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Raukola-Lindblom M, Kurki T, Ljungqvist L, Laasonen M, Hämäläinen H, Tenovuo O. Association of cognitive-linguistic deficits to diffusion tensor imaging parameters in moderate to severe traumatic diffuse axonal injury. Appl Neuropsychol Adult 2023:1-8. [PMID: 36688868 DOI: 10.1080/23279095.2023.2169885] [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] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Cognitive-linguistic functions are an essential part of adequate communication competence. Cognitive-linguistic deficits are common after traumatic diffuse axonal injury (DAI). We aimed to examine the integrity of perisylvian white matter tracts known to be associated with linguistic functions in individuals with DAI and their eventual association with poor cognitive-linguistic outcomes. Diffusion tensor imaging (DTI) results of 44 adults with moderate-to-severe DAI were compared with those of 67 controls. Fractional anisotropy (FA) values of the superior longitudinal fasciculus (SLF), arcuate fasciculus (AF), SLF with frontal connections to the lower parietal cortex, and AF with temporal connections to the lower parietal cortex were measured using tractography. The associations between white matter integrity FA values and cognitive-linguistic deficits were studied in the DAI group. Cognitive-linguistic deficits were determined based on our earlier study using the novel KAT test. No previous studies have examined the associations between white matter integrity and cognitive-linguistic deficits determined using the KAT test. Patients with DAI showed lower FA values in all left-side tracts than the controls. Unexpectedly, the poor cognitive-linguistic outcome in the language comprehension and production domains was associated with high FA values of several tracts. After excluding five cases with the poorest cognitive-linguistic performance, but with the highest values in the DTI variables, no significant associations with DTI metrics were found. The association between white matter integrity and cognitive-linguistic functioning is complex in patients with DAI of traumatic origin, probably reflecting the heterogeneity of TBI.
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Affiliation(s)
| | - Timo Kurki
- Department of Radiology, University of Turku, Turku, Finland.,Terveystalo Medical Center, Turku, Finland
| | - Linda Ljungqvist
- City of Turku, Welfare Division, Psychosocial Services, Turku, Finland
| | - Marja Laasonen
- Department of Logopedics, School of Humanities, University of Eastern Finland, Joensuu, Finland
| | - Heikki Hämäläinen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Olli Tenovuo
- Department of Clinical Neurosciences, University of Turku, Turku, Finland.,Turku Brain Injury Center, Neurocenter, Turku University Hospital, Turku, Finland
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Liu ZY, Zhai FF, Han F, Li ML, Zhou L, Ni J, Yao M, Zhang SY, Cui LY, Jin ZY, Zhu YC. Regional Disruption of White Matter Integrity and Network Connectivity Are Related to Cognition. J Alzheimers Dis 2022; 89:593-603. [PMID: 35912739 DOI: 10.3233/jad-220191] [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: 11/15/2022]
Abstract
BACKGROUND Cognitive impairment is common in the elderly population. Exploring patterns of white matter damage at the microstructural level would give important indications for the underlying mechanisms. OBJECTIVE To investigate the spatial patterns of white matter microstructure and structural network alternations in relation to different cognition domainsMethods:Participants from the community-based Shunyi Study were included to investigate the association between white matter measurements and cognition cross-sectionally, via both global and local analysis. Cognitive functions were assessed using digit span, trail making test (TMT)-A/B, Fuld object Memory, and 12-Word Philadelphia Verbal Learning Test (PVLT). White matter measurements including fractional anisotropy (FA), mean diffusivity (MD), and structural network parameters were calculated based on diffusion tensor imaging. RESULTS Of the 943 participants included, the mean (SD) age was 55.8 (9.1) years, and the mean (SD) education level was 6.7 (3.2) years. We found the whole set of cognitive measurements was related to diffused white matter microstructural integrity damage and lower global efficiency. Poor executive functions (TMTA/B complete time) were related to lower FA and higher MD predominantly on the anterior white matter skeleton, while verbal memory loss (PVLT test scores) was related to sub-network dysconnectivity in the midline and the right temporal lobe. CONCLUSION The anterior brain is dominantly involved in executive dysfunction, while midline and right temporal brain disconnection are more prominent in verbal memory loss. Global and regional disruption of white matter integrity and network connectivity is the anatomical basis of the cognitive impairment in the aging population.
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Affiliation(s)
- Zi-Yue Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei-Fei Zhai
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Han
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming-Li Li
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lixin Zhou
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Ni
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Yao
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu-Yang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Ying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng-Yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Cheng Zhu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Mao L, Wang K, Zhang Q, Wang J, Zhao Y, Peng W, Ding J. Felt Stigma and Its Underlying Contributors in Epilepsy Patients. Front Public Health 2022; 10:879895. [PMID: 35558541 PMCID: PMC9087196 DOI: 10.3389/fpubh.2022.879895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To explore the correlated clinical and psychological factors of stigmatization and investigate the relationship between stigma and white matter abnormalities in epilepsy patients. Methods Stigmatization was obtained by a three-item stigma scale in 256 epilepsy patients with genetic or unknown etiology. Personality and quality of life (QOL) were assessed by Eysenck Personality Questionnaire (EPQ) and QOL-31 questionnaire respectively. One hundred and fourteen of them were performed Hamilton Depression Scale-17 (HAMD) and scanned with diffusion tensor imaging in 3T MRI. Fractional anisotropy (FA) values of frontotemporal contact fibers were calculated. Results There were about 39.8% patients felt stigma, with the highest score (Score 3) in 8.2% (21/256). Stigma scores were significantly negatively correlated with education (P < 0.01), age of onset (P < 0.05), extraversion score of EPQ (P < 0.01), total and all the subscale QOL scores (P < 0.001), and positively correlated with duration (P < 0.01), HAMD score (P < 0.001), neuroticism score of EPQ (P < 0.001). We found negative correlation between stigma scores and FA values of right superior longitudinal fasciculus and left cingulum (P < 0.05). Logistic regression results showed that FA value of left cingulum (P = 0.011; OR = 0.000), social function (P = 0.000; OR = 0.935) of QOL, and neuroticism score of EPQ (P = 0.033; OR = 1.123) independently correlated to felt stigma. Conclusion Felt stigma in epilepsy patients was found to be correlated with neuroticism, depression, and deficient social function of QOL, which might be predisposed by the impairment of the left cingulum. Our results provide preliminary evidence for the underlying neural circuits in stigmatization.
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Affiliation(s)
- Lingyan Mao
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Keying Wang
- Teachers College, Columbia University, New York, NY, United States
| | - Qianqian Zhang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Wang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanan Zhao
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weifeng Peng
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
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Gwak DW, Park E, Park JS, Kim E, Kang MG, Kim AR, Lee JE, Jung SH, Jeong JG, Lee KY, Chang Y, Jung TD. Alterations of functional connectivity in auditory and sensorimotor neural networks: A case report in a patient with cortical deafness after bilateral putaminal hemorrhagic stroke. Medicine (Baltimore) 2021; 100:e24302. [PMID: 33546056 PMCID: PMC7837815 DOI: 10.1097/md.0000000000024302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 10/08/2020] [Revised: 12/09/2020] [Accepted: 12/24/2020] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Cortical deafness is a rare auditory dysfunction caused by damage to brain auditory networks. The aim was to report alterations of functional connectivity in intrinsic auditory, motor, and sensory networks in a cortical deafness patient. PATIENT CONCERNS A 41-year-old woman suffered a right putaminal hemorrhage. Eight years earlier, she had suffered a left putaminal hemorrhage and had minimal sequelae. She had quadriparesis, imbalance, hypoesthesia, and complete hearing loss. DIAGNOSES She was diagnosed with cortical deafness. After 6 months, resting-state functional magnetic resonance imaging (rs-fMRI) and diffuse tensor imaging (DTI) were performed. DTI revealed that the acoustic radiation was disrupted while the corticospinal tract and somatosensory track were intact using deterministic tracking methods. Furthermore, the patient showed decreased functional connectivity between auditory and sensorimotor networks. INTERVENTIONS The patient underwent in-patient stroke rehabilitation therapy for 2 months. OUTCOMES Gait function and ability for activities of daily living were improved. However, complete hearing impairment persisted in 6 months after bilateral putaminal hemorrhagic stroke. LESSONS Our case report seems to suggest that functional alterations of spontaneous neuronal activity in auditory and sensorimotor networks are related to motor and sensory impairments in a patient with cortical deafness.
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Affiliation(s)
- Dae-Won Gwak
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital
| | - Eunhee Park
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital
- Department of Rehabilitation Medicine, School of Medicine
| | - Jin-Su Park
- Department of Medical & Biological Engineering, Kyungpook National University, Daegu
| | - Eunji Kim
- Department of Medical & Biological Engineering, Kyungpook National University, Daegu
| | - Min-Gu Kang
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, School of Medicine
- Department of Rehabilitation Medicine
| | | | | | | | | | - Yongmin Chang
- Department of Medical & Biological Engineering, Kyungpook National University, Daegu
- Department of Radiology, Kyungpook National University Hospital
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital
- Department of Rehabilitation Medicine, School of Medicine
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Fidan E, Foley LM, New LA, Alexander H, Kochanek PM, Hitchens TK, Bayır H. Metabolic and Structural Imaging at 7 Tesla After Repetitive Mild Traumatic Brain Injury in Immature Rats. ASN Neuro 2018; 10:1759091418770543. [PMID: 29741097 PMCID: PMC5944144 DOI: 10.1177/1759091418770543] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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] [Received: 10/27/2017] [Revised: 03/03/2018] [Accepted: 03/20/2018] [Indexed: 11/15/2022] Open
Abstract
Mild traumatic brain injury (mTBI) in children is a common and serious public health problem. Traditional neuroimaging findings in children who sustain mTBI are often normal, putting them at risk for repeated mTBI (rmTBI). There is a need for more sensitive imaging techniques capable of detecting subtle neurophysiological alterations after injury. We examined neurochemical and white matter changes using diffusion tensor imaging of the whole brain and proton magnetic resonance spectroscopy of the hippocampi at 7 Tesla in 18-day-old male rats at 7 days after mTBI and rmTBI. Traumatic axonal injury was assessed by beta-amyloid precursor protein accumulation using immunohistochemistry. A significant decrease in fractional anisotropy and increase in axial and radial diffusivity were observed in several brain regions, especially in white matter regions, after a single mTBI versus sham and more prominently after rmTBI. In addition, we observed accumulation of beta-amyloid precursor protein in the external capsule after mTBI and rmTBI. mTBI and rmTBI reduced the N-acetylaspartate/creatine ratio (NAA/Cr) and increased the myoinositol/creatine ratio (Ins/Cr) versus sham. rmTBI exacerbated the reduction in NAA/Cr versus mTBI. The choline/creatine (Cho/Cr) and (lipid/Macro Molecule 1)/creatine (Lip/Cr) ratios were also decreased after rmTBI versus sham. Diffusion tensor imaging findings along with the decrease in Cho and Lip after rmTBI may reflect damage to axonal membrane. NAA and Ins are altered at 7 days after mTBI and rmTBI likely reflecting neuro-axonal damage and glial response, respectively. These findings may be relevant to understanding the extent of disability following mTBI and rmTBI in the immature brain and may identify possible therapeutic targets.
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Affiliation(s)
- Emin Fidan
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, PA, USA
| | - Lesley M. Foley
- Pittsburgh NMR Center for Biomedical Research, Carnegie Mellon University, PA, USA
- Animal Imaging Center, University of Pittsburgh, PA, USA
| | - Lee Ann New
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, PA, USA
| | - Henry Alexander
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, PA, USA
| | - Patrick M. Kochanek
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, PA, USA
| | - T. Kevin Hitchens
- Pittsburgh NMR Center for Biomedical Research, Carnegie Mellon University, PA, USA
- Animal Imaging Center, University of Pittsburgh, PA, USA
| | - Hülya Bayır
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, PA, USA
- Children's Neuroscience Institute
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Bernitsas E, Yarraguntla K, Bao F, Sood R, Santiago-Martinez C, Govindan R, Khan O, Seraji-Bozorgzad N. Structural and Neuronal Integrity Measures of Fatigue Severity in Multiple Sclerosis. Brain Sci 2017; 7:E102. [PMID: 28805691 DOI: 10.3390/brainsci7080102] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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] [Received: 06/24/2017] [Revised: 08/04/2017] [Accepted: 08/07/2017] [Indexed: 12/20/2022] Open
Abstract
Fatigue is a common and disabling symptom in Multiple Sclerosis (MS). However, consistent neuroimaging correlates of its severity are not fully elucidated. In this article, we study the neuronal correlates of fatigue severity in MS. Forty-three Relapsing Remitting MS (RRMS) patients with MS-related fatigue (Fatigue Severity Scale (FSS) range: 1–7) and Expanded Disability Status Scale (EDSS) ≤ 4, were divided into high fatigue (HF, FSS ≥ 5.1) and low fatigue groups (LF, FSS ≤ 3). We measured T2 lesion load using a semi-automated technique. Cortical thickness, volume of sub-cortical nuclei, and brainstem structures were measured using Freesurfer. Cortical Diffusion Tensor Imaging (DTI) parameters were extracted using a cross modality technique. A correlation analysis was performed between FSS, volumetric, and DTI indices across all patients. HF patients showed significantly lower volume of thalamus, (p = 0.02), pallidum (p = 0.01), and superior cerebellar peduncle ((SCP), p = 0.002). The inverse correlation between the FSS score and the above volumes was significant in the total study population. In the right temporal cortex (RTC), the Radial Diffusivity ((RD), p = 0.01) and Fractional Anisotropy ((FA), p = 0.01) was significantly higher and lower, respectively, in the HF group. After Bonferroni correction, thalamic volume, FA-RTC, and RD-RTC remained statistically significant. Multivariate regression analysis identified FA-RTC as the best predictor of fatigue severity. Our data suggest an association between fatigue severity and volumetric changes of thalamus, pallidum, and SCP. Early neuronal injury in the RTC is implicated in the pathogenesis of MS-related fatigue.
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Kim YJ, Kwon HK, Lee JM, Kim YJ, Kim HJ, Jung NY, Kim ST, Lee KH, Na DL, Seo SW. White matter microstructural changes in pure Alzheimer's disease and subcortical vascular dementia. Eur J Neurol 2015; 22:709-16. [PMID: 25603760 DOI: 10.1111/ene.12645] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 09/11/2014] [Accepted: 11/12/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Recent studies have demonstrated that Alzheimer's disease (AD) and subcortical vascular dementia (SVaD) have white matter (WM) microstructural changes. However, previous studies on AD and SVaD rarely eliminated the confounding effects of patients with mixed Alzheimer's and cerebrovascular disease pathologies. Therefore, our aim was to evaluate the divergent topography of WM microstructural changes in patients with pure AD and SVaD. METHODS Patients who were clinically diagnosed with AD and SVaD were prospectively recruited. Forty AD patients who were Pittsburgh compound B (PiB) positive [PiB(+) AD] without WM hyperintensities and 32 SVaD patients who were PiB negative [PiB(-) SVaD] were chosen. Fifty-six cognitively normal individuals were also recruited (NC). Tract-based spatial statistics of diffuse tensor imaging were used to compare patterns of fractional anisotropy (FA) and mean diffusivity (MD). RESULTS Compared with the NC group, the PiB(+) AD group showed decreased FA in the bilateral frontal, temporal and parietal WM regions and the genu and splenium of the corpus callosum as well as increased MD in the left frontal and temporal WM region. PiB(-) SVaD patients showed decreased FA and increased MD in all WM regions. Direct comparison between PiB(+) AD and PiB(-) SVaD groups showed that the PiB(-) SVaD group had decreased FA across all WM regions and increased MD in all WM regions except occipital regions. CONCLUSION Our findings suggest that pure AD and pure SVaD have divergent topography of WM microstructural changes including normal appearing WM.
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Affiliation(s)
- Y J Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
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Abstract
How do disturbances to perception and action relate to the deficiencies expressed by children with autism? The ability to predict what is going to happen next is crucial for the construction of all actions and children develop these predictive abilities early in development. Children with autism, however, are deficient in the ability to foresee future events and to plan movements and movement sequences. They are also deficient in the understanding of other people's actions. This includes communicative actions as they are ultimately based on movements. Today there are two promising neurobiological interpretation of Autism Spectrum Disorder (ASD). First, there is strong evidence that the Mirror Neuron System (MNS) is impaired. As stated by this hypothesis, action production and action understanding are intimately related. Both these functions rely on predictive models of the sensory consequences of actions and depend on connectivity between the parietal and premotor areas. Secondly, action prediction is accomplished through a system that includes a loop from the posterior parietal cortex (PPC) through the cerebellum and back to the premotor and motor areas of the brain. Impairment of this loop is probably also part of the explanation of the prediction problems in children with ASD. Both the cortico-cerebellar loop and the MNS rely on distant neural connections. There are multiple evidence that such connections are weak in children with autism.
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