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PURPOSE OF REVIEW: This review aims to rediscuss the leading theories concerning the role of basal ganglia and the thalamus in the genesis of aphasic symptoms in the absence of gross anatomical lesions in cortical language areas as assessed by conventional neuroimaging studies. RECENT FINDINGS: New concepts in language processing and modern neuroimaging techniques have enabled some progress in resolving the impasse between the current dominant theories: (a) direct and specific linguistic processing and (b) subcortical structures as processing relays in domain-general functions. Of particular interest are studies of connectivity based on functional magnetic resonance imaging (MRI) and tractography that highlight the impact of white matter pathway lesions on aphasia development and recovery. Connectivity studies have put into evidence the central role of the arcuate fasciculus (AF), inferior frontal occipital fasciculus (IFOF), and uncinate fasciculus (UF) in the genesis of aphasia. Regarding the thalamus, its involvement in lexical-semantic processing through modulation of the frontal cortex is becoming increasingly apparent.
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Afasia , Tálamo , Humanos , Afasia/fisiopatologia , Afasia/diagnóstico por imagem , Afasia/etiologia , Afasia/patologia , Tálamo/diagnóstico por imagem , Tálamo/fisiopatologia , Tálamo/patologia , Gânglios da Base/diagnóstico por imagem , Gânglios da Base/fisiopatologia , Gânglios da Base/patologia , Vias Neurais/fisiopatologia , Vias Neurais/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encéfalo/fisiopatologia , Imageamento por Ressonância MagnéticaRESUMO
Abnormal patterns of brain connectivity characterize epilepsy. However, little is known about these patterns during the stages preceding a seizure induced by pentylenetetrazol (PTZ). To investigate brain connectivity in male Wistar rats during the preictal phase of PTZ-induced seizures (60 mg/kg), we recorded local field potentials in the primary motor (M1) cortex, the ventral anterior (VA) nucleus of the thalamus, the hippocampal CA1 area, and the dentate gyrus (DG) during the baseline period and after PTZ administration. While there were no changes in power density between the baseline and preictal periods, we observed an increase in directional functional connectivity in theta from the hippocampal formation to M1 and VA, as well as in middle gamma from DG to CA1 and from CA1 to M1, and also in slow gamma from M1 to CA1. These findings are supported by increased phase coherence between DG-M1 in theta and CA1-M1 in middle gamma, as well as enhanced phase-amplitude coupling of delta-middle gamma in M1 and delta-fast gamma in CA1. Interestingly, we also noted a slight decrease in phase synchrony between CA1 and VA in slow gamma. Together, these results demonstrate increased functional connectivity between brain regions during the PTZ-induced preictal period, with this increase being particularly driven by the hippocampal formation.
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Encéfalo , Pentilenotetrazol , Ratos Wistar , Convulsões , Animais , Pentilenotetrazol/farmacologia , Masculino , Convulsões/induzido quimicamente , Convulsões/fisiopatologia , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Ratos , Vias Neurais/fisiopatologia , Vias Neurais/efeitos dos fármacos , Modelos Animais de Doenças , Eletroencefalografia/métodos , Região CA1 Hipocampal/efeitos dos fármacos , Região CA1 Hipocampal/fisiopatologia , Convulsivantes/toxicidade , Convulsivantes/farmacologia , Ondas Encefálicas/efeitos dos fármacos , Ondas Encefálicas/fisiologia , Córtex Motor/efeitos dos fármacos , Córtex Motor/fisiopatologiaRESUMO
Few resting-state functional magnetic resonance imaging (RS-fMRI) studies evaluated the impact of acute ischemic changes on cerebral functional connectivity (FC) and its relationship with functional outcomes after acute ischemic stroke (AIS), considering the side of lesions. To characterize alterations of FC of patients with AIS by analyzing 12 large-scale brain networks (NWs) with RS-fMRI. Additionally, we evaluated the impact of the side (right (RH) or left (LH) hemisphere) of insult on the disruption of brain NWs. 38 patients diagnosed with AIS (17 RH and 21 LH) who performed 3T MRI scans up to 72 h after stroke were compared to 44 healthy controls. Images were processed and analyzed with the software toolbox UF2C with SPM12. For the first level, we generated individual matrices based on the time series extraction from 70 regions of interest (ROIs) from 12 functional NWs, constructing Pearson's cross-correlation; the second-level analysis included an analysis of covariance (ANCOVA) to investigate differences between groups. The statistical significance was determined with p < 0.05, after correction for multiple comparisons with false discovery rate (FDR) correction. Overall, individuals with LH insults developed poorer clinical outcomes after six months. A widespread pattern of lower FC was observed in the presence of LH insults, while a contralateral pattern of increased FC was identified in the group with RH insults. Our findings suggest that LH stroke causes a severe and widespread pattern of reduction of brain networks' FC, presumably related to the impairment in their long-term recovery.
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Encéfalo , AVC Isquêmico , Imageamento por Ressonância Magnética , Humanos , Feminino , Masculino , AVC Isquêmico/fisiopatologia , AVC Isquêmico/diagnóstico por imagem , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Idoso , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , Lateralidade Funcional/fisiologia , Descanso/fisiologia , Vias Neurais/fisiopatologia , Vias Neurais/diagnóstico por imagem , Adulto , Mapeamento Encefálico/métodosRESUMO
Schizophrenia (SCZ) can be described as a functional dysconnectivity syndrome that affects brain connectivity and circuitry. However, little is known about how sensory stimulation modulates network parameters in schizophrenia, such as their small-worldness (SW) during visual processing. To address this question, we applied graph theory algorithms to multi-electrode EEG recordings obtained during visual stimulation with a checkerboard pattern-reversal stimulus. Twenty-six volunteers participated in the study, 13 diagnosed with schizophrenia (SCZ; mean age = 38.3 years; SD = 9.61 years) and 13 healthy controls (HC; mean age = 28.92 years; SD = 12.92 years). The visually evoked potential (VEP) showed a global amplitude decrease (p < 0.05) for SCZ patients as opposed to HC but no differences in latency (p > 0.05). As a signature of functional connectivity, graph measures were obtained from the Magnitude-Squared Coherence between signals from pairs of occipital electrodes, separately for the alpha (8-13 Hz) and low-gamma (36-55 Hz) bands. For the alpha band, there was a significant effect of the visual stimulus on all measures (p < 0.05) but no group interaction between SCZ and HZ (p > 0.05). For the low-gamma spectrum, both groups showed a decrease of Characteristic Path Length (L) during visual stimulation (p < 0.05), but, contrary to the HC group, only SCZ significantly lowered their small-world (SW) connectivity index during visual stimulation (SCZ p < 0.05; HC p > 0.05). This indicates dysconnectivity of the functional network in the low-gamma band of SCZ during stimulation, which might indirectly reflect an altered ability to react to new sensory input in patients. These results provide novel evidence about a possible electrophysiological signature of the global deficits revealed by the application of graph theory onto electroencephalography in schizophrenia.
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Mapeamento Encefálico , Eletroencefalografia , Vias Neurais , Estimulação Luminosa , Esquizofrenia , Adulto , Humanos , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Esquizofrenia/fisiopatologia , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Potenciais Evocados Visuais , Vias Neurais/fisiopatologiaRESUMO
The 22q11 deletion syndrome is a genetic disorder associated with a high risk of developing psychosis, and is therefore considered a neurodevelopmental model for studying the pathogenesis of schizophrenia. Studies have shown that localized abnormal functional brain connectivity is present in 22q11 deletion syndrome like in schizophrenia. However, it is less clear whether these abnormal cortical interactions lead to global or regional network disorganization as seen in schizophrenia. We analyzed from a graph-theory perspective fMRI data from 40 22q11 deletion syndrome patients and 67 healthy controls, and reconstructed functional networks from 105 brain regions. Between-group differences were examined by evaluating edge-wise strength and graph theoretical metrics of local (weighted degree, nodal efficiency, nodal local efficiency) and global topological properties (modularity, local and global efficiency). Connectivity strength was globally reduced in patients, driven by a large network comprising 147 reduced connections. The 22q11 deletion syndrome network presented with abnormal local topological properties, with decreased local efficiency and reductions in weighted degree particularly in hub nodes. We found evidence for abnormal integration but intact segregation of the 22q11 deletion syndrome network. Results suggest that 22q11 deletion syndrome patients present with similar aberrant local network organization as seen in schizophrenia, and this network configuration might represent a vulnerability factor to psychosis.
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Síndrome da Deleção 22q11/patologia , Conectoma/estatística & dados numéricos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Rede Nervosa/fisiopatologia , Vias Neurais/fisiopatologia , Descanso/fisiologia , Síndrome da Deleção 22q11/genética , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Adulto JovemRESUMO
To determine the role of early acquisition of blood oxygen level-dependent (BOLD) signals and diffusion tensor imaging (DTI) for analysis of the connectivity of the ascending arousal network (AAN) in predicting neurological outcomes after acute traumatic brain injury (TBI), cardiopulmonary arrest (CPA), or stroke. A prospective analysis of 50 comatose patients was performed during their ICU stay. Image processing was conducted to assess structural and functional connectivity of the AAN. Outcomes were evaluated after 3 and 6 months. Nineteen patients (38%) had stroke, 18 (36%) CPA, and 13 (26%) TBI. Twenty-three patients were comatose (44%), 11 were in a minimally conscious state (20%), and 16 had unresponsive wakefulness syndrome (32%). Univariate analysis demonstrated that measurements of diffusivity, functional connectivity, and numbers of fibers in the gray matter, white matter, whole brain, midbrain reticular formation, and pontis oralis nucleus may serve as predictive biomarkers of outcome depending on the diagnosis. Multivariate analysis demonstrated a correlation of the predicted value and the real outcome for each separate diagnosis and for all the etiologies together. Findings suggest that the above imaging biomarkers may have a predictive role for the outcome of comatose patients after acute TBI, CPA, or stroke.
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Transtornos da Consciência , Vias Neurais , Adulto , Idoso , Nível de Alerta , Biomarcadores , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Lesões Encefálicas/fisiopatologia , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/diagnóstico , Coma/diagnóstico por imagem , Coma/etiologia , Coma/fisiopatologia , Estado de Consciência/fisiologia , Transtornos da Consciência/diagnóstico por imagem , Transtornos da Consciência/etiologia , Transtornos da Consciência/fisiopatologia , Imagem de Tensor de Difusão , Feminino , Parada Cardíaca/complicações , Parada Cardíaca/diagnóstico , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Saturação de Oxigênio , Prognóstico , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnósticoRESUMO
From molecular mechanisms to global brain networks, atypical fluctuations are the hallmark of neurodegeneration. Yet, traditional fMRI research on resting-state networks (RSNs) has favored static and average connectivity methods, which by overlooking the fluctuation dynamics triggered by neurodegeneration, have yielded inconsistent results. The present multicenter study introduces a data-driven machine learning pipeline based on dynamic connectivity fluctuation analysis (DCFA) on RS-fMRI data from 300 participants belonging to three groups: behavioral variant frontotemporal dementia (bvFTD) patients, Alzheimer's disease (AD) patients, and healthy controls. We considered non-linear oscillatory patterns across combined and individual resting-state networks (RSNs), namely: the salience network (SN), mostly affected in bvFTD; the default mode network (DMN), mostly affected in AD; the executive network (EN), partially compromised in both conditions; the motor network (MN); and the visual network (VN). These RSNs were entered as features for dementia classification using a recent robust machine learning approach (a Bayesian hyperparameter tuned Gradient Boosting Machines (GBM) algorithm), across four independent datasets with different MR scanners and recording parameters. The machine learning classification accuracy analysis revealed a systematic and unique tailored architecture of RSN disruption. The classification accuracy ranking showed that the most affected networks for bvFTD were the SN + EN network pair (mean accuracy = 86.43%, AUC = 0.91, sensitivity = 86.45%, specificity = 87.54%); for AD, the DMN + EN network pair (mean accuracy = 86.63%, AUC = 0.89, sensitivity = 88.37%, specificity = 84.62%); and for the bvFTD vs. AD classification, the DMN + SN network pair (mean accuracy = 82.67%, AUC = 0.86, sensitivity = 81.27%, specificity = 83.01%). Moreover, the DFCA classification systematically outperformed canonical connectivity approaches (including both static and linear dynamic connectivity). Our findings suggest that non-linear dynamical fluctuations surpass two traditional seed-based functional connectivity approaches and provide a pathophysiological characterization of global brain networks in neurodegenerative conditions (AD and bvFTD) across multicenter data.
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Doença de Alzheimer/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Conectoma , Função Executiva , Demência Frontotemporal/diagnóstico por imagem , Vias Neurais/diagnóstico por imagem , Idoso , Doença de Alzheimer/fisiopatologia , Teorema de Bayes , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Rede de Modo Padrão/diagnóstico por imagem , Rede de Modo Padrão/fisiopatologia , Vias Eferentes/diagnóstico por imagem , Vias Eferentes/fisiopatologia , Feminino , Demência Frontotemporal/fisiopatologia , Neuroimagem Funcional , Humanos , Aprendizado de Máquina , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/fisiopatologia , Vias Visuais/diagnóstico por imagem , Vias Visuais/fisiopatologiaRESUMO
OBJECTIVE: Individuals with Parkinson's disease (PD) and freezing of gait (FOG) present peripheral and central sensitivity disturbances that impair motor performance. This study aimed to investigate long-term effects of plantar sensory stimulation on brain activity, brain connectivity, and gait velocity of individuals with PD and FOG. METHODS: Twenty-five participants were enrolled in this clinical trial (NCT02594540). Plantar sensory stimulation was delivered using the Automated Mechanical Peripheral Stimulation therapy (AMPS). Volunteers were randomly assigned to real or placebo AMPS groups and received eight sessions of treatment. The primary outcome was brain activity (task-based fMRI-active ankle dorsi-plantar flexion). Secondary outcomes were brain connectivity (resting state-RS fMRI) and gait velocity. fMRI was investigated on the left, right, and mid-sensory motor regions, left and right basal ganglia. RESULTS: No changes in brain activity were observed when task-based fMRI was analyzed. After real AMPS, RS functional connectivity between basal ganglia and sensory-related brain areas increased (insular and somatosensory cortices). Gait velocity also increased after real AMPS. A positive correlation was found between gait velocity and the increased connectivity between sensory, motor and supplementary motor cortices. CONCLUSION: Plantar sensory stimulation through AMPS was not able to modify brain activity. AMPS increased the RS brain connectivity mainly in areas related to sensory processing and sensorimotor integration. Plantar stimulation could be a way to improve plantar sensitivity and consequently ameliorate gait performance. However, the mechanisms behind the way AMPS influences brain pathways are still not completely known.
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Pé , Vias Neurais/fisiopatologia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/terapia , Estimulação Física/métodos , Idoso , Idoso de 80 Anos ou mais , Gânglios da Base/fisiopatologia , Método Duplo-Cego , Feminino , Marcha , Transtornos Neurológicos da Marcha/diagnóstico por imagem , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Motor/fisiopatologia , Vias Neurais/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , Resultado do TratamentoRESUMO
The significant public health burden associated with late-life depression (LLD) is magnified by the high rates of recurrence. In this manuscript, we review what is known about recurrence risk factors, conceptualize recurrence within a model of homeostatic disequilibrium, and discuss the potential significance and challenges of new research into LLD recurrence. The proposed model is anchored in the allostatic load theory of stress. We review the allostatic response characterized by neural changes in network function and connectivity and physiologic changes in the hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system, and circadian rhythm. We discuss the role of neural networks' instability following treatment response as a source of downstream disequilibrium, triggering and/or amplifying abnormal stress response, cognitive dysfunction and behavioral changes, ultimately precipitating a full-blown recurrent episode of depression. We propose strategies to identify and capture early change points that signal recurrence risk through mobile technology to collect ecologically measured symptoms, accompanied by automated algorithms that monitor for state shifts (persistent worsening) and variance shifts (increased variability) relative to a patient's baseline. Identifying such change points in relevant sensor data could potentially provide an automated tool that could alert clinicians to at-risk individuals or relevant symptom changes even in a large practice.
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Alostase , Encéfalo/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Estresse Psicológico/fisiopatologia , Idoso , Sistema Nervoso Autônomo , Ritmo Circadiano , Homeostase , Humanos , Sistema Hipotálamo-Hipofisário , Modelos Neurológicos , Modelos Psicológicos , Vias Neurais/fisiopatologia , Sistema Hipófise-Suprarrenal , RecidivaRESUMO
This study aimed to explore the structural and functional characteristics of the neural network of resting-state brain activities in patients with amnestic mild cognitive impairment (aMCI) by functional magnetic resonance imaging (fMRI) technology. Resting state fMRI scanning was performed on 10 clinically diagnosed aMCI patients and 10 healthy volunteers, and the difference in the resting-state brain activities between aMCI patients and healthy volunteers was compared using the brain function network regional homogeneity (ReHo) analysis method. Results of the ReHo analysis of aMCI patients and healthy volunteers revealed that the ReHo value significantly increased in the posterior cingulate gyrus region, medial frontal lobe, medial cortex of the prefrontal lobe, and part of the parietal lobe. Compared with the normal elderlies, ReHo decreased in aMCI patients in the left temporal lobe (middle temporal gyrus and inferior temporal gyrus), left parahippocampal gyrus, occipital lobe, lingual gyrus, precuneus, and other regions while ReHo increased in regions of the right frontal lobe (inferior frontal gyrus), left superior temporal gyrus, precentral gyrus (frontal lobe), right thalamus, left fusiform gyrus, and other regions. In the resting state, there may be regional abnormalities in brain functional areas in aMCI patients, which may be associated with cognitive impairment.
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Encéfalo/fisiologia , Disfunção Cognitiva/fisiopatologia , Idoso , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/fisiopatologiaRESUMO
OBJECTIVE: It is still unclear how temporal lobe epilepsy (TLE) with and without hippocampal atrophy (HA) affects cortical language distribution. We aimed to investigate the role of the hippocampus on language lateralization, activation pattern, and functional connectivity (FC) in patients with TLE. METHODS: We investigated 93 patients with TLE-divided into right HA (RHA), left HA (LHA), and negative magnetic resonance imaging (MRI) (non-HA)-and 101 controls using a semantic-language functional MRI (fMRI) task and the Boston Naming Test (BNT). RESULTS: Groups did not differ in the frequency of atypical language lateralization (LL), which correlated differently with handedness in each brain region and group. Blood-oxygen-level dependend (BOLD) activation patterns and region of interest (ROI)-to-ROI FC differed between LHA and controls, as well as between LHA and non-HA patients. In the task activation pattern analysis, there was a decrease in the activation of patients with LHA relative to controls, exactly in the left hippocampus. However, non-HA patients had increased FC relative to controls in the left superior temporal gyrus region. Seed-to-voxel FC demonstrated greater differences between patients and controls and smaller differences among patient groups. The non-HA group was similar to controls, except for increased BOLD activation and increase FC in the superior temporal gyri. RHA and LHA differed from controls in BNT. BNT correlated with fMRI activation in RHA and non-HA groups. SIGNIFICANCE: LHA affected naming performance, fMRI semantic task activation pattern, and FC more than RHA and non-HA. Contrary to our expectations, LHA did not increase the frequency of atypical LL. Regardless of the side, HA impacts negatively on the language network but not on hemispheric language lateralization.
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Epilepsia do Lobo Temporal/patologia , Epilepsia do Lobo Temporal/fisiopatologia , Lateralidade Funcional/fisiologia , Hipocampo/patologia , Hipocampo/fisiopatologia , Atrofia/patologia , Feminino , Humanos , Idioma , Imageamento por Ressonância Magnética/métodos , Masculino , Vias Neurais/patologia , Vias Neurais/fisiopatologiaRESUMO
Although primary progressive aphasia (PPA) is clinically typified by linguistic impairments, emerging evidence highlights the presence of early deficits in social cognition. This review systematically describes the latter patterns, specifying their relation to the characteristic linguistic dysfunctions and atrophy patterns of non-fluent, semantic, and logopenic variants of the disease (nfvPPA, svPPA, and lvPPA, respectively), relative to closely related dementia types. Whereas the evidence on lvPPA proves scant, studies on nfvPPA and svPPA patients show consistent deficits in emotion recognition, theory of mind, and empathy. Notably, these seem to be intertwined with language impairments in nfvPPA, but they prove primary and independent of language disturbances in svPPA. Also, only the profile of svPPA resembles that of behavioral variant frontotemporal dementia, probably reflecting the overlap of fronto-temporal disruptions in both conditions. In short, the neurocognitive relationship between linguistic and socio-cognitive deficits cannot be precisely predicated for PPA as a whole; instead, specific links must be acknowledged in each variant. These emergent patterns pave the way for fruitful dimensional research in the field.
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Afasia Primária Progressiva/fisiopatologia , Afasia Primária Progressiva/psicologia , Encéfalo/fisiopatologia , Emoções , Comportamento Social , Empatia , Humanos , Relações Interpessoais , Vias Neurais/fisiopatologia , Reconhecimento Psicológico , Teoria da MenteRESUMO
Contemporary neurocognitive models of drug addiction have associated this condition with changes in interoception -namely, the sensing and processing of body signals that fulfill homeostatic functions relevant for the onset and maintenance of addictive behavior. However, most previous evidence is inconsistent, behaviorally unspecific, and virtually null in terms of direct electrophysiological and multimodal markers. To circumvent these limitations, we conducted the first assessment of the relation between cardiac interoception and smoked cocaine dependence (SCD) in a sample of (a) 25 participants who fulfilled criteria for dependence on such a drug, (b) 22 participants addicted to insufflated clorhidrate cocaine (only for behavioral assessment), and (c) 25 healthy controls matched by age, gender, education, and socioeconomic status. We use a validated heartbeat-detection (HBD) task and measured modulations of the heart-evoked potential (HEP) during interoceptive accuracy and interoceptive learning conditions. We complemented this behavioral and electrophysiological data with offline structural (MRI) and functional connectivity (fMRI) analysis of the main interoceptive hubs. HBD and HEP results convergently showed that SCD subjects presented ongoing psychophysiological measures of enhanced interoceptive accuracy. This pattern was associated with a structural and functional tuning of interoceptive networks (reduced volume and specialized network segregation). Taken together, our findings provide the first evidence of an association between cardiac interoception and smoked cocaine, partially supporting models that propose hyper-interoception as a key aspect of addiction. More generally, our study shows that multimodal assessments of interoception could substantially inform the clinical and neurocognitive characterization of psychophysiological and neurocognitive adaptations triggered by addiction.
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Transtornos Relacionados ao Uso de Cocaína/fisiopatologia , Potenciais Evocados/fisiologia , Interocepção/fisiologia , Vias Neurais/fisiopatologia , Administração por Inalação , Cocaína/administração & dosagem , Transtornos Relacionados ao Uso de Cocaína/psicologia , Endofenótipos , Feminino , Frequência Cardíaca/fisiologia , Humanos , Aprendizagem/fisiologia , Imageamento por Ressonância Magnética , Masculino , Neuroimagem , Adulto JovemRESUMO
OBJECTIVE: To analyze the lifetime trajectories in genetic generalized epilepsies (GGEs) and investigate the impact of symptoms of anxiety and depression on resting state functional connectivity (FC). METHODS: Seventy-four GGE patients were classified according to the pharmacological response as seizure-free (12 patients), pharmacoresistant (PhR; 14 patients), and fluctuating (FL; 48 patients). Fifty-four subjects completed both the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), and 38 also underwent 3-T resting state functional magnetic resonance imaging. These 38 patients were subdivided into a positive group (13 patients with concurrent symptoms of depression and anxiety) and a negative group (21 asymptomatic patients and four with mild anxiety or depression symptoms). For FC analysis of resting state networks, we matched 38 healthy asymptomatic volunteers and used the UF2C toolbox running on MATLAB2017/SPM12. RESULTS: The PhR group presented shorter duration of epilepsy (P = 0.016) and follow-up (P < 0.001) compared to the FL group. The PhR group showed higher levels (median = 20) on the BAI and BDI. Myoclonic seizures were the most difficult to control, as 50% of subjects persisted with them at last appointment, compared to generalized tonic-clonic seizures and absence seizures (<40%). Patients with concurrent anxiety and depression symptoms were 7.7 times more likely to exhibit pharmacoresistant seizures, although an increase of 1 year of epilepsy duration was associated with a decrease in the odds of presenting pharmacoresistance by a factor of 0.9. Overall, FC was altered between default mode network (DMN) and visuospatial/dorsal attention. However, only the positive group displayed abnormal FC between DMN and left executive control network, and between salience and visuospatial/dorsal attention. SIGNIFICANCE: Our findings may help clinicians to have a better understanding of GGE clinical course and increase attention to the potential relationship of psychopathologies and brain connectivity.
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Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Depressão/fisiopatologia , Epilepsia Generalizada/fisiopatologia , Epilepsia Generalizada/psicologia , Adolescente , Adulto , Ansiedade/complicações , Criança , Depressão/complicações , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Vias Neurais/fisiopatologia , Adulto JovemRESUMO
Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by obsessions and/or compulsions. Different striatal subregions belonging to the cortico-striato-thalamic circuitry (CSTC) play an important role in the pathophysiology of OCD. The transcriptomes of 3 separate striatal areas (putamen (PT), caudate nucleus (CN) and accumbens nucleus (NAC)) from postmortem brain tissue were compared between 6 OCD and 8 control cases. In addition to network connectivity deregulation, different biological processes are specific to each striatum region according to the tripartite model of the striatum and contribute in various ways to OCD pathophysiology. Specifically, regulation of neurotransmitter levels and presynaptic processes involved in chemical synaptic transmission were shared between NAC and PT. The Gene Ontology terms cellular response to chemical stimulus, response to external stimulus, response to organic substance, regulation of synaptic plasticity, and modulation of synaptic transmission were shared between CN and PT. Most genes harboring common and/or rare variants previously associated with OCD that were differentially expressed or part of a least preserved coexpression module in our study also suggest striatum subregion specificity. At the transcriptional level, our study supports differences in the 3 circuit CSTC model associated with OCD.
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Núcleo Caudado , Vias Neurais/fisiopatologia , Núcleo Accumbens , Transtorno Obsessivo-Compulsivo/fisiopatologia , Putamen , Transcriptoma , Idoso , Idoso de 80 Anos ou mais , Mapeamento Encefálico/métodos , Estudos de Casos e Controles , Núcleo Caudado/metabolismo , Núcleo Caudado/fisiopatologia , Feminino , Perfilação da Expressão Gênica/métodos , Humanos , Masculino , Núcleo Accumbens/metabolismo , Núcleo Accumbens/fisiopatologia , Putamen/metabolismo , Putamen/fisiopatologiaRESUMO
For more than half a century, stereotactic neurosurgical procedures have been available to treat patients with severe, debilitating symptoms of obsessive-compulsive disorder (OCD) that have proven refractory to extensive, appropriate pharmacological, and psychological treatment. Although reliable predictors of outcome remain elusive, the establishment of narrower selection criteria for neurosurgical candidacy, together with a better understanding of the functional neuroanatomy implicated in OCD, has resulted in improved clinical efficacy for an array of ablative and non-ablative intervention techniques targeting the cingulum, internal capsule, and other limbic regions. It was against this backdrop that gamma knife capsulotomy (GKC) for OCD was developed. In this paper, we review the history of this stereotactic radiosurgical procedure, from its inception to recent advances. We perform a systematic review of the existing literature and also provide a narrative account of the evolution of the procedure, detailing how the procedure has changed over time, and has been shaped by forces of evidence and innovation. As the procedure has evolved and adverse events have decreased considerably, favorable response rates have remained attainable for approximately one-half to two-thirds of individuals treated at experienced centers. A reduction in obsessive-compulsive symptom severity may result not only from direct modulation of OCD neural pathways but also from enhanced efficacy of pharmacological and psychological therapies working in a synergistic fashion with GKC. Possible complications include frontal lobe edema and even the rare formation of delayed radionecrotic cysts. These adverse events have become much less common with new radiation dose and targeting strategies. Detailed neuropsychological assessments from recent studies suggest that cognitive function is not impaired, and in some domains may even improve following treatment. We conclude this review with discussions covering topics essential for further progress of this therapy, including suggestions for future trial design given the unique features of GKC therapy, considerations for optimizing stereotactic targeting and dose planning using biophysical models, and the use of advanced imaging techniques to understand circuitry and predict response. GKC, and in particular its modern variant, gamma ventral capsulotomy, continues to be a reliable treatment option for selected cases of otherwise highly refractory OCD.
Assuntos
Cápsula Interna/cirurgia , Transtorno Obsessivo-Compulsivo/cirurgia , Transtorno Obsessivo-Compulsivo/terapia , Lobo Frontal/fisiopatologia , Humanos , Vias Neurais/fisiopatologia , Testes Neuropsicológicos , Procedimentos Neurocirúrgicos/métodos , Transtorno Obsessivo-Compulsivo/fisiopatologia , Radiocirurgia/métodos , Resultado do TratamentoRESUMO
Graph theory has been extensively applied to investigate complex brain networks in current neuroscience research. Many metrics derived from graph theory, such as local and global efficiencies, are based on the path length between nodes. These approaches are commonly used in analyses of brain networks assessed by resting-state functional magnetic resonance imaging, although relying on the strong assumption that information flow throughout the network is restricted to the shortest paths. In this study, we propose the utilization of commute time as a tool to investigate regional centrality on the functional connectome. Our initial hypothesis was that an alternative approach that considers alternative routes (such as commute time) could provide further information into the organization of functional networks. However, our empirical findings on the ADHD-200 database suggest that at the group level, the commute time and shortest path are highly correlated. In contrast, at the subject level, we discovered that commute time is much less susceptible to head motion artifacts when compared with metrics based on shortest paths. Given the overall similarity between the measures, we argue that commute time might be advantageous particularly for connectomic studies in populations where motion artifacts are a major issue.
Assuntos
Conectoma/métodos , Vias Neurais/fisiopatologia , Neuroimagem/métodos , Adolescente , Algoritmos , Encéfalo/fisiopatologia , Criança , Biologia Computacional/métodos , Bases de Dados Factuais , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Modelos Neurológicos , Rede Nervosa/fisiopatologiaRESUMO
This study aimed to explore the structural and functional characteristics of the neural network of resting-state brain activities in patients with amnestic mild cognitive impairment (aMCI) by functional magnetic resonance imaging (fMRI) technology. Resting state fMRI scanning was performed on 10 clinically diagnosed aMCI patients and 10 healthy volunteers, and the difference in the resting-state brain activities between aMCI patients and healthy volunteers was compared using the brain function network regional homogeneity (ReHo) analysis method. Results of the ReHo analysis of aMCI patients and healthy volunteers revealed that the ReHo value significantly increased in the posterior cingulate gyrus region, medial frontal lobe, medial cortex of the prefrontal lobe, and part of the parietal lobe. Compared with the normal elderlies, ReHo decreased in aMCI patients in the left temporal lobe (middle temporal gyrus and inferior temporal gyrus), left parahippocampal gyrus, occipital lobe, lingual gyrus, precuneus, and other regions while ReHo increased in regions of the right frontal lobe (inferior frontal gyrus), left superior temporal gyrus, precentral gyrus (frontal lobe), right thalamus, left fusiform gyrus, and other regions. In the resting state, there may be regional abnormalities in brain functional areas in aMCI patients, which may be associated with cognitive impairment.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Encéfalo/fisiologia , Disfunção Cognitiva/fisiopatologia , Processamento de Imagem Assistida por Computador , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Imageamento por Ressonância Magnética , Disfunção Cognitiva/diagnóstico por imagem , Vias Neurais/fisiopatologiaRESUMO
Purpose Despite antiretroviral therapy, approximately half of individuals with human immunodeficiency virus (HIV) will develop HIV-associated neurocognitive disorder (HAND). Efficiency of brain networks is of great importance for cognitive functioning, since functional networks may reorganize or compensate to preserve normal cognition. This study aims to compare efficiency of the posterior cingulate cortex (PCC) between patients with and without HAND and controls. We hypothesize HAND negative (HAND-) patients will show higher PCC efficiency than HAND positive (HAND+) patients. Methods A total of 10 HAND + patients were compared with 9 HAND- patients and 17 gender-, age-, and education-matched controls. Resting-state functional MRI was acquired with a 3 Tesla scanner. Local efficiency, a measure of network functioning, was investigated for PCC. Network differences among HAND + , HAND- patients and controls were tested as well as correlations between network parameters and cognitive test performance in different domains. Results HAND- patients showed significantly increased PCC efficiency compared with healthy controls ( p = 0.015). No differences were observed between HAND + patients and either controls ( p = 0.327) or HAND- patients ( p = 0.152). In HAND- patients, PCC efficiency was positively related with cognitive performance in the attention/working memory domain ( p = 0.003). Conversely, in HAND + patients, PCC efficiency was negatively correlated with performance in the abstraction/executive domain ( p = 0.002). Conclusion HAND- patients showed a higher level of PCC efficiency compared with healthy subjects, and PCC efficiency was positively related to cognitive performance. These results support the functional reorganization hypothesis, that increased PCC efficiency is a compensation technique to maintain cognitive functioning.
Assuntos
Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Giro do Cíngulo/fisiopatologia , Infecções por HIV/fisiopatologia , Infecções por HIV/psicologia , Análise de Variância , Mapeamento Encefálico , Cognição/fisiologia , Disfunção Cognitiva/diagnóstico por imagem , Estudos de Coortes , Estudos Transversais , Feminino , Giro do Cíngulo/diagnóstico por imagem , Infecções por HIV/complicações , Infecções por HIV/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Testes Neuropsicológicos , DescansoRESUMO
Aim: Many particularities concerning interhemispheric differences still need to be explored and unveiled. Functional and anatomical differential features found between left and right brain sides are best known as asymmetries and are consequence of the unilateral neuronal recruitment or predominance that is set to organize some function. The outflow from different neural pathways involved in the autonomic control of the cardiovascular system may route through asymmetrically relayed efferences (ipsilateral/lateralized and/or contralateral). In spite of this, the literature reporting on the role of central nuclei involved in the autonomic control is not always dedicated on these interhemispheric comparisons. Considering the recent reports demonstrating that asymmetries may set differential functional responses, it is worth checking differences between right and left sides of central regions. This review aims to inspire neuroscientists with the idea that studying the interhemispheric differences may deepen the understanding on several centrally controlled responses, with special regard to the autonomic functions underlying the cardiovascular regulation. Conclusions: Thus, an avenue of knowledge may unfold from a field of research that requires further exploration.