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1.
Cereb Cortex ; 34(1)2024 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-38037470

RESUMEN

Even though deficits in social cognition constitute a core characteristic of autism spectrum disorders, a large heterogeneity exists regarding individual social performances and its neural basis remains poorly investigated. Here, we used eye-tracking to objectively measure interindividual variability in social perception and its correlation with white matter microstructure, measured with diffusion tensor imaging MRI, in 25 children with autism spectrum disorder (8.5 ± 3.8 years). Beyond confirming deficits in social perception in participants with autism spectrum disorder compared 24 typically developing controls (10.5 ± 2.9 years), results revealed a large interindividual variability of such behavior among individuals with autism spectrum disorder. Whole-brain analysis showed in both autism spectrum disorder and typically developing groups a positive correlation between number of fixations to the eyes and fractional anisotropy values mainly in right and left superior longitudinal tracts. In children with autism spectrum disorder a correlation was also observed in right and left inferior longitudinal tracts. Importantly, a significant interaction between group and number of fixations to the eyes was observed within the anterior portion of the right inferior longitudinal fasciculus, mainly in the right anterior temporal region. This additional correlation in a supplementary region suggests the existence of a compensatory brain mechanism, which may support enhanced performance in social perception among children with autism spectrum disorder.


Asunto(s)
Trastorno del Espectro Autista , Sustancia Blanca , Niño , Humanos , Imagen de Difusión Tensora/métodos , Trastorno del Espectro Autista/diagnóstico por imagen , Tecnología de Seguimiento Ocular , Encéfalo/diagnóstico por imagen , Imagen por Resonancia Magnética , Sustancia Blanca/diagnóstico por imagen , Percepción Social , Anisotropía
3.
Front Neurosci ; 17: 1127542, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37123350

RESUMEN

Zolpidem is a sedative drug that has been shown to induce a paradoxical effect, restoring brain function in wide range of neurological disorders. The underlying functional mechanism of the effect of zolpidem in the brain in clinical improvement is still poorly understood. Thus, we aimed to investigate rest brain function to study zolpidem-induced symptom improvement in a patient who developed postoperative pediatric cerebellar mutism syndrome, a postoperative complication characterized by delayed onset transient mutism/reduced speech that can occur after medulloblastoma resection. The patient experienced clinical recovery after a single dose of zolpidem. Brain function was investigated using arterial spin labeling MRI and resting-state functional MRI. Imaging was performed at three time-points: preoperative, postoperative during symptoms, and after zolpidem intake when the symptoms regressed. Whole brain rest cerebral blood flow (CBF) and resting state functional connectivity using Pearson coefficient correlations between pairs of regions of interest were investigated two-by-two at the different time points. A comparison between postoperative and preoperative images showed a significant decrease in rest CBF in the left supplementary motor area, Broca's area, and the left striatum and a decrease in functional connectivity within the dentato-thalamo-cortical and cortico-striato-pallido-thalamo-cortical loops. Post-zolpidem images showed increased CBF in the left striatum and increased functional connectivity within the disrupted loops relative to postoperative images. Thus, we observed functional changes within the broader speech network and thalamo-subcortical interactions associated with the paradoxical effect of zolpidem in promoting clinical recovery. This should encourage further functional investigations in the brain to better understand the mechanism of zolpidem in neurological recovery.

4.
Sci Rep ; 13(1): 5507, 2023 04 04.
Artículo en Inglés | MEDLINE | ID: mdl-37016041

RESUMEN

Emotional speech perception is a multisensory process. When speaking with an individual we concurrently integrate the information from their voice and face to decode e.g., their feelings, moods, and emotions. However, the physiological reactions-such as the reflexive dilation of the pupil-associated to these processes remain mostly unknown. That is the aim of the current article, to investigate whether pupillary reactions can index the processes underlying the audiovisual integration of emotional signals. To investigate this question, we used an algorithm able to increase or decrease the smiles seen in a person's face or heard in their voice, while preserving the temporal synchrony between visual and auditory channels. Using this algorithm, we created congruent and incongruent audiovisual smiles, and investigated participants' gaze and pupillary reactions to manipulated stimuli. We found that pupil reactions can reflect emotional information mismatch in audiovisual speech. In our data, when participants were explicitly asked to extract emotional information from stimuli, the first fixation within emotionally mismatching areas (i.e., the mouth) triggered pupil dilation. These results reveal that pupil dilation can reflect the dynamic integration of audiovisual emotional speech and provide insights on how these reactions are triggered during stimulus perception.


Asunto(s)
Percepción del Habla , Habla , Humanos , Pupila , Percepción Visual/fisiología , Percepción del Habla/fisiología , Emociones/fisiología
5.
Eur Radiol ; 33(1): 196-206, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36066730

RESUMEN

OBJECTIVE: To study longitudinal changes in tuber and whole-brain perfusion in children with tuberous sclerosis complex (TSC) using arterial spin labeling (ASL) perfusion MRI and correlate them with pathological EEG slow wave activity and neurodevelopmental outcomes. METHODS: Retrospective longitudinal cohort study of 13 children with TSC, 3 to 6 serial ASL-MRI scans between 2 months and 7 years of age (53 scans in total), and an EEG examination performed within 2 months of the last MRI. Tuber cerebral blood flow (CBF) values were calculated in tuber segmentation masks, and tuber:cortical CBF ratios were used to study tuber perfusion. Logistic regression analysis was performed to identify which initial tuber characteristics (CBF value, volume, location) in the first MRI predicted tubers subsequently associated with EEG slow waves. Whole-brain and lobar CBF values were extracted for all patient scans and age-matched controls. CBF ratios were compared in patients and controls to study longitudinal changes in whole-brain CBF. RESULTS: Perfusion was reduced in tubers associated with EEG slow waves compared with other tubers. Low tuber CBF values around 6 months of age and large tuber volumes were predictive of tubers subsequently associated with EEG slow waves. Patients with severe developmental delay had more severe whole-brain hypoperfusion than those with no/mild delay, which became apparent after 2 years of age and were not associated with a higher tuber load. CONCLUSIONS: Dynamic changes in tuber and brain perfusion occur over time. Perfusion is significantly reduced in tubers associated with EEG slow waves. Whole-brain perfusion is significantly reduced in patients with severe delay. KEY POINTS: • Tubers associated with EEG slow wave activity were significantly more hypoperfused than other tubers, especially after 1 year of age. • Larger and more hypoperfused tubers at 6 months of age were more likely to subsequently be associated with pathological EEG slow wave activity. • Patients with severe developmental delay had more extensive and severe global hypoperfusion than those without developmental delay.


Asunto(s)
Epilepsia , Esclerosis Tuberosa , Niño , Humanos , Circulación Cerebrovascular , Cognición , Estudios Longitudinales , Imagen por Resonancia Magnética , Estudios Retrospectivos , Marcadores de Spin , Esclerosis Tuberosa/complicaciones , Esclerosis Tuberosa/diagnóstico , Esclerosis Tuberosa/patología
6.
Brain Commun ; 4(5): fcac250, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36324869

RESUMEN

Periodic discharges are a rare peculiar electroencephalogram pattern, occasionally associated with motor or other clinical manifestations, usually observed in critically ill patients. Their underlying pathophysiology remains poorly understood. Epileptic spasms in clusters and periodic discharges with motor manifestations share similar electroencephalogram pattern and some aetiologies of unfavourable prognosis such as subacute sclerosing panencephalitis or herpes encephalitis. Arterial spin labelling magnetic resonance imaging identifies localizing ictal and inter-ictal changes in neurovascular coupling, therefore assumed able to reveal concerned cerebral structures. Here, we retrospectively analysed ictal and inter-ictal arterial spin labelling magnetic resonance imaging in patients aged 6 months to 15 years (median 3 years 4 months) with periodic discharges including epileptic spasms, and compared these findings with those of patients with drug-resistant focal epilepsy who never presented periodic discharges nor epileptic spasms as well as to those of age-matched healthy controls. Ictal electroencephalogram was recorded either simultaneously with arterial spin labelling magnetic resonance imaging or during the close time lapse of patients' periodic discharges, whereas inter-ictal examinations were performed during the patients' active epilepsy but without seizures during the arterial spin labelling magnetic resonance imaging. Ictal arterial spin labelling magnetic resonance imaging was acquired in five patients with periodic discharges [subacute sclerosing panencephalitis (1), stroke-like events (3), West syndrome with cortical malformation (1), two of them also had inter-ictal arterial spin labelling magnetic resonance imaging]. Inter-ictal group included patients with drug-resistant epileptic spasms of various aetiologies (14) and structural drug-resistant focal epilepsy (8). Cortex, striatum and thalamus were segmented and divided in six functional subregions: prefrontal, motor (rostral, caudal), parietal, occipital and temporal. Rest cerebral blood flow values, absolute and relative to whole brain, were compared with those of age-matched controls for each subregion. Main findings were diffuse striatal as well as cortical motor cerebral blood flow increase during ictal examinations in generalized periodic discharges with motor manifestations (subacute sclerosing panencephalitis) and focal cerebral blood flow increase in corresponding cortical-striatal-thalamic subdivisions in lateralized periodic discharges with or without motor manifestations (stroke-like events and asymmetrical epileptic spasms) with straight topographical correlation with the electroencephalogram focus. For inter-ictal examinations, patients with epileptic spasms disclosed cerebral blood flow changes in corresponding cortical-striatal-thalamic subdivisions (absolute-cerebral blood flow decrease and relative-cerebral blood flow increase), more frequently when compared with the group of drug-resistant focal epilepsies, and not related to Vigabatrin treatment. Our results suggest that corresponding cortical-striatal-thalamic circuits are involved in periodic discharges with and without motor manifestations, including epileptic spasms, opening new insights in their pathophysiology and new therapeutical perspectives. Based on these findings, we propose a model for the generation of periodic discharges and of epileptic spasms combining existing pathophysiological models of cortical-striatal-thalamic network dynamics.

7.
J Cereb Blood Flow Metab ; 41(12): 3339-3349, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34259072

RESUMEN

Postoperative pediatric cerebellar mutism syndrome (pCMS), characterized mainly by delayed onset transient mutism is a poorly understood complication that may occur after pediatric medulloblastoma (MB) resection. Our aim was to investigate postoperative changes in whole-brain cerebral blood flow (CBF) at rest in pCMS patients using arterial spin labeling (ASL) perfusion imaging. This study compared preoperative and postoperative T2-weighted signal abnormalities and CBF using a voxel-wise, whole-brain analysis in 27 children undergoing MB resection, including 11 patients who developed mutism and 16 who did not. Comparison of postoperative T2 signal abnormalities between patients who developed pCMS (mean age 7.0 years) and those who did not showed that pCMS (mean age 8.9 years) patients were significantly more likely to present with T2-weighted hyperintensities in the right dentate nucleus (DN) (p = 0.02). Comparison of preoperative and postoperative CBF in patients with pCMS showed a significant postoperative CBF decrease in the left pre-supplementary motor area (pre-SMA) (p = 0.007) and SMA (p = 0.009). In patients who did not develop pCMS, no significant differences were observed. Findings provide evidence of an association between pCMS, injury to the right DN, and left pre-SMA/SMA hypoperfusion, areas responsible for speech. This supports the relevance of CBF investigations in pCMS.


Asunto(s)
Encéfalo , Neoplasias Cerebelosas , Circulación Cerebrovascular , Meduloblastoma , Mutismo , Imagen de Perfusión , Complicaciones Posoperatorias/diagnóstico por imagen , Adolescente , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Neoplasias Cerebelosas/diagnóstico por imagen , Neoplasias Cerebelosas/cirugía , Niño , Preescolar , Femenino , Humanos , Masculino , Meduloblastoma/diagnóstico por imagen , Meduloblastoma/cirugía , Mutismo/diagnóstico por imagen , Mutismo/etiología , Perfusión , Marcadores de Spin
8.
Eur Radiol ; 31(12): 8913-8924, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34003354

RESUMEN

OBJECTIVES: The diffuse intrinsic pontine gliomas (DIPGs) are now defined by the type of histone H3 mutated at lysine 27. We aimed to correlate the multimodal MRI features of DIPGs, H3K27M mutant, with their histological and molecular characteristics. METHODS: Twenty-seven treatment-naïve children with histopathologically confirmed DIPG H3K27M mutant were prospectively included. MRI performed prior to biopsy included multi-b-value diffusion-weighted imaging, ASL, and dynamic susceptibility contrast (DSC) perfusion imaging. The ADC and cerebral blood flow (CBF) and blood volume (CBV) were measured at the biopsy site. We assessed quantitative histological data, including microvascular density, nuclear density, and H3K27M-positive nuclear density. Gene expression profiling was also assessed in the samples. We compared imaging and histopathological data according to histone subgroup. We correlated MRI quantitative data with histological data and gene expression. RESULTS: H3.1K27M mutated tumors showed higher ADC values (median 3151 µm2/s vs 1741 µm2/s, p = 0.003), and lower perfusion values (DSC-rCBF median 0.71 vs 1.43, p = 0.002, and DSC-rCBV median 1.00 vs 1.71, p = 0.02) than H3.3K27M ones. They had similar microvascular and nuclear density, but lower H3K27M-positive nuclear density (p = 0.007). The DSC-rCBV was positively correlated to the H3K27M-positive nuclear density (rho = 0.74, p = 0.02). ADC values were not correlated with nuclear density nor perfusion values with microvascular density. The expression of gated channel activity-related genes tended to be inversely correlated with ADC values and positively correlated with DSC perfusion. CONCLUSIONS: H3.1K27M mutated tumors have higher ADC and lower perfusion values than H3.3K27M ones, without direct correlation with microvascular or nuclear density. This may be due to tissular edema possibly related to gated channel activity-related gene expression. KEY POINTS: • H3.1K27M mutant DIPG had higher apparent diffusion coefficient (p = 0.003), lower α (p = 0.048), and lower relative cerebral blood volume (p = 0.02) than H3.3K27M mutant DIPG at their biopsy sites. • Biopsy samples obtained within the tumor's enhancing portion showed higher microvascular density (p = 0.03) than samples obtained outside the tumor's enhancing portion, but similar H3K27M-positive nuclear density (p = 0.84). • Relative cerebral blood volume measured at the biopsy site was significantly correlated with H3K27M-positive nuclear density (rho = 0.74, p = 0.02).


Asunto(s)
Neoplasias Encefálicas , Neoplasias del Tronco Encefálico , Glioma Pontino Intrínseco Difuso , Glioma , Neoplasias del Tronco Encefálico/diagnóstico por imagen , Neoplasias del Tronco Encefálico/genética , Niño , Glioma/diagnóstico por imagen , Glioma/genética , Histonas/genética , Humanos , Imagen por Resonancia Magnética
9.
Neuroimage Clin ; 29: 102510, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33369563

RESUMEN

Age at implantation is considered to be a major factor, influencing outcomes after pediatric cochlear implantation. In the absence of acoustic input, it has been proposed that cross-modal reorganization can be detrimental for adaptation to the new electrical input provided by a cochlear implant. Here, through a retrospective study, we aimed to investigate differences in cerebral blood flow (CBF) at rest prior to implantation in children with congenital deafness compared to normally hearing children. In addition, we looked at the putative link between pre-operative rest-CBF and the oral intelligibility scores at 12 months post-implantation. Finally, we observed the evolution of perfusion with age, within brain areas showing abnormal rest-CBF associated to deafness, in deaf children and in normally hearing children. In children older than 5 years old, results showed a significant bilateral hypoperfusion in temporal regions in deaf children, particularly in Heschl's gyrus, and a significant hyperperfusion of occipital regions. Furthermore, in children older than 5 years old, whole brain voxel-by-voxel correlation analysis between pre-operative rest-CBF and oral intelligibility scores at 12 months post-implantation, showed significant negative correlation localized in the occipital regions: children who performed worse in the speech perception test one year after implantation were those presenting higher preoperative CBF values in these occipital regions. Finally, when comparing mean relative perfusion (extracted from the temporal regions found abnormal on whole-brain voxel-based analysis) across ages in patients and controls, we observed that the temporal perfusion evolution was significantly different in deaf children than in normally hearing children. Indeed, while temporal perfusion increased with age in normally hearing children, it remained stable in deaf children. We showed a critical period around 4 years old, where in the context of auditory deprivation, there is a lack of synaptic activity in auditory regions. These results support the benefits of early cochlear implantation to maximize the effectiveness of auditory rehabilitation and to avoid cross-modal reorganization.


Asunto(s)
Implantación Coclear , Sordera , Percepción del Habla , Encéfalo/diagnóstico por imagen , Circulación Cerebrovascular , Niño , Preescolar , Sordera/diagnóstico por imagen , Sordera/cirugía , Humanos , Imagen por Resonancia Magnética , Perfusión , Estudios Retrospectivos , Resultado del Tratamiento
10.
Cereb Cortex ; 31(3): 1776-1785, 2021 02 05.
Artículo en Inglés | MEDLINE | ID: mdl-33230520

RESUMEN

The first year of life is a key period of brain development, characterized by dramatic structural and functional modifications. Here, we measured rest cerebral blood flow (CBF) modifications throughout babies' first year of life using arterial spin labeling magnetic resonance imaging sequence in 52 infants, from 3 to 12 months of age. Overall, global rest CBF significantly increased during this age span. In addition, we found marked regional differences in local functional brain maturation. While primary sensorimotor cortices and insula showed early maturation, temporal and prefrontal region presented great rest CBF increase across the first year of life. Moreover, we highlighted a late and remarkably synchronous maturation of the prefrontal and posterior superior temporal cortices. These different patterns of regional cortical rest CBF modifications reflect a timetable of local functional brain maturation and are consistent with baby's cognitive development within the first year of life.


Asunto(s)
Encéfalo/crecimiento & desarrollo , Neurogénesis/fisiología , Circulación Cerebrovascular/fisiología , Femenino , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética/métodos , Masculino , Descanso
11.
Cerebellum ; 19(1): 58-67, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31732920

RESUMEN

Posterior fossa arachnoid cysts (PFAC) may produce not only neurological symptoms but also other symptoms still poorly understood such as behavioral and learning deficits, awkwardness, and difficulties in social interaction. These subtle social impairments have not been formally described and their underlying brain mechanisms remain unknown. In the present case-control study, we aimed to empirically characterize social impairments in a pediatric population with PFAC using eye tracking. In addition, we investigated putative functional cortical abnormalities in these children using arterial spin labeling magnetic resonance imaging. Overall, 15 patients with PFAC (3f, age = 9.4 ± 4 years) and 43 typically developing volunteer children (16f, age = 9.3 ± 3.6 years) were enrolled in this study. Eye tracking was used to record gaze patterns during visualization of social interaction scenes. Viewing times to faces of characters and non-social background were analyzed. A voxel-wise whole-brain analysis was performed to investigate rest cerebral blood flow (CBF) abnormalities. Significantly reduced viewing time to faces was observed in patients compared with controls (p < 0.01). A ROC curve analysis revealed that 30% of PFAC patients presented viewing time to the face lower than the cutoff, while none of the controls did. The whole-brain analysis revealed a significant decrease in rest CBF in PFAC patients compared with controls bilaterally in the superior temporal gyrus and the temporoparietal junction (TPJ) (p < 0.05 FWE). These results suggest that early life PFAC may have an impact on functional activity of the temporal lobe, which could be associated with social perception deficits.


Asunto(s)
Quistes Aracnoideos/diagnóstico por imagen , Circulación Cerebrovascular/fisiología , Fosa Craneal Posterior/diagnóstico por imagen , Movimientos Oculares/fisiología , Descanso/fisiología , Percepción Social , Adolescente , Quistes Aracnoideos/psicología , Niño , Preescolar , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Estimulación Luminosa/métodos , Descanso/psicología
12.
Sci Rep ; 9(1): 9252, 2019 06 25.
Artículo en Inglés | MEDLINE | ID: mdl-31239453

RESUMEN

Social behavior is extremely variable among individuals, and the neural basis of this variability is still poorly understood. In this study, we aimed to investigate the neural basis of interindividual variability in the first step of social behavior, that is, social perception. For that purpose, we first used eye-tracking to measure social perception during the passive visualization of socially relevant movie clips. Second, we correlated eye-tracking data with measures of rest cerebral blood flow (CBF) obtained using arterial spin-labeling (ASL) MRI, an index of local rest brain function. The results showed a large interindividual variability in the number of fixations to the eyes of characters during passive visualization of movie clips displaying social interactions. Moreover, individual patterns remained stable across time, suggesting an individual signature of social behavior. Whole-brain analyses showed significant positive correlation between the number of fixations to the eyes and rest CBF: individuals who looked more to the eyes were those with higher rest CBF levels within the right superior temporal regions. Our results indicate the existence of a neural and behavioral signature associated with the interindividual variability in social perception.


Asunto(s)
Encéfalo/irrigación sanguínea , Circulación Cerebrovascular/fisiología , Movimientos Oculares/fisiología , Descanso/fisiología , Percepción Social , Adulto , Mapeo Encefálico , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Marcadores de Spin
13.
Neuroimage Clin ; 21: 101610, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30497982

RESUMEN

Kabuki syndrome (KS) is a rare congenital disorder (1/32000 births) characterized by distinctive facial features, intellectual disability, short stature, and dermatoglyphic and skeletal abnormalities. In the last decade, mutations in KMT2D and KDM6A were identified as a major cause of kabuki syndrome. Although genetic abnormalities have been highlighted in KS, brain abnormalities have been little explored. Here, we have investigated brain abnormalities in 6 patients with KS (4 males; Mage = 10.96 years, SD = 2.97 years) with KMT2D mutation in comparison with 26 healthy controls (17 males; Mage = 10.31 years, SD = 2.96 years). We have used MRI to explore anatomical and functional brain abnormalities in patients with KS. Anatomical abnormalities in grey matter volume were assessed by cortical and subcortical analyses. Functional abnormalities were assessed by comparing rest cerebral blood flow measured with arterial spin labeling-MRI. When compared to healthy controls, KS patients had anatomical alterations characterized by grey matter decrease localized in the bilateral precentral gyrus and middle frontal gyrus. In addition, KS patients also presented functional alterations characterized by cerebral blood flow decrease in the left precentral gyrus and middle frontal gyrus. Moreover, subcortical analyses revealed significantly decreased grey matter volume in the bilateral hippocampus and dentate gyrus in patients with KS. Our results strongly indicate anatomical and functional brain abnormalities in KS. They suggest a possible neural basis of the cognitive symptoms observed in KS, such as fine motor impairment, and indicate the need to further explore the consequences of such brain abnormalities in this disorder. Finally, our results encourage further imaging-genetics studies investigating the link between genetics, anatomical and functional brain alterations in KS.


Asunto(s)
Anomalías Múltiples/patología , Anomalías Múltiples/fisiopatología , Encéfalo/patología , Encéfalo/fisiopatología , Cara/anomalías , Enfermedades Hematológicas/patología , Enfermedades Hematológicas/fisiopatología , Enfermedades Vestibulares/patología , Enfermedades Vestibulares/fisiopatología , Anomalías Múltiples/diagnóstico por imagen , Adolescente , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Niño , Cara/irrigación sanguínea , Cara/diagnóstico por imagen , Cara/patología , Cara/fisiopatología , Femenino , Enfermedades Hematológicas/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Marcadores de Spin , Enfermedades Vestibulares/diagnóstico por imagen
14.
Neuro Oncol ; 20(7): 994-1002, 2018 06 18.
Artículo en Inglés | MEDLINE | ID: mdl-29244086

RESUMEN

Background: The interval between progression and death in diffuse intrinsic pontine glioma (DIPG) is usually <6 months. However, reports of longer patient survival following radiotherapy, in the presence of radiological signs of progression, suggest that these cases may be comparable to pseudoprogression observed in adult glioblastoma. Our aim was to identify such cases and compare their multimodal MRI features with those of patients who did not present the same evolution. Methods: Multimodal MRIs of 43 children treated for DIPG were retrospectively selected at 4 timepoints: baseline, after radiotherapy, during true progression, and at the last visit. The patients were divided into 2 groups depending on whether they presented conventional MRI changes that mimicked progression. The apparent diffusion coefficient, arterial spin labeling cerebral blood flow (ASL-CBF), and dynamic susceptibility contrast perfusion relative cerebral blood volume (DSCrCBV) and flow (DSCrCBF) values were recorded for each tumor voxel, avoiding necrotic areas. Results: After radiotherapy, 19 patients (44%) showed radiological signs that mimicked progression: 16 survived >6 months following so-called pseudoprogression, with a median of 8.9 months and a maximum of 35.6 months. All 43 patients exhibited increased blood volume and flow after radiotherapy, but the 90th percentile of those with signs of pseudoprogression had a greater increase of ASL-CBF (P < 0.001). Survival between the 2 groups did not differ significantly. During true progression, DSCrCBF and DSCrCBV values increased only in patients who had not experienced pseudoprogression. Conclusions: Pseudoprogression is a frequent phenomenon in DIPG patients. This condition needs to be recognized before considering treatment discontinuation. In this study, the larger increase of the ASL-CBF ratio after radiotherapy accurately distinguished pseudoprogression from true progression.


Asunto(s)
Neoplasias del Tronco Encefálico/patología , Circulación Cerebrovascular , Glioma/patología , Imagen Multimodal/métodos , Radioterapia/métodos , Adolescente , Neoplasias del Tronco Encefálico/irrigación sanguínea , Neoplasias del Tronco Encefálico/radioterapia , Estudios de Casos y Controles , Niño , Preescolar , Medios de Contraste , Imagen de Difusión por Resonancia Magnética , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Glioma/irrigación sanguínea , Glioma/radioterapia , Humanos , Estudios Longitudinales , Masculino , Pronóstico , Curva ROC , Estudios Retrospectivos
15.
Int J Radiat Oncol Biol Phys ; 99(2): 476-485, 2017 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-28871999

RESUMEN

PURPOSE: To use multimodal magnetic resonance imaging (MRI) to quantify treatment-induced changes in the whole volume of diffuse infiltrating pontine gliomas and correlate them with progression-free survival (PFS). METHODS AND MATERIALS: This prospective study included 22 children aged 3.3 to 14.7 years (median, 5.9 years). Multimodal MRI was performed at 3 distinct time points: before treatment, the first week following radiation therapy (RT), and 2 months after RT. The imaging protocol included morphologic, multi b-value diffusion; arterial spin labeling; and dynamic susceptibility contrast-enhanced perfusion. Morphologic and multimodal data-lesion volume, diffusion coefficients, relative cerebral blood flow, and relative cerebral blood volume (rCBV)-were recorded at the 3 aforementioned time points. The Wilcoxon test was used to compare each individual parameter variation between time points, and its correlation with PFS was assessed by the Spearman test. RESULTS: Following RT, the tumors' solid component volume decreased by 40% (P<.001). Their median diffusion coefficients decreased by 20% to 40% (P<.001), while median relative cerebral blood flow increased by 60% to 80% (P<.001) and median rCBV increased by 70% (P<.001). PFS was positively correlated with rCBV measured immediately after RT (P=.003), and in patients whose rCBV was above the cutoff value of 2.46, the median PFS was 4.6 months longer (P=.001). These indexes tended to return to baseline 2 months after RT. Lesion volume before or after RT was not correlated with survival. CONCLUSIONS: Multimodal MRI provides useful information about diffuse infiltrating pontine gliomas' response to treatment; rCBV increases following RT, and higher values are correlated with better PFS. High rCBV values following RT should not be mistaken for progression and could be an indicator of response to therapy.


Asunto(s)
Neoplasias del Tronco Encefálico/diagnóstico por imagen , Neoplasias del Tronco Encefálico/radioterapia , Encéfalo/irrigación sanguínea , Glioma/diagnóstico por imagen , Glioma/radioterapia , Adolescente , Antineoplásicos/uso terapéutico , Encéfalo/efectos de la radiación , Neoplasias del Tronco Encefálico/irrigación sanguínea , Neoplasias del Tronco Encefálico/patología , Quimioterapia Adyuvante , Niño , Preescolar , Medios de Contraste , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Clorhidrato de Erlotinib/administración & dosificación , Femenino , Glioma/irrigación sanguínea , Glioma/patología , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Estudios Prospectivos , Sirolimus/administración & dosificación , Estadísticas no Paramétricas , Análisis de Supervivencia , Factores de Tiempo , Carga Tumoral/efectos de la radiación
16.
Cereb Cortex ; 26(6): 2823-31, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26946130

RESUMEN

Processing eye-gaze information is a key step to human social interaction. Neuroimaging studies have shown that superior temporal sulcus (STS) is highly implicated in eye-gaze perception. In autism, a lack of preference for the eyes, as well as anatomo-functional abnormalities within the STS, has been described. To date, there are no experimental data in humans showing whether it is possible to interfere with eye-gaze processing by modulating STS neural activity. Here, we measured eye-gaze perception before and after inhibitory transcranial magnetic stimulation (TMS) applied over the posterior STS (pSTS) in young healthy volunteers. Eye-gaze processing, namely overt orienting toward the eyes, was measured using eye tracking during passive visualization of social movies. Inhibition of the right pSTS led participants to look less to the eyes of characters during visualization of social movies. Such effect was specific for the eyes and was not observed after inhibition of the left pSTS nor after placebo TMS. These results indicate for the first time that interfering with the right pSTS neural activity transitorily disrupts the behavior of orienting toward the eyes and thus indirectly gaze perception, a fundamental process for human social cognition. These results could open up new perspectives in therapeutic interventions in autism.


Asunto(s)
Fijación Ocular , Percepción Social , Lóbulo Temporal/fisiología , Percepción Visual/fisiología , Cognición/fisiología , Medidas del Movimiento Ocular , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Inhibición Neural , Lóbulo Temporal/diagnóstico por imagen , Estimulación Magnética Transcraneal , Adulto Joven
17.
Front Hum Neurosci ; 9: 171, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25870556

RESUMEN

Subjects with autism often show language difficulties, but it is unclear how they relate to neurophysiological anomalies of cortical speech processing. We used combined EEG and fMRI in 13 subjects with autism and 13 control participants and show that in autism, gamma and theta cortical activity do not engage synergistically in response to speech. Theta activity in left auditory cortex fails to track speech modulations, and to down-regulate gamma oscillations in the group with autism. This deficit predicts the severity of both verbal impairment and autism symptoms in the affected sample. Finally, we found that oscillation-based connectivity between auditory and other language cortices is altered in autism. These results suggest that the verbal disorder in autism could be associated with an altered balance of slow and fast auditory oscillations, and that this anomaly could compromise the mapping between sensory input and higher-level cognitive representations.

18.
Eur Arch Otorhinolaryngol ; 271(12): 3187-93, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24272140

RESUMEN

Most cochlear implantations are unilateral. To explore the benefits of a binaural cochlear implant, we used water-labelled oxygen-15 positron emission tomography. Relative cerebral blood flow was measured in a binaural implant group (n = 11), while the subjects were passively listening to human voice sounds, environmental sounds non-voice or silence. Binaural auditory stimulation in the cochlear implant group bilaterally activated the temporal voice areas, whereas monaural cochlear implant stimulation only activated the left temporal voice area. Direct comparison of the binaural and the monaural cochlear implant stimulation condition revealed an additional right temporal activation during voice processing in the binaural condition and the activation of a right fronto-parietal cortical network during sound processing that has been implicated in attention. These findings provide evidence that a bilateral cochlear implant stimulation enhanced the spectral cues associated with sound perception and improved brain processing of voice stimuli in the right temporal region when compared to a monaural cochlear implant stimulation. Moreover, the recruitment of sensory attention resources in a right fronto-parietal network allowed patients with bilateral cochlear implant stimulation to enhance their sound discrimination, whereas the same patients with only one cochlear implant stimulation had more auditory perception difficulties.


Asunto(s)
Implantación Coclear/métodos , Implantes Cocleares , Percepción del Habla/fisiología , Lóbulo Temporal , Estimulación Acústica/métodos , Adulto , Trastornos de la Percepción Auditiva/diagnóstico , Circulación Cerebrovascular/fisiología , Femenino , Audición/fisiología , Pérdida Auditiva Bilateral/diagnóstico , Humanos , Masculino , Tomografía de Emisión de Positrones/métodos , Lóbulo Temporal/irrigación sanguínea , Lóbulo Temporal/patología , Lóbulo Temporal/fisiopatología , Voz/fisiología
19.
Bull Acad Natl Med ; 197(4-5): 817-28; discussion 829, 2013.
Artículo en Francés | MEDLINE | ID: mdl-25518152

RESUMEN

Human beings are social animals. This ability to live together is ensured by cognitive functions, the neuroanatomical bases of which are starting to be unraveled by MRI-based studies. The regions and network engaged in this process are known as the "social brain ". The core of this network is the superior temporal sulcus (STS), which integrates sensory and emotional inputs. Modeling studies of healthy volunteers have shown the role of the STS.in recognizing others as biological beings, as well as facial and eye-gaze recognition, intentionality and emotions. This cognitive capacity has been described as the "theory of mind ". Pathological models such as autism, in which the main clinical abnormality is altered social abilities and communication, have confirmed the role of the STS in the social brain. Conceptualisation of this empathic capacity has been described as "meta cognition ", which forms the basis of human social organizationand culture.


Asunto(s)
Conducta Social , Lóbulo Temporal/fisiología , Teoría de la Mente/fisiología , Trastorno Autístico/patología , Empatía/fisiología , Expresión Facial , Neuroimagen Funcional , Humanos , Relaciones Interpersonales , Imagen por Resonancia Magnética , Reconocimiento Visual de Modelos/fisiología , Esquizofrenia/patología
20.
Neuroimage ; 63(1): 11-24, 2012 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-22781162

RESUMEN

Brain imaging is increasingly recognised as an intermediate phenotype to understand the complex path between genetics and behavioural or clinical phenotypes. In this context, a first goal is to propose methods to identify the part of genetic variability that explains some neuroimaging variability. Classical univariate approaches often ignore the potential joint effects that may exist between genes or the potential covariations between brain regions. In this paper, we propose instead to investigate an exploratory multivariate method in order to identify a set of Single Nucleotide Polymorphisms (SNPs) covarying with a set of neuroimaging phenotypes derived from functional Magnetic Resonance Imaging (fMRI). Recently, Partial Least Squares (PLS) regression or Canonical Correlation Analysis (CCA) have been proposed to analyse DNA and transcriptomics. Here, we propose to transpose this idea to the DNA vs. imaging context. However, in very high-dimensional settings like in imaging genetics studies, such multivariate methods may encounter overfitting issues. Thus we investigate the use of different strategies of regularisation and dimension reduction techniques combined with PLS or CCA to face the very high dimensionality of imaging genetics studies. We propose a comparison study of the different strategies on a simulated dataset first and then on a real dataset composed of 94 subjects, around 600,000 SNPs and 34 functional MRI lateralisation indexes computed from reading and speech comprehension contrast maps. We estimate the generalisability of the multivariate association with a cross-validation scheme and demonstrate the significance of this link, using a permutation procedure. Univariate selection appears to be necessary to reduce the dimensionality. However, the significant association uncovered by this two-step approach combining univariate filtering and L1-regularised PLS suggests that discovering meaningful genetic associations calls for a multivariate approach.


Asunto(s)
Mapeo Encefálico/métodos , Encéfalo/fisiología , Cognición/fisiología , Imagen por Resonancia Magnética/métodos , Red Nerviosa/fisiología , Reconocimiento de Normas Patrones Automatizadas/métodos , Polimorfismo de Nucleótido Simple/genética , Adulto , Interpretación Estadística de Datos , Femenino , Humanos , Análisis de los Mínimos Cuadrados , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Adulto Joven
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