1
|
Konak HE, Alemdaroğlu E, Altaş EU. The relationship between dysphagia and the localisation of brain lesion in stroke: is the involvement of the pons and medulla important? Somatosens Mot Res 2024; 41:34-41. [PMID: 36625230 DOI: 10.1080/08990220.2023.2165058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The presence of dysphagia in stroke is associated with mortality and morbidity. The aim of this retrospective study is to present the relationship between dysphagia and the demographic characteristics of the patient, and the type and localisation of brain lesion in the acute period in stroke patients with dysphagia. MATERIALS AND METHODS The data of 284 patients who had stroke-related dysphagia, had a disease duration 1-3 months, had no history of swallowing dysfunction before the event, and had their brain MRI/CT reports in the hospital were included. RESULTS The rate of tube-dependent oral areas was higher in the lesions located in the pons and the medulla than in the lesions located in the MCA cortex, the basal ganglia, and the cerebellum (p ˂ 0.001, p = 0.032 and p = 0.011, respectively) and the percentage of those fed with NG + TPN + PEG was statistically significantly higher (p = 0.002, p = 0.032 and p = 0.011, respectively). History of pneumonia was found to be statistically significantly higher in the lesions located in the pons and the medulla than in the lesions located in the MCA cortex, ACA cortex, PCA cortex, the basal ganglia, periventricular white matter, the thalamus, the cerebellum, and the midbrain (p ˂ 0.001, p = 0.005, p = 0.023, p ˂ 0.001, p = 0.023, p = 0.001, p = 0.011 and p = 0.023, respectively). CONCLUSION In conclusion, although lesion localisation in the acute period in patients with dysphagia varied in terms of clinical swallowing evaluation findings, weight loss, pneumonia history, the rate of tube-dependent intake, were shown to be higher in patients who had lesions in the pons and the medulla, which is a finding that should be considered in the clinical follow-up of acute stroke patients with lesions in the pons and the medulla.
Collapse
Affiliation(s)
- Hatice Ecem Konak
- Ankara Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Ebru Alemdaroğlu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Elif Umay Altaş
- Ankara Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
2
|
Uher T, Adzima A, Srpova B, Noskova L, Maréchal B, Maceski AM, Krasensky J, Stastna D, Andelova M, Novotna K, Vodehnalova K, Motyl J, Friedova L, Lindner J, Ravano V, Burgetova A, Dusek P, Fialova L, Havrdova EK, Horakova D, Kober T, Kuhle J, Vaneckova M. Diagnostic delay of multiple sclerosis: prevalence, determinants and consequences. Mult Scler 2023; 29:1437-1451. [PMID: 37840276 PMCID: PMC10580682 DOI: 10.1177/13524585231197076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Early diagnosis and treatment of patients with multiple sclerosis (MS) are associated with better outcomes; however, diagnostic delays remain a major problem. OBJECTIVE Describe the prevalence, determinants and consequences of delayed diagnoses. METHODS This single-centre ambispective study analysed 146 adult relapsing-remitting MS patients (2016-2021) for frequency and determinants of diagnostic delays and their associations with clinical, cognitive, imaging and biochemical measures. RESULTS Diagnostic delays were identified in 77 patients (52.7%), including 42 (28.7%) physician-dependent cases and 35 (24.0%) patient-dependent cases. Diagnosis was delayed in 22 (15.1%) patients because of misdiagnosis by a neurologist. A longer diagnostic delay was associated with trends towards greater Expanded Disability Status Scale (EDSS) scores (B = 0.03; p = 0.034) and greater z-score of the blood neurofilament light chain (B = 0.35; p = 0.031) at the time of diagnosis. Compared with patients diagnosed at their first clinical relapse, patients with a history of >1 relapse at diagnosis (n = 63; 43.2%) had a trend towards greater EDSS scores (B = 0.06; p = 0.006) and number of total (B = 0.13; p = 0.040) and periventricular (B = 0.06; p = 0.039) brain lesions. CONCLUSION Diagnostic delays in MS are common, often determined by early misdiagnosis and associated with greater disease burden.
Collapse
Affiliation(s)
- Tomas Uher
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Adrian Adzima
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Barbora Srpova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Libuse Noskova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Bénédicte Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland/Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland/Signal Processing Laboratory (LTS5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Aleksandra Maleska Maceski
- Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Jan Krasensky
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Dominika Stastna
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Michaela Andelova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Klara Novotna
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Karolina Vodehnalova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jiri Motyl
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Lucie Friedova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jiri Lindner
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Veronica Ravano
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland/Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland/Signal Processing Laboratory (LTS5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Andrea Burgetova
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Petr Dusek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic/Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Lenka Fialova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland/Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland/Signal Processing Laboratory (LTS5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Jens Kuhle
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital and University of Basel, Basel, Switzerland
| | - Manuela Vaneckova
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| |
Collapse
|
3
|
Mustafa S, Matarneh AS, Mohamed A, Fadul A, Musa M, Mohamed RI, Abdallah E, Mohamed TG. Cerebral Neuroschistosomiasis Presenting as a Brain Mass. Cureus 2023; 15:e45418. [PMID: 37854757 PMCID: PMC10581503 DOI: 10.7759/cureus.45418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/20/2023] Open
Abstract
Neuroschistosomiasis is a rare manifestation of schistosomal infections presenting with cerebral and spinal cord involvement. We reported a case of a 31-year-old woman who presented with a history of headache, dizziness, and nausea. Brain MRI with contrast showed features suggestive of brain lesion with edema, and a serology test for Schistosoma was positive. She was diagnosed with neuroschistosomiasis and treated with intravenous steroids followed by praziquantel resulting in a significant regression of the brain mass. Cerebral neuroschistosomiasis is a rare complication of Schistosoma infection, and clinicians should consider it among the differential diagnosis of unexplained brain lesions.
Collapse
Affiliation(s)
- Salma Mustafa
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | | | | | - Abdalla Fadul
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Muzamil Musa
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | | | | | | |
Collapse
|
4
|
Hossain ME, Kennedy KJ, Wilson HL, Spratt D, Koehler A, Gasser RB, Šlapeta J, Hawkins CA, Bandi HP, Senanayake SN. Human Neural Larva Migrans Caused by Ophidascaris robertsi Ascarid. Emerg Infect Dis 2023; 29:1900-1903. [PMID: 37610238 PMCID: PMC10461669 DOI: 10.3201/eid2909.230351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
We describe a case in Australia of human neural larva migrans caused by the ascarid Ophidascaris robertsi, for which Australian carpet pythons are definitive hosts. We made the diagnosis after a live nematode was removed from the brain of a 64-year-old woman who was immunosuppressed for a hypereosinophilic syndrome diagnosed 12 months earlier.
Collapse
|
5
|
Ghasemikhah R, Hakimzadeh Z, Gilani A, Sarmadian H, Sarmadian R, Yousefbeigi N. An HIV-positive woman with massive brain lesion due to toxoplasmosis: A case report. Clin Case Rep 2023; 11:e7688. [PMID: 37457995 PMCID: PMC10340077 DOI: 10.1002/ccr3.7688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Key Clinical Message Toxoplasmosis-related huge brain lesions may require decompressive craniectomy and lesion excision to avoid brain damage. In this situation, injectable cotrimoxazole is a better choice for treatment. Abstract Toxoplasma gondii is a worldly distributed obligate intracellular protozoa. Toxoplasmosis is a prevalent opportunistic infection in HIV-infected people, but it was rarely recorded prior to the identification of HIV infection. Here, we report a toxoplasmosis brain lesion in an Iranian HIV-positive patient. A 45-year-old woman with a complaint of malaise was referred to the Valiasr Hospital in Arak city. In her past clinical history, the patient had a history of anemia, deep vein thrombosis (DVT), and positive HIV. The patient was informed of the diagnosis of massive brain toxoplasmosis as a definite diagnosis. The patient was then taken to the operating room for a left decompressive craniectomy, during which the ensuing brain lesion was excised. After a few days, she was discharged from the hospital in good condition and without any complications.
Collapse
Affiliation(s)
- Reza Ghasemikhah
- Department of Parasitology & MycologyArak University of Medical SciencesArakIran
| | - Zahra Hakimzadeh
- Neurosciences Research Center (NSRC)Tabriz University of Medical SciencesEast AzerbaijanIran
| | - Abolfazl Gilani
- Sina Trauma & Surgery Research CenterTehran University of Medical SciencesTehranIran
| | - Hossein Sarmadian
- Department of Infectious DiseasesArak University of Medical SciencesArakIran
| | - Roham Sarmadian
- Infectious Diseases Research CenterArak University of Medical SciencesArakIran
| | | |
Collapse
|
6
|
Sperber C, Gallucci L, Umarova R. The low dimensionality of post-stroke cognitive deficits: it's the lesion anatomy! Brain 2023; 146:2443-2452. [PMID: 36408903 DOI: 10.1093/brain/awac443] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/01/2022] [Accepted: 11/10/2022] [Indexed: 10/06/2023] Open
Abstract
For years, dissociation studies on neurological single-case patients with brain lesions were the dominant method to infer fundamental cognitive functions in neuropsychology. In contrast, the association between deficits was considered to be of less epistemological value. Still, associational computational methods for dimensionality reduction-such as principal component analysis or factor analysis-became popular for the identification of fundamental cognitive functions and to understand human cognitive brain architecture from post-stroke neuropsychological profiles. In the present in silico study with lesion imaging of 300 stroke patients, we investigated the dimensionality of artificial simulated neuropsychological profiles that exclusively contained independent fundamental cognitive functions without any underlying low-dimensional cognitive architecture. Still, the anatomy of stroke lesions alone was sufficient to create a dependence between variables that allowed a low-dimensional description of the data with principal component analysis. All criteria that we used to estimate the dimensionality of data, including the Kaiser criterion, were strongly affected by lesion anatomy, while the Joliffe criterion provided the least affected estimates. The dimensionality of profiles was reduced by 62-70% for the Kaiser criterion, up to the degree that is commonly found in neuropsychological studies on actual cognitive measures. The interpretability of such low-dimensional factors as deficits of fundamental cognitive functions and their provided insights into human cognitive architecture thus seem to be severely limited, and the heavy focus of current cognitive neuroscience on group studies and associations calls for improvements. We suggest that qualitative criteria and dissociation patterns could be used to refine estimates for the dimensionality of the cognitive architecture behind post-stroke deficits. Further, given the strong impact of lesion anatomy on the associational structure of data, we see the need for further optimization of interpretation strategies of computational factors in post-stroke lesion studies of cognitive deficits.
Collapse
Affiliation(s)
- Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Laura Gallucci
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Roza Umarova
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| |
Collapse
|
7
|
Simula S, Garnier E, Contento M, Pizzo F, Makhalova J, Lagarde S, Bénar CG, Bartolomei F. Changes in Local and Network Brain Activity After Stereotactic Thermocoagulation in Patients with Drug-Resistant Epilepsy. Epilepsia 2023. [PMID: 37032394 DOI: 10.1111/epi.17613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVE Stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-guided RF-TC) aims to reduce seizure frequency by modifying epileptogenic networks through local thermocoagulative lesions. Although RF-TC is hypothesized to functionally modify brain networks, reports of changes in functional connectivity (FC) following the procedure are missing. We evaluated, by means of SEEG recordings, whether variation in brain activity after RF-TC is related to clinical outcome. METHODS Interictal SEEG recordings from 33 DRE patients were analyzed. Therapeutic response was defined as more than 50% reduction in seizure frequency for at least one month following RF-TC. Local (power spectral density, PSD) and FC changes were evaluated in three-minute segments recorded shortly before (baseline), shortly after and 15 minutes after RF-TC. The PSD and FC strength values after thermocoagulation were compared with baseline as well as between the responder and non-responder groups. RESULTS In responders, we found a significant reduction in PSD after RF-TC in channels that were thermocoagulated (TC) for all frequency bands (p-value =0.007 for broad, delta and theta, p-value <0.001 for alpha and beta bands). However, we did not observe such PSD decrease in non-responders. At the network level, non-responders displayed a significant FC increase in all frequency bands except theta (broad, delta, beta band: p-value < 0.001; alpha band: p-value < 0.01), while responders showed a significant FC decrease in delta (p-value<0.001) and alpha bands (p-value<0.05). Non-responders showed stronger FC changes with respect to responders exclusively in TC channels (broad, alpha, theta, beta: p-value>0.05; delta: p= 0.001). SIGNIFICANCE Thermocoagulation induces both local and network-related (FC) changes in electrical brain activity of patients with DRE lasting for at least 15 minutes. This study demonstrates that the observed short-term modifications in brain network and local activity significantly differ between responders and non-responders and opens new perspectives for studying the longer-lasting functional connectivity changes after RF-TC.
Collapse
Affiliation(s)
- S Simula
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France
| | - E Garnier
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France
| | - M Contento
- Department of Neurosciences, Drug Research, and Child's Health, University of Florence, Florence, Italy
| | - F Pizzo
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France; Member of the ERN network
| | - J Makhalova
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France; Member of the ERN network
| | - S Lagarde
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France; Member of the ERN network
| | - C G Bénar
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France
| | - F Bartolomei
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France
- APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France; Member of the ERN network
| |
Collapse
|
8
|
Lopes G, Nogueira J, Dimitriadis G, Menendez JA, Paton JJ, Kampff AR. A robust role for motor cortex. Front Neurosci 2023; 17:971980. [PMID: 36845435 PMCID: PMC9950416 DOI: 10.3389/fnins.2023.971980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/11/2023] [Indexed: 02/12/2023] Open
Abstract
The role of motor cortex in non-primate mammals remains unclear. More than a century of stimulation, anatomical and electrophysiological studies has implicated neural activity in this region with all kinds of movement. However, following the removal of motor cortex, rats retain most of their adaptive behaviors, including previously learned skilled movements. Here we revisit these two conflicting views of motor cortex and present a new behavior assay, challenging animals to respond to unexpected situations while navigating a dynamic obstacle course. Surprisingly, rats with motor cortical lesions show clear impairments facing an unexpected collapse of the obstacles, while showing no impairment with repeated trials in many motor and cognitive metrics of performance. We propose a new role for motor cortex: extending the robustness of sub-cortical movement systems, specifically to unexpected situations demanding rapid motor responses adapted to environmental context. The implications of this idea for current and future research are discussed.
Collapse
Affiliation(s)
- Gonçalo Lopes
- Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Sainsbury Wellcome Centre for Neural Circuits and Behaviour, University College London, London, United Kingdom
- NeuroGEARS Ltd., London, United Kingdom
| | - Joana Nogueira
- Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Sainsbury Wellcome Centre for Neural Circuits and Behaviour, University College London, London, United Kingdom
- NeuroGEARS Ltd., London, United Kingdom
| | - George Dimitriadis
- Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Sainsbury Wellcome Centre for Neural Circuits and Behaviour, University College London, London, United Kingdom
| | - Jorge Aurelio Menendez
- Sainsbury Wellcome Centre for Neural Circuits and Behaviour, University College London, London, United Kingdom
- Gatsby Computational Neuroscience Unit, University College London, London, United Kingdom
- Centre for Computation, Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, London, United Kingdom
| | - Joseph J. Paton
- Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Adam R. Kampff
- Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Sainsbury Wellcome Centre for Neural Circuits and Behaviour, University College London, London, United Kingdom
- Voight-Kampff Ltd., London, United Kingdom
| |
Collapse
|
9
|
Ahn HJ, Chun MH, Lee J. Compliance and effect of thickener use in dysphagia patients with brain lesions: An observational pilot study. Medicine (Baltimore) 2022; 101:e30600. [PMID: 36197259 PMCID: PMC9509132 DOI: 10.1097/md.0000000000030600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The study aimed to investigate the status of thickener use in dysphagia patients with brain lesions and incidence of adverse events based on fluid viscosity. Twenty dysphagia patients with brain lesions who were recommended to use thickeners following a videofluoroscopic swallowing study were enrolled in this observational pilot study. Patients were educated to use thickener as level 2 or 3 based on the International Dysphagia Diet Standardization Initiative flow test. We evaluated the viscosity of the fluid that patients drank once a week for 2 weeks, and reviewed medical records regarding adverse events. Patients were divided into 2 groups based on the average value obtained from the viscosity evaluations as thin (Levels 0-2) and thick fluid groups (Levels 3-4). Adverse events were compared between the groups. The number of patients who did not follow the recommendations increased from 35.0 to 45.0% during the 1-week follow-up period. No patient developed pneumonia or urinary tract infection. Constipation (P = 0.338) and dehydration status (P = 0.202) were not significantly different between the 2 groups. In 2 evaluations for 20 patients, 40.0% of the cases did not follow the educated viscosity, and the number gradually increased in the follow-up evaluation. Considering that there were no significant differences in the incidence of adverse effects including pneumonia according to the fluid viscosity, a further study is necessary to establish detailed criteria for thickener use in dysphagia patients with brain lesions.
Collapse
Affiliation(s)
- Hye Joon Ahn
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- *Correspondence: Min Ho Chun, Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea (e-mail: )
| | - Junekyung Lee
- Department of Rehabilitation Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Gyeonggi-do, Republic of Korea
| |
Collapse
|
10
|
van Honk J, Terburg D, Montoya ER, Grafman J, Stein DJ, Morgan B. Breakdown of utilitarian moral judgement after basolateral amygdala damage. Proc Natl Acad Sci U S A 2022; 119:e2119072119. [PMID: 35878039 DOI: 10.1073/pnas.2119072119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Most of us would regard killing another person as morally wrong, but when the death of one saves multiple others, it can be morally permitted. According to a prominent computational dual-systems framework, in these life-and-death dilemmas, deontological (nonsacrificial) moral judgments stem from a model-free algorithm that emphasizes the intrinsic value of the sacrificial action, while utilitarian (sacrificial) moral judgments are derived from a model-based algorithm that emphasizes the outcome of the sacrificial action. Rodent decision-making research suggests that the model-based algorithm depends on the basolateral amygdala (BLA), but these findings have not yet been translated to human moral decision-making. Here, in five humans with selective, bilateral BLA damage, we show a breakdown of utilitarian sacrificial moral judgments, pointing at deficient model-based moral decision-making. Across an established set of moral dilemmas, healthy controls frequently sacrifice one person to save numerous others, but BLA-damaged humans withhold such sacrificial judgments even at the cost of thousands of lives. Our translational research confirms a neurocomputational hypothesis drawn from rodent decision-making research by indicating that the model-based algorithm which underlies outcome-based, utilitarian moral judgements in humans critically depends on the BLA.
Collapse
|
11
|
Violas X, Rasschaert M, Santus R, Factor C, Corot C, Catoen S, Idée JM, Robert P. Small Brain Lesion Enhancement and Gadolinium Deposition in the Rat Brain: Comparison Between Gadopiclenol and Gadobenate Dimeglumine. Invest Radiol 2022; 57:130-139. [PMID: 34411032 PMCID: PMC8746880 DOI: 10.1097/rli.0000000000000819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/07/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the set of studies was to compare gadopiclenol, a new high relaxivity gadolinium (Gd)-based contrast agent (GBCA) to gadobenate dimeglumine in terms of small brain lesion enhancement and Gd retention, including T1 enhancement in the cerebellum. MATERIALS AND METHODS In a first study, T1 enhancement at 0.1 mmol/kg body weight (bw) of gadopiclenol or gadobenate dimeglumine was evaluated in a small brain lesions rat model at 2.35 T. The 2 GBCAs were injected in an alternated and cross-over manner separated by an interval of 4.4 ± 1.0 hours (minimum, 3.5 hours; maximum, 6.1 hours; n = 6). In a second study, the passage of the GBCAs into cerebrospinal fluid (CSF) was evaluated by measuring the fourth ventricle T1 enhancement in healthy rats at 4.7 T over 23 minutes after a single intravenous (IV) injection of 1.2 mmol/kg bw of gadopiclenol or gadobenate dimeglumine (n = 6/group). In a third study, Gd retention at 1 month was evaluated in healthy rats who had received 20 IV injections of 1 of the 2 GBCAs (0.6 mmol/kg bw) or a similar volume of saline (n = 10/group) over 5 weeks. T1 enhancement of the deep cerebellar nuclei (DCN) was assessed by T1-weighted magnetic resonance imaging at 2.35 T, performed before the injection and thereafter once a week up to 1 month after the last injection. Elemental Gd levels in central nervous system structures, in muscle and in plasma were determined by inductively coupled plasma mass spectrometry (ICP-MS) 1 month after the last injection. RESULTS The first study in a small brain lesion rat model showed a ≈2-fold higher number of enhanced voxels in lesions with gadopiclenol compared with gadobenate dimeglumine. T1 enhancement of the fourth ventricle was observed in the first minutes after a single IV injection of gadopiclenol or gadobenate dimeglumine (study 2), resulting, in the case of gadopiclenol, in transient enhancement during the injection period of the repeated administrations study (study 3). In terms of Gd retention, T1 enhancement of the DCN was noted in the gadobenate dimeglumine group during the month after the injection period. No such enhancement of the DCN was observed in the gadopiclenol group. Gadolinium concentrations 1 month after the injection period in the gadopiclenol group were slightly increased in plasma and lower by a factor of 2 to 3 in the CNS structures and muscles, compared with gadobenate dimeglumine. CONCLUSIONS In the small brain lesion rat model, gadopiclenol provides significantly higher enhancement of brain lesions compared with gadobentate dimeglumine at the same dose. After repeated IV injections, as expected for a macrocyclic GBCA, Gd retention is minimalized in the case of gadopiclenol compared with gadobenate dimeglumine, resulting in no T1 hypersignal in the DCN.
Collapse
|
12
|
Ha TT, Thieringer FM, Bammerlin M, Cordier D. High Precision Bone Cutting by Er: YAG Lasers Might Minimize the Invasiveness of Navigated Brain Biopsies. Front Oncol 2022; 11:690374. [PMID: 35047381 PMCID: PMC8762267 DOI: 10.3389/fonc.2021.690374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Abstract
Biopsies of brain tissue are sampled and examined to establish a diagnosis and to plan further treatment, e.g. for brain tumors. The neurosurgical procedure of sampling brain tissue for histologic examination is still a relatively invasive procedure that carries several disadvantages. The “proof of concept”-objective of this study is to answer the question if laser technology might be a potential tool to make brain biopsies less invasive, faster and safer. Laser technology might carry the opportunity to miniaturize the necessary burr hole and also to angulate the burr hole much more tangential in relation to the bone surface in order to take biopsies from brain regions that are usually only difficult and hazardous to access. We examined if it is possible to miniaturize the hole in the skull bone to such a high extent that potentially the laser-created canal itself may guide the biopsy needle with sufficient accuracy. The 2-dimensional, i.e. radial tolerance of the tip of biopsy needles inserted in these canals was measured under defined lateral loads which mimic mechanical forces applied by a surgeon. The canals through the skull bones were planned in angles of 90° (perpendicular) and 45° relative to the bone surface. We created a total of 33 holes with an Er : YAG laser in human skull bones. We could demonstrate that the achievable radial tolerance concerning the guidance of a biopsy needle by a laser created bone canal is within the range of the actual accuracy of a usual navigated device if the canal is at least 4 mm in length. Lateral mechanical loads applied to the biopsy needle had only minor impact on the measurable radial tolerance. Furthermore, in contrast to mechanical drilling systems, laser technology enables the creation of bone canals in pointed angles to the skull bone surface. The latter opens the perspective to sample biopsies in brain areas that are usually not or only hazardous to access.
Collapse
Affiliation(s)
- Thanh Tu Ha
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| | - Florian M Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.,Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | | | - Dominik Cordier
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| |
Collapse
|
13
|
Ortueta‐Olartecoechea A, Torres‐Peña JL, Muñoz‐Gallego A, Torres‐Valdivieso MJ, Vázquez‐Román S, De la Cruz J, Tejada‐Palacios P. Retinal ganglion cell complex thickness at school-age, prematurity and neonatal stressors. Acta Ophthalmol 2021; 100:e1253-e1263. [PMID: 34873863 DOI: 10.1111/aos.15073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 11/10/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the association between the ganglion cell complex (GCC) thickness at early school-age and prematurity and other neonatal factors. METHODS Cross-sectional study. The sample included very preterm children with gestational age (GA) below 32 weeks or birthweight below 1500 g enrolled in a follow-up program (n = 101) and a comparison group of term-born children (n = 49). Ganglion cell complex (GCC) thickness was measured at 4-8 years using high-quality optical coherence tomography (OCT) images. Data on neonatal and postnatal features were extracted from clinical records; analyses included mixed linear models. RESULTS Ganglion cell layer (GCL) and retinal nerve fiber layer (mRNFL) were thicker in term than in preterm born children (2.9 μm and 2.4 μm respectively, p < 0.001). Within the preterm group, lower GA was associated with a decrease in total GCL (0.7 μm per week, p < 0.001). Being small for GA was associated with further thinning in both layers (1.4 and 2.8 µm). Postnatal corticosteroids therapy and severe brain lesion were associated with thinning in the total GCL of 6 µm (p < 0.001) and 4.1 µm (p = 0.002), respectively, and shock was associated with thinning in total mRNFL of 6 µm (p < 0.001). CONCLUSIONS Lower GA or birthweight are associated with thinning of GCC layers. When performing an OCT examination at school-age and a decrease in GCC thickness is observed, it may be relevant to ask about a history of prematurity, and further enquire about neonatal shock, postnatal corticosteroids therapy or severe brain lesion that are related to additional decrease in GCC thickness.
Collapse
Affiliation(s)
| | - Jose L. Torres‐Peña
- Madrid University Hospital “12 de Octubre”, Department of Ophthalmology Madrid Spain
| | - Alicia Muñoz‐Gallego
- Madrid University Hospital “12 de Octubre”, Department of Ophthalmology Madrid Spain
| | | | - Sara Vázquez‐Román
- Madrid University Hospital “12 de Octubre”, Department of Neonatology Madrid Spain
| | - Javier De la Cruz
- Madrid University Hospital “12 de Octubre”, Research Institute (imas12) Madrid Spain
- Mother and Child Health, and Development Research Network SAMIDISCIII Madrid Spain
| | - Pilar Tejada‐Palacios
- Madrid University Hospital “12 de Octubre”, Department of Ophthalmology Madrid Spain
- Madrid University Hospital “12 de Octubre”, Research Institute (imas12) Madrid Spain
- Madrid University Complutense Madrid Spain
| |
Collapse
|
14
|
Cortese AM, Cacciante L, Schuler AL, Turolla A, Pellegrino G. Cortical Thickness of Brain Areas Beyond Stroke Lesions and Sensory-Motor Recovery: A Systematic Review. Front Neurosci 2021; 15:764671. [PMID: 34803596 PMCID: PMC8595399 DOI: 10.3389/fnins.2021.764671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The clinical outcome of patients suffering from stroke is dependent on multiple factors. The features of the lesion itself play an important role but clinical recovery is remarkably influenced by the plasticity mechanisms triggered by the stroke and occurring at a distance from the lesion. The latter translate into functional and structural changes of which cortical thickness might be easy to quantify one of the main players. However, studies on the changes of cortical thickness in brain areas beyond stroke lesion and their relationship to sensory-motor recovery are sparse. Objectives: To evaluate the effects of cerebral stroke on cortical thickness (CT) beyond the stroke lesion and its association with sensory-motor recovery. Materials and Methods: Five electronic databases (PubMed, Embase, Web of Science, Scopus and the Cochrane Library) were searched. Methodological quality of the included studies was assessed with the Newcastle-Ottawa Scale for non-randomized controlled trials and the Risk of Bias Cochrane tool for randomized controlled trials. Results: The search strategy retrieved 821 records, 12 studies were included and risk of bias assessed. In most of the included studies, cortical thinning was seen at the ipsilesional motor area (M1). Cortical thinning can occur beyond the stroke lesion, typically in regions anatomically connected because of anterograde degeneration. Nonetheless, studies also reported cortical thickening of regions of the unaffected hemisphere, likely related to compensatory plasticity. Some studies revealed a significant correlation between changes in cortical thickness of M1 or somatosensory (S1) cortical areas and motor function recovery. Discussion and Conclusions: Following a stroke, changes in cortical thickness occur both in regions directly connected to the stroke lesion and in contralateral hemisphere areas as well as in the cerebellum. The underlying mechanisms leading to these changes in cortical thickness are still to be fully understood and further research in the field is needed. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200539; PROSPERO 2020, identifier: CRD42020200539.
Collapse
Affiliation(s)
- Anna Maria Cortese
- Laboratory of Rehabilitation Technologies, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Luisa Cacciante
- Laboratory of Rehabilitation Technologies, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Anna-Lisa Schuler
- Laboratory of Clinical Imaging and Stimulation, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Andrea Turolla
- Laboratory of Rehabilitation Technologies, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| | - Giovanni Pellegrino
- Laboratory of Clinical Imaging and Stimulation, San Camillo Istituto di Ricovero e Cura a Carattere Scientifico, Venice, Italy
| |
Collapse
|
15
|
Neumann R, Völker J, Hajba Z, Seiler S. Lesions and reduced working memory impair emotion recognition in self and others. Cogn Emot 2021; 35:1527-1542. [PMID: 34623214 DOI: 10.1080/02699931.2021.1983521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ABSTRACTEmotion recognition (ER) can be conceived of as an integration of affective cues in working memory. We examined whether reduced working memory capacity and brain lesions in neural networks involved in emotion processing interactively impair ER of both one's own and another person's emotions. To assess the recognition of one's own and other's emotions, pictures from the International Affective Picture System (IAPS) and facial expressions from the Karolinska Directed Emotional Faces (KDEF) database representing fear, anger, disgust, and sadness were presented to 40 lesioned patients and 40 healthy students. To manipulate working memory, a math task was imposed between exposure to the stimuli and collection of responses. Participants indicated the intensity of each of the four emotions for each picture. ER was computed as the difference between trials where the elicited emotion matched the requested emotion and trials where the elicited and requested emotions did not match. Whereas lesions impaired ER in both self and others, working memory load exclusively decreased recognition of other persons' emotions.
Collapse
Affiliation(s)
- Roland Neumann
- Department of Psychology, University of Trier, Trier, Germany
| | - Juliane Völker
- Department of Psychology, University of Trier, Trier, Germany
| | - Zsuzsanna Hajba
- Department of Psychology, University of Trier, Trier, Germany
| | | |
Collapse
|
16
|
Affiliation(s)
- Nicola Romano
- Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Genoa, Italy
| | - Margherita Federici
- Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Genoa, Italy
| | - Antonio Castaldi
- Department of Diagnostic and Interventional Neuroradiology, E.O. Ospedali Galliera, Genoa, Italy
| |
Collapse
|
17
|
Limphaibool N, Maciejewska B, Kowal P, Kozubski W, Iwanowski P. Musical hallucinations in cerebrovascular disease. Postep Psychiatr Neurol 2021; 30:177-182. [PMID: 37082771 PMCID: PMC9881628 DOI: 10.5114/ppn.2021.110759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/07/2021] [Indexed: 04/22/2023]
Abstract
Purpose Musical hallucinations (MH) are a subset of complex auditory hallucinations in which individuals perceive music in the absence of an external auditory stimulus. It is a rare phenomenon, first described by Ballinger in 1846, with diverse presentations from familiar childhood melodies to a simple pitch which evolved into the harmonies Robert Schumann incorporated in his sole Violin Concerto. Views This uncommon phenomenon has diverse etiologies, including psychiatric and neurological backgrounds, which guide its classification and methods of treatment. The pathophysiological basis of MH remains understood incompletely, potentially resulting from lesions anywhere along the auditory pathway, from the external auditory canal to the auditory cortex. The strong association between MH and hearing impairment has led researchers to hypothesize that MH represent a "release phenomenon," in which sensory deprivation, eliminating the afferent input to the auditory sensory network, instigates spontaneous activity within a system - comparable to the Charles Bonnet syndrome, in which visual impairment precipitates the development of visual hallucinations (so called auditory Charles Bonnet syndrome), and phantom limb syndrome, in which amputees experience sensations in a limb that is not no longer there. In this paper, we report on six cases of MH in patients with cerebrovascular disease, who presented to the neurology department at the Poznan University of Medical Sciences from 2015 to 2018. Conclusions We discuss the findings of computed tomography and magnetic resonance imaging of six cases of MH in patients with cerebrovascular disease, and the treatment leading to its resolution. We briefly review the literature on MH in patients with cerebrovascular diseases, discussing their suggested pathophysiology, clinical presentations and response to medical treatment.
Collapse
Affiliation(s)
- Nattakarn Limphaibool
- Correspondence to: Dr. Nattakarn Limphaibool Poznan University of Medical Sciences Poznan, Poland e-mail:
| | | | | | | | | |
Collapse
|
18
|
Tarantino V, Burgio F, Toffano R, Rigon E, Meneghello F, Weis L, Vallesi A. Efficacy of a Training on Executive Functions in Potentiating Rehabilitation Effects in Stroke Patients. Brain Sci 2021; 11:1002. [PMID: 34439621 PMCID: PMC8392264 DOI: 10.3390/brainsci11081002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
Cognitive impairment after a stroke has a direct impact on patients' disability. In particular, impairment of Executive Functions (EFs) interferes with re-adaptation to daily life. The aim of this study was to explore whether adding a computer-based training on EFs to an ordinary rehabilitation program, regardless of the specific brain damage and clinical impairment (motor, language, or cognitive), could improve rehabilitation outcomes in patients with stroke. An EF training was designed to have minimal motor and expressive language demands and to be applied to a wide range of clinical conditions. A total of 37 stroke patients were randomly assigned to two groups: a training group, which performed the EF training in addition to the ordinary rehabilitation program (treatment as usual), and a control group, which performed the ordinary rehabilitation exclusively. Both groups were assessed before and after the rehabilitation program on neuropsychological tests covering multiple cognitive domains, and on functional scales (Barthel index, Functional Independence Measure). The results showed that only patients who received the training improved their scores on the Attentional Matrices and Phonemic Fluency tests after the rehabilitation program. Moreover, they showed a greater functional improvement in the Barthel scale as well. These results suggest that combining an EF training with an ordinary rehabilitation program potentiates beneficial effects of the latter, especially in promoting independence in activities of daily living.
Collapse
Affiliation(s)
- Vincenza Tarantino
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Francesca Burgio
- IRCCS San Camillo Hospital, 30126 Venice, Italy; (F.B.); (R.T.); (E.R.); (F.M.)
| | - Roberta Toffano
- IRCCS San Camillo Hospital, 30126 Venice, Italy; (F.B.); (R.T.); (E.R.); (F.M.)
| | - Elena Rigon
- IRCCS San Camillo Hospital, 30126 Venice, Italy; (F.B.); (R.T.); (E.R.); (F.M.)
| | | | - Luca Weis
- Department of Neuroscience, University of Padova, 35128 Padova, Italy;
| | - Antonino Vallesi
- IRCCS San Camillo Hospital, 30126 Venice, Italy; (F.B.); (R.T.); (E.R.); (F.M.)
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, 35128 Padova, Italy
| |
Collapse
|
19
|
Abstract
Chronic encapsulated intracerebral hematoma is a rare pathology which may present after spontaneous intracerebral hemorrhage (ICH) or radiosurgery for arteriovenous malformations. A 66-year-old male presented with recent diagnosis of cerebrovascular accident (CVA) status post-treatment with tissue plasminogen activator and mechanical thrombectomy. His recent diagnoses included infective endocarditis, septic bacteremia, meningitis, and aspiration pneumonia. One month following his CVA, the patient presented with delayed altered mental status. In the setting of increasing lethargy, computed tomography and magnetic resonance imaging of the brain were performed, which suggested a brain abscess, septic emboli, and ventriculitis. The patient was taken to surgery emergently. Intraoperatively, the patient was found to have an encapsulated mass of liquid consistency. Tissue pathology demonstrated ischemic cortical tissue and hemorrhage. Multiple cultures were negative for growth. The patient was ultimately determined to have an encapsulated intracerebral hematoma. Encapsulated intracerebral hematoma should be a part of the differential diagnosis when presented with a brain abscess in the setting of a patient who is at risk of ICH.
Collapse
Affiliation(s)
- Elise J Yoon
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Jake M Jasinski
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Doris Tong
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Karl Kado
- Radiology, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Boyd Richards
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| | - Robert W Mccabe
- Neurosurgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, USA
| |
Collapse
|
20
|
Riglietti A, Fanfulla F, Pagani M, Lucini D, Malacarne M, Manconi M, Ferretti G, Esposito F, Cereda CW, Pons M. Obstructive and Central Sleep Apnea in First Ever Ischemic Stroke are Associated with Different Time Course and Autonomic Activation. Nat Sci Sleep 2021; 13:1167-1178. [PMID: 34295200 PMCID: PMC8291804 DOI: 10.2147/nss.s305850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/14/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Sleep-related breathing disorders are highly prevalent in patients with ischemic stroke. Among sleep-disordered breathing disorders, obstructive sleep apnea is the most represented one, but central sleep apnea, isolated or in the context of a periodic breathing/Cheyne-Stokes respiration, is frequently reported in these patients. Altered baroreflex responses have been reported in the acute phases of a cerebral event. METHODS We conducted, in a group of patients with ischemic stroke (n=60), a prospective 3-month follow-up physiological study to describe the breathing pattern during sleep and baroreflex sensitivity in the acute phase and in the recovery phase. RESULTS In the acute phase, within 10 days from the onset of symptoms, 22.4% of patients had a normal breathing pattern, 40.3% had an obstructive pattern, 16.4% had a central pattern, and 29.9% showed a mixed pattern. Smaller variations in the Apnea-Hypopnea Index were found in normal breathing and obstructive groups (ΔAHI 2.1±4.1 and -2.8±11.6, respectively) in comparison with central and mixed patterns (ΔAHI -6.9±15.1 and -12.5±13.1, respectively; ANOVA p=0.01). The obstructive pattern became the most frequent pattern, in 38.3% of patients at baseline and 61.7% of patients at follow-up. Modification of baroreflex sensitivity over time was influenced by the site of the lesion and by the sleep disorder pattern in the acute phase (MANOVA p=0.005). CONCLUSION We suggest that a down-regulation of autonomic activity, possibly related to reduced vagal modulation, may help the recovery after stroke, or a transitory disconnection from the cortical node that participates in the regulation of sympathetic outflow.
Collapse
Affiliation(s)
- Alessia Riglietti
- Department of Pulmonology, Regional Hospital of Lugano (EOC), Lugano, 6900, Switzerland
| | - Francesco Fanfulla
- Respiratory Function and Sleep Unit - Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Massimo Pagani
- Exercise Medicine Unit, Istituto Auxologico Italiano, MIlan, 20133, Italy
| | - Daniela Lucini
- Exercise Medicine Unit, Istituto Auxologico Italiano, MIlan, 20133, Italy.,University of Milan, BIOMETRA Department, Milan, Italy
| | - Mara Malacarne
- Exercise Medicine Unit, Istituto Auxologico Italiano, MIlan, 20133, Italy.,University of Milan, BIOMETRA Department, Milan, Italy
| | - Mauro Manconi
- Sleep and Epilepsy Center, Neurocenter of the Southern Switzerland, Regional Hospital (EOC) of Lugano, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.,Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| | - Guido Ferretti
- Department APSI, University of Geneva, Geneva, Switzerland.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Carlo W Cereda
- Stroke Center EOC, Department of Neurology, Neurocenter of Southern Switzerland Regional Hospital (EOC) of Lugano, Lugano, Switzerland
| | - Marco Pons
- Department of Pulmonology, Regional Hospital of Lugano (EOC), Lugano, 6900, Switzerland
| |
Collapse
|
21
|
Zhu HM, Zhang SM, Yao C, Luo MQ, Ma HJ, Lei T, Yuan CH, Wu GF, Hu JS, Cai CQ, Liu ZS. The Clinical and Imaging Characteristics Associated With Neurological Sequelae of Pediatric Patients With Acute Necrotizing Encephalopathy. Front Pediatr 2021; 9:655074. [PMID: 34046375 PMCID: PMC8144495 DOI: 10.3389/fped.2021.655074] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Acute necrotizing encephalopathy of childhood (ANE) is a rare but rapidly progressing encephalopathy. Importantly, the exact pathogenesis and evidence-based treatment is scarce. Thus, we aimed to identify the clinical, imaging, and therapeutic characteristics that associated with prognosis of pediatric ANE patients. Methods: A retrospective study was conducted on pediatric patients with ANE who were admitted to Wuhan Children's Hospital between January 2014 and September 2019. All cases met the diagnostic criteria for ANE proposed by Mizuguchi in 1997. The clinical information and follow-up data were collected. The prognostic factors were analyzed by trend chi-square test and Goodman-Kruskal gamma test. Results: A total of 41 ANE patients ranging in age from 8.9 to 142 months were included in this study. Seven cases (17%) died, and the other 34 survivors had different degrees of neurological sequelae. Factors tested to be significantly correlated with the severity of neurological sequelae were the intervals from prodromal infection to acute encephalopathy (G = -0.553), conscious disturbance (r = 0.58), endotracheal intubation (r = 0.423), elevation of alanine aminotransferase (r = 0.345), aspartate aminotransferase (r = 0.393), and cerebrospinal fluid protein (r = 0.490). In addition, dynamic magnetic resonance imaging (MRI) evaluation on follow-up revealed that the total numbers of brain lesion location (χ2 = 6.29, P < 0.05), hemorrhage (r = 0.580), cavitation (r = 0.410), and atrophy (r = 0.602) status were significantly correlated with the severity of neurological sequelae, while early steroid therapy (r = -0.127 and 0.212, respectively) and intravenous immunoglobulin (IVIG) (r = 0.111 and -0.023, respectively) within 24 h or within 72 h after onset showed no association. Conclusions: Intervals from prodromal infection to acute encephalopathy (≤1 day), total numbers of brain lesion location (≥3), the recovery duration of hemorrhage and atrophy (>3 months), and the presence of cavitation predict severe neurological sequelae in pediatric patients with ANE. Early treatments, including steroid therapy and IVIG, had no correlation with better outcomes. Further studies are needed to establish a consensus guideline for the management of ANE.
Collapse
Affiliation(s)
- Hong-Min Zhu
- Pediatric Clinical College of Tianjin Medical University, Tianjin, China.,Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Si-Min Zhang
- Department of Emergency, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cong Yao
- Health Care Department, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng-Qing Luo
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui-Jing Ma
- Department of Radiology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Lei
- Department of Rehabilitation, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chun-Hui Yuan
- Department of Laboratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ge-Fei Wu
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia-Sheng Hu
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chun-Quan Cai
- Pediatric Clinical College of Tianjin Medical University, Tianjin, China.,Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.,Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Zhi-Sheng Liu
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
22
|
Diotel N, Lübke L, Strähle U, Rastegar S. Common and Distinct Features of Adult Neurogenesis and Regeneration in the Telencephalon of Zebrafish and Mammals. Front Neurosci 2020; 14:568930. [PMID: 33071740 PMCID: PMC7538694 DOI: 10.3389/fnins.2020.568930] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022] Open
Abstract
In contrast to mammals, the adult zebrafish brain shows neurogenic activity in a multitude of niches present in almost all brain subdivisions. Irrespectively, constitutive neurogenesis in the adult zebrafish and mouse telencephalon share many similarities at the cellular and molecular level. However, upon injury during tissue repair, the situation is entirely different. In zebrafish, inflammation caused by traumatic brain injury or by induced neurodegeneration initiates specific and distinct neurogenic programs that, in combination with signaling pathways implicated in constitutive neurogenesis, quickly, and efficiently overcome the loss of neurons. In the mouse brain, injury-induced inflammation promotes gliosis leading to glial scar formation and inhibition of regeneration. A better understanding of the regenerative mechanisms occurring in the zebrafish brain could help to develop new therapies to combat the debilitating consequences of brain injury, stroke, and neurodegeneration. The aim of this review is to compare the properties of neural progenitors and the signaling pathways, which control adult neurogenesis and regeneration in the zebrafish and mammalian telencephalon.
Collapse
Affiliation(s)
- Nicolas Diotel
- INSERM, UMR 1188, Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), Université de La Réunion, Saint-Denis, France
| | - Luisa Lübke
- Institute of Biological and Chemical Systems-Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Uwe Strähle
- Institute of Biological and Chemical Systems-Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Sepand Rastegar
- Institute of Biological and Chemical Systems-Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| |
Collapse
|
23
|
Markousis-Mavrogenis G, Mitsikostas DD, Koutsogeorgopoulou L, Dimitroulas T, Katsifis G, Argyriou P, Apostolou D, Velitsista S, Vartela V, Manolopoulou D, Tektonidou MG, Kolovou G, Kitas GD, Sfikakis PP, Mavrogeni SI. Combined Brain-Heart Magnetic Resonance Imaging in Autoimmune Rheumatic Disease Patients with Cardiac Symptoms: Hypothesis Generating Insights from a Cross-sectional Study. J Clin Med 2020; 9:jcm9020447. [PMID: 32041234 PMCID: PMC7074384 DOI: 10.3390/jcm9020447] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Autoimmune rheumatic diseases (ARDs) may affect both the heart and the brain. However, little is known about the interaction between these organs in ARD patients. We asked whether brain lesions are more frequent in ARD patients with cardiac symptoms compared with non-ARD patients with cardiovascular disease (CVD). METHODS 57 ARD patients with mean age of 48 ± 13 years presenting with shortness of breath, chest pain, and/or palpitations, and 30 age-matched disease-controls with non-autoimmune CVD, were evaluated using combined brain-heart magnetic resonance imaging (MRI) in a 1.5T system. RESULTS 52 (91%) ARD patients and 16 (53%) controls had white matter hyperintensities (p < 0.001) in at least one brain area (subcortical/deep/periventricular white matter, basal ganglia, pons, brainstem, or mesial temporal lobe). Only the frequency and number of subcortical and deep white matter lesions were significantly greater in ARD patients (p < 0.001 and 0.014, respectively). ARD vs. control status was the only independent predictor of having any brain lesion. Specifically for deep white matter lesions, each increase in ECV independently predicted a higher number of lesions [odds ratio (95% confidence interval): 1.16 (1.01-1.33), p = 0.031] in ordered logistic regression. Penalized logistic regression selected only ARD vs. control status as the most important feature for predicting whether brain lesions were present on brain MRI (odds ratio: 5.46, marginal false discovery rate = 0.011). CONCLUSIONS Subclinical brain involvement was highly prevalent in this cohort of ARD patients and was mostly independent of the severity of cardiac involvement. However, further research is required to determine the clinical relevance of these findings.
Collapse
Affiliation(s)
| | - Dimos D. Mitsikostas
- First Neurology Department, National and Kapodistrian University of Athens, 10679 Athens, Greece;
| | | | - Theodoros Dimitroulas
- Department of Rheumatology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Gikas Katsifis
- Rheumatology Department, Naval Hospital, 11521 Athens, Greece;
| | - Panayiotis Argyriou
- MRI Unit, Mediterraneo Hospital, 16675 Athens, Greece; (P.A.); (D.A.); (S.V.)
| | - Dimitrios Apostolou
- MRI Unit, Mediterraneo Hospital, 16675 Athens, Greece; (P.A.); (D.A.); (S.V.)
| | - Stella Velitsista
- MRI Unit, Mediterraneo Hospital, 16675 Athens, Greece; (P.A.); (D.A.); (S.V.)
| | - Vasiliki Vartela
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
| | - Dionysia Manolopoulou
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
| | - Maria G. Tektonidou
- First Department of Propaedeutic and Internal Medicine, Laikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.G.T.); (P.P.S.)
| | - Genovefa Kolovou
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
| | - George D. Kitas
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester M13 9PT, UK;
| | - Petros P. Sfikakis
- First Department of Propaedeutic and Internal Medicine, Laikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.G.T.); (P.P.S.)
| | - Sophie I. Mavrogeni
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (G.M.-M.); (V.V.); (D.M.); (G.K.)
- Correspondence: ; Tel./Fax: +30-210-98-82-797
| |
Collapse
|
24
|
Abstract
Individuals with left unilateral spatial neglect (USN) following a right hemisphere lesion show difficulty in orienting their attention toward stimuli presented on the left. In normal cognition, others' gaze direction and a pointing arrow naturally guide visual attention. Here, we explore a method to identify patients who may benefit from these skills as a base for compensation during rehabilitation. We tested gaze and arrow cueing effects in 26 healthy participants and in 13 patients with USN. Our data show that brain injuries causing USN do not affect gaze and arrow cueing in a consistent manner from one patient to another.
Collapse
Affiliation(s)
- Rindra Narison
- Laboratory Cognitive functioning and dysfunctioning (DysCo), University Paris Nanterre, Nanterre, France.,Neurological rehabilitation unit, Rehabilitation Center of "Le Bourbonnais" UGECAM BFC, Bourbon Lancy, France
| | - Marie De Montalembert
- Laboratory Cognitive functioning and dysfunctioning (DysCo), University Paris Nanterre, Nanterre, France
| | - Laurence Conty
- Laboratory Cognitive functioning and dysfunctioning (DysCo), University Paris Nanterre, Nanterre, France
| |
Collapse
|
25
|
Sharma M, Krivosheya D, Borghei-Razavi H, Barnett GH, Mohammadi AM. Laser interstitial thermal therapy for an eloquent region supratentorial brain lesion. Neurosurg Focus 2019; 44:V4. [PMID: 29570386 DOI: 10.3171/2018.4.focusvid.17737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Laser interstitial thermal therapy (LITT) is a minimally invasive stereotactic technique that causes tumor ablation using thermal energy. LITT has shown to be efficacious for the treatment of deep-seated brain lesions, including those near eloquent areas. In this video, the authors present the case of a 62-year-old man with a history of metastatic melanoma who presented with worsening right-sided hemiparesis. MRI revealed a contrast-enhancing lesion in left centrum semiovale in close proximity to corticospinal tracts, consistent with radiation necrosis. The authors review their stepwise technique of LITT with special attention to details for a lesion located near eloquent area. The video can be found here: https://youtu.be/ndrTgi6MXqE .
Collapse
Affiliation(s)
- Mayur Sharma
- 1Department of Neurosurgery, University of Louisville, Kentucky; and
| | - Daria Krivosheya
- 2Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Hamid Borghei-Razavi
- 2Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Gene H Barnett
- 2Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Alireza M Mohammadi
- 2Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
26
|
Chauhan S, Vig L, De Filippo De Grazia M, Corbetta M, Ahmad S, Zorzi M. A Comparison of Shallow and Deep Learning Methods for Predicting Cognitive Performance of Stroke Patients From MRI Lesion Images. Front Neuroinform 2019; 13:53. [PMID: 31417388 PMCID: PMC6684739 DOI: 10.3389/fninf.2019.00053] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 07/04/2019] [Indexed: 01/17/2023] Open
Abstract
Stroke causes behavioral deficits in multiple cognitive domains and there is a growing interest in predicting patient performance from neuroimaging data using machine learning techniques. Here, we investigated a deep learning approach based on convolutional neural networks (CNNs) for predicting the severity of language disorder from 3D lesion images from magnetic resonance imaging (MRI) in a heterogeneous sample of stroke patients. CNN performance was compared to that of conventional (shallow) machine learning methods, including ridge regression (RR) on the images' principal components and support vector regression. We also devised a hybrid method based on re-using CNN's high-level features as additional input to the RR model. Predictive accuracy of the four different methods was further investigated in relation to the size of the training set and the level of redundancy across lesion images in the dataset, which was evaluated in terms of location and topological properties of the lesions. The Hybrid model achieved the best performance in most cases, thereby suggesting that the high-level features extracted by CNNs are complementary to principal component analysis features and improve the model's predictive accuracy. Moreover, our analyses indicate that both the size of training data and image redundancy are critical factors in determining the accuracy of a computational model in predicting behavioral outcome from the structural brain imaging data of stroke patients.
Collapse
Affiliation(s)
- Sucheta Chauhan
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, India
| | | | | | - Maurizio Corbetta
- Department of Neurosciences, Padova Neuroscience Center, University of Padova, Padua, Italy
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Shandar Ahmad
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Marco Zorzi
- Department of General Psychology, Padova Neuroscience Center, University of Padova, Padua, Italy
- IRCCS San Camillo Hospital, Venice, Italy
| |
Collapse
|
27
|
Kamer AP, Bonnin JM, Spinner RJ, Cohen-Gadol AA. Ganglion cyst of the temporomandibular joint with intradural extension: case report. J Neurosurg 2019; 132:700-704. [PMID: 30738406 DOI: 10.3171/2018.10.jns182665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/26/2018] [Indexed: 11/06/2022]
Abstract
Intracranial extension of temporomandibular joint (TMJ) ganglion cysts is very rare. Two previously reported cases presented clinically due to effects on cranial nerves and had obvious association with the TMJ on imaging. To the authors' knowledge, intracranial extension of a TMJ ganglion cyst presenting with seizures and mimicking a primary brain tumor has not been previously reported. The patient underwent resection of a presumptive primary cystic temporal lobe tumor, but the lesion had histopathological features of a nonneoplastic cyst with a myxoid content. He was followed with serial imaging for 5 years before regrowth of the lesion caused new episodes of seizures requiring a repeat operation, during which the transdural defect was repaired after the adjacent segment of the TMJ was curetted. A thorough review of all imaging studies and the histopathological findings from the repeat operation led to the correct diagnosis of a TMJ ganglion cyst. This case highlights an unusual presentation of this rare lesion, as well as its potential for recurrence. TMJ ganglion cysts should be included in the differential diagnosis of cystic tumors involving the anterior temporal lobe, presenting with or without seizures. Focused imaging evaluation of the TMJ can be helpful to rule out the possible role of associated TMJ lesions.
Collapse
Affiliation(s)
| | - Jose M Bonnin
- 2Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Robert J Spinner
- 3Department of Neurologic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota; and
| | - Aaron A Cohen-Gadol
- 4Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| |
Collapse
|
28
|
Bishokarma S, Shrestha P, Koirala S, Raut M, Gongal DN. Venture in 101 Cranial Punctures: A Comparative Study between Frame-based versus Frameless Biopsy of 101 Intracranial Space Occupying Lesion. Asian J Neurosurg 2019; 14:175-180. [PMID: 30937031 PMCID: PMC6417303 DOI: 10.4103/ajns.ajns_137_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Presumptive diagnosis based solely on the clinical picture and imaging is not sufficient to provide appropriate treatment with certainty and hence histopathological confirmation of intracranial space occupying lesion (ICSOL) is essential. Needle biopsy via stereotactic frame-based or frameless neuronavigation technique is efficient procedure. The objective of this study is to compare their accuracy and efficacy and safety. Methods: This is a retrospective comparative study conducted among 101 biopsies of ICSOL. Patients data were retrieved from medical record. Data were analyzed in SPSS ver. 20. P value of <0.05 was considered significant. Results: Out of 101 patients, Frame-based stereotactic biopsy was done among 55 patients (54.4%) while 46 patients (45.6%) underwent frameless stealth neuronavigation guided biopsy. Male to female ration was 2.1:1. Age ranged from 5 to 82 years. 54.5% (55 patients) have deeper location of tumor while 45.5% (46 patients) have lobar location of tumor. Frontal (16.8%) and Thalamic (13.8%) were the common site. Mean size of tumor was 3.09±0.85cms. There was statistically significant difference in operative duration among study groups. Overall Diagnostic yield was 89.1%. Glioma was the most common (50.5%) diagnosis. Glioblastoma WHO Grade IV was 37.6% followed by lymphoma (12.8%). Conclusion: Needle biopsy via stereotactic frame-based or neuronavigation frameless technique is a safe and efficient procedure having high diagnostic yield. Reasons for negative biopsy could be missed target or retrieval of gliotic tissue.
Collapse
Affiliation(s)
- Suresh Bishokarma
- Department of Neurosurgery, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal
| | - Pratyush Shrestha
- Department of Neurosurgery, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal
| | - Sagar Koirala
- Department of Neurosurgery, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal
| | - Manita Raut
- Department of Neurosurgery, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal
| | - Dinesh Nath Gongal
- Department of Neurosurgery, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal
| |
Collapse
|
29
|
Chamudot R, Parush S, Rigbi A, Gross-Tsur V. Brain Lesions as a Predictor of Therapeutic Outcomes of Hand Function in Infants With Unilateral Cerebral Palsy. J Child Neurol 2018; 33:918-924. [PMID: 30307370 DOI: 10.1177/0883073818801632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM The present study aimed to investigate whether the response variability of infants to modified constraint-induced movement therapy and bimanual therapy are associated with different types of brain lesions. METHOD Infants with unilateral cerebral palsy (N = 22) ages 8-15 months (mean = 10.95, standard deviation = 2.15 months) were grouped according to having either a periventricular brain lesion or a middle cerebral artery infarct lesion. Improvement in hand function was analyzed based on the mini-Assistive Hand Assessment results. RESULTS Infants with periventricular brain lesion displayed greater positive response to upper limb treatment compared to those with middle cerebral artery infarct ( P = .02). A significant difference in improvement according to type of treatment was found in the middle cerebral artery infarct group but not in the periventricular brain lesion. CONCLUSION The present study showed an association between the type of brain lesion and the efficacy of upper limb treatment in infants. Infants with periventricular brain lesions displayed greater positive responses than those with middle cerebral artery infarct.
Collapse
Affiliation(s)
- Rena Chamudot
- 1 School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Shula Parush
- 1 School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Amihai Rigbi
- 2 Research Authority and Faculty of Education, Beit Berl Academic College, Kfar-Sava, Israel
| | - Varda Gross-Tsur
- 3 Neuropediatric Unit, Shaare Zedek Medical Center.,4 The Hebrew University School of Medicine, Jerusalem, Israel
| |
Collapse
|
30
|
Magalhães LVS, Winckler MIB, Bragatti JA, Procianoy RS, Silveira RC. Early Amplitude-Integrated Electroencephalogram as a Predictor of Brain Injury in Newborns With Very Low Birth Weight: A Cohort Study. J Child Neurol 2018; 33:659-663. [PMID: 29897002 DOI: 10.1177/0883073818778468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the relationship between abnormal early amplitude integrated electroencephalography (EEG) and severe lesions in imaging tests performed during the neonatal period in very low birth weight infants. METHODS An amplitude-integrated EEG was performed in 70 patients with a mean birth weight of 1226 g during the first 48 hours of life. Severe lesions on magnetic resonance imaging (MRI) or ultrasonography (US) during the neonatal period were considered as adverse conditions. Variables were compared using the χ2 test or analysis of variance. Sensitivity, specificity, and positive likelihood ratio were calculated. RESULTS Adverse outcomes were observed in 6 patients. There was a significant relationship ( P < .001) between abnormal amplitude-integrated EEG background and severe lesions on MRI and US. Sensitivity and specificity were 100% and 89%, respectively. CONCLUSION Early amplitude-integrated EEG with moderate/severe abnormalities in the background is associated with severe structural lesions detected in imaging studies and should be considered as an auxiliary screening tool for the detection of neonatal brain lesions in very low birth weight infants.
Collapse
Affiliation(s)
- Luiza V S Magalhães
- 1 Postgraduate Program in Child and Adolescent Health, UFRGS, Porto Alegre, Brazil
| | | | | | - Renato S Procianoy
- 1 Postgraduate Program in Child and Adolescent Health, UFRGS, Porto Alegre, Brazil.,4 Neonatology Section, HCPA, Porto Alegre, Brazil
| | - Rita C Silveira
- 1 Postgraduate Program in Child and Adolescent Health, UFRGS, Porto Alegre, Brazil.,4 Neonatology Section, HCPA, Porto Alegre, Brazil
| |
Collapse
|
31
|
Bellmann B, Rillig A, Skurk C, Leistner DM, Haeusler KG, Lin T, Geran R, Koehler L, Guttmann S, Tscholl V, Roser M, Lenz K, Villringer K, Wun Park J, Fiebach JB, Landmesser U. Long-term follow up of 3 T MRI-detected brain lesions after percutaneous catheter-based left atrial appendage closure. Catheter Cardiovasc Interv 2018; 92:327-333. [PMID: 29737618 DOI: 10.1002/ccd.27611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/05/2018] [Accepted: 03/02/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Left atrial appendage closure (LAAC) for stroke prevention is an increasingly performed intervention. AIMS This prospective study aims to evaluate the incidence of long-term magnetic resonance imaging (MRI)-detected brain lesions as well as potential changes of neurocognitive function after percutaneous LAAC. METHODS Brain MRI at 3 T was performed within 24 hr before and after LAAC. A follow-up MRI was carried out after three months. Neuro-cognitive examination using the National Institutes of Health Stroke Scale (NIHSS) score and the Montreal Cognitive Assessment (MoCA) Test was performed. RESULTS Successful device implantation was achieved in all 25 patients (age 74.6 ± 10.2 years, male = 17) using the Amulet (n = 20), Occlutech (n = 3), or a Lambre (n = 2) device. In 12/25 (48%) patients, acute brain lesions (ABL) were detected after LAAC. A three-month follow-up MRI was performed in seven patients, and no new ABLs were seen. In 5/7 (71%) patients, there were no residual changes from the ABLs detectable. However, the FLAIR sequence was still positive in two patients. After LAAC, there were no significant differences in the MoCA-test (mean 24.3 ± 4.5 vs. 23.5 ± 4.5; P = 0.1) and the NIHSS-score (mean 0.9 ± 1.6 vs. 1.2 ± 1.8; P = 0.1). This was the same at the three-month follow-up (MoCA-test 23.5 ± 4.5 vs. 23.8 ± 2.7; P = 0.3; NIHSS-score 1.2 ± 1.8 vs. 1.0 ± 0.8; P = 0.4). CONCLUSION While new MRI-detected brain lesions are commonly observed after percutaneous LAAC, ABLs were no longer detectable in 71% of the patients at the three-month follow-up. There were no significant changes in neurocognitive function after LAAC and at the three-month follow-up.
Collapse
Affiliation(s)
- Barbara Bellmann
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Andreas Rillig
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Carsten Skurk
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - David Manuel Leistner
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Karl Georg Haeusler
- Charité - Universitätsmedizin Berlin, University Hospital, Center for Stroke Research Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Tina Lin
- HeartCare Victoria, Melbourne, Australia
| | - Rohat Geran
- Charité - Universitätsmedizin Berlin, University Hospital, Center for Stroke Research Berlin, Berlin, Germany
| | - Luzie Koehler
- Charité - Universitätsmedizin Berlin, University Hospital, Center for Stroke Research Berlin, Berlin, Germany
| | - Selma Guttmann
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Verena Tscholl
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Mattias Roser
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Klaus Lenz
- Institute for Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kersten Villringer
- Charité - Universitätsmedizin Berlin, University Hospital, Center for Stroke Research Berlin, Berlin, Germany
| | - Jai- Wun Park
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| | - Jochen B Fiebach
- Charité - Universitätsmedizin Berlin, University Hospital, Center for Stroke Research Berlin, Berlin, Germany
| | - Ulf Landmesser
- Department of Cardiology, Charité - Universitätsmedizin Berlin, University Hospital, Berlin, Germany
| |
Collapse
|
32
|
Alex V, Vaidhya K, Thirunavukkarasu S, Kesavadas C, Krishnamurthi G. Semisupervised learning using denoising autoencoders for brain lesion detection and segmentation. J Med Imaging (Bellingham) 2017; 4:041311. [PMID: 29285516 DOI: 10.1117/1.jmi.4.4.041311] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 11/16/2017] [Indexed: 12/13/2022] Open
Abstract
The work explores the use of denoising autoencoders (DAEs) for brain lesion detection, segmentation, and false-positive reduction. Stacked denoising autoencoders (SDAEs) were pretrained using a large number of unlabeled patient volumes and fine-tuned with patches drawn from a limited number of patients ([Formula: see text], 40, 65). The results show negligible loss in performance even when SDAE was fine-tuned using 20 labeled patients. Low grade glioma (LGG) segmentation was achieved using a transfer learning approach in which a network pretrained with high grade glioma data was fine-tuned using LGG image patches. The networks were also shown to generalize well and provide good segmentation on unseen BraTS 2013 and BraTS 2015 test data. The manuscript also includes the use of a single layer DAE, referred to as novelty detector (ND). ND was trained to accurately reconstruct nonlesion patches. The reconstruction error maps of test data were used to localize lesions. The error maps were shown to assign unique error distributions to various constituents of the glioma, enabling localization. The ND learns the nonlesion brain accurately as it was also shown to provide good segmentation performance on ischemic brain lesions in images from a different database.
Collapse
Affiliation(s)
- Varghese Alex
- Indian Institute of Technology Madras, Department of Engineering Design, Chennai, India
| | - Kiran Vaidhya
- Indian Institute of Technology Madras, Department of Engineering Design, Chennai, India
| | | | - Chandrasekharan Kesavadas
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Radiology, Trivandrum, India
| | | |
Collapse
|
33
|
Lee KB, Kim JS, Hong BY, Sul B, Song S, Sung WJ, Hwang BY, Lim SH. Brain lesions affecting gait recovery in stroke patients. Brain Behav 2017; 7:e00868. [PMID: 29201557 PMCID: PMC5698874 DOI: 10.1002/brb3.868] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 09/26/2017] [Accepted: 09/30/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Gait recovery is an important goal in stroke patients. Several studies have sought to uncover relationships between specific brain lesions and the recovery of gait, but the effects of specific brain lesions on gait remain unclear. Thus, we investigated the effects of stroke lesions on gait recovery in stroke patients. MATERIALS AND METHODS In total, 30 subjects with stroke were assessed in a retrograde longitudinal observational study. To assess gait function, the functional ambulation category (FAC) was tested four times: initially (within 2 weeks) and 1, 3, and 6 months after the onset of the stroke. Brain lesions were analyzed via overlap, subtraction, and voxel-based lesion symptom mapping (VLSM). RESULTS Ambulation with FAC improved significantly with time. Subtraction analysis showed that involvement of the corona radiata, internal capsule, globus pallidus, and putamen were associated with poor recovery of gait throughout 6 months after onset. The caudate nucleus did influence poor recovery of gait at 6 months after onset. VLSM revealed that corona radiata, internal capsule, globus pallidus, putamen and cingulum were related with poor recovery of gait at 3 months after onset. Corona radiata, internal capsule, globus pallidus, putamen, primary motor cortex, and caudate nucleus were related with poor recovery of gait at 6 months after onset. CONCLUSION Results identified several important brain lesions for gait recovery in patients with stroke. These results may be useful for planning rehabilitation strategies for gait and understanding the prognosis of gait in stroke patients.
Collapse
Affiliation(s)
- Kyoung Bo Lee
- Department of Rehabilitation Medicine St. Vincent's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| | - Joon Sung Kim
- Department of Rehabilitation Medicine St. Vincent's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| | - Bo Young Hong
- Department of Rehabilitation Medicine St. Vincent's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| | - Bomi Sul
- Department of Rehabilitation Medicine St. Vincent's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| | - Seojin Song
- Department of Rehabilitation Medicine St. Vincent's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| | - Won Jin Sung
- Department of Rehabilitation Medicine St. Vincent's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| | | | - Seong Hoon Lim
- Department of Rehabilitation Medicine St. Vincent's Hospital College of Medicine The Catholic University of Korea Seoul Korea
| |
Collapse
|
34
|
Weiner KS, Jonas J, Gomez J, Maillard L, Brissart H, Hossu G, Jacques C, Loftus D, Colnat-Coulbois S, Stigliani A, Barnett MA, Grill-Spector K, Rossion B. The Face-Processing Network Is Resilient to Focal Resection of Human Visual Cortex. J Neurosci 2016; 36:8425-40. [PMID: 27511014 DOI: 10.1523/JNEUROSCI.4509-15.2016] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 06/22/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Human face perception requires a network of brain regions distributed throughout the occipital and temporal lobes with a right hemisphere advantage. Present theories consider this network as either a processing hierarchy beginning with the inferior occipital gyrus (occipital face area; IOG-faces/OFA) or a multiple-route network with nonhierarchical components. The former predicts that removing IOG-faces/OFA will detrimentally affect downstream stages, whereas the latter does not. We tested this prediction in a human patient (Patient S.P.) requiring removal of the right inferior occipital cortex, including IOG-faces/OFA. We acquired multiple fMRI measurements in Patient S.P. before and after a preplanned surgery and multiple measurements in typical controls, enabling both within-subject/across-session comparisons (Patient S.P. before resection vs Patient S.P. after resection) and between-subject/across-session comparisons (Patient S.P. vs controls). We found that the spatial topology and selectivity of downstream ipsilateral face-selective regions were stable 1 and 8 month(s) after surgery. Additionally, the reliability of distributed patterns of face selectivity in Patient S.P. before versus after resection was not different from across-session reliability in controls. Nevertheless, postoperatively, representations of visual space were typical in dorsal face-selective regions but atypical in ventral face-selective regions and V1 of the resected hemisphere. Diffusion weighted imaging in Patient S.P. and controls identifies white matter tracts connecting retinotopic areas to downstream face-selective regions, which may contribute to the stable and plastic features of the face network in Patient S.P. after surgery. Together, our results support a multiple-route network of face processing with nonhierarchical components and shed light on stable and plastic features of high-level visual cortex following focal brain damage. SIGNIFICANCE STATEMENT Brain networks consist of interconnected functional regions commonly organized in processing hierarchies. Prevailing theories predict that damage to the input of the hierarchy will detrimentally affect later stages. We tested this prediction with multiple brain measurements in a rare human patient requiring surgical removal of the putative input to a network processing faces. Surprisingly, the spatial topology and selectivity of downstream face-selective regions are stable after surgery. Nevertheless, representations of visual space were typical in dorsal face-selective regions but atypical in ventral face-selective regions and V1. White matter connections from outside the face network may support these stable and plastic features. As processing hierarchies are ubiquitous in biological and nonbiological systems, our results have pervasive implications for understanding the construction of resilient networks.
Collapse
|
35
|
Boccia M, Barbetti S, Piccardi L, Guariglia C, Giannini AM. Neuropsychology of Aesthetic Judgment of Ambiguous and Non-Ambiguous Artworks. Behav Sci (Basel) 2017; 7:bs7010013. [PMID: 28335460 PMCID: PMC5371757 DOI: 10.3390/bs7010013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/13/2017] [Accepted: 03/15/2017] [Indexed: 12/03/2022] Open
Abstract
Several affective and cognitive processes have been found to be pivotal in affecting aesthetic experience of artworks and both neuropsychological as well as psychiatric symptoms have been found to affect artistic production. However, there is a paucity of studies directly investigating effects of brain lesions on aesthetic judgment. Here, we assessed the effects of unilateral brain damage on aesthetic judgment of artworks showing part/whole ambiguity. We asked 19 unilaterally brain-damaged patients (10 left and 9 right brain damaged patients, respectively LBDP and RBDP) and 20 age- and education-matched healthy individuals (controls, C) to rate 10 Arcimboldo’s ambiguous portraits (AP), 10 realistic Renaissance portraits (RP), 10 still life paintings (SL), and 10 Arcimboldo’s modified portraits where only objects/parts are detectable (AO). They were also administered a Navon task, a facial recognition test, and evaluated on visuo-perceptual and visuo-constructional abilities. Patients included in the study did not show any deficits that could affect the capability to explore and enjoy artworks. SL and RP was not affected by brain damage regardless of its laterality. On the other hand, we found that RBDP liked AP more than the C participants. Furthermore, we found a positive correlation between aesthetic judgment of AP and visuo-perceptual skills even if the single case analyses failed to find a systematic association between neuropsychological deficits and aesthetic judgment of AP. On the whole, the present data suggest that a right hemisphere lesion may affect aesthetic judgment of ambiguous artworks, even in the absence of exploration or constructional deficits.
Collapse
Affiliation(s)
- Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy.
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia of Rome, 00179 Rome, Italy.
| | - Sonia Barbetti
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy.
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia of Rome, 00179 Rome, Italy.
| | - Laura Piccardi
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia of Rome, 00179 Rome, Italy.
- Department of Life, Health and Environmental Sciences, L'Aquila University, 67100 L'Aquila, Italy.
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy.
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia of Rome, 00179 Rome, Italy.
| | - Anna Maria Giannini
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy.
| |
Collapse
|
36
|
Jehna M, Becker J, Zaar K, von Campe G, Mahdy Ali K, Reishofer G, Payer F, Synowitz M, Fazekas F, Enzinger C, Deutschmann H. Symmetry of the arcuate fasciculus and its impact on language performance of patients with brain tumors in the language-dominant hemisphere. J Neurosurg 2017; 127:1407-1416. [PMID: 28128689 DOI: 10.3171/2016.9.jns161281] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cerebral damage in frontal, parietal, and temporal brain areas and, probably more importantly, their interconnections can lead to deficits in language. However, neural plasticity and repair allow the brain to partly compensate for neural injury, mediated by both functional and structural changes. In this study, the authors sought to systematically investigate the relationship between language performance in brain tumor patients and structural perisylvian pathways (i.e., the arcuate fasciculus [AF]) using probabilistic fiber tracking on diffusion tensor imaging. The authors used a previously proposed model in which the AF is divided into anterior, long, and posterior segments. The authors hypothesized that right-handed patients with gliomas in the language-dominant (left) hemisphere would benefit from a more symmetrical or right-lateralized language pathway in terms of better preservation of language abilities. Furthermore, they investigated to what extent specific tumor characteristics, including proximity to the AF, affect language outcome in such patients. METHODS Twenty-seven right-handed patients (12 males and 15 females; mean age 52 ± 16 years) with 11 low-grade and 16 high-grade gliomas of the left hemisphere underwent 3-T diffusion-weighted MRI (30 directions) and language assessment as part of presurgical planning. For a systematic quantitative evaluation of the AF, probabilistic fiber tracking with a 2 regions of interest approach was carried out. Volumes of the 3 segments of both hemispheric AFs were evaluated by quantifying normalized and thresholded pathways. Resulting values served to generate the laterality index of the AFs. RESULTS Patients without language deficits tended to have an AF that was symmetric or lateralized to the right, whereas patients with deficits in language significantly more often demonstrated a left-lateralized posterior segment of the AF. Patients with high-grade gliomas had more severe language deficits than those with low-grade gliomas. Backward logistic regression revealed the laterality index of the posterior AF segment and tumor grade as the only independent statistically significant predictors for language deficits in this cohort. CONCLUSIONS In addition to the well-known fact that tumor entity influences behavioral outcome, the authors' findings suggest that the right homologs of structural language-associated pathways could be supportive for language function and facilitate compensation mechanisms after brain damage in functionally eloquent areas. This further indicates that knowledge about preoperative functional redistribution (identified by neurofunctional imaging) increases the chance for total or near-total resections of tumors in eloquent areas. In the future, longitudinal studies with larger groups are mandatory to overcome the methodological limitations of this cross-sectional study and to map neuroplastic changes associated with language performance and rehabilitation in brain tumor patients.
Collapse
Affiliation(s)
- Margit Jehna
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, and
| | - Juliane Becker
- Department of Neurosurgery, University Hospital Center Schleswig Holstein, Kiel, Germany
| | | | | | | | - Gernot Reishofer
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, and
| | - Franz Payer
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, and.,Neurology, Medical University of Graz, Austria; and
| | - Michael Synowitz
- Department of Neurosurgery, University Hospital Center Schleswig Holstein, Kiel, Germany
| | - Franz Fazekas
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, and.,Neurology, Medical University of Graz, Austria; and
| | - Christian Enzinger
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, and.,Neurology, Medical University of Graz, Austria; and
| | - Hannes Deutschmann
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, and
| |
Collapse
|
37
|
Rosa PB, Orquiza B, Rocha FB, Donadel RW, Diniz RP, Beloni TM, Aniceto JT, Fragoso YD. Anger and stroke: a potential association that deserves serious consideration. Acta Neuropsychiatr 2016; 28:346-51. [PMID: 27363946 DOI: 10.1017/neu.2016.32] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the relationship between states of anger and stroke. METHODS Systematic review of the literature. RESULTS In total, 21 papers were selected for the systematic review of data published on the subject of anger and stroke. A state of anger may be a risk factor for stroke, as well as a consequence of brain lesions affecting specific areas that are caused by a stroke. Scales to assess anger varied among authors. There was no consensus regarding the area of brain lesions that might lead to a state of anger. Although some authors agreed that lesions on the right side led to angrier behaviour, others found that lesions on the left side were more relevant to anger. Likewise, there was no consensus regarding the prevalence of anger pre or post-stroke. Some authors did not even find that these two conditions were related. CONCLUSION Although most authors have accepted that there is a relationship between anger and stroke, studies with uniform methodology need to be conducted if this association is to be properly evaluated and understood.
Collapse
|
38
|
Dinomais M, Hertz-Pannier L, Groeschel S, Chabrier S, Delion M, Husson B, Kossorotoff M, Renaud C, Nguyen The Tich S. Long term motor function after neonatal stroke: Lesion localization above all. Hum Brain Mapp 2015; 36:4793-807. [PMID: 26512551 DOI: 10.1002/hbm.22950] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 08/07/2015] [Accepted: 08/11/2015] [Indexed: 12/21/2022] Open
Abstract
Motor outcome is variable following neonatal arterial ischemic stroke (NAIS). We analyzed the relationship between lesion characteristics on brain MRI and motor function in children who had suffered from NAIS. Thirty eight full term born children with unilateral NAIS were investigated at the age of seven. 3D T1- and 3D FLAIR-weighted MR images were acquired on a 3T MRI scanner. Lesion characteristics were compared between patients with and without cerebral palsy (CP) using the following approaches: lesion localization either using a category-based analysis, lesion mapping as well as voxel-based lesion-symptom mapping (VLSM). Using diffusion-weighted imaging the microstructure of the cortico-spinal tract (CST) was related to the status of CP by measuring DTI parameters. Whereas children with lesions sparing the primary motor system did not develop CP, CP was always present when extensive lesions damaged at least two brain structures involving the motor system. The VLSM approach provided a statistical map that confirmed the cortical lesions in the primary motor system and revealed that CP was highly correlated with lesions in close proximity to the CST. In children with CP, diffusion parameters indicated microstructural changes in the CST at the level of internal capsule and the centrum semiovale. White matter damage of the CST in centrum semiovale was a highly reproducible marker of CP. This is the first description of the implication of this latter region in motor impairment after NAIS. In conclusion, CP in childhood was closely linked to the location of the infarct in the motor system.
Collapse
Affiliation(s)
- Mickael Dinomais
- LUNAM, Université d'Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS) - EA7315, F-49000, Angers, France.,LUNAM, CHU Angers, Université d'Angers, Département de Médecine Physique et de Réadaptation, F- 49933, Angers, France
| | - Lucie Hertz-Pannier
- UNIACT, Neurospin, I2BM, DSV, CEA-Saclay, and INSERM U1129 Paris, Université Paris Descartes, Sorbonne Paris Cité, CEA, F-91191, Gif sur Yvette, France
| | - Samuel Groeschel
- Experimental Pediatric Neuroimaging, Department of Pediatric Neurology & Developmental Medicine, University Children's Hospital Tübingen, Germany
| | - Stéphane Chabrier
- CHU Saint-Étienne, Centre national de référence de l'AVC de l'enfant and Inserm CIC1408, F-42055, Saint-Étienne, France.,Université de Saint-x000C9;tienne, Groupe de recherche sur la thrombose - EA3065, F-42023, Saint-Étienne, France
| | - Matthieu Delion
- LUNAM, CHU Angers, Université d'Angers, Département de Neurochirurgie, F-49933, Angers, France.,LUNAM, Université d'Angers, Laboratoire d'Anatomie, Faculté de Médecine F-49045, Angers, France
| | - Béatrice Husson
- Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, Service d'Imagerie Pédiatrique and Centre national de référence de l'AVC de l'enfant, Paris, France
| | - Manoelle Kossorotoff
- Pediatric Neurology Department and French Center for Pediatric Stroke, University Hospital Necker-Enfants Malades, AP-HP Assistance Publique-Hôpitaux de Paris, F-75743, Paris, France
| | - Cyrille Renaud
- CHU Saint-Étienne, Centre national de référence de l'AVC de l'enfant and Inserm CIC1408, F-42055, Saint-Étienne, France
| | - Sylvie Nguyen The Tich
- LUNAM, Université d'Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS) - EA7315, F-49000, Angers, France.,LUNAM, CHU Angers, Université d'Angers, Département de Neuropédiatrie, F-49933, Angers, France
| | | |
Collapse
|
39
|
Thiebaut de Schotten M, Dell'Acqua F, Ratiu P, Leslie A, Howells H, Cabanis E, Iba-Zizen MT, Plaisant O, Simmons A, Dronkers NF, Corkin S, Catani M. From Phineas Gage and Monsieur Leborgne to H.M.: Revisiting Disconnection Syndromes. Cereb Cortex 2015; 25:4812-27. [PMID: 26271113 PMCID: PMC4635921 DOI: 10.1093/cercor/bhv173] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
On the 50th anniversary of Norman Geschwind's seminal paper entitled ‘Disconnexion syndrome in animal and man’, we pay tribute to his ideas by applying contemporary tractography methods to understand white matter disconnection in 3 classic cases that made history in behavioral neurology. We first documented the locus and extent of the brain lesion from the computerized tomography of Phineas Gage's skull and the magnetic resonance images of Louis Victor Leborgne's brain, Broca's first patient, and Henry Gustave Molaison. We then applied the reconstructed lesions to an atlas of white matter connections obtained from diffusion tractography of 129 healthy adults. Our results showed that in all 3 patients, disruption extended to connections projecting to areas distant from the lesion. We confirmed that the damaged tracts link areas that in contemporary neuroscience are considered functionally engaged for tasks related to emotion and decision-making (Gage), language production (Leborgne), and declarative memory (Molaison). Our findings suggest that even historic cases should be reappraised within a disconnection framework whose principles were plainly established by the associationist schools in the last 2 centuries.
Collapse
Affiliation(s)
- M Thiebaut de Schotten
- Natbrainlab, Department of FANS, Institute of Psychiatry, Psychology and Neuroscience and Brain Connectivity and Behaviour, Brain and Spine Institute, Paris, France Inserm U 1127; UPMC-Paris6, UMR_S 1127; CNRS UMR 7225, CRICM, GH Pitié-Salpêtrière, 75013 Paris, France
| | - F Dell'Acqua
- Natbrainlab, Department of FANS, Institute of Psychiatry, Psychology and Neuroscience and Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - P Ratiu
- Natbrainlab, Department of FANS, Institute of Psychiatry, Psychology and Neuroscience and
| | - A Leslie
- Natbrainlab, Department of FANS, Institute of Psychiatry, Psychology and Neuroscience and Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - H Howells
- Natbrainlab, Department of FANS, Institute of Psychiatry, Psychology and Neuroscience and Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - E Cabanis
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - M T Iba-Zizen
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - O Plaisant
- University of Paris-Descartes, GH Pitié-Salpêtrière, URDIA, EA4465, Paris, France
| | - A Simmons
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - N F Dronkers
- VA Northern California Health Care System, Martinez, CA, USA Department of Neurology, University of California, Davis, CA, USA National Research University Higher School of Economics, Russian Federation
| | - S Corkin
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - M Catani
- Natbrainlab, Department of FANS, Institute of Psychiatry, Psychology and Neuroscience and Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| |
Collapse
|
40
|
Abstract
Introduction: Short-term memory develops differently in navigation vs. manual space. The Magic Carpet (MC) is a novel navigation test derived from the Walking Corsi Test and the manual Corsi Block-tapping Task (CBT). The MC requires mental rotations and executive function. In Cerebral Palsy (CP), CBT, and MC scores relate differently to clinical and lesional factors. Hypotheses of this study are: that frontal lesion specifically affect navigation in CP; that brain lesions affect MC cognitive strategies. Materials and Methods: Twenty-two children with spastic CP, aged 5 to 14 years, 14 with a unilateral and 8 with a bilateral form, underwent the CBT and the MC. Errors were classified into seven patterns by a recently described algorithm. Brain lesions were quantified according to a novel semi-quantitative MRI scale. Control data were partially drawn from a previous study on 91 typically developing children. Results: Children with CP performed worse than controls on both tests. Right hemispheric impairment correlated with spatial memory. MC span was reduced less than CBT span and was more selectively related to right middle white-matter and frontal lesions. Error patterns were differently distributed in CP and in typical development, and depended on right brain impairment: children with more extensive right lesions made more positional than sequential errors. Discussion: In CP, navigation is affected especially by extensive lesions involving the right frontal lobe. In addition, these are associated with abnormal cognitive strategies. Whereas in typical development positional errors, preserving serial order, increase with age and performance, in CP they are associated with poorer performance and more extensive right-brain lesions. The explanation may lie in lesion side: right brain is crucial for mental rotations, necessary for spatial updating. Left-lateralized spatial memory strategies, relying on serial order, are not efficient if not accompanied by right-brain spatial functions.
Collapse
Affiliation(s)
- Vittorio Belmonti
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Calambrone, Italy
| | | | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Calambrone, Italy ; Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | - Simona Fiori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Calambrone, Italy
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Calambrone, Italy ; Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| |
Collapse
|
41
|
Abstract
BACKGROUND Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. OBJECTIVE To review the effects of published treatment methods for musical hallucinations. METHODS A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analyzed the treatment results in relation to the etiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion, and other pathology, epilepsy or intoxication/pharmacology. RESULTS Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct etiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g., more acoustic stimulation) are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being possibly more helpful than antiepileptics (which are still better than antipsychotics). The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication/pharmacology is the main etiological factor, it is important to stop or switch the causative substance or medication. CONCLUSION Treatments for musical hallucinations tend to yield favorable results when they target the main etiological factor of these phenomena. There is a need to establish the natural course of musical hallucinations, their response to non-pharmacological treatments, and their effects on the patient's quality of life. There is also a need to standardize the assessment of treatment responses, and document long-term follow up.
Collapse
Affiliation(s)
- Jan A. F. Coebergh
- Department of Neurology, Haga HospitalThe Hague, Netherlands
- Department of Neurology, Ashford/St. Peter's HospitalChertsey, UK
- Department of Neurology, St. George's HospitalLondon, UK
| | - R. F. Lauw
- Parnassia Psychiatric InstituteThe Hague, Netherlands
| | - R. Bots
- ‘S Heeren LooNoordwijk, Netherlands
| | - I. E. C. Sommer
- Department of Psychiatry, University Medical Center UtrechtUtrecht, Netherlands
- Brain Centre Rudolf MagnusUtrecht, Netherlands
| | - J. D. Blom
- Parnassia Psychiatric InstituteThe Hague, Netherlands
- Department of Psychiatry, University of GroningenGroningen, Netherlands
| |
Collapse
|
42
|
Gu X, Wang X, Hula A, Wang S, Xu S, Lohrenz TM, Knight RT, Gao Z, Dayan P, Montague PR. Necessary, yet dissociable contributions of the insular and ventromedial prefrontal cortices to norm adaptation: computational and lesion evidence in humans. J Neurosci 2015; 35:467-73. [PMID: 25589742 DOI: 10.1523/JNEUROSCI.2906-14.2015] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Social norms and their enforcement are fundamental to human societies. The ability to detect deviations from norms and to adapt to norms in a changing environment is therefore important to individuals' normal social functioning. Previous neuroimaging studies have highlighted the involvement of the insular and ventromedial prefrontal (vmPFC) cortices in representing norms. However, the necessity and dissociability of their involvement remain unclear. Using model-based computational modeling and neuropsychological lesion approaches, we examined the contributions of the insula and vmPFC to norm adaptation in seven human patients with focal insula lesions and six patients with focal vmPFC lesions, in comparison with forty neurologically intact controls and six brain-damaged controls. There were three computational signals of interest as participants played a fairness game (ultimatum game): sensitivity to the fairness of offers, sensitivity to deviations from expected norms, and the speed at which people adapt to norms. Significant group differences were assessed using bootstrapping methods. Patients with insula lesions displayed abnormally low adaptation speed to norms, yet detected norm violations with greater sensitivity than controls. Patients with vmPFC lesions did not have such abnormalities, but displayed reduced sensitivity to fairness and were more likely to accept the most unfair offers. These findings provide compelling computational and lesion evidence supporting the necessary, yet dissociable roles of the insula and vmPFC in norm adaptation in humans: the insula is critical for learning to adapt when reality deviates from norm expectations, and that the vmPFC is important for valuation of fairness during social exchange.
Collapse
|
43
|
Patel AS, Allen JE, Dicker DT, Sheehan JM, Glantz MJ, El-Deiry WS. Detection of circulating tumor cells in the cerebrospinal fluid of a patient with a solitary metastasis from breast cancer: A case report. Oncol Lett 2014; 7:2110-2112. [PMID: 24932298 PMCID: PMC4049668 DOI: 10.3892/ol.2014.1993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 12/13/2013] [Indexed: 11/06/2022] Open
Abstract
Brain lesions identified following the diagnosis and eradication of primary cancers are often ambiguous in origin, existing as a solitary metastasis or an independent primary brain tumor. The brain is a relatively common site of metastasis with breast cancer, although determining whether metastases have originated from the breast or brain is often not possible without invasive biopsies. In the current case report, a patient presented with a brain lesion identified by radiography and was without systemic disease. The patient had previously exhibited a complete response to chemotherapy and surgery for a poorly differentiated invasive ductal carcinoma. The origin of the brain lesion could not be determined by magnetic resonance imaging, giving rise to a diagnostic dilemma with diverging treatment options. We previously reported a method to isolate and enumerate tumor cells of epithelial origin in the cerebrospinal fluid (CSF). CSF tumor cell analysis of the patient revealed massive CSF tumor cell burden of epithelial origin, indicating that the brain lesion was likely of breast origin. The current case report highlights the use of CSF tumor cell detection as a differential diagnostic tool, in addition to its previously demonstrated use as a marker of disease burden and therapeutic response.
Collapse
Affiliation(s)
- Akshal S Patel
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, Department of Medicine (Hematology/Oncology), Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, PA 17033, USA ; Department of Neurological Surgery, Penn State Hershey Medical Center, Hershey, PA 17033, USA
| | - Joshua E Allen
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, Department of Medicine (Hematology/Oncology), Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, PA 17033, USA
| | - David T Dicker
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, Department of Medicine (Hematology/Oncology), Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Jonas M Sheehan
- Department of Neurological Surgery, Penn State Hershey Medical Center, Hershey, PA 17033, USA
| | - Michael J Glantz
- Department of Neurological Surgery, Penn State Hershey Medical Center, Hershey, PA 17033, USA
| | - Wafik S El-Deiry
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, Department of Medicine (Hematology/Oncology), Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, PA 17033, USA
| |
Collapse
|
44
|
Urgesi C, Candidi M, Avenanti A. Neuroanatomical substrates of action perception and understanding: an anatomic likelihood estimation meta-analysis of lesion-symptom mapping studies in brain injured patients. Front Hum Neurosci 2014; 8:344. [PMID: 24910603 PMCID: PMC4039011 DOI: 10.3389/fnhum.2014.00344] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 05/06/2014] [Indexed: 11/29/2022] Open
Abstract
Several neurophysiologic and neuroimaging studies suggested that motor and perceptual systems are tightly linked along a continuum rather than providing segregated mechanisms supporting different functions. Using correlational approaches, these studies demonstrated that action observation activates not only visual but also motor brain regions. On the other hand, brain stimulation and brain lesion evidence allows tackling the critical question of whether our action representations are necessary to perceive and understand others’ actions. In particular, recent neuropsychological studies have shown that patients with temporal, parietal, and frontal lesions exhibit a number of possible deficits in the visual perception and the understanding of others’ actions. The specific anatomical substrates of such neuropsychological deficits however, are still a matter of debate. Here we review the existing literature on this issue and perform an anatomic likelihood estimation meta-analysis of studies using lesion-symptom mapping methods on the causal relation between brain lesions and non-linguistic action perception and understanding deficits. The meta-analysis encompassed data from 361 patients tested in 11 studies and identified regions in the inferior frontal cortex, the inferior parietal cortex and the middle/superior temporal cortex, whose damage is consistently associated with poor performance in action perception and understanding tasks across studies. Interestingly, these areas correspond to the three nodes of the action observation network that are strongly activated in response to visual action perception in neuroimaging research and that have been targeted in previous brain stimulation studies. Thus, brain lesion mapping research provides converging causal evidence that premotor, parietal and temporal regions play a crucial role in action recognition and understanding.
Collapse
Affiliation(s)
- Cosimo Urgesi
- Laboratorio di Neuroscienze Cognitive, Dipartimento di Scienze Umane, Università di Udine Udine, Italy ; Istituto di Ricovero e Cura a Carattere Scientifico "Eugenio Medea," Polo Friuli Venezia Giulia, San Vito al Tagliamento Pordenone, Italy
| | - Matteo Candidi
- Dipartimento di Psicologia, Università "Sapienza" di Roma Rome, Italy ; IRCCS Fondazione Santa Lucia Rome, Italy
| | - Alessio Avenanti
- IRCCS Fondazione Santa Lucia Rome, Italy ; Dipartimento di Psicologia e Centro studi e ricerche in Neuroscienze Cognitive, Alma Mater Studiorum - Università di Bologna Campus di Cesena, Italy
| |
Collapse
|
45
|
Khalil A, Suff N, Thilaganathan B, Hurrell A, Cooper D, Carvalho JS. Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2014; 43:14-24. [PMID: 23737029 DOI: 10.1002/uog.12526] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 05/12/2013] [Accepted: 05/24/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Studies have demonstrated an association between congenital heart disease (CHD) and neurodevelopmental delay. Neuroimaging studies have also demonstrated a high incidence of preoperative brain abnormalities. The aim of this study was to perform a systematic review to quantify the non-surgical risk of brain abnormalities and of neurodevelopmental delay in infants with CHD. METHODS MEDLINE, EMBASE and The Cochrane Library were searched electronically without language restrictions, utilizing combinations of the terms congenital heart, cardiac, neurologic, neurodevelopment, magnetic resonance imaging, ultrasound, neuroimaging, autopsy, preoperative and outcome. Reference lists of relevant articles and reviews were hand-searched for additional reports. Cohort and case-control studies were included. Studies reporting neurodevelopmental outcomes and/or brain lesions on neuroimaging in infants with CHD before heart surgery were included. Cases of chromosomal or genetic abnormalities, case reports and editorials were excluded. Between-study heterogeneity was assessed using the I(2) test. RESULTS The search yielded 9129 citations. Full text was retrieved for 119 and the following were included in the review: 13 studies (n = 425 cases) reporting on brain abnormalities either preoperatively or in those who did not undergo congenital cardiac surgery and nine (n = 512 cases) reporting preoperative data on neurodevelopmental assessment. The prevalence of brain lesions on neuroimaging was 34% (95% CI, 24-46; I(2) = 0%) in transposition of the great arteries, 49% (95% CI, 25-72; I(2) = 65%) in left-sided heart lesions and 46% (95% CI, 40-52; I(2) =18.1%) in mixed/unspecified cardiac lesions, while the prevalence of neurodevelopmental delay was 42% (95% CI, 34-51; I(2) = 68.9). CONCLUSIONS In the absence of chromosomal or genetic abnormalities, infants with CHD are at increased risk of brain lesions as revealed by neuroimaging and of neurodevelopmental delay. These findings are independent of the surgical risk, but it is unclear whether the time of onset is fetal or postnatal.
Collapse
Affiliation(s)
- A Khalil
- Fetal Medicine Unit, St. George's Medical School, University of London, London, UK
| | | | | | | | | | | |
Collapse
|
46
|
Fiot JB, Cohen LD, Raniga P, Fripp J. Efficient brain lesion segmentation using multi-modality tissue-based feature selection and support vector machines. Int J Numer Method Biomed Eng 2013; 29:905-915. [PMID: 23303595 DOI: 10.1002/cnm.2537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 11/21/2012] [Accepted: 11/21/2012] [Indexed: 06/01/2023]
Abstract
Support vector machines (SVM) are machine learning techniques that have been used for segmentation and classification of medical images, including segmentation of white matter hyper-intensities (WMH). Current approaches using SVM for WMH segmentation extract features from the brain and classify these followed by complex post-processing steps to remove false positives. The method presented in this paper combines advanced pre-processing, tissue-based feature selection and SVM classification to obtain efficient and accurate WMH segmentation. Features from 125 patients, generated from up to four MR modalities [T1-w, T2-w, proton-density and fluid attenuated inversion recovery(FLAIR)], differing neighbourhood sizes and the use of multi-scale features were compared. We found that although using all four modalities gave the best overall classification (average Dice scores of 0.54 ± 0.12, 0.72 ± 0.06 and 0.82 ± 0.06 respectively for small, moderate and severe lesion loads); this was not significantly different (p = 0.50) from using just T1-w and FLAIR sequences (Dice scores of 0.52 ± 0.13, 0.71 ± 0.08 and 0.81 ± 0.07). Furthermore, there was a negligible difference between using 5 × 5 × 5 and 3 × 3 × 3 features (p = 0.93). Finally, we show that careful consideration of features and pre-processing techniques not only saves storage space and computation time but also leads to more efficient classification, which outperforms the one based on all features with post-processing.
Collapse
Affiliation(s)
- Jean-Baptiste Fiot
- CEREMADE, UMR 7534 CNRS Université Paris Dauphine, France; CSIRO Preventative Health National Research Flagship ICTC, The Australian e-Health Research Centre - BioMedIA, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
| | | | | | | |
Collapse
|
47
|
Avenanti A, Candidi M, Urgesi C. Vicarious motor activation during action perception: beyond correlational evidence. Front Hum Neurosci 2013; 7:185. [PMID: 23675338 PMCID: PMC3653126 DOI: 10.3389/fnhum.2013.00185] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 04/23/2013] [Indexed: 12/26/2022] Open
Abstract
Neurophysiological and imaging studies have shown that seeing the actions of other individuals brings about the vicarious activation of motor regions involved in performing the same actions. While this suggests a simulative mechanism mediating the perception of others' actions, one cannot use such evidence to make inferences about the functional significance of vicarious activations. Indeed, a central aim in social neuroscience is to comprehend how vicarious activations allow the understanding of other people's behavior, and this requires to use stimulation or lesion methods to establish causal links from brain activity to cognitive functions. In the present work, we review studies investigating the effects of transient manipulations of brain activity or stable lesions in the motor system on individuals' ability to perceive and understand the actions of others. We conclude there is now compelling evidence that neural activity in the motor system is critical for such cognitive ability. More research using causal methods, however, is needed in order to disclose the limits and the conditions under which vicarious activations are required to perceive and understand actions of others as well as their emotions and somatic feelings.
Collapse
Affiliation(s)
- Alessio Avenanti
- Dipartimento di Psicologia, Alma Mater Studiorum, Università di Bologna Bologna, Italy ; Centro Studi e Ricerche in Neuroscienze Cognitive, Campus di Cesena Cesena, Italy ; Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia Roma, Italy
| | | | | |
Collapse
|
48
|
Bozzali M, MacPherson SE, Cercignani M, Crum WR, Shallice T, Rees JH. White matter integrity assessed by diffusion tensor tractography in a patient with a large tumor mass but minimal clinical and neuropsychological deficits. Funct Neurol 2012; 27:239-246. [PMID: 23597438 PMCID: PMC3861348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Diffusion tensor imaging (DTI) tractography and image registration were used to investigate a patient with a massive left-sided brain tumor, whose size was largely disproportionate to his subtle neurological deficits. MRI was obtained from the patient and his healthy identical twin, who acted as anatomical reference for DTI and as a control for quantitative measures. To compensate for the patient's altered anatomy, seed and way points for probabilistic tractography were drawn on the color-coded direction maps of the healthy twin. Registration, based on the combination of b0-images, T2-weighted and T1-weighted images, was used to identify the corresponding regions in the patient. The corticospinal tract (CST), the superior longitudinal fasciculus (SLF), and the cingulum bundle (CB) showed displaced anatomy. A significant difference was found between fractional anisotropy distribution along the left SLF and CB, but not along the CST. These findings fit well with the patient's substantial preservation of his motor abilities, while abnormalities of the SLF and CB could explain the subtle but detectable cognitive deficits.
Collapse
Affiliation(s)
- Marco Bozzali
- Institute of Cognitive Neuroscience, University College London, London, UK.
| | | | | | | | | | | |
Collapse
|
49
|
Buchsbaum BR, Baldo J, Okada K, Berman KF, Dronkers N, D’Esposito M, Hickok G. Conduction aphasia, sensory-motor integration, and phonological short-term memory - an aggregate analysis of lesion and fMRI data. Brain Lang 2011; 119:119-28. [PMID: 21256582 PMCID: PMC3090694 DOI: 10.1016/j.bandl.2010.12.001] [Citation(s) in RCA: 196] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 12/11/2010] [Indexed: 05/13/2023]
Abstract
Conduction aphasia is a language disorder characterized by frequent speech errors, impaired verbatim repetition, a deficit in phonological short-term memory, and naming difficulties in the presence of otherwise fluent and grammatical speech output. While traditional models of conduction aphasia have typically implicated white matter pathways, recent advances in lesions reconstruction methodology applied to groups of patients have implicated left temporoparietal zones. Parallel work using functional magnetic resonance imaging (fMRI) has pinpointed a region in the posterior most portion of the left planum temporale, area Spt, which is critical for phonological working memory. Here we show that the region of maximal lesion overlap in a sample of 14 patients with conduction aphasia perfectly circumscribes area Spt, as defined in an aggregate fMRI analysis of 105 subjects performing a phonological working memory task. We provide a review of the evidence supporting the idea that Spt is an interface site for the integration of sensory and vocal tract-related motor representations of complex sound sequences, such as speech and music and show how the symptoms of conduction aphasia can be explained by damage to this system.
Collapse
Affiliation(s)
| | - Juliana Baldo
- VA Northern California Health Care System, Center for Aphasia and Related Disorders, Martinez, CA. USA
| | - Kayoko Okada
- Department of Cognitive Sciences, University of California, Irvine, CA. USA
| | - Karen F. Berman
- Section on Integrative Neuroimaging, National Institute of Mental Health, Bethesda, MD, USA
| | - Nina Dronkers
- VA Northern California Health Care System, Center for Aphasia and Related Disorders, Martinez, CA. USA
| | - Mark D’Esposito
- Department of Psychology, University of California, Berkeley, CA. USA
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA. USA
| |
Collapse
|
50
|
Raymont V, Salazar AM, Krueger F, Grafman J. "Studying injured minds" - the Vietnam head injury study and 40 years of brain injury research. Front Neurol 2011; 2:15. [PMID: 21625624 PMCID: PMC3093742 DOI: 10.3389/fneur.2011.00015] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 03/03/2011] [Indexed: 11/17/2022] Open
Abstract
The study of those who have sustained traumatic brain injuries (TBI) during military conflicts has greatly facilitated research in the fields of neuropsychology, neurosurgery, psychiatry, neurology, and neuroimaging. The Vietnam Head Injury Study (VHIS) is a prospective, long-term follow-up study of a cohort of 1,221 Vietnam veterans with mostly penetrating brain injuries, which has stretched over more than 40 years. The scope of this study, both in terms of the types of injury and fields of examination, has been extremely broad. It has been instrumental in extending the field of TBI research and in exposing pressing medical and social issues that affect those who suffer such injuries. This review summarizes the history of conflict-related TBI research and the VHIS to date, as well as the vast range of important findings the VHIS has established.
Collapse
Affiliation(s)
- Vanessa Raymont
- Vietnam Head Injury Study, Henry M. Jackson Foundation, National Naval Medical Center Bethesda, MD, USA
| | | | | | | |
Collapse
|