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Welch JF, Mitchell GS. Inaugural Review Prize 2023: The exercise hyperpnoea dilemma: A 21st-century perspective. Exp Physiol 2024; 109:1217-1237. [PMID: 38551996 PMCID: PMC11291877 DOI: 10.1113/ep091506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 03/12/2024] [Indexed: 08/02/2024]
Abstract
During mild or moderate exercise, alveolar ventilation increases in direct proportion to metabolic rate, regulating arterial CO2 pressure near resting levels. Mechanisms giving rise to the hyperpnoea of exercise are unsettled despite over a century of investigation. In the past three decades, neuroscience has advanced tremendously, raising optimism that the 'exercise hyperpnoea dilemma' can finally be solved. In this review, new perspectives are offered in the hope of stimulating original ideas based on modern neuroscience methods and current understanding. We first describe the ventilatory control system and the challenge exercise places upon blood-gas regulation. We highlight relevant system properties, including feedforward, feedback and adaptive (i.e., plasticity) control of breathing. We then elaborate a seldom explored hypothesis that the exercise ventilatory response continuously adapts (learns and relearns) throughout life and ponder if the memory 'engram' encoding the feedforward exercise ventilatory stimulus could reside within the cerebellum. Our hypotheses are based on accumulating evidence supporting the cerebellum's role in motor learning and the numerous direct and indirect projections from deep cerebellar nuclei to brainstem respiratory neurons. We propose that cerebellar learning may be obligatory for the accurate and adjustable exercise hyperpnoea capable of tracking changes in life conditions/experiences, and that learning arises from specific cerebellar microcircuits that can be interrogated using powerful techniques such as optogenetics and chemogenetics. Although this review is speculative, we consider it essential to reframe our perspective if we are to solve the till-now intractable exercise hyperpnoea dilemma.
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Affiliation(s)
- Joseph F. Welch
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental SciencesUniversity of BirminghamEdgbastonBirminghamUK
| | - Gordon S. Mitchell
- Breathing Research and Therapeutics Centre, Department of Physical Therapy, McKnight Brain InstituteUniversity of FloridaGainesvilleFloridaUSA
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Wang L, Xu H, Song Z, Wang H, Hu W, Gao Y, Zhang Z, Jiang J. fMRI signals in white matter rewire gray matter community organization. Neuroimage 2024; 297:120763. [PMID: 39084280 DOI: 10.1016/j.neuroimage.2024.120763] [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: 03/24/2024] [Revised: 07/17/2024] [Accepted: 07/29/2024] [Indexed: 08/02/2024] Open
Abstract
Human brain gray matter (GM) has usually been clustered into multiple functional networks. The white matter (WM) fiber bundles are known to interconnect these networks simultaneously, engaging in numerous cognitive functions. However, the exact interconnections between GM and WM are still unclear, whether functional signals in WM rewires GM community organization remains to be explored. In this study, we divided brain functional connections into three types by using edge-centric method, including intra-GM, intra-WM and GM-WM connections, and calculated the edge community evaluation indexes for quantifying GM community engagement. The results showed that the involvement of WM significantly enhanced community entropy in the heteromodal system, while the sensory-attention system remained barely changed. In addition, delta community entropy showed a significant correlation with clinical cognitive scale. Our results suggested that WM rewired GM community organization, enhancing the community engagement of brain regions in the heteromodal system. This involvement was observed to be disrupted in disease groups. Our study revealed that considering the functional signals of GM and WM simultaneously could better understand the brain's functional organization.
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Affiliation(s)
- Luyao Wang
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Huanyu Xu
- School of Communication and Information Engineering, Shanghai University, Shanghai 200444, China
| | - Ziyan Song
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Huanxin Wang
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Wenjing Hu
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Yiwen Gao
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Zhilin Zhang
- Research Center for Medical Artificial Intelligence, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China.
| | - Jiehui Jiang
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China.
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Sun H, Yan R, Hua L, Xia Y, Huang Y, Wang X, Yao Z, Lu Q. Based on white matter microstructure to early identify bipolar disorder from patients with depressive episode. J Affect Disord 2024; 350:428-434. [PMID: 38244786 DOI: 10.1016/j.jad.2024.01.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Because of similar clinical manifestations, bipolar disorder (BD) patients are often misdiagnosed as major depressive disorder (MDD). This study aimed to compare the difference between depressed patients later converting to BD and unipolar depression (UD) according to diffusion tensor imaging (DTI). METHOD Patients with MDD (562 participants) in depressive episode states and healthy controls (HCs) (145 participants) were recruited over 10 years. Demographic and magnetic resonance imaging (MRI) data were collected at the time of recruitment. All patients with MDD were followed up for 5 years and classified into the transfer to BD (tBD) group (83 participants) and UD group (160 participants) according to the follow-up results. DTI and functional magnetic resonance imaging at baseline were compared. RESULTS Common abnormalities were found in both tBD and UD groups, including left superior cerebellar peduncle (SCP.L), right anterior limb of the internal capsule (ALIC.R), right superior fronto-occipital fasciculus (SFOF.R), and right inferior fronto-occipital fasciculus (IFOF.R). The tBD showed more extensive abnormalities than the UD in the body of corpus callosum, fornix, left superior corona radiata, left posterior corona radiata, left superior longitudinal fasciculus, and left superior fronto-occipital fasciculus. CONCLUSION The study demonstrated the common and distinct abnormalities of tBD and UD when compared to HC. The tBD group showed more extensive disruptions of white matter integrity, which could be a potential biomarker for the early identification of BD.
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Affiliation(s)
- Hao Sun
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Rui Yan
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Lingling Hua
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Yinghong Huang
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Zhijian Yao
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China; School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing 210096, China.
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Novello M, Bosman LWJ, De Zeeuw CI. A Systematic Review of Direct Outputs from the Cerebellum to the Brainstem and Diencephalon in Mammals. CEREBELLUM (LONDON, ENGLAND) 2024; 23:210-239. [PMID: 36575348 PMCID: PMC10864519 DOI: 10.1007/s12311-022-01499-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 05/13/2023]
Abstract
The cerebellum is involved in many motor, autonomic and cognitive functions, and new tasks that have a cerebellar contribution are discovered on a regular basis. Simultaneously, our insight into the functional compartmentalization of the cerebellum has markedly improved. Additionally, studies on cerebellar output pathways have seen a renaissance due to the development of viral tracing techniques. To create an overview of the current state of our understanding of cerebellar efferents, we undertook a systematic review of all studies on monosynaptic projections from the cerebellum to the brainstem and the diencephalon in mammals. This revealed that important projections from the cerebellum, to the motor nuclei, cerebral cortex, and basal ganglia, are predominantly di- or polysynaptic, rather than monosynaptic. Strikingly, most target areas receive cerebellar input from all three cerebellar nuclei, showing a convergence of cerebellar information at the output level. Overall, there appeared to be a large level of agreement between studies on different species as well as on the use of different types of neural tracers, making the emerging picture of the cerebellar output areas a solid one. Finally, we discuss how this cerebellar output network is affected by a range of diseases and syndromes, with also non-cerebellar diseases having impact on cerebellar output areas.
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Affiliation(s)
- Manuele Novello
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| | | | - Chris I De Zeeuw
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
- Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands.
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5
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Krohn F, Novello M, van der Giessen RS, De Zeeuw CI, Pel JJM, Bosman LWJ. The integrated brain network that controls respiration. eLife 2023; 12:83654. [PMID: 36884287 PMCID: PMC9995121 DOI: 10.7554/elife.83654] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/29/2023] [Indexed: 03/09/2023] Open
Abstract
Respiration is a brain function on which our lives essentially depend. Control of respiration ensures that the frequency and depth of breathing adapt continuously to metabolic needs. In addition, the respiratory control network of the brain has to organize muscular synergies that integrate ventilation with posture and body movement. Finally, respiration is coupled to cardiovascular function and emotion. Here, we argue that the brain can handle this all by integrating a brainstem central pattern generator circuit in a larger network that also comprises the cerebellum. Although currently not generally recognized as a respiratory control center, the cerebellum is well known for its coordinating and modulating role in motor behavior, as well as for its role in the autonomic nervous system. In this review, we discuss the role of brain regions involved in the control of respiration, and their anatomical and functional interactions. We discuss how sensory feedback can result in adaptation of respiration, and how these mechanisms can be compromised by various neurological and psychological disorders. Finally, we demonstrate how the respiratory pattern generators are part of a larger and integrated network of respiratory brain regions.
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Affiliation(s)
- Friedrich Krohn
- Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands
| | - Manuele Novello
- Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands
| | | | - Chris I De Zeeuw
- Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands.,Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences, Amsterdam, Netherlands
| | - Johan J M Pel
- Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands
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Wang Q, Wang Y, Kuo HC, Xie P, Kuang X, Hirokawa KE, Naeemi M, Yao S, Mallory M, Ouellette B, Lesnar P, Li Y, Ye M, Chen C, Xiong W, Ahmadinia L, El-Hifnawi L, Cetin A, Sorensen SA, Harris JA, Zeng H, Koch C. Regional and cell-type-specific afferent and efferent projections of the mouse claustrum. Cell Rep 2023; 42:112118. [PMID: 36774552 PMCID: PMC10415534 DOI: 10.1016/j.celrep.2023.112118] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 12/17/2022] [Accepted: 01/30/2023] [Indexed: 02/13/2023] Open
Abstract
The claustrum (CLA) is a conspicuous subcortical structure interconnected with cortical and subcortical regions. Its regional anatomy and cell-type-specific connections in the mouse remain not fully determined. Using multimodal reference datasets, we confirmed the delineation of the mouse CLA as a single group of neurons embedded in the agranular insular cortex. We quantitatively investigated brain-wide inputs and outputs of CLA using bulk anterograde and retrograde viral tracing data and single neuron tracing data. We found that the prefrontal module has more cell types projecting to the CLA than other cortical modules, with layer 5 IT neurons predominating. We found nine morphological types of CLA principal neurons that topographically innervate functionally linked cortical targets, preferentially the midline cortical areas, secondary motor area, and entorhinal area. Together, this study provides a detailed wiring diagram of the cell-type-specific connections of the mouse CLA, laying a foundation for studying its functions at the cellular level.
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Affiliation(s)
- Quanxin Wang
- Allen Institute for Brain Science, Seattle, WA 98109, USA.
| | - Yun Wang
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Hsien-Chi Kuo
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Peng Xie
- Institute for Brain and Intelligence, Southeast University, Nanjing, Jiangsu, China
| | - Xiuli Kuang
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | | | - Maitham Naeemi
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Shenqin Yao
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Matt Mallory
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Ben Ouellette
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Phil Lesnar
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Yaoyao Li
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Min Ye
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Chao Chen
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Wei Xiong
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | | | | | - Ali Cetin
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | | | - Julie A Harris
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Hongkui Zeng
- Allen Institute for Brain Science, Seattle, WA 98109, USA
| | - Christof Koch
- Allen Institute for Brain Science, Seattle, WA 98109, USA.
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Chen Q, Lv H, Wang Z, Wei X, Zhao P, Yang Z, Gong S, Wang Z. Lateralization effects in brain white matter reorganization in patients with unilateral idiopathic tinnitus: a preliminary study. Brain Imaging Behav 2021; 16:11-21. [PMID: 33830430 DOI: 10.1007/s11682-021-00472-1] [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: 10/23/2020] [Accepted: 03/14/2021] [Indexed: 12/01/2022]
Abstract
Idiopathic tinnitus can cause significant auditory-related brain structural and functional changes in patients. However, changes in patterns of the lateralization effects in idiopathic tinnitus have yet to be established, especially on white matter (WM) reorganization. In this study, we studied 19 left-sided and 19 right-sided idiopathic tinnitus (LSIT, RSIT) patients and 19 healthy controls (HCs). We combined applied voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analyses to investigate altered features of the auditory-related brain WM. We also conducted correlation analyses between the clinical variables and WM changes in the patients. Compared with the HCs, both sided tinnitus patients showed significant auditory-related brain WM alterations. More interestingly, the LSIT patients demonstrated a greater decrease in white matter volume (WMV) in the right medial superior frontal gyrus (SFG) than the RSIT; meanwhile, we also found that compared with the RSIT group, the LSIT group showed significantly increased fractional anisotropy (FA) in the body of the corpus callosum (CC), left cingulum, and right superior longitudinal fasciculus (SLF) and decreased mean diffusivity (MD) in the body of CC. Moreover, relative to the RSIT group, the LSIT group also exhibited increases in WM axial diffusivity (AD) in the left SLF, left cingulum, right middle cerebellar peduncle (MCP), left thalamus, and bilateral forceps major (FM) and decreases in radial diffusivity (RD) in the genu of CC. Additionally, the FA value of the right SLF was closely associated with tinnitus severity in the LSIT. Our study suggests that lateralization has a significant effect on WM reorganization in patients with idiopathic tinnitus; in particular, LSIT patients may experience more severe and widespread alterations in WMV and WM microstructure than the RSIT group, and all these changes are indirectly auditory related. These findings provide new useful information that can lead to a better understanding of the tinnitus mechanisms.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China.
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Chen Q, Lv H, Wang Z, Wei X, Zhao P, Yang Z, Gong S, Wang Z. Outcomes at 6 months are related to brain structural and white matter microstructural reorganization in idiopathic tinnitus patients treated with sound therapy. Hum Brain Mapp 2020; 42:753-765. [PMID: 33098363 PMCID: PMC7814769 DOI: 10.1002/hbm.25260] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/16/2022] Open
Abstract
This study aimed to explore brain structural and white matter microstructural reorganization in the early stage of tinnitus and identify brain alterations that contribute to its relief after 6 months of sound therapy. We studied 64 patients with idiopathic tinnitus, including 29 patients who were categorized into an effective group (EG) and 35 who were categorized into an ineffective group (IG) according to the 6-month follow-up improvement of the Tinnitus Handicap Inventory score, along with 63 healthy controls (HCs). All participants underwent structural and diffusion tensor imaging scanning on a 3-T magnetic resonance system. Differences in brain gray/white matter volume and white matter microstructure were evaluated using voxel-based morphometry analysis and tract-based spatial statistics among the three groups. Associations between brain reorganization and the improvement of tinnitus symptoms were also investigated. Compared with EG patients, IG patients experienced a significant gray matter volume decrease in the right middle frontal gyrus (MFG)/right precentral gyrus (PreCG). Meanwhile, both EG and IG patients showed significant changes (decrease or increase) in brain white matter integrity in the auditory-related or nonauditory-related white matter fiber tracts compared with HCs, while EG patients showed decreased axial diffusivity in the bilateral middle cerebellar peduncle (MCP) compared with IG patients. We combined the gray matter change of the MFG/PreCG and the white matter integrity of the bilateral MCP as an imaging indicator to evaluate the patient's prognosis and screen patients before treatment; this approach reached a sensitivity of 77.1% and a specificity of 82.8%. Our study suggests that there was a close relationship between brain reorganization and tinnitus improvement. The right MFG/PreCG and bilateral MCP may be indicators that can be used to predict prognoses in patients with idiopathic tinnitus and may be used to screen patients before sound therapy. These findings may provide new useful information that can lead to a better understanding of the tinnitus mechanism.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
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High Frequency Deep Brain Stimulation of Superior Cerebellar Peduncles in a Patient with Cerebral Palsy. Tremor Other Hyperkinet Mov (N Y) 2020; 10:38. [PMID: 33101764 PMCID: PMC7546102 DOI: 10.5334/tohm.551] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Globus pallidus internus (GPi) deep brain stimulation (DBS) is widely used in patients with isolated dystonia; however, its use remains controversial in patients with acquired dystonia and cerebral palsy. Case presentation We report the first case of a cerebral palsy patient, who failed to recover 2 years after GPi DBS; DBS was administered on both superior cerebellar peduncles (SCPs) and dentate nuclei (DNs). The monopolar stimulation results suggested that DBS was better administered via the SCPs than via the DNs. At six months follow-up, the patient exhibited a significant improvement of dystonia and spasticity, as well as in her quality of life. Discussion SCP DBS may be a potential treatment for cerebral palsy patients with dystonia and spasticity who do not respond well to GPi DBS.
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Çavdar S, Esen Aydın A, Algin O, Aydoğmuş E. Fiber dissection and 3-tesla diffusion tensor tractography of the superior cerebellar peduncle in the human brain: emphasize on the cerebello-hypthalamic fibers. Brain Struct Funct 2019; 225:121-128. [PMID: 31776651 DOI: 10.1007/s00429-019-01985-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/09/2019] [Indexed: 11/30/2022]
Abstract
Experimental studies in various species using tract-tracing techniques showed clear evidence of the presence of cerebello-hypothalamic projections. However, these connections were not clearly described in humans. In the present study we aimed to describe the direct cerebello-hypothalamic connections within the superior cerebellar peduncle (SCP) using fiber dissection techniques on cadaveric brains and diffusion tensor tractography (DTI) in healthy adults. Fiber dissection was performed in a stepwise manner from lateral to medial on 6 cerebral hemispheres. The gray matter was decorticate and fiber tracts were revealed. The SCP was exposed and the fibers were traced distally using wooden spatulas. The MRI examinations were performed in seven cases using 3-tesla 3T unit. The direct cerebello-hyothalamic pathways were exposed using high-spatial-resolution DTI. The present study using both fiber dissection and DTI in adult human showed direct cerebello-hypothalamic fibers within the SCP. The SCP fibers course anterolateral to the cerebral aqueduct reaching the level of the red nucleus of the midbrain. The majority of the fibers crosses over and reached the contralateral diencephalic structures and some of these fibers terminated at the contralateral anterior hypothalamic area. Some of the uncrossed SCP fibers reached the ipsilateral diencephalic structures and terminated at the ipsilateral posterior hypothalamic area. We further reported the close relationship of the SCP with the MCP, lateral lemniscus, red nucleus and substantia nigra. In the DTI evaluations of the SCP we exposed unilateral left cerebello-hypothalamic fibers in five cases and bilateral cerebello-hypothalamic fibers in two cases. The present study demonstrates the direct cerebello-hypothalamic connections within the SCP for the first time using fiber dissection and DTI technique in the human brain. The detailed knowledge of the cerebello-hypothalamic fibers can outline the unexplained deficit that may occur during regional surgery.
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Affiliation(s)
- Safiye Çavdar
- Department of Anatomy, School of Medicine, Koç University, Sarıyer, 34450, Istanbul, Turkey.
| | - Ayşegül Esen Aydın
- Department of Neurosurgery, Bakırköy Ruh ve Sinir Hastanesi, Istanbul, Turkey
| | - Oktay Algin
- Radiology Department, City Hospital, Yıldırım Beyazıt University, Ankara, Turkey.,National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Evren Aydoğmuş
- Department of Neurosurgery, Dr. Lütfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
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11
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Bay HH, Özkan M, Onat F, Çavdar S. Do the Dento-Thalamic Connections of Genetic Absence Epilepsy Rats from Strasbourg Differ from Those of Control Wistar Rats? Brain Connect 2019; 9:703-710. [PMID: 31591912 DOI: 10.1089/brain.2019.0694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The thalamo-cortical circuit is important in the genesis of absence epilepsy. This circuit can be influenced by connecting pathways from various parts of central nervous system. The aim of the present study is to define the dento-thalamic connections in Wistar animals and compare the results with genetic absence epilepsy rats from Strasbourg (GAERS) using the biotinylated dextran amine (BDA) tracer. We injected BDA into the dentate nucleus of 13 (n = 6 Wistar and n = 7 GAERS) animals. The dento-thalamic connections in the Wistar animals were denser and were connected to a wider range of thalamic nuclei compared with GAERS. The dentate nucleus was bilaterally connected to the central (central medial [CM], paracentral [PC]), ventral (ventral medial [VM], ventral lateral [VL], and ventral posterior lateral [VPL]), and posterior (Po) thalamic nuclei in Wistar animals. The majority of these connections were dense contralaterally and scarce ipsilaterally. Contralateral connections were present with the parafascicular (PF), ventral posterior medial, ventral anterior (VA), and central lateral (CL) thalamic nuclei in Wistar animals. Whereas in GAERS, bilateral connections were observed with the VL and CM. Contralateral connections were present with the PC, VM, VA, and PF thalamic nuclei in GAERS. The CL, VPL, and Po thalamic nucleus connections were not observed in GAERS. The present study showed weak/deficit dento-thalamic connections in GAERS compared with control Wistar animals. The scarce information flow from the dentate nucleus to thalamus in GAERS may have a deficient modulatory role on the thalamus and thus may affect modulation of the thalamo-cortical circuit.
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Affiliation(s)
| | - Mazhar Özkan
- Department of Anatomy, Marmara University School of Medicine, Istanbul, Turkey
| | - Filiz Onat
- Department of Pharmacology and Clinic Pharmacology, Marmara University School of Medicine, Istanbul, Turkey
| | - Safiye Çavdar
- Department of Anatomy, Koç University School of Medicine, Istanbul, Turkey
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