was based on 76 patients (ECM n=36; MS-nurse n=40). No significant intervention effects were found for fatigue (overall difference CIS20r between the groups = -0.81; 95% CI -3.71 to 2.11; p=0.58), and for four out of five IPA domains. For the IPA domain social relations, an overall unfavorable effect for the ECM group was found (difference between the groups = 0.19, 95% CI 0.03 to 0.35, p=0.02). Conclusion: Energy conservation management does not lead to significant and clinically relevant changes in fatigue and participation compared to MS nurse consultations. Although both treatments achieved a statistically significant decline of fatigue during the treatment period, and for the ECM group also at long-term followup, these effects must be considered as clinically non-relevant