RESUMO
Alzheimer disease (AD) and vascular dementia (VaD) together represent the majority of dementia cases. Since their neuropsychological profiles often overlap and white matter lesions are observed in elderly subjects including AD, differentiating between VaD and AD can be difficult. Characterization of these different forms of dementia would benefit by identification of quantitative imaging biomarkers specifically sensitive to AD or VaD. Parameters of microstructural abnormalities derived from diffusion tensor imaging (DTI) have been reported to be helpful in differentiating between dementias, but only few studies have used them to compare AD and VaD with a voxelwise approach. Therefore, in this study a whole brain statistical analysis was performed on DTI data of 93 subjects (31 AD, 27 VaD, and 35 healthy controls-HC) to identify specific white matter patterns of alteration in patients affected by VaD and AD with respect to HC. Parahippocampal tracts were found to be mainly affected in AD, while VaD showed more spread white matter damages associated with thalamic radiations involvement. The genu of the corpus callosum was predominantly affected in VaD, while the splenium was predominantly affected in AD revealing the existence of specific patterns of alteration useful in distinguishing between VaD and AD. Therefore, DTI parameters of these regions could be informative to understand the pathogenesis and support the etiological diagnosis of dementia. Further studies on larger cohorts of subjects, characterized for brain amyloidosis, will allow to confirm and to integrate the present findings and, furthermore, to elucidate the mechanisms of mixed dementia. These steps will be essential to translate these advances to clinical practice.
RESUMO
Cerebellar involvement in cognition, as well as in sensorimotor control, is increasingly recognized and is thought to depend on connections with the cerebral cortex. Anatomical investigations in animals and post-mortem humans have established that cerebro-cerebellar connections are contralateral to each other and include the cerebello-thalamo-cortical (CTC) and cortico-ponto-cerebellar (CPC) pathways. CTC and CPC characterization in humans in vivo is still challenging. Here advanced tractography was combined with quantitative indices to compare CPC to CTC pathways in healthy subjects. Differently to previous studies, our findings reveal that cerebellar cognitive areas are reached by the largest proportion of the reconstructed CPC, supporting the hypothesis that a CTC-CPC loop provides a substrate for cerebro-cerebellar communication during cognitive processing. Amongst the cerebral areas identified using in vivo tractography, in addition to the cerebral motor cortex, major portions of CPC streamlines leave the prefrontal and temporal cortices. These findings are useful since provide MRI-based indications of possible subtending connectivity and, if confirmed, they are going to be a milestone for instructing computational models of brain function. These results, together with further multi-modal investigations, are warranted to provide important cues on how the cerebro-cerebellar loops operate and on how pathologies involving cerebro-cerebellar connectivity are generated.
Assuntos
Córtex Cerebral/fisiologia , Córtex Motor/fisiologia , Vias Neurais/fisiologia , Ponte/fisiologia , Humanos , Modelos NeurológicosRESUMO
In the present study, we studied the structural changes of the brain functional network in a group of schizophrenic (SCHZ) patients during a 2-back working memory task. Cortical signals were obtained from scalp EEG signals through the high-resolution EEG technique, which relies on realistic head models and linear inverse solutions. Functional networks were estimated by computing the spectral coherence--i.e. a measure of synchronization in the frequency domain--between the time series of all the available cortical sources. To analyze those cortical networks we followed a theoretical graph approach by computing the network density as the total number of links and the node degree as the number of links of each cortical source. The major result suggest that in the Alpha2 frequency band (11-13 Hz) the cortical functional networks of the SCHZ patients present the largest differences when compared with those of a group of control (CTRL) subjects. In particular, the structure of the SCHZ network altered radically during the memory task, as the number of links that were different from the REST condition increased sensibly with respect to the CTRL network. In addition, a compensatory mechanism was found in the SCHZ patients during the correct performance of the memory task where the node degree showed a frontal asymmetry with higher activation of the left frontal lobe--i.e. higher number of connections--in the Alpha2 frequency band.