Volumetric Assessment of the Insula in a Normally Functioning Human Brain Using Magnetic Resonance Imaging / Evaluación Volumétrica de la Ínsula en un Cerebro Humano que Funciona Normalmente Utilizando Imágenes de Resonancia Magnética

SUMMARY: Volumetric assessment of brain structures is an important tool in neuroscience research and clinical practice. The volumetric measurement of normally functioning human brain helps detect age-related changes in some regions, which can be observed at varying degrees. This study aims to estimate the insular volume in the normally functioning human brain in both genders, different age groups, and side variations. A cross-sectional retrospective study was conducted on 42 adult Sudanese participants in Al-Amal Hospital, Sudan, between May to August 2022, using magnetic resonance imaging (MRI) and automatic brain segmentation through a software program (BrainSuite). The statistical difference in total insular volume on both sides of the cerebral hemisphere was small. The insular volume on the right side was greater in males, while the left side showed no difference between both genders. A statistically significant difference between males and females was found (p > 0.05), and no statistical difference in different age groups was found according to the one-way ANOVA test (p>0.05). Adult Sudanese males showed a larger insular volume than females. MRI can be used to morphometrically assess the insula to detect any pathological variations based on volume changes.

La evaluación volumétrica de las estructuras cerebrales es una herramienta importante en la investigación y la práctica clínica de la neurociencia. La medición volumétrica del cerebro humano, que funciona normalmente, ayuda a detectar cambios relacionados con la edad en algunas regiones, las cuales se pueden observar en diversos grados. Este estudio tuvo como objetivo estimar el volumen insular en el cerebro humano que funciona normalmente, en ambos sexos, de diferentes grupos de edad y sus variaciones laterales. Se realizó un estudio retrospectivo transversal en 42 participantes sudaneses adultos en el Hospital Al-Amal, Sudán, entre mayo y agosto de 2022, utilizando imágenes de resonancia magnética y segmentación automática del cerebro a través de un software (BrainSuite). Fue pequeña la diferencia estadística en el volumen insular total, en los hemisferios cerebrales. El volumen insular del lado derecho fue mayor en los hombres, mientras que el lado izquierdo no mostró diferencia entre ambos sexos. Se encontró una diferencia estadísticamente significativa entre hombres y mujeres (p > 0,05), y no se encontró diferencia estadística en los diferentes grupos de edad, según la prueba de ANOVA de una vía (p> 0,05). Los hombres sudaneses adultos mostraron un mayor volumen insular que las mujeres. La resonancia magnética se puede utilizar para evaluar morfométricamente la ínsula y para detectar cualquier variación patológica basada en cambios de volumen.

Fisiología respiratoria: el control de la respiración / Respiratory fisiology: the breath control

El control de la respiración comprende un componente automático involuntario y un componente voluntario, con centros de control en el tronco encefálico, principalmente en la médula oblonga y en el puente, y en la corteza cerebral. Estos centros reciben aferencias provenientes de sensores que detectan señales químicas y no químicas, interactúan entre sí y generan respuestas que llegan a las neuronas motoras inferiores a nivel de médula espinal. Estos procesos determinan el funcionamiento de los músculos implicados en la respiración, y de ese modo permite garantizar que los niveles de pO2 p CO2 y pH en la sangre arterial se mantengan en forma óptima, frente a diferentes situaciones y demandas metabólicas. Se hace una revisión actualizada del tema que permita comprender estos procesos.

The control of breathing comprises an involuntary automatic component and a voluntary component, with control centers in the brain stem, mainly in the medulla oblongata and in the bridge, and in the cerebral cortex. These centers receive afferences from sensors that detect chemical and non-chemical signals, interact with each other and generate responses that reach the lower motor neurons at the spinal cord level. These processes determine the functioning of the muscles involved in breathing, and thus ensure that the levels of pO2 p CO2 and pH in arterial blood are optimally maintained, in the face of different situations and metabolic demands. An up-to-date review of the subject is carried out to understand these processes.

Releyendo a... Surgical Anatomy of Microneurosurgical Sulcal Key Points / Rereading... Surgical Anatomy of Microneurosurgical Sulcal Key Points

El reconocimiento de los puntos craneométricos, giros y surcos cerebrales es esencial para la localización de lesio-nes, tanto superficiales como profundas, y programar es-trategias quirúrgicas que impacten en la óptima evolución de nuestros pacientes. Si bien estas destrezas y aptitudes son posibles de adquirir a través del estudio de especíme-nes anatómicos formolizados y de imágenes de resonan-cia magnética, en un escenario quirúrgico real, esto no es tan simple. Al exponer la superficie cerebral, existen va-riaciones anatómicas de los giros y surcos que, a su vez, se encuentran cubiertos de venas y aracnoides con líquido cefalorraquídeo. El desarrollo de los corredores microqui-rúrgicos trans-cisternales, trans-surcales y a través de las fisuras exige el reconocimiento preciso de estas estructu-ras anatómicas

Marcello Malpighi: the nervous system under a microscope / Marcello Malpighi: o sistema nervoso sob um microscópio

ABSTRACT The longstanding study of gross anatomy experienced a considerable improvement with the advent of the microscope in the early 17th century. The representative personality of this new era certainly was Marcello Malpighi, seen as "founder of microscopic anatomy". He studied, with a rudimentary compound microscope, numerous tissues and organs of several classes of animals, as well as plants. He described, for the first time, the microscopic structure of the nervous system, identifying in the gray matter of its various levels minute elements he took as "glands". It should be reminded that the concept of "cell" (and "nerve cell") was unknown at his time. Many researchers followed, performing microscopic studies, but without better results, and Malpighi's view was maintained until the beginning of the 19th century, when new histological processing and staining techniques appeared, as well as improved microscopes.

RESUMO O estudo de longa data da anatomia macroscópica experimentou um incremento considerável com o advento do microscópio no início do século 17. A personalidade representativa dessa nova era foi, certamente, Marcello Malpighi, considerado "fundador da anatomia microscópica". Ele estudou, com um microscópio composto rudimentar, numerosos tecidos e órgãos de diversas classes de animais, assim como plantas. Descreveu, pela primeira vez, a estrutura microscópica do sistema nervoso, identificando na substância cinzenta dos vários níveis elementos de minúsculas dimensões, que denominou "glândulas". Deve-se lembrar que o conceito de "célula" (e de "célula nervosa") era desconhecido naquele tempo. Muitos pesquisadores seguiram realizando estudos microscópicos, mas sem resultados melhores, e o entendimento de Malpighi foi mantido até o início do século 19, quando apareceram técnicas histológicas novas de processamento e de coloração, assim como microscópios mais aprimorados.

Three Dimensional mapping of the root apex: distances between apexes and anatomical structures and external cortical plates

Abstract This study aimed to determine the mean distances between apexes of the maxillary posterior teeth and the maxillary sinus, between apexes of the mandibular posterior teeth and the mandibular canal, and between the root apexes of all teeth and the adjacent cortical plates. A total of 800 cone-beam computed tomography (CBCT) scans (400 maxillary and 400 mandibular) were obtained from patients indicated for several treatments. The proximity between apexes and anatomical structures, and the relationship between apexes and adjacent cortical plates were assessed together with the risk of over-instrumentation. Paired-sample comparisons were performed by using the paired t-test. The means were compared by ANOVA, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. a) Most of the apexes classified as A (high-risk proximity) were observed in maxillary first and second molars, in mandibular first and second molars, and in second premolars in relation to near anatomical structures. b) A predominance of class A (86.42%) was noticed in the first premolars, between apexes of maxillary teeth and adjacent cortical plates. c) The distance between apexes of mandibular teeth and buccal cortical plates showed a predominance of medium-risk proximity (B) in all the groups, except the first premolars, with the highest risk (82.22%), and the second molars, with low-risk proximity (C) to distal and mesiobuccal apexes (91.77% and 89.62%). CBCT images are important for endodontic diagnosis and treatment, since many teeth have high risk proximity to near anatomical structures and adjacent cortical plates.

Cortical volume is inversely correlated with interleukin-6 serum levels in patients with schizophrenia

Introduction: It is well established that cortical volume are decreased in patients with schizophrenia. One possible explanation is that the increased pro-inflammatory status in schizophrenia is related to volumetric decrease of gray matter. The aim of this study was to correlate interleukin 6 (IL-6) with cortical volume in patients with schizophrenia and controls. Methods: We selected 36 patients with schizophrenia and 35 controls. Interleukin 6 (IL-6) was correlated with cortical volume in patients with schizophrenia and controls. Results: IL-6 was negatively correlated with cortical volume (p = 0.027; rho = −0.370) in patients, but not in controls (p = 0.235). Discussion: Our results are in line with previous studies suggesting that chronic inflammatory activation in patients with schizophrenia could be one plausible mechanism that could contribute for the cortical volumetric decrease often seen in this population. However, this cross-sectional study with a small number of patients does not allow us to establish causal relations. (AU)

Cortical Brain Functions ­ The Brodmann Legacy in the 21st Century

In 1909, Korbinian Brodmann described 52 functional brain areas, 43 of them found in the human brain. More than a century later, his devoted functional map was incremented by Glasser et al in 2016, using functional nuclear magnetic resonance imaging techniques to propose the existence of 180 functional areas in each hemisphere, based on their cortical thickness, degree of myelination (cortical myelin content), neuronal interconnection, topographic organization, multitask answers, and assessment in their resting state. This opens a huge possibility, through functional neuroanatomy, to understand a little more about normal brain function and its functional impairment in the presence of a disease.

Subthalamic Nucleus: Neuroanatomical Review

Discovered in 1865 by Jules Bernard Luys, the subthalamic nucleus is a set of small nuclei located in the diencephalon, inferior to the thalamus and superior to the substantia nigra, that can be visualized in a posterior coronal section. Histologically, it consists of neurons compactly distributed and filled with a large number of blood vessels and sparse myelinated fibers. This review presents an analysis of this anatomical region, considering what is most recent in the literature. Subthalamic neurons are excitatory and use glutamate as the neurotransmitter. In healthy individuals, these neurons are inhibited by nerve cells located in the side globus pallidus. However, if the fibers that make up the afferent circuit are damaged, the neurons become highly excitable, thus causing motor disturbances that can be classified as hyperkinetic, for example ballism and chorea, or hypokinetic, for example Parkinson disease (PD). The advent of deep brain stimulation has given the subthalamic nucleus great visibility. Studies reveal that the stimulation of this nucleus improves themotor symptoms of PD.

Histomorphometric and immunohistochemical evaluation of the frontal cerebral cortex in diabetic rats after treatment with melatonin / Avaliação histomorfométrica e imuno-histoquímica do córtex cerebral frontal em ratos diabéticos após o tratamento com melatonina

The central nervous system is vulnerable to complications caused by diabetes. These complications lead to increased oxidative stress in the brain, resulting in damage to the cerebral cortex, among other regions. Insulin and hypoglycemic agents are still the most widely used treatments. However, current research with an experimental model of diabetes suggests the use of antioxidants, such as melatonin. Thus, we tested the hypothesis that exogenous melatonin may decrease or prevent the effects of diabetes in the frontal cortex of the rat brain. Fifty albino rats were allocated into five groups: GC = rats without diabetes induction, GD = diabetic rats induced by streptozotocin, GDM = streptozotocin-induced and melatonin-treated diabetic rats, GDI = diabetic rats induced by streptozotocin and treated with insulin, GDMI = diabetic rats induced by streptozotocin and treated with melatonin and insulin simultaneously. Diabetes was induced by intraperitoneal administration of streptozotocin (60mg/kg). Insulin (5U/day) was administered subcutaneously and melatonin (10mg/kg) by drinking water; both treatments last days after. We analyzed animals' weight, the cytokines IL-6 and TNF-α, apoptosis, glycogen, and did morphometry and histopathology of the frontal cortex were analyzed. The results showed that the cerebral cortex of the diabetic animals presented axonal degeneration, reduced number of neurons in the cortex, reduced glycogen, increased IL-6 and TNF-α expression, high apoptotic index, and reduced animal weight and the brain. Treatment with melatonin associated or not with insulin prevented such effects. Thus, we conclude that melatonin associated with insulin may be an alternative for avoiding the impact of diabetes in the brain's frontal cortex.(AU)

O sistema nervoso central é vulnerável a complicações originadas pelo diabetes estresse oxidativo no cérebro e resultando em lesões no córtex cerebral, dentre outras regiões. A insulina e hipoglicemiantes ainda são os tratamentos mais utilizados, entretanto, pesquisas atuais com modelo experimental do diabetes sugerem a utilização de antioxidantes como, por exemplo, a melatonina. Assim, testamos a hipótese de que a melatonina exógena pode diminuir ou prevenir os efeitos do diabetes no córtex frontal do cérebro de ratos. Foram utilizados 50 ratos albinos, divididos em 5 grupos: GC = ratos sem indução ao diabetes, GD = ratos induzidos ao diabetes pela estreptozotocina, GDM = ratos induzidos ao diabetes pela estreptozotocina e tratados com melatonina, GDI = ratos induzidos ao diabetes pela estreptozotocina e tratados com insulina, GDMI = ratos induzidos ao diabetes pela estreptozotocina e tratados com melatonina e insulina simultaneamente. O diabetes foi induzido pela administração intraperitoneal de estreptozotocina (60mg/kg). A insulina (5U/dia) foi administrada por via subcutânea e a melatonina (10mg/kg) pela água de beber. Ambos tratamentos foram realizados durante 30 dias após a indução. Foram analisados o peso dos animais, do cerebro, as citocinas IL-6 e TNF-α, apoptose, glicogênio, além da morfometria e histopatologia do córtex frontal. Os resultados mostraram que o córtex cerebral dos animais diabéticos apresentou degeneração axonal, redução do número de neurônios no córtex, redução do glicogênio, aumento da expressão do IL-6 e TNF-α, elevação do índice apoptótico, além da redução do peso dos animais e do cérebro. O tratamento com melatonina associada ou não a insulina preveniu tais efeitos. Assim, concluímos que a melatonina associada ou não a insulina pode ser uma alternativa na prevenção dos efeitos do diabetes no córtex frontal do cérebro.(AU)

Induction of brain injury and depression in rats by chronic unpredictable stress associated with the augmentation of nitrosative stress and apoptosis / Inducción de lesión cerebral y depresión en ratas por estrés crónico impredecible asociado con el aumento del estrés nitrosativo y la apoptosis

SUMMARY: Repeated stress is a risk factor for memory impairment and neurological abnormalities in both humans and animals. We sought to investigate the extent of (i) brain tissue injury; (ii) nitrosative and oxidative stress in brain tissue homogenates; (iii) apoptotic and survival biomarkers in brain tissue homogenates; and (iv) immobility and climbing abilities, induced over a period of three weeks by chronic unpredictable stress (CUS). Wistar rats were either left untreated (Control group) or exposed to a variety of unpredictable stressors daily before being sacrificed after 3 weeks (model group). Assessment of depression-like behavior was performed and animals were then culled and harvested brain tissues were stained with basic histological staining and examined under light microscopy. In addition, brain tissue homogenates were prepared and assayed for these parameters; inducible nitric oxide synthase (iNOS), malondialdehyde (MDA), superoxide dismutase (SOD), caspase-3, and B-cell lymphoma 2 (Bcl-2). Histology images showed CUS induced profound damage to the cerebral cortex as demonstrated by severe neuronal damage with shrunken cells, disrupted atrophic nuclei, perineuronal vacuolation and swollen glial cells. CUS also significantly (p<0.05) induced iNOS, MDA, and caspase-3, whereas SOD and Bcl-2 brain tissue levels were inhibited by CUS. In addition, data from the depression-like behavior, forced swimming test showed significant (p<0.05) increase in animal immobility and decrease in climbing ability in the model group of rats. Thus, here we demonstrated a reliable rat model of chronic stress-induced brain injury, which can further be used to investigate beneficial drugs or agents used for a period of three weeks to protect against CUS-induced brain damage.

RESUMEN: El estrés crónico es un factor de riesgo para el deterioro de la memoria y las anomalías neurológicas tanto en humanos como en animales. Intentamos investigar el alcance de lesión del tejido cerebral; (ii) estrés nitrosativo y oxidativo en homogeneizados de tejido cerebral; (iii) biomarcadores apoptóticos y de supervivencia en homogeneizados de tejido cerebral; y (iv) inmovilidad y habilidades de escalada, inducidas durante un período de tres semanas por estrés crónico impredecible (ECI). Se dejaron sin tratamiento (grupo control) ratas Wistar, o se expusieron a una variedad de factores estresantes impredecibles diariamente antes de ser sacrificadas después de 3 semanas (grupo modelo). Se realizó una evaluación del comportamiento similar a la depresión y luego se sacrificaron los animales y se tiñeron los tejidos cerebrales con tinción histológica básica y se examinaron con microscopía óptica. Además, se prepararon homogeneizados de tejido cerebral y se analizaron los siguientes parámetros; óxido nítrico sintasa inducible (iNOS), malondialdehído (MDA), superóxido dismutasa (SOD), caspasa- 3 y linfoma de células B 2 (Bcl-2). Las imágenes histológicas mostraron que el CUS indujo un daño profundo en la corteza cerebral como lo demuestra el daño neuronal severo con células encogidas, núcleos atróficos alterados, vacuolación perineuronal y células gliales inflamadas. ECI también indujo significativamente (p <0,05) iNOS, MDA y caspase-3, mientras que los niveles de tejido cerebral SOD y Bcl-2 fueron inhibidos por ECI. Además, los datos del comportamiento similar a la de- presión, la prueba de natación forzada mostró un aumento significativo (p <0,05) en la inmovilidad animal y una disminución en la capacidad de escalada en el grupo modelo de ratas. Por lo tanto, aquí demostramos un modelo confiable de daño cerebral crónico en rata inducido por el estrés, que se puede utilizar para investigar medicamentos o agentes beneficiosos usados durante un período de tres semanas para proteger el daño cerebral inducido por ECI.

Cerebral localization of higher functions: anatomic structures before the identification of their memory function / Localização cerebral de funções superiores: estruturas anatômicas antes da identificação de suas funções de memória

The nature of memory and the search for its localization have been a subject of interest since Antiquity. After millennia of hypothetical concepts the core memory-related structures finally began to be identified through modern scientifically-based methods at the diencephalic, hippocampal, and neocortical levels. However, there was a clear temporal delay between the finding of these anatomic structures ignoring their function, and their identification related to memory function. Thus, the core structures begun to be identified with a pure anatomical view in the late Middle Ages on, while the memory function related to them was discovered much later, in the late Modern Period.

A natureza da memória e a busca de sua localização tem sido objeto de interesse desde a Antiguidade. Após milênios de conceitos hipotéticos as estruturas centrais relacionadas com a memória finalmente começaram a ser identificadas através de métodos modernos com base científica, nos níveis diencefálico, hipocampal e neocortical. Entretanto, houve um claro retardo temporal entre o achado dessas estruturas anatômicas ignorando sua função e sua identificação relacionada à função da memória. Assim, as estruturas centrais começaram a ser identificadas com uma visão puramente anatômica da Idade Média tardia em diante, enquanto a função da memória relacionada com as mesmas foi descoberta muito mais tarde, no Período Moderno tardio.

Neuroimaging adolescents with depression in a middle-income country: feasibility of an fMRI protocol and preliminary results

Objective: To test the feasibility and to present preliminary results of a neuroimaging protocol to evaluate adolescent depression in a middle-income setting. Methods: We assessed psychotropic medication-free adolescents (age range 14-16 years) with a diagnosis of major depressive disorder (MDD). Participants underwent a comprehensive clinical evaluation and both structural and functional magnetic resonance imaging (fMRI). In this pilot study, a preliminary single-group analysis of resting-state fMRI (rs-fMRI) data was performed, with a focus on the default mode network (DMN), cognitive control network (CCN), and salience network (SN). Results: The sample included 29 adolescents with MDD (mean age 16.01, SD 0.78) who completed the protocol. Only two participants were excluded due to MRI quality issues (head movement), and were not included in the analyses. The scans showed significant connectivity between the medial prefrontal cortex and posterior cingulate cortex (DMN), the ACC and anterior insula (SN), and the lateral prefrontal cortex and dorsal parietal cortex (CCN). Conclusion: We demonstrated the feasibility of implementing a complex neuroimaging protocol in a middle-income country. Further, our preliminary rs-fMRI data revealed patterns of resting-state connectivity consistent with prior research performed in adolescents from high-income countries.

C-Fos expression in epileptogenic areas of nephropathic rats undergoing star fruit poisoning

Abstract Purpose Studies have demonstrated that star fruit consumption by nephropathic patients triggers severe neurotoxic effects that can lead to convulsions or even death. Brain areas likely susceptible to star fruit poisoning have not been investigated. The objective of the present study was to map possible epileptogenic areas susceptible to star fruit intoxication in nephropathic rats. Methods The study analyzed 25 rats (5 groups). Rats in the experimental group underwent bilateral ureteral obstruction surgery and orogastric gavages with star fruit juice. An electroencephalogram was used to confirm convulsive seizures. Urea and creatinine levels were used to confirm the uremia model. Immunohistochemical analysis was used to map cells with c-Fos protein (c-Fos+ cells) to identify brain areas with increased neuronal activity. Control groups included non-nephropathic and nephropathic rats that did not receive star fruit. Results A statistically significant increase (p<0.01) in c-Fos+ cells was noted in nephropathic animals receiving star fruit juice compared to control groups, in brain areas commonly related to epileptogenic neural circuits including the hippocampus, amygdala, rhinal cortex, anterior cingulate area, piriform area, and medial dorsal thalamus. Conclusion These data corroborate the neurotoxic capacity of star fruit in nephropathic patients.

Morphological relationship between the superficial cortical and deep grey matter structures in adult human brains: a cadaveric study / Relación morfológica entre las estructuras superficiales de la sustancia gris cortical y profunda en los cerebros humanos adultos: un estudio en cadáveres

While various neurodegenerative diseases affect cortical mass differently, finding an optimal and accurate method for measuring the thickness and surface area of cerebral cortex remains a challenging problem due to highly convoluted surface of the cortex. We therefore investigated cortical thickness in a sample of cadaveric specimens at the Discipline of Clinical Anatomy, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa to provide some clue as to possible variations in the parameters. Following ethical approval, 60 brain samples were uniformly sectioned (5 mm thickness) and eight slices taken from each brain across regions of interest (ROI) prepared and stained by Mulligan's technique. Thickness was measured at selected angles (0º, 45º, 90º, 135º and 180º) for both right and left cerebral hemispheres. Mulligan's stain produced good cortical differentiation and clear images that enabled manual delineation of structures. Cortical thickness ranged from 3 to 5 millimeters across the ROI. Interestingly, there was rightward hemispheric asymmetry of cortical thickness of selective slices at suggested angles which is related to structurally and functionally important brain regions. Moreover, there was no significant correlation between the surface area of superficial cortex and the deep nuclei at the same level. The superficial cortex and deep nuclei are manifested independently in normal aging, neuropsychiatric or developmental disorders. Providing accurate morphometric evaluation of cortical thickness and area based on gross staining of the brain slices could provide qualitative data that may support the study of human cerebral cortex even in disease conditions.

Si bien varias enfermedades neurodegenerativas afectan a la masa cortical de manera diferente, encontrar un método óptimo y preciso para medir el grosor y el área de la superficie de la corteza cerebral sigue siendo un problema difícil debido a la superficie altamente enrevesada de la corteza. Por lo tanto, investigamos el grosor cortical en una muestra de cadáveres del Departamento de Anatomía Clínica de la Facultad de Medicina Nelson R. Mandela de la Universidad de KwaZulu-Natal, Sudáfrica, para proporcionar alguna pista sobre posibles variaciones en dichos parámetros. Después de la aprobación ética, 60 muestras de cerebro se seccionaron uniformemente (5 mm de grosor) y se tomaron ocho cortes de cada cerebro en regiones de interés (ROI) preparadas y teñidas con la técnica de Mulligan. El espesor se midió en los ángulos seleccionados (0º, 45º, 90º, 135º y 180º) para los hemisferios cerebrales derecho e izquierdo. La tinción de Mulligan produjo una buena diferenciación cortical e imágenes claras que permitieron la delineación manual de las estructuras. El grosor cortical osciló entre 3 y 5 milímetros a través del ROI. Curiosamente, hubo una asimetría hemisférica hacia la derecha del grosor cortical de los cortes en ángulos sugeridos que se relacionan con regiones cerebrales estructural y funcionalmente importantes. Además, no hubo una correlación significativa entre el área de la superficial de la corteza superficial y los núcleos profundos en el mismo nivel. La corteza superficial y los núcleos profundos se manifiestan de manera independiente en el envejecimiento normal, en los trastornos neuropsiquiátricos o del desarrollo. Realizar una evaluación morfométrica precisa del grosorcortical y el área basada en la tinción macroscópica de los cortes del cerebro, podría proporcionar datos cualitativos que puedan respaldar el estudio de la corteza cerebral humana incluso en condiciones de enfermedad.

Desempeño neuropsicológico e indicadores de frecuencia, duración y tiempo de la sesión del ejercicio físico / Neuropsychological Performance and Indicators of Frequency, Duration and Time of the Physical Exercise Session / Desempenho Neuropsicológico e indicadores de frequência, duração e tempo da sessão do exercício físico

Resumen Objetivo. El ejercicio físico (EF) se relaciona con estructuras cerebrales y funcionamiento cognitivo; sin embargo, se desconocen indicadores de frecuencia, duración e intensidad del EF asociados a procesos neuropsicológicos. Estudiar la relación y las posibles diferencias entre las funciones ejecutivas (FE) y los indicadores del EF (frecuencia, duración y tiempo que lleva practicando EF). Método. Se seleccionó una muestra intencional de treinta sujetos físicamente activos, pareados por sexo ( Medad = 22.9, DE = 8.5). Se aplicó la totalidad de la Batería de Funciones Ejecutivas y Lóbulos Frontales (Banfe). Resultados. El desempeño neuropsicológico se relacionó con la frecuencia del EF en tareas que evalúan capacidades de control inhibitorio, seguimiento de límites y normas, memoria de trabajo visoespacial y anticipación de acciones de orden progresivo y regresivo. La duración y el tiempo de entrenamiento presentaron relación con la planeación, respeto por los límites y la inhibición. Aquellos participantes que se ejercitan más de seis veces por semana presentaron mejor desempeño en los aciertos y menor número de errores en el control inhibitorio. No se diferencia el desempeño neuropsicológico en función a indicadores y tipo de EF. Conclusión. Se confirma la hipótesis acerca de que el EF se asocia con procesos neuropsicológicos. Se abren posibles implicaciones científicas, educativas y clínicas.

Abstract Objective. Physical Exercise (PE) is related to cerebral structures and cognitive functioning. Nevertheless, PE indicators of frequency, duration, intensity and neuropsychological processes are unknown. The goal was to study the relationship and the possible differences between executive functions (EF) and PE indicators (frequency, duration and time PE is being practiced). Method. We selected an intentional sample of thirty physically active subjects, paired by sex (Age mean = 22.9, SD = 8.5). We used the whole assessment of Executive Functions and Frontal Lobes Battery (BANFE). Results. Neuropsychological performance was related to the PE frequency in tasks that assess inhibitory control, monitoring of limits and rules, visual-spatial working memory and predicting in reversal and progressive order actions. The duration and time of training showed relationship with planning and inhibition control. The participants who exercise more than six times a week showed a better performance and less number of inhibition control mistakes. Neuropsychological performance dependent on indicators and type of PE are not distinguished. Conclusion. The hypothesis is confirmed. There is a relationship between PE and neuropsychological processes with possible scientific, educational and clinical implications.

Resumo Escopo. O Exercício Físico (EF) está relacionado com estruturas cerebrais e funcionamento cognitivo. Porém são desconhecidos indicadores de frequência, duração e intensidade de EF associados aos processos neuropsicológicos. Estudar a relação e as possíveis diferenças entre as Funções Executivas (FE) e indicadores do EF (Frequência, Duração e Tempo que leva praticando EF). Metodologia. Foi selecionada uma amostra intencional de trinta sujeitos ativamente físicos, pareados por sexo ( Midade= 22.9, DE= 8.5). Foi aplicada a totalidade da Bateria de Funções Executivas e Lóbulos Frontais (BANFE). Resultados. O desempenho neuropsicológico esteve relacionado com a Frequência do EF em tarefas que avaliam capacidades de controle inibitório, seguimento de limites e normas, memória de trabalho vioespacial, e antecipação de ações de ordem progressiva e regressiva. A duração e o tempo de treinamento apresentaram relação com o planejamento, respeito pelos limites e a inibição. Aqueles participantes que se exercitaram mais de seis vezes por semana apresentaram melhor desempenho nos sucessos e menor número de erros no controle inibitório. Não houve diferença no desempenho neuropsicológico em função a indicadores e tipo de EF. Conclusão. Foi confirmada a hipótese de que o EF está associado com processos neuropsicológicos. Foram abertas possíveis implicações científicas, educativas e clínicas.

Topography of 11C-Pittsburgh compound B uptake in Alzheimer's disease: a voxel-based investigation of cortical and white matter regions

Objective: To compare results of positron emission tomography (PET) with carbon-11-labeled Pittsburgh compound B (11C-PIB) obtained with cerebellar or global brain uptake for voxel intensity normalization, describe the cortical sites with highest tracer uptake in subjects with mild Alzheimer's disease (AD), and explore possible group differences in 11C-PIB binding to white matter. Methods: 11C-PIB PET scans were acquired from subjects with AD (n=17) and healthy elderly controls (n=19). Voxel-based analysis was performed with statistical parametric mapping (SPM). Results: Cerebellar normalization showed higher 11C-PIB uptake in the AD group relative to controls throughout the cerebral cortex, involving the lateral temporal, orbitofrontal, and superior parietal cortices. With global uptake normalization, greatest cortical binding was detected in the orbitofrontal cortex; decreased 11C-PIB uptake in white matter was found in the posterior hippocampal region, corpus callosum, pons, and internal capsule. Conclusion: The present case-control voxelwise 11C-PIB PET comparison highlighted the regional distribution of amyloid deposition in the cerebral cortex of mildly demented AD patients. Tracer uptake was highest in the orbitofrontal cortex. Decreased 11C-PIB uptake in white-matter regions in this patient population may be a marker of white-matter damage in AD.

Comparison of conventional, amplitude-integrated and geodesic sensor net EEG used in premature neonates: a systematic review / Comparação do uso do EEG convencional, EEG de amplitude integrada e EEG geodésico em neonatos prematuros: uma revisão sistemática

ABSTRACT The use of methods to evaluate cortical activity in neonates has great importance in modern medicine, as it allows the observation and evaluation of several clinical aspects, which guarantees that the health team has knowledge about possible intervention measures that may be necessary in the treatment of newborns. Objective: This systematic review aimed to compare the main technologies available for the evaluation of brain functions in neonates, among them: the conventional electroencephalogram (EEG), the amplitude-integrated electroencephalogram (aEEG) and the geodesic sensor net EEG. Methods: A search was conducted forarticles from national and international periodicals included in the Web of Science, LILACS, SciELO and Medline electronic databases. Results: The search found 39 among 155 articles of interest and the analyses indicated that, in the clinical environment, the use of both conventional EEG and aEEG is highly recommended, as the combination of their functions allows, for example, a greater number of subclinical seizures to be detected. Conversely, the use of a geodesic sensor net EEG could be of great value, as it allows a large amount of data to be analyzed. Conclusion: This analysis may be useful in studies and research related to diseases and symptoms, such as seizures, a current challenge for neonatal neuromonitoring, as well as aspects of neurological development and functional studies. However, despite many advances in technology, electroencephalography in preterm neonates remains a challenge worldwide and still requires more robust research and efforts towards the best clinical assistance in this extremely early stage of life.

RESUMO Métodos para avaliar a atividade cortical em neonatos têm grande importância na Medicina moderna, pois permitem a observação e avaliação de diversos aspectos clínicos, garantindo que a equipe de saúde tenha conhecimento sobre possíveis medidas de intervenção que possam ser necessárias no tratamento de recém-nascidos. Objetivo: Esta revisão sistemática tem como objetivo comparar as principais tecnologias disponíveis para a avaliação das funções cerebrais em neonatos: eletroencefalograma convencional (EEG), eletroencefalograma de amplitude integrada (aEEG) e eletroencefalograma da rede do sensor geodésico. Métodos: Os artigos foram selecionados em periódicos nacionais e internacionais, incluídos nas bases de dados eletrônicas Web of Science, LILACS, SciELO e Medline. Resultados: Foram encontrados 39 artigos de interesse entre 155 artigos. As análises indicaram que, em relação ao ambiente clínico, o uso associativo de EEG convencional e aEEG é altamente recomendado, pois permite a combinação de funções, facilitando, por exemplo, que um maior número de convulsões sub-clínicas seja detectado. Por outro lado, o uso do eletroencefalograma da rede do sensor geodésico seria de grande valor, uma vez que permite que uma grande quantidade de dados seja analisada. Conclusão: Essa análise pode ser útil em estudos e pesquisas relacionados a doenças e sintomas, como convulsões, um desafio atual para a neuromonitorização neonatal, bem como aspectos de desenvolvimento neurológico e estudos funcionais. No entanto, apesar de muitos avanços tecnológicos, a eletroencefalografia em recém-nascidos prematuros ainda é um desafio em todo o mundo e requer pesquisas e esforços mais robustos para a melhor assistência clínica neste estágio extremamente precoce da vida.

Benign ovarian lesions with restricted diffusion / Lesões ovarianas benignas com restrição na difusão

Abstract Developments in magnetic resonance imaging have expanded its role in the assessment of the female pelvis, including the diagnosis of ovarian lesions. In this setting, diffusion-weighted imaging has proven its diagnostic value, which is particularly important in differentiating between benign and malignant ovarian tumors. In general, the latter show restricted diffusion, whereas the former do not. Exceptions include teratomas, endometriomas, hemorrhagic cysts, ovarian abscesses, ovarian infarction, and some benign stromal tumors. The aim of this review is to draw attention to benign ovarian lesions with restricted diffusion, with a special focus on diffusion-weighted imaging pearls and pitfalls.

Resumo Os recentes desenvolvimentos nas técnicas de ressonância magnética aumentaram o seu papel na avaliação da pelve em mulheres, incluindo o diagnóstico de lesões ovarianas. A imagem ponderada em difusão comprovou ter um valor diagnóstico indiscutível, fato particularmente importante na diferenciação entre tumores ovarianos benignos e malignos. Em geral, os últimos têm restrição na difusão, enquanto os primeiros não. As exceções incluem teratomas, endometriomas, cistos hemorrágicos, abcessos ovarianos, enfarte ovariano e alguns tumores benignos do estroma ovariano. Esta revisão tem como objetivo expor lesões ovarianas benignas com restrição na difusão, com especial enfoque nas pérolas e armadilhas da imagem ponderada em difusão.

Necrosis laminar cortical en tomografía computarizada: presentación de caso / Cortical Laminar Necrosis in Computed Tomography Scan: A Case Report

Introducción: Necrosis laminar cortical es un término imaginológico que se usa para describir lesiones de localización cortical, hiperdensas de distribución giriforme, en tomografía computarizada (TC). La etiología de este hallazgo involucra depleción de energía cerebral, la cual puede derivarse de múltiples patologías, que conllevan principalmente a hipoxia o alteraciones metabólicas. Presentación de caso: Es el caso de una paciente femenina de 3 meses de edad quien fue llevada a urgencias de la institución de los autores con un cuadro clínico de 1 semana de evolución consistente en elevación de la temperatura, disnea, cianosis, frialdad en extremidades, taquipnea, taquicardia y edema. Por medio de ecocardiografía se diagnosticó miocarditis de probable origen viral. Posteriormente, la paciente sufrió paro cardiorrespiratorio y choque prolongado que requirió reanimación cardiopulmonar e ingreso a UCI neonatal. Una TC cerebral tomada 1 semana después de estos eventos evidenció hallazgos compatibles con necrosis laminar cortical. Discusión: No hay descripciones epidemiológicas sobre este hallazgo; sin embargo, se ha teorizado un incremento en su frecuencia debido a la alta tasa de supervivencia de pacientes que padecen patologías hipóxico-isquémicas. A pesar de que los hallazgos de necrosis laminar cortical son descritos para la resonancia magnética (RM), también se pueden apreciar en la TC, donde típicamente se evidencian como una alta densidad cortical sutil, y los hallazgos más llamativos están relacionados con un peor pronóstico. Conclusión: Es necesaria la divulgación de este tipo de imágenes radiológicas, con el fin de promover la realización de pronósticos más acertados en pacientes en quienes se aprecien estos hallazgos.

Introduction: Cortical laminar necrosis is an imaging term used to describe gyriform hyperdense lesions in the cortical region that can be appreciated on the CT (Computed Tomography). The etiology of this finding involves brain energy depletion, which can be derived from multiple pathologies, that mainly lead to hypoxia or metabolic alterations. Case report: the case of a 3-month-old female patient is presented; she was taken to the emergency department with a 1-week clinical manifestations consisting of thermal rises, dyspnea, cyanosis coldness in extremities, tachypnea, tachycardia and edema. An echocardiography diagnosed myocarditis of probable viral origin. Subsequently, the patient presented cardiac arrest and prolonged shock that required cardiopulmonary resuscitation and admission to neonatal ICU. A cerebral CT scan taken 1 week after these events evidenced imaging findings compatible with cortical laminar necrosis. Discussion: There are no epidemiological descriptions of this finding, however, an increase has been theorized due to the high survival rates of patients suffering from ischemic hypoxic pathologies. Although findings of cortical laminar necrosis are typical of MRI, they can also be seen on CT scan, where they typically show as a subtle cortical hyperdensity, and the most striking findings are associated to a worst prognosis. Conclusion: Disclosure of these type of radiological images is necessary in order to promote more accurate prognoses in patients in whom these findings are appreciated.