Proxy-reported quality of life in adolescents and adults with dyskinetic cerebral palsy is associated with executive functions and cortical thickness.

PURPOSE: Quality of life (QOL) is a key outcome for people with cerebral palsy (CP), and executive functioning is an important predictor of QOL in other health-related conditions. Little is known about this association in CP or about its neural substrate. We aim to analyze the influence of executive functioning (including cognitive flexibility) as well as that of other psychological, motor, communication and socioeconomic variables on QOL and to identify neuroanatomical areas related to QOL in adolescents and adults with CP. METHODS: Fifty subjects diagnosed with dyskinetic CP (mean age 25.96 years) were recruited. Their caregivers completed the primary caregiver proxy report version of the CP QOL-Teen questionnaire. Motor status, communication, IQ, four executive function domains, anxiety/depression and socioeconomic status were evaluated. Correlations and multiple linear regression models were used to relate CP QOL domains and total score to these variables. Thirty-six participants underwent an MRI assessment. Correlations were examined between cortical thickness and CP QOL total score and between cortical thickness and variables that might predict the CP QOL total score. RESULTS: Executive functions predict scores in four domains of CP QOL (General well-being and participation, Communication and physical health, Family health and Feelings about functioning) in the regression model. Among the cognitive domains that comprise executive function, only cognitive flexibility measured in terms of performance on the Wisconsin card sorting test (WCST) predicts the CP QOL total score. Monthly income, fine motor functioning and communication ability predict scores on the domains Access to services and Family Health, Feelings about functioning and School well-being, respectively. The clusters resulting from the correlation between cortical thickness and both CP QOL total score and WCST performance overlapped in the posterior cingulate and precuneus cortices. CONCLUSIONS: Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.

Affected connectivity organization of the reward system structure in obesity.

With the prevalence of obesity rapidly increasing worldwide, understanding the processes leading to excessive eating behavior becomes increasingly important. Considering the widely recognized crucial role of reward processes in food intake, we examined the white matter wiring and integrity of the anatomical reward network in obesity. Anatomical wiring of the reward network was reconstructed derived from diffusion weighted imaging in 31 obese participants and 32 normal-weight participants. Network wiring was compared in terms of the white matter volume as well as in terms of white matter microstructure, revealing lower number of streamlines and lower fiber integrity within the reward network in obese subjects. Specifically, the orbitofrontal cortex and striatum nuclei including accumbens, caudate and putamen showed lower strength and network clustering in the obesity group as compared to healthy controls. Our results provide evidence for obesity-related disruptions of global and local anatomical connectivity of the reward circuitry in regions that are key in the reinforcing mechanisms of eating-behavior processes.

Functional connectivity in obesity during reward processing.

Obesity is a health problem that has become a major focus of attention in recent years. There is growing evidence of an association between obesity and differences in reward processing. However, it is not known at present whether these differences are linked exclusively to food, or whether they can be detected in other rewarding stimuli. We compared responses to food, rewarding non-food and neutral pictures in 18 young adults with obesity and 19 normal-weight subjects using independent component analysis. Both groups modulated task-related activity in a plausible way. However, in response to both food and non-food rewarding stimuli, participants with obesity showed weaker connectivity in a network involving activation of frontal and occipital areas and deactivation of the posterior part of the default mode network. In addition, obesity was related with weaker activation of the default mode network and deactivation of frontal and occipital areas while viewing neutral stimuli. Together, our findings suggest that obesity is related to a different allocation of cognitive resources in a fronto-occipital network and in the default mode network.

Neural responses to visual food cues: insights from functional magnetic resonance imaging.

The aim of this paper is to describe the patterns of functional magnetic resonance imaging activation produced by visual food stimuli in healthy participants, as well as in those with anorexia nervosa, bulimia nervosa, binge eating disorder and obesity. We conducted a systematic review of studies published in the last decade on normal and abnormal eating. This review suggested the existence of neural differences in response to the sight of food between healthy individuals, those with an eating disorder and obese subjects. Differences were identified in two brain circuits: (i) limbic and paralimbic areas associated with salience and reward processes and (ii) prefrontal areas supporting cognitive control processes.

Raven's Coloured Progressive Matrices as a measure of cognitive functioning in Cerebral Palsy.

BACKGROUND: Cognitive dysfunction is frequent in Cerebral Palsy (CP). CP motor impairment and associated speech deficits often hinder cognitive assessment, with the result being that not all CP studies consider cognitive dysfunction. Raven's Coloured Progressive Matrices is a simple, rapid test which can be used in persons with severe motor impairment and speech limitations. We studied whether this test can offer a reliable measure of cognitive functioning in CP. METHOD: Visuoperceptual, language, memory and frontal lobe functions were evaluated in 30 participants with severe motor impaired CP and a variety of speech difficulties. The relationship between Raven's Coloured Progressive Matrices and a variety of tests was analysed. RESULTS: Raven's Coloured Progressive Matrices performance was associated with visuoperceptual, language, visual and verbal memory but not with frontal functions. Receptive vocabulary and visuospatial measures were the best predictors of Raven's Coloured Progressive Matrices raw scores. CONCLUSIONS: Raven's Coloured Progressive Matrices is a fast, easy-to-administer test able to obtain a measure related with linguistic, visuoperceptual, and memory cognitive functioning in persons with CP despite their motor and speech disorders.

Memory performance in a sample of very low birth weight adolescents.

Prematurely born participants with very low birth weight (VLBW) are at high risk of brain injury in the perinatal period and of later cognitive impairment. Studies of long-term memory sequelae in VLBW participants are scarce and focus on verbal and visual memory assessed by standard clinical memory tests. There is even less research into everyday memory, and the results obtained are contradictory. This study explores long-term memory deficits in VLBW adolescents using 2 standard clinical memory tests and 1 everyday memory test. Results show impairment only in everyday memory. These memory deficits are not specific; they are related to an impaired general cognitive performance. Unlike birth weight, gestational age is a good predictor of intelligence.

Influence of APOE polymorphism on cognitive and behavioural outcome in moderate and severe traumatic brain injury.

AIM: To analyse the influence of apolipoprotein (APOE) epsilon4 status on the cognitive and behavioural functions usually impaired after moderate and severe traumatic brain injury (TBI). METHODS: In all, 77 patients with TBI selected from 140 consecutive admissions were genotyped for APOE. Each patient was subjected to neuropsychological and neurobehavioural assessment at least 6 months after injury. RESULTS: Performance of participants carrying the epsilon4 allele was notably worse on verbal memory (Auditory Verbal Learning Test), motor speed, fine motor coordination, visual scanning, attention and mental flexibility (Grooved Pegboard, Symbol Digit Modalities Test and part B of the Trail Making Test) and showed considerably more neurobehavioural disturbances (Neurobehavioral Rating Scale-Revised) than the group without the epsilon4 allele. CONCLUSIONS: In particular, performance on neuropsychological tasks that are presumed to be related to temporal lobe, frontal lobe and white matter integrity is worse in patients with the APOE epsilon4 allele than in those without it. More neurobehavioural disturbances are observed in APOE epsilon4 carriers than in APOE epsilon2 and epsilon3 carriers.

[Attention deficit hyperactivity disorder. Cerebral asymmetry observed on magnetic resonance]. / Trastorno por déficit de atención con hiperactividad. Asimetrías cerebrales observadas en resonancia magnética.

INTRODUCTION: Anatomical and functional neuroimaging data from subjects with Attention Deficit Hyperactivity Disorder (ADHD) have consistently implicated a reversal of cerebral asymmetry and suggested a fronto-striatal dysfunction in this disorder. OBJECTIVE: The aim of this study is to investigate the brain asymmetries in a homogeneous and non-medicated sample of adolescents with ADHD who had been previously studied in our laboratory. PATIENTS AND METHODS: T1-weighted magnetic resonance images were obtained for 11 adolescents with ADHD and 19 control subjects. Frontal and posterior brain regions, caudate nucleus, and ventricular system were quantitatively measured. RESULTS: A reversed pattern of asymmetry for the caudate nucleus (right > left) was found in ADHD when compared to the control group. We also found a reversed pattern of asymmetry for the frontal lobe (right < left) and a smaller right frontal volume (prefrontal specifically) in the ADHD subjects most severely impaired. Right caudate and frontal measures were inversely correlated. CONCLUSIONS: ADHD is associated with fronto-striatal abnormalities, which may be explicable via extant neurodevelopmental theories. Enlargement of the right caudate nucleus may suggest the failure of a process of synaptic 'pruning' by which attentional functions could be improperly transferred from the basal ganglia to frontal regions during development.

Fuzzy approach for identifying artistic pigments with Raman spectroscopy.

In this work, a fuzzy approach for automatically identifying artistic pigments from their Raman spectra is presented. The uncertainty introduced during the Raman spectrum measurement of pigments is considered in the design of the fuzzy system. The position of the Raman bands in the unknown spectrum can be subject to small displacements due to noise, misalignments in the calibration, etc. Fuzzy logic allows us to work with this uncertainty and to design a system based on the comparison between the Raman band positions in an unknown spectrum recorded from an artwork and the Raman band positions in spectra recorded from reference pigments gathered in databases. The fuzzy system provides the reference pigments whose Raman band positions match those of the unknown pigment analyzed and gives guidance to the decision-making process in the final identification.

MRI atrophy parameters related to cognitive and motor impairment in Parkinson's disease.

BACKGROUND: Patients with Parkinson's disease (PD) show specific neuropsychological deficits in attention, memory, visuospatial or frontal lobe functions, which can arise from degeneration of different cerebral structures. OBJECTIVE: The aim of the present study was to analyze the role of focal degeneration (basal ganglia and substantia nigra) and diffuse cerebral atrophy (ventricular enlargement) in motor/cognitive impairment in PD. PATIENTS AND METHODS: We administered to 14 patients with advanced PD the following tests: Purdue Pegboard, Rey's Auditory-Verbal Learning test (RAVLT), Benton's Line Orientation, Trail Making, phonemic verbal fluency and Stroop test. Ventricular system, caudate and putamen nuclei and pars compacta of the substantia nigra were quantitatively measured by magnetic resonance imaging. Correlation analyses were carried out. RESULTS: The results showed that ventricular enlargement is negatively correlated with the performance on RAVLT and Stroop test. No relationship was found between caudate atrophy and cognitive deficits. Degeneration of putamen nucleus was found to be associated with motor deficits. CONCLUSION: Memory and frontal impairment are related to diffuse cerebral degeneration and the motor deficit is related to degeneration of the putamen nucleus.

Cognitive and behavioral changes after unilateral posteroventral pallidotomy: relationship with lesional data from MRI.

We investigated cognitive and behavioral changes after unilateral posteroventral pallidotomy, and their relationship with lesion size and location as identified in magnetic resonance image quantitative analysis. Fifteen consecutive patients with Parkinson's disease were assessed neuropsychologically before and after unilateral posteroventral pallidotomy (five right and 10 left). Immediate postsurgery evaluation (1 week) demonstrated significant worsening of memory, motor learning, motor speed, and verbal fluency. In the 3-month follow up, learning, memory, and speed returned to the presurgical level, but verbal fluency remained below the baseline. Significant improvements were observed in visuospatial functions and obsessive-compulsive behavior. Lesional volume did not correlate with neuropsychologic changes. Left lesions produced more impairment in verbal fluency than right-sided lesions. Regression analysis identified two lesional areas in the pallidum mediale internum. These regions accounted for 68% of the variance in the visuospatial changes.

Trastorno por déficit de atención con hiperactividad. Asimetrías cerebrales observadas en resonancia magnética / Attention deficit hyperactivity disorder. Cerebral asymmetry observed on magnetic resonance

Introducción. Los estudios de neuroimagen estructural y funcional en sujetos con trastorno por déficit de atención con hiperactividad (TDAH) han sugerido una inversión de los patrones de asimetría cerebral y una disfunción del sistema fronto-estriatal. Objetivo. El propósito de esta investigación es estudiar las asimetrías cerebrales de una muestra homogénea y no medicada de adolescentes con TDAH. Pacientes y métodos. Se realizaron las resonancias magnéticas potenciadas en T1 de 11 adolescentes con TDAH y 19 sujetos normales que formaban el grupo control. Se realizó la medición cuantitativa semiautomatizada de diversas regiones y estructuras cerebrales: regiones frontal y posterior, núcleo caudado y sistemaventricular.Resultados.Seobservaunpatróninversodeasimetría del núcleo caudado (derecho > izquierdo) en el grupo TDAH en comparación con el grupo control. También en el grupo TDAH se aprecia la asimetría inversa de los lóbulos frontales (derecho < izquierdo) y un menor volumen frontal derecho (región prefrontal concretamente) en los sujetos con TDAH más gravemente afectados.El núcleo caudado y las medidas frontales presentaron una correlación negativa. Conclusiones. ElTDAH está asociado con alteraciones del sistema fronto-estriatal cerebral, alteración que es coherente conlas teorías del neurodesarrollo. El fracaso en el fenómeno regresivo que conlleva el proceso de apoptosiso `muerte neuronal programada' podría ser el mecanismo subyacente al mayor tamaño del núcleo caudado derecho. Como consecuencia, la transferencia de las funciones atencionales de los ganglios basales al lóbulo frontal se produciría de forma inapropiada a lo largo del desarrollo (AU)

Parámetros de atrofia por IRM relacionados con alteraciones cognitivas y motoras en la enfermedad de Parkinson / MRI atrophy parameters related to cognitive and motor impairment in Parkinson's disease

FUNDAMENTO: Los pacientes con la enfermedad de Parkinson (EP) manifiestan déficit neuropsicológicos en atención, memoria, visuospaciales o frontales, los cuales pueden ser debidos a la degeneración de diferentes estructuras cerebrales. OBJETIVO: El objetivo del presente estudio consistió en analizar el papel de la degeneración focal (ganglios basales y sustancia negra) y la atrofia cerebral difusa (dilatación ventricular) en la alteración motora/cognitiva en la EP. PACIENTES Y MÉTODOS: Se administraron a 14 pacientes con EP avanzada las siguientes pruebas: Purdue Pegboard, Prueba de Aprendizaje AuditivoVerbal de Rey (RAVLT), Orientación de Líneas de Benton, Trail Making, fluencia verbal fonética y test de Stroop. Se midieron cuantitativamente, a partir de imágenes de resonancia magnética, el sistema ventricular, núcleo caudado, putamen y la parte compacta de la sustancia negra. Se realizaron análisis de correlación. RESULTADOS: Los resultados demostraron que la dilatación ventricular está negativamente correlacionada con el rendimiento en el RAVLT y en el test de Stroop.No se encontró correlación entre la atrofia del caudado y los déficit cognitivos. Se halló relación entre la degeneración del núcleo putamen y los déficit motores. CONCLUSIóN: La alteración frontal y en memoria está relacionada con la degeneración cerebral difusa, en tanto que el déficit motor se relaciona con la degeneración del núcleo putamen (AU)