Reorganization of large-scale cognitive networks during automation of imagination of a complex sequential movement.

We investigated the functional reconfiguration of the cerebral networks involved in imagination of sequential movements of the left foot, both performed at regular and fast speed after mental imagery training. Thirty-five volunteers were scanned with a 3T MRI while they imagined a sequence of ankle movements (dorsiflexion, plantar flexion, varus and valgus) before and after mental practice. Subjects were distributed in two groups: the first group executed regular movements whereas the second group made fast movements. We applied the general linear model (GLM) and model-free, exploratory tensorial independent component analytic (TICA) approaches to identify plastic post-training effects on brain activation. GLM showed that post-training imagination of movement was accompanied by a dual effect: a specific recruitment of a medial prefronto-cingulo-parietal circuit reminiscent of the default-mode network, with the left putamen, and a decreased activity of a lateral fronto-parietal network. Training-related subcortical changes only consisted in an increased activity in the left striatum. Unexpectedly, no difference was observed in the cerebellum. TICA also revealed involvement of the left executive network, and of the dorsal control executive network but no significant differences were found between pre- and post-training phases. Therefore, repetitive motor mental imagery induced specific putamen (motor rehearsal) recruitment that one previously observed during learning of overt movements, and, simultaneously, a specific shift of activity from the dorsolateral prefrontal cortex (attention, working memory) to the medial posterior parietal and cingulate cortices (mental imagery and memory rehearsal). Our data complement and confirm the notion that differential and coupled recruitment of cognitive networks can constitute a neural marker of training effects.

Brain areas involved in the control of speed during a motor sequence of the foot: real movement versus mental imagery.

We investigated the cerebral networks involved in execution and mental imagery of sequential movements of the left foot, both performed at slow and fast speed. Twelve volunteers were scanned with a 3T MRI during execution and imagination of a sequence of ankle movements. Overt movement execution and motor imagery shared a common network including the premotor, parietal and cingulate cortices, the striatum and the cerebellum. Motor imagery recruited specifically the prefrontal cortex, whereas motor execution recruited specifically the sensorimotor cortex. We also found that slow movements specifically recruited frontopolar and right dorsomedian prefrontal areas bilaterally, during both execution and mental imagery, whereas fast movements strongly activated the sensorimotor cerebral cortex. Finally, we noted that anterior vermis, lobules VI/VII and VIII of the cerebellum were specifically activated during fast movements, both in imagination and execution. We show that the selection of the neural networks underlying voluntary movement of the foot is depending on the speed strategy and is sensitive to execution versus imagery. Moreover, to the light of surprising recent findings in monkeys showing that the vermis should no longer be considered as entirely isolated from the cerebral cortex (Coffman et al., 2011 [2]), we suggest that the anterior vermis contributes to computational aspects of fast commands, whereas more lateral cerebellar superior lobe and lobule VIII would regulate patterning and sequencing of submovements in conjunction with movement rate. We also suggest that execution of overt slow movements, which strongly involves prefrontal executive cortex as during motor mental imagery, is associated with conscious mental representation of the ongoing movements.

Brain imaging in cerebellar ataxia associated with autoimmune polyglandular syndrome type 2.

Autoimmune polyglandular syndrome (APS) type 2 (Schmidt syndrome) is a disorder characterized by a combination of autoimmune adrenal insufficiency, autoimmune thyroid disease, and type 1 autoimmune diabetes mellitus. We describe the first case of subacute cerebellar syndrome associated with APS type 2. Brain magnetic resonance imaging showed atrophy of the cerebellum and the vermis, as well as of the anterior pituitary gland. Magnetic resonance spectroscopy showed decreased N-acetylaspartate/creatine ratio in the cerebellum and in the pons. Our findings expand the spectrum of neurological deficits in APS type 2 and underlines that cerebellar pathways may be a main target of the disorder.

[New techniques of structural and functional MRI]. / Nouvelles techniques d'IRM morphologique et fonctionnelle.

Magnetic resonance imaging is an imaging technique allowing morphological and functional study of the brain. Algorithmic and technical advances offer new insights in such brain studies using new approaches to search epileptogenic lesion. Voxel based analysis appears as the dominant methodology to study grey and white matter using the following contrast: T1, T2, T2 relaxometry, magnetization transfert and diffusion weighted imaging. Ongoing development focuses on sulcal morphometry and gyrification index, to improve our understanding of developmental epilepsy. Magnetic resonance spectroscopy appears as a promising tool following availability of high field strength clinical MRI and evidence about its utility in the field of epileptology. Functional MRI benefits from such high field strength and new pulse sequence using diffusion gradients to probe neuronal firing.

Diffusion tensor imaging (DTI) and tractography of the cerebellar projections to prefrontal and posterior parietal cortices: a study at 3T.

OBJECTIVES: Previous diffusion tensor imaging (DTI) studies have identified cerebellar pathways and supratentorial connections, but none of them have isolated cerebellar projections to prefrontal and posterior parietal cortices using tractography. The aim of our study was to identify and visualize on 3D projections, as well as on 2D cross-sectional images, the cerebellar projections to prefrontal (PF) and posterior parietal (PP) cortices. MATERIAL AND METHODS: The study included 10 healthy volunteers, four males and six females aged 25 to 45 years (mean age 31 years). A DTI sequence was applied at 3 Tesla using diffusion sensitizing gradients in 32 directions. White matter tracts were reconstructed by applying a multiple ROI (region of interest) tractography technique. RESULTS: PF projections were obtained in all subjects. PP projections were obtained in six over 10 subjects. On 2D cross-sectional images, the tracts showed the same anatomical location in each ROI in all subjects. CONCLUSION: This DTI study at 3T resulted in a selective and full visualization of cerebellar projections to PF and PP cortices for the first time and is introductive for further optimized and quantitative DTI study of these tracts.

Information on heavy equipments and facilities in Belgium: gamma-knife.

PURPOSE: To explain the principles and indications of gamma knife radiosurgery and to illustrate the correlated neuroimaging features. METHODS AND MATERIAL: Between December 1999 and July 2007, 1620 patients were treated by GK for a large variety of indications (metastasis 26%, vascular malformations 7%, trigeminal neuralgia 14%, pituitary adenoma 3%, primary CNS tumour 8%, other tumours 6%, vestibular schwannoma 19%, meningioma 17%, functional disorders <1%). The patients benefited from MRI follow-ups. RESULTS: MRI is the imaging technique of choice for Gamma knife radiosurgery (GKRS) in almost all indications. Computed Tomography, Digital Subtraction Angiography and Positron Emission Tomography have an additional role in some indications. Significant MRI data is illustrated in most indications. Evaluation of the treatment is mainly performed using MRI follow-up studies. The main features of these MRI follow-ups are described. Stabilisation or shrinking of the lesions volumes was generally observed. T2 relaxation times were also modified in and around the treated target areas, in patients responding to treatment and without any symptomatic complications. Modifications in contrast uptake were also observed in those patients. A few patients presented symptomatic complications associated with T2 signal anomalies. The interpretation of those modifications is discussed. CONCLUSION: MRI is the method of choice for GKRS planning in most indications. Imaging changes after radiosurgery provide the best quality control available to assess the response to radiosurgical treatment and to identify and monitor potential complications.

Neurocutaneous melanosis in a newborn with giant congenital melanocytic nevus.

Neurocutaneous melanosis (NCM) is known as a rare phakomatose characterised by large or numerous pigmented congenital nevi associated with leptomeninges melanin-containing deposits. We report a case of a newborn presenting at birth with a giant nevus covering about 40% of the total body surface. MRI showed T1 hyperintensities in the right amygdala and predominantly in the cerebellum corresponding to melanocytic cells.

[Role of new MRI techniques in neuroradiologic practice]. / Place des nouvelles techniques IRM en pratique courante neuroradiologique.

Magnetic Resonance Imaging (MRI) has been introduced in clinical practice in the mid-eighties. However, MRI is an ever evolving imaging technique with constant new developments allowing broadening of clinical applications. In particular, angio-MRI involves many different acquisition techniques that will guide their clinical use. On the other hand, clinical applications of the following techniques are briefly discussed: diffusion, perfusion, tractography and diffusion tensor imaging, spectroscopy and functional imaging.