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PubMed2001

Neuroimaging findings in mild traumatic brain injury.

The role of neuroimaging in the diagnosis and management of mild traumatic brain injury (TBI) is evolving. In general, the structural imaging techniques play a role in acute diagnosis and management, while the functional imaging techniques show promise for clarification of pathophysiology, symptom genesis, and mechanisms of recovery. A wide array of neuropathological processes are involved in mild TBI including changes in bone (e.g., a skull fracture), tissue density and water content (edema), blood flow, white matter integrity and pathway connectivity (diffuse axonal injury), and subtle changes in the neuronal and extracellular biochemical milieu. No single imaging technique is capable of addressing all these processes. It is, therefore, important to be aware of the advantages and limitations of the various available imaging modalities. This paper selectively reviews the pertinent literature on the structural and functional imaging in mild TBI.

Brain↗
PubMed2004

Functional brain imaging and the induction of traumatic recall: a cross-correlational review between neuroimaging and hypnosis.

The behavioral and psychophysiological alterations during recall in patients with trauma disorders often resemble phenomena that are seen in hypnosis. In studies of emotional recall as well as in neuroimaging studies of hypnotic processes similar brain structures are involved: thalamus, hippocampus, amygdala, medial prefrontal cortex, anterior cingulate cortex. This paper focuses on cross-correlations in traumatic recall and hypnotic responses and reviews correlations between the involvement of brain structures in traumatic recall and processes that are involved in hypnotic responsiveness. To further improve uniformity of results of brain imaging specifically for traumatic recall studies, attention is needed for standardization of hypnotic variables, isolation of the emotional process of interest (state),and assessment of trait-related differences.

Brain↗
PubMed1998

Serial neuroimaging studies in Sotos syndrome (cerebral gigantism syndrome).

To elucidate the mechanism of excessive size of the head in Soto syndrome, serial neuroimaging features from birth were reviewed in two patients. Macrocephaly shortly after birth was attributed to increased volume of the cerebral parenchyma itself (megalencephalon). Subsequent excessive size of the head was related to retention of cerebrospinal fluid in the ventricles and the subarachnoid spaces. Thus, macrocephaly in Sotos syndrome reflects two different mechanisms. The value of serial evaluation of intracranial structures is emphasized.

Brain↗
PubMed2000

Neuroimaging variables related to development of Secondary Attention Deficit Hyperactivity Disorder after closed head injury in children and adolescents.

OBJECTIVE: To characterize children who develop Secondary Attention Deficit Hyperactivity Disorder (S-ADHD) after severe and moderate closed head injury (CHI) according to neuroimaging variables. METHOD: Ninety-nine children from 4-19 years who suffered severe and moderate CHI were prospectively followed for a year after injury. Premorbid psychiatric status was determined by administration to the parent of a structured psychiatric interview. This interview was readministered 1 year after injury to determine the presence of post-closed head injury S-ADHD. An MRI was performed 3 months after injury to define lesion locations and volumes. RESULTS: A set of multiple logistic regression models determined that the odds of developing S-ADHD were 3.64 times higher among children with thalamus injury, and 3.15 times higher among children with basal ganglia injury. There was no significant difference in lesion volumes in any of the locations of interest between the group who developed S-ADHD and the group who did not develop S-ADHD. CONCLUSION: The data support an association between S-ADHD and injury in either or both the thalamus and basal ganglia, but they do not definitively demonstrate whether injury in either structure has an effect on S-ADHD in the absence of injury in the other.

Adolescent↗
PubMed1996

Traumatic brain injury, alcohol and quantitative neuroimaging: preliminary findings.

Magnetic resonance (MR) quantitative neuroimaging analysis was undertaken with a large group of normal (n = 197) and traumatically brain injured (TBI, n = 99) adults. Of the TBI subjects 18 patients were identified with a history of substance-related abuse (TBI/Abuse group). Both the TBI/ Abuse group and the remaining sample of TBI patients (n = 81, TBI/Non-abuse group) without a history of substance-related abuse differed significantly from the control group on most quantitative MR imaging analyses. The TBI/Abuse group displayed the greatest degree of atrophic change. However, the TBI/Abuse group had a significantly lower Glasgow Coma Scale (GCS) score, ostensibly suggesting that those with substance-related abuse suffered more severe brain injury than non-abuse TBI patients. When a subset (n = 18) of the TBI/Non-abuse group was matched by GCS, gender and age to the TBI/Abuse group, both groups differed significantly from the control group on most morphometric measures, but did not differ from one another. Results are discussed in terms of the potential adverse role that substance-related abuse, particularly alcohol, plays in the individual who sustains traumatic injury to the brain.

Adolescent↗
PubMed2006

Neuroimaging in human amblyopia.

Functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and magnetoencephalography (MEG) have been the principal neuroimaging tools used to assess the site and nature of cortical deficits in human amblyopia. A review of this growing body of work is presented here with particular reference to various controversial issues, including whether or not the primary visual cortex is dysfunctional, the involvement of higher-order visual areas, neural differences between strabismic and anisometropic amblyopes, and the effects of modern-day drug treatments. We also present our own recent MEG work in which we used the analysis technique of synthetic aperture magnetometry (SAM) to examine the effects of strabismic amblyopia on cortical function. Our results provide evidence that the neuronal assembly associated with form perception in the extrastriate cortex may be dysfunctional in amblyopia, and that the nature of this dysfunction may relate to a change in the normal temporal pattern of neuronal discharges. Based on these results and existing literature, we conclude that a number of cortical areas show reduced levels of activation in amblyopia, including primary and secondary visual areas and regions within the parieto-occipital cortex and ventral temporal cortex.

Amblyopia↗
PubMed2005

Neuropsychological profile and neuroimaging in patients with 22Q11.2 Deletion Syndrome: a review.

22q11.2 Deletion Syndrome is associated with cognitive, behavioural, and psychiatric problems and is known to affect brain structure. Recently, 22q11.2 Deletion Syndrome has been proposed as a disease model for a genetic subtype of schizophrenia. In this paper we discuss the currently available literature on neurocognitive functioning and brain anatomy in patients with 22q11.2 Deletion Syndrome, and how this contributes to our understanding of the neurobiology of schizophrenia. Research on cognitive functioning in 22q11.2 Deletion Syndrome patients suggests a specific cognitive profile with impairments on arithmetical, visuo-spatial, and executive tasks and relatively preserved language skills. Prominent findings of neuroimaging studies in 22q11.2 Deletion Syndrome patients are: reduction of overall brain volume, midline defects, structural alterations of cerebellum and frontal lobe, white matter abnormalities, and decreased grey matter volumes in parietal and temporal areas. We describe how brain abnormalities in patients with 22q11.2 Deletion Syndrome may contribute to the understanding of the clinical syndrome including cognitive impairments, psychotic symptoms, and social and communication problems.

Brain↗
PubMedDate not supplied

Multimodal neuroimaging studies and neurodevelopment and neurodegeneration hypotheses of schizophrenia.

The interpretation of the huge number of results in schizophrenia research using neuroimaging is uncertain. However, the simultaneous use of complimentary data obtained with these techniques may yield more relevant information in this regard. In this paper we present a series of studies performed by our group in two schizophrenic samples with the use of structural (magnetic resonance imaging, MRI), functional [glucose positron emission tomography (PET) and N-acetyl-aspartate (NAA) magnetic resonance spectrocopy] and neurophysiological techniques (the P300 event-related potential). Transversal and longitudinal measurements were performed.The integrated vision of the results so obtained allows us to propose the hypothesis of a neurodevelopmentally determined state of prefrontal disinihibition, in which the degree of atrophy would directly relate to the metabolic rate. This state would already be present in the first stages of illness and could have neurotoxic consequences in the long term. This would explain the findings of an association between sulcal cerebrospinal fluid (CSF) and illness duration and decreased NAA levels in chronic but not in recent-onset cases. The prefrotnal disinhibition would overstimulate the limbic system and the hippocampus would become overactivated, the metabolic rate at this level being inversely related to P300 amplitude. Clozapine showed a more selective and intense action on that hyperactive metabolic tone than haloperidol.

Journal Article↗
PubMed2005

Neuroimaging studies of brain corpus striatum changes among heroin-dependent patients treated with herbal medicine, U'finer capsule.

Chronic exposure to heroin is associated with structural changes in dopaminergic (DA) neurones. The present study examined the effects of a new herbal medicine, U'finer capsule, on the brain corpus striatum and DA systems, comparing pre- and post- treatment in 36 heroin-dependent patients. Neuroimaging studies were performed by using single photon emission computed tomography (SPECT) with 99mTc-TRODAT-1 as radiotracer. The results show that U'finer significantly repaired the damaged bilateral corpus striatum, restoring it to a 'panda eye' shape, analogous in size and shape to that of the healthy volunteers. DA transporter (DAT) function in the bilateral corpus striatum was restored to a normal state after recovery from neurotoxic insult. These findings suggest that U'finer is a reliable herbal medicine in the treatment of heroin dependency.

Adult↗
PubMedDate not supplied

Neuroimaging predictors of dementia in stroke patients.

The risk of dementia is increased in stroke patients. Dementia syndromes associated with cerebrovascular diseases were commonly recognized as an immediate consequence of stroke. However, more and more data suggest that degenerative pathology and white matter changes (WMC) may play a role in the development of dementia in stroke patients. The aim of this paper was to review the literature concerning the neuroimaging predictors of dementia in stroke patients. From the literature data, it appears that although vascular lesions alone may lead to dementia, in stroke patients, no clear association between stroke location and size has yet been identified, even if the role of the left hemisphere has been suggested. The influence of silent infarcts remains undetermined while more and more data suggest that global cerebral atrophy and WMC are predictive factors of post-stroke dementia (PSD). The influence of medial temporal lobe atrophy on the risk of PSD has until now never been evaluated.

Dementia, Vascular↗
PubMed2000

Persistence of cryptococcomas on neuroimaging.

Three previously normal patients with cryptococcal meningitis had intracranial lesions on computed tomography and magnetic resonance imaging that persisted for >5 years after successful cure with antifungal drugs. Persistence of lesions on neuroimaging should not be misinterpreted as evidence of active cryptococcosis.

Adolescent↗
PubMed1999

A functional neuroimaging study of the variables that generate category-specific object processing differences.

Brain damage can cause remarkably selective deficits in processing specific categories of objects, indicating the high degree of functional segregation within the brain. The neuroimaging study presented here investigates differences in the neural activity associated with two categories of natural objects (animals and fruit) and two categories of man-made objects (vehicles and tools). Stimuli were outline drawings and the tasks were naming and word-picture matching. For man-made objects, the only category-specific effect was in the left posterior middle temporal cortex, which was most active for drawings of tools, as previously reported. For natural objects, drawings of animals and fruit (relative to drawings of man-made objects) enhanced activity in bilateral anterior temporal and right posterior middle temporal cortices. Critically, these effects with natural objects were not observed when the stimuli were coloured appropriately to facilitate identification. Furthermore, activation in the same right hemisphere areas was also observed for viewing and matching unfamiliar non-objects relative to naming and matching man-made objects. These results indicate that, in the right hemisphere, differences between processing natural relative to man-made objects overlap with the effects of increasing demands on object identification. In the left hemisphere, the effects are more consistent with functional specialization within the semantic system. We discuss (i) how category-specific differences can emerge for multiple reasons and (ii) the implications of these effects on the interpretation of functional imaging data and patients with category-specific deficits.

Adult↗
PubMed2000

Atypical and typical presentations of Alzheimer's disease: a clinical, neuropsychological, neuroimaging and pathological study of 13 cases.

There has been increasing awareness that some slowly progressive focal cortical syndromes can be the presenting features of Alzheimer's disease, but pathological evidence has been sparse. This clinico-pathological series presents our experience with pathologically proven atypical as well as typical Alzheimer's disease presentations. We report and compare four patterns of presentation: a typical pattern with initial amnesic syndrome (n = 4 cases), progressive visual dysfunction (n = 1), progressive biparietal syndrome (n = 2) and progressive aphasia (n = 6). The aphasic presentations include both fluent and non-fluent aphasic syndromes. The neuropsychological profiles and neuroimaging clearly reflect the presenting clinical features, and show a close relationship to the distribution of pathology in these cases. Of note was the sparing of medial temporal structures (hippocampus and/or entorhinal cortex) in several aphasic cases and the severe occipito-parietal involvement in those with prominent visuospatial disorders at presentation. Our data demonstrate the wide spectrum of Alzheimer's disease presentations. The recognition of atypical presentations of Alzheimer's disease is important when attempting to make an early accurate pre-morbid diagnosis of neurodegenerative disease.

Aged↗
PubMed2002

Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome.

Since the original description by Taylor, the term focal cortical dysplasia has been used to refer to a wide range of alterations of the cortical mantle. More recently, these conditions have been described from neuroimaging, neuropathological and genetic standpoints, generating several classifications. It is widely recognized that these classifications are unsatisfactory. We propose a simplified classification of focal cortical dysplasias based on easily recognized neuropathological characteristics. We retrospectively re-examined histological sections of cortex from 52 of 224 (23%) patients operated on for drug-resistant partial epilepsy in which cortical dysplasia was present but not associated with other brain pathologies except hippocampal sclerosis. Three subgroups were identified: (i) architectural dysplasia (31 patients) characterized by abnormal cortical lamination and ectopic neurones in white matter; (ii) cytoarchitectural dysplasia (six patients) characterized by giant neurofilament-enriched neurones in addition to altered cortical lamination; and (iii) Taylor-type cortical dysplasia (15 patients) with giant dysmorphic neurones and balloon cells (all but two patients) associated with cortical laminar disruption. The patients with architectural dysplasia had lower seizure frequency than those with cytoarchitectural and Taylor-type dysplasia, and the epileptogenic zone was mainly in the temporal lobe. In patients with Taylor-type dysplasia, the epileptogenic zone was mainly extratemporal, and interictal stereo-EEG was distinctive. MRI was unrevealing in 34% of patients, but distinctive signal alterations characterized most patients with Taylor-type dysplasia, while focal hypoplasia with MRI abnormalities was found in architectural dysplasia. Patients with Taylor-type dysplasia had the best outcome, with 75% seizure-free (Engel class Ia) after at least a year of follow-up compared with 50% of cytoarchitectural dysplasia and 43% of architectural dysplasia patients seizure-free. This three-category classification is based on easily recognized histopathological characteristics and avoids complicated terminology, while the distinctive ensemble of other characteristics defines clinically homogeneous groups.

Adult↗
PubMed2003

Human cingulate cortex and autonomic control: converging neuroimaging and clinical evidence.

Human anterior cingulate function has been explained primarily within a cognitive framework. We used functional MRI experiments with simultaneous electrocardiography to examine regional brain activity associated with autonomic cardiovascular control during performance of cognitive and motor tasks. Using indices of heart rate variability, and high- and low-frequency power in the cardiac rhythm, we observed activity in the dorsal anterior cingulate cortex (ACC) related to sympathetic modulation of heart rate that was dissociable from cognitive and motor-related activity. The findings predict that during effortful cognitive and motor behaviour the dorsal ACC supports the generation of associated autonomic states of cardiovascular arousal. We subsequently tested this prediction by studying three patients with focal damage involving the ACC while they performed effortful cognitive and motor tests. Each showed abnormalities in autonomic cardiovascular responses with blunted autonomic arousal to mental stress when compared with 147 normal subjects tested in identical fashion. Thus, converging neuroimaging and clinical findings suggest that ACC function mediates context-driven modulation of bodily arousal states.

Adult↗
PubMed2002

The role of rostral Brodmann area 6 in mental-operation tasks: an integrative neuroimaging approach.

Recent evidence indicates that classical 'motor' areas may also have cognitive functions. We performed three neuroimaging experiments to investigate the functional neuroanatomy underlying three types of nonmotor mental-operation tasks: numerical, verbal, and spatial. (i) Positron emission tomography showed that parts of the posterior frontal cortex, which are consistent with the pre-supplementary motor area (pre-SMA) and the rostral part of the dorsolateral premotor cortex (PMdr), were active during all three tasks. We also observed activity in the posterior parietal cortex and cerebellar hemispheres during all three tasks. Electrophysiological monitoring confirmed that there were no skeletomotor, oculomotor or articulatory movements during task performance. (ii) Functional magnetic resonance imaging (fMRI) showed that PMdr activity during the mental-operation tasks was localized in the depths of the superior precentral sulcus, which substantially overlapped the region active during complex finger movements and was located dorsomedial to the presumptive frontal eye fields. (iii) Single-trial fMRI showed a transient increase in activity time-locked to the performance of mental operations in the pre-SMA and PMdr. The results of the present study suggest that the PMdr is important in the rule-based association of symbolic cues and responses in both motor and nonmotor behaviors.

Adult↗
PubMed2004

Human functional neuroimaging of brain changes associated with practice.

The discovery that experience-driven changes in the human brain can occur from a neural to a cortical level throughout the lifespan has stimulated a proliferation of research into how neural function changes in response to experience, enabled by neuroimaging methods such as positron emission tomography and functional magnetic resonance imaging. Studies attempt to characterize these changes by examining how practice on a task affects the functional anatomy underlying performance. Results are incongruous, including patterns of increases, decreases and functional reorganization of regional activations. Following an extensive review of the practice-effects literature, we distinguish a number of factors affecting the pattern of practice effects observed, including the effects of task domain, changes at the level of behavioural and cognitive processes, the time-window of imaging and practice, and of a number of other influences and miscellaneous confounding factors. We make a novel distinction between patterns of reorganization and redistribution as effects of task practice on brain activation, and emphasize the need for careful attention to practice-related changes occurring on the behavioural, cognitive and neural levels of analysis. Finally, we suggest that functional and effective connectivity analyses may make important contributions to our understanding of changes in functional anatomy occurring as a result of practice on tasks.

Animals↗
PubMed2006

Automatic and intrinsic auditory "what" and "where" processing in humans revealed by electrical neuroimaging.

The auditory system includes 2 parallel functional pathways-one for treating sounds' identities and another for their spatial attributes (so-called "what" and "where" pathways). We examined the spatiotemporal mechanisms along auditory "what" and "where" pathways and whether they are automatically engaged in differentially processing spatial and pitch information of identical stimuli. Electrical neuroimaging of auditory evoked potentials (i.e., statistical analyses of waveforms, field strength, topographies, and source estimations) was applied to a passive "oddball" paradigm comprising 2 varieties of blocks of trials. On "what" blocks, band-pass-filtered noises varied in pitch, independently of perceived location. On "where" blocks, the identical stimuli varied in perceived location independently of pitch. Beginning 100 ms poststimulus, the electric field topography significantly differed between conditions, indicative of the automatic recruitment of distinct intracranial generators. A distributed linear inverse solution and statistical analysis thereof revealed activations within superior temporal cortex and prefrontal cortex bilaterally that were common for both conditions, as well as regions within the right temporoparietal cortices that were selective for the "where" condition. These findings support models of automatic and intrinsic parallel processing of auditory information, such that segregated processing of spatial and pitch features may be an organizing principle of auditory function.

Acoustic Stimulation↗