Functional decline of the precuneus associated with mild cognitive impairment: Magnetoencephalographic observations

Mild Cognitive Impairment (MCI) is a border or precursor state of dementia. To optimize implemented interventions for MCI, it is essential to clarify the underlying neural mechanisms. However, knowledge regarding the brain regions responsible for MCI is still limited. Here, we implemented the Montreal Cognitive Assessment (MoCA) test, a screening tool for MCI, in 20 healthy elderly participants (mean age, 67.5 years), and then recorded magnetoencephalograms (MEG) while they performed a visual sequential memory task. In the task, each participant memorized the four possible directions of seven sequentially presented arrow images. Recall accuracy for beginning items of the memory sequence was significantly positively related with MoCA score. Meanwhile, MEG revealed stronger alpha-band (8-13 Hz) rhythm desynchronization bilaterally in the precuneus (PCu) for higher MoCA (normal) participants. Most importantly, this PCu desynchronization response weakened in correspondence with lower MoCA score during the beginning of sequential memory encoding, a time period that should rely on working memory and be affected by declined cognitive function. Our results suggest that deactivation of the PCu is associated with early MCI, and corroborate pathophysiological findings based on post-mortem tissue which have implicated hypoperfusion of the PCu in early stages of Alzheimer disease. Our results indicate the possibility that cognitive decline can be detected early and non-invasively by monitoring PCu activity with electrophysiological methods.

Clinical factors affecting evoked magnetic fields in patients with Parkinson's disease

Studies on evoked responses in Parkinson's disease (PD) may be useful for elucidating the etiology and quantitative evaluation of PD. However, in previous studies, the association between evoked responses and detailed motor symptoms or cognitive functions has not been clear. This study investigated the characteristics of the visual (VEF), auditory (AEF), and somatosensory (SEF) evoked magnetic fields in patients with Parkinson’s disease (PD), and the correlations between evoked fields and the patient’s clinical characteristics, motor symptoms, and cognitive functions. Twenty patients with PD and 10 healthy controls (HCs) were recruited as participants. We recorded VEF, AEF, and SEF, collected clinical characteristics, performed physical examinations, and administered 10 cognitive tests. We investigated differences in the latencies of the evoked fields between patients with PD and HCs. We also evaluated the correlation of the latencies with motor symptoms and cognitive functioning. There were significant differences between the two groups in 6 of the cognitive tests, all of which suggested mild cognitive impairment in patients with PD. The latencies of the VEF N75m, P100m, N145m, AEF P50m, P100m, and SEF P60m components were greater in the patients with PD than in the HCs. The latencies mainly correlated with medication and motor symptoms, less so with cognitive tests, with some elements of the correlations remaining significant after Bonferroni correction. In conclusion, the latencies of the VEF, AEF, and SEF were greater in PD patients than in HCs and were mainly correlated with medication and motor symptoms rather than cognitive functioning. Findings from this study suggest that evoked fields may reflect basal ganglia functioning and are candidates for assessing motor symptoms or the therapeutic effects of medication in patients with PD.

Different roles for theta- and alpha-band brain rhythms during sequential memory

Numerous studies have demonstrated that brain rhythms are modulated according to memory performance or memory processing. In sequential memory tasks, memory performance can be reduced by shortening the intervals between memory item presentations. To clarify the neurophysiological mechanism underlying this, we recorded magnetoencephalograms in 33 healthy volunteers performing two sequential memory tasks with either short or long intervals between memory items (hereafter, fast and slow conditions, respectively). Memory accuracy, and theta- and alpha-band activities originating from occipital and frontal brain areas were analyzed. Memory performance was significantly lower for the fast condition than the slow condition. Meanwhile, occipital and frontal theta activities were significantly lower for the fast condition than the slow condition. Increased occipital-alpha, a sign of active inhibition of task-irrelevant visual input, occurred regardless of condition. However, memory processing related to occipital- and frontal-theta activities had some temporal limitations. Namely, the shorter intervals of the fast condition attenuated theta activity, likely disrupting working memory processing, thereby leading to the observed decline in memory performance.

Multiple Brain Activities During Sequential Memory Encoding - MEG Study Of Modulation Of Alpha-Band Rhythm

It is known that alpha-band rhythm during memory maintenance is enhanced by increasing memory load. This enhancement is generally thought to be caused by active inhibition of task-irrelevant visual inputs. During sequential memory processing, we previously found that alpha-band activity increases from beginning to midterm during memory encoding, and conversely decreases from midterm to ending. In the present study, we conducted two experiments to determine the spatial and functional role of alpha-band rhythm during sequential memory processing. The first experiment showed that alpha-band rhythm increased in the occipital brain region, suggesting that active inhibition of task-irrelevant visual inputs continues from midterm to ending of memory encoding. The second experiment, in which subjects could not anticipate the ending of the sequential presentation of memory items, demonstrated that alpha-band rhythm is suppressed in correspondence with preparation for memory recall. These results indicate that alpha-band rhythm is simultaneously modulated by multiple brain processes in sequential memory encoding.

Four-barrel aortic dissection involving the ascending aorta. A case report

A fifty-four-year-old woman was evaluated at the authors' hospital for symptoms of repeated chest and back pain. The symptoms had recurred for five months prior to admission. A dynamic computed tomographic scan was performed on admission and demonstrated an enlarged ascending aorta with four barrels secondary to split intimal flaps. This case is an extremely rare example of a patient with a four-barrel aortic dissection involving the ascending aorta.

Noninvasive evaluation of left ventricular performance by the shortest distance between mitral leaflets coaptation and interventricular septum at end-systole

We attempted to evaluate left ventricular performance from the shortest distance between the mitral leaflets coaptation and the interventricular septum at end-systole (MVC-IVS distance). The subjects were 37 patients with coronary artery disease (CAD) with prior myocardial infarction (MI), 8 with CAD without prior MI, 22 with atypical chest pain, and 4 with aortic regurgitation. The MVC-IVS distance was measured on a two-dimensional echocardiogram obtained from the parasternal or apical long-axis view and frozen at end-systole. Left ventricular end-systolic volume and end-diastolic volume were obtained by left ventriculography, and the left ventricular ejection fraction was calculated. A significant positive correlation was observed between the MVC-IVS distance and the end-systolic volume (r = 0.83, p less than 0.001); a close correlation was observed between the MVC-IVS distance end-systolic volume and ejection fraction by monoexponential fitting (r = -0.91, p less than 0.001). Thus, a significant negative correlation was observed between the MVC-IVS distance and the left ventricular ejection fraction (LVEF) (r = -0.83, p less than 0.001). An MVC-IVS distance of greater than or equal to 30 mm suggests diagnosis of left ventricular dysfunction (LVEF less than 50%) with high sensitivity (94.4%) and specificity (90.6%), while a value less than 30 mm suggests that the left ventricular performance is likely to be normal. Thus one can easily evaluate the left ventricular performance noninvasively using this new index.