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McLaren JR, Mitchell MK, Al-Maadid FM, Staley KJ. Clinical Reasoning: An 8-Year-Old With Acute Onset Ataxia. Neurology 2022; 99:305-310. [DOI: 10.1212/wnl.0000000000200906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/16/2022] [Indexed: 11/15/2022] Open
Abstract
Acute ataxia is a common neurologic presentation in the pediatric population that carries a broad differential diagnosis. The tempo of the presentation, distribution of the ataxia (focal or diffuse), exam findings, and paraclinical testing may be helpful in guiding diagnosis and management. While Guillain-Barré Syndrome (GBS), and its variant, Miller Fisher Syndrome (MFS), are well defined, frequently encountered acute autoimmune neuropathies, the GBS/MFS spectrum has at least twelve different phenotypes with distinct neurological features, four of which include ataxia. These lesser-known variants can be diagnosed clinically, in the absence of conclusive laboratory or neuroimaging data, and should always be considered in an acute presentation of ataxia. In this manuscript, we present a previously healthy 8-year-old with acute onset ataxia with associated hyporeflexia that occurred after resolution of a presumed viral infection. We discuss our approach to ataxia, the patient’s neurodiagnostic odyssey, and highlight the final diagnosis of acute ataxic neuropathy without ophthalmoplegia - a rare incomplete MFS subtype. Due to timely recognition of the condition, the patient was treated appropriately and recovered fully.
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Rao J, Li F, Zhong L, Wang J, Peng Y, Liu H, Wang P, Xu J. Bilateral Cerebellar Intermittent Theta Burst Stimulation Combined With Swallowing Speech Therapy for Dysphagia After Stroke: A Randomized, Double-Blind, Sham-Controlled, Clinical Trial. Neurorehabil Neural Repair 2022; 36:437-448. [PMID: 35574927 DOI: 10.1177/15459683221092995] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Previous studies have found that high-frequency repetitive transcranial magnetic stimulation (rTMS) of the cerebellar hemisphere could improve swallowing function, but whether intermittent theta burst stimulation (iTBS), which has similar excitatory effect and higher efficiency, can also improve swallowing function for dysphagia after stroke remains unclear. OBJECTIVE This trial aimed to explore the efficacy and safety of bilateral cerebellar transcranial magnetic stimulation with iTBS for dysphagia after stroke. METHODS Seventy patients with dysphagia after stroke were divided into 2 treatment groups: true bilateral cerebellar iTBS and sham bilateral cerebellar iTBS. The true iTBS group underwent ten 100% resting motor threshold (RMT) iTBS sessions for 2 weeks. In the sham iTBS group, the parameters were the same except that the figure-eight coil was perpendicular to the skull. Both groups received traditional swallowing rehabilitation treatment 5 times a week for 2 weeks. Swallowing function was assessed with the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration/Aspiration Scale (PAS), Standardized Swallowing Assessment (SSA), and Functional Oral Intake Scale (FOIS) at baseline, 2 weeks after the intervention, and at 4 weeks of follow-up. RESULTS There were significant time and group interaction effects in both multi-factorial adjusted and unadjusted FEDSS, PAS, SSA, and FOIS score (P < .001). In the pairwise comparison of the swallowing parameters among the 2 groups, the FEDSS, PAS, SSA, and FOIS scores at 2 weeks and 4 weeks showed a significantly higher improvement in the iTBS simulation group than sham group (P < .05). In both the true iTBS and sham iTBS stimulation groups, all FEDSS, PAS, SSA, and FOIS scores were significantly improved over time (P < .001). CONCLUSIONS The present study suggested that as a more efficient TMS stimulation mode, iTBS could efficiently improve swallowing function by stimulating the bilateral cerebellar hemisphere. In addition, 100% resting motor threshold bilateral cerebellar iTBS is a relatively safe treatment. CLINICAL TRIAL REGISTRATION Effect analysis of repeated transcranial magnetic stimulation of cerebellar on dysphagia after stroke. www.chictr.org.cn. Identifier: ChiCTR2100042092.
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Affiliation(s)
- Jinzhu Rao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, P.R. China.,Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, P.R. China
| | - Fang Li
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, P.R. China
| | - Lida Zhong
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, P.R. China
| | - Jing Wang
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, P.R. China
| | - Yang Peng
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, P.R. China
| | - Huiyu Liu
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, P.R. China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, P.R. China
| | - Jianwen Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, P.R. China
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García-Feijoo P, Reghin-Neto M, Holanda V, Rassi MS, Saceda-Gutierrez JM, Carceller-Benito FE, De Oliveira E. 3-Step didactic white matter dissection of human cerebellum: Micro-neuroanatomical training. NEUROCIRUGIA (ENGLISH EDITION) 2022; 33:61-70. [PMID: 35248300 DOI: 10.1016/j.neucie.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 11/06/2020] [Indexed: 06/14/2023]
Abstract
OBJECTIVES A thorough understanding of cerebellum anatomy is essential in 4th ventricle approaches (more frequent in pediatric neurosurgery), avoiding relevant complications such as cerebellar mutism. The aim of the present work is to show the feasibility of a didactic dissection of human cerebellum focusing on cerebellar peduncles and dentate nucleus (DN), which are structures at high risk during these surgical procedures. MATERIAL AND METHODS The cerebellum was dissected according to the Klingler method for white matter, using standard and specific microsurgery tools. Surgical microscope magnification (×6-×40) provided by a D.F. Vasconcellos M900 was required. A Canon EOS T7 18-55 mm digital camera was used and Adobe Lightroom Classic CC and Keynote were selected as photo enhancing software. Special methods such as LED light endoscopic transillumination were used for photographical reasons. RESULTS DN dissection was successfully achieved and the relations between these nucleus and the cerebellar peduncles, inferior vermis and medullary velums were described. Through this three steps dissection guide (1. tentorial surface; 2. suboccipital surface; 3. 4th ventricle structures), the most relevant anatomical structures were shown and its implications in different 4th ventricle approaches were characterised. CONCLUSION 3 D perspective provided by real specimen anatomical dissection is critical for learning neuroanatomy. LED transillumination was shown as a useful technique for the 4th ventricle structures photographic documentation which improves spatial recognition. This benefit can be applied for the study of the relations between the medullary velums and the rhomboid fossa foramina, which are permeable to light. The proposed three-steps dissection guide helps to a better understanding of human cerebellum and to gain self-confidence, allowing safer practice for neurosurgeons in all stages of their career.
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Affiliation(s)
| | - Mateus Reghin-Neto
- Hospital o do Servidor Público do Estado de São Paulo (HSPE), São Paulo, Brazil
| | - Vanesa Holanda
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | - Marcio S Rassi
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | | | | | - Evandro De Oliveira
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
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Yazici E, Kose S, Gunduz Y, Kurt EM, Yazici AB. Mega cisterna magna in bipolar mood disorder: a case report. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2022; 39:58-61. [PMID: 35067008 PMCID: PMC8895964 DOI: 10.12701/yujm.2020.00864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/06/2021] [Indexed: 11/18/2022]
Abstract
Mega cisterna magna (MCM), one of the members of the Dandy-Walker complex, is a developmental malformation of the posterior fossa that is larger than 10 mm but morphologically does not affect the vermis and cerebellar hemispheres. Reports of psychiatric disorders associated with this anomaly are rare. We present the case of a patient with MCM who presented with a psychotic manic attack and was diagnosed with bipolar disorder. A 28-year-old female, single housewife, university graduate, presented with irritability, decreased sleep and appetite, distraction, and agitation. The patient also had a delusion of reference. In the clinical follow-up, an increase in energy and an increase in the amount of speech were observed. Her neurological examination was normal, and cranial magnetic resonance imaging revealed an MCM. The relationship and clinical significance of MCM with psychosis and mood disorders have not yet been fully elucidated. It is not known whether this association is accidental or based on etiological commonality. The purpose of this case report is to review the relationship between the cerebellum and psychiatric symptoms and to contribute to the literature.
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Affiliation(s)
- Esra Yazici
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Sefanur Kose
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Yasemin Gunduz
- Department of Radiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Elif Merve Kurt
- Department of Psychiatry, Diyarbakır Dağkapı State Hospital, Diyarbakır, Turkey
| | - Ahmet Bulent Yazici
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
- Corresponding author: Ahmet Bulent Yazici, MD Department of Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey Tel: +90-5325994988 Fax: +90-2642552105 E-mail:
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Moon HI, Jeong YJ, Suh JH. Voxel-based lesion symptom mapping analysis for dysphagia in stroke patients with isolated cerebellar lesions. J Neural Transm (Vienna) 2021; 129:65-74. [PMID: 34773172 DOI: 10.1007/s00702-021-02438-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/02/2021] [Indexed: 12/01/2022]
Abstract
Because the cerebellum plays a role in motor coordination, timing, sequencing, and feedback, it is hypothesized to be involved in swallowing-related functions. The role of the cerebellum in deglutition has become increasing evident, but the exact nature of this role remains inconclusive because of limited data from pure cerebellar lesions. Therefore, we conducted location analysis in isolated cerebellar lesions to complement previous findings and provide additional information. We reviewed 40 stroke patients with isolated cerebellar lesion. Lesion location and volume were measured on brain magnetic resonance images. We generated statistical maps of lesions related to VDS using voxel-based lesion symptom mapping (VLSM). We also created an overlay map of subgroups according to VDS score, those who have low risk and those who have high risk. Patients with cerebellar lesion had difficulty swallowing, both in the oral and pharyngeal phases. Multivariate analysis of cognitive function was selected as an independent predictor. In the group of high-risk patients, the overlay map showed some bilateral asymmetry, with a wider distribution in the left hemisphere and involvement of deep cerebellar nuclei. Using VLSM, we found that lesion location was associated with dysphagia. Although these results were not statistically significant, they showed a lesion pattern with predominant distribution in the left posterior lobe. Our results suggest that damage to the posterior lobe of the left cerebellum tends be related to severity of dysphagia in patients with isolated cerebellar lesion.
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Affiliation(s)
- Hyun Im Moon
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seoungnam, Gyeonggi, 13590, Republic of Korea.
| | - Yoon Jeong Jeong
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seoungnam, Gyeonggi, 13590, Republic of Korea
| | - Ji Hyun Suh
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seoungnam, Gyeonggi, 13590, Republic of Korea
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Hua T(T, Bejoy J, Song L, Wang Z, Zeng Z, Zhou Y, Li Y, Sang QXA. Cerebellar Differentiation from Human Stem Cells Through Retinoid, Wnt, and Sonic Hedgehog Pathways. Tissue Eng Part A 2021; 27:881-893. [PMID: 32873223 PMCID: PMC8336229 DOI: 10.1089/ten.tea.2020.0135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/28/2020] [Indexed: 01/06/2023] Open
Abstract
Differentiating cerebellar organoids can be challenging due to complex cell organization and structure in the cerebellum. Different approaches were investigated to recapitulate differentiation process of the cerebellum from human-induced pluripotent stem cells (hiPSCs) without high efficiency. This study was carried out to test the hypothesis that the combination of different signaling factors including retinoic acid (RA), Wnt activator, and sonic hedgehog (SHH) activator promotes the cerebellar differentiation of hiPSCs. Wnt, RA, and SHH pathways were activated by CHIR99021 (CHIR), RA, and purmorphamine (PMR), respectively. Different combinations of the morphogens (RA/CHIR, RA/PMR, CHIR/PMR, and RA/CHIR/PMR) were utilized, and the spheroids (day 35) were characterized for the markers of three cerebellum layers (the molecular layer, the Purkinje cell layer, and the granule cell layer). Of all the combinations tested, RA/CHIR/PMR promoted both the Purkinje cell layer and the granule cell layer differentiation. The cells also exhibited electrophysiological characteristics using whole-cell patch clamp recording, especially demonstrating Purkinje cell electrophysiology. This study should advance the understanding of different signaling pathways during cerebellar development to engineer cerebellum organoids for drug screening and disease modeling. Impact statement This study investigated the synergistic effects of retinoic acid, Wnt activator, and sonic hedgehog activator on cerebellar patterning of human-induced pluripotent stem cell (hiPSC) spheroids and organoids. The results indicate that the combination promotes the differentiation of the Purkinje cell layer and the granule cell layer. The cells also exhibit electrophysiological characteristics using whole-cell patch clamp recording, especially demonstrating Purkinje cell electrophysiology. The findings are significant for understanding the biochemical signaling of three-dimensional microenvironment on neural patterning of hiPSCs for applications in organoid engineering, disease modeling, and drug screening.
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Affiliation(s)
- Thien (Timothy) Hua
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, Florida, USA
| | - Julie Bejoy
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, Florida, USA
| | - Liqing Song
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, Florida, USA
| | - Zhe Wang
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, Florida, USA
| | - Ziwei Zeng
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, Florida, USA
- Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yi Zhou
- Department of Biomedical Sciences, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Yan Li
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, Florida, USA
- Institute of Molecular Biophysics, Florida State University, Tallahassee, Florida, USA
| | - Qing-Xiang Amy Sang
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, Florida, USA
- Institute of Molecular Biophysics, Florida State University, Tallahassee, Florida, USA
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Spoto G, Amore G, Vetri L, Quatrosi G, Cafeo A, Gitto E, Nicotera AG, Di Rosa G. Cerebellum and Prematurity: A Complex Interplay Between Disruptive and Dysmaturational Events. Front Syst Neurosci 2021; 15:655164. [PMID: 34177475 PMCID: PMC8222913 DOI: 10.3389/fnsys.2021.655164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/17/2021] [Indexed: 12/14/2022] Open
Abstract
The cerebellum plays a critical regulatory role in motor coordination, cognition, behavior, language, memory, and learning, hence overseeing a multiplicity of functions. Cerebellar development begins during early embryonic development, lasting until the first postnatal years. Particularly, the greatest increase of its volume occurs during the third trimester of pregnancy, which represents a critical period for cerebellar maturation. Preterm birth and all the related prenatal and perinatal contingencies may determine both dysmaturative and lesional events, potentially involving the developing cerebellum, and contributing to the constellation of the neuropsychiatric outcomes with several implications in setting-up clinical follow-up and early intervention.
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Affiliation(s)
- Giulia Spoto
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Greta Amore
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Luigi Vetri
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
| | - Giuseppe Quatrosi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
| | - Anna Cafeo
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Eloisa Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Antonio Gennaro Nicotera
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Gabriella Di Rosa
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
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Zhong L, Rao J, Wang J, Li F, Peng Y, Liu H, Zhang Y, Wang P. Repetitive Transcranial Magnetic Stimulation at Different Sites for Dysphagia After Stroke: A Randomized, Observer-Blind Clinical Trial. Front Neurol 2021; 12:625683. [PMID: 34122294 PMCID: PMC8187758 DOI: 10.3389/fneur.2021.625683] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background: The clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) protocols on patients with poststroke dysphagia is still unclear. Objective: This trial aimed to explore and analyze the effectiveness of 5 Hz rTMS on the unaffected hemisphere, affected hemisphere, and cerebellum in stroke patients with dysphagia. Methods: This observer-blind and randomized controlled trial included a total of 147 patients with stroke. Patients were divided into four treatment groups: the unaffected hemispheric group, the affected hemispheric group, the cerebellum group and the control group. Each group received traditional dysphagia treatment 5 days a week for 2 weeks. All recruited patients except for those in the control group underwent 10 consecutive rTMS sessions for 2 weeks. For the affected hemispheric group and unaffected hemispheric group, 5 Hz rTMS was applied to the affected mylohyoid cortical region or to the unaffected mylohyoid cortical region. For the cerebellum group, 5 Hz rTMS was applied to the mylohyoid cortical representation of the cerebellum (4.3 cm lateral and 2.4 cm below the inion). The Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration/Aspiration Scale (PAS), Gugging Swallowing Screen (GUSS), and Standardized Swallowing Assessment (SSA) were used to evaluate clinical swallowing function before the intervention (baseline), immediately after the intervention and 2 weeks after the intervention. Results: There were significant time and intervention interaction effects on the FEDSS, PAS, SSA, and GUSS scores (p < 0.05). In a direct comparison of the swallowing parameters of the four groups, the changes in FEDSS, PAS, SSA, and GUSS scores showed a significantly greater improvement in the unaffected hemispheric group, the affected hemispheric group and cerebellum group than in the control group (p < 0.05). Conclusions: Whether stimulating the unaffected hemisphere or the affected hemisphere, 5 Hz high-frequency rTMS on mylohyoid cortical tissue might have a positive effect on poststroke patients with dysphagia. In addition, cerebellar rTMS is a safe method that represents a potential treatment for poststroke dysphagia, and more clinical trials are needed to develop this technique further. Clinical Trial Registration:chictr.org.cn, identifier: ChiCTR2000032255.
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Affiliation(s)
- Lida Zhong
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Jinzhu Rao
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Jing Wang
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Fang Li
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Yang Peng
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Huiyu Liu
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, China
| | - Yan Zhang
- School of Educational Science, Huazhong University of Science and Technology, Wuhan, China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China
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Reflections on Cerebellar Neuropathology in Classical Scrapie. Biomolecules 2021; 11:biom11050649. [PMID: 33924986 PMCID: PMC8146067 DOI: 10.3390/biom11050649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 01/15/2023] Open
Abstract
In this review, the most important neuropathological changes found in the cerebella of sheep affected by classical natural scrapie are discussed. This disease is the oldest known of a group of unconventional “infections” caused by toxic prions of different origins. Scrapie is currently considered a “transmissible spongiform encephalopathy” (due to its neuropathological characteristics and its transmission), which is the paradigm of prion pathologies as well as many encephalopathies (prion-like) that present aberrant deposits of insoluble protein with neurotoxic effects due to errors in their catabolization (“misfolding protein diseases”). The study of this disease is, therefore, of great relevance. Our work data from the authors’ previous publications as well as other research in the field. The four most important types of neuropathological changes are neuron abnormalities and loss, neurogliosis, tissue vacuolization (spongiosis) and pathological or abnormal prion protein (PrP) deposits/deposition. These findings were analyzed and compared to other neuropathologies. Various aspects related to the presentation and progression of the disease, the involution of different neuronal types, the neuroglial responses and the appearance of abnormal PrP deposits are discussed. The most important points of controversy in scrapie neuropathology are presented.
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Amore G, Spoto G, Ieni A, Vetri L, Quatrosi G, Di Rosa G, Nicotera AG. A Focus on the Cerebellum: From Embryogenesis to an Age-Related Clinical Perspective. Front Syst Neurosci 2021; 15:646052. [PMID: 33897383 PMCID: PMC8062874 DOI: 10.3389/fnsys.2021.646052] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
The cerebellum and its functional multiplicity and heterogeneity have been objects of curiosity and interest since ancient times, giving rise to the urge to reveal its complexity. Since the first hypothesis of cerebellar mere role in motor tuning and coordination, much more has been continuously discovered about the cerebellum’s circuitry and functioning throughout centuries, leading to the currently accepted knowledge of its prominent involvement in cognitive, social, and behavioral areas. Particularly in childhood, the cerebellum may subserve several age-dependent functions, which might be compromised in several Central Nervous System pathologies. Overall, cerebellar damage may produce numerous signs and symptoms and determine a wide variety of neuropsychiatric impairments already during the evolutive age. Therefore, an early assessment in children would be desirable to address a prompt diagnosis and a proper intervention since the first months of life. Here we provide an overview of the cerebellum, retracing its morphology, histogenesis, and physiological functions, and finally outlining its involvement in typical and atypical development and the age-dependent patterns of cerebellar dysfunctions.
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Affiliation(s)
- Greta Amore
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Giulia Spoto
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Antonio Ieni
- Unit of Pathology, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Luigi Vetri
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuseppe Quatrosi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Gabriella Di Rosa
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Antonio Gennaro Nicotera
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
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Impacts of the COVID-19 Pandemic on the Mental Health and Motor Deficits in Cuban Patients with Cerebellar Ataxias. THE CEREBELLUM 2021; 20:896-903. [PMID: 33768478 PMCID: PMC7993441 DOI: 10.1007/s12311-021-01260-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 12/14/2022]
Abstract
Although there are no convincing evidences of detrimental effect of SARS-CoV2 infection on the cerebellum, the COVID-19 pandemic could impact the life quality of patients with cerebellar ataxias, but few studies have addressed this concern. To assess the motor and mental health changes caused by the COVID-19 pandemics in Cuban patients with cerebellar ataxias, three hundred four patients with cerebellar ataxias and 167 healthy controls were interviewed for risks of exposure to COVID-19, and the self-perception of the pandemics’ impact on the disease progression and on the mental health. All subjects underwent the Hospital Anxiety and Depression Scale. The patients reported low exposition to SARS-CoV2 infection, but one case was confirmed with a mild COVID-19. Overall, depressive and anxiety symptoms were significantly and marginally increased in patients, respectively, with higher scores in cases with severe and moderate ataxia. Positive patient’s impression of psychopathological changes was associated to increased age, age at onset, and anxiety. Sixty-seven patients had a positive self-perception of ataxia progression, which was mainly influenced by higher anxiety scores but not by the adherence to at-home exercise programs. However, the practice of physical exercise was related with lower depression and anxiety scores, but this therapeutical effect was not significantly influenced by the disease stage. We demonstrated the negative effect of the COVID-19 pandemic on the mental and motor deficits in Cuban patients with cerebellar ataxias and the positive effect of the at-home physical exercise programs on their mental well-being. These findings give rationales to develop tele-medicine approaches to minimize these health impacts and to study the long-term effects of such sequelae and accordingly define their treatments.
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De Silva M, Sadeghinezhad J, Nyengaard JR, Aghabalazadeh Asl M, Saeidi A, De Sordi N, Chiocchetti R, Grandis A. Design-based stereological study of the guinea-pig (Cavia porcellus) cerebellum. J Anat 2021; 239:517-528. [PMID: 33763861 PMCID: PMC8273595 DOI: 10.1111/joa.13434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/05/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022] Open
Abstract
Guinea pigs have proved useful as experimental animal models in studying cerebellar anatomical and structural alterations in human neurological disease; however, they are also currently acquiring increasing veterinary interest as companion animals. The morphometric features of the normal cerebellum in guinea pigs have not been previously investigated using stereology. The objective of the present work was to establish normal volumetric and quantitative stereological parameters for cerebellar tissues in guinea pigs, by means of unbiased design-based stereology. Cerebellar total volume, gray and white matter volume fractions, molecular and granular layers volume fractions, cerebellar surface area, Purkinje cellular and nuclear volumes, and the Purkinje cell total count were stereologically estimated. For this purpose, cerebellar hemispheres from six adult male guinea pigs were employed. Isotropic, uniform random sections were obtained by applying the orientator method, and subsequently processed for light microscopy. The cerebellar total volume, the white and grey matter volume fractions, and the molecular and granular layer volumes were estimated using the Cavalieri's principle and the point counting system. The cerebellar surface area was estimated through the use of test lines; Purkinje cellular and nuclear volumes were analysed using the nucleator technique, whereas the Purkinje cell total count was obtained by means of the optical disector technique. The mean ± standard deviation total volume of a guinea-pig cerebellar hemisphere was 0.11 ± 0.01 cm3 . The mean volumetric proportions occupied by the gray and white matters were, respectively, 78.0 ± 2.6% and 22.0 ± 2.6%, whereas their mean absolute volumes were found to be 0.21 ± 0.02 cm3 and 0.059 ± 0.006 cm3 . The volumes of the molecular and granular layers were estimated at 112.4 ± 20.6 mm3 and 104.4 ± 7.3 mm3 , whereas their mean thicknesses were calculated to be 0.184 ± 0.020 mm and 0.17 ± 0.02 mm. The molecular and granular layers accounted for 40.7 ± 3.9% and 37.4 ± 1.8% of total cerebellar volume respectively. The surface area of the cerebellum measured 611.4 ± 96.8 mm2 . Purkinje cells with a cellular volume of 3210.1 µm3 and with a nuclear volume of 470.9 µm3 had a higher incidence of occurrence. The mean total number of Purkinje cells for a cerebellar hemisphere was calculated to be 253,090 ± 34,754. The morphometric data emerging from the present study provide a set of reference data which might prove valuable as basic anatomical contribution for practical applications in veterinary neurology.
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Affiliation(s)
- Margherita De Silva
- Department of Veterinary Medical Sciences (UNI EN ISO 9001:2008), University of Bologna, Bologna, Italy
| | - Javad Sadeghinezhad
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Jens R Nyengaard
- Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Mahdi Aghabalazadeh Asl
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Ava Saeidi
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Nadia De Sordi
- Department of Veterinary Medical Sciences (UNI EN ISO 9001:2008), University of Bologna, Bologna, Italy
| | - Roberto Chiocchetti
- Department of Veterinary Medical Sciences (UNI EN ISO 9001:2008), University of Bologna, Bologna, Italy
| | - Annamaria Grandis
- Department of Veterinary Medical Sciences (UNI EN ISO 9001:2008), University of Bologna, Bologna, Italy
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Miguel JC, Perez SE, Malek-Ahmadi M, Mufson EJ. Cerebellar Calcium-Binding Protein and Neurotrophin Receptor Defects in Down Syndrome and Alzheimer's Disease. Front Aging Neurosci 2021; 13:645334. [PMID: 33776745 PMCID: PMC7994928 DOI: 10.3389/fnagi.2021.645334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/04/2021] [Indexed: 12/11/2022] Open
Abstract
Cerebellar hypoplasia is a major characteristic of the Down syndrome (DS) brain. However, the consequences of trisomy upon cerebellar Purkinje cells (PC) and interneurons in DS are unclear. The present study performed a quantitative and qualitative analysis of cerebellar neurons immunostained with antibodies against calbindin D-28k (Calb), parvalbumin (Parv), and calretinin (Calr), phosphorylated and non-phosphorylated intermediate neurofilaments (SMI-34 and SMI-32), and high (TrkA) and low (p75NTR) affinity nerve growth factor (NGF) receptors as well as tau and amyloid in DS (n = 12), Alzheimer's disease (AD) (n = 10), and healthy non-dementia control (HC) (n = 8) cases. Our findings revealed higher Aβ42 plaque load in DS compared to AD and HC but no differences in APP/Aβ plaque load between HC, AD, and DS. The cerebellar cortex neither displayed Aβ40 containing plaques nor pathologic phosphorylated tau in any of the cases examined. The number and optical density (OD) measurements of Calb immunoreactive (-ir) PC soma and dendrites were similar between groups, while the number of PCs positive for Parv and SMI-32 were significantly reduced in AD and DS compared to HC. By contrast, the number of SMI-34-ir PC dystrophic axonal swellings, termed torpedoes, was significantly greater in AD compared to DS. No differences in SMI-32- and Parv-ir PC OD measurements were observed between groups. Conversely, total number of Parv- (stellate/basket) and Calr (Lugaro, brush, and Golgi)-positive interneurons were significantly reduced in DS compared to AD and HC. A strong negative correlation was found between counts for Parv-ir interneurons, Calr-ir Golgi and brush cells, and Aβ42 plaque load. Number of TrkA and p75NTR positive PCs were reduced in AD compared to HC. These findings suggest that disturbances in calcium binding proteins play a critical role in cerebellar neuronal dysfunction in adults with DS.
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Affiliation(s)
- Jennifer C. Miguel
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Sylvia E. Perez
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Michael Malek-Ahmadi
- Department of Biomedical Informatics, Banner Alzheimer's Institute, Phoenix, AZ, United States
| | - Elliott J. Mufson
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, United States
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, United States
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Abstract
The sensation that develops as a long breath hold continues is what this article is about. We term this sensation of an urge to breathe "air hunger." Air hunger, a primal sensation, alerts us to a failure to meet an urgent homeostatic need maintaining gas exchange. Anxiety, frustration, and fear evoked by air hunger motivate behavioral actions to address the failure. The unpleasantness and emotional consequences of air hunger make it the most debilitating component of clinical dyspnea, a symptom associated with respiratory, cardiovascular, and metabolic diseases. In most clinical populations studied, air hunger is the predominant form of dyspnea (colloquially, shortness of breath). Most experimental subjects can reliably quantify air hunger using rating scales, that is, there is a consistent relationship between stimulus and rating. Stimuli that increase air hunger include hypercapnia, hypoxia, exercise, and acidosis; tidal expansion of the lungs reduces air hunger. Thus, the defining experimental paradigm to evoke air hunger is to elevate the drive to breathe while mechanically restricting ventilation. Functional brain imaging studies have shown that air hunger activates the insular cortex (an integration center for perceptions related to homeostasis, including pain, food hunger, and thirst), as well as limbic structures involved with anxiety and fear. Although much has been learned about air hunger in the past few decades, much remains to be discovered, such as an accepted method to quantify air hunger in nonhuman animals, fundamental questions about neural mechanisms, and adequate and safe methods to mitigate air hunger in clinical situations. © 2021 American Physiological Society. Compr Physiol 11:1449-1483, 2021.
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Affiliation(s)
- Robert B Banzett
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert W Lansing
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Andrew P Binks
- Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
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García-Feijoo P, Reghin-Neto M, Holanda V, Rassi MS, Saceda-Gutierrez JM, Carceller-Benito FE, De Oliveira E. 3-Step didactic white matter dissection of human cerebellum: Micro-neuroanatomical training. Neurocirugia (Astur) 2021; 33:S1130-1473(20)30137-8. [PMID: 33549481 DOI: 10.1016/j.neucir.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/25/2020] [Accepted: 11/06/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES A thorough understanding of cerebellum anatomy is essential in 4th ventricle approaches (more frequent in pediatric neurosurgery), avoiding relevant complications such as cerebellar mutism. The aim of the present work is to show the feasibility of a didactic dissection of human cerebellum focusing on cerebellar peduncles and dentate nucleus (DN), which are structures at high risk during these surgical procedures. MATERIAL AND METHODS The cerebellum was dissected according to the Klingler method for white matter, using standard and specific microsurgery tools. Surgical microscope magnification (x6-x40) provided by a D.F. Vasconcellos M900 was required. A Canon EOS T7 18-55 mm digital camera was used and Adobe Lightroom Classic CC and Keynote were selected as photo enhancing software. Special methods such as LED light endoscopic transillumination were used for photographical reasons. RESULTS DN dissection was successfully achieved and the relations between these nucleus and the cerebellar peduncles, inferior vermis and medullary velums were described. Through this three steps dissection guide (1. tentorial surface; 2. suboccipital surface; 3. 4th ventricle structures), the most relevant anatomical structures were shown and its implications in different 4th ventricle approaches were characterised. CONCLUSION 3 D perspective provided by real specimen anatomical dissection is critical for learning neuroanatomy. LED transillumination was shown as a useful technique for the 4th ventricle structures photographic documentation which improves spatial recognition. This benefit can be applied for the study of the relations between the medullary velums and the rhomboid fossa foramina, which are permeable to light. The proposed three-steps dissection guide helps to a better understanding of human cerebellum and to gain self-confidence, allowing safer practice for neurosurgeons in all stages of their career.
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Affiliation(s)
| | - Mateus Reghin-Neto
- Hospital o do Servidor Público do Estado de São Paulo (HSPE), São Paulo, Brazil
| | - Vanesa Holanda
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | - Marcio S Rassi
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | | | | | - Evandro De Oliveira
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
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66
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The Developing Cerebellum as a Target for Toxic Substances: Protective Role of Antioxidants. THE CEREBELLUM 2021; 20:614-630. [PMID: 33474620 DOI: 10.1007/s12311-021-01231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
Cerebellar development begins during the late embryological period and continues to undergo organizational changes long after birth. The cerebellum is particularly susceptible to developmental abnormalities on exposure to oxidants and free radicals, thus leading to oxidative stress. Oxidative stress occurs when there is an imbalance between reactive oxygen species generation and antioxidant defences which may disrupt signalling pathways, leading to cerebellar anomalies and dysfunction. In this regard, this review assesses current research underlining the importance of the cerebellum, provides an update on substances affecting cerebellar development and highlights some promising antioxidants that may play a role in attenuating toxicity in the developing cerebellum. To accomplish this, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) system was employed and key scientific databases such as Science Direct, PubMed, Scopus, Web of Science and Google Scholar were searched to explore and collect information on the cerebellum and the role of antioxidants during its development. Originally, 109 articles were obtained but 22 articles which met the inclusion criteria were selected for the review. These findings provide an updated compilation of antioxidants capable of attenuating oxidative damage in the developing cerebellum, thus allowing future interdisciplinary studies in the form of clinical applications for screening and possible development of novel therapeutic agents from the identified products.
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Argyropoulos GD, Christidi F, Karavasilis E, Velonakis G, Antoniou A, Bede P, Seimenis I, Kelekis N, Douzenis A, Papakonstantinou O, Efstathopoulos E, Ferentinos P. Cerebro-cerebellar white matter connectivity in bipolar disorder and associated polarity subphenotypes. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110034. [PMID: 32710925 DOI: 10.1016/j.pnpbp.2020.110034] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cerebellum has a crucial role in mood regulation. While cerebellar grey matter (GM) alterations have been previously reported in bipolar disorder (BD), cerebro-cerebellar white matter (WM) connectivity alterations and cerebellar GM profiles have not been characterised in the context of predominant polarity (PP) and onset polarity (OP) subphenotypes of BD patients which is the aim of the present study. METHODS Forty-two euthymic BD patients stratified for PP and OP and 42 healthy controls (HC) were included in this quantitative neuroimaging study to evaluate cerebellar GM patterns and cerebro-cerebellar WM connections. Diffusion tensor tractography was used to characterise afferent and efferent cerebro-cerebellar tract integrity. False discovery rate corrections were applied in post-hoc comparisons. RESULTS BD patients exhibited higher fractional anisotropy (FA) in fronto-ponto-cerebellar tracts bilaterally compared to HC. Subphenotype-specific FA profiles were identified within the BD cohort. Regarding PP subgroups, we found FA changes in a) left contralateral fronto-ponto-cerebellar tract (depressive-PP > HC) and b) contralateral/ipsilateral fronto-ponto-cerebellar tracts bilaterally (manic-PP > HC). Regarding OP subgroups, we observed FA changes in a) left/right contralateral fronto-ponto-cerebellar tracts (depressive-OP > HC) and b) all fronto-ponto-cerebellar, most parieto-ponto-cerebellar and right contralateral occipito-ponto-cerebellar tracts (manic-OP>HC). In general, greater and more widespread cerebro-cerebellar changes were observed in manic-OP patients than in depressive-OP patients compared to HC. Manic-OP showed higher FA compared to depressive-OP patients in several afferent WM tracts. No GM differences were identified between BD and HC and across BD subgroups. CONCLUSIONS Our findings highlight fronto-ponto-cerebellar connectivity alterations in euthymic BD. Polarity-related subphenotypes have distinctive cerebro-cerebellar WM signatures with potential clinical and pathobiological implications.
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Affiliation(s)
- Georgios D Argyropoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Christidi
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Efstratios Karavasilis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniou
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Peter Bede
- Biomedical Imaging Laboratory, Sorbonne University, CNRS, INSERM, Paris, France; Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - Ioannis Seimenis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Douzenis
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Olympia Papakonstantinou
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Efstathopoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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D’Arrigo S, Loiacono C, Ciaccio C, Pantaleoni C, Faccio F, Taddei M, Bulgheroni S. Clinical, Cognitive and Behavioural Assessment in Children with Cerebellar Disorder. APPLIED SCIENCES 2021; 11:544. [DOI: 10.3390/app11020544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Abstract
Cerebellar disorders are characterised clinically by specific signs and symptoms, often associated with neurodevelopmental disorder. While the clinical signs of cerebellar disorders are clearly recognisable in adults and have a precise anatomo-functional correlation, in children the semiotics are less clear and vary with age because of the particular nature of the cerebellum’s maturation. Unlike other structures of the central nervous system, this begins at a later stage of foetal development and extends over a longer period of time, even after birth. As a result, the typical signs of cerebellar dysfunction will only become evident when the cerebellar functions have become integrated into the complex circuits of the central nervous system. This means that poor motor coordination in the very early years of life may not necessarily correlate with cerebellar dysfunction, and this may also be encountered in healthy children. The cerebellum’s role in cognitive and emotional functions relies on its structure and the complexity of its connections. Cognitive and behavioral impairment in cerebellar disorders can be the results of acquired lesions or the action of genetic and environmental risk factors, to which the cerebellum is particularly vulnerable considering its pattern of development. In the pathological setting, early evidence of cerebellar damage may be very vague, due, partly, to spontaneous compensation phenomena and the vicarious role of the connecting structures (an expression of the brain’s plasticity). Careful clinical assessment will nonetheless enable appropriate instrumental procedures to be arranged. It is common knowledge that the contribution of neuroimaging is crucial for diagnosis of cerebellar conditions, and neurophysiological investigations can also have a significant role. The ultimate goal of clinicians is to combine clinical data and instrumental findings to formulate a precise diagnostic hypothesis, and thus request a specific genetic test in order to confirm their findings, wherever possible.
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Affiliation(s)
- Stefano D’Arrigo
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, 20133 Milan, Italy
| | - Carmela Loiacono
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, 20133 Milan, Italy
| | - Claudia Ciaccio
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, 20133 Milan, Italy
| | - Chiara Pantaleoni
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, 20133 Milan, Italy
| | - Flavia Faccio
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, 20133 Milan, Italy
| | - Matilde Taddei
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, 20133 Milan, Italy
| | - Sara Bulgheroni
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, 20133 Milan, Italy
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Wilcox CE, Clifford J, Ling J, Mayer AR, Bigelow R, Bogenschutz MP, Tonigan JS. Stroop-related cerebellar and temporal activation is correlated with negative affect and alcohol use disorder severity. Brain Imaging Behav 2021; 14:586-598. [PMID: 31115861 DOI: 10.1007/s11682-019-00126-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Impairment in cognitive control in alcohol use disorder (AUD) contributes to difficulty controlling alcohol use and, in many populations, difficulties with emotion regulation. However, the most reliable and robust marker of clinically-relevant deficits in cognitive control in AUD is unclear. Our aims were to measure relationships between BOLD signal during a Stroop task and AUD severity and change in BOLD signal and change in drinking over three weeks. We also aimed to explore the relationships between BOLD signal and subjective negative affect. Thirty-three individuals with AUD underwent a multisensory Stroop task during functional magnetic resonance imaging (fMRI), as well as a battery of neuropsychological tests and self-report assessments of negative affect and AUD severity. Greater activation in temporal gyrus and cerebellum during incongruent trials compared to congruent trials was observed, and percent signal change (incongruent minus congruent) in both clusters was positively correlated with AUD severity and self-reported negative affect. Neuropsychological task performance and self-reported impulsivity were not highly correlated with AUD severity. Hierarchical regression analyses indicated that percent signal change (incongruent minus congruent) in cerebellum was independently associated with negative affect after controlling for recent and chronic drinking. In a subset of individuals (n = 23) reduction in cerebellar percent signal change (incongruent minus congruent) was correlated with increases in percent days abstinent over 3 weeks. BOLD activation during this Stroop task may therefore be an important objective marker of AUD severity and negative affect. The potential importance of the cerebellum in emotion regulation and AUD severity is highlighted.
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Affiliation(s)
- Claire E Wilcox
- Mind Research Network , 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA.
| | - Joshua Clifford
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Josef Ling
- Mind Research Network , 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA
| | - Andrew R Mayer
- Mind Research Network , 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA
| | - Rose Bigelow
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Michael P Bogenschutz
- Department of Psychiatry, New York University School of Medicine, New York, NY, 10016, USA
| | - J Scott Tonigan
- Department of Psychology, Center on Alcoholism, Substance Abuse & Addictions, University of New Mexico, Albuquerque, NM, USA
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Mennink LM, van Dijk J, van Dijk P. The cerebellar (para)flocculus: A review on its auditory function and a possible role in tinnitus. Hear Res 2020; 398:108081. [DOI: 10.1016/j.heares.2020.108081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/04/2020] [Accepted: 09/16/2020] [Indexed: 11/16/2022]
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The Effects of Midline Cerebellar rTMS on Human Pharyngeal Cortical Activity in the Intact Swallowing Motor System. THE CEREBELLUM 2020; 20:101-115. [PMID: 32979188 PMCID: PMC7862520 DOI: 10.1007/s12311-020-01191-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 12/25/2022]
Abstract
We sought to compare the effects of 10 Hz cerebellar vermis (vs. unilateral hemispheric and sham) repetitive transcranial magnetic stimulation (rTMS) on cortical neuroelectrical activity and thereafter 10 Hz cerebellar vermis (vs. sham) rTMS on swallowing behaviour. Healthy participants (n = 25) were randomly allocated to receive vermis, unilateral hemisphere or sham 10 Hz cerebellar rTMS. Recordings were made using pharyngeal electromyography and manometry catheters, obtaining motor-evoked potentials (MEPs) and pressure recordings. The amplitudes of MEPs elicited using single-pulse TMS delivered to the pharyngeal areas of the motor cortex bilaterally were measured pre- and post-cerebellar stimulation. As in previous studies, abductor policis brevis (APB) MEPs were measured to assess post-rTMS modulation specificity. Swallowing was assessed using a swallowing accuracy task. Measurements were made at baseline and 15-min intervals for an hour post-intervention. Measurements involved TMS being used to elicit 10 MEPs bilaterally over the pharyngeal areas of the motor cortex, over the APB cortical representation adjacent to the pharyngeal area with the lowest resting motor threshold and 5 MEPs bilaterally over pharyngeal areas of the cerebellar hemispheres. Swallowing accuracy was assessed by giving participants 10 attempts to swallow and hit a digital target. Cerebellar vermis rTMS caused significant suppression of cortical pharyngeal MEP amplitudes compared with unilateral rTMS and sham (P = 0.0005, 0.002). APB and cerebellar MEP amplitudes were unaffected as were pharyngeal and APB MEP latencies. Following cerebellar vermis rTMS there was a significant reduction in swallowing accuracy compared with sham (P = 0.001). Our findings demonstrate cerebellar vermis rTMS exerts a suppressive effect on pharyngeal motor cortical activity and swallowing behaviour.
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Neuroanatomic Correlates for the Neuropsychological Manifestations of Chiari Malformation Type I. World Neurosurg 2020; 136:462-469. [PMID: 32204298 DOI: 10.1016/j.wneu.2020.01.149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/15/2020] [Indexed: 01/13/2023]
Abstract
Chiari malformation comprises a spectrum of congenital malformations characterized by a herniation of the cerebellar tonsils below the foramen magnum. Chiari malformation type I (CM-I) is the most prevalent subtype seen in clinical practice. This condition variably compresses the cerebellum and medulla-spinal cord junction secondary to malformation of the posterior fossa. Most neurologists and neurosurgeons recognize the sensorimotor and lower brainstem manifestations that result in the clinical picture of CM-I. The effects of CM-I on cognitive functioning, however, and their impact on neuropsychological performance are poorly understood, despite having long been recognized. This article reviews neuropsychological deficits demonstrated by individuals with CM-I, and explores cerebellocortical neuroanatomic pathways to provide possible rationale for the neurocognitive impairments present in affected individuals.
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Sasegbon A, Smith CJ, Bath P, Rothwell J, Hamdy S. The effects of unilateral and bilateral cerebellar rTMS on human pharyngeal motor cortical activity and swallowing behavior. Exp Brain Res 2020; 238:1719-1733. [PMID: 32232540 PMCID: PMC7413876 DOI: 10.1007/s00221-020-05787-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/16/2020] [Indexed: 11/16/2022]
Abstract
The cerebellum is recognised to bilaterally modulate sensorimotor function and has recently been shown to play a role in swallowing. Unilateral cerebellar repetitive trans-cranial magnetic stimulation (rTMS) excites corticobulbar motor pathways to the pharynx but the effects of bilateral versus unilateral cerebellar rTMS on these pathways are unknown. In this three-part cross-over study, healthy participants (n = 13) were randomly allocated to receive unilateral or bilateral 10 Hz cerebellar rTMS. Participants were intubated with pharyngeal electromyography and/or manometry catheters for motor evoked potentials (MEPs) and pressure recordings. In part 1 of the study, single pulse TMS was used to measure baseline motor cortical pharyngeal MEP (PMEP) and hemispheric cerebellar MEP (CMEP) amplitudes, before cerebellar rTMS was administered. Repeat measures of PMEP amplitude were performed at 15-min intervals for an hour post unilateral and bilateral rTMS. Thereafter, in two further studies, a cortical ‘virtual lesion’ (V/L) was applied prior to cerebellar rTMS with pre and post PMEPs (part 2) and measurements of swallowing accuracy (part 3) using a behavioural task. Compared to baseline, unilateral and bilateral cerebellar rTMS provoked increases in pharyngeal cortical excitation (P = 0.028, 0.0005, respectively). Bilateral rTMS was significantly more effective than unilateral in causing cortical excitation (P = 0.0005) and in reversing the suppressive neurological (P = 0.0005) and behavioural (P = 0.0005) effects of a cortical V/L. Our findings suggest bilateral cerebellar rTMS has greater facilitatory effects on corticobulbar motor pathways to the pharynx than unilateral stimulation with the potential to be a more effective clinical therapy if its effects are reproduced in populations with neurogenic dysphagia.
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Affiliation(s)
- Ayodele Sasegbon
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Clinical Sciences Building, Eccles Old Road, Salford, M6 8HD, UK
| | - Craig J Smith
- Division of Cardiovascular Sciences, Manchester Centre for Clinical Neurosciences, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Salford Royal Hospital, Manchester Academic Health Sciences Centre (MAHSC), Salford, UK
| | - Philip Bath
- Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.,Stroke, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, London, UK
| | - Shaheen Hamdy
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Clinical Sciences Building, Eccles Old Road, Salford, M6 8HD, UK.
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Neural Foundations of Ayres Sensory Integration ®. Brain Sci 2019; 9:brainsci9070153. [PMID: 31261689 PMCID: PMC6680650 DOI: 10.3390/brainsci9070153] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 12/22/2022] Open
Abstract
Sensory integration, now trademarked as Ayres Sensory Integration® or ASI, is based on principles of neuroscience and provides a framework for understanding the contributions of the sensory and motor foundations of human behavior. The theory and practice of ASI continues to evolve as greater understanding of the neurobiology of human behavior emerges. In this paper we examine core constructs of ASI identified in the seminal work of Dr. Jean Ayres, and present current neuroscience research that underlies the main patterns of sensory integration function and dysfunction. We consider how current research verifies and clarifies Ayres’ propositions by describing functions of the vestibular, proprioceptive, and tactile sensory systems, and exploring their relationships to ocular, postural, bilateral integration, praxis, and sensory modulation. We close by proposing neuroplasticity as the mechanisms underlying change as a result of ASI intervention.
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Prasad S, Pandey U, Saini J, Ingalhalikar M, Pal PK. Atrophy of cerebellar peduncles in essential tremor: a machine learning-based volumetric analysis. Eur Radiol 2019; 29:7037-7046. [PMID: 31161314 DOI: 10.1007/s00330-019-06269-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/16/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Subtle cerebellar signs are frequently observed in essential tremor (ET) and may be associated with cerebellar dysfunction. This study aims to evaluate the macrostructural integrity of the superior, middle, and inferior cerebellar peduncles (SCP, MCP, ICP) and cerebellar gray and white matter (GM, WM) volumes in patients with ET, and compare these volumes between patients with and without cerebellar signs (ETc and ETnc). METHODS Forty patients with ET and 37 age- and gender-matched healthy controls were recruited. Atlas-based region-of-interest analysis of the SCP, MCP, and ICP and automated analysis of cerebellar GM and WM volumes were performed. Peduncular volumes were employed in a multi-variate classification framework to attempt discrimination of ET from controls. RESULTS Significant atrophy of bilateral MCP and ICP and bilateral cerebellar GM was observed in ET. Cerebellar signs were present in 20% of subjects with ET. Comparison of peduncular and cerebellar volumes between ETnc and ETc revealed atrophy of right SCP, bilateral MCP and ICP, and left cerebellar WM in ETc. The multi-variate classifier could discriminate between ET and controls with a test accuracy of 86.66%. CONCLUSIONS Patients with ET have significant atrophy of cerebellar peduncles, particularly the MCP and ICP. Additional atrophy of the SCP is observed in the ETc group. These abnormalities may contribute to the pathogenesis of cerebellar signs in ET. KEY POINTS • Patients with ET have significant atrophy of bilateral middle and inferior cerebellar peduncles and cerebellar gray matter in comparison with healthy controls. • Patients of ET with cerebellar signs have significant atrophy of right superior cerebellar peduncle, bilateral middle and inferior cerebellar peduncle, and left cerebellar white matter in comparison with ET without cerebellar signs. • A multi-variate classifier employing peduncular volumes could discriminate between ET and controls with a test accuracy of 86.66%.
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Affiliation(s)
- Shweta Prasad
- Department of Clinical Neurosciences and Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, Karnataka, 560029, India
| | - Umang Pandey
- Symbiosis Center for Medical Image Analysis, Symbiosis International (Deemed) University, Lavale, Mulshi, Pune, Maharashtra, 412115, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, Karnataka, 560029, India
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis International (Deemed) University, Lavale, Mulshi, Pune, Maharashtra, 412115, India.,Symbiosis Institute of Technology, Symbiosis International (Deemed) University, Lavale, Mulshi, Pune, Maharashtra, 412115, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, Karnataka, 560029, India.
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76
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Sasegbon A, Watanabe M, Simons A, Michou E, Vasant DH, Magara J, Bath PM, Rothwell J, Inoue M, Hamdy S. Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion. J Physiol 2019; 597:2533-2546. [PMID: 30907429 PMCID: PMC6487931 DOI: 10.1113/jp277545] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/21/2019] [Indexed: 01/14/2023] Open
Abstract
Key points Despite evidence that the human cerebellum has an important role in swallowing neurophysiology, the effects of cerebellar stimulation on swallowing in the disrupted brain have not been explored. In this study, for the first time, the application of cerebellar neurostimulation is characterized in a human model of disrupted swallowing (using a cortical virtual lesion). It is demonstrated that cerebellar stimulation can reverse the suppressed activity in the cortical swallowing system and restore swallowing function in a challenging behavioural task, suggesting the findings may have important therapeutic implications.
Abstract Repetitive transcranial magnetic stimulation (rTMS) can alter neuronal activity within the brain with therapeutic potential. Low frequency stimulation to the ‘dominant’ cortical swallowing projection induces a ‘virtual‐lesion’ transiently suppressing cortical excitability and disrupting swallowing behaviour. Here, we compared the ability of ipsi‐lesional, contra‐lesional and sham cerebellar rTMS to reverse the effects of a ‘virtual‐lesion’ in health. Two groups of healthy participants (n = 15/group) were intubated with pharyngeal catheters. Baseline pharyngeal motor evoked potentials (PMEPs) and swallowing performance (reaction task) were measured. Participants received 10 min of 1 Hz rTMS to the pharyngeal motor cortex which elicited the largest PMEPs to suppress cortical activity and disrupt swallowing behaviour. Over six visits, participants were randomized to receive 250 pulses of 10 Hz cerebellar rTMS to the ipsi‐lesional side, contra‐lesional side or sham while assessing PMEP amplitude or swallowing performance for an hour afterwards. Compared to sham, active cerebellar rTMS, whether administered ipsi‐lesionally (P = 0.011) or contra‐lesionally (P = 0.005), reversed the inhibitory effects of the cortical ‘virtual‐lesion’ on PMEPs and swallowing accuracy (ipsi‐lesional, P < 0.001, contra‐lesional, P < 0.001). Cerebellar rTMS was able to reverse the disruptive effects of a ‘virtual lesion’. These findings provide evidence for developing cerebellar rTMS into a treatment for post‐stroke dysphagia. Despite evidence that the human cerebellum has an important role in swallowing neurophysiology, the effects of cerebellar stimulation on swallowing in the disrupted brain have not been explored. In this study, for the first time, the application of cerebellar neurostimulation is characterized in a human model of disrupted swallowing (using a cortical virtual lesion). It is demonstrated that cerebellar stimulation can reverse the suppressed activity in the cortical swallowing system and restore swallowing function in a challenging behavioural task, suggesting the findings may have important therapeutic implications.
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Affiliation(s)
- Ayodele Sasegbon
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Salford, UK
| | - Masahiro Watanabe
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Salford, UK.,Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Andre Simons
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Salford, UK
| | - Emilia Michou
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Salford, UK.,Department of Speech and Language Therapy, Technological Educational Institute of Western Greece, Patras, Greece
| | - Dipesh H Vasant
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Salford, UK.,Manchester University Foundation Trust, Neurogastroenterology, Wythenshawe Hospital, Manchester, UK
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Philip M Bath
- Stroke, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, London, UK
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shaheen Hamdy
- Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), Salford, UK
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Kim Y, Im S, Kim SH, Park GY. Laterality of cerebellar afferent and efferent pathways in a healthy right-handed population: A diffusion tensor imaging study. J Neurosci Res 2018; 97:582-596. [PMID: 30582195 DOI: 10.1002/jnr.24378] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/16/2018] [Accepted: 12/07/2018] [Indexed: 11/11/2022]
Abstract
The cerebellum communicates with the cerebral cortex through the cortico-ponto-cerebellar tract (CPCT, cerebellar afferent) and the dentato-rubro-thalamo-cortical tract (DRTCT, cerebellar efferent). This study explored the laterality of CPCT and DRTCT in a right-handed population. Forty healthy right-handed subjects (18 males and 22 females with age range of 26-79 years old) who underwent diffusion tensor imaging (DTI) were retrospectively enrolled. Bilateral CPCT, DRTCT, and the corticospinal tract (CST) were reconstructed using probabilistic diffusion tensor tractography (DTT). Tract volume (TV) and fractional anisotropy (FA) were compared between dominant and non-dominant tracts. Subjects were divided into age groups (20-40, 41-60, and 61-80 years), and the DTI-derived parameters of the groups were compared to determine age-related differences. TV and FA of non-dominant CPCT were higher than those of dominant CPCT, and the dominant CST was higher than the non-dominant CST. The TV and FA of DRTCT showed no side-to-side difference. The 61-80 years age group had the highest TV of the dominant and non-dominant DRTCT among the three groups and the highest FA of the non-dominant CPCT and DRTCT. The results revealed the structural characteristics of CPCT and DRTCT using probabilistic DTT. Normal asymmetric patterns and age-related changes in cerebellar white matter tracts may be important to researchers investigating cerebro-cerebellar structural connectivity.
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Affiliation(s)
- Youngkook Kim
- Department of Rehabilitation Medicine, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Rehabilitation Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sun Im
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea
| | - Se-Hong Kim
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Geun-Young Park
- Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea
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78
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Shah A, Prasad S, Rastogi B, Dash S, Saini J, Pal PK, Ingalhalikar M. Altered structural connectivity of the motor subnetwork in multiple system atrophy with cerebellar features. Eur Radiol 2018; 29:2783-2791. [PMID: 30552481 DOI: 10.1007/s00330-018-5874-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/10/2018] [Accepted: 11/06/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate the structural connectivity of the motor subnetwork in multiple system atrophy with cerebellar features (MSA-C), a distinct subtype of MSA, characterized by predominant cerebellar symptoms. METHODS Twenty-three patients with MSA-C and 25 age- and gender-matched healthy controls were recruited for the study. Disease severity was quantified using the Unified Multiple System Atrophy Rating Scale (UMSARS). Diffusion MRI images were acquired and used to compute the structural connectomes (SCs) using probabilistic fiber tracking. The motor network with 12 brain regions and 26 cerebellar regions was extracted and was compared between the groups using analysis of variance at a global (network-wide), nodal (at each node), and edge (at each connection) levels, and was corrected for multiple comparisons. In addition, the acquired connectivity measures were correlated with duration of illness, total Unified MSA Rating Scale (UMSARS), and the motor component score. RESULTS Significantly lower global network metrics-global density, transitivity, clustering coefficient, and characteristic path length-were observed in MSA-C (corrected p < 0.05). Reduced nodal strength was observed in the bilateral ventral diencephalon, the left thalamus, and several cerebellar regions. Network-based statistics revealed significant abnormal edge-wise connectivity in 40 connections (corrected p < 0.01), with majority of deficits observed in the cerebellum. Finally, significant negative correlations were observed between UMSARS scores and thalamic and cerebellar connectivity (p < 0.05) as well as between duration of illness and cerebellar connectivity. CONCLUSIONS Abnormal connectivity of the basal ganglia and cerebellar network may be causally implicated for the motor features observed in MSA-C. KEY POINTS • Structural connectivity of the motor subnetwork was explored in patients with multiple system atrophy with cerebellar features (MSA-C) using probabilistic tractography. • The motor subnetwork in MSA-C has significant alterations in both basal ganglia and cerebellar connectivity, with a higher extent of abnormality in the cerebellum. • These findings may be causally implicated for the motor features of cerebellar dysfunction and parkinsonism observed in MSA-C.
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Affiliation(s)
- Apurva Shah
- Symbiosis Center for Medical Image Analysis and Symbiosis Institute of Technology, Symbiosis International University, Lavale, Mulshi, Pune, Maharashtra, 412115, India
| | - Shweta Prasad
- Department of Clinical Neurosciences and Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India
| | - Bharti Rastogi
- Symbiosis Center for Medical Image Analysis and Symbiosis Institute of Technology, Symbiosis International University, Lavale, Mulshi, Pune, Maharashtra, 412115, India
| | - Santosh Dash
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India
| | - Jitender Saini
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India.
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis and Symbiosis Institute of Technology, Symbiosis International University, Lavale, Mulshi, Pune, Maharashtra, 412115, India.
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79
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Bambico FR, Comai S, Diwan M, Hasan SN, Conway JD, Darvish-Ghane S, Hamani C, Gobbi G, Nobrega JN. High frequency stimulation of the anterior vermis modulates behavioural response to chronic stress: involvement of the prefrontal cortex and dorsal raphe? Neurobiol Dis 2018; 116:166-178. [DOI: 10.1016/j.nbd.2018.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 02/17/2018] [Accepted: 03/24/2018] [Indexed: 12/25/2022] Open
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80
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Maternal high-salt diet alters redox state and mitochondrial function in newborn rat offspring's brain. Br J Nutr 2018; 119:1003-1011. [PMID: 29502538 DOI: 10.1017/s0007114518000235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Excessive salt intake is a common feature of Western dietary patterns, and has been associated with important metabolic changes including cerebral redox state imbalance. Considering that little is known about the effect on progeny of excessive salt intake during pregnancy, the present study investigated the effect of a high-salt diet during pregnancy and lactation on mitochondrial parameters and the redox state of the brains of resulting offspring. Adult female Wistar rats were divided into two dietary groups (n 20 rats/group): control standard chow (0·675 % NaCl) or high-salt chow (7·2 % NaCl), received throughout pregnancy and for 7 d after delivery. On postnatal day 7, the pups were euthanised and their cerebellum, hypothalamus, hippocampus, prefrontal and parietal cortices were dissected. Maternal high-salt diet reduced cerebellar mitochondrial mass and membrane potential, promoted an increase in reactive oxygen species allied to superoxide dismutase activation and decreased offspring cerebellar nitric oxide levels. A significant increase in hypothalamic nitric oxide levels and mitochondrial superoxide in the hippocampus and prefrontal cortex was observed in the maternal high-salt group. Antioxidant enzymes were differentially modulated by oxidant increases in each brain area studied. Taken together, our results suggest that a maternal high-salt diet during pregnancy and lactation programmes the brain metabolism of offspring, favouring impaired mitochondrial function and promoting an oxidative environment; this highlights the adverse effect of high-salt intake in the health state of the offspring.
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81
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Fichtl A, Büttner A, Hof PR, Schmitz C, Kiessling MC. Delineation of Subregions in the Early Postnatal Human Cerebellum for Design-Based Stereologic Studies. Front Neuroanat 2018; 11:134. [PMID: 29358908 PMCID: PMC5766680 DOI: 10.3389/fnana.2017.00134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 12/20/2017] [Indexed: 01/05/2023] Open
Abstract
Recent design-based stereologic studies have shown that the early postnatal (<1 year of age) human cerebellum is characterized by very high plasticity and may thus be very sensitive to external and internal influences during the first year of life. A potential weakness of these studies is that they were not separately performed on functionally relevant subregions of the cerebellum, as was the case in a few design-based stereologic studies on the adult human cerebellum. The aim of the present study was to assess whether it is possible to identify unequivocally the primary, superior posterior, horizontal, ansoparamedian, and posterolateral fissures in the early postnatal human cerebellum, based on which functionally relevant subregions could be delineated. This was tested in 20 human post mortem cerebellar halves from subjects aged between 1 day and 11 months by means of a combined macroscopic and microscopic approach. We found that the superior posterior, horizontal, and posterolateral fissures can be reliably identified on all of the specimens. However, reliable and reproducible identification of the primary and ansoparamedian fissures was not possible. Accordingly, it appears feasible to perform subregion-specific investigations in the early postnatal human cerebellum when the identification of subregions is restricted to crus I (bordered by the superior posterior and horizontal fissures) and the flocculus (bordered by the posterolateral fissure). As such, it is recommended to define the entire cerebellar cortex as the region of interest in design-based stereologic studies on the early postnatal human cerebellum to guarantee reproducibility of results.
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Affiliation(s)
- Anna Fichtl
- Chair of Neuroanatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Andreas Büttner
- Institute of Forensic Medicine, University of Rostock, Rostock, Germany
| | - Patrick R Hof
- Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Christoph Schmitz
- Chair of Neuroanatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maren C Kiessling
- Chair of Neuroanatomy, Faculty of Medicine, Institute of Anatomy, Ludwig-Maximilians-Universität München, Munich, Germany
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82
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Affiliation(s)
- Vincent M Vacca
- Vincent M. Vacca, Jr., is a clinical nurse educator in the Neuroscience Intensive Care Unit at Brigham & Women's Hospital, Boston, Mass
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83
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Du Y, Liu J, Jiang Q, Duan Q, Mao L, Ma F. Paraflocculus plays a role in salicylate-induced tinnitus. Hear Res 2017; 353:176-184. [PMID: 28687184 DOI: 10.1016/j.heares.2017.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/23/2017] [Accepted: 06/28/2017] [Indexed: 12/17/2022]
Abstract
Tinnitus impairs quality of life of about 1-2% of the whole population. In most severe situation, tinnitus may cause social isolation, depression and suicide. Drug treatments for tinnitus are generally ineffective, and the mechanisms of tinnitus are still undetermined. Accumulating evidence suggests that tinnitus is related to changes of widespread brain networks. Recent studies propose that paraflocculus (PFL), which is indirectly connected to various cortical regions, may be a gating zone of tinnitus. So we examined the electrophysiological changes and neurotransmitter alterations of the PFL in a rat model of sodium salicylate (SS)-induced tinnitus. We found that spontaneous firing rate (SFR) of the putative excitatory interneurons of the PFL was significantly increased. The level of glutamic acid, which is the main excitatory neurotransmitter in the nervous system, was also dramatically increased in the PFL after SS treatment. These results confirmed the hyperactivity of PFL in the rats with SS-treatment, which might be due to the increased glutamic acid. Then we examined the SFR of the auditory cortex (AC), the center for auditory perception, before and after electrical stimulation of the PFL. 71.4% (105/147) of the recorded neurons showed a response to the stimulation of the PFL. The result demonstrated that stimulation of the PFL could modulate the activity of the AC. Our study suggests a role of PFL in SS-induced tinnitus and AC as a potential target of PFL in the process of tinnitus.
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Affiliation(s)
- Yali Du
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, PR China
| | - Junxiu Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, PR China
| | - Qin Jiang
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, the Chinese Academy of Sciences, Beijing, 100190, PR China
| | - Qingchuan Duan
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, PR China
| | - Lanqun Mao
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, the Chinese Academy of Sciences, Beijing, 100190, PR China.
| | - Furong Ma
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, PR China.
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84
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Different subregional metabolism patterns in patients with cerebellar ataxia by 18F-fluorodeoxyglucose positron emission tomography. PLoS One 2017; 12:e0173275. [PMID: 28319124 PMCID: PMC5358749 DOI: 10.1371/journal.pone.0173275] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/17/2017] [Indexed: 11/19/2022] Open
Abstract
We evaluated cerebellar subregional metabolic alterations in patients with cerebellar ataxia, a representative disease involving the spinocerebellum. We retrospectively analyzed 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) images in 44 patients with multiple system atrophy of the cerebellar type (MSA-C), 9 patients with spinocerebellar ataxia (SCA) type 2, and 14 patients with SCA type 6 and compared with 15 patients with crossed cerebellar diaschisis (CCD) and 89 normal controls. Cerebellar subregional metabolism was assessed using 13 cerebellar subregions (bilateral anterior lobes [ANT], superior/mid/inferior posterior lobes [SUPP/MIDP/INFP], dentate nucleus [DN], anterior vermis [ANTV], and superior/inferior posterior vermis [SUPV/INFV]) to determine FDG uptake ratios. MSA-C and SCA type 2 showed severely decreased metabolic ratios in all cerebellar subregions compared to normal controls (ANT, 0.58 ± 0.08 and 0.50 ± 0.06 vs. 0.82 ± 0.07, respectively, p < 0.001). SCA type 6 showed lower metabolic ratios in almost all cerebellar subregions (ANT, 0.57 ± 0.06, p < 0.001) except INFV. Anterior-posterior lobe ratio measurements revealed that SCA type 2 (Right, 0.81 ± 0.05 vs. 0.88 ± 0.04, p < 0.001; Left, 0.83 ± 0.05 vs. 0.88 ± 0.04, p = 0.003) and SCA type 6 (Right, 0.72 ± 0.05 vs. 0.88 ± 0.04, p < 0.001; Left, 0.72 ± 0.05 vs. 0.88 ± 0.04, p < 0.001) showed preferential hypometabolism in the anterior lobe compared to normal controls, which was not observed in CCD and MSA-C. Asymmetric indices were higher in CCD and MSA-C than in normal controls (p < 0.001), whereas such differences were not found in SCA types 2 and 6. In summary, quantitative analysis of cerebellar subregional metabolism ratios revealed preferential involvement of the anterior lobe, corresponding to the spinocerebellum, in patients with cerebellar ataxia, whereas patients with CCD and MSA-C exhibited more asymmetric hypometabolism in the posterior lobe.
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85
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The Role of the Pediatric Cerebellum in Motor Functions, Cognition, and Behavior: A Clinical Perspective. Neuroimaging Clin N Am 2017; 26:317-29. [PMID: 27423796 DOI: 10.1016/j.nic.2016.03.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This article discusses the contribution of the pediatric cerebellum to locomotion, ocular motor control, speech articulation, cognitive function, and behavior modulation. Hypotheses on cerebellar function are discussed. Clinical features in patients with cerebellar disorders are outlined. Cerebellar abnormalities in cognitive and behavioral disorders are detailed.
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86
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Longitudinal Changes in Cerebellar and Thalamic Spontaneous Neuronal Activity After Wide-Awake Surgery of Brain Tumors: a Resting-State fMRI Study. THE CEREBELLUM 2017; 15:451-65. [PMID: 26231514 DOI: 10.1007/s12311-015-0709-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hypometabolism has been observed in the contralesional cerebellar hemisphere after various supratentorial cortical lesions. It is unknown whether the consequences of the dee- and deafferentation subsequent to wide-awake surgery for brain diffuse low-grade glioma can be assessed within remote and unresected subcortical structures such as the cerebellum or thalamus. To answer this question, we have conducted several regional analyses. More specifically, we have performed amplitude of low-frequency fluctuations (neuronal activity magnitude) and regional homogeneity (local temporal correlations) analyses on resting state functional magnetic resonance imaging (rs-fMRI) data and at different time points, before and after surgery. Our main results demonstrated that it is possible to evaluate subtle subcortical changes using these tools dedicated to the analysis of rs-fMRI data. The observed variations of spontaneous neuronal activity were particularly significant within the cerebellum which showed altered regional homogeneity and neuronal activity intensity in very different, specialized and non-overlapping subregions, in accordance to its neuro-anatomo-functional topography. These variations were moreover observed in the immediate postoperative period and recovered after 3 months.
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Torres-da-Silva KR, Da Silva AV, Barioni NO, Tessarin GWL, De Oliveira JA, Ervolino E, Horta-Junior JAC, Casatti CA. Neurochemistry study of spinal cord in non-human primate (Sapajus spp.). Eur J Histochem 2016; 60:2623. [PMID: 27734991 PMCID: PMC5062631 DOI: 10.4081/ejh.2016.2623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 08/07/2016] [Accepted: 08/17/2016] [Indexed: 02/06/2023] Open
Abstract
The spinal cord is involved in local, ascending and descending neural pathways. Few studies analyzed the distribution of neuromediators in the laminae of non-human primates along all segments. The present study described the classic neuromediators in the spinal cord of the non-human primate Sapajus spp. through histochemical and immunohistochemical methods. Nicotinamide adenine dinucleotide hydrogen phosphate-diaphorase (NADPH-d) method showed neuronal somata in the intermediolateral column (IML), central cervical nucleus (CCN), laminae I, II, III, IV, V, VI, VII, VIII and X, besides dense presence of nerve fibers in laminae II and IX. Acetylcholinesterase (AChE) activity was evident in the neuronal somata in laminae V, VI, VII, VIII, IX, CCN, IML and in the Clarke’s column (CC). Immunohistochemistry data revealed neuronal nitric oxide synthase (nNOS) immunoreactivity in neuronal somata and in fibers of laminae I, II, III, VII, VIII, X and IML; choline acetyltransferase (ChAT) in neuronal somata and in fibers of laminae VII, VIII and IX; calcitonin gene-related peptide (CGRP) was noticed in neuronal somata of lamina IX and in nerve fibers of laminae I, II, III, IV, V, VI and VII; substance P (SP) in nerve fibers of laminae I, II, III, IV, V, VI, VII, VIII, IX, X, CCN, CC and IML; serotonin (5-HT) and vesicular glutamate transporter-1 (VGLUT1) was noticed in nerve fibers of all laminae; somatostatin (SOM) in neuronal somata of laminae III, IV, V, VI, VII, VIII and IX and nerve fibers in laminae I, II, V, VI, VII, X and IML; calbindin (Cb) in neuronal somata of laminae I, II, VI, VII, IX and X; parvalbumin (PV) was found in neuronal somata and in nerve fibers of laminae III, IV, V, VI, VII, VIII, IX and CC; finally, gamma-amino butyric acid (GABA) was present in neuronal somata of laminae V, VI, VII, VIII, IX and X. This study revealed interesting results concerning the chemoarchitecture of the Sapajus spp. spinal cord with a distribution pattern mostly similar to other mammals. The data corroborate the result described in literature, except for some differences in CGRP, SP, Cb, PV and GABA immunoreactivities present in neuronal somata and in nerve fibers. This could suggest certain specificity for the neurochemistry distribution in this non-human primate species, besides adding relevant data to support further studies related to processes involving spinal cord components.
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88
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Cortical connectivity modulation induced by cerebellar oscillatory transcranial direct current stimulation in patients with chronic disorders of consciousness: A marker of covert cognition? Clin Neurophysiol 2016; 127:1845-54. [PMID: 26754875 DOI: 10.1016/j.clinph.2015.12.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/09/2015] [Accepted: 12/15/2015] [Indexed: 11/20/2022]
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89
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Dahlem K, Valko Y, Schmahmann JD, Lewis RF. Cerebellar contributions to self-motion perception: evidence from patients with congenital cerebellar agenesis. J Neurophysiol 2016; 115:2280-5. [PMID: 26888100 DOI: 10.1152/jn.00763.2015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 02/16/2016] [Indexed: 11/22/2022] Open
Abstract
The cerebellum was historically considered a brain region dedicated to motor control, but it has become clear that it also contributes to sensory processing, particularly when sensory discrimination is required. Prior work, for example, has demonstrated a cerebellar contribution to sensory discrimination in the visual and auditory systems. The cerebellum also receives extensive inputs from the motion and gravity sensors in the vestibular labyrinth, but its role in the perception of head motion and orientation has received little attention. Drawing on the lesion-deficit approach to understanding brain function, we evaluated the contributions of the cerebellum to head motion perception by measuring perceptual thresholds in two subjects with congenital agenesis of the cerebellum. We used a set of passive motion paradigms that activated the semicircular canals or otolith organs in isolation or combination, and compared results of the agenesis patients with healthy control subjects. Perceptual thresholds for head motion were elevated in the agenesis subjects for all motion protocols, most prominently for paradigms that only activated otolith inputs. These results demonstrate that the cerebellum increases the sensitivity of the brain to the motion and orientation signals provided by the labyrinth during passive head movements.
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Affiliation(s)
- Kilian Dahlem
- Rijksuniversity Groningen University Medical Center, Groningen, The Netherlands; Jenks Vestibular Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Yulia Valko
- Jenks Vestibular Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Neurology, University Hospital Zurich/University of Zurich, Zurich, Switzerland
| | - Jeremy D Schmahmann
- Department of Neurology, Harvard Medical School, Boston, Massachusetts; Ataxia Unit, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; and
| | - Richard F Lewis
- Jenks Vestibular Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Neurology, Harvard Medical School, Boston, Massachusetts; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
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90
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Roostaei T, Sadaghiani S, Park MTM, Mashhadi R, Nazeri A, Noshad S, Salehi MJ, Naghibzadeh M, Moghadasi AN, Owji M, Doosti R, Taheri APH, Rad AS, Azimi A, Chakravarty MM, Voineskos AN, Nazeri A, Sahraian MA. Channelopathy-related SCN10A gene variants predict cerebellar dysfunction in multiple sclerosis. Neurology 2016; 86:410-7. [PMID: 26740675 DOI: 10.1212/wnl.0000000000002326] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 07/27/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To determine the motor-behavioral and neural correlates of putative functional common variants in the sodium-channel NaV1.8 encoding gene (SCN10A) in vivo in patients with multiple sclerosis (MS). METHODS We recruited 161 patients with relapsing-onset MS and 94 demographically comparable healthy participants. All patients with MS underwent structural MRI and clinical examinations (Expanded Disability Status Scale [EDSS] and Multiple Sclerosis Functional Composite [MSFC]). Whole-brain voxel-wise and cerebellar volumetry were performed to assess differences in regional brain volumes between genotype groups. Resting-state fMRI was acquired from 62 patients with MS to evaluate differences in cerebellar functional connectivity. All participants were genotyped for 4 potentially functional SCN10A polymorphisms. RESULTS Two SCN10A polymorphisms in high linkage disequilibrium (r(2) = 0.95) showed significant association with MSFC performance in patients with MS (rs6795970: p = 6.2 × 10(-4); rs6801957: p = 0.0025). Patients with MS with rs6795970(AA) genotype performed significantly worse than rs6795970(G) carriers in MSFC (p = 1.8 × 10(-4)) and all of its subscores. This association was independent of EDSS and cerebellar atrophy. Although the genotype groups showed no difference in regional brain volumes, rs6795970(AA) carriers demonstrated significantly diminished cerebellar functional connectivity with the thalami and midbrain. No significant SCN10A-genotype effect was observed on MSFC performance in healthy participants. CONCLUSIONS Our data suggest that SCN10A variation substantially influences functional status, including prominent effects on motor coordination in patients with MS. These findings were supported by the effects of this variant on a neural system important for motor coordination, namely cerebello-thalamic circuitry. Overall, our findings add to the emerging evidence that suggests that sodium channel NaV1.8 could serve as a target for future drug-based interventions to treat cerebellar dysfunction in MS.
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Affiliation(s)
- Tina Roostaei
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Shokufeh Sadaghiani
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Min Tae M Park
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Rahil Mashhadi
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Aria Nazeri
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Sina Noshad
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Mohammad Javad Salehi
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Maryam Naghibzadeh
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Abdorreza Naser Moghadasi
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Mahsa Owji
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Rozita Doosti
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Amir Pejman Hashemi Taheri
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Ali Shakouri Rad
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Amirreza Azimi
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - M Mallar Chakravarty
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Aristotle N Voineskos
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada
| | - Arash Nazeri
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada.
| | - Mohammad Ali Sahraian
- From the MS Research Center, Neuroscience Institute (T.R., S.S., Aria Nazeri, S.N., M.N., A.N.M., M.O., R.D., A.A., Arash Nazeri, M.A.S.), Interdisciplinary Neuroscience Research Program (T.R., S.S., M.N., Arash Nazeri), Urology Research Center (R.M.), Department of Neurology (A.N.M., M.A.S.), and Department of Radiology (A.P.H.T., A.S.R.), Tehran University of Medical Sciences, Iran; Kimel Family Translational Imaging-Genetics Laboratory (T.R., A.N.V., Arash Nazeri), Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto; Department of Psychiatry (T.R., A.N.V., Arash Nazeri), University of Toronto; Cerebral Imaging Centre (M.T.M.P., M.M.C.), Douglas Mental Health Institute, Verdun; Schulich School of Medicine and Dentistry (M.T.M.P.), Western University, London, Canada; Department of Electrical Engineering (M.J.S.), Sharif University of Technology, Tehran, Iran; Department of Neurology (A.A.), Thomas Jefferson University, Philadelphia, PA; and Departments of Psychiatry and Biomedical Engineering (M.M.C.), McGill University, Montreal, Canada.
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Functional consequences of neurite orientation dispersion and density in humans across the adult lifespan. J Neurosci 2015; 35:1753-62. [PMID: 25632148 DOI: 10.1523/jneurosci.3979-14.2015] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
As humans age, a characteristic pattern of widespread neocortical dendritic disruption coupled with compensatory effects in hippocampus and other subcortical structures is shown in postmortem investigations. It is now possible to address age-related effects on gray matter (GM) neuritic organization and density in humans using multishell diffusion-weighted MRI and the neurite-orientation dispersion and density imaging (NODDI) model. In 45 healthy individuals across the adult lifespan (21-84 years), we used a multishell diffusion imaging and the NODDI model to assess the intraneurite volume fraction and neurite orientation-dispersion index (ODI) in GM tissues. We also determined the functional correlates of variations in GM microstructure by obtaining resting-state fMRI and behavioral data. We found a significant age-related deficit in neocortical ODI (most prominently in frontoparietal regions), whereas increased ODI was observed in hippocampus and cerebellum with advancing age. Neocortical ODI outperformed cortical thickness and white matter fractional anisotropy for the prediction of chronological age in the same individuals. Higher GM ODI sampled from resting-state networks with known age-related susceptibility (default mode and visual association networks) was associated with increased functional connectivity of these networks, whereas the task-positive networks tended to show no association or even decreased connectivity. Frontal pole ODI mediated the negative relationship of age with executive function, whereas hippocampal ODI mediated the positive relationship of age with executive function. Our in vivo findings align very closely with the postmortem data and provide evidence for vulnerability and compensatory neural mechanisms of aging in GM microstructure that have functional and cognitive impact in vivo.
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