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Pain is a complex physiological and psychological activity, involving at least three dimensions, including pain sensation, pain emotion, and pain cognition. Acupuncture can clearly relieve the pain sensation of patients and improve pain emotion and pain cognition induced by pain; acupuncture participates in the multi-dimensional regulation of pain through brain regions of the limbic system such as anterior cingulate cortex (ACC), amygdala (AMY), and hippocampus. By analyzing relevant literature, it has been found that the regulation of acupuncture on pain emotion is mainly related to the activation of pertinent opioid receptors in the ACC, the decrease of the expression of extracellular signal-regulated kinase (ERK), and the promotion of the expression of glutamic acid (Glu) A1, metabotropic glutamate receptor-1 (mGluR1), and γ-aminobutyric acid aminobutyric acid (GABA) B2 protein in the AMY. The regulation of acupuncture on pain cognition is mainly related to the elevation of the expression of protein kinase A (PKA) and phospho-p38 mitogen-activated protein kinase (phospho-p38 MAPK) and the inhibition of cyclic adenosine monophosphate (cAMP)/PKA/cAMP response element-binding protein (CREB) signaling pathway in the ACC.
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Objective:To investigate the clinical manifestations, risk factors and outcomes of patients with acute cingulate cortex (CC) infarction.Methods:Patients with acute CC infarction admitted to the Department of Neurology, the First Affiliated Hospital of Nanjing Medical University from December 2019 to April 2022 were enrolled retrospectively. According to the location of infarction, they were divided into anterior cingulate cortex (ACC) infarction group and posterior cingulate cortex (PCC) infarction group. The clinical manifestations, stroke risk factors, imaging examination and National Institutes of Health Stroke Scale (NIHSS) score of the patients were analyzed. At one month after onset, the modified Rankin Scale was used to evaluate the short-term outcome.Results:A total of 21 patients with acute CC infarction were enrolled, including 12 males (57.14%), aged 67.14±12.36 years (range, 45-89 years). There were 16 patients (76.19%) with ACC infarction, including 13 (81.25%) unilateral CC infarction. The clinical manifestations were mainly apathy, decreased concentration, and executive dysfunction. There were 5 patients (23.81%) with PCC infarction, all with unilateral onset, mainly manifested as memory loss and visual space disorder. Among the 21 patients, 18 (85.71%) had ≥2 vascular risk factors, and 13 patients (61.90%) had ≥3 vascular risk factors, of which hypertension was most common (90.48%); 19 (90.48%) were caused by atherosclerosis, and 2 (9.52%) were caused by cardiogenic embolism. After treatment, the symptoms of both groups were improved significantly, and there was statistical difference in the NIHSS score before and after treatment ( Z=4.07, P<0.01). During the follow-up, 16 patients (76.19%) had a good outcome, 5 (23.81%) had a poor outcome and no death occurred. Conclusions:ACC and PCC infarction mainly showed different forms of cognitive impairment. If the diagnosis and treatment are timely, the overall outcome of CC infarction is good.
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Objective: To detect and evaluate brain metabolism abnormalities and white matter changes of posterior cingulate cortex (PCC) in type 2 diabetes mellitus (T2DM) patients with 1H-MRS combined with DTI, and to explore the correlation between the changes and cognitive impairment. Methods: Single-voxel 1H-MRS and DTI in PCC were performed in 43 patients with T2DM (21 with cognitive impairment [T2DM+CD group], 22 without cognitive impairment [T2DM group] ) and 23 healthy volunteers (HC group). The integral value of related crest area and fractional anisotropy (FA), mean diffusivity (MD) values were calculated, and their correlation with cognitive function indicators were analyzed. Results: The value of myo-inositol/creatine (mI/Cr) in PCC region of T2DM+CD group was higher than that of T2DM and HC groups, and the value of glutamate+glutamine/creatine (Glx/Cr) value was lower than that of T2DM and HC groups (all P<0.05). Glx/Cr was significantly positively correlated with Montreal cognitive assessment score (MoCA; r=0.59, P<0.01). FA values in the whole brain and PCC regions of T2DM+CD group were lower than those of T2DM and HC groups, and the MD values were higher than those of T2DM and HC groups (all P<0.05). FA value was significantly positively correlated with the score of MoCA (r=0.57, P=0.01). Conclusion: The combination of 1H-MRS and DTI with PCC as ROI can be used to quantitatively reflect and mutually confirm the neuropathological basis of cognitive impairment induced by T2DM, which is expected to be a clinical indicator of early warning.
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Purpose To explore the role of posterior cingulate cortex (PCC) dysfunction in the pathogenesis of depression and its relationship with the clinical features of depression by analyzing the effective connection among the inner areas of PCC of patients in depression.Materials and Methods The spectral dynamic causal model (spDCM) was used to analyze the resting state functional magnetic resonance imaging (fMRI) data from the PCC inner areas Brodmann area (BA) 23,BA29,BA30,BA31 in the major depressive disorder group (MDD,n=23) and healthy control group (HC,n=36).Results Compared with HC group,the strength of BA30 self-connection of MDD group existed significant difference (t=2.53,P＜0.05).In MDD group,the connection of BA23 toward BA31 had abnormal activation,and the abnormal inhibition occurred in BA23 toward BA30;compared with HC group and after a＜0.05 Hz correction,there were significant differences in the bi-directional connections for BA23 and BA31,BA39 and BA31,BA30 and BA31,and in the unidirectional connections for BA23 to BA31,BA30 to BA23,BA30 to BA29 in MDD group.Conelusion The effective connection and connective nodes and edges in the inner areas of PCC in the depression disorder patients were abnormal.
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Objective To study the functional connectivity (FC) pattern of anterior cingulated cortex in patients with vascular cognitive impairment with no dementia (VCIND) after subcortical ischemic vascular disease,and to analyze the relationship between FC and cognitive function.Methods Resting state functional magnetic resonance imaging (MRI) data were acquired from 14 patients with VCIND and 16 healthy volunteers with normal cognition.The altered functional connectivity pattern in VCIND was valuated by comparing to normal control.Then a correlation analysis was performed between the strength of FC and the Montreal Cognitive Assessment (MoCA) scores in patients with VCICD.Results (1) The visual space or executive function (3.14 ± 0.29),attention or computing power (3.79 ± 0.37),language (1.14 ± 0.21),directional power (4.14 ± 0.53) items,and the total points of MoCA (17.29 ± 1.53) in VCIND were significantly lower than that in the normal control group (4.93 ± 0.07,5.93 ± 0.07,2.93 ± 0.26,5.93 ± 0.07,27.57 ± 0.33 ; t =31.62,32.50,28.51,12.00,39.71,all P ＜ 0.05).While the abstract ability or memory (4.36 ± 0.74),the naming (2.79 ± 0.11) items in VCIND were not significantly different with that in the control group (4.79 ± 0.80,2.93 ± 0.07 ; t =1.76,1.00,both P ＞ 0.05).(2) Compared with the control group,the patients showed FC decrease between the anterior cingulated cortex and several brain regions,including the left middle temporal gyrus/left superior temporal gyrus,the left superior frontal gyrus/left middle frontal gyrus/left inferior frontal gyrus,the left posterior cingulated cortex/left precuneus,the left inferior parietal lobule/left angular gyrus,the right middle temporal gyrus/right superior temporal gyrus,the right orbit frontal cortex/right inferior frontal gyrus,the right inferior parietal lobule/right angular gyrums,and the right superior frontal gyrus/right middle frontal gyrus.There were also some regions that showed increased FC,which included the right posterior lobe of the cerebellum,the calcarine fissure,the left middle frontal gyrus,and the left precentral gyrus.(3) In the VCIND patients,the brain regions which positively correlated with the MoCA scores were the left inferior parietal lobule,the right middle temporal gyrus,the right superior frontal gyrus,and the left superior temporal gyrus.The negativerelated brain regions were the right posterior limb of internal capsule,the left middle temporal gyrus,the left precuneus,and the right anterior limb of internal capsule.Conclusions VCIND patients show abnormal FC pattern of anterior cingulated cortex,which could be the pathological basis of VCIND,and have certain predictive value for VCIND.
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Objective To examine brain regions with a functional connection to posterior cingulate cortex (PCC) in a relapsing-remitting multiple sclerosis (RRMS) group compared with matched control subjects,and to employ resting-state functional MRI (rs-fMRI) to PCC connectivity gathered by investigating synchronic low frequency fMRI signal fluctuations of default mode network with seed-based correlation analysis (SCA).Methods Twenty-seven patients with RRMS (RRMS group) and 27 age-,and sexmatched healthy controls (HC group) were examined by resting-state fMRI,DTI and 3D-T1 on Siemens Trio Tim 3.0T.The fMRI data preprocessing and processing was performed using Data Processing Assistant for Resting-State fMRI Advanced Edition (DPARSFA) based on Matlab 2012a,and PCC (-5,-49,40)was selected as seed.An SCA approach was used to analyze the rs-fMRI data.We examined the differences in SCA-derived connectivity metrics in patients with RRMS and healthy controls,and analyzed correlations between connectivity correlation coefficient of the differences regions and MRI-derived metrics (brain parenchymal fraction,T2 lesion load),as well as clinical metrics (expanded disability status scale,paced auditory serial addition test,and disease duration) of the disease.Results The SCA via functional connectivity of PCC showed that the temporal correlation between the blood-oxygen-level-dependent signals of the default mode network was reliable spatial patterns of activation in patients with RRMS.The lower connectivity in right superior frontal gyrus within default mode network,and higher connectivity in right posterior lobe of cerebellum,right crus of cerebellum,right medial frontal gyrus,right medial occipital gyrus,left precuneus/cingulate gyrus,right angular gyrus and right cingulate gyrus were found in our study.Significant negative-related was observed between the paced auditory serial addition test and functional connectivity in right middle temporal gyrus (0.387 ± 0.216) of RRMS patients (r =-0.59,P =0.001).Significant negative correlation also was observed between the course of disease and functional connectivity in right superior frontal gyrus (0.039 ± 0.293) in patients (r =-0.39,P =0.041).There was no significant correlations between other regions with different functional connectivity and expanded disability status scale,disease duration,or brain atrophy.The connectivity in right superior frontal gyrus,left medial occipital gyrus,left precentral gyrus was decreased; and connectivity in right cerebellum anterior lobe (dentate),right frontal lobe white matter was significantly increased.Significant positive correlation was observed between the course of disease and functional connectivity in left precentral gyrus (-0.924 ± 0.253),right cerebellum anterior lobe (dentate ;0.217 ± 0.208) of RRMS patients (r =0.650,P =0.000;r =0.436,P =0.023),respectively.Conclusion These findings reveal the compensatory mechanism of the brain in response to structural damage,by means of increased activation or synchronization of default mode network,which seems to be finite.
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Rejection sensitivity is the heightened tendency to perceive or anxiously expect disengagement from others during social interaction. There has been a recent wave of neuroimaging studies of rejection. The aim of the current review was to determine key brain regions involved in social rejection by selectively reviewing neuroimaging studies that employed one of three paradigms of social rejection, namely social exclusion during a ball-tossing game, evaluating feedback about preference from peers and viewing scenes depicting rejection during social interaction. Across the different paradigms of social rejection, there was concordance in regions for experiencing rejection, namely dorsal anterior cingulate cortex (ACC), subgenual ACC and ventral ACC. Functional dissociation between the regions for experiencing rejection and those for emotion regulation, namely medial prefrontal cortex, ventrolateral prefrontal cortex (VLPFC) and ventral striatum, was evident in the positive association between social distress and regions for experiencing rejection and the inverse association between social distress and the emotion regulation regions. The paradigms of social exclusion and scenes depicting rejection in social interaction were more adept at evoking rejection-specific neural responses. These responses were varyingly influenced by the amount of social distress during the task, social support received, self-esteem and social competence. Presenting rejection cues as scenes of people in social interaction showed high rejection sensitive or schizotypal individuals to under-activate the dorsal ACC and VLPFC, suggesting that such individuals who perceive rejection cues in others down-regulate their response to the perceived rejection by distancing themselves from the scene.
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Ganglios Basales , Encéfalo , Señales (Psicología) , Trastornos Disociativos , Glucanos , Glucosa , Giro del Cíngulo , Relaciones Interpersonales , Competencia Mental , Neuroimagen , Corteza Prefrontal , Rechazo en PsicologíaRESUMEN
ObjectiveTo investigate the central nervous system mechanisms of active of movement switch in the patients with Tourette' s syndrome( TS),and to explore the possible underlying distinct neural networks for tic trigger and generation. Methods Participants were 14 patients with TS and 14 age- and gender-matched healthy volunteers with no history of physical,psychiatric or neurological disease: All patients were assessed with functional magnetic resonances imaging (fMRI)of the brain during the intermittent performance of finger-tapping switch tasks,Blood-oxygen-level dependent-fMRI was performed using a 3.0 Tesla MR.The area over which the activation was distributed was calculated,and the activation volumes were also compared between the patients with TS and the control subjects.ResultsThe regions activated in the patients with TS and in the volunteers were similar in several brain regions,including contralateral precentral and postcentral gyrus,contralateral mesia pre-front gyrus,contralateral cingulate gyrus,contralateral insula and ipsilataral cerebellum. There were also many different activation areas between the patients and the control subjects. The patients with TS demonstrated more significant and extended activation in the contralateral pre- and postcentral gyrus than the healthy volunteers.The volume of the left pre- and postcentral gyrus of the TS patients was (8.024 ±0.071 ) cm3,while the volume of the left pre-and postcentral gyrus of the control subjects was ( 6.480 ± 0.026) cm3 ( t =3.026,P ＜ 0.01 ) ; The volume of the right pre- and postcentral gyrus was (6.192 ± 0.019) cm3 in the TS cases,while there was (5.608 ±0.037) cm3 in the control subjects (t =2.752,P ＜0.05).There were significant differences in the volumes of bilateral pre- and postcetral gyrus between the TS and control subjects. The activations of conralateral thalamus without contralateral insula were found in the patients with TS. Conversely, the contralateral insula activation without thalamus activation could be found in the healthy volunteers.ConclusionThe thalamus might play an important role in the aetiological and physiopathologic mechanisms of the TS. The thalamus along with the parietal cortex,cingulate cortex and insular cortex appear to constitute a distinct neural network for tic trigger and generation.
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INTRODUÇÃO: O teste de fluência verbal fonológica é uma tarefa neuropsicológica amplamente utilizada em estudos de neuroimagem funcional que analisam os circuitos neurais relevantes para a produção de linguagem. A maioria dos estudos que utilizam a RMf para analisar as áreas cerebrais de maior ativação durante a tarefa de fluência verbal é realizado na língua inglesa. Embora estudos anteriores tenham demonstrado que dependendo da língua falada possa ocorrer diferença de desempenho na tarefa de fluência verbal, ainda não está claro se esta diferença leva a mudanças do padrão de ativação cerebral. Há indícios na literatura que a ativação cerebral regional durante a tarefa de fluência verbal pode variar com o aumento de dificuldade da tarefa, sendo o cíngulo anterior a área cerebral que parece estar envolvida no processo de adaptação ao grau de dificuldade da tarefa. Estudos com sujeitos saudáveis demonstram também a influência de variáveis demográficas, como idade, escolaridade, gênero e classificação socioeconômica no desempenho na produção de palavras, com alguns estudos reportando maior ativação cortical nos homens em comparação às mulheres. OBJETIVOS: Avaliar os efeitos da variação do grau de dificuldade da tarefa de fluência verbal utilizando a técnica de ressonância magnética funcional. Analisar se há correlação entre os dados demográficos e o desempenho na tarefa de fluência verbal. Comparar o padrão de ativação cerebral entre os gêneros. MÉTODOS: Foram incluídos 21 voluntários saudáveis (12 homens), destros e falantes do português do Brasil como primeira língua. Foram colhidos dados sociodemográficos, neuropsicológicos e de desempenho dos voluntários. Comparamos os achados adquiridos através da técnica de ressonância magnética funcional durante a produção de palavras iniciadas com letras classificadas anteriormente como fáceis e difíceis para produzir palavras na língua portuguesa. As imagens foram adquiridas em aparelho de ressonância...
INTRODUCTION: Phonological verbal fluency is a neuropsychological test used in numerous functional neuro imaging studies to allow the assessment of the neural circuits relevant to language production. The majority of studies that use functional magnetic resonance imaging (fMRI) to analyze the cerebral areas with greater activation during the verbal fluency task have been carried out in English. Although there is evidence that the verbal fluency performance varies as a function of the spoken language, it is unclear if this difference is associated with differences in cerebral activation patterns. Added to that, there is neuroimaging evidence that patterns of regional cerebral activation during VF task may vary with task demand. In particular, the anterior cingulate cortex seems critical to the adaptation process to the level of difficult. Studies of healthy individuals have demonstrated the influence of demographic variables, such as age, level of education, gender and socio-economic status, on word production performance, and some authors have shown greater cortical activation in men than in women. OBJECTIVES: To use the fMRI technique to evaluate the effect of varying levels of difficult of verbal fluency task on the brain activation patterns in healthy subjects. To analyze whether there is a significant correlation between demographic variables and verbal fluency performance. To compare cerebral activation patterns between genders. METHODS: We recruited 21 (12 men) right-handed healthy volunteers, having Portuguese as their first language. Demographic, neuropsychological and behavioral data were collected. We compared fMRI data acquired during production of words beginning with letters classified as easy or hard for word production in Portuguese. Images were acquired in 1,5 T magnet through a clustered image acquisition sequence that allowed overt verbal responses to be made in the absence of scanner noise. Data were analyzed through XBAM software...
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Giro del Cíngulo , Lenguaje , Imagen por Resonancia Magnética , Pruebas NeuropsicológicasRESUMEN
Objective Beta-amyloid (AB) plaque is one of the most important hallmarks of Alzhe-imer disease (AD). [N-methyl-11C]-[4'-methylaminophenyl]-6-hydroxybenzothiazole (11C-PIB) can have a strong binding potential (BP) of AB plaques in the brains of patients with dementia of Alzheimer type (DAT). This study was to investigate the value of rostral anterior cingnlate cortex (rACC) in diagnosing human AD with 11C-PIB PET imaging. Methods All the subjects were enrolled through ads by Washington University School of Medicine (WUSM) in USA. Clinical dementia rating (CDR) was the practical grading standard for AD. There were 129 cases of normal control (HC) with CDR =0 and 40 cases of AD patients with CDR >0 (but there were only 120 HC cases and 34 DAT patients with data of rACC PIB BP. All 169 cases had PIB BP data of other studied cerebral subregions). Brain subregions were localized with MRI. PET imaging was performed immediately after intravenous injection of11C-PIB. MRI and PET images were aligned and fused with the help of software. BP was calculated using the Logan graphical analysis and the cerebellar cortex as the reference tissue. The distribution characters of 11C-PIB BP in rACC were analyzed and compared with other brain subregions studied by other scholars with the same research cases. The corre-lation analysis, t-test or variance analysis were calculated with SPSS 11.5. Results rACC PIB BP of 120 HC and 34 AD patients was calculated, rACC PIB BP was statistically linear and positively correlated with CDR significantly (BP=0.2865±0.442,CDR=0.143±0.290,r=0.545,P<0.01). There was no sta-tistical difference among the rACC PIB BP of DAT patients (0.6719±0.1545 vs 0.8933±0.0880,inde-pendent-samples t-test in both groups of CDR =0.5and1, indicated t=-1.245,P>0.05), but signifi-cant difference was found between rACC PIB BPs of HC and DAT patients (0.1589±0.0219 vs 0.7370±0.1125, independent-samples t-test in both group of CDR=0 and>0,indicatedt=-7.998, P<0.01). The threshold of rACC PIB BP for differentiating DAT was 0.4592, greater than what could be thought as suffering from DAT with sensitivity 67.65 % (23/34) and specificity 88.33% (106/120). The BP values of both groups partially overlap each other. In all the studied cerebral subregions, the highest 3 subregions in mean PIB BP of DAT patients or in the difference of mean PIB BP between DAT patients and HC group were precuneus, rACC and prefrontal cortices. Conclusion rACC PIB BP can be used to differentiate DAT patients from normal persons; rACC, precuneus and prefrontal cortices are together the most sensitive brain subregions in the diagnosing DAT.
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Pilomotor seizures have been reported frequently with temporal lesions or sometimes with ictal discharges from temporal area. The stimulation on cingulate gyrus also induced the piloerection in animals. We present a 27-year-old man with pilomotor seizures originating from the right frontal lobe. The subtracted ictal 99mTc-ECD SPECT of the patient showed hyperperfusion mainly on the right cingulate gyrus. Electrocorticography demonstrated the epileptogenic focus in the anterior part of the right cingulate gyrus. After resection of the focus, the patient has been free from seizures.
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Adulto , Animales , Humanos , Electroencefalografía , Epilepsia del Lóbulo Frontal , Lóbulo Frontal , Giro del Cíngulo , Piloerección , Convulsiones , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
Objective To investigate the effects of propofol on ketamine-induced HSP 70 mRNA and protein expression in the rat posterior cingulate cortex and to explore the possibility of using propofol to prevent or treat ketamine-induced psychotomimetic effects and neuronal damage. Methods Thirty male Wistar rats weighing 250-300 g were randomly divided into 5 groups with 6 animals in each group: group 1 received normal saline intraperitoneally ip (NS); group 2 received ketamine 100 mg? kg-1 ip (K); group 3 received propofol 100 mg ? kg-1 ip (P); group 4 received propofol 50 mg?kg-1 + ketamine 100 mg?kg-1 ip (P1 K) and group 5 received propofol 100 mg?kg + ketamine 100 mg?kg-1 ip (P2K) . In group 4 and 5 the interval between propofol and ketamine administration was 15 min. Twenty-four hours after ketamine and/or propofol administration, the animals were decapitated and brain was removed. HSP 70 mRNA expression in the posterior cingulate cortex was detected by using semi-quantitative RT-PCR technique; HSP 70 protein expression in posterior cingulated cortex was determined by immuno-histochemical method. Results The levels of HSP 70 mRNA and HSP 70 protein expression were significantly different among the 5 groups. Ketamine induced marked HSP 70 mRNA and HSP 70 protein expression in the posterior cingulated cortex. Propofol itself did not induce HSP 70 gene expression in this brain region. Propofol significantly inhibited ketamine-induced HSP 70 mRNA and HSP 70 protein expression in the posterior cingulate cortex in a dose-dependent manner. Conclusions Propofol pretreatment can significantly inhibit ketamine-induced HSP 70 mRNA and protein expression in the posterior cingulated cortex. It may be one of the mechanisms of inhibition of ketamine-induced psychotomimetic effect and neuronal damage by propofol.