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Many people with autism spectrum disorders (ASD) are remarkably proficient at remembering how things look and sound and are good at rote learning. However, all ASD sufferers have poor ability to recall personal memories and relive experiences. This book assembles research to examine why this happens and the effects it has.

\"In the past 25 years, the frontal lobes have dominated human neuroscience research. Functional neuroimaging studies have revealed their importance to brain networks involved in nearly every aspect of mental and cognitive functioning. Studies of patients with focal brain lesions have expanded on early case study evidence of behavioral, emotional, and cognitive changes associated with frontal lobe brain damage. The role of frontal lobe function and dysfunction in human development (in both children and older adults), psychiatric disorders, the dementias, and other brain diseases has also received rapidly increasing attention. In this useful text, 14 leading frontal lobe researchers review and synthesize the current state of knowledge on frontal lobe function, including structural and functional brain imaging, brain network analysis, aging and dementia, traumatic brain injury, rehabilitation, attention, memory, and consciousness. The book therefore provides a state-of-the-art account of research in this exciting area, and also highlights a number of new findings by some of the world's top researchers\"-- Provided by publisher.

Objectives: Osteochondritis dissecans (OCD) is a condition characterized by abnormal subchondral bone with disturbance of overlying articular cartilage. Pathophysiology for the etiology and underlying mechanism of OCD lesion development is not fully understood. The purpose of this study was to determine the association of lower extremity weightbearing axis with femoral condyle OCD lesion location, and if this association was affected by certain patient and OCD lesion characteristics such as lesion stability, skeletal maturity, and the presence of the OCD lesion on the medial versus lateral femoral condyle. Methods: This was a retrospective case series at a single, large academic institution. The primary outcome was the association of femoral condyle OCD lesion location with lower extremity weightbearing axis as categorized by Cahill and Berg zones of the knee. Secondary outcomes included sub-group analyses (treatment, skeletal maturity, and lesion stability) and contribution of femoral and tibial mechanical axis to lower extremity weightbearing axis deviations (mechanical lateral distal femoral angle [mLDFA] and medial proximal tibial angle [MPTA]). For unilateral OCD lesions, mechanical axis was compared between affected and unaffected lower extremities. Results: Eighty-six patients and 95 knees with an OCD lesion of the femoral condyle were identified, with 9 patients (11%) having bilateral OCD lesions. There were 74% male patients with average age of 21 years old. 65% of knees had closed distal femoral physes, 82% of OCD lesions were unstable on MRI imaging, and 85% underwent a surgical procedure. Seventy-five percent of OCD lesions were located in Cahill and Berg zone 2 at the lateral aspect of the medial femoral condyle. Lower extremity mechanical axis was located in the same zone as the OCD lesion in 48% of cases and within the same knee compartment in 56% of cases. Over 90% of OCD lesions were within ±1 zone of the weightbearing axis. There were no significant differences in the association of mechanical axis and OCD lesion location in subgroup analysis of medial versus lateral femoral condyle OCD lesions, skeletal maturity, stability of the lesion, or treatment group. For patients with varus alignment and medial femoral condyle OCD lesions, the mean mLDFA was 89.9° and MPTA was 85.4°, whereas for valgus alignment and lateral femoral condyle lesions, the mLDFA was 84.8° and MPTA was 88.8°. Both the mLDFA and MPTA were significantly different when comparing medial to lateral femoral condyle OCD lesions (p <0.001 and <0.001, respectively). Patients with unilateral medial femoral condyle OCD lesions were more likely to have varus alignment of the affected extremity compared to the contralateral extremity (59% vs. 36%, p = 0.01). Conclusions: This study demonstrated a relationship between lower extremity mechanical weightbearing axis and femoral condyle OCD location. Patients with unilateral medial femoral condyle OCD lesions are more likely to have varus alignment in the affected extremity. Varus alignment associated with medial femoral condyle lesions had similar varus contributions from both femoral and tibial alignment whereas valgus alignment in the setting of lateral femoral condyle lesions appear to have predominantly femoral contributions. There were no significant differences in association with mechanical axis among medial versus lateral femoral condyle lesions, OCD lesion stability, or distal femoral physeal status. More work is required to better understand the relationship between mechanical axis and femoral condyle OCD lesion pathophysiology with the long-term goal of identifying patients at risk for progression of lesion instability and developing potential interventions to preserve articular cartilage.

Introduction Sexsomnia is a variant of confusional arousal, a NREM parasomnia (NREMP), typically consisting of sexual behaviors manifesting upon partial arousal from deep NREM sleep; however, its pathophysiology is not well understood, and literature is limited. We present a series of patients with non-dominant hand sexsomnia behaviors that may reveal important new clues about the neurophysiologic mechanisms of sexsomnias. Report of case(s) Case 1: 22 y/o right-handed (RH) female, no history of NREMP, or snoring. Presenting complaint (PC): 8-year history of sleep masturbatory behavior (MB) including partial awakening from MB with bloody fingers (left hand) during her menstrual period in the setting of delayed sleep phase disorder. Case 2: 30 y/o ambidextrous male with a history of NREMP. PC: MB involving the left hand, observed by bed partner (BP) in the setting of weight gain and apneas. PSG: AHI 17/h and PLMI 23/h. Case 3: 33 y/o RH female with a history of NREMP. PC: left-handed sleep MB observed by BP in the setting of multiple sclerosis with C2-3 and C4 right posterolateral demyelinating lesions on C-spine MRI. Case 4: A 44 y/o RH male with OCD, depression, and no history of NREMP. PC: bilateral MB and dream enactment behaviors observed by BP, in the setting of sertraline. Events resolved upon switching to quetiapine. Case 5: A 59- y/o RH female with multiple system atrophy (MSA) and RBD, no previous NREMP. PC: sleep MB, noted by BP involving the left hand in the setting of worsening dysautonomia. Dream enactment occurred bilaterally. PSG: AHI 34/h, PLMI: 70/h and REM sleep without atonia. Spells improved with melatonin and PAP. Conclusion This case series highlights a pattern of adult sleep MB involving the non-dominant (left) hand in 4/5 cases and the left hand in one ambidextrous patient. There was no evidence of gender predilection. We speculate that sexsomnia originates from central pattern generators in the brainstem and spinal cord, as opposed to the cerebral cortex (which would likely involve the dominant hand). The lack of involvement of cerebral motor control is further substantiated by amnesia for sexsomnia events. Support (if any)

IntroductionDiabetes mellitus is a common comorbidity in people with heart failure and is associated with worse clinical outcomes. Type 1 and type 2 diabetes are likely to have different disease patterns and pathophysiology in developing heart failure. However, research in this area is lacking. The majority of research has focused on type 2 diabetes (T2D). In contrast, there are little data on heart failure in type 1 diabetes (T1D).PurposeThis study aimed to compare baseline characteristics, use of heart failure guideline-directed medical therapy (GDMT) and all-cause mortality in individuals with incident heart failure and type 1 diabetes and those with heart failure and type 2 diabetes.MethodsWe conducted an observational study using TriNetX, a global federated health research network (n=138 million) providing access to real time electronic health records from 142 health care organisations worldwide. We included individuals aged ≥ 18 years with incident heart failure and type 1 diabetes (n=7,744) and heart failure and type 2 diabetes (n= 1,049,321) between February 2005 and February 2025. Propensity score matching for age, gender, and other relevant baseline clinical characteristics was performed. In the matched cohort we assessed prescribing of GDMT and mortality up to 1 year after heart failure diagnosis.Results45% of the overall cohort was female. Individuals with type 1 diabetes were younger than those with type 2 diabetes at the time of heart failure diagnosis (63.7 ± 15.4 years vs. 69.7 ± 12.7 years, p<0.001) and had fewer comorbidities. Hypertension 4% vs. 59.8%, p<0.001; ischaemic heart disease 29% vs. 33.2%, p<0.001. T1D and heart failure had higher NTproBNP than T2D and heart failure at baseline, 3755 ± 8327 ng/L vs. 2981 ± 7092 ng/L, p 0.023. Glycaemic control was similar in both groups (HbA1C 7.2 ± 2.1% vs. 7.1 ± 1.9%, p<0.41). In the propensity-matched cohort (n=7,367 in both groups), the likelihood of being prescribed GDMT at 1 year following heart failure diagnosis was significantly less in T1D patients compared to T2D. ACE inhibitors/ ARB 71.4% vs. 78.23%, p<0.001; MRA 19.3% vs. 22.1%, p<0.001; Beta blocker 79.1% vs. 86%, p<0.001; SGLT2i 3.3% vs. 7.5%, p<0.001. At 1 year heart failure patients with T1D had significantly higher all-cause mortality than those with T2D (unmatched cohort: 17.4% vs. 14.6%, HR 1.19, 95% CI 1.12, 1.26, p<0.001; matched cohort: 18.1% vs. 12.6%, HR 1.469, 95% CI 1.340, 1.611, p<0.001).ConclusionDespite being younger with fewer comorbidities, individuals with type 1 diabetes and heart failure appeared to have more severe heart failure at baseline than those with type 2 diabetes, with higher NTproBNP at baseline. Individuals with T1D were less likely to be prescribed GDMT and had higher all-cause mortality at 1 year. These results highlight a need for improvements in our understanding of the pathophysiology and treatment options in individuals with T1D and heart failure.Abstract 5-017 Figure 1One year mortality in patients with diabetes diagnosed after heart failure[Figure omitted. See PDF]