Evaluation of corpus callosum absence and intracranial accompanying abnormalities via prenatal MRI / 实用放射学杂志

Objective To evaluate the absence of corpus callosum(ACC)and intracranial accompanying abnormalities in fetus via prenatal MRI.Methods A total of 61 cases of fetal ACC diagnosed by prenatal MRI were analyzed retrospectively.The types and numbers of intracranial accompanying abnormalities were observed,and the probability of accompanying abnormalities was counted.According to whether the corpus callosum was completely absent,all cases were divided into complete ACC and partial ACC.Statistical differences of probability of accompanying abnormalities between the two groups were analyzed.Results A total of 54.1%(33/61)patients were complicated with other intracranial abnormalities,among which the most common was cerebral cortical dysplasia,accounting for 26.2%(16/61).The probability of complete ACC and partial ACC complicated with other intracranial abnormalities was 63.4%(26/41)and 35.0%(7/20),respectively,and there was statistical difference in intracranial abnormalities between complete ACC and partial ACC(χ2=4.37,P=0.037).The probability of complete ACC and partial ACC complicated with cerebral cortical dysplasia was 39.0%(16/41)and 5.0%(1/20),respectively,and there was statistical difference in cerebral cortical dysplasia between complete ACC and partial ACC(χ2=7.74,P=0.005).Conclusion MRI can accurately diagnose the fetal ACC and intracranial accompanying abnormalities.Complex ACC is more common than isolated ACC.Compared with partial ACC,complete ACC is more likely to be complicated with other intracranial abnormalities,and cerebral cortical dysplasia is the most common,which provides reliable diagnostic basis for fetal prognosis in clinical practice.

Three-dimensional magnetization prepared rapid acquisition gradient echo for evaluation on the corpus callosum morphological alterations in children with spastic cerebral palsy / 实用放射学杂志

Objective To analyze the morphological alterations of corpus callosum in children with spastic cerebral palsy(SCP)using three-dimensional magnetization prepared rapid acquisition gradient echo(3D-MPRAGE)technology and to investigate the correlation between morphological indexes and gross motor function.Methods Sagittal T1WI 3D-MPRAGE data was collected from 136 children with SCP(SCP group)and 132 age-and gender-matched healthy controls(HC)(HC group),and the gross motor function measure-88(GMFM-88)was applied to assess the gross motor function.Independent sample t-test was used to compare the corpus callosum surface area,volume,maximum anterior-posterior diameter,median sagittal area(total area and area of Ⅰ-Ⅴ zone)between the two groups.Partial correlation analysis was performed to calculate the correlation between morphological indexes of the corpus callosum and GMFM-88 with age as a covariate.Results Children under 3 years old,the corpus callosum surface area of the SCP group(3 914.51 mm2±1 207.97 mm2)was lower than that of the HC group(5 725.51 mm2±1 412.66 mm2).The volume of the corpus callosum(6 108.46 mm3±2 803.97 mm3)in the SCP group was lower than that of the HC group(11 297.96 mm3±4 109.02 mm3).Also,the maximum anterior-posterior diameter of the corpus callosum in the SCP group(53.40 mm±6.31 mm)was lower than that of the HC group(57.74 mm±6.04 mm)(all P<0.05).Children over 3 years old,the corpus callosum surface area of the SCP group(4 970.06 mm2±1 191.31 mm2)was lower than that of the HC group(6 372.55 mm2±1 445.59 mm2).The volume of the corpus callosum(8 330.20 mm3±2 888.20 mm3)in the SCP group was lower than that of the HC group(13 599.82 mm3±3 429.81 mm3)(all P<0.05).Partial correlation analysis showed significant correlation between corpus callosum volume,median sagittal area and gross motor score(P<0.01)with age as a covari-ate.Conclusion The 3D-MPRAGE technology can be useful for the comprehensive assessment of morphological alterations of the corpus callosum in SCP.The corpus callosum volume,and median sagittal area may become neuroimaging references for the assess-ment of motor development in cerebral palsy(CP).

Measurement of the diameter of the corpus callosum in children on the midsagittal plane of MRI / 实用放射学杂志

Objective To measure the diameter of the corpus callosum in children aged 0-14 years using midsagittal high-resolution MRI,and to find the normal reference values of the diameter of the corpus callosum in children of different ages.Methods The imaging data of 967 children with normal brain MRI were retrospectively selected and grouped according to age.The anteroposterior diameter(APD),thickness of the genu(GT),thickness of the body(BT),thickness of the isthmus(IT),thickness of the splenium(ST)and fronto-occipital diameter(FOD)of the corpus callosum were measured on the midsagittal plane of the brain.The diameters of the corpus callosum on the midsagittal plane of the brain of children at different ages were measured.The correlation analysis between the diameter of the corpus callosum and age were performed.Results The APD,GT,BT,IT,ST and FOD were positively correlated with age(r=0.660,0.590,0.528,0.521,0.660,0.597,P<0.01).The IT variation was the greatest in the subregions of the corpus callosum.The growth peak of GT and ST of corpus callosum appeared before 2 years of age.Conclusion The establishment of the normal reference value of different subregions of the corpus callosum in children can help to accurately evaluate the development of the corpus callosum,which is conducive to the evaluation of the prognosis of diseases related to the corpus callosum.

Diagnóstico prenatal de quistes interhemisféricos asociados a agenesia del cuerpo calloso / Prenatal diagnosis of callosal agenesis with interhemispheric cyst

Introducción: Los quistes interhemisféricos asociados a agenesia del cuerpo calloso constituyen un grupo infrecuente y heterogéneo de anomalías del SNC. Objetivo: Reportar nuestra experiencia en quistes interhemisféricos asociados a agenesia del cuerpo calloso (QIH/ACC), haciendo énfasis en sus características en la neurosonografía (NSG), su comparación con la resonancia magnética (RM) y su evolución clínica posterior. Método: Se incluyeron todas las pacientes con QIH/ACC evaluadas desde el año 2008. En todos los casos se consignaron los datos clínicos, de NSG y de RM cuando se realizó. Se entrevistó telefónicamente a los padres. Resultados: Fueron seleccionados 9 casos con QIH/ACC. De ellos, 5 fueron quistes tipo 1, 3 tuvieron anomalías asociadas y en los 3 hubo una anomalía genética patogénica. Cuatro casos fueron quistes tipo 2, 3 de ellos con un patrón NSG sugerente de síndrome de Aicardi. Hubo una excelente correlación entre NSG y RM, ya fuera esta última realizada ante- o posnatal, particularmente con relación a las malformaciones del desarrollo cortical asociadas al QIH/ACC. Conclusiones: En comparación con la RM y el resultado final, hubo alta concordancia con lo diagnosticado en la NSG, en especial en cuanto a malformaciones del desarrollo cortical asociadas, lo que añade valor al método diagnóstico que ofrecemos a nuestra población consultante.

Background: Callosal agenesis associated with interhemispheric cysts correspond to a rare and heterogenous group of CNS anomalies. Objective: To report our experience in interhemispheric cysts associated with agenesis of the corpus callosum (QIH/ACC), emphasizing its characteristics in neurosonography (NSG), its comparison with magnetic resonance imaging (MRI) and its subsequent clinical evolution. Method: All patients with QIH/ACC evaluated since 2008 were included. In all cases, clinical, NSG and MRI data were recorded when performed. The parents were interviewed by telephone. Results: A total of 9 cases were selected with QIH/ACC. 5 cases were type 1 cysts, 3 of them had associated abnormalities and in all 3 there was a pathogenic genetic anomaly. 4 cases were type 2 cysts, 3 of them with an NSG pattern suggestive of Aicardi syndrome. There was an excellent correlation between NSG and MRI, either before or postnatally, particularly in relation to cortical developmental malformations associated with QIH/ACC. Conclusions: Compared to MRI and the final result, there was high agreement with what was diagnosed in NSG, especially in what corresponds to associated cortical developmental malformations, which adds value to the diagnostic method we offer to our consulting population.

Corpus callosum stroke with seizure as primary symptom

The corpus callosum is a large commissural fiber connecting the two hemispheres. The anterior communicating artery, pericallosal artery, and posterior pericallosal artery supply it. Stroke in this area is indeed rare, with an incidence rate of 0.9% to 2.8% per year. There were no documented seizure cases as a manifestation of corpus callosum stroke. We report a case of a 42-year-old right-handed male with a history of hypertension and heart failure who presented with focal motor seizure with intact awareness, alien hand syndrome, and hemianesthesia. His cranial magnetic resonance imaging (MRI) showed a corpus callosum stroke and focal delta slowing on electroencephalography (EEG). This study showed that the corpus callosum is a possible epileptogenic focus.

Mutación genética RAB11B: retraso psicomotor, braquicefalia, hipoplasia de cuerpo calloso. Primer caso descrito en España / Genetic mutation RAB11B: psychomotor retardation, brachycephaly, and corpus callosum hypoplasia. First case described in Spain

El complejo proteico RAB11B, miembro del complejo Rab GTPasa, codificado por el gen RAB11B, juega un papel importante en el desarrollo neuronal y en la formación de las funciones cognitivas. El gen RAB11B codifica un miembro de la subfamilia de las Rab11 GTPasas que se asocia con el reciclaje de las endosomas y participa en la regulación del tráfico de vesículas endoplásmicas. Se presenta el primer caso descrito en España de mutación en el gen RAB11B (mutación c.64G>A en heterocigosis), clínicamente caracterizado por retraso psicomotor, epilepsia, discapacidad intelectual, hipotonía, braquicefalia e hipoplasia del cuerpo calloso. Se realiza comparación del presente caso con otros cinco casos descritos a nivel mundial con la misma mutación, presentando las similitudes y rasgos distintivos(AU)

GTPase complex, encoded by the RAB11B gene, a member of the Rab protein complex which plays a significant role in neuronal development and the shaping of cognitive functions. The RAB11B gene encodes a member of the Rab11 GTPase subfamily that particularly associates with the recycling of endosomes and participates in the regulation of vesicular trafficking. We present the first case described in Spain of psychomotor retardation, intellectual disability due to a mutation in the RAB11B gene (c.64G>A mutation in heterozygosis), clinically characterized by psychomotor retardation, brachycephaly, corpus callosum hypoplasia, epilepsy and intellectual disability. The case is compared with other five cases described worldwide with the same mutation, presenting their similarities and distinctive features(AU)

Metronidazole: A culprit to balance and speech

In a country like India, oral metronidazole is the commonly prescribed drug of choice for entities such as amebiasis and visceral abscesses. Oral such cases, it is usually well tolerated and safe but can cause serious neurological adverse events. Peripheral neuropathy commonly encounters in practice but central nervous system toxicity is also well documented as it crosses the blood–brain barrier easily. Neurological toxicity of metronidazole may be due to prolonged administration, high doses, or high cumulative doses. Magnetic resonance imaging (MRI) of brain is the modality of choice to evaluate brain involvement. In the brain, the splenium of the corpus callosum, dentate nucleus of the cerebellum, and posterior pons involvement are commonly seen and diagnostic. Here, we have an interesting case report of a patient who was on oral metronidazole treatment for his large liver abscess, presenting with a complaint of neurological symptoms of unsteady gait, vertigo, dysdiadochokinesia, and difficulty in speech. Moreover, thus suspected as metronidazole drug toxicity and further investigated for the same, and MRI typically shows cerebellar and posterior corpus callosal involvement

Ischemic Stroke in Dengue Fever: Unusual Complication of a Common Disease

Dengue fever is an arboviral infection, which is highly prevalent in tropical and subtropical climates. It is frequently associated with neurological complications but its association with ischemic stroke is ill defined. We present a case of an apparently healthy young male admitted with dengue fever complicated by ischemic infarct in corpus callosum. Our patient was managed conservatively, improved clinically and discharged in satisfactory condition.

Síndrome de Aicardi: revisión bibliográfica

Introducción: el síndrome de Aicardi (SA; OMIM #304050) es un trastorno genético raro, cuya incidencia es de aproximadamente 1/100.000. Fue descrito en 1965 como una triada consistente en agenesia del cuerpo calloso, lagunas coriorretinianas y espasmos infantiles. Asocia discapacidad intelectual severa y epilepsia de difícil control. Aunque su espectro clínico es variable, tiene por lo general un pronóstico infausto debido a la elevada morbimortalidad asociada. Se considera un trastorno esporádico causado por variantes patogénicas en heterocigosis de un gen ligado al cromosoma X, que causa mortalidad embrionaria en varones hemicigotos. Objetivo: este trabajo pretende llevar a cabo una revisión bibliográfica acerca de la literatura científica disponible del síndrome de Aicardi. De esta manera se hará una actualización sobre esta entidad en cuanto a definiciones, prevalencia e incidencia, etiología, espectro clínico y pronóstico de los pacientes afectos. Materiales y métodos: se lleva a cabo una búsqueda bibliográfica retrospectiva en las principales bases de datos científicas. Para ello, se utilizan las palabras clave "Aicardi", "agenesia del cuerpo calloso", "espasmos infantiles" y "encefalopatía epiléptica". Conclusiones: desde su descripción se ha ido ampliando el espectro de manifestaciones clínicas del síndrome. Actualmente no se conoce la existencia de un biomarcador que posibilite el diagnóstico, por lo que éste continúa siendo eminentemente clínico. Se debe tener un alto nivel de sospecha en espasmos infantiles de debut precoz en mujeres con alteraciones en neuroimagen.

Introduction: Aicardi syndrome (AS; OMIM #304050) is a rare genetic disorder, with an incidence of approximately 1/100,000. It was described in 1965 as a triad consisting of agenesis of the corpus callosum, chorioretinal lacunae, and infantile spasms. It is associated with severe intellectual disability and difficult-to-control epilepsy. Although its clinical spectrum is variable, it generally has a poor prognosis due to the associated morbidity and mortality. It is considered a sporadic disorder caused by heterozygous pathogenic variants of a gene linked to the X chromosome, which causes embryonic mortality in hemizygous males. Objective: this article performs a bibliographic review of the available scientific literature on Aicardi syndrome. In doing so, we hope to update the disorder's definitions, prevalence and incidence, etiology, clinical spectrum and prognosis of affected patients. Materials and methods: we performed a retrospective bibliographic search in the main scientific databases. For this, we searched for the keywords "Aicardi", "agenesia of the corpus callosum", "infantile spasms" and "epileptic encephalopathy". Conclusions: since it was first described, the spectrum of clinical manifestations of the syndrome has been expanding. Currently, there is no known biomarker that makes diagnosis possible, so it continues to be eminently clinical diagnosis. A high level of suspicion should be present in cases of early-onset infantile spasms in women with neuroimaging abnormalities.

The impact of multiple sclerosis on the size and morphology of corpus callosum: an MRI-based retrospective study / Impacto de la esclerosis múltiple en el tamaño y la morfología del cuerpo calloso: un estudio retrospectivo basado en resonancia magnética

SUMMARY: The corpus callosum (CC) includes the majority of fibers linking the two brain hemispheres. Several cross sectional studies showed an association between callosal atrophy and malfunction and neurodegenerative diseases, which may play a role in their pathological manifestations. As a result, the accurate quantification of the corpus callosum is important to have normative values according to sex, age and ethnicity. The purpose of this study is to determine the size of CC in patients suffering from multiple sclerosis, and compare it to CC size in healthyindividuals. Midsagittal size of CC were recorded prospectively from 404 routine MR brain examinations in normal individuals. The internal skull surface was measured to calculate CC/ internal skull surface ratio. Two groups of patients were studied: 200 (100 male /100 female) healthy individuals and 204 (101 males/103 females) with multiple sclerosis (MS). Mean surface area of CC in controls was 6.58±1.04 cm2 and there was no significant difference between males and females (P< 0.627). CC/ internal skull surface ratio was 4.44±0.77 %. MS patients showed a significant decrease in CC size compared to normal controls. Using MR imaging, we measured the mean sizes of the various portions of the CC in normal individuals, in addition to MS patients; these values may provide a useful basis to determine changes occurring in CC structures.

El cuerpo calloso (CC) incluye la mayoría de las fibras que unen los dos hemisferios cerebrales. Varios estudios transversales mostraron una asociación entre la atrofia y el mal funcionamiento calloso y las enfermedades neurodegenerativas, lo que puede desempeñar un papel en sus manifestaciones patológicas. En consecuencia, la cuantificación precisa del cuerpo calloso es importante para tener valores normativos según sexo, edad y etnia. El propósito de este estudio fue determinar el tamaño de CC en pacientes que padecen esclerosis múltiple y compararlo con el tamaño de CC en individuos sanos. El tamaño sagital medio del CC se registró prospectivamente a partir de 404 exámenes cerebrales de RM de rutina en individuos normales. Se midió la superficie interna del cráneo para calcular la relación CC/superficie interna del cráneo. Se estudiaron dos grupos de pacientes: 200 (100 hombres/100 mujeres) sanos y 204 (101 hombres/103 mujeres) con esclerosis múltiple (EM). El área superficial media de CC en los controles fue de 6,58±1,04 cm2 y no hubo diferencia significativa entre hombres y mujeres (P< 0,627). La relación CC/superficie interna del cráneo fue de 4,44±0,77 %. Los pacientes con EM mostraron una disminución significativa en el tamaño de CC en comparación con los controles normales. Usando imágenes de RM, medimos los tamaños medios de las diversas porciones del CC en individuos normales, además de pacientes con EM; estos valores pueden proporcionar una base útil para determinar los cambios que ocurren en las estructuras CC.

Estimulación de nervio vago en epilepsia refractaria y callosotomía previa sin mejoría. Reporte de caso / Vagus nerve stimulation in refractory epilepsy and previous callosotomy without vimprovement. Case report / Estimulação do nervo vago em epilepsia refratária e calosotomia prévia sem melhora. Relato de caso

La epilepsia refractaria tanto generalizada como focal, es una patología sumamente incapacitante, para el tratamiento de la misma se ha establecido a la callosotomía desde hace décadas como primera línea quirúrgica para su control, la cual puede presentar efectos secundarios importantes como síndrome de desconexión y pérdida de memoria, sin embargo, existen pacientes que no responden a la callosotomía y necesitan nuevas líneas de tratamiento, buscando en la estimulación de nervio vago una respuesta a su condición. Descripción del caso de estudio. Se presenta el caso de paciente masculino de 24 años de edad con antecedente patológico de convulsiones tipo tónico clónicas generalizadas confirmadas por video electroencefalograma de 24 horas, de predominio nocturno de 13 años de evolución, es sometido a 2 regímenes farmacológicos antiepilépticos diferentes en un período de 7 años de duración, posteriormente diagnosticado con epilepsia refractaria, por lo que se realiza callosotomía sin control de su cuadro clínico, el mismo año se realiza estimulación de nervio vago, presentando resultados favorables en su evolución. Conclusión. Luego de evidenciar el presente caso de estudio se concluye que el tratamiento de epilepsia refractaria con la colocación de un estimulador de nervio vago izquierdo asociado a un correcto régimen FAE es una alternativa muy eficaz para considerar en estos pacientes.

Refractory epilepsy, both generalized and focal, is an extremely disabling pathology. For its treatment, callosotomy has been established for decades as the first surgical line for its control, which can present important side effects such as disconnection and loss syndrome. by heart, however, there are patients who do not respond to callosotomy and need new lines of treatment, looking for an answer to their condition in vagus nerve stimulation. Description of the case study. We present the case of a 24-year-old male patient with a pathological history of generalized tonic-clonic seizures confirmed by a 24-hour video electroencephalogram, predominantly nocturnal for 13 years, undergoing 2 different antiepileptic pharmacological mechanisms over a period of 7 years in duration, later diagnosed with refractory epilepsy, for which callosotomy was performed without control of its clinical picture, the same year vagus nerve stimulation was performed, presenting favorable results in its evolution. Conclution. After evidencing the present case study, it is concluded that the treatment of refractory epilepsy with the placement of a left vagus nerve stimulator associated with a correct AED regimen is a very effective alternative to consider in these patients.

A epilepsia refratária, tanto generalizada quanto focal, é uma patologia extremamente incapacitante. Para seu tratamento, a calosotomia se estabeleceu há décadas como a primeira linha cirúrgica para seu controle, que pode apresentar importantes efeitos colaterais como desconexão e síndrome de perda., há pacientes que não respondem à calosotomia e precisam de novas linhas de tratamento, buscando resposta para sua condição na estimulação do nervo vago. Descrição do estudo de caso. Apresentamos o caso de um doente do sexo masculino, 24 anos, com antecedentes patológicos de crises tónico-clónicas generalizadas confirmadas por videoeletroencefalograma de 24 horas, predominantemente nocturnas há 13 anos, submetido a 2 mecanismos farmacológicos antiepilépticos diferentes ao longo de 7 anos de duração, posteriormente diagnosticada com epilepsia refratária, para a qual foi realizada calosotomia sem controle de seu quadro clínico, no mesmo ano foi realizada estimulação do nervo vago, apresentando resultados favoráveis em sua evolução. Conclusão. Depois de evidenciar o presente estudo de caso, conclui-se que o tratamento da epilepsia refratária com a colocação de um estimulador de nervo vago esquerdo associado a um esquema correto de DEA é uma alternativa muito eficaz a ser considerada nesses pacientes.

Severe COVID-19 complicated with mild encephalitis/encephalopathy with reversible splenial lesion of the corpus callosum: a case report / 中华神经科杂志

Since the global COVID-19 pandemic, SARS-CoV-2 infection, which causes COVID-19, has been associated with a range of diseases whose atypical manifestations have been increasingly reported. The mild encephalitis or encephalopathy associated with reversible corpus callosum lesions or mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is a rare clinical and radiographic syndrome. At present, the pathogenesis of MERS caused by COVID-19 is still unclear, and its pathogenesis may include hypoxic damage, inflammatory response, immune disorders, changes in osmotic pressure, excitatory amino acid toxicity, oxidative stress and functional abnormalities of renin-angiotensin system. This paper reports a case of severe COVID-19 complicated with MERS, and discusses the pathogenesis from a pathophysiological point of view.

Ischemic Stroke in Dengue Fever: Unusual Complication of a Common Disease

Dengue fever is an arboviral infection, which is highly prevalent in tropical and subtropical climates. It is frequently associated with neurological complications but its association with ischemic stroke is ill defined. We present a case of an apparently healthy young male admitted with dengue fever complicated by ischemic infarct in corpus callosum. Our patient was managed conservatively, improved clinically and discharged in satisfactory condition.

"Stable" vs. "silent progressive multiple sclerosis": a real-world retrospective clinical imaging Brazilian study / Esclerose múltipla "estável" vs. "silenciosamente progressiva": um estudo brasileiro retrospectivo de correlatos clínicos e imagem

ABSTRACT Background: Clinical and imaging are required to characterize activity and progression in MS. The parameters for activity are well defined but not those for progression. The ideal aim for long-term treatment is that neither clinical nor imaging signs of disease should be present, and also no brain atrophy. Objectives: To conduct a comparative clinical-imaging study focusing on MRI brain volumetry. Methods: 174 consecutive relapsing-remitting MS patients (McDonald 2001) were studied, focusing on activity and progression. Annual clinical evaluations (relapse rate and EDSS) and MRI data, along with the annualized evolution of the corpus callosum index (CCI), were compared. Results: Out of 174 patients, 148 were considered clinically "stable" based on EDSS. However, 33 (22.2%) out of this group showed annualized reductions in CCI of more than 0.5%, which was the cutoff for defining significant brain atrophy. Conclusions: Among apparently "stable" relapsing-remitting MS patients, 1/5 showed significant brain atrophy over a follow-up period of at least 7 years. We consider it reasonable to suggest that MRI volume sequences should be included in follow-up protocols, so as to provide information on the real treatment response status.

RESUMO Antecedentes: Critérios clínicos e de imagem são necessários para caracterizar atividade e progressão em esclerose múltipla (EM). Os parâmetros para a atividade são bem definidos, o que não ocorre com a progressão. O objetivo ideal para tratamento em longo prazo inclui ausência de sinais clínicos e de imagem, assim como inexistência de atrofia cerebral. Objetivos: Estudo comparativo de aspectos clínicos e correlatos de imagem, com foco em volumetria cerebral. Métodos: Foram avaliados 174 pacientes consecutivos com o diagnóstico de EM surto-remissiva (McDonald 2001), com foco em dados de atividade e progressão. A avaliação clínica anual (taxa de surtos e escala expandida do estado de incapacidade - EDSS) e dados de imagem, assim como a evolução anualizada do Índice de Corpo Caloso (CCI), foram comparados. Resultados: Da amostra inicial de 174 pacientes, 148 foram considerados "clinicamente estáveis" com base na EDSS. Todavia, 33 (22,2%) pacientes desse grupo mostraram redução volumétrica anualizada no índice de corpo caloso acima de 0,5%, nível de corte para definir a atrofia cerebral significativa. Conclusões: Entre pacientes de EM surto-remissiva aparentemente estáveis, cerca de 1/5 apresentou sinais de atrofia cerebral significativa em sete anos de seguimento. Consideramos razoável sugerir que sequências de volumetria deveriam ser incluídas nos protocolos de seguimento, fornecendo informação quanto ao real estado da resposta ao tratamento.

Estresse juvenil de curta frequência e intensidade não afeta a substância branca cerebral de ratos / Juvenile stress of short frequency and intensity does not affect rats´ brain white matter

O objetivo deste estudo foi avaliar os efeitos duradouros de dois tipos de estresse sobre o corpo caloso (CC). Foram estudados 42 ratos Wistar machos divididos aleatoriamente em três grupos: Grupo Controle (GC), Estresse Físico (EF, imobilização) e Estresse Psicológico (EP, exposição ao predador). Os procedimentos de estresse ocorreram durante três dias consecutivos na idade juvenil (P25-P27) e foram analisados na idade adulta (P74). Os cérebros foram coletados, processados com a técnica de Klüver-Barrera, e secções foram analisadas por meio de morfometria. Os resultados demonstraram que não houve alterações em aspectos gerais como peso dos animais, e histológicos como espessura do CC e quantidade dos núcleos gliais nesta região. O estudo sugere que os efeitos duradouros de ambos os modelos de estresse juvenil de curta frequência (3 dias) e intensidade (90 minutos/EF e 20 minutos/EP) não foram nem prejudiciais e nem protetores, o que pode ser considerado uma adaptação positiva.

The current study evaluates the lasting effects of two types of stress on the corpus callosum (CC). Forty-two male Wistar rats were randomly divided into three groups: Control Group (CG), Physical Stress (FS, immobilization) and Psychological Stress (PS, exposure to predators). Stress procedures occurred for three consecutive days at the juvenile stage (P25-P27) and analyzed at the adult age (P74); brains were retrieved and processed by Klüver-Barrera technique and sections were analyzed by morphometry. Results showed that there were no changes in the general aspects such as animal weight, and in the histological aspects such as CC thickness and quantity of the region´s glia nuclei. Current research suggests that the lasting effects of both models of juvenile stress of short frequency (3 days) and intensity (90 minutes/FS and 20 minutes/PS) were neither detrimental nor protective, featuring a positive adaptation.

Prenatal genetic diagnosis of the fetuses with isolated corpus callosum abnormality / 中华妇产科杂志

Objective:To explore the application value of chromosome karyotype analysis, chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in prenatal diagnosis of isolated corpus callosum abnormality (CCA) fetus.Methods:Fetuses diagnosed with isolated CCA by ultrasound and MRI and receiving invasive prenatal diagnosis in Guangzhou Women and Children′s Medical Center and Qingyuan People′s Hospital from January 2010 to April 2021 were selected. Karyotype analysis and/or CMA [or copy number variation sequencing (CNV-seq)] were performed on all fetal samples, and WES was performed on fetal samples and their parents whose karyotype analysis and/or CMA (or CNV-seq) results were not abnormal.Results:Among 65 fetuses with isolated CCA, 38 cases underwent karyotype analysis, and 3 cases were detected with abnormal karyotypes, with a detection rate of 8% (3/38). A total of 49 fetuses with isolated CCA underwent CMA (or CNV-seq) detection, and 6 cases of pathogenic CNV were detected, the detection rate was 12% (6/49). Among them, the karyotype analysis results were abnormal, and the detection rate of further CMA detection was 1/1. The karyotype results were normal, and the detection rate of further CMA (or CNV-seq) detection was 14% (3/21). The detection rate of CMA as the first-line detection technique was 7% (2/27). A total of 25 fetuses with isolated CCA with negative results of karyotyping and/or CMA were tested by WES, and 9 cases (36%, 9/25) were detected with pathogenic genes. The gradient genetic diagnosis of chromosomal karyotyping, CMA and WES resulted in a definite genetic diagnosis of 26% (17/65) of isolated CCA fetuses.Conclusions:Prenatal genetic diagnosis of isolated CCA fetuses is of great clinical significance. The detection rate of CMA is higher than that of traditional karyotyping. CMA detection could be used as a first-line detection technique for fetuses with isolated CCA. WES could increase the pathogenicity detection rate of fetuses with isolated CCA when karyotype analysis and/or CMA test results are negative.

A case of reversible splenial lesion syndrome characterized by increased antithyroid antibodies / 中华神经科杂志

Reversible splenial lesion syndrome (RESLES) is a rare clinical imaging syndrome caused by various etiologies and has no specific clinical manifestations, of which magnetic resonance imaging is characterized by reversible splenial lesion. Its etiology is complex, with infection more common, rare due to thyroid disease.The clinical data of a patient of RESLES with significantly increased anti-thyroid antibody are reported to enrich the etiology and further improve the understanding of the disease.

Effects of ginsenoside Rg1 on chronic white matter injury / 中国药理学通报

Aim To study whether ginsenoside Rg1 could improve white matter injury caused by chronic cerebral ischemia.Methods C57BL/6 mice were randomly divided into Sham group,Model group,Donepezil group,and ginsenoside Rg1(10,5 mg·kg-1)group.BCAS was established by using bilateral common carotid artery stenosis.Drug treatment was started one day after the operation,and the stomach was given continuously for 30 days.During this period,the body weight and CBF changes were observed,and observed by climbing rods,new object recognition and Y maze experiments.The movement coordination and cognitive abilities of each group of animals were improved.The improvement of the myelin sheath of the corpus callosum was detected by LFB staining,the damage of corpus callosum neurons was observed by Nissl staining,and the expression level of MBP in the corpus callosum was detected by immunofluorescence and Western blot.Results The test results of body weight and CBF showed that compared with model group,ginsenoside Rg1 group did not significantly improve the animal's body weight and CBF values; the results of climbing rod,new object recognition,and Y maze experiment showed that ginsenoside Rg1 group significantly shortened the time it took animals to climb rods,and improved the animal's new object recognition index and the number of autonomous alternations; LFB and Nissl staining results showed that ginsenoside Rg1 group significantly improved the myelin and neuron damage of the animal corpus callosum.The results of immunofluorescence and Western blot showed that ginsenoside Rg1 group significantly increased the expression level of animal myelin basic protein MBP.Conclusion Ginsenoside Rg1 can significantly improve white matter injury caused by chronic cerebral ischemia.

Diagnostic value of two-dimensional ultrasound combined with volume contrast imaging and MRI in fetal corpus callosum dysplasia / 国际生物医学工程杂志

Objective:To investigate the diagnostic value of two-dimensional ultrasound combined with volumetric contrast imaging (VCI) and magnetic resonance imaging (MRI) for the developmental abnormalities of the fetal corpus callosum.Methods:Seventy-three fetuses who underwent cranial MRI within 1 week after suspected fetal corpus callosum dysplasia on ultrasound and received a definitive diagnosis in the neonatal period were retrospectively recruited for the study. The fetal corpus callosum was observed in the transverse, coronal, and sagittal views of the fetus, and the hyaline septal cavity, lateral ventricle, third ventricle, and corpus callosum were observed in the MRI scan. The diagnostic results and sensitivity of two-dimensional ultrasound combined with volumetric contrast imaging and MRI were analyzed.Results:Neonatal imaging showed that among 73 fetuses, 32 had agenesis of the corpus callosum, 29 had hypoplasia of the corpus callosum, and 12 had normal development of the corpus callosum. The differences in diagnostic results and sensitivity between 2D ultrasound combined with volumetric contrast imaging and MRI testing for agenesis of the corpus callosum were not statistically significant (all P>0.05), and the differences in diagnostic results and sensitivity for hypoplasia of the corpus callosum were statistically significant ( P<0.05). Conclusions:Both 2D ultrasound combined with volumetric contrast imaging and MRI are of high value for the diagnosis of partial-type agenesis of the corpus callosum, but MRI is more advantageous for the diagnosis of agenesis of the corpus callosum, and MRI can be a useful supplement and verification tool for ultrasound to provide a more accurate clinical diagnosis.

Anatomía del cuerpo calloso en ratas sometidas a estrés prenatal crónico / Anatomy of corpus callosum in rats submitted to chronic prenatal stress

RESUMEN: El cuerpo calloso (CC), es la mayor comisura de sustancia blanca del encéfalo de los mamíferos placentados, constituida por numerosos haces de fibras transversales que conectan áreas corticales de ambos hemisferios cerebrales. Por otro lado, el estrés se define como una respuesta general del organismo ante demandas externas o internas, inicialmente amenazantes, que consiste en movilizar recursos fisiológicos y psicológicos para poderlas afrontar. Dada la importancia del cuerpo calloso en las conexiones cortico-corticales, el objetivo del presente estudio, fue evaluar el efecto en ratas, de un estrés prenatal crónico por inmovilización, sobre la anatomía macroscópica del CC. Se utilizaron seis ratas preñadas de la cepa Wistar de 250 g, de las cuales tres fueron sometidas, a partir del octavo día postconcepción, a una restricción de movimiento por diez días (2h/día). Posteriormente, las madres prosiguieron su gestación, parto y lactancia. Al nacimiento, las camadas fueron ajustadas a seis crías machos por madre (n=36), destetadas a los 21 días y sacrificadas a los 45-52 días de edad. Los encéfalos fueron seccionados a través de la cisura interhemisférica y ambos hemisferios fotografiados por su cara medial. Las imágenes fueron digitalizadas y analizadas mediante el programa Scion Image®, para la medición del área total, parciales (tercio anterior, medio, posterior y quinto posterior) y perímetro callosal. Es así como, el estrés prenatal por inmovilización, afectó significativamente (p<0,01), la morfología macroscópica del cuerpo calloso. Evidenciándose una disminución del área total, áreas parciales y perímetro callosal, en los animales sometidos a restricción prenatal. Estableciendo una relación directa entre número de axones y área callosal e inversa entre diámetro y densidad axonal; lo observado podría tener incidencia en la transferencia interhemisférica.

SUMMARY: The Corpus Callosum (CC) is the largest white matter commissure in the brain of placental mammals, consisting of numerous transverse fiber bundles that connect cortical areas of both cerebral hemispheres. On the other hand, stress is defined as a general response of the organism to external or internal demands, initially threatening, which consists of mobilizing physiological and psychological resources to be able to face them. Given the importance of CC in cortico-cortical connections, the aim of the present study, was to evaluate the effect of chronic pre-natal immobilization stress on the macroscopic anatomy of CC in rats. Six 250g pregnant rats of the Wistar strain were used, of which three were subjected, starting on the eighth post-conception day, to movement restriction for ten days (2h/day). Subsequently, the mothers continued their gestation, delivery and lactation. At birth, litters were adjusted to six male offspring per mother (n=36), which were weaned at 21 days and slaughtered at 45-52 days of age. The brains were fixed, and later sectioned through the interhemispheric fissure and both hemispheres photographed by their medial aspect. The images were digitized and analyzed using the Scion Image® program, for the measurement of the total area, partial area (ante- rior, middle and posterior thirds, as well as posterior fifth) and callosal perimeter. Thus, prenatal stress due to immobilization significantly affected (p<0.01), the macroscopic morphology of the CC. Evidence shows a decrease in the total area, partial areas and callosal perimeter in the animals subjected to prenatal restraint, as compared to normal animals. Establishing a direct relationship between number of axons and callosal area and an inverse relationship between diameter and axonal density, what was observed may have an impact on interhemispheric transfer.