Sex-specific disruption in corticospinal excitability and hemispheric (a)symmetry in multiple sclerosis

Multiple Sclerosis (MS) is a neurodegenerative disease in which pathophysiology and symptom progression presents differently between the sexes. In a cohort of people with MS (n = 110), we used transcranial magnetic stimulation (TMS) to investigate sex differences in corticospinal excitability (CSE) and sex-specific relationships between CSE and cognitive function. Although demographics and disease characteristics did not differ between sexes, males were more likely to have cognitive impairment as measured by the Montreal Cognitive Assessment (MoCA); 53.3% compared to females at 26.3%. Greater CSE asymmetry was noted in females compared to males. Females demonstrated higher active motor thresholds and longer silent periods in the hemisphere corresponding to the weaker hand which was more typical of hand dominance patterns in healthy individuals. Males, but not females, exhibited asymmetry of nerve conduction latency (delayed MEP latency in the hemisphere corresponding to the weaker hand). In males, there was also a relationship between delayed onset of ipsilateral silent period (measured in the hemisphere corresponding to the weaker hand) and MoCA, suggestive of cross-callosal disruption. Our findings support that a sex-specific disruption in CSE exists in MS, pointing to interhemispheric disruption as a potential biomarker of cognitive impairment and target for neuromodulating therapies.

On the outside looking in: a phenomenological study of the lived experience of Australian adults with a disorder of the corpus callosum

Background

While classified as a rare condition, a congenital disorder of the corpus callosum (DCC) is one of the most commonly identified brain anomalies in newborns, occurring in 1:4000 live births. Advances in imaging techniques have improved early diagnosis for children, yet adults with a DCC—who may present with extreme heterogeneity in cause and impact—often experience challenges in receiving a definitive diagnosis and accessing appropriate services and supports. To date, the dearth of evidence documenting the lived experiences of adults with DCC has made it difficult to determine adequate policy and service responses. This exploratory research aims to address this gap by presenting the first qualitative examination of the experiences and impact of complete or partial agenesis of the corpus callosum among adults.

Results

Eight face-to-face interviews were conducted with Australian adults, aged 23–72 years, to explore their lived experience. Data was collected in four Australian states from June to August 2017. Thematic and interpretive analyses were employed to analyse data. Three emergent themes described difficulties related to: (1) reactions to the diagnosis; (2) access to supports and key life domains, and (3) identifying as an adult. Interview analysis described lived experiences typically outlining a lifetime of exclusion and misunderstanding from family, educators and disability and health support services.

Conclusions

This paper contributes to filling the knowledge gap around a rare congenital brain disorder affecting the lives of adults. Findings confirm a considerable lack of information and support for adults living with corpus callosum disorders. Greater professional and societal understanding is needed to improve access to the key life domains of education, employment and social inclusion for adults with a DCC. To instigate truly effective change, social research must tackle the issues of applicability and impact to alter the dominance of uninformed practices, hindered by prevailing myths. This research paves the way for further phenomenological studies in which participant narrative is vital. Further research will elicit stronger policy and service responses for all current and emerging adults with a DCC.

The diffusion-tensor imaging reveals alterations in water diffusion parameters in acute pediatric concussion

Wide-spread visualization methods which are computed tomography (CT) and magnetic resonance imaging (MRI) are not sensitive to mild traumatic brain injury (mTBI). However, mTBI may cause changes of cerebral microstructure that could be found using diffusion-tensor imaging. The aim of this study is to reveal the impact of acute mTBI (no more than 3 days after trauma) on diffusion parameters in corpus callosum, corticospinal tract, and thalamus in children (aged 14-18). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were analyzed. Significant increase in FA and decrease in ADC were observed in thalamus. The trend to an increase in FA is observed in corpus callosum.

Handedness and midsagittal corpus callosum morphology: a meta-analytic evaluation

Following a series of seminal studies in the 1980s, left or mixed hand preference is widely thought to be associated with a larger corpus callosum than right handedness, influencing the interpretation of findings and various theories related to interhemispheric processing, brain lateralisation, and hand preference. Recent reviews, however, find inconsistencies in the literature and cast doubt on the existence of such an association. The present study was conducted to clarify the relationship between hand preference and callosal morphology in a series of meta-analyses. For this purpose, articles were identified via a search in PubMed and Web Of Science databases. Studies reporting findings relating to handedness (assessed as hand preference) and corpus-callosum morphology in healthy participants were considered eligible. On the basis of a total of k = 24 identified studies and databases, random-effects meta-analyses were conducted considering four different group comparisons: (a) dominantly right- (dRH) and left-hand preference (dLH), (b) consistent right (cRH) and non-cRH preference, (c) cRH with mixed-hand preference (MH), and (d) cRH with consistent left-hand hand preference (cLH). For none of these meta-analyses did we find a significant effect of hand preference, and narrow confidence intervals suggest that the existence of population effects larger than 1% explained variance could be excluded. For example, considering the comparison of dRH and dLH (k = 14 studies; 1910 dRH and 646 dLH participants) the mean effect size was Hedge’s g = 0.016 (95% confidence interval: − 0.12 to 0.15; explained variance: < 0.001%). Thus, the common practice of assuming an increase in callosal connectivity based on mixed or left hand preference is likely invalid.

Biochemical Alterations in White Matter Tracts of the Aging Mouse Brain Revealed by FTIR Spectroscopy Imaging

White matter degeneration in the central nervous system (CNS) has been correlated with a decline in cognitive function during aging. Ultrastructural examination of the aging human brain shows a loss of myelin, yet little is known about molecular and biochemical changes that lead to myelin degeneration. In this study, we investigate myelination across the lifespan in C57BL/6 mice using electron microscopy and Fourier transform infrared (FTIR) spectroscopic imaging to better understand the relationship between structural and biochemical changes in CNS white matter tracts. A decrease in the number of myelinated axons was associated with altered lipid profiles in the corpus callosum of aged mice. FTIR spectroscopic imaging revealed alterations in functional groups associated with phospholipids, including the lipid acyl, lipid ester and phosphate vibrations. Biochemical changes in white matter were observed prior to structural changes and most predominant in the anterior regions of the corpus callosum. This was supported by biochemical analysis of fatty acid composition that demonstrated an overall trend towards increased monounsaturated fatty acids and decreased polyunsaturated fatty acids with age. To further explore the molecular mechanisms underlying these biochemical alterations, gene expression profiles of lipid metabolism and oxidative stress pathways were investigated. A decrease in the expression of several genes involved in glutathione metabolism suggests that oxidative damage to lipids may contribute to age-related white matter degeneration.

The functional characterization of callosal connections

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The functional characterization of callosal connections is informed by anatomical data.

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Callosal connections play a conditional driving role depending on the brain state and behavioral demands.

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Callosal connections play a modulatory function, in addition to a driving role.

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The corpus callosum participates in learning and interhemispheric transfer of sensorimotor habits.

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The corpus callosum contributes to language processing and cognitive functions.

The brain operates through the synaptic interaction of distant neurons within flexible, often heterogeneous, distributed systems. Histological studies have detailed the connections between distant neurons, but their functional characterization deserves further exploration. Studies performed on the corpus callosum in animals and humans are unique in that they capitalize on results obtained from several neuroscience disciplines. Such data inspire a new interpretation of the function of callosal connections and delineate a novel road map, thus paving the way toward a general theory of cortico-cortical connectivity. Here we suggest that callosal axons can drive their post-synaptic targets preferentially when coupled to other inputs endowing the cortical network with a high degree of conditionality. This might depend on several factors, such as their pattern of convergence-divergence, the excitatory and inhibitory operation mode, the range of conduction velocities, the variety of homotopic and heterotopic projections and, finally, the state-dependency of their firing. We propose that, in addition to direct stimulation of post-synaptic targets, callosal axons often play a conditional driving or modulatory role, which depends on task contingencies, as documented by several recent studies.

Revisiting the attentional bias in the split brain

Previous research has revealed a strong right bias in allocation of attention in split brain subjects, suggesting that a pathological attention bias occurs not only after unilateral (usually right-hemispheric) damage but also after functional disconnection of intact right-hemispheric areas involved in allocation of attention from those in the left hemisphere. Here, we investigated the laterality bias in spatial attention, as measured with the greyscales task, in two split-brain subjects (D.D.C. and D.D.V.) who had undergone complete callosotomy. The greyscales task requires participants to judge the darker (or brighter) of two left-right mirror-reversed luminance gradients under conditions of free viewing, and offers an efficient means of quantifying pathological attentional biases in patients with unilateral lesions. As predicted, the results of the two split-brain subjects revealed a pathological rightward bias in allocation of attention, suggesting strong dependence on a single hemisphere (the left) in spatial attention, which is opposite to what one expects from people with intact commissures, and is remarkable in that it occurs in free viewing. In that sense both split-brain patients are behaving as though the brain is indeed split, especially in D.D.C. who had undergone partial resection of the anterior commissure in addition to complete callosotomy, whereas the anterior commissure is still intact in D.D.V. The findings support the view that the commissural pathways play a significant role in integration of attentional processes across cerebral hemispheres.

Phenotypic and molecular spectra of patients with switch/sucrose nonfermenting complex-related intellectual disability disorders in Korea

Background

The switch/sucrose nonfermenting (SWI/SNF) complex is an adenosine triphosphate-dependent chromatin-remodeling complex associated with the regulation of DNA accessibility. Germline mutations in the components of the SWI/SNF complex are related to human developmental disorders, including the Coffin–Siris syndrome (CSS), Nicolaides–Baraitser syndrome (NCBRS), and nonsyndromic intellectual disability. These disorders are collectively referred to as SWI/SNF complex-related intellectual disability disorders (SSRIDDs).

Methods

Whole-exome sequencing was performed in 564 Korean patients with neurodevelopmental disorders. Twelve patients with SSRIDDs (2.1%) were identified and their medical records were retrospectively analyzed.

Results

ARID1B, found in eight patients, was the most frequently altered gene. Four patients harbored pathogenic variants in SMARCA4, SMARCB1, ARID2, and SMARCA2. Ten patients were diagnosed with CSS, and one patient without a typical phenotype was diagnosed with ARID1B-related nonsyndromic intellectual disability. Another patient harboring the SMARCA2 pathogenic variant was diagnosed with NCBRS. All pathogenic variants in ARID1B were truncating, whereas variants in SMARCA2, SMARCB1, and SMARCA4 were nontruncating (missense). Frequently observed phenotypes were thick eyebrows (10/12), hypertrichosis (8/12), coarse face (8/12), thick lips (8/12), and long eyelashes (8/12). Developmental delay was observed in all patients, and profound speech delay was also characteristic. Agenesis or hypoplasia of the corpus callosum was observed in half of the patients (6/12).

Conclusions

SSRIDDs have a broad disease spectrum, including NCBRS, CSS, and ARID1B-related nonsyndromic intellectual disability. Thus, SSRIDDs should be considered as a small but important cause of human developmental disorders.

Evaluation of the corpus callosum shape in patients with obstructive sleep apnea

BACKGROUND

The aim of this study was to examine whether or not there was a difference in corpus callosum shape between patients with mild to moderate and severe obstructive sleep apnea (OSA) compared with patients who have simple snoring.

METHODS

The landmark coordinate data was obtained from the mid-sagittal magnetic resonance imaging (MRI) images of 70 patients who underwent polysomnography. For comparisons, mild and moderate OSA groups were combined and analyses were performed on three groups; simple snoring/control group, mild or moderate OSA group, and severe OSA group.

RESULTS

The corpus callosum shape of controls was significantly different from that of the severe OSA group. The most prominent deformities were observed in the genu and rostral body of the corpus callosum for the patients with severe OSA. No significant difference was found between mild/moderate OSA group and simple snoring group in terms of global corpus callosum shape.

CONCLUSION

The data demonstrated that severe OSA patients have structural changes in the corpus callosum and deformities may vary as the severity of disease changes.

Axon diameter inferences in the human corpus callosum using oscillating gradient spin echo sequences

Previous methods used to infer axon diameter distributions using magnetic resonance imaging (MRI) primarily use single diffusion encoding sequences such as pulsed gradient spin echo (PGSE) and are thus sensitive to axons of diameters >5 μm. We applied oscillating gradient spin echo (OGSE) sequences to study human axons in the 1-2 μm range in the corpus callosum, which include the majority of axons constituting cortical connections. The ActiveAx model was applied to calculate the fitted mean effective diameter for axons (AxD) and was compared with values found using histology. Axon diameters from histological data were calculated using three different datasets; true diameters (minimum diameter), a combination of minimum and maximum diameters, and diameters measured across a consistent diffusion direction. The AxD estimates from MRI were 1.8 ± 0.1 μm to 2.34 ± 0.04 μm with an average of 2.0 ± 0.2 μm for the ActiveAx model. The histology AxD values were 1.43 ± 0.02 μm when using the true minimum axon diameters, 5.52 ± 0.02 μm when using the combination of minimum and maximum axon diameters, and 2.20 ± 0.02 μm when collecting measurements across a consistent diffusion direction. This experiment demonstrates the first known usage of OGSE to calculate axon diameters in the human corpus callosum on a 1-2 μm scale. The importance for the model to account for axonal orientation dispersion is indicated by histological results which more closely match the MRI model results depending on the direction of axon diameter measurements. These initial steps using this non-invasive imaging method can be applied to future methodology to develop in vivo axon diameter measurements in human brain tissue.

Appreciation of Social Norms in Agenesis of the Corpus Callosum

OBJECTIVE

Anecdotal reports regarding high-functioning adults with agenesis of the corpus callosum (AgCC) suggest that they often lack psychosocial insight. We attempted to determine whether adults with AgCC are able to correctly identify appropriate behaviors within social contexts using the Social Norms Questionnaire.

METHOD

The Social Norms Questionnaire measures knowledge of norms and judgments of what is appropriate to do in particular contexts. It was administered online to individuals with AgCC and control participants.

RESULTS

Individuals with AgCC scored significantly lower in understanding social norms than controls, tending to over-adhere to social norms significantly more than controls. There was no significant difference regarding breaking of social norms.

CONCLUSION

Results suggest that adults with AgCC have deficient judgment regarding the nuances of appropriate behaviors in social contexts. They adhere to social norms concretely, lacking the ability to integrate context in social scenarios to make appropriately nuanced judgments.

[Effects of electroacupuncture on myelin-related protein in corpus callosum of rats with focal cerebral ischemia]

OBJECTIVE

To observe the effect of electroacupuncture(EA)on the expression of myelin basic protein (MBP), axon growth inhibitor Nogo-A and Nogo receptor (NgR) in corpus callosum of rats with focal cerebral ischemia, so as to explore the mechanism of EA underlying improving ischemic white matter injury.

METHODS

Fourty male SD rats were randomly divided into normal, sham operation, model and EA groups, with 10 rats in each group. The focal cerebral ischemia rat model was established by occlusion of the middle cerebral artery (MCAO). EA was applied to "Baihui"(GV20) and "Zusanli"(ST36) on the left side for 30 min, once daily for 14 days. Neurological function score and the adhensive removal test were used to evaluate neurological deficit severity; Hematoxylin-esion staining was used to observe the pathological changes in myelin of corpus callosum and luxol fast blue（LFB） staining was used to observe the myelin of corpus callosum. Immunohistochemical staining and Western blot were used to detect the expressions of MBP、Nogo-A and NgR in the ischemic corpus callosum.

RESULTS

After MCAO, the neurological function score was significantly increased (P<0.05), the time required for contact with tape and tape removal was longer (P<0.001), the intensity of LFB staining and the expression of MBP decreased, while the veside area and the expression of Nogo-A and its receptor NgR increased (P<0.01, P<0.05) in the model group relevant to the normal and sham operation groups. The fiber arrangement of the corpus callosum on the ischemic side was disordered and a large amount of myelin sheath was lost in the model group. Following the treatment, the neurological deficit score of EA group was gradually decreased and significantly decreased on the 3^rd, 7^th and 14^th day (P<0.05), and the time to remove the adhesive tape was shortened at the 7^th and 14^th day (P<0.001). The shape of the corpus callosum in the EA group was close to normal, and the myelin structure was relatively complete. The intensity of LFB staining and the expression of MBP was increased (P<0.05, P<0.01) while the expression of Nogo-A and its receptor NgR were decreased in the EA group relevant to the model group (P<0.01).

CONCLUSION

EA can play a protective role in myelin of the corpus callosum after cerebral ischemia, which may be related to down-regulating the expressions of Nogo-A and NgR.

Sudden onset hearing loss as initial presentation of Susac syndrome: a rare case report and brief review

Susac syndrome is a rare disease presenting with a classic triad of symptoms. These are sensorineural hearing loss, encephalopathy, and branch retinal artery occlusions. Initial presentation is usually headache and symptoms of encephalopathy. Hearing loss is unusual in the early stages but, when it does present, can often lead to a misdiagnosis of sudden sensorineural hearing loss. Hence, neurological and retinal examinations are essential to an accurate diagnosis. In this study, we aimed to raise awareness of Susac syndrome among physicians and facilitate recognition of its manifestation, especially in those patients presenting with hearing loss alone. Identifying Susac syndrome that presents as sudden sensorineural hearing loss can be challenging but a number of case reviews have been reported in recent years and treatment guidelines are available.

Paradoxical facilitation alongside interhemispheric inhibition

Neurophysiological experiments using transcranial magnetic stimulation (TMS) have sought to probe the function of the motor division of the corpus callosum. Primary motor cortex sends projections via the corpus callosum with a net inhibitory influence on the homologous region of the opposite hemisphere. Interhemispheric inhibition (IHI) experiments probe this inhibitory pathway. A test stimulus (TS) delivered to the motor cortex in one hemisphere elicits motor evoked potentials (MEPs) in a target muscle, while a conditioning stimulus (CS) applied to the homologous region of the opposite hemisphere modulates the effect of the TS. We predicted that large CS MEPs would be associated with increased IHI since they should be a reliable index of how effectively contralateral motor cortex was stimulated and therefore of the magnitude of interhemispheric inhibition. However, we observed a strong tendency for larger CS MEPs to be associated with reduced interhemispheric inhibition which in the extreme lead to a net effect of facilitation. This surprising effect was large, systematic, and observed in nearly all participants. We outline several hypotheses for mechanisms which may underlie this phenomenon to guide future research.

White Matter Alterations Associated with Pro-inflammatory Cytokines in Patients with Major Depressive Disorder

Objective

Regarding the neuroinflammatory theory of major depressive disorder (MDD), little is known about the effect of pro-inflammatory cytokines on white matter (WM) changes in MDD. We aimed to investigate the relationship between pro-inflammatory cytokines and WM alterations in patients with MDD.

Methods

Twenty-two patients with MDD and 22 healthy controls (HC) were evaluated for brain imaging and pro-inflammatory cytokines including interleukin (IL)-1β, IL-6, IL-8, interferon-γ and tumor necrosis factor (TNF)-α. Tract-based spatial statistics and FreeSurfer were used for brain image analysis.

Results

The levels of TNF-α and IL-8 were significantly higher in the MDD group than in HC. Compared to HC, lower fractional anisotropy (FA), and higher median diffusivity (MD) and radial diffusivity (RD) values were found in the MDD group for several WM regions. Voxel-wise correlation analysis showed that the level of TNF-α was negatively correlated with FA, and positively correlated with MD and RD in the left body and genu of the corpus callosum, left anterior corona radiata, and left superior corona radiata.

Conclusion

Our findings suggest that TNF-α may play an important role in the WM alterations in depression, possibly through demyelination.

Structural properties of corpus callosum are associated differently with verbal creativity and visual creativity

Recent neuroimaging studies demonstrate that creativity is related to brain regions across both hemispheres, and the corpus callosum forms the structural basis of inter-hemispheric information exchange. However, the findings regarding the relationship between inter-hemispheric interaction and creativity remain inconsistent, which may be caused by different types of creativity and neural features being adopted. To clarify the inconsistency, and understand how inter-hemispheric interactions are related to different kinds of creativity, we explored the correlation between eight structural measures of the corpus callosum (CC) and two different domains of creativity [verbal creativity (VerC) and visual creativity (VisC)] using a large healthy-adult sample (n = 446). The results showed that VerC was positively correlated with fractional anisotropy (FA) and negatively correlated with the radial diffusivity (RD) of CC; whereas there was no significant association between VisC and CC measures. These results persisted after regressing VisC from VerC, regressing VerC from VisC, and regress out general intelligence from both creativity measures. In summary, we showed that the structural properties of corpus collosum are associated in different ways with two domains of creativity, i.e., verbal creativity and visual creativity, which enriches our understanding of the underlying neural mechanism in different types of creativity.

Semi-automated assessment of the principal diffusion direction in the corpus callosum: differentiation of idiopathic normal pressure hydrocephalus from neurodegenerative diseases

BACKGROUND

Idiopathic normal pressure hydrocephalus (iNPH) shares clinical and radiological features with progressive supranuclear palsy (PSP) and Alzheimer's disease (AD). Corpus callosum (CC) involvement in these disorders is well established on structural MRI and diffusion tensor imaging (DTI), but alterations overlap and lack specificity to underlying tissue changes.

OBJECTIVE

We propose a semi-automated approach to assess CC integrity in iNPH based on the spatial distribution of DTI-derived principal diffusion direction orientation (V1).

METHODS

We processed DTI data from 121 subjects (Site1: iNPH = 23, PSP = 27, controls = 14; ADNI: AD = 35, controls = 22) to obtain V1, fractional anisotropy (FA) and mean diffusivity (MD) maps. To increase the estimation accuracy of DTI metrics, analyses were restricted to the midsagittal CC portion (± 6 slices from midsagittal plane). Group-wise comparison of normalized altered voxel count in midsagittal CC was performed using Kruskal-Wallis tests, followed by post hoc comparisons (Bonferroni-corrected p < 0.05). ROC analysis was used to evaluate the diagnostic power of DTI alterations compared to callosal volume.

RESULTS

We found specific changes of V1 distribution in CC splenium of iNPH compared to AD and PSP, while MD and FA showed patterns of alterations common to all disorders. ROC curves showed that, compared to splenial volume, V1 represented the most accurate marker of iNPH diagnosis versus AD and PSP.

CONCLUSIONS

Our results provide evidence that V1 is a powerful biomarker for distinguishing patients with iNPH from patients with AD or PSP. Indeed, our findings also provide more specific insight into the pathophysiological mechanisms that underlie tissue damage across iNPH and its mimics.

Single-direction diffusion-weighted imaging may be a simple complementary sequence for evaluating fetal corpus callosum

OBJECTIVES

To explore the feasibility of single-direction diffusion-weighted imaging (DWI) for assessing the fetal corpus callosum (CC).

METHODS

This prospective study included 67 fetuses with normal CC and 35 fetuses suspected with agenesis of the corpus callosum (ACC). The MR protocols included HASTE, TrueFISP, and single-direction DWI. Two radiologists independently evaluated the optimal visibility and the contrast ratio (CR) of the normal fetal CC. The Chi-squared test or Fisher's exact test was used to compare the proportions of "good" visibility (score ≥ 3, and the CC was almost/entirely visible) between single-direction DWI and HASTE/TrueFISP. The CR difference between single-direction DWI and HASTE/TrueFISP was detected using the paired t-test. The diagnostic accuracies were determined by comparison with postnatal imaging. In fetuses suspected of ACC, we measured and compared the length and area of the mid-sagittal CC in the single-direction DWI images.

RESULTS

The proportion of "good" visibility in single-direction DWI was higher than that in HASTE/TrueFISP, with p < 0.0001. The mean CR from single-direction DWI was also higher than that of TrueFISP and HASTE (both with p < 0.0001). The diagnostic accuracy of the single-direction DWI combined with HASTE/TrueFisp (97.1%, 34/35) was higher than that of the Haste/TrueFISP (74.3%, 26/35) (p = 0.013). The length and area of the PACC (p < 0.001, p = 0.001, respectively) and HCC (p < 0.001, p = 0.018, respectively) groups were significantly lower than those of the normal group.

CONCLUSIONS

The single-direction DWI is feasible in displaying fetal CC and can be a complementary sequence in diagnosing ACC.

KEY POINTS

• We suggest a simple method for the display of the fetal CC. • The optimal visibility and contrast ratio from single-direction DWI were higher than those from HASTE and TrueFISP. • The diagnostic accuracy of the single-direction DWI combined with HASTE/TrueFISP sequences (97.1%, 34/35) was higher than that of the Haste/TrueFISP (74.3%, 26/35).

Restricted diffusion in the corpus callosum: A neuroradiological marker in hypoxic-ischemic encephalopathy

Background:

Restricted diffusion within the splenium of the corpus callosum has been described by other authors in various conditions, however, restricted diffusion in the entire corpus callosum or isolated involvement of the splenium, genu, or body has been infrequently reported on magnetic resonance imaging (MRI) in neonatal hypoxic–ischemic encephalopathy. We report a series of cases showing different patterns of involvement.

Methods and Materials:

Perinatal imaging with MRI including diffusion-weighted imaging was performed in 40 neonates with hypoxic–ischemic encephalopathy, including 11 premature neonates. Sixteen out of 40 patients demonstrated restricted diffusion within the corpus callosum. Out of 16 patients, 9 showed restricted diffusion in the entire corpus callosum, 4 had isolated splenium involvement, 2 had body and splenium signal abnormality, and 1 showed diffusion restriction only in the genu.

Conclusions:

Changes in the corpus callosum were also associated with more severe clinical presentation of encephalopathy. Restricted diffusion within the corpus callosum in infants with hypoxic–ischemic encephalopathy is often associated with extensive brain injury and appears to be an early neuroradiologic marker of adverse neurologic outcome.

Callosal Diffusion-Restriction in Patients with Intracranial Hemorrhage

OBJECTIVE

We aim to report the incidence and clinical characteristics of patients who were found to have diffusion restricting lesions of the corpus callosum (CC) on Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) following intracranial hemorrhage (ICH).

DESIGN/METHODS

A retrospective cross-sectional analysis was performed of medical records of all adult patients admitted to a single tertiary center with a primary diagnosis of ICH and received nicardipine infusion over a 2-year period. Patients without MRI brain available or patients who underwent digital subtraction angiography (DSA) prior to MRI were excluded. ICH and intraventricular hemorrhage (IVH) volumes and scores were calculated. MRI brain scans were evaluated for presence and locations of DWI lesions.

RESULTS

Among 162 patients who met inclusion criteria, 6 patients (4%, median age 53, range 37-71, 100% male, 33% white) were found to have DWI lesions in the CC with a median ICH volume of 17ml (range 1-105ml). The ICH locations were lobar (n=3), deep (n=2) and cerebellum (n=1). All patients (100%) had intraventricular hemorrhage (IVH) with median IVH volume of 25ml (range 2.7-55ml). Four patients were on levetiracetam. No identifiable infections or metabolic abnormalities were found among these patients. All but one patient had normal DSA. Follow up MRI was only available in one patient and showed no reversibility at 14 days.

CONCLUSION

Although rare, diffusion restricting corpus callosum lesions can be seen in patients with ICH, especially in patients with IVH. The etiology and clinical significance of these lesions remains unknown and warrant further research.

Improved outcomes associated with maximal extent of resection for butterfly glioblastoma: insights from institutional and national data

BACKGROUND

Butterfly glioblastomas (bGBMs) are grade IV gliomas that infiltrate the corpus callosum and spread to bilateral cerebral hemispheres. Due to the rarity of cases, there is a dearth of information in existing literature. Herein, we evaluate clinical and genetic characteristics, associated predictors, and survival outcomes in an institutional series and compare them to a national cohort.

METHODS

We identified all adult patients with bGBM treated at Brigham & Women's Hospital (2008-2018). The National Cancer Database (NCDB) was also queried for bGBM patients. Survival was analyzed with Kaplan-Meier methods, and Cox models were built to assess for predictive factors.

RESULTS

Of 993 glioblastoma patients, 62 cases (6.2%) of bGBM were identified. Craniotomy for resection was attempted in 26 patients (41.9%), with a median volumetric extent of resection (vEOR) of 72.3% (95% confidence interval [95%CI] 58.3-82.1). The IDH1 R132H mutation was detected in two patients (3.2%), and MGMT promoter was methylated in 55.5% of the assessed cases. In multivariable regression, factors predictive of longer OS were increased vEOR, MGMT promoter methylation, and receipt of adjuvant therapy. Median OS for the resected cases was 11.5 months (95%CI 7.7-18.8) vs. 6.3 (95%CI 5.1-8.9) for the biopsied. Of 21,353 GBMs, 719 (3.37%) bGBM patients were identified in the NCDB. Resection was more likely to be pursued in recent years, and GTR was independently associated with prolonged OS (p < 0.01).

CONCLUSION

Surgical resection followed by adjuvant chemoradiation is associated with significant survival gains and should be pursued in carefully selected bGBM patients.

Subcortical brain segment volumes in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

AIMS

There is controversy about brain volumes in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (CFS) and Gulf War Illness (GWI). Subcortical regions were assessed because of significant differences in blood oxygenation level dependent signals in the midbrain between these diseases.

MATERIALS AND METHOD

Magnetization-prepared rapid acquisition with gradient echo (MPRAGE) images from 3 Tesla structural magnetic resonance imaging scans from sedentary control (n = 34), CFS (n = 38) and GWI (n = 90) subjects were segmented in FreeSurfer. Segmented subcortical volumes were regressed against intracranial volume and age, then iteratively analyzed by multivariate general linear modeling with disease status, gender and demographics as independent co-variates.

KEY FINDINGS

The optimal model for all subjects used disease status and gender as fixed factors with independent variables eliminated after iteration. Volumes of anterior and midanterior corpus callosum were significantly larger in GWI than CFS. Gender was a significant variable for many segment volumes, and so female and male subjects were analyzed separately. CFS females had smaller left putamen, right caudate and left cerebellum white matter than control women. CFS males had larger left hippocampus than GWI males. Orthostatic status and posttraumatic distress syndrome were not significant covariates.

SIGNIFICANCE

CFS and GWI were appropriate "illness controls" for each other. The different patterns of adjusted segment volumes suggested that sexual dimorphisms contributed to pathological changes. Previous volumetric studies may need to be reevaluated to account for gender differences. The findings are framed by comparison to the spectrum of magnetic resonance imaging outcomes in the literature.

Extreme Glycemic Fluctuations Debilitate NRG1, ErbB Receptors and Olig1 Function: Association with Regeneration, Cognition and Mood Alterations During Diabetes

Neuronal regeneration is crucial for maintaining intact neural interactions for perpetuation of cognitive and emotional functioning. The NRG1-ErbB receptor signaling is a key pathway for regeneration in adult brain and also associated with learning and mood stabilization by modulating synaptic transmission. Extreme glycemic stress is known to affect NRG1-ErbB-mediated regeneration in brain; yet, it remains unclear how the ErbB receptor subtypes are differentially affected due to such metabolic variations. Here, we assessed the alterations in NRG1, ErbB receptor subtypes to study the regenerative potential, both in rodents as well as in neuronal and glial cell models of hyperglycemia and hypoglycemic insults during hyperglycemia. The pro-oxidant and anti-oxidant status leading to degenerative changes in brain regions were determined. The spatial memory and anxiogenic behaviour of experimental rodents were tested using 'T' maze and Elevated Plus Maze. Our data revealed that the extreme glycemic discrepancies during diabetes and recurrent hypoglycemia lead to altered expression of NRG1, ErbB receptor subtypes, Syntaxin1 and Olig1 that shows association with impaired regeneration, synaptic dysfunction, demyelination, cognitive deficits and anxiety.

Aicardi syndrome in a 7-month-old girl with tonic seizures and skeletal defects: A case report

Introduction

and importance: Aicardi syndrome (AS) is a rare genetic syndrome characterized by a triad of features: agenesis or hypogenesis of corpus callosum, chorioretinal lacunae, and infantile spasms, along with other neurodevelopmental, ocular, craniofacial, gastrointestinal, and musculoskeletal disorders. The precise etiology of AS is unknown, and establishing a diagnosis is challenging since it is an extremely rare syndrome and may mimic other congenital neurological defects.

Case presentation

A 2-month-old girl was brought to our hospital, she developed multiple episodes of generalized spasticity with hyperflexion of upper and lower extremities on trunk (tonic seizure), with fast jerking movements of the eye, with signs of Psychomotor Development delay.

Clinical discussion

Ophthalmic examination showed bilateral medial strabismus without nystagmus, Retinal examination showed bilateral small peripapillary well-circumscribed chorioretinal lacunae with hyperpigmented borders, thoracic spine x-ray (AP view) showed hemivertebrae and loss of height in the 7th and 8th thoracic vertebral body. Magnetic Resonance Imaging (MRI) revealed grey matter heterotopia, underdevelopment of the left operculum, hypogenesis of the corpus callosum, hypogenesis of inferior vermis, and multiple cysts with peripheral enhancing. Eventually, the diagnosis of AS is confirmed by the results of radiological imaging and ophthalmology exam.

Conclusion

In this paper, we report a case of Aicardi syndrome diagnosed in a 7-month-old girl with frequent tonic seizures. We report this case to highlight that Aicardi syndrome should be considered in the differential diagnosis in cases of frequent tonic seizures with abnormal findings on retinal examination and characteristic findings on MRI.

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Aicardi syndrome (AS) is a rare syndrome characterized by a triad of features.

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AS triad is callosal hypogenesis, chorioretinal lacunae, and infantile spasms.

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Establishing the diagnosis of AS is challenging.

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AS may mimic other congenital neurological defects.

Reversible splenial lesion syndrome in sisters with sensorineural deafness as the first manifestation

Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological disorder syndrome with unclear pathophysiology. Here, two sisters with sensorineural deafness as the chief complaint diagnosed with RESLES was reported. Although the sisters had the disease successively, they were divided into two types on imaging by isolated lesions of splenium of the corpus callosum (SCC) and extensive lesions of the corpus callosum. The clinical manifestations and lesions on MRI disappeared after 6 months. The sensorineural deafness of the sisters in this article may be caused by transcallosal auditory pathway (TCAP) injury. Auditory handicap has been found in previous RESLES cases, indicating that we know little about the connection between the SCC and the auditory pathway, and further research is needed.

A rare presentation of Susac syndrome: Report of three pediatric cases

Susac syndrome is a rare disorder that is clinically characterized by encephalopathy, retinopathy and hearing loss. Most of the reported cases in the literature are adult patients, pediatric presentation is extremely rare. Here we present three pediatric patients aged between 10-15; diagnosed as Susac syndrome. They all had thalamic involvement in addition to typical callosal lesions. All of the three patients had a monophasic course and good treatment response.

Diffusion tensor imaging of corpus callosum in adolescent females with borderline personality disorder

OBJECTIVES

The aim of this study was to assess the structural alteration of corpus callosum (CC) in adolescent females with Borderline Personality Disorder (BPD) and detect the relationship between these changes and BPD symptoms.

METHODS

A comparative case control study was conducted on 50 adolescent females that were divided into 2 groups; 25 outpatients suffering from BPD (according to DSM-IV-TR diagnostic criteria) compared to 25 healthy adolescents. All subjects were assessed by Borderline Personality Questionnaire, Barratt impulsivity scale-11, Brief Non-Suicidal Self-Injury Assessment tool, Beck Scale for Suicidal Ideation, and Diffusion tensor imaging.

RESULTS

Relative to control subjects, BPD patients had significantly lower fractional anisotropy (FA) values in the genu and lower mean diffusivity (MD) values in the body of CC. There was a negative correlation between FA values in the genu and body of CC and impulsivity. MD in the body of CC was positively correlated with motor impulsiveness and negatively correlated with suicidality.

CONCLUSION

Adolescent females with BPD show structural alterations in the CC that are related to symptoms of emotional dysregulation and impulsivity.

Improvement in callosal disconnection syndrome with recovery of callosal connectivity

Recent advancements in radiological techniques have enabled the observation of the topographic distribution of the human corpus callosum. However, its functional connectivity remains to be elucidated. The symptoms of callosal disconnection syndrome (CDS) can potentially reveal the functional connections between the cerebral hemispheres. Herein, we report a patient with CDS, whose callosal lesion was restricted to the posterior midbody, isthmus, and an anterior part of the dorsal splenium. A 53-year-old right-handed woman demonstrated CDS following cerebral infarction associated with subarachnoid hemorrhage. She exhibited CDS including ideomotor apraxia, and tactile anomia with the left hand, cross-replication of hand postures, cross-localization of the fingers, and constructional impairment with the right hand. Six months after onset, the left-handed ideomotor apraxia on imitation improved, but that to command did not, which indicated the difference in the nature of the transcallosal connections between ideomotor apraxia on imitation and ideomotor apraxia to command. Longitudinal CDS observation and corpus callosum tractography will prove useful in expanding our understanding of the nature of the organization of interhemispheric information transference.

Reversible splenial lesions during febrile illness with or without white matter lesions

OBJECTIVE

Reversible splenium lesions during febrile illness (RESLEF) are found in a spectrum. There are two types of corpus callosum (CC) lesions: CC-only type, with limited lesions and the CC (+) type, with extensive white-matter lesions. This retrospective study aimed to describe the differences in clinical findings between CC-only and CC (+) lesions and the association between onset age and clinico-radiological features in RESLEF.

METHODS

Fifty-two episodes of CC-only or CC (+) lesions accompanied by neurological symptoms, e.g., seizures, delirious behavior (DB), and disturbance of consciousness (DC), from January 2008 to October 2019 were included. We analyzed the etiology (pathogen), clinical course, laboratory data, magnetic resonance imaging and electroencephalography findings, therapy, and prognosis.

RESULTS

The rate of DC in the CC (+) was significantly higher than that in the CC-only group (5/6 [83%] vs 7/46 [15%]; p = 0.0016). The median number of seizures in the CC (+) was also significantly higher than that in the CC-only group (4 [0-7] vs 0 [0-7]; p = 0.034). Further, in RESLEF, the median onset age (months) in the seizure was significantly lower than that in the no-seizure group (39 [12-74] vs 83 [28-174]; p = 0.0007). The median onset age (months) in the DB was significantly higher than that in the no-DB group (74.5 [26-174] vs 28 [12-139]; p = 0.003).

CONCLUSIONS

In RESLEF, CC (+) is a more severe neurological symptom than CC-only. Furthermore, the onset age is related to the type of neurological symptoms that appear.

White matter variability in auditory callosal pathways contributes to variation in the cultural transmission of auditory symbolic systems

The cultural transmission of spoken language and music relies on human capacities for encoding and recalling auditory patterns. In this experiment, we show that interindividual differences in this ability are associated with variation in the organization of cross-callosal white matter pathways. First, high-angular resolution diffusion MRI (dMRI) data were analyzed in a large participant sample (N = 51). Subsequently, these participants underwent a behavioral test that models in the laboratory the cultural transmission of auditory symbolic systems: the signaling game. Cross-callosal and intrahemispheric (arcuate fasciculus) pathways were reconstructed and analyzed using conventional diffusion tensor imaging (DTI) as well as a more advanced dMRI technique: fixel-based analysis (FBA). The DTI metric of fractional anisotropy (FA) in auditory callosal pathways predicted-weeks after scanning-the fidelity of transmission of an artificial tone system. The ability to coherently transmit auditory signals in one signaling game, irrespective of the signals learned during the previous game, was predicted by morphological properties of the fiber bundles in the most anterior portions of the corpus callosum. The current study is the first application of dMRI in the field of cultural transmission, and the first to connect individual characteristics of callosal pathways to core behaviors in the transmission of auditory symbolic systems.

Corpus Callosum and Its Connections: A Fiber Dissection Study

OBJECTIVE

We performed a fine white fiber dissection to demonstrate the extensive connections of the corpus callosum.

MATERIAL AND METHODS

Three formalin-fixed frozen cadaveric human brain specimens were dissected using Klingler's technique. On one half of each hemisphere, the superior connections of the corpus callosum were dissected and in the other half the inferior connections of the corpus callosum were dissected.

RESULTS

The mean length of the corpus callosum from the rostrum to the splenium was 7.8 cm. The fibers of the corpus callosum were classified as superior/dorsal radiations, inferior/ventral radiations, anterior radiations, and posterior radiations. The entire transverse length of the dorsal callosal radiation from one hemisphere to the other was 8.1 cm. For anterior interhemispheric approaches, an incision in the anterior part of the body not extending beyond 3.5 cm from the genu was found to be safe with regards to crossing motor fibers.

CONCLUSIONS

The corpus callosum was found to have intricate connections with all the lobes of the cerebral hemispheres, including the insular region and the limbic and paralimbic areas. Based on the course and traverse of the callosal fibers, a transverse incision in the corpus callosum should be preferred when performing a callosotomy to access intraventricular lesions as this splits the callosal fibers instead of transecting them. The analysis of the course of the callosal radiations enhances understanding of the growth pattern of primary corpus callosal gliomas and helps to design a safe surgical strategy.

Mapping and anatomo-surgical techniques for SMA-cingulum-corpus callosum gliomas; how I do it

Background

Awake brain mapping paradigms are variable, particularly in SMA, and not personalised to each patient. In addition, subpial resections do not offer full protection to vascular injury, as the pia can be easily violated.

Methods

Mapping paradigms developed by a multidisciplinary brain mapping team. During resection, a combined subpial/interhemispheric approach allowed early identification and arterial skeletonization. Precise anatomo-surgical dissection of the affected cingulum and corpus callosum was achieved.

Conclusions

In SMA-cingulum-CC tumours, a combined subpial/interhemispheric approach reduces risk of vascular injury allowing precise anatomo-surgical dissections. Knowledge of cognitive functions of affected parcels is likely to offer best outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00701-021-04774-7.

Functional and structural impairment of transcallosal motor fibres in ALS: a study using transcranial magnetic stimulation, diffusion tensor imaging, and diffusion weighted spectroscopy

Imaging studies showed that the structure of the corpus callosum (CC) is affected in amyotrophic lateral sclerosis (ALS). Some clinical studies also suggest that interhemispheric connectivity is altered, since mirror movements seem to occur in ALS. Finally, reduced interhemispheric inhibition (IHI), studied by transcranial magnetic stimulation (TMS), has been reported. It is not known whether there is any association between these findings. Here, we studied the integrity of the CC in ALS on the morphological, the functional, the electrophysiological, and the clinical level. Twenty-seven right-handed ALS patients and 21 healthy right-handed controls were included. Mirror activity (MA) was quantified using surface EMG. Diffusion tensor imaging tractography was used to segment the CC and quantify fractional anisotropy (FA). We studied the diffusivity of the intra-axonal markers N-acetylaspartate+N-acetyl aspartyl glutamate D(tNAA) within the CC. IHI was studied as a marker of CC function using a double-pulse TMS protocol. ALS patients showed significantly decreased FA in the motor segment of the CC (p < 0.01), and IHI was significantly reduced compared to controls (p = 0.01). However, no differences were observed regarding D(tNAA) and MA. The morphological as well as the functional integrity of the CC are altered in ALS. IHI was reduced in ALS, associated with decreased FA in the motor CC. Patients did not exhibit increased MA. Also, no differences within the CC were observed using diffusion-weighted spectroscopy. IHI might serve as a marker of transcallosal pathway disruption in ALS, even before clinical deficits become apparent.

A preliminary investigation of corpus callosum subregion white matter vulnerability and relation to chronic outcome in boxers

Microstructural neuropathology occurs in the corpus callosum (CC) after repetitive sports concussion in boxers and can be dose-dependent. However, the specificity and relation of CC changes to boxing exposure extent and post-career psychiatric and neuropsychological outcomes are largely unknown. Using deterministic diffusion tensor imaging (DTI) techniques, boxers and demographically-matched, noncontact sport athletes were compared to address literature gaps. Ten boxers and 9 comparison athletes between 26 and 59 years old (M = 44.63, SD = 9.24) completed neuropsychological testing and MRI. Quantitative DTI metrics were estimated for CC subregions. Group×Region interaction effects were observed on fractional anisotropy (FA; η²_p ≥ .21). Follow-up indicated large effects of group (η²_p ≥ .26) on splenium FA (boxers<comparisons) and genu mean diffusivity (MD; boxers>comparisons), but not radial diffusivity (RD). The group of boxers had moderately elevated number of psychiatric symptoms and reduced neuropsychological scores relative to the comparison group. In boxers, years sparring, professional bouts, and knockout history correlated strongly (r > |.40|) with DTI metrics and fine motor dexterity. In the comparison group, splenium FA correlated positively with psychiatric symptoms. In the boxer group, neuropsychological scores correlated with DTI metrics in all CC subregions. Results suggested relative vulnerability of the splenium and, to a lesser extent, the genu to chronic, repetitive head injury from boxing. Dose-dependent associations of professional boxing history extent with DTI white matter structure indices as well as fine motor dexterity were supported. Results indicated that symptoms of depression and executive dysfunction may provide the strongest indicators of global CC disruption from boxing.

A 16-year study of longitudinal volumetric brain development in males with autism

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with unknown brain etiology. Our knowledge to date about structural brain development across the lifespan in ASD comes mainly from cross-sectional studies, thereby limiting our understanding of true age effects within individuals with the disorder that can only be gained through longitudinal research. The present study describes FreeSurfer-derived volumetric findings from a longitudinal dataset consisting of 607 T1-weighted magnetic resonance imaging (MRI) scans collected from 105 male individuals with ASD (349 MRIs) and 125 typically developing male controls (258 MRIs). Participants were six to forty-five years of age at their first scan, and were scanned up to 5 times over a period of 16 years (average inter-scan interval of 3.7 years). Atypical age-related volumetric trajectories in ASD included enlarged gray matter volume in early childhood that approached levels of the control group by late childhood, an age-related increase in ventricle volume resulting in enlarged ventricles by early adulthood and reduced corpus callosum age-related volumetric increase resulting in smaller corpus callosum volume in adulthood. Larger corpus callosum volume was related to a lower (better) ADOS score at the most recent study visit for the participants with ASD. These longitudinal findings expand our knowledge of volumetric brain-based abnormalities in males with ASD, and highlight the need to continue to examine brain structure across the lifespan and well into adulthood.

Corpus Callosum Remodeling in Glioma: Constancy of Fiber Density and Anisotropy in MRI

Corpus callosum (CC) is the primary fiber system bridging the cerebral hemispheres and is of critical importance for glioma migration which downgrades the prognosis. Here we present the specific pattern of CC restructuring in glioma patients. We probe that the magnetic resonance imaging-based fiber count decrease can be a ready noninvasive indicator of glioma aggressivity and prognosis. We find that to maintain the callosal neural transmission efficiency, the optimum architectural density of white matter fibers remains unchanged, even though there is gross fiber loss. This adaptation occurs by CC's isotonic restructuration, a protective compensatory behavior for maintaining CC's optimal functional efficiency despite malignant infiltration.

Neuroimaging patterns in paediatric onset hereditary spastic paraplegias

Hereditary spastic paraplegias (HSPs) are a clinically and genetically heterogeneous group of neurodegenerative disorders characterized by progressive spasticity and weakness of the lower limbs with a notable phenotypic variation and an autosomal recessive (AR), autosomal dominant (AD), and X-linked inheritance pattern. The recent clinical use of next generation sequencing methods has facilitated the diagnostic approach to HSPs, but the diagnosis remains quite challenging considering its wide clinical and genetic heterogeneity. In this scenario, magnetic resonance imaging (MRI) emerges as a valuable tool in helping to exclude mimicking disorders and to guide genetic testing. The aim of this study is to investigate the presence of possible patterns of morphostructural MRI findings that may provide relevant clues for a specific genetic HSP subtype. In our cohort, for example, white matter abnormalities were the most common finding followed by the thinning of the corpus callosum, which, interestingly, presented different thinning characteristics depending on the HSP subtype.

Interhemispheric arachnoid cyst

Background

Interhemispheric arachnoid cysts are uncommon and typically associated with other midline neurodevelopmental disorders, such as complete or partial agenesis of the corpus callosum.

Case Description

We report a case of a 27-year-old woman with worsening headache, memory deficit, and radiological progression of an interhemispheric arachnoid cyst. The treatment consisted of craniotomy for interhemispheric cyst fenestration into both the interhemispheric cistern and lateral ventricle. The postoperative course was unremarkable, with considerable clinical improvement and significant reduction in cyst size.

Conclusion

We successfully treat a patient with an enlarging arachnoid cyst and associated progressive symptoms with microsurgical fenestration.

Clinical Significance of Cytotoxic Lesions of the Corpus Callosum in Subarachnoid Hemorrhage Patients: A Retrospective Analysis

INTRODUCTION

Cytotoxic lesions of the corpus callosum are secondary lesions induced by significant increases in cytokine levels in the brain and are associated with subarachnoid hemorrhage (SAH). However, their clinical significance in SAH patients remains unclear.

METHODS

We retrospectively analyzed SAH patients who were treated in our hospital and evaluated between-group differences in the backgrounds, clinical findings, and outcomes between SAH patients who developed cytotoxic lesions of the corpus callosum and those who did not. We further compared patients who achieved good outcomes with those who had poor outcomes. Multivariate logistic regression analysis was used to identify risk factors for poor clinical outcomes.

RESULTS

We analyzed 159 SAH patients; 17 patients (10.7%) had cytotoxic lesions of the corpus callosum. Patients with cytotoxic lesions of the corpus callosum were more likely to be in a severe condition (World Federation of Neurosurgical Societies grading IV-V: odds ratio [OR], 4.53; 95% confidence interval [95% CI]: 1.60-12.84; p = 0.0042) and have an intraventricular (OR, 5.98; 95% CI: 1.32-27.13; p = 0.0054) or an intraparenchymal hematoma (OR, 3.62; 95% CI: 1.25-10.45; p = 0.023). Patients with cytotoxic lesions of the corpus callosum had a greater propensity of a poor outcome 3 months after onset (modified Rankin Scale score 0-2: OR, 0.22; 95% CI: 0.07-0.66; p = 0.0043). Multivariate analysis confirmed that cytotoxic lesions of the corpus callosum increased the risk of a poor outcome (OR, 4.39; 95% CI: 1.06-18.1; p = 0.037).

DISCUSSION/CONCLUSIONS

The development of cytotoxic lesions of the corpus callosum may be related to the extent of hematomas in SAH patients. Although they are usually reversible lesions, the development of cytotoxic lesions of the corpus callosum may be a predictor of poor outcomes in SAH patients.

Social Inferences in Agenesis of the Corpus Callosum and Autism: Semantic Analysis and Topic Modeling

Impoverished capacity for social inference is one of several symptoms that are common to both agenesis of the corpus callosum (AgCC) and Autism Spectrum Disorder (ASD). This research compared the ability of 14 adults with AgCC, 13 high-functioning adults with ASD and 14 neurotypical controls to accurately attribute social meaning to the interactions of animated triangles. Descriptions of the animations were analyzed in three ways: subjective ratings, Linguistic Inquiry and Word Count, and topic modeling (Latent Dirichlet Allocation). Although subjective ratings indicated that all groups made similar inferences from the animations, the index of perplexity (atypicality of topic) generated from topic modeling revealed that inferences from individuals with AgCC or ASD displayed significantly less social imagination than those of controls.

Corpus callosum morphology across the lifespan in baboons (Papio anubis): A cross-sectional study of relative mid-sagittal surface area and thickness

The corpus callosum enables integration and coordination of cognitive processing between the cerebral hemispheres. In the aging human brain, these functions are affected by progressive axon and myelin deteriorations, reflected as atrophy of the midsagittal corpus callosum in old age. In non-human primates, these degenerative processes are less pronounced as previous morphometric studies on capuchin monkey, rhesus monkeys, and chimpanzees do not find old-age callosal atrophy. In the present study, we extend these previous findings by studying callosal development of the olive baboon (Papio anubis) across the lifespan and compare it to chimpanzee and human data. For this purpose, total relative (to forebrain volume) midsagittal area, subsectional area, and regional thickness of the corpus callosum were assessed in 91 male and female baboons using non-invasive MRI-based morphometry. The studied age range was 2.5-26.6 years and lifespan trajectories were fitted using general additive modelling. Relative area of the total and anterior corpus callosum showed a positive linear trajectory. That is, both measures increased slowly but continuously from childhood into old age, and no decline was observed in old age. Thus, comparable with all other non-human primates studied to-date, baboons do not show callosal atrophy in old age. This observation lends supports to the notion that atrophy of the corpus callosum is a unique characteristic of human brain aging.

Prenatal Imaging Features and Postnatal Outcome of Short Corpus Callosum: A Series of 42 Cases

OBJECTIVES

Our goal was to provide a better understanding of isolated short corpus callosum (SCC) regarding prenatal diagnosis and postnatal outcome.

METHODS

We retrospectively reviewed prenatal and postnatal imaging, clinical, and biological data from 42 cases with isolated SCC.

RESULTS

Prenatal imaging showed SCC in all cases (n = 42). SCC was limited to rostrum and/or genu and/or splenium in 21 cases, involved body in 16 cases, and was more extensive in 5 cases. Indirect imaging features included typical buffalo horn ventricles (n = 14), septal dysmorphism (n = 14), parallel lateral ventricles (n = 12), and ventriculomegaly (n = 4), as well as atypical features in 5 cases. SCC was associated with interhemispheric cysts and pericallosal lipomas in 3 and 6 cases, respectively. Aneuploidy was found in 2 cases. Normal psychomotor development, mild developmental disorders, and global developmental delay were found in 70, 15, and 15% of our cases, respectively.

CONCLUSIONS

SCC should be investigated to look for pericallosal lipoma and typical versus atypical indirect features of corpus callosum agenesis (CCA). Prenatal counselling should be guided by imaging as well as clinical and genetic context. Outcome of patients with SCC was similar to the one presenting with complete CCA.

Biomolecular alterations in acute traumatic brain injury (TBI) using Fourier transform infrared (FTIR) imaging spectroscopy

Acute injury is one of the substantial stage post-traumatic brain injury (TBI) occurring at the moment of impact. Decreased metabolism, unregulated cerebral blood flow and direct tissue damage are triggered by acute injury. Understating the biochemical alterations associated with acute TBI is critical for brain plasticity and recovery. The objective of this study was to investigate the biochemical and molecular changes in hippocampus, corpus callosum and thalamus brain regions post-acute TBI in rats. Fourier Transform Infrared (FTIR) imaging spectroscopy were used to collect chemical images from control and 3 hrs post-TBI (Marmarou model was used for the TBI induction) rat brains and adjacent sections were treated by hematoxylin and eosin (H&E) staining to correlate with the disruption in tissue morphology and injured brain biochemistry. Our results revealed that the total lipid and total protein content decreased significantly in the hippocampus, corpus callosum and thalamus after brain injury. Reduction in lipid acyl chains (-CH₂) associated with an increase in methyl (-CH₃) and unsaturated lipids olefin = CH concentrations is observed. Furthermore, there is a decrease in the lipid order (disorder), which leads to an increase in acyl chain fluidity in injured rats. The results suggest acute TBI damages brain tissues mechanically rather than chemical alterations. This will help in assessing successful therapeutic strategy in order to mitigate tissue damage in acute TBI period.

Music Playing and Interhemispheric Communication: Older Professional Musicians Outperform Age-Matched Non-Musicians in Fingertip Cross-Localization Test

OBJECTIVE

Numerous investigations have documented that age-related changes in the integrity of the corpus callosum are associated with age-related decline in the interhemispheric transfer of information. Conversely, there is accumulating evidence for more efficient white matter organization of the corpus callosum in individuals with extensive musical training. However, the relationship between making music and accuracy in interhemispheric transfer remains poorly explored.

METHODS

To test the hypothesis that musicians show enhanced functional connectivity between the two hemispheres, 65 professional musicians (aged 56-90 years) and 65 age- and sex-matched non-musicians performed the fingertip cross-localization test. In this task, subjects must respond to a tactile stimulus presented to one hand using the ipsilateral (intra-hemispheric test) or contralateral (inter-hemispheric test) hand. Because the transfer of information from one hemisphere to another may imply a loss of accuracy, the value of the difference between the intrahemispheric and interhemispheric tests can be utilized as a reliable measure of the effectiveness of hemispheric interactions.

RESULTS

Older professional musicians show significantly greater accuracy in tactile interhemispheric transfer than non-musicians who suffer from age-related decline.

CONCLUSIONS

Musicians have more efficient interhemispheric communication than age-matched non-musicians. This finding is in keeping with studies showing that individuals with extensive musical training have a larger corpus callosum. The results are discussed in relation to relevant data suggesting that music positively influences aging brain plasticity.

Dump the "dimorphism": Comprehensive synthesis of human brain studies reveals few male-female differences beyond size

With the explosion of neuroimaging, differences between male and female brains have been exhaustively analyzed. Here we synthesize three decades of human MRI and postmortem data, emphasizing meta-analyses and other large studies, which collectively reveal few reliable sex/gender differences and a history of unreplicated claims. Males' brains are larger than females' from birth, stabilizing around 11 % in adults. This size difference accounts for other reproducible findings: higher white/gray matter ratio, intra- versus interhemispheric connectivity, and regional cortical and subcortical volumes in males. But when structural and lateralization differences are present independent of size, sex/gender explains only about 1% of total variance. Connectome differences and multivariate sex/gender prediction are largely based on brain size, and perform poorly across diverse populations. Task-based fMRI has especially failed to find reproducible activation differences between men and women in verbal, spatial or emotion processing due to high rates of false discovery. Overall, male/female brain differences appear trivial and population-specific. The human brain is not "sexually dimorphic."

Acute treatment with TrkB agonist LM22A-4 confers neuroprotection and preserves myelin integrity in a mouse model of pediatric traumatic brain injury

Young children have a high risk of sustaining a traumatic brain injury (TBI), which can have debilitating life-long consequences. Importantly, the young brain shows particular vulnerability to injury, likely attributed to ongoing maturation of the myelinating nervous system at the time of insult. Here, we examined the effect of acute treatment with the partial tropomyosin receptor kinase B (TrkB) agonist, LM22A-4, on pathological and neurobehavioral outcomes after pediatric TBI, with the hypothesis that targeting TrkB would minimize tissue damage and support functional recovery. We focused on myelinated tracts-the corpus callosum and external capsules-based on recent evidence that TrkB activation potentiates oligodendrocyte remyelination. Male mice at postnatal day 21 received an experimental TBI or sham surgery. Acutely post-injury, extensive cell death, a robust glial response and disruption of compact myelin were evident in the injured brain. TBI or sham mice then received intranasal saline vehicle or LM22A-4 for 14 days. Behavior testing was performed from 4 weeks post-injury, and brains were collected at 5 weeks for histology. TBI mice showed hyperactivity, reduced anxiety-like behavior, and social memory impairments. LM22A-4 ameliorated the abnormal anxiolytic phenotype but had no effect on social memory deficits. Use of spectral confocal reflectance microscopy detected persistent myelin fragmentation in the external capsule of TBI mice at 5 weeks post-injury, which was accompanied by regionally distinct deficits in oligodendrocyte progenitor cells and post-mitotic oligodendrocytes, as well as chronic reactive gliosis and atrophy of the corpus callosum and injured external capsule. LM22A-4 treatment ameliorated myelin deficits in the perilesional external capsule, as well as tissue volume loss and the extent of reactive gliosis. However, there was no effect of this TrkB agonist on oligodendroglial populations detected at 5 weeks post-injury. Collectively, our results demonstrate that targeting TrkB immediately after TBI during early life confers neuroprotection and preserves myelin integrity, and this was associated with some improved neurobehavioral outcomes as the pediatric injured brain matures.

Reversible splenial lesion syndrome associated with SARS-CoV-2 infection in two children

BACKGROUND

Reversible splenial lesion syndrome (RESLES) is characterized by a temporary lesion in the splenium of the corpus callosum, emerging related to encephalitis, seizures, antiepileptic drug withdrawal, or metabolic disturbances. Among RESLES, mild encephalitis/encephalopathy with reversible splenial lesion (MERS) has been defined as a distinct clinicoradiologic syndrome associated with viral infections.

CASE PRESENTATION

We report two children with multisystem inflammatory syndrome-children related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed RESLES during the disease course. Encephalopathy was the main central nervous system symptom. Both of the children showed a rapid recovery, and brain magnetic resonance imaging revealed complete resolution of the splenial lesion within 1 week.

CONCLUSION

The complete resolution of the splenial lesion and rapid recovery from encephalopathy in RESLES associated with SARS CoV-2 were similar to observed in MERS.