ABSTRACT
Objective: Borderline personality disorder (BPD) is a devastating condition that causes intense disruption of patients' lives and relationships. Proper understanding of BPD neurobiology could help provide the basis for earlier and effective interventions. As neuroimaging studies of patients with BPD are still scarce, volumetric and geometric features of the cortical structure were assessed to ascertain whether structural cortical alterations are present in BPD patients. Methods: Twenty-five female outpatients with BPD underwent psychiatric evaluation (SCID-I and II) and a 1.5 T magnetic resonance imaging (MRI) brain scan. The control group comprised 25 healthy age-matched females. Images were processed with the FreeSurfer package, which allows analysis of cortical morphology with more detailed descriptions of volumetric and geometric features of cortical structure. Results: Compared with controls, BPD patients exhibited significant cortical abnormalities in the fronto-limbic and paralimbic regions of both hemispheres. Conclusion: Significant morphologic abnormalities were observed in patients with BPD on comparison with a healthy control group through a multimodal approach. This study highlights the involvement of regions associated with mood regulation, impulsivity, and social behavior in BPD patients and presents a new approach for further investigation through a method of structural analysis based on distinct and simultaneous volumetric and geometric parameters. .
Subject(s)
Adult , Female , Humans , Middle Aged , Young Adult , Borderline Personality Disorder/physiopathology , Cerebral Cortex/abnormalities , Cerebral Cortex/physiopathology , Case-Control Studies , Gyrus Cinguli/abnormalities , Gyrus Cinguli/physiopathology , Magnetic Resonance Imaging , Multimodal Imaging , Neuroimaging , Neuropsychological Tests , Organ Size , Reference ValuesABSTRACT
Não existem bons marcadores de dano e atividade de doença no envolvimento neuropsiquiátrico do lúpus eritematoso sistêmico. Níveis elevados da proteína S100B no soro e no liquor têm sido estudados como marcadores de dano cerebral. Objetivo: Estudar os níveis séricos da proteína S100B no lúpus neuropsiquiátrico e correlacioná-los com achados de exames de imagem. Métodos: Concentrações da proteína S100B no soro foram avaliadas por meio de quimiluminescência em 48 pacientes lúpicos (LESNPS) com ou sem sintomas neurosiquiátricos (LES). Vinte e três pacientes foram estudados usando ressonância magnética (RM) e tomografia computadorizada de emissão fotônica única (SPECT). Resultados: Pacientes com LESNP apresentaram um número aumentado de lesões de substância branca (LSB) maiores ou iguais a 6 mm, comparado aos pacientes com LES sem envolvimento neuropsiquiátrico (p= 0,028). Todos os pacientes com lúpus eritematoso sistêmico (com ou sem sitomas neuropsiquiátricos) apresentaram níveis séricos elevados da proteína S100B em comparação com os controles normais. Pacientes com LESNPS apresentaram níveis significativamente mais elevados da proteína S100B do que os pacientes com LES (p < 0,0001). Foi encontrada correlação entre o índice de atividade da doença (SLEDA), a concentração sérica da proteína S100B e o número de LSB 6 mm (p= 0,0082). Conclusões: Os achados demonstraram níveis séricos elevados da proteína S100B no envolvimento neuropsiquiátrico do LES. Será necessário estudar um número maior de pacientes para correlacionar estes níveis elevados com as diversas formas de apresentação desta complicação e com os achados dos exames de imagem.
Subject(s)
Humans , Female , Adult , Middle Aged , Lupus Erythematosus, Systemic/complications , Magnetic Resonance Imaging , Osteocalcin , Tomography, Emission-Computed, Single-Photon , Lupus Vasculitis, Central Nervous System/etiologyABSTRACT
In the surgical management of skull base lesions and vascular diseases such as giant aneurysms, involvement of the internal carotid artery may require the resection or the occlusion of the vessel. The anastomosis of the external carotid artery and the middle cerebral artery with venous graft may be indicated to re-establish the blood flow. To determine the best suture site in the middle cerebral artery, an anatomical study was carried out. Fourteen cerebral hemispheres were analysed after the injection of red latex into the internal carotid artery. The superior and inferior trunk of the main division of the middle cerebral artery have more than 2 mm of diameter. They are superficial allowing an anastomosis using a venous graft. The superior trunk has a disadvantage, it gives rise to branches for the precentral and post-central giri. The anastomosis with the inferior trunk presents lower risk of neurological deficit even though the angular artery originates from it.