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1.
Cerebellum ; 23(5): 2169-2192, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38769243

RESUMO

Cerebellum is a key-structure for the modulation of motor, cognitive, social and affective functions, contributing to automatic behaviours through interactions with the cerebral cortex, basal ganglia and spinal cord. The predictive mechanisms used by the cerebellum cover not only sensorimotor functions but also reward-related tasks. Cerebellar circuits appear to encode temporal difference error and reward prediction error. From a chemical standpoint, cerebellar catecholamines modulate the rate of cerebellar-based cognitive learning, and mediate cerebellar contributions during complex behaviours. Reward processing and its associated emotions are tuned by the cerebellum which operates as a controller of adaptive homeostatic processes based on interoceptive and exteroceptive inputs. Lobules VI-VII/areas of the vermis are candidate regions for the cortico-subcortical signaling pathways associated with loss aversion and reward sensitivity, together with other nodes of the limbic circuitry. There is growing evidence that the cerebellum works as a hub of regional dysconnectivity across all mood states and that mental disorders involve the cerebellar circuitry, including mood and addiction disorders, and impaired eating behaviors where the cerebellum might be involved in longer time scales of prediction as compared to motor operations. Cerebellar patients exhibit aberrant social behaviour, showing aberrant impulsivity/compulsivity. The cerebellum is a master-piece of reward mechanisms, together with the striatum, ventral tegmental area (VTA) and prefrontal cortex (PFC). Critically, studies on reward processing reinforce our view that a fundamental role of the cerebellum is to construct internal models, perform predictions on the impact of future behaviour and compare what is predicted and what actually occurs.


Assuntos
Cerebelo , Recompensa , Humanos , Cerebelo/fisiologia , Animais , Consenso , Vias Neurais/fisiologia
2.
Hum Brain Mapp ; 44(4): 1629-1646, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36458984

RESUMO

Neuropsychological deficits and brain damage following SARS-CoV-2 infection are not well understood. Then, 116 patients, with either severe, moderate, or mild disease in the acute phase underwent neuropsychological and olfactory tests, as well as completed psychiatric and respiratory questionnaires at 223 ± 42 days postinfection. Additionally, a subgroup of 50 patients underwent functional magnetic resonance imaging. Patients in the severe group displayed poorer verbal episodic memory performances, and moderate patients had reduced mental flexibility. Neuroimaging revealed patterns of hypofunctional and hyperfunctional connectivities in severe patients, while only hyperconnectivity patterns were observed for moderate. The default mode, somatosensory, dorsal attention, subcortical, and cerebellar networks were implicated. Partial least squares correlations analysis confirmed specific association between memory, executive functions performances and brain functional connectivity. The severity of the infection in the acute phase is a predictor of neuropsychological performance 6-9 months following SARS-CoV-2 infection. SARS-CoV-2 infection causes long-term memory and executive dysfunctions, related to large-scale functional brain connectivity alterations.


Assuntos
Mapeamento Encefálico , COVID-19 , Humanos , Mapeamento Encefálico/métodos , COVID-19/complicações , COVID-19/diagnóstico por imagem , SARS-CoV-2 , Encéfalo , Função Executiva , Transtornos da Memória , Testes Neuropsicológicos , Imageamento por Ressonância Magnética/métodos
3.
Cerebellum ; 22(5): 852-864, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35999332

RESUMO

The cerebellum's role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for affective disruptions following cerebellar damage. To improve the characterization of emotion processing and investigate how attention allocation impacts this processing, we conducted a meta-analysis on task activation foci using GingerALE software. Eighty human neuroimaging studies of emotion including 2761 participants identified through Web of Science and ProQuest databases were analyzed collectively and then divided into two categories based on the focus of attention during the task: explicit or implicit emotion processing. The results examining the explicit emotion tasks identified clusters within the posterior cerebellar hemispheres (bilateral lobule VI/Crus I/II), the vermis, and left lobule V/VI that were likely to be activated across studies, while implicit tasks activated clusters including bilateral lobules VI/Crus I/II, right Crus II/lobule VIII, anterior lobule VI, and lobules I-IV/V. A direct comparison between these categories revealed five overlapping clusters in right lobules VI/Crus I/Crus II and left lobules V/VI/Crus I of the cerebellum common to both the explicit and implicit task contrasts. There were also three clusters activated significantly more for explicit emotion tasks compared to implicit tasks (right lobule VI, left lobule VI/vermis), and one cluster activated more for implicit than explicit tasks (left lobule VI). These findings support previous studies indicating affective processing activates both the lateral hemispheric lobules and the vermis of the cerebellum. The common and distinct activation of posterior cerebellar regions by tasks with explicit and implicit attention demonstrates the supportive role of this structure in recognizing, appraising, and reacting to emotional stimuli.


Assuntos
Vermis Cerebelar , Cerebelo , Humanos , Cerebelo/diagnóstico por imagem , Cerebelo/fisiologia , Emoções , Imageamento por Ressonância Magnética/métodos , Neuroimagem , Mapeamento Encefálico
4.
Rev Med Suisse ; 19(824): 800-802, 2023 Apr 26.
Artigo em Francês | MEDLINE | ID: mdl-37133938

RESUMO

Recent observations suggest the persistence of neurological and neuropsychological symptoms in the long-term following SARS-CoV-2 infection. Currently described within the post-COVID-19 syndrome. The objective of this article is to discuss recent epidemiological data and data from neuroimaging studies. Finally, a discussion is proposed regarding recent suggestions regarding the existence of distinct phenotypes of post-COVID-19 syndrome.


De récentes observations suggèrent la persistance de symptômes neurologiques et neuropsychologiques à long terme suite à une infection par le SARS-CoV-2, actuellement décrit au sein du syndrome post-Covid-19. L'objectif de cet article est d'aborder les récentes données épidémiologiques et les données provenant d'études en neuro-imagerie. Finalement, une discussion est proposée quant aux récentes suggestions concernant l'existence de phénotypes distincts au sein du syndrome post-Covid-19.


Assuntos
COVID-19 , Humanos , Síndrome de COVID-19 Pós-Aguda , SARS-CoV-2 , Existencialismo , Neuroimagem
5.
Rev Med Suisse ; 19(827): 972-974, 2023 May 17.
Artigo em Francês | MEDLINE | ID: mdl-37195112

RESUMO

The study of post-COVID-19 symptomatology revealed a first wave of post-acute (persistence of symptoms less than 3 months) neurocognitive symptoms. However, some of these symptoms worsened, while others improved. To our knowledge, these symptoms may persist for up to 1 to 2 years after infection. The intensity, variability and persistence of neurocognitive symptoms may rise the hypotheses of accelerated neurodegenerative processes, as well as neuropsychiatric and/or genetic vulnerabilities that are still poorly understood. Moreover, the multi-organ manifestations of post-COVID-19 symptoms remind us of the importance of promoting an interdisciplinary perspective at both clinical and fundamental levels. Finally, many social and economic issues parallel to the neuropathological consequences remain to be investigated.


L'étude de la symptomatologie post-Covid-19 a permis de mettre en évidence une première vague de symptômes neurocognitifs postaigus (persistance des symptômes inférieurs à 3 mois). Certains se sont aggravés, tandis que d'autres se sont améliorés. Ils peuvent perdurer jusqu'à 1 à 2 ans après l'infection. L'intensité, la variabilité et la persistance des symptômes neurocognitifs pourraient suggérer des hypothèses d'accélération de processus neurodégénératifs et des vulnérabilités neuropsychiatriques et/ou génétiques encore mal comprises. De plus, les manifestations multi-organiques des symptômes post-Covid-19 nous rappellent l'importance de promouvoir une perspective multidisciplinaire sur les plans clinique et fondamental. Finalement, de nombreuses questions sociales et économiques parallèles aux conséquences neuropathologiques restent à investiguer.


Assuntos
COVID-19 , Síndrome de COVID-19 Pós-Aguda , Humanos , Estudos Interdisciplinares , Conhecimento
6.
Cogn Affect Behav Neurosci ; 22(5): 1030-1043, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35474566

RESUMO

There is growing evidence that both the basal ganglia and the cerebellum play functional roles in emotion processing, either directly or indirectly, through their connections with cortical and subcortical structures. However, the lateralization of this complex processing in emotion recognition remains unclear. To address this issue, we investigated emotional prosody recognition in individuals with Parkinson's disease (model of basal ganglia dysfunction) or cerebellar stroke patients, as well as in matched healthy controls (n = 24 in each group). We analysed performances according to the lateralization of the predominant brain degeneration/lesion. Results showed that a right (basal ganglia and cerebellar) hemispheric dysfunction was likely to induce greater deficits than a left one. Moreover, deficits following left hemispheric dysfunction were only observed in cerebellar stroke patients, and these deficits resembled those observed after degeneration of the right basal ganglia. Additional analyses taking disease duration / time since stroke into consideration revealed a worsening of performances in patients with predominantly right-sided lesions over time. These results point to the differential, but complementary, involvement of the cerebellum and basal ganglia in emotional prosody decoding, with a probable hemispheric specialization according to the level of cognitive integration.


Assuntos
Doença de Parkinson , Acidente Vascular Cerebral , Gânglios da Base , Cerebelo , Emoções , Humanos , Acidente Vascular Cerebral/complicações
7.
Adv Exp Med Biol ; 1378: 13-24, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35902462

RESUMO

Affective neurosciences have largely contributed to the elaboration of theoretical and neuroanatomical models through research conducted in non-primate animals and human beings. However, for methodological and historical reasons, knowledge has developed by focusing mainly on the cerebral cortex, resulting in a lack of investigations of the functional aspects of subcortical structures such as the cerebellum and the basal ganglia. The close anatomical connections revealed between these two structures, as well as their reciprocal connections with the cerebral cortex, lead to a vertically organized model of the brain. Both the cerebellum and the basal ganglia are involved in the different components required during an emotional episode. Their respective specificity in the analysis of temporal patterns contributes to the optimal processing of emotional signals such as those that can be conveyed by the voice (emotional prosody). Internal temporally structured event representation, built from the salient modulation extractions performed by the cerebellum, is used by the basal ganglia to recruit and synchronize the activity of the cortical and subcortical structures required for the relevant processes.


Assuntos
Gânglios da Base , Encéfalo , Animais , Cerebelo , Córtex Cerebral , Emoções , Humanos , Vias Neurais
8.
Adv Exp Med Biol ; 1378: 125-140, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35902469

RESUMO

There is growing evidence of the cerebellum's contribution to emotion processing from neuroimaging studies of healthy function and clinical studies of cerebellar patients. As demonstrated initially in the motor domain, one of the cerebellum's functions is to construct internal models of an individual's state and make predictions about how future behaviors will impact that state. By utilizing widespread connections with neocortex and subcortical regions such as the basal ganglia, the cerebellum can monitor and modulate precisely timed patterns of events using prediction and reward-based error feedback in a diverse range of tasks including auditory emotion prosody recognition. In coordination with a broader affective network, the cerebellum helps to select and refine emotional responses that are the most rewarded in a particular context, strengthening neural activity in relevant regions to form a representational chunk. This chunked set of affective stimuli, cognitive evaluations, and physiological responses subsequently can be enacted as a unitary response (i.e., an emotional habit) more quickly and with less attentional control than for a novel stimulus or goal-oriented action. Such emotional habits can allow for efficient, automatic, stimulus-triggered responses while maintaining the flexibility to adapt output when prediction errors signal a renewed need for cerebellar modification of cortical activity, or, conversely, may lead to behavioral or mood disorders when habitual responses persist despite negative consequences.


Assuntos
Cerebelo , Emoções , Atenção , Cerebelo/fisiologia , Emoções/fisiologia , Hábitos , Humanos , Recompensa
9.
Rev Med Suisse ; 17(736): 822-826, 2021 Apr 28.
Artigo em Francês | MEDLINE | ID: mdl-33908718

RESUMO

Among the long-COVID symptoms, neuropsychological sequelae are frequent after an infection by SARS-CoV-2, whatever the severity of the respiratory disease in the acute phase. These deficits seem to result from a neurological disorder, but also from psychiatric symptoms. Not only inflammatory components, which can play a major role in the genesis of the neuropsychological sequelae, but also the hypotheses of vascular systemic lesions, the neurotropism of SARS-CoV-2, or the effect of the stress and the hypothalamic-pituitary-adrenal axis (HPA) are suggested. Psychiatric complications due to SSARS-CoV-2 infection would partly explain these neuropsychological sequelae.


Parmi les symptômes de Covid long, les séquelles neuropsychologiques sont fréquentes dans les suites d'une infection par le SARS-CoV-2, et ce quel que soit le degré de sévérité de l'atteinte respiratoire en phase aiguë. Ces déficits semblent résulter d'une atteinte neurologique, mais aussi de l'installation de troubles psychiatriques. En plus de l'inflammation, qui joue un rôle majeur dans la genèse des séquelles neuropsychologiques, les hypothèses de lésions endothéliales systémiques, de l'existence d'un neurotropisme du SARS-CoV-2, de même que de celles de l'effet du stress et de la mise en jeu de l'axe hypothalamo-hypophysaire-surrénalien, sont proposées. Les complications psychiatriques de l'infection par le SARS-CoV-2 semblent, quant à elles, n'expliquer qu'une partie des séquelles neuropsychologiques.


Assuntos
COVID-19 , Doenças do Sistema Nervoso , Humanos , Sistema Hipotálamo-Hipofisário , Sistema Hipófise-Suprarrenal , SARS-CoV-2
10.
Neuroimage ; 222: 117215, 2020 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-32745674

RESUMO

The subthalamic nucleus (STN) is involved in different aspects of emotional processes and more specifically in emotional prosody recognition. Recent studies on the behavioral effects of deep brain stimulation (DBS) in patients with Parkinson's disease (PD) have uncovered an asymmetry in vocal emotion decoding in PD, with left-onset PD patients showing deficits for the processing of happy voices. Whether and how PD asymmetry affects STN electrophysiological responses to emotional prosody, however, remains unknown. In the current study, local field potential activity was recorded from eight left- and six right-lateralized motor-onset PD patients (LOPD/ROPD) undergoing DBS electrodes implantation, while they listened to angry, happy and neutral voices. Time-frequency decomposition revealed that theta (2-6 Hz), alpha (6-12 Hz) and gamma (60-150 Hz) band responses to emotion were mostly bilateral with a differential pattern of response according to patient's sides-of onset. Conversely, beta-band (12-20 Hz and 20-30 Hz) emotional responses were mostly lateralized in the left STN for both patient groups. Furthermore, STN theta, alpha and gamma band responses to happiness were either absent (theta band) or reduced (alpha and gamma band) in the most affected STN hemisphere (contralateral to the side-of onset), while a late low-beta band left STN happiness-specific response was present in ROPD patients and did not occur in LOPD patients. Altogether, in this study, we demonstrate a complex pattern of oscillatory activity in the human STN in response to emotional voices and reveal a crucial influence of disease laterality on STN low-frequency oscillatory activity.


Assuntos
Percepção Auditiva/fisiologia , Ondas Encefálicas/fisiologia , Emoções/fisiologia , Potenciais Evocados/fisiologia , Doença de Parkinson/fisiopatologia , Percepção Social , Núcleo Subtalâmico/fisiopatologia , Adulto , Estimulação Encefálica Profunda , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção da Fala/fisiologia
11.
Neuroimage ; 197: 232-242, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31051290

RESUMO

Cognitive action control depends on cortical-subcortical circuits, involving notably the subthalamic nucleus (STN), as evidenced by local field potentials recordings (LFPs) studies. The STN consistently shows an increase in theta oscillations power during conflict resolution. Some studies have shown that cognitive action control in Parkinson's disease (PD) could be influenced by the occurrence of monetary reward. In this study, we investigated whether incentive motivation could modulate STN activity, and notably STN theta activity, during response conflict resolution. To achieve this objective, we recorded STN LFPs during a motivated Simon task in PD patients who had undergone deep brain stimulation surgery. Behavioral results revealed that promised rewards increased the difficulty in resolving conflict situations, thus replicating previous findings. Signal analyses locked on the imperative stimulus onset revealed the typical pattern of increased theta power in a conflict situation. However, this conflict-related modulation of theta power was not influenced by the size of the reward cued. We nonetheless identified a significant effect of the reward size on local functional organization (indexed by inter-trial phase clustering) of theta oscillations, with higher organization associated with high rewards while resolving conflict. When focusing on the period following the onset of the reward cue, we unveiled a stronger beta power decrease in higher reward conditions. However, these LFPs results were not correlated to behavioral results. Our study suggests that the STN is involved in how reward information can influence computations during conflict resolution. However, considering recent studies as well as the present results, we suspect that these effects are subtle.


Assuntos
Conflito Psicológico , Motivação/fisiologia , Doença de Parkinson/fisiopatologia , Recompensa , Núcleo Subtalâmico/fisiopatologia , Ritmo beta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/psicologia , Ritmo Teta
12.
Mov Disord ; 33(1): 169-173, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29266392

RESUMO

BACKGROUND: We investigated the acute effect of short pulse widths on the therapeutic window in subthalamic nucleus deep brain stimulation in Parkinson's disease. METHODS: We assessed 10 PD patients with STN-DBS at a 60-µs pulse width. We randomly and double-blindedly applied 10- to 50-µs pulse widths. The principal outcome was the therapeutic window (difference between the amplitude thresholds for visible muscle contraction and for best rigidity control). The secondary outcome was the charge per pulse (which reflects the efficiency of the stimulation) needed to control rigidity. Two-way analysis of variance and pairwise t tests were applied. RESULTS: The therapeutic window widened when the pulse width shortened (r = -0.45; P < 0.001), and charge per pulse was reduced (P < 0.05). CONCLUSIONS: This randomized, double-blind study showed that shorter pulse widths widen the therapeutic window of STN-DBS in PD without increasing the electrical charge required to obtain the same acute clinical benefit. © 2017 International Parkinson and Movement Disorder Society.


Assuntos
Estimulação Encefálica Profunda/métodos , Doença de Parkinson/terapia , Núcleo Subtalâmico/fisiologia , Biofísica , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Resultado do Tratamento
13.
J Neurol Neurosurg Psychiatry ; 85(10): 1153-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24403280

RESUMO

Apathy is a disabling non-motor symptom that is frequently observed in Parkinson's disease (PD). Its description and physiopathology suggest that it is partially mediated by emotional impairment, but this research issue has never been addressed at a clinical and metabolic level. We therefore conducted a metabolic study using (18)fluorodeoxyglucose positron emission tomography ((18)FDG PET) in 36 PD patients without depression and dementia. Apathy was assessed on the Apathy Evaluation Scale (AES), and emotional facial recognition (EFR) performances (ie, percentage of correct responses) were calculated for each patient. Confounding factors such as age, antiparkinsonian and antidepressant medication, global cognitive functions and depressive symptoms were controlled for. We found a significant negative correlation between AES scores and performances on the EFR task. The apathy network was characterised by increased metabolism within the left posterior cingulate (PC) cortex (Brodmann area (BA) 31). The impaired EFR network was characterised by decreased metabolism within the bilateral PC gyrus (BA 31), right superior frontal gyrus (BAs 10, 9 and 6) and left superior frontal gyrus (BA 10 and 11). By applying conjunction analyses to both networks, we identified the right premotor cortex (BA 6), right orbitofrontal cortex (BA 10), left middle frontal gyrus (BA 8) and left posterior cingulate gyrus (BA 31) as the structures supporting the association between apathy and impaired EFR. These results confirm that apathy in PD is partially mediated by impaired EFR, opening up new prospects for alleviating apathy in PD, such as emotional rehabilitation.


Assuntos
Apatia/fisiologia , Lobo Frontal/fisiopatologia , Giro do Cíngulo/fisiopatologia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/psicologia , Reconhecimento Psicológico/fisiologia , Idoso , Mapeamento Encefálico , Expressão Facial , Fluordesoxiglucose F18 , Humanos , Processamento de Imagem Assistida por Computador , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons
14.
J Neuropsychiatry Clin Neurosci ; 26(3): 221-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24921969

RESUMO

BACKGROUND: Whereas apathy is known as a common consequence of subthalamic nucleus deep brain stimulation in Parkinson's disease, few studies have investigated the psychiatric consequences of internal globus pallidus deep brain stimulation. METHOD: Twenty consecutive parkinsonian patients who underwent bilateral pallidal stimulation were assessed 3 months prior to surgery (M‒3) and at both 3 (M3) and 6 months (M6) after surgery, using psychiatric, neuropsychological, and motor scales. Apathy, mood state, and anxiety state were scored using the Apathy Evaluation Scale, the Montgomery-Åsberg Depression Rating Scale, and the anxiety scale from the Association for Methodology and Documentation in Psychiatry, respectively. RESULTS: The mean apathy score remained stable between the preoperative M‒3 assessment (37.2±6.2) and both the postoperative M3 (36.9±7.5) and M6 (37.2±5.0) assessments. The mean depression score did not differ between the M‒3 assessment and M3 and M6 assessments. There was no difference between the preoperative mean anxiety score and both the postoperative M3 and M6 scores. The mean score for the Mattis Dementia Rating Scale remained stable at each study visit. CONCLUSIONS: The main result of this study is the absence of deterioration in psychiatric and cognitive scores 3 months and 6 months after pallidal stimulation.


Assuntos
Apatia , Estimulação Encefálica Profunda/métodos , Globo Pálido/fisiologia , Doença de Parkinson/terapia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Testes Neuropsicológicos , Doença de Parkinson/complicações , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos
15.
Cortex ; 179: 261-270, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39213778

RESUMO

In the ever-evolving field of clinical neuropsychology, significant methodological and conceptual limitations hinder progress. To ensure the continued relevance of this discipline amidst remarkable advancements in neuroscience, medicine, and methodology, these obstacles must be addressed. This opinion article identifies inherent limitations within current clinical neuropsychology, including issues such as multi-collinearity in neuropsychological assessments, lack of validated tools reflecting contemporary cognitive function models, and the use of divergent theoretical frameworks in evaluations, leading to a gap between theory and practice. The disconnect between behavior and biomarkers, particularly evident in neurodegenerative diseases but also relevant for other pathologies, together with the rise of genetic analyses, necessitate change. Methodological improvements are crucial for ensuring the discipline's future relevance. Looking ahead, key perspectives and challenges are outlined, emphasizing the need for a holistic approach to cognitive functioning and congruent tools, patient engagement in experimental studies, rectification of biases, and exploration of variables like personality. Training professionals to bridge the gap between practice and research is essential. By addressing these challenges, clinical neuropsychology can not only adapt to the evolving landscape but also shape it, ensuring a brighter future for the field.


Assuntos
Neuropsicologia , Humanos , Cognição/fisiologia , Testes Neuropsicológicos , Neuropsicologia/tendências , Neuropsicologia/métodos
16.
J Alzheimers Dis ; 101(4): 1205-1216, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39302366

RESUMO

Background: Idiopathic normal pressure hydrocephalus (iNPH) can present with both episodic amnestic syndrome and biomarkers of Alzheimer's disease (AD) pathology. Objective: To examine the associations between amnestic syndrome and cerebrospinal fluid (CSF) AD biomarkers in iNPH and the CSF tap test response in iNPH patients with amnestic syndrome. Methods: We used the Free and Cued Selective Reminding Test to divide iNPH into amnestic and non-amnestic patients. We compared their clinical, biological, and radiological characteristics and examined the reversibility of gait spatiotemporal parameters and neuropsychological performances after a CSF tap test. Univariate and multiple linear regression models examined the association between memory performance and clinical-biological characteristics. Results: Sixty-two non-amnestic patients (mean age 77.0±7.0 years, 38.7% female) and thirty-eight amnestic patients (mean age 77.0±5.9 years, 36.8% female) presented similar levels of AD biomarkers and clinical-radiological profiles. Global cognition and education levels were lower in the amnestic iNPH group. We found no association between AD biomarkers and memory performances (total tau: ß= -4.50; 95% CI [-11.96;2.96]; p = 0.236; amyloid-ß (1-42): ß= 8.60, 95% CI [-6.30;23.50]; p = 0.240). At baseline, amnestic iNPH patients performed worse on executive functions, attention, and gait speed but improved similarly to the non-amnestic iNPH patients after the tap test. Conclusions: In our clinical sample of iNPH patients, we confirm the lack of specificity of the amnestic profile for predicting AD pathology. Clinicians should not preclude amnestic iNPH patients from undergoing an invasive procedure of CSF derivation.


Assuntos
Amnésia , Peptídeos beta-Amiloides , Hidrocefalia de Pressão Normal , Testes Neuropsicológicos , Proteínas tau , Humanos , Hidrocefalia de Pressão Normal/líquido cefalorraquidiano , Hidrocefalia de Pressão Normal/psicologia , Hidrocefalia de Pressão Normal/complicações , Hidrocefalia de Pressão Normal/diagnóstico por imagem , Feminino , Masculino , Idoso , Amnésia/líquido cefalorraquidiano , Amnésia/psicologia , Proteínas tau/líquido cefalorraquidiano , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Idoso de 80 Anos ou mais , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/psicologia , Doença de Alzheimer/complicações , Fragmentos de Peptídeos/líquido cefalorraquidiano
17.
PET Clin ; 2024 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-39482218

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has led to a variety of health challenges, with "long COVID" emerging as a widespread and debilitating post-acute syndrome among a considerable number of infected patients. This PET review synthesizes current evidence of the neurologic and psychiatric sequelae of COVID. This review also explores the pathophysiological mechanisms of these results, including astrocyte dysfunction and glutamate dysregulation, as well as the multimodal comparison to MR imaging findings. The findings underscore the potential for long-term brain injury. Additionally, the authors discuss the role of advanced imaging multimodal techniques in diagnosing, monitoring, and guiding treatment strategies for long COVID.

18.
Case Rep Neurol ; 16(1): 6-17, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38179211

RESUMO

Introduction: Emotional apathy has recently been identified as a common symptom of long COVID. While recent meta-analyses have demonstrated generalized EEG slowing with the emergence of delta rhythms in patients hospitalized for severe SARS-CoV-2 infection, no EEG study or dopamine transporter scintigraphy (DaTSCAN) has been performed in patients with long COVID presenting with apathy. The objective of this case report was to explore the pathophysiology of neuropsychological symptoms in long COVID. Case Presentation: A 47-year-old patient who developed a long COVID with prominent apathy following an initially clinically mild SARS-CoV-2 infection underwent neuropsychological assessment, cerebral MRI, DaTSCAN, and resting-state high-density EEG 7 months after SARS-CoV-2 infection. The EEG data were compared to those of 21 healthy participants. The patient presented with apathy, cognitive difficulties with dysexecutive syndrome, moderate attentional and verbal episodic memory disturbances, and resolution of premorbid mild gaming disorder, mild mood disturbances, and sleep disturbances. His MRI and DaTSCAN were unremarkable. EEG revealed a complex pattern of oscillatory abnormalities compared to the control group, with a strong increase in whole-scalp delta and beta band activity, as well as a decrease in alpha band activity. Overall, these effects were more prominent in the frontal-central-temporal region. Conclusion: These results suggest widespread changes in EEG oscillatory patterns in a patient with long COVID characterized by neuropsychological complications with prominent apathy. Despite the inherent limitations of a case report, these results suggest dysfunction in the cortical networks involved in motivation and emotion.

19.
Heliyon ; 10(19): e38711, 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-39430528

RESUMO

Background: Deficits in self are commonly described through different neuro-pathologies, based on clinical evaluations and experimental paradigms. However, currently available approaches lack appropriate clinical validation, making objective evaluation and discrimination of self-related deficits challenging. Methods: We applied a statistical standardized method to assess the clinical discriminatory capacity of a Self-Other Voice Discrimination (SOVD) task. This task, validated experimentally as a marker for self-related deficits, was administered to 17 patients eligible for neurosurgery due to focal hemispheric brain tumors or epileptic lesions. Results: The clinical discriminatory capacity of the SOVD task was evident in three patients who exhibited impairments for self-voice perception that could not be predicted by other neuropsychological deficits. Impairments in other-voice perception were linked to inhibitory neuropsychological deficits, suggesting a potential association with executive deficits in voice recognition. Conclusions: This exploratory study highlights the clinical discriminatory potential of the SOVD task and suggests that it could complement the standard neuropsychological assessment, paving the way for enhanced diagnoses and tailored treatments for self-related deficits.

20.
Sci Rep ; 14(1): 22660, 2024 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-39349924

RESUMO

Cognitive symptoms persisting beyond the acute phase of COVID-19 infection are commonly described for up to 2 years after infection. The relationship between cognitive performance, in particular episodic memory processes observed chronically after infection, and cytokine levels in the acute phase of COVID-19 has not yet been identified in humans. To determine whether the levels of cytokines IL1ß, IL-6 and TNFα secreted in the acute phase of SARS-CoV-2 infection are associated and predict verbal and visuospatial episodic memory performance in humans 6 to 9 months and 12 to 15 months post-infection. The associations and predictive value of the concentration of cytokines measured in acute phase (IL-1ß, IL-6, TNFα) from plasma samples of N = 33 hospitalized COVID-19 patients (mean age 61 years, 39-78, 65% in intensive care) in relation to their verbal and visuospatial episodic memory performance measured at 6-9 months and 12-15 months post-infection were analyzed. To do this, we used Spearman correlations and generalised linear mixed models. IL-1ß levels were associated with verbal episodic memory total recall scores 6-9 months post-infection. At 12-15 months post-infection IL-6 predicted verbal episodic memory score. This study demonstrated that the severity of inflammatory reaction at acute phase of SARS-CoV-2 infection predicts verbal episodic memory performance in the long-term post-infection.


Assuntos
COVID-19 , Citocinas , Interleucina-1beta , SARS-CoV-2 , Humanos , COVID-19/sangue , COVID-19/imunologia , Pessoa de Meia-Idade , Masculino , Feminino , Idoso , Adulto , Citocinas/sangue , Interleucina-1beta/sangue , Interleucina-6/sangue , Memória Episódica , Fator de Necrose Tumoral alfa/sangue
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