Anxiety Symptoms are Associated with Progression to Dementia in Patients with Amyloid-Positive Mild Cognitive Impairment

OBJECTIVE: Anxiety is prevalent in patients with mild cognitive impairment (MCI) and are considered to be a risk factor for conversion to dementia. The purpose of this study was to evaluate whether Anxiety symptoms in MCI promote disease progression in a manner related to amyloid status, and to determine the relationship between anxiety symptoms and longitudinal cerebral structural changes. METHODS: Baseline data for 230 patients with amyloid-positive MCI (52 with anxiety and 178 without) from the Alzheimer's Disease Neuroimaging Initiative study were analyzed. All participants underwent comprehensive cognitive testing, volumetric MRI, and [18F]AV45 positron emission tomography amyloid imaging. Anxiety symptoms were measured using the Neuropsychiatric Inventory Questionnaire. A voxel-based morphometric analysis using volumetric brain MRI data was used to compare longitudinal structural changes related to anxiety symptoms. RESULTS: The conversion rate to dementia was different between patients with and without anxiety in amyloid-positive MCI (37.7% vs. 16.1%, respectively ; p=0.001). Anxiety in amyloid-positive MCI was associated with longitudinal cortical atrophy in the left superior temporal gyrus, left Heschl's gyrus, left parahippocampal gyrus, left anterior cingulum, bilateral anterior cingulum and right superior orbital gyrus. CONCLUSION: Our study indicates that the presence of anxiety in patients with amyloid-positive MCI is associated with higher conversion to dementia and longitudinal cortical atrophy.

Regional Brain Activity During Rest and Gastric Water Load in Subtypes of Functional Dyspepsia: A Preliminary Brain Functional Magnetic Resonance Imaging Study

BACKGROUND/AIMS: Functional dyspepsia (FD) remains a great clinical challenge since the FD subtypes, defined by Rome III classification, still have heterogeneous pathogenesis. Previous studies have shown notable differences in visceral sensation processing in the CNS in FD compared to healthy subjects (HS). However, the role of CNS in the pathogenesis of each FD subtype has not been recognized. METHODS: Twenty-eight FD patients, including 10 epigastric pain syndrome (EPS), 9 postprandial distress syndrome (PDS), and 9 mixed-type, and 10 HS, were enrolled. All subjects underwent a proximal gastric perfusion water load test and the regional brain activities during resting state and water load test were investigated by functional magnetic resonance imaging. RESULTS: For regional brain activities during the resting state and water load test, each FD subtype was significantly different from HS (P < 0.05). Focusing on EPS and PDS, the regional brain activities of EPS were stronger than PDS in the left paracentral lobule, right inferior frontal gyrus pars opercularis, postcentral gyrus, precuneus, insula, parahippocampal gyrus, caudate nucleus, and bilateral cingulate cortices at the resting state (P < 0.05), and stronger than PDS in the left inferior temporal and fusiform gyri during the water load test (P < 0.05). CONCLUSIONS: Compared to HS, FD subtypes had different regional brain activities at rest and during water load test, whereby the differences displayed distinct manifestations for each subtype. Compared to PDS, EPS presented more significant differences from HS at rest, suggesting that the abnormality of central visceral pain processing could be one of the main pathogenesis mechanisms for EPS.

Analysis of Altered Baseline Brain Activity in Drug-Naive Adult Patients with Social Anxiety Disorder Using Resting-State Functional MRI

OBJECTIVE: We hypothesize that the amplitude of low-frequency fluctuations (ALFF) is involved in the altered regional baseline brain function in social anxiety disorder (SAD). The aim of the study was to analyze the altered baseline brain activity in drug-naive adult patients with SAD. METHODS: We investigated spontaneous and baseline brain activities by obtaining the resting-state functional magnetic resonance imaging data of 20 drug-naive adult SAD patients and 19 healthy controls. Voxels were used to analyze the ALFF values using one- and two-sample t-tests. A post-hoc correlation of clinical symptoms was also performed. RESULTS: Our findings show decreased ALFF in the bilateral insula, left medial superior frontal gyrus, left precuneus, left middle temporal gyrus, right middle temporal pole, and left fusiform gyrus of the SAD group. The SAD patients exhibited significantly increased ALFF in the right inferior temporal gyrus, right middle temporal gyrus, bilateral middle occipital gyrus, orbital superior frontal gyrus, right fusiform gyrus, right medial superior frontal gyrus, and left parahippocampal gyrus. Moreover, the Liebowitz Social Anxiety Scale results for the SAD patients were positively correlated with the mean Z values of the right middle occipital and right inferior occipital but showed a negative correlation with the mean Z values of the right superior temporal gyrus and right medial superior frontal gyrus. CONCLUSION: These results of the altered regional baseline brain function in SAD suggest that the regions with abnormal spontaneous activities are involved in the underlying pathophysiology of SAD patients.

Non-paraneoplastic Autoantibody-negative Limbic Encephalitis Characterized by Mild Memory Impairment: A Case Report

Encephalitis that primarily involves limbic system structures such as the hippocampus and parahippocampal gyrus has been described in early papers, most commonly characterized by a subacute progressive impairment of short-term memory, psychiatric features and seizures. While these findings might be caused by viral infections or systemic autoimmune disorders, many patients with limbic encephalitis have an immune-mediated etiology (paraneoplastic or not) characterized with serum or CSF antineuronal antibodies. This case reports about non-paraneoplastic autoantibody-negative limbic encephalitis in which there are no detection of antigens and no evidence of tumors.

Neuroradiological and Neurophysiological Characteristics of Patients With Dyskinetic Cerebral Palsy

OBJECTIVE: To investigate neuroradiological and neurophysiological characteristics of patients with dyskinetic cerebral palsy (CP), by using magnetic resonance imaging (MRI), voxel-based morphometry (VBM), diffusion tensor tractography (DTT), and motor evoked potential (MEP). METHODS: Twenty-three patients with dyskinetic CP (13 males, 10 females; mean age 34 years, range 16-50 years) were participated in this study. Functional evaluation was assessed by the Gross Motor Functional Classification System (GMFCS) and Barry-Albright Dystonia Scale (BADS). Brain imaging was performed on 3.0 Tesla MRI, and volume change of the grey matter was assessed using VBM. The corticospinal tract (CST) and superior longitudinal fasciculus (SLF) were analyzed by DTT. MEPs were recorded in the first dorsal interossei, the biceps brachii and the deltoid muscles. RESULTS: Mean BADS was 16.4+/-5.0 in ambulatory group (GMFCS levels I, II, and III; n=11) and 21.3+/-3.9 in non-ambulatory group (GMFCS levels IV and V; n=12). Twelve patients showed normal MRI findings, and eleven patients showed abnormal MRI findings (grade I, n=5; grade II, n=2; grade III, n=4). About half of patients with dyskinetic CP showed putamen and thalamus lesions on MRI. Mean BADS was 20.3+/-5.7 in normal MRI group and 17.5+/-4.0 in abnormal MRI group. VBM showed reduced volume of the hippocampus and parahippocampal gyrus. In DTT, no abnormality was observed in CST, but not in SLF. In MEPs, most patients showed normal central motor conduction time. CONCLUSION: These results support that extrapyramidal tract, related with basal ganglia circuitry, may be responsible for the pathophysiology of dyskinetic CP rather than CST abnormality.

Neuroradiological and Neurophysiological Characteristics of Patients With Dyskinetic Cerebral Palsy

OBJECTIVE: To investigate neuroradiological and neurophysiological characteristics of patients with dyskinetic cerebral palsy (CP), by using magnetic resonance imaging (MRI), voxel-based morphometry (VBM), diffusion tensor tractography (DTT), and motor evoked potential (MEP). METHODS: Twenty-three patients with dyskinetic CP (13 males, 10 females; mean age 34 years, range 16-50 years) were participated in this study. Functional evaluation was assessed by the Gross Motor Functional Classification System (GMFCS) and Barry-Albright Dystonia Scale (BADS). Brain imaging was performed on 3.0 Tesla MRI, and volume change of the grey matter was assessed using VBM. The corticospinal tract (CST) and superior longitudinal fasciculus (SLF) were analyzed by DTT. MEPs were recorded in the first dorsal interossei, the biceps brachii and the deltoid muscles. RESULTS: Mean BADS was 16.4+/-5.0 in ambulatory group (GMFCS levels I, II, and III; n=11) and 21.3+/-3.9 in non-ambulatory group (GMFCS levels IV and V; n=12). Twelve patients showed normal MRI findings, and eleven patients showed abnormal MRI findings (grade I, n=5; grade II, n=2; grade III, n=4). About half of patients with dyskinetic CP showed putamen and thalamus lesions on MRI. Mean BADS was 20.3+/-5.7 in normal MRI group and 17.5+/-4.0 in abnormal MRI group. VBM showed reduced volume of the hippocampus and parahippocampal gyrus. In DTT, no abnormality was observed in CST, but not in SLF. In MEPs, most patients showed normal central motor conduction time. CONCLUSION: These results support that extrapyramidal tract, related with basal ganglia circuitry, may be responsible for the pathophysiology of dyskinetic CP rather than CST abnormality.

A Case of Anterograde Amnesia with Bilateral Hippocampus Involvement After Acute Glufosinate Ammonium Intoxication

A 51-year-old man developed anterograde amnesia following the ingestion of glufosinate ammonium. Brain MRI revealed hyperintense lesions involving the bilateral hippocampus and parahippocampal gyrus, and the right occipital lobe. The mechanism underlying acute glufosinate ammonium intoxication and the differential diagnosis of hippocampal lesions are discussed.

Internet Game Overuser and Disembodiment : Neural Correlates as Revealed by Functional Magnetic Resonance Imaging

OBJECTIVES: The purpose of this study was to investigate the difference of brain activity between internet game overusers in adulthood and normal adults in a state of disembodiment. METHODS: The fMRI images were taken while the internet game overuser group (n = 14) and the control group (n = 15) were asked to perform the task composed of ball-throwing animations. The task reflected on either self-agency about ball-throwing or location of a ball. And each block was shown with either different (changing viewpoint) or same animations (fixed viewpoint). The disembodiment-related condition was the interaction between agency task and changing viewpoint. RESULTS: 1) In within-group analyses, the control group exhibited higher brain activation in the left precentral gyrus, the left inferior frontal gyrus, and the left insula. And the overuser group exhibited higher activation in the right cuneus, the left posterior middle occipital gyrus, and the left parahippocampal gyrus. 2) In between-group analyses, the control group exhibited higher activation in the right posterior superior temporal gyrus. And the overuser group exhibited higher activation in the left cuneus, and the left posterior middle occipital area. CONCLUSIONS: These results show that the disembodiment-related brain activation of internet game overusers in adulthood is different from that of normal adults.

Medial Temporal Activation in Mal de Debarquement Syndrome Revealed by Standardized Low-Resolution Brain Electromagnetic Tomography

BACKGROUND: Mal de debarquement (MdD) literally means "sickness of disembarkation", and refers to the illusion of movement perceived as an after-effect of traveling on a boat, train, or airplane. The pathophysiology of MdD is currently unknown. CASE REPORT: A 20-year-old man presented with dizziness and swaying sensation for 3 days after a boat trip. Compared with the follow-up EEG without symptoms, the EEG recorded while having MdD symptoms disclosed a significantly decreased alpha-band current source density at the precentral gyrus of the left frontal lobe and increased beta-2 activity at the parahippocampal gyrus of right mesial temporal region. CONCLUSIONS: Our results provide evidence of deranged cortical activity in MdD. To the best of our knowledge this is the first study to document cortical correlates of MdD using an EEG source-localization method.

Effects of Antidepressant Treatment on Sexual Arousal in Depressed Women: A Preliminary fMRI Study

OBJECTIVE: There was a recent study to explore the cerebral regions associated with sexual arousal in depressed women using functional magnetic resonance imaging (fMRI). The purpose of this neuroimaging study was to investigate the effects of antidepressant treatment on sexual arousal in depressed women. METHODS: Seven depressed women with sexual arousal dysfunction (mean age: 41.7+/-13.8, mean scores of the Beck Depression Inventory (BDI) and the 17-item Hamilton Rating Scale for Depression (HAMD-17): 35.6+/-7.1 and 34.9+/-3.1, respectively) and nine healthy women (mean age: 40.3+/-11.6) underwent fMRI before and after antidepressant treatment. The fMRI paradigm contrasted a 1 minute rest period viewing non-erotic film with 4 minutes of sexual stimulation viewing an erotic video film. Data were analyzed by SPM 2. The relative number of pixels activated in each period was used as an index of activation. All depressed women were treated with mirtazapine (mean dosage: 37.5 mg/day) for 8 to 10 weeks. RESULTS: Levels of brain activity during sexual arousal in depressed women significantly increased with antidepressant treatment (p<0.05) in the regions of the hypothalamus (3.0% to 11.2%), septal area (8.6% to 27.8%) and parahippocampal gyrus (5.8% to 14.6%). Self-reported sexual arousal during visual sexual stimulation also significantly increased post-treatment, and severity of depressive symptoms improved, as measured by the BDI and HAMD-17 (p<0.05). CONCLUSION: These results show that sexual arousal dysfunction of depressed women may improve after treatment of depression, and that this improvement is associated with increased activation of the hypothalamus, septal area, and parahippocampal gyrus during sexual arousal.

Neuro-Anatomical Evaluation of Human Suitability for Rural and Urban Environment by Using fMRI / 의학물리

The purpose of this study was to identify different cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla functional magnetic resonance imaging (fMRI) and further to investigate the human suitability for rural and urban environments. A total of 27 right-handed participants (mean age: 27.3+/-3.7) underwent fMRI study on a 3.0T MR scanner. The brain activation patterns were induced by visual stimulation with each rural and urban sceneries. The participants were divided into two groups as 26 subjects favorable to rural scenery and 14 subjects unfavorable to urban scenery based on their filled-in questionnaire. The differences of the brain activation in response to two extreme types of pictures by the two sample t-test were characterized as follows: the activation areas observed in rural scenery over urban were the insula, middle frontal gyrus, precuneus, caudate nucleus, superior parietal gyrus, superior occipital gyrus, fusiform gyrus, and globus pallidus. In urban scenery over rural, the inferior frontal gyrus, parahippocampal gyrus, postcentral gyrus, superior temporal gyrus, amygdala, and posterior cingulate gyrus were activated. The fMRI patterns also clearly show that rural scenery elevated positive emotion such as happiness and comfort. On the contrary, urban scenery elevated negative emotion, resulting in activation of the amygdala which is the key region for the feelings of fear, anxiety and unpleasantness. This study evaluated differential cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla fMRI. These findings will be useful as an objective evaluation guide to human suitability for ecological environments that are related to brain activation with joy, anger, sorrow and pleasure.

Papez circuit: An anatomical study by cadaveric dissection

This study was done to completely the Papez circuit by cadaveric dissection and it's relation to ventricles and other related anatomical structures. Eight formalin fixed cerebral hemispheres were microscopically dissected for Papez circuit. Klingler's technique of fibre dissection was adopted. The circuit was dissected from medial and superior-lateral cerebral surfaces. Bilateral hemispheric dissection was done simultaneously in intact brain from superior-lateral surface in two brains [4 hemispheres]. During and after dissection it's relation with lateral ventricles and other related structures were studied. Papez circuit was demonstrated by total dissection. Fibres leave the hippocampal formation and proceed through the fomix; most of these fibres have been shown to terminate in the mammillary nuclei of the hypothalamus. From here, the mammillothalamic tract ascends to the anterior group of thalamic nuclei. This group of nuclei projects to the cingulated gyrus through the anterior limb of internal capsule to anterior cingulated gyrus. From the cingulated gyrus there is an association bundle; the cingulum, which connects the cingulated gyrus with the parahippocampal gyrus part of the limbic lobe. The parahippocampal gyrus projects to the hippocampal formation and circuit is completed. Relation of different parts of the circuit with surrounding structures were also clearly seen. Knowledge of the microsurgical anatomy of the Papez circuit is not only important for understanding memory mechanism and other limbic functions but also very important in management of lateral and third ventricular lesions, in transcallosal, transventricular, supraseller and temporal lobe surgery, and for psycho-neurosurgery

Abnormal Cerebral Benzodiazepine Receptors Binding Measured with (123)I-Iomazenil SPECT in Panic Disorder / 신경정신의학

OBJECTIVES: Researchers have long hypothesized that the benzodiazepine-GABA system plays a role in the pathophysiology of panic disorder (PD). However, previous neuroimaging studies have been inconclusive, possibly due to matching discrepancies between patients and controls, confounding medication factors, and/or image analyzing methods. This study aimed to compare benzodiazepine receptor binding between PD patients and healthy controls. METHODS: Via (123)I-iomazenil single-photon emission computed tomography (IMZ-SPECT), we obtained regional brain patterns of benzodiazepine receptor binding for 12 unmedicated PD patients and 8 healthy age-and sex-matched volunteer controls. To analyze the image data, we used statistical parametric mapping (SPM). RESULTS: Benzodiazepine receptor binding showed a decrease in both the parietal and occipital lobes in PD patients as compared to controls. The anterior cingulate cortex, left parahippocampal gyrus, and both temporal lobes showed increased binding in PD patients. CONCLUSION: Our findings provide evidence of an abnormal BZD-GABA system in PD patients, suggesting that basal and/or compensatory changes in inhibitory neurotransmissions contribute to the pathogenesis of human PD.

Changes in Cerebral Cortex and Limbic Brain Functions after Short-Term Paroxetine Treatment in Panic Disorder: An 18FFDG-PET Pilot Study

OBJECTIVE: Panic disorder (PD) is a common and often chronic psychiatric illness, and serotonin-specific reuptake inhibitors (SSRIs) are the drugs of choice for the treatment of PD. Previous studies suggested the cerebral cortex and limbic brain structures played a major role in the development of PD, but the therapeutic effect of SSRIs on specific brain structures remains unclear in PD. We examined the changes in PD patients' glucose metabolism using the [18F] Fluorodeoxy-glucose-positron emission tomography (FDG-PET) before and after 12 weeks of paroxetine treatment. METHODS: We assessed the brain glucose metabolism of 5 PD patients, using the [18F]FDG-PET, and treated them with paroxetine (12.5-37.5 mg/day) for 12 weeks. Then, we compared before and after treatment PET images of the patients, using voxel-based statistical analysis and a post hoc regions of interest analysis. Furthermore, we measured the patients' clinical variables, including information from the Panic Disorder Severity Scale (PDSS), Clinical Global Impression for Severity (CGI-S), and Hamilton Anxiety Rating Scale (HAMA). RESULTS: After 12 weeks of paroxetine treatment, the patients showed significant clinical improvement in terms of PDSS, CGI-S and HAMA scores (12.8+/-1.8 vs. 3.8+/-2.3, 4.6+/-0.5 vs. 2.0+/-1.4, and 15.2+/-4.0 vs. 5.0+/-1.2, respectively; all p values<0.05). After treatment, patients' glucose metabolism increased significantly in global brain areas: the right precentral gyrus, right middle frontal gyrus, right amygdala, right caudate body, right putamen, left middle frontal gyrus, left precentral gyrus, left insula, left parahippocampal gyrus, and left inferior frontal gyrus (All areas were significant at uncorrected p<0.001 and cluster level corrected p<0.05). CONCLUSION: In these PD patients, cerebral cortex and limbic brain functions changed after short-term treatment with paroxetine. The therapeutic action of paroxetine may be related to altered glucose metabolism at both the cerebral cortex and limbic brain areas.

Increased EEG Current-Source Density in the High Beta Frequency Band Induced by Levetiracetam Adjunctive Therapy in Refractory Partial Epilepsy

BACKGROUND AND PURPOSE: Levetiracetam (LEV) is an antiepileptic drug (AED) that has favorable effects on cognition. Although neuropsychological studies have demonstrated these favorable outcomes on cognition, there are few electrophysiologic data describing the functional changes exerted by LEV. The purpose of this study was to determine the effects of LEV adjunctive therapy on the current-source density (CSD) in the high beta frequency band (22-30 Hz) of EEG background activity in refractory partial epilepsy (RPE). METHODS: We conducted a 24-week, open-label, prospective study in 24 patients with RPE. Scalp electroencephalography and neuropsychological tests (NPTs) were conducted twice, once before the LEV trial and then again after 24 weeks of medication. RESULTS: The CSD in the 22-30 Hz band of EEG background activity increased in the bilateral anterior cingulate gyri, left parahippocampal gyrus, and a small area of the right anterior parahippocampal gyrus after the LEV trial. Neither seizure freedom nor the dosage increment of LEV elicited meaningful CSD changes. Verbal memory and executive function were improved after the 24-week LEV trial. CONCLUSIONS: To our knowledge, this is the first study to examine the changes in CSD induced by LEV adjunctive therapy in RPE patients. The CSD changes and NPT results suggest that LEV enhances the activities of the neuronal networks in the prefrontal cortex and left hippocampus.

Gray Matter Changes in Patients with Pathological Gambling: A Preliminary Study Using Voxel-Based Morphometry Study

OBJECTIVES: The purpose of this study was to examine structural abnormalities of brain in patients with pathological gambling(PG) using voxel-based morphometry. METHODS: We compared gray matter(GM) volumes between 10 patients with PG and 14 age- and IQmatched healthy controls and examined the relationship of GM volumes with clinical variables in patients with PG. RESULTS: We found significant increase of GM volume in the superior, middle, and inferior frontal gyri, the midbrain, the middle temporal gyrus, the precuneus, and the fusiform gyrus of patients with PG. A significant decrease of GM volume was observed in the parahippocampal gyrus and the lingual gyrus of the patient group. In addition, GM volumes in some of these regions were positively associated with South Oaks Gambling Screen score and negatively with age of onset in patients with PG. CONCLUSION: Current findings indicate that structural abnormalities in the fronto-temporal cortex, the midbrain, and the precuneus might be involved in the pathophysiology of PG, and contribute to some of the behavioral changes observed in patients with PG.

Correlação entre memória e volume de estruturas cerebrais em idosos deprimidos: um estudo de morfometria baseada no voxel / Correlation between memory and volume of brain structures in depressed elderly: a study using voxel-based morphometry

Déficits cognitivos e alterações cerebrais estruturais são comumente encontrados em idosos deprimidos. Este estudo teve como objetivos comparar o volume de regiões de interesse, hipocampo e giro para-hipocampal, de idosos com transtornos depressivos e sem transtornos depressivos utilizando a técnica de morfometria baseada no voxel, investigando se há correlação entre o volume dessas regiões e os escores dos testes cognitivos. Neste estudo, as diferenças clínicas, demográficas e de volume de substância cerebral total foram avaliadas por meio de exames de ressonância magnética estrutural em 48 idosos com transtornos depressivos e 31 controles. Os dados contínuos dos grupos de indivíduos foram comparados pelo teste t de Student ou pelo teste de Mann-Whitney, e a análise das freqüências de categorias foi feita utilizando-se o teste exato de Fisher ou o teste do qui quadrado com correção de continuidade. A comparação dos escores nos testes cognitivos dos dois grupos foi feita por meio da análise de covariância, pois os grupos eram diferentes quanto à escolaridade. A correlação entre o volume de cada estrutura e os escores nos testes cognitivos, para cada grupo estudado, foi feita utilizando-se o programa "Statistical Parametric Mapping" e o coeficiente de correlação de Pearson. Pacientes e controles eram similares quanto ao volume cerebral total e quanto às regiões de interesse, mas os pacientes apresentaram desempenho inferior em testes de avaliação da memória, das funções executivas e da velocidade de processamento. No grupo de idosos com transtornos depressivos, foi verificada correlação entre teste de memória episódica verbal e volume do hipocampo esquerdo (p = 0,023) e giro para-hipocampal direito (p = 0,044) e esquerdo (p = 0,007). Nesse grupo, também foi verificada correlação entre giro para-hipocampal esquerdo, teste de memória episódica visual (p = 0,039) e evocação tardia em teste de aprendizagem visuo-verbal (p = 0,040)...

Cognitive deficits and structural brain alterations are usually found in depressed elderly. The objective of this study was to compare the volume of the regions of interest, hippocampus and parahippocampal gyrus, of elderly with and without depressive disorders using the voxel-based morphometry technique, investigating whether there is a correlation between the volume of these regions and the scores on these cognitive tests. In this study, the clinical and demographic differences, as well as the difference in the volume of the total brain matter were assessed using structural magnetic resonance imaging in 48 elderly people with depressive disorders and 31 controls. The continuous data of the groups of subjects were compared using the Student's t test or the Mann-Whitney test; and the analysis of category frequency was performed using the Fisher's Exact Test or the Chi-square test with Continuity Correction. The comparison of the scores on the cognitive tests of both groups was carried out using the Analysis of Covariance, since the groups were different in terms of level of education. The correlation between the volume of each structure and the scores on the cognitive tests for each group studied was made using the Statistical Parametric Mapping program and Pearson's Correlation Coefficient. Patients and controls were similar regarding the total brain volume and also with respect to the regions of interest; however, the patients presented lower performance on the tests that assessed memory, executive functions and processing speed. In the group of elderly subjects with depressive disorder, there was a correlation between the verbal episodic memory test and the volume of the left hippocampus (p = 0.023); right (p = 0.044) and left (p = 0.007) parahippocampal gyrus...

As bases neuroanatômicas do comportamento: histórico e contribuições recentes / Neuroanatomical basis of behavior: history and recent contributions

Tendo em vista as mais recentes contribuições, as áreas corticais límbicas - originalmente denominadas em conjunto de grande lobo límbico -, além dos giros do cíngulo e parahipocampal, são constituídas pelas regiões mais posteriores do córtex fronto-orbitário e pelo córtex insular. Em contraposição ao restante do córtex cerebral, que se projeta sobre os gânglios da base (particularmente sobre as porções mais dorsais e mais extensas do striatum, constituídas fundamentalmente pelo núcleo caudado e pelo putame), as áreas corticais límbicas se caracterizam por se projetarem principalmente sobre o hipotálamo e também sobre a porção mais ventral do striatum (principalmente sobre o núcleo accumbens). Uma vez que todo o striatum se projeta para o globo pálido - e este para o tálamo, que se projeta para o córtex cerebral, constituindo-se, assim, circuitos córtico-subcorticais reentrantes -, tem-se que, enquanto as alças relacionadas com o striatum e o pallidum dorsais são responsáveis por atividades e rotinas motoras, as alças relacionadas com o striatum e o pallidum ventrais caracterizam circuitos córtico-subcorticais reentrantes e segregados que se relacionam particularmente com funções comportamentais. A amígdala estendida (amígdala centromedial, componente dorsal ou estria terminal, componente ventral e núcleo da estria terminal), por sua vez, também recebe aferências de todas as áreas corticais límbicas, é particularmente modulada pelas áreas corticais pré-frontais e, ao invés de se projetar sobre o striatum, projeta-se diretamente sobre o hipotálamo e o tronco encefálico. Ao receber também conexões diretas do tálamo, a amígdala estendida pode ainda desencadear respostas principalmente autonômicas, de forma inespecífica, porém rápida, através da ativação de centros do tronco encefálico. Os sistemas macro-anatômicos fronto-basais, estriatal-palidal ventral e amígdala estendida, em conjunto com o núcleo basal de Meynert e com o sistema septo-banda...

Considering the most recent contributions, the limbic cortical areas, originally known as the greater limbic lobe, besides the cingulated and the parahippocampal gyri also includes the insula and the posterior orbital cortex. In contrast to the nonlimbic cortical areas that project to the basal ganglia (particularly over the dorsal aspects of the striatum, constituted by the caudate nucleus and by the putamen), the limbic cortical areas are characterized by projecting to the hypothalamus and also to the ventral striatum (particularly to the nucleus accumbens). Once all the striatum projects to the globus pallidus which projects to the thalamus and then to the cortex, generating cortical-subcortical reentrant circuits, while the dorsal striatum and pallidum related cortico-subcortical loops are involved with motor activities, the ventral cortical-striatal-pallidal system is particularly related with behavior functions. The extended amygdala (central medial amygdala, stria terminalis or dorsal component, ventral component, and bed nucleus of stria terminalis) receives inputs primarily from the limbic cortical areas, is particularly modulated by the prefrontal cortex, and receives also direct connections from the thalamus that enables the amygdala to generate nonspecific and quick responses through its projections to the hypothalamus and to the brainstem. The ventral striatal-pallidal and the extended amygdala are then two basal forebrain macro-anatomical systems, that together with the basal nucleus of Meynert and with the septal-diagonal band system, constitute the main structures that are particularly connected with the limbic cortical areas, and that altogether project to the hypothalamus and to the brainstem which give rise to the autonomic, endocrine and somatosensory components of the emotional experiences, and that regulate the basic activities of drinking, eating, and related to the sexual behavior.

Differences of Tc-99m HMPAO SPECT Imaging in the Early Stage of Subcortical Vascular Dementia Compared with Alzheimer's Disease / 핵의학분자영상

PURPOSE: The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. MATERIALS AND METHODS: Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. RESULTS: SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected p<0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected p<0.01). CONCLUSION: Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness.

Location of Brain Electrical Source Activation by Visually Stimulated Sexual Arousal in Young Men and Women: a Cross Spectral Analysis using Low Resolution Brain Electromagnetic Tomography (LORETA) / 대한비뇨기과학회지

PURPOSE: To investigate the locations of the cerebral cortex activated by visually stimulated sexual arousal, and to discriminate the gender differences between the cortical activation patterns in response to sexual stimuli. MATERIALS AND METHODS: Thirty-two male and the twenty-one female volunteers from right-handed medical students were enrolled in this study. The electroencephalography (EEGs) included the segments recorded during resting, watching a music-video, intermission and watching a pornographic video. The low-resolution brain electromagnetic tomography (LORETA) images of cross-spectral analysis were obtained from the segments using the LORETA-KEY software. RESULTS: The beta 1, 2 and 3 activities of males showed the point of maximal current densities in both the uncus and parahippocampal gyrus of the left limbic lobe, the anterior cingulate of the right limbic lobe, the superior temporal gyrus of both temporal lobes, the precuneus of the right parietal lobe, the medial frontal gyrus and superior frontal gyrus of the right frontal lobe, the superior parietal lobule of the right parietal lobe, and the middle occipital gyrus of both occipital lobes. The delta, theta, alpha and beta 1 activities of females showed the point of maximal current densities in the postcentral gyrus and inferior parietal lobule of the left parietal lobe, the middle frontal gyrus of the left frontal lobe, the middle occipital gyrus of the left occipital lobe, the left cuneus, the superior temporal gyrus of both temporal lobes and the left parahippocampal gyrus. CONCLUSIONS: There was a difference in the visually stimulated sexual arousal-associated with the cerebral neuroanatomical areas between men and women, as estimated using the LORETA software. These areas; therefore, were thought to play important roles in the sexual arousal of males and females in response to audiovisual sexual stimulation.