Structural changes of the frontal cortex in depressed mice are associated with decreased expression of brain-derived neurotrophic factor / 南方医科大学学报

OBJECTIVE@#To investigate the changes in gray matter volume in depressive-like mice and explore the possible mechanism.@*METHODS@#Twenty-four 6-week-old C57 mice were randomized equally into control group and model group, and the mice in the model group were subjected to chronic unpredictable mild stimulation (CUMS) for 35 days. Magnetic resonance imaging was performed to examine structural changes of the grey matter volume in depressive-like mice. The expression of brain-derived neurotrophic factor (BDNF) in the grey matter of the mice was detected using Western blotting and immunofluorescence staining.@*RESULTS@#Compared with the control mice, the mice with CUMS showed significantly decreased central walking distance in the open field test (P < 0.05) and increased immobile time in forced swimming test (P < 0.05). Magnetic resonance imaging showed that the volume of the frontal cortex was significantly decreased in CUMS mice (P < 0.001, when the mass level was greater than or equal to 10 756, the FDRc was corrected with P=0.05). Western blotting showed that the expression of mature BDNF in the frontal cortex was significantly decreased in CUMS mice (P < 0.05), and its expression began to decrease after the exposure to CUMS as shown by immunofluorescence staining. The volume of different clusters obtained by voxel-based morphometry (VBM) analysis was correlated with the expression level of mature BDNF detected by Western blotting (P < 0.05).@*CONCLUSION@#The decrease of frontal cortex volume after CUMS is related with the reduction of mature BDNF expression in the frontal cortex.

Reflexões sobre o trabalho on-line da neuropsicologia infantil numa visão histórico-cultural / Reflections on the online work of child neuropsychology from a cultural-historical perspective / Reflexiones sobre el trabajo online de la neuropsicología infantil desde una perspectiva histórico-cultural

O isolamento social provocado pela pandemia de covid-19 exigiu uma intensificação no estabelecimento de parâmetros para o trabalho do neuropsicólogo com suas especificidades. Assim, o objetivo deste artigo é levantar reflexões sobre a prática neuropsicológica infantil via internet baseada na nossa experiência prática vivenciada no período, relacionando com as referências teóricas da abordagem histórico-cutural e outros trabalhos que discorrem sobre as particularidades dessa modalidade de atendimento. Para isso, foi realizada uma pesquisa bibliográfica em fontes reconhecidas, como SciELO e Google Acadêmico, utilizando-se marcadores como "neuropsicologia on-line" e "teleneuropsicologia", entre outros, em português, inglês e espanhol. Os trabalhos encontrados foram utilizados como fundamento para discutir as ideias aqui apresentadas, a partir da experiência dos autores durante esse período. Considera-se que os neuropsicólogos precisam enfrentar a possível necessidade do trabalho on-line, considerando que as situações vividas durante a pandemia tendem a aumentar a necessidade de avaliações e intervenções neuropsicológicas. Ao mesmo tempo, se prevê que essa via de trabalho deve se intensificar após o isolamento, dentro do que se tem denominado como "o novo normal". Para isso, é essencial que haja esforço por parte da comunidade neuropsicológica para mostrar como essa área de trabalho pode ser útil para crianças, seus pais e professores. Conclui-se que é preciso ter a noção de que nenhuma via ou metodologia de trabalho é absolutamente completa, sendo essencial a instrumentalização das vantagens e desvantagens de todas elas.(AU)

The social isolation caused by the COVID-19 pandemic demanded intensification in the establishment of parameters for the neuropsychologist's work with its specificities. Thus, the aim of this article is to raise reflections on child neuropsychological practice via the internet, based on our practical experience in this period, relating to the theoretical references of the cultural-historical approach and other works that discuss the particularities of this type of care. For this, a bibliographic research was carried out in recognized sources such as SciELO and Google Scholar, using markers such as "online neuropsychology" and teleneuropsychology, among others, in Portuguese, English and Spanish. The works found were used as a basis for discussing the ideas presented here which are based on the authors' experience during this period. It is considered that neuropsychologists need to face the possible need for online work, considering that situations experienced during the pandemic tend to increase the need for neuropsychological assessments and interventions. At the same time, it is expected that this work path should intensify after isolation, within of what has been called "the new normal". For this, an effort by the neuropsychological community is essential to show how this area of work can be useful for children, their parents and teachers. It is concluded that it is necessary to have the notion that no way or work methodology is absolutely complete, being essential the instrumentalization of the advantages and disadvantages of all of them.(AU)

El aislamiento social provocado por la pandemia de Covid-19 exigió una intensificación en el establecimiento de parámetros para el trabajo del neuropsicólogo con sus especificidades. Así, el objetivo de este artículo es plantear reflexiones sobre la práctica neuropsicológica infantil a través de internet, a partir de nuestra experiencia práctica en este período, en relación con los referentes teóricos del enfoque histórico-cultural y otros trabajos que discuten las particularidades de este tipo de cuidado. Para esto, se realizó una investigación bibliográfica en fuentes reconocidas como SciELO y Google Académico, utilizando marcadores como "neuropsicología en línea" y teleneuropsicología, entre otros, en portugués, inglés y español. Los trabajos encontrados sirvieron de base para discutir las ideas aquí presentadas a partir de la experiencia de los autores durante este período. Se considera que los neuropsicólogos necesitan enfrentar la posible necesidad de trabajo en línea, considerando que las situaciones vividas durante la pandemia tienden a incrementar la necesidad de evaluaciones e intervenciones neuropsicológicas. Al mismo tiempo, se espera que esta vía de trabajo se intensifique después del aislamiento, dentro de lo que se ha denominado "la nueva normalidad". Para esto, un esfuerzo de la comunidad neuropsicológica es fundamental para mostrar cómo esta área de trabajo puede ser útil para los niños, sus padres y profesores. Se concluye que es necesario tener la noción de que ninguna vía o metodología de trabajo es absolutamente completa, siendo imprescindible la instrumentalización de las ventajas y desventajas de todas ellas.(AU)

Habilitación de funciones frontales básicas en cardiópatas congénitos a través de LEGO® Education / Basic frontal functions qualification in congenital heart disease with LEGO® Education

Las cardiopatías congénitas se consideran una de las anomalías que alteran la irrigación y el intercambio de oxigenación adecuado a las principales venas y arterias. Esto puede generar consecuencias en el desarrollo neurológico que se puede traducir en retraso psicomotor, déficits de aprendizaje, dificultades académicas y problemas de integración social. Para mejorar los trastornos cognitivos, se propone la habilitación cognitiva basada en los principios de mecánica y robótica de LEGO® Education. El objetivo de este estudio fue medir el efecto de un programa de intervención, basado en el uso de ensamblado y programación robótica con LEGO® Education, sobre las funciones frontales básicas como primera aproximación a un modelo propuesto en pacientes cardiópatas congénitos que han sido sometidos a cirugía cardiovascular. Se trató de un estudio de serie de casos, en el que finalizaron el tratamiento una niña y dos niños con cardiopatías congénitas con RACHS 2 y 3. Se aplicaron sub-escalas BANFE-2 y el cuestionario neuropsicológico de daño frontal antes y después del tratamiento; así como una escala para medir el nivel de ejecución por intervención, durante las ocho sesiones. Los resultados muestran en la escala BANFE2, cambios en las medias de las funciones frontales básicas, de daño leve-moderado y normal a normal alto, principalmente en memoria de trabajo y fluidez verbal. En esta primera aproximación, el método LEGO® Education mostró ser una buena herramienta para la habilitación neuropsicológica de estos pacientes.

Congenital heart diseases are considered to be an anomaly which alter the irrigation and the adequate exchange of oxygenation to the main veins and arteries. They can have neurodevelopmental consequences that could translate into psychomotor retardation, learning deficits, academic difficulties, and social integration problems. Cognitive empowerment based on the mechanics and robotics principles of LEGO® Education is proposed to improve cognitive disorders. In this study, the objective was to measure the effect of an intervention program, based on the use of assembly and robotic programming with LEGO® Education, upon basic frontal functions as a first approach to a proposed model in congenital heart disease patients who have undergone cardiovascular surgery. This was a case-series study, in which a girl and two boys with congenital heart disease with RACHS 2 and 3, completed the treatment. BANFE-2 subscales and the neuropsychological questionnaire of frontal damage were applied before and after the treatment; as well as a scale to measure the level of performance per intervention, through all the eight sessions. The BANFE-2 scale showed changes in the means of frontal functions, from mild-moderate damage and normal to high normal, mainly in working memory and verbal fluency. In this first approach, LEGO® Education method proved to be a useful tool for the neuropsychological empowerment of these patients.

Influencia de la actividad deportiva en el funcionamiento ejecutivo de los lóbulos frontales / Influence of sports activity on executive functioning of the frontal lobes

Esta investigación tuvo como objetivo determinar la influencia de la práctica deportiva sobre el desempeño de las funciones ejecutivas y, a su vez, indagar si la ejecución individual y/o grupal del deporte establece diferencias en el desarrollo de estas habilidades cognitivas y las posibles relaciones asociadas a los tiempos de entrenamiento. Para esto, se estableció una metodología cuantitativa, de diseño comparativo-correlacional. La muestra estuvo conformada por 100 participantes entre 18 y 25 años de edad de ambos géneros, distribuidos en tres grupos, uno de deportes de ejecución individual, otro de deportistas de actividad grupal y un grupo control con personas sin participación en actividades deportivas. Se encontraron, por ejemplo, mayores desempeños en funciones de planeación, memoria de trabajo, control inhibitorio y subtipos de atención por parte de quienes practicaban algún tipo de deporte, independiente de la modalidad de ejecución; pese a que, para algunas funciones cognitivas el participar de un deporte grupal generaba mayores puntuaciones en las tareas propuestas y, en otras, la ventaja la presentaron los integrantes de deportes individuales. Asimismo, se pudo establecer que existe una relación entre el tiempo semanal de entrenamiento y el funcionamiento de la actividad ejecutiva; esto, permitió corroborar la influencia de la actividad deportiva sobre el funcionamiento cognitivo subyacente en los lóbulos frontales.

This research aimed to determine the influence of sports practice on the performance of executive functions and, in turn, to inquire whether the individual and/or group performance of sports establishes differences in the development of these cognitive skills and the possible associated relationships to training times. To do this, a quantitative, comparative-correlational design methodology was established. The sample consisted of 100 participants between 18 and 25 years of age of both genders, divided into three groups, one for individual sports, another for athletes with group activity, and a control group with people without participation in sports activities. For example, greater performance was found in planning functions, working memory, inhibitory control and attention subtypes by those who practiced some type of sport, independent of the execution modality; Despite the fact that, for some cognitive functions, participating in a group sport generated higher scores in the proposed tasks and, in others, the advantage was presented by the members of individual sports. Likewise, it was established that there is a relationship between weekly training time and the performance of executive activity; This allowed to corroborate the influence of sports activity on underlying cognitive functioning on the frontal lobes.

Association between pain, anxiety, and alpha2 frontal activity in women with fibromyalgia

Fibromyalgia is a disorder of the central nervous system, with the presence of chronic generalized pain, fatigue, morning stiffness, anxiety and depression symptoms. Higher amplitudes of the frequency band alpha2 have been associated with higher relaxationin this population. In the present study, we analysed the association between pain, anxiety, and the spectral power of alpha2 frontal in women with fibromyalgia. Thirty-one women diagnosed with fibromyalgia, for at least three months, took part in the study. Results revealed a statistically significant positive relationship between pain and anxiety levels. However, we found no association between the spectral power of alpha2 in the frontal cortex and the measures between anxiety and pain in the patients. Present findings emphasize the importance of understanding the cortical activity and the central control mechanisms in fibromyalgia.

Research on the influence of mental fatigue on information resources allocation of working memory / 生物医学工程学杂志

Mental fatigue is the subjective state of people after excessive consumption of information resources. Its impact on cognitive activities is mainly manifested as decreased alertness, poor memory and inattention, which is highly related to the performance after impaired working memory. In this paper, the partial directional coherence method was used to calculate the coherence coefficient of scalp electroencephalogram (EEG) of each electrode. The analysis of brain network and its attribute parameters was used to explore the changes of information resource allocation of working memory under mental fatigue. Mental fatigue was quickly induced by the experimental paradigm of adaptive N-back working memory. Twenty-five healthy college students were randomly recruited as subjects, including 14 males and 11 females, aged from 20 to 27 years old, all right-handed. The behavioral data and resting scalp EEG data were collected simultaneously. The results showed that the main information transmission pathway of the brain changed under mental fatigue, mainly in the frontal lobe and parietal lobe. The significant changes in brain network parameters indicated that the information transmission path of the brain decreased and the efficiency of information transmission decreased significantly. In the causal flow of each electrode and the information flow of each brain region, the inflow of information resources in the frontal lobe decreased under mental fatigue. Although the parietal lobe region and occipital lobe region became the main functional connection areas in the fatigue state, the inflow of information resources in these two regions was still reduced as a whole. These results indicated that mental fatigue affected the information resources allocation of working memory, especially in the frontal and parietal regions which were closely related to working memory.

Research on enhancement of mental rotation ability based on transcranial direct current stimulation / 生物医学工程学杂志

Transcranial direct current stimulation (tDCS) is a non-invasive low-current brain stimulation technique, which is mainly based on the different polarity of electrode stimulation to make the activation threshold of neurons different, thereby regulating the excitability of the cerebral cortex. In this paper, healthy subjects were randomly divided into three groups: anodal stimulation group, cathodal stimulation group and sham stimulation group, with 5 subjects in each group. Then, the performance data of the three groups of subjects were recorded before and after stimulation to test their mental rotation ability, and resting state and task state electroencephalogram (EEG) data were collected. Finally, through comparative analysis of the behavioral data and EEG data of the three groups of subjects, the effect of electrical stimulation of different polarities on the three-dimensional mental rotation ability was explored. The results of the study found that the correct response time/accuracy rate and the accuracy rate performance of the anodal stimulation group were higher than those of the cathodal stimulation and sham stimulation groups, and there was a significant difference (

Síndrome de Otelo secundario a tuberculoma cerebral: a propósito de un caso / Othello Syndrome Secondary to Cerebral Tuberculoma: A Case Report

RESUMEN Introducción: El síndrome de Otelo, epónimo del personaje de Shakespeare, es un término diagnóstico transnosológico que designa un cuadro caracterizado por delirios de infidelidad respecto a la pareja que, por consiguiente, puede acarrear actitudes celotípicas y conductas violentas hacia ella. En su forma pura, corresponde al trastorno delirante de infidelidad, pero también puede ser secundario a organicidad cerebral y a consumo de drogas. Métodos: Reporte de caso y revisión no sistemática de la literatura relevante. Presentación del caso: Varón de 26 arios con antecedente de consumo de drogas y víctima de maltrato infantil, 3 años antes había sufrido crisis convulsivas tónico-clónicas e hipertensión intracraneal, por lo que se sometió a una craneotomía, en la que se halló un tuberculoma cerebral frontal derecho. Tras un lapso, comenzó con delirios de infidelidad y conductas violentas hacia su pareja. Revisión de la literatura: Los celos delirantes se asocian, como otros delirios, a lesiones del lóbulo frontal derecho. Pese a la elevada y creciente prevalencia mundial de tuberculosis, no se han publicado casos de síndrome de Otelo secundario a tuberculoma cerebral. Conclusiones: El síndrome de Otelo, aunque no es la principal causa de violencia doméstica, puede asociarse con manifestaciones particularmente violentas y ser secundario a tuberculoma cerebral. Este es el primer caso de tal índole que se publica.

ABSTRACT Introduction: Othello syndrome, an eponym of Shakespeare's character, is a transnosological diagnostic term that designates a clinical picture characterised by the presence of delusions of infidelity with respect to a partner and that, consequently, can lead to typical jealousy attitudes and violent behaviour towards the partner. In its pure form, it corresponds to delusional disorder of infidelity, but it may also be secondary to brain organicity and drug use. Methods: Case report and non-systematic review of the relevant literature. Case presentation: A 26-year-old man, with a history of drug abuse and a victim of domestic violence as a child, presented with tonic-clonic seizures and intracranial hypertension three years ago, for which he underwent a craniotomy with the finding of a right frontal cerebral tuberculoma. After a lapse, he developed a clinical picture of delusions of infidelity regarding his partner and violent behaviour towards her. Literature review: Delusional jealousy is associated, like other delusions, with lesions of the right frontal lobe. Despite the high and growing prevalence of tuberculosis worldwide, there are no reported cases of Othello syndrome secondary to cerebral tuberculoma in the literature. Conclusion: Othello syndrome, although not the main cause of domestic violence, can be associated with particularly violent manifestations and be secondary to cerebral tuberculoma. This is the first published case of its kind.

Correlation between Depressive Behavior and Expressions of S100β and Brain-derived Neurotrophic Factor in Hippocampus and Frontal Cortex of Rats / 中国医学科学院学报

To investigate the association between chronic unpredictable mild stress (CUMS)-induced depressive-like behavior in rats and expressions of brain-derived neurotrophic factor (BDNF) and S100β in the hippocampal and prefrontal cortex. Rats were randomly assigned to three groups:saline control group,saline+CUMS group,and citalopram +CUMS group. CUMS was used for depression modeling in rats. Depressive-like behavior in rats were evaluated by open-field test,sucrose preference test,and novel object recognition test. S100β and BDNF expressions were tested by enzyme-linked immunosorbent assay. Rats in the saline+CUMS group had significantly lower score in sucrose preference [(52.48±13.14)%],basic motor tasks [(845.8±371.4)s],fine motor tasks [(565.6±211.9)s],and longer resting time [(282.6±11.8)s] compared to the control group [(84.30±6.15)% (=7.49,=0.000),(1239.1±281.6)s (=2.83,=0.008),(801.8±150.9)s (=3.05,=0.003),(268.2±12.8)s (=2.72,=0.001)]. Compared with the citalopram+CUMS group,rats from the saline+CUMS group also showed significantly lower results in sucrose preference [(80.55±11.31)%,=5.39,=0.000],basic motor tasks [(1156.4±314.7)s,=2.13,=0.031],and fine motor tasks [(736.1±150.0)s,=2.21,=0.008]. There were no significant differences in the expression of hippocampal and prefrontal BDNF between these two groups,but rats from the saline+CUMS group expressed significantly higher levels of S100β compared to rats from the citalopram+CUMS group [(13.22±2.23) ng/g (10.55±2.72) ng/g,=2.67,=0.014]. Pearson correlation analysis revealed that the expression of S100β was positively correlated with the expression of BDNF in the prefrontal cortex and hippocampus (=0.35,=0.034;=0.36,=0.034).The novel object recognition index was positively correlated with the expression of BDNF in the hippocampus(=0.38,=0.021),and the duration of fine-motor activities was negatively correlated with S100β in the prefrontal cortex (=-0.36,=0.037). Different types of depressive behaviors in rats induced by CUMS are associated with the selective expression of S100β and BDNF in two different brain cortex. S100β protein and BDNF may independently participate in the pathogenesis of depression.

Rehabilitación de las funciones ejecutivas en un caso de oligoastrocitoma frontal derecho / Rehabilitation of executive functions in a case of right frontal oligoastrocytoma

El desarrollo tecnológico y científico en salud de los últimos años ha permitido mejoras en el diagnóstico y mayor eficacia en el tratamiento de pacientes con tumores cerebrales, generado un aumento no solo en la supervivencia, sino también una mayor demanda de los servicios de neuropsicología y rehabilitación, debido a las alteraciones cognitivas asociadas y dificultades en cuanto a la funcionalidad e independencia, disminuyendo significativamente la calidad de vida de estos pacientes. La presente investigación documenta el caso de un paciente masculino de 43 años, remitido al servicio de neuropsicología tras la resección de oligoastrocitoma frontal derecho, en la evaluación neuropsicológica se evidenció alteraciones en funciones ejecutivas, fluidez de lenguaje discursivo y dificultad en habilidades instrumentales. La investigación se realizó bajo el diseño cuasi experimental de caso único, donde se aplicó en repetidas ocasiones a lo largo del tratamiento el Inventario de Adaptabilidad Mayo-Portland (MPAI-4) para determinar las dificultades funcionales del paciente. El objetivo de la rehabilitación neuropsicológica se centró en implementar estrategias de autoinstrucciones y automonitoreo, que pudieran ser aplicadas en contextos cotidianos y en intereses específicos del paciente. Los resultados indican que el proceso de rehabilitación neuropsicológica demostró tener un efecto positivo en la funcionalidad del paciente y las estrategias aprendidas pueden ser trasladadas a su vida cotidiana

The technological and scientific development on health in recent years has allowed improvements in diagnosis and treatment on brain tumor patients, have increase not only their survivor rate but also their need of neuropsychology and rehabilitation services due to cognitive alterations associated and the subsequent struggling with independence and functionality that reduces significantly their life quality. The present research documents the case of a male patient, 43 years old, referred to the service after resection of right frontal oligoastrocytoma, in the neuropsychologic evaluation evidenced executive functions, discursive language fluency alterations and difficulties in instrumental skills. The research was carried out under the quasi experimental design of a single case where there will be applied repeatedly during the course of treatment the Mayo-Portland Adaptability Inventory (MPAI-4) to identify functional difficulties on the patient. The objective of the neuropsychological rehabilitation focuses on implementing self-instruction and self-observance strategies in order to apply them on an ordinary context and the patient's specific areas of interest. The results indicate that the neuropsychological rehabilitation treatment has shown a positive effect on the patient's functionality and an improvement on his ability to apply the learned strategies to his day to day life.

Funciones ejecutivas y ajuste clínico en adolescentes colombianos policonsumidores / Executive functions and clinical adjustment in Colombian adolescents polydrug

Resumen El estudio tuvo como objetivo analizar el funcionamiento ejecutivo y el ajuste clínico en una muestra de adolescentes colombianos policonsumidores. Se efectuó un estudio ex post facto con 204 participantes entre 12 y 17 años (M = 14,50, DT = 1,71). Se aplicó la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales BANFE-2 y para la evaluación clínica se utilizó la Escala de Autoestima de Rosenberg, Cuestionario de Afrontamiento COPE, Escala de Impulsividad de Dickman y Cuestionario de 90 Síntomas SCL-90-R. Se identificó un rendimiento significativamente inferior del grupo policonsumidor en las funciones ejecutivas, bajos niveles de autoestima, altos niveles de impulsividad disfuncional y de diversidad psicopatológica, así como estilo de afrontamiento a través del consumo de sustancias. Así mismo, se detectó un efecto predictor de la interacción edad x tiempo de consumo en el funcionamiento ejecutivo, observándose un menor rendimiento de los policonsumidores más jóvenes a medida que se incrementaba el tiempo de consumo.

Abstract The research aim was to analyze the executive functioning and the clinical adjustment in a sample of Colombian teen polydrug users. An ex post facto study was carried out with 204 participants, 12-17 years old (M= 14,50, SD = 1,71). The neuropsychological test BANFE-2 was applied for analyzing frontal lobes and executive functioning and the Rosenberg self esteem scale, a COPE questionnaire, the Dickman impulsivity scale and the SCL-90-R questionnaire were used for clinical adjustment respectively. A lower executive functioning throughput were observed in polydrug users. Low self-esteem, high dysfunctional impulsivity, high diverse psychopathologies and coping strategies for drug use were also observed. A predictor effect between age and consumption time on the executive functioning were also determined. A lower throughput in younger polydrug users increase through consumption time.

Síntomas disejecutivos y reflejos frontales en pacientes con enfermedad de Alzheimer / Dysexecutive symptoms and frontal reflexes in patients with Alzheimer disease

INTRODUCCIÓN. La enfermedad de Alzheimer, supone la primera causa de demencia y produce múltiples alteraciones cognitivas como la afectación de las funciones ejecutivas. Esos pacientes presentan síntomas disejecutivos y alteración en los reflejos de liberación frontal, aunque se desconoce si están afectados en función del grado de severidad de la demencia. OBJETIVO. Determinar si existe una relación entre los Síntomas Disejecutivos y los Reflejos de Liberación Frontal en pacientes con enfermedad de Alzheimer. MATERIALES Y MÉTODOS. Se realizó un estudio descriptivo, retrospectivo; se analizaron 23 pacientes con demencia tipo Alzheimer del Centro de Referencia Estatal de Atención a Personas con Enfermedad de Alzheimer, durante el periodo 2013-2014. Los datos fueron obtenidos mediante el cuestionario disejecutivo, y analizados mediante la prueba X2 y la U de Mann-Whitney. RESULTADOS. Las edades de los participantes oscilaron entre 55 y 90 años. La media de puntuaciones según el cuestionario disejecutivo, arrojó un valor de 21,69. En la planificación se observó diferencias significativas entre los pacientes con Alzheimer leve y moderado (p=0,020); así como, entre la fase leve y la moderadamente grave (p=0,014). En la conciencia social resultó similar entre la etapa leve y la moderada (p=0,036). CONCLUSIÓN. Los reflejos de liberación frontal y los síntomas disejecutivos estuvieron afectados, pero no se evidenció relación entre estos y el grado de severidad de enfermedad de Alzheimer. Se refutó la hipótesis que, a mayor grado de severidad, mayor afectación disejecutiva y de los reflejos de liberación frontal.

INTRODUCTION. Alzheimer's disease is the leading cause of dementia and produces multiple cognitive disorders such as the involvement of executive functions. These patients present with dysexecutive symptoms and impaired frontal release reflexes, although it is unknown whether they are affected depending on the severity of the dementia. OBJECTIVE. To determine if there is a relationship between the Dissecutive Symptoms and the Frontal Release Reflexes in patients with Alzheimer's disease. MATERIALS AND METHODS. A descriptive, retrospective study was carried out; 23 patients with Alzheimer's dementia from the State Reference Center for Care for People with Alzheimer's Disease were analyzed during the 2013-2014 period. The data were obtained through the dissertation questionnaire, and analyzed using the X2 test and the Mann-Whitney U test. RESULTS. The ages of the participants ranged from 55 to 90 years. The average of scores according to the executive questionnaire showed a value of 21,69. In the planning, significant differences were observed between patients with mild and moderate Alzheimer's disease (p = 0.020); as well as between the mild and moderately severe phase (p = 0.014). In social consciousness it was similar between the mild and moderate stages (p = 0.036). CONCLUSION. Frontal release reflexes and dissecting symptoms were affected, but no relationship between them and the severity of Alzheimer's disease was evident. The hypothesis was refuted that, to a greater degree of severity, greater disejecutiva involvement and frontal release reflexes.

El pensamiento moral después del daño cerebral adquirido / Moral thought after acquired cerebral damage

Resumen Introducción: El pensamiento moral es una habilidad mental que permite a los seres humanos respetar las normativas sociales implícitas y explícitas. Un factor que puede alterar su funcionamiento es el daño cerebral adquirido, como suele suceder en sujetos que han sufrido una injuria encefálica a nivel frontal. Objetivo: Analizar la relación entre el proceso del pensamiento moral y el funcionamiento cerebral, a través de la descripción de casos que han sufrido un daño cerebral adquirido, con la finalidad de explicitar la situación que vive un individuo luego de presentar un daño cerebral y volverse incapaz de respetar las normas sociales. Desarrollo: Se expone la clínica de pacientes que han sufrido un daño cerebral a nivel frontal, como es el caso de Phineas Gage, NN y Elliot, en los cuales se observó que su estado posterior al evento traumático, se caracterizó por retroceder a estadios previos del pensamiento moral, a diferencia de pacientes como el clásico HM, quien presentó un daño cerebral en una estructura diferente a la frontal. Conclusiones: Se discute el análisis realizado en torno al papel que desempeña el lóbulo frontal en el proceso de respeto de las normas sociales, su influencia en la interacción humana y cómo puede verse afectado el pensamiento moral cuando existe un daño cerebral a este nivel.

Introduction: Moral thinking is a mental skill that allows respecting implicit and explicit social norms. One factor that can alter its functioning is acquired brain damage, as is the case of subjects who have suffered a brain injury at the frontal lobe. Aim: To analyze the relationship between the process of moral thinking and brain functioning, through the description of cases that have suffered acquired brain damage, with the purpose of explaining the situation that an individual lives after presenting brain damage and becoming unable to respect social norms. Development: The clinic of patients who have suffered brain damage at the frontal level, such as Phineas Gage, NN and Elliot, is shown, in which it was observed that its state after the traumatic event was characterized by going back to previous stages of thinking moral, unlike a subject who may present brain damage in later structures. Conclusions: We discuss the analysis performed on the role of the frontal lobe in the process of respecting social norms that allow human interaction and how it can be affected by brain damage.

Neuroanatomical Predictors of Dysphagia after Stroke: Voxel-Based Lesion Symptom Mapping Study / 대한연하장애학회지

OBJECTIVE: Dysphagia is a common consequence of stroke with a negative effect on the clinical outcome. Given these potential outcomes, it is important to identify the precursors to dysphagia after stroke. The aims of this study were to identify lesions associated with dysphagia after an ischemic supratentorial stroke using voxel-based lesion symptom mapping (VLSM) and compare the difference in the lesion pattern between the oral and pharyngeal phase dysphagia. METHODS: Stroke patients who met the following inclusion criteria were screened retrospectively between January 2012 and November 2014: a first-ever stroke, supratentorial lesion and who underwent brain MRI and functional dysphagia scale (FDS) from videofluoroscopic swallowing study (VFSS). Finally, the MRI data of 83 patients were analyzed. Statistical maps of the lesion contribution related to dysphagia were generated using VLSM. RESULTS: VLSM showed that FDS was associated with damage to the putamen, caudate, insula, frontal precentral gyrus, and inferior frontal gyrus. The lesions were distributed more widely in the left than right hemisphere. Lesions correlated with the FDS oral score were distributed mainly in the frontal lobe and insula. Otherwise, the associated lesion with the FDS pharyngeal score was mainly the basal ganglia. CONCLUSION: In these results, lesions that correlated with dysphagia were distributed more widely in the left hemisphere, reflecting the possibility of lateralization of the swallowing function. Oral phase dysphagia was associated with left frontal lobe and insula; the lesion correlated with the cognitive function or apraxia. On the other hand, VLSM revealed the lesions associated with pharyngeal dysphagia to be the basal ganglia, which is a structure that plays a role in the automatic motor control network.

Cerebral Amyloid Quantification in Cognitively Normal Korean Adults Using F-18 Florbetaben PET / 대한핵의학회잡지

PURPOSE: To investigate regional cerebral amyloid beta retention in cognitively normal Korean adults using F-18 florbetaben (FBB).METHODS: We prospectively analyzed F-18 FBB positron emission tomography (PET)/CT scans of 30 cognitively healthy adults (age range, 50??0 years) using automated quantification. The standardized uptake value ratios (SUVRs) of F-18 FBB were calculated for predefined regions by normalizing the regional count with cerebellar cortex.RESULTS: The distribution of amyloid beta for each brain region revealed no age-related trends (p > 0.05). From all subjects, mean SUVR of amyloid deposit was 1.30 ± 0.18. The right parietal lobe showed the highest SUVR value (1.46 ± 0.23), whereas the right frontal lobe and left precuneus showed the lowest SUVR (1.23 ± 0.25).CONCLUSIONS: We provide reference values of normative data obtained from healthy elderly Koreans and suggest its use for accurate diagnosis of patients with Alzheimer's disease.

Brain Activation Related to Perspective-Taking in Adolescents: Differences from Adults

OBJECTIVES: The purpose of this study was to investigate the differences between adolescents and adults, in the perspective-taking ability, as well as the brain activation patterns during the perspective-taking situation.METHODS: We recruited healthy adolescents aged 13 years to 15 years (n = 20) and adults aged 19 years to 29 years (n = 20). All the subjects were scanned while performing the perspective-taking task, in which an emotional situation was presented in the form of statements comprising first person, as well as third person perspectives. Differences in brain activation between groups were assessed by contrasting neural activity during the tasks.RESULTS: In the between-group analysis, while performing the third-person perspective-taking task, the adolescent group showed greater neural activities in the middle frontal gyrus and precentral gyrus as compared to the adult group. Positive correlation was observed between the activity in the frontal areas (Brodmann area 6/9) and the score of scales related to perspective-taking and social cognition in the adolescent group.CONCLUSIONS: This study suggests that several frontal brain areas of adolescents needs to be overactivated in order to compensate for low perspective-taking ability when they ought to take another person's point of view.

Fear Network Model in Panic Disorder: The Past and the Future

The core concept for pathophysiology in panic disorder (PD) is the fear network model (FNM). The alterations in FNM might be linked with disturbances in the autonomic nervous system (ANS), which is a common phenomenon in PD. The traditional FNM included the frontal and limbic regions, which were dysregulated in the feedback mechanism for cognitive control of frontal lobe over the primitive response of limbic system. The exaggerated responses of limbic system are also associated with dysregulation in the neurotransmitter system. The neuroimaging studies also corresponded to FNM concept. However, more extended areas of FNM have been discovered in recent imaging studies, such as sensory regions of occipital, parietal cortex and temporal cortex and insula. The insula might integrate the filtered sensory information via thalamus from the visuospatial and other sensory modalities related to occipital, parietal and temporal lobes. In this review article, the traditional and advanced FNM would be discussed. I would also focus on the current evidences of insula, temporal, parietal and occipital lobes in the pathophysiology. In addition, the white matter and functional connectome studies would be reviewed to support the concept of advanced FNM. An emerging dysregulation model of fronto-limbic-insula and temporooccipito-parietal areas might be revealed according to the combined results of recent neuroimaging studies. The future delineation of advanced FNM model can be beneficial from more extensive and advanced studies focusing on the additional sensory regions of occipital, parietal and temporal cortex to confirm the role of advanced FNM in the pathophysiology of PD.

fNIRS Assessment during an Emotional Stroop Task among Patients with Depression: Replication and Extension

OBJECTIVE: Accumulated evidence collected via functional near-infrared spectroscopy (fNIRS) has been reported with regard to mental disorders. A previous finding revealed that emotional words evoke left frontal cortex activity in patients with depression. The primary aim of the current study was to replicate this finding using an independent dataset and evaluate the brain region associated with the severity of depression using an emotional Stroop task. METHODS: Oxygenized and deoxygenized hemoglobin recording in the brain by fNIRS on 14 MDD patients and 20 normal controls. RESULTS: Hyperactivated oxygenized hemoglobin was observed in the left frontal cortex on exposure to unfavorable stimuli, but no significant difference was found among patients with depression compared with healthy controls on exposure to favorable stimuli. This result is consistent with previous findings. Moreover, an evoked wave associated with the left upper frontal cortex on favorable stimuli was inversely correlated with the severity of depression. CONCLUSION: Our current work using fNIRS provides a potential clue regarding the location of depression symptom severity in the left upper frontal cortex. Future studies should verify our findings and expand them into a precise etiology of depression.

Distinct Topographical Patterns of Spike-Wave Discharge in Transgenic and Pharmacologically Induced Absence Seizure Models

Absence seizures (AS) are generalized non-convulsive seizures characterized by a brief loss of consciousness and spike-and-wave discharges (SWD) in an electroencephalogram (EEG). A number of animal models have been developed to explain the mechanisms of AS, and thalamo-cortical networks are considered to be involved. However, the cortical foci have not been well described in mouse models of AS. This study aims to use a high density EEG in pathophysiologically different AS models to compare the spatiotemporal patterns of SWDs. We used two AS models: a pharmacologically induced model (gamma-hydroxybutyric acid, GHB model) and a transgenic model (phospholipase beta4 knock-out, PLCβ4 model). The occurrences of SWDs were confirmed by thalamic recordings. The topographical analysis of SWDs showed that the onset and propagation patterns were markedly distinguishable between the two models. In the PLCβ4 model, the foci were located within the somatosensory cortex followed by propagation to the frontal cortex, whereas in the GHB model, a majority of SWDs was initiated in the prefrontal cortex followed by propagation to the posterior cortex. In addition, in the GHB model, foci were also observed in other cortical areas. This observation indicates that different cortical networks are involved in the generation of SWDs across the two models.

Effects of Amisulpride Adjunctive Therapy on Working Memory and Brain Metabolism in the Frontal Cortex of Patients with Schizophrenia: A Preliminary Positron Emission Tomography/Computerized Tomography Investigation

OBJECTIVE: Dopamine plays a significant role in working memory by acting as a key neuromodulator between brain networks. Additionally, treatment of patients with schizophrenia using amisulpride, a pure dopamine class 2/3 receptor antagonist, improves their clinical symptoms with fewer side effects. We hypothesized that patients with schizophrenia treated with amisulpride and aripiprazole show increased working memory and glucose metabolism compared with those treated with cognitive behavioral therapy (CBT) and aripiprazole instead. METHODS: Sixteen patients with schizophrenia (eight in the amisulpride group [aripiprazole+amisulpride] and eight in the CBT group [aripiprazole+CBT]) and 15 age- and sex-matched healthy control subjects were recruited for a 12-week-long prospective trial. An [18F]-fluorodeoxyglucose-positron emission tomography/computerized tomography scanner was used to acquire the images. RESULTS: After 12 weeks of treatment, the amisulpride group showed greater improvement in the Letter-Number Span scores than the CBT group. Additionally, although brain metabolism in the left middle frontal gyrus, left occipital lingual gyrus, and right inferior parietal lobe was increased in all patients with schizophrenia, the amisulpride group exhibited a greater increase in metabolism in both the right superior frontal gyrus and right frontal precentral gyrus than the CBT group. CONCLUSION: This study suggests that a small dose of amisulpride improves the general psychopathology, working memory performance, and brain glucose metabolism of patients with schizophrenia treated with aripiprazole.