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1.
Proc Natl Acad Sci U S A ; 119(28): e2118192119, 2022 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-35867740

RESUMO

Studies with experimental animals have revealed a mood-regulating neural pathway linking intrinsically photosensitive retinal ganglion cells (ipRGCs) and the prefrontal cortex (PFC), involved in the pathophysiology of mood disorders. Since humans also have light-intensity-encoding ipRGCs, we asked whether a similar pathway exists in humans. Here, functional MRI was used to identify PFC regions and other areas exhibiting light-intensity-dependent signals. We report 26 human brain regions having activation that either monotonically decreases or monotonically increases with light intensity. Luxotonic-related activation occurred across the cerebral cortex, in diverse subcortical structures, and in the cerebellum, encompassing regions with functions related to visual image formation, motor control, cognition, and emotion. Light suppressed PFC activation, which monotonically decreased with increasing light intensity. The sustained time course of light-evoked PFC responses and their susceptibility to prior light exposure resembled those of ipRGCs. These findings offer a functional link between light exposure and PFC-mediated cognitive and affective phenomena.


Assuntos
Afeto , Cognição , Iluminação , Córtex Pré-Frontal , Células Ganglionares da Retina , Humanos , Imageamento por Ressonância Magnética , Estimulação Luminosa
2.
J Neurosci Res ; 102(1): e25287, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38284862

RESUMO

It has been suggested that substance use disorders could lead to accelerated biological aging, but only a few neuroimaging studies have investigated this hypothesis so far. In this cross-sectional study, structural neuroimaging was performed to measure cortical thickness (CT) in tricenarian adults with cocaine use disorder (CUD, n1 = 30) and their age-paired controls (YC, n1 = 30), and compare it with octogenarian elder controls (EC, n1 = 20). We found that CT in the right fusiform gyrus was similar between CUD and EC, thinner than the expected values of YC. We also found that regarding CT of the right inferior temporal gyrus, right inferior parietal cortex, and left superior parietal cortex, the CUD group exhibited parameters that fell in between EC and YC groups. Finally, CT of the right pars triangularis bordering with orbitofrontal gyrus, right superior temporal gyrus, and right precentral gyrus were reduced in CUD when contrasted with YC, but those areas were unrelated to CT of EC. Despite the 50-year age gap between our age groups, CT of tricenarian cocaine users assembles features of an octogenarian brain, reinforcing the accelerated aging hypothesis in CUD.


Assuntos
Cocaína , Octogenários , Adulto , Idoso de 80 Anos ou mais , Humanos , Idoso , Estudos Transversais , Encéfalo/diagnóstico por imagem , Cabeça
3.
J Neurooncol ; 167(1): 201-210, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38427132

RESUMO

INTRODUCTION: Diffuse hemispheric glioma, H3 G34-mutant (DHGs), is a newly categorized tumor in pediatric-type diffuse high-grade gliomas, World Health Organization grade 4, with a poor prognosis. Although prognostic factors associated with genetic abnormalities have been reported, few reports have examined the clinical presentation of DHGs, especially from the viewpoint of imaging findings. In this study, we investigated the relationship between clinical factors, including imaging findings, and prognosis in patients with DHGs. METHODS: We searched Medline through the PubMed database using two search terms: "G34" and "glioma", between 1 April 2012 and 1 July 2023. We retrieved articles that described imaging findings and overall survival (OS), and added one DHG case from our institution. We defined midline invasion (MI) as invasion to the contralateral cerebrum, brainstem, corpus callosum, thalamus, and basal ganglia on magnetic resonance imaging. The primary outcome was 12-month survival, estimated using Kaplan-Meier curves and logistic regression. RESULTS: A total of 96 patients were included in this study. The median age was 22 years, and the proportion of male patients was 48.4%. Lesions were most frequently located in the frontal lobe (52.6%). MI was positive in 39.6% of all patients. The median OS was 14.4 months. Univariate logistic regression analysis revealed that OS was significantly worse in the MI-positive group compared with the MI-negative group. Multivariate logistic regression analysis revealed that MI was an independent prognostic factor in DHGs. CONCLUSIONS: In this study, MI-positive cases had a worse prognosis compared with MI-negative cases. PREVIOUS PRESENTATIONS: No portion of this study has been presented or published previously.


Assuntos
Neoplasias Encefálicas , Glioma , Humanos , Masculino , Criança , Adulto Jovem , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Histonas/genética , Mutação , Glioma/diagnóstico por imagem , Glioma/genética , Prognóstico
4.
Eur J Neurol ; : e16348, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38984476

RESUMO

BACKGROUND AND PURPOSE: 'Dancing-like' semiology is extremely rare and described in few case reports. It is characterized by rhythmic, oscillatory movements of the pelvis and/or limbs during which the subject appears to be dancing. It has been associated with both the frontal and temporal epileptic zone; however, the possible network involved in these fascinating seizures is unclear. METHODS: The case of a 45-year-old woman suffering from drug-resistant focal epilepsy with multi-day seizures of bizarre semiology is described. A structural and perfusion magnetic resonance imaging study (interictal and peri-ictal) and video-electroencephalograms were carried out, and several home videos were employed. A vagal stimulator was implanted. RESULTS: Home videos documented the 'dancing' semiology of seizures better than video- electroencephalogram recordings. The imaging study revealed a focal frontal polymicrogyria with a peri-ictal cerebral blood flow increase at the perisylvian lesion foci. The combination of add-on cenobamate and vagal nerve stimulation resulted in complete seizure freedom. CONCLUSION: The unusual and complex dancing-like semiology observed during our patient's seizures adds to the repertoire of fascinating complex motor manifestations of frontal lobe epilepsy.

5.
Brain ; 146(6): 2377-2388, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-37062539

RESUMO

Around 50% of patients undergoing frontal lobe surgery for focal drug-resistant epilepsy become seizure free post-operatively; however, only about 30% of patients remain seizure free in the long-term. Early seizure recurrence is likely to be caused by partial resection of the epileptogenic lesion, whilst delayed seizure recurrence can occur even if the epileptogenic lesion has been completely excised. This suggests a coexistent epileptogenic network facilitating ictogenesis in close or distant dormant epileptic foci. As thalamic and striatal dysregulation can support epileptogenesis and disconnection of cortico-thalamostriatal pathways through hemispherotomy or neuromodulation can improve seizure outcome regardless of focality, we hypothesize that projections from the striatum and the thalamus to the cortex may contribute to this common epileptogenic network. To this end, we retrospectively reviewed a series of 47 consecutive individuals who underwent surgery for drug-resistant frontal lobe epilepsy. We performed voxel-based and tractography disconnectome analyses to investigate shared patterns of disconnection associated with long-term seizure freedom. Seizure freedom after 3 and 5 years was independently associated with disconnection of the anterior thalamic radiation and anterior cortico-striatal projections. This was also confirmed in a subgroup of 29 patients with complete resections, suggesting these pathways may play a critical role in supporting the development of novel epileptic networks. Our study indicates that network dysfunction in frontal lobe epilepsy may extend beyond the resection and putative epileptogenic zone. This may be critical in the pathogenesis of delayed seizure recurrence as thalamic and striatal networks may promote epileptogenesis and disconnection may underpin long-term seizure freedom.


Assuntos
Epilepsia Resistente a Medicamentos , Epilepsia do Lobo Frontal , Humanos , Epilepsia do Lobo Frontal/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Eletroencefalografia , Convulsões/cirurgia , Epilepsia Resistente a Medicamentos/cirurgia
6.
Brain ; 146(3): 935-953, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35511160

RESUMO

Cognitive impairment is a common comorbidity of epilepsy and adversely impacts people with both frontal lobe (FLE) and temporal lobe (TLE) epilepsy. While its neural substrates have been investigated extensively in TLE, functional imaging studies in FLE are scarce. In this study, we profiled the neural processes underlying cognitive impairment in FLE and directly compared FLE and TLE to establish commonalities and differences. We investigated 172 adult participants (56 with FLE, 64 with TLE and 52 controls) using neuropsychological tests and four functional MRI tasks probing expressive language (verbal fluency, verb generation) and working memory (verbal and visuo-spatial). Patient groups were comparable in disease duration and anti-seizure medication load. We devised a multiscale approach to map brain activation and deactivation during cognition and track reorganization in FLE and TLE. Voxel-based analyses were complemented with profiling of task effects across established motifs of functional brain organization: (i) canonical resting-state functional systems; and (ii) the principal functional connectivity gradient, which encodes a continuous transition of regional connectivity profiles, anchoring lower-level sensory and transmodal brain areas at the opposite ends of a spectrum. We show that cognitive impairment in FLE is associated with reduced activation across attentional and executive systems, as well as reduced deactivation of the default mode system, indicative of a large-scale disorganization of task-related recruitment. The imaging signatures of dysfunction in FLE are broadly similar to those in TLE, but some patterns are syndrome-specific: altered default-mode deactivation is more prominent in FLE, while impaired recruitment of posterior language areas during a task with semantic demands is more marked in TLE. Functional abnormalities in FLE and TLE appear overall modulated by disease load. On balance, our study elucidates neural processes underlying language and working memory impairment in FLE, identifies shared and syndrome-specific alterations in the two most common focal epilepsies and sheds light on system behaviour that may be amenable to future remediation strategies.


Assuntos
Epilepsia do Lobo Frontal , Epilepsia do Lobo Temporal , Adulto , Humanos , Memória de Curto Prazo , Epilepsia do Lobo Frontal/psicologia , Encéfalo , Semântica , Testes Neuropsicológicos , Imageamento por Ressonância Magnética
7.
Epilepsy Behav ; 158: 109910, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38959746

RESUMO

Epilepsy is characterized by recurrent, chronic, and unprovoked seizures. Epilepsy has a significant negative impact on a patient's quality of life even if seizures are well controlled. In addition to the distress caused by seizures, patients with epilepsy (PwE) may suffer from cognitive impairment with serious social consequences such as poor interpersonal relationships, loss of employment, and reduced social networks. Pathological changes and functional connectivity abnormalities observed in PwE can disrupt the neural network responsible for the theory of mind. Theory of mind is the ability to attribute mental states to other people (intentions, beliefs, and emotions). It is a complex aspect of social cognition and includes cognitive and affective constructs. In recent years, numerous studies have assessed the relationship between social cognition, including the theory of mind, in PwE, and suggested impairment in this domain. Interventions targeting the theory of mind can be potentially helpful in improving the quality of life of PwE.

8.
Epilepsy Behav ; 153: 109687, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38368791

RESUMO

OBJECTIVE: We investigated neuropsychological outcome in patients with pharmacoresistant pediatric-onset epilepsy caused by focal cortical dysplasia (FCD), who underwent frontal lobe resection during adolescence and young adulthood. METHODS: Twenty-seven patients were studied, comprising 15 patients who underwent language-dominant side resection (LDR) and 12 patients who had languagenondominant side resection (n-LDR). We evaluated intelligence (language function, arithmetic ability, working memory, processing speed, visuo-spatial reasoning), executive function, and memory in these patients before and two years after resection surgery. We analyzed the relationship between neuropsychological outcome and resected regions (side of language dominance and location). RESULTS: Although 75% of the patients showed improvement or no change in individual neuropsychological tests after surgical intervention, 25% showed decline. The cognitive tests that showed improvement or decline varied between LDR and n-LDR. In patients who had LDR, decline was observed in Vocabulary and Phonemic Fluency (both 5/15 patients), especially after resection of ventrolateral frontal cortex, and improvement was observed in WCST-Category (7/14 patients), Block Design (6/15 patients), Digit Symbol (4/15 patients), and Delayed Recall (3/9 patients). In patients who underwent n-LDR, improvement was observed in Vocabulary (3/12 patients), but decline was observed in Block Design (2/9 patients), and WCST-Category (2/9 patients) after resection of dorsolateral frontal cortex; and Arithmetic (3/10 patients) declined after resection of dorsolateral frontal cortex or ventrolateral frontal cortex. General Memory (3/8 patients), Visual Memory (3/8 patients), Delayed Recall (3/8 patients), Verbal Memory (2/9 patients), and Digit Symbol (3/12 patients) also declined after n-LDR. CONCLUSION: Postoperative changes in cognitive function varied depending on the location and side of the resection. For precise presurgical prediction of neuropsychological outcome after surgery, further prospective studies are needed to accumulate data of cognitive changes in relation to the resection site.


Assuntos
Epilepsia do Lobo Temporal , Epilepsia , Displasia Cortical Focal , Criança , Humanos , Adolescente , Adulto Jovem , Adulto , Resultado do Tratamento , Epilepsia/etiologia , Epilepsia/cirurgia , Epilepsia/psicologia , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/cirurgia , Memória de Curto Prazo , Testes Neuropsicológicos , Epilepsia do Lobo Temporal/cirurgia , Estudos Retrospectivos
9.
Neurol Sci ; 45(4): 1377-1388, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37985635

RESUMO

Gait and balance difficulties pose significant clinical challenges in Parkinson's disease (PD). The impairment of physiological mechanisms responsible for maintaining natural orthostatism plays a central role in the pathophysiology of postural instability observed in PD. In addition to the well-known rigidity and abnormalities in muscles and joints, various brain regions involved in the regulation of posture, balance, and gait, such as the basal ganglia, cerebellum, and brainstem regions like the pontine peduncle nucleus, are affected in individuals with PD. The recognition of the cerebellum's role in PD has been increasingly acknowledged. Cortical areas and their connections are associated with freezing of gait, a type of frontal lobe ataxia commonly observed in PD. Furthermore, impairments in the peripheral nervous system, including those caused by levodopatherapy, can contribute to gait impairment and imbalance in PD patients. Consequently, individuals with PD may exhibit frontal ataxia, sensory ataxia, and even cerebellar ataxia as underlying causes of gait disturbances and imbalance, starting from the early stages of the disease. The complex interplay between dysfunctional brain regions, impaired cortical connections, and peripheral nervous system abnormalities contributes to the multifaceted nature of gait and balance difficulties in PD. Understanding the intricate mechanisms is crucial for the development of effective therapeutic approaches targeting these specific deficits in PD.


Assuntos
Ataxia Cerebelar , Transtornos Neurológicos da Marcha , Doença de Parkinson , Humanos , Ataxia Cerebelar/complicações , Transtornos Neurológicos da Marcha/etiologia , Ataxia/complicações , Marcha/fisiologia , Equilíbrio Postural/fisiologia
10.
J Clin Ultrasound ; 52(1): 32-36, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37883124

RESUMO

PURPOSE: To determine the effects of gestational diabetes mellitus (GDM) on fetal frontal lobe development. METHODS: This study was conducted prospectively between May 2023 and August 2023 in Ankara City Hospital perinatology clinic. Maternal age, maternal body mass index (BMI), gestational week (GW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), estimated fetal weight (EFW), frontal antero-posterior diameter (FAPD), occipito-frontal diameter (OFD), FAPD/OFD ratio, and FAPD/HC ratio, were compared between GDM (n = 40) and low risk controls (n = 56). RESULTS: The mean maternal age was found higher in the GDM group compared to control group (p = 0.002). Maternal BMI was significantly higher in the GDM group than the control group (p = 0.01). Abdominal circumference (AC) was significantly higher in the GDM group compared to control group (p = 0.04). EFW was significantly higher in the GDM group compared to control group (p = 0.04). FAPD/OFD ratio was found to be higher in the GDM group than in the control group (p = 0.001). Among GDM patients, no statistically significant difference was found in the ultrasound measurements between the groups receiving insulin treatment and those without treatment. According to the correlation analysis results a moderate, positive, and statistically significant correlation was present between FAPD/OFD and GDM. In perinatal outcomes, the rate of neonatal intensive care unit admission was significantly higher in the GDM group. DISCUSSION: Fetal frontal lobe development seems to be affected by GDM.


Assuntos
Diabetes Gestacional , Gravidez , Recém-Nascido , Feminino , Humanos , Estudos de Casos e Controles , Desenvolvimento Fetal , Feto , Peso Fetal , Idade Gestacional , Ultrassonografia Pré-Natal/métodos
11.
Nervenarzt ; 2024 May 14.
Artigo em Alemão | MEDLINE | ID: mdl-38743106

RESUMO

Hermann Oppenheim (1858-1919) was a German neurologist without an academic career, who in his productive period around 1900 made a name for himself during his lifetime as a major player in the history of German neurology with his many contributions to multiple sclerosis, syphilis and the controversial study of traumatic neurosis; however, it is almost unknown that in 1890 he introduced the term "witzelsucht", which is still used internationally today. Moritz Jastrowitz dealt with behavioral abnormalities due to frontal brain injuries 1 year earlier and used the term "moria" for a form of mental disorder associated with a kind of childish behavior and inappropriate jocularity. Oppenheim was critical of this and differentiated his "witzelsucht" from this. With this term he wanted to describe humoristic feeble-mindedness in a much narrower sense, which stands in striking contrast to the usual symptoms in cases of cerebral tumors. Oppenheim recognized the frontal brain, particularly the right brain, to be an important functional unit for humorous behavior. Modern research has confirmed that the processing of humor requires a complex interaction of multiple brain regions. Damage to the right frontal lobe or to connecting structures can lead to the disorder "witzelsucht". Whether a simultaneous damage to the left hemisphere must be present or if this is dependent on the individual dominant hemisphere, needs further research.

12.
Hum Brain Mapp ; 44(4): 1456-1475, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36366744

RESUMO

The ability to regulate emotions is indispensable for maintaining psychological health. It heavily relies on frontal lobe functions which are disrupted in frontal lobe epilepsy. Accordingly, emotional dysregulation and use of maladaptive emotion regulation strategies have been reported in frontal lobe epilepsy patients. Therefore, it is of clinical and scientific interest to investigate emotion regulation in frontal lobe epilepsy. We studied neural correlates of upregulating and downregulating emotions toward aversive pictures through reappraisal in 18 frontal lobe epilepsy patients and 17 healthy controls using functional magnetic resonance imaging. Patients tended to report more difficulties with impulse control than controls. On the neural level, patients had diminished activity during upregulation in distributed left-sided regions, including ventrolateral and dorsomedial prefrontal cortex, angular gyrus and anterior temporal gyrus. Patients also showed less activity than controls in the left precuneus for upregulation compared to downregulation. Unlike controls, they displayed no task-related activity changes in the left amygdala, whereas the right amygdala showed task-related modulations in both groups. Upregulation-related activity changes in the left inferior frontal gyrus, insula, orbitofrontal cortex, anterior and posterior cingulate cortex, and precuneus were correlated with questionnaire data on habitual emotion regulation. Our results show that structural or functional impairments in the frontal lobes disrupt neural mechanisms underlying emotion regulation through reappraisal throughout the brain, including posterior regions involved in semantic control. Findings on the amygdala as a major target of emotion regulation are in line with the view that specifically the left amygdala is connected with semantic processing networks.


Assuntos
Regulação Emocional , Epilepsia do Lobo Frontal , Humanos , Voluntários Saudáveis , Encéfalo , Emoções/fisiologia , Mapeamento Encefálico , Lobo Frontal/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos
13.
Psychol Med ; 53(3): 741-749, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078485

RESUMO

BACKGROUND: Childhood trauma increases risk for psychopathology and cognitive impairment. Prior research mainly focused on the hippocampus and amygdala in single diagnostic categories. However, other brain regions may be impacted by trauma as well, and effects may be independent of diagnosis. This cross-sectional study investigated cortical and subcortical gray matter volume in relation to childhood trauma severity. METHODS: We included 554 participants: 250 bipolar-I patients, 84 schizophrenia-spectrum patients and 220 healthy individuals without a psychiatric history. Participants filled in the Childhood Trauma Questionnaire. Anatomical T1 MRI scans were acquired at 3T, regional brain morphology was assessed using Freesurfer. RESULTS: In the total sample, trauma-related gray matter reductions were found in the frontal lobe (ß = -0.049, p = 0.008; q = 0.048), this effect was driven by the right medial orbitofrontal, paracentral, superior frontal regions and the left precentral region. No trauma-related volume reductions were observed in any other (sub)cortical lobes nor the hippocampus or amygdala, trauma-by-group (i.e. both patient groups and healthy subjects) interaction effects were absent. A categorical approach confirmed a pattern of more pronounced frontal gray matter reductions in individuals reporting multiple forms of trauma and across quartiles of cumulative trauma scores. Similar dose-response patterns were revealed within the bipolar and healthy subgroups, but did not reach significance in schizophrenia-spectrum patients. CONCLUSIONS: Findings show that childhood trauma is linked to frontal gray matter reductions, independent of psychiatric morbidity. Our results indicate that childhood trauma importantly contributes to the neurobiological changes commonly observed across psychiatric disorders. Frontal volume alterations may underpin affective and cognitive disturbances observed in trauma-exposed individuals.


Assuntos
Experiências Adversas da Infância , Substância Cinzenta , Humanos , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Estudos Transversais , Encéfalo/patologia , Imageamento por Ressonância Magnética/métodos
14.
J Int Neuropsychol Soc ; 29(2): 205-229, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35249578

RESUMO

OBJECTIVE: Despite the importance of social cognitive functions to mental health and social adjustment, examination of these functions is absent in routine assessment of epilepsy patients. Thus, this review aims to provide a comprehensive overview of the literature on four major aspects of social cognition among temporal and frontal lobe epilepsy, which is a critical step toward designing new interventions. METHOD: Papers from 1990 to 2021 were reviewed and examined for inclusion in this study. After the deduplication process, a systematic review and meta-analysis of 44 and 40 articles, respectively, involving 113 people with frontal lobe epilepsy and 1482 people with temporal lobe epilepsy were conducted. RESULTS: Our results indicated that while patients with frontal or temporal lobe epilepsy have difficulties in all aspects of social cognition relative to nonclinical controls, the effect sizes were larger for theory of mind (g = .95), than for emotion recognition (g = .69) among temporal lobe epilepsy group. The frontal lobe epilepsy group exhibited significantly greater impairment in emotion recognition compared to temporal lobe. Additionally, people with right temporal lobe epilepsy (g =  1.10) performed more poorly than those with a left-sided (g = .90) seizure focus, specifically in the theory of mind domain. CONCLUSIONS: These data point to a potentially important difference in the severity of deficits within the emotion recognition and theory of mind abilities depending on the laterlization of seizure side. We also suggest a guide for the assessment of impairments in social cognition that can be integrated into multidisciplinary clinical evaluation for people with epilepsy.


Assuntos
Epilepsia do Lobo Frontal , Epilepsia do Lobo Temporal , Humanos , Epilepsia do Lobo Frontal/psicologia , Cognição Social , Testes Neuropsicológicos , Cognição , Convulsões , Lobo Frontal
15.
BMC Neurol ; 23(1): 195, 2023 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-37208614

RESUMO

BACKGROUND: The main objective of this research was to analyze the characteristics of electrical activity in the brain during REM (Rapid Eye Movements) sleep, by using an experimental model a pathology that affects the frontal lobes, such as brain tumors. In addition to determining the impact of variables such as the frontal area (dorsolateral, medial and orbital), laterality and size of the lesion; as well as the demographic and clinical characteristics of the patients evaluated. METHODS: By using polysomnographic recordings, 10 patients were evaluated. We obtained power spectra through a homemade program. For quantitative EEG (Electroencephalogram) (qEEG) analysis, the Fast Fourier Transform (FFT) algorithm was used to obtain the spectral power of each participant, channel, and frequency band. RESULTS: Sleep architecture and spectral power was found to be modified in patients compared to normative values. Other sociodemographic and clinical characteristics of the patients were also influenced, such as age range and antiepileptic drugs. CONCLUSIONS: Brain tumors in the frontal lobe can modify the rhythmogenesis of REM sleep, possibly due to changes of brain plasticity as an effect of the pathology. In addition to this, through this study we were able to show the association between neuroanatomical and functional changes, on the characteristics of brain electrical activity in patients with frontal brain tumor. Finally, this qEEG analysis technique allows, on the one hand, to deepen the knowledge and relationship between psychophysiological processes and, on the other hand, to be able to guide therapeutic decisions.


Assuntos
Neoplasias Encefálicas , Sono REM , Humanos , Sono REM/fisiologia , Eletroencefalografia/métodos , Sono/fisiologia , Encéfalo
16.
Epilepsy Behav ; 148: 109471, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37866248

RESUMO

RATIONALE: The International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) was recently introduced as a consensus-based, empirically-driven taxonomy of cognitive disorders in epilepsy and has been effectively applied to patients with temporal lobe epilepsy (TLE). The purpose of this study was to apply the IC-CoDE to patients with frontal lobe epilepsy (FLE) using national multicenter data. METHODS: Neuropsychological data of 455 patients with FLE aged 16 years or older were available across four US-based sites. First, we examined test-specific impairment rates across sites using two impairment thresholds (1.0 and 1.5 standard deviations below the normative mean). Following the proposed IC-CoDE guidelines, patterns of domain impairment were determined based on commonly used tests within five cognitive domains (language, memory, executive functioning, attention/processing speed, and visuospatial ability) to construct phenotypes. Impairment rates and distributions across phenotypes were then compared with those found in patients with TLE for which the IC-CoDE classification was initially validated. RESULTS: The highest rates of impairment were found among tests of naming, verbal fluency, speeded sequencing and set-shifting, and complex figure copy. The following IC-CoDE phenotype distributions were observed using the two different threshold cutoffs: 23-40% cognitively intact, 24-29% single domain impairment, 13-20% bi-domain impairment, and 18-33% generalized impairment. Language was the most common single domain impairment (68% for both thresholds) followed by attention and processing speed (15-18%). Overall, patients with FLE reported higher rates of cognitive impairment compared with patients with TLE. CONCLUSIONS: These results demonstrate the applicability of the IC-CoDE to epilepsy syndromes outside of TLE. Findings indicated generally stable and reproducible phenotypes across multiple epilepsy centers in the U.S. with diverse sample characteristics and varied neuropsychological test batteries. Findings also highlight opportunities for further refinement of the IC-CoDE guidelines as the application expands.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Epilepsia do Lobo Frontal , Epilepsia do Lobo Temporal , Humanos , Epilepsia do Lobo Frontal/complicações , Epilepsia do Lobo Frontal/diagnóstico , Epilepsia do Lobo Frontal/psicologia , Função Executiva , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/psicologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Testes Neuropsicológicos , Cognição
17.
Epilepsy Behav ; 142: 109215, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37075512

RESUMO

PURPOSE: Decision-making is crucial to daily life and can impact our society as well as economic conditions. Although the frontal lobes have been identified as important for decision-making, this capacity has only been studied to a limited extent in frontal lobe epilepsy and not at all after frontal lobe resection (FLR) for epilepsy. This study aimed to explore decision-making under ambiguity after FLR for epilepsy. METHODS: Fourteen patients having undergone FLR for epilepsy completed the Iowa Gambling Task (IGT) which is a widely used tool to measure decision-making under ambiguity. Iowa Gambling Task scores included in the analysis were: total net score, separate scores from five blocks across the test, and a change score (last block of IGT minus first block). A group of healthy controls (n = 30) was used as a comparison. Associations between IGT and standardized neuropsychological methods for assessment of executive functions, self-rating questionnaires of mental health, fatigue, and behavior linked to frontal lobe dysfunction were also investigated. RESULTS: The patient group performed inferior to controls at the final block of the IGT (p =.001).A group difference in IGT change scores was found (p =.005), reflectingthe absence of a positive change in performance over time for the FLR group compared to the control group. Correlations with tests of executive functions as well as self-rating scales were mainly statistically nonsignificant. CONCLUSIONS: This study shows that patients having undergone FLR for epilepsy have difficulties with decision-making under ambiguity. The performance illustrated a failure to learn throughout the task. Executive as well as emotional deficits may impact decision-making processes in this patient group and need to be considered in further studies. Prospective studies with larger cohorts are needed.


Assuntos
Epilepsia do Lobo Frontal , Jogo de Azar , Humanos , Tomada de Decisões , Estudos Prospectivos , Testes Neuropsicológicos , Jogo de Azar/psicologia , Lobo Frontal/cirurgia , Epilepsia do Lobo Frontal/cirurgia
18.
Neuroradiology ; 65(2): 297-305, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36208304

RESUMO

PURPOSE: Neuroplasticity can partially compensate for the neurological deficits caused by brain tumors. However, the structural plasticity of the brain caused by brain tumors is not fully understood. This study aimed to assess the structural plasticity of the contralesional hemisphere in patients with frontal low-grade gliomas (LGGs). METHODS: A total of 25 patients with left frontal LGGs (LFLGGs), 19 patients with right frontal LGGs (RFLGGs), and 25 healthy controls (HCs) were enrolled in this study. High-resolution structural T1-weighted imaging and fluid attenuation inversion recovery were performed on all participants. Voxel-based morphometry (VBM) analysis was used to detect differences in the brain structural plasticity between patients with unilateral LGGs and HCs. RESULTS: VBM analysis revealed that compared with HCs, the gray matter volume (GMV) of the contralesional putamen and amygdala was significantly smaller and larger in the patients with RFLGGs and LFLGGs, respectively, while the GMVs of the contralesional cuneus and superior temporal gyrus (STG) were significantly larger in the patients with LFLGGs. The surviving clusters of the right hemisphere included 1357 voxels in the amygdala, 1680 voxels in the cuneus, 384 voxels in the STG, and 410 voxels in the putamen. The surviving clusters of the left hemisphere were 522 voxels in the amygdala and 320 voxels in the putamen. CONCLUSION: The unilateral frontal LGGs are accompanied by structural plasticity in the contralesional cortex and vary with tumor laterality. Contralesional structural reorganization may be one of the physiological basis for functional reorganization or compensation in the frontal LGGs.


Assuntos
Neoplasias Encefálicas , Glioma , Humanos , Encéfalo/patologia , Córtex Cerebral/patologia , Substância Cinzenta/patologia , Glioma/patologia , Imageamento por Ressonância Magnética/métodos , Neoplasias Encefálicas/patologia
19.
Cereb Cortex ; 32(13): 2797-2815, 2022 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34727188

RESUMO

Age-related differences in the functional hierarchical organization of the frontal lobe remain unclear. We adopted task-related functional magnetic resonance imaging (fMRI) to investigate age differences in the functional hierarchical organization of the frontal lobe. Behavioral results report both reaction time and efficiency declined as the levels of abstraction increased in the selection of a set of stimulus-response mappings in older adults compared with young adults. fMRI findings suggest trends of the hierarchical organization along the rostro-caudal axis in both groups, and brain-behavior correlation further suggests neural dedifferentiation in older adults when performing at the highest level of control demands experiment. Behavioral performances and age difference overactivations at the highest level of control demands were both associated with working memory capacity, suggesting the working memory capacity is important for processing the highest task demands. Region-of-interest analysis revealed age differences in brain overactivation and common activation across experiments in the primary motor cortex, parietal lobule, and the fusiform gyrus may serve as shared mechanisms underlying tasks that are required for the selection of stimulus-response mapping sets. Overall, older adults reflect maladaptive overactivation in task-irrelevant regions that are detrimental to performance with the highest control demands.


Assuntos
Mapeamento Encefálico , Lobo Frontal , Idoso , Cognição/fisiologia , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/fisiologia , Humanos , Imageamento por Ressonância Magnética , Memória de Curto Prazo/fisiologia , Tempo de Reação/fisiologia , Adulto Jovem
20.
Nutr Neurosci ; : 1-10, 2023 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-37603004

RESUMO

Previous research has linked obesity with an altered perception of rewards. This study aimed to contrast frontal cortical activities across body mass index (BMI) groups, in responding to differential rewards (monetary versus food). A total of 60 male participants (27.43 ± 6.07 years of age; 21 normal weight [BMI: 18.5-24.9 kg·m-2]; 20 overweight [BMI: 25.0-29.9 kg·m-2]; and 19 individuals with obesity [BMI ≥ 30 kg·m-2]) were tested for their response bias towards food and money rewards using the Probabilistic Reward Task (PRT), while their frontal cortical responses were recorded using electroencephalography (EEG). The feedback-related negativity (FRN), a reliable measure of reward valuation and learning, was calculated for food (FRN(Food)) and money (FRN(Money)). Results indicate a left-lateralised frontal cortical activity associated with the food reward condition, in the group of overweight and obesity. In contrast, a right-lateralisation was observed in the money reward condition only in the group with obesity. More specifically, FRN(Food) was shown to significantly differ between left and right frontal cortical areas among individuals with obesity (p = 0.035) and overweight (p = 0.012), but not in normal-weight individuals (p = 0.153). Additionally, results revealed that FRN(Food) and FRN(Money) were significantly different for individuals with obesity (p = 0.019), but such a significant difference was not evident in the overweight and normal-weight individuals (p ≥ 0.05). These findings offer intriguing new insights into neuropsychological differentiation across BMI groups, adding to the understanding of obesity-related behaviour.

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