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Bradshaw J, Choi PMC, Wrigley S. Long-term cognitive recovery following isolated bilateral infarction of the fornix presenting with amnesia. BMJ Neurol Open 2024; 6:e000655. [PMID: 38736581 PMCID: PMC11085788 DOI: 10.1136/bmjno-2024-000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Isolated infarction of the fornix is a relatively rare stroke syndrome frequently associated with amnesia. The long-term cognitive outcome in cases of acute fornix infarction is poorly understood. This is largely due to the limited number of case studies that have documented cognitive outcomes beyond the acute recovery phase on quantifiable neuropsychological measures. We describe a patient who developed acute amnesia and was subsequently diagnosed on cerebral MRI with bilateral infarction in the anterior columns of the fornix. Method Comprehensive neuropsychological review was undertaken prospectively at baseline, early and late phases of recovery. Results At 9 months post-stroke, there was some reduction in the severity of memory dysfunction, but a significant anterograde amnesia persisted. Conclusion This is one of the very few cases in the literature where neuropsychological function has been comprehensively and serially examined over the first year post-isolated bilateral fornix infarction. It is concluded that amnesia can persist well beyond 6 months in these cases, with associated functional impairment in daily life.
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Affiliation(s)
- Jennifer Bradshaw
- Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
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2
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Kılıç AE, Yaltırık Bilgin E, Ünal Ö. Metastases and Primary Brain Tumors Affecting the Fornix of the Brain. Cureus 2024; 16:e57612. [PMID: 38689678 PMCID: PMC11057945 DOI: 10.7759/cureus.57612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
Background The aim of this study is to evaluate the clinical and radiological findings of metastatic tumors and primary brain tumors affecting the fornix. Methods Between January 2015 and March 2023, we retrospectively evaluated 1087 patients of both sexes who underwent cranial magnetic resonance imaging (MRI) for a preliminary diagnosis of intracranial malignancy in the radiology department of our hospital. Two radiologists with six and 10 years of experience in MRI examination assessed the relationship between primary and metastatic tumors and the fornix. Results Involvement of the fornix was diagnosed in 29 of the 1087 patients (2.66%), of which fornix was affected by metastatic lesions in 14 patients (48.2%) and primary tumors in 15 patients (51.7%). The majority of metastatic lesions were from lung and breast cancers, with other tumor types including osteosarcoma, renal cell carcinoma, pancreatic adenocarcinoma, pleomorphic sarcoma, and diffuse large B-cell lymphoma. Among all primary tumors, glioblastoma was the most common primary brain tumor invading the fornix, with other diagnoses including diffuse astrocytoma, medulloblastoma, and anaplastic oligodendroglioma. Metastatic and primary brain tumors affecting the fornix were detected over a broad timeline, from the time of diagnosis up to 120 months after diagnosis. A retrospective evaluation of medical records revealed memory deficits in four patients. Conclusion The fornix can be affected by both metastatic and primary brain tumors. It is crucial to understand the relevant neuroanatomical relationships when evaluating lesions that affect the fornix.
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Affiliation(s)
- Abidin Emre Kılıç
- Radiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, TUR
| | - Ezel Yaltırık Bilgin
- Radiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, TUR
| | - Özkan Ünal
- Radiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, TUR
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Mazzacane F, Ferrari F, Malvaso A, Mottese Y, Gastaldi M, Costa A, Pichiecchio A, Cavallini A. Acute amnestic syndrome in fornix lesions: a systematic review of reported cases with a focus on differential diagnosis. Front Neurol 2024; 15:1338291. [PMID: 38333604 PMCID: PMC10850356 DOI: 10.3389/fneur.2024.1338291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Acute amnestic syndrome is an uncommon clinical presentation of neurological disease. Differential diagnosis encompasses several syndromes including Wernicke-Korsakoff and transient global amnesia (TGA). Structural lesions of the fornix account for a minority of cases of acute amnestic syndromes. Etiology varies from iatrogenic injury to ischemic, inflammatory, or neoplastic lesions. A prompt diagnosis of the underlying pathology is essential but challenging. The aim of this review is to systematically review the existing literature regarding cases of acute amnestic syndrome associated with non-iatrogenic lesions of the fornix. Methods We performed a systematic literature search on PubMed, Scopus, and Web of Science up to September 2023 to identify case reports and case series of patients with amnestic syndrome due to fornix lesions. The systematic review was conducted according to PRISMA guidelines. The research was limited to articles written in English. Cases of fornix damage directly ascribable to a surgical procedure were excluded. Results A total of 52 publications reporting 55 cases were included in the review. Focusing on acute/subacute onset, vascular etiology was highly prevalent, being responsible for 78% of cases, 40/55 (74%) of which were due to acute ischemic stroke. The amnestic syndrome was characterized by anterograde amnesia in all patients, associated with retrograde amnesia in 27% of cases. Amnesia was an isolated presentation in most cases. Up to two thirds of patients had persistent memory deficits of any severity at follow-up. Discussion Acute amnestic syndrome can be rarely caused by fornix lesions. In most cases of acute/subacute presentation, the etiology is ischemic stroke, mainly caused by strokes involving the subcallosal artery territory. The differential diagnosis is challenging and a distinction from common mimics is often difficult on a clinical basis. A high index of suspicion should be maintained to avoid misdiagnosis and provide adequate acute treatment to patients with time-dependent disease, also employing advanced neuroimaging. More research is needed to better understand the outcome and identify prognostic factors in patients with amnestic syndrome due to fornix lesions.
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Affiliation(s)
- F. Mazzacane
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Emergency Neurology and Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italy
- Unit of Behavioral Neurology, Mondino Foundation, Pavia, Italy
| | - F. Ferrari
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Emergency Neurology and Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italy
| | - A. Malvaso
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Neuroimmunology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Y. Mottese
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - M. Gastaldi
- Neuroimmunology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - A. Costa
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Unit of Behavioral Neurology, Mondino Foundation, Pavia, Italy
| | - A. Pichiecchio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - A. Cavallini
- Department of Emergency Neurology and Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italy
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Sharma R, Kumarasamy M, Parihar VK, Ravichandiran V, Kumar N. Monoamine Oxidase: A Potential Link in Papez Circuit to Generalized Anxiety Disorders. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:638-655. [PMID: 37055898 DOI: 10.2174/1871527322666230412105711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 04/15/2023]
Abstract
Anxiety is a common mental illness that affects a large number of people around the world, and its treatment is often based on the use of pharmacological substances such as benzodiazepines, serotonin, and 5-hydroxytyrosine (MAO) neurotransmitters. MAO neurotransmitters levels are deciding factors in the biological effects. This review summarizes the current understanding of the MAO system and its role in the modulation of anxiety-related brain circuits and behavior. The MAO-A polymorphisms have been implicated in the susceptibility to generalized anxiety disorder (GAD) in several investigations. The 5-HT system is involved in a wide range of physiological and behavioral processes, involving anxiety, aggressiveness, stress reactions, and other elements of emotional intensity. Among these, 5-HT, NA, and DA are the traditional 5-HT neurons that govern a range of biological activities, including sleep, alertness, eating, thermoregulation, pains, emotion, and memory, as anticipated considering their broad projection distribution in distinct brain locations. The DNMTs (DNA methyltransferase) protein family, which increasingly leads a prominent role in epigenetics, is connected with lower transcriptional activity and activates DNA methylation. In this paper, we provide an overview of the current state of the art in the elucidation of the brain's complex functions in the regulation of anxiety.
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Affiliation(s)
- Ravikant Sharma
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, Vaishali- 844102, Bihar, India
| | - Murali Kumarasamy
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, Vaishali- 844102, Bihar, India
| | - Vipan Kumar Parihar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, Vaishali-844102, Bihar, India
| | - V Ravichandiran
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, Vaishali- 844102, Bihar, India
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, Vaishali-844102, Bihar, India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, Vaishali-844102, Bihar, India
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Mei Y, Wang W, Qiu D, Yuan Z, Bai X, Tang H, Zhang P, Zhang X, Zhang Y, Yu X, Sui B, Wang Y. Micro-structural white matter abnormalities in new daily persistent headache: a DTI study using TBSS analysis. J Headache Pain 2023; 24:80. [PMID: 37394419 DOI: 10.1186/s10194-023-01620-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND New daily persistent headache (NDPH) is a rare primary headache disorder characterized by daily and persistent sudden onset headaches. The pathogenesis of NDPH remains unclear, and there are few white matter imaging studies related to NDPH. The purpose of this study was to investigate the micro-structural abnormalities of white matter in NDPH and provided insights into the pathogenesis of this disease based on tract-based spatial statistics (TBSS). METHODS Twenty-one patients with NDPH and 25 healthy controls (HCs) were included in this study. T1 structural and diffusion magnetic resonance imaging (MRI) were acquired from all participants. Differences in the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between patients with NDPH and HCs were investigated using TBSS analysis. RESULTS Significantly decreased FA, increased MD and RD were found in patients with NDPH compared to HCs. White matter regions overlaid with decreased FA, increased MD and RD were found in 16 white matter tracts from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas and Johns Hopkins University White-Matter Tractography Atlas. Specifically, these white matter regions included the right anterior thalamic radiation (ATR), body of the corpus callosum (BCC), bilateral cingulum, left hippocampal cingulum (CGH), left corticospinal tract (CST), forceps major, fornix, left inferior fronto-occipital fasciculus (IFOF), bilateral inferior longitudinal fasciculus (ILF), left posterior limb of the internal capsule (PLIC), right retrolenticular part of the internal capsule (RPIC), splenium of the corpus callosum (SCC), right superior longitudinal fasciculus (SLF) and left uncinate fasciculus (UF). After Bonferroni correction, there were no correlations between the FA, MD, AD and RD values and the clinical characteristics of patients with NDPH (p > 0.05/96). CONCLUSION The results of our research indicated that patients with NDPH might have widespread abnormalities in the white matter of the brain.
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Affiliation(s)
- Yanliang Mei
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Dong Qiu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xiaoyan Bai
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Neurosurgical Institute, Beijing, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xue Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Neurosurgical Institute, Beijing, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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Zhou W, He J, Zhang C, Pan Y, Sang T, Qiu X. Fiber-specific white matter alterations in Parkinson's disease patients with freezing of gait. Brain Res 2023:148440. [PMID: 37271491 DOI: 10.1016/j.brainres.2023.148440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/06/2023]
Abstract
Freezing of gait (FOG) is a gait disorder that usually occurs in advanced stages of Parkinson's disease (PD). Understanding the underlying mechanism of FOG is important for treatment and prevention. Previous studies have investigated white matter (WM) structure to explore the pathology of FOG. However, the pathology is still unclear, possibly due to the methodological limitation in identifying specific fiber tracts. This study aimed to investigate tract-specific WM structural changes in FOG patients and their relationships with clinical characteristics. We enrolled 19 PD patients with FOG (PD-FOG), 19 without FOG (PD-woFOG) and 21 controls. Fixel-based analysis is a novel framework to avoid the effect of crossing fibers, which provides the metrics to assess WM morphology. By combining a method for segmenting fibers, we identified abnormalities in the specific fiber tracts. Compared to PD-woFOG, PD-FOG showed significant increased fiber-bundle cross-section (FC) in the corpus callosum (CC), fornix (FX), inferior longitudinal fasciculus (ILF), striato-premotor (ST_PREM), superior thalamic radiation (STR), thalamo-premotor (T_PREM), increased fiber density and cross-section (FDC) in the STR, and decreased fiber density (FD) in the CC and ILF. Additionally, the ILF was correlated with motor, cognition and memory, the CC was correlated with anxiety, and the T_PREM was also correlated with cognition. In conclusion, in addition to impairments of WM found in PD-FOG, we found enhancements in WM, which may imply compensatory mechanisms. Furthermore, multiple fiber tracts were correlated with clinical characteristics, especially the ILF, validating the involvement of transmission circuits of multiple distinct information in mechanisms of FOG.
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Affiliation(s)
- Wenyang Zhou
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, People's Republic of China
| | - Jianzhong He
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, People's Republic of China
| | - Chengzhe Zhang
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, People's Republic of China
| | - Yiang Pan
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, People's Republic of China
| | - Tian Sang
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, People's Republic of China
| | - Xiang Qiu
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, People's Republic of China; Department of Automation, Zhejiang University of Technology, Hangzhou 310023, People's Republic of China.
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7
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Xie Y, Cai K, Dai J, Wei G. Enhanced Integrity of White Matter Microstructure in Mind-Body Practitioners: A Whole-Brain Diffusion Tensor Imaging Study. Brain Sci 2023; 13:brainsci13040691. [PMID: 37190656 DOI: 10.3390/brainsci13040691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Tai Chi Chuan (TCC) is an increasingly popular multimodal mind-body practice with potential cognitive benefits, yet the neurobiological mechanisms underlying these effects, particularly in relation to brain white matter (WM) microstructure, remain largely unknown. In this study, we used diffusion tensor imaging (DTI) and the attention network test (ANT) to compare 22 TCC practitioners and 18 healthy controls. We found extensive differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between the two groups. Specifically, TCC practitioners had significantly different diffusion metrics in the corticospinal tract (CST), fornix (FX)/stria terminalis (ST), and cerebral peduncle (CP). We also observed a significant correlation between increased FA values in the right CP and ANT performance in TCC practitioners. Our findings suggest that optimized regional WM microstructure may contribute to the complex information processing associated with TCC practice, providing insights for preventing cognitive decline and treating neurological disorders with cognitive impairment in clinical rehabilitation.
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Affiliation(s)
- Yingrong Xie
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Kelong Cai
- College of Physical Education, Yangzhou University, Yangzhou 225127, China
| | - Jingang Dai
- Experimental Research Center, China Academy of Chinese Medical Sciences, National Chinese Medicine Experts Inheritance Office of Song Jun, Beijing 100700, China
| | - Gaoxia Wei
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
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8
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Teske N, Chiquillo-Domínguez M, Skrap B, Harter PN, Rejeski K, Blobner J, von Baumgarten L, Tonn JC, Kunz M, Thon N, Karschnia P. Shunt dependency in supratentorial intraventricular tumors depends on the extent of tumor resection. Acta Neurochir (Wien) 2023; 165:1053-1064. [PMID: 36862214 PMCID: PMC10068640 DOI: 10.1007/s00701-023-05532-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/13/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Supratentorial intraventricular tumors (SIVTs) are rare lesions of various entities characteristically presenting with hydrocephalus and often posing a surgical challenge due to their deep-seated localization. We aimed to elaborate on shunt dependency after tumor resection, clinical characteristics, and perioperative morbidity. METHODS We retrospectively searched the institutional database for patients with supratentorial intraventricular tumors treated at the Department of Neurosurgery of the Ludwig-Maximilians-University in Munich, Germany, between 2014 and 2022. RESULTS We identified 59 patients with over 20 different SIVT entities, most often subependymoma (8/59 patients, 14%). Mean age at diagnosis was 41 ± 3 years. Hydrocephalus and visual symptoms were observed in 37/59 (63%) and 10/59 (17%) patients, respectively. Microsurgical tumor resection was provided in 46/59 patients (78%) with complete resection in 33/46 patients (72%). Persistent postoperative neurological deficits were encountered in 3/46 patients (7%) and generally mild in nature. Complete tumor resection was associated with less permanent shunting in comparison to incomplete tumor resection, irrespective of tumor histology (6% versus 31%, p = 0.025). Stereotactic biopsy was utilized in 13/59 patients (22%), including 5 patients who received synchronous internal shunt implantation for symptomatic hydrocephalus. Median overall survival was not reached and did not differ between patients with or without open resection. CONCLUSIONS SIVT patients display a high risk of developing hydrocephalus and visual symptoms. Complete resection of SIVTs can often be achieved, preventing the need for long-term shunting. Stereotactic biopsy along with internal shunting represents an effective approach to establish diagnosis and ameliorate symptoms if resection cannot be safely performed. Due to the rather benign histology, the outcome appears excellent when adjuvant therapy is provided.
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Affiliation(s)
- Nico Teske
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. .,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
| | | | - Benjamin Skrap
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Patrick N Harter
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.,Center for Neuropathology and Prion Research, University Hospital, LMU Munich, Munich, Germany
| | - Kai Rejeski
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.,Department of Medicine III, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Jens Blobner
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Louisa von Baumgarten
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Joerg-Christian Tonn
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Mathias Kunz
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Niklas Thon
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Philipp Karschnia
- Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. .,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
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Li M, Wu F, Cao Y, Jiang X, Kong L, Tang Y. Abnormal white matter integrity in Papez circuit in first-episode medication-naive adults with anxious depression: A combined voxel-based analysis and region of interest study. J Affect Disord 2023; 324:489-495. [PMID: 36610591 DOI: 10.1016/j.jad.2022.12.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/25/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Anxious depression is one of the subtypes of major depressive disorder (MDD), usually defined as "patients with MDD and high levels of anxiety symptoms". Compared to non-anxious MDD (naMDD), patients with anxious MDD (aMDD) have more severe depressive symptoms and suicidal ideation, worse treatment outcomes and remission rates, and poorer prognosis. Current research suggests that the Papez circuit is an important brain structure closely related to emotion, memory, and cognition. This study applied DTI to explore the altered white matter integrity in Papez circuit of patients with aMDD. METHODS DTI data were acquired from 30 medication-naive outpatients with naMDD and 55 with aMDD and 88 demographically similar healthy control (HC) subjects. Voxel-based analysis (VBM) and region of interest (ROI) analysis were conducted to explore the significant difference of fractional anisotropy (FA) values among 3 groups. Pearson's correlations were performed to analyze the correlation between FA values and the score of HAMA-14 and HAMD-17. RESULTS We found that aMDD patients had significantly higher FA values in left fornix (belong to Papez circuit) and left posterior thalamic radiation and right anterior corona radiata (belong to limbic-thalamo-cortical circuitry) compared with HC. And there was variability in the white matter integrity in right posterior thalamic radiation (belong to limbic-thalamo-cortical circuitry) and left fornix (belong to Papez circuit) between aMDD and naMDD patients. LIMITATIONS The cross-sectional study and the population vary between aMDD group and naMDD group are limitations. CONCLUSIONS Abnormal white matter integrity in Papez circuit and Limbic-Thalamo-Cortical circuitry may play an important role in the neuropathology of aMDD and might help to identify aMDD.
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Affiliation(s)
- Mengxue Li
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang 110001, Liaoning, China
| | - Feng Wu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang 110001, Liaoning, China
| | - Yang Cao
- Shenyang Mental Health Center, Shenyang 110168, Liaoning, China
| | - Xiaowei Jiang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang 110001, Liaoning, China
| | - Lingtao Kong
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang 110001, Liaoning, China.
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang 110001, Liaoning, China
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Bobrowski-Khoury N, Sequeira JM, Quadros EV. Brain Uptake of Folate Forms in the Presence of Folate Receptor Alpha Antibodies in Young Rats: Folate and Antibody Distribution. Nutrients 2023; 15:nu15051167. [PMID: 36904166 PMCID: PMC10005127 DOI: 10.3390/nu15051167] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
In a rat model, following exposure to rat folate receptor alpha antibodies (FRαAb) during gestation, FRαAb accumulates in the placenta and the fetus and blocks folate transport to the fetal brain and produces behavioral deficits in the offspring. These deficits could be prevented with folinic acid. Therefore, we sought to evaluate folate transport to the brain in young rat pups and determine what effect FRαAb has on this process, to better understand the folate receptor autoimmune disorder associated with cerebral folate deficiency (CFD) in autism spectrum disorders (ASD). When injected intraperitoneally (IP), FRαAb localizes to the choroid plexus and blood vessels including the capillaries throughout the brain parenchyma. Biotin-tagged folic acid shows distribution in the white matter tracts in the cerebrum and cerebellum. Since these antibodies can block folate transport to the brain, we orally administered various folate forms to identify the form that is better-absorbed and transported to the brain and is most effective in restoring cerebral folate status in the presence of FRαAb. The three forms of folate, namely folic acid, D,L-folinic acid and levofolinate, are converted to methylfolate while L-methylfolate is absorbed as such and all are efficiently distributed to the brain. However, significantly higher folate concentration is seen in the cerebrum and cerebellum with levofolinate in the presence or absence of FRαAb. Our results in the rat model support testing levofolinate to treat CFD in children with ASD.
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Affiliation(s)
| | - Jeffrey M. Sequeira
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Edward V. Quadros
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
- Correspondence:
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Cruz-Carrillo G, Trujillo-Villarreal LA, Ángeles-Valdez D, Concha L, Garza-Villarreal EA, Camacho-Morales A. Prenatal Cafeteria Diet Primes Anxiety-like Behavior Associated to Defects in Volume and Diffusion in the Fimbria-fornix of Mice Offspring. Neuroscience 2023; 511:70-85. [PMID: 36592924 DOI: 10.1016/j.neuroscience.2022.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/25/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022]
Abstract
Prenatal exposure to high-energy diets primes brain alterations that increase the risk of developing behavioral and cognitive failures. Alterations in the structure and connectivity of brain involved in learning and memory performance are found in adult obese murine models and in humans. However, the role of prenatal exposure to high-energy diets in the modulation of the brain's structure and function during cognitive decline remains unknown. We used female C57BL6 mice (n = 10) exposed to a high-energy diets (Cafeteria diet (CAF)) or Chow diet for 9 weeks (before, during and after pregnancy) to characterize their effect on brain structural organization and learning and memory performance in the offspring at two-month-old (n = 17). Memory and learning performance were evaluated using the Y-maze test including forced and spontaneous alternation, novel object recognition (NORT), open field and Barnes maze tests. We found no alterations in the short- or long-time spatial memory performance in male offspring prenatally exposed to CAF diet when compared to the control, but they increased time spent in the edges resembling anxiety-like behavior. By using deformation-based morphometry and diffusion tensor imaging analysis we found that male offspring exposed to CAF diet showed increased volume in primary somatosensory cortex and a reduced volume of fimbria-fornix, which correlate with alterations in its white matter integrity. Biological modeling revealed that prenatal exposure to CAF diet predicts low volume in the fimbria-fornix, which was associated with anxiety in the offspring. The findings suggest that prenatal exposure to high-energy diets prime brain structural alterations related to anxiety in the offspring.
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Affiliation(s)
- Gabriela Cruz-Carrillo
- Universidad Autónoma de Nuevo Leon, College of Medicine, Department of Biochemistry, Monterrey, NL, Mexico; Universidad Autónoma de Nuevo Leon, Center for Research and Development in Health Sciences, Neurometabolism Unit, San Nicolás de los Garza, NL, Mexico
| | - Luis Angel Trujillo-Villarreal
- Universidad Autónoma de Nuevo Leon, College of Medicine, Department of Biochemistry, Monterrey, NL, Mexico; Universidad Autónoma de Nuevo Leon, Center for Research and Development in Health Sciences, Neurometabolism Unit, San Nicolás de los Garza, NL, Mexico
| | - Diego Ángeles-Valdez
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Departamento de Neurobiología Conductual y Cognitiva, Campus UNAM-Juriquilla, 76230 Queretaro, Mexico
| | - Luis Concha
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Departamento de Neurobiología Conductual y Cognitiva, Campus UNAM-Juriquilla, 76230 Queretaro, Mexico
| | - Eduardo A Garza-Villarreal
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Departamento de Neurobiología Conductual y Cognitiva, Campus UNAM-Juriquilla, 76230 Queretaro, Mexico
| | - Alberto Camacho-Morales
- Universidad Autónoma de Nuevo Leon, College of Medicine, Department of Biochemistry, Monterrey, NL, Mexico; Universidad Autónoma de Nuevo Leon, Center for Research and Development in Health Sciences, Neurometabolism Unit, San Nicolás de los Garza, NL, Mexico.
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Abu-Alya AI, Halthore V, Khosla T, Chavda D, Veerappan V. A Case Report of Transient Amnesia Following Spontaneous Intracerebral Hemorrhage of the Fornix. Cureus 2023; 15:e34519. [PMID: 36874308 PMCID: PMC9981547 DOI: 10.7759/cureus.34519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/04/2023] Open
Abstract
In this report, we share the case of a 65-year-old male with a remote history of brain concussion who presented to the emergency department for evaluation of transient amnesia that lasted 30 minutes to one hour. He was found to have spontaneous intracerebral hemorrhage of the fornix as a cause of his amnesic episode. To date from the creation of this case report (January 2023), spontaneous hemorrhage of the fornix resulting in transient amnesia has not been previously described in the literature. The fornix is an unusual location for spontaneous hemorrhage to occur. The differential diagnosis of transient amnesia is broad and includes, but is not limited to, transient global amnesia, traumatic injury, hippocampal infraction, and various metabolic derangements. Determination of the etiology of transient amnesia can result in changes in treatment decisions. Because of this unique patient presentation, we propose that spontaneous hemorrhage of the fornix should be considered in patients who present with transient amnesia.
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Affiliation(s)
- Ali I Abu-Alya
- Neurology, Hospital Corporation of America (HCA) Healthcare, Southern Hills Hospital, Las Vegas, USA
| | - Vishnu Halthore
- Neurology, Hospital Corporation of America (HCA) Healthcare, Southern Hills Hospital, Las Vegas, USA
| | - Tanvir Khosla
- Neurology, Hospital Corporation of America (HCA) Healthcare, Southern Hills Hospital, Las Vegas, USA
| | - Devraj Chavda
- Epilepsy, Columbia University, New York City, USA.,Pediatric Neurology, State University of New York Downstate Medical Center, Brooklyn, USA
| | - Venkatachalam Veerappan
- Neurology, Hospital Corporation of America (HCA) Healthcare, Southern Hills Hospital, Las Vegas, USA
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13
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Kano S, Matsuki M, Furukawa R, Nakata W, Oguma H, Gomi A, Mori H. A case of germinoma located in the fornix inducing transsynaptic atrophy of the Papez circuit. Radiol Case Rep 2023; 18:405-409. [DOI: 10.1016/j.radcr.2022.10.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/19/2022] Open
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Majdi A, Deng Z, Sadigh-Eteghad S, De Vloo P, Nuttin B, Mc Laughlin M. Deep brain stimulation for the treatment of Alzheimer's disease: A systematic review and meta-analysis. Front Neurosci 2023; 17:1154180. [PMID: 37123370 PMCID: PMC10133458 DOI: 10.3389/fnins.2023.1154180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
Background One of the experimental neuromodulation techniques being researched for the treatment of Alzheimer's disease (AD) is deep brain stimulation (DBS). To evaluate the effectiveness of DBS in AD, we performed a systematic review and meta-analysis of the available evidence. Methods From the inception through December 2021, the following databases were searched: Medline via PubMed, Scopus, Embase, Cochrane Library, and Web of Science. The search phrases used were "Alzheimer's disease," "AD," "deep brain stimulation," and "DBS." The information from the included articles was gathered using a standardized data-collecting form. In the included papers, the Cochrane Collaboration methodology was used to evaluate the risk of bias. A fixed-effects model was used to conduct the meta-analysis. Results Only five distinct publications and 6 different comparisons (one study consisted of two phases) were included out of the initial 524 papers that were recruited. DBS had no impact on the cognitive ability in patients with AD [0.116 SMD, 95% confidence interval (CI), -0.236 to 0.469, p = 0.518]. The studies' overall heterogeneity was not significant (κ2 = 6.23, T 2 = 0.053, df = 5, I 2 = 19.76%, p = 0.284). According to subgroup analysis, the fornix-DBS did not improve cognitive function in patients with AD (0.145 SMD, 95%CI, -0.246 to 0.537, p = 0.467). Unfavorable neurological and non-neurological outcomes were also reported. Conclusion The inconsistencies and heterogeneity of the included publications in various target and age groups of a small number of AD patients were brought to light by this meta-analysis. To determine if DBS is useful in the treatment of AD, further studies with larger sample sizes and randomized, double-blinded, sham-controlled designs are required.
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Affiliation(s)
- Alireza Majdi
- Exp ORL, Department of Neuroscience, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Zhengdao Deng
- Research Group Experimental Neurosurgery and Neuroanatomy, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Saeed Sadigh-Eteghad
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Philippe De Vloo
- Research Group Experimental Neurosurgery and Neuroanatomy, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Neurosurgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Bart Nuttin
- Research Group Experimental Neurosurgery and Neuroanatomy, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Neurosurgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Myles Mc Laughlin
- Exp ORL, Department of Neuroscience, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- *Correspondence: Myles Mc Laughlin
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15
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Nikolenko VN, Rizaeva NA, Oganesyan MV, Vekhova KA, Alyautdinova NAF, Balan SI, Karashaeva TA, Bolotskaya AA. Brain commissures and related pathologies. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2022. [DOI: 10.14412/2074-2711-2022-6-73-79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- V. N. Nikolenko
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University); Lomonosov Moscow State University
| | - N. A. Rizaeva
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University); Lomonosov Moscow State University
| | - M. V. Oganesyan
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University); Lomonosov Moscow State University
| | - K. A. Vekhova
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)
| | | | | | - T. A. Karashaeva
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)
| | - A. A. Bolotskaya
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)
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16
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A multimodal study regarding neural correlates of the subjective well-being in healthy individuals. Sci Rep 2022; 12:13688. [PMID: 35953523 PMCID: PMC9372135 DOI: 10.1038/s41598-022-18013-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022] Open
Abstract
Although happiness or subjective well-being (SWB) has drawn much attention from researchers, the precise neural structural correlates of SWB are generally unknown. In the present study, we aimed to investigate the associations between gray matter (GM) volumes, white matter (WM) microstructures, and SWB in healthy individuals, mainly young adults using multimodal T1 and diffusion tensor imaging studies. We enrolled 70 healthy individuals using magnetic resonance imaging. We measured their SWB using the Concise Measure of Subjective Well-Being. Voxel-wise statistical analysis of GM volumes was performed using voxel-based morphometry, while fractional anisotropy (FA) values were analyzed using tract-based spatial statistics. In healthy individuals, higher levels of SWB were significantly correlated with increased GM volumes of the anterior insula and decreased FA values in clusters of the body of the corpus callosum, precuneus WM, and fornix cres/stria terminalis. A correlational analysis revealed that GM volumes and FA values in these significant regions were significantly correlated with severity of psychological symptoms such as depression, anxiety, and quality of life. Our findings indicate that GM volumes and WM microstructures in these regions may contribute to SWB, and could be the neural basis for psychological symptom severity as well as quality of life in healthy individuals.
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17
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Biswas A, Krishnan P, Vidarsson L, Shroff M. Cerebral White Matter Tract Anatomy. Neuroimaging Clin N Am 2022; 32:507-528. [PMID: 35843659 DOI: 10.1016/j.nic.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Advances in MR imaging techniques have allowed for detailed in vivo depiction of white matter tracts. The study of white matter structure and connectivity is of paramount importance in leukodystrophies, demyelinating disorders, neoplasms, and various cognitive, neuropsychiatric, and developmental disorders. The advent of advanced "function-preserving" surgical techniques also makes it imperative to understand white matter anatomy and connectivity, to provide accurate road maps for tumor and epilepsy surgery. In this review, we will describe cerebral white matter anatomy with the help of conventional MRI and diffusion tensor imaging.
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Affiliation(s)
- Asthik Biswas
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada; Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London WC1N3JH, United Kingdom.
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada
| | - Logi Vidarsson
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada
| | - Manohar Shroff
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada
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18
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Li R, Zhang C, Rao Y, Yuan TF. Deep brain stimulation of fornix for memory improvement in Alzheimer's disease: A critical review. Ageing Res Rev 2022; 79:101668. [PMID: 35705176 DOI: 10.1016/j.arr.2022.101668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/16/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
Memory reflects the brain function in encoding, storage and retrieval of the data or information, which is a fundamental ability for any live organism. The development of approaches to improve memory attracts much attention due to the underlying mechanistic insight and therapeutic potential to treat neurodegenerative diseases with memory loss, such as Alzheimer's disease (AD). Deep brain stimulation (DBS), a reversible, adjustable, and non-ablative therapy, has been shown to be safe and effective in many clinical trials for neurodegenerative and neuropsychiatric disorders. Among all potential regions with access to invasive electrodes, fornix is considered as it is the major afferent and efferent connection of the hippocampus known to be closely associated with learning and memory. Indeed, clinical trials have demonstrated that fornix DBS globally improved cognitive function in a subset of patients with AD, indicating fornix can serve as a potential target for neurosurgical intervention in treating memory impairment in AD. The present review aims to provide a better understanding of recent progresses in the application of fornix DBS for ameliorating memory impairments in AD patients.
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Affiliation(s)
- Ruofan Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanxia Rao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Laboratory Animal Science, Fudan University, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.
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Karadag A, Camlar M, Turkis OF, Bayramli N, Middlebrooks EH, Tanriover N. Endoscopic Endonasal Approach to the Third Ventricle Using the Surgical Corridor of the Reverse Third Ventriculostomy: Anatomo-Surgical Nuances. J Neurol Surg B Skull Base 2022. [DOI: 10.1055/s-0042-1748630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Objective Surgical access to the third ventricle can be achieved through various corridors depending on the location and extent of the lesion; however, traditional transcranial approaches risk damage to multiple critical neural structures.
Methods Endonasal approach similar to corridor of the reverse third ventriculostomy (ERTV) was surgically simulated in eight cadaveric heads. Fiber dissections were additionally performed within the third ventricle along the endoscopic route. Additionally, we present a case of ERTV in a patient with craniopharyngioma extending into the third ventricle.
Results The ERTV allowed adequate intraventricular visualization along the third ventricle. The extracranial step of the surgical corridor included a bony window in the sellar floor, tuberculum sella, and the lower part of the planum sphenoidale. ERTV provided an intraventricular surgical field along the foramen of Monro to expose an area bordered by the fornix anteriorly, thalamus laterally, anterior commissure anterior superiorly, posterior commissure, habenula and pineal gland posteriorly, and aqueduct of Sylvius centered posterior inferiorly.
Conclusion The third ventricle can safely be accessed through ERTV either above or below the pituitary gland. ERTV provides a wide exposure of the third ventricle through the tuber cinereum and offers access to the anterior part as far as the anterior commissure and precommissural part of fornix and the whole length of the posterior part. Endoscopic ERTV may be a suitable alternative to transcranial approaches to access the third ventricle in selected patients.
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Affiliation(s)
- Ali Karadag
- Department of Neurosurgery, Health Science University, Tepecik Research and Training Hospital, Izmir, Turkey
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University–Cerrahpasa, Istanbul, Turkey
| | - Mahmut Camlar
- Department of Neurosurgery, Health Science University, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Omer Furkan Turkis
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University–Cerrahpasa, Istanbul, Turkey
- Department of Neurosurgery, Health Science University, Van Research and Training Hospital, Van, Turkey
| | - Nijat Bayramli
- Department of Neurosurgery, Health Science University, Tepecik Research and Training Hospital, Izmir, Turkey
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University–Cerrahpasa, Istanbul, Turkey
| | - Erik H. Middlebrooks
- Departments of Neurosurgery and Radiology, Mayo Clinic, Jacksonville, Florida, United States
| | - Necmettin Tanriover
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University–Cerrahpasa, Istanbul, Turkey
- Department of Neurosurgery, Cerrahpasa Faculty of Medicine, Istanbul University–Cerrahpasa, Istanbul, Turkey
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20
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Tsanov M. Basal Forebrain Impairment: Understanding the Mnemonic Function of the Septal Region Translates in Therapeutic Advances. Front Neural Circuits 2022; 16:916499. [PMID: 35712645 PMCID: PMC9194835 DOI: 10.3389/fncir.2022.916499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
The basal forebrain is one of the three major brain circuits involved in episodic memory formation together with the hippocampus and the diencephalon. The dysfunction of each of these regions is known to cause anterograde amnesia. While the hippocampal pyramidal neurons are known to encode episodic information and the diencephalic structures are known to provide idiothetic information, the contribution of the basal forebrain to memory formation has been exclusively associated with septo-hippocampal cholinergic signaling. Research data from the last decade broadened our understanding about the role of septal region in memory formation. Animal studies revealed that septal neurons process locomotor, rewarding and attentional stimuli. The integration of these signals results in a systems model for the mnemonic function of the medial septum that could guide new therapeutic strategies for basal forebrain impairment (BFI). BFI includes the disorders characterized with basal forebrain amnesia and neurodegenerative disorders that affect the basal forebrain. Here, we demonstrate how the updated model of septal mnemonic function can lead to innovative translational treatment approaches that include pharmacological, instrumental and behavioral techniques.
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Affiliation(s)
- Marian Tsanov
- UCD School of Medicine, University College Dublin, Dublin, Ireland
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21
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Berger M, Pirpamer L, Hofer E, Ropele S, Duering M, Gesierich B, Pasternak O, Enzinger C, Schmidt R, Koini M. Free water diffusion MRI and executive function with a speed component in healthy aging. Neuroimage 2022; 257:119303. [PMID: 35568345 PMCID: PMC9465649 DOI: 10.1016/j.neuroimage.2022.119303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/12/2022] Open
Abstract
Extracellular free water (FW) increases are suggested to better provide pathophysiological information in brain aging than conventional biomarkers such as fractional anisotropy. The aim of the present study was to determine the relationship between conventional biomarkers, FW in white matter hyperintensities (WMH), FW in normal appearing white matter (NAWM) and in white matter tracts and executive functions (EF) with a speed component in elderly persons. We examined 226 healthy elderly participants (median age 69.83 years, IQR: 56.99–74.42) who underwent brain MRI and neuropsychological examination. FW in WMH and in NAWM as well as FW corrected diffusion metrics and measures derived from conventional MRI (white matter hyperintensities, brain volume, lacunes) were used in partial correlation (adjusted for age) to assess their correlation with EF with a speed component. Random forest analysis was used to assess the relative importance of these variables as determinants. Lastly, linear regression analyses of FW in white matter tracts corrected for risk factors of cognitive and white matter deterioration, were used to examine the role of specific tracts on EF with a speed component, which were then ranked with random forest regression. Partial correlation analyses revealed that almost all imaging metrics showed a significant association with EF with a speed component (r = −0.213 – 0.266). Random forest regression highlighted FW in WMH and in NAWM as most important among all diffusion and structural MRI metrics. The fornix (R2=0.421, p = 0.018) and the corpus callosum (genu (R2 = 0.418, p = 0.021), prefrontal (R2 = 0.416, p = 0.026), premotor (R2 = 0.418, p = 0.021)) were associated with EF with a speed component in tract based regression analyses and had highest variables importance. In a normal aging population FW in WMH and NAWM is more closely related to EF with a speed component than standard DTI and brain structural measures. Higher amounts of FW in the fornix and the frontal part of the corpus callosum leads to deteriorating EF with a speed component.
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Affiliation(s)
- Martin Berger
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Auenbruggerplatz 22, Graz 8036, Austria
| | - Lukas Pirpamer
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Auenbruggerplatz 22, Graz 8036, Austria
| | - Edith Hofer
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Auenbruggerplatz 22, Graz 8036, Austria; Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Stefan Ropele
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Auenbruggerplatz 22, Graz 8036, Austria
| | - Marco Duering
- Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Benno Gesierich
- Institute for Stroke and Dementia Research (ISD), University Hospital, Munich, Germany
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Reinhold Schmidt
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Auenbruggerplatz 22, Graz 8036, Austria.
| | - Marisa Koini
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Auenbruggerplatz 22, Graz 8036, Austria
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Alves IS, Coutinho AMN, Vieira APF, Rocha BP, Passos UL, Gonçalves VT, Silva PDS, Zhan MX, Pinho PC, Delgado DS, Docema MFL, Lee HW, Policeni BA, Leite CC, Martin MGM, Amancio CT. Imaging Aspects of the Hippocampus. Radiographics 2022; 42:822-840. [PMID: 35213261 DOI: 10.1148/rg.210153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The hippocampus is one of the most sophisticated structures in the brain, owing to its complex anatomy, intriguing functions, relationship with other structures, and relevant associated symptoms. Despite being a structure analyzed for centuries, its anatomy and physiology in the human body are still being extensively studied, as well as associated pathologic conditions and potential biomarkers. It can be affected by a broad group of diseases that can be classified as congenital, degenerative, infectious or inflammatory, neoplastic, vascular, or toxic-metabolic disease. The authors present the anatomy and close structures, function, and development of the hippocampus, as well as an original algorithm for imaging diagnosis. The algorithm includes pathologic conditions that typically affect the hippocampus and groups them into nodular (space occupying) and nonnodular pathologic conditions, serving as a guide to narrow the differential diagnosis. MRI is the imaging modality of choice for evaluation of the hippocampus, and CT and nuclear medicine also improve the analysis. The MRI differential diagnosis depends on anatomic recognition and careful characterization of associated imaging findings such as volumetric changes, diffusion restriction, cystic appearance, hyperintensity at T1-weighted imaging, enhancement, or calcification, which play a central role in diagnosis along with clinical findings. Some pathologic conditions arising from surrounding structures such as the amygdala are also important to recognize. Pathologic conditions of the hippocampus can be a challenge to diagnose because they usually manifest as similar clinical syndromes, so the imaging findings play a potential role in guiding the final diagnosis. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Isabela S Alves
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Artur M N Coutinho
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Ana P F Vieira
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Bruno P Rocha
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Ula L Passos
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Vinicius T Gonçalves
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Paulo D S Silva
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Malia X Zhan
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Paula C Pinho
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Daniel S Delgado
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Marcos F L Docema
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Hae W Lee
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Bruno A Policeni
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Claudia C Leite
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Maria G M Martin
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
| | - Camila T Amancio
- From the Neuroradiology Section, Department of Radiology, Hospital Sírio-Libanês, Adma Jafet 91, Bela Vista, São Paulo SP 01308-050, Brazil (I.S.A., A.M.N.C., A.P.F.V., B.P.R., U.L.P., V.T.G., P.C.P., D.S.D., M.F.L.D., H.W.L., M.G.M.M., C.T.A.); Neuroradiology Section, Department of Radiology, University of São Paulo, Brazil (A.M.N.C., P.C.P., C.C.L., M.G.M.M.); Department of Neurology, Prevent Senior, São Paulo, Brazil (P.D.S.S.); and Neuroradiology Section, Department of Radiology, University of Iowa, Iowa City, Iowa (M.X.Z., B.A.P.)
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Karadag A, Camlar M, Turkis OF, Bayramli N, Middlebrooks EH, Tanriover N. Endoscopic Endonasal Approach to the Third Ventricle using the Corridor of the Reverse Third Ventriculostomy: anatomo-surgical nuances. J Neurol Surg B Skull Base 2022; 84:296-306. [PMID: 37187474 PMCID: PMC10171930 DOI: 10.1055/a-1808-1359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 03/18/2022] [Indexed: 10/18/2022] Open
Abstract
Objective: Surgical access to the third ventricle can be achieved through various corridors depending on the location and extent of the lesion; however, traditional transcranial approaches risk damage to multiple critical neural structures.
Methods: Endonasal approach similar to corridor of the reverse third ventriculostomy (ERTV) was surgically simulated in eight cadaveric heads. Fiber dissections were additionally performed within the third ventricle along the endoscopic route. Additionally, we present a case of ERTV in a patient with craniopharyngioma extending into the third ventricle.
Results: The ERTV allowed adequate intraventricular visualization along the third ventricle. The extracranial step of the surgical corridor included a bony window in the sellar floor, tuberculum sella and the lower part of the planum sphenoidale. ERTV provided an intraventricular surgical field along the foramen of Monro to expose an area bordered by the fornix anteriorly, thalamus laterally, anterior commissure anterior superiorly, posterior commissure, habenula and pineal gland posteriorly, and aqueduct of Sylvius centered posterior inferiorly.
Conclusion: The third ventricle can safely be accessed through ERTV either above or below the pituitary gland. ERTV provides a wide exposure of the third ventricle through the tuber cinereum and offers access to the anterior part as far as the anterior commissure and pre-commissural part of fornix and the whole length of the posterior part. Endoscopic ERTV may be a suitable alternative to transcranial approaches to access the third ventricle in selected patients.
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Affiliation(s)
- Ali Karadag
- Neurosurgery, Tepecik Egitim ve Arastirma Hastanesi Kliniklerimiz, Izmir, Turkey
| | - Mahmut Camlar
- Neurosurgery, Tepecik Egitim ve Arastirma Hastanesi Kliniklerimiz, Izmir, Turkey
| | | | - Nijat Bayramli
- Neurosurgery, Tepecik Egitim ve Arastirma Hastanesi Kliniklerimiz, Izmir, Turkey
| | - Erik H Middlebrooks
- Neurological Surgery and Radiology, Mayo Clinic Hospital Jacksonville, Jacksonville, United States
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Rootman M, Kornreich L, Osherov A, Konen O. DWI Hyperintensity in the Fornix Fimbria on MRI in Children. AJNR Am J Neuroradiol 2022; 43:480-485. [PMID: 35210274 PMCID: PMC8910804 DOI: 10.3174/ajnr.a7437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/01/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The fornix-fimbria complex is mainly involved in emotions and memory. In brain MR imaging studies of young children, we have occasionally noted DWI hyperintensity in this region. The significance of this finding remains unclear. This study evaluated the DWI signal in the fornix-fimbria complex of children 0-2 years of age, including the frequency of signal hyperintensity and clinical context. MATERIALS AND METHODS Brain MR imaging of 714 children 0-2 years of age (mean, 11 months), performed between September 2018 and May 2021, was reviewed and evaluated for DWI signal changes in the fornix-fimbria. All children with available MR imaging studies including DWI were included. Children with poor image quality, poor visualization of the fornix-fimbria region, and missing medical data were excluded. Additional imaging findings were also evaluated. Demographic data were retrieved from the medical files. We compared the ADC values of the fimbria and fornix between children with and without signal changes. The unpaired 2-tailed Student t test and χ2 test were used for statistical analysis. RESULTS DWI signal hyperintensity of the Fornix-fimbria complex was noted in 53 (7.4%) children (mean age, 10 months). Their mean ADC values were significantly lower than those of the children with normal DWI findings (P < .05). About half of the children had otherwise normal MR imaging findings. When detected, the most common abnormality was parenchymal volume loss (15%). The most common indication for imaging was seizures (26.5%). CONCLUSIONS DWI hyperintensity in the fornix-fimbria complex was detected in 7.4% of children 0-2 years of age. The etiology is not entirely clear, possibly reflecting a transient phenomenon.
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Affiliation(s)
- M.S. Rootman
- From the Department of Radiology (M.S.R., L.K., A.N.O., O.K.), Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel,The Sackler Faculty of Medicine (M.S.R., L.K., A.N.O., O.K.), Tel Aviv University, Tel Aviv, Israel
| | - L. Kornreich
- From the Department of Radiology (M.S.R., L.K., A.N.O., O.K.), Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel,The Sackler Faculty of Medicine (M.S.R., L.K., A.N.O., O.K.), Tel Aviv University, Tel Aviv, Israel
| | - A.N. Osherov
- From the Department of Radiology (M.S.R., L.K., A.N.O., O.K.), Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel,The Sackler Faculty of Medicine (M.S.R., L.K., A.N.O., O.K.), Tel Aviv University, Tel Aviv, Israel
| | - O. Konen
- From the Department of Radiology (M.S.R., L.K., A.N.O., O.K.), Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel,The Sackler Faculty of Medicine (M.S.R., L.K., A.N.O., O.K.), Tel Aviv University, Tel Aviv, Israel
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25
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Bullock DN, Hayday EA, Grier MD, Tang W, Pestilli F, Heilbronner SR. A taxonomy of the brain's white matter: twenty-one major tracts for the 21st century. Cereb Cortex 2022; 32:4524-4548. [PMID: 35169827 PMCID: PMC9574243 DOI: 10.1093/cercor/bhab500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 01/26/2023] Open
Abstract
The functional and computational properties of brain areas are determined, in large part, by their connectivity profiles. Advances in neuroimaging and network neuroscience allow us to characterize the human brain noninvasively, but a comprehensive understanding of the human brain demands an account of the anatomy of brain connections. Long-range anatomical connections are instantiated by white matter, which itself is organized into tracts. These tracts are often disrupted by central nervous system disorders, and they can be targeted by neuromodulatory interventions, such as deep brain stimulation. Here, we characterized the connections, morphology, traversal, and functions of the major white matter tracts in the brain. There are major discrepancies across different accounts of white matter tract anatomy, hindering our attempts to accurately map the connectivity of the human brain. However, we are often able to clarify the source(s) of these discrepancies through careful consideration of both histological tract-tracing and diffusion-weighted tractography studies. In combination, the advantages and disadvantages of each method permit novel insights into brain connectivity. Ultimately, our synthesis provides an essential reference for neuroscientists and clinicians interested in brain connectivity and anatomy, allowing for the study of the association of white matter's properties with behavior, development, and disorders.
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Affiliation(s)
- Daniel N Bullock
- Department of Psychological and Brain Sciences, Program in Neuroscience, Indiana University Bloomington, Bloomington, IN 47405, USA,Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Elena A Hayday
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Mark D Grier
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | | | | | - Sarah R Heilbronner
- Address correspondence to Sarah R. Heilbronner, Department of Neuroscience, University of Minnesota, 2-164 Jackson Hall, 321 Church St SE, Minneapolis, MN 55455, USA.
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26
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Valdés Cabrera D, Smyth P, Blevins G, Emery D, Beaulieu C. Diffusion imaging of fornix and interconnected limbic deep grey matter is linked to cognitive impairment in multiple sclerosis. Eur J Neurosci 2021; 55:277-294. [PMID: 34806796 DOI: 10.1111/ejn.15539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/29/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022]
Abstract
Diffusion tensor imaging (DTI) and volumetric magnetic resonance imaging (MRI) have shown white matter (WM) and deep grey matter (GM) abnormalities in the limbic system of multiple sclerosis (MS) participants. Structures like the fornix have been associated with cognitive impairment (CI) in MS, but the diffusion metrics are often biased by partial volume effects from cerebrospinal fluid (CSF) due to its small bundle size and intraventricular location. These errors in DTI parameter estimation worsen with atrophy in MS. The goal here was to evaluate DTI parameters and volumes of the fornix, as well as associated deep GM structures like the thalamus and hippocampus, with high-resolution fluid-attenuated inversion recovery (FLAIR)-DTI at 3T in 43 MS patients, with and without CI, versus 43 controls. The fornix, thalamus and hippocampus displayed atrophy and/or abnormal diffusion metrics, with the fornix showing the most extensive changes within the structures studied here, mainly in CI MS. The affected fornix volumes and diffusion metrics were associated with thalamic atrophy and atypical diffusion metrics in interconnected limbic GM, larger total lesion volume and global brain atrophy. Lower fractional anisotropy (FA) and higher mean and radial diffusivity in the fornix, lower hippocampus FA and lower thalamus volume were strongly correlated with CI in MS. Hippocampus FA and thalamus atrophy were negatively correlated with fatigue and longer time since MS symptoms onset, respectively. FLAIR-DTI and volumetric analyses provided methodologically superior evidence for microstructural abnormalities and extensive atrophy of the fornix and interconnected deep GM in MS that were associated with cognitive deficits.
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Affiliation(s)
| | - Penelope Smyth
- Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Gregg Blevins
- Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Derek Emery
- Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Christian Beaulieu
- Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
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27
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Sato Y, Endo T, Kayano S, Nemoto H, Shimada K, Ito A, Endo H, Mugikura S, Niizuma K, Tominaga T. Comparison between ultra-high-resolution computed tomographic angiography and conventional computed tomographic angiography in the visualization of the subcallosal artery. Surg Neurol Int 2021; 12:528. [PMID: 34754578 PMCID: PMC8571191 DOI: 10.25259/sni_887_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/26/2021] [Indexed: 11/24/2022] Open
Abstract
Background: The subcallosal artery (ScA) is a single dominant artery arising from the anterior communicating artery. Its injury causes amnesia and cognitive disturbance. The conventional computed tomographic angiography (C-CTA) is a common evaluation method of the intracranial artery. However, to image tinny perforating arteries such as the ScA is technically demanding for C-CTA. The purpose of this study is to investigate whether the ultra-high-resolution CTA (UHR-CTA) could image the ScA better than C-CTA. UHR-CTA became available in clinical practice in 2017. Its novel features are the improvement of the detector system and a small X-ray focus. Methods: Between April 2019 and May 2020, 77 and 49 patients who underwent intracranial UHR-CTA and C-CTA, respectively, were enrolled in this study. Two board-certified neurosurgeons participated as observers to identify the ScA based on UHR-CTA and C-CTA images. Results: UHR-CTA and C-CTA detected the ScA in 56–58% and 30–40% of the patients, respectively. In visualization of the ScA, UHR-CTA was better than C-CTA (P < 0.05, Fisher’s exact test). Between the two observers, the Cohen’s kappa coefficient was 0.77 for UHR-CTA and 0.78 for C-CTA. Conclusions: UHR-CTA is a simple and accessible method to evaluate intracranial vasculature. Visualization of the ScA with UHR-CTA was better than that with C-CTA. The high quality of UHR-CTA could provide useful information in the neurosurgery field.
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Affiliation(s)
- Yoshimichi Sato
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Toshiki Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shingo Kayano
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hitoshi Nemoto
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kazuki Shimada
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Akira Ito
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hidenori Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shunji Mugikura
- Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Biomedical Engineering, Sendai, Miyagi, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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28
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Gabery S, Kwa JE, Cheong RY, Baldo B, Ferrari Bardile C, Tan B, McLean C, Georgiou-Karistianis N, Poudel GR, Halliday G, Pouladi MA, Petersén Å. Early white matter pathology in the fornix of the limbic system in Huntington disease. Acta Neuropathol 2021; 142:791-806. [PMID: 34448021 PMCID: PMC8500909 DOI: 10.1007/s00401-021-02362-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/09/2021] [Accepted: 08/18/2021] [Indexed: 12/13/2022]
Abstract
Huntington disease (HD) is a fatal neurodegenerative disorder caused by an expanded CAG repeat in the huntingtin (HTT) gene. The typical motor symptoms have been associated with basal ganglia pathology. However, psychiatric and cognitive symptoms often precede the motor component and may be due to changes in the limbic system. Recent work has indicated pathology in the hypothalamus in HD but other parts of the limbic system have not been extensively studied. Emerging evidence suggests that changes in HD also include white matter pathology. Here we investigated if the main white matter tract of the limbic system, the fornix, is affected in HD. We demonstrate that the fornix is 34% smaller already in prodromal HD and 41% smaller in manifest HD compared to controls using volumetric analyses of MRI of the IMAGE-HD study. In post-mortem fornix tissue from HD cases, we confirm the smaller fornix volume in HD which is accompanied by signs of myelin breakdown and reduced levels of the transcription factor myelin regulating factor but detect no loss of oligodendrocytes. Further analyses using RNA-sequencing demonstrate downregulation of oligodendrocyte identity markers in the fornix of HD cases. Analysis of differentially expressed genes based on transcription-factor/target-gene interactions also revealed enrichment for binding sites of SUZ12 and EZH2, components of the Polycomb Repressive Complex 2, as well as RE1 Regulation Transcription Factor. Taken together, our data show that there is early white matter pathology of the fornix in the limbic system in HD likely due to a combination of reduction in oligodendrocyte genes and myelin break down.
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Affiliation(s)
- Sanaz Gabery
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, BMC D11, 22184, Lund, Sweden
| | - Jing Eugene Kwa
- Translational Laboratory in Genetic Medicine (TLGM), Agency for Science, Technology and Research (A*STAR), Singapore, 138648, Singapore
| | - Rachel Y Cheong
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, BMC D11, 22184, Lund, Sweden
| | - Barbara Baldo
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, BMC D11, 22184, Lund, Sweden
- Evotec SE, HD Research and Translational Sciences, 22419, Hamburg, Germany
| | - Costanza Ferrari Bardile
- Translational Laboratory in Genetic Medicine (TLGM), Agency for Science, Technology and Research (A*STAR), Singapore, 138648, Singapore
- Department of Medical Genetics, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, V5Z 4H4, Canada
| | - Brendan Tan
- School of Psychological Sciences, Monash University, Clayton, VIC, 3180, Australia
| | - Catriona McLean
- Department of Pathology, Alfred Hospital, Melbourne, VIC, Australia
| | | | - Govinda R Poudel
- School of Psychological Sciences, Monash University, Clayton, VIC, 3180, Australia
| | - Glenda Halliday
- The Brain and Mind Centre and Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney, Australia
| | - Mahmoud A Pouladi
- Translational Laboratory in Genetic Medicine (TLGM), Agency for Science, Technology and Research (A*STAR), Singapore, 138648, Singapore
- Department of Medical Genetics, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, V5Z 4H4, Canada
- Department of Physiology, National University of Singapore (NUS), Singapore, 117597, Singapore
| | - Åsa Petersén
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, BMC D11, 22184, Lund, Sweden.
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Forno G, Lladó A, Hornberger M. Going round in circles-The Papez circuit in Alzheimer's disease. Eur J Neurosci 2021; 54:7668-7687. [PMID: 34656073 DOI: 10.1111/ejn.15494] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
The hippocampus is regarded as the pivotal structure for episodic memory symptoms associated with Alzheimer's disease (AD) pathophysiology. However, what is often overlooked is that the hippocampus is 'only' one part of a network of memory critical regions, the Papez circuit. Other Papez circuit regions are often regarded as less relevant for AD as they are thought to sit 'downstream' of the hippocampus. However, this notion is oversimplistic, and increasing evidence suggests that other Papez regions might be affected before or concurrently with the hippocampus. In addition, AD research has mostly focused on episodic memory deficits, whereas spatial navigation processes are also subserved by the Papez circuit with increasing evidence supporting its valuable potential as a diagnostic measure of incipient AD pathophysiology. In the current review, we take a step forward analysing recent evidence on the structural and functional integrity of the Papez circuit across AD disease stages. Specifically, we will review the integrity of specific Papez regions from at-genetic-risk (APOE4 carriers), to mild cognitive impairment (MCI), to dementia stage of sporadic AD and autosomal dominant AD (ADAD). We related those changes to episodic memory and spatial navigation/orientation deficits in AD. Finally, we provide an overview of how the Papez circuit is affected in AD diseases and their specific symptomology contributions. This overview strengthened the need for moving away from a hippocampal-centric view to a network approach on how the whole Papez circuit is affected in AD and contributes to its symptomology, informing future research and clinical approaches.
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Affiliation(s)
- Gonzalo Forno
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,School of Psychology, Universidad de los Andes, Santiago, Chile.,Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, ICBM, Neurosciences Department, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
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30
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Oh SL, Chen CM, Wu YR, Valdes Hernandez M, Tsai CC, Cheng JS, Chen YL, Wu YM, Lin YC, Wang JJ. Fixel-Based Analysis Effectively Identifies White Matter Tract Degeneration in Huntington's Disease. Front Neurosci 2021; 15:711651. [PMID: 34588947 PMCID: PMC8473742 DOI: 10.3389/fnins.2021.711651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Microstructure damage in white matter might be linked to regional and global atrophy in Huntington's Disease (HD). We hypothesize that degeneration of subcortical regions, including the basal ganglia, is associated with damage of white matter tracts linking these affected regions. We aim to use fixel-based analysis to identify microstructural changes in the white matter tracts. To further assess the associated gray matter damage, diffusion tensor-derived indices were measured from regions of interest located in the basal ganglia. Diffusion weighted images were acquired from 12 patients with HD and 12 healthy unrelated controls using a 3 Tesla scanner. Reductions in fixel-derived metrics occurs in major white matter tracts, noticeably in corpus callosum, internal capsule, and the corticospinal tract, which were closely co-localized with the regions of increased diffusivity in basal ganglia. These changes in diffusion can be attributed to potential axonal degeneration. Fixel-based analysis is effective in studying white matter tractography and fiber changes in HD.
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Affiliation(s)
- Sher Li Oh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Chiung-Mei Chen
- Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Maria Valdes Hernandez
- Row Fogo Centre for Research into Ageing and the Brain, Department of Neuroimaging Sciences, The University of Edinburgh, Edinburgh, United Kingdom.,Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Chih-Chien Tsai
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Jur-Shan Cheng
- Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yao-Liang Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yi-Ming Wu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Chun Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Jiun-Jie Wang
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan.,Medical Imaging Research Center, Institute for Radiological Research, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
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31
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Ghannam M, Alshaer Q, Ukatu H, Alkuwaiti M, Streib C. Acute Amnestic Syndrome and Ischemic Stroke: A Case Series. Neurol Clin Pract 2021; 11:263-267. [PMID: 34484894 DOI: 10.1212/cpj.0000000000000928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/24/2020] [Indexed: 11/15/2022]
Abstract
Purpose of Review Stroke is an uncommon cause of amnesia. We describe in detail 3 cases of anterograde amnesia and confabulation secondary to acute ischemic stroke and review the available literature. Recent Findings In our case series, all 3 patients presented with anterograde amnesia and 2 of 3 copresented with prominent confabulation. These symptoms were recognized in delayed fashion, and no patients received IV tissue plasminogen activator (tPA). Although stroke infarct topology was variable, all 3 patients had infarction of the fornix. Long-term follow-up was obtained in 2 of 3 patients: both had persistent memory impairment and were no longer functionally independent. Summary Acute onset anterograde amnesia and confabulation may uncommonly represent acute ischemic stroke. Delays in this diagnosis typically exclude patients from emergent stroke treatment or timely diagnostic stroke evaluation. Clinicians should maintain a high degree of suspicion for ischemic stroke in this setting, especially in patients with comorbid vascular risk factors. Memory impairment secondary to ischemic stroke can produce considerable long-term disability.
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Affiliation(s)
- Malik Ghannam
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Qasem Alshaer
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Hope Ukatu
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Mohammed Alkuwaiti
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Christopher Streib
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
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32
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Duan J, Wei Y, Womer FY, Zhang X, Chang M, Zhu Y, Liu Z, Li C, Yin Z, Zhang R, Sun J, Wang P, Wang S, Jiang X, Wei S, Zhang Y, Tang Y, Wang F. Neurobiological substrates of major psychiatry disorders: transdiagnostic associations between white matter abnormalities, neuregulin 1 and clinical manifestation. J Psychiatry Neurosci 2021; 46:E506-E515. [PMID: 34467747 PMCID: PMC8526153 DOI: 10.1503/jpn.200166] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Schizophrenia, bipolar disorder and major depressive disorder are increasingly being conceptualized as a transdiagnostic continuum. Disruption of white matter is a common alteration in these psychiatric disorders, but the molecular mechanisms underlying the disruption remain unclear. Neuregulin 1 (NRG1) is genetically linked with susceptibility to schizophrenia, bipolar disorder and major depressive disorder, and it is also related to white matter. METHODS Using a transdiagnostic approach, we aimed to identify white matter differences associated with NRG1 and their relationship to transdiagnostic symptoms and cognitive function. We examined the white matter of 1051 participants (318 healthy controls and 733 patients with major psychiatric disorders: 254 with schizophrenia, 212 with bipolar disorder and 267 with major depressive disorder) who underwent diffusion tensor imaging. We measured the plasma NRG1-β1 levels of 331 participants. We also evaluated clinical symptoms and cognitive function. RESULTS In the patient group, abnormal white matter was negatively associated with NRG1-β1 levels in the genu of the corpus callosum, right uncinate fasciculus, bilateral inferior fronto-occipital fasciculus, right external capsule, fornix, right optic tract, left straight gyrus white matter and left olfactory radiation. These NRG1-associated white matter abnormalities were also associated with depression and anxiety symptoms and executive function in patients with a major psychiatric disorder. Furthermore, across the 3 disorders we observed analogous alterations in white matter, NRG1-β1 levels and clinical manifestations. LIMITATIONS Medication status, the wide age range and our cross-sectional findings were limitations of this study. CONCLUSION This study is the first to provide evidence for an association between NRG1, white matter abnormalities, clinical symptoms and cognition in a transdiagnostic psychiatric cohort. These findings provide further support for an understanding of the molecular mechanisms that underlie the neuroimaging substrates of major psychiatric disorders and their clinical implications.
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Affiliation(s)
- Jia Duan
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Yange Wei
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Fay Y Womer
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Xizhe Zhang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Miao Chang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Yue Zhu
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Zhuang Liu
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Chao Li
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Zhiyang Yin
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Ran Zhang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Jiaze Sun
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Pengshuo Wang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Shuai Wang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Xiaowei Jiang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Shengnan Wei
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Yanbo Zhang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Yanqing Tang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
| | - Fei Wang
- From the Department of Psychiatry, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Duan, Zhu, Yin, R. Zhang, Sun, P. Wang, S. Wang, Tang, F. Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, PR China (Duan, Y. Wei, R. Zhang, F. Wang); the Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO (Womer); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, PR China (X. Zhang); the Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang, Li, Jiang, S.Wei); the School of Public Health, China Medical University, Shenyang, Liaoning, PR China (Liu); the Department of Psychiatry, College of Medicine, University of Saskatchewan, SK (Y. Zhang)
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Sidra M, Hattingh L, Ramadan H. Don't forget the fornix. Pract Neurol 2021; 21:336-337. [PMID: 33785563 DOI: 10.1136/practneurol-2020-002802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Maurice Sidra
- Neurology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK .,Neurology, Leeds General Infirmary, Leeds, UK
| | - Louise Hattingh
- Radiology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Hawraman Ramadan
- Neurology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Jiang J, Wang X, Chen Y, Shang X. What Causes Anterograde Amnesia? Eur Neurol 2021; 84:139-144. [PMID: 33794519 DOI: 10.1159/000512408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/14/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Jiwei Jiang
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang City, China
| | - Xiaoting Wang
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang City, China
| | - Yutong Chen
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang City, China
| | - Xiuli Shang
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang City, China
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Bekiesinska-Figatowska M, Duczkowski M, Duczkowska A, Taybert J, Krzywdzinska A, Sykut-Cegielska J. Increasing the spectrum of white matter diseases with tigroid pattern on MRI: glutaric aciduria type 1 - case report. BMC Pediatr 2021; 21:146. [PMID: 33773571 PMCID: PMC8004449 DOI: 10.1186/s12887-021-02603-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 03/09/2021] [Indexed: 01/18/2023] Open
Abstract
Background Most white matter diseases present on magnetic resonance imaging as focal or diffuse T2-hyperintensities. However, in a few of them, radially oriented stripes of low (relatively normal) signal intensity are observed within diffusely affected T2-hyperintense cerebral white matter and are called “tigroid pattern” in the literature. The fornix is a tiny white matter fibers bundle playing crucial role in cognitive functioning, easily overlooked on magnetic resonance imaging and not described in inborn errors of metabolism. Case presentation We present a case of glutaric aciduria type 1 with a follow-up of over nine years. The course of the disease is presented in three magnetic resonance scans at the age of 8 and 21 months, and 10 years, with diffusion restriction in the fornix in scan 1 and 2 and with tigroid pattern in scan 3. Despite appropriate diet and supplementation, injury of white matter progressed achieving diffuse stage with tigroid pattern. Psychological tests revealed deficits in patient’s specific cognitive skills, most likely related to damage to the fornix. Conclusions To our knowledge, this is the first report of tigroid pattern of white matter involvement in glutaric aciduria type 1 and the first report of forniceal injury in this disease which seems to be correlated with patient’s low functioning in all kinds of memory skills, previously not reported in glutaric aciduria type 1.
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Affiliation(s)
| | - Marek Duczkowski
- Department of Diagnostic Imaging, Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland
| | - Agnieszka Duczkowska
- Department of Diagnostic Imaging, Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland
| | - Joanna Taybert
- Department of Inborn Errors of Metabolism and Paediatrics, Institute of Mother and Child, Warsaw, Poland
| | - Amanda Krzywdzinska
- Department of Inborn Errors of Metabolism and Paediatrics, Institute of Mother and Child, Warsaw, Poland
| | - Jolanta Sykut-Cegielska
- Department of Inborn Errors of Metabolism and Paediatrics, Institute of Mother and Child, Warsaw, Poland
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36
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Degiorgis L, Karatas M, Sourty M, Faivre E, Lamy J, Noblet V, Bienert T, Reisert M, von Elverfeldt D, Buée L, Blum D, Boutillier AL, Armspach JP, Blanc F, Harsan LA. Brain network remodelling reflects tau-related pathology prior to memory deficits in Thy-Tau22 mice. Brain 2021; 143:3748-3762. [PMID: 33184651 DOI: 10.1093/brain/awaa312] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 11/12/2022] Open
Abstract
In Alzheimer's disease, the tauopathy is known as a major mechanism responsible for the development of cognitive deficits. Early biomarkers of such affectations for diagnosis/stratification are crucial in Alzheimer's disease research, and brain connectome studies increasingly show their potential establishing pathology fingerprints at the network level. In this context, we conducted an in vivo multimodal MRI study on young Thy-Tau22 transgenic mice expressing tauopathy, performing resting state functional MRI and structural brain imaging to identify early connectome signatures of the pathology, relating with histological and behavioural investigations. In the prodromal phase of tauopathy, before the emergence of cognitive impairments, Thy-Tau22 mice displayed selective modifications of brain functional connectivity involving three main centres: hippocampus (HIP), amygdala (AMG) and the isocortical areas, notably the somatosensory (SS) cortex. Each of these regions showed differential histopathological profiles. Disrupted ventral HIP-AMG functional pathway and altered dynamic functional connectivity were consistent with high pathological tau deposition and astrogliosis in both hippocampus and amygdala, and significant microglial reactivity in amygdalar nuclei. These patterns were concurrent with widespread functional hyperconnectivity of memory-related circuits of dorsal hippocampus-encompassing dorsal HIP-SS communication-in the absence of significant cortical histopathological markers. These findings suggest the coexistence of two intermingled mechanisms of response at the functional connectome level in the early phases of pathology: a maladaptive and a likely compensatory response. Captured in the connectivity patterns, such first responses to pathology could further be used in translational investigations as a lead towards an early biomarker of tauopathy as well as new targets for future treatments.
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Affiliation(s)
- Laetitia Degiorgis
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France
| | - Meltem Karatas
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France.,Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University Freiburg, 79085 Freiburg, Germany.,CNRS, University of Strasbourg, INCI, UMR 7168, 67000 Strasbourg, France
| | - Marion Sourty
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France.,The University of Sydney, Faculty of Engineering, School of Aerospace, Mechanical and Mechatronic Engineering, NSW 2006 Sydney, Australia
| | - Emilie Faivre
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc, LabEx DISTALZ, F-59000 Lille, France
| | - Julien Lamy
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France
| | - Vincent Noblet
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France
| | - Thomas Bienert
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University Freiburg, 79085 Freiburg, Germany
| | - Marco Reisert
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University Freiburg, 79085 Freiburg, Germany
| | - Dominik von Elverfeldt
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University Freiburg, 79085 Freiburg, Germany
| | - Luc Buée
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc, LabEx DISTALZ, F-59000 Lille, France
| | - David Blum
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc, LabEx DISTALZ, F-59000 Lille, France
| | - Anne-Laurence Boutillier
- Laboratoire de Neuroscience Cognitives et Adaptatives (LNCA), CNRS UMR 7364, 67000 Strasbourg, France
| | - Jean-Paul Armspach
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France
| | - Frédéric Blanc
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France.,University Hospital of Strasbourg, CM2R (Memory Resource and Research Centre), Day Hospital, Geriatrics Department, 67000 Strasbourg, France
| | - Laura-Adela Harsan
- Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), UMR 7357, University of Strasbourg, 67000 Strasbourg, France.,Department of Biophysics and Nuclear Medicine, University Hospital of Strasbourg, 67000 Strasbourg, France
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37
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Masuda Y, Okada G, Takamura M, Shibasaki C, Yoshino A, Yokoyama S, Ichikawa N, Okuhata S, Kobayashi T, Yamawaki S, Okamoto Y. Age-related white matter changes revealed by a whole-brain fiber-tracking method in bipolar disorder compared to major depressive disorder and healthy controls. Psychiatry Clin Neurosci 2021; 75:46-56. [PMID: 33090632 PMCID: PMC7894167 DOI: 10.1111/pcn.13166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/23/2020] [Accepted: 10/15/2020] [Indexed: 02/01/2023]
Abstract
AIM Several studies have reported altered age-associated changes in white matter integrity in bipolar disorder (BD). However, little is known as to whether these age-related changes are illness-specific. We assessed disease-specific effects by controlling for age and investigated age-associated changes and Group × Age interactions in white matter integrity among major depressive disorder (MDD) patients, BD patients, and healthy controls. METHODS Healthy controls (n = 96; age range, 20-77 years), MDD patients (n = 101; age range, 25-78 years), and BD patients (n = 58; age range, 22-76 years) participated in this study. Fractional anisotropy (FA) derived from diffusion tensor imaging in 54 white matter tracts were compared after controlling for the linear and quadratic effect of age using a generalized linear model. Age-related effects and Age × Group interactions were also assessed in the model. RESULTS The main effect of group was significant in the left column and body of the fornix after controlling for both linear and quadratic effects of age, and in the left body of the corpus callosum after controlling for the quadratic effect of age. BD patients exhibited significantly lower FA relative to other groups. There was no Age × Group interaction in the tracts. CONCLUSION Significant FA reductions were found in BD patients after controlling for age, indicating that abnormal white matter integrity in BD may occur at a younger age rather than developing progressively with age.
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Affiliation(s)
- Yoshikazu Masuda
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Go Okada
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Chiyo Shibasaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Atsuo Yoshino
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Naho Ichikawa
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Shiho Okuhata
- Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | | | - Shigeto Yamawaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
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38
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Hescham S, Temel Y. Electrical stimulation of the fornix for the treatment of brain diseases. HANDBOOK OF CLINICAL NEUROLOGY 2021; 180:447-454. [PMID: 34225947 DOI: 10.1016/b978-0-12-820107-7.00028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Deep brain stimulation (DBS) has proven to be safe and effective for both hypo- and hyperkinetic movement disorders of basal ganglia origin, while its application to other neural pathways such as the circuit of Papez is under investigation. In particular, the fornix has gained interest as potential DBS target to decrease rates of cognitive decline, enhance memory, aid visuospatial memorization, and improve verbal recollection. While the exact mechanisms of action of fornix DBS are not completely understood, studies found enhanced hippocampal acetylcholine release, synaptic plasticity, and decreased inflammatory responses in cortex and hippocampus. Nevertheless, it is still premature to conclude that fornix DBS can be used in the treatment of cognitive disorders, and the field needs sound, preclinically tested, and disease-specific a posteriori hypotheses.
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Affiliation(s)
- Sarah Hescham
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
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39
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Hannawi Y, Yanek LR, Kral BG, Becker LC, Vaidya D, Haughey NJ, Becker DM, Nyquist PA. White Matter Injury Is Associated with Reduced Manual Dexterity and Elevated Serum Ceramides in Subjects with Cerebral Small Vessel Disease. Cerebrovasc Dis 2020; 50:100-107. [PMID: 33279889 PMCID: PMC7878290 DOI: 10.1159/000511937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/30/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We have demonstrated that asymptomatic cerebral small vessel disease (cSVD) measured by white matter hyperintensity volume is associated with reduced manipulative manual dexterity on the Grooved Peg Board Test (GPBT) in middle-aged healthy individuals with a family history of early coronary artery disease. In this current study, we aim to identify the association of subcortical white matter microstructural impairment measured by diffusion tensor imaging, manual dexterity measured by GPBT and circulating serums ceramide, another marker for white matter injury. We hypothesize that lower regional fractional anisotropy (rFA) is associated with worse performance on GPBT and elevated serum ceramides in the same study population. METHODS rFA of 48 regions representing the subcortical white matters were analyzed in GeneSTAR participants in addition to serum ceramides and GPBT scores. Unadjusted univariable analyses with Bonferroni correction for multiple comparisons were completed using Spearman correlation for testing the associations between ceramides, rFA of subcortical white matter, and GPBT performance. Subsequently, sensitivity analyses were performed after excluding the participants that had any physical limitation that may influence their performance on GPBT. Finally, in the adjusted analysis using generalized estimating equation, linear regression models were performed for the areas that met significance threshold in the unadjusted analyses. RESULTS 112 subjects (age [49 ± 11], 51% female, 39.3% African American) were included. Adjusted analyses for the significant correlations that met the Bonferroni correction threshold in the unadjusted univariable analyses identified significant negative associations between rFA of the right fornix (RF) and log-GPBT score (β = -0.497, p = 0.037). In addition, rFA of RF negatively correlated with log serum ceramide levels (C18: β = -0.03, p = 0.003, C20: β = -0.0002, p = 0.004) and rFA of left genu of corpus callosum negatively correlated with log C18 level (β = -0.0103, p = 0.027). CONCLUSIONS These results demonstrate that subcortical microstructural white matter disruption is associated with elevated serum ceramides and reduced manual dexterity in a population with cSVD. These findings suggest that injury to white matter tracts undermines neural networks, with functional consequences in a middle-aged population with cardiovascular risk factors.
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Affiliation(s)
- Yousef Hannawi
- Division of Cerebrovascular Diseases and Neurocritical Care, Department of Neurology, The Ohio State University, Columbus, Ohio, USA
| | - Lisa R Yanek
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brian G Kral
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lewis C Becker
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dhananjay Vaidya
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Norman J Haughey
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Diane M Becker
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul A Nyquist
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,
- Neurosciences Critical Care Division, Departments of Neurology, Anesthesiology and Critical Care Medicine, Neurosurgery, Johns Hopkins University, University School of Medicine, Baltimore, Maryland, USA,
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40
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Srisaikaew P, Wongpakaran N, Anderson ND, Chen JJ, Kothan S, Varnado P, Unsrisong K, Mahakkanukrauh P. Fornix Integrity Is Differently Associated With Cognition in Healthy Aging and Non-amnestic Mild Cognitive Impairment: A Pilot Diffusion Tensor Imaging Study in Thai Older Adults. Front Aging Neurosci 2020; 12:594002. [PMID: 33343334 PMCID: PMC7745667 DOI: 10.3389/fnagi.2020.594002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/02/2020] [Indexed: 02/05/2023] Open
Abstract
Damage to the fornix leads to significant memory impairment and executive dysfunction and is associated with dementia risk. We sought to identify if fornix integrity and fiber length are disrupted in mild cognitive impairment (MCI) and how they associate with cognition. Data from 14 healthy older adult controls (HCs) and 17 subjects with non-amnestic MCI (n-aMCI) were analyzed. Diffusion tensor imaging (DTI) at 1.5 Tesla MRI was performed to enable manual tracing of the fornix and calculation of DTI parameters. Higher fractional anisotropy of body and column of the fornix was associated with better executive functioning and memory, more strongly in the HC than in the n-aMCI group. Fornix fiber tract length (FTL) was associated with better executive function, more strongly in the n-aMCI than in the HC group, and with better memory, more strongly in the HC than in the n-aMCI group. These results highlight a decline in the contributions of the fornix to cognition in n-aMCI and suggest that maintenance of fornix FTL is essential for sustaining executive functioning in people with n-aMCI.
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Affiliation(s)
- Patcharaporn Srisaikaew
- Ph.D. Program in Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicole D. Anderson
- Rotman Research Institute, Baycrest Health Science, Toronto, ON, Canada
- Department of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J. Jean Chen
- Rotman Research Institute, Baycrest Health Science, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Suchart Kothan
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Pairada Varnado
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittisak Unsrisong
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, Thailand
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41
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Multishell Diffusion MRI Reflects Improved Physical Fitness Induced by Dance Intervention. Neural Plast 2020; 2020:8836925. [PMID: 33204249 PMCID: PMC7661125 DOI: 10.1155/2020/8836925] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/17/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022] Open
Abstract
Using multishell diffusion MRI and both tract-based spatial statistics (TBSS) and probabilistic tracking of specific tracts of interest, we evaluated the neural underpinnings of the impact of a six-month dance intervention (DI) on physical fitness and cognitive outcomes in nondemented seniors. The final cohort had 76 nondemented seniors, randomized into DI and control (life as usual) groups. Significant effects were observed between the DI and control groups in physical fitness measures and in attention. We detected associations between improved physical fitness and changes in diffusion tensor imagining (DTI) measures in the whole white matter (WM) skeleton and in the corticospinal tract and the superior longitudinal fascicle despite the fact that no significant differences in changes to the WM microstructure were found between the two groups.
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42
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Jin Z, Sethi SK, Li B, Tang R, Li Y, Hsu CCT, He N, Haacke EM, Yan F. Susceptibility and Volume Measures of the Mammillary Bodies Between Mild Cognitively Impaired Patients and Healthy Controls. Front Neurosci 2020; 14:572595. [PMID: 33041764 PMCID: PMC7522522 DOI: 10.3389/fnins.2020.572595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose To investigate the baseline values and differences for susceptibility and volume of the mammillary bodies between mild cognitively impaired (MCI) patients and healthy controls (HCs), and further explore their differences in relation to gender, MCI subtypes and apolipoprotein E (APOE) genotypes. Methods T1-weighted and multi-echo gradient echo imaging sequences were acquired on a 3T MR scanner to evaluate the T1W based volume and susceptibility differences in the mammillary body for 47 MCI and 47 HCs. T-tests were performed to compare volume and susceptibility between groups, and right and left hemispheres. Correlation analysis was used to relate the volume and mean susceptibility as a function of age in MCI and HC groups separately, and to investigate the relationship of susceptibility with the neuro-psychological scales in the MCI group. Results Susceptibility was found to be elevated within the right mammillary body in MCI patients compared to HCs (p < 0.05). There were no differences for the mammillary body volumes between the MCI and HC groups, although there was a reduction in volume with age for the MCI group (p = 0.007). Women showed decreased mammillary body volume compared to men in the HC group (p = 0.004). No significant differences were found in relation to MCI subtypes and APOE genotypes. No significant correlations were observed between mammillary body susceptibility with neuro-psychological scales. Conclusion This work provides a quantitative baseline for both the volume and susceptibility of the mammillary body which can be used for future studies of cognitive impairment patients underlying the pathology of the Papez circuit.
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Affiliation(s)
- Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sean K Sethi
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States.,Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Binyin Li
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongbiao Tang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufei Li
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Charlie Chia-Tsong Hsu
- Department of Medical Imaging, Gold Coast University Hospital, Southport, QLD, Australia
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States.,Department of Radiology, Wayne State University, Detroit, MI, United States.,Department of Biomedical Engineering, Wayne State University, Detroit, MI, United States
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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43
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Wu A. Overview of Modern Surgical Management of Central Nervous System Tumors: North American Experience. CURRENT CANCER THERAPY REVIEWS 2020. [DOI: 10.2174/1573394715666190212112842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A wide variety of neoplasms can affect the central nervous system. Surgical management
is impacted by tumor biology and anatomic location. In this review, an overview is presented
of common and clinically significant CNS tumor types based on anatomic location.
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Affiliation(s)
- Adam Wu
- University of Saskatchewan, Saskatoon, Saskatchewan, SK, Canada
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Liu H, Temel Y, Boonstra J, Hescham S. The effect of fornix deep brain stimulation in brain diseases. Cell Mol Life Sci 2020; 77:3279-3291. [PMID: 31974655 PMCID: PMC7426306 DOI: 10.1007/s00018-020-03456-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/17/2019] [Accepted: 01/08/2020] [Indexed: 01/02/2023]
Abstract
Deep brain stimulation is used to alleviate symptoms of neurological and psychiatric disorders including Parkinson's disease, epilepsy, and obsessive-compulsive-disorder. Electrically stimulating limbic structures has been of great interest, and in particular, the region of the fornix. We conducted a systematic search for studies that reported clinical and preclinical outcomes of deep brain stimulation within the fornix up to July 2019. We identified 13 studies (7 clinical, 6 preclinical) that examined the effects of fornix stimulation in Alzheimer's disease (n = 9), traumatic brain injury (n = 2), Rett syndrome (n = 1), and temporal lobe epilepsy (n = 1). Overall, fornix stimulation can lead to decreased rates of cognitive decline (in humans), enhanced memory (in humans and animals), visuo-spatial memorization (in humans and animals), and improving verbal recollection (in humans). While the exact mechanisms of action are not completely understood, studies suggest fornix DBS to be involved with increased functional connectivity and neurotransmitter levels, as well as enhanced neuroplasticity.
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Affiliation(s)
- Huajie Liu
- Department of Neurosurgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
- European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
- European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
| | - Jackson Boonstra
- Department of Neurosurgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
- European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
| | - Sarah Hescham
- Department of Neurosurgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
- European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands.
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Hescham S, Liu H, Jahanshahi A, Temel Y. Deep brain stimulation and cognition: Translational aspects. Neurobiol Learn Mem 2020; 174:107283. [PMID: 32739395 DOI: 10.1016/j.nlm.2020.107283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/10/2020] [Accepted: 07/26/2020] [Indexed: 11/19/2022]
Abstract
Many neurological patients suffer from memory loss. To date, pharmacological treatments for memory disorders have limited and short-lasting effects. Therefore, researchers are investigating novel therapies such as deep brain stimulation (DBS) to alleviate memory impairments. Up to now stimulation of the fornix, nucleus basalis of Meynert and entorhinal cortex have been found to enhance memory performance. Here, we provide an overview of the different DBS targets and mechanisms within the memory circuit, which could be relevant for enhancing memory in patients. Future studies are warranted, accelerating the efforts to further unravel mechanisms of action of DBS in memory-related disorders and develop stimulation protocols based on these mechanisms.
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Affiliation(s)
- Sarah Hescham
- Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, the Netherlands.
| | - Huajie Liu
- Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, the Netherlands
| | - Ali Jahanshahi
- Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, the Netherlands
| | - Yasin Temel
- Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, the Netherlands
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Lee JC, Nopoulos PC, Tomblin JB. Procedural and declarative memory brain systems in developmental language disorder (DLD). BRAIN AND LANGUAGE 2020; 205:104789. [PMID: 32240854 PMCID: PMC7161705 DOI: 10.1016/j.bandl.2020.104789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 02/24/2020] [Accepted: 03/03/2020] [Indexed: 05/29/2023]
Abstract
The aim of the current study was to examine microstructural differences in white matter relevant to procedural and declarative memory between adolescents/young adults with and without Developmental Language Disorder (DLD) using diffusion tensor imaging (DTI). The findings showed atypical age-related changes in white matter structures in the corticostriatal system, in the corticocerebellar system, and in the medial temporal region in individuals with DLD. Results highlight the importance of considering the age factor in research on DLD. Future studies are needed to examine the developmental relationship between long-term memory and individual differences in language development and learning.
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Affiliation(s)
- Joanna C Lee
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, United States
| | - Peggy C Nopoulos
- Department of Psychiatry, The University of Iowa, The Roy J and Lucille A Carver College of Medicine, Iowa City, IA 52242, United States
| | - J Bruce Tomblin
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, United States
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Chaitanya G, Toth E, Ilyas A, Pati S. Sensing limbic seizures within the fornical white matter: A technical report. Clin Neurophysiol 2020; 131:1320-1322. [PMID: 32304845 DOI: 10.1016/j.clinph.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Ganne Chaitanya
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Epilepsy and Cognitive Neurophysiology Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emilia Toth
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Epilepsy and Cognitive Neurophysiology Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adeel Ilyas
- Epilepsy and Cognitive Neurophysiology Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandipan Pati
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Epilepsy and Cognitive Neurophysiology Laboratory, University of Alabama at Birmingham, Birmingham, AL, USA.
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Holla VV, Pene SS, Rakesh Sharma MN. Acute Amnestic Syndrome - "Watch Out" for Fornix Infarct. Neurol India 2020; 68:498-499. [PMID: 32189703 DOI: 10.4103/0028-3886.280642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Vikram V Holla
- Department of Neurology, Narayana Multispecialty Hospital, Mysuru, Karnataka, India
| | | | - M N Rakesh Sharma
- Department of Radiology, Narayana Multispecialty Hospital, Mysuru, Karnataka, India
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Patterns of individual differences in fiber tract integrity of the face processing brain network support neurofunctional models. Neuroimage 2020; 204:116229. [DOI: 10.1016/j.neuroimage.2019.116229] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/19/2019] [Accepted: 09/25/2019] [Indexed: 12/22/2022] Open
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Structural and functional brain correlates of theory of mind impairment post-stroke. Cortex 2019; 121:427-442. [DOI: 10.1016/j.cortex.2019.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/20/2019] [Accepted: 09/26/2019] [Indexed: 12/19/2022]
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