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Wang S, Xiao Y, Hou Y, Li C, Zhang L, Ou R, Wei Q, Lin J, Yang T, Che N, Jiang Q, Zheng X, Liu J, Shang H. Comparison of spontaneous brain activity in distinguishing parkinsonian variant of multiple system atrophy from Parkinson's disease at an early stage. Front Aging Neurosci 2024; 16:1427991. [PMID: 39267719 PMCID: PMC11390528 DOI: 10.3389/fnagi.2024.1427991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 08/19/2024] [Indexed: 09/15/2024] Open
Abstract
Background The overlapping clinical manifestations in parkinsonian variant of multiple system atrophy (MSA-P) and Parkinson's Disease (PD) can complicate clinical diagnostic accuracy, particularly in the early stage. The study aims to uncover the patterns of brain function in the initial phase of the two conditions. Methods We recruited 24 MSA-P patients, 34 PD patients and 27 healthy controls (HC). Voxel-wise fractional amplitude of low-frequency fluctuation (fALFF) was compared to characterize regional brain function, followed by seed-based functional connectivity (FC) analysis. Receiver operating characteristic (ROC) analyses were used to examine the diagnostic accuracy of fALFF. Results Compared to HC, decreased fALFF was observed in the bilateral basal ganglia (BG) of MSA-P patients, while decreased fALFF was identified in the left BG of PD patients. Additionally, elevated fALFF was found in the superior cerebellum for MSA-P patients and the temporo-occipital cortex for PD patients. Furthermore, PD patients exhibited increased FC in the cortico-striatal loop compared to MSA-P patients. The fALFF of the left caudate distinguished MSA-P from HC with an area under the curve (AUC) of 0.838 (p < 0.001) and from PD with an AUC of 0.772 (p < 0.001). The fALFF of the left putamen distinguished PD from HC with an AUC of 0.736 (p = 0.002). Conclusion Our findings indicated common and distinct abnormalities in spontaneous brain activity within BG, cerebellum, and cortices in early-stage MSA-P and PD patients. PD patients employed more compensatory mechanisms than MSA-P patients. Furthermore, fALFF may aid in early differentiation between MSA-P and PD.
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Affiliation(s)
- Shichan Wang
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Yi Xiao
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Yanbing Hou
- National Clinical Research Center for Geriatrics (WCH), West China Hospital, Sichuan University, Chengdu, China
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Chunyu Li
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Lingyu Zhang
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Ruwei Ou
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Qianqian Wei
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Junyu Lin
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Tianmi Yang
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Ningning Che
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Qirui Jiang
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Xiaoting Zheng
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Jiyong Liu
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
| | - Huifang Shang
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Department of Neurology, Sichuan University, Chengdu, China
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2
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Abram SV, Hua JPY, Nicholas S, Roach B, Keedy S, Sweeney JA, Mathalon DH, Ford JM. Pons-to-Cerebellum Hypoconnectivity Along the Psychosis Spectrum and Associations With Sensory Prediction and Hallucinations in Schizophrenia. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:693-702. [PMID: 38311290 PMCID: PMC11227403 DOI: 10.1016/j.bpsc.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/10/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Sensory prediction allows the brain to anticipate and parse incoming self-generated sensory information from externally generated signals. Sensory prediction breakdowns may contribute to perceptual and agency abnormalities in psychosis (hallucinations, delusions). The pons, a central node in a cortico-ponto-cerebellar-thalamo-cortical circuit, is thought to support sensory prediction. Examination of pons connectivity in schizophrenia and its role in sensory prediction abnormalities is lacking. METHODS We examined these relationships using resting-state functional magnetic resonance imaging and the electroencephalography-based auditory N1 event-related potential in 143 participants with psychotic spectrum disorders (PSPs) (with schizophrenia, schizoaffective disorder, or bipolar disorder); 63 first-degree relatives of individuals with psychosis; 45 people at clinical high risk for psychosis; and 124 unaffected comparison participants. This unique sample allowed examination across the psychosis spectrum and illness trajectory. Seeding from the pons, we extracted average connectivity values from thalamic and cerebellar clusters showing differences between PSPs and unaffected comparison participants. We predicted N1 amplitude attenuation during a vocalization task from pons connectivity and group membership. We correlated participant-level connectivity in PSPs and people at clinical high risk for psychosis with hallucination and delusion severity. RESULTS Compared to unaffected comparison participants, PSPs showed pons hypoconnectivity to 2 cerebellar clusters, and first-degree relatives of individuals with psychosis showed hypoconnectivity to 1 of these clusters. Pons-to-cerebellum connectivity was positively correlated with N1 attenuation; only PSPs with heightened pons-to-postcentral gyrus connectivity showed this pattern, suggesting a possible compensatory mechanism. Pons-to-cerebellum hypoconnectivity was correlated with greater hallucination severity specifically among PSPs with schizophrenia. CONCLUSIONS Deficient pons-to-cerebellum connectivity linked sensory prediction network breakdowns with perceptual abnormalities in schizophrenia. Findings highlight shared features and clinical heterogeneity across the psychosis spectrum.
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Affiliation(s)
- Samantha V Abram
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California; San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Jessica P Y Hua
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California; San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Spero Nicholas
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Brian Roach
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Sarah Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California; San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Judith M Ford
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California; San Francisco Veterans Affairs Health Care System, San Francisco, California.
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Feil K, Rattay TW, Adeyemi AK, Goldschagg N, Strupp ML. [What's behind cerebellar dizziness? - News on diagnosis and therapy]. Laryngorhinootologie 2024; 103:337-343. [PMID: 37989215 DOI: 10.1055/a-2192-7278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Vertigo and dizziness comprise a multisensory and multidisciplinary syndrome of different etiologies. The term "cerebellar vertigo and dizziness" comprises a heterogenous group of disorders with clinical signs of cerebellar dysfunction and is caused by vestibulo-cerebellar, vestibulo-spinal or cerebellar systems. About 10 % of patients in an outpatient clinic for vertigo and balance disorders suffer from cerebellar vertigo and dizziness. According to the course of the symptoms, one can considers 3 types: permanent complaints, recurrent episodes of vertigo and balance disorders, or an acute onset of complaints. The most common diagnoses in patients with cerebellar vertigo and dizziness were as follows: degenerative disease, hereditary forms and acquired forms. In a subgroup of patients with cerebellar vertigo, central cerebellar oculomotor dysfunction is indeed the only clinical correlate of the described symptoms. 81 % of patients with cerebellar vertigo suffer from permanent, persistent vertigo and dizziness, 31 % from vertigo attacks, and 21 % from both. Typical clinical cerebellar signs, including gait and limb ataxia or dysarthria, were found less frequently. Key to diagnosis is a focused history as well as a thorough clinical examination with particular attention to oculomotor function. Regarding oculomotor examination, the most common findings were saccadic smooth pursuit, gaze-evoked nystagmus, provocation nystagmus, rebound nystagmus, central fixation nystagmus, most commonly downbeat nystagmus, and disturbances of saccades. Thus, oculomotor examination is very sensitive in diagnosing cerebellar vertigo and dizziness, but not specific in distinguishing different etiologies. Laboratory examinations using posturography and a standardized gait analysis can support the diagnosis, but also help to estimate the risk of falls and to quantify the course and possible symptomatic treatment effects. Patients with cerebellar vertigo and dizziness should receive multimodal treatment.
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Affiliation(s)
- Katharina Feil
- Schwerpunkt neurovaskuläre Erkrankungen, Neurologische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Tim W Rattay
- Schwerpunkt neurodegenerative Erkrankungen, Neurologische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany
- Hertie-Institut für klinische Hirnforschung, Universitätsklinikum Tübingen, Tübingen
| | - Adedolapo Kamaldeen Adeyemi
- Schwerpunkt neurovaskuläre Erkrankungen, Neurologische Universitätsklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Nicolina Goldschagg
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Germany
- Deutsches Schwindel- und Gleichgewichtszentrum, DSGZ, Ludwig-Maximilians-Universität München, München, Germany
| | - Michael Leo Strupp
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Germany
- Deutsches Schwindel- und Gleichgewichtszentrum, DSGZ, Ludwig-Maximilians-Universität München, München, Germany
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4
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Peña-Casanova J, Sánchez-Benavides G, Sigg-Alonso J. Updating functional brain units: Insights far beyond Luria. Cortex 2024; 174:19-69. [PMID: 38492440 DOI: 10.1016/j.cortex.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/15/2024] [Accepted: 02/15/2024] [Indexed: 03/18/2024]
Abstract
This paper reviews Luria's model of the three functional units of the brain. To meet this objective, several issues were reviewed: the theory of functional systems and the contributions of phylogenesis and embryogenesis to the brain's functional organization. This review revealed several facts. In the first place, the relationship/integration of basic homeostatic needs with complex forms of behavior. Secondly, the multi-scale hierarchical and distributed organization of the brain and interactions between cells and systems. Thirdly, the phylogenetic role of exaptation, especially in basal ganglia and cerebellum expansion. Finally, the tripartite embryogenetic organization of the brain: rhinic, limbic/paralimbic, and supralimbic zones. Obviously, these principles of brain organization are in contradiction with attempts to establish separate functional brain units. The proposed new model is made up of two large integrated complexes: a primordial-limbic complex (Luria's Unit I) and a telencephalic-cortical complex (Luria's Units II and III). As a result, five functional units were delineated: Unit I. Primordial or preferential (brainstem), for life-support, behavioral modulation, and waking regulation; Unit II. Limbic and paralimbic systems, for emotions and hedonic evaluation (danger and relevance detection and contribution to reward/motivational processing) and the creation of cognitive maps (contextual memory, navigation, and generativity [imagination]); Unit III. Telencephalic-cortical, for sensorimotor and cognitive processing (gnosis, praxis, language, calculation, etc.), semantic and episodic (contextual) memory processing, and multimodal conscious agency; Unit IV. Basal ganglia systems, for behavior selection and reinforcement (reward-oriented behavior); Unit V. Cerebellar systems, for the prediction/anticipation (orthometric supervision) of the outcome of an action. The proposed brain units are nothing more than abstractions within the brain's simultaneous and distributed physiological processes. As function transcends anatomy, the model necessarily involves transition and overlap between structures. Beyond the classic approaches, this review includes information on recent systemic perspectives on functional brain organization. The limitations of this review are discussed.
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Affiliation(s)
- Jordi Peña-Casanova
- Integrative Pharmacology and Systems Neuroscience Research Group, Neuroscience Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Bellaterra, Barcelona, Spain; Test Barcelona Services, Teià, Barcelona, Spain.
| | | | - Jorge Sigg-Alonso
- Department of Behavioral and Cognitive Neurobiology, Institute of Neurobiology, National Autonomous University of México (UNAM), Queretaro, Mexico
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Campbell T, Diuguid C, Vasaya S, Janda P, Vickers A. Mixed Aphasia Caused by Bilateral Cerebellar Infarcts: a Case Report. CEREBELLUM (LONDON, ENGLAND) 2024; 23:255-259. [PMID: 36690828 DOI: 10.1007/s12311-023-01521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
Although neuroanatomical and physiological understanding of the cerebellum has evolved over recent decades and continues to develop, there is much that remains to be expounded upon, especially with regard to nonmotor roles. Neurocognitive and language processing is one area where involvement of the cerebellum is no longer in question, but the extent and mechanism of this relationship have yet to be defined. For example, which of the cerebellar hemispheres is involved continues to be debated. We present a case wherein a thrombus in the basilar artery led to bihemispheric cerebellar strokes with profound mixed effects on the patient's language and cognition. To the authors' knowledge, this is the first reported case of bilateral cerebellar strokes resulting in a mixed aphasia reported in scientific literature. This demonstrates the importance of continued research into a model for cerebellar function and the clinical impact of lesions to various cerebellar regions.
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Affiliation(s)
- Taylor Campbell
- Valley Hospital Medical Center, Las Vegas, USA.
- Las Vegas Neurology Center, 2020 Wellness Way Ste. 300, Las Vegas, NV, 89106, USA.
| | - Christy Diuguid
- Kirk Kerkorian School of Medicine at University of Nevada Las Vegas, 1650 W Charleston Blvd, NV, 89016, Las Vegas, USA
| | - Sannah Vasaya
- Valley Hospital Medical Center, Las Vegas, USA
- Las Vegas Neurology Center, 2020 Wellness Way Ste. 300, Las Vegas, NV, 89106, USA
| | - Paul Janda
- Valley Hospital Medical Center, Las Vegas, USA
- Las Vegas Neurology Center, 2020 Wellness Way Ste. 300, Las Vegas, NV, 89106, USA
- Neurology, Touro University Nevada, Henderson, USA
| | - Aroucha Vickers
- Valley Hospital Medical Center, Las Vegas, USA
- Las Vegas Neurology Center, 2020 Wellness Way Ste. 300, Las Vegas, NV, 89106, USA
- Neurology and Neuro-Ophthalmology, Touro University Nevada, Henderson, USA
- Neuro-Ophthalmology Department, Las Vegas Neurology Center, Las Vegas, USA
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6
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van der Giessen RS, Satoer D, Koudstaal PJ. The CODECS study: COgnitive DEficits in Cerebellar Stroke. Brain Cogn 2023; 173:106102. [PMID: 37922627 DOI: 10.1016/j.bandc.2023.106102] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/28/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
Part of the extra-pyramidal system, the cerebellum is more and more recognized by its non-motor functions known as the cerebellar cognitive affective syndrome. Several studies have identified disturbances specifically in executive and attentional functions after focal cerebellar lesions. However, most studies were performed in small and heterogeneous patient groups. Furthermore, there is a substantial variation in the methodology of assessment. Here, we present the results of a large and homogeneous cohort of patients with isolated uniform cerebellar lesions. After three months post-stroke all patients underwent structural neuroimaging to confirm an isolated lesion and were given neuropsychological testing. The results show that cerebellar lesions relate to mild but long-term cognitive impairment in a broad spectrum of neurocognitive functions compared to normative values. These findings confirm involvement of the cerebellum in cognitive processing and supports the theory of 'dysmetria of thought' based upon uniform cerebellar processing in multiple cognitive domains. This study highlights the following results: 1-Cognitive impairments after isolated cerebellar stroke is confirmed in several cognitive domains. 2-Semantic and phonemic fluency are most affected in cerebellar stroke patients. 3-Verbal deficits show an age-independent long term effect post-stroke and should be studied further in depth. 4-Cognitive disorders after cerebellar stroke are more prominent in women than men.
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Affiliation(s)
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus University, Rotterdam, The Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus University, Rotterdam, The Netherlands
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7
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Kang Q, Lang EJ, Sahin M. Transsynaptic entrainment of cerebellar nuclear cells by alternating currents in a frequency dependent manner. Front Neurosci 2023; 17:1282322. [PMID: 38027520 PMCID: PMC10667418 DOI: 10.3389/fnins.2023.1282322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Transcranial alternating current stimulation (tACS) is a non-invasive neuromodulation technique that is being tested clinically for treatment of a variety of neural disorders. Animal studies investigating the underlying mechanisms of tACS are scarce, and nearly absent in the cerebellum. In the present study, we applied 10-400 Hz alternating currents (AC) to the cerebellar cortex in ketamine/xylazine anesthetized rats. The spiking activity of cerebellar nuclear (CN) cells was transsynaptically entrained to the frequency of AC stimulation in an intensity and frequency-dependent manner. Interestingly, there was a tuning curve for modulation where the frequencies in the midrange (100 and 150 Hz) were more effective, although the stimulation frequency for maximum modulation differed for each CN cell with slight dependence on the stimulation amplitude. CN spikes were entrained with latencies of a few milliseconds with respect to the AC stimulation cycle. These short latencies and that the transsynaptic modulation of the CN cells can occur at such high frequencies strongly suggests that PC simple spike synchrony at millisecond time scales is the underlying mechanism for CN cell entrainment. These results show that subthreshold AC stimulation can induce such PC spike synchrony without resorting to supra-threshold pulse stimulation for precise timing. Transsynaptic entrainment of deep CN cells via cortical stimulation could help keep stimulation currents within safety limits in tACS applications, allowing development of tACS as an alternative treatment to deep cerebellar stimulation. Our results also provide a possible explanation for human trials of cerebellar stimulation where the functional impacts of tACS were frequency dependent.
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Affiliation(s)
- Qi Kang
- Biomedical Engineering Department, New Jersey Institute of Technology, Newark, NJ, United States
| | - Eric J. Lang
- Department of Neuroscience and Physiology, Neuroscience Institute, New York University Grossman School of Medicine, New York City, NY, United States
| | - Mesut Sahin
- Biomedical Engineering Department, New Jersey Institute of Technology, Newark, NJ, United States
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Batin S, Payas A, Bal E, Ekinci Y, Kurtoğlu E, Uçar I, Arik M, Seber T, Varol BK, Ulusoy EK, Bayram AK, Ekinci D, Unur E. Evaluation of cerebellum volume and trunk oscillation velocity in cases with adolescent idiopathic scoliosis: a preliminary report. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:4012-4019. [PMID: 37725163 DOI: 10.1007/s00586-023-07948-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE It has been suggested that the cause of the balance disorder seen in adolescent idiopathic scoliosis (AIS) originates from the central nervous system. However, the extent of the balance problem and the dysfunction of which part of the central nervous system has not been investigated in detail. This study aimed to correlate the values obtained by balance analysis and cerebellum volume measurement in female individuals with AIS with healthy individuals. METHODS Cerebellum volume was calculated via the cloud-based software " https://volbrain.upv.es " using brain magnetic resonance images of 27 healthy and 26 individuals with AIS. The duration of stay in the test positions, the movement strategy used during this time and the amount of postural sway were analyzed by using a computer-assisted force platform and compared statistically. RESULTS Significant differences were found between the AIS and control groups in cerebellum total volume, vermis cerebelli volume (cm3), and trunk oscillation velocity (mm/s) parameters (p < 0.05). Cerebellum and vermis cerebelli volumes were found to be lower and trunk oscillation velocity was found to be greater in patients with AIS. CONCLUSION Balance problems in patients with AIS are correlated with decreased cerebellum volume and increased trunk oscillation velocity.
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Affiliation(s)
- Sabri Batin
- Department of Traumatology, Kayseri City Education and Training Hospital Orthopedics, Kayseri, Turkey
| | - Ahmet Payas
- Vocational College of Sungurlu, Hitit University, Çorum, Turkey
| | - Emre Bal
- Fatih Sultan Mehmet Education and Training Hospital Orthopedics and Traumatology Department, Istanbul, Turkey
| | - Yakup Ekinci
- Department of Traumatology, Kayseri City Education and Training Hospital Orthopedics, Kayseri, Turkey.
| | - Erdal Kurtoğlu
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ilyas Uçar
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mustafa Arik
- Orthopedics and Traumatology Department, Aksaray Ortaköy Public Hospital, Aksaray, Turkey
| | - Turgut Seber
- Radiology Department, Kayseri City Education and Training Hospital, Kayseri, Turkey
| | - Büşra Kepenek Varol
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri, Turkey
| | | | - Ayşe Kaçar Bayram
- Pediatric Neurology Clinic, Kayseri City Education and Training Hospital, Kayseri, Turkey
| | - Duygu Ekinci
- Pediatrics Clinic, Kayseri City Education and Training Hospital, Kayseri, Turkey
| | - Erdoğan Unur
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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9
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Hogan D, Bishburg E, Suryadevara M. Cerebellitis associated with cryptococcal-immune reconstitution inflammatory syndrome. IDCases 2023; 33:e01790. [PMID: 37273775 PMCID: PMC10236292 DOI: 10.1016/j.idcr.2023.e01790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Cerebellitis associated with cryptococcal immune reconstitution inflammatory syndrome (IRIS) has not been previously reported. We describe a unique case of IRIS associated cerebellitis in an AIDS patient with cryptococcosis.
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10
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Heck DH, Fox MB, Correia Chapman B, McAfee SS, Liu Y. Cerebellar control of thalamocortical circuits for cognitive function: A review of pathways and a proposed mechanism. Front Syst Neurosci 2023; 17:1126508. [PMID: 37064161 PMCID: PMC10097962 DOI: 10.3389/fnsys.2023.1126508] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/13/2023] [Indexed: 04/18/2023] Open
Abstract
There is general agreement that cerebrocerebellar interactions via cerebellothalamocortical pathways are essential for a cerebellar cognitive and motor functions. Cerebellothalamic projections were long believed target mainly the ventral lateral (VL) and part of the ventral anterior (VA) nuclei, which project to cortical motor and premotor areas. Here we review new insights from detailed tracing studies, which show that projections from the cerebellum to the thalamus are widespread and reach almost every thalamic subnucleus, including nuclei involved in cognitive functions. These new insights into cerebellothalamic pathways beyond the motor thalamus are consistent with the increasing evidence of cerebellar cognitive function. However, the function of cerebellothalamic pathways and how they are involved in the various motor and cognitive functions of the cerebellum is still unknown. We briefly review literature on the role of the thalamus in coordinating the coherence of neuronal oscillations in the neocortex. The coherence of oscillations, which measures the stability of the phase relationship between two oscillations of the same frequency, is considered an indicator of increased functional connectivity between two structures showing coherent oscillations. Through thalamocortical interactions coherence patterns dynamically create and dissolve functional cerebral cortical networks in a task dependent manner. Finally, we review evidence for an involvement of the cerebellum in coordinating coherence of oscillations between cerebral cortical structures. We conclude that cerebellothalamic pathways provide the necessary anatomical substrate for a proposed role of the cerebellum in coordinating neuronal communication between cerebral cortical areas by coordinating the coherence of oscillations.
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Affiliation(s)
- Detlef H. Heck
- Department of Biomedical Sciences, University of Minnesota Medical School, Duluth, MN, United States
| | - Mia B. Fox
- Department of Anatomy and Neurobiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Brittany Correia Chapman
- Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Samuel S. McAfee
- St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Yu Liu
- Department of Biomedical Sciences, University of Minnesota Medical School, Duluth, MN, United States
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11
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Zyuzin J, Combs D, Melrose J, Kodaverdian N, Leather C, Carrillo JD, Monterosso JR, Brocas I. The neural correlates of value representation: From single items to bundles. Hum Brain Mapp 2023; 44:1476-1495. [PMID: 36440955 PMCID: PMC9921239 DOI: 10.1002/hbm.26137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 11/30/2022] Open
Abstract
One of the core questions in Neuro-economics is to determine where value is represented. To date, most studies have focused on simple options and identified the ventromedial prefrontal cortex (VMPFC) as the common value region. We report the findings of an fMRI study in which we asked participants to make pairwise comparisons involving options of varying complexity: single items (Control condition), bundles made of the same two single items (Scaling condition) and bundles made of two different single items (Bundling condition). We construct a measure of choice consistency to capture how coherent the choices of a participant are with one another. We also record brain activity while participants make these choices. We find that a common core of regions involving the left VMPFC, the left dorsolateral prefrontal cortex (DLPFC), regions associated with complex visual processing and the left cerebellum track value across all conditions. Also, regions in the DLPFC, the ventrolateral prefrontal cortex (VLPFC) and the cerebellum are differentially recruited across conditions. Last, variations in activity in VMPFC and DLPFC value-tracking regions are associated with variations in choice consistency. This suggests that value based decision-making recruits a core set of regions as well as specific regions based on task demands. Further, correlations between consistency and the magnitude of signal change with lateral portions of the PFC suggest the possibility that activity in these regions may play a causal role in decision quality.
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Affiliation(s)
| | - Dalton Combs
- University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - James Melrose
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Niree Kodaverdian
- Argyros School of Business and EconomicsChapman UniversityOrangeCAUSA
| | - Calvin Leather
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Juan D. Carrillo
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - John R. Monterosso
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Isabelle Brocas
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
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12
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Hou Y, Zhang L, Ou R, Wei Q, Liu K, Lin J, Yang T, Xiao Y, Gong Q, Shang H. Resting-state fMRI study on drug-naïve early-stage patients with Parkinson's disease and with fatigue. Parkinsonism Relat Disord 2022; 105:75-82. [PMID: 36395541 DOI: 10.1016/j.parkreldis.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Fatigue is one of the most common and debilitating non-motor symptoms in patients with Parkinson's disease (PD), which could manifest during the early stage of the disease and persist through the disease course. However, the treatment options for fatigue remain limited for patients with PD. METHODS Using seed-based resting-state functional magnetic resonance imaging, we explored the fatigue-related functional deficiencies in the anterior caudate nucleus, anterior putamen, and posterior putamen in a cohort of early-stage drug-naïve patients with PD. Thirty-eight patients with PD, 19 with and 19 without fatigue, and 31 matched healthy controls were selected. The fatigue status was defined based on the score obtained from the fatigue severity scale (FSS). RESULTS Patients with PD with fatigue exhibited a decreased connectivity in the cerebellar-striatal, cortico-striatal, and mesolimbic-striatal loops. No increased functional connectivity was observed. The abnormal connections of the dorsal striatum subdivisions overlapped to extensive brain regions, including the cerebellum, inferior frontal gyrus, inferior temporal gyrus, lingual gyrus, rolandic operculum, insular, and hippocampus. CONCLUSIONS Our findings revealed that the widespread functional deficiency in the striatal-cerebellar-cerebral cortical network may be critical to the pathology underlying fatigue in the early-stage PD. The key feature of fatigue-related connectivity was observed between the caudate nucleus and the cerebellum, which could serve as a potential biomarker or treatment target for fatigue in early-stage patients with PD in future studies.
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Affiliation(s)
- Yanbing Hou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lingyu Zhang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruwei Ou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianqian Wei
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kuncheng Liu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junyu Lin
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tianmi Yang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Xiao
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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13
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Manto M. The underpinnings of cerebellar ataxias. Clin Neurophysiol Pract 2022; 7:372-387. [PMID: 36504687 PMCID: PMC9731828 DOI: 10.1016/j.cnp.2022.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/07/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022] Open
Abstract
The human cerebellum contains more than 60% of all neurons of the brain. Anatomically, the cerebellum is divided into 10 lobules (I-X). The cerebellar cortex is arranged into three layers: the molecular layer (external), the Purkinje cell layer and the granular layer (internal). Purkinje neurons and interneurons are inhibitory, except for granule cells. The layer of Purkinje neurons inhibit cerebellar nuclei, the sole output of the cerebellar circuitry, as well as vestibular nuclei. The cerebellum is arranged into a series of olivo-cortico-nuclear modules arranged longitudinally in the rostro-caudal plane. The cerebro-cerebellar connectivity is organized into multiple loops running in parallel. From the clinical standpoint, it is now considered that cerebellar symptoms can be gathered into 3 cerebellar syndromes: a cerebellar motor syndrome (CMS), a vestibulocerebellar syndrome (VCS) and a cerebellar cognitive affective syndrome/Schmahmann syndrome (CCAS/SS). CMS remains a cornerstone of modern clinical ataxiology, and relevant lesions involve lobules I-V, VI and VIII. The core feature of cerebellar symptoms is dysmetria, covering motor dysmetria (errors in the metrics of motion) and dysmetria of thought. The cerebellar circuitry plays a key-role in the generation and maintenance of internal models which correspond to neural representations reproducing the dynamic properties of the body. These models allow predictive computations for motor, cognitive, social, and affective operations. Cerebellar circuitry is endowed with noticeable plasticity properties.
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14
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Abram SV, Hua JPY, Ford JM. Consider the pons: bridging the gap on sensory prediction abnormalities in schizophrenia. Trends Neurosci 2022; 45:798-808. [PMID: 36123224 PMCID: PMC9588719 DOI: 10.1016/j.tins.2022.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/04/2022] [Accepted: 08/23/2022] [Indexed: 01/18/2023]
Abstract
A shared mechanism across species heralds the arrival of self-generated sensations, helping the brain to anticipate, and therefore distinguish, self-generated from externally generated sensations. In mammals, this sensory prediction mechanism is supported by communication within a cortico-ponto-cerebellar-thalamo-cortical loop. Schizophrenia is associated with impaired sensory prediction as well as abnormal structural and functional connections between nodes in this circuit. Despite the pons' principal role in relaying and processing sensory information passed from the cortex to cerebellum, few studies have examined pons connectivity in schizophrenia. Here, we first briefly describe how the pons contributes to sensory prediction. We then summarize schizophrenia-related abnormalities in the cortico-ponto-cerebellar-thalamo-cortical loop, emphasizing the dearth of research on the pons relative to thalamic and cerebellar connections. We conclude with recommendations for advancing our understanding of how the pons relates to sensory prediction failures in schizophrenia.
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Affiliation(s)
- Samantha V Abram
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; University of California, San Francisco, CA, USA
| | - Jessica P Y Hua
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; University of California, San Francisco, CA, USA; Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, The University of California, San Francisco, CA, USA
| | - Judith M Ford
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; University of California, San Francisco, CA, USA.
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15
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Kattah JC, Martinez C, Zalazar G, Batuecas Á, Lemos J, Carmona S. Role of incubitus truncal ataxia, and equivalent standing grade 3 ataxia in the diagnosis of central acute vestibular syndrome. J Neurol Sci 2022; 441:120374. [PMID: 36063733 DOI: 10.1016/j.jns.2022.120374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES acute vestibular syndrome is a diagnostic challenge, requiring a rapid and precise diagnosis to take therapeutic actions. Truncal ataxia, inability to sit still, and Babinski flexor dysergy were evaluated. Material anf methods: 52 patients with central pathology (stroke in aica and pica territory) and vestibular neuritis were prospectively studied. MRI of the brain was used as the gold standard. RESULTS A combination of grade 2-3 ataxia to differentiate patients with vestibular neuritis from patients with stroke resulted in a 92% sensitivity (95% CI 79-100%), a 67% specificity (95% CI 47-86%). Flexion asynergy had a 70% sensitivity (95% CI 47-92%), and an 88% specificity (95% CI 69-100%). The inability to sit still correlated well with truncal ataxia. CONCLUSIONS vestibulospinal signs are useful in the differential diagnosis of acute vestibular syndromes, and the inability to sit is a good substitute for truncal ataxia when it cannot be evaluated.
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Affiliation(s)
- Jorge C Kattah
- Professor and Head of Neurology and Neurosurgery, University of Illinois College of Medicine, Peoria. IL, United States
| | | | - Guillermo Zalazar
- Neurologist, Hospital Central Dr. Ramón Carrillo, San Luis, Argentina.
| | - Ángel Batuecas
- Unidad de Otoneurología, Servicio de Otorrinolaringología y Patología Máxilofacial, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Joao Lemos
- Department of Neurology, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Sergio Carmona
- Neuro-otologist, Fundación San Lucas para la Neurociencia, Rosario, Santa Fe, Argentina
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16
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Starowicz-Filip A, Bętkowska-Korpała B, Yablonska T, Kwiatkowski S, Milczarek O, Klasa Ł, Chrobak AA. Involvement of the cerebellum in the regulation of executive functions in children—Preliminary analysis based on a neuropsychological study of children after cerebellar tumour surgery. Front Psychol 2022; 13:961577. [PMID: 36275206 PMCID: PMC9583864 DOI: 10.3389/fpsyg.2022.961577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
Aim Preliminary assessment of executive functions in children with cerebellar lesions, description of their emotional-social functioning and selection of sensitive neuropsychological tools to detect the cerebellar cognitive affective syndrome (CCAS). Materials and methods The study group consisted of 10 children after cerebellar tumour surgery. The control group consisted of 10 healthy children, matched for age and sex: The IDS-2 executive functions battery, the Conners 3 ADHD questionnaire, the Autism Spectrum Rating Scales (ASRS) and the International Cooperative Ataxia Rating Scale (ICARS) were used. Results Statistical analysis showed statistically significant differences between the experimental and control groups in terms of two dimensions of executive functioning. Children from experimental group was characterised by worse planning and divided attention than healthy controls. Moreover children with cerebellar lesions were characterised by significantly higher levels of some behaviours similar to that observed in autism spectrum disorders, namely difficulties in social relationships, self-regulation of emotions, attention, and greater behavioural rigidity. Test power analysis and estimation of the effect size by the Cohen’s d coefficient indicated that with a slight increase in the size of the experimental group, the probability of detecting statistically significant difference in the executive functions total measure score as well as in several ASRS subscales increased, but not in Conners 3 subscales. Conclusions Cerebellar damage may pose a risk for dysexecutive syndrome and social-emotional problems in children. The IDS-2 executive functions battery and the ASRS test are sufficiently sensitive tools to assess elements of the CCAS in children.
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Affiliation(s)
- Anna Starowicz-Filip
- Department of Medical Psychology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
- *Correspondence: Anna Starowicz-Filip,
| | - Barbara Bętkowska-Korpała
- Department of Medical Psychology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tetiana Yablonska
- Department of Developmental Psychology, Faculty of Psychology, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Stanisław Kwiatkowski
- Department of Pediatric Neurosurgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Olga Milczarek
- Department of Pediatric Neurosurgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Klasa
- Department of Pediatric Neurosurgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Adrian Andrzej Chrobak
- Department of Adult Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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17
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Kattah JC, Zalazar G, Martinez C, Carmona S. Truncal ataxia and the vestibulo spinal reflex. A historical review. J Neurol Sci 2022; 441:120375. [PMID: 35988348 DOI: 10.1016/j.jns.2022.120375] [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: 03/31/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 10/15/2022]
Abstract
The vestibulospinal pathway was described many years ago. Along with it, the vestibulospinal signs that are used for the diagnosis of vestibular disorders were described. In this work we summarize the history of the vestibulospinal pathway, the classic signs and the new signs that can be used in the diagnosis of vestibular disorders, paying special attention to truncal ataxia as a useful element to differentiate central from peripheral pathology.
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Affiliation(s)
- Jorge C Kattah
- Professor and Head of Neurology and Neurosurgery, University of Illinois College of Medicine. Peoria, IL, United States
| | - Guillermo Zalazar
- Neurologist, Hospital Central Dr. Ramón Carrillo, San Luis, Argentina.
| | | | - Sergio Carmona
- Neuro-otologist, Fundación San Lucas para la Neurociencia, Rosario, Santa Fe, Argentina
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18
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Valberg SJ. Movement Disorders and Cerebellar Abiotrophy. Vet Clin North Am Equine Pract 2022; 38:409-426. [PMID: 35811199 DOI: 10.1016/j.cveq.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Movement disorders are defined as involuntary movements that are not due to a painful stimulus or associated with changes in consciousness or proprioception. Diagnosis involves ruling out any lameness and neurologic disease and characterizing the gait during walking backward and forward and trotting. Shivers causes abnormal hindlimb hypertonicity during walking backward and, when advanced, a few strides walking forward. Stringhalt causes consistent hyperflexion during walking forward and trotting and variable difficulty when walking backward. Classification and potential causes are discussed as well as other enigmatic movement disorders in horses are presented. Cerebellar abiotrophy is reviewed.
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Affiliation(s)
- Stephanie J Valberg
- Michigan State University, Large Animal Clinical Sciences, College of Veterinary Medicine, 736 Wilson Road, East Lansing, MI 48824, USA.
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19
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Disruption of cerebellar-cortical functional connectivity predicts balance instability in alcohol use disorder. Drug Alcohol Depend 2022; 235:109435. [PMID: 35395501 PMCID: PMC9106918 DOI: 10.1016/j.drugalcdep.2022.109435] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND A neural substrate of alcohol-related instability of gait and balance is the cerebellum. Whether disruption of neural communication between cerebellar and cortical brain regions exerts an influence on ataxia in alcohol use disorder (AUD) was the focus of this study. METHODS Study groups comprised 32 abstinent AUD participants and 22 age- and sex-matched healthy controls (CTL). All participants underwent clinical screening, motor testing, and resting-state functional MR imaging analyzed for functional connectivity (FC) among 90 regions across the whole cerebrum and cerebellum. Ataxia testing quantified gait and balance with the Fregly-Graybiel Ataxia Battery conducted with and without vision. RESULTS The AUD group achieved lower scores than the CTL group on balance performance, which was disproportionately worse for eyes open than eyes closed in the AUD relative to the CTL group. Differences in ataxia were accompanied by differences in FC marked by cerebellar-frontal and cerebellar-parietal hyperconnectivity and cortico-cortical hypoconnectivity in the AUD relative to the control group. Lifetime alcohol consumption correlated significantly with AUD-related FC aberrations, which explained upwards of 69% of the AUD ataxia score variance. CONCLUSION Heavy, chronic alcohol consumption is associated with disorganized neural communication among cerebellar-cortical regions and contributes to ataxia in AUD. Ataxia, which is known to accelerate with age and be exacerbated with AUD, can threaten functional independence. Longitudinal studies are warranted to address whether extended sobriety quells ataxia and normalizes aberrant FC contributing to instability.
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LaGrappe D, Massey L, Kruavit A, Howarth T, Lalara G, Daniels B, Wunungmurra JG, Flavell K, Barker R, Flavell H, Heraganahally SS. Sleep disorders among Aboriginal Australians with Machado-Joseph Disease: Quantitative results from a multiple methods study to assess the experience of people living with the disease and their caregivers. Neurobiol Sleep Circadian Rhythms 2022; 12:100075. [PMID: 35516836 PMCID: PMC9062757 DOI: 10.1016/j.nbscr.2022.100075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/12/2022] [Accepted: 04/17/2022] [Indexed: 12/31/2022] Open
Abstract
Background Machado-Joseph Disease (MJD), or Spinocerebellar Ataxia Type 3 (SCA3), is a genetic disorder that causes progressive muscle weakness, loss of motor control, ataxia and permanent physical disability. Sleep disturbances are associated with MJD but remain poorly understood. Objective To investigate frequency and characteristics of sleep disorders and their association with health-related quality of life and psychosocial wellbeing for Aboriginal Australians living with MJD. Methods A convenience sample of MJD participants n = 24 participated in a semi-attended, ambulatory diagnostic sleep study to capture polysomnography, actigraphy and sleep diary data. Self-report measures collected were the Pittsburgh Sleep Quality Index (PSQI), STOP-BANG Questionnaire for Obstructive Sleep Apnoea (OSA), International Restless Legs Syndrome Study Group rating scale (IRLS), Kessler-5 (K5) and EuroQoL-5 Dimension (EQ5D). Caregivers (n = 22) reported EQ-5D, K5 and bed partners’ sleep behaviour (Mayo Sleep Questionnaire-Informant). Environmental factors were measured. Results We observed Nocturia, Sleep Related Leg Cramps, OSA, REM Behaviour Disorder, and RLS, respectively in 100%, 71%, 47%, 43%, and 33% of participants with a significant positive correlation between Body mass index (BMI) and Apnoea hypopnea index (AHI). The majority of sleep was spent in non-rapid eye movement sleep (NREM)-N2 stage (77.8% (67.7, 81.6)). Overcrowding (92%) and overnight care needs (42%) interrupted sleep. MJD participants and caregivers reported high psychological distress (K5 median 12.5 IQR 7, 16.5 & 8 IQR 6, 12 respectively). Conclusion Poor sleep quality and sleep disturbances are prevalent among this cohort. Disease manifestations and environmental factors are driving factors. Larger sample sizes are required to predict risk factors and confirm observed associations. Aboriginal People living with MJD in Australia experience numerous sleep disorders. Majority of sleep was spent in non-rapid eye movement sleep. Overcrowding and overnight care needs interrupt sleep. MJD participants and caregivers reported high psychological distress.
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Affiliation(s)
- Desireé LaGrappe
- Centre for Disease Control, Public Health Unit, Northern Territory Government Department of Health, O'Keefe House, Katherine Hospital, George Rd, Katherine, Northern Territory, 0850, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Level 3, George Sinclair Building, Bundoora, Victoria, 3086, Australia
| | - Libby Massey
- MJD Foundation, PO Box 414, Alyangula, Northern Territory, 0885, Australia
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Bebegu Yumba, Douglas Campus, 1 James Cook Drive, QLD, 4814, Australia
- Corresponding author. MJD Foundation Ltd, PO Box 414, Alyangula, Northern Territory, 0885, Australia.
| | - Anuk Kruavit
- Adelaide Respiratory, Level 5, Calvary Adelaide Hospital, Adelaide, South Australia, 5000, Australia
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, Northern Territory, 0810, Australia
| | - Timothy Howarth
- College of Health and Human Sciences, Charles Darwin University, Ellengowan Drive, Casuarina, Northern Territory, 0810, Australia
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia
| | - Gayangwa Lalara
- MJD Foundation, PO Box 414, Alyangula, Northern Territory, 0885, Australia
| | - Bronwyn Daniels
- MJD Foundation, PO Box 414, Alyangula, Northern Territory, 0885, Australia
| | | | - Kimberley Flavell
- College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, Adelaide, South Australia, Australia
| | - Ruth Barker
- College of Healthcare Sciences, James Cook University, Box 6811, Cairns, 4870, Townsville, QLD, Australia
| | - Howard Flavell
- Department of Rehabilitation Medicine, Palmerston Regional Hospital, Linco Rd, Holtze, Northern Territory, 0829, Australia
| | - Subash S. Heraganahally
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, Northern Territory, 0810, Australia
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, Adelaide, South Australia, Australia
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21
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Shivering and Stringhalt in horses. Vet J 2022; 282:105829. [PMID: 35462036 DOI: 10.1016/j.tvjl.2022.105829] [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: 11/08/2021] [Revised: 03/02/2022] [Accepted: 04/18/2022] [Indexed: 11/23/2022]
Abstract
Pelvic limb movement disorders unrelated to lameness or proprioceptive ataxia have been described in horses for centuries. The two best described are Shivering and Stringhalt. Shivering is unique in that it is primarily apparent when horses are asked to walk backward, without affecting forward gaits until quite advanced. Horses exhibit abduction and either hyperflexion or marked hyperextension of one or both pelvic limbs when walking backward, resulting in a pause at the peak of the stride cycle and reluctance to move backward. Generally, Stringhalt differs from Shivering in that it produces consistent hyperflexion without abduction in forward gaits including walk and trot. This review will focus on the two most common pelvic limb movement disorders, Shivering and Stringhalt, their clinical presentation, differential diagnosis, etiopathology, and treatment.
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22
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Li H, Yuan Q, Luo YJ, Tao W. A new perspective for understanding the contributions of the cerebellum to reading: The cerebro-cerebellar mapping hypothesis. Neuropsychologia 2022; 170:108231. [DOI: 10.1016/j.neuropsychologia.2022.108231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 02/07/2023]
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Cordani C, Preziosa P, Gatti R, Castellani C, Filippi M, Rocca MA. Mapping brain structure and function in professional fencers: A model to study training effects on central nervous system plasticity. Hum Brain Mapp 2022; 43:3375-3385. [PMID: 35362649 PMCID: PMC9248301 DOI: 10.1002/hbm.25854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/10/2022] [Accepted: 03/16/2022] [Indexed: 11/12/2022] Open
Abstract
Brain magnetic resonance imaging (MRI) studies have shown different patterns of structural and functional reorganization in high‐level athletes compared with controls, but little is known about their relationship with interlimb coordination mechanisms. To this aim, we investigated brain structural and functional differences in high‐level fencers compared with nonathlete controls and the MRI substrates of interlimb coordination in elite athletes. Fourteen right‐handed male fencers (median age = 22.3 years) and 15 right‐handed age‐ and sex‐matched healthy subjects (median age = 22.4 years) underwent structural and functional MRI acquisition during the execution of cyclic bimanual‐movements as well as during in‐phase and antiphase hand/foot‐movements of the dominant‐right limbs. No between‐group differences were found in gray matter volumes and white matter architecture. Active‐fMRI showed that controls versus fencers had higher activations in parietal and temporal areas during bimanual‐task; whereas fencers versus controls had higher activations in the basal ganglia. During in‐phase task, controls versus fencers showed higher activation of right cerebellum, whereas fencers had higher activity mainly in frontal areas. The functional‐connectivity (FC) analysis showed that fencers versus controls had an increased FC between left motor cortex and fronto‐temporal areas as well as bilateral thalami during the different tasks. Intensive and prolonged fencing activity is associated with brain functional changes mainly involving frontal regions related to high‐level motor control and planning of complex tasks. These modifications are likely to reflect an optimization of brain networks involved in motor activities, including interlimb coordination tasks, occurring after intensive training.
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Affiliation(s)
- Claudio Cordani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Gatti
- Humanitas Clinical and Research Center, IRCCS and Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Assunta Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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24
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Grégoire A, Deggouj N, Dricot L, Decat M, Kupers R. Brain Morphological Modifications in Congenital and Acquired Auditory Deprivation: A Systematic Review and Coordinate-Based Meta-Analysis. Front Neurosci 2022; 16:850245. [PMID: 35418829 PMCID: PMC8995770 DOI: 10.3389/fnins.2022.850245] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
Neuroplasticity following deafness has been widely demonstrated in both humans and animals, but the anatomical substrate of these changes is not yet clear in human brain. However, it is of high importance since hearing loss is a growing problem due to aging population. Moreover, knowing these brain changes could help to understand some disappointing results with cochlear implant, and therefore could improve hearing rehabilitation. A systematic review and a coordinate-based meta-analysis were realized about the morphological brain changes highlighted by MRI in severe to profound hearing loss, congenital and acquired before or after language onset. 25 papers were included in our review, concerning more than 400 deaf subjects, most of them presenting prelingual deafness. The most consistent finding is a volumetric decrease in gray matter around bilateral auditory cortex. This change was confirmed by the coordinate-based meta-analysis which shows three converging clusters in this region. The visual areas of deaf children is also significantly impacted, with a decrease of the volume of both gray and white matters. Finally, deafness is responsible of a gray matter increase within the cerebellum, especially at the right side. These results are largely discussed and compared with those from deaf animal models and blind humans, which demonstrate for example a much more consistent gray matter decrease along their respective primary sensory pathway. In human deafness, a lot of other factors than deafness could interact on the brain plasticity. One of the most important is the use of sign language and its age of acquisition, which induce among others changes within the hand motor region and the visual cortex. But other confounding factors exist which have been too little considered in the current literature, such as the etiology of the hearing impairment, the speech-reading ability, the hearing aid use, the frequent associated vestibular dysfunction or neurocognitive impairment. Another important weakness highlighted by this review concern the lack of papers about postlingual deafness, whereas it represents most of the deaf population. Further studies are needed to better understand these issues, and finally try to improve deafness rehabilitation.
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Affiliation(s)
- Anaïs Grégoire
- Department of ENT, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of NeuroScience (IoNS), UCLouvain, Brussels, Belgium
| | - Naïma Deggouj
- Department of ENT, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of NeuroScience (IoNS), UCLouvain, Brussels, Belgium
| | - Laurence Dricot
- Institute of NeuroScience (IoNS), UCLouvain, Brussels, Belgium
| | - Monique Decat
- Department of ENT, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of NeuroScience (IoNS), UCLouvain, Brussels, Belgium
| | - Ron Kupers
- Institute of NeuroScience (IoNS), UCLouvain, Brussels, Belgium
- Department of Neuroscience, Panum Institute, University of Copenhagen, Copenhagen, Denmark
- Ecole d’Optométrie, Université de Montréal, Montréal, QC, Canada
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25
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Machetanz K, Grimm F, Wang S, Schuhmann MU, Tatagiba M, Gharabaghi A, Naros G. Rediscovery of the transcerebellar approach: improving the risk-benefit ratio in robot-assisted brainstem biopsies. Neurosurg Focus 2022; 52:E12. [DOI: 10.3171/2021.10.focus21359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 10/18/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Conventional frame-based stereotaxy through a transfrontal approach (TFA) is the gold standard in brainstem biopsies. Because of the high surgical morbidity and limited impact on therapy, brainstem biopsies are controversial. The introduction of robot-assisted stereotaxy potentially improves the risk-benefit ratio by simplifying a transcerebellar approach (TCA). The aim of this single-center cohort study was to evaluate the risk-benefit ratio of transcerebellar brainstem biopsies performed by 2 different robotic systems. In addition to standard quality indicators, a special focus was set on trajectory selection for reducing surgical morbidity.
METHODS
This study included 25 pediatric (n = 7) and adult (n = 18) patients who underwent 26 robot-assisted biopsies via a TCA. The diagnostic yield, complication rate, trajectory characteristics (i.e., length, anatomical entry, and target-point location), and skin-to-skin (STS) time were evaluated. Transcerebellar and hypothetical transfrontal trajectories were reconstructed and transferred into a common MR space for further comparison with anatomical atlases.
RESULTS
Robot-assisted, transcerebellar biopsies demonstrated a high diagnostic yield (96.2%) while exerting no surgical mortality and no permanent morbidity in both pediatric and adult patients. Only 3.8% of cases involved a transient neurological deterioration. Transcerebellar trajectories had a length of 48.4 ± 7.3 mm using a wide stereotactic corridor via crus I or II of the cerebellum and the middle cerebellar peduncle. The mean STS time was 49.5 ± 23.7 minutes and differed significantly between the robotic systems (p = 0.017). The TFA was characterized by longer trajectories (107.4 ± 11.8 mm, p < 0.001) and affected multiple eloquent structures. Transfrontal target points were located significantly more medial (−3.4 ± 7.2 mm, p = 0.042) and anterior (−3.9 ± 8.4 mm, p = 0.048) in comparison with the transcerebellar trajectories.
CONCLUSIONS
Robot-assisted, transcerebellar stereotaxy can improve the risk-benefit ratio of brainstem biopsies by avoiding the restrictions of a TFA and conventional frame-based stereotaxy. Profound registration and anatomical-functional trajectory selection were essential to reduce mortality and morbidity.
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Affiliation(s)
- Kathrin Machetanz
- Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen
- Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen, Germany
| | - Florian Grimm
- Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen
- Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen, Germany
| | - Sophie Wang
- Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen
| | - Martin U. Schuhmann
- Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen
| | - Marcos Tatagiba
- Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen
| | - Alireza Gharabaghi
- Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen
- Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen, Germany
| | - Georgios Naros
- Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen
- Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen, Germany
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26
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Starowicz-Filip A, Prochwicz K, Kłosowska J, Chrobak AA, Myszka A, Bętkowska-Korpała B, Kwinta B. Cerebellar Functional Lateralization From the Perspective of Clinical Neuropsychology. Front Psychol 2021; 12:775308. [PMID: 34955995 PMCID: PMC8703197 DOI: 10.3389/fpsyg.2021.775308] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: The cerebellar functional laterality, with its right hemisphere predominantly involved in verbal performance and the left one engaged in visuospatial processes, has strong empirical support. However, the clinical observation and single research results show that the damage to the right cerebellar hemisphere may cause extralinguistic and more global cognitive decline. The aim of our research was to assess the pattern of cognitive functioning, depending on the cerebellar lesion side, with particular emphasis on the damage to the right cerebellar hemisphere. Method: The study sample consisted of 31 patients with focal cerebellar lesions and 31 controls, free of organic brain damage. The Addenbrooke’s Cognitive Examination ACE III and the Trail Making Test TMT were used to assess patients’ cognitive functioning. Results: Left-sided cerebellar lesion patients scored lower than controls in attention and visuospatial domain, but not in language, fluency, and memory functions. Participants with right-sided cerebellar lesion demonstrated a general deficit of cognitive functioning, with impairments not only in language and verbal fluency subscales but also in all ACE III domains, including memory, attention, and visuospatial functions. The TMT results proved that cerebellar damage is associated with executive function impairment, regardless of the lesion side. Conclusion: The cognitive profiles of patients with cerebellum lesions differ with regard to the lesion side. Left-sided cerebellar lesions are associated with selective visuospatial and attention impairments, whereas the right-sided ones may result in a more global cognitive decline, which is likely secondary to language deficiencies, associated with this lateral cerebellar injury.
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Affiliation(s)
- Anna Starowicz-Filip
- Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland.,Department of Neurosurgery, University Hospital in Krakow, Kraków, Poland
| | | | - Joanna Kłosowska
- Institute of Psychology, Jagiellonian University, Kraków, Poland
| | | | - Aneta Myszka
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
| | | | - Borys Kwinta
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
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27
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Integrity of the Inferior Cerebellar Peduncle Correlates with Ambulatory Function after Hemorrhagic Stroke. J Stroke Cerebrovasc Dis 2021; 30:106164. [PMID: 34655972 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106164] [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: 07/13/2021] [Revised: 09/28/2021] [Accepted: 10/03/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Cerebro-cerebellar connectivity plays a critical role in motor recovery after stroke; however, the underlying mechanism of walking recovery is unclear. The dorsal spinocerebellar pathway has been suggested as a biomarker of poststroke ambulatory function. We aimed to explore the association between ambulatory function and the dorsal spinocerebellar pathway's integrity after intracerebral hemorrhage (ICH). MATERIALS AND METHODS Twenty-seven patients with ICH who were admitted for inpatient rehabilitation during the subacute phase of stroke and 27 age-matched healthy controls were included retrospectively. Ambulatory function was assessed using the Berg Balance Scale and Mobility score. We measured the fractional anisotropy (FA) values of the corticospinal tract (CST) and inferior cerebellar peduncle (ICP) as the final route of the dorsal spinocerebellar pathway. The FA laterality indices, representing the degree of degeneration, were calculated. A Spearman correlation analysis and multivariate linear regression models were used to determine the associations between the FA laterality indices and ambulatory function. RESULTS An FA reduction was found in both the ipsilesional CST and contralesional ICP of the patients. The ICP FA laterality index exhibited a moderate correlation with ambulatory function (Berg Balance Scale, ρBBS=0.589; Mobility score, ρMS=0.619). On dividing the patient group into the moderate (mRS 3, 4) and severe disability (mRS 5) groups, a stronger correlation was found (ρBBS=0.777, ρMS=0.856, moderate disability; ρBBS=0.732, ρMS=0.797, severe disability). The ICP FA laterality index and age were independently associated with the Mobility score (R2=0.525). CONCLUSIONS ICP degeneration occurs after ICH, and its degree is associated with ambulatory function after ICH.
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28
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Morimoto C, Nakamura Y, Kuwabara H, Abe O, Kasai K, Yamasue H, Koike S. Unique Morphometric Features of the Cerebellum and Cerebellocerebral Structural Correlation Between Autism Spectrum Disorder and Schizophrenia. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:219-228. [PMID: 36325298 PMCID: PMC9616290 DOI: 10.1016/j.bpsgos.2021.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/13/2021] [Accepted: 05/23/2021] [Indexed: 12/13/2022] Open
Abstract
Background Although cerebellar morphological involvement has been increasingly recognized in autism spectrum disorder (ASD) and schizophrenia (SZ), the extent to which there are morphological differences between them has not been definitively quantified. Furthermore, although previous studies have demonstrated increased anatomical cerebellocerebral correlations in both conditions, differences between their associations have not been well characterized. Methods We compared cerebellar volume between males with ASD (n = 31), males with SZ (n = 28), and typically developing males (n = 49). A total of 31 cerebellar subregions were investigated with the cerebellum segmented into their constituent lobules, in gray matter (GM) and white matter (WM) separately. Additionally, structural correlations with the contralateral cerebrum were analyzed for each cerebellar lobule. Results We found significantly larger WM volume in the bilateral lobules VI and Crus I in the ASD group than in other groups. While WM or GM volumes of these right lobules had positive associations with ASD symptoms, there was a negative association between GM volume of the right Crus I and SZ symptoms. We further observed, in the ASD group specifically, significant correlations between WM of the right lobule VI and WM of the left frontal pole (r = 0.67) and between GM of the right lobule VI and the left caudate (r = 0.60). Conclusions Our findings support evidence that cerebellar morphology is involved in ASD and SZ with different mechanisms. Furthermore, this study showed that these biological differences require consideration when determining diagnostic criteria and treatment for these disorders.
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Affiliation(s)
- Chie Morimoto
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yuko Nakamura
- UTokyo Center for Integrative Science of Human Behaviour, Graduate School of Art and Sciences, University of Tokyo, Tokyo, Japan
| | - Hitoshi Kuwabara
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
- Center for Evolutionary Cognitive Science, Graduate School of Art and Sciences, University of Tokyo, Tokyo, Japan
- International Research Center for Neurointelligence, University of Tokyo Institutes for Advanced Study, University of Tokyo, Tokyo, Japan
- UTokyo Institute for Diversity and Adaptation of Human Mind, University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Shinsuke Koike
- UTokyo Center for Integrative Science of Human Behaviour, Graduate School of Art and Sciences, University of Tokyo, Tokyo, Japan
- Center for Evolutionary Cognitive Science, Graduate School of Art and Sciences, University of Tokyo, Tokyo, Japan
- International Research Center for Neurointelligence, University of Tokyo Institutes for Advanced Study, University of Tokyo, Tokyo, Japan
- UTokyo Institute for Diversity and Adaptation of Human Mind, University of Tokyo, Tokyo, Japan
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29
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Parmar K, Fonov VS, Naegelin Y, Amann M, Wuerfel J, Collins DL, Gaetano L, Magon S, Sprenger T, Kappos L, Granziera C, Tsagkas C. Regional Cerebellar Volume Loss Predicts Future Disability in Multiple Sclerosis Patients. THE CEREBELLUM 2021; 21:632-646. [PMID: 34417983 PMCID: PMC9325849 DOI: 10.1007/s12311-021-01312-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 01/18/2023]
Abstract
Cerebellar symptoms in multiple sclerosis (MS) are well described; however, the exact contribution of cerebellar damage to MS disability has not been fully explored. Longer-term observational periods are necessary to better understand the dynamics of pathological changes within the cerebellum and their clinical consequences. Cerebellar lobe and single lobule volumes were automatically segmented on 664 3D-T1-weighted MPRAGE scans (acquired at a single 1.5 T scanner) of 163 MS patients (111 women; mean age: 47.1 years; 125 relapsing–remitting (RR) and 38 secondary progressive (SP) MS, median EDSS: 3.0) imaged annually over 4 years. Clinical scores (EDSS, 9HPT, 25FWT, PASAT, SDMT) were determined per patient per year with a maximum clinical follow-up of 11 years. Linear mixed-effect models were applied to assess the association between cerebellar volumes and clinical scores and whether cerebellar atrophy measures may predict future disability progression. SPMS patients exhibited faster posterior superior lobe volume loss over time compared to RRMS, which was related to increase of EDSS over time. In RRMS, cerebellar volumes were significant predictors of motor scores (e.g. average EDSS, T25FWT and 9HPT) and SDMT. Atrophy of motor-associated lobules (IV-VI + VIII) was a significant predictor of future deterioration of the 9HPT of the non-dominant hand. In SPMS, the atrophy rate of the posterior superior lobe (VI + Crus I) was a significant predictor of future PASAT performance deterioration. Regional cerebellar volume reduction is associated with motor and cognitive disability in MS and may serve as a predictor for future disease progression, especially of dexterity and impaired processing speed.
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Affiliation(s)
- Katrin Parmar
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland. .,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland. .,Reha Rheinfelden, Rheinfelden, Switzerland.
| | - Vladimir S Fonov
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, CA, USA
| | - Yvonne Naegelin
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Michael Amann
- Medical Image Analysis Center (MIAC AG), Basel, Switzerland.,Quantitative Biomedical Imaging Group (Qbig), Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Jens Wuerfel
- Medical Image Analysis Center (MIAC AG), Basel, Switzerland.,Quantitative Biomedical Imaging Group (Qbig), Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, CA, USA
| | - Laura Gaetano
- Neuroscience/Digital Medicine, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Stefano Magon
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.,Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Till Sprenger
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.,Department of Neurology, DKD HELIOS Klinik Wiesbaden, Wiesbaden, Germany
| | - Ludwig Kappos
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Cristina Granziera
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Charidimos Tsagkas
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
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30
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Liu G, Guo Y, Dang C, Peng K, Tan S, Xie C, Xing S, Zeng J. Longitudinal changes in the inferior cerebellar peduncle and lower limb motor recovery following subcortical infarction. BMC Neurol 2021; 21:320. [PMID: 34404371 PMCID: PMC8369783 DOI: 10.1186/s12883-021-02346-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/06/2021] [Indexed: 02/02/2023] Open
Abstract
Background The cerebellum receives afferent signals from spinocerebellar pathways regulating lower limb movements. However, the longitudinal changes in the spinocerebellar pathway in the early stage of unilateral supratentorial stroke and their potential clinical significance have received little attention. Methods Diffusion tensor imaging and Fugl-Meyer assessment of lower limb were performed 1, 4, and 12 weeks after onset in 33 patients with acute subcortical infarction involving the supratentorial areas, and in 33 healthy subjects. We evaluated group differences in diffusion metrics in the bilateral inferior cerebellar peduncle (ICP) and analyzed the correlation between ICP diffusion metrics and changes to the Fugl-Meyer scores of the affected lower limb within 12 weeks after stroke. Results Significantly decreased fractional anisotropy and increased mean diffusivity were found in the contralesional ICP at week 12 after stroke compared to controls (all P < 0.01) and those at week 1 (all P < 0.05). There were significant fractional anisotropy decreases in the ipsilesional ICP at week 4 (P = 0.008) and week 12 (P = 0.004) compared to controls. Both fractional anisotropy (rs = 0.416, P = 0.025) and mean diffusivity (rs = -0.507, P = 0.005) changes in the contralesional ICP correlated with changes in Fugl-Meyer scores of the affected lower limb in all patients. Conclusions Bilateral ICP degeneration occurs in the early phase of supratentorial stroke, and diffusion metric values of the contralesional ICP are useful indicators of affected lower limb function after supratentorial stroke. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02346-x.
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Affiliation(s)
- Gang Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No. 58, Zhongshan Road 2, Guangzhou, Guangdong, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, Guangdong, China
| | - Yaomin Guo
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No. 58, Zhongshan Road 2, Guangzhou, Guangdong, China
| | - Chao Dang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No. 58, Zhongshan Road 2, Guangzhou, Guangdong, China
| | - Kangqiang Peng
- Department of Medical Imaging, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Shuangquan Tan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No. 58, Zhongshan Road 2, Guangzhou, Guangdong, China
| | - Chuanmiao Xie
- Department of Medical Imaging, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Shihui Xing
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No. 58, Zhongshan Road 2, Guangzhou, Guangdong, China
| | - Jinsheng Zeng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No. 58, Zhongshan Road 2, Guangzhou, Guangdong, China.
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31
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Morigaki R, Miyamoto R, Matsuda T, Miyake K, Yamamoto N, Takagi Y. Dystonia and Cerebellum: From Bench to Bedside. Life (Basel) 2021; 11:776. [PMID: 34440520 PMCID: PMC8401781 DOI: 10.3390/life11080776] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 12/31/2022] Open
Abstract
Dystonia pathogenesis remains unclear; however, findings from basic and clinical research suggest the importance of the interaction between the basal ganglia and cerebellum. After the discovery of disynaptic pathways between the two, much attention has been paid to the cerebellum. Basic research using various dystonia rodent models and clinical studies in dystonia patients continues to provide new pieces of knowledge regarding the role of the cerebellum in dystonia genesis. Herein, we review basic and clinical articles related to dystonia focusing on the cerebellum, and clarify the current understanding of the role of the cerebellum in dystonia pathogenesis. Given the recent evidence providing new hypotheses regarding dystonia pathogenesis, we discuss how the current evidence answers the unsolved clinical questions.
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Affiliation(s)
- Ryoma Morigaki
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan; (N.Y.); (Y.T.)
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan; (T.M.); (K.M.)
| | - Ryosuke Miyamoto
- Department of Neurology, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan;
| | - Taku Matsuda
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan; (T.M.); (K.M.)
| | - Kazuhisa Miyake
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan; (T.M.); (K.M.)
| | - Nobuaki Yamamoto
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan; (N.Y.); (Y.T.)
- Department of Neurology, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan;
| | - Yasushi Takagi
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan; (N.Y.); (Y.T.)
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima 770-8501, Japan; (T.M.); (K.M.)
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32
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Starowicz-Filip A, Prochwicz K, Kłosowska J, Chrobak AA, Krzyżewski R, Myszka A, Rajtar-Zembaty A, Bętkowska-Korpała B, Kwinta B. Is Addenbrooke's Cognitive Examination III Sensitive Enough to Detect Cognitive Dysfunctions in Patients with Focal Cerebellar Lesions? Arch Clin Neuropsychol 2021; 37:423-436. [PMID: 34128041 DOI: 10.1093/arclin/acab045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The main aim of the study was to evaluate whether the available brief test of mental functions Addenbrooke's cognitive examination III (ACE III) detects cognitive impairment in patients with cerebellar damage. The second goal was to show the ACE III cognitive impairment profile of patients with focal cerebellar lesions. METHOD The study sample consisted of 31 patients with focal cerebellar lesions, 78 patients with supratentorial brain damage, and 31 subjects after spine surgery or with spine degeneration considered as control group, free of organic brain damage. The ACE III was used. RESULTS Patients with cerebellar damage obtained significantly lower results in the ACE III total score and in several subscales: attention, fluency, language, and visuospatial domains than healthy controls without brain damage. With the cut-off level of 89 points, the ACE III was characterized by the sensitivity of 71%, specificity of 72%, and accuracy of 72%. The cerebellar cognitive impairment profile was found to be "frontal-like" and similar to that observed in patients with anterior supratentorial brain damage, with decreased ability to retrieve previously learned material and its preserved recognition, impaired word fluency, and executive dysfunction. The results are consistent with cerebellar cognitive affective syndrome. CONCLUSIONS The ACE III can be used as a sensitive screening tool to detect cognitive impairments in patients with cerebellar damage.
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Affiliation(s)
- Anna Starowicz-Filip
- Chair of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland.,Department of Neurosurgery, University Hospital, Kraków, Poland
| | | | | | | | - Roger Krzyżewski
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
| | - Aneta Myszka
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Rajtar-Zembaty
- Chair of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Bętkowska-Korpała
- Chair of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland
| | - Borys Kwinta
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
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33
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Liu G, Gao Y, Liu Y, Guo Y, Yan Z, Ou Z, Zhong L, Xie C, Zeng J, Zhang W, Peng K, Lv Q. Machine Learning for Predicting Individual Severity of Blepharospasm Using Diffusion Tensor Imaging. Front Neurosci 2021; 15:670475. [PMID: 34054417 PMCID: PMC8155629 DOI: 10.3389/fnins.2021.670475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
Accumulating diffusion tensor imaging (DTI) evidence suggests that white matter abnormalities evaluated by local diffusion homogeneity (LDH) or fractional anisotropy (FA) occur in patients with blepharospasm (BSP), both of which are significantly correlated with disease severity. However, whether the individual severity of BSP can be identified using these DTI metrics remains unknown. We aimed to investigate whether a combination of machine learning techniques and LDH or FA can accurately identify the individual severity of BSP. Forty-one patients with BSP were assessed using the Jankovic Rating Scale and DTI. The patients were assigned to non-functionally and functionally limited groups according to their Jankovic Rating Scale scores. A machine learning scheme consisting of beam search and support vector machines was designed to identify non-functionally versus functionally limited outcomes, with the input features being LDH or FA in 68 white matter regions. The proposed machine learning scheme with LDH or FA yielded an overall accuracy of 88.67 versus 85.19% in identifying non-functionally limited versus functionally limited outcomes. The scheme also identified a sensitivity of 91.40 versus 85.87% in correctly identifying functionally limited outcomes, a specificity of 83.33 versus 83.67% in accurately identifying non-functionally limited outcomes, and an area under the curve of 93.7 versus 91.3%. These findings suggest that a combination of LDH or FA measurements and a sophisticated machine learning scheme can accurately and reliably identify the individual disease severity in patients with BSP.
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Affiliation(s)
- Gang Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Yanan Gao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China.,Department of Information, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Yaomin Guo
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Zhicong Yan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Zilin Ou
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Linchang Zhong
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Chuanmiao Xie
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jinsheng Zeng
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Weixi Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China
| | - Kangqiang Peng
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Qingwen Lv
- Department of Information, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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34
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Altiparmak T, Nazliel B, Caglayan HB, Tokgoz N, Gurses AA, Ucar M. Headache features of cerebellar ischemic strokes: Clinical and radiological-experiences of a single center. J Clin Neurosci 2021; 88:173-177. [PMID: 33992180 DOI: 10.1016/j.jocn.2021.03.036] [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: 01/16/2021] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 11/27/2022]
Abstract
The prevalence of headache in stroke has been reported between 8% and 34%. Determining the prevalence, features, and effects on prognosis of cerebellar ischemic strokes that presented with headache solely and/or with other cerebellar signs were the aims of our study.All patients diagnosed with cerebellar ischemia were included. Electronic medical records were reviewed. Patients have been followed up for 6th month. Descriptive statistics were generated. A total of 4763 patients were evaluated retrospectively, 200 patients had cerebellar ischemia and 22 patients of these cerebellar ischemias (11%) had a headache at initial presentation. Ataxia, dysarthria, dysmetria were the most common neurological findings. There was no significant difference whether ischemic lesion single or multiple and whether above or below 1.5 cm diameter. Ischemic lesions generally were in cortical/ juxtacortical layer. According to vascular perfusion areas, 54.5% patients' ischemia was located in PICA (posterior inferior cerebellar artery) territory. Patients presenting with a headache, predominantly had left hemispheric (vermian > hemispheric > pedincular) involvement. Although these patients generally had high modified Rankin Scale scores at the first evaluation, they had low NIHSS (National Institutes of Health Stroke Scale) scores (0-5), and nearly all patients recovered, with low mRS at the 6-month follow-up.Cerebellar ischemic strokes with headache presentation are significantly prevalent in patients with left hemispheric, cortical/juxtacortical, PICA perfusion territory ischemias and are associated with low morbidity unless there was a conscious disorder. We believe this is one of the first studies that evaluated the clinical and radiological parameters of cerebellar stroke patients with headache.
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Affiliation(s)
- Taylan Altiparmak
- Gazi University, Faculty of Medicine, Department of Neurology, Ankara, Turkey.
| | - Bijen Nazliel
- Gazi University, Faculty of Medicine, Department of Neurology, Ankara, Turkey
| | - Hale Batur Caglayan
- Gazi University, Faculty of Medicine, Department of Neurology, Ankara, Turkey.
| | - Nil Tokgoz
- Gazi University, Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Aslı Akyol Gurses
- Gazi University, Faculty of Medicine, Department of Neurology, Ankara, Turkey
| | - Murat Ucar
- Gazi University, Faculty of Medicine, Department of Radiology, Ankara, Turkey
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Saunier G, Fontana AP, De Oliveira JM, Py MO, Pozzo T, Vargas CD. Cerebellar damage affects the inference of human motion. Neurocase 2021; 27:169-177. [PMID: 33779507 DOI: 10.1080/13554794.2021.1905853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present study aims at the cerebellum's role in prediction mechanisms triggered by action observation. Five cerebellar patients and six age-paired control subjects were asked to estimate the occluded end point position of the shoulder's trajectories in Sit-to-Stand (STS) or Back-to-Sit (BTS) conditions, following or not biological rules. Contrarily to the control group, the prediction accuracy of the end point position in cerebellar patients did not depend on biological rules. Interestingly, both groups presented similar results when estimating the vanishing position of the target. Taken together, these results suggest that cerebellar damage affectsthe capacity of predicting upcoming actions by observation.
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Affiliation(s)
- Ghislain Saunier
- Laboratório de Cognição Motora, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Anatomia Humana Funcional, Universidade Federal do Pará, Belém, Brazil.,Programa de Pos-Graduação de Ciências do Movimento Humano, Universidade Federal do Pará, Belém, Brazil
| | - Ana Paula Fontana
- Physiotherapy School,Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - José M De Oliveira
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal de Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marco Oliveira Py
- Laboratório de Neurociência e Reabilitação do Instituto de Neurologia Deolindo Couto, Universidade Federal de Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thierry Pozzo
- IT@UniFe Center for Translational Neurophysiology, Istituto Italiano di Tecnologia, Via Fossato di Mortara, 17-19, Ferrara, Italy.,INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté UFR des Sciences du Sport, F-21000, Dijon, France
| | - Claudia D Vargas
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal de Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Neurociência e Reabilitação do Instituto de Neurologia Deolindo Couto, Universidade Federal de Rio de Janeiro, Rio de Janeiro, Brazil
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36
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Comorbidities associated with genetic abnormalities in children with intellectual disability. Sci Rep 2021; 11:6563. [PMID: 33753861 PMCID: PMC7985145 DOI: 10.1038/s41598-021-86131-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 02/02/2021] [Indexed: 12/03/2022] Open
Abstract
Intellectual disability (ID) has emerged as the commonest manifestation of underlying genomic abnormalities. Given that molecular genetic tests for diagnosis of ID usually require high costs and yield relatively low diagnostic rates, identification of additional phenotypes or comorbidities may increase the genetic diagnostic yield and are valuable clues for pediatricians in general practice. Here, we enrolled consecutively 61 children with unexplained moderate or severe ID and performed chromosomal microarray (CMA) and sequential whole-exome sequencing (WES) analysis on them. We identified 13 copy number variants in 12 probands and 24 variants in 25 probands, and the total diagnostic rate was 60.7%. The genetic abnormalities were commonly found in ID patients with movement disorder (100%) or with autistic spectrum disorder (ASD) (93.3%). Univariate analysis showed that ASD was the significant risk factor of genetic abnormality (P = 0.003; OR 14, 95% CI 1.7–115.4). At least 14 ID-ASD associated genes were identified, and the majority of ID-ASD associated genes (85.7%) were found to be expressed in the cerebellum based on database analysis. In conclusion, genetic testing on ID children, particularly in those with ASD is highly recommended. ID and ASD may share common cerebellar pathophysiology.
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37
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Qiao YL, Xiang WQ, Liu F, Jin S. Clinical therapeutic effects of gastrodin in combination with betahistine on vertigo: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e23825. [PMID: 33725810 PMCID: PMC7969318 DOI: 10.1097/md.0000000000023825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Vertigo is a well-known presenting complaint common in the main care offices as well as departments. It is also regarded as a symptom of vestibular dysfunction and has been expressed as a feeling of motion, specifically rotational motion. As patients grow older, vertigo also becomes a commonly presenting complaint. The current study will carry out a widespread systematic review to estimate clinical therapeutic effects of gastrodin in combination with betahistine on vertigo. METHODS We will systematically search different databases, including PubMed, EMBASE, Web of Science, the Cochrane Library, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure Database (CNKI), and WanFang to collect the randomised controlled studies that evaluate the efficiency of gastrodin and betahistine in treating patients with vertigo from their inception to November 2020. However, only studies in English or Chinese will be included. Two authors will independently perform selection, data extraction, and assessment of risk of bias for the included papers. Accordingly, any disagreements between the independent authors will be addressed via discussion or by consulting a third author when needful. Additionally, we will use RevMan 5.3 software to perform the data synthesis. RESULTS The efficiency of gastrodin and betahistine in treating patients with vertigo will be systematically evaluated. CONCLUSIONS The current study aims to stipulate more consistent substantiation to explore whether gastrodin combined with betahistine is more effective for the treatment of vertigo. REGISTRATION NUMBER DOI 10.17605/OSF.IO/HQTZA (https://osf.io/hqtza/).
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Affiliation(s)
- Yu-Lin Qiao
- Department of Neurology, Hanyang Hospital of Wuhan
| | | | - Fang Liu
- Department of Respiratory Medicine, Hubei NO.3 People's Hospital of Jianghan University
| | - Sheng Jin
- Nephrology Department of Integrated Traditional Chinese and Western Medicine, Hubei NO.3 People's Hospital of Jianghan University, Wuhan, Hubei, China
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38
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Selective Cerebellar Atrophy Associates with Depression and Fatigue in the Early Phases of Relapse-Onset Multiple Sclerosis. THE CEREBELLUM 2020; 19:192-200. [PMID: 31898280 DOI: 10.1007/s12311-019-01096-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cerebellar dysfunctions have been associated to depressive disorders and cognitive impairment in neurodegenerative diseases. The objective is to analyze the associations between cerebellar atrophy, depression, and fatigue in the early phases of relapse-onset multiple sclerosis (RRMS). Sixty-one RRMS patients and 50 healthy controls (HC) were enrolled and clinically evaluated by means of expanded disability status scale (EDSS), Rao's brief repeatable battery of neuropsychological tests (BRB-NT), Delis-Kaplan executive function system sorting test, beck depression inventory II (BDI-II), and fatigue severity scale (FSS). The relationships between MRI variables and clinical scores were assessed. Depressed RRMS (dRRMS) had significantly lower Vermis Crus I volume compared with not depressed RRMS (ndRRMS) (p = 0.009). Vermis Crus I volume was lower in dRRMS suffering from fatigue than in ndRRMS without fatigue (p = 0.01). The hierarchical regression models which included demographic and clinical data (age, sex, and disease duration, FSS or BDI-II) and cerebellar volumes disclosed that cerebellar lobule right V atrophy explained an increase of 4% of the variability in FSS (p = 0.25) and Vermis Crus I atrophy explained an increase of 6% of variability in BDI-II (p = 0.049). Since clinical onset, atrophy of specific cerebellar lobules associates with important clinical aspects of RRMS. Cerebellar pathology may be one of the determinants of fatigue and depression that contribute to worsen disability in RRMS.
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Contribution of the Cerebellum and the Basal Ganglia to Language Production: Speech, Word Fluency, and Sentence Construction-Evidence from Pathology. THE CEREBELLUM 2020; 20:282-294. [PMID: 33120434 PMCID: PMC8004516 DOI: 10.1007/s12311-020-01207-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
Abstract
Evidence reported in recent decades increasingly confirms that both the cerebellum and the basal ganglia, which are primarily involved in movement control, also have a significant role in a vast range of cognitive and affective functions. Evidence from pathology indicates that the disorders of some aspects of language production which follow damage of the cerebellum or respectively basal ganglia, i.e., disorders of speech, word fluency, and sentence construction, have identifiable neuropsychological profiles and that most manifestations can be specifically attributed to the dysfunctions of mechanisms supported by one or the other of these structures. The cerebellum and the basal ganglia are reciprocally interconnected. Thus, it is plausible that some disorders observed when damage involves one of these structures could be remote effects of abnormal activity in the other. However, in a purely clinical-neuropsychological perspective, primary and remote effects in the network are difficult to disentangle. Functional neuroimaging and non-invasive brain stimulation techniques likely represent the indispensable support for achieving this goal.
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40
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Velázquez-Pérez L, Rodriguez-Labrada R, González-Garcés Y, Arrufat-Pie E, Torres-Vega R, Medrano-Montero J, Ramirez-Bautista B, Vazquez-Mojena Y, Auburger G, Horak F, Ziemann U, Gomez CM. Prodromal Spinocerebellar Ataxia Type 2 Subjects Have Quantifiable Gait and Postural Sway Deficits. Mov Disord 2020; 36:471-480. [PMID: 33107647 DOI: 10.1002/mds.28343] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The search for valid preclinical biomarkers of cerebellar dysfunction is a key research goal for the upcoming era of early interventional approaches in spinocerebellar ataxias. This study aims to describe novel preclinical biomarkers of subtle gait and postural sway abnormalities in prodromal spinocerebellar ataxia type 2 (pre-SCA2). METHODS Thirty pre-SCA2 patients and their matched healthy controls underwent quantitative assessments of gait and postural sway using a wearable sensor-based system and semiquantitative evaluation of cerebellar features by SARA (Scale for the Assessment and Rating of Ataxia) score. RESULTS Quantitative analysis of natural gait showed a significantly larger variability of the swing period, toe-off angle and toe-out angle in pre-SCA2, and larger mean coronal and transverse ranges of motion of the trunk at the lumbar location and of the sagittal range of motion of the trunk at the sternum location compared to controls. During tandem gait, pre-SCA2 subjects showed larger lumbar, trunk, and arm ranges of motion than controls. Postural sway analysis showed excessive body oscillation that was increased in tandem stance. Overall, these abnormalities were detected in pre-SCA2 patients without clinical evidence of abnormalities in SARA. The toe-off angle and swing time variability were significantly correlated with the time to ataxia onset, whereas the toe-off angle and transverse range of motion at trunk position during tandem gait were significantly associated with the SARA score. CONCLUSIONS This study demonstrates early alteration of gait and postural sway control in prodromal SCA2 using a wearable sensor-based system. This offers new pathophysiological hints into this early disease stage and provides novel potential biomarkers for future clinical trials. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Luis Velázquez-Pérez
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, La Habana Vieja, Cuba
| | - Roberto Rodriguez-Labrada
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Yasmani González-Garcés
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Eduardo Arrufat-Pie
- Department of Neurorehabilitation, Clinical & Surgical Hospital "Manuel Piti Fajardo,", Plaza de la Revolución, Cuba
| | - Reidenis Torres-Vega
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | | | - Yaimeé Vazquez-Mojena
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Georg Auburger
- Experimental Neurology, Department of Neurology, Experimental Neurology, Medical School, Goethe University, Frankfurt am Main, Germany
| | - Fay Horak
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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41
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Zhang D, Qi F, Gao J, Yan X, Wang Y, Tang M, Zhe X, Cheng M, Wang M, Xie Q, Su Y, Zhang X. Altered Cerebellar-Cerebral Circuits in Patients With Type 2 Diabetes Mellitus. Front Neurosci 2020; 14:571210. [PMID: 33071743 PMCID: PMC7541847 DOI: 10.3389/fnins.2020.571210] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022] Open
Abstract
The role of the cerebellum in type 2 diabetes mellitus (T2DM) has been receiving increased attention. However, the functional connectivity (FC) between the cerebellar subregions and the cerebral cortex has not been investigated in T2DM. Therefore, the purpose of this study was to investigate cerebellar-cerebral FC and the relationship between FC and clinical/cognitive variables in patients with T2DM. A total of 34 patients with T2DM and 30 healthy controls were recruited for this study to receive a neuropsychological assessment and undergo resting-state FC. We selected four subregions of the cerebellum (bilateral lobules IX, right and left Crus I/II, and left lobule VI) as regions of interest (ROIs) to examine the differences in cerebellar-cerebral circuits in patients with T2DM compared to healthy controls. Correlation analysis was performed to examine the relationship between FC and clinical/cognitive variables in the patients. Compared to healthy controls, patients with T2DM showed significantly decreased cerebellar-cerebral FC in the default-mode network (DMN), executive control network (ECN), and visuospatial network (VSN). In the T2DM group, the FC between the left cerebellar lobule VI and the right precuneus was negatively correlated with the Trail Making Test A (TMT-A) score (r = −0.430, P = 0.013), after a Bonferroni correction. In conclusion, patients with T2DM have altered FC between the cerebellar subregions and the cerebral networks involved in cognitive and emotional processing. This suggests that a range of cerebellar-cerebral circuits may be involved in the neuropathology of T2DM cognitive dysfunction.
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Affiliation(s)
- Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Fei Qi
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xuejiao Yan
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yarong Wang
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xia Zhe
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Miao Cheng
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Man Wang
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Qingming Xie
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Yu Su
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
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Rodríguez-Takeuchi S, Baena-Caldas G, Orejuela-Zapata J, Granados Sánchez A. Analysis of the pattern of functional activation of the cerebellum and its topographical correlation. RADIOLOGIA 2020. [DOI: 10.1016/j.rxeng.2020.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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43
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Rodríguez-Takeuchi S, Baena-Caldas G, Orejuela-Zapata J, Granados Sánchez A. Análisis del patrón de activación funcional del cerebelo y su correlación topográfica. RADIOLOGIA 2020; 62:298-305. [DOI: 10.1016/j.rx.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/18/2019] [Accepted: 11/29/2019] [Indexed: 10/25/2022]
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44
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D'Amico A, Sala F. Intraoperative neurophysiology of the cerebellum: a tabula rasa. Childs Nerv Syst 2020; 36:1181-1186. [PMID: 32246192 DOI: 10.1007/s00381-020-04565-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 02/27/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Cerebellar mutism (CM) is a condition that occurs predominantly in children, after posterior fossa surgery (PFS). It is characterized by motor, speech, and behavioral disorders. Despite widespread use of intraoperative neurophysiological monitoring (IONM), little is known about the neurophysiological aspects involved in the pathophysiology of CM. We reviewed the IONM literature to identify working hypotheses aimed to investigate intraoperatively the circuits involved in CM. METHODS A systematic review of the literature was conducted using PubMed central database. Papers describing the use of IONM techniques in the cerebellum were selected, thoroughly reviewed, and discussed. RESULTS AND DISCUSSION Only two studies reported the use of intraoperative neurophysiology of the cerebellum, suggesting a possible somatotopic motor organization of the cerebellar cortex. In addition, extra-operative studies using transcranial magnetic stimulation showed the possibility to modulate-possibly through the dentato-thalamic-cortical (DTC) pathway-primary motor cortex output using an appropriate cerebellar stimulus. In theory, the preservation of this either inhibitory or facilitatory modulation may predict the preservation of this pathway, while a loss of the effect may indicate an injury to the pathway, and predict a CM. Analogously, in the extra-operative setting, the comparison of pre-operative and post-operative transcranial magnetic stimulation of the cerebellum may predict the onset of CM whenever a pre-existing modulatory effect is lost as a result of surgery. CONCLUSION Virtually, no data exist on the intraoperative neurophysiology of the cerebellum. This limited knowledge, nevertheless, offers a unique opportunity to pediatric neurosurgeons to develop and test working hypotheses on the pathophysiology of CM, through the use of IONM.
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Affiliation(s)
- Alberto D'Amico
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Piazzale Stefani 1, 37124, Verona, Italy
| | - Francesco Sala
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Piazzale Stefani 1, 37124, Verona, Italy.
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45
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Neurocognitive function and quality of life after proton beam therapy for brain tumour patients. Radiother Oncol 2020; 143:108-116. [DOI: 10.1016/j.radonc.2019.12.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/06/2019] [Accepted: 12/27/2019] [Indexed: 11/21/2022]
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46
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Wagner MJ, Luo L. Neocortex-Cerebellum Circuits for Cognitive Processing. Trends Neurosci 2019; 43:42-54. [PMID: 31787351 DOI: 10.1016/j.tins.2019.11.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/28/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022]
Abstract
Although classically thought of as a motor circuit, the cerebellum is now understood to contribute to a wide variety of cognitive functions through its dense interconnections with the neocortex, the center of brain cognition. Recent investigations have shed light on the nature of cerebellar cognitive processing and information exchange with the neocortex. We review findings that demonstrate widespread reward-related cognitive input to the cerebellum, as well as new studies that have characterized the codependence of processing in the neocortex and cerebellum. Together, these data support a view of the neocortex-cerebellum circuit as a joint dynamic system both in classical sensorimotor contexts and reward-related, cognitive processing. These studies have also expanded classical theory on the computations performed by the cerebellar circuit.
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Affiliation(s)
- Mark J Wagner
- Department of Biology and Howard Hughes Medical Institute, Stanford University, Stanford, CA 94305, USA.
| | - Liqun Luo
- Department of Biology and Howard Hughes Medical Institute, Stanford University, Stanford, CA 94305, USA.
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Blithikioti C, Miquel L, Batalla A, Rubio B, Maffei G, Herreros I, Gual A, Verschure P, Balcells‐Oliveró M. Cerebellar alterations in cannabis users: A systematic review. Addict Biol 2019; 24:1121-1137. [PMID: 30811097 DOI: 10.1111/adb.12714] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 01/18/2023]
Abstract
Cannabis is the most used illicit substance in the world. As many countries are moving towards decriminalization, it is crucial to determine whether and how cannabis use affects human brain and behavior. The role of the cerebellum in cognition, emotion, learning, and addiction is increasingly recognized. Because of its high density in CB1 receptors, it is expected to be highly affected by cannabis use. The aim of this systematic review is to investigate how cannabis use affects cerebellar structure and function, as well as cerebellar-dependent behavioral tasks. Three databases were searched for peer-reviewed literature published until March 2018. We included studies that focused on cannabis effects on cerebellar structure, function, or cerebellar-dependent behavioral tasks. A total of 348 unique records were screened, and 40 studies were included in the qualitative synthesis. The most consistent findings include (1) increases in cerebellar gray matter volume after chronic cannabis use, (2) alteration of cerebellar resting state activity after acute or chronic use, and (3) deficits in memory, decision making, and associative learning. Age of onset and higher exposure to cannabis use were frequently associated with increased cannabis-induced alterations. Chronic cannabis use is associated with alterations in cerebellar structure and function, as well as with deficits in behavioral paradigms that involve the cerebellum (eg, eyeblink conditioning, memory, and decision making). Future studies should consider tobacco as confounding factor and use standardized methods for assessing cannabis use. Paradigms exploring the functional activity of the cerebellum may prove useful as monitoring tools of cannabis-induced impairment.
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Affiliation(s)
- Chrysanthi Blithikioti
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
| | - Laia Miquel
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
| | - Albert Batalla
- Department of Psychiatry, Brain Center Rudolf MagnusUniversity Medical Center Utrecht Utrecht the Netherlands
- Nijmegen Institute for Scientist‐Practitioners in Addiction (NISPA)Radboud University Nijmegen The Netherlands
| | - Belen Rubio
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
| | - Giovanni Maffei
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
| | - Ivan Herreros
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
| | - Antoni Gual
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
| | - Paul Verschure
- Laboratory of Synthetic Perceptive, Emotive and Cognitive SystemsInstitute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology Barcelona Spain
- ICREAInstitucio Catalana de Recerca I Estudis Avançats, Passeig Lluis Companys Barcelona Spain
| | - Mercedes Balcells‐Oliveró
- Grup de Recerca en Addiccions Clínic (GRAC)Institut Clínic de Neurociències Barcelona Spain
- IDIBAPSInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
- Hospital ClínicUniversitat de Barcelona Barcelona Spain
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Freudenburg ZV, Branco MP, Leinders S, van der Vijgh BH, Pels EGM, Denison T, van den Berg LH, Miller KJ, Aarnoutse EJ, Ramsey NF, Vansteensel MJ. Sensorimotor ECoG Signal Features for BCI Control: A Comparison Between People With Locked-In Syndrome and Able-Bodied Controls. Front Neurosci 2019; 13:1058. [PMID: 31680806 PMCID: PMC6805728 DOI: 10.3389/fnins.2019.01058] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 09/20/2019] [Indexed: 01/10/2023] Open
Abstract
The sensorimotor cortex is a frequently targeted brain area for the development of Brain-Computer Interfaces (BCIs) for communication in people with severe paralysis and communication problems (locked-in syndrome; LIS). It is widely acknowledged that this area displays an increase in high-frequency band (HFB) power and a decrease in the power of the low frequency band (LFB) during movement of, for example, the hand. Upon termination of hand movement, activity in the LFB band typically shows a short increase (rebound). The ability to modulate the neural signal in the sensorimotor cortex by imagining or attempting to move is crucial for the implementation of sensorimotor BCI in people who are unable to execute movements. This may not always be self-evident, since the most common causes of LIS, amyotrophic lateral sclerosis (ALS) and brain stem stroke, are associated with significant damage to the brain, potentially affecting the generation of baseline neural activity in the sensorimotor cortex and the modulation thereof by imagined or attempted hand movement. In the Utrecht NeuroProsthesis (UNP) study, a participant with LIS caused by ALS and a participant with LIS due to brain stem stroke were implanted with a fully implantable BCI, including subdural electrocorticography (ECoG) electrodes over the sensorimotor area, with the purpose of achieving ECoG-BCI-based communication. We noted differences between these participants in the spectral power changes generated by attempted movement of the hand. To better understand the nature and origin of these differences, we compared the baseline spectral features and task-induced modulation of the neural signal of the LIS participants, with those of a group of able-bodied people with epilepsy who received a subchronic implant with ECoG electrodes for diagnostic purposes. Our data show that baseline LFB oscillatory components and changes generated in the LFB power of the sensorimotor cortex by (attempted) hand movement differ between participants, despite consistent HFB responses in this area. We conclude that the etiology of LIS may have significant effects on the LFB spectral components in the sensorimotor cortex, which is relevant for the development of communication-BCIs for this population.
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Affiliation(s)
- Zachary V Freudenburg
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mariana P Branco
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sacha Leinders
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Benny H van der Vijgh
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Elmar G M Pels
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Timothy Denison
- Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Leonard H van den Berg
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kai J Miller
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Erik J Aarnoutse
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Nick F Ramsey
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mariska J Vansteensel
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
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Learning to play badminton altered resting-state activity and functional connectivity of the cerebellar sub-regions in adults. PLoS One 2019; 14:e0223234. [PMID: 31574108 PMCID: PMC6771995 DOI: 10.1371/journal.pone.0223234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/17/2019] [Indexed: 11/19/2022] Open
Abstract
Previous studies have shown that sport experts are different from novices in functions and structures of the cerebellar sub-regions and the functional connectivity (FC) associated with the cerebellum, suggesting the role of the cerebellum on motor skill learning (MSL). However, the manipulation of individuals with different motor skills fails to exclude the effects of innate talents. In addition, individuals with higher motor skills often start with the MSL in their young ages. It is still unclear whether the effects regarding the cerebellum would be shown at one's adult age. The present study was to directly alter individuals' motor skills to investigate whether MSL (taking learning to play badminton as an example) in adulthood influences resting-state activity in the cerebellum. To this end, young adults without ball training experience were recruited as participants and were assigned randomly into the experimental group and the control group. Participants in the experimental group were asked to attend a badminton training course for 12 weeks, while the control group did not regularly attend any ball sports during this period. Resting-state functional magnetic resonance imaging (fMRI) was recorded before and after the training. Results showed that compared to the control group, the experimental group had smaller amplitude of low-frequency fluctuation (ALFF) in right cerebellar hemispheric VI and left VIII after training. For the experimental group, right hemispheric VIII had a stronger FC with left hemispheric IV-V, cerebellar vermal IX, left middle cingulate gyrus and right hippocampus after training. Taken together, these findings suggested that MSL, at least learning to play badminton in adulthood, reduces resting-state activity in different sub-regions in the cerebellum but increases FC between sub-regions of the cerebellum as well as between sub-regions of the cerebellum and cerebral cortices (e.g., middle cingulate cortex and hippocampus).
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Kim JS, Kim SH, Lim SH, Im S, Hong BY, Oh J, Kim Y. Degeneration of the Inferior Cerebellar Peduncle After Middle Cerebral Artery Stroke: Another Perspective on Crossed Cerebellar Diaschisis. Stroke 2019; 50:2700-2707. [PMID: 31446886 DOI: 10.1161/strokeaha.119.025723] [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] [Indexed: 12/21/2022]
Abstract
Background and Purpose- Deafferentation of the cortico-ponto-cerebellar pathway has been proposed as a key mechanism of crossed cerebellar diaschisis. Although the cerebellum receives afferent stimuli from both cortico-ponto-cerebellar and spinocerebellar pathways, evidence on whether spinocerebellar deafferentation contributes to a hypofunctional cerebellum is lacking. Therefore, we aimed to determine whether changes in the spinocerebellar pathway occur after middle cerebral artery stroke. Methods- Twenty-three patients admitted to our inpatient rehabilitation facility and 23 age-matched healthy controls were retrospectively enrolled. Patients' functional ambulation category was determined and the Medical Research Council muscle scale test of the lower limb muscles was performed at admission and discharge. The fractional anisotropy (FA) values of the corticospinal tract and the inferior cerebellar peduncle (ICP), as the final route of the dorsal spinocerebellar pathway, were compared between the groups. The FA laterality indices of the ICP and corticospinal tract were calculated as follows: (FAaffected-FAunaffected)/(FAaffected+FAunaffected). Pearson correlation analysis and multivariate linear regression models were used to determine the associations between the FA laterality indices and ambulatory function. Results- The FAs of the corticospinal tract and ICP were lower in the patient group than in the control group. The FA laterality index of the corticospinal tract was not correlated with the functional ambulation category or Medical Research Council muscle scale score at admission or discharge. The FA laterality index of the ICP at the pontomedullary junction was positively correlated with the functional ambulation category and Medical Research Council muscle scale scores of all hemiplegic lower limb muscles at admission and discharge. The FA laterality index of the ICP at the pontomedullary junction was independently associated with the functional ambulation category according to the multivariate regression models. Conclusions- ICP degeneration occurs in the subacute and early chronic phase of middle cerebral artery stroke. The lower FA laterality index of the ICP was indicative of poorer ambulatory and lower limb function.
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Affiliation(s)
- Joon Sung Kim
- From the Department of Rehabilitation Medicine (J.S.K., S.H.L., B.Y.H.), St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon
| | - Se-Hong Kim
- Department of Family Medicine (S.-H.K.), St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon
| | - Seong Hoon Lim
- From the Department of Rehabilitation Medicine (J.S.K., S.H.L., B.Y.H.), St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon
| | - Sun Im
- Department of Rehabilitation Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea (S.I.)
| | - Bo Young Hong
- From the Department of Rehabilitation Medicine (J.S.K., S.H.L., B.Y.H.), St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon
| | - Jeehae Oh
- Rehabilitation Medicine, Independent Scholar, Seoul, Republic of Korea (J.O.)
| | - Youngkook Kim
- Department of Rehabilitation Medicine, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul (Y.K.)
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