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BACKGROUND:In clinical application,the therapeutic effect of transcranial magnetic stimulation depends on the ability to accurately target the areas of the brain that need to be stimulated.In recent years,with the development of neuronavigation systems,mobile augmented reality technology,and the new methods of processing magnetic resonance imaging(MRI)data,the accuracy of stimulus target localization and the optimization of target selection are expected to improve further. OBJECTIVE:To review the principle of MRI-based image navigation and its application in transcranial magnetic stimulation and summarize the roles of different modal MRI data analyses in guiding the selection of target areas for transcranial magnetic stimulation. METHODS:An online computer search for relevant literature was performed in PubMed,CNKI database and WanFang database,with the keywords"transcranial magnetic stimulation,coil positioning,neuronavigation,augmented reality,magnetic resonance,theory."Finally,63 documents were included for review. RESULTS AND CONCLUSION:Among the traditional methods of positioning transcranial magnetic stimulation coils,the"5 cm rule"and the international electroencephalogram 10-20 positioning method are the most commonly used.These methods have the advantages of simplicity and economy,but they rely too much on the operator's experience and there were technical differences between operators.The neuronavigation system,which is based on stereotactic technology,is the guiding method for positioning transcranial magnetic stimulation coils with the highest visual degree and accuracy.It achieves visual positioning through MRI data acquisition,3D brain reconstruction,head model registration and stereogeometric positioning.It has high application value in clinical treatment and scientific research,but it cannot be promoted in medical institutions due to its high cost.For various medical institutions,mobile augmented reality is a cost-effective and efficient alternative to the neuronavigation system,which achieves visual positioning of brain tissue under the scalp through MRI data acquisition,2D/3D image construction,virtual image and real brain image superposition.It has the advantages of directly visualization and low cost,and is expected to be popularized and applied in primary medical units.Although the superiority of clinical efficacy of visual coil positioning over the electroencephalogram 10-20 localization strategy has not yet been fully demonstrated,with the progress of brain MRI data analysis,visual positioning is expected to further optimize the target selection strategy of transcranial magnetic stimulation therapy and to improve the response rate and individuation degree of transcranial magnetic stimulation treatment.This is a promising and challenging research direction in the future.
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Objective:To analyze whether patients with myasthenia gravis (MG) have cognitive impairment and changes of brain structure, and explore the possible mechanisms of cognitive impairment in MG patients from the perspective of brain structure.Methods:Twenty-eight patients with MG admitted to Department of Neurology, First Affiliated Hospital of Soochow University from July 2019 to December 2021 were selected as MG group, and 30 family members from MG patients or healthy subjects who underwent physical examination in Physical Examination Center during the same period were selected as healthy control group. Neuropsychological test was used to evaluate the cognitive function. VBM was used to analyze the changes of brain structure on structural MRI (sMRI). Correlations of gray matter volumes of different brain regions with cognitive function between the two groups were analyzed.Results:Compared with the healthy control group, the MG group had significantly decreased scores of Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Painting Test (CDT), and Verbal Fluency Test (VFT), and significantly decreased Rey Auditory Verbal Learning Test (RAVLT) immediate memory and delayed memory scores, while statistically increased time consuming in Making Track Test Part A (TMT-A), and Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores ( P<0.05). Compared with healthy control group, MG group had significantly decreased gray matter volumes of the left orbital superior frontal gyrus, right orbital middle frontal gyrus, right triangular inferior frontal gyrus, left insula, left middle frontal gyrus, right superior limbic gyrus, right anterior cingulate gyrus, right lateral cingulate gyrus, left medial cingulate gyrus, left lateral cingulate gyrus, left medial superior frontal gyrus, and left dorsalateral superior frontal gyrus ( P<0.05). Correlation analysis showed that gray matter volume in the left insula was negatively correlated with time consuming in Stroop Color-Word Test-A ( r=-0.407, P=0.035). Conclusion:Patients with MG may have cognitive decline and gray matter cortical atrophy of some brain regions, and brain areas with gray matter cortical atrophy correspond to areas of cognitive impairment.
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Objective:To explore the brain structural changes in patients with post-traumatic stress disorder (PTSD) after traffic accident.Methods:Forty-six patients with PTSD (PTSD group) who received treatment in Psychology Department, Second People's Hospital of Guangdong Province from January 2021 to June 2022 after traffic accidents and 49 gender- and age-matched normal healthy subjects (control group) were selected; all subjects underwent MRI 3D-T1WI structural imaging of the whole brain. Voxel-based morphometry (VBM) was used to detect the volume differences of the gray matter between the two groups. The correlations of volumes of the gray matter in PTSD group which was different from that in the control group with Clinician-Administered PTSD Scale (CAPS), PTSD Checklist-Civilian Version (PCL-C) and Hamilton Rating Scale for Depression (HAMD) were analyzed.Results:Compared with control group, patients in PTSD group had significantly decreased gray matter volumes in the left hippocampus, left postcentral gyrus and right superior frontal gyrus ( P<0.001, adjusted GRF); no regions with increased gray matter volumes were noted. The gray matter volume in the left postcentral gyrus was negatively correlated with CAPS scores in PTSD patients ( r=-0.443, P=0.002); the gray matter volumes in other brain regions with differences were not correlated with CAPS, PCL-C or HAMD scores ( P>0.05). Conclusion:Structural changes of the left hippocampus, left postcentral gyrus and right superior frontal gyrus are observed in PTSD patients caused by traffic accidents, and the gray matter volume of left postcentral gyrus is related to severity of PTSD clinical symptoms.
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In this review paper, the influence of the changes of sex hormone levels in the reproductive transition period such as puberty, menstrual cycle, pregnancy, postpartum and menopause on the brain structure was retrospectively analyzed. The results showed that the fluctuation of sex hormone level in different reproductive cycles caused the change of neuroplasticity, which have a macroscopic and microscopic impact on the brain, causing normal or pathological changes in the brain, and there was a significant correlation between the changes of brain volume and sex hormone levels. These results indicated that sex hormones played an important role in the plasticity of brain structure at different stages of female reproductive transition, and the periodic and progressive changes in sex hormone levels were also critical to the influence of mood, cognitive function and psychoneurosis throughout the female life cycle. Therefore, a full understanding of the changes of brain structural plasticity and pathology related to sex hormones is helpful to understand the neural mechanism of the influence of sex hormones on brain structure, and provide effective theoretical basis for the prevention and treatment of diseases in different hormonal transition periods for women in the future.
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Objective This study aims to investigate the sex difference in the hippocampus and parahippocampus in patients with bipolar disorder. Methods We acquired T1－weighted structural MRI from 133 bipolar type I patients (60 males) and 144 normal controls (81 males). The General Linear Model was used to examine the relationship between sex and brain volumes of the hippocampus and parahippocampus, with age and intracranial volume as covariates. Results Patients showed significantly smaller volumes of the bilateral hippocampus and parahippocampus (P＜0.01). There were sex－by－diagnosis interactions in the left parahippocampus gyrus (F=6.534, P=0.044). Male patients had significant smaller volumes of the left parahippocampus gyrus compared to the male normal controls (P＜0.001) whereas the volumes were not significantly different between female patients and female normal controls (P＞0.05). Conclusion The results suggest sex difference in the left parahippocampus gyrus volume in patients with bipolar type I disorder, which deserves further investigation in the future bipolar imaging researches.
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Objective To investigate the impulsivity and aggressiveness characteristics of patients with hepatolenticular degeneration (HLD) and its relationship with brain structure.Methods The Chinese version of the Barratt impulsiveness scale,11 version (BIS-1 1-C) and Buss-Perry aggression questionnaire (BPAQ) were assessed in 78 patients with hepatolenticular degeneration(HLD group) and 86 normal adults (health control group).HLD patients were examined by 3.0T magnetic resonance imaging (MRI).The differences in impulsivity and aggressiveness of the two groups were compared,and the relationship was analyzed between impulsivity,aggressiveness and different brain structures in patients with HLD.Results The total impulsive score,unplanned factor score,the total aggressive score and anger factor score of patients with cerebral HLD (61.74±9.82,26.08±5.06,82.71 ± 15.92,20.06± 5.74,respectively) were higher than those in patients with hepatic HLD (56.73±7.11,23.02±4.20,72.84± 11.15,16.64±5.01,respectively),and health control group(52.19±7.53,21.50± 3.93,64.64±9.83,14.27 ±4.38,respectively),and the differences were significant (F=3.193,4.646,11.830,8.270,all P＜0.05).Total impulsive score was positively correlated with aggressive score and physical aggression in HLD group(r=0.299,0.290,both P＜0.05).Unplanned score was positively correlated with aggressive total score (r=0.324) and physical aggression (r=0.320) in HLD group (P＜0.05).Frontal lobe injury was the influencing factor of total impulsive score(B=10.263,95％CI=0.467-19.946,P=0.008),attention score(B=2.837,95％CI=0.382-5.600,P=0.010) and unplanned factor score (B=3.977,95％ CI=0.848-8.502,P=0.046).Thalamus injury was the influencing factor of aggressive total score and its factor score.Caudate nucleus injury was the influencing factor of aggressive total score (B=10.030,95％ CI=3.351-18.039,P=0.017) and physical aggression score (B =4.432,95％ CI=1.193-7.729,P=0.016).Conclusion Patients with HLD have higher impulsive and aggressive tendencies,which are mainly manifested in unplanned impulsive and anger tendencies.Brain injury may be an important factor affecting impulsiveness and aggression in patients with HLD.Impulsiveness is related with frontal lobe injury and aggression to thalamus and caudate nucleus injury.Impulsiveness and aggressiveness in patients with HLD are not caused by damage to isolated brain areas,but are related to damage to multiple brain areas.
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Objective To explore the association between the ZNF804A gene genetic variation poly-morphism rs1344706 and brain structure and function in patients with schizophrenia. Methods Literature search was conducted in Pubmed and other databases,the processes were performed in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,then the Comprehensive Meta-Analysis software was used for meta-analysis. Results Schizophrenia patients with rs1344706 risk al-lele had lager gray matter in the amount of brain regions including frontal lobe (z＝3.445,P＝0.001),tempo-ral lobe (z＝2.140,P＝0.032) and other brain regions; healthy controls with the risk allele had smaller gray matter and regional activity in the frontal lobe ( gray matter: z＝－2.008, P＝0.045, regional activity: z＝－4.036,P＜0.01) and other regions. Sensitivity analysis was stable,but publication bias existed in a few ana-lyses of indexes. Conclusion The risk allele in ZNF804A gene rs1344706 has positive effects on the brain structure in patients with schizophrenia,but negative effects on the brain structure and function in the healthy individuals.
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Depression is a common psychiatric disorder, and approximately 30% patients with depression do not respond effectively to standard antidepressant medication; this condition is termed treatment resistant depression (TRD) and its neurobiological mechanism remains unclear. Neuroimaging techniques can non-invasively explore changes in brain structure, function and metabolism. These techniques have been applied in neurobiological research of TRD and revealed critical abnormalities in brain structure, function and metabolism in fronto-limbic system. In this paper, we reviewed the latest progress in neuroimaging researches on TRD, providing new insight and imaging evidence for further neurobiological studies of TRD.
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Introducción: los cambios estructurales del cerebro se pueden observar en fases tempranas de la infección por VIH y acelerarse en estadios avanzados, aunque queda por profundizar con más estudios clínicos la relación que pueda existir entre la adherencia al tratamiento antirretroviral y los cambios en los volúmenes de las estructuras cerebrales. Objetivo: identificar los cambios en estructurascerebrales de personas infectadas con VIH por medio de la resonancia magnética y explorar su relación con el tratamiento antirretroviral. Materiales y métodos: se eligieron 2 grupos, cada uno con 16 individuos; el primero conformado por personas infectadas con VIH y tratamiento adherente y el segundo con individuos no infectados (grupo control). Los volúmenes de las estructuras corticales, subcorticales, las regiones superficiales de la sustancia blanca y gris fueron calculados para los dos hemisferios, en los cuales se utilizaron algoritmos automáticos de la plataforma de análisis de imágenesFreeSurfer. Los datos anatómicos de los individuos fueron adquiridos en un equipo de resonancia magnética 3T en el Instituto de Alta Tecnología Médica (IATM), Medellín, Colombia. Resultados: el análisis de las estructuras corticales y subcorticales no arrojó diferencias significativas entre las volumetríasdel grupo control y los individuos infectados con VIH/adherentes al tratamiento. Conclusión: los hallazgos muestran que el cerebro puede estar posiblemente sin alteraciones en sus estructuras corticales y subcorticales en los individuos con VIH adherentes al tratamiento, en primera o segunda línea de tratamiento antirretroviral, y, a la vez, estos resultados pueden aportar nuevas estrategias de neuroprotección ante el autocuidado frente al esquema de tratamento.
Introduction: structural brain changes can be detected in early stages of HIV infection and may be accelerated in advanced stages, however it still important to have more clinic studies for analyze the relationship between the adherence to antiretroviral therapy and changes in the volume of brain structures. Objective: To identify changes in brain structures from HIV subjects by using Magnetic Resonance Imaging (MRI) and to correlate the findings with the antiretroviral treatment. Materials and methods: Two groups with 16 subjects were chosen: a HIV group of subjects with medication adherence and healthy subjects (control group). By using the automatic segmentation software for brain Freesurfer, cortical and subcortical structures volumes as well as grey and white matter surface area were calculated for both brain hemispheres. Data were acquired through 3T MRI scanner in the Instituto de Alta Tecnología Médica (IATM) from Medellin (Colombia). Results: There were not statistically significant differences in cortical and subcortical structures between control group and subjects HIV infected with adherence to treatment. Conclusion: These findings show that subjects infectedwith VIH in first or second line of antiretroviral treatment probably do not have any change on the brain cortical and subcortical structures. In addition, this allows developing new neuroprotection and self-care strategies during the current treatment plans.
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Humains , Thérapie antirétrovirale hautement active , Cartographie cérébrale , Infections à VIH , Imagerie par résonance magnétiqueRÉSUMÉ
Neuroimaging in psychiatry encompasses the powerful tools available for the in vivo study of brain structure and function. MRI including the volumetry, voxel-base morphometry(VBM) and diffusion tensor imaging (DTI) are useful for assessing brain structure, whereas function MRI, positron emission tomography(PET) and magnetoencephalography(MEG) are well established for probing brain function. These tools are well tolerated by the vast majority of psychiatric patients because they provide a powerful but noninvasive means to directly evaluate the brain. Although neuroimaging technology is currently used only to rule in or rule out general medical conditions as opposed to diagnosing primary mental disorders, it may be used to confirm or make psychiatric diagnoses in the future. In addition, neuroimaging may be valuable for predicting the natural course of psychiatric illness as well as treatment response.
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Humains , Encéphale , Imagerie par tenseur de diffusion , Électrons , Troubles mentaux , NeuroimagerieRÉSUMÉ
Developmental dyslexia is a specific learning disability. The cerebral mechanism of development dyslexia is an important topic that has fascinated many researchers. With the introduction of brain imaging in studies of cerebral mechanism of development dyslexia, many achievements have been made. Studies of developmental dyslexia structure image found that development dyslexia showed brain structure abnormal in the parietotemporal region, occipitotemporal cortex, inferior frontal gyrus, and cerebellum et al, manifesting either in one specific area or by the asymmetry of one area; the functional image studies revealed that development dyslexia showed activity abnormal in most regions that proved to display structure abnormality; studies of brain functional connectivity demonstrates that the abnormality of development dyslexia happened not only in the connection between front-back part in one cerebral hemisphere, but also in the connection between the two hemispheres. In addition, some studies indicate Chinese development dyslexia has different brain mechanisms compared to that of alphabetic languages. These findings provide valuable insight for future developmental cerebral mechanisms research and for the expansion of Chinese development dyslexia research.