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1.
Hum Brain Mapp ; 45(9): e26771, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38925589

RESUMEN

Neuroimaging studies have consistently demonstrated concurrent activation of the human precuneus and temporal pole (TP), both during resting-state conditions and various higher-order cognitive functions. However, the precise underlying structural connectivity between these brain regions remains uncertain despite significant advancements in neuroscience research. In this study, we investigated the connectivity of the precuneus and TP by employing parcellation-based fiber micro-dissections in human brains and fiber tractography techniques in a sample of 1065 human subjects and a sample of 41 rhesus macaques. Our results demonstrate the connectivity between the posterior precuneus area POS2 and the areas 35, 36, and TG of the TP via the fifth subcomponent of the cingulum (CB-V) also known as parahippocampal cingulum. This finding contributes to our understanding of the connections within the posteromedial cortices, facilitating a more comprehensive integration of anatomy and function in both normal and pathological brain processes. PRACTITIONER POINTS: Our investigation delves into the intricate architecture and connectivity patterns of subregions within the precuneus and temporal pole, filling a crucial gap in our knowledge. We revealed a direct axonal connection between the posterior precuneus (POS2) and specific areas (35, 35, and TG) of the temporal pole. The direct connections are part of the CB-V pathway and exhibit a significant association with the cingulum, SRF, forceps major, and ILF. Population-based human tractography and rhesus macaque fiber tractography showed consistent results that support micro-dissection outcomes.


Asunto(s)
Imagen de Difusión Tensora , Macaca mulatta , Vías Nerviosas , Lóbulo Parietal , Lóbulo Temporal , Humanos , Lóbulo Temporal/diagnóstico por imagen , Lóbulo Temporal/fisiología , Lóbulo Temporal/anatomía & histología , Lóbulo Parietal/diagnóstico por imagen , Lóbulo Parietal/fisiología , Lóbulo Parietal/anatomía & histología , Animales , Imagen de Difusión Tensora/métodos , Masculino , Adulto , Femenino , Vías Nerviosas/diagnóstico por imagen , Vías Nerviosas/anatomía & histología , Vías Nerviosas/fisiología , Adulto Joven , Axones/fisiología , Conectoma , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/anatomía & histología , Sustancia Blanca/fisiología , Giro del Cíngulo/diagnóstico por imagen , Giro del Cíngulo/fisiología , Giro del Cíngulo/anatomía & histología
2.
Brain ; 146(1): 20-41, 2023 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-36331542

RESUMEN

Following prolonged neglect during the formative decades of behavioural neurology, the temporopolar region has become a site of vibrant research on the neurobiology of cognition and conduct. This turnaround can be attributed to increasing recognition of neurodegenerative diseases that target temporopolar regions for peak destruction. The resultant syndromes include behavioural dementia, associative agnosia, semantic forms of primary progressive aphasia and semantic dementia. Clinicopathological correlations show that object naming and word comprehension are critically dependent on the language-dominant (usually left) temporopolar region, whereas behavioural control and non-verbal object recognition display a more bilateral representation with a rightward bias. Neuroanatomical experiments in macaques and neuroimaging in humans show that the temporoparietal region sits at the confluence of auditory, visual and limbic streams of processing at the downstream (deep) pole of the 'what' pathway. The functional neuroanatomy of this region revolves around three axes, an anterograde horizontal axis from unimodal to heteromodal and paralimbic cortex; a radial axis where visual (ventral), auditory (dorsal) and paralimbic (medial) territories encircle temporopolar cortex and display hemispheric asymmetry; and a vertical depth-of-processing axis for the associative elaboration of words, objects and interoceptive states. One function of this neural matrix is to support the transformation of object and word representations from unimodal percepts to multimodal concepts. The underlying process is likely to start at canonical gateways that successively lead to generic (superordinate), specific (basic) and unique levels of recognition. A first sign of left temporopolar dysfunction takes the form of taxonomic blurring where boundaries among categories are preserved but not boundaries among exemplars of a category. Semantic paraphasias and coordinate errors in word-picture verification tests are consequences of this phenomenon. Eventually, boundaries among categories are also blurred and comprehension impairments become more profound. The medial temporopolar region belongs to the amygdalocentric component of the limbic system and stands to integrate exteroceptive information with interoceptive states underlying social interactions. Review of the pertinent literature shows that word comprehension and conduct impairments caused by temporopolar strokes and temporal lobectomy are far less severe than those seen in temporopolar atrophies. One explanation for this unexpected discrepancy invokes the miswiring of residual temporopolar neurons during the many years of indolently progressive neurodegeneration. According to this hypothesis, the temporopolar regions become not only dysfunctional but also sources of aberrant outputs that interfere with the function of areas elsewhere in the language and paralimbic networks, a juxtaposition not seen in lobectomy or stroke.


Asunto(s)
Accidente Cerebrovascular , Lóbulo Temporal , Humanos , Lóbulo Temporal/patología , Encéfalo/diagnóstico por imagen , Corteza Cerebral/patología , Lenguaje , Semántica , Pruebas Neuropsicológicas , Imagen por Resonancia Magnética/métodos
3.
Neuroradiology ; 2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39207553

RESUMEN

Symmetrical lesions in the temporal poles and external capsules on brain MRI are known as radiological markers of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL); however, similar imaging findings have also been reported in neuromyelitis optica spectrum disorder (NMOSD), and this study investigated the frequency of such findings. The study included 55 NMOSD patients who met the 2015 international NMO diagnosis panel (IPND) criteria and were positive for aquaporin-4 antibodies (AQP4-Ab). Images were evaluated based on the consensus of two neuroradiologists, and brain lesions were detected in 33 patients, of whom 2 (6%) had symmetrical lesions in both the temporal poles and external capsules, and 1 (3%) had symmetrical lesions confined to the external capsules. Therefore, when symmetrical lesions in the temporal poles and external capsules are observed on MRI, NMOSD should be considered in the differential diagnosis.

4.
Hum Brain Mapp ; 43(11): 3461-3468, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35420729

RESUMEN

Human neuroimaging studies have demonstrated that exercise influences the cortical structural plasticity as indexed by gray or white matter volume. It remains elusive, however, whether exercise affects cortical changes at the finer-grained myelination structure level. To answer this question, we scanned 28 elite golf players in comparison with control participants, using a novel neuroimaging technique-quantitative magnetic resonance imaging (qMRI). The data showed myeloarchitectonic plasticity in the left temporal pole of the golf players: the microstructure of this brain region of the golf players was better proliferated than that of control participants. In addition, this myeloarchitectonic plasticity was positively related to golfing proficiency. Our study has manifested that myeloarchitectonic plasticity could be induced by exercise, and thus, shed light on the potential benefits of exercise on brain health and cognitive enhancement.


Asunto(s)
Golf , Sustancia Blanca , Encéfalo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Neuroimagen , Sustancia Blanca/diagnóstico por imagen
5.
Neurocase ; 28(5): 439-447, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36548912

RESUMEN

While there is strong evidence from lesion and functional imaging studies implicating the left anterior temporal pole (LTP) in naming unique entities, less is known about white matter tracts in category-specific naming. We present evidence that implicates the uncinate fasciculus (UF) in proper noun naming. First, we describe two patients with left LTP gliomas who developed category specific worsening in proper noun naming in real time during awake surgery when the UF was surgically involved . We then describe a third case involving targeted electrical stimulation of the UF using stereo-electroencephalography (sEEG) that resulted in category specific naming disturbance for proper nouns..


Asunto(s)
Neoplasias Encefálicas , Sustancia Blanca , Humanos , Neoplasias Encefálicas/patología , Fascículo Uncinado/patología , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/cirugía , Sustancia Blanca/patología , Vigilia , Electroencefalografía , Estimulación Eléctrica
6.
Dement Geriatr Cogn Disord ; 50(1): 17-28, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33756466

RESUMEN

INTRODUCTION: Semantic dementia (SD) is characterized by fluent speech, anomia, and loss of word and object knowledge with varying degrees of right and left anterior-medial temporal lobe hypometabolism on [18F] fluorodeoxyglucose (FDG)-PET. We assessed neurobehavioral features in SD patients across 3 FDG-PET-defined metabolic patterns and investigated progression over time. METHODS: Thirty-four patients with SD who completed FDG-PET were classified into a left- and right-dominant group based on the degree of hypometabolism in each temporal lobe. The left-dominant group was further subdivided depending on whether hypometabolism in the right temporal lobe was more or less than 2 standard deviations from controls (left+ group). Neurobehavioral characteristics determined using the Neuropsychiatric Inventory Questionnaire (NPI-Q) were compared across groups. Progression of NPI-Q scores and FDG-PET hypometabolism was assessed in 14 patients with longitudinal follow-up. RESULTS: The right-dominant group performed worse on the NPI-Q and had a greater frequency of abnormal behaviors and more severe disinhibition compared to the left-dominant group. Performance on the NPI-Q and severity of disinhibition correlated with right medial and lateral, but not left, temporal lobe hypometabolism. Severity of abnormal behaviors worsened over time in most left-dominant and left+ patients but appeared to improve in the 2 right-dominant patients with longitudinal follow-up. All groups showed progressive worsening of metabolism in both temporal lobes over time, with hypometabolism spreading from anteromedial to posterior temporal regions. However, the degree of temporal lobe asymmetry remained relatively constant over time. CONCLUSION: In SD, neurobehavioral features, especially disinhibition, are associated with right medial and lateral temporal lobe hypometabolism and commonly develop over time even in patients that present with left-dominant patterns of hypometabolism.


Asunto(s)
Fluorodesoxiglucosa F18 , Demencia Frontotemporal/diagnóstico por imagen , Demencia Frontotemporal/psicología , Tomografía de Emisión de Positrones , Femenino , Demencia Frontotemporal/patología , Demencia Frontotemporal/fisiopatología , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Lóbulo Temporal/diagnóstico por imagen , Lóbulo Temporal/patología , Lóbulo Temporal/fisiopatología
7.
Epilepsy Behav ; 116: 107742, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33493809

RESUMEN

OBJECTIVE: Postictal generalized suppression (PGES) may be associated with SUDEP risk. We aimed to study metabolic changes on 18Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in patients with focal to bilateral (generalized) seizures (GTCS) and PGES on stereoelectroencephalography (SEEG). METHODS: We analyzed interictal brain metabolism in a group of 19 patients with widespread postictal suppression (PGES+) associated with SEEG-recorded GTCS. This group was compared to 25 patients without widespread suppression (PGES-) as defined by SEEG, matched for epilepsy localization and lateralization. Frequency of GTCS was observed to be higher in the PGES+ group (high risk group for SUDEP). Analysis of metabolic data was performed by statistical parametric mapping (SPM) on the whole-brain, and principal component analysis (PCA) on AAL (automated anatomical labeling) atlas. RESULTS: Statistical parametric mapping showed right temporal pole hypometabolism in the PGES+ group (T-score = 3.90; p < 0.001; k = 185), in comparison to the PGES- group. Principal component analysis showed association between the metabolic values of certain regions of interest and PGES+/PGES- groups, confirmed by a significant difference (p < 0.05) in the values of the right dorsal temporal pole and of the left temporal pole between the two groups. Principal component analysis showed two dimensions significantly related to the PGES+/PGES- partition, involving the following regions: right temporal pole, right parahippocampal gyrus, right Rolandic operculum, bilateral paracentral lobule, right precuneus, right thalamus, right caudate and pallidum, bilateral cerebellum, left temporal pole, left Heschl's gyrus, left calcarine region, and left caudate, with loss of connection in PGES+ patients. Metabolic differences were independent of epilepsy localization and lateralization and persisted after correction for GTCS frequency. SIGNIFICANCE: Interictal metabolic changes within a predominantly right-sided network involving temporal lobe and connected cortical and subcortical structures were seen in patients with frequent GTCS presenting widespread postictal suppression.


Asunto(s)
Fluorodesoxiglucosa F18 , Muerte Súbita e Inesperada en la Epilepsia , Electroencefalografía , Humanos , Tomografía de Emisión de Positrones , Convulsiones/diagnóstico por imagen
8.
BMC Geriatr ; 20(1): 486, 2020 11 20.
Artículo en Inglés | MEDLINE | ID: mdl-33218309

RESUMEN

BACKGROUND: The present study aimed to provide a basis for future research examining the neural mechanisms that underlie the beneficial effect of an intervention program, Photo-Integrated Conversation Moderated by Robots (PICMOR), on verbal fluency in older adults as identified in our previous randomized controlled trial. In this preliminary report, we conducted an additional experiment using resting-state functional magnetic resonance imaging (rsfMRI) after the intervention period. Specifically, we investigated the resting-state functional connectivity (rsFC) characteristics of the intervention group (INT) compared to the control group (CONT). METHODS: rsfMRI data were acquired from 31 and 30 participants in INT and CONT, respectively, after the intervention. In the analyses, two of the most important regions in verbal fluency, the left inferior and middle frontal gyri, were selected as seed regions, and the rsFCs were compared between groups. We also conducted regression analyses for rsFCs using the difference in individual phonemic verbal fluency task (PVFT) scores between the pre- and post-intervention periods (i.e., post- minus pre-intervention) as an independent variable. RESULTS: We found higher rsFC in INT than in CONT between the left inferior frontal gyrus as a seed region and the temporal pole and middle frontal gyrus. The rsFC strength between the left inferior frontal gyrus and temporal pole positively correlated with an increased PVFT score between the pre- and post-intervention periods. In contrast, we found lower rsFC in INT than in CONT between the left middle frontal gyrus as a seed region and the posterior cingulate cortex, precuneus, and postcentral gyrus. CONCLUSIONS: Our findings suggest that the beneficial intervention effect of PICMOR on verbal fluency is characterized by enhanced rsFC of the left inferior frontal gyrus with semantic and executive control-related regions and suppressed rsFC between the left middle frontal gyrus and posterior cortical midline structures. No definitive conclusions can be made because of a lack of rsfMRI data before the intervention. However, this pilot study provides the candidates for rsFCs, reflecting the beneficial effects of PICMOR on the brain network involved in verbal fluency. TRIAL REGISTRATION: The trial was retrospectively registered at the UMIN Clinical Trials Registry ( UMIN000036667 ) (May 7th, 2019).


Asunto(s)
Encéfalo , Imagen por Resonancia Magnética , Anciano , Encéfalo/diagnóstico por imagen , Función Ejecutiva , Humanos , Proyectos Piloto
9.
Neurosurg Focus ; 48(4): E14, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-32234992

RESUMEN

OBJECTIVE: Mesial temporal lobe epilepsy (MTLE) is the most common type of focal epilepsy in adolescents and adults, and in 65% of cases, it is related to hippocampal sclerosis (HS). Selective surgical approaches to the treatment of MTLE have as their main goal resection of the amygdala and hippocampus with minimal damage to the neocortex, temporal stem, and optic radiations (ORs). The object of this study was to evaluate late postoperative imaging findings on the temporal lobe from a structural point of view. METHODS: The authors conducted a retrospective evaluation of all patients with refractory MTLE who had undergone transsylvian selective amygdalohippocampectomy (SAH) in the period from 2002 to 2015. A surgical group was compared to a control group (i.e., adults with refractory MTLE with an indication for surgical treatment of epilepsy but who did not undergo the surgical procedure). The inferior frontooccipital fasciculus (IFOF), uncinate fasciculus (UF), and ORs were evaluated on diffusion tensor imaging analysis. The temporal pole neocortex was evaluated using T2 relaxometry. RESULTS: For the IFOF and UF, there was a decrease in anisotropy, voxels, and fibers in the surgical group compared with those in the control group (p < 0.001). An increase in relaxometry time in the surgical group compared to that in the control group (p < 0.001) was documented, suggesting gliosis and neuronal loss in the temporal pole. CONCLUSIONS: SAH techniques do not seem to totally preserve the temporal stem or even spare the neocortex of the temporal pole. Therefore, although the transsylvian approaches have been considered to be anatomically selective, there is evidence that the temporal pole neocortex suffers structural damage and potentially functional damage with these approaches.


Asunto(s)
Amígdala del Cerebelo/cirugía , Epilepsia del Lóbulo Temporal/cirugía , Hipocampo/cirugía , Procedimientos Neuroquirúrgicos , Lóbulo Temporal/cirugía , Adolescente , Adulto , Imagen de Difusión Tensora/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Procedimientos Neuroquirúrgicos/métodos , Periodo Posoperatorio , Estudios Retrospectivos
10.
Neurosurg Focus ; 48(2): E7, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32006945

RESUMEN

OBJECTIVE: The functional importance of the superior temporal lobe at the level of Heschl's gyrus is well known. However, the organization and function of these cortical areas and the underlying fiber tracts connecting them remain unclear. The goal of this study was to analyze the area formed by the organization of the intersection of Heschl's gyrus-related fiber tracts, which the authors have termed the "Heschl's gyrus fiber intersection area" (HGFIA). METHODS: The subcortical connectivity of Heschl's gyrus tracts was analyzed by white matter fiber dissection and by diffusion tensor imaging tractography. The white matter tracts organized in relation to Heschl's gyrus were isolated in 8 human hemispheres from cadaveric specimens and in 8 MRI studies in 4 healthy volunteers. In addition, these tracts and their functions were described in the surgical cases of left temporal gliomas next to the HGFIA in 6 patients who were awake during surgery and underwent intraoperative electrical stimulation mapping. RESULTS: Five tracts were observed to pass through the HGFIA: the anterior segment of the arcuate fasciculus, the middle longitudinal fasciculus, the acoustic radiation, the inferior fronto-occipital fasciculus, and the optic radiation. In addition, U fibers originating at the level of Heschl's gyrus and heading toward the middle temporal gyrus were identified. CONCLUSIONS: This investigation of the HGFIA, a region where 5 fiber tracts intersect in a relationship with the primary auditory area, provides new insights into the subcortical organization of Wernicke's area. This information is valuable when a temporal surgical approach is planned, in order to assess the surgical risk related to language disturbances.


Asunto(s)
Corteza Auditiva/diagnóstico por imagen , Corteza Auditiva/fisiología , Vías Auditivas/diagnóstico por imagen , Vías Auditivas/fisiología , Percepción Auditiva/fisiología , Lenguaje , Adulto , Anciano , Anciano de 80 o más Años , Corteza Auditiva/anatomía & histología , Vías Auditivas/anatomía & histología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fibras Nerviosas/fisiología , Vías Nerviosas/diagnóstico por imagen , Vías Nerviosas/fisiología
11.
BMC Neurol ; 19(1): 193, 2019 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-31409291

RESUMEN

BACKGROUND: Emotional processes and responses are underestimated in stroke patients because the massive clinical picture of large hemispheric strokes often hides these symptoms. We report on a patient with peculiar unpleasant emotional responses after temporal stroke. CASE PRESENTATION: We describe a 62-years old man with significant unpleasant emotional responses that occurred after an acute episode of confusional state, disorientation, agitation, vertigo, postural instability, vomiting, and photophobia. Since then, he complained that vision of pictures containing curved/multicolored lines or tangles was associated with an uncomfortable feeling of fear and disgust, lasting few minutes, so that he avoided looking at them. Notably, he also showed an abnormal facial expression of disgust and fear, together with neurovegetative reaction and horripilation, at the presentation of pictures of objects or animals containing curved, multicolored, or tangled lines. A post-acute infarction of the right temporal-insular region, together with mild periventricular white matter changes, were evident at the brain magnetic resonance imaging. CONCLUSIONS: The anterior insula is crucial in transforming unpleasant sensory input into visceromotor reactions and the accompanying feeling of disgust. It is also known that temporal pole modulates visceral emotional functions in response to emotionally evocative perceptual stimuli. In the present case, the ischemic lesion of anterior part of the insula and temporal pole may have caused a decoupling of emotional and visceral response to complex visual stimuli. Further reports will provide a significant contribution to the taxonomy of these complex and relatively uncommon non-motor post-stroke symptoms that negatively affect quality of life.


Asunto(s)
Síntomas Afectivos/etiología , Asco , Miedo , Accidente Cerebrovascular/psicología , Miedo/fisiología , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Percepción/etiología , Accidente Cerebrovascular/patología , Percepción Visual/fisiología
12.
Proc Natl Acad Sci U S A ; 113(36): 10180-5, 2016 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-27551087

RESUMEN

Recent advances in neuroscience have given us unprecedented insight into the neural mechanisms of false memory, showing that artificial memories can be inserted into the memory cells of the hippocampus in a way that is indistinguishable from true memories. However, this alone is not enough to explain how false memories can arise naturally in the course of our daily lives. Cognitive psychology has demonstrated that many instances of false memory, both in the laboratory and the real world, can be attributed to semantic interference. Whereas previous studies have found that a diverse set of regions show some involvement in semantic false memory, none have revealed the nature of the semantic representations underpinning the phenomenon. Here we use fMRI with representational similarity analysis to search for a neural code consistent with semantic false memory. We find clear evidence that false memories emerge from a similarity-based neural code in the temporal pole, a region that has been called the "semantic hub" of the brain. We further show that each individual has a partially unique semantic code within the temporal pole, and this unique code can predict idiosyncratic patterns of memory errors. Finally, we show that the same neural code can also predict variation in true-memory performance, consistent with an adaptive perspective on false memory. Taken together, our findings reveal the underlying structure of neural representations of semantic knowledge, and how this semantic structure can both enhance and distort our memories.


Asunto(s)
Recuerdo Mental/fisiología , Distorsión de la Percepción/fisiología , Reconocimiento en Psicología/fisiología , Semántica , Lóbulo Temporal/fisiopatología , Adolescente , Adulto , Mapeo Encefálico , Femenino , Hipocampo/anatomía & histología , Hipocampo/fisiología , Hipocampo/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Lóbulo Temporal/anatomía & histología , Lóbulo Temporal/fisiología
13.
Synapse ; 72(2)2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28960527

RESUMEN

Despite much research, bipolar depression remains poorly understood, with no clinically useful biomarkers for its diagnosis. The paralimbic system has become a target for biomarker research, with paralimbic structural connectivity commonly reported to distinguish bipolar patients from controls in tractography-based diffusion MRI studies, despite inconsistent findings in voxel-based studies. The purpose of this analysis was to validate existing findings with traditional diffusion MRI metrics and investigate the utility of a novel diffusion MRI metric, entropy of diffusion, in the search for bipolar depression biomarkers. We performed group-level analysis on 9 un-medicated (6 medication-naïve; 3 medication-free for at least 33 days) bipolar patients in a major depressive episode and 9 matched healthy controls to compare: (1) average mean diffusivity (MD) and fractional anisotropy (FA) and; (2) MD and FA histogram entropy-a statistical measure of distribution homogeneity-in the amygdala, hippocampus, orbitofrontal cortex and temporal pole. We also conducted classification analyses with leave-one-out and separate testing dataset (N = 11) approaches. We did not observe statistically significant differences in average MD or FA between the groups in any region. However, in the temporal pole, we observed significantly lower MD entropy in bipolar patients; this finding suggests a regional difference in MD distributions in the absence of an average difference. This metric allowed us to accurately characterize bipolar patients from controls in leave-one-out (accuracy = 83%) and prediction (accuracy = 73%) analyses. This novel application of diffusion MRI yielded not only an interesting separation between bipolar patients and healthy controls, but also accurately classified bipolar patients from controls.


Asunto(s)
Trastorno Bipolar/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Adolescente , Adulto , Área Bajo la Curva , Trastorno Bipolar/fisiopatología , Trastorno Bipolar/terapia , Encéfalo/fisiopatología , Trastorno Depresivo Mayor/diagnóstico por imagen , Trastorno Depresivo Mayor/fisiopatología , Trastorno Depresivo Mayor/terapia , Imagen de Difusión Tensora/métodos , Entropía , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Curva ROC , Adulto Joven
14.
Neurosurg Rev ; 41(1): 347-354, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29039074

RESUMEN

The authors report a case of 18-year-old woman with partial complex seizures compatible with temporal epilepsy by semiology. Due to medical refractoriness, she was referred to pre-surgical evaluation. Initially, MRI showed no significant structural abnormality and superficial scalp EEG demonstrated epileptiform activity in the frontotemporal areas. Due to the lack of clear MRI abnormalities and the potential involvement of dominant mesial temporal structures by seizure semiology and non-invasive data, extra-operative invasive evaluation using stereo-electroencephalography (SEEG) methodology was indicated. Invasive monitoring demonstrated seizure onset in the left temporal pole with early spread to ipsilateral amygdala. Surgical treatment resulted in resection of the temporal pole and amygdala, with preservation of the remaining mesial temporal lobe structures. Intraoperatively, it was observed that multiple dural defects in the anterior middle temporal fossa with invagination of adjacent temporal pole parenchyma are compatible with temporal encephalocele. Patient remains seizure-free since surgery (12 months follow-up period) with preservation of neuropsychological functions. Although temporal pole resection plus amygdalohippocampectomy has been described as an adequate surgical approach in temporal encephalocele cases, we demonstrated the usefulness of the SEEG methodology in minimizing the volume of temporal lobe resection without compromising seizure and neuropsychological outcomes. The optimal results in this case and the review of the literature may suggest that in medically refractory epilepsies caused by temporal pole encephaloceles, preservation of the temporal lobe mesial structures should be attempted.


Asunto(s)
Electroencefalografía , Encefalocele/diagnóstico , Encefalocele/cirugía , Epilepsia del Lóbulo Temporal/diagnóstico , Epilepsia del Lóbulo Temporal/cirugía , Adolescente , Amígdala del Cerebelo/cirugía , Encefalocele/complicaciones , Epilepsia del Lóbulo Temporal/complicaciones , Femenino , Humanos , Imagen por Resonancia Magnética , Convulsiones/etiología , Convulsiones/prevención & control
15.
Int J Mol Sci ; 18(9)2017 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-28902129

RESUMEN

CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) is caused by mutations in the NOTCH3 gene, affecting the number of cysteines in the extracellular domain of the receptor, causing protein misfolding and receptor aggregation. The pathogenic role of cysteine-sparing NOTCH3 missense mutations in patients with typical clinical CADASIL syndrome is unknown. The aim of this article is to describe these mutations to clarify if any could be potentially pathogenic. Articles on cysteine-sparing NOTCH3 missense mutations in patients with clinical suspicion of CADASIL were reviewed. Mutations were considered potentially pathogenic if patients had: (a) typical clinical CADASIL syndrome; (b) diffuse white matter hyperintensities; (c) the 33 NOTCH3 exons analyzed; (d) mutations that were not polymorphisms; and (e) Granular osmiophilic material (GOM) deposits in the skin biopsy. Twenty-five different mutations were listed. Four fulfill the above criteria: p.R61W; p.R75P; p.D80G; and p.R213K. Patients carrying these mutations had typical clinical CADASIL syndrome and diffuse white matter hyperintensities, mostly without anterior temporal pole involvement. Cysteine-sparing NOTCH3 missense mutations are associated with typical clinical CADASIL syndrome and typical magnetic resonance imaging (MRI) findings, although with less involvement of the anterior temporal lobe. Hence, these mutations should be further studied to confirm their pathological role in CADASIL.


Asunto(s)
CADASIL/genética , Cisteína/genética , Mutación Missense , Receptor Notch3/genética , Biopsia , CADASIL/diagnóstico por imagen , CADASIL/metabolismo , Cisteína/metabolismo , Bases de Datos Factuales , Exones/genética , Humanos , Imagen por Resonancia Magnética , Polimorfismo Genético , Receptor Notch3/metabolismo
16.
J Headache Pain ; 18(1): 115, 2017 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-29322264

RESUMEN

BACKGROUND: To date, few MRI studies have been performed in patients affected by chronic migraine (CM), especially in those without medication overuse. Here, we performed magnetic resonance imaging (MRI) voxel-based morphometry (VBM) analyses to investigate the gray matter (GM) volume of the whole brain in patients affected by CM. Our aim was to investigate whether fluctuations in the GM volumes were related to the clinical features of CM. METHODS: Twenty untreated patients with CM without a past medical history of medication overuse underwent 3-Tesla MRI scans and were compared to a group of 20 healthy controls (HCs). We used SPM12 and the CAT12 toolbox to process the MRI data and to perform VBM analyses of the structural T1-weighted MRI scans. The GM volume of patients was compared to that of HCs with various corrected and uncorrected thresholds. To check for possible correlations, patients' clinical features and GM maps were regressed. RESULTS: Initially, we did not find significant differences in the GM volume between patients with CM and HCs (p < 0.05 corrected for multiple comparisons). However, using more-liberal uncorrected statistical thresholds, we noted that compared to HCs, patients with CM exhibited clusters of regions with lower GM volumes including the cerebellum, left middle temporal gyrus, left temporal pole/amygdala/hippocampus/pallidum/orbitofrontal cortex, and left occipital areas (Brodmann areas 17/18). The GM volume of the cerebellar hemispheres was negatively correlated with the disease duration and positively correlated with the number of tablets taken per month. CONCLUSION: No gross morphometric changes were observed in patients with CM when compared with HCs. However, using more-liberal uncorrected statistical thresholds, we observed that CM is associated with subtle GM volume changes in several brain areas known to be involved in nociception/antinociception, multisensory integration, and analgesic dependence. We speculate that these slight morphometric impairments could lead, at least in a subgroup of patients, to the development and continuation of maladaptive acute medication usage.


Asunto(s)
Corteza Cerebral/diagnóstico por imagen , Sustancia Gris/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Trastornos Migrañosos/diagnóstico por imagen , Adulto , Corteza Cerebral/patología , Femenino , Sustancia Gris/patología , Humanos , Masculino , Trastornos Migrañosos/patología , Uso Excesivo de Medicamentos Recetados , Adulto Joven
17.
J Neurosci ; 35(4): 1513-20, 2015 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-25632128

RESUMEN

Retrieving the names of friends, loved ones, and famous people is a fundamental human ability. This ability depends on the left anterior temporal lobe (ATL), where lesions can be associated with impaired naming of people regardless of modality (e.g., picture or voice). This finding has led to the idea that the left ATL is a modality-independent convergence region for proper naming. Hypotheses for how proper-name dispositions are organized within the left ATL include both a single modality-independent (heteromodal) convergence region and spatially discrete modality-dependent (unimodal) regions. Here we show direct electrophysiologic evidence that the left ATL is heteromodal for proper-name retrieval. Using intracranial recordings placed directly on the surface of the left ATL in human subjects, we demonstrate nearly identical responses to picture and voice stimuli of famous U.S. politicians during a naming task. Our results demonstrate convergent and robust large-scale neurophysiologic responses to picture and voice naming in the human left ATL. This finding supports the idea of heteromodal (i.e., transmodal) dispositions for proper naming in the left ATL.


Asunto(s)
Ondas Encefálicas/fisiología , Lateralidad Funcional/fisiología , Recuerdo Mental/fisiología , Nombres , Lóbulo Temporal/fisiología , Estimulación Acústica , Adulto , Mapeo Encefálico , Estimulación Eléctrica , Electrodos Implantados , Electroencefalografía , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estimulación Luminosa , Semántica , Análisis Espectral
18.
Neuroimage ; 132: 213-224, 2016 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-26908315

RESUMEN

The uncinate fasciculus connects portions of the anterior and medial temporal lobes to the lateral orbitofrontal cortex, so it has long been thought that this limbic fiber pathway plays an important role in episodic memory. Some types of episodic memory are impaired after damage to the uncinate, while others remain intact. Because of this, the specific role played by the uncinate fasciculus in episodic memory remains undetermined. In the present study, we tested the hypothesis that the uncinate fasciculus is involved in episodic memory tasks that have high competition between representations at retrieval. To test this hypothesis, healthy young adults performed three tasks: Experiment 1 in which they learned to associate names with faces through feedback provided at the end of each trial; Experiment 2 in which they learned to associate fractals with cued locations through feedback provided at the end of each trial; and Experiment 3 in which unique faces were remembered in a paradigm with low retrieval competition. Diffusion tensor imaging and deterministic tractography methods were used to extract measures of uncinate fasciculus microstructure. Results revealed that microstructural properties of the uncinate, but not a control tract, the inferior longitudinal fasciculus, significantly predicted individual differences in performance on the face-name and fractal-location tasks. However, no relationship was observed for simple face memory (Experiment 3). These findings suggest that the uncinate fasciculus may be important for adjudicating between competing memory representations at the time of episodic retrieval.


Asunto(s)
Aprendizaje por Asociación , Lóbulo Frontal/anatomía & histología , Memoria Episódica , Lóbulo Temporal/anatomía & histología , Adolescente , Adulto , Imagen de Difusión por Resonancia Magnética , Imagen de Difusión Tensora , Femenino , Lóbulo Frontal/fisiología , Humanos , Individualidad , Masculino , Recuerdo Mental , Vías Nerviosas/anatomía & histología , Vías Nerviosas/fisiología , Lóbulo Temporal/fisiología , Sustancia Blanca/anatomía & histología , Adulto Joven
19.
J Neurophysiol ; 115(6): 3052-61, 2016 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-27075536

RESUMEN

Naming people, places, and things is a fundamental human ability that is often impaired in patients with language-dominant anterior temporal lobe (ATL) dysfunction or ATL resection as part of epilepsy treatment. Convergent lines of evidence point to the importance of the ATL in name retrieval. The physiologic mechanisms that mediate name retrieval in the ATL, however, are not well understood. The purpose of this study was to characterize the electrophysiologic responses of the human ATL during overt cued naming of famous people and objects. Eight neurosurgical patients with suspected temporal lobe epilepsy who underwent implantation of intracranial electrodes for seizure focus localization were the subjects of this study. Specialized coverage of the ATL was achieved in each subject. The subjects named pictures of U.S. presidents and images of common hand-held tools. Event-related band power was measured for each ATL recording site. Both the left and right ATL demonstrated robust and focal increases in beta-band (14-30 Hz) power during person and tool naming. The onset of this response typically occurred at 400 ms but sometimes as early as 200 ms. Visual naming of famous people and tools is associated with robust and localized modulation of the beta band in both the left and right ATL. Measurement of visual naming responses may provide the groundwork for future mapping modalities to localize eloquent cortex in the ATL.


Asunto(s)
Ritmo beta/fisiología , Epilepsia del Lóbulo Temporal/fisiopatología , Recuerdo Mental/fisiología , Nombres , Lóbulo Temporal/fisiopatología , Adulto , Aprendizaje por Asociación/fisiología , Mapeo Encefálico , Señales (Psicología) , Electrodos Implantados , Electroencefalografía , Epilepsia del Lóbulo Temporal/cirugía , Análisis de Fourier , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estimulación Luminosa , Adulto Joven
20.
Cereb Cortex ; 25(5): 1405-13, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-24323497

RESUMEN

While humor typically involves a surprising discovery, not all discoveries are perceived as humorous or lead to a feeling of mirth. Is there a difference in the neural signature of humorous versus nonhumorous discovery? Subjects viewed drawings that were uninterpretable until a caption was presented that provided either: 1) a nonhumorous interpretation (or insight) of an object from an unusual or partial view (UV) or 2) a humorous interpretation (HU) of the image achieved by linking remote and unexpected concepts. fMRI activation elicited by the UV captions was a subset of that elicited by the humorous HU captions, with only the latter showing activity in the temporal poles and temporo-occipital junction (linking remote concepts), and medial prefrontal cortex (unexpected reward). Mirth may be a consequence of the linking of remote ideas producing high-and unexpected-activation in association and classical reward areas. We suggest that this process is mediated by opioid activity as part of a system rewarding attention to novel information.


Asunto(s)
Encéfalo/fisiología , Imagen por Resonancia Magnética , Vías Nerviosas/fisiología , Ingenio y Humor como Asunto/psicología , Adulto , Femenino , Humanos , Masculino , Lóbulo Occipital/fisiología , Corteza Prefrontal/fisiología , Recompensa , Lóbulo Temporal/fisiología , Adulto Joven
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