Neural Correlates of Facial Expression Recognition in Earthquake Witnesses.

Major adverse events, like an earthquake, trigger different kinds of emotional dysfunctions or psychiatric disorders in the exposed subjects. Recent literature has also shown that exposure to natural disasters can increase threat detection. In particular, we previously found a selective enhancement in the ability to read emotional facial expressions in L'Aquila earthquake witnesses, suggesting hypervigilance to stimuli signaling a threat. In light of previous neuroimaging data showing that trauma exposure is related to derangement of resting-state brain activity, in the present study we investigated the neurofunctional changes related to the recognition of emotional faces in L'Aquila earthquake witnesses. Specifically, we tested the relationships between accuracy in recognizing facial expressions and activity of the visual network (VN) and of the default-mode network (DMN). Resting-state functional connectivity (FC) with the main hub of the VN (primary, ventral, right-dorsal, and left-dorsal visual cortices) and DMN (posterior cingulate/precuneus, medial prefrontal, and right and left inferior parietal cortices) was investigated through a seed-based functional magnetic resonance imaging (fMRI) analysis in both earthquake-exposed subjects and non-exposed persons who did not live in an earthquake-affected area. The results showed that, in earthquake-exposed subjects, there is a significant reduction in the correlation between accuracy in recognizing facial expressions and the FC of the dorsal seed of the VN with the right inferior occipito-temporal cortex and the left lateral temporal cortex, and of two parietal seeds of DMN, i.e., lower parietal and medial prefrontal cortex, with the precuneus bilaterally. These findings suggest that a functional modification of brain systems involved in detecting and interpreting emotional faces may represent the neurophysiological basis of the specific "emotional expertise" observed in the earthquake witnesses.

Coronary computed tomography angiography in the evaluation of intermediate risk asymptomatic individuals.

Cardiovascular disease is still one of the main causes of death and an early identification of coronary artery disease (CAD) remains the primary step in clinical management of patients with cardiovascular risk factor. Coronary computed tomography angiography (CCTA) has shown high sensitivity in CAD detection and could be helpful as screening method. The purpose of this study was to assess the prevalence of coronary artery disease detected by CCTA in asymptomatic patients with an intermediate risk of CAD. MATERIALS AND METHODS: We retrospectively selected 185 asymptomatic patients with an intermediate Framingan Risk Score (mean age was 62.3 ± 12.4 years); all patients underwent CCTA, using 640-slice CT. RESULTS: Atherosclerotic plaques were present in 112 out of 185 patients (60.5%); 56 subjects (30.2%) had mild stenosis, 49 (26.5%) moderate stenosis, only 3 patients (1.6%) had severe stenosis and in 4 cases (2.2%) the "blooming effect" did not allow for evaluation of the degree of stenosis. Among the positive cases, a high number of patients (44.6%) [50] showed coronary artery disease in one vessel, 33 patients (29.4%) in two vessels, 22 patients (19.6%) in three vessels and 5 patients in four vessels or more (4.5%). Patients with moderate stenosis were older, had hypertension in most cases, higher total cholesterol levels and more often were smokers. The radiation dose (mSv) dispensed to the patients was 3.7 ± 1.6 mSv. CONCLUSION: High prevalence of coronary stenosis detected by low-dose CCTA in patients not properly classified by the traditional methods of risk stratification commonly used in clinical practice emphasizes the need to extend the risk stratification to other diagnostic tools with higher capability to detect CAD.

Magnetic resonance imaging (MRI) of the lumbar spine with dedicated G-scan machine in the upright position: a retrospective study and our experience in 10 years with 4305 patients.

PURPOSE: To evaluate the pathological changes of the lumbar spine and the instability of the lumbar intervertebral joints observed in patients with low back pain, with the study of the transition from supine to orthostatic position through the use of dedicated MRI-G-scan machine. MATERIALS AND METHODS: Within 10 years, 4305 patients, aged between 21 and 80 years old, with history of low back pain with or without sciatica, underwent MRI examinations in upright and in supine position. The open MRI-scanner used is Esaote G-scan, which enables the acquisition of images in supine and standing positions. The used sequences were sagittal T2-weighted FSE, T1-weighted SE and axial 3D HYCE. Patients were divided into two groups: "negatives", with no changes in the two positions (supine and upright), and "positives", with MRI modifications of imaging in upright position. RESULTS: Orthostatic examination showed MRI changes in 2870 out of 4305 (66.6%) patients, including 1252 males and 1618 females. CONCLUSIONS: The G-scan is useful to assess instability of the lumbar spine detecting hidden modifications of protrusions and/or herniated discs already present in the supine position. It is also helpful in assessing the presence or modification of spondylolisthesis and lumbar canal stenosis.