No abstract

Thyroid dysfunction and dementia are conditions that become more prevalent with advancing age. Localised hypothyroidism of the central nervous system has been sugested in some patients with Alzheimer's disease. We investigated the consequence of adult-onset hypothyroidism on beta-amyloid precursor protein (APP) degrading pathways in rats treated with propylthiouracyl over a period of 5 weeks. We evaluated the amount of 3,5,3'-triiodothyronine nuclear receptors (TRalpha1 and TRbeta) and the expression of some APP processing indicators (i.e. APP, ADAM 10, BACE and PS1). The activity of secretases and Abeta peptides has been also quantified. The results obtained show that hypoactivity of the thyroid signalling pathway in the hippocampus induced an increase in the APP770-751/APP695 ratio accompanied by a modification in the amyloidogenic pathway for APP processing, leading to an increased amount of Abeta peptides. In this area of the brain, modification in the non-amyloidogenic pathway of APP processing characterised by alpha-secretase activity was only approximately 10% in hypothyroid rats compared to control rats. We suggest that hypothyroidism, which becomes more prevalent with advancing age, increased the vulnerability to the formation of amyloid deposits.

Anatomic and metabolic changes in central nervous system induced by 14 wk of vitamin A deprivation (VAD) were monitored and quantified in rats. In vivo brain magnetic resonance imaging (4.7T) was performed at 5, 7, 9, 11, and 14 wk of each diet after weaning in the following: 1) VAD group; 2) control pair-fed group; and 3) control group that consumed the diet ad libitum (1.15 microg retinol/g diet). After 14 wk, high-resolution magic angle spinning proton NMR spectroscopy (11.7T) was performed on small samples of cortex, hippocampus, and striatum. Serum retinol concentrations remained stable and cerebral volume (CV) increased as a linear function of body weight in the ad libitum group (R(2) = 0.78; P = 0.047) and pair-fed controls (R(2) = 0.78; P = 0.046). In VAD rats, retinol decreased from the onset of deprivation (2.2 +/- 0.14 micromol/L) to reach 0.3 +/- 0.13 micromol/L at wk 5, followed by a stopping of body weight gain from wk 7. In VAD rats, the CV decreased from wk 5 and reached a value 11% lower than that of the control group (P < 0.001) at wk 14 and was correlated with retinol status (R(2) = 0.99; P = 0.002). The VAD hippocampal volume decreased beginning at wk 9 and was 22% lower than that of the control group at wk 14 (P < 0.001). Compared with the control, VAD led to lower N acetyl aspartate:creatine+phosphocreatine (Cr) in cortex (-36%), striatum (-22%), and hippocampus (-19%) and higher myoinositol:Cr in cortex (+127%) and striatum (+150%). VAD induced anatomic and metabolic changes comparable to those associated with neurodegenerative disorders. By wk 7 of deprivation, the slowing in cerebral growth that correlated with the retinol level could be considered as a predictive marker of brain disorders, confirmed by metabolic data from VAD rats after 14 wk.

A new teaching format, the LecturePlus was formulated as a lecture followed by small group learning activities. This study assessed the effectiveness of LecturePlus in medical education. An interventional study was conducted among final-year medical students with 74 students in the experimental group and 96 students in the control group. Each LecturePlus lasted about 1 hour and was conducted with 12 to 18 students. A LecturePlus session comprised of a lecture followed by small-group problem-solving exercises. The exercises were clinical cases with open-ended short-answer questions. Students were divided into groups of three each (triads) for these exercises. A faculty tutor assisted the small groups as needed. Closure was achieved through a discussion moderated by the tutor. Learning outcomes were assessed via the National Board of Medical Examiners (NBME) subject scores and compared with those of the preceding academic year. An additional multiple-choice questions (MCQ) test was administered before and after the clerkship. The MCQ test showed improvement in knowledge application (p < 0.001, partial eta squared, 0.42). There was a statistically significant improvement in adjusted NBME scores among female students (74.8 vs. 71.8; p = 0.017) but not among male students. An anonymous written questionnaire survey showed high ratings for LecturePlus (95% selecting yes or partly yes to overall satisfaction). LecturePlus is an instructional strategy that integrates a lecture with learning activities. It can be scaled to large class sizes facilitated by one teacher. By combining didactic teaching with problem solving, this new instructional strategy may foster application of knowledge.