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1.
Cereb Cortex ; 34(5)2024 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-38771243

RESUMEN

Variability in brain structure is associated with the capacity for behavioral change. However, a causal link between specific brain areas and behavioral change (such as motor learning) has not been demonstrated. We hypothesized that greater gray matter volume of a primary motor cortex (M1) area active during a hand motor learning task is positively correlated with subsequent learning of the task, and that the disruption of this area blocks learning of the task. Healthy participants underwent structural MRI before learning a skilled hand motor task. Next, participants performed this learning task during fMRI to determine M1 areas functionally active during this task. This functional ROI was anatomically constrained with M1 boundaries to create a group-level "Active-M1" ROI used to measure gray matter volume in each participant. Greater gray matter volume in the left hemisphere Active-M1 ROI was related to greater motor learning in the corresponding right hand. When M1 hand area was disrupted with repetitive transcranial stimulation (rTMS), learning of the motor task was blocked, confirming its causal link to motor learning. Our combined imaging and rTMS approach revealed greater cortical volume in a task-relevant M1 area is causally related to learning of a hand motor task in healthy humans.


Asunto(s)
Sustancia Gris , Mano , Aprendizaje , Imagen por Resonancia Magnética , Corteza Motora , Estimulación Magnética Transcraneal , Humanos , Corteza Motora/fisiología , Corteza Motora/diagnóstico por imagen , Masculino , Femenino , Mano/fisiología , Aprendizaje/fisiología , Adulto , Adulto Joven , Sustancia Gris/fisiología , Sustancia Gris/diagnóstico por imagen , Destreza Motora/fisiología , Mapeo Encefálico , Lateralidad Funcional/fisiología
2.
Neurology ; 102(10): e209387, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38701386

RESUMEN

BACKGROUND AND OBJECTIVES: Motor outcomes after stroke relate to corticospinal tract (CST) damage. The brain leverages surviving neural pathways to compensate for CST damage and mediate motor recovery. Thus, concurrent age-related damage from white matter hyperintensities (WMHs) might affect neurologic capacity for recovery after CST injury. The role of WMHs in post-stroke motor outcomes is unclear. In this study, we evaluated whether WMHs modulate the relationship between CST damage and post-stroke motor outcomes. METHODS: We used data from the multisite ENIGMA Stroke Recovery Working Group with T1 and T2/fluid-attenuated inversion recovery imaging. CST damage was indexed with weighted CST lesion load (CST-LL). WMH volumes were extracted with Freesurfer's SAMSEG. Mixed-effects beta-regression models were fit to test the impact of CST-LL, WMH volume, and their interaction on motor impairment, controlling for age, days after stroke, and stroke volume. RESULTS: A total of 223 individuals were included. WMH volume related to motor impairment above and beyond CST-LL (ß = 0.178, 95% CI 0.025-0.331, p = 0.022). Relationships varied by WMH severity (mild vs moderate-severe). In individuals with mild WMHs, motor impairment related to CST-LL (ß = 0.888, 95% CI 0.604-1.172, p < 0.001) with a CST-LL × WMH interaction (ß = -0.211, 95% CI -0.340 to -0.026, p = 0.026). In individuals with moderate-severe WMHs, motor impairment related to WMH volume (ß = 0.299, 95% CI 0.008-0.590, p = 0.044), but did not significantly relate to CST-LL or a CST-LL × WMH interaction. DISCUSSION: WMHs relate to motor outcomes after stroke and modify relationships between motor impairment and CST damage. WMH-related damage may be under-recognized in stroke research as a factor contributing to variability in motor outcomes. Our findings emphasize the importance of brain structural reserve in motor outcomes after brain injury.


Asunto(s)
Tractos Piramidales , Accidente Cerebrovascular , Sustancia Blanca , Humanos , Tractos Piramidales/diagnóstico por imagen , Tractos Piramidales/patología , Masculino , Femenino , Anciano , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/patología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Persona de Mediana Edad , Imagen por Resonancia Magnética , Recuperación de la Función/fisiología , Anciano de 80 o más Años
3.
medRxiv ; 2023 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-37961329

RESUMEN

Motor outcomes after stroke relate to corticospinal tract (CST) damage. Concurrent damage from white matter hyperintensities (WMHs) might impact neurological capacity for recovery after CST injury. Here, we evaluated if WMHs modulate the relationship between CST damage and post-stroke motor impairment outcome. We included 223 individuals from the ENIGMA Stroke Recovery Working Group. CST damage was indexed with weighted CST lesion load (CST-LL). Mixed effects beta-regression models were fit to test the impact of CST-LL, WMH volume, and their interaction on motor impairment. WMH volume related to motor impairment above and beyond CST-LL (ß = 0.178, p = 0.022). We tested if relationships varied by WMH severity (mild vs. moderate-severe). In individuals with mild WMHs, motor impairment related to CST-LL (ß = 0.888, p < 0.001) with a CST-LL x WMH interaction (ß = -0.211, 0.026). In individuals with moderate-severe WMHs, motor impairment related to WMH volume (ß = 0.299, p = 0.044), but did not significantly relate to CST-LL or a CST-LL x WMH interaction. WMH-related damage may be under-recognised in stroke research as a factor contributing to variability in motor outcomes. Our findings emphasize the importance of brain structural reserve in motor outcomes after brain injury.

4.
Neurorehabil Neural Repair ; 37(2-3): 119-130, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36786394

RESUMEN

BACKGROUND: After stroke, increases in contralesional primary motor cortex (M1CL) activity and excitability have been reported. In pre-clinical studies, M1CL reorganization is related to the extent of ipsilesional M1 (M1IL) injury, but this has yet to be tested clinically. OBJECTIVES: We tested the hypothesis that the extent of damage to the ipsilesional M1 and/or its corticospinal tract (CST) determines the magnitude of M1CL reorganization and its relationship to affected hand function in humans recovering from stroke. METHODS: Thirty-five participants with a single subacute ischemic stroke affecting M1 or CST and hand paresis underwent MRI scans of the brain to measure lesion volume and CST lesion load. Transcranial magnetic stimulation (TMS) of M1IL was used to determine the presence of an electromyographic response (motor evoked potential (MEP+ and MEP-)). M1CL reorganization was determined by TMS applied to M1CL at increasing intensities. Hand function was quantified with the Jebsen Taylor Hand Function Test. RESULTS: The extent of M1CL reorganization was related to greater lesion volume in the MEP- group, but not in the MEP+ group. Greater M1CL reorganization was associated with more impaired hand function in MEP- but not MEP+ participants. Absence of an MEP (MEP-), larger lesion volumes and higher lesion loads in CST, particularly in CST fibers originating in M1 were associated with greater impairment of hand function. CONCLUSIONS: In the subacute post-stroke period, stroke volume and M1IL output determine the extent of M1CL reorganization and its relationship to affected hand function, consistent with pre-clinical evidence.ClinicalTrials.gov Identifier: NCT02544503.


Asunto(s)
Corteza Motora , Accidente Cerebrovascular , Humanos , Volumen Sistólico , Encéfalo , Estimulación Magnética Transcraneal , Potenciales Evocados Motores/fisiología
5.
Front Neurol ; 13: 836716, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35693005

RESUMEN

Abnormal contralesional M1 activity is consistently reported in patients with compromised upper limb and hand function after stroke. The underlying mechanisms and functional implications of this activity are not clear, which hampers the development of treatment strategies targeting this brain area. The goal of the present study was to determine the extent to which contralesional M1 activity can be explained by the demand of a motor task, given recent evidence for increasing ipsilateral M1 activity with increasing demand in healthy age-matched controls. We hypothesized that higher activity in contralesional M1 is related to greater demand on precision in a hand motor task. fMRI data were collected from 19 patients with ischemic stroke affecting hand function in the subacute recovery phase and 31 healthy, right-handed, age-matched controls. The hand motor task was designed to parametrically modulate the demand on movement precision. Electromyography data confirmed strictly unilateral task performance by all participants. Patients showed significant impairment relative to controls in their ability to perform the task in the fMRI scanner. However, patients and controls responded similarly to an increase in demand for precision, with better performance for larger targets and poorer performance for smaller targets. Patients did not show evidence of elevated ipsilesional or contralesional M1 blood oxygenation level-dependent (BOLD) activation relative to healthy controls and mean BOLD activation levels were not elevated for patients with poorer performance relative to patients with better task performance. While both patients and healthy controls showed demand-dependent increases in BOLD activation in both ipsilesional/contralateral and contralesional/ipsilateral hemispheres, patients with stroke were less likely to show evidence of a linear relationship between the demand on precision and BOLD activation in contralesional M1 than healthy controls. Taken together, the findings suggest that task demand affects the BOLD response in contralesional M1 in patients with stroke, though perhaps less strongly than in healthy controls. This has implications for the interpretation of reported abnormal bilateral M1 activation in patients with stroke because in addition to contralesional M1 reorganization processes it could be partially related to a response to the relatively higher demand of a motor task when completed by patients rather than by healthy controls.

6.
Sci Data ; 9(1): 320, 2022 06 16.
Artículo en Inglés | MEDLINE | ID: mdl-35710678

RESUMEN

Accurate lesion segmentation is critical in stroke rehabilitation research for the quantification of lesion burden and accurate image processing. Current automated lesion segmentation methods for T1-weighted (T1w) MRIs, commonly used in stroke research, lack accuracy and reliability. Manual segmentation remains the gold standard, but it is time-consuming, subjective, and requires neuroanatomical expertise. We previously released an open-source dataset of stroke T1w MRIs and manually-segmented lesion masks (ATLAS v1.2, N = 304) to encourage the development of better algorithms. However, many methods developed with ATLAS v1.2 report low accuracy, are not publicly accessible or are improperly validated, limiting their utility to the field. Here we present ATLAS v2.0 (N = 1271), a larger dataset of T1w MRIs and manually segmented lesion masks that includes training (n = 655), test (hidden masks, n = 300), and generalizability (hidden MRIs and masks, n = 316) datasets. Algorithm development using this larger sample should lead to more robust solutions; the hidden datasets allow for unbiased performance evaluation via segmentation challenges. We anticipate that ATLAS v2.0 will lead to improved algorithms, facilitating large-scale stroke research.


Asunto(s)
Encéfalo , Accidente Cerebrovascular , Algoritmos , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Neuroimagen , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/patología
7.
J Am Heart Assoc ; 11(10): e025109, 2022 05 17.
Artículo en Inglés | MEDLINE | ID: mdl-35574963

RESUMEN

Background Persistent sensorimotor impairments after stroke can negatively impact quality of life. The hippocampus is vulnerable to poststroke secondary degeneration and is involved in sensorimotor behavior but has not been widely studied within the context of poststroke upper-limb sensorimotor impairment. We investigated associations between non-lesioned hippocampal volume and upper limb sensorimotor impairment in people with chronic stroke, hypothesizing that smaller ipsilesional hippocampal volumes would be associated with greater sensorimotor impairment. Methods and Results Cross-sectional T1-weighted magnetic resonance images of the brain were pooled from 357 participants with chronic stroke from 18 research cohorts of the ENIGMA (Enhancing NeuoImaging Genetics through Meta-Analysis) Stroke Recovery Working Group. Sensorimotor impairment was estimated from the FMA-UE (Fugl-Meyer Assessment of Upper Extremity). Robust mixed-effects linear models were used to test associations between poststroke sensorimotor impairment and hippocampal volumes (ipsilesional and contralesional separately; Bonferroni-corrected, P<0.025), controlling for age, sex, lesion volume, and lesioned hemisphere. In exploratory analyses, we tested for a sensorimotor impairment and sex interaction and relationships between lesion volume, sensorimotor damage, and hippocampal volume. Greater sensorimotor impairment was significantly associated with ipsilesional (P=0.005; ß=0.16) but not contralesional (P=0.96; ß=0.003) hippocampal volume, independent of lesion volume and other covariates (P=0.001; ß=0.26). Women showed progressively worsening sensorimotor impairment with smaller ipsilesional (P=0.008; ß=-0.26) and contralesional (P=0.006; ß=-0.27) hippocampal volumes compared with men. Hippocampal volume was associated with lesion size (P<0.001; ß=-0.21) and extent of sensorimotor damage (P=0.003; ß=-0.15). Conclusions The present study identifies novel associations between chronic poststroke sensorimotor impairment and ipsilesional hippocampal volume that are not caused by lesion size and may be stronger in women.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Estudios Transversales , Femenino , Hipocampo/diagnóstico por imagen , Humanos , Masculino , Calidad de Vida , Recuperación de la Función , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico por imagen , Rehabilitación de Accidente Cerebrovascular/métodos , Extremidad Superior
8.
Brain Commun ; 3(4): fcab254, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34805997

RESUMEN

Up to two-thirds of stroke survivors experience persistent sensorimotor impairments. Recovery relies on the integrity of spared brain areas to compensate for damaged tissue. Deep grey matter structures play a critical role in the control and regulation of sensorimotor circuits. The goal of this work is to identify associations between volumes of spared subcortical nuclei and sensorimotor behaviour at different timepoints after stroke. We pooled high-resolution T1-weighted MRI brain scans and behavioural data in 828 individuals with unilateral stroke from 28 cohorts worldwide. Cross-sectional analyses using linear mixed-effects models related post-stroke sensorimotor behaviour to non-lesioned subcortical volumes (Bonferroni-corrected, P < 0.004). We tested subacute (≤90 days) and chronic (≥180 days) stroke subgroups separately, with exploratory analyses in early stroke (≤21 days) and across all time. Sub-analyses in chronic stroke were also performed based on class of sensorimotor deficits (impairment, activity limitations) and side of lesioned hemisphere. Worse sensorimotor behaviour was associated with a smaller ipsilesional thalamic volume in both early (n = 179; d = 0.68) and subacute (n = 274, d = 0.46) stroke. In chronic stroke (n = 404), worse sensorimotor behaviour was associated with smaller ipsilesional putamen (d = 0.52) and nucleus accumbens (d = 0.39) volumes, and a larger ipsilesional lateral ventricle (d = -0.42). Worse chronic sensorimotor impairment specifically (measured by the Fugl-Meyer Assessment; n = 256) was associated with smaller ipsilesional putamen (d = 0.72) and larger lateral ventricle (d = -0.41) volumes, while several measures of activity limitations (n = 116) showed no significant relationships. In the full cohort across all time (n = 828), sensorimotor behaviour was associated with the volumes of the ipsilesional nucleus accumbens (d = 0.23), putamen (d = 0.33), thalamus (d = 0.33) and lateral ventricle (d = -0.23). We demonstrate significant relationships between post-stroke sensorimotor behaviour and reduced volumes of deep grey matter structures that were spared by stroke, which differ by time and class of sensorimotor measure. These findings provide additional insight into how different cortico-thalamo-striatal circuits support post-stroke sensorimotor outcomes.

9.
J Neurophysiol ; 124(3): 728-739, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32727264

RESUMEN

In functional magnetic resonance imaging (fMRI) studies, performance of unilateral hand movements is associated with primary motor cortex activity ipsilateral to the moving hand (M1ipsi), in addition to contralateral activity (M1contra). The magnitude of M1ipsi activity increases with the demand on precision of the task. However, it is unclear how demand-dependent increases in M1ipsi recruitment relate to the control of hand movements. To address this question, we used fMRI to measure blood oxygenation level-dependent (BOLD) activity during performance of a task that varied in demand on precision. Participants (n = 23) manipulated an MRI-compatible joystick with their right or left hand to move a cursor into targets of different sizes (small, medium, large, extra large). Performance accuracy, movement time, and number of velocity peaks scaled with target size, whereas reaction time, maximum velocity, and initial direction error did not. In the univariate analysis, BOLD activation in M1contra and M1ipsi was higher for movements to smaller targets. Representational similarity analysis, corrected for mean activity differences, revealed multivoxel BOLD activity patterns during movements to small targets were most similar to those for medium targets and least similar to those for extra-large targets. Only models that varied with demand (target size, performance accuracy, and number of velocity peaks) correlated with the BOLD dissimilarity patterns, though differently for right and left hands. Across individuals, M1contra and M1ipsi similarity patterns correlated with each other. Together, these results suggest that increasing demand on precision in a unimanual motor task increases M1 activity and modulates M1 activity patterns.NEW & NOTEWORTHY Contralateral primary motor cortex (M1) predominantly controls unilateral hand movements, but the role of ipsilateral M1 is unclear. We used functional magnetic resonance imaging (fMRI) to investigate how M1 activity is modulated by unimanual movements at different levels of demand on precision. Our results show that task characteristics related to demand on precision influence bilateral M1 activity, suggesting that in addition to contralateral M1, ipsilateral M1 plays a key role in controlling hand movements to meet performance precision requirements.


Asunto(s)
Mapeo Encefálico , Lateralidad Funcional/fisiología , Mano/fisiología , Actividad Motora/fisiología , Corteza Motora/fisiología , Desempeño Psicomotor/fisiología , Anciano , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Corteza Motora/diagnóstico por imagen
10.
Neurorehabil Neural Repair ; 34(2): 159-171, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31976804

RESUMEN

Background. Stroke often involves primary motor cortex (M1) and its corticospinal (CST) projections. As hand function is critically dependent on these structures, its recovery is often incomplete. Objective. To determine whether impaired hand function in patients with chronic ischemic stroke involving M1 or CST benefits from the enhancing effect of Hebbian-type stimulation (pairing M1 afferent stimulation and M1 activity in a specific temporal relationship) on M1 plasticity and hand function. Methods. In a double-blind, randomized, sham-controlled design, 20 patients with chronic ischemic stroke affecting M1 or CST were randomly assigned to 5 days of hand motor training that was combined with either Hebbian-type (trainingHebb) or sham stimulation (trainingsham) of the lesioned M1. Measures of hand function and task-based M1 functional magnetic resonance imaging (fMRI) activity were collected prior to, immediately following, and 4 weeks after the intervention. Results. Both interventions were effective in improving affected hand function at the completion of training, but only participants in the trainingHebb group maintained functional gains. Changes in hand function and fMRI activity were positively correlated in both ipsilesional and contralesional M1. Compared with trainingsham, participants in the trainingHebb group showed a stronger relationship between improved hand function and changes in M1 functional activity. Conclusions. Only when motor training was combined with Hebbian-type stimulation were functional gains maintained over time and correlated with measures of M1 functional plasticity. As hand dexterity is critically dependent on M1 function, these results suggest that functional reorganization in M1 is facilitated by Hebbian-type stimulation. ClinicalTrials.gov Identifier: NCT01569607.


Asunto(s)
Mano/fisiopatología , Accidente Cerebrovascular Isquémico/fisiopatología , Accidente Cerebrovascular Isquémico/terapia , Corteza Motora/fisiopatología , Plasticidad Neuronal/fisiología , Evaluación de Resultado en la Atención de Salud , Rehabilitación de Accidente Cerebrovascular/métodos , Estimulación Magnética Transcraneal , Adulto , Anciano , Enfermedad Crónica , Método Doble Ciego , Femenino , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Corteza Motora/diagnóstico por imagen
11.
Brain Cogn ; 138: 105507, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31855701

RESUMEN

The Dynamic Interacting Shape Clips (DISC) is a novel stimulus set designed to examine mentalizing, specifically social attribution, suitable for use with diverse methodologies including fMRI. The DISC offer some advantages compared to other social attribution stimuli including a large number of stimuli, subsets of stimuli depicting different kinds of social interactions (i.e., friendly approach, aggression, and avoidance), and two control tasks-one that contrasts interpretations of socially contingent movement versus random, inanimate movement, and the other that examines the impact of attentional shifts on mentalizing using the same visual stimuli with a different cue. This study describes both behavioral and fMRI findings from a sample of 22 typically developing adults (mage = 21.7 years, SD = 1.72). Behavioral data supports participants anthropomorphized the stimuli and the social intent of the clips were perceived as intended. Neuroimaging findings demonstrate that brain areas associated with processing animacy and mental state attribution were activated when participants were shown clips featuring social interactions compared to random movement, and when attention was cued to social versus physical aspects of the same stimuli. Results lend empirical support for the use of the DISC in future studies of social cognition.


Asunto(s)
Mapeo Encefálico , Mentalización/fisiología , Percepción Social , Teoría de la Mente/fisiología , Adolescente , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Adulto Joven
12.
J Exp Psychol Learn Mem Cogn ; 44(5): 680-698, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29094990

RESUMEN

Although the relationship between sound and meaning in language is assumed to be largely arbitrary, reliable correspondences between sound and meaning in natural language appear to facilitate word learning. Using a set of independently normed pseudoword and shape stimuli, we examined the real-time effects of sound-to-shape correspondences at initial presentation and throughout an extended learning process resulting in high accuracy. In addition to accuracy and response time (RT) measures, we monitored participants' eye movements to investigate the extent to which visual orienting to objects is influenced by the sound symbolic characteristics of novel labels at initial exposure and throughout learning. Over the course of word learning, congruency of sound and shape properties affected both accuracy and RT with higher accuracy and faster responses for congruent than incongruent items. Eye tracking data reveal that congruent targets were fixated faster than incongruent targets throughout learning and that nontargets consistent with the sound symbolic properties of the word remained attractive distracters, even after overt behavioral differences in accuracy disappeared. This demonstrates the sustained influence of sound symbolism and the importance of sensitive, continuous measures of assessing sound symbolic effects in word learning and lexical processing. Arbitrariness resulted in better final individuation performance only when the arbitrary items were more phonologically distinct than the sound symbolic stimuli. These findings suggest that the advantages of sound symbolism may persist beyond early word learning and serve to significantly influence online lexical processing. (PsycINFO Database Record


Asunto(s)
Medidas del Movimiento Ocular , Percepción de Forma/fisiología , Aprendizaje/fisiología , Reconocimiento Visual de Modelos/fisiología , Psicolingüística , Percepción del Habla/fisiología , Adulto , Asociación , Conducta de Elección/fisiología , Femenino , Humanos , Masculino , Simbolismo , Adulto Joven
13.
J Hepatol ; 63(6): 1368-77, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26220754

RESUMEN

BACKGROUND & AIMS: In patients with hepatocellular carcinoma (HCC), liver transplantation (LT) is an excellent therapy if tumor characteristics are within the Milan criteria. We aimed to define genomic features enabling to identify HCC patients beyond Milan criteria who have acceptable transplant outcomes. METHODS: Among 770 consecutive HCC patients transplanted between 1990 and 2013, 132 had tumors exceeding Milan criteria on pathology and were enrolled in the study; 44% of the patients satisfied the 'up-to-7 rule' [7=sum of the size of the largest tumor and the number of tumors]. Explant tumors were assessed for genomic signatures and immunohistochemical markers associated with poor outcome. RESULTS: At a median follow-up of 88months, 64 patients had died and 45 recurred; the 5-year overall survival (OS) and recurrence rates were 57% and 35%, respectively. Cytokeratin 19 (CK19) gene signature was independently associated with recurrence [Hazard ratio (HR)=2.95, p<0.001], along with tumor size (HR=3.37, p=0.023) and presence of satellites (HR=2.98, p=0.001). S2 subclass signature was independently associated with poor OS (HR=3.18, p=0.001), along with tumor size (HR=5.06, p<0.001) and up-to-7 rule (HR=2.50, p=0.002). Using the presence of progenitor cell markers (either CK19 or S2 signatures) patients were classified into poor prognosis (n=58; 5-year recurrence 53%, survival 45%) and good prognosis (n=74; 5-year recurrence 19%, survival 67%) (HR=3.16, p<0.001 for recurrence, and HR=1.72, p=0.04 for OS). CONCLUSIONS: HCC patients transplanted beyond Milan criteria without gene signatures of progenitor markers (CK19 and S2) achieved survival rates similar as those within Milan criteria. Once prospectively validated, these markers may support a limited expansion of LT indications.


Asunto(s)
Biomarcadores de Tumor/genética , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/cirugía , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/cirugía , Trasplante de Hígado , Adulto , Anciano , Antígenos de Neoplasias/metabolismo , Biomarcadores de Tumor/metabolismo , Carcinoma Hepatocelular/mortalidad , Moléculas de Adhesión Celular/metabolismo , Estudios de Cohortes , Molécula de Adhesión Celular Epitelial , Femenino , Perfilación de la Expresión Génica , Humanos , Inmunohistoquímica , Queratina-19/genética , Queratina-19/metabolismo , Neoplasias Hepáticas/mortalidad , Masculino , Persona de Mediana Edad , Células Madre Neoplásicas/metabolismo , Pronóstico
14.
Nat Commun ; 6: 6087, 2015 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-25608663

RESUMEN

Intrahepatic cholangiocarcinoma (iCCA) is a fatal bile duct cancer with dismal prognosis and limited therapeutic options. By performing RNA- and exome-sequencing analyses, we report a novel fusion event, FGFR2-PPHLN1 (16%), and damaging mutations in the ARAF oncogene (11%). Here we demonstrate that the chromosomal translocation t(10;12)(q26;q12) leading to FGFR2-PPHLN1 fusion possesses transforming and oncogenic activity, which is successfully inhibited by a selective FGFR2 inhibitor in vitro. Among the ARAF mutations, N217I and G322S lead to activation of the pathway and N217I shows oncogenic potential in vitro. Screening of a cohort of 107 iCCA patients reveals that FGFR2 fusions represent the most recurrent targetable alteration (45%, 17/107), while they are rarely present in other primary liver tumours (0/100 of hepatocellular carcinoma (HCC); 1/21 of mixed iCCA-HCC). Taken together, around 70% of iCCA patients harbour at least one actionable molecular alteration (FGFR2 fusions, IDH1/2, ARAF, KRAS, BRAF and FGF19) that is amenable for therapeutic targeting.


Asunto(s)
Antígenos de Neoplasias/genética , Neoplasias de los Conductos Biliares/genética , Colangiocarcinoma/genética , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Mutación , Proteínas Nucleares/genética , Proteínas Proto-Oncogénicas A-raf/genética , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/genética , Células 3T3 , Anciano , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Línea Celular Tumoral , Estudios de Cohortes , Exoma , Exones , Femenino , Humanos , Hibridación Fluorescente in Situ , Masculino , Ratones , Persona de Mediana Edad , Datos de Secuencia Molecular , Análisis de Secuencia por Matrices de Oligonucleótidos , Proteínas Recombinantes de Fusión/química , Análisis de Secuencia de ARN , Homología de Secuencia de Aminoácido , Translocación Genética
15.
J Neurophysiol ; 112(4): 999-1009, 2014 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-24848477

RESUMEN

The role of ipsilateral primary motor cortex (M1) in hand motor control during complex task performance remains controversial. Bilateral M1 activation is inconsistently observed in functional (f)MRI studies of unilateral hand performance. Two factors limit the interpretation of these data. As the motor tasks differ qualitatively in these studies, it is conceivable that M1 contributions differ with the demand on skillfulness. Second, most studies lack the verification of a strictly unilateral execution of the motor task during the acquisition of imaging data. Here, we use fMRI to determine whether ipsilateral M1 activity depends on the demand for precision in a pointing task where precision varied quantitatively while movement trajectories remained equal. Thirteen healthy participants used an MRI-compatible joystick to point to targets of four different sizes in a block design. A clustered acquisition technique allowed simultaneous fMRI/EMG data collection and confirmed that movements were strictly unilateral. Accuracy of performance increased with target size. Overall, the pointing task revealed activation in contralateral and ipsilateral M1, extending into contralateral somatosensory and parietal areas. Target size-dependent activation differences were found in ipsilateral M1 extending into the temporal/parietal junction, where activation increased with increasing demand on accuracy. The results suggest that ipsilateral M1 is active during the execution of a unilateral motor task and that its activity is modulated by the demand on precision.


Asunto(s)
Corteza Motora/fisiología , Destreza Motora , Anciano , Femenino , Lateralidad Funcional , Mano/inervación , Mano/fisiología , Humanos , Masculino , Persona de Mediana Edad , Corteza Somatosensorial/fisiología
16.
Cancer Cell ; 25(2): 196-209, 2014 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-24486181

RESUMEN

Ubiquitin-like with PHD and RING finger domains 1 (UHRF1) is an essential regulator of DNA methylation that is highly expressed in many cancers. Here, we use transgenic zebrafish, cultured cells, and human tumors to demonstrate that UHRF1 is an oncogene. UHRF1 overexpression in zebrafish hepatocytes destabilizes and delocalizes Dnmt1 and causes DNA hypomethylation and Tp53-mediated senescence. Hepatocellular carcinoma (HCC) emerges when senescence is bypassed. tp53 mutation both alleviates senescence and accelerates tumor onset. Human HCCs recapitulate this paradigm, as UHRF1 overexpression defines a subclass of aggressive HCCs characterized by genomic instability, TP53 mutation, and abrogation of the TP53-mediated senescence program. We propose that UHRF1 overexpression is a mechanism underlying DNA hypomethylation in cancer cells and that senescence is a primary means of restricting tumorigenesis due to epigenetic disruption.


Asunto(s)
Proteínas Potenciadoras de Unión a CCAAT/metabolismo , Carcinoma Hepatocelular/patología , Metilación de ADN , Neoplasias Hepáticas/patología , Animales , Proteínas Potenciadoras de Unión a CCAAT/genética , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/mortalidad , Células Cultivadas , Senescencia Celular , Estudios de Cohortes , Biología Computacional , Hepatocitos/citología , Hepatocitos/metabolismo , Humanos , Immunoblotting , Hígado/metabolismo , Hígado/patología , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/metabolismo , Mutación/genética , Pronóstico , Tasa de Supervivencia , Proteína p53 Supresora de Tumor/genética , Proteína p53 Supresora de Tumor/metabolismo , Ubiquitina-Proteína Ligasas , Pez Cebra
17.
Brain Lang ; 128(1): 18-24, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24316238

RESUMEN

Non-arbitrary correspondences between spoken words and categories of meanings exist in natural language, with mounting evidence that listeners are sensitive to this sound symbolic information. Native English speakers were asked to choose the meaning of spoken foreign words from one of four corresponding antonym pairs selected from a previously developed multi-language stimulus set containing both sound symbolic and non-symbolic stimuli. In behavioral (n=9) and fMRI (n=15) experiments, participants showed reliable sensitivity to the sound symbolic properties of the stimulus set, selecting the consistent meaning for the sound symbolic words at above chances rates. There was increased activation for sound symbolic relative to non-symbolic words in left superior parietal cortex, and a cluster in left superior longitudinal fasciculus showed a positive correlation between fractional anisotropy (FA) and an individual's sensitivity to sound symbolism. These findings support the idea that crossmodal correspondences underlie sound symbolism in spoken language.


Asunto(s)
Encéfalo/fisiología , Lenguaje , Semántica , Percepción del Habla/fisiología , Simbolismo , Adolescente , Adulto , Mapeo Encefálico , Imagen de Difusión Tensora , Femenino , Humanos , Lingüística , Imagen por Resonancia Magnética , Masculino , Lóbulo Parietal/fisiología , Adulto Joven
18.
Gastroenterology ; 145(6): 1424-35.e1-25, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24012984

RESUMEN

BACKGROUND & AIMS: Epigenetic silencing of tumor suppressor genes contributes to the pathogenesis of hepatocellular carcinoma (HCC). To identify clinically relevant tumor suppressor genes silenced by DNA methylation in HCC, we integrated DNA methylation data from human primary HCC samples with data on up-regulation of gene expression after epigenetic unmasking. METHODS: We performed genome-wide methylation analysis of 71 human HCC samples using the Illumina HumanBeadchip27K array; data were combined with those from microarray analysis of gene re-expression in 4 liver cancer cell lines after their exposure to reagents that reverse DNA methylation (epigenetic unmasking). RESULTS: Based on DNA methylation in primary HCC and gene re-expression in cell lines after epigenetic unmasking, we identified 13 candidate tumor suppressor genes. Subsequent validation led us to focus on functionally characterizing 2 candidates, sphingomyelin phosphodiesterase 3 (SMPD3) and neurofilament, heavy polypeptide (NEFH), which we found to behave as tumor suppressor genes in HCC. Overexpression of SMPD3 and NEFH by stable transfection of inducible constructs into an HCC cell line reduced cell proliferation by 50% and 20%, respectively (SMPD3, P = .003 and NEFH, P = .003). Conversely, knocking down expression of these genes with small hairpin RNA promoted cell invasion and migration in vitro (SMPD3, P = .0001 and NEFH, P = .022), and increased their ability to form tumors after subcutaneous injection or orthotopic transplantation into mice, confirming their role as tumor suppressor genes in HCC. Low levels of SMPD3 were associated with early recurrence of HCC after curative surgery in an independent patient cohort (P = .001; hazard ratio = 3.22; 95% confidence interval: 1.6-6.5 in multivariate analysis). CONCLUSIONS: Integrative genomic analysis identified SMPD3 and NEFH as tumor suppressor genes in HCC. We provide evidence that SMPD3 is a potent tumor suppressor gene that could affect tumor aggressiveness; a reduced level of SMPD3 is an independent prognostic factor for early recurrence of HCC.


Asunto(s)
Carcinoma Hepatocelular/genética , Metilación de ADN/genética , ADN de Neoplasias/genética , Epigenómica/métodos , Genes Supresores de Tumor , Estudio de Asociación del Genoma Completo/métodos , Neoplasias Hepáticas/genética , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patología , Línea Celular Tumoral , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Proteínas de Neurofilamentos/genética , Pronóstico , Recurrencia , Esfingomielina Fosfodiesterasa/genética
19.
Proc Natl Acad Sci U S A ; 109(21): 8212-7, 2012 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-22566646

RESUMEN

The large chromosomal deletions frequently observed in cancer genomes are often thought to arise as a "two-hit" mechanism in the process of tumor-suppressor gene (TSG) inactivation. Using a murine model system of hepatocellular carcinoma (HCC) and in vivo RNAi, we test an alternative hypothesis, that such deletions can arise from selective pressure to attenuate the activity of multiple genes. By targeting the mouse orthologs of genes frequently deleted on human 8p22 and adjacent regions, which are lost in approximately half of several other major epithelial cancers, we provide evidence suggesting that multiple genes on chromosome 8p can cooperatively inhibit tumorigenesis in mice, and that their cosuppression can synergistically promote tumor growth. In addition, in human HCC patients, the combined down-regulation of functionally validated 8p TSGs is associated with poor survival, in contrast to the down-regulation of any individual gene. Our data imply that large cancer-associated deletions can produce phenotypes distinct from those arising through loss of a single TSG, and as such should be considered and studied as distinct mutational events.


Asunto(s)
Carcinoma Hepatocelular/genética , Eliminación de Gen , Genes Supresores de Tumor/fisiología , Genómica/métodos , Neoplasias Hepáticas Experimentales/genética , Monosomía , Animales , Carcinoma Hepatocelular/mortalidad , Línea Celular Transformada , Línea Celular Tumoral , Cromosomas Humanos Par 8 , Femenino , Regulación Neoplásica de la Expresión Génica/genética , Haploinsuficiencia/genética , Humanos , Hígado/citología , Neoplasias Hepáticas Experimentales/mortalidad , Ratones , Ratones Endogámicos C57BL , Ratones Desnudos , Interferencia de ARN , Células Madre/citología
20.
Genome Med ; 3(11): 71, 2011 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-22085423

RESUMEN

A report on the Wellcome Trust Scientific Conference 'Epigenomics of Common Diseases', Hinxton, Cambridge, UK, September 13-16, 2011.

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