The cerebellum monitors errors and entrains executive networks

Frontal midline θ (Fmθ) activity occurs in medial prefrontal cortices (mPFC), when expected and actual outcomes conflict. Cerebellar forward models could inform the mPFC about this mismatch. To verify this hypothesis we correlated the mPFC activation during a visuomotor tracking task (VM) with performance accuracy, in control and cerebellum-lesioned participants. Additionally, purely visual (V), motor (M) and a motor plus visual tasks (V + M) were performed. An Independent Component, with a mid-frontal topography scalp map and equivalent dipole location in the dorsal anterior cingulate cortex accounted for Fmθ. In control participants Fmθ power increased during VM, when the error level crossed a threshold, but not during V + M, M and V. This increase scaled with tracking error. Fmθ power failed to increase during VM in cerebellar participants, even at highest tracking errors. Thus, in control participants, activation of mPFC is induced when a continuous monitoring effort for online error detection is required. The presence of a threshold error for enhancing Fmθ, suggests the switch from an automatic to an executive tracking control, which recruits the mPFC. Given that the cerebellum stores forward models, the absence of Fmθ increases during tracking errors in cerebellar participants indicates that cerebellum is necessary for supplying the mPFC with prediction error-related information. This occurs when automatic control falters, and a deliberate correction mechanism needs to be triggered. Further studies are needed to verify if this alerting function also occurs in the context of the other cognitive and non-cognitive functions in which the cerebellum is involved.

A randomized study of the efficacy of postconsolidation therapy in adult acute nonlymphocytic leukemia: a report of the Italian Cooperative Group GIMEMA

The Italian Co-operative Group GIMEMA conducted a randomized trial in adult acute nonlymphocytic leukemia (ANLL) to assess the role of postconsolidation treatment. Of 448 evaluable patients entered into the study, 305 (68%) achieved a complete remission after a standard induction with daunorubicin and cytosine arabinoside (3 + 7; 2 + 5). Those in remission after a consolidation therapy including 4 courses of daunorubicin, cytosine arabinoside, and 6-thioguanine (DAT) were allocated to one of three arms: no treatment, conventional maintenance, or intensive postconsolidation therapy. The median disease-free survival (DFS) was 13 months, and the median survival was 14 months, with 26% surviving at 6.5 years. There was no difference in survival and in disease-free survival among the three postconsolidation arms. In conclusion our study, as others, suggests that the critical period of ANLL treatment is within the first 5-6 months.

Serum ferritin in beta-thalassaemia intermedia

The iron status of 10 patients with beta-thalassaemia intermedia has been investigated in order to assess whether the liver iron overload could be constantly predicted through the patients' S-ferritin levels. Our data have shown that only when the iron overload is in the far advanced stages do the S-ferritin concentrations appear to be strongly raised, whilst in the early stages of the disease the levels fall to normal ranges with consequent underestimation of the expanding iron stores. Thus, in the early stages of the iron overload the liver iron burden of such patients is only reflected by both chemical and histochemical investigations performed on the liver biopsy specimens long before the rise in their S-ferritin levels.

Plasma cell acid phosphatase as an adjunct in the differential diagnosis of monoclonal immunoglobulinemias

Plasma cell acid phosphatase has been studied in 51 patients, 30 of whom were affected with multiple myeloma (MM) and 21 with nonmyelomatous monoclonal immunoglobulinemias (NMMI). Scoring of results displayed a highly significant difference between the median of the MM and NMMI group (343 vs. 204). The use of plasma cell acid phosphatase as a further criterion in the differential diagnosis of monoclonal immunoglobulinemiasis emphasized.