RESUMEN
OBJECTIVE: To evaluate the extent of signal abnormality in impaired ocular motor nerves using high signal and spatial resolution MRI sequences and to discuss the involvement of inflammatory or microvascular impairment in patients with diabetic ophthalmoplegia. METHODS: We conducted a retrospective study of 10 patients referred for acute ocular motor nerve palsy in the context of diabetes mellitus from September 15th, 2021 to April 24th, 2022. 3T MRI evaluation included diffusion, 3D TOF, FLAIR, coronal STIR and post-injection 3D T1 SPACE DANTE sequences. RESULTS: Ten patients were included: 9 males and 1 female aged from 46 to 79 years. Five patients presented with cranial nerve (CN) III palsy, and 5 presented with CN VI palsy. Third nerve palsy was pupil-sparing in 4 patients and pupil-involved in 1 patient. Pain was associated in all patients with CN III deficiencies and in 2 patients CN VI deficiencies. In all patients, MRI sequences ruled out mass effect and vascular pathology, such as acute stroke or aneurysm. Eight patients presented with STIR hypersignals, some with enlargement of the involved nerve. The diagnosis was confirmed through a post-injection 3D T1 SPACE DANTE sequence, which showed extended enhancement along the abnormal portion of the nerve. CONCLUSION: High-resolution MRI evaluation of diplopia in diabetic patients is used to rule out a diagnosis of acute stroke and contributes to the positive diagnosis of ocular motor nerve impairment, possibly combining the influences of inflammatory and microvascular phenomena. Dedicated MR imaging should be included in the initial diagnosis and longitudinal follow-up of patients with diabetic ophthalmoplegia.
Asunto(s)
Diabetes Mellitus , Enfermedades del Nervio Oculomotor , Oftalmoplejía , Accidente Cerebrovascular , Masculino , Humanos , Femenino , Estudios Retrospectivos , Enfermedades del Nervio Oculomotor/diagnóstico por imagen , Enfermedades del Nervio Oculomotor/etiología , Parálisis/complicaciones , Oftalmoplejía/complicaciones , Accidente Cerebrovascular/complicaciones , Imagen por Resonancia MagnéticaRESUMEN
OBJECTIVES: To analyze postoperative CT dacryography features in patients with persistent epiphora after endonasal surgery. METHODS: We conducted a retrospective study of 76 patients with a history of persistent epiphora after endonasal ENT surgery who underwent CT dacryography between January 2014 and February 2020. Volume acquisition of sub-millimeter sections allowed 2D and 3D reconstructions with virtual endoscopy of the nasosinusal cavities and the lacrimal canal. RESULTS: The postsurgical appearance of the nasosinusal cavities revealed a middle meatal antrostomy in 37% of cases, less frequently an ethmoidectomy or an inferior meatal antrostomy, sometimes completed by a middle or inferior turbinectomy. In thirty-five patients (46%), the lacrimal canal was distant from the endonasal ENT procedure. Epiphora was related to mucosal hypertrophy, constricting all or part of the lacrimal canal. Thirty-three patients (43%) showed changes in the lacrimal canal at the surgical site. In the inferior meatus, the nasolacrimal orifice was sometimes involved in the inferior turbinectomy or meatotomy, but most of the time, in the middle meatus, resection of the uncinate process prior to ethmoidectomy or middle meatotomy was associated with a lesion of the contiguous lacrimal canal. CONCLUSION: As a rare cause of persistent tearing, involvement of the nasolacrimal duct at the edge of the endonasal ENT surgery highlights the importance of intraoperative localization of the nasolacrimal duct before resection of the uncinate process or the inferior turbinate, ideally predicted by preoperative CT imaging.
Asunto(s)
Dacriocistorrinostomía , Enfermedades del Aparato Lagrimal , Aparato Lagrimal , Conducto Nasolagrimal , Dacriocistorrinostomía/métodos , Endoscopía/métodos , Humanos , Aparato Lagrimal/diagnóstico por imagen , Aparato Lagrimal/cirugía , Enfermedades del Aparato Lagrimal/diagnóstico por imagen , Enfermedades del Aparato Lagrimal/etiología , Conducto Nasolagrimal/diagnóstico por imagen , Conducto Nasolagrimal/patología , Conducto Nasolagrimal/cirugía , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
Transcranial direct current stimulation (tDCS) is growingly applied to the cerebellum to modulate the activity of cerebellar circuitry, affecting both motor and cognitive performances in a polarity-specific manner. The remote effects of tDCS are mediated in particular via the dentato-thalamo-cortical pathway. We showed recently that tDCS of the cerebellum exerts dynamic effects on resting state networks. We tested the neural hypothesis that tDCS reconfigurates brain networks involved in motor execution (ME) and motor mental imagery (MMI). We combined tDCS applied over the right cerebellum and fMRI to investigate tDCS-induced reconfiguration of ME- and MMI-related networks using a randomized, sham-controlled design in 21 right-handed healthy volunteers. Subjects were instructed to draw circles at comfortable speed and to imagine drawing circles with their right hand. fMRI data were recorded after real anodal stimulation (1.5 mA, 20 min) or sham tDCS. Real tDCS compared with SHAM specifically reconfigurated the functional links between the main intrinsic connected networks, especially the central executive network, in relation with lobule VII, and the salience network. The right cerebellum mainly influenced prefrontal and anterior cingulate areas in both tasks, and improved the overt motor performance. During MMI, the cerebellum also modulated the default-mode network and associative visual areas. These results demonstrate that tDCS of the cerebellum represents a novel tool to modulate cognitive brain networks controlling motor execution and mental imagery, tuning the activity of remote cortical regions. This approach opens novel doors for the non-invasive neuromodulation of disorders involving cerebello-thalamo-cortical paths.
Asunto(s)
Estimulación Transcraneal de Corriente Directa , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Mapeo Encefálico/métodos , Cerebelo/fisiología , Humanos , Imagen por Resonancia Magnética , Estimulación Transcraneal de Corriente Directa/métodosRESUMEN
BACKGROUND: Transcranial direct current stimulation (tDCS) of the cerebellum dynamically modulates cerebello-thalamo-cortical excitability in a polarity-specific manner during motor, visuo- motor and cognitive tasks. It remains to be established whether tDCS of the cerebellum impact also on resting-state intrinsically connected networks (ICNs). Such impact would open novel research and therapeutical doors for the neuromodulation of ICNs in human. METHOD: We combined tDCS applied over the right cerebellum and fMRI to investigate tDCS- induced resting-state intrinsic functional reconfiguration, using a randomized, sham-controlled design. fMRI data were recorded both before and after real anodal stimulation (2 mA, 20 min) or sham tDCS in 12 right-handed healthy volunteers. We resorted to a region-of-interest static correlational analysis and to a sliding window analysis to assess temporal variations in resting state FC between the cerebellar lobule VII and nodes of the main ICNs. RESULTS: After real tDCS and compared with sham tDCS, functional changes were observed between the cerebellum and ICNs. Static FC showed enhanced or decreased correlation between cerebellum and brain areas belonging to visual, default-mode (DMN), sensorimotor and salience networks (SN) (p-corrected < 0.05). The temporal variability (TV) of BOLD signal was significantly modified after tDCS displaying in particular a lesser TV between the whole lobule VII and DMN and central executive network and a greater TV between crus 2 and SN. Static and dynamic FC was also modified between cerebellar lobuli. CONCLUSION: These results demonstrate short- and long-range static and majorly dynamic effects of tDCS stimulation of the cerebellum affecting distinct resting-state ICNs, as well as intracerebellar functional connectivity, so that tDCS of the cerebellum appears as a non-invasive tool reconfigurating the dynamics of ICNs.
RESUMEN
Ischemic optic neuropathies are among the leading causes of severe visual acuity loss in people over 50 years of age. They constitute a set of various entities that are clinically, etiologically and therapeutically different. Anatomically, it is necessary to distinguish anterior and posterior forms. From an etiological point of view, the diagnosis of the arteritic form due to giant cell arteritis requires emergent management to prevent blindness and even death in the absence of prompt corticosteroid treatment. When this diagnosis has been ruled out with certainty, non-arteritic ischemic optic neuropathies represent a vast etiological context that in the majority of cases involves a local predisposing factor (small optic nerves, disc drusen) with a precipitating factor (severe hypotension, general anesthesia or dialysis) in a context of vascular disease (sleep apnea syndrome, hypertension, diabetes, etc.). In the absence of specific available treatment, it is the responsibility of the clinician to identify the risk factors involved, in order to reduce the risk of contralateral recurrence that may occur even several years later. Due to their complexity, these pathologies are the subject of debates regarding both the pathophysiological and therapeutic perspectives; this review aims to provide a synthesis of validated knowledge while discussing controversial data.
Asunto(s)
Neuropatía Óptica Isquémica , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Ceguera/diagnóstico , Ceguera/etiología , Ceguera/terapia , Arteritis de Células Gigantes/complicaciones , Arteritis de Células Gigantes/diagnóstico , Arteritis de Células Gigantes/terapia , Humanos , Persona de Mediana Edad , Disco Óptico/patología , Neuropatía Óptica Isquémica/diagnóstico , Neuropatía Óptica Isquémica/etiología , Neuropatía Óptica Isquémica/terapia , Agudeza Visual/fisiologíaRESUMEN
Ischemic optic neuropathies are among the leading causes of severe visual acuity loss in people over 50 years of age. They constitute a set of various entities that are clinically, etiologically and therapeutically different. Anatomically, it is necessary to distinguish anterior and posterior forms. From an etiological point of view, the diagnosis of the arteritic form due to giant cell arteritis requires emergent management to prevent blindness and even death in the absence of prompt corticosteroid treatment. When this diagnosis has been ruled out with certainty, non-arteritic ischemic optic neuropathies represent a vast etiological context that in the majority of cases involves a local predisposing factor (small optic nerves, disc drusen) with a precipitating factor (severe hypotension, general anesthesia or dialysis) in a context of vascular disease (sleep apnea syndrome, hypertension, diabetes, etc.). In the absence of specific available treatment, it is the responsibility of the clinician to identify the risk factors involved, in order to reduce the risk of contralateral recurrence that may occur even several years later. Due to their complexity, these pathologies are the subject of debates regarding both the pathophysiological and therapeutic perspectives; this review aims to provide a synthesis of validated knowledge while discussing controversial data.
Asunto(s)
Neuropatía Óptica Isquémica/diagnóstico , Neuropatía Óptica Isquémica/etiología , Neuropatía Óptica Isquémica/terapia , Enfermedad Aguda , Edad de Inicio , Anciano , Anciano de 80 o más Años , Ceguera/diagnóstico , Ceguera/epidemiología , Ceguera/etiología , Ceguera/terapia , Arteritis de Células Gigantes/complicaciones , Arteritis de Células Gigantes/diagnóstico , Arteritis de Células Gigantes/epidemiología , Arteritis de Células Gigantes/terapia , Humanos , Persona de Mediana Edad , Neuropatía Óptica Isquémica/epidemiología , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/epidemiología , Trastornos de la Visión/etiología , Trastornos de la Visión/terapiaRESUMEN
Over the past three decades, insights into the role of the cerebellum in emotional processing have substantially increased. Indeed, methodological refinements in cerebellar lesion studies and major technological advancements in the field of neuroscience are in particular responsible to an exponential growth of knowledge on the topic. It is timely to review the available data and to critically evaluate the current status of the role of the cerebellum in emotion and related domains. The main aim of this article is to present an overview of current facts and ongoing debates relating to clinical, neuroimaging, and neurophysiological findings on the role of the cerebellum in key aspects of emotion. Experts in the field of cerebellar research discuss the range of cerebellar contributions to emotion in nine topics. Topics include the role of the cerebellum in perception and recognition, forwarding and encoding of emotional information, and the experience and regulation of emotional states in relation to motor, cognitive, and social behaviors. In addition, perspectives including cerebellar involvement in emotional learning, pain, emotional aspects of speech, and neuropsychiatric aspects of the cerebellum in mood disorders are briefly discussed. Results of this consensus paper illustrate how theory and empirical research have converged to produce a composite picture of brain topography, physiology, and function that establishes the role of the cerebellum in many aspects of emotional processing.
Asunto(s)
Cerebelo/fisiología , Emociones/fisiología , Animales , HumanosRESUMEN
We investigated the functional reconfiguration of the cerebral networks involved in imagination of sequential movements of the left foot, both performed at regular and fast speed after mental imagery training. Thirty-five volunteers were scanned with a 3T MRI while they imagined a sequence of ankle movements (dorsiflexion, plantar flexion, varus and valgus) before and after mental practice. Subjects were distributed in two groups: the first group executed regular movements whereas the second group made fast movements. We applied the general linear model (GLM) and model-free, exploratory tensorial independent component analytic (TICA) approaches to identify plastic post-training effects on brain activation. GLM showed that post-training imagination of movement was accompanied by a dual effect: a specific recruitment of a medial prefronto-cingulo-parietal circuit reminiscent of the default-mode network, with the left putamen, and a decreased activity of a lateral fronto-parietal network. Training-related subcortical changes only consisted in an increased activity in the left striatum. Unexpectedly, no difference was observed in the cerebellum. TICA also revealed involvement of the left executive network, and of the dorsal control executive network but no significant differences were found between pre- and post-training phases. Therefore, repetitive motor mental imagery induced specific putamen (motor rehearsal) recruitment that one previously observed during learning of overt movements, and, simultaneously, a specific shift of activity from the dorsolateral prefrontal cortex (attention, working memory) to the medial posterior parietal and cingulate cortices (mental imagery and memory rehearsal). Our data complement and confirm the notion that differential and coupled recruitment of cognitive networks can constitute a neural marker of training effects.
Asunto(s)
Encéfalo/fisiología , Cognición/fisiología , Imaginación/fisiología , Movimiento/fisiología , Red Nerviosa/fisiología , Plasticidad Neuronal/fisiología , Adulto , Atención/fisiología , Mapeo Encefálico/métodos , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Análisis y Desempeño de TareasRESUMEN
It is commonly believed that sulci offer a natural path to reach deep-seated lesions. However, it has also been argued that this approach carries a risk of damaging the vessels during the opening of the sulcus.We therefore were prompted to test the possibility of finding a transcortical path identified as non-functional by intraoperative brain mapping. A successful resection is presented of a left posterior is thmusclear cell ependymoma through a selected corridor based on functional mapping in an awake patient.MRI performed at 12 months showed no tumour recurrence. Pre- and postoperative extensive testing confirmed an improvement of the patient's cognitive functions. Therefore, we were able to demonstrate the feasibility of a functionally tailored transcortical approach as an alternative to the transulcal approach for deep-seated lesions. This concept should be validated in a larger patient series.
Asunto(s)
Neoplasias Encefálicas/cirugía , Ependimoma/cirugía , Adulto , Mapeo Encefálico , Neoplasias Encefálicas/patología , Ependimoma/patología , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Procedimientos Neuroquirúrgicos/métodos , Resultado del TratamientoRESUMEN
We investigated the cerebral networks involved in execution and mental imagery of sequential movements of the left foot, both performed at slow and fast speed. Twelve volunteers were scanned with a 3T MRI during execution and imagination of a sequence of ankle movements. Overt movement execution and motor imagery shared a common network including the premotor, parietal and cingulate cortices, the striatum and the cerebellum. Motor imagery recruited specifically the prefrontal cortex, whereas motor execution recruited specifically the sensorimotor cortex. We also found that slow movements specifically recruited frontopolar and right dorsomedian prefrontal areas bilaterally, during both execution and mental imagery, whereas fast movements strongly activated the sensorimotor cerebral cortex. Finally, we noted that anterior vermis, lobules VI/VII and VIII of the cerebellum were specifically activated during fast movements, both in imagination and execution. We show that the selection of the neural networks underlying voluntary movement of the foot is depending on the speed strategy and is sensitive to execution versus imagery. Moreover, to the light of surprising recent findings in monkeys showing that the vermis should no longer be considered as entirely isolated from the cerebral cortex (Coffman et al., 2011 [2]), we suggest that the anterior vermis contributes to computational aspects of fast commands, whereas more lateral cerebellar superior lobe and lobule VIII would regulate patterning and sequencing of submovements in conjunction with movement rate. We also suggest that execution of overt slow movements, which strongly involves prefrontal executive cortex as during motor mental imagery, is associated with conscious mental representation of the ongoing movements.
Asunto(s)
Articulación del Tobillo/fisiología , Encéfalo/fisiología , Imaginación/fisiología , Movimiento/fisiología , Red Nerviosa/fisiología , Esfuerzo Físico/fisiología , Desempeño Psicomotor/fisiología , Adulto , Mapeo Encefálico/métodos , Potenciales Evocados Motores/fisiología , Retroalimentación Fisiológica/fisiología , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: This study was designed to evaluate proton magnetic resonance spectroscopy ((1)H-MRS) for monitoring the WHO grade II glioma (low-grade glioma (LGG)) treated with temozolomide (TMZ). METHODS: This prospective study included adult patients with progressive LGG that was confirmed by magnetic resonance imaging (MRI). Temozolomide was administered at every 28 days. Response to TMZ was evaluated by monthly MRI examinations that included MRI with volumetric calculations and (1)H-MRS for assessing Cho/Cr and Cho/NAA ratios. Univariate, multivariate and receiver-operating characteristic statistical analyses were performed on the results. RESULTS: A total of 21 LGGs from 31 patients were included in the study, and followed for at least n=14 months during treatment. A total of 18 (86%) patients experienced a decrease in tumour volume with a greater decrease of metabolic ratios. Subsequently, five (28%) of these tumours resumed growth despite the continuation of TMZ administration with an earlier increase of metabolic ratios of 2 months. Three (14%) patients did not show any volume or metabolic change. The evolutions of the metabolic ratios, mean(Cho/Cr)(n) and mean(Cho/NAA)(n), were significantly correlated over time (Spearman ρ=+0.95) and followed a logarithmic regression (P>0.001). The evolutions over time of metabolic ratios, mean(Cho/Cr)(n) and mean(Cho/NAA)(n), were significantly correlated with the evolution of the mean relative decrease of tumour volume, mean(ΔV(n)/V(o)), according to a linear regression (P<0.001) in the 'response/no relapse' patient group, and with the evolution of the mean tumour volume (meanV(n)), according to an exponential regression (P<0.001) in the 'response/relapse' patient group. The mean relative decrease of metabolic ratio, mean(Δ(Cho/Cr)(n)/(Cho/Cr)(o)), at n=3 months was predictive of tumour response over the 14 months of follow-up. The mean relative change between metabolic ratios, mean((Cho/NAA)(n)-(Cho/Cr)(n))/(Cho/NAA)(n), at n=4 months was predictive of tumour relapse with a significant cutoff of 0.046, a sensitivity of 60% and a specificity of 100% (P=0.004). CONCLUSIONS: The (1)H-MRS profile changes more widely and rapidly than tumour volume during the response and relapse phases, and represents an early predictive factor of outcome over 14 months of follow-up. Thus, (1)H-MRS may be a promising, non-invasive tool for predicting and monitoring the clinical response to TMZ.
Asunto(s)
Antineoplásicos Alquilantes/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Dacarbazina/análogos & derivados , Glioma/tratamiento farmacológico , Espectroscopía de Resonancia Magnética/métodos , Adulto , Anciano , Ácido Aspártico/análogos & derivados , Ácido Aspártico/análisis , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patología , Colina/análisis , Creatina/análisis , Dacarbazina/uso terapéutico , Femenino , Glioma/metabolismo , Glioma/patología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Protones , Temozolomida , Resultado del TratamientoRESUMEN
OBJECTIVE: This article shows that functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) are very useful in the in vivo description of the visual pathways using today's most advanced techniques and allowing fusion between fMRI and tractography. Two complementary techniques were combined: (1) DTI coupled with the tractography and (2) fMRI. MATERIALS AND METHODS: A group of 205 cases, normal and pathological, children and adults, were studied for tractographic reconstitution of visual pathways. In addition, 11 patients underwent an acquisition in fMRI (BOLD effect), with a stimulation of a black-and-white flickering checkerboard. Acquisition was carried out on a 3.0 Tesla GEHC MRI unit. Activated arrays of fMRI are overlaid with those of neurotractography (neural tractography) having like results a functional neurotractography. RESULTS AND DISCUSSION: The main components of the visual pathways were successfully reconstructed in tractography: the optic nerves, optic chiasm, optic tracts, and optic radiations. It was also possible to visualize fiber decussation within the chiasma (possible direct pathways to the hypothalamus and thalamus were also identified). CONCLUSIONS: The tensor of diffusion is increasingly used and is a promising technology to improve the diagnosis of neurological diseases. Sophisticated algorithms contribute a new vision of the anatomy, with the possibility of isolating distinct anatomical entities. With the software used, the charts of fMRI activation are overlaid on the anisotropy charts. The tractograms that link two regions of the same functional network thus provide information on subjacent structural connectivity. Consequently, one speaks about functional neurotractography.
Asunto(s)
Imagen de Difusión por Resonancia Magnética , Imagen de Difusión Tensora , Vías Visuales/anatomía & histología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND AND PURPOSE: Previous structural data obtained with diffusion tensor imaging axonal tracking have demonstrated possible in vivo connections between the human red nucleus (RN) and the sensorimotor and associative cortical areas. However, tractographic reconstructions can include false trajectories because of, for instance, the low spatial resolution of diffusion images or the inability to precisely detect fiber crossings. The rubral network was therefore reassessed by functional connectivity during the brain resting state. Because the RN is located very close to the substantia nigra (SN), the nigral network was also studied to ensure that these 2 circuits were correctly dissociated. MATERIALS AND METHODS: Data from 14 right-handed healthy volunteers were acquired at rest and analyzed by region-of-interest (ROI)-based functional connectivity. The blood oxygen level-dependent (BOLD) signal intensity fluctuations of separate ROIs located in the RN and SN were successively used to identify significant temporal correlations with BOLD signal intensity fluctuations of other brain regions. RESULTS: Low-frequency BOLD signal intensity of the RN correlated with signal intensity fluctuations in the cerebellum; mesencephalon; SN; hypothalamus; pallidum; thalamus; insula; claustrum; posterior hippocampus; precuneus; and occipital, prefrontal, and fronto-opercular cortices. Despite some cortical and subcortical overlaps with nigral connectivity, this rubral network was clearly distinct from the nigral network, which showed a strong correlation with the striatum; cerebellar vermis; and more widespread frontal, prefrontal, and orbitofrontal cortical areas. CONCLUSIONS: During the brain resting state, the human RN participates in cognitive circuits related to salience and executive control, and that may partly represent a subclass of its structural connectivity as revealed by tractography.
Asunto(s)
Mapeo Encefálico , Corteza Cerebral/citología , Imagen por Resonancia Magnética , Núcleo Rojo/citología , Descanso , Adulto , Humanos , Vías Nerviosas/citología , Sustancia Negra/citología , Adulto JovenRESUMEN
BACKGROUND AND PURPOSE: The cerebral and cerebellar networks involved in bimanual object recognition were assessed by blood oxygen level-dependent functional MR imaging by using multivariate model-free analysis, because conventional univariate model-based analysis, such as the general linear model (GLM), does not allow investigation of resting, background, and transiently task-related brain activities. MATERIALS AND METHODS: Data from 14 healthy right-handed volunteers, scanned while successively performing bilateral finger movements and a bimanual tactile-tactile matching discrimination task were analyzed by using tensor-independent component analysis (TICA), which computes statistically independent spatiotemporal processes (P > .7) thought to reflect specific and distinct anatomofunctional neural networks. These results were compared with the network obtained in a previous study by using the same paradigm based on GLM to evaluate the advantages of TICA. RESULTS: TICA characterized and distinguished the following: 1) resting-state networks such as the default-mode networks, 2) networks transiently synchronized with the beginning and end of the task, such as temporo-pericentral and temporo-pericentral-occipital networks, and 3) task-related networks such as cerebello-fronto-parietal, cerebello-prefrontocingulo-insular, and cerebello-parietal networks. CONCLUSION: Bimanual tactile-tactile matching discrimination specifically recruits a complex neural network, which can be dissociated into 3 distinct but cooperative neural subnetworks related to sensorimotor function, salience detection, executive control, and, possibly, sensory expectation. This tripartite network involved in bimanual object recognition could not be demonstrated by GLM. Moreover, TICA allowed monitoring of the temporal succession of the networks recruited during the resting phase, audition of the "go" and "stop" signals, and the tactile discrimination task.
Asunto(s)
Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Redes Neurales de la Computación , Reconocimiento en Psicología/fisiología , Estereognosis/fisiología , Tacto/fisiología , Adulto , Atención/fisiología , Mapeo Encefálico , Cerebelo/fisiología , Corteza Cerebral/fisiología , Discriminación en Psicología/fisiología , Femenino , Lateralidad Funcional/fisiología , Humanos , Masculino , Modelos Estadísticos , Red Nerviosa/fisiología , Oxígeno/sangre , Reclutamiento Neurofisiológico/fisiología , Adulto JovenAsunto(s)
Anemia de Células Falciformes/complicaciones , Anomalías Craneofaciales/diagnóstico , Enfermedad de Moyamoya/diagnóstico , Adolescente , Círculo Arterial Cerebral , Anomalías Craneofaciales/complicaciones , Anomalías Craneofaciales/diagnóstico por imagen , Humanos , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Masculino , Enfermedad de Moyamoya/complicaciones , Enfermedad de Moyamoya/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
In a previous study, we showed that the second homunculus in lobule VIII of the cerebellum is activated during bilateral out-of-phase index finger-thumb opposition, implying a role in motor coordination. However, several recent studies indicate that the cerebellum could be more actively involved in sensory information processing during movement. Therefore, as lobule VIII activation could involve either a motor or a proprioceptive component, these two components must be distinguished and their relative contribution must be determined. Using functional imaging, we studied cerebellar activation of the same region during passively induced index finger-thumb opposition of both hands in in-phase and out-of-phase modes, thereby excluding the voluntary movement component. No significant activation was detected in lobule VIII. Intense activation of lobule VIII, obtained during active, out-of-phase bimanual movements, therefore does not involve a significant sensory component related to direct proprioceptive feedback. This result is strongly in favour of the specific recruitment of lobule VIII during out-of-phase movements related more to complex motor timing than to sensory function.
Asunto(s)
Cerebelo/fisiología , Lateralidad Funcional/fisiología , Mano/inervación , Movimiento/fisiología , Desempeño Psicomotor/fisiología , Rango del Movimiento Articular/fisiología , Adulto , Mapeo Encefálico , Cerebelo/anatomía & histología , Cerebelo/irrigación sanguínea , Mano/fisiología , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética/métodos , Oxígeno/sangre , Tiempo de ReacciónRESUMEN
Diffusion tensor MR tractography allows in vivo depiction of anatomical bundles composing the white matter of the brain and of spinal cord. Diffusion MRI uses the effects of heterogeneous water molecule movement to determine for each pixel the main axis and magnitude of local anisotropy. Tractography exploits these data to reconstruct the tridimensional geometry of the bundles providing neurologists with precise information about white matter tract architecture involvement by various pathologies. In this paper, the basic principles of molecular diffusion and the subsequent diffusion tensor that describes its geometrical and quantitative characteristics will be reviewed, in particular within bundles of white matter. Then main principles of diffusion tensor MR imaging and tractography will be presented.
Asunto(s)
Imagen de Difusión por Resonancia Magnética , Sistema Nervioso/anatomía & histología , Fenómenos Biofísicos , Biofisica , HumanosRESUMEN
We used fMRI to study cerebellar activation during index finger-thumb opposition of the right hand and index finger-thumb opposition of both hands in in-phase and out-of-phase modes. The right hand movement activates the contralateral anterior lobe of the cerebellum. During bimanual in-phase movements, this activity pattern becomes bilateral. More interestingly, bilateral out-of-phase movements recruit the cerebellar posterior lobe VIII, which likely corresponds to the second homunculus. As out-of-phase movements differ from the in-phase movements only by their temporal complexity and their attentional awareness, this study demonstrates the preferential involvement of the cerebellar second homunculus in the control of complex movements.
Asunto(s)
Cerebelo/fisiología , Lateralidad Funcional/fisiología , Mano/inervación , Destreza Motora/fisiología , Movimiento/fisiología , Adulto , Atención/fisiología , Mapeo Encefálico , Cerebelo/anatomía & histología , Retroalimentación/fisiología , Mano/fisiología , Humanos , Imagen por Resonancia Magnética , Masculino , Propiocepción/fisiología , Tiempo de Reacción/fisiología , Factores de Tiempo , Percepción del Tiempo/fisiologíaRESUMEN
The dynamic theoretic approach regards motor coordination not as a supervised sequential planning but as a spontaneous self-organized process. Owing only to transitory local interactions between sensorimotor areas (without any pre-existing motor program) a coherent collective neural behavior should emerge and underlie voluntary rhythmic synergies (in our example, bimanual on-phase and out-of-phase movements). Therefore this collective behavior should govern and reflect functional constraints slaving independent movement of effectors in a global synergy. In order to understand such a process, it proves necessary to study movement from the effector level to the cerebral level, by experimentally ascertaining: (1) the set of all possible synergies for a given movement, (2) the order parameters and the control parameters, (3) the task-dependent laws for the movement of each effector, and (4) the general and slaving laws responsible for the synergy itself which must be qualitatively similar to those applying to cerebral collective behavior. This paper tries to introduce experimental results for bimanual rhythmic movements as well as the main theoretic tools issued from dynamics of dissipative systems located far from equilibrium (order parameter, multistability, bifurcation, fluctuation...) used to grasp the self-organized nature of motor synergies.
Asunto(s)
Modelos Biológicos , Movimiento/fisiología , Periodicidad , Humanos , Músculo Esquelético/fisiologíaRESUMEN
Afferent neurotransmission of a given neuronal group and its subsequent dendritic activity are followed by a transient hemodynamic response such as an increase of the local blood flow and of the intravascular level of oxygen. This neurovascular regulation involves neurons, astrocytes, interneurons and various transmitter substances. The resulting changes in the magnetic susceptibility is then detected by the MRI machine which can specifically localize regional brain activity. Blood oxygenation level dependent contrast reflects afferent inputs and their post-synaptic (dendritic) processing, rather than the output from the concerned cerebral zone (spiking). In other words, this contrast depends on local informational treatment of an active zone without implying any effective influence upon its targets.