Methods: Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down "on-bed" without inflated rectal balloon and "on-commode (toilet)" with 60-mL inflated rectal balloon. Eleven healthy volunteers were also evaluated.
Results: Ninety-three of 117 screened participants (F/M = 77/16) were included. Balloon expulsion time was abnormal (＞ 60 seconds) in 56% (mean 214.4 seconds). A modest correlation between HRPT and WM was observed for sphincter length (R = 0.4) and likewise agreement between dyssynergic subtypes (κ = 0.4). During bearing down, 2 or more anal pressure-segments (distal and proximal) could be appreciated and their expansion measured with HRPT but not WM. In constipated vs healthy participants, the proximal segment was more expanded (2.0 cm vs 1.0 cm, P = 0.003) and of greater pressure (94.8 mmHg vs 54.0 mmHg, P = 0.010) during bearing down on-commode but not on-bed.
Conclusions: Because of its better resolution, HRPT may identify more structural and functional abnormalities including puborectal dysfunction (proximal expansion) than WM. Bearing down on-commode with an inflated rectal balloon may provide additional dimension in characterizing DD.
Materials and Methods: The odorant descriptors and distractors of the original version of Sniffin' Sticks were translated into Malay language. It was then tested for familiarity and identifiability in 30 normosmic subjects. The descriptors were replaced until the familiarity of all descriptors and identification rates of odorants achieved ≥ 70%. The validity of the new cultural-adapted version was tested in 60 hypo-anosmic subjects and 60 normosmic subjects with Student t-test. The test-retest reliability was evaluated after two weeks with interclass correlation.
Results: Two odorant descriptors and nine distractors achieved familiarity <70% (13.3% - 66.7%) and were replaced. Another three culturally inappropriate distractors were also replaced. The mean score among the healthy subjects was significantly higher than the subject with smell dysfunction [13.7 (1.12) and 7.3 (3.42); t = 7.24 (df = 34.23), P<0.001]. The coefficient of correlation (r) between test and retest scores was 0.93 (P<0.001).
Conclusion: The cultural adapted Malaysian version of Sniffin' Sticks smell identification test is valid and has high test-retest reliability. This is the first smell identification test validated in Malaysia. It is effective for evaluation of olfactory function in local population.
OBJECTIVE: We evaluated whether transorbital ACS modulates BOLD activity in early visual cortex using high-resolution 7 Tesla functional magnetic resonance imaging (fMRI).
METHODS: In this feasibility study transorbital ACS in the alpha range and sham ACS was applied in a random block design in five healthy subjects for 20 min at 1 mA. Brain activation in the visual areas V1, V2 and V3 were measured using 7 Tesla fMRI-based retinotopic mapping at the time points before (baseline) and after stimulation. In addition, we collected data from one hemianopic stroke patient with visual cortex damage after ten daily sessions with 25-50 min stimulation duration.
RESULTS: In healthy subjects transorbital ACS increased the activated cortical surface area, decreased the fMRI response amplitude and increased coherence in the visual cortex, which was most prominent in the full field task. In the patient, stimulation improved contrast sensitivity in the central visual field. BOLD amplitudes and coherence values were increased in most early visual areas in both hemispheres, with the most pronounced activation detected during eccentricity testing in retinotopic mapping.
CONCLUSIONS: This feasibility study showed that transorbital ACS modifies BOLD activity to visual stimulation, which outlasts the duration of the AC stimulation. This is in line with earlier neurophysiological findings of increased power in EEG recordings and functional connectivity reorganization in patients with impaired vision. Accordingly, the larger BOLD response area after stimulation can be explained by more coherent activation and lower variability in the activation. Alternatively, increased neuronal activity can also be taken into account. Controlled trials are needed to systematically evaluate the potential of repetitive transorbital ACS to improve visual function after visual pathway stroke and to determine the cause-effect relationship between neural and BOLD activity changes.