Common data elements (CDEs) for concussion, as established by international bodies, are not being widely used in Ontario, resulting in significant variability in the data being assessed and collected across clinics. CDEs support standardization of care as well as large-scale data sharing for high impact research. A collaborative network – Concussion Ontario Network: Neuroinformatics to Enhance Clinical care and Translation (CONNECT) – comprised of health care professionals, researchers, members from advocacy groups, and patients was formed to establish and implement CDEs for concussion care and research. While the seeds have been planted and initial effectiveness demonstrated, future challenges exist.

Cerebral visual impairments have been of great interest to neurologists, ophthalmologists, and neuroscientists. Complicated or partial varieties related to cortical blindness are discussed in this review. They are a fascinating alphabet of eponymic clinical syndromes, bordering neurology, ophthalmology, and even psychiatry. Recent functional imaging and experimental studies have contributed further knowledge of cognitive visual organization in addition to the classical lesion evidence.

Psychomotor activity is one of the traits we most immediately perceive in others. Psychomotor slowing, which can be easily noticed on a first medical examination, is a symptom which may be prodromal of psychic disturbances.

Historically, psychomotor retardation is a characteristic attached to depression, especially melancholia. Some studies show that psychomotor retardation is associated with good therapeutic prognosis, including positive response to electro-convulsivo-therapy. The cluster of non-verbal symptoms includes both basic aspects related to motor behavior such as attitudes and movements and more complex aspects such as goal-directed behaviors. We will see that this intuitive and fundamental dimension of clinical depression is not homogeneous. From a motor point of view, hypo-bradykinesia in depression may be compared to the one found in cortico-subcortical syndromes such as Parkinson's disease. This comparison suggests that key brain structures such as the basal ganglia could be involved in depression.

Moreover, the loss of vital energy is the dominant psychopathological explanation linked to psychomotor retardation. From a phenomenological point of view, this interpretation seems to be relevant but appears disappointing as an experimental variable. However, motivation, understood as the factor that energizes the behavior seems to be an interesting and promising concept.

Experimentally, it is possible to measure how much an individual is able to invest energy in order to achieve a goal.

The impact of depression on the process of incentive motivation will be analyzed before turning to a description of therapeutic interventions related to psychomotor field such as sports or sensorimotor stimulations that appear to be promising tracks for clinical improvement.

Le binge drinking (c’est-à-dire la consommation excessive mais épisodique d’alcool, typique du milieu étudiant) constitue désormais un problème majeur de santé publique, en particulier chez les adolescents et jeunes adultes. Les conséquences psychologiques, interpersonnelles et sociétales de ce mode de consommation sont largement établies, mais ses effets cognitifs et cérébraux n’ont été investigués que durant cette dernière décennie. Il a ainsi été clairement montré, sur base d’études en neuropsychologie et en neurosciences, que les binge drinkers présentent des modifications marquées du fonctionnement cérébral. Cependant, ces études se sont centrées sur des tâches cognitives (explorant par exemple la mémoire, l’attention ou les fonctions exécutives) et les déficits émotionnels associés au binge drinking restent totalement inconnus malgré le rôle majeur joué par ces altérations dans le maintien des troubles liés à la consommation excessive d’alcool. Après un passage en revue des données relatives aux troubles cognitifs, nous présenterons ici des études récentes ayant exploré pour la première fois les déficits émotionnels dans le binge drinking ainsi que leurs corrélats cérébraux, sur base d’une approche multidisciplinaire combinant électrophysiologie et neuroimagerie. Les résultats montrent clairement que le binge drinking conduit, au-delà des altérations cognitives, à des déficits marqués pour le traitement de stimulations émotionnelles, déficits qui pourraient être impliqués dans le développement et le maintien des troubles liés à la consommation d’alcool. Enfin, les limites des connaissances actuelles seront décrites, de même que les perspectives majeures pour les recherches futures. En particulier, sur base de résultats obtenus récemment via une analyse en clusters sur une large population de binge drinkers, nous insisterons sur la nécessité de sortir de la vision unitaire du binge drinking afin de considérer les sous-types de binge drinkers, qui présentent de grandes variations aux niveaux psychologique et cognitif.

La psychopathologie est précieuse pour guider l’application de l’imagerie cérébrale fonctionnelle à l’étude des troubles mentaux. En permettant une approche basée sur les processus mentaux plutôt que sur des catégories diagnostiques (par ex. rumination plutôt que dépression), elle offre l’opportunité d’identifier des biomarqueurs susceptibles d’enrichir la nosographie psychiatrique et de renseigner les stratégies diagnostiques et thérapeutiques. En revanche, savoir si l’imagerie cérébrale fonctionnelle peut être un outil au service de la psychopathologie, c’est-à-dire de la compréhension des processus mentaux sous-jacents aux troubles psychiatriques, reste une question controversée. Un intérêt potentiel de l’imagerie cérébrale fonctionnelle pourrait être l’identification de processus mentaux non conscients et inaccessibles à une mesure comportementale. C’est ainsi que la constatation de bases cérébrales communes entre douleur morale et douleur physique a pu donner lieu à des spéculations fascinantes sur l’origine de leur parenté lexicale. Ou encore que certains envisagent de pouvoir distinguer conversion et simulation sur la base de l’activité cérébrale. Mais interpréter cette activité comme témoignant d’un processus mental, raisonnement appelé inférence inverse, pose plusieurs problèmes, que le processus mental soit rapportable ou non. Par exemple, l’activité cérébrale observée peut ne pas être pas spécifique du processus mental en question. Ou alors cette activité cérébrale peut ne pas être définie avec assez de précision. L’ensemble de ces problèmes peut être formalisé dans une perspective bayésienne. En dépit de ces limites, l’inférence inverse est néanmoins un outil heuristique puissant pour susciter des hypothèses secondairement réfutables concernant la nature des processus mentaux et leurs relations (par ex. évocation de l’objet perdu et renforcement lors d’un deuil compliqué). Combinée à des paradigmes expérimentaux de qualité, l’imagerie cérébrale fonctionnelle est donc susceptible d’apporter des connaissances nouvelles à la psychopathologie.

Head rotation causes compression and occlusion of the ipsilateral internal jugular (IJ) vein. This can result in raised intracranial pressure and increased bleeding if the patient is having or has recently had surgery. The amount of head rotation in adults resulting in occlusion of the ipsilateral IJ vein is unknown however. We measured the amount of head turn that produced occlusion of the ipsilateral IJ vein in 25 patients having surgery under general anesthesia. On average, 80% of IJ veins occlude at a mean of 55.6° on the left and 53.3° on the right.

In the contemporary debate on the use of the neurosciences in ethics and law, numerous arguments have been bandied about among scientists and philosophers looking to uphold or reject the reliability and validity of scientific findings obtained by brain imaging technologies. Among the most vexing questions is, Can we trust that technology? One point of disagreement is whether brain scans offer a window through which to observe the functioning of the mind, in such a way as to enable lawyers, judges, physicians, and lawmakers to detect anomalies in brain function that may account for criminal unconscious behavior. Those who stand behind brain imaging believe that this can indeed be achieved, whereas those in opposition stress that brain scans are highly open to interpretation and that the data they provide is insufficient to establish causal connections. The question essentially comes down to whether technology can reliably be used to determine the intentions of the individual, thus establishing mens rea, for example, and hence responsibility. This article focuses on the latter notion and explores whether we can rely on the neurosciences to shed light on a complex form of moral and legal reasoning, as well as the role of the neurosciences in reawakening a philosophical and legal interest in trying to set responsibility on an empirical basis.

On February 11, 2015, the Canadian Food Inspection Agency announced that a cow born and raised in Alberta had tested positive for bovine spongiform encephalopathy (BSE), commonly known as mad cow disease. BSE is a prion disease of cattle that, when transmitted to humans, produces a fatal neurodegenerative disease known as variant Creutzfeldt-Jakob disease. We believe that this latest case of BSE in Canadian cattle suggests the timeliness of a review of the management of BSE in Canada from a historically and scientifically informed perspective. In this article, we ask: how did the Canadian management of BSE between 1990 and 2014 engage with the contemporary understanding of BSE’s human health implications? We propose that Canadian policies largely ignored the implicit medical nature of BSE, treating it as a purely agricultural and veterinary issue. In this way, policies to protect Canadians were often delayed and incomplete, in a manner disturbingly reminiscent of Britain’s failed management of BSE. Despite assurances to the contrary, it is premature to conclude that BSE (and with it the risk of variant Creutzfeldt-Jakob disease) is a thing of Canada’s past: BSE remains very much an issue in Canada’s present.

After traumatic injury, the brain undergoes a prolonged period of degenerative change that is paradoxically accompanied by cognitive recovery. The spatiotemporal pattern of atrophy and the specific relationships of atrophy to cognitive changes are ill understood. The present study used tensor-based morphometry and neuropsychological testing to examine brain volume loss in 17 traumatic brain injury (TBI) patients and 13 controls over a 4-year period. Patients were scanned at 2 months, 1 year, and 4 years post-injury. High-dimensional warping procedures were used to create change maps of each subject's brain for each of the two intervals. TBI patients experienced volume loss in both cortical areas and white matter regions during the first interval. We also observed continuing volume loss in extensive regions of white matter during the second interval. Neuropsychological correlations indicated that cognitive tasks were associated with subsequent volume loss in task-relevant regions. The extensive volume loss in brain white matter observed well beyond the first year post-injury suggests that the injured brain remains malleable for an extended period, and the neuropsychological relationships suggest that this volume loss may be associated with subtle cognitive improvements. (JINS, 2012, 18, 1–13)

It is widely acknowledged that the quality of research is greatly improved when nurses are involved at the investigators’ site. Many papers highlight the knowledge, skills and expertise required by nurses for the conduct of trials. The known skills include reliability, organization, communication, motivation, self-discipline and critical thought. The responsibilities of nurses in the conduction of research trials are wide ranging from the collection and recording of data, recruitment and screening of patients, ensuring informed consent has been gained, randomization of drugs, the follow-up of patients to development and training for staff to the required international standards. In the past, clinical research nurses have been considered as data collectors by their peers, due to the lack of knowledge of the true extent of the role of the clinical research nurse. The rise in popularity of the role and the publication of an employment brief for clinical research nurses by the Royal College of Nursing (RCN) and the UK Clinical Research Collaboration (UKCRC) publication on ‘Developing the best research professionals’ has readdressed this prior imbalance; recognizing in detail their role, knowledge, skills, expertize with appropriate grading and remuneration. The role of the clinical research nurse in the neuroscience setting is equally as diverse with the added requirement of a higher level of knowledge and understanding of the pathophysiology of neurological diseases and specific skills required to work in the intensive care environment. This paper will attempt to explore the role of the specialized neurosciences intensive care nurse and the relationship with high-quality neuroscience research.