RESUMEN
The relationships between impaired cortical development and consequent malformations in neurodevelopmental disorders, as well as the genes implicated in these processes, are not fully elucidated to date. In this study, we report six novel cases of patients affected by BBSOAS (Boonstra-Bosch-Schaff optic atrophy syndrome), a newly emerging rare neurodevelopmental disorder, caused by loss-of-function mutations of the transcriptional regulator NR2F1. Young patients with NR2F1 haploinsufficiency display mild to moderate intellectual disability and show reproducible polymicrogyria-like brain malformations in the parietal and occipital cortex. Using a recently established BBSOAS mouse model, we found that Nr2f1 regionally controls long-term self-renewal of neural progenitor cells via modulation of cell cycle genes and key cortical development master genes, such as Pax6. In the human fetal cortex, distinct NR2F1 expression levels encompass gyri and sulci and correlate with local degrees of neurogenic activity. In addition, reduced NR2F1 levels in cerebral organoids affect neurogenesis and PAX6 expression. We propose NR2F1 as an area-specific regulator of mouse and human brain morphology and a novel causative gene of abnormal gyrification.
Asunto(s)
Factor de Transcripción COUP I/metabolismo , Neocórtex/embriología , Células-Madre Neurales/metabolismo , Lóbulo Occipital/embriología , Atrofias Ópticas Hereditarias/embriología , Lóbulo Parietal/embriología , Animales , Factor de Transcripción COUP I/genética , Modelos Animales de Enfermedad , Humanos , Ratones , Neocórtex/patología , Células-Madre Neurales/patología , Lóbulo Occipital/patología , Atrofias Ópticas Hereditarias/genética , Atrofias Ópticas Hereditarias/patología , Factor de Transcripción PAX6/genética , Factor de Transcripción PAX6/metabolismo , Lóbulo Parietal/patologíaRESUMEN
BACKGROUND: Loss of retinal ganglion cells after occipital lobe damage is known to occur through transsynaptic retrograde degeneration in congenital lesions; however, studies of this phenomenon in acquired pathology, such as strokes affecting postgenicular visual pathway, are scant. We studied a cohort of adult patients with known onset of occipital lobe stroke to look for the presence, rate, and timing of macular ganglion cell loss on optical coherence tomography. METHODS: Retrospective review of patients seen in tertiary neuro-ophthalmology practice with homonymous hemianopia secondary to occipital lobe stroke of known onset. Optical coherence tomography of the macular ganglion cell complex (GCC) was performed, and hemifields corresponding to the side of the visual field (VF) defect were compared with the control retinal hemifield. RESULTS: Fifteen patients with homonymous VF defects were included in the study, and 8 of these (53.3%) demonstrated GCC hemifield thickness of less than 90% on the side corresponding to VF loss including 2/9 (22%) patients who had a stroke less than 2.5 years ago and 6/6 (100%) patients who had a stroke longer than 2.5 years ago. The amount of hemifield atrophy correlated to the logarithm of time since stroke onset ( P =0.030) but not age ( P = 0.95) or mean deviation on VF ( P = 0.19). Three patients with longitudinal data showed GCC thinning rates of 1.99, 5.13, and 5.68 µm per year. CONCLUSION: Transsynaptic retrograde degeneration occurs after occipital lobe stroke as early as 5.5 months after injury and was observed in all patients 2.5 years after stroke.
Asunto(s)
Degeneración Retrógrada , Accidente Cerebrovascular , Humanos , Adulto , Degeneración Retrógrada/complicaciones , Degeneración Retrógrada/patología , Fibras Nerviosas/patología , Vías Visuales/patología , Pruebas del Campo Visual , Trastornos de la Visión , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico , Infarto Cerebral/complicaciones , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Occipital/patología , Tomografía de Coherencia Óptica/métodosRESUMEN
ABSTRACT: A 74-year-old man with chronic obstructive pulmonary disease, glaucoma, and Stage IIIB squamous cell lung cancer experienced several minutes of flashing lights in his right visual hemifield, followed by onset of a right visual field defect. On examination, the patient had a right homonymous hemianopsia that was most dense inferiorly by confrontation testing. Emergent CT scan of the head revealed a 2.5 × 3 cm hypodensity in the left occipital lobe, which was interpreted as an acute stroke. Continuous EEG monitoring captured left posterior quadrant seizures that were temporally correlated to the positive visual phenomena. Subsequent MRI of the brain with and without contrast revealed a conglomerate of centrally necrotic and peripherally enhancing mass lesions. On biopsy, a thick purulent material was drained and Gram stain of the sample revealed gram-positive beaded rods, which speciated to Nocardia farcinica . The patient was treated with a six-week course of intravenous meropenem and a one-year course of oral trimethroprim-sulfamethoxazole. On follow-up, the patient experienced resolution of the right visual field deficit.
Asunto(s)
Nocardiosis , Nocardia , Masculino , Humanos , Anciano , Hemianopsia/diagnóstico , Hemianopsia/etiología , Absceso/patología , Nocardiosis/complicaciones , Nocardiosis/diagnóstico , Nocardiosis/patología , Encéfalo/patología , Trastornos de la Visión , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Occipital/patologíaRESUMEN
BACKGROUND: Two major approaches exist for the surgical removal of pineal region tumors: the supracebellar infratentorial and the sub-occipital transtentorial. METHODS: We present the Lyon's technique of the sub-occipital transtentorial approach for pineal region tumors and our tricks to avoid complications. The principle is to expose the pineal region under the occipital lobe and not through the interhemispheric fissure. CONCLUSIONS: The sub-occipital transtentorial approach is a direct, extra cerebral, safe, and effective way to access tumors of the pineal region.
Asunto(s)
Neoplasias Encefálicas , Glándula Pineal , Pinealoma , Humanos , Pinealoma/diagnóstico por imagen , Pinealoma/cirugía , Pinealoma/patología , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/patología , Glándula Pineal/cirugía , Glándula Pineal/patología , Procedimientos Neuroquirúrgicos/métodos , Lóbulo Occipital/cirugía , Lóbulo Occipital/patologíaRESUMEN
Younger age at first exposure (AFE) to repetitive head impacts while playing American football increases the risk for later-life neuropsychological symptoms and brain alterations. However, it is not known whether AFE is associated with cortical thickness in American football players. Sixty-three former professional National Football League players (55.5 ± 7.7 years) with cognitive, behavioral, and mood symptoms underwent neuroimaging and neuropsychological testing. First, the association between cortical thickness and AFE was tested. Second, the relationship between clusters of decreased cortical thickness and verbal and visual memory, and composite measures of mood/behavior and attention/psychomotor speed was assessed. AFE was positively correlated with cortical thickness in the right superior frontal cortex (cluster-wise P value [CWP] = 0.0006), the left parietal cortex (CWP = 0.0003), and the occipital cortices (right: CWP = 0.0023; left: CWP = 0.0008). A positive correlation was found between cortical thickness of the right superior frontal cortex and verbal memory (R = 0.333, P = 0.019), and the right occipital cortex and visual memory (R = 0.360, P = 0.012). In conclusion, our results suggest an association between younger AFE and decreased cortical thickness, which in turn is associated with worse neuropsychological performance. Furthermore, an association between younger AFE and signs of neurodegeneration later in life in symptomatic former American football players seems likely.
Asunto(s)
Atletas , Grosor de la Corteza Cerebral , Lesiones Traumáticas del Encéfalo/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Encefalopatía Traumática Crónica/diagnóstico por imagen , Fútbol Americano , Adulto , Afecto/fisiología , Factores de Edad , Anciano , Atención/fisiología , Lesiones Traumáticas del Encéfalo/fisiopatología , Corteza Cerebral/patología , Encefalopatía Traumática Crónica/fisiopatología , Lóbulo Frontal/diagnóstico por imagen , Lóbulo Frontal/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Memoria/fisiología , Persona de Mediana Edad , Pruebas Neuropsicológicas , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Occipital/patología , Tamaño de los Órganos , Lóbulo Parietal/diagnóstico por imagen , Lóbulo Parietal/patología , Desempeño Psicomotor/fisiologíaRESUMEN
We semiquantitatively compared the frequency and severity of cerebral amyloid angiopathy (CAA) in the cerebellum and CAA-positive occipital lobe of 60 subjects from routine autopsies. In the 60 subjects with a CAA-positive occipital lobe, cerebellar CAA was observed in 29 subjects (48.3%), and the severity of cerebellar CAA was relatively mild compared with occipital lobe CAA. Capillary CAA was observed in the occipital lobe of 12 subjects and the cerebellum of three subjects. CAA-related vasculopathies were observed in the occipital lobe of 15 subjects and the cerebellum of two subjects. The severity of CAA-related vasculopathy was mild in both of these subjects. Amyloid-ß plaques were observed in the occipital lobe of 54 subjects (90%) and the cerebellum of 16 subjects (26.7%). The severity of amyloid-ß plaques in the cerebellum was mild compared with the occipital lobe. In summary, we confirmed that cerebellar CAA is frequently observed in the cerebellum but with a lower severity than CAA in the occipital lobe.
Asunto(s)
Enfermedad de Alzheimer , Angiopatía Amiloide Cerebral , Humanos , Enfermedad de Alzheimer/patología , Angiopatía Amiloide Cerebral/patología , Péptidos beta-Amiloides/metabolismo , Placa Amiloide/patología , Encéfalo/patología , Lóbulo Occipital/patologíaRESUMEN
A 56-year-old, right-handed man with no known past medical history presented with sudden onset of inability to recognize familiar individuals in person, including his wife and his mother. He also couldn't recognize himself in the mirror. There was no weakness, numbness, visual disturbances, or speech difficulty. Face recognition test, using Warrington Recognition Memory Test (1), showed the presence of complete prosopagnosia. The rest of the neurological and cranial nerves examinations were normal. Magnetic resonance imaging (MRI) of the brain showed restricted diffusion at the right temporal and occipital lobes (the fusiform gyrus) [Figure 1]. Magnetic resonance angiogram (MRA) of the brain was unremarkable. The 24-hours Holter monitoring showed paroxysmal atrial fibrillation. The transthoracic echocardiogram and carotid doppler ultrasound scan were normal. He was then treated with rivaroxaban 20mg daily for secondary stroke prevention in non-valvular atrial fibrillation. Face recognition skill training was started in the ward, which includes compensatory strategies to achieve person recognition by circumventing the face processing impairment, and remediation to enhance mnemonic function for face recognition. His prosopagnosia resolved completely after one week. Prosopagnosia, also known as face blindness, is an impairment in recognizing faces. The core defects are the loss of familiarity with previously known faces and the inability to recognize new faces. Patients with prosopagnosia may present with poor recognition of familiar individuals in person or in the photograph, confusion with plotlines in movies or plays with numerous characters, and difficulty distinguishing individuals wearing a uniform or similar clothing. Stroke is the most common cause of acquired prosopagnosia (2). Other less common aetiologies include traumatic brain injury, carbon monoxide poisoning, temporal lobectomy, and encephalitis. Literature has shown that areas involved in acquired prosopagnosia are the right fusiform gyrus or anterior temporal cortex, or both (3). The fusiform gyrus is part of the lateral temporal lobe and occipital lobe in 'Brodmann area 37' (4). The fusiform gyrus is considered a key structure for functionally specialized computations of high-level vision such as face perception, object recognition, and reading. Individuals with fusiform lesions are more likely to have apperceptive prosopagnosia, while those with anterior temporal lesions have an amnestic variant (5). In summary, prosopagnosia can be the sole presentation for the right fusiform gyrus stroke. It is important to recognize prosopagnosia for early stroke diagnosis and avoid misdiagnosing it as a psychiatric or ocular disorder. Keywords: prosopagnosia, fusiform gyrus, stroke.
Asunto(s)
Prosopagnosia , Accidente Cerebrovascular , Humanos , Infarto/complicaciones , Infarto/patología , Imagen por Resonancia Magnética/efectos adversos , Masculino , Persona de Mediana Edad , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Occipital/patología , Prosopagnosia/diagnóstico , Prosopagnosia/etiología , Accidente Cerebrovascular/complicaciones , Lóbulo Temporal/diagnóstico por imagen , Lóbulo Temporal/patologíaRESUMEN
Adults with large multilobar lesions of temporal, parietal and occipital lobes of the dominant hemisphere suffering from drug-resistant epilepsy were considered inoperable for a long time. OBJECTIVE: To demonstrate favorable postoperative outcome in a patient with massive periventricular heterotopia of the left temporal and occipital lobes complicated by drug-resistant epilepsy. MATERIAL AND METHODS: We analyzed localization of the brain malformation (massive periventricular heterotopia) and its relationship with surrounding structures in a 38-year-old patient considering preoperative MRI, functional MRI and MR tractography data. Quality of modified posterior quadrant disconnection was assessed within a day and 6 months after surgery in accordance with MRI data. Transcranial stimulation, direct cortical and subcortical monopolar stimulation were used for intraoperative monitoring of corticospinal tract. We also assessed neurological status and linguistic testing data before surgery, 4 days and 6 months after surgery. RESULTS: Modified posterior disconnection of temporal, parietal and occipital lobes was performed. Intraoperative neurophysiological cortical mapping (asleep-awake-sedation protocol) verified localization of Wernicke's area. There was an expected right-sided homonymous hemianopsia in postoperative period without speech disorders. Postoperative outcome Engel grade 1A under anticonvulsant therapy was obtained. CONCLUSION: The authors report successful surgical treatment of massive malformation of the left temporal, parietal and occipital lobes and literature review devoted to this issue.
Asunto(s)
Epilepsia , Heterotopia Nodular Periventricular , Adulto , Humanos , Heterotopia Nodular Periventricular/cirugía , Lóbulo Occipital/patología , Lóbulo Occipital/cirugía , Imagen por Resonancia Magnética , Monitoreo Intraoperatorio , Epilepsia/patología , Epilepsia/cirugía , Resultado del TratamientoRESUMEN
Stroke damage to the primary visual cortex (V1) causes a loss of vision known as hemianopia or cortically-induced blindness. While perimetric visual field improvements can occur spontaneously in the first few months post-stroke, by 6 months post-stroke, the deficit is considered chronic and permanent. Despite evidence from sensorimotor stroke showing that early injury responses heighten neuroplastic potential, to date, visual rehabilitation research has focused on patients with chronic cortically-induced blindness. Consequently, little is known about the functional properties of the post-stroke visual system in the subacute period, nor do we know if these properties can be harnessed to enhance visual recovery. Here, for the first time, we show that 'conscious' visual discrimination abilities are often preserved inside subacute, perimetrically-defined blind fields, but they disappear by â¼6 months post-stroke. Complementing this discovery, we now show that training initiated subacutely can recover global motion discrimination and integration, as well as luminance detection perimetry, just as it does in chronic cortically-induced blindness. However, subacute recovery was attained six times faster; it also generalized to deeper, untrained regions of the blind field, and to other (untrained) aspects of motion perception, preventing their degradation upon reaching the chronic period. In contrast, untrained subacutes exhibited spontaneous improvements in luminance detection perimetry, but spontaneous recovery of motion discriminations was never observed. Thus, in cortically-induced blindness, the early post-stroke period appears characterized by gradual-rather than sudden-loss of visual processing. Subacute training stops this degradation, and is far more efficient at eliciting recovery than identical training in the chronic period. Finally, spontaneous visual improvements in subacutes were restricted to luminance detection; discrimination abilities only recovered following deliberate training. Our findings suggest that after V1 damage, rather than waiting for vision to stabilize, early training interventions may be key to maximize the system's potential for recovery.
Asunto(s)
Ceguera Cortical/fisiopatología , Ceguera Cortical/rehabilitación , Rehabilitación de Accidente Cerebrovascular/métodos , Adulto , Anciano , Ceguera Cortical/etiología , Femenino , Lateralidad Funcional/fisiología , Humanos , Aprendizaje/fisiología , Masculino , Persona de Mediana Edad , Percepción de Movimiento/fisiología , Plasticidad Neuronal/fisiología , Lóbulo Occipital/patología , Accidente Cerebrovascular/complicaciones , Visión Ocular/fisiología , Corteza Visual/fisiopatología , Campos Visuales/fisiología , Percepción Visual/fisiologíaRESUMEN
Alcohol Use Disorder (AUD) is a chronic, relapsing disease that impacts almost a third of Americans. Despite effective treatments for attaining sobriety, the majority of patients relapse within a year, making relapse a substantial barrier to long-term treatment success. A major factor contributing to relapse is heightened negative affect that results from the combination of abstinence-related increases in stress-reactivity and decreases in reward sensitivity. Substantial research has contributed to the understanding of reward-related changes in AUD. However, less is known about anxiety during abstinence, a critical component of understanding addiction as anxiety during abstinence can trigger relapse. Most of what we know about abstinence-related negative affect comes from rodent studies which have identified key brain regions responsible for abstinence-related behaviors. This abstinence network is composed of brain regions that make up the extended amygdala: the nucleus accumbens (NAcc), the central nucleus of the amygdala (CeA), and the bed nucleus of the stria terminalis (BNST). More recently, emerging evidence from rodent and human studies suggests a fourth brain region, the anterior insula, might be part of the abstinence network. Here, we review current rodent and human literature on the extended amygdala's role in alcohol abstinence and anxiety, present evidence for the anterior insula's role in the abstinence network, and provide future directions for research to further elucidate the neural underpinnings of abstinence in humans. A better understanding of the abstinence network is critical toward understanding and possibly preventing relapse in AUD.
Asunto(s)
Abstinencia de Alcohol/psicología , Alcoholismo/patología , Ansiedad/patología , Conducta Adictiva/patología , Lóbulo Occipital/patología , Amígdala del Cerebelo/diagnóstico por imagen , Amígdala del Cerebelo/patología , Animales , Humanos , Lóbulo Occipital/diagnóstico por imagen , Recurrencia , Recompensa , RoedoresRESUMEN
The superficial anatomy of the occipital lobe has been described as irregular and highly complex. This notion mainly arises from the variability of the regional sulco-gyral architecture. Our aim was to investigate the prevalence, morphology, and correlative anatomy of the sulci and gyri of the occipital region in cadaveric specimens and to summarize the nomenclature used in the literature to describe these structures. To this end, 33 normal, adult, formalin-fixed hemispheres were studied. In addition, a review of the relevant literature was conducted with the aim to compare our findings with data from previous studies. Hence, in the lateral occipital surface, we recorded the lateral occipital sulcus and the intraoccipital sulcus in 100%, the anterior occipital sulcus in 24%, and the inferior occipital sulcus in 15% of cases. In the area of the occipital pole, we found the transverse occipital sulcus in 88% of cases, the lunate sulcus in 64%, the occipitopolar sulcus in 24%, and the retrocalcarine sulcus in 12% of specimens. In the medial occipital surface, the calcarine fissure and parieto-occipital sulcus were always present. Finally, the basal occipital surface was always indented by the posterior occipitotemporal and posterior collateral sulci. A sulcus not previously described in the literature was identified on the supero-lateral aspect of the occipital surface in 85% of cases. We named this sulcus "marginal occipital sulcus" after its specific topography. In this study, we offer a clear description of the occipital surface anatomy and further propose a standardized taxonomy for clinical and anatomical use.
Asunto(s)
Mapeo Encefálico/clasificación , Mapeo Encefálico/métodos , Lóbulo Occipital/anatomía & histología , Terminología como Asunto , Adulto , Anciano , Cadáver , Femenino , Humanos , Masculino , Persona de Mediana Edad , Lóbulo Occipital/patologíaRESUMEN
Intracranial meningiomas mostly affect patients in their fifth decade and beyond, raising pertinent questions regarding the risk of surgery, particularly in the elderly. Here, we describe the case of a septuagenarian patient with occipital meningioma causing severe visual field cuts that experienced full recovery of the visual function after a Simpson I resection of the lesion. This case illustrates the potential of recovery of the brain, even in the case of severely impaired function in elderly patients. To complete the picture, we review the literature on occipital meningiomas, advocating for systematic reports and increase data collection on post-operative neurological recovery in the elderly.
Asunto(s)
Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Lóbulo Occipital/cirugía , Campos Visuales , Anciano , Humanos , Masculino , Procedimientos Neuroquirúrgicos/métodos , Lóbulo Occipital/patologíaRESUMEN
BACKGROUND: Optical coherence tomography (OCT) gives the opportunity to examine retrograde degeneration of visual pathway damaged at various levels. OBJECTIVE: To estimate OCT data on retrograde degeneration of visual pathway damaged at various levels. MATERIAL AND METHODS: Ganglion cell layer (GCL) thickness was measured by OCT in 79 patients with visual pathway damaged at various levels and known duration of visual disturbances. Twenty-One patients were diagnosed with traumatic lesions of the optic nerves and/or chiasma. Fifty-eight patients had retro-genicular visual pathway damage. Thirty-three patients were examined for postoperative homonymous hemianopia after surgery for drug-resistant temporal lobe epilepsy. Twenty-five patients were diagnosed with occipital lobe damage following stroke (12 patients), surgery for arteriovenous malformation (11 patients) and traumatic brain injury (2 patients). All patients underwent assessment of visual acuity, automatic static perimetry, MRI/CT of the brain. Retinal ganglion cell complex was analyzed during OCT. RESULTS: GCL thinning following anterior visual pathway damage was detected in 20 out of 21 patients after ≥22 days. In case of post-genicular visual pathway damage, GCL thinning was found in 25 out of 58 patients (9 out of 33 ones after surgery for temporal lobe epilepsy and 16 out of 25 patients with occipital lobe lesion). After surgery for temporal lobe epilepsy, minimum period until GCL thinning detection after previous visual pathway damage was 3 months, in case of occipital lobe lesion - 5 months. CONCLUSION: Retrograde visual pathway degeneration is followed by GCL thinning and depends on the level of visual pathway lesion.
Asunto(s)
Degeneración Retrógrada , Vías Visuales , Humanos , Lóbulo Occipital/patología , Células Ganglionares de la Retina/patología , Degeneración Retrógrada/patología , Tomografía de Coherencia Óptica , Vías Visuales/diagnóstico por imagen , Vías Visuales/patologíaRESUMEN
Given the current lack of understanding of brain volume changes caused by HIV infection, this study aimed to longitudinally assess the changes in regional brain tissue volume following HIV infection and to explore its relationship with peripheral blood absolute CD4+ lymphocyte count (CD4+), the percentage of monocytes in plasma(MON%) and cerebrospinal fluid viral load (CFVL).Four adult male rhesus monkeys were examined in healthy status and following infection with simian immunodeficiency virus using high-resolution 3D T1-weighted sagittal whole brain magnetic resonance imaging. DPABI and SPM were used to process and record changes in brain tissue volume. Correlation analyses were then used to explore the above relationships. Compared with brain tissue volume during the healthy stage, there was no change at 12 and 24 weeks postinoculation (12 wpi, 24 wpi). At 36 wpi, 48 wpi, and 60 wpi, basal ganglia, left inferior temporal gyrus, left occipital gyrus, and left superior frontal gyrus exhibited varying degrees of atrophy. There was no association found between CD4+, MON%, CFVL, and brain volume loss in any brain region. Our research demonstrated that in the early stage of HIV infection, local brain tissue atrophy can be demonstrated by MRI technique; furthermore, MRI can identify the earliest site of atrophy as well as the most severely affected site. Although there was no significant correlation between brain tissue volume loss and CD4+, MON%, and CFVL, our findings provided some evidence in the application of volumetric MR imaging in the early diagnosis and treatment follow-up of patients with HIV infection.
Asunto(s)
Atrofia/patología , Ganglios Basales/patología , Lóbulo Occipital/patología , Corteza Prefrontal/patología , Síndrome de Inmunodeficiencia Adquirida del Simio/patología , Lóbulo Temporal/patología , Animales , Atrofia/líquido cefalorraquídeo , Atrofia/diagnóstico por imagen , Atrofia/inmunología , Ganglios Basales/diagnóstico por imagen , Ganglios Basales/inmunología , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/virología , Humanos , Estudios Longitudinales , Macaca mulatta , Imagen por Resonancia Magnética , Masculino , Monocitos/inmunología , Monocitos/virología , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Occipital/inmunología , Corteza Prefrontal/diagnóstico por imagen , Corteza Prefrontal/inmunología , Síndrome de Inmunodeficiencia Adquirida del Simio/líquido cefalorraquídeo , Síndrome de Inmunodeficiencia Adquirida del Simio/diagnóstico por imagen , Síndrome de Inmunodeficiencia Adquirida del Simio/inmunología , Virus de la Inmunodeficiencia de los Simios/crecimiento & desarrollo , Virus de la Inmunodeficiencia de los Simios/patogenicidad , Lóbulo Temporal/diagnóstico por imagen , Lóbulo Temporal/inmunología , Carga ViralRESUMEN
Background: White matter network alterations have increasingly been implicated in major depressive disorder, bipolar disorder and schizophrenia. The aim of this study was to identify shared and distinct white matter network alterations among the 3 disorders. Methods: We used analysis of covariance, with age and gender as covariates, to investigate white matter network alterations in 123 patients with schizophrenia, 123 with bipolar disorder, 124 with major depressive disorder and 209 healthy controls. Results: We found significant group differences in global network efficiency (F = 3.386, p = 0.018), nodal efficiency (F = 8.015, p < 0.001 corrected for false discovery rate [FDR]) and nodal degree (F = 5.971, pFDR < 0.001) in the left middle occipital gyrus, as well as nodal efficiency (F = 6.930, pFDR < 0.001) and nodal degree (F = 5.884, pFDR < 0.001) in the left postcentral gyrus. We found no significant alterations in patients with major depressive disorder. Post hoc analyses revealed that compared with healthy controls, patients in the schizophrenia and bipolar disorder groups showed decreased global network efficiency, nodal efficiency and nodal degree in the left middle occipital gyrus. Furthermore, patients in the schizophrenia group showed decreased nodal efficiency and nodal degree in the left postcentral gyrus compared with healthy controls. Limitations: Our findings could have been confounded in part by treatment differences. Conclusion: Our findings implicate graded white matter network alterations across the 3 disorders, enhancing our understanding of shared and distinct pathophysiological mechanisms across diagnoses and providing vital insights into neuroimaging-based methods for diagnosis and research.
Asunto(s)
Trastorno Bipolar/patología , Trastorno Depresivo Mayor/patología , Imagen de Difusión Tensora/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Red Nerviosa/patología , Lóbulo Occipital/patología , Esquizofrenia/patología , Corteza Somatosensorial/patología , Sustancia Blanca/patología , Adolescente , Adulto , Trastorno Bipolar/diagnóstico por imagen , Conectoma , Trastorno Depresivo Mayor/diagnóstico por imagen , Imagen Eco-Planar/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Red Nerviosa/diagnóstico por imagen , Lóbulo Occipital/diagnóstico por imagen , Esquizofrenia/diagnóstico por imagen , Corteza Somatosensorial/diagnóstico por imagen , Sustancia Blanca/diagnóstico por imagen , Adulto JovenRESUMEN
We report a patient with alexia with agraphia accompanied by letter-by-letter reading after hemorrhage in the left middle and inferior occipital gyri that spared the angular gyrus and the fusiform gyrus. Kanji (Japanese morphograms) and kana (Japanese phonetic writing) reading and writing tests revealed that alexia with agraphia was characterized by kana-predominant alexia and kanji-predominant agraphia. This type of "dorsal" letter-by-letter reading is discernable from conventional ventral type letter-by-letter reading that is observed in pure alexia in that (1) kinesthetic reading is less effective, (2) kana or literal agraphia coexists, and (3) fundamental visual discrimination is nearly normal.
Asunto(s)
Agrafia/fisiopatología , Hemorragia Cerebral/patología , Dislexia Adquirida/fisiopatología , Lóbulo Occipital/patología , Agrafia/etiología , Hemorragia Cerebral/complicaciones , Dislexia Adquirida/etiología , Humanos , Masculino , Persona de Mediana Edad , Reconocimiento Visual de Modelos/fisiología , PsicolingüísticaRESUMEN
A 63-year-old woman was referred for visuospatial difficulties. The clinical and neuropsychological examination in association with imaging and biomarkers led to a diagnosis of posterior cortical atrophy (PCA). The patient, an amateur watercolor artist, continued to paint throughout her disease and her paintings illustrate in an original way the progression of her disorders. At an advanced stage, the evolution of neurovisual disorders is difficult to evaluate in patients. While studies have shown changes in artistic style in neurodegenerative diseases, none of them concerned PCA. Artistic production enables a different approach to trying to understand the progression of disorders.
Asunto(s)
Arte , Enfermedades Neurodegenerativas , Lóbulo Occipital , Lóbulo Parietal , Desempeño Psicomotor/fisiología , Percepción Espacial/fisiología , Percepción Visual/fisiología , Progresión de la Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Enfermedades Neurodegenerativas/patología , Enfermedades Neurodegenerativas/fisiopatología , Lóbulo Occipital/patología , Lóbulo Occipital/fisiopatología , Lóbulo Parietal/fisiología , Lóbulo Parietal/fisiopatologíaRESUMEN
We assessed visuospatial abilities in PCA. Sequential display of two simple geometric figures enhanced detection and discrimination relative to simultaneous display (Exps 1 & 2). Comparing edges of a single object enhanced discrimination relative to comparing edges of two separate objects, consistent with object-based attention (Exp. 3). Recognition of complex line drawings was spared for a single object but disrupted by an attention-grabbing small circle (Exp. 4). A covert orienting task showed difficulty disengaging from previous locations and attentional bias toward the right visual field (Exp. 5). These findings shed light on the role of visual attention in perceptual awareness.
Asunto(s)
Atención/fisiología , Enfermedades Neurodegenerativas/patología , Enfermedades Neurodegenerativas/fisiopatología , Lóbulo Occipital/patología , Lóbulo Parietal/patología , Reconocimiento Visual de Modelos/fisiología , Trastornos de la Percepción/fisiopatología , Percepción Espacial/fisiología , Anciano , Atrofia/patología , Discriminación en Psicología/fisiología , Humanos , Masculino , Enfermedades Neurodegenerativas/complicaciones , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Parietal/diagnóstico por imagen , Trastornos de la Percepción/etiologíaRESUMEN
We report a patient with asymmetric Bálint's syndrome (predominantly right-sided oculomotor apraxia and simultanagnosia and optic ataxia for the right hemispace), and multimodal agnosia (apperceptive visual agnosia and bilateral associative tactile agnosia) with accompanying right hemianopia, bilateral agraphesthesia, hemispatial neglect, global alexia with unavailable kinesthetic reading, and lexical agraphia for kanji (Japanese morphograms), after hemorrhage in the left parieto-occipito-temporal area. The coexistence of tactile agnosia, bilateral agraphesthesia, and ineffective kinesthetic reading suggests that tactile-kinesthetic information can be interrupted because of damage to the fiber connection from the parietal lobe to the occipito-temporal area, leading to these tactually related cognitive impairments.
Asunto(s)
Apraxias/congénito , Ataxia , Hemorragia Cerebral , Síndrome de Cogan , Trastornos del Lenguaje , Trastornos de la Percepción , Anciano , Agnosia/etiología , Agnosia/patología , Agnosia/fisiopatología , Agrafia/etiología , Agrafia/patología , Agrafia/fisiopatología , Apraxias/etiología , Apraxias/patología , Apraxias/fisiopatología , Ataxia/etiología , Ataxia/patología , Ataxia/fisiopatología , Hemorragia Cerebral/complicaciones , Hemorragia Cerebral/patología , Hemorragia Cerebral/fisiopatología , Síndrome de Cogan/etiología , Síndrome de Cogan/patología , Síndrome de Cogan/fisiopatología , Dislexia/etiología , Dislexia/patología , Dislexia/fisiopatología , Humanos , Trastornos del Lenguaje/etiología , Trastornos del Lenguaje/patología , Trastornos del Lenguaje/fisiopatología , Imagen por Resonancia Magnética , Masculino , Lóbulo Occipital/patología , Lóbulo Parietal/patología , Trastornos de la Percepción/etiología , Trastornos de la Percepción/patología , Trastornos de la Percepción/fisiopatología , Síndrome , Lóbulo Temporal/patología , Percepción del Tacto/fisiología , Percepción Visual/fisiologíaRESUMEN
The concept of acute stress disorder (ASD) was introduced as a diagnostic entity to improve the identification of traumatized people who are likely to develop posttraumatic stress disorder (PTSD). Neuroanatomical models suggest that changes in the prefrontal cortex, amygdala, and hippocampus play a role in the development of PTSD. Using voxel-based morphometry, this study aimed to investigate the predictive power of gray matter volume (GMV) alterations for developing PTSD. The GMVs of ASD patients (n = 21) were compared to those of PTSD patients (n = 17) and healthy controls (n = 18) in whole-brain and region-of-interest analyses. The GMV alterations seen in ASD patients shortly after the traumatic event (T1) were also correlated with PTSD symptom severity and symptom clusters 4 weeks later (T2). Compared with healthy controls, the ASD patients had significantly reduced GMV in the left visual cortex shortly after the traumatic event (T1) and in the left occipital and prefrontal regions 4 weeks later (T2); no significant differences in GMV were seen between the ASD and PTSD patients. Furthermore, a significant negative association was found between the GMV reduction in the left lateral temporal regions seen after the traumatic event (T1) and PTSD hyperarousal symptoms 4 weeks later (T2). Neither amygdala nor hippocampus alterations were predictive for the development of PTSD. These data suggest that gray matter deficiencies in the left hemispheric occipital and temporal regions in ASD patients may predict a liability for developing PTSD.