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1.
Neuroimage ; 228: 117702, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33385558

RESUMEN

The development of the organization of the motor representation areas in children and adolescents is not well-known. This cross-sectional study aimed to provide an understanding for the development of the functional motor areas of the upper extremity muscles by studying healthy right-handed children (6-9 years, n = 10), preadolescents (10-12 years, n = 13), adolescents (15-17 years, n = 12), and adults (22-34 years, n = 12). The optimal representation site and resting motor threshold (rMT) for the abductor pollicis brevis (APB) were assessed in both hemispheres using navigated transcranial magnetic stimulation (nTMS). Motor mapping was performed at 110% of the rMT while recording the EMG of six upper limb muscles in the hand and forearm. The association between the motor map and manual dexterity (box and block test, BBT) was examined. The mapping was well-tolerated and feasible in all but the youngest participant whose rMT exceeded the maximum stimulator output. The centers-of-gravity (CoG) for individual muscles were scattered to the greatest extent in the group of preadolescents and centered and became more focused with age. In preadolescents, the CoGs in the left hemisphere were located more laterally, and they shifted medially with age. The proportion of hand compared to arm representation increased with age (p = 0.001); in the right hemisphere, this was associated with greater fine motor ability. Similarly, there was less overlap between hand and forearm muscles representations in children compared to adults (p<0.001). There was a posterior-anterior shift in the APB hotspot coordinate with age, and the APB coordinate in the left hemisphere exhibited a lateral to medial shift with age from adolescence to adulthood (p = 0.006). Our results contribute to the elucidation of the developmental course in the organization of the motor cortex and its associations with fine motor skills. It was shown that nTMS motor mapping in relaxed muscles is feasible in developmental studies in children older than seven years of age.


Asunto(s)
Mapeo Encefálico/métodos , Antebrazo/inervación , Mano/inervación , Corteza Motora/crecimiento & desarrollo , Músculo Esquelético/inervación , Adolescente , Adulto , Niño , Estudios Transversales , Potenciales Evocados Motores/fisiología , Femenino , Humanos , Masculino , Estimulación Magnética Transcraneal/métodos , Adulto Joven
2.
Hum Brain Mapp ; 40(8): 2320-2335, 2019 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-30648321

RESUMEN

The combination of transcranial magnetic stimulation with simultaneous electroencephalography (TMS-EEG) offers direct neurophysiological insight into excitability and connectivity within neural circuits. However, there have been few developmental TMS-EEG studies to date, and they all have focused on primary motor cortex stimulation. In the present study, we used navigated high-density TMS-EEG to investigate the maturation of the superior frontal cortex (dorsal premotor cortex [PMd]), which is involved in a broad range of motor and cognitive functions known to develop with age. We demonstrated that reactivity to frontal cortex TMS decreases with development. We also showed that although frontal cortex TMS elicits an equally complex TEP waveform in all age groups, the statistically significant between-group differences in the topography of the TMS-evoked peaks and differences in current density maps suggest changes in effective connectivity of the right PMd with maturation. More generally, our results indicate that direct study of the brain's excitability and effective connectivity via TMS-EEG co-registration can also be applied to pediatric populations outside the primary motor cortex, and may provide useful information for developmental studies and studies on developmental neuropsychiatric disorders.


Asunto(s)
Ondas Encefálicas/fisiología , Conectoma/métodos , Electroencefalografía/métodos , Lóbulo Frontal/fisiología , Desarrollo Humano/fisiología , Estimulación Magnética Transcraneal/métodos , Adolescente , Adulto , Niño , Femenino , Lóbulo Frontal/crecimiento & desarrollo , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Corteza Motora/fisiología , Adulto Joven
3.
Eur Radiol ; 29(10): 5717-5722, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30915565

RESUMEN

OBJECTIVES: The gold standard of postpartum anal sphincter imaging has been the 3D endoanal ultrasound (EAUS). Development of magnetic resonance imaging (MRI) has allowed anal sphincter evaluation without the use of endoanal coils. The aim of this study is to compare these two modalities in diagnosing residual sphincter lesions post obstetric anal sphincter injury (OASI). METHODS: Forty women were followed up after primary repair of OASI with both 3D EAUS and external phased array MRI. Details of the anal sphincter injury and sphincter musculature were gathered and analysed. RESULTS: There was a moderate interrater reliability (κ = 0.510) between the two imaging modalities in detecting sphincter lesions, with more lesions detected by MRI. There was a moderate intraclass correlation (ICC) between the circumference of the tear (κ = 0.506) and a fair ICC between the external anal sphincter thickness measurements at locations 3 and 9 on the proctologic clock face (κ = 0.320) and (κ = 0.336). CONCLUSIONS: The results of our study indicate that the use of external phased array MRI is feasible for detecting obstetric anal sphincter lesions postpartum. This allows for imaging of the sphincter defects in centres where EAUS imaging is not available. KEY POINTS: • A two centre prospective study that showed external phased array MRI to be a valid imaging modality for diagnosing obstetric anal sphincter injuries.


Asunto(s)
Canal Anal/diagnóstico por imagen , Canal Anal/lesiones , Parto Obstétrico/efectos adversos , Endosonografía/métodos , Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Adulto , Femenino , Humanos , Proyectos Piloto , Periodo Posparto , Embarazo , Estudios Prospectivos , Reproducibilidad de los Resultados , Rotura
4.
Brain Topogr ; 32(3): 504-518, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30949863

RESUMEN

Motor functions are frequently impaired in Asperger syndrome (AS). In this study, we examined the motor cortex structure and function using navigated transcranial magnetic stimulation (nTMS) and voxel-based morphometry (VBM) and correlated the results with the box and block test (BBT) of manual dexterity and physical activity in eight boys with AS, aged 8-11 years, and their matched controls. With nTMS, we found less focused cortical representation areas of distinct hand muscles in AS. There was hemispheric asymmetry in the motor maps, silent period duration and active MEP latency in the AS group, but not in controls. Exploratory VBM analysis revealed less gray matter in the left postcentral gyrus, especially in the face area, and less white matter in the precentral area in AS as compared to controls. On the contrary, in the right leg area, subjects with AS displayed an increased density of gray matter. The structural findings of the left hemisphere correlated negatively with BBT score in controls, whereas the structure of the right hemisphere in the AS group correlated positively with motor function as assessed by BBT. These preliminary functional (neurophysiological and behavioral) findings are indicative of asymmetry, and co-existing structural alterations may reflect the motor impairments causing the deteriorations in manual dexterity and other motor functions commonly encountered in children with AS.


Asunto(s)
Síndrome de Asperger/diagnóstico por imagen , Corteza Motora/diagnóstico por imagen , Síndrome de Asperger/fisiopatología , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Mapeo Encefálico/métodos , Niño , Potenciales Evocados Motores/fisiología , Ejercicio Físico , Cara , Lateralidad Funcional , Sustancia Gris/diagnóstico por imagen , Mano , Humanos , Imagen por Resonancia Magnética , Masculino , Corteza Motora/fisiopatología , Músculo Esquelético , Corteza Somatosensorial/diagnóstico por imagen , Corteza Somatosensorial/fisiopatología , Estimulación Magnética Transcraneal/métodos , Sustancia Blanca/diagnóstico por imagen
5.
Nord J Psychiatry ; 72(8): 586-592, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30348049

RESUMEN

BACKGROUND AND AIM: Prevention of the recurrence of major depression and its residual symptoms requires effective treatment. Our aim was to study the effects of bifrontal active rTMS controlled by sham rTMS in treatment-resistant unipolar major depressive disorder (MDD). METHODS: Thirty-seven patients with treatment-resistant MDD were randomized into two groups. One group received a total of 30 sessions of active bifrontal rTMS (10 Hz rTMS on left dorsolateral prefrontal cortex (DLPFC) and 1 Hz rTMS on right DLPFC) and the other group received bilateral sham rTMS on five days a week for six weeks. RESULTS: Depressive symptoms significantly improved in both the groups, but without a significant group difference. Furthermore, patients with psychotic depression improved similarly to those with moderate or severe depression. CONCLUSIONS: The results of present study indicate a large sham effect of stimulation treatment. The intensive structured treatment protocol may explain the positive outcome in both the groups. It is important to recognize, appreciate, and utilize placebo effects as a significant means of rehabilitation in psychiatric care.


Asunto(s)
Trastorno Depresivo Resistente al Tratamiento/terapia , Corteza Prefrontal/fisiopatología , Estimulación Magnética Transcraneal/métodos , Adulto , Trastorno Depresivo Resistente al Tratamiento/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
6.
Brain Topogr ; 30(1): 77-86, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27761665

RESUMEN

Associations between long-term physical activity and cortical function and brain structure are poorly known. Our aim was to assess whether brain functional and/or structural modulation associated with long-term physical activity is detectable using a discordant monozygotic male twin pair design. Nine monozygotic male twin pairs were carefully selected for an intrapair difference in their leisure-time physical activity of at least three years duration (mean age 34 ± 1 years). We registered somatosensory mismatch response (SMMR) in EEG to electrical stimulation of fingers and whole brain MR images. We obtained exercise history and measured physical fitness and body composition. Equivalent electrical dipole sources of SMMR as well as gray matter (GM) voxel counts in regions of interest indicated by source analysis were evaluated. SMMR dipolar source strengths differed between active and inactive twins within twin pairs in postcentral gyrus, medial frontal gyrus and superior temporal gyrus and in anterior cingulate (AC) GM voxel counts differed similarly. Compared to active twins, their inactive twin brothers showed greater dipole strengths in short periods of the deviant-elicited SMMR and larger AC GM voxel counts. Stronger activation in early unattended cortical processing of the deviant sensory signals in inactive co-twins may imply less effective gating of somatosensory information in inactive twins compared to their active brothers. Present findings indicate that already in 30's long-term physical activity pattern is linked with specific brain indices, both in functional and structural domains.


Asunto(s)
Ejercicio Físico/fisiología , Sustancia Gris/anatomía & histología , Corteza Somatosensorial/fisiología , Gemelos Monocigóticos , Adulto , Sustancia Gris/fisiología , Humanos , Imagen por Resonancia Magnética , Masculino , Tamaño de los Órganos/fisiología
7.
Dement Geriatr Cogn Disord ; 40(5-6): 243-55, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26305064

RESUMEN

BACKGROUND: Treatment of Alzheimer's disease (AD) with cholinesterase inhibitors (ChEI) enhances cholinergic activity and alleviates clinical symptoms. However, there is variation in the clinical response as well as system level changes revealed by functional MRI (fMRI) studies. METHODS: We investigated 18 newly diagnosed mild AD patients with fMRI using a face recognition task after a single oral dose of rivastigmine, a single dose of placebo and 1-month treatment with rivastigmine. The clinical follow-up took place at 6 and 12 months. RESULTS: MMSE score difference between baseline and the follow-ups showed a positive correlation with fMRI activation difference between treatment and placebo in the right prefrontal cortex. A negative correlation was found for the left prefrontal cortex and the left fusiform gyrus. In addition, greater signal intensity in the right versus the left fusiform gyrus predicted a response to ChEI with increasing MMSE scores during the follow-up with 77.8% sensitivity and 77.8% specificity. CONCLUSIONS: The increased fMRI activation by cholinergic stimulation in brain areas associated with the processing of the visual task reveals still functioning brain networks and a subsequent positive effect of ChEI on cognition. Thus, fMRI may be useful for identifying AD patients most likely to respond to treatment with ChEI.


Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Inhibidores de la Colinesterasa/uso terapéutico , Imagen por Resonancia Magnética , Rivastigmina/uso terapéutico , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/metabolismo , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Mapeo Encefálico , Inhibidores de la Colinesterasa/farmacología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Rivastigmina/farmacología
8.
Mov Disord ; 28(13): 1860-7, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23925991

RESUMEN

Unverricht-Lundborg disease is the most common form of progressive myoclonus epilepsies. In addition to generalized seizures, it is characterized by myoclonus, which usually is the most disabling feature of the disease. Classically, the myoclonus has been attributed to increased excitability of the primary motor cortex. However, inhibitory cortical phenomena have also been described along with anatomical alterations. We aimed to characterize the relationship between the excitability and anatomy of the motor cortex and their association with the severity of the clinical symptoms. Seventy genetically verified patients were compared with forty healthy controls. The symptoms were evaluated with the Unified Myoclonus Rating Scale. Navigated transcranial magnetic stimulation was applied to characterize the excitability of the primary motor cortex by determining the motor thresholds and cortical silent periods. In addition, the induced cortical electric fields were estimated using individual scalp-to-cortex distances measured from MRIs. A cortical thickness analysis was performed to elucidate possible disease-related anatomical alterations. The motor thresholds, cortical electric fields, and silent periods were significantly increased in the patients (P < 0.01). The silent periods correlated with the myoclonus scores (r = 0.48 to r = 0.49, P < 0.001). The scalp-to-cortex distance increased significantly with disease duration (r = 0.56, P < 0.001) and correlated inversely with cortical thickness. The results may reflect the refractory nature of the myoclonus and indicate a possible reactive cortical inhibitory mechanism to the underlying disease process. This is the largest clinical series on Unverricht-Lundborg disease and the first study describing parallel pathophysiological and structural alterations associated with the severity of the symptoms.


Asunto(s)
Potenciales Evocados Motores/fisiología , Corteza Motora/fisiopatología , Síndrome de Unverricht-Lundborg/patología , Adulto , Cistatina B/genética , Electromiografía , Potenciales Evocados Motores/genética , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Mutación/genética , Índice de Severidad de la Enfermedad , Estimulación Magnética Transcraneal , Síndrome de Unverricht-Lundborg/genética , Adulto Joven
9.
Br J Psychiatry ; 203(2): 152-3, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23908342

RESUMEN

The presence of cavum septum pellucidum (CSP) has been reported to be a neurodevelopmental marker of psychopathy. We scanned 26 violent offenders and 25 controls; 2 offenders and 2 controls had CSP (8% in both groups). Thus, the presence of CSP is not a common or a unique feature of antisocial personality disorder or psychopathy.


Asunto(s)
Trastorno de Personalidad Antisocial/patología , Criminales , Tabique Pelúcido/anomalías , Adulto , Humanos , Masculino
10.
Alcohol Clin Exp Res (Hoboken) ; 47(7): 1341-1351, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37526579

RESUMEN

BACKGROUND: Adolescence is a particularly vulnerable stage of development in terms of the deleterious effects of alcohol. Both lower gray matter (GM) volume and greater GABAergic activity have been associated with chronic alcohol consumption during adolescence. However, the association between these measures has not been investigated. METHODS: In this exploratory study, we compared 26 young adults with a 10year history of heavy alcohol consumption with 21 controls who used little or no alcohol. Simultaneous transcranial magnetic stimulation and electroencephalography were used to assess transcranial magnetic stimulation-evoked N45 potentials, reflecting a balance between GABAergic inhibition and N-methyl-D-aspartate (NMDA) receptor-mediated glutaminergic excitation in the brain. GM thickness was measured from magnetic resonance images and GM and N45 potentials were then correlated. RESULTS: Cortical thickness was significantly lower in several brain regions in the heavy-drinking group than the light-drinking group. The N45 amplitude was significantly larger frontally in the heavy-drinking group. Among heavy drinkers, there were several statistically significant correlations between thinner GM and larger frontal N45 amplitudes that were not detectable in the light-drinking group. The strongest correlations were detected in the frontal and parietal lobes, especially in the left superior frontal gyrus and the left supramarginal gyrus, and in both hemispheres in the superior parietal lobes. CONCLUSIONS: These findings show that a thinner cortex and greater inhibitory neurotransmission are correlated in certain brain regions among young, long-term heavy alcohol users. Studies are needed to explore the possible causal mechanisms underlying these effects.

11.
Neuroradiology ; 54(4): 393-405, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21932015

RESUMEN

INTRODUCTION: The purpose of this study is to establish the most suitable combination of functional magnetic resonance imaging (fMRI) language tasks for clinical use in determining language dominance and to define the variability in laterality index (LI) and activation power between different combinations of language tasks. METHODS: Activation patterns of different fMRI analyses of five language tasks (word generation, responsive naming, letter task, sentence comprehension, and word pair) were defined for 20 healthy volunteers (16 right-handed). LIs and sums of T values were calculated for each task separately and for four combinations of tasks in predefined regions of interest. Variability in terms of activation power and lateralization was defined in each analysis. In addition, the visual assessment of lateralization of language functions based on the individual fMRI activation maps was conducted by an experienced neuroradiologist. RESULTS: A combination analysis of word generation, responsive naming, and sentence comprehension was the most suitable in terms of activation power, robustness to detect essential language areas, and scanning time. In general, combination analyses of the tasks provided higher overall activation levels than single tasks and reduced the number of outlier voxels disturbing the calculation of LI. CONCLUSIONS: A combination of auditory and visually presented tasks that activate different aspects of language functions with sufficient activation power may be a useful task battery for determining language dominance in patients.


Asunto(s)
Mapeo Encefálico/métodos , Lateralidad Funcional/fisiología , Lenguaje , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Persona de Mediana Edad , Programas Informáticos , Análisis y Desempeño de Tareas
12.
Eur J Neurosci ; 34(2): 320-30, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21692882

RESUMEN

Medial temporal lobe (MTL) atrophy and posteromedial cortical hypometabolism are consistent imaging findings in Alzheimer's disease (AD). As the MTL memory structures are affected early in the course of AD by neurofibrillary tangle pathology, the posteromedial metabolic abnormalities have been postulated to represent remote effects of MTL alterations. In this study, we investigated with functional MRI (fMRI) the structure-function relationship between the MTL and posteromedial regions, including the retrosplenial, posterior cingulate and precuneal cortices, in 21 older controls (OCs), 18 subjects with amnestic mild cognitive impairment (MCI) and 16 AD patients during a word list learning task. In the voxel-based morphometric and volumetric analyses, the MCI subjects showed smaller entorhinal volume than OCs (P = 0.0001), whereas there was no difference in the hippocampal or posteromedial volume. AD patients, as compared with MCI patients, showed pronounced loss of volume in the entorhinal (P = 0.0001), hippocampal (P = 0.01) and posteromedial (P = 0.001) regions. The normal pattern of posteromedial fMRI task-induced deactivation during active encoding of words was observed bilaterally in the OCs, but only in restricted unilateral left posteromedial areas in the MCI and AD patients. Across all subjects, more extensive impairment of the retrosplenial and posterior cingulate function was significantly related to smaller entorhinal (P = 0.001) and hippocampal (P = 0.0002) volume. These findings demonstrate that entorhinal atrophy and posteromedial cortical dysfunction are early characteristics of prodromal AD, and precede and/or overwhelm atrophy of the hippocampus and posteromedial cortices. Disturbances in posteromedial cortical function are associated with morphological changes in the MTL across the continuum from normal aging to clinical AD.


Asunto(s)
Enfermedad de Alzheimer/patología , Enfermedad de Alzheimer/fisiopatología , Lóbulo Temporal/anatomía & histología , Lóbulo Temporal/patología , Lóbulo Temporal/fisiopatología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Lóbulo Temporal/fisiología
13.
NMR Biomed ; 24(2): 209-15, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20949638

RESUMEN

The aim of this study was to explain the temporal variations between subjects in the blood oxygenation level-dependent (BOLD) response. Somatosensory responses were elicited with the electrical forepaw stimulus at a frequency of 10 Hz in urethane-anesthetized rats, and functional magnetic resonance imaging (fMRI) with BOLD contrast and local field potential (LFP) measurements were performed simultaneously. BOLD fMRI activation was evaluated by two different models, one based on the stimulus paradigm (the block model) and the other on the simultaneously measured evoked LFP responses. In the initial analysis, the LFP model captured the BOLD activation in the primary somatosensory cortex in all cases, and the block model in 10 of 12 rats. A statistical comparison of the two models revealed that the LFP-derived model was able to explain additional BOLD variation over the block model in the somatosensory cortex in nine of 12 rats. These results suggest that there is more information regarding neuronal activity in the BOLD signal than can be exploited using the block model alone. Furthermore, the hemodynamic coupling remains unchanged in the case of temporally variable BOLD signals.


Asunto(s)
Potenciales Evocados Somatosensoriales/fisiología , Oxígeno/sangre , Corteza Somatosensorial/fisiología , Animales , Estimulación Eléctrica , Masculino , Ratas , Ratas Wistar , Factores de Tiempo
14.
Hum Brain Mapp ; 31(8): 1272-80, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20082330

RESUMEN

Navigated transcranial magnetic stimulation (TMS) can be used to stimulate functional cortical areas at precise anatomical location to induce measurable responses. The stimulation has commonly been focused on anatomically predefined motor areas: TMS of that area elicits a measurable muscle response, the motor evoked potential. In clinical pathologies, however, the well-known homunculus somatotopy theory may not be straightforward, and the representation area of the muscle is not fixed. Traditionally, the anatomical locations of TMS stimulations have not been reported at the group level in standard space. This study describes a methodology for group-level analysis by investigating the normal representation areas of thenar and anterior tibial muscle in the primary motor cortex. The optimal representation area for these muscles was mapped in 59 healthy right-handed subjects using navigated TMS. The coordinates of the optimal stimulation sites were then normalized into standard space to determine the representation areas of these muscles at the group-level in healthy subjects. Furthermore, 95% confidence interval ellipsoids were fitted into the optimal stimulation site clusters to define the variation between subjects in optimal stimulation sites. The variation was found to be highest in the anteroposterior direction along the superior margin of the precentral gyrus. These results provide important normative information for clinical studies assessing changes in the functional cortical areas because of plasticity of the brain. Furthermore, it is proposed that the presented methodology to study TMS locations at the group level on standard space will be a suitable tool for research purposes in population studies.


Asunto(s)
Mapeo Encefálico , Potenciales Evocados Motores/fisiología , Corteza Motora/fisiología , Músculo Esquelético/inervación , Estimulación Magnética Transcraneal , Adulto , Factores de Edad , Anciano , Estimulación Eléctrica/métodos , Femenino , Lateralidad Funcional/fisiología , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Estimulación Magnética Transcraneal/métodos , Adulto Joven
15.
Neuroimage ; 44(3): 790-5, 2009 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-18976714

RESUMEN

Transcranial magnetic stimulation (TMS) can be used for non-invasive assessment of cortical physiology and descending motor pathways. However, the focus/exact site of cortical activation is considerably widespread in traditional TMS. When combined with MRI-based navigation, it allows specific anatomical areas of the cortex to be stimulated. The peripheral muscle responses to TMS are commonly measured as motor evoked potentials (MEPs). We compared the accuracy of cortical mapping, as well as the congruity of the motor thresholds (MT) and MEPs between navigated and non-navigated TMS procedures. Eight volunteers were studied in two sessions. In each session both hemispheres were stimulated with and without navigation. Non-navigated TMS: Both hemispheres were mapped without navigation to find the representation area of the thenar muscles based on induced MEP amplitudes. MT was then determined at the optimum coil location. Navigated TMS: Individual MR-images were used for the on-line navigation procedure. The cortical representation area of the thenar musculature was mapped at the "hand knob". The optimum stimulus target was used for MT determination. The order of these two procedures was randomized. Following the MT determination, MEPs were recorded from 20 consecutive stimuli. The MTs were similar from session-to-session with no inter-hemispheric differences, and with and without navigation. The stimulus location was more spatially discrete in navigated TMS producing more stable MEPs with significantly higher amplitudes and shorter latencies. In summary, MEPs exhibit significant differences depending on whether navigation is used. However, the MTs are not significantly dependent on the discrete stimulation site.


Asunto(s)
Algoritmos , Mapeo Encefálico/métodos , Umbral Diferencial/fisiología , Potenciales Evocados/fisiología , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Corteza Motora/anatomía & histología , Corteza Motora/fisiología , Estimulación Magnética Transcraneal/métodos , Adulto , Femenino , Humanos , Aumento de la Imagen/métodos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
16.
Hippocampus ; 19(2): 166-75, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18777563

RESUMEN

We investigated structural and functional changes in the medial temporal lobe (MTL) using magnetic resonance imaging (MRI) and compared the discriminative power of these measures with neuropsychological testing in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Functional MRI (fMRI) was performed in 21 elderly controls, 14 MCI subjects, and 15 mild AD patients during encoding and cued retrieval of word-picture pairs. A region-of-interest-based approach in SPM2 was used to extract the extent of hippocampal activation. The volumes of the hippocampus and entorhinal cortex (EC) were manually outlined from anatomical MR images. Discriminant analyses were conducted to assess the ability of hippocampal fMRI, MTL volumetry, and neuropsychological measures to classify subjects into clinical groups. Entorhinal but not hippocampal volumes differed significantly between the control and MCI subjects. Both entorhinal and hippocampal volumes differed between MCI and AD patients. There were no significant differences in the extent of hippocampal fMRI activation during encoding or retrieval between the groups. Entorhinal volume was the best discriminator with a discriminating accuracy of 85.7% between controls and MCI, 86.2% between MCI and AD, and 97.2% between controls and AD. Delayed recall of a wordlist classified the subjects, second best, with a discriminating accuracy of 81.8% between controls and MCI, 75% between MCI and AD and 93.5% between controls and AD. The accuracy of hippocampal volumetry ranged from 42.9 to 69.4%, and hippocampal fMRI activation during encoding and retrieval had a classification accuracy of only 41.4-57.7% between the groups. Our results suggest that evaluation of entorhinal atrophy, in addition to the prevailing diagnostic criteria, seems promising in the identification of prodromal AD. Future technical improvements may improve the utilization of hippocampal fMRI for early diagnostic purposes.


Asunto(s)
Enfermedad de Alzheimer/fisiopatología , Trastornos del Conocimiento/fisiopatología , Corteza Entorrinal/fisiopatología , Hipocampo/fisiopatología , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/patología , Trastornos del Conocimiento/patología , Corteza Entorrinal/patología , Femenino , Hipocampo/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Recuerdo Mental/fisiología , Pruebas Neuropsicológicas
17.
Dement Geriatr Cogn Disord ; 28(5): 404-12, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19907176

RESUMEN

BACKGROUND/AIMS: Mild cognitive impairment (MCI) is associated with an increased risk of Alzheimer's disease (AD). It would be advantageous to be able to distinguish the characteristics of those MCI patients with a high probability to progress to AD if one wishes to monitor the disease development and treatment. METHODS: We assessed the baseline MRI and maximum of 7 years clinical follow-up data of 60 MCI subjects in order to examine differences in cortical thickness (CTH) between the progressive MCI (P-MCI) and stable MCI (S-MCI) subjects. CTH was measured using an automatic computational surface-based method. During the follow-up, 15 MCI subjects converted to AD on average 1.9 +/- 1.3 years after the baseline examination, while 45 MCI subjects remained stable. RESULTS: The P-MCI group displayed significantly reduced CTH bilaterally in the superior and middle frontal, superior, middle and inferior temporal, fusiform and parahippocampal regions as well as the cingulate and retrosplenial cortices and also in the right precuneal and paracentral regions compared to S-MCI subjects. CONCLUSIONS: Analysis of CTH could be used in conjunction with neuropsychological testing to identify those subjects with imminent conversion from MCI to AD several years before dementia diagnosis.


Asunto(s)
Enfermedad de Alzheimer/patología , Corteza Cerebral/patología , Trastornos del Conocimiento/patología , Imagen por Resonancia Magnética/métodos , Índice de Severidad de la Enfermedad , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/epidemiología , Trastornos del Conocimiento/epidemiología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo
18.
Neuroradiology ; 51(11): 711-22, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19568738

RESUMEN

INTRODUCTION: Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. METHODS: Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. RESULTS: The comparisons between controls and either all patients (n = 37) or the subgroup of surgically treated patients (n = 17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. CONCLUSION: Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms.


Asunto(s)
Encéfalo/patología , Trastornos del Conocimiento/patología , Aneurisma Intracraneal/patología , Hemorragia Subaracnoidea/patología , Enfermedad Aguda , Atrofia , Encéfalo/cirugía , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/terapia , Femenino , Estudios de Seguimiento , Humanos , Procesamiento de Imagen Asistido por Computador , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/terapia , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Fibras Nerviosas Amielínicas/patología , Pruebas Neuropsicológicas , Estudios Prospectivos , Hemorragia Subaracnoidea/etiología , Hemorragia Subaracnoidea/terapia , Resultado del Tratamiento
19.
J Phys Act Health ; 16(8): 637­643, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-31310988

RESUMEN

BACKGROUND: Physical activity (PA) is said to be beneficial to many bodily functions. However, the effects of PA in the brain are still inadequately known. The authors aimed to uncover possible brain modulation linked with PA. Here, they combine 4 of their studies with monozygotic twins, who were within-pair discordant in PA for a minimum of 1 year. METHODS: The authors performed brain imaging, brain electrophysiology, and cardiovascular and body composition assessments, and collected questionnaire-based data. The present synopsis elucidates the differences associated with differing PA history in conditions without genetic variability. They present new structural and electrophysiological results. Participants, healthy, 45 male monozygotic twins (mean age 34.5 [1.5] y) differed in aerobic capacity and fat percentage (P < .001). RESULTS: More active co-twins showed larger gray matter volumes in striatal, prefrontal, and hippocampal regions, and smaller gray matter volumes in the anterior cingulate area than less active co-twins. Functionally, visual and somatosensory automatic change detection processes differed between more and less active co-twins. CONCLUSIONS: In monozygotic twins, who differed in their PA history, differences were observed in identifiable anatomic brain locations involved with motor control and memory functions, as well as in electrophysiological measures detecting brain's automatic processes. Better aerobic capacity may modify brain morphology and sensory function.


Asunto(s)
Encéfalo/anatomía & histología , Ejercicio Físico/fisiología , Adulto , Encéfalo/fisiopatología , Voluntarios Sanos , Humanos , Masculino , Adulto Joven
20.
Alcohol ; 75: 89-97, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30513444

RESUMEN

Our aim was to analyze metabolite profile changes in serum associated with moderate-to-heavy consumption of alcohol in young adults and to evaluate whether these changes are connected to reduced brain gray matter volumes. These study population consisted of young adults with a 10-year history of moderate-to-heavy alcohol consumption (n = 35) and light-drinking controls (n = 27). We used the targeted liquid chromatography mass spectrometry method to measure concentrations of metabolites in serum, and 3.0 T magnetic resonance imaging to assess brain gray matter volumes. Alterations in amino acid and energy metabolism were observed in the moderate-to-heavy drinking young adults when compared to the controls. After correction for multiple testing, the group of moderate-to-heavy drinking young adults had increased serum concentrations of 1-methylhistamine (p = 0.001, d = 0.82) when compared to the controls. Furthermore, concentrations of 1-methylhistamine (r = -0.48, p = 0.004) and creatine (r = -0.52, p = 0.001) were negatively correlated with the brain gray matter volumes in the females. Overall, our results show association between moderate-to-heavy use of alcohol and altered metabolite profile in young adults as well as suggesting that some of these changes could be associated with the reduced brain gray matter volume.


Asunto(s)
Consumo de Bebidas Alcohólicas/sangre , Consumo de Bebidas Alcohólicas/tendencias , Corteza Cerebral/metabolismo , Sustancia Gris/metabolismo , Metabolómica/tendencias , Adolescente , Consumo de Bebidas Alcohólicas/patología , Biomarcadores/sangre , Corteza Cerebral/diagnóstico por imagen , Estudios de Cohortes , Femenino , Sustancia Gris/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética/tendencias , Masculino , Tamaño de los Órganos/fisiología , Distribución Aleatoria , Encuestas y Cuestionarios , Adulto Joven
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