RESUMO
Prenatal alcohol exposure is strongly associated with disruptive behaviour in childhood and antisocial behaviour later in life. There are numerous confounding risk factors in the lives of alcohol-abusing mothers that may contribute to the behaviour problems seen in their children, rather than direct brain injury by alcohol. In fact, many of these additional environmental and genetic risk factors for childhood behaviour problems co-occur with prenatal alcohol exposure and affect the same child, creating a confluence of risk. As a result, one cannot with any certainty attribute behaviour problems in an individual child to prenatal alcohol exposure. This has important clinical and legal implications.
Assuntos
Transtornos do Espectro Alcoólico Fetal/diagnóstico , Comportamento Impulsivo/diagnóstico , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/genética , Consumo de Bebidas Alcoólicas/psicologia , Criança , Feminino , Transtornos do Espectro Alcoólico Fetal/genética , Transtornos do Espectro Alcoólico Fetal/psicologia , Predisposição Genética para Doença/genética , Predisposição Genética para Doença/psicologia , Humanos , Comportamento Impulsivo/genética , Comportamento Impulsivo/psicologia , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/genética , Efeitos Tardios da Exposição Pré-Natal/psicologia , Fatores de RiscoRESUMO
Functional MRI (fMRI) is routinely used to non-invasively localize language areas. Magnetoencephalography (MEG) is being explored as an alternative technique. MEG tasks to localize receptive language are well established although there are no standardized tasks to localize expressive language areas. We developed two expressive language tasks for MEG and validated their localizations against fMRI data. Ten right-handed adolescents (µ=17.5 years) were tested with fMRI and MEG on two tasks: verb generation to pictures and verb generation to words. MEG and fMRI data were normalized and overlaid. The number of overlapping voxels activated in fMRI and MEG were counted for each subject, for each task, at different thresholding levels. For picture verb generation, there was 100% concordance between MEG and fMRI lateralization, and for word verb generation, there was 75% concordance. A count showed 79.6% overlap of voxels activated by both MEG and fMRI for picture verb generation and 50.2% overlap for word verb generation. The percentage overlap decreased with increasingly stringent activation thresholds. Our novel MEG expressive language tasks successfully identified neural regions involved in language production and showed high concordance with fMRI laterality. Percentage overlap of activated voxels was also high when validated against fMRI, but showed task-specific and threshold-related effects. The high concordance and high percentage overlap between fMRI and MEG activations confirm the validity of our new MEG task. Furthermore, the higher concordance from the picture verb generation task suggests that this is a promising task for use in the young clinical population.
Assuntos
Mapeamento Encefálico , Lobo Frontal/irrigação sanguínea , Lobo Frontal/fisiologia , Imageamento por Ressonância Magnética , Magnetoencefalografia , Comportamento Verbal/fisiologia , Adolescente , Feminino , Lateralidade Funcional , Humanos , Processamento de Imagem Assistida por Computador , Testes de Linguagem , Masculino , Oxigênio/sangue , Adulto JovemRESUMO
We report a 15-year-old cardiac transplant recipient who developed a monomorphic posttransplant lymphoproliferative disorder (PTLPD) which demonstrated morphological and immunohistochemical features of anaplastic large cell lymphoma including CD30 and anaplastic lymphoma kinase (ALK) immunopositivity but lacking the commonly associated t(2;5) translocation. The neoplastic cells were Epstein-Barr Virus (EBV)-negative. T-cell PTLPD is an uncommon but recognized late complication in solid organ transplant recipients. This is the first reported case, to our knowledge, of PTLPD occurring in childhood with an ALK+, CD30+ anaplastic large cell lymphoma phenotype.
