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Despite optimal oral drug treatment, about 90% of patients with Parkinson's disease develop motor fluctuation and dyskinesia within 5-10 years from the diagnosis. Moreover, the patients show non-motor symptoms in different sensory domains. Bilateral deep brain stimulation (DBS) applied to the subthalamic nucleus is considered the most effective treatment in advanced Parkinson's disease, and it has been suggested to affect sensorimotor modulation and relate to motor improvement in patients. However, observations on the relationship between sensorimotor activity and clinical improvement have remained sparse. Here, we studied the somatosensory evoked magnetic fields in 13 right-handed patients with advanced Parkinson's disease before and 7 months after stimulator implantation. Somatosensory processing was addressed with magnetoencephalography during alternated median nerve stimulation at both wrists. The strengths and the latencies of the ~60-ms responses at the contralateral primary somatosensory cortices were highly variable but detectable and reliably localized in all patients. The response strengths did not differ between preoperative and postoperative DBSON measurements. The change in the response strength between preoperative and postoperative condition in the dominant left hemisphere of our right-handed patients correlated with the alleviation of their motor symptoms (p = .04). However, the result did not survive correction for multiple comparisons. Magnetoencephalography appears an effective tool to explore non-motor effects in patients with Parkinson's disease, and it may help in understanding the neurophysiological basis of DBS. However, the high interindividual variability in the somatosensory responses and poor tolerability of DBSOFF condition warrants larger patient groups and measurements also in non-medicated patients.
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Estimulação Encefálica Profunda , Doença de Parkinson , Núcleo Subtalâmico , Humanos , Magnetoencefalografia , Doença de Parkinson/cirurgia , Núcleo Subtalâmico/fisiologia , Resultado do TratamentoRESUMO
We report the case of a patient who had an important experience with painful events, allowing the investigation of brain concomitants to painful (P) memories in fMRI. The patient had to recall P events that were contrasted with non-painful (NP) memories. Painful memories of the right lower limb activated the left paracentral lobule,fronto-insular operculum and superior parietal cortex. Additionally, whilst the recall of non-painful events activated the hippocampus, the recall of painful events did not enhance the hippocampal signal to significant levels. These suggest that brain activations differ for the autobiographical recall of painful and non-painful memories.
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Encéfalo/diagnóstico por imagem , Memória Episódica , Rememoração Mental/fisiologia , Membro Fantasma/diagnóstico por imagem , Membro Fantasma/fisiopatologia , Mapeamento Encefálico , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Oxigênio/sangue , Inquéritos e QuestionáriosRESUMO
Recent advances in brain mapping tools have enabled the study of brain activity during functional tasks, revealing neuroplasticity after early brain injuries and resulting from rehabilitation. Understanding the neural correlates of mobility limitations is crucial for treating individuals with cerebral palsy (CP). The aim is to summarize the neural correlates of mobility in children with CP and to describe the brain mapping methods that have been utilized in the existing literature. This systematic review was conducted based on PRISMA guidelines and was registered on PROSPERO (n° CRD42021240296). The literature search was conducted in the PubMed and Embase databases. Observational studies involving participants with CP, with a mean age of up to 18 years, that utilized brain mapping techniques and correlated these with mobility outcomes were included. The results were analyzed in terms of sample characteristics, brain mapping methods, mobility measures, and main results. The risk of bias was evaluated using a checklist previously created by our research group, based on STROBE guidelines, the Cochrane Handbook, and the Critical Appraisal Skills Programme (CASP). A total of 15 studies comprising 313 children with CP and 229 with typical development using both static and mobile techniques met the inclusion criteria. The studies indicate that children"with'CP have increased cerebral activity and higher variability in brain reorganization during mobility activities, such as gait, quiet standing, cycling, and gross motor tasks when compared with children with typical development. Altered brain activity and reorganization underline the importance of conducting more studies to investigate the neural correlates during mobility activities in children with CP. Such information could guide neurorehabilitation strategies targeting brain neuroplasticity for functional gains.
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Paralisia Cerebral , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/reabilitação , Humanos , Criança , Adolescente , Pré-Escolar , Encéfalo/fisiopatologia , Mapeamento EncefálicoRESUMO
This study aimed to elucidate whether muscle blood flow restriction during maximal exercise is associated with alterations in hemodynamics, cerebral oxygenation, cerebral activation, and deterioration of exercise performance in male participants. Thirteen healthy males, cyclists (age 33 ± 2 yrs., body mass: 78.6 ± 2.5 kg, and body mass index: 25.57 ± 0.91 kg·m-1), performed a maximal incremental exercise test on a bicycle ergometer in two experimental conditions: (a) with muscle blood flow restriction through the application of thigh cuffs inflated at 120 mmHg (with cuffs, WC) and (b) without restriction (no cuffs, NC). Exercise performance significantly deteriorated with muscle blood flow restriction, as evidenced by the reductions in VËO2max (-17 ± 2%, p < 0.001), peak power output (-28 ± 2%, p < 0.001), and time to exhaustion (-28 ± 2%, p < 0.001). Muscle oxygenated hemoglobin (Δ[O2Hb]) during exercise declined more in the NC condition (p < 0.01); however, at exhaustion, the magnitude of muscle oxygenation and muscle deoxygenation were similar between conditions (p > 0.05). At maximal effort, lower cerebral deoxygenated hemoglobin (Δ[HHb]) and cerebral total hemoglobin (Δ[THb]) were observed in WC (p < 0.001), accompanied by a lower cardiac output, heart rate, and stroke volume vs. the NC condition (p < 0.01), whereas systolic blood pressure, rating of perceived exertion, and cerebral activation (as assessed by electroencephalography (EEG) activity) were similar (p > 0.05) between conditions at task failure, despite marked differences in exercise duration, maximal aerobic power output, and VËO2max. In conclusion, in trained cyclists, muscle blood flow restriction during an incremental cycling exercise test significantly limited exercise performance. Exercise intolerance with muscle blood flow restriction was mainly associated with attenuated cardiac responses, despite cerebral activation reaching similar maximal levels as without muscle blood flow restriction.
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Enhancing computability of cerebral recordings and connections made with human/non-human brain have been on track and are expected to propel in our current era. An effective contribution towards said ends is improving accuracy of attempts at discerning intricate phenomena taking place within human brain. Here and in two different capacities of experiments, we attempt to distinguish cerebral perceptions shaped and affective states surfaced during observation of samples of media incorporating distinct audio-visual and emotional contents, through employing electroencephalograph/EEG recorded sessions of two reputable datasets of DEAP and SEED. Here we introduce AltSpec(E3) the inceptive form of CollectiveNet intelligent computational architectures employing collective and concurrent multi-spec analysis to exploit complex patterns in complex data-structures. This processing technique uses a full array of diversification protocols with multifarious parts enabling surgical levels of optimization while integrating a holistic analysis of patterns. Data-structures designed here contain multi-electrode neuroinformatic and neurocognitive features studying emotion reactions and attentive patterns. These spatially and temporally featured 2D/3D constructs of domain-augmented data are eventually AI-processed and outputs are defragmented forming one definitive judgement. The media-perception tracing is arguably first of its kind, at least when implemented on mentioned datasets. Backed by this multi-directional approach and in subject-independent configurations for perception-tracing on 5-media-class basis, mean accuracies of 81.00% and 68.93% were obtained on DEAP and SEED, respectively. We also managed to classify emotions with accuracies of 61.59% and 66.21% in cross-dataset validation followed by 81.47% and 88.12% in cross-subject validation settings trained on DEAP and SEED, consecutively.
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Encéfalo , Emoções , Eletroencefalografia/métodos , Eletrodos , PercepçãoRESUMO
The "voice areas" in the superior temporal cortex have been identified in both humans and non-human primates as selective to conspecific vocalizations only (i.e., expressed by members of our own species), suggesting its old evolutionary roots across the primate lineage. With respect to non-human primate species, it remains unclear whether the listening of vocal emotions from conspecifics leads to similar or different cerebral activations when compared to heterospecific calls (i.e., expressed by another primate species) triggered by the same emotion. Using a neuroimaging technique rarely employed in monkeys so far, functional Near Infrared Spectroscopy, the present study investigated in three lightly anesthetized female baboons (Papio anubis), temporal cortex activities during exposure to agonistic vocalizations from conspecifics and from other primates (chimpanzees-Pan troglodytes), and energy matched white noises in order to control for this low-level acoustic feature. Permutation test analyses on the extracted OxyHemoglobin signal revealed great inter-individual differences on how conspecific and heterospecific vocal stimuli were processed in baboon brains with a cortical response recorded either in the right or the left temporal cortex. No difference was found between emotional vocalizations and their energy-matched white noises. Despite the phylogenetic gap between Homo sapiens and African monkeys, modern humans and baboons both showed a highly heterogeneous brain process for the perception of vocal and emotional stimuli. The results of this study do not exclude that old evolutionary mechanisms for vocal emotional processing may be shared and inherited from our common ancestor. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-022-00164-z.
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We previously reported that cerebral activation at the onset of voluntary locomotion suppressed baroreflex control of heart rate (HR) and increased arterial pressure via vasopressin V1a receptors in the brain. Here, we examined whether these responses were associated with food seeking, a motivated behavior, using free-moving wild type (WT, n = 10), V1a receptor knockout (KO, n = 9), and wild-type mice locally infused with a V1a receptor antagonist into the nucleus tractus solitarii (BLK, n = 10). For three consecutive days, mice were fed ad libitum (Fed), food deprived (FD), and refed (RF) under a dark/light cycle (1900/0700). Food was removed on day 2 and restored on day 3 at 1800. Throughout the protocol, cerebral activity was determined from the power density ratio of θ- to δ-wave band (θ/δ) by electroencephalogram every 4 s. Baroreflex was evaluated by the cross-correlation function [R(t)] between changes in HR and arterial pressure every 4 s. The cerebro-baroreflex linkage was then evaluated by the cross-correlation function between θ/δ and R(t). Behavior was recorded with CCD camera. We found that cerebro-baroreflex linkage, enhanced in WT at night after FD (P = 0.006), returned to Fed level after RF (P = 0.68). Similarly, food-seeking behavior increased after FD to a level twofold higher than during Fed (P < 0.001) and returned to Fed level after RF (P = 0.54). However, none of these changes occurred in KO or BLK (P > 0.11). Thus, the suppression of baroreflex control of HR linked with cerebral activation via central V1a receptors might play an important role at the onset of motivated behaviors, such as food seeking induced by FD.NEW & NOTEWORTHY Motivated behaviors, characterized by goal-directed and persistent movements, are indispensable for living. However, how cerebro-cardiovascular adjustment occurs during such behaviors remains unknown. By focusing on food-seeking behavior in a food-deprived condition using free-moving mice, we found that this condition enhanced the linkage between cerebral activation and suppression of baroreflex control of heart rate through central vasopressin V1a receptors, making it easier to start motivated behaviors by enhancing pressor response.
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Pressão Arterial , Barorreflexo , Animais , Barorreflexo/fisiologia , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Camundongos , Vasopressinas/farmacologiaRESUMO
Swallowing is a complex function that relies on both brainstem and cerebral control. Cerebral neurofunctional evaluations are mostly based on functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), performed with the individual laying down; which is a non-ecological/non-natural position for swallowing. According to the PRISMA guidelines, a review of the non-invasive non-radiating neurofunctional tools, other than fMRI and PET, was conducted to explore the cerebral activity in swallowing during natural food intake, in accordance with the PRISMA guidelines. Using Embase and PubMed, we included human studies focusing on neurofunctional imaging during an ecologic swallowing task. From 5948 unique records, we retained 43 original articles, reporting on three different techniques: electroencephalography (EEG), magnetoencephalography (MEG) and functional near infra-red spectroscopy (fNIRS). During swallowing, all three techniques showed activity of the pericentral cortex. Variations were associated with the modality of the swallowing process (volitional or non-volitional) and the substance used (mostly water and saliva). All techniques have been used in both healthy and pathological conditions to explore the precise time course, localization or network structure of the swallowing cerebral activity, sometimes even more precisely than fMRI. EEG and MEG are the most advanced and mastered techniques but fNIRS is the most ready-to-use and the most therapeutically promising. Ongoing development of these techniques will support and improve our future understanding of the cerebral control of swallowing.
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Decision-making is a process that allows adapting behavior in response to feedback to achieve a goal. Previous studies have suggested that the cerebral cortex shows different activation patterns in response to feedback. However, the effects of reward and punishment on learning contexts and decision-making are not clear. Thus, this experiment compared the effects of reward and punishment on behavior and the electroencephalographic activity of cortical areas related to decision-making in a no-risk context. Twenty healthy males were asked to perform a decision-making task under two conditions in which the goal was to finish in the shortest time possible. In the reward condition, the more points the participant accumulated the sooner the task ended, while in the punishment condition, the more points accumulated the longer the task lasted. Lower reaction times were found in the reward condition, characterized by a higher absolute power of the slow bands in almost all the cortices recorded. Changes in the interhemispheric correlation were also obtained in the comparison of the two feedback conditions. Results suggest that changes in the type of feedback affect cortical functionality and behavioral execution during decision-making, with the reward being related to a quick emotional response strategy and punishment associated with slower and, likely, more reasoned responses.
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Ondas Encefálicas/fisiologia , Córtex Cerebral/fisiologia , Tomada de Decisões/fisiologia , Eletroencefalografia , Retroalimentação Psicológica/fisiologia , Desempenho Psicomotor/fisiologia , Punição , Recompensa , Adolescente , Adulto , Humanos , Masculino , Adulto JovemRESUMO
Background and aim: Neonatal brain monitoring is increasingly used due to reports of brain injury perioperatively. Little is known about the effect of sedatives (midazolam) and anesthetics (sevoflurane) on cerebral oxygenation (rScO2) and cerebral activity. This study aims to determine these effects in the perioperative period. Methods: This is an observational, prospective study in two tertiary pediatric surgical centers. All neonates with a congenital diaphragmatic hernia received perioperative cerebral oxygenation and activity measurements. Patients were stratified based on intraoperatively administrated medication: the sevoflurane group (continuous sevoflurane, bolus fentanyl, bolus rocuronium) and the midazolam group (continuous midazolam, continuous fentanyl, and continuous vecuronium). Results: Intraoperatively, rScO2 was higher in the sevoflurane compared to the midazolam group (84%, IQR 77-95 vs. 65%, IQR 59-76, p = < 0.001), fractional tissue oxygen extraction was lower (14%, IQR 5-21 vs. 31%, IQR 29-40, p = < 0.001), the duration of hypoxia was shorter (2%, IQR 0.4-9.6 vs. 38.6%, IQR 4.9-70, p = 0.023), and cerebral activity decreased more: slow delta: 2.16 vs. 4.35 µV 2 (p = 0.0049), fast delta: 0.73 vs. 1.37 µV 2 (p = < 0.001). In the first 30 min of the surgical procedure, a 3-fold increase in fast delta (10.48-31.22 µV 2) and a 5-fold increase in gamma (1.42-7.58 µV 2) were observed in the midazolam group. Conclusion: Sevoflurane-based anesthesia resulted in increased cerebral oxygenation and decreased cerebral activity, suggesting adequate anesthesia. Midazolam-based anesthesia in neonates with a more severe CDH led to alarmingly low rScO2 values, below hypoxia threshold, and increased values of EEG power during the first 30 min of surgery. This might indicate conscious experience of pain. Integrating population-pharmacokinetic models and multimodal neuromonitoring are needed for personalized pharmacotherapy in these vulnerable patients. Trial Registration: https://www.trialregister.nl/trial/6972, identifier: NL6972.
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This study investigated functional alterations in the cerebral network of patients with hypertensive retinopathy (HR) by resting-state functional magnetic resonance imaging (rs-fMRI) and degree centrality (DC) methods. 31 patients with HR along with 31 healthy controls (HC) closely matched in gender and age were enrolled for the research. All participants were examined by rs-fMRI, and the DC method was applied to evaluate alterations in spontaneous cerebral activity between the 2 groups. We used the independent samples t test to evaluate demographic and general information differences between HR patients and HCs. The 2-sample t test was used to compare the DC values of different cerebral regions between the 2 groups. The accuracy of differential diagnostic HR was analyzed by receiver operating characteristic (ROC) curve method for rs-fMRI DC values changes. Pearson's correlation coefficient was applied to determine the correlation between differences in DC in specific cerebral areas and clinical manifestation. Results showed that DC values were higher in the left cerebellum posterior lobe (LCPL), left medial occipital gyrus (LMOG), and bilateral precuneus (BP) of HR patients compared to HCs. Mean DC values were lower in the right medial frontal gyrus/bilateral anterior cingulate cortex of HR patients. Anxiety and depression scores were positively correlated with DC values of LMOG and LCPL, respectively. Bilateral best-corrected visual acuity in HR patients was negatively correlated with the DC value of BP. Hence, changes in DC in specific cerebral areas of patients with HR reflect functional alterations that provide insight into the pathophysiologic mechanisms of HR.
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Encéfalo/patologia , Retinopatia Hipertensiva/fisiopatologia , Imageamento por Ressonância Magnética , Rede Nervosa/patologia , Adulto , Encéfalo/fisiopatologia , Feminino , Humanos , Retinopatia Hipertensiva/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Rede Nervosa/fisiopatologia , Córtex Pré-Frontal/metabolismo , Córtex Pré-Frontal/patologia , Curva ROCRESUMO
Music has the capacity to elicit strong positive feelings in humans by activating the brain's reward system. Because group emotional dynamics is a central concern of social neurosciences, the study of emotion in natural/ecological conditions is gaining interest. This study aimed to show that high-density EEG (HD-EEG) is able to reveal patterns of cerebral activities previously identified by fMRI or PET scans when the subject experiences pleasurable musical chills. We used HD-EEG to record participants (11 female, 7 male) while listening to their favorite pleasurable chill-inducing musical excerpts; they reported their subjective emotional state from low pleasure up to chills. HD-EEG results showed an increase of theta activity in the prefrontal cortex when arousal and emotional ratings increased, which are associated with orbitofrontal cortex activation localized using source localization algorithms. In addition, we identified two specific patterns of chills: a decreased theta activity in the right central region, which could reflect supplementary motor area activation during chills and may be related to rhythmic anticipation processing, and a decreased theta activity in the right temporal region, which may be related to musical appreciation and could reflect the right superior temporal gyrus activity. The alpha frontal/prefrontal asymmetry did not reflect the felt emotional pleasure, but the increased frontal beta to alpha ratio (measure of arousal) corresponded to increased emotional ratings. These results suggest that EEG may be a reliable method and a promising tool for the investigation of group musical pleasure through musical reward processing.
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Contact with nature has been proposed as a solution to achieve physiological relaxation and stress recovery, and a number of scientific verification outcomes have been shown. Compared with studies of the other senses, studies investigating the visual effects of nature have been at the forefront of this research field. A variety of physiological indicators adopted for use in indoor experiments have shown the benefits of viewing nature. In this systematic review, we examined current peer-reviewed articles regarding the physiological effects of visual stimulation from elements or representations of nature in an indoor setting. The articles were analyzed for their stimulation method, physiological measures applied, groups of participants, and outcomes. Thirty-seven articles presenting evidence of the physiological effects of viewing nature were selected. The majority of the studies that used display stimuli, such as photos, 3D images, virtual reality, and videos of natural landscapes, confirmed that viewing natural scenery led to more relaxed body responses than viewing the control. Studies that used real nature stimuli reported that visual contact with flowers, green plants, and wooden materials had positive effects on cerebral and autonomic nervous activities compared with the control. Accumulation of scientific evidence of the physiological relaxation associated with viewing elements of nature would be useful for preventive medicine, specifically nature therapy.
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Terapia de Relaxamento/métodos , Relaxamento/fisiologia , Pressão Sanguínea , Flores , Frequência Cardíaca/fisiologia , Humanos , Estimulação Luminosa , SensaçãoRESUMO
Context: cognitive remediation involves either intensive training of impaired functions or implementing strategies to compensate for these impairments. In cases of schizophrenia, both methods have demonstrated benefits in terms of behavior and cerebral activity. However, despite the major differences between these two approaches, their impact has not yet been compared. Method: We searched the PsychInfo, Pubmed, and ScienceDirect databases using the key words "cognitive remediation," "schizophrenia," "cerebral activity," and "magnetic resonance imaging," in order to select studies investigating the effects of cognitive remediation on patients with schizophrenia. The studies selected had to present their approach in detail and measure its impact in terms of both cerebral activity and cognitive function, both before and after therapy. We divided the studies into two groups, those using the strategy method and those using the training method. Results: Eight studies were included in the review, four for the strategy method (88 patients, 44 of whom underwent remediation) and 4 for the training method (87 patients, 43 of whom underwent remediation). The analysis of the results of this study indicates that the training method is capable of activating more the targeted brain areas than the strategy method. However, the latter appears to encourage more extensive activation of the cerebral networks. Discussion: The studies used for this review vary widely in terms of the imaging methods and protocol. However, differences were found between the two methods and lead us to suggest that further studies, with proper bias control, should be conducted to systematically compare the two approaches.
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Encéfalo/fisiopatologia , Remediação Cognitiva/métodos , Esquizofrenia/fisiopatologia , Esquizofrenia/terapia , Adulto , Cognição , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of such drugs in neonates. METHODS: We aim to provide an overview of the frequently used monitoring tools to assess drug effects on the hemodynamic status as well as the cerebral circulation, oxygenation and cerebral metabolism in neonates. RESULTS: The use of blood pressure measurements, heart rate variability, functional echocardiography, nearinfrared spectroscopy and (amplitude-integrated) electroencephalography in neonates is discussed, as well as new parameters introduced by these tools. Based on the 'brain circulation model', the hemodynamic effects on the brain and their interplay are summarized. In this model, 3 processes (i.e. blood processes, vascular smooth muscle processes and tissue processes) and 3 mechanisms (i.e. autoregulation, blood flow metabolism coupling and cerebral oxygen balance) are distinguished, which all may be influenced by drug administration. Finally, propofol, sevoflurane, midazolam and inotropes are used as examples of which PD has been studied using the available hemodynamic and/or cerebral monitoring tools. CONCLUSION: The implementation of (non-)invasive monitoring tools to document hemodynamic and cerebral PD effects in neonates is of relevance both in a neonatal research and intensive clinical care setting. We highlight the need to integrate these tools in future PD research. Furthermore, besides short-term drug effects, long-term outcome of drug therapy in neonates also warrants further attention.
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Encéfalo/efeitos dos fármacos , Circulação Cerebrovascular/efeitos dos fármacos , Monitoramento de Medicamentos/métodos , Hemodinâmica/efeitos dos fármacos , Preparações Farmacêuticas/administração & dosagem , Encéfalo/irrigação sanguínea , Encéfalo/metabolismo , Circulação Cerebrovascular/fisiologia , Hemodinâmica/fisiologia , Humanos , Recém-Nascido , Consumo de Oxigênio/efeitos dos fármacos , Consumo de Oxigênio/fisiologia , Preparações Farmacêuticas/metabolismoRESUMO
OBJECTIVE: To determine differences in cerebral activity evoked by acupuncture and conventional stroke treatment, and identify the treatment targets. METHODS: In total, 21 patients were randomly divided into two groups. Group A (11 patients) received both acupuncture and conventional treatment, while group B (10 patients) received conventional treatment only. Resting-state functional magnetic resonance imaging (fMRI) was performed on each participant before and after treatment. Regional homogeneity analysis was performed to investigate the potential mechanism of acupuncture treatment by comparing differences in cerebral activity between treatments. RESULTS: Group A showed higher ReHo in the frontal lobe (BA6, BA46), supra-marginal gyrus (BA40), middle temporal gyrus (BA21), cerebellum, and insula. Group B showed higher ReHo in the frontal lobe (BA6) and parietal lobe (BA3, BA7). CONCLUSION: Acupuncture and conventional treatment triggered relatively different clinical efficacy and brain responses. Acupuncture treatment more significantly improved the symptoms of stroke patients. More marked changes in sensory, emotional, and motor areas (including the frontal lobe, middle temporal gyrus, cerebellum, and insula) might reflect the specific acupuncture mechanism.
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AIM: To analyze whether in term neonates during immediate transition after birth low cerebral activity measured by amplitude-integrated EEG (aEEG) is linked to cerebral regional oxygen saturation (crSO2) measured by near-infrared spectroscopy (NIRS). Additionally, the cerebral fractional tissue oxygen extraction (cFTOE) was calculated to analyze whether cerebral activity is linked to cFTOE. METHODS: A total of 244 term neonates delivered by primary cesarean section were studied. In addition to routine monitoring with pulse oximetry, aEEG and NIRS measurements were performed during the first 15min after birth. The mean minimum (Vmin) and maximum (Vmax) amplitude of the cerebral activity as well as crSO2 and cFTOE for each minute was determined. Neonates with initial Vmin<5µV or Vmax<10µV, which normalized during transition (study group) were compared to neonates with normal aEEG values throughout the whole monitoring period (control group). RESULTS: 9 neonates fulfilled inclusion criteria to the study group and were compared to 50 neonates in the control group. Vmin, Vmax, crSO2, SpO2 and cFTOE were compared from the 4th to 15thmin after birth. During our study period, Vmin and Vmax were significantly lower in the study group than in the control group. crSO2 was significantly lower in the study group until minute 11, dropping below the 10th centile in minute 8. cFTOE was significantly higher in the study group until minute 10, rising above the 90th centile in minutes 8 and 9. SpO2 was within normal ranges in both groups. crSO2 and cFTOE were within normal ranges in the control group. CONCLUSION: The present study demonstrates that neonates with initially low cerebral activity during immediate transition after birth concurrently showed low crSO2 (<10th percentile), but increased cerebral oxygen extraction (cFTOE>90th percentile). Cerebral monitoring with aEEG and NIRS might provide useful information on the neonates' condition during immediate transition.
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Encéfalo/metabolismo , Monitorização Fisiológica/métodos , Oxigênio/metabolismo , Encéfalo/fisiologia , Estudos de Casos e Controles , Eletroencefalografia , Humanos , Recém-Nascido , Oximetria , Consumo de Oxigênio , Estudos Prospectivos , Espectroscopia de Luz Próxima ao Infravermelho , Estatísticas não ParamétricasRESUMO
BACKGROUND: To investigate the similarities and differences in cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia (FD). METHODS: Twenty right-handed FD patients were enrolled and randomized divided into two groups. Each patient received 20 sessions' electro-acupuncture treatment. The acupoints used in Group A were four acupoints on the Stomach Meridian, and the acupoints used in Group B were four acupoints on the Gallbladder Meridian. PET-CT scans were performed before and after acupuncture treatment to record the changes of cerebral glycometabolism. KEY RESULTS: After treatment, the dyspepsia symptoms and the quality of life (QOL) of the patients in each group were significantly improved (p < 0.05) and there was insignificant difference in efficacy between the two groups (p > 0.05). In Group A, deactivation in brainstem, bilateral anterior cingulate cortex (ACC) and cerebellum, left superior medial frontal gyrus, orbital frontal cortex (OFC), and thalamus, etc., and activation in bilateral middle cingulate cortex (MCC), precuneus and lingual gyrus, etc. were observed. In Group B, deactivation in brainstem, bilateral thalamus, putamen, ACC, postterior cingulate cortex, hippocampus and cerebellum, etc., and activation in bilateral MCC, precuneus, left OFC, etc. were observed (p < 0.05, Family-wise error corrected). CONCLUSIONS & INFERENCES: Different acupoints have similar clinical efficacy but relatively different cerebral responses. The influence on the sensory transduction regions (brainstem and thalamus) and visceral modulation regions might be the common mechanism of different acupoints treating for FD, and the modulation on some emotion/cognition-related areas (e.g., prefrontal cortex) is the potential difference between the different acupoints.