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1.
J Neurol Sci ; 454: 120826, 2023 11 15.
Article in English | MEDLINE | ID: mdl-37832379

ABSTRACT

INTRODUCTION: Posterior Cortical Atrophy (PCA), a visual variant of Alzheimer's disease, initially manifests with higher-order visual disorders and parieto/temporo-occipital atrophy. Recent studies have shown remote functional impairment in both distant brain networks and along the calcarine sulcus (V1). Functional alteration in the calcarine differs along its length, reflecting center to periphery visual space differences. Herein, we aim to connect between these two sets of findings by looking at the retinotopic patterns of functional connectivity between large-scale brain networks and V1, comparing patients with normally sighted subjects. METHODS: Resting state functional magnetic resonance imaging (fMRI) and T1 anatomical scans were obtained from 11 PCA patients and 17 age-matched healthy volunteers. Default mode network (DMN) and fronto parietal network (FPN) were defined and differences between the networks in patients and healthy controls were evaluated at the whole brain level, specifically their connectivity to V1. RESULTS: Connectivity patterns within the DMN and the FPN were similar between the groups, although differences were found in regions within and beyond the networks. Focusing on V1, in the control group we identified the expected pattern of a distributed connectivity along eccentricity, with foveal regions showing stronger connectivity to the FPN and peripheral regions showing stronger connectivity to the DMN. However, in PCA patients we could not identify a clear difference in connectivity along the eccentricities. CONCLUSION: Lost specialization of function along the calcarine in PCA patients may have further implications on large-scale networks or vice versa. This impairment, distant from the core pathology, might explain patients' visual disabilities.


Subject(s)
Neurodegenerative Diseases , Visual Cortex , Humans , Magnetic Resonance Imaging , Brain , Brain Mapping/methods , Atrophy , Visual Cortex/diagnostic imaging , Neural Pathways/diagnostic imaging
2.
Biol Psychiatry ; 94(6): 492-500, 2023 09 15.
Article in English | MEDLINE | ID: mdl-37031779

ABSTRACT

BACKGROUND: Premenstrual dysphoric disorder (PMDD) is characterized by affective, cognitive, and physical symptoms, suggesting alterations at the brain network level. Women with PMDD demonstrate aberrant discrimination of facial emotions during the luteal phase of the menstrual cycle and altered reactivity to emotional stimuli. However, previous studies assessing emotional task-related brain reactivity using region-of-interest or whole-brain analysis have reported conflicting findings. Therefore, we utilized both region-of-interest task-reactivity and seed-voxel functional connectivity (FC) approaches to test for differences in the default mode network, salience network, and central executive network between women with PMDD and control participants during an emotional-processing task that yields an optimal setup for investigating brain network changes in PMDD. METHODS: Twenty-four women with PMDD and 27 control participants were classified according to the Daily Record of Severity of Problems. Participants underwent functional magnetic resonance imaging scans while completing the emotional face-matching task during the midfollicular and late-luteal phases of their menstrual cycle. RESULTS: No significant between-group differences in brain reactivity were found using region-of-interest analysis. In the FC analysis, a main effect of diagnosis was found showing decreased default mode network connectivity, increased salience network connectivity, and decreased central executive network connectivity in women with PMDD compared with control participants. A significant interaction between menstrual cycle phase and diagnosis was found in the central executive network for right posterior parietal cortex and left inferior lateral occipital cortex connectivity. A post hoc analysis revealed stronger FC during the midfollicular than the late-luteal phase of PMDD. CONCLUSIONS: Aberrant FC in the 3 brain networks involved in PMDD may indicate vulnerability to experience affective and cognitive symptoms of the disorder.


Subject(s)
Premenstrual Dysphoric Disorder , Female , Humans , Premenstrual Dysphoric Disorder/diagnostic imaging , Brain/diagnostic imaging , Menstrual Cycle , Emotions , Luteal Phase
3.
Front Psychiatry ; 14: 1022537, 2023.
Article in English | MEDLINE | ID: mdl-36937709

ABSTRACT

Introduction: Episodes of eating great quantities of extremely sweet and often aversive tasting food are a hallmark of bulimia nervosa. This unique eating pattern led researchers to seek and find differences in taste perception between patients and healthy control subjects. However, it is currently not known if these originate from central or peripheral impairment in the taste perception system. In this cross sectional study, we compare brain response to sweet and sour stimuli in 5 bulimic and 8 healthy women using functional magnetic resonance imaging (fMRI). Materials and methods: Sweet, sour and neutral (colorless and odorless) taste solutions were presented to subjects while undergoing fMRI scanning. Data were analyzed using a block design paradigm. Results: Between-group differences in brain activation in response to both sweet and sour tastes were found in 11 brain regions, including operculum, anterior cingulate cortex, midbrain, and cerebellum. These are all considered central to perception and processing of taste. Conclusion: Our data propose that sweet and sour tastes may have reward or aversion eliciting attributes in patients suffering from bulimia nervosa not found in healthy subjects, suggesting that alteration in taste processing may be a core dysfunction in bulimia nervosa (BN).

4.
Front Neurol ; 13: 867190, 2022.
Article in English | MEDLINE | ID: mdl-35401390

ABSTRACT

Background: Myelin oligodendrocyte glycoprotein antibody disorders (MOGAD) have evolved as a distinct group of inflammatory, demyelinating diseases of the CNS. MOGAD can present with a monophasic or relapsing disease course with distinct clinical manifestations.However, data on the disease course and disability outcomes of these patients are scarce. We aim to compare brain volumetric changes for MOGAD patients with different disease phenotypes and HCs. Methods: Brain magnetic resonance imaging (MRI) scans and clinical data were obtained for 22 MOGAD patients and 22 HCs. Volumetric brain information was determined using volBrain and MDbrain platforms. Results: We found decreased brain volume in MOGAD patients compared to HCs, as identified in volume of total brain, gray matter, white matter and deep gray matter (DGM) structures. In addition, we found significantly different volumetric changes between patients with relapsing and monophasic disease course, with significantly decreased volume of total brain and DGM, cerebellum and hippocampus in relapsing patients during the first year of diagnosis. A significant negative correlation was found between EDSS and volume of thalamus. Conclusions: Brain MRI analyses revealed volumetric differences between MOGAD patients and HCs, and between patients with different disease phenotypes. Decreased gray matter volume during the first year of diagnosis, especially in the cerebrum and hippocampus of MOGAD patients was associated with relapsing disease course.

5.
J Neural Eng ; 18(4)2021 05 17.
Article in English | MEDLINE | ID: mdl-33906182

ABSTRACT

Objective.Adaptive deep brain stimulation (aDBS) based on subthalamic nucleus (STN) electrophysiology has recently been proposed to improve clinical outcomes of DBS for Parkinson's disease (PD) patients. Many current models for aDBS are based on one or two electrophysiological features of STN activity, such as beta or gamma activity. Although these models have shown interesting results, we hypothesized that an aDBS model that includes many STN activity parameters will yield better clinical results. The objective of this study was to investigate the most appropriate STN neurophysiological biomarkers, detectable over long periods of time, that can predict OFF and ON levodopa states in PD patients.Approach.Long-term local field potentials (LFPs) were recorded from eight STNs (four PD patients) during 92 recording sessions (44 OFF and 48 ON levodopa states), over a period of 3-12 months. Electrophysiological analysis included the power of frequency bands, band power ratio and burst features. A total of 140 engineered features was extracted for 20 040 epochs (each epoch lasting 5 s). Based on these engineered features, machine learning (ML) models classified LFPs as OFF vs ON levodopa states.Main results.Beta and gamma band activity alone poorly predicts OFF vs ON levodopa states, with an accuracy of 0.66 and 0.64, respectively. Group ML analysis slightly improved prediction rates, but personalized ML analysis, based on individualized engineered electrophysiological features, were markedly better, predicting OFF vs ON levodopa states with an accuracy of 0.8 for support vector machine learning models.Significance.We showed that individual patients have unique sets of STN neurophysiological biomarkers that can be detected over long periods of time. ML models revealed that personally classified engineered features most accurately predict OFF vs ON levodopa states. Future development of aDBS for PD patients might include personalized ML algorithms.


Subject(s)
Deep Brain Stimulation , Parkinson Disease , Biomarkers , Humans , Levodopa/therapeutic use , Machine Learning , Parkinson Disease/diagnosis , Parkinson Disease/drug therapy
6.
Neuropsychologia ; 154: 107796, 2021 04 16.
Article in English | MEDLINE | ID: mdl-33610615

ABSTRACT

Parallel cohorts of Hebrew speakers learning English in the U.S., and American-English speakers learning Hebrew in Israel were tracked over the course of two years of immersion in their L2. We utilised a functional MRI semantic judgement task with print and speech tokens, as well as a battery of linguistic and cognitive behavioural measures prior to and after immersion, to track changes in both L1 and L2 processing. fMRI activation for print tokens produced a similar network of activation in both English and Hebrew, irrespective of L1 or L2 status. Significant convergence of print and speech processing was also observed in both languages across a network of left-hemisphere regions joint for both L1 and L2. Despite significant increases in behavioural measures of L2 proficiency, only a few signs of longitudinal change in L2 brain activation were found. In contrast, L1 showed widespread differences in processing across time, suggesting that the neurobiological footprint of reading is dynamic and plastic even in adults, with L2 immersion impacting L1 processing. Print/speech convergence showed little longitudinal change, suggesting that it is a stable marker of the differences in L1 and L2 processing across L2 proficiency.


Subject(s)
Magnetic Resonance Imaging , Multilingualism , Adult , Humans , Immersion , Israel , Language , Semantics
7.
Hum Brain Mapp ; 42(3): 615-625, 2021 02 15.
Article in English | MEDLINE | ID: mdl-33125770

ABSTRACT

Adverse childhood experiences (ACEs) have been acknowledged as risk factors for increased mental health complications in adulthood, specifically increasing susceptibility to developing psychopathology upon exposure to trauma. Yet, little is known regarding the impact of mild ACEs on highly functioning population. In this study forty participants were selected from a group of 366 highly selected military parachute trainees using the self-report "childhood trauma questionnaire," and classified into two groups of 20 each, with and without ACEs. Behavioral measurements were obtained before and at the peak of an intensive combat training period, including anxiety, depression and executive function assessment. Functional MRI including a negative emotional face perception task was conducted at the first time point. Psychometric and cognitive measurements revealed higher levels of anxiety and depressive symptoms, and more difficulties in executive functioning in the ACE group at baseline. Slower reaction time to emotional faces presentation was found in the ACE group. Lower activation in response to negative emotional faces stimuli was found in this group in bilateral secondary visual areas, left anterior insula, left parietal cortex and left primary motor and sensory regions. In contrast, higher activation in the ACE group was found in the right ventral lateral prefrontal cortex (Vlpfc). No significant differences between groups were detected in the amygdala. To conclude, mild adverse childhood experiences produce long-term sequela on psychological wellbeing and neurocircuitry even in high functioning population. Brain regions modulated by childhood trauma may instigate avoidance mechanisms dampening the emotional and cognitive effects of intensive stress.


Subject(s)
Adverse Childhood Experiences , Amygdala/physiology , Cerebral Cortex/physiology , Emotions/physiology , Executive Function/physiology , Facial Recognition/physiology , Military Personnel , Adolescent , Adult , Amygdala/diagnostic imaging , Anxiety/diagnostic imaging , Anxiety/physiopathology , Cerebral Cortex/diagnostic imaging , Depression/diagnostic imaging , Depression/physiopathology , Facial Expression , Functional Neuroimaging , Humans , Magnetic Resonance Imaging , Male , Young Adult
8.
Brain Topogr ; 33(5): 600-612, 2020 09.
Article in English | MEDLINE | ID: mdl-32761400

ABSTRACT

Posterior cortical atrophy (PCA), considered a visual variant of Alzheimer's disease, has similar pathological characteristics yet shows a selective visual manifestation with relative preservation of other cortical areas, at least at early stages of disease. Using a gamut of imaging methods, we aim to evaluate the global aspect of this relatively local disease and describe the interplay of the involvement of the different brain components. Ten PCA patients and 14 age-matched controls underwent MRI scans. Cortical thickness was examined to identify areas of cortical thinning. Hippocampal volume was assessed using voxel-based morphometry. The integrity of 20 fiber tracts was assessed by Diffusion Tensor Imaging. Regions of difference in global functional connectivity were identified by resting-state fMRI, using multi-variant pattern analysis. Correlations were examined to evaluate the connection between grey matter atrophy, the network changes and the disease load. The patients presented bilateral cortical thinning, primarily in their brains' posterior segments. Impaired segments of white matter integrity were evident only within three fiber tracts in the left hemisphere. Four areas were identified as different in their global connectivity pattern. The visual network-related areas showed reduced connectivity and was correlated to atrophy. Right Broadman area 39 showed in addition increased connectivity to the frontal areas. Global structural and functional imaging pointed to the highly localized nature of PCA. Functional connectivity followed grey matter atrophy in visual regions. White matter involvement seemed less prominent, however damage is directly related to presence of disease and not mediated only by grey matter damage.


Subject(s)
Brain , Diffusion Tensor Imaging , Gray Matter , Atrophy/pathology , Brain/diagnostic imaging , Brain/pathology , Gray Matter/diagnostic imaging , Gray Matter/pathology , Humans , Magnetic Resonance Imaging
9.
Neurobiol Dis ; 136: 104716, 2020 03.
Article in English | MEDLINE | ID: mdl-31846735

ABSTRACT

The subthalamic nucleus (STN), a preferred target for treating movement disorders, has a crucial role in inhibition and execution of movement. To better understand the mechanism of movement regulation in the STN of Parkinson's disease patients, we compared the same movement with different context, facilitation vs. inhibition context. We recorded subthalamic multiunit activity intra-operatively while parkinsonian patients (off medications, n = 43 patients, 173 recording sites) performed increasingly complex oddball paradigms with frequent and deviant tones: first, passive listening to tone series with no movement ('None-Go' task, n = 7, 28 recording sites); second, pressing a button after every tone ('All-Go' task, n = 7, 26 recording sites); and third, pressing a button only for frequent tones, thus adding inhibition of movement following deviant tones ('Go-NoGo' task, n = 29, 119 recording sites). The STN responded mainly to movement-involving tasks. In the limbic-associative STN, evoked response to the deviant tone (inhibitory cue) was not significantly different between the Go-NoGo and the All-Go task. However, the evoked response to the frequent tone (go cue) in the Go-NoGo task was significantly reduced. The reduction was mainly prominent in the negative component of the evoked response amplitude aligned to the press. Successful movement inhibition was correlated with higher baseline activity. We suggest that the STN in Parkinson's disease patients adapts to movement inhibition context by selectively decreasing the amplitude of neuronal activity. Thus, the STN enables movement inhibition not by increasing responses to the inhibitory cue but by reducing responses to the release cue. The negative component of the evoked response probably facilitates movement and a higher baseline activity enables successful inhibition of movement. These discharge modulations were found in the ventromedial, non-motor domain of the STN and therefore suggest a significant role of the limbic- associative STN domains in movement planning and in global movement regulation.


Subject(s)
Limbic Lobe/physiology , Motor Cortex/physiology , Movement/physiology , Parkinson Disease/physiopathology , Psychomotor Performance/physiology , Subthalamic Nucleus/physiology , Acoustic Stimulation/methods , Aged , Deep Brain Stimulation/instrumentation , Deep Brain Stimulation/methods , Electrodes, Implanted , Female , Humans , Male , Middle Aged , Neurons/physiology , Parkinson Disease/therapy
10.
Mov Disord ; 35(2): 337-343, 2020 02.
Article in English | MEDLINE | ID: mdl-31758821

ABSTRACT

BACKGROUND: Therapeutic outcomes of STN-DBS for movement and psychiatric disorders depend on electrode location within the STN. Electrophysiological and functional mapping of the STN has progressed considerably in the past years, identifying beta-band oscillatory activity in the dorsal STN as a motor biomarker. It also has been suggested that STN theta-alpha oscillations, involved in impulse control and action inhibition, have a ventral source. However, STN local field potential mapping of motor, associative, and limbic areas is often limited by poor spatial resolution. OBJECTIVES: Providing a high-resolution electrophysiological map of the motor, associative and limbic anatomical sub-areas of the subthalamic nucleus. METHODS: We have analyzed high-spatial-resolution STN microelectrode electrophysiology recordings of PD patients (n = 303) that underwent DBS surgery. The patients' STN intraoperative recordings of spiking activity (933 electrode trajectories) were combined with their imaging data (n = 83 patients, 151 trajectories). RESULTS: We found a high theta-alpha (7-10 Hz) oscillatory area, located near the STN ventromedial border in 29% of the PD patients. Theta-alpha activity in this area has higher power and lower central frequency in comparison to theta-alpha activity in more dorsal subthalamic areas. When projected on the DISTAL functional atlas, the theta-alpha oscillatory area overlaps with the STN limbic subarea. CONCLUSIONS: We suggest that theta-alpha oscillations can serve as an electrophysiological marker for the ventral subthalamic nucleus limbic subarea. Therefore, theta-alpha oscillations can guide optimal electrode placement in neuropsychiatric STN-DBS procedures and provide a reliable biomarker input for future closed-loop DBS device. © 2019 International Parkinson and Movement Disorder Society.


Subject(s)
Deep Brain Stimulation , Parkinson Disease/physiopathology , Parkinson Disease/therapy , Subthalamic Nucleus/physiopathology , Adult , Aged , Deep Brain Stimulation/methods , Electrophysiological Phenomena/physiology , Female , Humans , Male , Microelectrodes , Middle Aged , Movement/physiology , Subthalamic Nucleus/physiology
11.
Harefuah ; 158(7): 418-422, 2019 Jul.
Article in Hebrew | MEDLINE | ID: mdl-31339238

ABSTRACT

INTRODUCTION: Treatment-resistant obsessive-compulsive disorder (OCD) is considered a severe psychiatric disorder that causes severe functional decline. In the past, these patients were treated by selective ablation of neuronal pathways related to the pathophysiology of OCD. Deep brain stimulation is an effective and safe treatment alternative that enables reversible changes in neural circuits and reduces OCD symptoms. In this paper we present the outcome of a treatment-resistant OCD patient who underwent deep brain stimulation procedure for the first time in Israel. The patient has achieved a significant decline in OCD symptoms as well as improvement in personal and social functioning. The discussion focuses on methods to implement deep brain stimulation for OCD patients in Israel.


Subject(s)
Deep Brain Stimulation , Obsessive-Compulsive Disorder/therapy , Humans , Israel , Treatment Outcome
12.
J Neurolinguistics ; 50: 7-16, 2019 May.
Article in English | MEDLINE | ID: mdl-30976136

ABSTRACT

Recent evidence has shown that convergence of print and speech processing across a network of primarily left-hemisphere regions of the brain is a predictor of future reading skills in children, and a marker of fluent reading ability in adults. The present study extends these findings into the domain of second-language (L2) literacy, through brain imaging data of English and Hebrew L2 learners. Participants received an fMRI brain scan, while performing a semantic judgement task on spoken and written words and pseudowords in both their L1 and L2, alongside a battery of L1 and L2 behavioural measures. Imaging results show, overall, show a similar network of activation for reading across the two languages, alongside significant convergence of print and speech processing across a network of left-hemisphere regions in both L1 and L2 and in both cohorts. Importantly, convergence is greater for L1 in occipito-temporal regions tied to automatic skilled reading processes including the visual word-form area, but greater for L2 in frontal regions of the reading network, tied to more effortful, active processing. The main groupwise brain effects tell a similar story, with greater L2 than L1 activation across frontal, temporal and parietal regions, but greater L1 than L2 activation in parieto-occipital regions tied to automatic mapping processes in skilled reading. These results provide evidence for the shifting of the reading networks towards more automatic processing as reading proficiency rises and the mappings and statistics of the new orthography are learned and incorporated into the reading system.

13.
J Neurol ; 266(5): 1160-1166, 2019 May.
Article in English | MEDLINE | ID: mdl-30788617

ABSTRACT

BACKGROUND: Emphasis is often placed on the good recovery of vision following optic neuritis (ON). However, patients continue to perceive difficulties in performing everyday visual tasks and have reduced visual quality of life. This is in addition to documented permanent loss of retinal volume. METHODS: Seventy-five subjects following monocular ON (> 3 months prior to assessment), were evaluated by the Rabin cone contrast test (CCT). Red, green and blue cone contrast scores were extracted for the affected and fellow eyes. Retinal nerve fiber layer (RNFL) and macular volume (MV) were assessed using optical coherence tomography. RESULTS: Fifty-seven patients had multiple sclerosis and 17 had clinically isolated syndrome. Median time from ON to evaluation was 47 months. Expanded Disability Status Scale (EDSS) ranged between 0 and 6.5 with average of 2 ± 1.3. Cone contrast scores for red, green and blue in the affected eyes were significantly lower than in the fellow eyes. RNFL thickness and MV were reduced in the affected compared to the fellow eyes. Positive correlations between CCT and RNFL were found in both eyes, but much stronger in the affected eyes (r = 0.72, 0.74, 0.5 and 0.53, 0.58, 0.46 for red green and blue in each eye, respectively). Positive correlations between CCT and MV were found in both eyes, but only modestly stronger in the affected eyes. CONCLUSIONS: Impaired chromatic discrimination thresholds quantitatively document persistent functional complaints after ON. There is evidence of dysfunction in both the affected eye and the fellow eye.


Subject(s)
Color Perception/physiology , Optic Neuritis/complications , Perceptual Disorders/etiology , Retina/pathology , Adolescent , Adult , Aged , Atrophy/etiology , Child , Cohort Studies , Disability Evaluation , Female , Humans , Male , Middle Aged , Nerve Fibers/pathology , Tomography, Optical Coherence , Young Adult
14.
Neurosurgery ; 84(3): 749-757, 2019 03 01.
Article in English | MEDLINE | ID: mdl-29800386

ABSTRACT

BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a proven and effective therapy for the management of the motor symptoms of Parkinson's disease (PD). While accurate positioning of the stimulating electrode is critical for success of this therapy, precise identification of the STN based on imaging can be challenging. We developed a method to accurately visualize the STN on a standard clinical magnetic resonance imaging (MRI). The method incorporates a database of 7-Tesla (T) MRIs of PD patients together with machine-learning methods (hereafter 7 T-ML). OBJECTIVE: To validate the clinical application accuracy of the 7 T-ML method by comparing it with identification of the STN based on intraoperative microelectrode recordings. METHODS: Sixteen PD patients who underwent microelectrode-recordings guided STN DBS were included in this study (30 implanted leads and electrode trajectories). The length of the STN along the electrode trajectory and the position of its contacts to dorsal, inside, or ventral to the STN were compared using microelectrode-recordings and the 7 T-ML method computed based on the patient's clinical 3T MRI. RESULTS: All 30 electrode trajectories that intersected the STN based on microelectrode-recordings, also intersected it when visualized with the 7 T-ML method. STN trajectory average length was 6.2 ± 0.7 mm based on microelectrode recordings and 5.8 ± 0.9 mm for the 7 T-ML method. We observed a 93% agreement regarding contact location between the microelectrode-recordings and the 7 T-ML method. CONCLUSION: The 7 T-ML method is highly consistent with microelectrode-recordings data. This method provides a reliable and accurate patient-specific prediction for targeting the STN.


Subject(s)
Deep Brain Stimulation/methods , Machine Learning , Neuroimaging/methods , Subthalamic Nucleus/diagnostic imaging , Aged , Female , Humans , Magnetic Resonance Imaging , Male , Microelectrodes , Middle Aged , Parkinson Disease/therapy
15.
Brain Imaging Behav ; 13(5): 1292-1301, 2019 Oct.
Article in English | MEDLINE | ID: mdl-30145717

ABSTRACT

Posterior cortical atrophy (PCA), a localized neurodegenerative syndrome involving the occipito-parietal cortices, can serve as a good model to elaborate on the consequence of a localized damage on the anatomical and functional connectivity within an affected system. Ten PCA patients and 14 aged-matched controls were enrolled. Structural connectivity was measured via Diffusion Tensor Imaging (DTI) and probabilistic tractography. The optic tracts and radiations and the splenial fibers were delineated and their microstructural properties were evaluated. Functional connectivity was measured by resting state functional MRI (rsfMRI). Voxel-based morphometry (VBM) was used to assess atrophy. Dorsal stream visual functions were tested and correlation between these behavioral data, volume measures, white matter integrity and connectivity were examined. Impaired white matter integrity was evident in patients' optic radiations and occipito-callosal fibers, in the segments located in close proximity to the occipital cortex, suggesting a localized damage. Degeneration did not proceed to the optic tracts, opposing trans-synaptic changes. rsfMRI revealed reduced connectivity within the visual network and between the visual and other related areas such as the frontal eye field. Correlations were found between grey matter volume and spatial perception abilities and between the integrity of the affected fibers and motion perception. White matter involvement in PCA seems to be grey matter dependent. Functional connectivity, on the other hand, showed a more diffuse pattern of damage. Correlations were found between the integrity of the affected fibers and patients' visual abilities suggesting that fiber integrity plays a role in determining behavioral manifestation.


Subject(s)
Gray Matter/pathology , Occipital Lobe/pathology , Parietal Lobe/pathology , White Matter/pathology , Diffusion Tensor Imaging , Female , Humans , Middle Aged , Neural Pathways , Neuropsychological Tests
16.
Transl Psychiatry ; 8(1): 118, 2018 06 18.
Article in English | MEDLINE | ID: mdl-29915200

ABSTRACT

Obsessive-compulsive disorder (OCD) is a common and serious psychiatric disorder. Although subthalamic nucleus deep brain stimulation (DBS) has been studied as a treatment for OCD patients the underlying mechanism of this treatment and the optimal method of stimulation are unknown. To study the neural basis of subthalamic nucleus DBS in OCD patients we used a novel, implantable DBS system with long-term local field potential sensing capability. We focus our analysis on two patients with OCD who experienced severe treatment-resistant symptoms and were implanted with subthalamic nucleus DBS systems. We studied them for a year at rest and during provocation of OCD symptoms (46 recording sessions) and compared them to four Parkinson's disease (PD) patients implanted with subthalamic nucleus DBS systems (69 recording sessions). We show that the dorsal (motor) area of the subthalamic nucleus in OCD patients displays a beta (25-35 Hz) oscillatory activity similar to PD patients whereas the ventral (limbic-cognitive) area of the subthalamic nucleus displays distinct theta (6.5-8 Hz) oscillatory activity only in OCD patients. The subthalamic nucleus theta oscillatory activity decreases with provocation of OCD symptoms and is inversely correlated with symptoms severity over time. We conclude that beta oscillations at the dorsal subthalamic nucleus in OCD patients challenge their pathophysiologic association with movement disorders. Furthermore, theta oscillations at the ventral subthalamic nucleus in OCD patients suggest a new physiological target for OCD therapy as well as a promising input signal for future emotional-cognitive closed-loop DBS.


Subject(s)
Obsessive-Compulsive Disorder/physiopathology , Subthalamic Nucleus/physiology , Theta Rhythm , Adult , Aged , Deep Brain Stimulation , Electrophysiological Phenomena , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Obsessive-Compulsive Disorder/therapy , Treatment Outcome
17.
J Clin Endocrinol Metab ; 102(9): 3406-3414, 2017 09 01.
Article in English | MEDLINE | ID: mdl-28911135

ABSTRACT

Context: Homeostatic energy balance is controlled via the hypothalamus, whereas regions controlling reward and cognitive decision-making are critical for hedonic eating. Eating varies across the menstrual cycle peaking at the midluteal phase. Objective: To test responses of females with regular cycles during midfollicular and midluteal phase and of users of monophasic oral contraception pills (OCPs) to visual food cues. Design: Participants performed a functional magnetic resonance imaging while exposed to visual food cues in four time points: fasting and fed conditions in midfollicular and midluteal phases. Patients: Twenty females with regular cycles and 12 on monophasic OCP, aged 18 to 35 years. Main Outcome Measures: Activity in homeostatic (hypothalamus), reward (amygdala, putamen and insula), frontal (anterior cingulate cortex, dorsolateral prefrontal cortex), and visual regions (calcarine and lateral occipital cortex). Setting: Tertiary hospital. Results: In females with regular cycles, brain regions associated with homeostasis but also the reward system, executive frontal areas, and afferent visual areas were activated to a greater degree during the luteal compared with the follicular phase. Within the visual areas, a dual effect of hormonal and prandial state was seen. In females on monophasic OCPs, characterized by a permanently elevated progesterone concentration, activity reminiscent of the luteal phase was found. Androgen, cortisol, testosterone, and insulin levels were significantly correlated with reward and visual region activation. Conclusions: Hormonal mechanisms affect the responses of women's homeostatic, emotional, and attentional brain regions to food cues. The relation of these findings to eating behavior throughout the cycle needs further investigation.


Subject(s)
Cerebral Cortex/diagnostic imaging , Feeding Behavior/physiology , Magnetic Resonance Imaging/methods , Menstrual Cycle/physiology , Neurosecretory Systems/physiology , Photic Stimulation , Adolescent , Adult , Amygdala/physiology , Cerebral Cortex/physiology , Cues , Feeding Behavior/psychology , Female , Follicular Phase/physiology , Humans , Hypothalamus/physiology , Luteal Phase/physiology , Menstrual Cycle/psychology , Sampling Studies , Young Adult
18.
J Neurosci ; 37(27): 6394-6407, 2017 07 05.
Article in English | MEDLINE | ID: mdl-28546311

ABSTRACT

Investigation of the functional macro-scale organization of the human cortex is fundamental in modern neuroscience. Although numerous studies have identified networks of interacting functional modules in the gray-matter, limited research was directed to the functional organization of the white-matter. Recent studies have demonstrated that the white-matter exhibits blood oxygen level-dependent signal fluctuations similar to those of the gray-matter. Here we used these signal fluctuations to investigate whether the white-matter is organized as functional networks by applying a clustering analysis on resting-state functional MRI (RSfMRI) data from white-matter voxels, in 176 subjects (of both sexes). This analysis indicated the existence of 12 symmetrical white-matter functional networks, corresponding to combinations of white-matter tracts identified by diffusion tensor imaging. Six of the networks included interhemispheric commissural bridges traversing the corpus callosum. Signals in white-matter networks correlated with signals from functional gray-matter networks, providing missing knowledge on how these distributed networks communicate across large distances. These findings were replicated in an independent subject group and were corroborated by seed-based analysis in small groups and individual subjects. The identified white-matter functional atlases and analysis codes are available at http://mind.huji.ac.il/white-matter.aspx Our results demonstrate that the white-matter manifests an intrinsic functional organization as interacting networks of functional modules, similarly to the gray-matter, which can be investigated using RSfMRI. The discovery of functional networks within the white-matter may open new avenues of research in cognitive neuroscience and clinical neuropsychiatry.SIGNIFICANCE STATEMENT In recent years, functional MRI (fMRI) has revolutionized all fields of neuroscience, enabling identifications of functional modules and networks in the human brain. However, most fMRI studies ignored a major part of the brain, the white-matter, discarding signals from it as arising from noise. Here we use resting-state fMRI data from 176 subjects to show that signals from the human white-matter contain meaningful information. We identify 12 functional networks composed of interacting long-distance white-matter tracts. Moreover, we show that these networks are highly correlated to resting-state gray-matter networks, highlighting their functional role. Our findings enable reinterpretation of many existing fMRI datasets, and suggest a new way to explore the white-matter role in cognition and its disturbances in neuropsychiatric disorders.


Subject(s)
Brain Mapping/methods , Brain/physiology , Evoked Potentials/physiology , Nerve Net/physiology , White Matter/physiology , Adult , Female , Humans , Male , Neural Pathways/physiology
19.
J Neurophysiol ; 117(6): 2140-2151, 2017 06 01.
Article in English | MEDLINE | ID: mdl-28202569

ABSTRACT

Subthalamic nucleus field potentials have attracted growing research and clinical interest over the last few decades. However, it is unclear whether subthalamic field potentials represent locally generated neuronal subthreshold activity or volume conductance of the organized neuronal activity generated in the cortex. This study aimed at understanding of the physiological origin of subthalamic field potentials and determining the most accurate method for recording them. We compared different methods of recordings in the human subthalamic nucleus: spikes (300-9,000 Hz) and field potentials (3-100 Hz) recorded by monopolar micro- and macroelectrodes, as well as by differential-bipolar macroelectrodes. The recordings were done outside and inside the subthalamic nucleus during electrophysiological navigation for deep brain stimulation procedures (150 electrode trajectories) in 41 Parkinson's disease patients. We modeled the signal and estimated the contribution of nearby/independent vs. remote/common activity in each recording configuration and area. Monopolar micro- and macroelectrode recordings detect field potentials that are considerably affected by common (probably cortical) activity. However, bipolar macroelectrode recordings inside the subthalamic nucleus can detect locally generated potentials. These results are confirmed by high correspondence between the model predictions and actual correlation of neuronal activity recorded by electrode pairs. Differential bipolar macroelectrode subthalamic field potentials can overcome volume conductance effects and reflect locally generated neuronal activity. Bipolar macroelectrode local field potential recordings might be used as a biological marker of normal and pathological brain functions for future electrophysiological studies and navigation systems as well as for closed-loop deep brain stimulation paradigms.NEW & NOTEWORTHY Our results integrate a new method for human subthalamic recordings with a development of an advanced mathematical model. We found that while monopolar microelectrode and macroelectrode recordings detect field potentials that are considerably affected by common (probably cortical) activity, bipolar macroelectrode recordings inside the subthalamic nucleus (STN) detect locally generated potentials that are significantly different than those recorded outside the STN. Differential bipolar subthalamic field potentials can be used in navigation and closed-loop deep brain stimulation paradigms.


Subject(s)
Action Potentials , Subthalamic Nucleus/physiology , Deep Brain Stimulation , Electrodes , Female , Humans , Male , Models, Neurological , Neural Pathways/physiology , Neural Pathways/physiopathology , Parkinson Disease/physiopathology , Parkinson Disease/therapy , Periodicity , Subthalamic Nucleus/physiopathology
20.
Isr Med Assoc J ; 18(6): 341-5, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27468527

ABSTRACT

BACKGROUND: Neurolathyrism is a toxic nutritional disorder caused by consumption of the grass pea, Lathyrus sativus. The disease, which manifests as an acute or insidiously evolving spastic paraparesis, continues to occur throughout Africa and Asia. Research on this disease is limited, and to our knowledge no imaging studies of patients with neurolathyrism have been published. OBJECTIVES: To better localize the site of damage in neurolathyrism using advanced imaging methods. METHODS: Three male patients, immigrants from Ethiopia, were included in the study. All had a history of arrested spastic paraparesis that had evolved before their emigration from Ethiopia, and a past history of exposure to grass pea without any other cause. Functional magnetic resonance imaging (fMRI) included simple motor tasks to evaluate cortical motor areas. Anatomic scans included diffusion tensor imaging (DTI) to evaluate the corticospinal tracts. RESULTS: In all patients clear activation was found in motor regions, and the patients' activity pattern was qualitatively similar to that in control sublects. In one patient in whom clinical symptoms were asymmetric, an asymmetric activity pattern in Ml was identified. DTI analysis identified intact corticospinal tracts connecting the pons and the primary motor regions, similar to control subjects. CONCLUSIONS: Advanced neuroimaging clearly identified well-functioning motor regions and tracts in neurolathyrism patients, suggesting a spinal etiology.


Subject(s)
Lathyrism , Magnetic Resonance Imaging/methods , Motor Cortex , Pyramidal Tracts , Adult , Case-Control Studies , Humans , Israel , Lathyrism/diagnosis , Lathyrism/etiology , Lathyrism/physiopathology , Lathyrus/toxicity , Male , Motor Cortex/pathology , Motor Cortex/physiopathology , Neurologic Examination/methods , Pyramidal Tracts/drug effects , Pyramidal Tracts/pathology
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