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Objective: In the present study, we aimed to assess the cognition of post-COVID-19 condition (PCC) participants in relation to their subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI) and to analyse possible moderators of this effect, such as quality of life (European Quality of Life-5 Dimensions, EQ-5D), fatigue (Chadler Fatigue Questionnaire, CFQ), cognitive reserve (Cognitive Reserve Questionnaire, CRC), and subjective cognitive complaints (Memory Failures of Everyday Questionnaire, MFE-30). Methods: We included 373 individuals with PCC and 126 healthy controls (HCs) from the NAUTILUS Project (NCT05307549 and NCT05307575) who were assessed with a comprehensive neuropsychological battery and various questionnaires. Results: We found that PCC participants with poor sleep quality had a 4.3% greater risk of immediate verbal memory deficits than those with good sleep quality, as indicated by the greater odds ratio (OR) of 1.043 and confidence interval (CI) of 1.023-1.063. Additionally, their risk of immediate verbal memory disorders was multiplied by 2.4 when their EQ-5D score was low (OR 0.33; CI 0.145-0.748), and they had a lower risk of delayed visual memory deficits with a greater CRC (OR 0.963; CI 0.929-0.999). With respect to processing speed, PCC participants with poor sleep quality had a 6.7% greater risk of deficits as the MFE increased (OR 1.059; CI 1.024-1.096), and the risk of slowed processing speed tripled with a lower EQ-5D (OR 0.021; CI 0.003-0.141). Conclusion: These results indicate that poor subjective sleep quality is a potential trigger for cognitive deficits. Therapeutic strategies to maximize sleep quality could include reducing sleep disturbances and perhaps cognitive impairment in PCC individuals.
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The study aimed to assess sleep quality in PCC patients and its predictors by analysing its relationship with emotional, cognitive and functional variables, as well as possible differences based on COVID-19 severity. We included 368 individuals with PCC and 123 healthy controls (HCs) from the NAUTILUS Project (NCT05307549 and NCT05307575). We assessed sleep quality (Pittsburgh Sleep Quality Index, PSQI), anxiety (Generalized Anxiety Disorder, GAD-7), depression (Patient Health Questionnaire, PHQ-9), global cognition (Montreal Cognitive Assessment, MoCA), everyday memory failures (Memory Failures of Everyday Questionnaire, MFE-30), fatigue (Chadler Fatigue Questionnaire, CFQ), quality of life (European Quality of Life-5 Dimensions, EQ-5D), and physical activity levels (International Physical Activity Questionnaire, IPAQ). 203 were nonhospitalized, 83 were hospitalized and 82 were admitted to the intensive care unit (ICU). We found statistically significant differences in the PSQI total score between the PCC and HC groups (p < 0.0001), but there were no differences among the PCC groups. In the multiple linear regressions, the PHQ-9 score was a predictor of poor sleep quality for mild PCC patients (p = 0.003); GAD-7 (p = 0.032) and EQ-5D (p = 0.011) scores were predictors of poor sleep quality in the hospitalized PCC group; and GAD-7 (p = 0.045) and IPAQ (p = 0.005) scores were predictors of poor sleep quality in the group of ICU-PCC. These results indicate that worse sleep quality is related to higher levels of depression and anxiety, worse quality of life and less physical activity. Therapeutic strategies should focus on these factors to have a positive impact on the quality of sleep.
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BACKGROUND: Parkinson's disease (PD) is a heterogeneous condition. Cluster analysis based on cortical thickness has been used to define distinct patterns of brain atrophy in PD. However, the potential of other neuroimaging modalities, such as white matter (WM) fractional anisotropy (FA), which has also been demonstrated to be altered in PD, has not been investigated. OBJECTIVE: We aim to characterize PD subtypes using a multimodal clustering approach based on cortical and subcortical gray matter (GM) volumes and FA measures. METHODS: We included T1-weighted and diffusion-weighted MRI data from 62 PD patients and 33 healthy controls. We extracted mean GM volumes from 48 cortical and 17 subcortical regions using FSL-VBM, and the mean FA from 20 WM tracts using Tract-Based Spatial Statistics (TBSS). Hierarchical cluster analysis was performed with the PD sample using Ward's linkage method. Whole-brain voxel-wise intergroup comparisons of VBM and TBSS data were also performed using FSL. Neuropsychological and demographic statistical analyses were conducted using IBM SPSS Statistics 25.0. RESULTS: We identified three PD subtypes, with prominent differences in GM patterns and little WM involvement. One group (n = 15) with widespread cortical and subcortical GM volume and WM FA reductions and pronounced cognitive deficits; a second group (n = 21) with only cortical atrophy limited to frontal and temporal regions and more specific neuropsychological impairment, and a third group (n = 26) without detectable atrophy or cognition impairment. CONCLUSION: Multimodal MRI data allows classifying PD patients into groups according to GM and WM patterns, which in turn are associated with the cognitive profile.
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Disfunção Cognitiva/classificação , Disfunção Cognitiva/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Imageamento por Ressonância Magnética , Doença de Parkinson/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Atrofia/patologia , Análise por Conglomerados , Disfunção Cognitiva/patologia , Disfunção Cognitiva/fisiopatologia , Imagem de Tensor de Difusão/métodos , Feminino , Substância Cinzenta/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Doença de Parkinson/classificação , Doença de Parkinson/patologia , Doença de Parkinson/fisiopatologia , Substância Branca/patologiaRESUMO
BACKGROUND: Idiopathic Rapid eye movement sleep behavior disorder (IRBD) is recognized as the prodromal stage of the alpha-Synucleinopathies. Although some studies have addressed the characterization of brain structure in IRBD, little is known about its progression. OBJECTIVE: The present work aims at further characterizing gray matter progression throughout IRBD relative to normal aging and investigating how these changes are associated with cognitive decline. METHODS: Fourteen patients with polysomnography-confirmed IRBD and 18 age-matched healthy controls (HC) underwent neuropsychological, olfactory, motor, and T1-weighted MRI evaluation at baseline and follow-up. We compared the evolution of cortical thickness (CTh), subcortical volumes, smell, motor and cognitive performance in IRBD and HC after a mean of 1.6 years. FreeSurfer was used for CTh and volumetry preprocessing and analyses. The symmetrized percent of change (SPC) of the CTh was correlated with the SPC of motor and neuropsychological performance. RESULTS: IRBD and HC differed significantly in the cortical thinning progression in regions encompassing bilateral superior parietal and precuneus, the right cuneus, the left occipital pole and lateral orbitofrontal gyri (FWE corrected, p < 0.05). The Visual form discrimination test showed worse progression in the IRBD relative to HC, that was associated with gray matter loss in the right superior parietal and the left precuneus. Increasing motor signs in IRBD were related to cortical thinning mainly involving frontal regions, and late-onset IRBD was associated with cortical thinning involving posterior areas (FWE corrected, p < 0.05). Despite finding olfactory identification deficits in IRBD, results did not show decline over the disease course. CONCLUSION: Progression in IRBD patients is characterized by parieto-occipital and orbitofrontal thinning and visuospatial loss. The cognitive decline in IRBD is associated with degeneration in parietal regions.
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Disfunção Cognitiva , Transtorno do Comportamento do Sono REM , Encéfalo , Disfunção Cognitiva/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Transtorno do Comportamento do Sono REM/diagnóstico por imagemRESUMO
BACKGROUND: Resting-state functional MRI has been proposed as a new biomarker of prodromal neurodegenerative disorders, but it has been poorly investigated in the idiopathic form of rapid-eye-movement sleep behavior disorder (IRBD), a clinical harbinger of subsequent synucleinopathy. Particularly, a complex-network approach has not been tested to study brain functional connectivity in IRBD patients. OBJECTIVES: The aim of the current work is to characterize resting-state functional connectivity in IRBD patients using a complex-network approach and to determine its possible relation to cognitive impairment. METHOD: Twenty patients with IRBD and 27 matched healthy controls (HC) underwent resting-state functional MRI with a 3T scanner and a comprehensive neuropsychological battery. The functional connectome was studied using threshold-free network-based statistics. Global and local network parameters were calculated based on graph theory and compared between groups. Head motion, age and sex were introduced as covariates in all analyses. RESULTS: IRBD patients showed reduced cortico-cortical functional connectivity strength in comparison with HC in edges located in posterior regions (pâ¯<0.05, FWE corrected). This regional pattern was also shown in an independent analysis comprising posterior areas where a decreased connectivity in 51 edges was found, whereas no significant results were detected when an anterior network was considered (pâ¯<0.05, FWE corrected). In the posterior network, the left superior parietal lobule had reduced centrality in IRBD. Functional connectivity strength between left inferior temporal lobe and right superior parietal lobule positively correlated with mental processing speed in IRBD (râ¯=â¯.633; pâ¯=â¯.003). No significant correlations were found in the HC group. CONCLUSION: Our findings support the presence of disrupted posterior functional brain connectivity of IRBD patients similar to that found in synucleinopathies. Moreover, connectivity reductions in IRBD were associated with lower performance in mental processing speed domain.
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Encéfalo/fisiopatologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Vias Neurais/fisiopatologia , Transtorno do Comportamento do Sono REM/complicações , Transtorno do Comportamento do Sono REM/fisiopatologia , Idoso , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Olfactory impairment increases the risk of developing neurodegenerative diseases in patients with idiopathic REM sleep behavior disorder (IRBD). Knowing the test properties of distinct olfactory measures could contribute to their selection for clinical or research purposes. OBJECTIVE: To compare the accuracy in distinguishing IRBD patients from controls with the University of Pennsylvania Smell Identification Test (UPSIT-40) and Sniffin' Sticks Extended test, and to assess the gray-matter volume correlates of these tests. METHOD: Twenty-one patients with IRBD and 27 healthy controls were assessed using both olfactory tests. Independent logistic regressions were computed with diagnosis as a dependent variable and olfactory measures as predictive variables. Receiver operating characteristic curves were computed for each olfactory subtest. Diagnostic accuracy for IRBD was calculated according to the resulting optimal cut-off score. Structural MRI data, acquired with a 3T scanner, were analyzed with voxel-based morphometry. RESULTS: Patients differed from controls in all olfactory measures. The Sniffin-Identification correctly classified 89.1% of cases; the UPSIT-40, 85.4%; the Sniffin-Discrimination, 82.6%; the Sniffin-Total, 81.8%; and the Sniffin-Threshold, 77.3%. Respective AUROC, optimal cut-off, sensitivity, and specificity for each test were: 0.902, ≤26, 85.7%, and 85.2% for the UPSIT-40; 0.884, ≤29, 89.5%, and 76.0% for the Sniffin-Total; 0.922, ≤11, 90.5%, and 88.0% for the Sniffin-Identification; 0.739, ≤4, 73.7%, and 76.0% for the Sniffin-Threshold; and 0.838, ≤11, 85.7%, and 76.0% for the Sniffin-Discrimination. UPSIT-40 scores correlated with gray-matter volumes in orbitofrontal regions in anosmic patients. CONCLUSIONS: UPSIT-40 and Sniffin' Identification showed similar discrimination accuracy, but only the UPSIT-40 showed structural correlates (pâ¯≤â¯.05 FDR-corrected).
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Córtex Cerebral/patologia , Técnicas de Diagnóstico Neurológico/normas , Transtornos do Olfato/diagnóstico , Córtex Pré-Frontal/patologia , Transtorno do Comportamento do Sono REM/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Córtex Cerebral/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/diagnóstico por imagem , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: The University of Pennsylvania Smell Identification Test (UPSIT) is the most commonly used test to detect olfactory impairment in Parkinson's disease (PD), but the cut-off score for clinical purposes is often difficult to establish because of age and sex effects. The current work aims to study the sensitivity and specificity of the UPSIT Spanish version and its accuracy in discriminating PD patients at different age groups from healthy controls (HC), and to perform an item analysis. METHOD: Ninety-seven non-demented PD patients and 65 HC were assessed with the UPSIT Spanish version. Sensitivity, specificity, and diagnostic accuracy for PD were calculated. Multiple regression analysis was used to define predictors of UPSIT scores. RESULTS: Using the normative cut-off score for anosmia (≤18), the UPSIT showed a sensitivity of 54.6% with a specificity of 100.0% for PD. We found that, using the UPSIT cut-off score of ≤25, sensitivity was 81.4% and specificity 84.6% (area under the receiver operating characteristic curve = 0.908). Diagnosis and age were good predictors of UPSIT scores (B = -10.948; p < .001; B = -0.203; p < .001). When optimal cut-off scores were considered according to age ranges (≤60, 61-70, and ≥71), sensitivity and specificity values were >80.0% for all age groups. CONCLUSIONS: In the Spanish UPSIT version, sensitivity and specificity are improved when specific cut-off scores for different age groups are computed.
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Testes Neuropsicológicos , Transtornos do Olfato/complicações , Transtornos do Olfato/diagnóstico , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Traduções , Fatores Etários , Idoso , Estudos de Casos e Controles , Feminino , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/fisiopatologia , Percepção Olfatória/fisiologia , Sensibilidade e Especificidade , Espanha/etnologiaRESUMO
Overweight and stress are both related to brain structural abnormalities. The allostatic load model states that frequent disruption of homeostasis is inherently linked to oxidative stress and inflammatory responses that in turn can damage the brain. However, the effects of the allostatic load on the central nervous system remain largely unknown. The current study aimed to assess the relationship between the allostatic load and the composition of whole-brain white matter tracts in overweight subjects. Additionally, we have also tested for grey matter changes regarding allostatic load increase. Thirty-one overweight-to-obese adults and 21 lean controls participated in the study. Our results showed that overweight participants presented higher allostatic load indexes. Such increases correlated with lower fractional anisotropy in the inferior fronto-occipital fasciculi and the right anterior corona radiata, as well as with grey matter reductions in the left precentral gyrus, the left lateral occipital gyrus, and the right pars opercularis. These results suggest that an otherwise healthy overweight status is linked to long-term biological changes potentially harmful to the brain.
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Alostase/fisiologia , Sobrepeso/patologia , Substância Branca/ultraestrutura , Adulto , Mapeamento Encefálico , Estudos de Casos e Controles , Imagem de Difusão por Ressonância Magnética , Imagem de Tensor de Difusão , Feminino , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Substância Branca/diagnóstico por imagem , Adulto JovemRESUMO
BACKGROUND: Growing evidence highlights the relevance of posterior cortically-based cognitive deficits in Parkinson's disease (PD) as possible biomarkers of the evolution to dementia. Cross-sectional correlational studies have established a relationship between the degree of atrophy in posterior brain regions and visuospatial and visuoperceptual (VS/VP) impairment. The aim of this study is to address the progressive cortical thinning correlates of VS/VP performance in PD. METHODS: Forty-four PD patients and 20 matched healthy subjects were included in this study and followed for 4 years. Tests used to assess VS/VP functions included were: Benton's Judgement of Line Orientation (JLOT), Facial Recognition (FRT), and Visual Form Discrimination (VFDT) Tests; Symbol Digit Modalities Test (SDMT); and the Pentagon Copying Test (PCT). Structural magnetic resonance imaging data and FreeSurfer were used to evaluate cortical thinning evolution. RESULTS: PD patients with normal cognition (PD-NC) and PD patients with mild cognitive impairment (PD-MCI) differed significantly in the progression of cortical thinning in posterior regions. In PD-MCI patients, the change in VS/VP functions assessed by PCT, JLOT, FRT, and SMDT correlated with the symmetrized percent change of cortical thinning of occipital, parietal, and temporal regions. In PD-NC patients, we also observed a correlation between changes in FRT and thinning in parieto-occipital regions. CONCLUSION: In this study, we establish the neuroanatomical substrate of progressive changes in VS/VP performance in PD patients with and without MCI. In agreement with cross-sectional data, VS/VP changes over time are related to cortical thinning in posterior regions.
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Córtex Cerebral/patologia , Disfunção Cognitiva/patologia , Disfunção Cognitiva/fisiopatologia , Doença de Parkinson/patologia , Doença de Parkinson/fisiopatologia , Transtornos da Percepção/fisiopatologia , Percepção Espacial/fisiologia , Percepção Visual/fisiologia , Adulto , Córtex Cerebral/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico por imagem , Transtornos da Percepção/etiologiaRESUMO
With the prevalence of obesity rapidly increasing worldwide, understanding the processes leading to excessive eating behavior becomes increasingly important. Considering the widely recognized crucial role of reward processes in food intake, we examined the white matter wiring and integrity of the anatomical reward network in obesity. Anatomical wiring of the reward network was reconstructed derived from diffusion weighted imaging in 31 obese participants and 32 normal-weight participants. Network wiring was compared in terms of the white matter volume as well as in terms of white matter microstructure, revealing lower number of streamlines and lower fiber integrity within the reward network in obese subjects. Specifically, the orbitofrontal cortex and striatum nuclei including accumbens, caudate and putamen showed lower strength and network clustering in the obesity group as compared to healthy controls. Our results provide evidence for obesity-related disruptions of global and local anatomical connectivity of the reward circuitry in regions that are key in the reinforcing mechanisms of eating-behavior processes.
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Imagem de Difusão por Ressonância Magnética/métodos , Neostriado/patologia , Rede Nervosa/patologia , Obesidade/patologia , Córtex Pré-Frontal/patologia , Recompensa , Substância Branca/patologia , Adolescente , Adulto , Criança , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Cognitive impairment in Parkinson's disease (PD) is common and recent studies have focused on addressing the most suitable screening tool for its assessment. MMSE is commonly used in clinical practice and longitudinal studies found a relationship between the MMSE pentagon copying item and progression to dementia, but its neuroanatomical correlates have been poorly investigated. The aim of this study is to investigate the MRI structural correlates of the global MMSE and the pentagon item scores in PD patients in the absence of dementia. METHODS: We selected a sample of 92 PD patients and 36 controls. MMSE was used as a global measure of cognitive status, and the pentagon copying test as a measure of visuospatial performance. FreeSurfer software was used to assess intergroup differences in cortical thickness (CTh) and global atrophy measures, as well as their relationship with cognitive performance. RESULTS: Compared to controls, patients showed significant differences in measures of global atrophy, which correlated with performance on MMSE and the pentagon item. Regional differences in CTh were seen between PD patients and controls bilaterally in the temporo-parietal-occipital region. Patients with impaired performance compared with those of normal performance also showed CTh reductions in these regions. CONCLUSION: Our results suggest MMSE and the pentagon item reflect brain changes which at a regional level involve mainly posterior regions. Correlates of the pentagon item were seen in the same regions where PD patients exhibited significant thinning, and involved more areas and bigger cluster sizes than the correlates of MMSE global scores.
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Transtornos Cognitivos/etiologia , Imageamento por Ressonância Magnética , Lobo Occipital/patologia , Lobo Parietal/patologia , Doença de Parkinson/complicações , Doença de Parkinson/patologia , Idoso , Atrofia/patologia , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade , Testes NeuropsicológicosRESUMO
BACKGROUND: Hippocampal abnormalities have been demonstrated in schizophrenia. It is unclear whether these abnormalities worsen with age, and whether they affect cognition and function. AIMS: To determine whether hippocampal abnormalities in chronic schizophrenia are associated with age, cognition and socio-occupational function. METHOD: Using 3 T magnetic resonance imaging we scanned 100 persons aged 19-82 years: 51 were out-patients with stable schizophrenia at least 2 years after diagnosis and 49 were healthy volunteers matched for age and gender. Automated analysis was used to determine hippocampal volume and shape. RESULTS: There were differential effects of age in the schizophrenia and control samples on total hippocampal volume (group × age interaction: F(1,95) = 6.57, P = 0.012), with steeper age-related reduction in the schizophrenia group. Three-dimensional shape analysis located the age-related deformations predominantly in the mid-body of the hippocampus. In the schizophrenia group similar patterns of morphometric abnormalities were correlated with impaired cognition and poorer socio-occupational function. CONCLUSIONS: Hippocampal abnormalities are associated with age in people with chronic schizophrenia, with a steeper decline than in healthy individuals. These abnormalities are associated with cognitive and functional deficits, suggesting that hippocampal morphometry may be a biomarker for cognitive decline in older patients with schizophrenia.
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Envelhecimento/patologia , Cognição , Hipocampo/patologia , Esquizofrenia/patologia , Psicologia do Esquizofrênico , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Pacientes Ambulatoriais , Adulto JovemRESUMO
Obesity is a health problem that has become a major focus of attention in recent years. There is growing evidence of an association between obesity and differences in reward processing. However, it is not known at present whether these differences are linked exclusively to food, or whether they can be detected in other rewarding stimuli. We compared responses to food, rewarding non-food and neutral pictures in 18 young adults with obesity and 19 normal-weight subjects using independent component analysis. Both groups modulated task-related activity in a plausible way. However, in response to both food and non-food rewarding stimuli, participants with obesity showed weaker connectivity in a network involving activation of frontal and occipital areas and deactivation of the posterior part of the default mode network. In addition, obesity was related with weaker activation of the default mode network and deactivation of frontal and occipital areas while viewing neutral stimuli. Together, our findings suggest that obesity is related to a different allocation of cognitive resources in a fronto-occipital network and in the default mode network.
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Mapeamento Encefálico , Encéfalo/fisiopatologia , Vias Neurais/fisiopatologia , Obesidade/fisiopatologia , Recompensa , Adulto , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Adulto JovemRESUMO
PRIMARY OBJECTIVE: To examine the relationship between traditional executive function measures and everyday competence in Spanish-speaking individuals with moderate-to-severe traumatic brain injury (TBI). METHODS AND PROCEDURES: Thirty-two TBI patients (24 men, eight women) with an age range of 17-59 years (mean age = 30.73 years; SD = 13.34) were administered a battery of performance-based executive function measures. Such measures included the Trail Making Test part B, Wisconsin Card Sorting Test, Stroop Colour Word Interference Test, Controlled Oral Word Association Test and Letter-Number Sequencing. Behavioural manifestations of executive deficits were assessed by the Behaviour Rating Inventory of Executive Function-Adult version (BRIEF-A). Patient's everyday functioning was examined with the Patient Competency Rating Scale (PCRS). MAIN OUTCOMES AND RESULTS: Traditional performance-based executive measures correlated significantly, although moderately, with the PCRS; this relationship was more significant in the Controlled Oral Word Association Test and Trail Making Test part B. A significant correlation was obtained between the BRIEF-A clinical scales and patient's everyday competence as measured by the PCRS. CONCLUSIONS: The current findings suggest that traditional performance-based executive measures reveal some degree of ecological validity or real-world relevance, providing relevant information for predicting everyday competence after moderate-to-severe TBI.
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Atividades Cotidianas , Lesões Encefálicas/psicologia , Transtornos Cognitivos/psicologia , Função Executiva , Testes Neuropsicológicos , Adolescente , Adulto , Lesões Encefálicas/complicações , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/fisiopatologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/fisiopatologia , Compreensão , Feminino , Escala de Coma de Glasgow , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Espanha/epidemiologia , Adulto JovemRESUMO
The ability to recognize facial emotion expressions, especially negative ones, is described to be impaired in Parkinson's disease (PD) patients. Previous neuroimaging work evaluating the neural substrate of facial emotion recognition (FER) in healthy and pathological subjects has mostly focused on functional changes. This study was designed to evaluate gray matter (GM) and white matter (WM) correlates of FER in a large sample of PD. Thirty-nine PD patients and 23 healthy controls (HC) were tested with the Ekman 60 test for FER and with magnetic resonance imaging. Effects of associated depressive symptoms were taken into account. In accordance with previous studies, PD patients performed significantly worse in recognizing sadness, anger and disgust. In PD patients, voxel-based morphometry analysis revealed areas of positive correlation between individual emotion recognition and GM volume: in the right orbitofrontal cortex, amygdala and postcentral gyrus and sadness identification; in the right occipital fusiform gyrus, ventral striatum and subgenual cortex and anger identification, and in the anterior cingulate cortex (ACC) and disgust identification. WM analysis through diffusion tensor imaging revealed significant positive correlations between fractional anisotropy levels in the frontal portion of the right inferior fronto-occipital fasciculus and the performance in the identification of sadness. These findings shed light on the structural neural bases of the deficits presented by PD patients in this skill.
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Gânglios da Base/fisiopatologia , Córtex Cerebral/fisiopatologia , Emoções , Expressão Facial , Sistema Límbico/fisiopatologia , Doença de Parkinson/fisiopatologia , Reconhecimento Psicológico , Idoso , Gânglios da Base/patologia , Mapeamento Encefálico , Estudos de Casos e Controles , Córtex Cerebral/patologia , Imagem de Tensor de Difusão , Feminino , Humanos , Sistema Límbico/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Doença de Parkinson/patologiaRESUMO
OBJECTIVE: This study explores the functional and structural patterns of connectivity underlying working memory impairment after severe traumatic axonal injury. METHODS: We performed an fMRI n-back task and acquired diffusion tensor images (DTI) in a group of 19 chronic-stage patients with severe traumatic brain injury (TBI) and evidence of traumatic axonal injury and 19 matched healthy controls. We performed image analyses with FSL software and fMRI data were analyzed using probabilistic independent component analysis. Fractional anisotropy (FA) maps from DTI images were analyzed with FMRIB's Diffusion Toolbox. RESULTS: We identified working memory and default mode networks. Global FA values correlated with both networks and FA whole-brain analysis revealed correlations in several tracts associated with the functional activation. Furthermore, working memory performance in the patient group correlated with the functional activation patterns and with the FA values of the associative fasciculi. CONCLUSION: Combining structural and functional neuroimaging data, we were able to describe structural white matter changes related to functional network alterations and to lower performance in working memory in chronic TBI.
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Lesões Encefálicas/patologia , Lesões Encefálicas/psicologia , Encéfalo/patologia , Memória de Curto Prazo/fisiologia , Rede Nervosa/patologia , Adulto , Idoso , Mapeamento Encefálico , Estudos Transversais , Bases de Dados Factuais , Demografia , Imagem de Tensor de Difusão , Escolaridade , Feminino , Lateralidade Funcional/fisiologia , Escala de Coma de Glasgow , Traumatismos Cranianos Fechados/patologia , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/patologia , Testes Neuropsicológicos , Análise de Componente Principal , Recuperação de Função Fisiológica , Fatores Sexuais , Espanha/epidemiologiaRESUMO
For evaluating the patterns of brain activation in sensorimotor areas following motor rehabilitation, seven male patients diagnosed with TBI underwent an fMRI study before and after being subjected to motor rehabilitation. Six patients showed a reduction in the BOLD signal of their motor cortical areas during the second fMRI evaluation. A decrease in cerebellum activation was also observed in two patients. Newly activated areas, were observed in four patients after treatment. In addition, an increase in the activation of the supplementary motor area (SMA) following rehabilitation was observed in only one test subject. The findings show that motor rehabilitation in TBI patients produces a decrease in the BOLD signal for the sensorimotor areas that were activated prior to treatment. In addition, we observed the recruitment of different brain areas to compensate for functional loss due to TBI in line with the cortical reorganisation mechanism.
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Lesões Encefálicas/patologia , Lesões Encefálicas/reabilitação , Córtex Motor/patologia , Córtex Somatossensorial/patologia , Adulto , Peso Corporal , Cerebelo/fisiologia , Interpretação Estatística de Dados , Marcha/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Oxigênio/sangue , Educação Física e Treinamento , Recrutamento Neurofisiológico , Adulto JovemRESUMO
Neurocognitive impairment is a core feature of schizophrenia and is closely associated with functional outcome. The importance of cognitive assessment is broadly accepted today, and an easy-to-use, internationality validated cognitive assessment tool is needed by researchers and in daily clinical practice. The Brief Assessment of Cognition in Schizophrenia (BACS) has been validated in English, French, Japanese and Italian. It is as sensitive to cognitive dysfunction as a standard test battery, with the advantage of requiring less than 35minutes to complete. In our study, we tested the psychometric characteristics of a Spanish version of the BACS in 117 patients with schizophrenia-spectrum disorders and 36 healthy controls. All BACS cognitive subtests discriminated between patients and controls (P<.001), and the concurrent validity between the BACS and a traditional neuropsychological test battery was similar to that reported in other languages. We conclude that the BACS can facilitate the comparison of the cognitive performance of patients with schizophrenia in many different countries.
Assuntos
Transtornos Cognitivos/diagnóstico , Testes Neuropsicológicos/normas , Transtornos Psicóticos/diagnóstico , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Adulto , Estudos de Casos e Controles , Doença Crônica , Transtornos Cognitivos/etiologia , Comparação Transcultural , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/estatística & dados numéricos , Transtornos Psicóticos/etiologia , Reprodutibilidade dos Testes , Esquizofrenia/complicações , Espanha , Tradução , Adulto JovemRESUMO
BACKGROUND: Although metabolic syndrome is associated with cardiovascular disease and stroke, limited information is available on specific brain damage in patients with this syndrome. We investigated the relationship of the syndrome with white matter (WM) alteration using a voxel-based approach with diffusion tensor imaging (DTI). METHODS: We compared fractional anisotropy (FA) and apparent diffusion coefficient (ADC) measurements of DTI in 19 patients with metabolic syndrome aged between 50 and 80 years and 19 age-matched controls without any vascular risk factors for the syndrome. RESULTS: Patients with metabolic syndrome showed an anterior-posterior pattern of deterioration in WM with reduced FA and increased ADC values compared with controls. WM changes were not related to any isolated vascular risk factor. CONCLUSION: Although the mechanism of this damage is not clear, the results indicate microstructural white matter alterations in patients with metabolic syndrome, mainly involving the frontal lobe.
Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Síndrome Metabólica/patologia , Fibras Nervosas Mielinizadas/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Fibras Nervosas Mielinizadas/metabolismo , Fatores de RiscoRESUMO
Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, urinary incontinence and dementia, and is associated with variable ventricular enlargement. The most accepted treatment of NPH is the placement of a cerebrospinal fluid shunt. Owing to the characteristics of the patients and the invasive nature of the surgical treatment, it is fundamental to detect those patients who could obtain a greater benefit from the treatment. Neuropsychological assessment of these patients could significantly contribute to a better diagnosis of NPH, determining a cognitive deterioration profile for these patients, allowing the assessment of treatment efficacy and helping to detect other additional causes of dementia. The aim of this study is to describe the cognitive deterioration profile of NPH patients and to present the clinical, functional and neuropsychological assessment protocol used in our hospital.