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1.
Int J Mol Sci ; 22(6)2021 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-33799851

RESUMEN

Multiple lines of evidence suggest that dysfunction of the metabotropic glutamate receptor subtype 5 (mGluR5) plays a role in the pathogenesis of autism spectrum disorder (ASD). Yet animal and human investigations of mGluR5 expression provide conflicting findings about the nature of dysregulation of cerebral mGluR5 pathways in subtypes of ASD. The demonstration of reduced mGluR5 expression throughout the living brains of men with fragile X syndrome (FXS), the most common known single-gene cause of ASD, provides a clue to examine mGluR5 expression in ASD. We aimed to (A) compare and contrast mGluR5 expression in idiopathic autism spectrum disorder (IASD), FXS, and typical development (TD) and (B) show the value of positron emission tomography (PET) for the application of precision medicine for the diagnosis and treatment of individuals with IASD, FXS, and related conditions. Two teams of investigators independently administered 3-[18F]fluoro-5-(2-pyridinylethynyl)benzonitrile ([18F]FPEB), a novel, specific mGluR5 PET ligand to quantitatively measure the density and the distribution of mGluR5s in the brain regions, to participants of both sexes with IASD and TD and men with FXS. In contrast to participants with TD, mGluR5 expression was significantly increased in the cortical regions of participants with IASD and significantly reduced in all regions of men with FXS. These results suggest the feasibility of this protocol as a valuable tool to measure mGluR5 expression in clinical trials of individuals with IASD and FXS and related conditions.


Asunto(s)
Trastorno del Espectro Autista/metabolismo , Corteza Cerebral/metabolismo , Síndrome del Cromosoma X Frágil/metabolismo , Receptor del Glutamato Metabotropico 5/metabolismo , Adolescente , Adulto , Animales , Trastorno del Espectro Autista/diagnóstico por imagen , Trastorno del Espectro Autista/genética , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Corteza Cerebral/diagnóstico por imagen , Femenino , Síndrome del Cromosoma X Frágil/diagnóstico por imagen , Síndrome del Cromosoma X Frágil/genética , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Tomografía de Emisión de Positrones/métodos , Receptor del Glutamato Metabotropico 5/genética , Adulto Joven
2.
Int J Mol Sci ; 22(6)2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33808700

RESUMEN

The prevalence of obesity has increased rapidly in recent years and has put a huge burden on healthcare worldwide. Obesity is associated with an increased risk for many comorbidities, such as cardiovascular diseases, type 2 diabetes and hypertension. The hypothalamus is a key brain region involved in the regulation of food intake and energy expenditure. Research on experimental animals has shown neuronal loss, as well as microglial activation in the hypothalamus, due to dietary-induced obesity. Microglia, the resident immune cells in the brain, are responsible for maintaining the brain homeostasis and, thus, providing an optimal environment for neuronal function. Interestingly, in obesity, microglial cells not only get activated in the hypothalamus but in other brain regions as well. Obesity is also highly associated with changes in hippocampal function, which could ultimately result in cognitive decline and dementia. Moreover, changes have also been reported in the striatum and cortex. Microglial heterogeneity is still poorly understood, not only in the context of brain region but, also, age and sex. This review will provide an overview of the currently available data on the phenotypic differences of microglial innate immunity in obesity, dependent on brain region, sex and age.


Asunto(s)
Variación Biológica Poblacional , Mapeo Encefálico , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Microglía/metabolismo , Obesidad/diagnóstico por imagen , Factores de Edad , Animales , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/metabolismo , Cuerpo Estriado/diagnóstico por imagen , Cuerpo Estriado/metabolismo , Hipocampo/diagnóstico por imagen , Hipocampo/metabolismo , Humanos , Hipotálamo/diagnóstico por imagen , Hipotálamo/metabolismo , Factores Sexuales
3.
J Vis Exp ; (168)2021 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-33682856

RESUMEN

The overall goal of this article is to demonstrate a state-of-the-art ultrahigh field (UHF) magnetic resonance (MR) protocol of the brain at 7.0 Tesla in multiple sclerosis (MS) patients. MS is a chronic inflammatory, demyelinating, neurodegenerative disease that is characterized by white and gray matter lesions. Detection of spatially and temporally disseminated T2-hyperintense lesions by the use of MRI at 1.5 T and 3 T represents a crucial diagnostic tool in clinical practice to establish accurate diagnosis of MS based on the current version of the 2017 McDonald criteria. However, the differentiation of MS lesions from brain white matter lesions of other origins can sometimes be challenging due to their resembling morphology at lower magnetic field strengths (typically 3 T). Ultrahigh field MR (UHF-MR) benefits from increased signal-to-noise ratio and enhanced spatial resolution, both key to superior imaging for more accurate and definitive diagnoses of subtle lesions. Hence, MRI at 7.0 T has shown encouraging results to overcome the challenges of MS differential diagnosis by providing MS-specific neuroimaging markers (e.g., central vein sign, hypointense rim structures and differentiation of MS grey matter lesions). These markers and others can be identified by other MR contrasts other than T1 and T2 (T2*, phase, diffusion) and substantially improve the differentiation of MS lesions from those occurring in other neuroinflammatory conditions such as neuromyelitis optica and Susac syndrome. In this article, we describe our current technical approach to study cerebral white and grey matter lesions in MS patients at 7.0 T using different MR acquisition methods. The up-to-date protocol includes the preparation of the MR setup including the radio-frequency coils customized for UHF-MR, standardized screening, safety and interview procedures with MS patients, patient positioning in the MR scanner and acquisition of dedicated brain scans tailored for examining MS.


Asunto(s)
Imagen por Resonancia Magnética , Esclerosis Múltiple/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Esclerosis Múltiple/patología , Neuroimagen , Programas Informáticos , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología
4.
J Vis Exp ; (168)2021 02 21.
Artículo en Inglés | MEDLINE | ID: mdl-33682857

RESUMEN

The use of electrocorticographic (ECoG) recordings in rodents is relevant to sleep research and to the study of a wide range of neurological conditions. Adeno-associated viruses (AAVs) are increasingly used to improve understanding of brain circuits and their functions. The AAV-mediated manipulation of specific cell populations and/or of precise molecular components has been tremendously useful to identify new sleep regulatory circuits/molecules and key proteins contributing to the adverse effects of sleep loss. For instance, inhibiting activity of the filamentous actin-severing protein cofilin using AAV prevents sleep deprivation-induced memory impairment. Here, a protocol is described that combines the manipulation of cofilin function in a cerebral cortex area with the recording of ECoG activity to examine whether cortical cofilin modulates the wakefulness and sleep ECoG signals. AAV injection is performed during the same surgical procedure as the implantation of ECoG and electromyographic (EMG) electrodes in adult male and female mice. Mice are anesthetized, and their heads are shaved. After skin cleaning and incision, stereotaxic coordinates of the motor cortex are determined, and the skull is pierced at this location. A cannula prefilled with an AAV expressing cofilinS3D, an inactive form of cofilin, is slowly positioned in the cortical tissue. After AAV infusion, gold-covered screws (ECoG electrodes) are screwed through the skull and cemented to the skull with gold wires inserted in the neck muscles (EMG electrodes). The animals are allowed three weeks to recover and to ensure sufficient expression of cofilinS3D. The infected area and cell type are verified using immunohistochemistry, and the ECoG is analyzed using visual identification of vigilance states and spectral analysis. In summary, this combined methodological approach allows the investigation of the precise contribution of molecular components regulating neuronal morphology and connectivity to the regulation of synchronized cerebral cortex activity during wakefulness and sleep.


Asunto(s)
Factores Despolimerizantes de la Actina/metabolismo , Corteza Cerebral/diagnóstico por imagen , Dependovirus/metabolismo , Electrocorticografía , Animales , Electrodos , Electromiografía , Femenino , Inyecciones , Masculino , Ratones Endogámicos C57BL , Sueño/fisiología , Vigilia/fisiología
5.
Nat Commun ; 12(1): 1922, 2021 03 26.
Artículo en Inglés | MEDLINE | ID: mdl-33771999

RESUMEN

Despite major advances in measuring human brain activity during and after educational experiences, it is unclear how learners internalize new content, especially in real-life and online settings. In this work, we introduce a neural approach to predicting and assessing learning outcomes in a real-life setting. Our approach hinges on the idea that successful learning involves forming the right set of neural representations, which are captured in canonical activity patterns shared across individuals. Specifically, we hypothesized that learning is mirrored in neural alignment: the degree to which an individual learner's neural representations match those of experts, as well as those of other learners. We tested this hypothesis in a longitudinal functional MRI study that regularly scanned college students enrolled in an introduction to computer science course. We additionally scanned graduate student experts in computer science. We show that alignment among students successfully predicts overall performance in a final exam. Furthermore, within individual students, we find better learning outcomes for concepts that evoke better alignment with experts and with other students, revealing neural patterns associated with specific learned concepts in individuals.


Asunto(s)
Corteza Cerebral/diagnóstico por imagen , Aprendizaje , Imagen por Resonancia Magnética/métodos , Programas Informáticos , Estudiantes/estadística & datos numéricos , Curriculum , Evaluación Educacional/métodos , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Factores de Tiempo , Universidades , Adulto Joven
6.
J Clin Neurophysiol ; 38(2): 112-123, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33661787

RESUMEN

SUMMARY: High-density EEG (HD-EEG) recordings use a higher spatial sampling of scalp electrodes than a standard 10-20 low-density EEG montage. Although several studies have demonstrated improved localization of the epileptogenic cortex using HD-EEG, widespread implementation is impeded by cost, setup and interpretation time, and lack of specific or sufficient procedural billing codes. Despite these barriers, HD-EEG has been in use at several institutions for years. These centers have noted utility in a variety of clinical scenarios where increased spatial resolution from HD-EEG has been required, justifying the extra time and cost. We share select scenarios from several centers, using different recording techniques and software, where HD-EEG provided information above and beyond the standard low-density EEG. We include seven cases where HD-EEG contributed directly to current clinical care of epilepsy patients and highlight two novel techniques which suggest potential opportunities to improve future clinical care. Cases illustrate how HD-EEG allows clinicians to: case 1-lateralize falsely generalized interictal epileptiform discharges; case 2-improve localization of falsely generalized epileptic spasms; cases 3 and 4-improve localization of interictal epileptiform discharges in anatomic regions below the circumferential limit of standard low-density EEG coverage; case 5-improve noninvasive localization of the seizure onset zone in lesional epilepsy; cases 6 and 7-improve localization of the seizure onset zone to guide invasive investigation near eloquent cortex; case 8-identify epileptic fast oscillations; and case 9-map language cortex. Together, these nine cases illustrate that using both visual analysis and advanced techniques, HD-EEG can play an important role in clinical management.


Asunto(s)
Mapeo Encefálico/métodos , Electroencefalografía/métodos , Epilepsia/diagnóstico por imagen , Epilepsia/fisiopatología , Adolescente , Adulto , Anciano , Mapeo Encefálico/tendencias , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/fisiopatología , Niño , Electrodos/tendencias , Electroencefalografía/tendencias , Femenino , Predicción , Humanos , Lactante , Masculino , Persona de Mediana Edad , Cuero Cabelludo/diagnóstico por imagen , Cuero Cabelludo/fisiopatología , Convulsiones/diagnóstico por imagen , Convulsiones/fisiopatología , Adulto Joven
7.
Brain ; 144(1): 266-277, 2021 02 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578418

RESUMEN

Multiple neuropathological processes can manifest in life as a corticobasal syndrome. We sought to relate retention of the tau-PET tracer 18F-AV-1451 and structural magnetic resonance measures of regional atrophy to clinical features in clinically diagnosed and neuropathologically confirmed cases of corticobasal syndrome and to determine whether these vary with the underlying neuropathological changes. In this observational, cross-sectional study, 11 subjects (eight female and three male, median age 72 years) with corticobasal syndrome underwent structural MRI, tau-PET with 18F-AV-1451, amyloid-PET with 11C-Pittsburgh compound B, detailed clinical examinations and neuropsychological testing. Of the 11, three had evidence of high amyloid burden consistent with Alzheimer's disease while eight did not. Neuropathological evaluations were acquired in six cases. Mixed effects general linear models were used to compare 18F-AV-1451 retention and atrophy in amyloid-negative corticobasal syndrome cases to 32 age-matched healthy control subjects and to relate cortical and subcortical 18F-AV-1451 retention and atrophy to clinical features. Subjects without amyloid, including three with pathologically confirmed corticobasal degeneration, showed greater regional 18F-AV-1451 retention and associated regional atrophy in areas commonly associated with corticobasal degeneration pathology than healthy control subjects [retention was higher compared to healthy controls (P = 0.0011), driven especially by the precentral gyrus (P = 0.011) and pallidum (P < 0.0001), and greater atrophy was seen in subjects compared to control subjects (P = 0.0004)]. Both 18F-AV-1451 retention and atrophy were greater in the clinically more affected hemisphere [on average, retention was 0.173 standardized uptake value ratio units higher on the more affected side (95% confidence interval, CI 0.11-0.24, P < 0.0001), and volume was 0.719 lower on the more affected side (95% CI 0.35-1.08, P = 0.0001)]. 18F-AV-1451 retention was greater in subcortical than in cortical regions, P < 0.0001. In contrast to these findings, subjects with amyloid-positive corticobasal syndrome, including two neuropathologically confirmed cases of Alzheimer's disease, demonstrated greater and more widespread 18F-AV-1451 retention and regional atrophy than observed in the amyloid-negative cases. There was thalamic 18F-AV-1451 retention but minimal cortical and basal ganglia uptake in a single corticobasal syndrome subject without neuropathological evidence of tau pathology, likely representing non-specific signal. Asymmetric cortical and basal ganglia 18F-AV-1451 retention consonant with the clinical manifestations characterize corticobasal syndrome due to corticobasal degeneration, whereas the cortical retention in cases associated with Alzheimer's disease is greater and more diffuse.


Asunto(s)
Enfermedades de los Ganglios Basales/patología , Corteza Cerebral/patología , Vías Nerviosas/patología , Anciano , Anciano de 80 o más Años , Enfermedades de los Ganglios Basales/diagnóstico por imagen , Carbolinas , Corteza Cerebral/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vías Nerviosas/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos
8.
Neurology ; 96(13): e1743-e1754, 2021 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-33597290

RESUMEN

OBJECTIVE: To test the hypothesis that white matter hyperintensities (WMH) in behavioral-variant frontotemporal dementia (bvFTD) and Alzheimer disease (AD) are associated with disease variables such as disease severity, cortical atrophy, and cognition, we conducted a cross-sectional brain MRI study with volumetric and voxel-wise analyses. METHODS: A total of 129 patients (64 bvFTD, 65 AD) and 66 controls underwent high-resolution brain MRI and clinical and neuropsychological examination. Genetic screening was conducted in 124 cases (54 bvFTD, 44 AD, 26 controls) and postmortem pathology was available in 18 cases (13 bvFTD, 5 AD). WMH were extracted using an automated segmentation algorithm and analyses of total volumes and spatial distribution were conducted. Group differences in total WMH volume and associations with vascular risk and disease severity were examined. Syndrome-specific voxel-wise associations between WMH, cortical atrophy, and performance across different cognitive domains were assessed. RESULTS: Total WMH volumes were larger in patients with bvFTD than patients with AD and controls. In bvFTD, WMH volumes were associated with disease severity but not vascular risk. Patients with bvFTD and patients with AD showed distinct spatial patterns of WMH that mirrored characteristic patterns of cortical atrophy. Regional WMH load correlated with worse cognitive performance in discrete cognitive domains. WMH-related cognitive impairments were shared between syndromes, with additional associations found in bvFTD. CONCLUSION: Increased WMH are common in patients with bvFTD and patients with AD. Our findings suggest that WMH are partly independent of vascular pathology and associated with the neurodegenerative process. WMH occur in processes independent of and related to cortical atrophy. Furthermore, increased WMH in different regions contributes to cognitive deficits.


Asunto(s)
Enfermedad de Alzheimer/diagnóstico por imagen , Demencia Frontotemporal/diagnóstico por imagen , Leucoencefalopatías/diagnóstico por imagen , Sustancia Blanca/diagnóstico por imagen , Anciano , Enfermedad de Alzheimer/genética , Enfermedad de Alzheimer/fisiopatología , Atrofia , Proteína C9orf72/genética , Estudios de Casos y Controles , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/patología , Femenino , Demencia Frontotemporal/genética , Demencia Frontotemporal/fisiopatología , Humanos , Leucoencefalopatías/genética , Leucoencefalopatías/fisiopatología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Tamaño de los Órganos , Progranulinas/genética , Índice de Severidad de la Enfermedad , Análisis Espacial , Sustancia Blanca/patología , Proteínas tau/genética
9.
Nat Commun ; 12(1): 721, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526780

RESUMEN

Aging and Alzheimer's disease (AD) are associated with progressive brain disorganization. Although structural asymmetry is an organizing feature of the cerebral cortex it is unknown whether continuous age- and AD-related cortical degradation alters cortical asymmetry. Here, in multiple longitudinal adult lifespan cohorts we show that higher-order cortical regions exhibiting pronounced asymmetry at age ~20 also show progressive asymmetry-loss across the adult lifespan. Hence, accelerated thinning of the (previously) thicker homotopic hemisphere is a feature of aging. This organizational principle showed high consistency across cohorts in the Lifebrain consortium, and both the topological patterns and temporal dynamics of asymmetry-loss were markedly similar across replicating samples. Asymmetry-change was further accelerated in AD. Results suggest a system-wide dedifferentiation of the adaptive asymmetric organization of heteromodal cortex in aging and AD.


Asunto(s)
Envejecimiento/fisiología , Enfermedad de Alzheimer/patología , Corteza Cerebral/patología , Adulto , Anciano , Anciano de 80 o más Años , Corteza Cerebral/diagnóstico por imagen , Femenino , Voluntarios Sanos , Humanos , Estudios Longitudinales , Imagen por Resonancia Magnética/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos/fisiología , Factores de Tiempo , Adulto Joven
10.
Nat Commun ; 12(1): 1080, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-33597538

RESUMEN

Clinicians have long been interested in functional brain monitoring, as reversible functional losses often precedes observable irreversible structural insults. By characterizing neonatal functional cerebral networks, resting-state functional connectivity is envisioned to provide early markers of cognitive impairments. Here we present a pioneering bedside deep brain resting-state functional connectivity imaging at 250-µm resolution on human neonates using functional ultrasound. Signal correlations between cerebral regions unveil interhemispheric connectivity in very preterm newborns. Furthermore, fine-grain correlations between homologous pixels are consistent with white/grey matter organization. Finally, dynamic resting-state connectivity reveals a significant occurrence decrease of thalamo-cortical networks for very preterm neonates as compared to control term newborns. The same method also shows abnormal patterns in a congenital seizure disorder case compared with the control group. These results pave the way to infants' brain continuous monitoring and may enable the identification of abnormal brain development at the bedside.


Asunto(s)
Encéfalo/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Epilepsia/diagnóstico por imagen , Sustancia Gris/diagnóstico por imagen , Sustancia Blanca/diagnóstico por imagen , Algoritmos , Encéfalo/fisiopatología , Corteza Cerebral/fisiopatología , Epilepsia/diagnóstico , Epilepsia/fisiopatología , Femenino , Sustancia Gris/fisiopatología , Humanos , Recién Nacido , Recien Nacido Prematuro , Imagen por Resonancia Magnética/métodos , Masculino , Modelos Neurológicos , Red Nerviosa/diagnóstico por imagen , Red Nerviosa/fisiopatología , Ultrasonografía Doppler/métodos , Sustancia Blanca/fisiopatología
11.
Biol Psychol ; 159: 108017, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33450326

RESUMEN

Theoretical approaches propose a blending between interoception and time estimation. Interoception might constitute a neurophysiological mechanism for encoding duration. However, no study has assessed the convergence between interoception and time estimation using behavioral, neurophysiological, and functional anatomy signatures. We examined the multimodal convergence between interoception and time estimation using a two-fold approach. In study 1, we developed a dual design combining interoception (measuring heartbeat detection - HBD, and heartbeat evoked potential - HEP) with a time estimation paradigm (TEP, estimation of duration of a 120 s interval). In study 2, we performed a conjoint metanalysis (Multi-level Kernel Density Analysis, MKDA) of neuroimaging, including reports of interoception and time estimation. Both studies provide convergent evidence of time estimation's significant involvement in behavioral, electrophysiological (enhanced HEP), and neuroimaging (overlapping cluster in the right insula and operculum) signatures of interoception. Convergent results from both studies offer direct support for a shared mechanism of interoception and time estimation.


Asunto(s)
Interocepción , Corteza Cerebral/diagnóstico por imagen , Potenciales Evocados , Frecuencia Cardíaca , Humanos , Neuroimagen
12.
Br J Anaesth ; 126(4): 835-844, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33386125

RESUMEN

BACKGROUND: Propofol, a commonly used intravenous anaesthetic, binds to type A gamma aminobutyric acid (GABA) receptors in mammalian brain. Previous work on its anaesthetic action has characterised either the biochemistry underlying propofol binding or the associated changes in brain network dynamics during sedation. Despite these advances, no study has focused on understanding how propofol action at the cellular level results in changes in brain network connectivity. METHODS: We used human whole-brain microarray data to generate distribution maps for genes that mark the primary GABAergic cortical interneurone subtypes (somatostatin, parvalbumin [PV], and 5-hydroxytryptamine 3A. Next, 25 healthy participants underwent propofol-induced sedation during resting state functional MRI scanning. We used partial least squares analysis to identify the brain regions in which connectivity patterns were most impacted by propofol sedation. We then correlated these multimodal cortical patterns to determine if a specific interneurone subtype was disproportionately expressed in brain regions in which connectivity patterns were altered during sedation. RESULTS: Brain networks that were significantly altered by propofol sedation had a high density of PV-expressing GABAergic interneurones. Brain networks that anticorrelated during normal wakefulness, namely the default mode network and attentional and frontoparietal control networks, increased in correlation during sedation. CONCLUSIONS: PV-expressing interneurones are highly expressed in brain regions with altered connectivity profiles during propofol-induced sedation. This study also demonstrates the utility of leveraging multiple datasets to address multiscale neurobiological problems.


Asunto(s)
Corteza Cerebral/efectos de los fármacos , Hipnóticos y Sedantes/farmacología , Interneuronas/efectos de los fármacos , Red Nerviosa/efectos de los fármacos , Parvalbúminas , Propofol/farmacología , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/metabolismo , Femenino , Neuronas GABAérgicas/metabolismo , Humanos , Interneuronas/metabolismo , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Red Nerviosa/diagnóstico por imagen , Red Nerviosa/metabolismo , Parvalbúminas/metabolismo , Análisis por Matrices de Proteínas/métodos
13.
Lakartidningen ; 1182021 01 21.
Artículo en Sueco | MEDLINE | ID: mdl-33491762

RESUMEN

Posterior cortical atrophy (PCA) is a neurodegenerative disease which was described originally in 1988 by dr Frank Benson. PCA is characterized by progressive deficits in higher visual functions while episodic memory and speech are relatively preserved. Studies have shown that the neuropathologic findings in most cases are consistent with Alzheimer's disease (AD). However, patients with PCA show greater occipitoparietal atrophy on neuroimaging compared with the more prominent mesiotemporal atrophy in patients with amnestic AD. Until recently, diagnostics were based mainly on clinical experience due to the lack of validated diagnostic criteria. In 2017, new consensus criteria for the diagnosis and classification of PCA were published. In this article we make a brief review of the disease and describe a 58 year old man with complex visual deficits and apraxia who was ultimately diagnosed with PCA.


Asunto(s)
Enfermedad de Alzheimer , Enfermedades Neurodegenerativas , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/diagnóstico por imagen , Atrofia/patología , Corteza Cerebral/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Neurodegenerativas/diagnóstico , Enfermedades Neurodegenerativas/diagnóstico por imagen
14.
Trials ; 22(1): 93, 2021 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-33499916

RESUMEN

BACKGROUND: All of the existing medication and surgical therapies currently cannot completely inhibit intracerebral hemorrhage (ICH)-mediated brain damage, resulting in disability in different degrees in the involved patients. Normobaric oxygenation (NBO) was reported attenuating ischemic brain injury. Herein, we aimed to explore the safety and efficacy of NBO on rescuing the damaged brain tissues secondary to acute ICH, especially those in the perihematoma area being threatened by ischemia and hypoxia. METHODS: A total of 150 patients confirmed as acute spontaneous ICH by computed tomography (CT) within 6 h after symptoms onset, will enroll in this study after signing the informed consent, and enter into the NBO group or control group randomly according to a random number. In the NBO group, patients will inhale high-flow oxygen (8 L/min, 1 h each time for 6 cycles daily) and intake low-flow oxygen (2 L/min) in intermittent periods by mask for a total of 7 days. While in the control group, patients will breathe in only low-flow oxygen (2 L/min) by mask for 7 consecutive days. Computed tomography and perfusion (CT/CTP) will be used to evaluate cerebral perfusion status and brain edema. CT and CTP maps in the two groups at baseline and day 7 and 14 after NBO or low-flow oxygen control will be compared. The primary endpoint is mRS at both Day14 post-ICH and the end of the 3rd month follow-up. The secondary endpoints include NIHSS and plasma biomarkers at baseline and Day-1, 7, and 14 after treatment, as well as the NIHSS at the end of the 3rd month post-ICH and the incidence of bleeding recurrence and the mortalities within 3 months post-ICH. DISCUSSION: This study will provide preliminary clinical evidence about the safety and efficacy of NBO on correcting acute ICH and explore some mechanisms accordingly, to offer reference for larger clinical trials in the future. TRIAL REGISTRATION: ClinicalTrials.gov NCT04144868 . Retrospectively registered on October 29, 2019.


Asunto(s)
Edema Encefálico/terapia , Lesiones Encefálicas/terapia , Hemorragia Cerebral/terapia , Terapia por Inhalación de Oxígeno/efectos adversos , Oxígeno/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Edema Encefálico/diagnóstico , Edema Encefálico/etiología , Lesiones Encefálicas/diagnóstico , Lesiones Encefálicas/etiología , Corteza Cerebral/diagnóstico por imagen , Hemorragia Cerebral/complicaciones , Hemorragia Cerebral/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Máscaras , Persona de Mediana Edad , Oxígeno/administración & dosificación , Terapia por Inhalación de Oxígeno/instrumentación , Terapia por Inhalación de Oxígeno/métodos , Imagen de Perfusión/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
15.
Medicine (Baltimore) ; 100(1): e24262, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33429834

RESUMEN

ABSTRACT: The study aimed to explore the cortical thickness and gyrification abnormalities in acute brainstem ischemic patients in both the ipsilateral and contralateral hemisphere compared with healthy controls. Structural magnetic resonance imaging data were prospectively acquired in 48 acute brainstem ischemic patients, 21 patients with left lesion and 27 with right lesion, respectively. Thirty healthy controls were recruited. Cortical morphometry based on surface-based data analysis driven by CAT12 toolbox implemented in SPM12 was used to compare changes in cortical thickness and gyrification. Significant decreases of cortical thickness loss were found in bilateral cerebral hemispheres of the brainstem ischemic patients compared to the healthy controls (P < .05, family-wise error (FWE)-corrected). We also found significant gyrification decreases in the insula, transverse temporal, supramarginal of the ipsilateral on hemisphere in the right brainstem ischemic patients compared to the healthy controls (P < .05, FWE-corrected). Brainstem ischemic patients have widely morphological changes in the early phase and may be helpful in designing individualized rehabilitative strategies for these patients.


Asunto(s)
Tronco Encefálico/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , /diagnóstico por imagen , Estudios de Casos y Controles , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Prospectivos
16.
Zhonghua Nei Ke Za Zhi ; 60(2): 122-127, 2021 Feb 01.
Artículo en Chino | MEDLINE | ID: mdl-33503722

RESUMEN

Objective: To investigate the intrinsic organization of cortical circuitry in individuals with subjective cognitive decline (SCD) via resting-state functional magnetic resonance imaging (rs-fMRI) connectome analysis and its correlation with cognitive level. Methods: From June 2017 to November 2019, thirty-six middle-aged and elderly individuals with complaints of memory decline and 32 normal controls (NC) were enrolled from communities in Nanjing. We collected cognitive scale performance,T1-weighted imaging (T1WI) and rs-fMRI data of all subjects. There were 5 males and 31 females in the SCD group, with an average age of (64±5) years. In the NC group, there were 8 males and 24 females, with an average age of (65±5) years. Preprocessing of rs-fMRI data was conducted, then the cerebral cortex was divided into 333 cortical parcels (nodes) and 10 predefined communities according to the prior template. Further, we established full connection matrices between cortical parcels and calculated the within-module degree (WMD) and participation coefficient (PC) of each node based on the matrices. The WMD and PC values were compared between the SCD and NC groups,and their correlations with cognitive scale performance were analyzed. Results: Compared to the NC group,the SCD group showed increased WMD in the dorsolateral prefrontal cortex (DLPFC)(P<0.05,FDR corrected) and the middle frontal gyrus (P<0.005,uncorrected) of the right frontoparietal network (FPN). The SCD group also showed decreased WMD(P<0.05,FDR corrected) in the superior occipital gyrus of the left visual network (VN) and decreased PC (P<0.005,uncorrected) in the supramarginal gyrus of the left dorsal attention network (DAN). The WMD values in the DLPFC showed significant positive correlations with the auditory verbal learning test (AVLT)short-delayed memory (r=0.364,P=0.029),recognition memory (r=0.364, P=0.029) and the Boston naming test scores (BNT, r=0.356, P=0.033)in the SCD group. The PC values in the supramarginal gyrus were significantly positively correlated with the BNT scores (r=0.413, P=0.012) in the SCD group. Conclusion: Cortical network imbalance and reconstruction characterized by decreased intra-module connectivity of VN and inter-module connectivity of DAN exist in SCD subjects,while increased intra-module connectivity of FPN may serve in a compensatory way for the early cognitive decline.


Asunto(s)
Disfunción Cognitiva , Conectoma , Anciano , Corteza Cerebral/diagnóstico por imagen , Disfunción Cognitiva/diagnóstico por imagen , Femenino , Lóbulo Frontal , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad
17.
Stroke ; 52(1): 339-343, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33370180

RESUMEN

BACKGROUND AND PURPOSE: Lacunar syndromes correlate with a lacunar stroke on imaging in 50% to 60% of cases. Computed tomography perfusion (CTP) is becoming the preferred imaging modality for acute stroke triage. We aimed to estimate the sensitivity, specificity, and predictive values for noncontrast computed tomography and CTP in lacunar syndromes, and for cortical, subcortical, and posterior fossa regions. METHODS: A retrospective analysis of confirmed ischemic stroke patients who underwent acute CTP and follow-up magnetic resonance imaging between 2010 and 2018 was performed. Brain noncontrast computed tomography and CTP were assessed independently by 2 stroke neurologists. Receiver operating characteristic curve analysis was performed to estimate sensitivity, specificity, and area under the curve (AUC) for the detection of strokes in patients with lacunar syndromes using different CTP maps. RESULTS: We found 106 clinical lacunar syndromes, but on diffusion-weighted imaging, these consisted of 59 lacunar, 33 cortical, and 14 posterior fossa strokes. The discrimination of ischemia identification was very poor using noncontrast computed tomography in all 3 regions, but good for cortical (AUC, 0.82) and poor for subcortical and posterior regions (AUCs, 0.55 and 0.66) using automated core-penumbra maps. The addition of delay time and mean transient time maps substantially increased subcortical (AUC, 0.80) and slightly posterior stroke detection (AUC, 0.69). CONCLUSIONS: Analysis of mean transient time and delay time maps in combination with core-penumbra maps improves detection of subcortical and posterior strokes.


Asunto(s)
Imagen de Perfusión/métodos , Accidente Vascular Cerebral Lacunar/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Anciano , Mapeo Encefálico , Corteza Cerebral/diagnóstico por imagen , Diagnóstico Diferencial , Imagen de Difusión por Resonancia Magnética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Curva ROC , Estudios Retrospectivos , Sensibilidad y Especificidad , Accidente Vascular Cerebral Lacunar/diagnóstico , Síndrome , Triaje/métodos , Triaje/tendencias
18.
Neurosci Lett ; 740: 135428, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33086092

RESUMEN

Human social activities are realized by a synergy of neuronal activity over various regions of the brain, which is supported by their connectivity. In the present study, we examined associations between social activities, represented by work hours, and brain connectivity as quantified using diffusion tensor imaging (DTI). In 483 healthy participants, DTI analysis was performed using 3 T magnetic resonance imaging, and work hours were calculated, considering hours of paid employment (the "Work for Pay" category), hours of housework (the "Work at Home" category), and hours of school-related study (the "Student" category). The correlations between each class of work time and DTI indices were analyzed. The mean diffusivity (MD) values of the anterior limb of the internal capsule (ALIC) and the superior fronto-occipital fasciculus (SFO) were negatively correlated with total work hours (ALIC: r = -0.192, p = 2.3 × 10-5; SFO: r = -0.161, p = 3.8 × 10-4). We also found that the MD values of the ALIC and the SFO were correlated with work hours in the Work for Pay category (ALIC: r = -0.211, p = 3.2 × 10-6; SFO: r = -0.163, p = 3.4 × 10-4) but not with those in the Work at Home category or the Student category. These results suggest that social activity is associated with the white matter microstructure of the ALIC and the SFO. The main difference between "Work for Pay" and the other two social activities appears to be the type of motivation-for example, external versus internal. Therefore, the white matter microstructure of the ALIC and SFO may be related to externally motivated social activities.


Asunto(s)
Sustancia Blanca/fisiología , Tolerancia al Trabajo Programado/fisiología , Adulto , Mapeo Encefálico , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/fisiología , Imagen de Difusión Tensora , Empleo , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Pruebas Neuropsicológicas , Medio Social , Estudiantes , Sustancia Blanca/diagnóstico por imagen , Trabajo , Tolerancia al Trabajo Programado/psicología
19.
Elife ; 92020 12 22.
Artículo en Inglés | MEDLINE | ID: mdl-33350380

RESUMEN

Cerebral cortical architecture at birth encodes regionally differential dendritic arborization and synaptic formation. It underlies behavioral emergence of 2-year-olds. Brain changes in 0-2 years are most dynamic across the lifespan. Effective prediction of future behavior with brain microstructure at birth will reveal structural basis of behavioral emergence in typical development and identify biomarkers for early detection and tailored intervention in atypical development. Here we aimed to evaluate the neonate whole-brain cortical microstructure quantified by diffusion MRI for predicting future behavior. We found that individual cognitive and language functions assessed at the age of 2 years were robustly predicted by neonate cortical microstructure using support vector regression. Remarkably, cortical regions contributing heavily to the prediction models exhibited distinctive functional selectivity for cognition and language. These findings highlight regional cortical microstructure at birth as a potential sensitive biomarker in predicting future neurodevelopmental outcomes and identifying individual risks of brain disorders.


Asunto(s)
Corteza Cerebral/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Interpretación de Imagen Asistida por Computador/métodos , Trastornos del Neurodesarrollo/diagnóstico por imagen , Neuroimagen/métodos , Desarrollo Infantil , Preescolar , Femenino , Humanos , Recién Nacido , Masculino , Máquina de Vectores de Soporte
20.
Sci Rep ; 10(1): 22096, 2020 12 16.
Artículo en Inglés | MEDLINE | ID: mdl-33328539

RESUMEN

Higher cortisol levels due to a hyperactive hypothalamic-pituitary-adrenal axis have been reported in patients with major depressive disorder (MDD). Increased cortisol levels change both the brain morphology and function in MDD patients. The multivariate source-based morphometry (SBM) technique has been applied to investigate neuroanatomical changes in some neuropsychiatric diseases, but not MDD. We aimed to examine the alterations in gray matter (GM) networks and their relationship with serum cortisol levels in first-episode, drug-naïve MDD patients using SBM. Forty-two patients with MDD and 39 controls were recruited via interviews. Morning serum cortisol levels were measured, and high-resolution T1-weighted imaging followed by SBM analysis was performed in all participants. The patients had significantly higher serum cortisol levels than the controls. We found two GM sources, which were significantly different between patients with MDD and controls (prefrontal network, p < .01; insula-temporal network, p < .01). Serum cortisol levels showed a statistically significant negative correlation with the loading coefficients of the prefrontal network (r = - 0.354, p = 0.02). In conclusion, increased serum cortisol levels were associated with reductions in the prefrontal network in the early stage of MDD, and SBM may be a useful approach for analyzing structural MRI data.


Asunto(s)
Encéfalo/fisiopatología , Corteza Cerebral/fisiopatología , Trastorno Depresivo Mayor/sangre , Hidrocortisona/sangre , Adulto , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Corteza Cerebral/diagnóstico por imagen , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/diagnóstico por imagen , Trastorno Depresivo Mayor/fisiopatología , Femenino , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/fisiopatología , Humanos , Sistema Hipotálamo-Hipofisario/fisiopatología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Sistema Hipófiso-Suprarrenal/diagnóstico por imagen , Sistema Hipófiso-Suprarrenal/fisiopatología
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