ABSTRACT
Counterfactual thoughts (CFT) are mental simulations of what might have been if another behavior had been executed. They are pervasive in everyday life, help people learn from experience, modulate their emotional state, and contribute to decision-making and social functioning. To test the hypothesis that the prefrontal cortex (PFC) is involved in the generation, content, and use of CFT, we studied 18 patients with strictly prefrontal cortex lesions. Our results indicated that the PFC is crucial only for self-generated counterfactual reflections. We did not detect CFT generation differences based on lesion location within the PFC. CFT performance correlated positively with measures of attention, creativity, verbal skills, conscientiousness, and self-esteem and negatively with depression and dysexecutive symptoms. An impairment in counterfactual thinking may contribute to the lack of regret and insight often observed in patients with frontal lobe lesions.
Subject(s)
Brain Diseases/psychology , Mental Processes/physiology , Prefrontal Cortex/physiopathology , Adult , Brain Diseases/complications , Brain Diseases/etiology , Cerebral Infarction/pathology , Cerebral Infarction/physiopathology , Cerebral Infarction/psychology , Cues , Depressive Disorder/psychology , Emotions , Female , Humans , Magnetic Resonance Imaging , Male , Personality Tests , Postoperative Complications/psychology , Prefrontal Cortex/injuries , Prefrontal Cortex/pathology , Stroke/complications , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To describe the MR findings of bone marrow edema syndrome (BMES) of the foot and its evolution at 1 year follow-up. DESIGN AND PATIENTS: Twenty-five of 32 patients with disabling foot and ankle pain unrelated to trauma diagnosed as BMES when MR imaging demonstrated a bone marrow edema pattern in one or more bones without any radiological or underlying clinical cause, were re-evaluated by MR imaging 1 year later. RESULTS: On the initial MR examinations an average of 4.7 individual bones were involved by bone marrow edema. Soft tissue edema was present in every patient and joint effusion in 10 patients. MR imaging at 1 year showed resolution of bone edema in 18 patients (72%), partial improvement in five (20%) and no improvement in two (8%). Six patients (24%) developed similar symptoms in the other foot during follow-up. Ten of 17 available plain radiographs showed some loss of radiodensity. Further bone marrow edema developed in bones of the same foot that were initially normal, or in uninvolved distant bone marrow areas in the same affected bone, in six of seven patients on follow-up MR imaging. CONCLUSIONS: The evolution of the MR findings of BMES of the foot is to complete resolution or partial improvement at 1 year in the majority of cases. Migration to the other foot occurs in up to a quarter of patients.
Subject(s)
Bone Marrow Diseases/diagnosis , Edema/diagnosis , Magnetic Resonance Imaging , Follow-Up Studies , Foot , Humans , SyndromeABSTRACT
OBJECTIVE: To date, ERCP has been the reference technique in the diagnosis of pancreatic duct pathology. The aim of the present study was to evaluate the accuracy of magnetic resonance cholangiopancreatography (MRCP), a relatively new, noninvasive diagnostic method, in studying the pancreatic duct. METHODS: A prospective 15-month study was done of 78 patients with suspected biliopancreatic pathology and indications for ERCP. In all cases, MRCP was performed <72 h before ERCP. Both techniques were used to assess the size of the pancreatic tract (normal or dilated), the presence or absence of obstruction, the level of obstruction where present, and its etiology. RESULTS: Both techniques found the pancreatic tract to be normal and nondilated in 60 patients. The specificity and sensitivity of MRCP in evaluating the normal pancreatic duct were 98% and 94%, respectively. In nine cases, a stenotic duct of Wirsung was detected (seven at the head of the pancreas and two in the body), with the same correlation being shown by ERCP (sensitivity 100%). The sensitivity and specificity of MRCP relating to diffuse irregular and dilated morphologies of the entire pancreatic duct was 86% and 100%, respectively. Nine patients were diagnosed with pancreatic neoplasms by both techniques, with an accuracy of 100%. Four patients presented chronic pancreatitis, which was correctly diagnosed by MRCP in each case. CONCLUSIONS: MRCP is an effective technique for evaluating both the normal and diseased duct of Wirsung, and for establishing the underlying pathology.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde/methods , Magnetic Resonance Imaging/methods , Pancreatic Ducts/diagnostic imaging , Pancreatic Ducts/pathology , Adult , Aged , Female , Humans , Male , Middle Aged , Pancreatic Diseases/diagnosis , Prospective Studies , Sensitivity and SpecificityABSTRACT
We report 2 cases of cat-scratch disease that had similar characteristic magnetic resonance images. Although this technique is not specific for the disease, we believe that it might be useful for diagnosis of this condition in atypical cases.
