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Tankus A, Stern E, Klein G, Kaptzon N, Nash L, Marziano T, Shamia O, Gurevitch G, Bergman L, Goldstein L, Fahoum F, Strauss I. A Speech Neuroprosthesis in the Frontal Lobe and Hippocampus: Decoding High-Frequency Activity into Phonemes. Neurosurgery 2024:00006123-990000000-01250. [PMID: 38934637 DOI: 10.1227/neu.0000000000003068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/05/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Loss of speech due to injury or disease is devastating. Here, we report a novel speech neuroprosthesis that artificially articulates building blocks of speech based on high-frequency activity in brain areas never harnessed for a neuroprosthesis before: anterior cingulate and orbitofrontal cortices, and hippocampus. METHODS A 37-year-old male neurosurgical epilepsy patient with intact speech, implanted with depth electrodes for clinical reasons only, silently controlled the neuroprosthesis almost immediately and in a natural way to voluntarily produce 2 vowel sounds. RESULTS During the first set of trials, the participant made the neuroprosthesis produce the different vowel sounds artificially with 85% accuracy. In the following trials, performance improved consistently, which may be attributed to neuroplasticity. We show that a neuroprosthesis trained on overt speech data may be controlled silently. CONCLUSION This may open the way for a novel strategy of neuroprosthesis implantation at earlier disease stages (eg, amyotrophic lateral sclerosis), while speech is intact, for improved training that still allows silent control at later stages. The results demonstrate clinical feasibility of direct decoding of high-frequency activity that includes spiking activity in the aforementioned areas for silent production of phonemes that may serve as a part of a neuroprosthesis for replacing lost speech control pathways.
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Affiliation(s)
- Ariel Tankus
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Neurology and Neurosurgery, School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Einat Stern
- Department of Neurology and Neurosurgery, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Klein
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Nufar Kaptzon
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Lilac Nash
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Tal Marziano
- School of Electrical Engineering, Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Omer Shamia
- School of Electrical Engineering, Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Guy Gurevitch
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lottem Bergman
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Lilach Goldstein
- Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Firas Fahoum
- Department of Neurology and Neurosurgery, School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ido Strauss
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Neurology and Neurosurgery, School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Diao Y, Xie H, Wang Y, Zhao B, Yang A, Hlavnicka J, Zhang J. Acoustic assessment in mandarin-speaking Parkinson's disease patients and disease progression monitoring and brain impairment within the speech subsystem. NPJ Parkinsons Dis 2024; 10:115. [PMID: 38866758 PMCID: PMC11169641 DOI: 10.1038/s41531-024-00720-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/10/2024] [Indexed: 06/14/2024] Open
Abstract
Approximately 90% of Parkinson's patients (PD) suffer from dysarthria. However, there is currently a lack of research on acoustic measurements and speech impairment patterns among Mandarin-speaking individuals with PD. This study aims to assess the diagnosis and disease monitoring possibility in Mandarin-speaking PD patients through the recommended speech paradigm for non-tonal languages, and to explore the anatomical and functional substrates. We examined total of 160 native Mandarin-speaking Chinese participants consisting of 80 PD patients, 40 healthy controls (HC), and 40 MRI controls. We screened the optimal acoustic metric combination for PD diagnosis. Finally, we used the objective metrics to predict the patient's motor status using the Naïve Bayes model and analyzed the correlations between cortical thickness, subcortical volumes, functional connectivity, and network properties. Comprehensive acoustic screening based on prosodic, articulation, and phonation abnormalities allows differentiation between HC and PD with an area under the curve of 0.931. Patients with slowed reading exhibited atrophy of the fusiform gyrus (FDR p = 0.010, R = 0.391), reduced functional connectivity between the fusiform gyrus and motor cortex, and increased nodal local efficiency (NLE) and nodal efficiency (NE) in bilateral pallidum. Patients with prolonged pauses demonstrated atrophy in the left hippocampus, along with decreased NLE and NE. The acoustic assessment in Mandarin proves effective in diagnosis and disease monitoring for Mandarin-speaking PD patients, generalizing standardized acoustic guidelines beyond non-tonal languages. The speech impairment in Mandarin-speaking PD patients not only involves motor aspects of speech but also encompasses the cognitive processes underlying language generation.
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Affiliation(s)
- Yu Diao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hutao Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanwen Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Jan Hlavnicka
- Centre of Clinical Neuroscience, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Neurostimulation, Beijing, China.
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Alahmadi AA, Alotaibi NO, Hakami NY, Almutairi RS, Darwesh AM, Abdeen R, Alghamdi J, Abdulaal OM, Alsharif W, Sultan SR, Kanbayti IH. Gender and cytoarchitecture differences: Functional connectivity of the hippocampal sub-regions. Heliyon 2023; 9:e20389. [PMID: 37780771 PMCID: PMC10539667 DOI: 10.1016/j.heliyon.2023.e20389] [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: 12/10/2022] [Revised: 07/27/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction The hippocampus plays a significant role in learning, memory encoding, and spatial navigation. Typically, the hippocampus is investigated as a whole region of interest. However, recent work has developed fully detailed atlases based on cytoarchitecture properties of brain regions, and the hippocampus has been sub-divided into seven sub-areas that have structural differences in terms of distinct numbers of cells, neurons, and other structural and chemical properties. Moreover, gender differences are of increasing concern in neuroscience research. Several neuroscience studies have found structural and functional variations between the brain regions of females and males, and the hippocampus is one of these regions. Aim The aim of this study to explore whether the cytoarchitecturally distinct sub-regions of the hippocampus have varying patterns of functional connectivity with different networks of the brain and how these functional connections differ in terms of gender differences. Method This study investigated 200 healthy participants using seed-based resting-state functional magnetic resonance imaging (rsfMRI). The primary aim of this study was to explore the resting connectivity and gender distinctions associated with specific sub-regions of the hippocampus and their relationship with major functional brain networks. Results The findings revealed that the majority of the seven hippocampal sub-regions displayed functional connections with key brain networks, and distinct patterns of functional connectivity were observed between the hippocampal sub-regions and various functional networks within the brain. Notably, the default and visual networks exhibited the most consistent functional connections. Additionally, gender-based analysis highlighted evident functional resemblances and disparities, particularly concerning the anterior section of the hippocampus. Conclusion This study highlighted the functional connectivity patterns and involvement of the hippocampal sub-regions in major brain functional networks, indicating that the hippocampus should be investigated as a region of multiple distinct functions and should always be examined as sub-regions of interest. The results also revealed clear gender differences in functional connectivity.
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Affiliation(s)
- Adnan A.S. Alahmadi
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Nada O. Alotaibi
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Norah Y. Hakami
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Raghad S. Almutairi
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Afnan M.F. Darwesh
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rawan Abdeen
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jamaan Alghamdi
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osamah M. Abdulaal
- Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Madina, Saudi Arabia
| | - Walaa Alsharif
- Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Madina, Saudi Arabia
| | - Salahaden R. Sultan
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ibrahem H. Kanbayti
- Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Billig AJ, Lad M, Sedley W, Griffiths TD. The hearing hippocampus. Prog Neurobiol 2022; 218:102326. [PMID: 35870677 PMCID: PMC10510040 DOI: 10.1016/j.pneurobio.2022.102326] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/08/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
The hippocampus has a well-established role in spatial and episodic memory but a broader function has been proposed including aspects of perception and relational processing. Neural bases of sound analysis have been described in the pathway to auditory cortex, but wider networks supporting auditory cognition are still being established. We review what is known about the role of the hippocampus in processing auditory information, and how the hippocampus itself is shaped by sound. In examining imaging, recording, and lesion studies in species from rodents to humans, we uncover a hierarchy of hippocampal responses to sound including during passive exposure, active listening, and the learning of associations between sounds and other stimuli. We describe how the hippocampus' connectivity and computational architecture allow it to track and manipulate auditory information - whether in the form of speech, music, or environmental, emotional, or phantom sounds. Functional and structural correlates of auditory experience are also identified. The extent of auditory-hippocampal interactions is consistent with the view that the hippocampus makes broad contributions to perception and cognition, beyond spatial and episodic memory. More deeply understanding these interactions may unlock applications including entraining hippocampal rhythms to support cognition, and intervening in links between hearing loss and dementia.
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Affiliation(s)
| | - Meher Lad
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - William Sedley
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Timothy D Griffiths
- Biosciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK; Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, USA
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Ahn MH, Alsabbagh N, Lee HJ, Kim HJ, Jung MH, Hong SK. Neurobiological Signatures of Auditory False Perception and Phantom Perception as a Consequence of Sensory Prediction Errors. BIOLOGY 2022; 11:biology11101501. [PMID: 36290405 PMCID: PMC9598671 DOI: 10.3390/biology11101501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
In this study, we hypothesized that top-down sensory prediction error due to peripheral hearing loss might influence sensorimotor integration using the efference copy (EC) signals as functional connections between auditory and motor brain areas. Using neurophysiological methods, we demonstrated that the auditory responses to self-generated sound were not suppressed in a group of patients with tinnitus accompanied by significant hearing impairment and in a schizophrenia group. However, the response was attenuated in a group with tinnitus accompanied by mild hearing impairment, similar to a healthy control group. The bias of attentional networks to self-generated sound was also observed in the subjects with tinnitus with significant hearing impairment compared to those with mild hearing impairment and healthy subjects, but it did not reach the notable disintegration found in those in the schizophrenia group. Even though the present study had significant constraints in that we did not include hearing loss subjects without tinnitus, these results might suggest that auditory deafferentation (hearing loss) may influence sensorimotor integration process using EC signals. However, the impaired sensorimotor integration in subjects with tinnitus with significant hearing impairment may have resulted from aberrant auditory signals due to sensory loss, not fundamental deficits in the reafference system, as the auditory attention network to self-generated sound is relatively well preserved in these subjects.
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Affiliation(s)
- Min-Hee Ahn
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
| | - Nour Alsabbagh
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
| | - Hyo-Jeong Lee
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
| | - Myung-Hun Jung
- Department of Psychiatry, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (M.-H.J.); (S.-K.H.); Tel.: +82-31-380-3849 (S.-K.H.)
| | - Sung-Kwang Hong
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (M.-H.J.); (S.-K.H.); Tel.: +82-31-380-3849 (S.-K.H.)
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Kang M, Lee DB, Kwon S, Lee E, Kim WJ. Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data. J Clin Med 2022; 11:jcm11164661. [PMID: 36012898 PMCID: PMC9409895 DOI: 10.3390/jcm11164661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The clinical benefits of nootropics in the treatment of cognitive decline has been either limited or controversial. This study aimed to observe the effectiveness of cholinesterase inhibitor (ChEI) and nootropics combination in the treatment of cognitive impairment in dementia. Data were based on electronic medical records in a university health system. Patients with mild-to-moderate dementia and no history of prior cognitive enhancer use were included (n = 583). The subjects were categorized into the ChEI only group and the ChEI and nootropics combination group. The primary outcome measure was the change in cognitive function, as assessed by the mini-mental state examination (MMSE) from baseline to 300–400 days after the first ChEI prescription. Subsequent analyses were conducted in consideration of the dementia type, medical adherence, and type of nootropics. The changes in MMSE scores from baseline to endpoint were not significantly different between the two groups. In Alzheimer’s dementia, the combination group showed significantly less deterioration in MMSE language subscale scores compared to the ChEI only group (F = 6.86, p = 0.009), and the difference was consistent in the highly adherent subjects (F = 10.16, p = 0.002). The choline alfoscerate and the ginkgo biloba extract subgroups in Alzheimer’s dementia showed more significant improvements in the MMSE language subscale scores compared to the other nootropics subgroup (F = 7.04, p = 0.001). The present study showed that the effectiveness of ChEI and nootropics combination on cognition may appear differently according to the dementia type. This emphasizes the need for well-controlled studies to generalize the effectiveness of nootropics across various clinical settings.
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Affiliation(s)
- Minjae Kang
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Dan Bee Lee
- Medical Information Team, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea
| | - Sungchan Kwon
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Eun Lee
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Woo Jung Kim
- Medical Information Team, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea
- Correspondence:
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Gui SY, Wu KJ, Sun Y, Chen YN, Liang HR, Liu W, Lu Y, Hu CY. Traffic noise and adiposity: a systematic review and meta-analysis of epidemiological studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:55707-55727. [PMID: 35320480 DOI: 10.1007/s11356-022-19056-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Traffic noise has attracted much attention as a significant and intractable public health threat. This study was designed as a systematical review to explore the association of traffic noise with different indicators of obesity, thus providing updated quantitative estimates for the pooled effect estimates of the existing literature. We conducted an extensive search for epidemiological studies that investigated the association of traffic noise with obesity in three electronic databases till February 23, 2021. We used random-effects meta-analysis to calculate the summary effect estimates for each 10-dB(A) increase in noise and compared the highest with the lowest category of noise in relation to seven obesity indicators. Meanwhile, we assessed the risk of bias and the overall quality of the evidence of each study as well as the level of evidence for each exposure-outcome pair. The initial search identified 30 studies, 13 of which were ultimately included. The meta-analysis for the highest versus the lowest category of noise exposure was generally associated with higher waist circumfluence (WC) ranging from 0.326 cm (95% confidence interval (CI) = 0.078, 0.574) to 0.705 cm (95% CI = 0.071, 1.340) and higher odds of central obesity ranging from 1.055 (95% CI = 1.000, 1.109) to 1.167 (95% CI = 1.037, 1.298). When the continuous exposure (each 10 dB(A) increase in noise) was introduced, similar results were found. This study indicated positive associations of traffic noise with WC and central obesity. However, in consideration of some limitations, there is an urgent need for future studies to increase the sample size, discriminate the etiological differences in different noise and obesity indicators, and thoroughly consider socioeconomic status.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Ke-Jia Wu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yue Sun
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, China
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yue-Nan Chen
- Department of Clinical Pharmacy, School of Pharmacy, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Huan-Ru Liang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Wen Liu
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yao Lu
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, China.
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Takeda T, Kokubun S, Saito Y, Tsuneyama A, Ishikawa A, Isose S, Ito K, Arai K, Koreki A, Sugiyama A, Kuwabara S, Honda K. Progressive medial temporal degeneration with TDP-43 pathology is associated with upper limb and bulbar onset types of amyotrophic lateral sclerosis. J Neurol 2022; 269:5497-5509. [PMID: 35708789 DOI: 10.1007/s00415-022-11217-5] [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: 03/28/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aimed to clarify the relationship between progressive medial temporal atrophy and onset subtype in patients with amyotrophic lateral sclerosis (ALS). METHODS Medial temporal atrophy, ALS functional rating scale (ALSFRS), and cognitive function were assessed in 119 patients who were grouped into three ALS subtypes: bulbar, upper limb, and lower limb onset. Medial temporal atrophy, represented by a Z-score, was determined using an analysis software of magnetic resonance images known as the voxel-based specific regional analysis system for Alzheimer's disease (VSRAD). Among 119 patients, 60 underwent follow-up VSRAD, ALSFRS, and cognitive testing. The sequential data were compared among onset subtypes. Furthermore, TDP-43 pathology was assessed in 20 autopsied patients (including seven who underwent VSRAD before death) to examine the relationships among medial temporal atrophy, onset subtypes, and severity of the hippocampal TDP-43 pathology. RESULTS Multiple regression analysis revealed that the Z-score at baseline was associated with the age of onset and duration of illness. A high Z-score at baseline and the bulbar/upper limb subtypes affected the progression rate of Z-score. Pathological examination revealed increased hippocampal TDP-43 pathology score associated with bulbar and upper limb subtypes. Moreover, the Z-score before death correlated with the hippocampal TDP-43 pathology score. CONCLUSION Medial temporal atrophy in ALS is associated with bulbar and upper limb onset subtypes. This progression may be related to the extent of TDP-43 pathology.
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Affiliation(s)
- Takahiro Takeda
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan.
| | - Sayuri Kokubun
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
| | - Yumiko Saito
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
| | - Atsuko Tsuneyama
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
| | - Ai Ishikawa
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
| | - Sagiri Isose
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
| | - Kimiko Ito
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
| | - Kimihito Arai
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
| | - Akihiro Koreki
- Department of Psychiatry, National Hospital Organisation Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Atsuhiko Sugiyama
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhiro Honda
- Department of Neurology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba, 260-8712, Japan
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Regional Alteration within the Cerebellum and the Reorganization of the Cerebrocerebellar System following Poststroke Aphasia. Neural Plast 2022; 2022:3481423. [PMID: 35360259 PMCID: PMC8964230 DOI: 10.1155/2022/3481423] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/24/2022] [Indexed: 12/26/2022] Open
Abstract
Recently, an increasing number of studies have highlighted the role of the cerebellum in language processing. However, the role of neural reorganization within the cerebellum as well as within the cerebrocerebellar system caused by poststroke aphasia remains unknown. To solve this problem, in the present study, we investigated regional alterations of the cerebellum as well as the functional reorganization of the cerebrocerebellar circuit by combining structural and resting-state functional magnetic resonance imaging (fMRI) techniques. Twenty patients diagnosed with aphasia following left-hemispheric stroke and 20 age-matched healthy controls (HCs) were recruited in this study. The Western Aphasia Battery (WAB) test was used to assess the participants' language ability. Gray matter volume, spontaneous brain activity, functional connectivity, and effective connectivity were examined in each participant. We discovered that gray matter volumes in right cerebellar lobule VI and right Crus I were significantly lower in the patient group, and the brain activity within these regions was significantly correlated with WAB scores. We also discovered decreased functional connectivity within the crossed cerebrocerebellar circuit, which was significantly correlated with WAB scores. Moreover, altered information flow between the cerebellum and the contralateral cerebrum was found. Together, our findings provide evidence for regional alterations within the cerebellum and the reorganization of the cerebrocerebellar system following poststroke aphasia and highlight the important role of the cerebellum in language processing within aphasic individuals after stroke.
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