Effects of COVID-19 on brain and cerebellum: a voxel based morphometrical analysis.

OBJECTIVE: COVID-19 is caused by SARS-CoV-2 virus and turned into a pandemic in a short time, affects many organs and systems, especially the nervous system. In the present study, it was aimed to determine the morphological and volumetric changes in cortical and subcortical structures in recovered COVID-19 patients. BACKGROUND: We think that COVID-19 has a long-term effect on cortical and subcortical structures. METHODS: In our study, 50 post-COVID-19 patients and 50 healthy volunteers participated. In both groups, brain parcellations were made with Voxel-Based Morphometry (VBM) and regions showing density changes in the brain and cerebellum were determined. Gray matter (GM), white matter, cerebrospinal fluid and total intracranial volume were calculated. RESULTS: Neurological symptoms developed in 80% of COVID-19 patients. In post-COVID-19 patients, a decrease in GM density was detected in pons, gyrus frontalis inferior, gyri orbitales, gyrus rectus, gyrus cinguli, lobus parietalis, gyrus supramarginalis, gyrus angularis, hippocampus, lobulus semilunaris superior of cerebellum, declive, and Brodmann area 7-11-39-40. There was a significant decrease in GM density in these regions and an increase in GM density in amygdala (p<0.001). The GM volume of post-COVID-19 group was found to be less than in the healthy group. CONCLUSIONS: As a result, it was seen that COVID-19 negatively affected many structures related to the nervous system. This study is a pioneering study to determine the consequences of COVID-19, especially in the nervous system, and to determine the etiology of these possible problems (Tab. 4, Fig. 5, Ref. 25). Text in PDF www.elis.sk Keywords: COVID-19, pandemic, Voxel-based morphometry (VBM), brain, magnetic resonance imaging (MRI).

A new supportive approach in the diagnosis of Chiari malformation type 1 in pediatric patients.

PURPOSE: Chiari malformation type 1 (CM-1) is a posterior fossa anomaly characterized by herniation of the cerebellar tonsils from the foramen magnum (FM). This study compares FM, medulla spinalis (MS), and herniated cerebellar tonsils ratios by making area measurements from axial plane MRI in CM-1 patients and the control group. METHODS: Our study evaluated 30 pediatric patients with CM-1 and 30 people in the control group. The lengths of the McRae line, twining line, and clivus line were measured on the posterior cranial fossa evaluation. The areas of FM (AFM), MS (AMS), and herniated cerebellar tonsils (ATONSILS) were measured by axial images. RESULTS: As a result of area measurements obtained from axial cross-sectional MRI, a statistically significant difference was found between CM-1 patients and the control group. According to the results of the ROC analysis, if an individual's AMS/AFM value is above 17.9% or the ATONSILS/AFM value is above 18.4%, it can be interpreted as a CM-1 patient. CONCLUSION: It will be easier to diagnose the patient with the new approach we obtained from axial MR images in addition to sagittal MR images. This method can be a guide in some cases when the surgeons are undecided.

An unique unilateral tendon variation of the extensor digitorum longus muscle.

PURPOSE: The double tendon of extensor digitorum longus (EDL) muscle was observed on the left leg of a 80-year-old male cadaver. METHODS: A male cadaver 80 years old was subjected to routine anatomical dissection for research and teaching purposes. RESULTS: The main tendon of the EDL muscle started just at the end of the muscle belly. However, the accessory tendon started at the tendinous end of the muscle as a continuation of the muscle. The main and accessory tendons split into two more slips after passing through the same tunnel below the extensor retinaculum. There was also difference on ending of the tendon slips of EDL muscle. The main tendon divided into two tendinous slips on the dorsum of the foot attached to the second and third toes. The accessory tendon divided into two tendinous slips on the dorsum of the foot attached to the fourth and the fifth toes. CONCLUSION: Knowledge of the tendons and anatomical differences of this muscle is important for surgeons in interventional procedures involving the dorsum of the foot.

Golden ratio for the foramen magnum on CT images: a morphological and morphometrical study / Proporción áurea para el foramen magnum en imágenes de TC: un estudio morfológico y morfométrico

SUMMARY: The foramen magnum (FM) is a transition zone between the spine and skull. There is a study in the literature showing the golden ratio (4.62) and harmony between both FM and the anteroposterior and transverse diameters of the skull. The aim of this study is to examine the existence of this ratio on CT images and to investigate whether this ratio changes according to the FM shape types. In this study, 402 adult CT images belonging to the Turkish population were examined. Maximum cranial length (MCL), maximum cranial width (MCW) and the FM length (FML) and FM width (FMW) were measured. The different shapes of the FM were macroscopically classified. The number and incidence of each type in the studied skull was registered. In the 402 CT images used in the study, 12 FM shapes were detected. Three of the shape types observed in our study have not been reported in the literature until now, and were found in our study for the first time. In addition, our data supported that by using the ratio of 4.62, there was a great harmony between the skull and FM. The results obtained from the research show that there is a ratio of 4.62 between the basic cranial measurements and FM dimensions in all shapes except triangular shape. It is thought that repeating the calculated coefficients over more different FM shapes will contribute to the effectiveness of the proposed golden ratio.

RESUMEN: El foramen magno (FM) es una zona de transición entre la columna y el cráneo. Existe un estudio en la literatura que muestra la proporción áurea (4,62) y la armonía entre el FM y los diámetros anteroposterior y transversal del cráneo. El objetivo de este estudio fue examinar la existencia de esta relación en las imágenes de TC e investigar si esta relación cambia según los tipos de forma del FM. Se examinaron 402 imágenes de TC de adultos pertenecientes a la población turca. Se midieron la longitud craneal máxima, el ancho craneal máximo y la longitud del FM y la anchura del FM. Las diferentes formas del FM se clasificaron macroscópicamente. Se registró el número e incidencia de cada tipo en el cráneo estudiado. En las 402 imágenes de TC utilizadas en el estudio, se detectaron 12 formas de FM. Tres de los tipos de formas observados en nuestro estudio no se han reportado en la literatura consultada describiéndose por primera vez. Además, nuestros datos respaldaron que al usar la proporción de 4,62, había una armonía importante entre el cráneo y el FM. Los resultados obtenidos de la investigación muestran que existe una relación de 4,62 entre las medidas craneales básicas y las dimensiones de la FM en todas las formas excepto en la triangular. Se cree que la repetición de los coeficientes calculados en más formas de FM diferentes contribuirá a la eficacia de la proporción áurea propuesta.

Structural neuroimaging findings in migraine patients with restless legs syndrome.

PURPOSE: One out of three migraine patients might have accompanying restless legs syndrome (RLS). In our study, we aimed to compare the volumes of the brain structures of migraineurs with and without RLS. METHODS: We had 37 female patients with migraine and 17 females as the control group. Nineteen migraineurs had no RLS (RLS0) and 18 migraineurs had comorbidity of RLS (RLS1). The volumes of the brain structures were obtained by manual measurements, volBrain, and voxel-based morphometry (VBM). Manually, we measured caudate and putamen volumes. We used age, years of education, depression, anxiety scores, and total intracranial volume as covariates. RESULTS: According to VBM analyses, the volumes of the left superior occipital gyrus and precuneus were increased, and the substantia nigra and cuneus were decreased in the RLS1 group compared with the RLS0 group. RLS1 patients had larger superior temporal gyrus, Brodmann area 38, and left insula, and RLS0 patients had larger Brodmann area 22, right superior temporal gyrus, and Heschl gyrus compared with controls. Migraine and RLS0 patients had a smaller corpus callosum anteriorly, whereas RLS1 patients had a smaller splenium. Caudate volumes were larger in migraine patients via the three techniques. There was a positive relation between the caudate and putamen volumes and attack frequency. CONCLUSIONS: Comorbidity of RLS might be a confounding factor in structural neuroimaging studies in migraine. Deficits in the visual network seem to be related to accompanying RLS; deficits in the auditory network are particularly related to migraine.