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Horses are often stabled in individual boxes, a method that does not meet their natural needs and may cause psychical and musculoskeletal diseases. This problem is particularly evident in Iceland, where horses often spend the long winter periods in cramped boxes. The aim of this study was to analyze the suitability of a group housing system in Iceland, but the results are also applicable to horses of other regions. Eight Icelandic horses were observed in an active stable system, and their behavior and time budget were recorded. Movement and lying behavior were studied with ALT (Activity, Lying, Temperature detection) pedometers. The effect of an automatic concentrate feeding station (CFS) on the horses' behavior was examined. In the first period of investigation, the horses were fed concentrates manually, and in the second period, they were fed with the CFS. Additional behavioral observations and a determination of social hierarchy occurred directly or by video surveillance. The physical condition of the horses was recorded by body weight (BW) measurement and body condition scoring (BCS). The results showed a significant increase between the first and second trial periods in both the activity (P < 0.001) and the lying time (P = 0.003) of the horses with use of the CFS. However, there was no significant change in BW during the first period without the CFS (P = 0.884) or during the second period with the CFS (P = 0.540). The BCS of the horses was constant at a very good level during both trial periods, and the horses showed a low level of aggression, a firm social hierarchy and behavioral synchronization. This study concludes that group housing according to the active stable principle is a welfare-friendly option for keeping horses and is a suitable alternative to conventional individual boxes.

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A door-to-door population-based epidemiological study of the prevalence of migraine and headache in a sample of 3,246 people older than 15 years of age was carried out in Cuzco, a high-altitude town in the Peruvian Andes, located at 3,380 meters. Among the 3,246 screened people, there were 172 cases of migraine and 930 cases of headache, yielding a crude 1-year prevalence of 5.3% for migraine (2.3% among men and 7.8% among women) and 28.7% for headache (17.5% among men and 38.2% among women). Our results suggest that migraine prevalence in Cuzco is close to that of other developing countries, whereas headache prevalence may be higher than in other developing countries. Multivariate logistic regression suggested that both migraine and headache were related to the female sex, age, and anxiety and/or depression. This study suggests that migraine is a relatively common disorder in Cuzco, but does not show any difference which could significantly related to altitude. In contrast, our results suggest that headache may be more frequent at high altitude than at sea level.

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OBJECTIVE: To determine which brain structures are involved in symptomatic unilateral dystonia caused by localized cerebral infarction. DESIGN: Three-dimensional T1-weighted magnetic resonance imaging sequence and stereotactic analysis were used to analyze the topography of the lesions. Stereotactic localization of thalamic lesions was conducted according to the atlas of Hassler with a Voxtool software (Advantage Windows Workstation, General Electric, Milwaukee, Wis) workstation system. PATIENTS: Eight patients with hemidystonia, segmental dystonia, or focal dystonia were selected from among 51 consecutive patients (between January 1988 and May 1993) with symptomatic unilateral dystonia. RESULTS: Patients had dystonic spasms (n=4) or myoclonic dystonia (n=4). Lesions associated with dystonic spasms were located in the striatopallidal complex, and those with myoclonic dystonia were in the thalamus contralateral to the dystonia. Lesions of the striatopallidal complex involved the putamen posterior to the anterior commissure in all patients and extended variably into the dorsolateral part of the caudate nucleus, the posterior limb of the internal capsule, or the lateral segment of the globus pallidus. These lesions were centered in the "sensorimotor" part of the striatopallidal complex, with a trend toward a somatotopical distribution. Lesions of the thalamus were located in the ventral intermediate and ventral caudal nuclei, while the ventral oral anterior and posterior nuclei (which receive pallidal efferents) were largely spared. CONCLUSIONS: These results suggest that striatopallidal and thalamic dystonia may have different pathophysiologic bases.

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Cholinergic systems are markedly affected both in cortical and subcortical cerebral areas of patients with progressive supranuclear palsy (PSP). To determine whether it is possible to modify the clinical picture of PSP through the enhancement of brain cholinergic neurotransmission, we studied the effects of physostigmine, an anticholinesterase reference drug, on symptoms and brain glucose metabolism using [18F]fluorodeoxyglucose (FDG) and PET. Patients were evaluated blind in a randomized order with both placebo and physostigmine infusions after an individual determination of maximal tolerated dose. Under steady-state physostigmine infusions, although glucose consumption was not significantly modified, the entry of glucose from blood to brain was regionally increased from 8 to 32% of placebo values suggesting an increase in cerebral blood flow (CBF) or an increase in the activity of brain glucose transporter. Following physostigmine administration in the same patients: the errors in antisaccades during ocular movement testing were significantly reduced, a significant reduction in errors or performance was found in four out of seven neuropsychological tests, and motor disability was not significantly altered. Although the precise pathophysiology of these physostigmine-induced effects needs further investigations, our study suggests that part of the clinical symptomatology in PSP could be relieved by the enhancement of brain cholinergic neurotransmission.

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BACKGROUND AND PURPOSE: We carried out a door-to-door survey on stroke prevalence at high altitude in Cuzco City, a town in the Peruvian Andes located 3380 m above sea level. METHODS AND RESULTS: Among the 3246 screened individuals over 15 years old, there were 21 cases of first-ever completed stroke, yielding a crude prevalence ratio of 6.47 per 1000 (95% confidence interval [CI], 3.71 to 8.93 per 1000). The age-adjusted to WHO population point prevalence ratio was 5.74 per 1000 (95% CI, 3.14 to 8.35 per 1000), and the age-adjusted to North American US population point prevalence ratio was 8.58 per 1000 (95% CI, 5.44 to 11.75 per 1000). Multivariate logistic regression analysis suggested that age, polycythemia, high consumption of alcohol, and area of residence were associated with stroke prevalence. Our results suggest that the stroke prevalence in the central areas of Cuzco with sedentary people having a relatively high standard of living was higher than that in the peripheral areas with people with a relatively lower standard of living and less sedentary activities (odds ratio, 5.8; 95% CI, 1.4 to 23). CONCLUSIONS: The prevalence of stroke suggests that stroke may be a public health problem in developing countries. This study suggests the importance of environmental factors such as altitude and lifestyle in stroke occurrence. The role of these factors should be confirmed and taken into account in future stroke prevalence studies.

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