RESUMEN
Understanding others' intentions requires both the identification of social cues (e.g., emotional facial expressions, gaze direction) and the attribution of a mental state to another. The neural substrates of these processes have often been studied separately, and results are heterogeneous, in part attributable to the variety of paradigms used. The aim of the present study was to explore the neural regions underlying these sociocognitive processes, using a novel naturalistic task in which participants engage with human protagonists featured in videos. A total of 51 right-handed volunteers underwent functional magnetic resonance imaging while performing the Dynamic Inference Task (DIT), manipulating the degree of inference (high vs. low), the presence of emotion (emotional vs. nonemotional), and gaze direction (direct vs. averted). High nonemotional inference elicited neural activation in temporal regions encompassing the right posterior superior temporal sulcus. The presence (vs. absence) of emotion in the high-inference condition elicited a bilateral pattern of activation in internal temporal areas around the amygdala and orbitofrontal structures, as well as activation in the right dorsomedial part of the superior frontal gyrus and the left precuneus. On account of its dynamic, naturalistic approach, the DIT seems a suitable task for exploring social interactions and the way we interact with others, both in nonclinical and clinical populations.
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Encéfalo/fisiología , Mentalización/fisiología , Cognición Social , Adulto , Mapeo Encefálico , Señales (Psicología) , Emociones/fisiología , Empatía , Expresión Facial , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Percepción Social , Teoría de la Mente/fisiología , Adulto JovenRESUMEN
AIMS: Emotional processing is a crucial ability in human and impairments in the processing of emotions are considered as transdiagnostic processes in psychopathology. In alcohol use disorder, numerous studies have investigated emotional processing and showed emotional deficits related to the perpetuation of alcohol use. Recent studies have also explored this topic in binge drinking, but few studies are available. In this paper, we explored whether emotional difficulties in binge drinking may be extended to implicit emotion processing. METHODS: We compared 39 binge drinkers (BD) and 40 non-binge drinkers who performed a gender categorization task while faces represented emotional expressions of anger, fear, happiness and sadness. Emotional brain responses were assessed thanks to functional magnetic resonance imaging. Emotional versus non-emotional conditions were first contrasted in the whole sample and groups were then compared. RESULTS: Emotional condition led to differential activations than non-emotional condition, supporting the validity of the paradigm. Regarding group comparisons, BD exhibited higher activations in the left posterior cerebellum (anger processing) and the right anterior cingulate (fear processing) as well as lower activations in the left insula (happiness), the right post-central gyrus, the right cingulate gyrus and the right medial frontal gyrus (sadness processing). CONCLUSIONS: Beyond emotional identification, BD presented differential brain responses following the implicit processing of emotions. Emotional difficulties in binge drinking might be related to a more automatic/unconscious processing of emotions.
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Consumo Excesivo de Bebidas Alcohólicas/psicología , Emociones/fisiología , Expresión Facial , Adulto , Cerebelo/fisiología , Miedo , Femenino , Giro del Cíngulo/fisiología , Felicidad , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Corteza Prefrontal/fisiología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND AND PURPOSE: Data about non-invasive follow-up of aneurysm after stent-assisted coiling is scarce. We aimed to compare time-of-flight (TOF) magnetic resonance angiography (MRA) (3D-TOF-MRA) and contrast-enhanced MRA (CE-MRA) at 3-Tesla, with digital subtraction angiography (DSA) for evaluating aneurysm occlusion and parent artery patency after stent-assisted coiling. MATERIALS AND METHODS: In this retrospective single-center study, patients were included if they had an intracranial aneurysm treated by stent-assisted coiling between March 2008 and June 2015, followed with both MRA sequences (3D-TOF-MRA and CE-MRA) at 3-Tesla and DSA, performed in an interval<48hours. RESULTS: Thirty-five aneurysms were included. Regarding aneurysm occlusion evaluation, agreement with DSA was better for CE-MRA (K=0.53) than 3D-TOF-MRA (K=0.28). Diagnostic accuracies for aneurysm remnant depiction were similar for 3D-TOF-MRA and CE-MRA (P=1). Both 3D-TOF-MRA (K=0.05) and CE-MRA (K=-0.04) were unable to detect pathological vessel compared to DSA, without difference in accuracy (P=0.68). For parent artery occlusion detection, agreement with DSA was substantial for 3D-TOF-MRA (K=0.64) and moderate for CE-MRA (K=0.45), with similar good diagnostic accuracies (P=1). CONCLUSION: After stent-assisted coiling treatment, 3D-TOF-MRA and CE-MRA demonstrated good accuracy to detect aneurysm remnant (but tended to overestimation). Although CE-MRA agreement with DSA was better, there was no statistical difference between 3D-TOF-MRA and CE-MRA accuracies. Both MRAs were unable to provide a precise evaluation of in-stent status but could detect parent vessel occlusion.
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Angiografía de Substracción Digital/métodos , Embolización Terapéutica , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/terapia , Angiografía por Resonancia Magnética/métodos , Anciano , Medios de Contraste , Femenino , Estudios de Seguimiento , Humanos , Imagenología Tridimensional , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Estudios Retrospectivos , Sensibilidad y Especificidad , Stents , Resultado del TratamientoRESUMEN
Hypomanic personality traits are present in the general population and represent a risk factor for developing bipolar disorder. This personality style, notably its social component, is linked to difficulties in theory of mind (i.e., ability to infer mental states). Exploring the neural correlates of mental states' inference in individuals with these personality traits can provide meaningful insights into the development of bipolar disorder. The aim of the present study was therefore to investigate the potential impact of hypomanic traits on brain activation and task-based connectivity strength during a dynamic theory of mind task in a nonclinical population. A total of 52 nonclinical participants were recruited, and hypomanic traits were assessed with the Hypomanic Personality Scale. The severity of hypomanic traits was positively associated with right middle and inferior frontal gyri activations (in high vs. low inference in nonemotional condition and emotion vs. no emotion in high inference, respectively). It was also associated with stronger connectivity between the salience network (i.e., bilateral putamen and pallidum) and bilateral superior temporal gyri (high inference in nonemotional condition), and between cerebellar and temporal areas (high inference in emotional condition). These changes may either reflect adaptations or differential processing, and further studies are therefore mandatory.
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Trastorno Bipolar , Encéfalo , Humanos , Emociones/fisiología , Personalidad/fisiología , Trastorno CiclotímicoRESUMEN
BACKGROUND: Magnetic resonance angiography (MRA) has been evaluated for the detection of unruptured intracranial aneurysms with favorable results at 3 Tesla (3T) and with similar diagnostic accuracy as both 3D time-of-flight (3D-TOF) and contrast-enhanced (CE-MRA) MRA. However, the diagnostic value and place of MRA in the detection of ruptured aneurysms has been little evaluated. Thus, the goal of this prospective single-center series was to assess the feasibility and diagnostic value of 3T 3D-TOF MRA and CE-MRA for aneurysm detection in acute non-traumatic subarachnoid hemorrhage (SAH). METHODS: From March 2006 to December 2007, all consecutive patients admitted to our hospital with acute non-traumatic SAH (≤10 days) were prospectively included in this study evaluating MRA in the diagnostic workup of SAH. Feasibility of MRA and sensitivity/specificity of 3D-TOF and CE-MRA were assessed compared with gold standard DSA. RESULTS: In all, 84 consecutive patients (45 women, 39 men; age 23-86 years) were included. The feasibility of MRA was low (43/84, 51.2%). The reasons given for patients not undergoing magnetic resonance imaging (MRI) examination were clinical status (27 patients), potential delay in aneurysm treatment (11 patients) and contraindications to MRI (three patients). In patients explored by MRA, the sensitivity of CE-MRA (95%) was higher compared with 3D-TOF (86%) with similar specificity (80%). Also, 3D-TOF missed five aneurysms while CE-MRA missed two. CONCLUSION: The value of MRA in the diagnostic workup of ruptured aneurysms is limited due to its low feasibility during the acute phase of bleeding. Sensitivity for aneurysm detection was good for both MRA techniques, but tended to be better with CE-MRA.
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Aneurisma Intracraneal/diagnóstico , Hemorragia Subaracnoidea/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Aneurisma Intracraneal/complicaciones , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sensibilidad y Especificidad , Hemorragia Subaracnoidea/complicacionesRESUMEN
Schizophrenia, a severe psychiatric disorder, is associated with abnormal brain activation during theory of mind (ToM) processing. Researchers recently suggested that there is a continuum running from subclinical schizotypal personality traits to fully expressed schizophrenia symptoms. Nevertheless, it remains unclear whether schizotypal personality traits in a nonclinical population are associated with atypical brain activation during ToM tasks. Our aim was to investigate correlations between fMRI brain activation during affective ToM (ToMA) and cognitive ToM (ToMC) tasks and scores on the Schizotypal Personality Questionnaire (SPQ) and the Basic Empathy Scale in 39 healthy individuals. The total SPQ score positively correlated with brain activation during ToMA processing in clusters extending from the left medial temporal gyrus (MTG), lingual gyrus and fusiform gyrus to the parahippocampal gyrus (Brodmann area: 19). During ToMA processing, the right inferior occipital gyrus, right MTG, precuneus and posterior cingulate cortex negatively correlated with the emotional disconnection subscore and the total score of self-reported empathy. These posterior brain regions are known to be involved in memory and language, as well as in creative reasoning, in nonclinical individuals. Our findings highlight changes in brain processing associated with trait schizotypy in nonclinical individuals during ToMA but not ToMC processing.
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Esquizofrenia , Trastorno de la Personalidad Esquizotípica , Teoría de la Mente , Humanos , Trastorno de la Personalidad Esquizotípica/diagnóstico por imagen , Trastorno de la Personalidad Esquizotípica/psicología , Teoría de la Mente/fisiología , Encéfalo/diagnóstico por imagen , Lóbulo Temporal , Imagen por Resonancia MagnéticaRESUMEN
BACKGROUND: Longitudinal measures of structural brain changes using MRI in relation to clinical features and progression patterns in PD have been assessed in previous studies, but few were conducted in well-defined and large cohorts, including prospective clinical assessments of both motor and non-motor symptoms. OBJECTIVE: We aimed to identify brain volumetric changes characterizing PD patients, and determine whether regional brain volumetric characteristics at baseline can predict motor, psycho-behavioral and cognitive evolution at one year in a prospective cohort of PD patients. METHODS: In this multicentric 1 year longitudinal study, PD patients and healthy controls from the MPI-R2* cohort were assessed for demographical, clinical and brain volumetric characteristics. Distinct subgroups of PD patients according to motor, cognitive and psycho-behavioral evolution were identified at the end of follow-up. RESULTS: One hundred and fifty PD patients and 73 control subjects were included in our analysis. Over one year, there was no significant difference in volume variations between PD and control subjects, regardless of the brain region considered. However, we observed a reduction in posterior cingulate cortex volume at baseline in PD patients with motor deterioration at one year (p = 0.017). We also observed a bilateral reduction of the volume of the amygdala (p = 0.015 and p = 0.041) and hippocampus (p = 0.015 and p = 0.053) at baseline in patients with psycho-behavioral deterioration, regardless of age, dopaminergic treatment and center. CONCLUSION: Brain volumetric characteristics at baseline may predict clinical trajectories at 1 year in PD as posterior cingulate cortex atrophy was associated with motor decline, while amygdala and hippocampus atrophy were associated with psycho-behavioral decline.
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Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Estudios Longitudinales , Estudios Prospectivos , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Atrofia/patologíaRESUMEN
BACKGROUND: Autobiographical memory retrieval is impaired in schizophrenia. AIMS: To determine the neural basis of this impairment. METHOD: Thirteen patients with schizophrenia and 14 healthy controls performed an autobiographical memory retrieval task based on cue words during functional magnetic resonance imaging. Patients were selected on the basis of their ability to perform the task and all participants received training. RESULTS: Although patients and controls activated a similar brain network during autobiographical memory retrieval, patients displayed decreased activation in several of these regions, including the anterior cingulate cortex, left lateral prefrontal cortex, right cerebellum and ventral tegmental area (k≥10, P<0.001, uncorrected). In addition, activation of the caudate nuclei was negatively correlated with retrieval performance in controls but positively correlated with performance in patients. CONCLUSIONS: The autobiographical memory retrieval brain network is impaired in schizophrenia. Patients with schizophrenia display decreased activation of the cognitive control network during retrieval, possibly due to aberrant functioning of the dorsal striatum.
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Encefalopatías/psicología , Encéfalo/fisiopatología , Memoria Episódica , Esquizofrenia Paranoide/psicología , Psicología del Esquizofrénico , Adulto , Encefalopatías/fisiopatología , Estudios de Casos y Controles , Humanos , Imagen por Resonancia Magnética , Masculino , Procesos Mentales/fisiología , Recuerdo Mental , Pruebas Psicológicas , Esquizofrenia Paranoide/fisiopatologíaRESUMEN
OBJECTIVES: To compare 3D-TOF magnetic resonance angiography (MRA) and contrast-enhanced MRA (CE-MRA) sequences at 3T in the follow-up of coiled aneurysms with digital subtracted angiography (DSA) as the gold standard. METHODS: DSA, 3D-TOF and CE-MRA were performed in a prospective series of 126 aneurysms in 96 patients (57 female, 39 male; age: 25-75 years, mean: 51.3 ± 11.3 years). The quality of aneurysm occlusion was assessed independently and anonymously by a core laboratory. RESULTS: Using DSA (gold standard technique), total occlusion was depicted in 57 aneurysms (45.2%), neck remnant in 34 aneurysms (27.0%) and aneurysm remnant in 35 aneurysms (27.8%). Sensitivity, specificity, positive predictive value and negative predictive value were very similar with 3D-TOF and CE-MRA. Visibility of coils was much better with 3D-TOF (95.2%) than with CE-MRA (23.0%) (P < 0.001). Also, substantial artefacts were less frequent with 3D-TOF (4.0%) than with CE-MRA (11.9%; P = 0.012). CONCLUSIONS: In this large prospective series of patients with coiled aneurysms, at 3T 3D-TOF MRA was equivalent to CE-MRA for the evaluation of aneurysm occlusion, but coil visibility was superior at 3D-TOF. Thus the use of 3D-TOF at 3T is recommended for the follow-up of coiled intracranial aneurysms. KEY POINTS: ⢠Different Magnetic Resonance (MR) imaging techniques are used to evaluate intracranial aneurysms. ⢠At 3T MR, 3D-TOF and CE-MRA appear equivalent for evaluating coiled aneurysms.. ⢠Coils are better visualised on 3D-TOF than on CE-MRA. ⢠Combined analysis of 3D-TOF and CE-MRA does not seem helpful. ⢠At 3T, 3D-TOF techniques are recommended for monitoring patients with coiled aneurysms.
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Aneurisma Intracraneal/diagnóstico , Aneurisma Intracraneal/terapia , Angiografía por Resonancia Magnética , Adulto , Anciano , Medios de Contraste , Femenino , Estudios de Seguimiento , Humanos , Angiografía por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Prótesis e ImplantesRESUMEN
Do not tumble dry: Gadolinium-DOTA encapsulated into polysaccharide nanoparticles (GdDOTA NPs) exhibited high relaxivity (r(1) =101.7 s(-1) mM(-1) per Gd(3+) ion at 37 °C and 20 MHz). This high relaxation rate is due to efficient Gd loading, reduced tumbling of the Gd complex, and the hydrogel nature of the nanoparticles. The efficacy of the nanoparticles as a T(1)/T(2) dual-mode contrast agent was studied in C6 cells.
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Medios de Contraste/química , Compuestos Heterocíclicos/química , Hidrogeles/química , Compuestos Organometálicos/química , Animales , Línea Celular Tumoral , Imagen por Resonancia Magnética , Nanopartículas/química , Polisacáridos/química , RatasRESUMEN
Several postmortem studies have shown iron accumulation in the substantia nigra of Parkinson's disease patients. Iron concentration can be estimated via MRI-R2∗ mapping. To assess the changes in R2∗ occurring in Parkinson's disease patients compared to controls, a multicentre transversal study was carried out on a large cohort of Parkinson's disease patients (n = 163) with matched controls (n = 82). In this study, 44 patients and 11 controls were removed due to motion artefacts, 21 patient and 6 controls to preserve matching. Thus, 98 patients and 65 age and sex-matched healthy subjects were selected with enough image quality. The study was conducted on patients with early to late stage Parkinson's disease. The images were acquired at 3Tesla in 12 clinical centres. R2∗ values were measured in subcortical regions of interest (substantia nigra, red nucleus, striatum, globus pallidus externus and globus pallidus internus) contralateral (dominant side) and ipsilateral (non dominant side) to the most clinically affected hemibody. As the observed inter-subject R2∗ variability was significantly higher than the disease effect, an original strategy (intrasubject subcortical quantitative referencing, ISQR) was developed using the measurement of R2∗ in the red nucleus as an intra-subject reference. R2∗ values significantly increased in Parkinson's disease patients when compared with controls; in the substantia nigra (SN) in the dominant side (D) and in the non dominant side (ND), respectively (PSN_D and PSN_ND < 0.0001). After stratification into four subgroups according to the disease duration, no significant R2∗ difference was found in all regions of interest when comparing Parkinson's disease subgroups. By applying our ISQR strategy, R2(ISQR)∗ values significantly increased in the substantia nigra (PSN_D and PSN_ND < 0.0001) when comparing all Parkinson's disease patients to controls. R2(ISQR)∗ values in the substantia nigra significantly increased with the disease duration (PSN_D = 0.01; PSN_ND = 0.03) as well as the severity of the disease (Hoehn & Yahr scale <2 and ≥ 2, PSN_D = 0.02). Additionally, correlations between R2(ISQR)∗ and clinical features, mainly related to the severity of the disease, were found. Our results support the use of ISQR to reduce variations not directly related to Parkinson's disease, supporting the concept that ISQR strategy is useful for the evaluation of Parkinson's disease.
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Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/diagnóstico por imagen , Sustancia Negra/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Núcleo Rojo , HierroRESUMEN
In addition to symptoms specifically related to mood dysregulation, patients with bipolar disorder (BD) show frequent alterations in formal thought organization. A disruption in semantic processing, notably in semantic inhibition, is one of the possible mechanisms that might explain this modified organization. However, to date, little is known about these mechanisms and their underlying neural substrates. This study aimed to identify the neural correlates of the semantic inhibition process in BD patients in comparison to healthy controls. Seventeen BD patients and 17 matched controls were recruited and underwent a 3T MRI scan. A semantic ambiguity resolution task was used during the scan to explore semantic inhibition. Whole-brain analyses were conducted on 13 BD patients and 16 controls. When compared to controls, BD patients had stronger activation in the bilateral temporal areas and right middle frontal gyrus, and less activation in the right hippocampus, parahippocampal area, and bilateral precunei. The present study revealed an altered fronto-temporo-parietal semantic inhibition network in BD patients that could reflect compensative mechanisms or modified semantic processing inducing abnormal thought organization, which has a major impact on the occupational and social functioning of the BD population.
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Trastorno Bipolar , Semántica , Trastorno Bipolar/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Humanos , Imagen por Resonancia MagnéticaRESUMEN
BACKGROUND: FIGHTDIGO study has shown the feasibility of handgrip strength (HGS) measurements in 201 consecutive digestive cancer patients undergoing chemotherapy. OBJECTIVE: This study focuses on a secondary aim of FIGHTDIGO study: the relationship between muscle mass and HGS. DESIGN: Two consecutive bilateral measures of HGS were performed using a Jamar dynamometer before the start of each chemotherapy. The highest value was chosen for final evaluation. Dynapenia (loss of muscle strength) was defined as HGS < 30 kg (men) and < 20 kg (women). Muscle mass was measured at lumbar level (L3) on Computed Tomography (CT) scans performed less than 3 weeks before or after the measurement of HGS. Muscle mass loss was defined by skeletal muscle index (SMI) < 53 cm2 /m2 (in men with a body mass index (BMI)> 25 kg/m2 ), < 43 cm2 /m2 (in men with a BMI < 25 kg/m2 ), and < 41 cm2 /m2 (in women regardless of BMI). Sarcopenia was defined by the association of a dynapenia and a loss of muscle mass. RESULTS: A total of 150 patients were included in this analysis (mean age: 65.6 ± 10.9 years, 87 males (58%), colorectal cancer (47.3%), metastatic stage (76.7%)). A total of 348 CT scans were evaluated. For the 348 measurements, mean SMI and HGS were 41.8 ± 8.7 cm2 /m2 and 32.1 ± 11.0 kg, respectively. Muscle mass loss, dynapenia, or sarcopenia were reported at least once, in 120 (80%), 45 (30%), and 30 (20%) patients, respectively. SMI was significantly correlated with HGS (Pearson coefficient = 0.53, P < 0.0001). At concordance analysis, 188 dyad SMI/HGS (54%) were in agreement (Kappa = 0.14 [95% CI, 0.07-0.21]). CONCLUSION: Correlation between the measurements of HGS and SMI is strong but the concordance between dynapenia and muscle mass loss is poor. Further studies should be performed to confirm the diagnostic thresholds, and to study the chronology of dynapenia and loss of muscle mass.
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Neoplasias del Sistema Digestivo/epidemiología , Fuerza de la Mano , Desnutrición/epidemiología , Desnutrición/patología , Músculo Esquelético/patología , Músculo Esquelético/fisiopatología , Anciano , Índice de Masa Corporal , Neoplasias del Sistema Digestivo/complicaciones , Neoplasias del Sistema Digestivo/diagnóstico , Femenino , Humanos , Masculino , Desnutrición/etiología , Persona de Mediana Edad , Músculo Esquelético/diagnóstico por imagen , Tamaño de los Órganos , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Few studies have examined the prevalence and correlates of subsyndromal and syndromal depressive symptoms (SSSD) among older adults with schizophrenia spectrum disorder. In this report, we examined the prevalence of SSSD and their associations with sociodemographic characteristics, clinical characteristics of schizophrenia, comorbidity, psychotropic medications, quality of life, functioning and mental health care utilization in a large, multicenter sample of older adults with schizophrenia spectrum disorder. METHODS: Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of SSSD, defined using the Center of Epidemiologic Studies Depression (CESD) scale. Clinical characteristics associated with SSSD were explored. RESULTS: Among 343 older adults with schizophrenia spectrum disorder, 78.1% had either subsyndromal (30.6%) or syndromal (47.5%) depressive symptoms. SSSD were independently associated with positive and negative symptoms, lower quality of life, non-late-onset psychosis, benzodiazepine use and urbanicity. There were no significant associations of SSSD with other sociodemographic characteristics and psychotropic medications, or with general medical conditions. We found no significant differences in the proportion of participants who were treated with antidepressants between those with syndromal depressive symptoms and those without depression (22.1% vs. 20.0%, pâ¯=â¯0.89). SSSD were not associated with higher mental health care utilization. LIMITATIONS: Data were cross-sectional and depression was not evaluated with a semi-structured interview. CONCLUSION: SSSD may be highly prevalent and under-assessed and/or undertreated among older adults with schizophrenia spectrum disorder. Our findings should alert clinicians about the need to assess systematically and regularly depression in this vulnerable population.
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Trastorno Depresivo/epidemiología , Esquizofrenia/epidemiología , Anciano , Antidepresivos/uso terapéutico , Benzodiazepinas/uso terapéutico , Estudios de Cohortes , Comorbilidad , Estudios Transversales , Trastorno Depresivo/tratamiento farmacológico , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/psicología , Calidad de Vida/psicología , Factores de Riesgo , Esquizofrenia/tratamiento farmacológicoRESUMEN
Metabolic syndrome and its associated morbidity and mortality have been well documented in adults with schizophrenia. However, data is lacking for their geriatric counterparts. We sought to investigate the frequency of screening and the prevalence of metabolic syndrome in older adults with schizophrenia, as well as its possible correlates, using the Cohort of individuals with schizophrenia Aged 55 years or more study (nâ¯=â¯353). We found that 42.2% (nâ¯=â¯149) of our sample was screened for metabolic syndrome. Almost half of those (nâ¯=â¯77; 51.7%) screened positive according to ATPIII criteria. Hypertension and abdominal obesity were the two most prevalent metabolic abnormalities. Screening was positively associated with male gender and urbanicity, and metabolic syndrome diagnosis was positively associated with cardiovascular disorders and consultation with a general practitioner (all p < 0.05). However, there were no significant associations of metabolic syndrome with socio-demographic or clinical characteristics, psychotropic medications, other medical conditions and other indicators of mental health care utilization. Our findings support that the prevalence of metabolic syndrome among older adults with schizophrenia spectrum disorder is high and screening is crucial mainly in those patients with hypertension and/or abdominal obesity. Factors at play might be different than those in the younger population.
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Síndrome Metabólico/epidemiología , Síndrome Metabólico/psicología , Esquizofrenia/complicaciones , Anciano , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/psicología , Estudios de Cohortes , Femenino , Humanos , Hipertensión/epidemiología , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Obesidad Abdominal/epidemiología , Obesidad Abdominal/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Prevalencia , Psicotrópicos/uso terapéutico , Factores de RiesgoRESUMEN
OBJECTIVE: To investigate the ability of T2* and fluid-attenuated inversion recovery (FLAIR) MR sequences to detect hemosiderin deposition 3â months after aneurysmal subarachnoid hemorrhage (SAH) in comparison with early non-enhanced CT (NECT) as a gold standard. MATERIALS AND METHODS: From September 2008 through May 2013, patients with aneurysmal SAH were included if a NECT less than 24â h after the onset of symptoms showed a SAH, and MRI, including T2* and FLAIR sequences, was performed 3â months later. All aneurysms were treated endovascularly. NECT and MR sequences were blindly analyzed for the presence of SAH (NECT) or hemosiderin deposition (MRI). When positive, details of the spatial distribution of SAH or hemosiderin deposits were noted. Sensitivities were calculated for each patient. Sensitivities, specificities, and positive predictive values (PPVs) were calculated for each location. RESULTS: Forty-nine patients (mean age 52.9â years) were included. Bleeding-related patterns were identified in 43 patients (87.8%) on T2* and 10 patients (20.4%) on FLAIR. T2* was highly predictive of the location of the initial hemorrhage, especially in the Sylvian cisterns (PPVs 95% and 100%) and the anterior interhemispheric fissure (PPV 90%). CONCLUSIONS: The T2* sequence can detect and localize a previous SAH a few months after aneurysmal bleeding.
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Angiografía Cerebral/métodos , Hemorragia Cerebral/diagnóstico por imagen , Angiografía por Resonancia Magnética/métodos , Hemorragia Subaracnoidea/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anciano de 80 o más Años , Hemorragia Cerebral/cirugía , Venas Cerebrales/diagnóstico por imagen , Procedimientos Endovasculares , Femenino , Hemosiderina/metabolismo , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Estándares de Referencia , Reproducibilidad de los Resultados , Hemorragia Subaracnoidea/cirugíaRESUMEN
BACKGROUND AND PURPOSE: Follow-up of intracranial aneurysms treated by flow diverter with MRI is complicated by imaging artifacts produced by these devices. This study compares the diagnostic accuracy of three-dimensional time-of-flight MR angiography (3D-TOF-MRA) and contrast-enhanced MRA (CE-MRA) at 3â T for the evaluation of aneurysm occlusion and parent artery patency after flow diversion treatment, with digital subtraction angiography (DSA) as the gold standard. MATERIALS AND METHODS: Patients treated with flow diverters between January 2009 and January 2013 followed by MRA at 3â T (3D-TOF-MRA and CE-MRA) and DSA within a 48â h period were included in a prospective single-center study. Aneurysm occlusion was assessed with full and simplified Montreal scales and parent artery patency with three-grade and two-grade scales. RESULTS: Twenty-two patients harboring 23 treated aneurysms were included. Interobserver agreement using simplified scales for occlusion (Montreal) and parent artery patency were higher for DSA (0.88 and 0.61) and CE-MRA (0.74 and 0.55) than for 3D-TOF-MRA (0.51 and 0.02). Intermodality agreement was higher for CE-MRA (0.88 and 0.32) than for 3D-TOF-MRA (0.59 and 0.11). CE-MRA yielded better accuracy than 3D-TOF-MRA for aneurysm remnant detection (sensitivity 83% vs 50%; specificity 100% vs 100%) and for the status of the parent artery (specificity 63% vs 32%; sensitivity 100% vs 100%). CONCLUSIONS: At 3â T, CE-MRA is superior to 3D-TOF-MRA for the evaluation of aneurysm occlusion and parent artery patency after flow diversion treatment. However, intraluminal evaluation remains difficult with MRA regardless of the sequence used.
Asunto(s)
Angiografía de Substracción Digital/normas , Angiografía Cerebral/normas , Circulación Cerebrovascular/fisiología , Procedimientos Endovasculares/métodos , Aneurisma Intracraneal/diagnóstico , Aneurisma Intracraneal/terapia , Angiografía por Resonancia Magnética/normas , Adulto , Anciano , Angiografía de Substracción Digital/métodos , Angiografía Cerebral/métodos , Femenino , Estudios de Seguimiento , Humanos , Aumento de la Imagen , Imagenología Tridimensional , Angiografía por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Resultado del TratamientoRESUMEN
Irony is a kind of figurative language used by a speaker to say something that contrasts with the context and, to some extent, lends humor to a situation. However, little is known about the brain regions that specifically support the processing of these two common features of irony. The present study had two main aims: (i) investigate the neural basis of irony processing, by delivering short ironic spoken sentences (and their literal counterparts) to participants undergoing fMRI; and (ii) assess the neural effect of two irony parameters, obtained from normative studies: degree of contrast and humor appreciation. Results revealed activation of the bilateral inferior frontal gyrus (IFG), posterior part of the left superior temporal gyrus, medial frontal cortex, and left caudate during irony processing, suggesting the involvement of both semantic and theory-of-mind networks. Parametric models showed that contrast was specifically associated with the activation of bilateral frontal and subcortical areas, and that these regions were also sensitive to humor, as shown by a conjunction analysis. Activation of the bilateral IFG is consistent with the literature on humor processing, and reflects incongruity detection/resolution processes. Moreover, the activation of subcortical structures can be related to the reward processing of social events.
Asunto(s)
Encéfalo/fisiología , Lenguaje , Ingenio y Humor como Asunto , Conducta , Mapeo Encefálico , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Adulto JovenRESUMEN
Despite the growing literature on figurative language processing, there is still debate as to which cognitive processes and neural bases are involved. Furthermore, most studies have focused on nominal metaphor processing without any context, and very few have used auditory presentation. We therefore investigated the neural bases of the comprehension of predicative metaphors presented in a brief context, in an auditory, ecological way. The comprehension of their literal counterparts served as a control condition. We also investigated the link between working memory and verbal skills and regional activation. Comparisons of metaphorical and literal conditions revealed bilateral activation of parietal areas including the left angular (lAG) and right inferior parietal gyri (rIPG) and right precuneus. Only verbal skills were associated with lAG (but not rIPG) activation. These results indicated that predicative metaphor comprehension share common activations with other metaphors. Furthermore, individual verbal skills could have an impact on figurative language processing.