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1.
Acta Neuropathol Commun ; 8(1): 141, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32819430

RESUMO

Down syndrome (DS) occurs with triplication of human chromosome 21 and is associated with deviations in cortical development evidenced by simplified gyral appearance and reduced cortical surface area. Radial glia are neuronal and glial progenitors that also create a scaffolding structure essential for migrating neurons to reach cortical targets and therefore play a critical role in cortical development. The aim of this study was to characterise radial glial expression pattern and morphology in the frontal lobe of the developing human fetal brain with DS and age-matched controls. Secondly, we investigated whether microstructural information from in vivo magnetic resonance imaging (MRI) could reflect histological findings from human brain tissue samples. Immunohistochemistry was performed on paraffin-embedded human post-mortem brain tissue from nine fetuses and neonates with DS (15-39 gestational weeks (GW)) and nine euploid age-matched brains (18-39 GW). Radial glia markers CRYAB, HOPX, SOX2, GFAP and Vimentin were assessed in the Ventricular Zone, Subventricular Zone and Intermediate Zone. In vivo diffusion MRI was used to assess microstructure in these regions in one DS (21 GW) and one control (22 GW) fetal brain. We found a significant reduction in radial glial progenitor SOX2 and subtle deviations in radial glia expression (GFAP and Vimentin) prior to 24 GW in DS. In vivo, fetal MRI demonstrates underlying radial projections consistent with immunohistopathology. Radial glial alterations may contribute to the subsequent simplified gyral patterns and decreased cortical volumes observed in the DS brain. Recent advances in fetal MRI acquisition and analysis could provide non-invasive imaging-based biomarkers of early developmental deviations.


Assuntos
Síndrome de Down/embriologia , Síndrome de Down/patologia , Células Ependimogliais/patologia , Lobo Frontal/embriologia , Lobo Frontal/patologia , Feminino , Feto , Humanos , Recém-Nascido , Masculino , Neurogênese/fisiologia
2.
Dev Sci ; 23(1): e12844, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31056844

RESUMO

Low socioeconomic status (SES) is associated with greater risk for symptoms of attention-deficit/hyperactivity disorder (ADHD). One mechanism through which SES may confer risk for ADHD is by influencing brain structure. Alterations to cortical thickness, surface area and subcortical volume have been associated with low SES and with the presence of ADHD across multiple studies. The current study examined whether cortical thickness, surface area or subcortical volume mediate the associations between SES and ADHD in youth 3-21 years old (N = 874) from the Pediatric Imaging, Neurocognition and Genetics Study. Freesurfer was used to estimate cortical thickness, surface area and subcortical volume from structural magnetic resonance imaging. Parents reported on demographics, family SES, ADHD diagnoses and the presence of child attention problems. Statistical mediation was assessed using a bootstrap resampling procedure. Controlling for parental ADHD, child age, gender, birth weight and scanner, children in low SES families were more likely to be in the ADHD group. Consistent with previous reports in this sample, low SES was associated with reduced surface area across the frontal lobe and reduced subcortical volume in the amygdala, cerebellum, hippocampus and basal ganglia. Of these regions, a significant indirect effect of SES on ADHD status through subcortical volume was observed for the left cerebellum (95% confidence interval: 0.004, 0.022), the right cerebellum (95% confidence interval: 0.006, 0.025), and the right caudate (95% confidence interval: 0.002, 0.022). Environmentally mediated changes in the cerebellum and the caudate may be neurodevelopmental mechanisms explaining elevated risk of ADHD in children in low SES families.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Encéfalo/ultraestrutura , Classe Social , Adolescente , Tonsila do Cerebelo/patologia , Encéfalo/anatomia & histologia , Encéfalo/patologia , Mapeamento Encefálico/métodos , Criança , Pré-Escolar , Feminino , Lobo Frontal/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Adulto Jovem
3.
JAMA Netw Open ; 2(3): e190261, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30924889

RESUMO

Importance: Criminal and socially inappropriate behavior is encountered among patients with dementia, and it is sometimes the first sign of a dementing disorder. This behavior constitutes a significant burden to society, patients' relatives, and patients themselves. Objectives: To investigate and compare the prevalence and type of criminal and socially inappropriate behavior, as well as recurrence of criminal behavior, associated with Alzheimer disease (AD) and frontotemporal dementia (FTD) neuropathologically verified post mortem, and to assess whether there is a specific type of protein pathology more closely associated with criminal behavior in patients with FTD. Design, Setting, and Participants: Cohort study using medical record review of 220 Swedish patients with a postmortem neuropathologic diagnosis of AD (n = 101) or frontotemporal lobar degeneration (n = 119) (hereinafter referred to as FTD) diagnosed between January 1, 1967, and December 31, 2017. Main Outcomes and Measures: Patient notes containing reports of criminal and socially inappropriate behavior, as well as data on dominant protein pathology for patients with FTD, were duly reviewed and recorded. The Fisher exact test or logistic regression was used to assess possible differences between groups. Results: Of the 220 patients studied, 128 (58.2%) were female, the median (range) age at disease onset was 63 (30-88) years and at death was 72 (34-96) years, and the median (range) disease duration was 9 (1-28) years. Instances of criminal behavior were found in 65 of the 220 patients (29.5%): in 15 of the 101 patients (14.9%) with AD and 50 of the 119 patients (42.0%) with FTD (P < .001). Recurrence of criminal behavior was significantly higher in the FTD group (89.0%) than in the AD group (53.3%) (P = .04). Instances of socially inappropriate behavior were found in 57 patients (56.4%) with AD and 89 (74.8%) with FTD (P = .004). An expression of non-tau pathology increased the odds for criminal behavior by a factor of 9.0 (95% CI, 3.4-24.0) among patients with FTD. Conclusions and Relevance: These results suggest that criminal and socially inappropriate behaviors may be more prevalent and criminal behaviors may be more recurrent in patients with FTD than in those with AD. Non-tau pathology, but not tau pathology, appears to be associated with criminal behavior. These findings may help with the clinical diagnostic process.


Assuntos
Doença de Alzheimer , Efeitos Psicossociais da Doença , Comportamento Criminoso/fisiologia , Lobo Frontal/patologia , Demência Frontotemporal , Lobo Temporal/patologia , Adulto , Idoso , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/patologia , Doença de Alzheimer/psicologia , Diagnóstico , Feminino , Demência Frontotemporal/epidemiologia , Demência Frontotemporal/patologia , Demência Frontotemporal/psicologia , Humanos , Masculino , Prontuários Médicos/estatística & dados numéricos , Neuropatologia/métodos , Prevalência , Recidiva , Comportamento Social , Suécia/epidemiologia
4.
Appl Neuropsychol Adult ; 26(4): 319-330, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29351381

RESUMO

The Frontal Assessment Battery (FAB) has been shown to be useful in several clinical settings. The aim of the present study was to examine the performance of patients with traumatic brain injury (TBI) on the FAB and to predict their acute outcome. The FAB was administered to 89 patients with mild (27 = uncomplicated and 39 = complicated) and moderate (n = 23) TBI during hospitalization in an acute care setting. The length of stay in days (LOS), Glasgow Outcome Scale-Revised score (GOSE) and Disability Rating Scale (DRS) score were collected. Results showed no significant differences between the three groups on the FAB score, but age and education were significantly associated with the FAB score. Parietal lesions were associated with lower total FAB score, and with the Similarities, Motor series and Conflicting instructions subscales, while frontal lesions were associated with lower performance on the Motor series and Conflicting instructions subscales. Total FAB score was significantly correlated with all outcome measures, and together the FAB total score and the Glasgow Coma Scale (GCS) score explained 30.8% of the variance in the DRS score. The FAB may be useful clinically to acutely assess frontal and parietal lobe functions at bedside in patients with TBI and, in combination with the GCS score to measure TBI severity, can enable clinicians to predict early outcome.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico , Testes Neuropsicológicos , Avaliação de Resultados em Cuidados de Saúde , Adolescente , Adulto , Fatores Etários , Idoso , Lesões Encefálicas Traumáticas/patologia , Avaliação da Deficiência , Escolaridade , Feminino , Lobo Frontal/patologia , Escala de Coma de Glasgow , Escala de Resultado de Glasgow , Hospitalização , Hospitais Gerais , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Lobo Parietal/patologia , Adulto Jovem
5.
J Alzheimers Dis ; 62(2): 699-711, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29480171

RESUMO

Alzheimer's disease (AD) and vascular dementia (VaD) lead to progressive decline in executive function. We estimated the prevalence of executive dysfunction in AD and VaD patients, investigating cognitive, functional, and clinical correlates and also using a multidimensional approach based on a standardized comprehensive geriatric assessment (CGA). We included 215 patients (115 AD patients and 100 VaD patients) consecutively evaluated with a complete cognitive and affective assessment, a CGA, and the Frontal Assessment Battery (FAB) with six subtests investigating conceptualization, mental flexibility, motor programming, sensitivity to interference, inhibitory control, and environmental autonomy. The prevalence of dysexecutive syndrome screened with a FAB score <12 points was high in both AD (97 patients) and VaD (77 patients) (84.3% versus 77.0%, p = 0.171). AD patients were significantly younger, with higher grade of cognitive impairment and less severe comorbidity and polypharmacy than VaD patients. AD patients showed a significantly higher impairment in FAB total score and five FAB subtests (conceptualization, motor programming, sensitivity to interference, inhibitory control, and environmental autonomy) than VaD patients. These findings were largely confirmed in a sub-analysis conducted subdividing the sample in mild and moderate-to-severe demented patients and suggesting that in moderate-to-severe AD there was higher impairment in FAB total score and four FAB subtests (conceptualization, sensitivity to interference, inhibitory control, and environmental autonomy). Executive dysfunction could be greater in AD patients with moderate-to-severe dementia compared to VaD patients, although our groups were also not matched for age, comorbidity or polypharmacy, which could also exert an effect.


Assuntos
Doença de Alzheimer/psicologia , Disfunção Cognitiva/diagnóstico , Demência Vascular/psicologia , Função Executiva , Avaliação Geriátrica/métodos , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Comorbidade , Demência Vascular/complicações , Feminino , Lobo Frontal/patologia , Humanos , Modelos Logísticos , Masculino , Polimedicação , Índice de Gravidade de Doença
6.
Int J Geriatr Psychiatry ; 33(5): 703-709, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29280514

RESUMO

OBJECTIVE: Caregivers of patients with dementia experience physical and mental deterioration. We have previously reported a correlation between caregiver burden and the Frontal Assessment Battery (FAB) total scores of patients with Alzheimer's disease (AD), especially regarding the dependency factor from the Zarit Burden Interview. The present study aimed to identify an objective biomarker for predicting caregiver burden. METHODS: The participants were 26 pairs of caregivers and patients with AD and mild-to-moderate dementia. Correlations between regional gray matter volumes in the patients with AD and the FAB total scores were explored by using whole-brain voxel-based morphometric analysis. Path analysis was used to estimate the relationships between regional gray matter volumes, FAB total scores, and caregiver burden based on the Zarit Burden Interview. RESULTS: The voxel-based morphometric revealed a significant positive correlation between the FAB total scores and the volume of the left dorsolateral prefrontal cortex. This positive correlation persisted after controlling for the effect of general cognitive dysfunction, which was assessed by using the Mini-Mental State Examination. Path analysis revealed that decreases in FAB scores, caused by reduced frontal lobe volumes, negatively affected caregiver burden. CONCLUSIONS: The present study revealed that frontal lobe function, based on FAB scores, was affected by the volume of the left dorsolateral prefrontal cortex. Decreased scores were associated with greater caregiver burden, especially for the dependency factor. These findings may facilitate the development of an objective biomarker for predicting caregiver burden.


Assuntos
Doença de Alzheimer/fisiopatologia , Cuidadores/psicologia , Lobo Frontal/fisiopatologia , Córtex Pré-Frontal/patologia , Idoso , Idoso de 80 Anos ou mais , Atrofia , Disfunção Cognitiva , Efeitos Psicossociais da Doença , Feminino , Lobo Frontal/patologia , Substância Cinzenta/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade
7.
Brain Behav ; 7(6): e00707, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28638712

RESUMO

OBJECTIVES: To determine the potential utility of the frontal assessment battery (FAB) in assessing cognitive impairments in amyotrophic lateral sclerosis (ALS), we investigated the association between the FAB score and regional gray matter volume, and ascertained whether the regional brain alterations related to cognitive impairments occur in relatively mild stage of ALS. MATERIALS AND METHODS: Twenty-four ALS patients with a Mini-Mental State Examination score of >23, a normal score on the Self-Rating Depression Scale, little or no disturbance in speech and handling utensils on the ALS Functional Rating Scale (ALSFRS), and normal measures on respiratory tests (respiratory function test and arterial blood gas analysis), and two age-matched normal control groups (one for FAB assessment and the other for brain morphometry) underwent FAB testing and structural magnetic resonance imaging. We applied voxel-based morphometry to investigate the relationship between the FAB score and regional brain alteration, and assessed the relationship between the altered regional brain volume and ALSFRS or respiratory tests. RESULTS: Frontal assessment battery scores were significantly lower in ALS patients than in normal controls. Volume reduction in the right orbitofrontal gyrus in ALS was correlated with a lower FAB score. There was no correlation between the right orbitofrontal gyrus volume and ALSFRS or respiratory tests. CONCLUSIONS: The results suggest that the FAB is an adequate tool for detecting cognitive impairments related to frontal lobe pathology in the relatively mild stage of ALS, independent of physical dysfunctions.


Assuntos
Esclerose Lateral Amiotrófica , Disfunção Cognitiva , Lobo Frontal , Adulto , Idoso , Esclerose Lateral Amiotrófica/diagnóstico , Esclerose Lateral Amiotrófica/fisiopatologia , Esclerose Lateral Amiotrófica/psicologia , Atrofia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/fisiopatologia , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos
8.
Eur Neurol ; 77(5-6): 327-332, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28472801

RESUMO

BACKGROUND AND PURPOSE: Our aim in this study was to assess whether the frontal assessment battery (FAB) could contribute to the differential diagnosis of cerebrospinal fluid tap test (CSFTT) responders and nonresponders with the hypothesis that CSFTT nonresponders had greater frontal lobe dysfunction. We also explored whether a relationship exists between FAB scores and gait disturbance in idiopathic normal-pressure hydrocephalus (INPH) patients. METHODS: INPH subjects were selected in a consecutive order from a prospectively enrolled INPH registry. Fifty-one INPH patients constituted the final sample for analysis. RESULTS: Logistic regression analysis using the FAB score as independent variable showed a significant influence of the FAB on the differential diagnosis of CSFTT responders and nonresponders (p = 0.025; OR 1.186; 95% CI 1.022-1.377). The FAB scores were negatively correlated with the Timed Up and Go test score (r = -0.382; p = 0.007), 10-meter walking test score (r = -0.351; p = 0.014), Gait Status Scale score (r = -0.382; p = 0.007), and INPH Grading Scale gait score (r = -0.370; p = 0.009). CONCLUSIONS: Our findings may indicate a possibility for considering FAB scores in patients with ventriculomegaly as potential cognitive markers for the prediction of CSFTT response. Association between gait function and FAB scores suggests the involvement of similar circuits producing gait symptom and frontal lobe functions in INPH.


Assuntos
Lobo Frontal/fisiopatologia , Hidrocefalia de Pressão Normal/diagnóstico , Testes Neuropsicológicos , Punção Espinal , Idoso , Feminino , Lobo Frontal/patologia , Humanos , Hidrocefalia de Pressão Normal/complicações , Masculino , Pessoa de Meia-Idade
9.
J Alzheimers Dis ; 58(3): 701-709, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28482638

RESUMO

BACKGROUND: The early and selective loss of von Economo neurons in the anterior cingulate cortex has been linked to behavioral deficits in frontotemporal dementia (FTD). Importantly, whether these neurons are also targeted in patients with the C9ORF72 repeat expansion has yet to be established. This is of particular interest given the recent evidence highlighting the thalamus rather than anterior cingulate cortex as a region of significant degeneration in patients with the C9ORF72 repeat expansion. OBJECTIVE: To assess the von Economo neuron density and thalamus volumes in behavioral variant FTD (bvFTD) cases with the C9ORF72 repeat expansion, sporadic bvFTD, sporadic ALS, and controls. METHODS: Volumetric and quantitative cell counting methods were employed to assess the von Economo neuron density and thalamus volumes in 37 pathologically-confirmed cases comprised of patients with bvFTD (n = 13) cases with the C9ORF72 repeat expansion (62% with psychosis), sporadic bvFTD (n = 8), sporadic amyotrophic lateral sclerosis (n = 7) and controls (n = 9). RESULTS: von Economo neuron density was significantly reduced in sporadic bvFTD cases only. Thalamus degeneration was identified only in bvFTD cases with the C9ORF72 repeat expansion, and to a similar extent in cases with and without psychosis. No significant difference in von Economo neuron density or thalamus degeneration was seen between bvFTD cases with or without the C9ORF72 repeat expansion. CONCLUSION: The present histological findings converge with neuroimaging results to corroborate the anterior cingulate cortex as a core region involved in sporadic bvFTD, and the thalamus as a major region targeted in patients with the C9ORF72 expansion.


Assuntos
Proteína C9orf72/genética , Expansão das Repetições de DNA , Demência Frontotemporal/genética , Demência Frontotemporal/patologia , Neurônios/patologia , Tálamo/patologia , Idoso , Idoso de 80 Anos ou mais , Esclerose Lateral Amiotrófica/genética , Esclerose Lateral Amiotrófica/patologia , Contagem de Células , Estudos de Coortes , Feminino , Lobo Frontal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Transtornos Psicóticos/genética , Transtornos Psicóticos/patologia , Lobo Temporal/patologia
10.
Nat Commun ; 6: 10120, 2015 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-26658289

RESUMO

Value-based decisions are biased by the time people spend viewing each option: Options fixated longer are chosen more often, even when previously rated as less appealing. This bias is thought to reflect 'value updating' as new evidence is accumulated. Prior work has shown that ventromedial prefrontal cortex (PFC) carries a fixation-dependent value comparison signal, while other studies implicate dorsomedial PFC in representing the value of alternative options. Here, we test whether these regions are necessary for fixation-related value updating in 33 people with frontal lobe damage and 27 healthy controls performing a simple choice task. We show that damage to dorsomedial PFC leads to an exaggerated influence of fixations on choice, while damage to ventromedial or lateral PFC has no effect on this bias. These findings suggest a critical role for dorsomedial, and not ventromedial PFC, in mediating the relative influence of current fixations and a priori value on choice.


Assuntos
Tomada de Decisões/fisiologia , Lobo Frontal/patologia , Lobo Frontal/fisiologia , Atenção/fisiologia , Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/psicologia , Mapeamento Encefálico , Estudos de Casos e Controles , Humanos , Modelos Psicológicos
11.
Age Ageing ; 44(5): 891-5, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26025914

RESUMO

BACKGROUND: Theory of mind (ToM), the capacity to infer the intention, beliefs and emotional states of others, is frequently impaired in behavioural variant fronto-temporal dementia patients (bv-FTDp); however, its impact on caregiver burden is unexplored. SETTING: National Institute of Neurological Disorders and Stroke, National Institutes of Health. SUBJECTS: bv-FTDp (n = 28), a subgroup of their caregivers (n = 20) and healthy controls (n = 32). METHODS: we applied a faux-pas (FP) task as a ToM measure in bv-FTDp and healthy controls and the Zarit Burden Interview as a measure of burden in patients' caregivers. Patients underwent structural MRI; we used voxel-based morphometry to examine relationships between regional atrophy and ToM impairment and caregiver burden. RESULTS: FP task performance was impaired in bv-FTDp and negatively associated with caregiver burden. Atrophy was found in areas involved in ToM. Caregiver burden increased with greater atrophy in left lateral premotor cortex, a region associated in animal models with the presence of mirror neurons, possibly involved in empathy. CONCLUSION: ToM impairment in bv-FTDp is associated with increased caregiver burden.


Assuntos
Cuidadores/psicologia , Efeitos Psicossociais da Doença , Lobo Frontal/fisiopatologia , Demência Frontotemporal/terapia , Lobo Temporal/fisiopatologia , Teoria da Mente , Atrofia , Estudos de Casos e Controles , Cognição , Feminino , Lobo Frontal/patologia , Demência Frontotemporal/diagnóstico , Demência Frontotemporal/fisiopatologia , Demência Frontotemporal/psicologia , Humanos , Inteligência , Entrevistas como Assunto , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Lobo Temporal/patologia
12.
BMC Neurol ; 13: 179, 2013 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-24237624

RESUMO

BACKGROUND: The Frontal Assessment Battery (FAB) is a brief battery of six neuropsychological tasks designed to assess frontal lobe function at bedside [Neurology 55:1621-1626, 2000]. The six FAB tasks explore cognitive and behavioral domains that are thought to be under the control of the frontal lobes, most notably conceptualization and abstract reasoning, lexical verbal fluency and mental flexibility, motor programming and executive control of action, self-regulation and resistance to interference, inhibitory control, and environmental autonomy. METHODS: We examined the sensitivity of performance on the FAB to frontal lobe damage in right-hemisphere-damaged first-ever stroke patients based on voxel-based lesion-behavior mapping. RESULTS: Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score. Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9). Finally, the FAB inhibitory control score was sensitive to damage of the right inferior frontal gyrus (IFG; BA44/45). CONCLUSIONS: These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG.


Assuntos
Lesões Encefálicas/patologia , Lobo Frontal/patologia , Lobo Frontal/fisiopatologia , Testes Neuropsicológicos , Acidente Vascular Cerebral/complicações , Idoso , Lesões Encefálicas/etiologia , Compreensão , Formação de Conceito , Feminino , Lobo Frontal/diagnóstico por imagem , Lateralidade Funcional/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Inibição Psicológica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Desempenho Psicomotor , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
13.
Brain Imaging Behav ; 7(3): 282-92, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23504597

RESUMO

Persons with mild Alzheimer's disease (AD) have significant deficits in financial abilities. This study examined the relationship between brain structure volumes, cognition, and financial capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining financial skills in patients with mild AD.


Assuntos
Doença de Alzheimer/patologia , Doença de Alzheimer/fisiopatologia , Disfunção Cognitiva/patologia , Disfunção Cognitiva/fisiopatologia , Reserva Cognitiva , Financiamento Pessoal , Lobo Frontal/patologia , Idoso , Doença de Alzheimer/complicações , Disfunção Cognitiva/complicações , Tomada de Decisões , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estatística como Assunto
14.
J Card Fail ; 19(2): 94-100, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23384634

RESUMO

BACKGROUND: Heart failure (HF) patients exhibit depression and executive function impairments that contribute to HF mortality. Using specialized magnetic resonance imaging (MRI) analysis procedures, brain changes appear in areas regulating these functions (mammillary bodies, hippocampi, and frontal cortex). However, specialized MRI procedures are not part of standard clinical assessment for HF (which is usually a visual evaluation), and it is unclear whether visual MRI examination can detect changes in these structures. METHODS AND RESULTS: Using brain MRI, we visually examined the mammillary bodies and frontal cortex for global and hippocampi for global and regional tissue changes in 17 HF and 50 control subjects. Significantly global changes emerged in the right mammillary body (HF 1.18 ± 1.13 vs control 0.52 ± 0.74; P = .024), right hippocampus (HF 1.53 ± 0.94 vs control 0.80 ± 0.86; P = .005), and left frontal cortex (HF 1.76 ± 1.03 vs control 1.24 ± 0.77; P = .034). Comparison of the visual method with specialized MRI techniques corroborates right hippocampal and left frontal cortical, but not mammillary body, tissue changes. CONCLUSIONS: Visual examination of brain MRI can detect damage in HF in areas regulating depression and executive function, including the right hippocampus and left frontal cortex. Visual MRI assessment in HF may facilitate evaluation of injury to these structures and the assessment of the impact of potential treatments for this damage.


Assuntos
Encéfalo/patologia , Transtornos Cognitivos/patologia , Depressão/patologia , Função Executiva , Insuficiência Cardíaca/patologia , Imageamento por Ressonância Magnética/normas , Adulto , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Depressão/epidemiologia , Depressão/psicologia , Função Executiva/fisiologia , Feminino , Lobo Frontal/patologia , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/psicologia , Hipocampo/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Corpos Mamilares/patologia , Pessoa de Meia-Idade
15.
Support Care Cancer ; 21(3): 857-62, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22996396

RESUMO

BACKGROUND: The number of elderly cancer patients has been rising in recent years, and decreases in cognitive function are reportedly seen in 25-50% of these patients. However, no validated and practical tests are available for the assessment of cognitive function in cancer patients. Age and the effects of cancer treatment have been pointed out as possible causes of these decreases in cognitive function; in both instances, a strong possibility of a decrease in frontal lobe function exists. METHODS: We administered the Frontal Assessment Battery at bedside (FAB), the Mini-Mental State Examination (MMSE), the Barthel Index, and the Instrumental Activities of Daily Living (IADL) to 54 cancer patients who were 65 years of age or older and assessed the clinical usefulness of the FAB. RESULTS: The results showed that the FAB scores were significantly correlated with the MMSE and IADL scores and were unaffected by the number of years of education. Moreover, when the subjects were divided into two groups according to whether their total FAB score was less than 16 points or 16 points or more, significant differences in the total MMSE scores and the total IADL scores were observed. CONCLUSIONS: Based on these findings and because the FAB sensitively detected decreases in cognitive function, accurately reflected the status of everyday life, and could be performed conveniently and in a short time, we concluded that the FAB may be very useful clinically as a means of evaluating the cognitive function of elderly cancer patients.


Assuntos
Transtornos Cognitivos/diagnóstico , Lobo Frontal/patologia , Neoplasias/terapia , Atividades Cotidianas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/etiologia , Feminino , Humanos , Masculino , Sistemas Automatizados de Assistência Junto ao Leito , Fatores de Tempo
16.
Geriatr Gerontol Int ; 13(3): 630-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23035777

RESUMO

AIM: To examine whether the Frontal Assessment Battery is associated with the immediate effects of physical therapy on gait disturbance in patients with Parkinson's disease. METHODS: A total of 18 patients with idiopathic Parkinson's disease (Hoehn and Yahr stage range 3-4) who were able to ambulate independently and who were not demented were included. Patients were divided into two groups on the basis of Frontal Assessment Battery scores: the high score group (score ≥ 13, n=11) and the low score group (score ≤ 12, n=7). A 3-D motion analysis system was used to acquire gait parameter data before and after a 30-min physical therapy program. Stride length, step length, cadence, walking velocity, single support time and double support time were measured. The range of motion of the hip, knee and ankle joint, and maximal trunk displacement on the horizontal plane were measured. RESULTS: In the high-score group, significant improvement was observed in walking velocity, stride length and step length, and in the range of motion of the hip and knee joint. Maximal trunk displacement decreased significantly. In contrast, no significant improvement was observed in the low-score group. Multivariate logistic regression analysis showed that Frontal Assessment Battery scores were a predictor of improvement in the range of motion of bilateral hip and knee joints, and maximal trunk displacement. CONCLUSIONS: We showed that the subtests of motor learning of the Frontal Assessment Battery might be associated with the immediate effects of physical therapy on gait disturbance in Parkinson's disease.


Assuntos
Lobo Frontal/fisiopatologia , Transtornos Neurológicos da Marcha/reabilitação , Marcha/fisiologia , Doença de Parkinson/reabilitação , Modalidades de Fisioterapia , Caminhada/fisiologia , Idoso , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Prognóstico , Tomografia Computadorizada de Emissão de Fóton Único
17.
J Int Neuropsychol Soc ; 18(6): 972-85, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23158228

RESUMO

The aim of this study was to explore the cerebral correlates of functional deficits that occur in behavioral variant frontotemporal dementia (bvFTD). A specific neuropsychological battery, the Social cognition & Emotional Assessment (SEA; Funkiewiez et al., 2012), was used to assess impaired social and emotional functions in 20 bvFTD patients who also underwent structural MRI scanning. The SEA subscores of theory of mind, reversal-learning tests, facial emotion identification, and apathy evaluation were entered as covariates in a voxel-based morphometry analysis. The results revealed that the gray matter volume in the rostral part of the medial prefrontal cortex [mPFC, Brodmann area (BA) 10] was associated with scores on the theory of mind subtest, while gray matter volume within the orbitofrontal (OFC) and ventral mPFC (BA 11 and 47) was related to the scores observed in the reversal-learning subtest. Gray matter volume within BA 9 in the mPFC was correlated with scores on the emotion recognition subtest, and the severity of apathetic symptoms in the Apathy scale covaried with gray matter volume in the lateral PFC (BA 44/45). Among these regions, the mPFC and OFC cortices have been shown to be atrophied in the early stages of bvFTD. In addition, SEA and its abbreviated version (mini-SEA) have been demonstrated to be sensitive to early impairments in bvFTD (Bertoux et al., 2012). Taken together, these results suggest a differential involvement of orbital and medial prefrontal subregions in SEA subscores and support the use of the SEA to evaluate the integrity of these regions in the early stages of bvFTD.


Assuntos
Sintomas Afetivos/etiologia , Transtornos Cognitivos/etiologia , Lobo Frontal/patologia , Degeneração Lobar Frontotemporal , Testes Neuropsicológicos , Comportamento Social , Idoso , Idoso de 80 Anos ou mais , Aprendizagem da Esquiva , Feminino , Degeneração Lobar Frontotemporal/complicações , Degeneração Lobar Frontotemporal/patologia , Degeneração Lobar Frontotemporal/psicologia , Humanos , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Reconhecimento Psicológico , Estatística como Assunto , Teoria da Mente
18.
Einstein (Sao Paulo) ; 10(1): 11-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23045819

RESUMO

OBJECTIVE: The objective was to establish a pattern of tumor growth of the C6 model of glioblastoma multiform in Wistar rats via magnetic resonance imaging (MRI) for the subsequent verification of tumor volume reduction due to magnetic hyperthermia therapy. METHODS: Young male Wistar rats weighing between 250 and 300 g were used for the C6 model. After the rats were anesthetized (55 mg/ kg ketamine and 11 mg/kg xylazine), C6 lineage tumorigenic cells suspended in culture medium (10(5) cells in 10 microl) were stereotaxically injected into the right frontal cortex (bregma coordinates: 2.0 mm anteroposterior, 3.0 mm laterolateral, and 2.5 mm depth) of the rats using a Hamilton syringe. For the control group, the rats were injected with culture medium without cells. MRI scans were performed at 14, 21, and 28 d after the injection using a 2.0 T MRI scanner (Bruker BioSpec, Germany). The animals were anesthetized with 55 mg/kg ketamine and 11 mg/kg xylazine before being examined. Coronal multilayers were acquired using a standard spin echo sequence with the following parameters: repetition/echo time = 4.000 ms/67.1 ms, field of view = 3.50, matrix = 192, slice thickness = 0.4 mm, and slice separation = 0 mm. RESULTS: The MRI analysis enabled a clear visualization of the tumor mass, and it was possible to establish the tumor volume parameters on the various days that were examined. The volume at 14 d after induction was 13.7 +/- 2.5 mm3. On days 21 and 28, the tumor volumes were 31.7 +/- 6.5 mm3 and 122.1 +/- 11.8 mm3, respectively. CONCLUSION: These results demonstrated that it is possible to evaluate the C6 model tumor volume in rats, which will allow for the future implementation and verification of magnetic hyperthermia therapy.


Assuntos
Neoplasias Encefálicas/terapia , Glioblastoma/terapia , Hipertermia Induzida/métodos , Magnetoterapia/métodos , Imageamento por Ressonância Magnética , Animais , Neoplasias Encefálicas/patologia , Linhagem Celular Tumoral/transplante , Lobo Frontal/patologia , Glioblastoma/patologia , Masculino , Ratos , Ratos Wistar , Carga Tumoral
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