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Sample records for acquired brain lesions

  1. Acquired Focal Brain Lesions in Childhood: Effects on Development and Reorganization of Language

    ERIC Educational Resources Information Center

    Chilosi, A. M.; Cipriani, P.; Pecini, C.; Brizzolara, D.; Biagi, L.; Montanaro, D.; Tosetti, M.; Cioni, G.

    2008-01-01

    In the present paper, we address brain-behaviour relationships in children with acquired aphasia, by reviewing some recent studies on the effects of focal brain lesions on language development. Timing of the lesion, in terms of its occurrence, before or after the onset of speech and language acquisition, may be a major factor determining language…

  2. Acquired focal brain lesions in childhood: effects on development and reorganization of language.

    PubMed

    Chilosi, A M; Cipriani, P; Pecini, C; Brizzolara, D; Biagi, L; Montanaro, D; Tosetti, M; Cioni, G

    2008-09-01

    In the present paper, we address brain-behaviour relationships in children with acquired aphasia, by reviewing some recent studies on the effects of focal brain lesions on language development. Timing of the lesion, in terms of its occurrence, before or after the onset of speech and language acquisition, may be a major factor determining language outcome. However, it is still unclear which are the effects of aphasia occurring between 2 and 5 years of age, a time window which is crucial for acquiring and automatizing the basic rules of native language. A comprehensive review of the literature on acquired childhood aphasia precedes the description of long-term follow-up (20 years) of two identical twins, one of whom became aphasic at 3 years and 4 months after infarction of the left sylvian artery. Psycholinguistic analysis and fMRI data show a slow and incomplete recovery from non-fluent aphasia associated to an intra-hemispheric organization of language. These data, which support the potential but also the limits of neural plasticity during language development, are discussed in the light of the literature on the time-course and neural bases of acquired childhood aphasia.

  3. Brain Lesions

    MedlinePlus

    ... MRI scans, brain lesions appear as dark or light spots that don't look like normal brain tissue. Usually, a brain lesion is an incidental finding unrelated to the condition or symptom that led to the imaging test in the first place. ...

  4. Internally and externally generated emotions in people with acquired brain injury: preservation of emotional experience after right hemisphere lesions.

    PubMed

    Salas Riquelme, Christian E; Radovic, Darinka; Castro, Osvaldo; Turnbull, Oliver H

    2015-01-01

    The study of emotional changes after brain injury has contributed enormously to the understanding of the neural basis of emotion. However, little attention has been placed on the methods used to elicit emotional responses in people with brain damage. Of particular interest are subjects with right hemisphere [RH] cortical lesions, who have been described as presenting impairment in emotional processing. In this article, an internal and external mood induction procedure [MIP] was used to trigger positive and negative emotions, in a sample of 10 participants with RH damage, and 15 healthy controls. Emotional experience was registered by using a self-report questionnaire. As observed in previous studies, internal and external MIPs were equally effective in eliciting the target emotion, but the internal procedure generated higher levels of intensity. Remarkably, participants with RH lesions were equally able to experience both positive and negative affect. The results are discussed in relation to the role of the RH in the capacity to experience negative emotions.

  5. Acquired Brain Injury Program.

    ERIC Educational Resources Information Center

    Schwartz, Stacey Hunter

    This paper reviews the Acquired Brain Injury (ABI) Program at Coastline Community College (California). The ABI Program is a two-year, for-credit educational curriculum designed to provide structured cognitive retraining for adults who have sustained an ABI due to traumatic (such as motor vehicle accident or fall) or non-traumatic(such as…

  6. Internally and externally generated emotions in people with acquired brain injury: preservation of emotional experience after right hemisphere lesions

    PubMed Central

    Salas Riquelme, Christian E.; Radovic, Darinka; Castro, Osvaldo; Turnbull, Oliver H.

    2015-01-01

    The study of emotional changes after brain injury has contributed enormously to the understanding of the neural basis of emotion. However, little attention has been placed on the methods used to elicit emotional responses in people with brain damage. Of particular interest are subjects with right hemisphere [RH] cortical lesions, who have been described as presenting impairment in emotional processing. In this article, an internal and external mood induction procedure [MIP] was used to trigger positive and negative emotions, in a sample of 10 participants with RH damage, and 15 healthy controls. Emotional experience was registered by using a self-report questionnaire. As observed in previous studies, internal and external MIPs were equally effective in eliciting the target emotion, but the internal procedure generated higher levels of intensity. Remarkably, participants with RH lesions were equally able to experience both positive and negative affect. The results are discussed in relation to the role of the RH in the capacity to experience negative emotions. PMID:25762951

  7. Surgical salvage of acquired lung lesions in extremely premature infants.

    PubMed

    Sacks, Greg D; Chung, Katherine; Jamil, Kevin; Garg, Meena; Dunn, James C Y; DeUgarte, Daniel A

    2014-05-01

    Acquired neonatal lung lesions including pneumatoceles, cystic bronchopulmonary dysplasia, and pulmonary interstitial emphysema can cause extrinsic mediastinal compression, which may impair pulmonary and cardiac function. Acquired lung lesions are typically managed medically. Here we report a case series of three extremely premature infants with acquired lung lesions. All three patients underwent aggressive medical management and ultimately required tube thoracostomies. These interventions were unsuccessful and emergency thoracotomies were performed in each case. Two infants with acquired pneumatoceles underwent unroofing of the cystic structure and primary repair of a bronchial defect. The third infant with pulmonary interstitial emphysema, arising from cystic bronchopulmonary dysplasia, required a middle lobectomy for severe and diffuse cystic disease. When medical management fails, tube thoracostomy can be attempted, leaving surgical intervention for refractory cases. Surgical options include oversewing a bronchial defect in the setting of a bronchopleural fistula or lung resection in cases of an isolated expanding lobe.

  8. Group Treatment in Acquired Brain Injury Rehabilitation

    ERIC Educational Resources Information Center

    Bertisch, Hilary; Rath, Joseph F.; Langenbahn, Donna M.; Sherr, Rose Lynn; Diller, Leonard

    2011-01-01

    The current article describes critical issues in adapting traditional group-treatment methods for working with individuals with reduced cognitive capacity secondary to acquired brain injury. Using the classification system based on functional ability developed at the NYU Rusk Institute of Rehabilitation Medicine (RIRM), we delineate the cognitive…

  9. Stereotypic movement disorder after acquired brain injury.

    PubMed

    McGrath, Cynthia M; Kennedy, Richard E; Hoye, Wayne; Yablon, Stuart A

    2002-05-01

    Stereotypic movement disorder (SMD) consists of repetitive, non-functional motor behaviour that interferes with daily living or causes injury to the person. It is most often described in patients with mental retardation. However, recent evidence indicates that this condition is common among otherwise normal individuals. This case study describes a patient with new-onset SMD occurring after subdural haematoma and brain injury. SMD has rarely been reported after acquired brain injury, and none have documented successful treatment. The current psychiatric literature regarding neurochemistry, neuroanatomy, and treatment of SMD are reviewed with particular application to one patient. Treatment options include serotonin re-uptake inhibitors, opioid antagonists and dopamine antagonists. SMD has been under-appreciated in intellectually normal individuals, and may also be unrecognized after brain injury. Further investigation is needed in this area, which may benefit other individuals with SMD as well.

  10. Human brain lesion-deficit inference remapped.

    PubMed

    Mah, Yee-Haur; Husain, Masud; Rees, Geraint; Nachev, Parashkev

    2014-09-01

    Our knowledge of the anatomical organization of the human brain in health and disease draws heavily on the study of patients with focal brain lesions. Historically the first method of mapping brain function, it is still potentially the most powerful, establishing the necessity of any putative neural substrate for a given function or deficit. Great inferential power, however, carries a crucial vulnerability: without stronger alternatives any consistent error cannot be easily detected. A hitherto unexamined source of such error is the structure of the high-dimensional distribution of patterns of focal damage, especially in ischaemic injury-the commonest aetiology in lesion-deficit studies-where the anatomy is naturally shaped by the architecture of the vascular tree. This distribution is so complex that analysis of lesion data sets of conventional size cannot illuminate its structure, leaving us in the dark about the presence or absence of such error. To examine this crucial question we assembled the largest known set of focal brain lesions (n = 581), derived from unselected patients with acute ischaemic injury (mean age = 62.3 years, standard deviation = 17.8, male:female ratio = 0.547), visualized with diffusion-weighted magnetic resonance imaging, and processed with validated automated lesion segmentation routines. High-dimensional analysis of this data revealed a hidden bias within the multivariate patterns of damage that will consistently distort lesion-deficit maps, displacing inferred critical regions from their true locations, in a manner opaque to replication. Quantifying the size of this mislocalization demonstrates that past lesion-deficit relationships estimated with conventional inferential methodology are likely to be significantly displaced, by a magnitude dependent on the unknown underlying lesion-deficit relationship itself. Past studies therefore cannot be retrospectively corrected, except by new knowledge that would render them redundant

  11. Male body image following acquired brain injury.

    PubMed

    Howes, Hannah; Edwards, Stephen; Benton, David

    2005-02-01

    The purpose of this study was to investigate body image concerns and psycho-emotional health in males with acquired brain injury (ABI). Using a between subjects study of 25 males with ABI and 25 matched controls, variables were analysed using correlations and 2 x 2 analyses of variance (ANOVAs) with head injury and injury type as independent variables. Body image and psycho-emotional health were evaluated using self-report questionnaires. Disability and cognitive impairment were measured using a mixture of self-report, cognitive testing and clinical notes. Results indicated that males with ABI had significantly lower self-esteem and body dissatisfaction on a number of items relating to physical and sexual functioning. There were significant differences in body image between stroke and TBI, but there was no corresponding relationship with psycho-emotional health. These body image differences might be explained by age. The finding that ABI has a negative effect on body image and that this relates to psycho-emotional health should be investigated further, perhaps being included in future rehabilitation strategies.

  12. Fractal analysis of tumoral lesions in brain.

    PubMed

    Martín-Landrove, Miguel; Pereira, Demian; Caldeira, María E; Itriago, Salvador; Juliac, María

    2007-01-01

    In this work, it is proposed a method for supervised characterization and classification of tumoral lesions in brain, based on the analysis of irregularities at the lesion contour on T2-weighted MR images. After the choice of a specific image, a segmentation procedure with a threshold selected from the histogram of intensity levels is applied to isolate the lesion, the contour is detected through the application of a gradient operator followed by a conversion to a "time series" using a chain code procedure. The correlation dimension is calculated and analyzed to discriminate between normal or malignant structures. The results found showed that it is possible to detect a differentiation between benign (cysts) and malignant (gliomas) lesions suggesting the potential of this method as a diagnostic tool.

  13. Glioblastoma multiforme of the brain stem in a patient with acquired immunodeficiency syndrome.

    PubMed

    Wolff, R; Zimmermann, M; Marquardt, Gerhard; Lanfermann, H; Nafe, R; Seifert, V

    2002-09-01

    Glioblastoma of the brain stem is rare and there is no description of such a lesion in patients suffering from acquired immunodeficiency syndrome. The majority of intracerebral mass lesions are due either to toxoplasmosis or primary central nervous system lymphomas so that it is usually not included in the differential diagnosis of enhancing lesions of the central nervous system in these patients. A 31-year-old human immunodeficiency virus (HIV) infected man presented with a four months history of slowly progressive deterioration of brainstem associated symptoms despite antitoxoplasmic therapy. Magnetic resonance imaging revealed a large ring enhancing lesion in the brainstem. Clinical and neuroradiological data could not establish a proper diagnosis and a stereotactic serial biopsy was undertaken. Histological examination of the specimen showed a glioblastoma multiforme (GBM) as the first reported case of GBM located in the brainstem in an acquired immunodeficiency syndrome (AIDS) patient. Patient management and effectiveness of stereotactic serial biopsy are discussed.

  14. Cohort study of multiple brain lesions in sport divers: role of a patent foramen ovale.

    PubMed Central

    Knauth, M.; Ries, S.; Pohimann, S.; Kerby, T.; Forsting, M.; Daffertshofer, M.; Hennerici, M.; Sartor, K.

    1997-01-01

    OBJECTIVE: To investigate the role of a patient foramen ovale in the pathogenesis of multiple brain lesions acquired by sport divers in the absence of reported decompression symptoms. DESIGN: Prospective double blind cohort study. SETTING: Diving clubs around Heidelberg and departments of neuroradiology and neurology. SUBJECTS: 87 sport divers with a minimum of 160 scuba dives (dives with self contained underwater breathing apparatus). MAIN OUTCOME MEASURES: Presence of multiple brain lesions visualised by cranial magnetic resonance imaging and presence and size of patent foramen ovale as documented by echocontrast transcranial Doppler ultrasonography. RESULTS: 25 subjects were found to have a right-to-left shunt, 13 with a patent foramen ovale of high haemodynamic relevance. A total of 41 brain lesions were detected in 11 divers. There were seven brain lesions in seven divers without a right-to-left shunt and 34 lesions in four divers with a right-to-left shunt. Multiple brain lesions occurred exclusively in three divers with a large patent foramen ovale (P = 0.004). CONCLUSIONS: Multiple brain lesions in sport divers were associated with presence of a large patent foramen ovale. This association suggests paradoxical gas embolism as the pathological mechanism. A patent foramen ovale of high haemodynamic relevance seems to be an important risk factor for developing multiple brain lesions in sport divers. PMID:9116544

  15. Cohort Study of Multiple Brain Lesions in Sport Divers: Role of a Patent Foramen Ovale

    NASA Technical Reports Server (NTRS)

    Knauth, Michael; Ries, Stefan; Pohimann, Stefan; Kerby, Tina; Forstring, Michael; Daffertshofer, Michael; Hennerici,Michael; Sartor, Klaus

    1997-01-01

    To investigate the role of a patent foramen ovale in the pathogenesis of multiple brain lesions acquired by sport divers in the absence of reported decompression symptoms. Design: Prospective double blind cohort study. . Setting Diving clubs around Heidelberg and departments of neuroradiology and neurology. Subjects: 87 sport divers with a minimum of 160 scuba dives (dives with self contained underwater breathing apparatus). Main outcome measures: Presence of multiple brain lesions visualised by cranial magnetic resonance imaging and presence and size of patent foramen ovale as documented by echocontrast transcranial Doppler ultrasonograhy. Results: 25 subjects were found to have a right-to-left shunt, 13 with a patent foramen ovale of high haemodynamic relevance. A total of 41 brain lesions were detected in 11 divers. There were seven brain lesions in seven divers without a right-to-left shunt and 34 lesions in four divers with a right-to-left shunt Multiple brain lesions occurred exclusively in three divers with a large patent foramen ovale (P=0.004). Conclusions: Multiple brain lesions in sport divers were associated with presence of a large patent foramen ovale. This association suggests paradoxical gas embolism as the pathological mechanism. A patent foramen ovale of high haemodynamic relevance seems to be an important risk factor for developing multiple brain lesions in sport divers.

  16. Behavior Management for Children and Adolescents with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Slifer, Keith J.; Amari, Adrianna

    2009-01-01

    Behavioral problems such as disinhibition, irritability, restlessness, distractibility, and aggression are common after acquired brain injury (ABI). The persistence and severity of these problems impair the brain-injured individual's reintegration into family, school, and community life. Since the early 1980s, behavior analysis and therapy have…

  17. Students with Acquired Brain Injury. The School's Response.

    ERIC Educational Resources Information Center

    Glang, Ann, Ed.; Singer, George H. S., Ed.; Todis, Bonnie, Ed.

    Designed for educators, this book focuses on educational issues relating to students with acquired brain injury (ABI), and describes approaches that have been effective in improving the school experiences of students with brain injury. Section 1 provides an introduction to issues related to ABI in children and youth and includes: "An Overview of…

  18. Organic Brain Syndromes: Conditions of Acquired Intellectual Deficit

    PubMed Central

    Roy, John R.

    1979-01-01

    The term 'organic brain syndrome' covers a multitude of ills, many of which are treatable conditions. Diagnosis must concentrate on defining which syndrome is involved; this article presents a diagnostic schema with illustrative case histories. Clinical aspects of acquired mental deficit are also outlined. The approach to organic brain syndromes is the classic medical observation of signs and symptoms. PMID:21297811

  19. Ocular Lesions in Red-Tailed Hawks ( Buteo jamaicensis) With Naturally Acquired West Nile Disease.

    PubMed

    Wünschmann, A; Armién, A G; Khatri, M; Martinez, L C; Willette, M; Glaser, A; Alvarez, J; Redig, P

    2017-03-01

    Ocular lesions are common in red-tailed hawks with West Nile (WN) disease. These lesions consist of pectenitis, choroidal or retinal inflammation, or retinal necrosis, but detailed investigation of the ocular lesions is lacking. Postmortem examination of the eyes of 16 red-tailed hawks with naturally acquired WN disease and 3 red-tailed hawks without WN disease was performed using histopathology, immunohistochemistry for West Nile virus (WNV) antigen, glial fibrillary acid protein, cleaved caspase-3, and the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling method. Retinal lesions were classified as type I or type II lesions. Type I lesions were characterized by lymphoplasmacytic infiltrates in the subjacent choroid with degeneration limited to the outer retina (type Ia lesion) or with degeneration and necrosis of the outer retina or outer and inner retina (type Ib lesion) while retinal collapse, atrophy, and scarring were hallmarks of type II lesions. Type II retinal lesions were associated with a more pronounced choroiditis. Although not statistically significant, WNV antigen tended to be present in larger quantity in type Ib lesions. Type I lesions are considered acute while type II lesions are chronic. The development of retinal lesions was associated with the presence of an inflammatory infiltrate in the choroid. A breakdown of the blood-retina barrier is suspected to be the main route of infection of the retina. Within the retina, virus appeared to spread via both neuronal and Müller cell processes.

  20. Functional Topography of Early Periventricular Brain Lesions in Relation to Cytoarchitectonic Probabilistic Maps

    ERIC Educational Resources Information Center

    Staudt, Martin; Ticini, Luca F.; Grodd, Wolfgang; Krageloh-Mann, Ingeborg; Karnath, Hans-Otto

    2008-01-01

    Early periventricular brain lesions can not only cause cerebral palsy, but can also induce a reorganization of language. Here, we asked whether these different functional consequences can be attributed to topographically distinct portions of the periventricular white matter damage. Eight patients with pre- and perinatally acquired left-sided…

  1. Predictors of Outcome following Acquired Brain Injury in Children

    ERIC Educational Resources Information Center

    Johnson, Abigail R.; DeMatt, Ellen; Salorio, Cynthia F.

    2009-01-01

    Acquired brain injury (ABI) in children and adolescents can result from multiple causes, including trauma, central nervous system infections, noninfectious disorders (epilepsy, hypoxia/ischemia, genetic/metabolic disorders), tumors, and vascular abnormalities. Prediction of outcomes is important, to target interventions, allocate resources,…

  2. Brain lesion-pattern analysis in patients with olfactory dysfunctions following head trauma

    PubMed Central

    Lötsch, Jörn; Ultsch, Alfred; Eckhardt, Maren; Huart, Caroline; Rombaux, Philippe; Hummel, Thomas

    2016-01-01

    The presence of cerebral lesions in patients with neurosensory alterations provides a unique window into brain function. Using a fuzzy logic based combination of morphological information about 27 olfactory-eloquent brain regions acquired with four different brain imaging techniques, patterns of brain damage were analyzed in 127 patients who displayed anosmia, i.e., complete loss of the sense of smell (n = 81), or other and mechanistically still incompletely understood olfactory dysfunctions including parosmia, i.e., distorted perceptions of olfactory stimuli (n = 50), or phantosmia, i.e., olfactory hallucinations (n = 22). A higher prevalence of parosmia, and as a tendency also phantosmia, was observed in subjects with medium overall brain damage. Further analysis showed a lower frequency of lesions in the right temporal lobe in patients with parosmia than in patients without parosmia. This negative direction of the differences was unique for parosmia. In anosmia, and also in phantosmia, lesions were more frequent in patients displaying the respective symptoms than in those without these dysfunctions. In anosmic patients, lesions in the right olfactory bulb region were much more frequent than in patients with preserved sense of smell, whereas a higher frequency of carriers of lesions in the left frontal lobe was observed for phantosmia. We conclude that anosmia, and phantosmia, are the result of lost function in relevant brain areas whereas parosmia is more complex, requiring damaged and intact brain regions at the same time. PMID:26937377

  3. Network localization of neurological symptoms from focal brain lesions.

    PubMed

    Boes, Aaron D; Prasad, Sashank; Liu, Hesheng; Liu, Qi; Pascual-Leone, Alvaro; Caviness, Verne S; Fox, Michael D

    2015-10-01

    A traditional and widely used approach for linking neurological symptoms to specific brain regions involves identifying overlap in lesion location across patients with similar symptoms, termed lesion mapping. This approach is powerful and broadly applicable, but has limitations when symptoms do not localize to a single region or stem from dysfunction in regions connected to the lesion site rather than the site itself. A newer approach sensitive to such network effects involves functional neuroimaging of patients, but this requires specialized brain scans beyond routine clinical data, making it less versatile and difficult to apply when symptoms are rare or transient. In this article we show that the traditional approach to lesion mapping can be expanded to incorporate network effects into symptom localization without the need for specialized neuroimaging of patients. Our approach involves three steps: (i) transferring the three-dimensional volume of a brain lesion onto a reference brain; (ii) assessing the intrinsic functional connectivity of the lesion volume with the rest of the brain using normative connectome data; and (iii) overlapping lesion-associated networks to identify regions common to a clinical syndrome. We first tested our approach in peduncular hallucinosis, a syndrome of visual hallucinations following subcortical lesions long hypothesized to be due to network effects on extrastriate visual cortex. While the lesions themselves were heterogeneously distributed with little overlap in lesion location, 22 of 23 lesions were negatively correlated with extrastriate visual cortex. This network overlap was specific compared to other subcortical lesions (P < 10(-5)) and relative to other cortical regions (P < 0.01). Next, we tested for generalizability of our technique by applying it to three additional lesion syndromes: central post-stroke pain, auditory hallucinosis, and subcortical aphasia. In each syndrome, heterogeneous lesions that themselves had

  4. Mapping Functional Connectivity in Patients with Brain Lesions

    PubMed Central

    Guggisberg, Adrian G.; Honma, Susanne M.; Findlay, Anne M.; Dalal, Sarang S.; Kirsch, Heidi E.; Berger, Mitchel S.; Nagarajan, Srikantan S.

    2013-01-01

    OBJECTIVE Although electrophysiological measures of functional connectivity between brain areas are widely used, the spatial distribution of functional interactions as well as the disturbance introduced by focal brain lesions remains poorly understood. Based on the rationale that damaged brain tissue can be expected to be disconnected from the physiological interactions among healthy areas, this study aimed to map the functionality of brain areas according to their connectivity with other areas. METHODS Magnetoencephalographic (MEG) recordings of spontaneous cortical activity during resting state were obtained from 15 consecutive patients with focal brain lesions and from 14 healthy controls. Neural activity at each volume element (voxel) in the brain was estimated using an adaptive spatial filtering technique. For each brain voxel, the mean imaginary coherence of all its connections with other brain voxels was then caluculated as an index of functional connectivity, and the results compared across brain regions and between subjects. RESULTS The magnitude of the mean imaginary coherence of all voxels and subjects was greatest in the alpha frequency range corresponding to the human cortical idling rhythm. In healthy subjects, functionally critical brain areas such as the somatosensory and language cortices had the highest alpha coherence. When compared to healthy controls, all lesion patients had diffuse or scattered brain areas with decreased coherence. Patients with lesion-induced neurological deficits displayed decreased connectivity estimates in the corresponding brain area compared to intact contralateral regions. In tumor patients without preoperative neurological deficits, brain areas showing decreased coherence could be surgically resected without the occurrence of post-surgical deficits. CONCLUSION Resting state coherence measured with MEG is capable of mapping the functional connectivity of the brain, and can therefore offer valuable information for use in

  5. Pediatric Awake Craniotomy for Brain Lesions.

    PubMed

    Akay, Ali; Rükşen, Mete; Çetin, H Yurday; Seval, H Özer; İşlekel, Sertaç

    2016-01-01

    Awake craniotomy is a special method to prevent motor deficits during the resection of lesions that are located in, or close to, functional areas. Although it is more commonly performed in adult patients, reports of pediatric cases undergoing awake craniotomy are limited in the literature. In our clinic, where we frequently use awake craniotomy in adult patients, we performed this method in 2 selected pediatric cases for lesion surgery. At an early age, these 2 cases diagnosed with epilepsy presented cerebral lesions, but since the lesions enclosed functional areas, surgical resection was not regarded as a treatment option at this time. In these 2 pediatric cases, we successfully completed lesion surgery with awake craniotomy. The method and the techniques employed during surgery are presented concomitant with other reports in the literature.

  6. Finding the imposter: brain connectivity of lesions causing delusional misidentifications.

    PubMed

    Darby, R Ryan; Laganiere, Simon; Pascual-Leone, Alvaro; Prasad, Sashank; Fox, Michael D

    2017-02-01

    SEE MCKAY AND FURL DOI101093/AWW323 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Focal brain injury can sometimes lead to bizarre symptoms, such as the delusion that a family member has been replaced by an imposter (Capgras syndrome). How a single brain lesion could cause such a complex disorder is unclear, leading many to speculate that concurrent delirium, psychiatric disease, dementia, or a second lesion is required. Here we instead propose that Capgras and other delusional misidentification syndromes arise from single lesions at unique locations within the human brain connectome. This hypothesis is motivated by evidence that symptoms emerge from sites functionally connected to a lesion location, not just the lesion location itself. First, 17 cases of lesion-induced delusional misidentifications were identified and lesion locations were mapped to a common brain atlas. Second, lesion network mapping was used to identify brain regions functionally connected to the lesion locations. Third, regions involved in familiarity perception and belief evaluation, two processes thought to be abnormal in delusional misidentifications, were identified using meta-analyses of previous functional magnetic resonance imaging studies. We found that all 17 lesion locations were functionally connected to the left retrosplenial cortex, the region most activated in functional magnetic resonance imaging studies of familiarity. Similarly, 16 of 17 lesion locations were functionally connected to the right frontal cortex, the region most activated in functional magnetic resonance imaging studies of expectation violation, a component of belief evaluation. This connectivity pattern was highly specific for delusional misidentifications compared to four other lesion-induced neurological syndromes (P < 0.0001). Finally, 15 lesions causing other types of delusions were connected to expectation violation (P < 0.0001) but not familiarity regions, demonstrating specificity for delusion content. Our

  7. Endoscopic laser stereotaxis: management of brain lesions

    NASA Astrophysics Data System (ADS)

    Zamorano, Lucia J.; Chavantes, Maria C.; Moure, Federico; Diaz, Fernando

    1994-05-01

    Image-guided stereotaxis is an accurate and safe method of directing therapy to target volumes defined in 2D multi-planes or 3D perspectives using computer reconstruction of image data. The major limitations of stereotactic techniques are the lack of intraoperative visualization and the ability to directly monitor the procedures, and changes of intracranial coordinates after decompression of cystic lesions or aspiration of cerebrospinal fluid in the management of intraventricular lesions. Stereotactic neuroendoscopy involves integration of rigid-flexible endoscopy and the Nd-YAG laser in 2D/3D multiplanar image-guided stereotactic procedures. The major advantages of endoscopic laser surgery include being minimally invasive (burrhole or small craniotomy surgery), direct intraoperative visualization, hemostasis, evacuation or resection assessment, and wide exploration of intracranial cavities or ventricles. We used endoscopic laser surgery in the management of 202 patients undergoing biopsy, aspiration, resection, and internal decompression of deep and subcortical intracranial lesions, and for different types of fenestration procedures. Image-guidance combined with endoscopic techniques may offer a safe, accurate alternative to conventional neurosurgical procedures in treating small solid, cystic, intraventricular lesions, and in fenestration procedures.

  8. Inferential stereomorphology of human brain lesions

    NASA Astrophysics Data System (ADS)

    Gedye, John L.

    1980-07-01

    I very much appreciated the invitation to contribute a paper to this Symposium on Applications of Human Biostereometrics, as it provides a valuable opportunity for me to take a fresh look at a problemâ€""the cerebral localisation of psychological function"â€"in which I have been interested for many years. This interest grew out of considerations of the clinically important problem of how we should go about the task of relating the form of the changes in human behavior consequent upon damage to the human brain following, say, head injury, to the form of the changes in brain morphology which constitute that damage, and related issues.

  9. Do brain lesions in stroke affect basic emotions and attachment?

    PubMed

    Farinelli, Marina; Panksepp, Jaak; Gestieri, Laura; Maffei, Monica; Agati, Raffaele; Cevolani, Daniela; Pedone, Vincenzo; Northoff, Georg

    2015-01-01

    The aim of the current study was to investigate basic emotions and attachment in a sample of 86 stroke patients. We included a control group of 115 orthopedic patients (matched for age and cognitive status) without brain lesions to control for unspecific general illness effects of a traumatic recent event on basic emotions and attachment. In order to measure basic emotions and attachment style we applied the Affective Neuroscience Personality Scale (ANPS) and the Attachment Style Questionnaire (ASQ). The stroke patients showed significantly different scores in the SEEKING, SADNESS, and ANGER subscales of the ANPS as well as in the Relationship as Secondary Attachment dimension of the ASQ when compared to the control group. These differences show a pattern influenced by lesion location mainly as concerns basic emotions. Anterior, medial, left, and subcortical patients provide scores significantly lower in ANPS-SEEKING than the control group; ANPS-SADNESS scores in anterior, right, medial, and subcortical patients were significantly higher than those of the control group. ANPS-ANGER scores in posterior, right, and lateral patients were significantly higher than those in the control group; finally, the ANPS-FEAR showed slightly lower scores in posterior patients than in the control group. Minor effects on brain lesions were also individuated in the attachment style. Anterior lesion patients showed a significantly higher average score in the ASQ-Need for Approval subscale than the control group. ASQ-Confidence subscale scores differed significantly in stroke patients with lesions in medial brain regions when compared to control subjects. Scores at ANPS and ASQ subscales appear significantly more correlated in stroke patients than in the control group. Such finding of abnormalities, especially concerning basic emotions in stroke brain-lesioned patients, indicates that the effect of brain lesions may enhance the interrelation between basic emotions and attachment with

  10. Brain lesions in mallard ducklings from parents fed methylmercury

    USGS Publications Warehouse

    Heinz, G.H.; Locke, L.N.

    1976-01-01

    Methylmercury dicyandiamide was fed to mallard ducks at 3 ppm mercury. Mercury accumulated in the eggs to an average of 7.18 and 5.46 ppm on a wet-weight basis in 2 successive years. Mercury in the eggs is believed to have caused brain lesions in the hatched ducklings. Lesions included demyelination, neuron shrink-age, necrosis, and hemorrhage in the meninges overlying the cerebellum. Brains of dead ducklings contained an average of 6.17 and 5.19 ppm mercury on a wet-weight basis in 2 successive years.

  11. Visual search in school-aged children with unilateral brain lesions.

    PubMed

    Netelenbos, J Bernard; Van Rooij, Louise

    2004-05-01

    In this preliminary study, visual search for targets within and beyond the initial field of view was investigated in seven school-aged children (five females, two males; mean age at testing 8 years 10 months, SD 1 year 3 months; range 6 to 10 years) with various acquired, postnatal, focal brain injuries (haematoma, haemorrhage, meningioma, neuroblastoma, and cerebral abscess) in anterior or posterior sites of the left or right hemisphere, and seven control children (matched for age and sex) were also studied. All participants attended mainstream primary schools. The children with lesions underwent surgery after diagnosis (mean age at diagnosis 5 years 4 months, SD 2 years 7 months). Group results indicated that for the overall scores on three psychometric tests of visuospatial and fine motor abilities (Southern California Figure Ground Perception Test, Visual Organization Test, and Visual-Motor Integration Test), no difference between the children with left and right lesions was present. However, children with lesions in the right hemisphere, and not in the left hemisphere, took significantly more time than the controls to locate visual targets presented within and beyond the field of view. Examination of individual data suggested that, in accordance with brain imaging research, right-sided anterior cerebral lesions sustained in early childhood might have an enduring detrimental effect on voluntary visual search performance during development. This persistent effect of early brain injury might imply that developmental plasticity of the brain does not apply to certain specific functions of particular areas of the right hemisphere.

  12. Inability to acquire spatial information and deploy spatial search strategies in mice with lesions in dorsomedial striatum.

    PubMed

    Pooters, Tine; Gantois, Ilse; Vermaercke, Ben; D'Hooge, Rudi

    2016-02-01

    Dorsal striatum has been shown to contribute to spatial learning and memory, but the role of striatal subregions in this important aspect of cognitive functioning remains unclear. Moreover, the spatial-cognitive mechanisms that underlie the involvement of these regions in spatial navigation have scarcely been studied. We therefore compared spatial learning and memory performance in mice with lesions in dorsomedial (DMS) and dorsolateral striatum (DLS) using the hidden-platform version of the Morris water maze (MWM) task. Compared to sham-operated controls, animals with DMS damage were impaired during MWM acquisition training. These mice displayed delayed spatial learning, increased thigmotaxis, and increased search distance to the platform, in the absence of major motor dysfunction, working memory defects or changes in anxiety or exploration. They failed to show a preference for the target quadrant during probe trials, which further indicates that spatial reference memory was impaired in these animals. Search strategy analysis moreover demonstrated that DMS-lesioned mice were unable to deploy cognitively advanced spatial search strategies. Conversely, MWM performance was barely affected in animals with lesions in DLS. In conclusion, our results indicate that DMS and DLS display differential functional involvement in spatial learning and memory. Our results show that DMS, but not DLS, is crucial for the ability of mice to acquire spatial information and their subsequent deployment of spatial search strategies. These data clearly identify DMS as a crucial brain structure for spatial learning and memory, which could explain the occurrence of neurocognitive impairments in brain disorders that affect the dorsal striatum.

  13. Imaging of congenital anomalies and acquired lesions of the inner ear.

    PubMed

    Krombach, Gabriele A; Honnef, Dagmar; Westhofen, Martin; Di Martino, Ercole; Günther, Rolf W

    2008-02-01

    Imaging of the temporal bone is under continous developement. In the recent decades the technical advances of magnetic resonance imaging and computed tomography have contributed to improved imaging quality in assessment of the temporal bone. Dedicated imaging protocols have been developed and are routinely employed in most institutions. However, imaging interpretation remains challenging, since the temporal bone is an anatomically highly complex region and most diseases of the inner ear occur with low incidence, so that even radiologists experienced in the field may be confronted with such entities for the first time. The current review gives an overview about symptoms and imaging appearance of malformations and acquired lesion of the inner ear.

  14. Brain lesion induced by 1319nm laser radiation

    NASA Astrophysics Data System (ADS)

    Yang, Zaifu; Chen, Hongxia; Wang, Jiarui; Chen, Peng; Ma, Ping; Qian, Huanwen

    2010-11-01

    The laser-tissue interaction has not been well defined at the 1319 nm wavelength for brain exposure. The goal of this research effort was to identify the behavioral and histological changes of brain lesion induced by 1319 nm laser. The experiment was performed on China Kunming mice. Unilateral brain lesions were created with a continuous-wave Nd:YAG laser (1319nm). The brain lesions were identified through behavioral observation and histological haematoxylin and eosin (H&E) staining method. The behavior change was observed for a radiant exposure range of 97~773 J/cm2. The histology of the recovery process was identified for radiant exposure of 580 J/cm2. Subjects were sacrificed 1 hour, 1 week, 2 weeks, 3 months, 7 months and 13 months after laser irradiation. Results showed that after laser exposure, behavioral deficits, including kyphosis, tail entasia, or whole body paralysis could be noted right after the animals recovered from anesthesia while gradually disappeared within several days and never recurred again. Histologically, the laser lesion showed a typical architecture dependent on the interval following laser treatment. The central zone of coagulation necrosis is not apparent right after exposure but becomes obvious within several days. The nerotic tissue though may persist for a long time, will finally be completely resorbed. No carbonization granules formed under our exposure condition.

  15. Solitary ring enhancing brain lesion in a patient with AIDS

    PubMed Central

    Aldeen, Taha; Lunn, Michael

    2009-01-01

    Toxoplasmosis in immune competent patients usually causes asymptomatic infection or mild symptoms, while in immunocompromised and AIDS patients it can be a life threatening condition. We report a case of cerebral toxoplasmosis in a patient with AIDS and review the causes of brain ring enhancing lesions. PMID:22132018

  16. [Sense of personal identity and focal brain lesions].

    PubMed

    Morin, Catherine

    2009-03-01

    The sense of personal identity is an element of the Jasperian definition of self-conscience. Each of us is convinced of being a unique and stable individual, different from other individuals. These properties - stability ad coherence - belong to an image of ourselves that was proposed to us by the Other's look during the mirror phase. Brain focal lesions may threaten this certitude in two ways: 1) brain lesions result in deficiency, disability or handicap, which are experienced as a narcissistic injury. The patient questions himself about the image he offers to the Other's look, and, as a result, his sense of personal identity is unsettled; 2) a variety of focal brain lesions or dysfunctions may alter the activity of areas which are necessary for maintaining a stable image of the patients' body or self. This may lead patients to experience depersonalisation, autoscopy, somatoparaphrenic "delusions" or disturbed agency. The sense of personal identity may be disturbed during brief paroxystic or psychologically traumatic phenomena. However, this is not observed in chronic sequelae of brain lesions (e.g. right hemisphere syndrome or amnesic syndrome), even though the patients may present a broken up image of themselves.

  17. Visuospatial attention deficit in patients with local brain lesions.

    PubMed

    Xu, Guang-Qing; Lan, Yue; Huang, Dong-Feng; Rao, De-Zhong; Pei, Zhong; Chen, Ling; Zeng, Jin-Sheng

    2010-03-31

    The disability of visuospatial attention can lead to poor volitional movement and functional recovery in patients with brain lesions. However, the accurate clinical method to assess visuospatial attention is limited. The frontoparietal network including the posterior parietal cortex and the frontal eye fields has been shown to involve in visuospatial attention. The Attention Network Test provided measures for three different components of visuospatial attention: alerting, orienting and executive control. This study was to probe the deficit and relationship of visuospatial attention using Attention Network Test paradigm in patients with frontoparietal network lesions. During this task, patients responded significantly slower on each cue condition and target type than controls, and showed deficits in the alerting and orienting networks. The efficiency of resolving conflict was decreased in patients with frontal lesions whereas this was increased in patients with parietal lesions. These findings suggest that the frontoparietal network is involved in the alerting and orienting attentional function and the executive function is possibly selectively associated with the frontal lobe. The Attention Network Test paradigm produces sensitive, valid and reliable subject estimates of visuospatial attention function in patients with brain lesions, and may be useful for clinical rehabilitation strategy selection for patients with the frontoparietal network lesions.

  18. Outcomes of a multicomponent intervention on occupational performance in persons with unilateral acquired brain injury

    PubMed Central

    Hoyas, Elisabet Huertas; Pérez, Eduardo José Pedrero; Águila Maturana, Ana M.; Mota, Gloria Rojo; Piédrola, Rosa Martínez; de Heredia Torres, Marta Pérez

    2016-01-01

    Summary Complications after unilateral acquired brain injury (ABI) can affect various areas of expertise causing (depending on the location of the lesion) impairment in occupational performance. The aim of this study was to analyze and compare the concepts of occupational performance and functional independence, both before and after a multicomponent intervention including occupational therapy, in persons with unilateral brain damage. This was a longitudinal quasi-experimental pretest post-test study in a sample of 58 patients with unilateral brain injury (28 with traumatic brain injury and 30 with ischemic stroke). The patients’ level of independence was measured using the short version of the International Classification of Functioning, Disability and Health. We also measured quality of performance using the Assessment of Motor and Process Skills. The findings of this study showed that patients with injury in the right hemisphere improved more than those with left hemisphere damage (p<0.001). All the patients with ABI, especially those with right-sided injury, derived benefit from the multicomponent intervention, except in the area of motor skills. More research is needed on the specific techniques that might address such skills. PMID:27358224

  19. Outcomes of a multicomponent intervention on occupational performance in persons with unilateral acquired brain injury.

    PubMed

    Huertas Hoyas, E; Pedrero Pérez, E J; Águila Maturana, A M; Rojo Mota, G; Martínez Piédrola, R; Pérez de Heredia Torres, M

    2016-01-01

    Complications after unilateral acquired brain injury (ABI) can affect various areas of expertise causing (depending on the location of the lesion) impairment in occupational performance. The aim of this study was to analyze and compare the concepts of occupational performance and functional independence, both before and after a multicomponent intervention including occupational therapy, in persons with unilateral brain damage. This was a longitudinal quasi-experimental pretest post-test study in a sample of 58 patients with unilateral brain injury (28 with traumatic brain injury and 30 with ischemic stroke). The patients' level of independence was measured using the short version of the International Classification of Functioning, Disability and Health. We also measured quality of performance using the Assessment of Motor and Process Skills. The findings of this study showed that patients with injury in the right hemisphere improved more than those with left hemisphere damage (p<0.001). All the patients with ABI, especially those with right-sided injury, derived benefit from the multicomponent intervention, except in the area of motor skills. More research is needed on the specific techniques that might address such skills.

  20. Behavior management for children and adolescents with acquired brain injury.

    PubMed

    Slifer, Keith J; Amari, Adrianna

    2009-01-01

    Behavioral problems such as disinhibition, irritability, restlessness, distractibility, and aggression are common after acquired brain injury (ABI). The persistence and severity of these problems impair the brain-injured individual's reintegration into family, school, and community life. Since the early 1980s, behavior analysis and therapy have been used to address the behavioral sequelae of ABI. These interventions are based on principles of learning and behavior that have been robustly successful when applied across a broad range of other clinical populations. Most of the research on behavioral treatment after ABI has involved clinical case studies or studies employing single-subject experimental designs across a series of cases. The literature supports the effectiveness of these interventions across ages, injury severities, and stages of recovery after ABI. Recommended guidelines for behavior management include: direct behavioral observations, systematic assessment of environmental and within-patient variables associated with aberrant behavior, antecedent management to minimize the probability of aberrant behavior, provision of functionally equivalent alternative means of controlling the environment, and differential reinforcement to shape positive behavior and coping strategies while not inadvertently shaping emergent, disruptive sequelae. This package of interventions requires direction by a highly skilled behavioral psychologist or therapist who systematically monitors target behavior to evaluate progress and guide treatment decisions. A coordinated multisite effort is needed to design intervention protocols that can be studied prospectively in randomized controlled trials. However, there will continue to be an important role for single subject experimental design for studying the results of individualized interventions and obtaining pilot data to guide subsequent randomized controlled trails.

  1. Acquired Brain Injury, Social Work and the Challenges of Personalisation

    PubMed Central

    Holloway, Mark; Fyson, Rachel

    2016-01-01

    Increasing numbers of adults in the UK are living with acquired brain injury (ABI), with those affected requiring immediate medical care and longer-term rehabilitative and social care. Despite their social needs, limited attention has been paid to people with ABI within the social work literature and their needs are also often overlooked in policy and guidance. As a means of highlighting the challenge that ABI presents to statutory social work, this paper will start by outlining the common characteristics of ABI and consider the (limited) relevant policy guidance. The particular difficulties of reconciling the needs of people with ABI with the prevailing orthodoxies of personalisation will then be explored, with a particular focus on the mismatch between systems which rest on presumptions autonomy and the circumstances of individuals with ABI—typified by executive dysfunction and lack of insight into their own condition. Composite case studies, drawn from the first author's experiences as a case manager for individuals with ABI, will be used to illustrate the arguments being made. The paper will conclude by considering the knowledge and skills which social workers need in order to better support people with ABI. PMID:27559229

  2. Reorganization of Functional Connectivity as a Correlate of Cognitive Recovery in Acquired Brain Injury

    ERIC Educational Resources Information Center

    Castellanos, Nazareth P.; Paul, Nuria; Ordonez, Victoria E.; Demuynck, Olivier; Bajo, Ricardo; Campo, Pablo; Bilbao, Alvaro; Ortiz, Tomas; del-Pozo, Francisco; Maestu, Fernando

    2010-01-01

    Cognitive processes require a functional interaction between specialized multiple, local and remote brain regions. Although these interactions can be strongly altered by an acquired brain injury, brain plasticity allows network reorganization to be principally responsible for recovery. The present work evaluates the impact of brain injury on…

  3. Association between traumatic brain injury-related brain lesions and long-term caregiver burden

    PubMed Central

    Brioschi Guevara, Andrea; Demonet, Jean-Francois; Polejaeva, Elena; Knutson, Kristine M.; Wassermann, Eric M.; Grafman, Jordan; Krueger, Frank

    2015-01-01

    Objective To investigate the association between traumatic brain injury (TBI) related brain lesions and long-term caregiver burden in relation to dysexecutive syndrome. Setting National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland. Participants A total of 256 participants: 105 combat veterans with TBI, 23 healthy control combat veterans (HCv), and 128 caregivers. Outcome Measure Caregiver burden assessed by the Zarit Burden Interview (ZBI) at 40 years post-injury. Design Participants with penetrating TBI were compared with HCv on perceived caregiver burden and neuropsychological assessment measures. Data of Computed Tomography scans (overlay lesion maps of participants with a penetrating TBI whose caregivers have a significantly high burden) and behavioral statistical analyses were combined to identify brain lesions associated with caregiver burden. Results Burden was greater in caregivers of veterans with TBI than caregivers of HCv. Caregivers of participants with lesions affecting cognitive and behavioral indicators of dysexecutive syndrome (i.e., left dorsolateral prefrontal cortex and dorsal anterior cingulate cortex) showed greater long-term burden than caregivers of participants with lesions elsewhere in the brain. Conclusion and Implication TBI-related brain lesions have a lasting effect on long-term caregiver burden due to cognitive and behavioral factors associated with dysexecutive syndrome. PMID:26098258

  4. Unfolded Maps for Quantitative Analysis of Cortical Lesion Location and Extent after Traumatic Brain Injury.

    PubMed

    Ekolle Ndode-Ekane, Xavier; Kharatishvili, Irina; Pitkänen, Asla

    2017-01-15

    We aimed to generate two-dimensional (2D) unfolded cortical maps from magnetic resonance (MR) images to delineate the location of traumatic brain injury (TBI)-induced cortical damage in functionally diverse cytoarchitectonic areas of the cerebral cortex, and to predict the severity of functional impairment after TBI based on the lesion location and extent. Lateral fluid-percussion injury was induced in adult rats and T2 maps were acquired with magnetic resonance imaging (MRI) at 3 days post-TBI. Somatomotor deficits were assessed based on the composite neuroscore and beam balance test, and spatial learning was assessed in the Morris water maze. Animals were perfused for histology at 13 days post-injury. A 2D template was generated by unfolding the cerebral cortex from 26 sections of the rat brain atlas, covering the lesion extent. Next, 2D unfolded maps were generated from T2 maps and thionin-stained histological sections from the same animals. Unfolding of the T2 maps revealed the lesion core in the auditory, somatosensory, and visual cortices. The unfolded histological lesion at 13 days post-injury was 12% greater than the MRI lesion at 3 days post-TBI, as the lesion area increased laterally and caudally; the larger the MRI lesion area, the larger the histological lesion area. Further, the larger the MRI lesion area in the barrel field of the primary somatosensory cortex (S1BF), upper lip of the primary somatosensory cortex (S1ULp), secondary somatosensory division (S2), and ectorhinal (Ect) and perirhinal (PRh) cortices, the more impaired the performance in the beam balance and Morris water maze tests. Subsequent receiver operating characteristic analysis indicated that severity of the MRI lesion in S1ULp and S2 was a sensitive and specific predictor of poor performance in the beam balance test. Moreover, MRI lesions in the S1ULp, S2, S1BF, and Ect and PRh cortices predicted poor performance in the Morris water maze test. Our findings indicate that 2D

  5. Enhancing brain lesions after endovascular treatment of aneurysms.

    PubMed

    Cruz, J P; Marotta, T; O'Kelly, C; Holtmannspötter, M; Saliou, G; Willinsky, R; Krings, T; Agid, R

    2014-10-01

    Complications of endovascular therapy of aneurysms mainly include aneurysm rupture and thromboembolic events. The widespread use of MR imaging for follow-up of these patients revealed various nonvascular complications such as aseptic meningitis, hydrocephalus, and perianeurysmal brain edema. We present 7 patients from 5 different institutions that developed MR imaging-enhancing brain lesions after endovascular therapy of aneurysms, detected after a median time of 63 days. The number of lesions ranged from 4-46 (median of 10.5), sized 2-20 mm, and were mostly in the same vascular territory used for access. Three patients presented with symptoms attributable to these lesions. After a median follow-up of 21.5 months, the number of lesions increased in 2, was stable in 1, decreased in 3, and disappeared in 1. The imaging and clinical characteristics suggested a foreign body reaction. We could find no correlation to a specific device, but a possible source may be the generic hydrophilic coating.

  6. Acquired Brain Injury Club at a Community College: Opportunities for Support, Involvement, and Leadership

    ERIC Educational Resources Information Center

    Chinn, Nancy Resendes

    2009-01-01

    College students with acquired brain injuries face unique challenges. The likelihood of individuals with acquired brain injury experiencing isolation, lack of social support, and diminished self-esteem, along with cognitive impairments, is well documented in the literature. This article presents an overview of a community college's club for…

  7. Children with Acquired Brain Injury: A Silent Voice in the Ontario School System

    ERIC Educational Resources Information Center

    Bennett, Sheila; Good, Dawn; Zinga, Dawn; Kumpf, John

    2004-01-01

    The leading cause of death and injuries in school age children is acquired brain injury (Savage & Wolcott, 1994). Each year approximately 1 in 450 school age children and 1 in 200 adolescents/young adults suffer an injury as a result of some form of acquired brain injury. Approximately 27,000 students in the Ontario school system have acquired…

  8. Ultrastructure of Diaschisis Lesions after Traumatic Brain Injury.

    PubMed

    Wiley, Clayton A; Bissel, Stephanie J; Lesniak, Andrew; Dixon, C Edward; Franks, Jonathan; Beer Stolz, Donna; Sun, Ming; Wang, Guoji; Switzer, Robert; Kochanek, Patrick M; Murdoch, Geoffrey

    2016-10-15

    We used controlled cortical impact in mice to model human traumatic brain injury (TBI). Local injury was accompanied by distal diaschisis lesions that developed within brain regions anatomically connected to the injured cortex. At 7 days after injury, histochemistry documented broadly distributed lesions, particularly in the contralateral cortex and ipsilateral thalamus and striatum. Reactive astrocytosis and microgliosis were noted in multiple neural pathways that also showed silver-stained cell processes and bodies. Wisteria floribunda agglutinin (WFA) staining, a marker of perineuronal nets, was substantially diminished in the ipsilateral, but less so in the contralateral cortex. Contralateral cortical silver positive diaschisis lesions showed loss of both phosphorylated and unphosphorylated neurofilament staining, but overall preservation of microtubule-associated protein (MAP)-2 staining. Thalamic lesions showed substantial loss of MAP-2 and unphosphorylated neurofilaments in addition to moderate loss of phosphorylated neurofilament. One animal demonstrated contralateral cerebellar degeneration at 7 days post-injury. After 21 days, the gliosis had quelled, however persistent silver staining was noted. Using a novel serial section technique, we were able to perform electron microscopy on regions fully characterized at the light microscopy level. Cell bodies and processes that were silver positive at the light microscopy level showed hydropic disintegration consisting of: loss of nuclear heterochromatin; dilated somal and neuritic processes with a paucity of filaments, tubules, and mitochondria; and increased numbers of electron-dense membranous structures. Importantly the cell membrane itself was still intact 3 weeks after injury. Although the full biochemical nature of these lesions remains to be deciphered, the morphological preservation of damaged neurons and processes raises the question of whether this is a reversible process.

  9. GLP-1 improves neuropathology after murine cold lesion brain trauma

    PubMed Central

    DellaValle, Brian; Hempel, Casper; Johansen, Flemming Fryd; Kurtzhals, Jørgen Anders Lindholm

    2014-01-01

    Objectives In this study, we address a gap in knowledge regarding the therapeutic potential of acute treatment with a glucagon-like peptide-1 (GLP-1) receptor agonist after severe brain trauma. Moreover, it remains still unknown whether GLP-1 treatment activates the protective, anti-neurodegenerative cAMP response element binding protein (CREB) pathway in the brain in vivo, and whether activation leads to observable increases in protective, anti-neurodegenerative proteins. Finally, we report the first use of a highly sensitive in vivo imaging agent to assess reactive species generation after brain trauma. Methods Severe trauma was induced with a stereotactic cryo-lesion in mice and thereafter treated with vehicle, liraglutide, or liraglutide + GLP-1 receptor antagonist. A therapeutic window was established and lesion size post-trauma was determined. Reactive oxygen species were visualized in vivo and quantified directly ex vivo. Hematological analysis was performed over time. Necrotic and apoptotic tone and neuroinflammation was assessed over time. CREB activation and CREB-regulated cytoprotective proteins were assessed over time. Results Lira treatment reduced lesion size by ∼50% through the GLP-1 receptor. Reactive species generation was reduced by ∼40–60%. Necrotic and apoptotic tone maintained similar to sham in diseased animals with Lira treatment. Phosphorylation of CREB was markedly increased by Lira in a GLP-1 receptor-dependent manner. CREB-regulated cytoprotective and anti-neurodegenerative proteins increased with Lira-driven CREB activation. Interpretation These results show that Lira has potent effects after experimental trauma in mice and thus should be considered a candidate for critical care intervention post-injury. Moreover, activation of CREB in the brain by Lira – described for the first time to be dependent on pathology – should be investigated further as a potential mechanism of action in neurodegenerative disorders. PMID:25493285

  10. Brain lesions and their implications in criminal responsibility.

    PubMed

    Batts, Shelley

    2009-01-01

    For over 200 years, Western courts have considered pleas of "not guilty by reason of insanity" (NGRI) for defendants in possession of a mental defect rendering them unable to understand the wrongfulness of their act. Until recently, determining the mental state of a defendant has fallen largely upon the shoulders of court psychologists and experts in psychiatry for qualitative assessments related to NGRI pleas and mitigation at sentencing. However, advances in neuroscience--particularly neurological scanning techniques such as magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), computed tomography scanning (CT), and positron emission tomography scanning (PET)--may provide additional, pertinent biological evidence as to whether an organically based mental defect exists. With increasing frequency, criminal defense attorneys are integrating neuroimaging data into hearings related to determinations of guilt and sentencing mitigation. This is of concern, since not all brain lesions and abnormalities indicate a compromised mental state that is relevant to knowing whether the act was wrong at the time of commission, and juries may be swayed by neuroscientific evidence that is not relevant to the determination of the legal question before them. This review discusses historical and modern cases involving the intersection of brain lesions and criminality, neuroscientific perspectives of how particular types of lesions may contribute to a legally relevant mental defect, and how such evidence might best be integrated into a criminal trial.

  11. [Trismus, trigeminal motor dyssynergy with brain stem lesions (author's transl)].

    PubMed

    Jelasic, F; Freitag, V

    1975-08-01

    Paradox activity of masticatory muscles was observed clinically and electromyographically in 4 patients with brain steem lesions who had trismus. There was no activity in the elevators of the jaw on the side affected during voluntary biting, as if the muscles were paralyzed. There was strong activity of the elevators on the side of the trismus on opening the mouth, inactivity on the unaffected side, or inverse activity appeared on both sides. In view of the trigeminal anesthesia on the side of paradox activation, and the absence of pyramidal signs, a stretch reflex mechanism and abolition of inhibition can not be the only basis for these phenomena; so, a disturbance of bilateral synergism, in the sense of an internuclear lesion, is postulated. In one case of motor and sensory paralysis after the extirpation of a meningioma of the cerebellopontine angle, intensive paradox activity was observed, without trismus.

  12. Limitations on the Developing Preterm Brain: Impact of Periventricular White Matter Lesions on Brain Connectivity and Cognition

    ERIC Educational Resources Information Center

    Pavlova, Marina A.; Krageloh-Mann, Ingeborg

    2013-01-01

    Brain lesions to the white matter in peritrigonal regions, periventricular leukomalacia, in children who were born prematurely represent an important model for studying limitations on brain development. The lesional pattern is of early origin and bilateral, that constrains the compensatory potential of the brain. We suggest that (i) topography and…

  13. Brain lesion detection in MRI with fuzzy and geostatistical models.

    PubMed

    Pham, Tuan D

    2010-01-01

    Automated image detection of white matter changes of the brain is essentially helpful in providing a quantitative measure for studying the association of white matter lesions with other types of biomedical data. Such study allows the possibility of several medical hypothesis validations which lead to therapeutic treatment and prevention. This paper presents a new clustering-based segmentation approach for detecting white matter changes in magnetic resonance imaging with particular reference to cognitive decline in the elderly. The proposed method is formulated using the principles of fuzzy c-means algorithm and geostatistics.

  14. Brain involvement by leprosy presenting as a frontal cystic lesion.

    PubMed

    Lee, Kyung-Hwa; Moon, Kyung-Sub; Yun, Sook Jung; Won, Young Ho; Lee, Jae-Hyuk; Lee, Min-Cheol; Jung, Shin

    2014-07-01

    Leprosy has a predilection for peripheral nerves and is not considered to involve the CNS. The idea that the CNS is exempt from Mycobacterium leprae bacilli has been suspected from a clinical perspective or CSF study in leprosy patients. However, there has been no direct evidence for CNS involvement by leprosy in a living patient. To the best of the authors' knowledge, the present case is the first report providing histopathological and molecular evidence for CNS involvement by leprosy in a living patient. Brain MRI revealed a 2-cm cystic lesion in the right frontal lobe of the patient. The medical history revealed that the patient had been receiving multidrug therapy for borderline lepromatous leprosy. Neuronavigation-guided craniotomy and lesion removal were performed due to a presumptive diagnosis of low-grade glioma. The brain specimen demonstrated variably thickened blood vessels and densely scattered foamy macrophages in the perivascular spaces and parenchymal stroma. Fite acid-fast stain displayed red granular inclusions that were suggestive for fragmented M. leprae. M. leprae-specific nested polymerase chain reaction amplification showed positive bands, and DNA sequencing also demonstrated homology with the M. leprae genome. This case supports the notion that M. leprae can involve the cerebral cortex regardless of cranial nerve engagement.

  15. Electrocardiographic abnormalities and cardiac arrhythmias in structural brain lesions.

    PubMed

    Katsanos, Aristeidis H; Korantzopoulos, Panagiotis; Tsivgoulis, Georgios; Kyritsis, Athanassios P; Kosmidou, Maria; Giannopoulos, Sotirios

    2013-07-31

    Cardiac arrhythmias and electrocardiographic abnormalities are frequently observed after acute cerebrovascular events. The precise mechanism that leads to the development of these arrhythmias is still uncertain, though increasing evidence suggests that it is mainly due to autonomic nervous system dysregulation. In massive brain lesions sympathetic predominance and parasympathetic withdrawal during the first 72 h are associated with the occurrence of severe secondary complications in the first week. Right insular cortex lesions are also related with sympathetic overactivation and with a higher incidence of electrocardiographic abnormalities, mostly QT prolongation, in patients with ischemic stroke. Additionally, female sex and hypokalemia are independent risk factors for severe prolongation of the QT interval which subsequently results in malignant arrhythmias and poor outcome. The prognostic value of repolarization changes commonly seen after aneurysmal subarachnoid hemorrhage, such as ST segment, T wave, and U wave abnormalities, still remains controversial. In patients with traumatic brain injury both intracranial hypertension and cerebral hypoperfusion correlate with low heart rate variability and increased mortality. Given that there are no firm guidelines for the prevention or treatment of the arrhythmias that appear after cerebral incidents this review aims to highlight important issues on this topic. Selected patients with the aforementioned risk factors could benefit from electrocardiographic monitoring, reassessment of the medications that prolong QTc interval, and administration of antiadrenergic agents. Further research is required in order to validate these assumptions and to establish specific therapeutic strategies.

  16. Cognitive correlates of white matter lesion load and brain atrophy

    PubMed Central

    Dong, Chuanhui; Nabizadeh, Nooshin; Caunca, Michelle; Cheung, Ying Kuen; Rundek, Tatjana; Elkind, Mitchell S.V.; DeCarli, Charles; Sacco, Ralph L.; Stern, Yaakov

    2015-01-01

    Objective: We investigated white matter lesion load and global and regional brain volumes in relation to domain-specific cognitive performance in the stroke-free Northern Manhattan Study (NOMAS) population. Methods: We quantified white matter hyperintensity volume (WMHV), total cerebral volume (TCV), and total lateral ventricular (TLV) volume, as well as hippocampal and cortical gray matter (GM) lobar volumes in a subgroup. We used general linear models to examine MRI markers in relation to domain-specific cognitive performance, adjusting for key covariates. Results: MRI and cognitive data were available for 1,163 participants (mean age 70 ± 9 years; 60% women; 66% Hispanic, 17% black, 15% white). Across the entire sample, those with greater WMHV had worse processing speed. Those with larger TLV volume did worse on episodic memory, processing speed, and semantic memory tasks, and TCV did not explain domain-specific variability in cognitive performance independent of other measures. Age was an effect modifier, and stratified analysis showed that TCV and WMHV explained variability in some domains above age 70. Smaller hippocampal volume was associated with worse performance across domains, even after adjusting for APOE ε4 and vascular risk factors, whereas smaller frontal lobe volumes were only associated with worse executive function. Conclusions: In this racially/ethnically diverse, community-based sample, white matter lesion load was inversely associated with cognitive performance, independent of brain atrophy. Lateral ventricular, hippocampal, and lobar GM volumes explained domain-specific variability in cognitive performance. PMID:26156514

  17. Identifying Lesions on Structural Brain Images-Validation of the Method and Application to Neuropsychological Patients

    ERIC Educational Resources Information Center

    Stamatakis, E.A.; Tyler, L.K.

    2005-01-01

    The study of neuropsychological disorders has been greatly facilitated by the localization of brain lesions on MRI scans. Current popular approaches for the assessment of MRI brain scans mostly depend on the successful segmentation of the brain into grey and white matter. These methods cannot be used effectively with large lesions because lesions…

  18. Fetal brain lesions after subcutaneous inoculation of Zika virus in a pregnant nonhuman primate.

    PubMed

    Adams Waldorf, Kristina M; Stencel-Baerenwald, Jennifer E; Kapur, Raj P; Studholme, Colin; Boldenow, Erica; Vornhagen, Jay; Baldessari, Audrey; Dighe, Manjiri K; Thiel, Jeff; Merillat, Sean; Armistead, Blair; Tisoncik-Go, Jennifer; Green, Richard R; Davis, Michael A; Dewey, Elyse C; Fairgrieve, Marian R; Gatenby, J Christopher; Richards, Todd; Garden, Gwenn A; Diamond, Michael S; Juul, Sandra E; Grant, Richard F; Kuller, LaRene; Shaw, Dennis W W; Ogle, Jason; Gough, G Michael; Lee, Wonsok; English, Chris; Hevner, Robert F; Dobyns, William B; Gale, Michael; Rajagopal, Lakshmi

    2016-11-01

    We describe the development of fetal brain lesions after Zika virus (ZIKV) inoculation in a pregnant pigtail macaque. Periventricular lesions developed within 10 d and evolved asymmetrically in the occipital-parietal lobes. Fetal autopsy revealed ZIKV in the brain and significant cerebral white matter hypoplasia, periventricular white matter gliosis, and axonal and ependymal injury. Our observation of ZIKV-associated fetal brain lesions in a nonhuman primate provides a model for therapeutic evaluation.

  19. Integral Whole Brain Dose from Stereotactic Radiosurgery of 47 Metastatic Lesions: A Dosimetric Case Study

    PubMed Central

    Chen, Joseph C; Miller, Michael J; Lodin, Kenneth; Girvigian, Michael R

    2015-01-01

    This report describes the case of a 15-year-old male diagnosed with primary ALK-positive adenocarcinoma of the lung metastatic to the brain. He was treated with surgical resection for a single lesion followed by whole brain radiotherapy and subsequently underwent 10 courses of stereotactic radiosurgery for 47 lesions delivered over a four-year period. Currently, all metastatic lesions in the brain are completely resolved or locally controlled. PMID:26858917

  20. Students with Acquired Brain Injury: A Legal Analysis

    ERIC Educational Resources Information Center

    Zirkel, Perry A.

    2011-01-01

    This article provides a comprehensive and current synthesis of the legislation, regulations, policy interpretations, and case law concerning students with traumatic and nontraumatic brain injury from pre-K to grade 12. The primary focus is the Individuals with Disabilities Education Act, but the scope extends to other applicable legal bases. The…

  1. Computer-Aided Relearning Activity Patterns for People with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Montero, Francisco; Lopez-Jaquero, Victor; Navarro, Elena; Sanchez, Enriqueta

    2011-01-01

    People with disabilities constitute a collective that requires continuous and customized attention, since their conditions or abilities are affected with respect to specific standards. People with "Acquired Brain Injury" (ABI), or those who have suffered brain injury at some stage after birth, belong to this collective. The treatment these people…

  2. Efficacy of Interdisciplinary Assessment and Treatment for Infants and Preschoolers with Congenital and Acquired Brain Injury.

    ERIC Educational Resources Information Center

    Bagnato, Stephen J.; Neisworth, John T.

    1985-01-01

    The study examined effectiveness of a team approach for two etiologically distinct groups of children (acquired brain injury, N=7; congenital brain injury, N=10). Results revealed significant pre-post gains for both groups. Significant team therapy effects were evident across four developmental domains and five behavioral processes. Progress was…

  3. Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution

    PubMed Central

    Marasco, Rita; Jenkinson, Mark; Küker, Wilhelm; Luppe, Sebastian; Leite, Maria Isabel; Giorgio, Antonio; De Stefano, Nicola; Robertson, Neil; Johansen-Berg, Heidi; Evangelou, Nikos; Palace, Jacqueline

    2013-01-01

    Objective: Neuromyelitis optica and its spectrum disorder (NMOSD) can present similarly to relapsing-remitting multiple sclerosis (RRMS). Using a quantitative lesion mapping approach, this research aimed to identify differences in MRI brain lesion distribution between aquaporin-4 antibody–positive NMOSD and RRMS, and to test their diagnostic potential. Methods: Clinical brain MRI sequences for 44 patients with aquaporin-4 antibody–positive NMOSD and 50 patients with RRMS were examined for the distribution and morphology of brain lesions. T2 lesion maps were created for each subject allowing the quantitative comparison of the 2 conditions with lesion probability and voxel-wise analysis. Results: Sixty-three percent of patients with NMOSD had brain lesions and of these 27% were diagnostic of multiple sclerosis. Patients with RRMS were significantly more likely to have lesions adjacent to the body of the lateral ventricle than patients with NMOSD. Direct comparison of the probability distributions and the morphologic attributes of the lesions in each group identified criteria of “at least 1 lesion adjacent to the body of the lateral ventricle and in the inferior temporal lobe; or the presence of a subcortical U-fiber lesion; or a Dawson's finger-type lesion,” which could distinguish patients with multiple sclerosis from those with NMOSD with 92% sensitivity, 96% specificity, 98% positive predictive value, and 86% negative predictive value. Conclusion: Careful inspection of the distribution and morphology of MRI brain lesions can distinguish RRMS and NMOSD. PMID:23486868

  4. Seeing mathematics: perceptual experience and brain activity in acquired synesthesia.

    PubMed

    Brogaard, Berit; Vanni, Simo; Silvanto, Juha

    2013-01-01

    We studied the patient JP who has exceptional abilities to draw complex geometrical images by hand and a form of acquired synesthesia for mathematical formulas and objects, which he perceives as geometrical figures. JP sees all smooth curvatures as discrete lines, similarly regardless of scale. We carried out two preliminary investigations to establish the perceptual nature of synesthetic experience and to investigate the neural basis of this phenomenon. In a functional magnetic resonance imaging (fMRI) study, image-inducing formulas produced larger fMRI responses than non-image inducing formulas in the left temporal, parietal and frontal lobes. Thus our main finding is that the activation associated with his experience of complex geometrical images emerging from mathematical formulas is restricted to the left hemisphere.

  5. Characterization of T2 hyperintensity lesions in patients with mild traumatic brain injury

    NASA Astrophysics Data System (ADS)

    Caban, Jesus J.; Green, Savannah A.; Riedy, Gerard

    2013-03-01

    Mild traumatic brain injury (TBI) is often an invisible injury that is poorly understood and its sequelae can be difficult to diagnose. Recent neuroimaging studies on patients diagnosed with mild TBI (mTBI) have demonstrated an increase in hyperintense brain lesions on T2-weighted MR images. This paper presents an in-depth analysis of the multi-modal and morphological properties of T2 hyperintensity lesions among service members diagnosed with mTBI. A total of 790 punctuate T2 hyperintensity lesions from 89 mTBI subjects were analyzed and used to characterize the lesions based on different quantitative measurements. Morphological analysis shows that on average, T2 hyperintensity lesions have volumes of 23mm3 (+/-24.75), a roundness measure of 0.83 (+/-0.08) and an elongation of 7.90 (+/-2.49). The frontal lobe lesions demonstrated significantly more elongated lesions when compared to other areas of the brain.

  6. Limitations on the developing preterm brain: impact of periventricular white matter lesions on brain connectivity and cognition.

    PubMed

    Pavlova, Marina A; Krägeloh-Mann, Ingeborg

    2013-04-01

    Brain lesions to the white matter in peritrigonal regions, periventricular leukomalacia, in children who were born prematurely represent an important model for studying limitations on brain development. The lesional pattern is of early origin and bilateral, that constrains the compensatory potential of the brain. We suggest that (i) topography and severity of periventricular lesions may have a long-term predictive value for cognitive and social capabilities in preterm birth survivors; and (ii) periventricular lesions may impact cognitive and social functions by affecting brain connectivity, and thereby, the dissociable neural networks underpinning these functions. A further pathway to explore is the relationship between cerebral palsy and cognitive outcome. Restrictions caused by motor disability may affect active exploration of surrounding and social participation that may in turn differentially impinge on cognitive development and social cognition. As an outline for future research, we underscore sex differences, as the sex of a preterm newborn may shape the mechanisms by which the developing brain is affected.

  7. In Vivo NMR Studies of the Brain with Hereditary or Acquired Metabolic Disorders.

    PubMed

    Sherry, Erica B; Lee, Phil; Choi, In-Young

    2015-12-01

    Metabolic disorders, whether hereditary or acquired, affect the brain, and abnormalities of the brain are related to cellular integrity; particularly in regard to neurons and astrocytes as well as interactions between them. Metabolic disturbances lead to alterations in cellular function as well as microscopic and macroscopic structural changes in the brain with diabetes, the most typical example of metabolic disorders, and a number of hereditary metabolic disorders. Alternatively, cellular dysfunction and degeneration of the brain lead to metabolic disturbances in hereditary neurological disorders with neurodegeneration. Nuclear magnetic resonance (NMR) techniques allow us to assess a range of pathophysiological changes of the brain in vivo. For example, magnetic resonance spectroscopy detects alterations in brain metabolism and energetics. Physiological magnetic resonance imaging (MRI) detects accompanying changes in cerebral blood flow related to neurovascular coupling. Diffusion and T1/T2-weighted MRI detect microscopic and macroscopic changes of the brain structure. This review summarizes current NMR findings of functional, physiological and biochemical alterations within a number of hereditary and acquired metabolic disorders in both animal models and humans. The global view of the impact of these metabolic disorders on the brain may be useful in identifying the unique and/or general patterns of abnormalities in the living brain related to the pathophysiology of the diseases, and identifying future fields of inquiry.

  8. Effects of brain lesions on moral agency: ethical dilemmas in investigating moral behavior.

    PubMed

    Christen, Markus; Müller, Sabine

    2015-01-01

    Understanding how the "brain produces behavior" is a guiding idea in neuroscience. It is thus of no surprise that establishing an interrelation between brain pathology and antisocial behavior has a long history in brain research. However, interrelating the brain with moral agency--the ability to act in reference to right and wrong--is tricky with respect to therapy and rehabilitation of patients affected by brain lesions. In this contribution, we outline the complexity of the relationship between the brain and moral behavior, and we discuss ethical issues of the neuroscience of ethics and of its clinical consequences. First, we introduce a theory of moral agency and apply it to the issue of behavioral changes caused by brain lesions. Second, we present a typology of brain lesions both with respect to their cause, their temporal development, and the potential for neural plasticity allowing for rehabilitation. We exemplify this scheme with case studies and outline major knowledge gaps that are relevant for clinical practice. Third, we analyze ethical pitfalls when trying to understand the brain-morality relation. In this way, our contribution addresses both researchers in neuroscience of ethics and clinicians who treat patients affected by brain lesions to better understand the complex ethical questions, which are raised by research and therapy of brain lesion patients.

  9. Serum creatine kinase isoenzyme BB is a poor index to the size of various brain lesions.

    PubMed

    Schwartz, J G; Bazan, C; Gage, C L; Prihoda, T J; Gillham, S L

    1989-04-01

    We divided patients with brain lesions into three groups: (a) patients with primary or metastatic brain cancer, (b) brain infarctions, and (c) brain contusion(s). We analyzed each patient's sera for creatine kinase isoenzyme BB (CK-BB), using a monoclonal antibody kit (Impres-BB; International Immunoassay Laboratories). Computerized axial tomography (CAT) scans were performed on each patient. The size of the various lesions was measured from the CAT scan and recorded in milliliters. Total CK, CK-BB, and their ratios were compared with the volume of damaged brain tissue. We found no correlation between any of the variables and the various brain lesions. We attribute this lack of correlation to an intact blood-brain barrier, the rapid elimination or inactivation of CK-BB, or some combination of these factors.

  10. Lateralization of Egocentric and Allocentric Spatial Processing after Parietal Brain Lesions

    ERIC Educational Resources Information Center

    Iachini, Tina; Ruggiero, Gennaro; Conson, Massimiliano; Trojano, Luigi

    2009-01-01

    The purpose of this paper was to verify whether left and right parietal brain lesions may selectively impair egocentric and allocentric processing of spatial information in near/far spaces. Two Right-Brain-Damaged (RBD), 2 Left-Brain-Damaged (LBD) patients (not affected by neglect or language disturbances) and eight normal controls were submitted…

  11. Segmentation of brain structures in presence of a space-occupying lesion.

    PubMed

    Pollo, Claudio; Cuadra, Meritxell Bach; Cuisenaire, Olivier; Villemure, Jean-Guy; Thiran, Jean-Philippe

    2005-02-15

    Brain deformations induced by space-occupying lesions may result in unpredictable position and shape of functionally important brain structures. The aim of this study is to propose a method for segmentation of brain structures by deformation of a segmented brain atlas in presence of a space-occupying lesion. Our approach is based on an a priori model of lesion growth (MLG) that assumes radial expansion from a seeding point and involves three steps: first, an affine registration bringing the atlas and the patient into global correspondence; then, the seeding of a synthetic tumor into the brain atlas providing a template for the lesion; finally, the deformation of the seeded atlas, combining a method derived from optical flow principles and a model of lesion growth. The method was applied on two meningiomas inducing a pure displacement of the underlying brain structures, and segmentation accuracy of ventricles and basal ganglia was assessed. Results show that the segmented structures were consistent with the patient's anatomy and that the deformation accuracy of surrounding brain structures was highly dependent on the accurate placement of the tumor seeding point. Further improvements of the method will optimize the segmentation accuracy. Visualization of brain structures provides useful information for therapeutic consideration of space-occupying lesions, including surgical, radiosurgical, and radiotherapeutic planning, in order to increase treatment efficiency and prevent neurological damage.

  12. Reliability of the Motor Learning Strategy Rating Instrument for Children and Youth with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Kamath, Trishna; Pfeifer, Megan; Banerjee-Guenette, Priyanka; Hunter, Theresa; Ito, Julia; Salbach, Nancy M.; Wright, Virginia; Levac, Danielle

    2012-01-01

    Purpose: To evaluate reliability and feasibility of the Motor Learning Strategy Rating Instrument (MLSRI) in children with acquired brain injury (ABI). The MLSRI quantifies the extent to which motor learning strategies (MLS) are used within physiotherapy (PT) interventions. Methods: PT sessions conducted by ABI team physiotherapists with a…

  13. Behavioral Treatment for Pathological Gambling in Persons with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Guercio, John M.; Johnson, Taylor; Dixon, Mark R.

    2012-01-01

    The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week…

  14. Acquired Brain Injury and Return to Work in Australia and New Zealand.

    ERIC Educational Resources Information Center

    Athanasou, James A.

    2003-01-01

    A research review of 9 Australian-New Zealand (n=1,010) and 23 international (n=2,182) studies found the overall return-to-work rates after head injury were 44% and 45% respectively. Methodological issues might have inflated these numbers. Only an estimated 7-10% of persons with acquired brain injury returned to the same job. (Contains 46…

  15. The Use of Narratives to Identify Characteristics Leading to a Productive Life following Acquired Brain Injury

    ERIC Educational Resources Information Center

    Fraas, Michael R.; Calvert, Margaret

    2009-01-01

    Purpose: To determine the factors leading to successful recovery and productive lifestyles after acquired brain injury (ABI). Method: Qualitative investigation examined semistructured interviews of 31 survivors of ABI. Thematic analysis followed a phenomenological approach and revealed 4 major themes and 28 subthemes in the interviews. Four…

  16. Exploring the Use of Cognitive Intervention for Children with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Missiuna, Cheryl; DeMatteo, Carol; Hanna, Steven; Mandich, Angela; Law, Mary; Mahoney, William; Scott, Louise

    2010-01-01

    Introduction: Children with acquired brain injury (ABI) often experience cognitive, motor, and psychosocial deficits that affect participation in everyday activities. Cognitive Orientation to Daily Occupational Performance (CO-OP) is an individualized treatment that teaches cognitive strategies necessary to support successful performance.…

  17. Expressive Electronic Journal Writing: Freedom of Communication for Survivors of Acquired Brain Injury

    ERIC Educational Resources Information Center

    Fraas, Michael; Balz, Magdalen A.

    2008-01-01

    In addition to the impaired ability to effectively communicate, adults with acquired brain injury (ABI) also experience high incidences of depression, social isolation, and decreased quality of life. Expressive writing programs have been shown to be effective in alleviating these concomitant impairments in other populations including incarcerated…

  18. Where Have They All Gone?: Classroom Attention Patterns after Acquired Brain Injury

    ERIC Educational Resources Information Center

    Rees, Siân A.

    2016-01-01

    Certain groups of pupils who have sustained an Acquired Brain Injury (ABI) have a different pattern of attention within the classroom which interferes with learning and social interactions. The delineation of these groups is suggested. By looking in detail at the classroom behaviour of eight pupils, a common account for classroom behaviour…

  19. Redesigning the Scaffolding Metaphor to Suit Pupils with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Rees, Sian A.; Skidmore, David

    2008-01-01

    This paper extends and develops the metaphor of scaffolding to take account of the specific needs of pupils with an Acquired Brain Injury (ABI), drawing on observational evidence gathered for an empirical enquiry into the learning of pupils with ABI in mainstream classroom conditions. This is an area in which there are few published studies to…

  20. Using Differential Reinforcement to Decrease Academic Response Latencies of an Adolescent with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Heinicke, Megan R.; Carr, James E.; Mozzoni, Michael P.

    2009-01-01

    The present study investigated the effects of contingency-specifying rules and a token economy to decrease the latency to comply with academic instructions by a 16-year-old girl with acquired brain injury. Results showed that treatment was successful in reducing academic response latencies. These results replicate previous research in which…

  1. Using differential reinforcement to decrease academic response latencies of an adolescent with acquired brain injury.

    PubMed

    Heinicke, Megan R; Carr, James E; Mozzoni, Michael P

    2009-01-01

    The present study investigated the effects of contingency-specifying rules and a token economy to decrease the latency to comply with academic instructions by a 16-year-old girl with acquired brain injury. Results showed that treatment was successful in reducing academic response latencies. These results replicate previous research in which differential reinforcement was used to decrease slow responding to academic tasks.

  2. A Review of Family Intervention Guidelines for Pediatric Acquired Brain Injuries

    ERIC Educational Resources Information Center

    Cole, Wesley R.; Paulos, Stephanie K.; Cole, Carolyn A. S.; Tankard, Carol

    2009-01-01

    Pediatric acquired brain injury (BI) not only affects the child with the injury, but also greatly impacts their family. Studies suggest there are higher rates of caregiver and sibling psychological distress after a child in the family has sustained a BI. Also, family functioning after BI impacts the child's recovery. In reviewing the literature,…

  3. Etiology of microglial nodules in brains of patients with acquired immunodeficiency syndrome.

    PubMed

    Nebuloni, M; Pellegrinelli, A; Ferri, A; Tosoni, A; Bonetto, S; Zerbi, P; Boldorini, R; Vago, L; Costanzi, G

    2000-02-01

    Microglial nodules associated with opportunistic and HIV-related lesions are frequently found in the brains of AIDS patients. However, in many cases, the causative agent is only presumptively suspected. We reviewed 199 brains of AIDS patients with micronodular lesions to clarify their etiology by immunohistochemistry (to Toxoplasma gondii, cytomegalovirus, herpes simplex virus I/II, varicella zoster virus and HIV-p24 core protein), PCR (for herpetic viruses and Mycobacterium tuberculosis) and electron microscopy. Productive HIV infection was observed in 110 cases (55.1%): 30 cases with Toxoplasma gondii encephalitis, 30 with cytomegalovirus encephalitis, eight with multiple cerebral diseases, while in the remaining 42 cases HIV was the only pathogenetic agent. Multinucleated giant cells (hallmark of HIV infection) were found in the MGNs of 85/110 cases with HIV-related lesions; the remaining 25 cases had only p24 positive cells but no multinucleated giant cells. In these latter cases the micronodular lesions had been initially attributed to the main opportunistic agent found in the brain, or defined as subacute encephalitis. Individual microglial nodules positive for an opportunistic pathogen were generally negative for HIV antigens. In 13 cases no opportunistic agent or HIV productive infection was found. In these cases, PCR and electron microscopy examination for HIV and other viral infections were negative. Our data suggest that HIV-immunohistochemistry should be used for the etiological diagnosis of micronodular lesions in AIDS brains, even in the presence of other pathogens. After extensive search, the etiology of the microglial nodules remains unknown in only a small percentage of cases.

  4. Altered Recruitment of the Attention Network Is Associated with Disability and Cognitive Impairment in Pediatric Patients with Acquired Brain Injury

    PubMed Central

    Strazzer, Sandra; Rocca, Maria A.; Molteni, Erika; De Meo, Ermelinda; Recla, Monica; Valsasina, Paola; Arrigoni, Filippo; Galbiati, Susanna; Bardoni, Alessandra; Filippi, Massimo

    2015-01-01

    We assessed abnormalities of brain functional magnetic resonance imaging (fMRI) activity during a sustained attention task (Conners' Continuous Performance Test (CCPT)) in 20 right-handed pediatric acquired brain injury (ABI) patients versus 7 right-handed age-matched healthy controls, and we estimated the correlation of such abnormalities with clinical and cognitive deficits. Patients underwent the Wechsler Intelligence Scale for Children (WISC), Wisconsin Card Sorting Test, and Functional Independence Measure (FIM) evaluations. During fMRI, patients and controls activated regions of the attention network. Compared to controls, ABI patients experienced a decreased average fMRI recruitment of the left cerebellum and a decreased deactivation of the left anterior cingulate cortex. With increasing task demand, compared to controls, ABI patients had an impaired ability to increase the recruitment of several posterior regions of the attention network. They also experienced a greater activation of frontal regions, which was correlated with worse performance on FIM, WISC, and fMRI CCPT. Such abnormal brain recruitment was significantly influenced by the type of lesion (focal versus diffuse axonal injury) and time elapsed from the event. Pediatric ABI patients experienced an inability to optimize attention network recruitment, especially when task difficulty was increased, which likely contributes to their clinical and cognitive deficits. PMID:26448878

  5. Lesion Analysis of the Brain Areas Involved in Language Comprehension

    ERIC Educational Resources Information Center

    Dronkers, Nina F.; Wilkins, David P.; Van Valin, Robert D., Jr.; Redfern, Brenda B.; Jaeger, Jeri J.

    2004-01-01

    The cortical regions of the brain traditionally associated with the comprehension of language are Wernicke's area and Broca's area. However, recent evidence suggests that other brain regions might also be involved in this complex process. This paper describes the opportunity to evaluate a large number of brain-injured patients to determine which…

  6. Challenges in understanding the epidemiology of acquired brain injury in India

    PubMed Central

    Kamalakannan, Suresh Kumar; Gudlavalleti, Aashrai S.V.; Murthy Gudlavalleti, Venkata S.; Goenka, Shifalika; Kuper, Hannah

    2015-01-01

    An acquired brain injury (ABI) is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. In India, rapid urbanization, economic growth and changes in lifestyle have led to a tremendous increase in the incidence of ABI, so much so that it is being referred to as a ‘silent epidemic’. Unlike developed countries, there is no well-established system for collecting and managing information on various diseases in India. Thus it is a daunting task to obtain reliable information about acquired brain injury. In the course of conducting a systematic review on the epidemiology of ABI in India, we recognized several challenges which hampered our effort. Inadequate case definition, lack of centralized reporting mechanisms, lack of population based studies, absence of standardized survey protocols and inadequate mortality statistics are some of the major obstacles. Following a standard case definition, linking multiple hospital-based registries, initiating a state or nationwide population-based registry, conducting population-based studies that are methodologically robust and introducing centralized, standard reporting mechanisms for ABI, are some of the strategies that could help facilitate a thorough investigation into the epidemiology and understanding of ABI. This may help improve policies on prevention and management of acquired brain injury in India. PMID:25745314

  7. Association of Mild Kidney Dysfunction with Silent Brain Lesions in Neurologically Normal Subjects

    PubMed Central

    Toyoda, Genya; Bokura, Hirokazu; Mitaki, Shingo; Onoda, Keiichi; Oguro, Hiroaki; Nagai, Atsushi; Yamaguchi, Shuhei

    2015-01-01

    Background Chronic kidney disease (CKD) has been closely associated with stroke. Although a large number of studies reported the relationship between CKD and different types of asymptomatic brain lesions, few comprehensive analyses have been performed for all types of silent brain lesions. Methods We performed a cross-sectional study involving 1,937 neurologically normal subjects (mean age 59.4 years). Mild CKD was defined as an estimated glomerular filtration rate between 30 and 60 ml/min/1.73 m2 or positive proteinuria. Results The prevalence of mild CKD was 8.7%. Univariate analysis revealed an association between CKD and all silent brain lesions, including silent brain infarction, periventricular hyperintensity, subcortical white matter lesion, and microbleeds, in addition to hypertension and diabetes mellitus after adjusting for age and sex. In binary logistic regression analysis, the presence of CKD was a significant risk factor for all types of silent brain lesions, independent of other risk factors. Conclusions These results suggest that mild CKD is independently associated with all types of silent brain lesions, even in neurologically normal subjects. PMID:25873927

  8. The evaluation of contrast-enhancing brain lesions: pitfalls in current practice.

    PubMed Central

    Piszczor, M.; Thornton, G.; Bia, F. J.

    1985-01-01

    The definitive diagnosis of space-occupying brain lesions can be established more readily since the advent of computerized tomographic (CT) scanning. Some brain lesions are more clearly defined when contrast-enhancing agents are utilized; however, so-called ring-enhancing lesions are not pathognomonic for specific neurological entities. Review of the literature suggests that at least four disorders must be considered in the differential diagnosis of contrast-enhancing lesions. These include mature brain abscesses of any etiology, cerebrovascular accidents, and primary or metastatic brain tumors. Since the medical and surgical management of these conditions is quite different, it is critical to establish a diagnosis before therapy is instituted. In many instances the combination of history, physical examination, laboratory, and radiologic examination will enable physicians to correctly diagnose the etiology of such brain lesions. However, we present two cases for which the above clinical and non-invasive parameters led to incorrect working diagnoses. Brain biopsy was required before appropriate management was eventually instituted. Potentially, such delays in diagnosis and institution of therapy can result in unnecessary morbidity and mortality. Each case illustrates the need to substantiate a presumptive diagnosis based on these clinical and radiographic criteria, regardless of how "typical" lesions may appear on CT scans. Images FIG. 1 FIG. 2 FIG. 3 PMID:4013370

  9. Expressive electronic journal writing: freedom of communication for survivors of acquired brain injury.

    PubMed

    Fraas, Michael; Balz, Magdalen A

    2008-03-01

    In addition to the impaired ability to effectively communicate, adults with acquired brain injury (ABI) also experience high incidences of depression, social isolation, and decreased quality of life. Expressive writing programs have been shown to be effective in alleviating these concomitant impairments in other populations including incarcerated inmates (Lane, Writing as a road to self-discovery, F & W, Cincinnati 1993). In addition, computer applications such as email have been suggested as an effective means of improving communication and social isolation in adults with brain injury (Sohlberg et al. [2003]. Brain Injury, 17(7), 609-629). This investigation examines the effects of on-line expressive journal writing on the communication, emotional status, social integration and quality of life of individuals with brain injury.

  10. Sodium MRI in Multiple Sclerosis is Compatible with Intracellular Sodium Accumulation and Inflammation-Induced Hyper-Cellularity of Acute Brain Lesions

    PubMed Central

    Biller, Armin; Pflugmann, Isabella; Badde, Stephanie; Diem, Ricarda; Wildemann, Brigitte; Nagel, Armin M.; Jordan, J.; Benkhedah, Nadia; Kleesiek, Jens

    2016-01-01

    The cascade of inflammatory pathogenetic mechanisms in multiple sclerosis (MS) has no specific conventional MRI correlates. Clinicians therefore stipulate improved imaging specificity to define the pathological substrates of MS in vivo including mapping of intracellular sodium accumulation. Based upon preclinical findings and results of previous sodium MRI studies in MS patients we hypothesized that the fluid-attenuated sodium signal differs between acute and chronic lesions. We acquired brain sodium and proton MRI data of N = 29 MS patients; lesion type was defined by the presence or absence of contrast enhancement. N = 302 MS brain lesions were detected, and generalized linear mixed models were applied to predict lesion type based on sodium signals; thereby controlling for varying numbers of lesions among patients and confounding variables such as age and medication. Hierarchical model comparisons revealed that both sodium signals average tissue (χ2(1) = 27.89, p < 0.001) and fluid-attenuated (χ2(1) = 5.76, p = 0.016) improved lesion type classification. Sodium MRI signals were significantly elevated in acute compared to chronic lesions compatible with intracellular sodium accumulation in acute MS lesions. If confirmed in further studies, sodium MRI could serve as biomarker for diagnostic assessment of MS, and as readout parameter in clinical trials promoting attenuation of chronic inflammation. PMID:27507776

  11. Predictors of Change in Participation Rates Following Acquired Brain Injury: Results of a Longitudinal Study

    ERIC Educational Resources Information Center

    Anaby, Dana; Law, Mary; Hanna, Steven; DeMatteo, Carol

    2012-01-01

    Aim: The purpose of this study was (1) to examine the changes in participation rates over 1 year among children and adolescents after acquired brain injury and (2) to explore the effect of child and family factors on these changes. Method: The participation levels of 136 children and young people (88 males; 48 females; age range 4y 11mo-17y 6mo;…

  12. Perceptions of physical activity and walking in an early stage after stroke or acquired brain injury

    PubMed Central

    2017-01-01

    Background Physical activity has been established as being highly beneficial for health after stroke. There are considerable global efforts to find rehabilitation programs that encourage increased physical activity for persons with stroke. However, many persons with stroke or acquired brain injury do not reach recommended levels of physical activity and increased knowledge about why is needed. We aimed to explore views and experiences of physical activity and walking among persons with stroke or acquired brain injury. Method A qualitative study was conducted, among persons with stroke (n = 8) or acquired brain injury (n = 2) from a rehabilitation unit at Sahlgrenska University Hospital in Sweden. Semi-structured in-depth interviews were held about perceptions and experiences of walking and physical activity in general. Data were analyzed using qualitative content analysis, with categories that were determined inductively. Results Physical activity in general and walking ability more specifically were considered very important by the participants. However, physical activity was, regardless of exercising habits pre-injury, associated with different kinds of negative feelings and experiences. Commonly reported internal barriers in the current study were; fatigue, fear of falling or getting hurt in traffic, lack of motivation and depression. Reported external barriers were mostly related to walking, for example; bad weather, uneven ground, lack of company or noisy or too busy surroundings. Conclusion Persons with stroke or acquired brain injury found it difficult to engage in and sustain an eligible level of physical activity. Understanding individual concerns about motivators and barriers surrounding physical activity may facilitate the work of forming tailor-made rehabilitation for these groups, so that the levels of physical activity and walking can increase. PMID:28273158

  13. Atlas-based segmentation of pathological MR brain images using a model of lesion growth.

    PubMed

    Cuadra, Meritxell Bach; Pollo, Claudio; Bardera, Anton; Cuisenaire, Olivier; Villemure, Jean-Guy; Thiran, Jean-Philippe

    2004-10-01

    We propose a method for brain atlas deformation in the presence of large space-occupying tumors, based on an a priori model of lesion growth that assumes radial expansion of the lesion from its starting point. Our approach involves three steps. First, an affine registration brings the atlas and the patient into global correspondence. Then, the seeding of a synthetic tumor into the brain atlas provides a template for the lesion. The last step is the deformation of the seeded atlas, combining a method derived from optical flow principles and a model of lesion growth. Results show that a good registration is performed and that the method can be applied to automatic segmentation of structures and substructures in brains with gross deformation, with important medical applications in neurosurgery, radiosurgery, and radiotherapy.

  14. Dynamics of rabbit brain edema in focal lesion and perilesion area after traumatic brain injury: a MRI study.

    PubMed

    Wei, Xiao-Er; Zhang, Yu-Zhen; Li, Yue-Hua; Li, Ming-Hua; Li, Wen-Bin

    2012-09-20

    To understand the dynamics of brain edema in different areas after traumatic brain injury (TBI) in rabbit, we used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) to monitor blood-brain barrier (BBB) permeability and cytotoxic brain edema after weight drop-induced TBI in rabbit. The dynamics of BBB permeability and brain edema were quantified using K(trans) and apparent diffusion coefficient (ADC) in the focal and perifocal lesion areas, as well as the area contralateral to the lesion. In the focal lesion area, K(trans) began to increase at 3 h post-TBI, peaked at 3 days, and decreased gradually while remaining higher than sham injury animals at 7 and 30 days. ADC was more variable, increased slightly at 3 h, decreased to its lowest value at 7 days, then increased to a peak at 30 days. In the perifocal lesion area, K(trans) began to increase at 1 day, peaked at 3-7 days, and returned to control level by 30 days. ADC showed a trend to increase at 1 day, followed by a continuous increase thereafter. In the contralateral area, no changes in K(trans) and ADC were observed at any time-point. These data demonstrate that different types of brain edema predominate in the focal and perifocal lesion areas. Specifically cytotoxic edema was predominant in the focal lesion area while vasogenic edema predominated in the perifocal area in acute phase. Furthermore, secondary opening of the BBB after TBI may appear if secondary injury is not controlled. BBB damage may be a driving force for cytotoxic brain edema and could be a new target for TBI intervention.

  15. Predicting Outcome after Pediatric Traumatic Brain Injury by Early Magnetic Resonance Imaging Lesion Location and Volume

    PubMed Central

    Smitherman, Emily; Hernandez, Ana; Stavinoha, Peter L.; Huang, Rong; Kernie, Steven G.; Diaz-Arrastia, Ramon

    2016-01-01

    Abstract Brain lesions after traumatic brain injury (TBI) are heterogeneous, rendering outcome prognostication difficult. The aim of this study is to investigate whether early magnetic resonance imaging (MRI) of lesion location and lesion volume within discrete brain anatomical zones can accurately predict long-term neurological outcome in children post-TBI. Fluid-attenuated inversion recovery (FLAIR) MRI hyperintense lesions in 63 children obtained 6.2±5.6 days postinjury were correlated with the Glasgow Outcome Scale Extended-Pediatrics (GOS-E Peds) score at 13.5±8.6 months. FLAIR lesion volume was expressed as hyperintensity lesion volume index (HLVI)=(hyperintensity lesion volume / whole brain volume)×100 measured within three brain zones: zone A (cortical structures); zone B (basal ganglia, corpus callosum, internal capsule, and thalamus); and zone C (brainstem). HLVI-total and HLVI-zone C predicted good and poor outcome groups (p<0.05). GOS-E Peds correlated with HLVI-total (r=0.39; p=0.002) and HLVI in all three zones: zone A (r=0.31; p<0.02); zone B (r=0.35; p=0.004); and zone C (r=0.37; p=0.003). In adolescents ages 13–17 years, HLVI-total correlated best with outcome (r=0.5; p=0.007), whereas in younger children under the age of 13, HLVI-zone B correlated best (r=0.52; p=0.001). Compared to patients with lesions in zone A alone or in zones A and B, patients with lesions in all three zones had a significantly higher odds ratio (4.38; 95% confidence interval, 1.19–16.0) for developing an unfavorable outcome. PMID:25808802

  16. Quantifying brain tissue volume in multiple sclerosis with automated lesion segmentation and filling

    PubMed Central

    Valverde, Sergi; Oliver, Arnau; Roura, Eloy; Pareto, Deborah; Vilanova, Joan C.; Ramió-Torrentà, Lluís; Sastre-Garriga, Jaume; Montalban, Xavier; Rovira, Àlex; Lladó, Xavier

    2015-01-01

    Lesion filling has been successfully applied to reduce the effect of hypo-intense T1-w Multiple Sclerosis (MS) lesions on automatic brain tissue segmentation. However, a study of fully automated pipelines incorporating lesion segmentation and lesion filling on tissue volume analysis has not yet been performed. Here, we analyzed the % of error introduced by automating the lesion segmentation and filling processes in the tissue segmentation of 70 clinically isolated syndrome patient images. First of all, images were processed using the LST and SLS toolkits with different pipeline combinations that differed in either automated or manual lesion segmentation, and lesion filling or masking out lesions. Then, images processed following each of the pipelines were segmented into gray matter (GM) and white matter (WM) using SPM8, and compared with the same images where expert lesion annotations were filled before segmentation. Our results showed that fully automated lesion segmentation and filling pipelines reduced significantly the % of error in GM and WM volume on images of MS patients, and performed similarly to the images where expert lesion annotations were masked before segmentation. In all the pipelines, the amount of misclassified lesion voxels was the main cause in the observed error in GM and WM volume. However, the % of error was significantly lower when automatically estimated lesions were filled and not masked before segmentation. These results are relevant and suggest that LST and SLS toolboxes allow the performance of accurate brain tissue volume measurements without any kind of manual intervention, which can be convenient not only in terms of time and economic costs, but also to avoid the inherent intra/inter variability between manual annotations. PMID:26740917

  17. Cognitive rehabilitation after severe acquired brain injury: current evidence and future directions.

    PubMed

    De Luca, Rosaria; Calabrò, Rocco Salvatore; Bramanti, Placido

    2016-07-25

    Severe acquired brain injury (SABI) is damage to the brain, occurring after birth from traumatic or non-traumatic causes, and often resulting in deterioration of physical, cognitive, and emotional functions. Cognitive rehabilitation (CR) is aimed to help brain-injured or otherwise cognitively impaired individuals to restore normal functioning, or to compensate for cognitive deficits. Over the last years, the development of new technologies in the field of CR has led to a growing use of computer-based cognitive tools in patients with SABI. This review aims to investigate the efficacy of CR in individuals suffering from SABI, and evaluates the role of virtual reality and other innovative technologies in improving behavioural and functional outcomes. The current evidence for CR in the treatment of SABI-related deficits does not allow conclusive results to be achieved and further research is needed to identity the patient and treatment factors that contribute to successful outcomes.

  18. Impact of correction factors in human brain lesion-behavior inference.

    PubMed

    Sperber, Christoph; Karnath, Hans-Otto

    2017-03-01

    Statistical voxel-based lesion-behavior mapping (VLBM) in neurological patients with brain lesions is frequently used to examine the relationship between structure and function of the healthy human brain. Only recently, two simulation studies noted reduced anatomical validity of this method, observing the results of VLBM to be systematically misplaced by about 16 mm. However, both simulation studies differed from VLBM analyses of real data in that they lacked the proper use of two correction factors: lesion size and "sufficient lesion affection." In simulation experiments on a sample of 274 real stroke patients, we found that the use of these two correction factors reduced misplacement markedly compared to uncorrected VLBM. Apparently, the misplacement is due to physiological effects of brain lesion anatomy. Voxel-wise topographies of collateral damage in the real data were generated and used to compute a metric for the inter-voxel relation of brain damage. "Anatomical bias" vectors that were solely calculated from these inter-voxel relations in the patients' real anatomical data, successfully predicted the VLBM misplacement. The latter has the potential to help in the development of new VLBM methods that provide even higher anatomical validity than currently available by the proper use of correction factors. Hum Brain Mapp 38:1692-1701, 2017. © 2017 Wiley Periodicals, Inc.

  19. [Evaluation of the community integration of persons with lateralised post-acute acquired brain injury].

    PubMed

    Huertas-Hoyas, E; Pedrero-Perez, E J; Aguila-Maturana, A M; Gonzalez-Alted, C

    2013-08-16

    INTRODUCTION. Hemispheric specialization is a topic of interest that has motivated an enormous amount of research in recent decades. After a unilateral brain injury, the consequences can affect various areas of specialization, leading, depending on the location of the injury, impairment in quality of life and community integration. PATIENTS AND METHODS. Cross-sectional study with a sample of 58 patients, 28 traumatic brain injury (TBI) and 30 cerebrovascular accidents, both lateralized. The level of integration in the community is measured by the Community Integration Questionnaire. RESULTS. There were three groups analyzed by considering unilateral injury (full sample, stroke sample, and TBI sample). Results showed a significantly high community integration of people with right hemisphere injury. However, to measure the level of community integration between TBI and stroke, the results showed no significant differences. CONCLUSION. According to the results of the study people with brain injury in the right hemisphere have a better community integration than people with lesions in the left hemisphere regardless of the origin of the lesions (vascular or traumatic). We discussed the reasons that may motivate the differences and clinical implications.

  20. Application of radiosurgical techniques to produce a primate model of brain lesions

    PubMed Central

    Kunimatsu, Jun; Miyamoto, Naoki; Ishikawa, Masayori; Shirato, Hiroki; Tanaka, Masaki

    2015-01-01

    Behavioral analysis of subjects with discrete brain lesions provides important information about the mechanisms of various brain functions. However, it is generally difficult to experimentally produce discrete lesions in deep brain structures. Here we show that a radiosurgical technique, which is used as an alternative treatment for brain tumors and vascular malformations, is applicable to create non-invasive lesions in experimental animals for the research in systems neuroscience. We delivered highly focused radiation (130–150 Gy at ISO center) to the frontal eye field (FEF) of macaque monkeys using a clinical linear accelerator (LINAC). The effects of irradiation were assessed by analyzing oculomotor performance along with magnetic resonance (MR) images before and up to 8 months following irradiation. In parallel with tissue edema indicated by MR images, deficits in saccadic and smooth pursuit eye movements were observed during several days following irradiation. Although initial signs of oculomotor deficits disappeared within a month, damage to the tissue and impaired eye movements gradually developed during the course of the subsequent 6 months. Postmortem histological examinations showed necrosis and hemorrhages within a large area of the white matter and, to a lesser extent, in the adjacent gray matter, which was centered at the irradiated target. These results indicated that the LINAC system was useful for making brain lesions in experimental animals, while the suitable radiation parameters to generate more focused lesions need to be further explored. We propose the use of a radiosurgical technique for establishing animal models of brain lesions, and discuss the possible uses of this technique for functional neurosurgical treatments in humans. PMID:25964746

  1. Management strategies for neoplastic and vascular brain lesions presenting during pregnancy: A series of 29 patients

    PubMed Central

    Pereira, Celestino Esteves; Lynch, Jose Carlos

    2017-01-01

    Background: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. Methods: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D’Or/São Luis. The Neurosurgery Department teamed up with Obstetrics Anesthesiology Departments in establishing the procedures. The patients’ records, surgical descriptions, imaging studies, and histopathological material were reviewed. Results: Among 12 patients presenting with brain tumors, there were neither operative mortality nor fetal deaths. Among the vascular lesions, aneurysm rupture was responsible for bleeding in 6 instances. Arteriovenous malformation was diagnosed in 7 patients. In this subgroup, the maternal and fetal mortality rates were 11.7% and 23.7%, respectively. Conclusions: We can assert that the association between a brain tumor and vascular lesions with pregnancy is a very unusual event, which jeopardizes both the lives of the mother and infant. It remains incompletely characterized due to the rare nature of these potentially devastating events. Knowing the exact mechanism responsible for the interaction of pregnancy and with these lesions will improve the treatment of these patients. PMID:28303207

  2. Vertically acquired neonatal citrobacter brain abscess - case report and review of the literature.

    PubMed

    Agrawal, Deepak; Mahapatra, Ashok Kumar

    2005-02-01

    Vertically acquired citrobacter meningitis in the neonate is very rare and carries a very high mortality and morbidity. Overall, approximately 30% of neonates with Citrobacter meningitis die and 50% sustain some damage to the CNS. The authors describe a case of a newborn with Citrobacter koseri meningitis with multiple brain abscesses, with a successful outcome following multiple burr-hole aspirations and prolonged antibiotic therapy. An aggressive surgical approach combined with intravenous antibiotics (including imipenems, to which the organism is very sensitive) for a minimum of 4 weeks appears to improve the outcome of infection with this virulent organism.

  3. Macrostructural and Microstructural Brain Lesions Relate to Gait Pathology in Children With Cerebral Palsy.

    PubMed

    Meyns, Pieter; Van Gestel, Leen; Leunissen, Inge; De Cock, Paul; Sunaert, Stefan; Feys, Hilde; Duysens, Jacques; Desloovere, Kaat; Ortibus, Els

    2016-10-01

    Background Even though lower-limb motor disorders are core features of spastic cerebral palsy (sCP), the relationship with brain lesions remains unclear. Unraveling the relation between gait pathology, lower-limb function, and brain lesions in sCP is complex for several reasons; wide heterogeneity in brain lesions, ongoing brain maturation, and gait depends on a number of primary motor functions/deficits (eg, muscle strength, spasticity). Objective To use a comprehensive approach combining conventional MRI and diffusion tensor imaging (DTI) in children with sCP above 3 years old to relate quantitative parameters of brain lesions in multiple brain areas to gait performance. Methods A total of 50 children with sCP (25 bilateral, 25 unilateral involvement) were enrolled. The investigated neuroradiological parameters included the following: (1) volumetric measures of the corpus callosum (CC) and lateral ventricles (LVs), and (2) DTI parameters of the corticospinal tract (CST). Gait pathology and primary motor deficits, including muscle strength and spasticity, were evaluated by 3D gait analysis and clinical examination. Results In bilateral sCP (n = 25), volume of the LV and the subparts of the CC connecting frontal, (pre)motor, and sensory areas were most related to lower-limb functioning and gait pathology. DTI measures of the CST revealed additional relations with the primary motor deficits (n = 13). In contrast, in unilateral sCP, volumetric (n = 25) and diffusion measures (n = 14) were only correlated to lower-limb strength. Conclusions These results indicate that the combined influence of multiple brain lesions and their impact on the primary motor deficits might explain a large part of the gait pathology in sCP.

  4. Educational action in the rehabilitation of severe acquired brain injuries: the role of self-awareness.

    PubMed

    Silvestro, Daniela; Mazzetti, Maria; Melia, Chiara; Stagno, Maria Teresa; Carlesimo, Giovanni Augusto; Bivona, Umberto; Formisano, Rita

    2017-01-01

    Severe acquired brain injuries (ABI) cause a range of short-or long-term limitations in physical and neuropsychological abilities. The aim of rehabilitation is to promote the harmonious development of the individual through collaboration between medical and educational sciences, involved in the educability of the whole person, in which the aim is not only functional recovery but also social-reintegration. This "functional synergy" permits the development of the person, and establishes an indissoluble link between functions and attitudes, thus allowing the achievement of the greater possible autonomy. In this way classical and pedagogical rehabilitation may be combined in a single concept of educational action. To realize this integrated educational process it is important to evaluate and promote awareness development, based on the possibilities of brain plasticity and on the presence of multiple intelligences skillfully intertwined each other. Therefore, self-awareness plays a prime role in educational actions for the rehabilitation of persons with severe ABI.

  5. BEHAVIORAL TREATMENT FOR PATHOLOGICAL GAMBLING IN PERSONS WITH ACQUIRED BRAIN INJURY

    PubMed Central

    Guercio, John M; Johnson, Taylor; Dixon, Mark R

    2012-01-01

    The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week one-on-one client–patient format, a treatment program was developed in which the patient learned about the antecedents, consequences, and motivating operations that controlled the emission of gambling behavior. Data were collected on both self-report of gambling urges and behavior following therapy and during in situ gambling opportunities. The therapy program reduced urges to gamble and actual gambling for all patients. The potential of behavior-analytic therapy for reducing the pathological gambling of patients with and without brain injury is discussed. PMID:23060663

  6. Stereotaxic Surgery for Excitotoxic Lesion of Specific Brain Areas in the Adult Rat

    PubMed Central

    Kirby, Elizabeth D.; Jensen, Kelly; Goosens, Ki A.; Kaufer, Daniela

    2012-01-01

    Many behavioral functions in mammals, including rodents and humans, are mediated principally by discrete brain regions. A common method for discerning the function of various brain regions for behavior or other experimental outcomes is to implement a localized ablation of function. In humans, patient populations with localized brain lesions are often studied for deficits, in hopes of revealing the underlying function of the damaged area. In rodents, one can experimentally induce lesions of specific brain regions. Lesion can be accomplished in several ways. Electrolytic lesions can cause localized damage but will damage a variety of cell types as well as traversing fibers from other brain regions that happen to be near the lesion site. Inducible genetic techniques using cell-type specific promoters may also enable site-specific targeting. These techniques are complex and not always practical depending on the target brain area. Excitotoxic lesion using stereotaxic surgery, by contrast, is one of the most reliable and practical methods of lesioning excitatory neurons without damaging local glial cells or traversing fibers. Here, we present a protocol for stereotaxic infusion of the excitotoxin, N-methyl-D-aspartate (NMDA), into the basolateral amygdala complex. Using anatomical indications, we apply stereotaxic coordinates to determine the location of our target brain region and lower an injection needle in place just above the target. We then infuse our excitotoxin into the brain, resulting in excitotoxic death of nearby neurons. While our experimental subject of choice is a rat, the same methods can be applied to other mammals, with the appropriate adjustments in equipment and coordinates. This method can be used on a variety of brain regions, including the basolateral amygdala1-6, other amygdala nuclei6, 7, hippocampus8, entorhinal cortex9 and prefrontal cortex10. It can also be used to infuse biological compounds such as viral vectors1, 11. The basic stereotaxic

  7. Brain microbiota disruption within inflammatory demyelinating lesions in multiple sclerosis

    PubMed Central

    Branton, W. G.; Lu, J. Q.; Surette, M. G.; Holt, R. A.; Lind, J.; Laman, J. D.; Power, C.

    2016-01-01

    Microbial communities reside in healthy tissues but are often disrupted during disease. Bacterial genomes and proteins are detected in brains from humans, nonhuman primates, rodents and other species in the absence of neurological disease. We investigated the composition and abundance of microbiota in frozen and fixed autopsied brain samples from patients with multiple sclerosis (MS) and age- and sex-matched nonMS patients as controls, using neuropathological, molecular and bioinformatics tools. 16s rRNA sequencing revealed Proteobacteria to be the dominant phylum with restricted diversity in cerebral white matter (WM) from MS compared to nonMS patients. Both clinical groups displayed 1,200–1,400 bacterial genomes/cm3 and low bacterial rRNA:rDNA ratios in WM. RNAseq analyses showed a predominance of Proteobacteria in progressive MS patients’ WM, associated with increased inflammatory gene expression, relative to a broader range of bacterial phyla in relapsing-remitting MS patients’ WM. Although bacterial peptidoglycan (PGN) and RNA polymerase beta subunit immunoreactivities were observed in all patients, PGN immunodetection was correlated with demyelination and neuroinflammation in MS brains. Principal component analysis revealed that demyelination, PGN and inflammatory gene expression accounted for 86% of the observed variance. Thus, inflammatory demyelination is linked to an organ-specific dysbiosis in MS that could contribute to underlying disease mechanisms. PMID:27892518

  8. Oxidative Glial Cell Damage Associated with White Matter Lesions in the Aging Human Brain.

    PubMed

    Al-Mashhadi, Sufana; Simpson, Julie E; Heath, Paul R; Dickman, Mark; Forster, Gillian; Matthews, Fiona E; Brayne, Carol; Ince, Paul G; Wharton, Stephen B

    2015-09-01

    White matter lesions (WML) are common in brain aging and are associated with dementia. We aimed to investigate whether oxidative DNA damage and occur in WML and in apparently normal white matter in cases with lesions. Tissue from WML and control white matter from brains with lesions (controls lesional) and without lesions (controls non-lesional) were obtained, using post-mortem magnetic resonance imaging-guided sampling, from the Medical Research Council Cognitive Function and Ageing Study. Oxidative damage was assessed by immunohistochemistry to 8-hydroxy-2'-deoxoguanosine (8-OHdG) and Western blotting for malondialdehyde. DNA response was assessed by phosphorylated histone H2AX (γH2AX), p53, senescence markers and by quantitative Reverse transcription polymerase chain reaction (RT-PCR) panel for candidate DNA damage-associated genes. 8-OHdG was expressed in glia and endothelium, with increased expression in both WML and controls lesional compared with controls non-lesional (P < 0.001). γH2Ax showed a similar, although attenuated difference among groups (P = 0.03). Expression of senescence-associated β-galactosidase and p16 suggested induction of senescence mechanisms in glia. Oxidative DNA damage and a DNA damage response are features of WML pathogenesis and suggest candidate mechanisms for glial dysfunction. Their expression in apparently normal white matter in cases with WML suggests that white matter dysfunction is not restricted to lesions. The role of this field-effect lesion pathogenesis and cognitive impairment are areas to be defined.

  9. On imputing function to structure from the behavioural effects of brain lesions.

    PubMed Central

    Young, M P; Hilgetag, C C; Scannell, J W

    2000-01-01

    What is the link, if any, between the patterns of connections in the brain and the behavioural effects of localized brain lesions? We explored this question in four related ways. First, we investigated the distribution of activity decrements that followed simulated damage to elements of the thalamocortical network, using integrative mechanisms that have recently been used to successfully relate connection data to information on the spread of activation, and to account simultaneously for a variety of lesion effects. Second, we examined the consequences of the patterns of decrement seen in the simulation for each type of inference that has been employed to impute function to structure on the basis of the effects of brain lesions. Every variety of conventional inference, including double dissociation, readily misattributed function to structure. Third, we tried to derive a more reliable framework of inference for imputing function to structure, by clarifying concepts of function, and exploring a more formal framework, in which knowledge of connectivity is necessary but insufficient, based on concepts capable of mathematical specification. Fourth, we applied this framework to inferences about function relating to a simple network that reproduces intact, lesioned and paradoxically restored orientating behaviour. Lesion effects could be used to recover detailed and reliable information on which structures contributed to particular functions in this simple network. Finally, we explored how the effects of brain lesions and this formal approach could be used in conjunction with information from multiple neuroscience methodologies to develop a practical and reliable approach to inferring the functional roles of brain structures. PMID:10703050

  10. Cellular distribution of glucose and monocarboxylate transporters in human brain white matter and multiple sclerosis lesions.

    PubMed

    Nijland, Philip G; Michailidou, Iliana; Witte, Maarten E; Mizee, Mark R; van der Pol, Susanne M A; van Het Hof, Bert; Reijerkerk, Arie; Pellerin, Luc; van der Valk, Paul; de Vries, Helga E; van Horssen, Jack

    2014-07-01

    To ensure efficient energy supply to the high demanding brain, nutrients are transported into brain cells via specific glucose (GLUT) and monocarboxylate transporters (MCT). Mitochondrial dysfunction and altered glucose metabolism are thought to play an important role in the progression of neurodegenerative diseases, including multiple sclerosis (MS). Here, we investigated the cellular localization of key GLUT and MCT proteins in human brain tissue of non-neurological controls and MS patients. We show that in control brain tissue GLUT and MCT proteins were abundantly expressed in a variety of central nervous system cells, particularly in microglia and endothelial cells. In active MS lesions, GLUTs and MCTs were highly expressed in infiltrating leukocytes and reactive astrocytes. Astrocytes manifest increased MCT1 staining and maintain GLUT expression in inactive lesions, whereas demyelinated axons exhibit significantly reduced GLUT3 and MCT2 immunoreactivity in inactive lesions. Finally, we demonstrated that the co-transcription factor peroxisome proliferator-activated receptor gamma co-activator 1-alpha (PGC-1α), an important protein involved in energy metabolism, is highly expressed in reactive astrocytes in active MS lesions. Overexpression of PGC-1α in astrocyte-like cells resulted in increased production of several GLUT and MCT proteins. In conclusion, we provide for the first time a comprehensive overview of key nutrient transporters in white matter brain samples. Moreover, our data demonstrate an altered expression of these nutrient transporters in MS brain tissue, including a marked reduction of axonal GLUT3 and MCT2 expression in chronic lesions, which may impede efficient nutrient supply to the hypoxic demyelinated axons thereby contributing to the ongoing neurodegeneration in MS.

  11. Investigation of the best model to characterize diffuse correlation spectroscopy measurements acquired directly on the brain

    NASA Astrophysics Data System (ADS)

    Verdecchia, K.; Diop, M.; St. Lawrence, K.

    2015-03-01

    Diffuse correlation spectroscopy (DCS) is a non-invasive optical technique capable of monitoring tissue perfusion changes, particularly in the brain. The normalized temporal intensity autocorrelation function generated by DCS is typically characterized by assuming that the movement of erythrocytes can be modeled as a Brownian diffusion-like process instead of the expected random flow model. Carp et al. [Biomedical Optics Express, 2011] proposed a hybrid model, referred to as the hydrodynamic diffusion model, to capture both the random ballistic and diffusive nature of erythrocyte motion. The purpose of this study was to compare how well the Brownian diffusion and the hydrodynamic diffusion models characterized DCS data acquired directly on the brain, avoiding the confounding effects of scalp and skull. Data were acquired from seven pigs during normocapnia (39.9 +/- 0.7 mmHg) and hypocapnia (22.1 +/- 1.6 mmHg) with the DCS fibers placed 7 mm apart, directly on the cerebral cortex. The hydrodynamic diffusion model was found to provide a consistently better fit to the autocorrelation functions compared to the Brownian diffusion model and was less sensitive to the chosen start and end time points used in the fitting. However, the decrease in cerebral blood flow from normocapnia to hypocapnia determined was similar for the two models (-42.6 +/- 8.6 % for the Brownian model and -42.2 +/- 10.2 % for the hydrodynamic model), suggesting that the latter is reasonable for monitoring flow changes.

  12. Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria.

    PubMed

    Baguley, Ian J; Perkes, Iain E; Fernandez-Ortega, Juan-Francisco; Rabinstein, Alejandro A; Dolce, Giuliano; Hendricks, Henk T

    2014-09-01

    A syndrome of paroxysmal, episodic sympathetic hyperactivity after acquired brain injury has been recognized for almost 60 years. This project sought to simplify the confused nomenclature for the condition (>31 eponyms) and simplify the nine overlapping sets of diagnostic criteria. A consensus-developed questionnaire based on a systematic review of the literature was circulated to a widely representative, international expert group utilizing a Delphi approach. Diagnostic criteria were dropped if group consensus failed to agree on their relative importance, with a goal of reaching a Cronbach α of 0.8 (suitable for research purposes). The resulting criteria were combined into an assessment measure for clinical and research settings. The consensus group recommend that the term "paroxysmal sympathetic hyperactivity" replace previous terms to describe the "syndrome, recognised in a subgroup of survivors of severe acquired brain injury, of simultaneous, paroxysmal transient increases in sympathetic [elevated heart rate, blood pressure, respiratory rate, temperature, sweating] and motor [posturing] activity." An 11 point probabilistic diagnostic scale was developed with reference to published criteria, yielding an acceptable Cronbach α of 0.8. These 11 items were proceduralized and combined with a symptom severity index to produce a diagnostic tool for use with adults (the paroxysmal sympathetic hyperactivity assessment measure [PSH-AM]). Development of a pediatric version of the scale and further research into the validity of the PSH-AM is recommended. The consensus position builds on previous literature to establish diagnostic definitions and criteria, an important move to standardize research and management of this condition.

  13. Early Gesture Predicts Language Delay in Children with Pre- Or Perinatal Brain Lesions

    ERIC Educational Resources Information Center

    Sauer, Eve; Levine, Susan C.; Goldin-Meadow, Susan

    2010-01-01

    Does early gesture use predict later productive and receptive vocabulary in children with pre- or perinatal unilateral brain lesions (PL)? Eleven children with PL were categorized into 2 groups based on whether their gesture at 18 months was within or below the range of typically developing (TD) children. Children with PL whose gesture was within…

  14. Consistency of Intermanual Discrepancies in Normal and Unilateral Brain Lesion Patients.

    ERIC Educational Resources Information Center

    Bornstein, R. A.

    1986-01-01

    The distribution of intermanual discrepancies on three motor tests (Grooved Pegboard, Finger Tapping and Dynamometer) were examined in normal and unilateral brain lesion samples. Considerable variability in the intermanual discrepancies was observed in all three samples. Therefore, the consistency of discrepancies across tasks was examined. The…

  15. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis

    PubMed Central

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD. PMID:27936193

  16. Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis.

    PubMed

    Kim, Su-Hyun; Hyun, Jae-Won; Joung, AeRan; Lee, Sang Hyun; Kim, Ho Jin

    2016-01-01

    We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD.

  17. Depth of lesion model in children and adolescents with moderate to severe traumatic brain injury: use of SPGR MRI to predict severity and outcome

    PubMed Central

    Grados, M; Slomine, B; Gerring, J; Vasa, R; Bryan, N; Denckla, M

    2001-01-01

    OBJECTIVES—The utility of a depth of lesion classification using an SPGR MRI sequence in children with moderate to severe traumatic brain injury (TBI) was examined. Clinical and depth of lesion classification measures of TBI severity were used to predict neurological and functional outcome after TBI.
METHODS—One hundred and six children, aged 4 to 19, with moderate to severe TBI admitted to a rehabilitation unit had an SPGR MRI sequence obtained 3 months afterTBI. Acquired images were analyzed for location, number, and size of lesions. The Glasgow coma scale (GCS) was the clinical indicator of severity. The deepest lesion present was used for depth of lesion classification. Speed of injury was inferred from the type of injury. The disability rating scale at the time of discharge from the rehabilitation unit (DRS1) and at 1 year follow up (DRS2) were functional outcome measures.
RESULTS—The depth of lesion classification was significantly correlated with GCS severity, number of lesions, and both functional measures, DRS1 and DRS2. This result was more robust for time 1, probably due to the greater number of psychosocial factors impacting on functioning at time 2. Lesion volume was not correlated with the depth of lesion model. In multivariate models, depth of lesion was most predictive of DRS1, whereas GCS was most predictive of DRS2.
CONCLUSIONS—A depth of lesion classification of TBI severity may have clinical utility in predicting functional outcome in children and adolescents with moderate to severe TBI.

 PMID:11181858

  18. A genome-wide association study of brain lesion distribution in multiple sclerosis.

    PubMed

    Gourraud, Pierre-Antoine; Sdika, Michael; Khankhanian, Pouya; Henry, Roland G; Beheshtian, Azadeh; Matthews, Paul M; Hauser, Stephen L; Oksenberg, Jorge R; Pelletier, Daniel; Baranzini, Sergio E

    2013-04-01

    Brain magnetic resonance imaging is widely used as a diagnostic and monitoring tool in multiple sclerosis and provides a non-invasive, sensitive and reproducible way to track the disease. Topological characteristics relating to the distribution and shape of lesions are recognized as important neuroradiological markers in the diagnosis of multiple sclerosis, although these have been much less well characterized quantitatively than have traditional measures such as T2 hyperintense or T1 hypointense lesion volumes. Here, we used voxel-level 3 T magnetic resonance imaging T1-weighted scans to reconstruct the 3D topology of lesions in 284 subjects with multiple sclerosis and tested whether this is a heritable phenotype. To this end, we extracted the genotypes from a published genome-wide association study on these same individuals and searched for genetic associations with lesion load, shape and topological distribution. Lesion probability maps were created to identify frequently affected areas and to assess the overall distribution of T1 lesions in the subject population as a whole. We then developed an original algorithm to cluster adjacent lesional voxels (cluxels) in each subject and tested whether cluxel topology was significantly associated with any single-nucleotide polymorphism in our data set. To focus on patterns of lesion distribution, we computed the first 10 principal components. Although principal component 1 correlated with lesion load, none of the remaining orthogonal components correlated with any other known variable. We then conducted genome-wide association studies on each of these and found 31 significant associations (false discovery rate <0.01) with principal component 8, which represents a mode of variation of lesion topology in the population. The majority of the loci can be linked to genes related to immune cell function and to myelin and neural growth; some (SYK, MYT1L, TRAPPC9, SLITKR6 and RIC3) have been previously associated with the

  19. Two brief measures of executive function in the prediction of driving ability after acquired brain injury.

    PubMed

    Hargrave, David D; Nupp, Jason M; Erickson, Rey J

    2012-01-01

    The question of fitness to drive following acquired brain injury is commonly encountered in rehabilitation settings. Pre-driving assessments are usually performed prior to on-road assessments, but there is no uniformity as to the instruments employed. Neuropsychological tests are often employed to assess different functional domains. One domain that has been suggested to be critical to driving is executive functioning. The present study examined the utility of the Frontal Assessment Battery (FAB) and the Trail Making Test Part B (TMTB) in predicting on-road driving performance after stroke or traumatic brain injury. While the TMTB has previously been demonstrated to be useful in this regard, the FAB has never been examined for this purpose. Participants were 76 patients referred for driving assessment after diagnosis of stroke or traumatic brain injury. Results indicated that scores on the TMTB, but not the FAB, were significantly predictive of on-road driving performance (p < .05). A cutoff score of 90 seconds or greater on the TMTB correctly identified 77% of those failing on-road evaluation. Implications and limitations are discussed.

  20. In vivo pink-beam imaging and fast alignment procedure for rat brain lesion microbeam radiation therapy

    PubMed Central

    Serduc, Raphaël; Berruyer, Gilles; Brochard, Thierry; Renier, Michel; Nemoz, Christian

    2010-01-01

    A fast 50 µm-accuracy alignment procedure has been developed for the radiosurgery of brain lesions in rats, using microbeam radiation therapy. In vivo imaging was performed using the pink beam (35–60 keV) produced by the ID17 wiggler at the ESRF opened at 120 mm and filtered. A graphical user interface has been developed in order to define the irradiation field size and to position the target with respect to the skull structures observed in X-ray images. The method proposed here allows tremendous time saving by skipping the swap from white beam to monochromatic beam and vice versa. To validate the concept, the somatosensory cortex or thalamus of GAERS rats were irradiated under several ports using this alignment procedure. The magnetic resonance images acquired after contrast agent injection showed that the irradiations were selectively performed in these two expected brain regions. Image-guided microbeam irradiations have therefore been realised for the first time ever, and, thanks to this new development, the ID17 biomedical beamline provides a major tool allowing brain radiosurgery trials on animal patients. PMID:20400830

  1. Time-dependent diffuse reflectance spectroscopy for in vivo characterization of pediatric epileptogenic brain lesions

    NASA Astrophysics Data System (ADS)

    Oh, Sanghoon; Ragheb, John; Bhatia, Sanjiv; Sandberg, David; Johnson, Mahlon; Fernald, Bradley; Lin, Wei-Chiang

    2008-02-01

    Optical spectroscopy for in vivo tissue diagnosis is performed traditionally in a static manner; a snap shot of the tissue biochemical and morphological characteristics is captured through the interaction between light and the tissue. This approach does not capture the dynamic nature of a living organ, which is critical to the studies of brain disorders such as epilepsy. Therefore, a time-dependent diffuse reflectance spectroscopy system with a fiber-optic probe was designed and developed. The system was designed to acquire broadband diffuse reflectance spectra (240 ~ 932 nm) at an acquisition rate of 33 Hz. The broadband spectral acquisition feature allows simultaneous monitoring of various physiological characteristics of tissues. The utility of such a system in guiding pediatric epilepsy surgery was tested in a pilot clinical study including 13 epilepsy patients and seven brain tumor patients. The control patients were children undergoing suregery for brain tumors in which measurements were taken from normal brain exposed during the surgery. Diffuse reflectance spectra were acquired for 12 seconds from various parts of the brain of the patients during surgery. Recorded spectra were processed and analyzed in both spectral and time domains to gain insights into the dynamic changes in, for example, hemodynamics of the investigated brain tissue. One finding from this pilot study is that unsynchronized alterations in local blood oxygenation and local blood volume were observed in epileptogenic cortex. These study results suggest the advantage of using a time-dependent diffuse reflectance spectroscopy system to study epileptogenic brain in vivo.

  2. Measuring Oxygen Cost During Level Walking in Individuals with Acquired Brain Injury in the Clinical Setting

    PubMed Central

    Dawes, Helen; Collett, Johnathen; Ramsbottom, Roger; Howells, Ken; Sackley, Cath; Wade, Derick

    2004-01-01

    This study examined the test-retest reliability of oxygen cost (ml·kg-1·min-1) during level walking in individuals with acquired brain injury (ABI). Ten individuals with ABI (5 men, 5 women) (Traumatic brain injury, 1, central pontine myelinolysis, 1, stroke 8) and 21 healthy controls (11 men, 10 women). Measurements of gross and net (walking minus resting) oxygen consumption (ml·kg-1·min-1), and oxygen cost (ml·kg-1·min-1) during level walking at self-selected speeds. Measurements were taken on two occasions within one week. Oxygen cost was significantly lower (p < 0.05) in individuals with ABI on the second test versus the first test. Percentage variability in oxygen cost from test to re-test ranged from 14.7 to 17.3% in the control group and from 17.4 to 20.8% in the brain injury group. Clinical populations may demonstrate a significant decrease in oxygen cost between testing occasions. Individuals require at least one period of familiarisation if oxygen cost is used as an outcome measure during level walking in clinical groups. The amount of familiarisation has yet to be investigated in individuals with ABI. Key Points Individuals with brain injury during level walking May demonstrate a significant decrease in oxygen cost between testing occasions. May require at least one period of familiarisation if oxygen cost is used as an outcome measure The degree of familiarisation required in this clinical group needs further investigation PMID:24482582

  3. Automated Ischemic Lesion Segmentation in MRI Mouse Brain Data after Transient Middle Cerebral Artery Occlusion

    PubMed Central

    Mulder, Inge A.; Khmelinskii, Artem; Dzyubachyk, Oleh; de Jong, Sebastiaan; Rieff, Nathalie; Wermer, Marieke J. H.; Hoehn, Mathias; Lelieveldt, Boudewijn P. F.; van den Maagdenberg, Arn M. J. M.

    2017-01-01

    Magnetic resonance imaging (MRI) has become increasingly important in ischemic stroke experiments in mice, especially because it enables longitudinal studies. Still, quantitative analysis of MRI data remains challenging mainly because segmentation of mouse brain lesions in MRI data heavily relies on time-consuming manual tracing and thresholding techniques. Therefore, in the present study, a fully automated approach was developed to analyze longitudinal MRI data for quantification of ischemic lesion volume progression in the mouse brain. We present a level-set-based lesion segmentation algorithm that is built using a minimal set of assumptions and requires only one MRI sequence (T2) as input. To validate our algorithm we used a heterogeneous data set consisting of 121 mouse brain scans of various age groups and time points after infarct induction and obtained using different MRI hardware and acquisition parameters. We evaluated the volumetric accuracy and regional overlap of ischemic lesions segmented by our automated method against the ground truth obtained in a semi-automated fashion that includes a highly time-consuming manual correction step. Our method shows good agreement with human observations and is accurate on heterogeneous data, whilst requiring much shorter average execution time. The algorithm developed here was compiled into a toolbox and made publically available, as well as all the data sets. PMID:28197090

  4. Outcomes of tongue-pressure strength and accuracy training for dysphagia following acquired brain injury

    PubMed Central

    2013-01-01

    The purpose of this study was to measure treatment outcomes in a group of six adults with chronic dysphagia following acquired brain injury, who each completed 24 sessions of tongue-pressure resistance training, over a total of 11–12 weeks. The treatment protocol emphasized both strength and accuracy. Biofeedback was provided using the Iowa Oral Performance Instrument. Amplitude accuracy targets were set between 20–90% of the patient's maximum isometric pressure capacity. Single subject methods were used to track changes in tongue strength (maximum isometric pressures), with functional swallowing outcomes measured using blinded ratings of a standard pre- and post-treatment videofluoroscopy protocol. Improvements were seen in post-treatment measures of tongue pressure and penetration–aspiration. No improvements were seen in pharyngeal residues, indeed worsening residue was seen in some patients. PMID:23336825

  5. Alzheimer Lesions in the Autopsied Brains of People 30 to 50 Years of Age

    PubMed Central

    Pletnikova, Olga; Rudow, Gay L.; Hyde, Thomas M.; Kleinman, Joel E.; Ali, Sabeen Z.; Bharadwaj, Rahul; Gangadeen, Salina; Crain, Barbara J.; Fowler, David R.; Rubio, Ana I.; Troncoso, Juan C.

    2015-01-01

    Objective To test the hypothesis that asymptomatic Alzheimer disease lesions may appear before 50 years of age. Background Alzheimer disease has an asymptomatic stage during which people are cognitively intact despite having substantial pathologic changes in the brain. While this asymptomatic stage is common in older people, how early in life it may develop has been unknown. Methods We microscopically examined the postmortem brains of 154 people aged 30-39 years (n = 59) and 40-50 years (n = 95) for specific Alzheimer lesions: beta-amyloid plaques, neurofibrillary tangles, and tau-positive neurites. We genotyped DNA samples for the apolipoprotein E gene (APOE). Results We found beta-amyloid lesions in 13 brains, all of them from people aged 40 to 49 with no history of dementia. These plaques were of the diffuse type only and appeared throughout the neocortex. Among these 13 brains, 5 had very subtle tau lesions in the entorhinal cortex and/or hippocampus. All individuals with beta-amyloid deposits carried 1 or 2 APOE4 alleles. Among the individuals aged 40 to 50 with genotype APOE3/4, 10 (36%) had beta-amyloid deposits but 18 (64%) had none. Conclusions Our study demonstrates that beta-amyloid deposits in the cerebral cortex appear as early as 40 years of age in APOE4 carriers, suggesting that these lesions may constitute a very early stage of Alzheimer disease. Future preventive and therapeutic measures for this disease may have to be stratified by risk factors like APOE genotype and target people in their 40s or even earlier. PMID:26413742

  6. Further validation of the Motivation for Traumatic Brain Injury Rehabilitation Questionnaire (MOT-Q) in patients with acquired brain injury.

    PubMed

    Boosman, Hileen; van Heugten, Caroline M; Winkens, Ieke; Smeets, Sanne M J; Visser-Meily, Johanna M A

    2016-01-01

    The Motivation for Traumatic Brain Injury Rehabilitation Questionnaire (MOT-Q) evaluates motivation for rehabilitation in four subscales: Interest in rehabilitation, Lack of anger, Lack of denial, and Reliance on professional help. The objective of this study was to further validate the MOT-Q in 122 inpatients and 92 outpatients with acquired brain injury (ABI). The main measures were motivation for rehabilitation (MOT-Q), self-awareness (Patient Competency Rating Scale), and treatment motivation (Visual Analogue Scale). The MOT-Q showed adequate feasibility in terms of few items with missing responses and few undecided responses. We found no floor or ceiling effects, and significant item-total MOT-Q correlations for 29 of 31 items. Internal consistency was good for the MOT-Q total and acceptable to good for the subscales. The MOT-Q scores were significantly intercorrelated except for the subscales Lack of denial and Reliance on professional help in the inpatient group. The MOT-Q total and subscales were significantly associated with treatment motivation. The Lack of denial subscale showed no significant association with treatment motivation and no to moderate significant associations with self-awareness. In conclusion, the overall MOT-Q is a valid instrument to assess motivation for rehabilitation in patients with ABI. Further research is needed to examine the validity of the subscales.

  7. Clinical assessment of decision-making capacity in acquired brain injury with personality change

    PubMed Central

    Owen, Gareth S.; Freyenhagen, Fabian; Martin, Wayne; David, Anthony S.

    2017-01-01

    Assessment of decision-making capacity (DMC) can be difficult in acquired brain injury (ABI) particularly with the syndrome of organic personality disorder (OPD) (the “frontal lobe syndrome”). Clinical neuroscience may help but there are challenges translating its constructs to the decision-making abilities considered relevant by law and ethics. An in-depth interview study of DMC in OPD was undertaken. Six patients were purposefully sampled and rich interview data were acquired for scrutiny using interpretative phenomenological analysis. Interview data revealed that awareness of deficit and thinking about psychological states can be present. However, the awareness of deficit may not be “online” and effectively integrated into decision-making. Without this online awareness of deficit the ability to appreciate or use and weigh information in the process of deciding some matters appeared absent. We argue that the decision-making abilities discussed are: (1) necessary for DMC, (2) threatened by ABI , and (3) assessable at interview. Some advice for practically incorporating these abilities within assessments of DMC in patients with OPD is outlined. PMID:26088818

  8. Total cerebral blood flow, white matter lesions and brain atrophy: the SMART-MR study.

    PubMed

    Appelman, Auke P A; van der Graaf, Yolanda; Vincken, Koen L; Tiehuis, Audrey M; Witkamp, Theo D; Mali, Willem P T M; Geerlings, Mirjam I

    2008-03-01

    We investigated whether total cerebral blood flow (CBF) was associated with brain atrophy, and whether this relation was modified by white matter lesions (WML). Within the Second Manifestations of ARTerial disease-magnetic resonance (SMART-MR) study, a prospective cohort study among patients with arterial disease, cross-sectional analyses were performed in 828 patients (mean age 58+/-10 years, 81% male) with quantitative flow, atrophy, and WML measurements on magnetic resonance imaging (MRI). Total CBF was measured with MR angiography and was expressed per 100 mL brain volume. Total brain volume and ventricular volume were divided by intracranial volume to obtain brain parenchymal fraction (BPF) and ventricular fraction (VF). Lower BPF indicates more global brain atrophy, whereas higher VF indicates more subcortical brain atrophy. Mean CBF was 52.0+/-10.2 mL/min per 100 mL, mean BPF was 79.2+/-2.9%, and mean VF was 2.03+/-0.96%. Linear regression analyses showed that lower CBF was associated with more subcortical brain atrophy, after adjusting for age, sex, vascular risk factors, intima-media thickness, and lacunar infarcts, but only in patients with moderate to severe WML (upper quartile of WML): Change in VF per s.d. decrease in CBF 0.18%, 95% CI: 0.02 to 0.34%. Our findings suggest that cerebral hypoperfusion in the presence of WML may be associated with subcortical brain atrophy.

  9. The impact of acquired brain damage in terms of epidemiology, economics and loss in quality of life

    PubMed Central

    2011-01-01

    Background Patients with acquired brain damage (ABD) have suffered a brain lesion that interrupts vital development in the physical, psychological and social spheres. Stroke and traumatic brain injury (TBI) are the two main causes. The objectives of this study were to estimate the incidence and prevalence of ABD in the population of the Basque Country and Navarre in 2008, to calculate the associated cost of the care required and finally to assess the loss in health-related quality of life. Methods On the one hand, a cross-sectional survey was carried out, in order to estimate the incidence of ABD and its consequences in terms of costs and loss in quality of life from the evolution of a sample of patients diagnosed with stroke and TBI. On the other hand, a discrete event simulation model was built that enabled the prevalence of ABD to be estimated. Finally, a calculation was made of the formal and informal costs of ABD in the population of the Basque Country and Navarre (2,750,000 people). Results The cross-sectional study showed that the incidences of ABD caused by stroke and TBI were 61.8 and 12.5 cases per 100,000 per year respectively, while the overall prevalence was 657 cases per 100,000 people. The SF-36 physical and mental component scores were 28.9 and 44.5 respectively. The total economic burden was calculated to be 382.14 million euro per year, distributed between 215.27 and 166.87 of formal and informal burden respectively. The average cost per individual was 21,040 € per year. Conclusions The main conclusion of this study is that ABD has a high impact in both epidemiological and economic terms as well as loss in quality of life. The overall prevalence obtained is equivalent to 0.7% of the total population. The substantial economic burden is distributed nearly evenly between formal and informal costs. Specifically, it was found that the physical dimensions of quality of life are the most severely affected. The prevalence-based approach showed adequate

  10. Automated metastatic brain lesion detection: a computer aided diagnostic and clinical research tool

    NASA Astrophysics Data System (ADS)

    Devine, Jeremy; Sahgal, Arjun; Karam, Irene; Martel, Anne L.

    2016-03-01

    The accurate localization of brain metastases in magnetic resonance (MR) images is crucial for patients undergoing stereotactic radiosurgery (SRS) to ensure that all neoplastic foci are targeted. Computer automated tumor localization and analysis can improve both of these tasks by eliminating inter and intra-observer variations during the MR image reading process. Lesion localization is accomplished using adaptive thresholding to extract enhancing objects. Each enhancing object is represented as a vector of features which includes information on object size, symmetry, position, shape, and context. These vectors are then used to train a random forest classifier. We trained and tested the image analysis pipeline on 3D axial contrast-enhanced MR images with the intention of localizing the brain metastases. In our cross validation study and at the most effective algorithm operating point, we were able to identify 90% of the lesions at a precision rate of 60%.

  11. [Method of automatic detection of brain lesion based on wavelet feature vector].

    PubMed

    Fan, Ya; Liu, Wei; Feng, Huanqing

    2011-06-01

    A new method of automatic detection of brain lesion based on wavelet feature vector of CT images has been proposed in the present paper. Firstly, we created training samples by manually segmenting normal CT images into gray matter, white matter and cerebrospinal fluid sub images. Then, we obtained the cluster centers using FCM clustering algorithm. When detecting lesions, the CT images to be detected was automatically segmented into sub images, with a certain degree of over-segmenting allowed under the premise of ensuring accuracy as much as possible. Then we extended these sub images and extracted the features to compute the distances with the cluster centers and to determine whether they belonged to the three kinds of normal samples, or, otherwise, belonged to lesions. The proposed method was verified by experiments.

  12. Texture Analysis of T2-Weighted MR Images to Assess Acute Inflammation in Brain MS Lesions

    PubMed Central

    Michoux, Nicolas; Guillet, Alain; Rommel, Denis; Mazzamuto, Giosué; Sindic, Christian; Duprez, Thierry

    2015-01-01

    Brain blood barrier breakdown as assessed by contrast-enhanced (CE) T1-weighted MR imaging is currently the standard radiological marker of inflammatory activity in multiple sclerosis (MS) patients. Our objective was to evaluate the performance of an alternative model assessing the inflammatory activity of MS lesions by texture analysis of T2-weighted MR images. Twenty-one patients with definite MS were examined on the same 3.0T MR system by T2-weighted, FLAIR, diffusion-weighted and CE-T1 sequences. Lesions and mirrored contralateral areas within the normal appearing white matter (NAWM) were characterized by texture parameters computed from the gray level co-occurrence and run length matrices, and by the apparent diffusion coefficient (ADC). Statistical differences between MS lesions and NAWM were analyzed. ROC analysis and leave-one-out cross-validation were performed to evaluate the performance of individual parameters, and multi-parametric models using linear discriminant analysis (LDA), partial least squares (PLS) and logistic regression (LR) in the identification of CE lesions. ADC and all but one texture parameter were significantly different within white matter lesions compared to within NAWM (p < 0.0167). Using LDA, an 8-texture parameter model identified CE lesions with a sensitivity Se = 70% and a specificity Sp = 76%. Using LR, a 10-texture parameter model performed better with Se = 86% / Sp = 84%. Using PLS, a 6-texture parameter model achieved the highest accuracy with Se = 88% / Sp = 81%. Texture parameter from T2-weighted images can assess brain inflammatory activity with sufficient accuracy to be considered as a potential alternative to enhancement on CE T1-weighted images. PMID:26693908

  13. Locations and Clinical Significance of Non-Hemorrhagic Brain Lesions in Diffuse Axonal Injuries

    PubMed Central

    Chung, Sang Won; Nam, Taek Kyun; Kwon, Jeong Taik; Min, Byung Kook; Hwang, Sung Nam

    2012-01-01

    Objective Detection of focal non-hemorrhagic lesion (NHL) has become more efficient in diffuse axonal injury (DAI) patients using an MRI. The aims of this study are to find out the radiological distribution, progress of NHL and its clinical significance. Methods Between September 2005 and October 2011, 32 individuals with NHLs on brain MRI were enrolled. NHLs were classified by brain location into 4 major districts and 13 detailed locations including cortical and subcortical, corpus callosum, deep nuclei and adjacent area, and brainstem. The severity of NHL was scored from grades 1 to 4, according to the number of districts involved. Fourteen patients with NHL were available for MRI follow-up and an investigation of the changes was conducted. Results Thirty-two patients had 59 NHLs. The most common district of NHL was cortical and subcortical area; 15 patients had 20 NHSs. However the most common specific location was the splenium of the corpus callosum; 14 patients had 14 lesions. The more lesions patients had, the lower the GCS, however, this was not a statistically meaningful difference. On follow-up MRI in 14 patients, out of 24 lesions, 13 NHLs resolved, 5 showed cystic change, and 6 showed atrophic changes. Conclusion NHLs were located most commonly in the splenium and occur frequently in the thalamus and the mesial temporal lobe. Because most NHS occur concomitantly with hemorrhagic lesions, it was difficult to determine their effects on prognosis. Since most NHLs resolve completely, they are probably less significant to prognosis than hemorrhagic lesions. PMID:23133728

  14. Encephalitozoon cuniculi: Grading the Histological Lesions in Brain, Kidney, and Liver during Primoinfection Outbreak in Rabbits

    PubMed Central

    Rodríguez-Tovar, Luis E.; Nevárez-Garza, Alicia M.; Trejo-Chávez, Armando; Hernández-Martínez, Carlos A.; Zarate-Ramos, Juan J.; Castillo-Velázquez, Uziel

    2016-01-01

    This is the first confirmed report of Encephalitozoon cuniculi (E. cuniculi) in farm meat rabbits located in Northern Mexico. Eighty young rabbits exhibited clinical signs of this zoonotic emerging disease, like torticollis, ataxia, paresis, circling, and rolling. Samples of brain, kidney, and liver were examined for histology lesions. For the first time the lesions caused by E. cuniculi were graded according to their severity (I, II, and III) and the size of the granulomas (Types A, B, and C). The main cerebral injuries were Grade III, coinciding with the presence of Type C granulomas. The cerebral lesions were located in the cortex, brain stem, and medulla. The renal lesions were also Grade III distributed throughout cortex and renal medulla, with no granuloma formation. The involvement of hypersensitivity Types III and IV is suggested. All of the rabbits were seropositive to E. cuniculi by CIA testing, suggesting that this zoonotic and emerging pathogen is widely distributed among animals intended for human consumption. We believe this work could be used as a guide when examining E. cuniculi and will provide direction to confirm the diagnosis of this pathogen. PMID:27022485

  15. Encephalitozoon cuniculi: Grading the Histological Lesions in Brain, Kidney, and Liver during Primoinfection Outbreak in Rabbits.

    PubMed

    Rodríguez-Tovar, Luis E; Nevárez-Garza, Alicia M; Trejo-Chávez, Armando; Hernández-Martínez, Carlos A; Hernández-Vidal, Gustavo; Zarate-Ramos, Juan J; Castillo-Velázquez, Uziel

    2016-01-01

    This is the first confirmed report of Encephalitozoon cuniculi (E. cuniculi) in farm meat rabbits located in Northern Mexico. Eighty young rabbits exhibited clinical signs of this zoonotic emerging disease, like torticollis, ataxia, paresis, circling, and rolling. Samples of brain, kidney, and liver were examined for histology lesions. For the first time the lesions caused by E. cuniculi were graded according to their severity (I, II, and III) and the size of the granulomas (Types A, B, and C). The main cerebral injuries were Grade III, coinciding with the presence of Type C granulomas. The cerebral lesions were located in the cortex, brain stem, and medulla. The renal lesions were also Grade III distributed throughout cortex and renal medulla, with no granuloma formation. The involvement of hypersensitivity Types III and IV is suggested. All of the rabbits were seropositive to E. cuniculi by CIA testing, suggesting that this zoonotic and emerging pathogen is widely distributed among animals intended for human consumption. We believe this work could be used as a guide when examining E. cuniculi and will provide direction to confirm the diagnosis of this pathogen.

  16. Lesion detection in magnetic resonance brain images by hyperspectral imaging algorithms

    NASA Astrophysics Data System (ADS)

    Xue, Bai; Wang, Lin; Li, Hsiao-Chi; Chen, Hsian Min; Chang, Chein-I.

    2016-05-01

    Magnetic Resonance (MR) images can be considered as multispectral images so that MR imaging can be processed by multispectral imaging techniques such as maximum likelihood classification. Unfortunately, most multispectral imaging techniques are not particularly designed for target detection. On the other hand, hyperspectral imaging is primarily developed to address subpixel detection, mixed pixel classification for which multispectral imaging is generally not effective. This paper takes advantages of hyperspectral imaging techniques to develop target detection algorithms to find lesions in MR brain images. Since MR images are collected by only three image sequences, T1, T2 and PD, if a hyperspectral imaging technique is used to process MR images it suffers from the issue of insufficient dimensionality. To address this issue, two approaches to nonlinear dimensionality expansion are proposed, nonlinear correlation expansion and nonlinear band ratio expansion. Once dimensionality is expanded hyperspectral imaging algorithms are readily applied. The hyperspectral detection algorithm to be investigated for lesion detection in MR brain is the well-known subpixel target detection algorithm, called Constrained Energy Minimization (CEM). In order to demonstrate the effectiveness of proposed CEM in lesion detection, synthetic images provided by BrainWeb are used for experiments.

  17. Morphology of pineal glands in human foetuses and infants with brain lesions.

    PubMed

    Laure-Kamionowska, Milena; Maślińska, Danuta; Deregowski, Krzysztof; Czichos, Elzbieta; Raczkowska, Barbara

    2003-01-01

    The pineal gland is an organ involved in regulation of homeostasis and body rhythms. It plays an important role in the growth foetuses and adaptation of newborns to new environmental conditions. The requirements of foetuses and newborns progressively change during development. The purpose of the study was to evaluate morphological changes of pineal glands in foetuses and infants with brain lesions. The results of our study showed that parenchyma of developing pineal glands was susceptible to injury in most autopsied foetal and infantile cases. Morphological changes in pineal glands were found in 90% of autopsied brains but 100% of the cases had infections. The lesions in the pineal included mainly haemorrhagic, necrotic and cystic changes. In our autopsied foetuses and children, morphological changes in pineal glands were concomitant with various lesions of brain parenchyma. All results of our study lead to the conclusion that the pineal gland during its development is very susceptible to injury. The failure of normal pineal gland development and subsequent impaired production of melatonin decrease resistance of newborns and children to various environmental harmful agents.

  18. Astrocytic TYMP and VEGFA drive blood-brain barrier opening in inflammatory central nervous system lesions.

    PubMed

    Chapouly, Candice; Tadesse Argaw, Azeb; Horng, Sam; Castro, Kamilah; Zhang, Jingya; Asp, Linnea; Loo, Hannah; Laitman, Benjamin M; Mariani, John N; Straus Farber, Rebecca; Zaslavsky, Elena; Nudelman, German; Raine, Cedric S; John, Gareth R

    2015-06-01

    In inflammatory central nervous system conditions such as multiple sclerosis, breakdown of the blood-brain barrier is a key event in lesion pathogenesis, predisposing to oedema, excitotoxicity, and ingress of plasma proteins and inflammatory cells. Recently, we showed that reactive astrocytes drive blood-brain barrier opening, via production of vascular endothelial growth factor A (VEGFA). Here, we now identify thymidine phosphorylase (TYMP; previously known as endothelial cell growth factor 1, ECGF1) as a second key astrocyte-derived permeability factor, which interacts with VEGFA to induce blood-brain barrier disruption. The two are co-induced NFκB1-dependently in human astrocytes by the cytokine interleukin 1 beta (IL1B), and inactivation of Vegfa in vivo potentiates TYMP induction. In human central nervous system microvascular endothelial cells, VEGFA and the TYMP product 2-deoxy-d-ribose cooperatively repress tight junction proteins, driving permeability. Notably, this response represents part of a wider pattern of endothelial plasticity: 2-deoxy-d-ribose and VEGFA produce transcriptional programs encompassing angiogenic and permeability genes, and together regulate a third unique cohort. Functionally, each promotes proliferation and viability, and they cooperatively drive motility and angiogenesis. Importantly, introduction of either into mouse cortex promotes blood-brain barrier breakdown, and together they induce severe barrier disruption. In the multiple sclerosis model experimental autoimmune encephalitis, TYMP and VEGFA co-localize to reactive astrocytes, and correlate with blood-brain barrier permeability. Critically, blockade of either reduces neurologic deficit, blood-brain barrier disruption and pathology, and inhibiting both in combination enhances tissue preservation. Suggesting importance in human disease, TYMP and VEGFA both localize to reactive astrocytes in multiple sclerosis lesion samples. Collectively, these data identify TYMP as an

  19. Astrocytic TYMP and VEGFA drive blood–brain barrier opening in inflammatory central nervous system lesions

    PubMed Central

    Chapouly, Candice; Tadesse Argaw, Azeb; Horng, Sam; Castro, Kamilah; Zhang, Jingya; Asp, Linnea; Loo, Hannah; Laitman, Benjamin M.; Mariani, John N.; Straus Farber, Rebecca; Zaslavsky, Elena; Nudelman, German; Raine, Cedric S.

    2015-01-01

    In inflammatory central nervous system conditions such as multiple sclerosis, breakdown of the blood–brain barrier is a key event in lesion pathogenesis, predisposing to oedema, excitotoxicity, and ingress of plasma proteins and inflammatory cells. Recently, we showed that reactive astrocytes drive blood–brain barrier opening, via production of vascular endothelial growth factor A (VEGFA). Here, we now identify thymidine phosphorylase (TYMP; previously known as endothelial cell growth factor 1, ECGF1) as a second key astrocyte-derived permeability factor, which interacts with VEGFA to induce blood–brain barrier disruption. The two are co-induced NFκB1-dependently in human astrocytes by the cytokine interleukin 1 beta (IL1B), and inactivation of Vegfa in vivo potentiates TYMP induction. In human central nervous system microvascular endothelial cells, VEGFA and the TYMP product 2-deoxy-d-ribose cooperatively repress tight junction proteins, driving permeability. Notably, this response represents part of a wider pattern of endothelial plasticity: 2-deoxy-d-ribose and VEGFA produce transcriptional programs encompassing angiogenic and permeability genes, and together regulate a third unique cohort. Functionally, each promotes proliferation and viability, and they cooperatively drive motility and angiogenesis. Importantly, introduction of either into mouse cortex promotes blood–brain barrier breakdown, and together they induce severe barrier disruption. In the multiple sclerosis model experimental autoimmune encephalitis, TYMP and VEGFA co-localize to reactive astrocytes, and correlate with blood–brain barrier permeability. Critically, blockade of either reduces neurologic deficit, blood–brain barrier disruption and pathology, and inhibiting both in combination enhances tissue preservation. Suggesting importance in human disease, TYMP and VEGFA both localize to reactive astrocytes in multiple sclerosis lesion samples. Collectively, these data identify TYMP

  20. The need for improved brain lesion segmentation techniques for children with cerebral palsy: A review.

    PubMed

    Pagnozzi, Alex M; Gal, Yaniv; Boyd, Roslyn N; Fiori, Simona; Fripp, Jurgen; Rose, Stephen; Dowson, Nicholas

    2015-12-01

    Cerebral palsy (CP) describes a group of permanent disorders of posture and movement caused by disturbances in the developing brain. Accurate diagnosis and prognosis, in terms of motor type and severity, is difficult to obtain due to the heterogeneous appearance of brain injury and large anatomical distortions commonly observed in children with CP. There is a need to optimise treatment strategies for individual patients in order to lead to lifelong improvements in function and capabilities. Magnetic resonance imaging (MRI) is critical to non-invasively visualizing brain lesions, and is currently used to assist the diagnosis and qualitative classification in CP patients. Although such qualitative approaches under-utilise available data, the quantification of MRIs is not automated and therefore not widely performed in clinical assessment. Automated brain lesion segmentation techniques are necessary to provide valid and reproducible quantifications of injury. Such techniques have been used to study other neurological disorders, however the technical challenges unique to CP mean that existing algorithms require modification to be sufficiently reliable, and therefore have not been widely applied to MRIs of children with CP. In this paper, we present a review of a subset of available brain injury segmentation approaches that could be applied to CP, including the detection of cortical malformations, white and grey matter lesions and ventricular enlargement. Following a discussion of strengths and weaknesses, we suggest areas of future research in applying segmentation techniques to the MRI of children with CP. Specifically, we identify atlas-based priors to be ineffective in regions of substantial malformations, instead propose relying on adaptive, spatially consistent algorithms, with fast initialisation mechanisms to provide additional robustness to injury. We also identify several cortical shape parameters that could be used to identify cortical injury, and shape

  1. Reappraisal generation after acquired brain damage: The role of laterality and cognitive control

    PubMed Central

    Salas, Christian E.; Gross, James J.; Turnbull, Oliver H.

    2014-01-01

    In the past decade, there has been growing interest in the neuroanatomical and neuropsychological bases of reappraisal. Findings suggest that reappraisal activates a set of areas in the left hemisphere (LH), which are commonly associated with language abilities and verbally mediated cognitive control. The main goal of this study was to investigate whether individuals with focal damage to the LH (n = 8) were more markedly impaired on a reappraisal generation task than individuals with right hemisphere lesions (RH, n = 8), and healthy controls (HC, n = 14). The reappraisal generation task consisted of a set of ten pictures from the IAPS, depicting negative events of different sorts. Participants were asked to quickly generate as many positive reinterpretations as possible for each picture. Two scores were derived from this task, namely difficulty and productivity. A second goal of this study was to explore which cognitive control processes were associated with performance on the reappraisal task. For this purpose, participants were assessed on several measures of cognitive control. Findings indicated that reappraisal difficulty – defined as the time taken to generate a first reappraisal – did not differ between LH and RH groups. However, differences were found between patients with brain injury (LH + RH) and HC, suggesting that brain damage in either hemisphere influences reappraisal difficulty. No differences in reappraisal productivity were found across groups, suggesting that neurological groups and HC are equally productive when time constraints are not considered. Finally, only two cognitive control processes inhibition and verbal fluency- were inversely associated with reappraisal difficulty. Implications for the neuroanatomical and neuropsychological bases of reappraisal generation are discussed, and implications for neuro-rehabilitation are considered. PMID:24711799

  2. A Lesion-Proof Brain? Multidimensional Sensorimotor, Cognitive, and Socio-Affective Preservation Despite Extensive Damage in a Stroke Patient

    PubMed Central

    García, Adolfo M.; Sedeño, Lucas; Herrera Murcia, Eduar; Couto, Blas; Ibáñez, Agustín

    2017-01-01

    In this study, we report an unusual case of mutidimensional sensorimotor, cognitive, and socio-affective preservation in an adult with extensive, acquired bilateral brain damage. At age 43, patient CG sustained a cerebral hemorrhage and a few months later, she suffered a second (ischemic) stroke. As a result, she exhibited extensive damage of the right hemisphere (including frontal, temporal, parietal, and occipital regions), left Sylvian and striatal areas, bilateral portions of the insula and the amygdala, and the splenium. However, against all probability, she was unimpaired across a host of cognitive domains, including executive functions, attention, memory, language, sensory perception (e.g., taste recognition and intensity discrimination), emotional processing (e.g., experiencing of positive and negative emotions), and social cognition skills (prosody recognition, theory of mind, facial emotion recognition, and emotional evaluation). Her functional integrity was further confirmed through neurological examination and contextualized observation of her performance in real-life tasks. In sum, CG's case resists straightforward classifications, as the extent and distribution of her lesions would typically produce pervasive, multidimensional deficits. We discuss the rarity of this patient against the backdrop of other reports of atypical cognitive preservation, expound the limitations of several potential accounts, and highlight the challenges that the case poses for current theories of brain organization and resilience. PMID:28119603

  3. Neuroaxonal regeneration is more pronounced in early multiple sclerosis than in traumatic brain injury lesions.

    PubMed

    Schirmer, Lucas; Merkler, Doron; König, Fatima B; Brück, Wolfgang; Stadelmann, Christine

    2013-01-01

    The extent of irreversible neuroaxonal damage is the key determinant of permanent disability in traumatic and inflammatory conditions of the central nervous system (CNS). Structural damage is nevertheless in part compensated by neuroplastic events. However, it is unknown whether the same kinetics and mechanisms of neuroaxonal de- and regeneration take place in inflammatory and traumatic conditions. We analyzed neuroaxonal degeneration and plasticity in early multiple sclerosis (MS) lesions and traumatic brain injury (TBI). Neuroaxonal degeneration identified by the presence of SMI31+ chromatolytic neurons and SMI32+ axonal profiles were characteristic features of leukocortical TBI lesions. Axonal transport disturbances as determined by amyloid precursor protein (APP)+ spheroids were present in both TBI and MS lesions to a similar degree. Neurons expressing growth-associated protein 43 (GAP43) and synaptophysin (Syn) were found under both pathological conditions. However, axonal swellings immunopositive for GAP43 and Syn clearly prevailed in subcortical MS lesions, suggesting a higher regenerative potential in MS. In this context, GAP43+/APP+ axonal spheroid ratios correlated with macrophage infiltration in TBI and MS lesions, supporting the idea that phagocyte activation might promote neuroplastic events. Furthermore, axonal GAP43+ and Syn+ swellings correlated with prolonged survival after TBI, indicating a sustained regenerative response.

  4. Iron porphyrinate Fe(TPPS) reduces brain cell damage in rats intrastriatally lesioned by quinolinate.

    PubMed

    González-Cortés, Carolina; Salinas-Lara, Citlaltepetl; Gómez-López, Marcos Artemio; Tena-Suck, Martha Lilia; Pérez-De La Cruz, Verónica; Rembao-Bojórquez, Daniel; Pedraza-Chaverrí, José; Gómez-Ruiz, Celedonio; Galván-Arzate, Sonia; Ali, Syed F; Santamaría, Abel

    2008-01-01

    It has been recently demonstrated that the reactive nitrogen species (RNS) peroxynitrite (ONOO(-)) is involved in the neurotoxic pattern produced by quinolinic acid in the rat brain [V. Pérez-De La Cruz, C. González-Cortés, S. Galván-Arzate, O.N. Medina-Campos, F. Pérez-Severiano, S.F. Ali, J. Pedraza-Chaverrí, A. Santamaría, Excitotoxic brain damage involves early peroxynitrite formation in a model of Huntington's disease in rats: protective role of iron porphyrinate 5,10,15,20-tetrakis (4-sulfonatophenyl)porphyrinate iron (III), Neuroscience 135 (2005) 463-474.]. The aim of this work was to investigate whether ONOO(-) can also be responsible for morphological alterations and inflammatory events in the same paradigm. For this purpose, we evaluated the effect of a pre-treatment with the iron porphyrinate Fe(TPPS), a well-known ONOO(-) decomposition catalyst (10 mg/kg, i.p., 120 min before lesion), on the quinolinate-induced striatal cell damage and immunoreactivities to glial-fibrilar acidic protein (GFAP), interleukin 6 (IL-6) and inducible nitric oxide synthase (iNOS), one and seven days after the intrastriatal infusion of quinolinate (240 nmol/microl) to rats. The striatal tissue from animals lesioned by quinolinate showed a significant degree of damage and enhanced immunoreactivities to GFAP, IL-6 and iNOS, both at 1 and 7 days post-lesion. Pre-treatment of rats with Fe(TPPS) significantly attenuated or prevented all these markers at both post-lesion times tested, except for GFAP immunoreactivity at 7 days post-lesion and iNOS immunoreactivity at 1 day post-lesion. Altogether, our results suggest that ONOO(-) is actively participating in triggering inflammatory events and morphological alterations in the toxic model produced by quinolinate, since the use of agents affecting its formation, such as Fe(TPPS), are effective experimental tools to reduce the brain lesions associated to excitotoxic and oxidative damage.

  5. Automated tissue segmentation of MR brain images in the presence of white matter lesions.

    PubMed

    Valverde, Sergi; Oliver, Arnau; Roura, Eloy; González-Villà, Sandra; Pareto, Deborah; Vilanova, Joan C; Ramió-Torrentà, Lluís; Rovira, Àlex; Lladó, Xavier

    2017-01-01

    Over the last few years, the increasing interest in brain tissue volume measurements on clinical settings has led to the development of a wide number of automated tissue segmentation methods. However, white matter lesions are known to reduce the performance of automated tissue segmentation methods, which requires manual annotation of the lesions and refilling them before segmentation, which is tedious and time-consuming. Here, we propose a new, fully automated T1-w/FLAIR tissue segmentation approach designed to deal with images in the presence of WM lesions. This approach integrates a robust partial volume tissue segmentation with WM outlier rejection and filling, combining intensity and probabilistic and morphological prior maps. We evaluate the performance of this method on the MRBrainS13 tissue segmentation challenge database, which contains images with vascular WM lesions, and also on a set of Multiple Sclerosis (MS) patient images. On both databases, we validate the performance of our method with other state-of-the-art techniques. On the MRBrainS13 data, the presented approach was at the time of submission the best ranked unsupervised intensity model method of the challenge (7th position) and clearly outperformed the other unsupervised pipelines such as FAST and SPM12. On MS data, the differences in tissue segmentation between the images segmented with our method and the same images where manual expert annotations were used to refill lesions on T1-w images before segmentation were lower or similar to the best state-of-the-art pipeline incorporating automated lesion segmentation and filling. Our results show that the proposed pipeline achieved very competitive results on both vascular and MS lesions. A public version of this approach is available to download for the neuro-imaging community.

  6. Coarse electrocorticographic decoding of ipsilateral reach in patients with brain lesions.

    PubMed

    Hotson, Guy; Fifer, Matthew S; Acharya, Soumyadipta; Benz, Heather L; Anderson, William S; Thakor, Nitish V; Crone, Nathan E

    2014-01-01

    In patients with unilateral upper limb paralysis from strokes and other brain lesions, strategies for functional recovery may eventually include brain-machine interfaces (BMIs) using control signals from residual sensorimotor systems in the damaged hemisphere. When voluntary movements of the contralateral limb are not possible due to brain pathology, initial training of such a BMI may require use of the unaffected ipsilateral limb. We conducted an offline investigation of the feasibility of decoding ipsilateral upper limb movements from electrocorticographic (ECoG) recordings in three patients with different lesions of sensorimotor systems associated with upper limb control. We found that the first principal component (PC) of unconstrained, naturalistic reaching movements of the upper limb could be decoded from ipsilateral ECoG using a linear model. ECoG signal features yielding the best decoding accuracy were different across subjects. Performance saturated with very few input features. Decoding performances of 0.77, 0.73, and 0.66 (median Pearson's r between the predicted and actual first PC of movement using nine signal features) were achieved in the three subjects. The performance achieved here with small numbers of electrodes and computationally simple decoding algorithms suggests that it may be possible to control a BMI using ECoG recorded from damaged sensorimotor brain systems.

  7. Dental management in dysphagia syndrome patients with previously acquired brain damages

    PubMed Central

    Bramanti, Ennio; Arcuri, Claudio; Cecchetti, Francesco; Cervino, Gabriele; Nucera, Riccardo; Cicciù, Marco

    2012-01-01

    Dysphagia is defined as difficulty in swallowing food (semi-solid or solid), liquid, or both. Difficulty in swallowing affects approximately 7% of population, with risk incidence increasing with age. There are many disorder conditions predisposing to dysphagia such as mechanical strokes or esophageal diseases even if neurological diseases represent the principal one. Cerebrovascular pathology is today the leading cause of death in developing countries, and it occurs most frequently in individuals who are at least 60 years old. Swallowing disorders related to a stroke event are common occurrences. The incidence ranging is estimated from 18% to 81% in the acute phase and with a prevalence of 12% among such patients. Cerebral, cerebellar, or brain stem strokes can influence swallowing physiology while cerebral lesions can interrupt voluntary control of mastication and bolus transport during the oral phase. Among the most frequent complications of dysphagia are increased mortality and pulmonary risks such as aspiration pneumonia, dehydration, malnutrition, and long-term hospitalization. This review article discusses the epidemiology of dysphagia, the normal swallowing process, pathophysiology, signs and symptoms, diagnostics, and dental management of patients affected. PMID:23162574

  8. Evaluation of a Reading Comprehension Strategy Package to Improve Reading Comprehension of Adult College Students with Acquired Brain Injuries

    ERIC Educational Resources Information Center

    Griffiths, Gina G.

    2013-01-01

    Adults with mild to moderate acquired brain injury (ABI) often pursue post-secondary or professional education after their injuries in order to enter or re-enter the job market. An increasing number of these adults report problems with reading-to-learn. The problem is particularly concerning given the growing population of adult survivors of ABI.…

  9. A Systematic Review of Psychological Interventions to Alleviate Cognitive and Psychosocial Problems in Children with Acquired Brain Injury

    ERIC Educational Resources Information Center

    Ross, Kimberley A.; Dorris, Liam; McMillan, Tom

    2011-01-01

    Aim: It is now generally accepted that paediatric acquired brain injury (ABI) can have an impact on a child's cognitive, social, and behavioural functioning. However, the lack of guidelines on effective interventions for the affected children and their families, particularly beyond the acute recovery phase, can limit access to effective support.…

  10. Expressive Art for the Social and Community Integration of Adolescents with Acquired Brain Injuries: A Systematic Review

    ERIC Educational Resources Information Center

    Goyal, Anita; Keightley, Michelle L.

    2008-01-01

    Adolescents with acquired brain injuries suffer from social and community withdrawal that result in isolation from their peer groups. The review highlights the evidence of effectiveness of expressive art interventions in the form of theatre for populations with difficulties in physical, emotional, cognitive, or social functioning. A systematic…

  11. Usual and Virtual Reality Video Game-Based Physiotherapy for Children and Youth with Acquired Brain Injuries

    ERIC Educational Resources Information Center

    Levac, Danielle; Miller, Patricia; Missiuna, Cheryl

    2012-01-01

    Little is known about how therapists promote learning of functional motor skills for children with acquired brain injuries. This study explores physiotherapists' description of these interventions in comparison to virtual reality (VR) video game-based therapy. Six physiotherapists employed at a children's rehabilitation center participated in…

  12. How Can Educational Psychologists Support the Reintegration of Children with an Acquired Brain Injury upon Their Return to School?

    ERIC Educational Resources Information Center

    Ball, Heather; Howe, Julia

    2013-01-01

    This study explores the process of reintegration into school for children with an acquired brain injury (ABI) and considers the role of the educational psychologist (EP) in supporting these children. Interviews were conducted with a range of professionals in two specialist settings: a specialist rehabilitation centre and a children's hospital with…

  13. Promoting Adaptive Behavior in Persons with Acquired Brain Injury, Extensive Motor and Communication Disabilities, and Consciousness Disorders

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Belardinelli, Marta Olivetti; Buonocunto, Francesca; Sacco, Valentina; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa; Badagliacca, Francesco

    2012-01-01

    These two studies extended the evidence on the use of technology-based intervention packages to promote adaptive behavior in persons with acquired brain injury and multiple disabilities. Study I involved five participants in a minimally conscious state who were provided with intervention packages based on specific arrangements of optic, tilt, or…

  14. Social communication features in children following moderate to severe acquired brain injury: a cross-sectional pilot study.

    PubMed

    Breau, Lynn M; Clark, Brenda; Scott, Ori; Wilkes, Courtney; Reynolds, Shawn; Ricci, Florencia; Sonnenberg, Lyn; Zwaigenbaum, Lonnie; Rashid, Marghalara; Goez, Helly R

    2015-04-01

    We compared the social communication deficits of children with moderate to severe acquired brain injury or autism spectrum disorder, while accounting for the role of attention-deficit hyperactivity disorder (ADHD) symptoms. Parents of 20 children aged 6 to 10 years (10 acquired brain injury; 10 autism spectrum disorder) completed the Social Communication Questionnaire, and Conners 3 Parent Short. A multivariate analysis of covariance revealed significant differences between groups in Social Communication Questionnaire restricted repetitive behavior scores, but not reciprocal social interaction or social communication. Multiple linear regressions indicated diagnosis did not predict reciprocal social interaction or social communication scores and that Conners 3 Parent Short Form hyperactivity scores were the strongest predictor of Social Communication Questionnaire reciprocal social interaction scores after accounting for age and Intelligence Quotient. The lack of difference in social communication deficits between groups may help in understanding the pathophysiology underlying the behavioral consequences of acquired brain injury. The link between hyperactivity and reciprocal interaction suggests that targeting hyperactivity may improve social outcomes in children following acquired brain injury.

  15. Vascular brain lesions, brain atrophy, and cognitive decline. The Second Manifestations of ARTerial disease--Magnetic Resonance (SMART-MR) study.

    PubMed

    Kooistra, Minke; Geerlings, Mirjam I; van der Graaf, Yolanda; Mali, Willem P T M; Vincken, Koen L; Kappelle, L Jaap; Muller, Majon; Biessels, Geert Jan

    2014-01-01

    We examined the association between brain atrophy and vascular brain lesions (i.e., white matter lesions [WMLs] or brain infarcts), alone or in combination, with decline in memory and executive functioning over 4 years of follow-up in 448 patients (57 ± 9.5 years) with symptomatic atherosclerotic disease from the Second Manifestations of ARTerial disease--Magnetic Resonance SMART-MR study. Automated brain segmentation was used to quantify volumes of total brain, ventricles, cortical gray matter, and WMLs on 1.5-T magnetic resonance imaging (MRI). Brain infarcts were rated visually. WML volume was associated with significant decline in z score of executive functioning. No independent associations between MRI measures and memory decline were found. Significant declines in z scores of memory performance and of executive functioning were observed in patients with a combination of severe atrophy (upper quartile) and most vascular brain lesions (upper quartile) compared with those with minimal atrophy (lowest quartile) and fewest vascular brain lesions (lowest quartile). Our findings suggest that in patients with symptomatic atherosclerotic disease, the combination of brain atrophy and WMLs or brain infarcts accelerates cognitive decline over 4 years.

  16. Brain structural changes as vulnerability factors and acquired signs of post-earthquake stress.

    PubMed

    Sekiguchi, A; Sugiura, M; Taki, Y; Kotozaki, Y; Nouchi, R; Takeuchi, H; Araki, T; Hanawa, S; Nakagawa, S; Miyauchi, C M; Sakuma, A; Kawashima, R

    2013-05-01

    Many survivors of severe disasters, even those without posttraumatic stress disorder (PTSD), need psychological support. To understand the pathogenesis of PTSD symptoms and prevent the development of PTSD, the critical issue is to distinguish neurological abnormalities as vulnerability factors from acquired signs of PTSD symptoms in the early stage of adaptation to the trauma in the normal population. The neurological underpinnings of PTSD have been well characterized, but the causal relationships with the traumatic event are still unclear. We examined 42 non-PTSD subjects to find brain morphometric changes related to the severity of PTSD symptoms in a longitudinal magnetic resonance imaging study extending through the Great East Japan Earthquake. We found that regional grey matter volume (rGMV) in the right ventral anterior cingulate cortex (ACC) before the earthquake, and decreased rGMV in the left orbitofrontal cortex (OFC) through the earthquake were negatively associated with PTSD symptoms. Our results indicate that subjects with smaller GMV in the ACC before the earthquake, and subjects with decreased GMV in the OFC through the earthquake were likely to have PTSD symptoms. As the ACC is involved in processing of fear and anxiety, our results indicate that these processing are related to vulnerability for PTSD symptoms. In addition, decreased OFC volume was induced by failing to extinct conditioned fear soon after the traumatic event. These findings provide a better understanding of posttraumatic responses in early stage of adaptation to the trauma and may contribute to the development of effective methods to prevent PTSD.

  17. Caregiver and nurse hopes for recovery of patients with acquired brain injury.

    PubMed

    Gebhardt, Mary Catherine; McGehee, Linda A; Grindel, Cecelia Gatson; Testani-Dufour, Linda

    2011-01-01

    From the moment an adolescent with acquired brain injury (ABI) is admitted to the hospital, his or her caregiver develops hopes for the recovery and future of the patient; however, rehabilitation nurses have reported that these hopes are not always congruent with the nurse's observations of the adolescent's progression. The purpose of this study was threefold: (1) explore the caregiver's hope for recovery of his or her family member who has experienced an ABI, (2) compare the nurse's hopes for the patient with ABI to those of the caregiver, and (3) identify what caregivers and nurses do to maintain hope for recovery during the rehabilitation process. This qualitative study validated that in some cases there was a disconnect between caregivers' and nurses' hopes for recovery. Four themes related to the caregiver's maintenance of hope were identified: "the importance of family," "taking one day at a time," "knowing the patient better," and "spiritual strength brings me through." Enhancing the perceptual congruence between nurse and caregiver hope during rehabilitation will ultimately improve patient outcomes.

  18. Perceived difficulties using everyday technology after acquired brain injury: influence on activity and participation.

    PubMed

    Lindén, Anita; Lexell, Jan; Lund, Maria Larsson

    2010-12-01

    Using everyday technology (ET) is a prerequisite for activities and participation at home and in the community. It is well known that persons with an acquired brain injury (ABI) can have limitations in activities of daily living but our knowledge of their difficulties using ET is not known. Thirty-six persons (27 men and 9 women, mean age 44 years, age range 26-60) with an ABI (2-10 years post injury) were interviewed, using the Everyday Technology Use Questionnaire (ETUQ), about their perceived difficulties using ET and how these difficulties influenced their everyday activities and their possibilities to participate at home and in the community. A majority (78%) of the persons reported difficulties using ET. The most common difficulties were related to the use of telecommunication and computers. Despite these difficulties, a majority still used most objects and services independently. Twenty-six participants (72%) perceived that their difficulties using ET influenced their everyday activities and their possibility to participate at home and in the community. The results indicate that rehabilitation following an ABI should consider whether clients' use of ET influences their activity and participation and adopt interventions accordingly. The results also indicate that difficulties using ET need to be considered in the design of community services to prevent societal barriers.

  19. Factors associated with self-esteem following acquired brain injury in adults: A systematic review.

    PubMed

    Curvis, William; Simpson, Jane; Hampson, Natalie

    2016-03-03

    Self-esteem is potentially a key factor in psychological and psychosocial well-being following acquired brain injury (ABI). The current review aimed to identify, synthesise and appraise all existing quantitative empirical studies on predictors or correlates of self-esteem following ABI in adulthood. In total, 27 papers met the inclusion criteria. A range of clinical factors were related to self-esteem after ABI, including the degree of physical and functional impairment. It is unclear if cognitive impairment is related to high or low self-esteem. Additionally, psychological variables such as coping styles, adjustment and perception of problems or rehabilitation are related to self-esteem following ABI. Depression is strongly associated with low self-esteem, alongside anxiety, psychological distress and quality of life. Limitations of the available research and recommendations for clinical practice and further research are discussed. In particular, there is a need to engage with contemporary theoretical understandings of self-esteem, integrated with and supported by developments in how self-esteem is conceptualised and measured over time in an ABI population. The findings of the review suggest that self-esteem is an important factor to consider following ABI, particularly in the context of developing individualised, formulation-driven rehabilitation interventions that take into account biological, social and psychological factors.

  20. Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective

    PubMed Central

    Matérne, Marie; Lundqvist, Lars-Olov; Strandberg, Thomas

    2016-01-01

    BACKGROUND: Many people who suffer an acquired brain injury (ABI) are of working age. There are benefits, for the patient, the workplace, and society, to finding factors that facilitate successful return to work (RTW). OBJECTIVE: The aim was to increase knowledge of opportunities and barriers for a successful RTW in patients with ABI. METHOD: Five men and five women with ABI participated. All had successfully returned to work at least 20 hours a week. Their experiences were gathered by semi-structured interviews, which were subsequently subjected to qualitative content analysis. RESULTS: Three themes that influenced RTW were identified: individually adapted rehabilitation; motivation for RTW; and cognitive and social abilities. An individually adapted rehabilitation was judged important because the patients were involved in their own rehabilitation and required individually adapted support from rehabilitation specialists, employers, and colleagues. A moderate level of motivation for RTW was needed. Awareness of the person’s cognitive and social abilities is essential, in finding compensatory strategies and adaptations. CONCLUSIONS: It seems that the vocational rehabilitation process is a balancing act in individualized planning and support, as a partnership with the employer needs to be developed, motivation needs to be generated, and awareness built of abilities that facilitate or hinder RTW. PMID:28035941

  1. Google Calendar: a new memory aid to compensate for prospective memory deficits following acquired brain injury.

    PubMed

    McDonald, A; Haslam, C; Yates, P; Gurr, B; Leeder, G; Sayers, A

    2011-12-01

    Prospective memory impairment is common following acquired brain injury (ABI) and intervention has proved challenging. The current treatment of choice involves using external memory aids as a method of compensation, with those incorporating active reminders proving most successful. In this paper we report findings of an investigation into the effectiveness of a novel external memory aid, Google Calendar. This aid incorporates active reminders and overcomes some of the limitations associated with existing aids. Twelve participants with ABI took part in the study incorporating a randomised control crossover within-subjects design, consisting of a 5-week baseline phase, followed by two 5-week intervention phases where either Google Calendar or a standard diary were used. Participants identified activities to target during the study and a family member monitored their success. Google Calendar was more effective than the diary in enhancing prospective memory performance. It also proved more popular, on account of its active reminders which helped trigger the retrieval of intentions, whilst reducing the need for monitoring. While further research is required to substantiate these initial findings, it is recommended that clinicians familiarise themselves with using Google Calendar, as it appears to offer additional potential in the management of prospective memory deficits following ABI.

  2. Music evoked autobiographical memory after severe acquired brain injury: preliminary findings from a case series.

    PubMed

    Baird, A; Samson, S

    2014-01-01

    Music evoked autobiographical memories (MEAMs) have been characterised in the healthy population, but not, to date, in patients with acquired brain injury (ABI). Our aim was to investigate music compared with verbal evoked autobiographical memories. Five patients with severe ABI and matched controls completed the experimental music (MEAM) task (a written questionnaire) while listening to 50 "Number 1 Songs of the Year" (from 1960 to 2010). Patients also completed the Autobiographical Memory Interview (AMI) and a standard neuropsychological assessment. With the exception of Case 5, who reported no MEAMs and no autobiographical incidents on the AMI and who also had impaired pitch perception, the range of frequency and type of MEAMs in patients was broadly in keeping with their matched controls. The relative preservation of MEAMs in four cases was particularly noteworthy given their impaired verbal and/or visual anterograde memory, and in three cases, autobiographical memory impairment. The majority of MEAMs in both cases and matched controls were of a person/people or a period of life. In three patients music was more efficient at evoking autobiographical memories than the AMI verbal prompts. This is the first study of MEAMs after ABI. The findings suggest that music is an effective stimulus for eliciting autobiographical memories, and may be beneficial in the rehabilitation of autobiographical amnesia, but only in patients without a fundamental deficit in autobiographical recall memory and intact pitch perception.

  3. Changes in impaired self-awareness after acquired brain injury in patients following intensive neuropsychological rehabilitation.

    PubMed

    Smeets, Sanne M J; Vink, Martie; Ponds, Rudolf W H M; Winkens, Ieke; van Heugten, Caroline M

    2017-01-01

    The objective of this study was to investigate changes in self-awareness impairments in outpatients with acquired brain injury (ABI) and the effects these changes have on rehabilitation. Participants were 78 patients with ABI (8.3 years post-injury) who followed an intensive outpatient neuropsychological rehabilitation programme. This longitudinal study comprised pre (T1) and post (T2) measurements and a one-year follow-up (T3). Thirty-eight patients completed the study. The main outcome domains were self-awareness, depressive symptoms, psychological and physical dysfunction, and health-related quality of life (HRQoL). Patients were divided into three awareness groups: underestimation, accurate estimation, and overestimation of competencies. Most patients who underestimated their competencies at the start of treatment accurately estimated their competencies directly after treatment (9 out of 11 patients). These patients also exhibited the largest treatment effects regarding depressive symptoms, psychological and physical dysfunction, and HRQoL. Most patients with impaired self-awareness (i.e., overestimation of competencies) at the start of treatment continued to overestimate their competencies after treatment (10 out of 14 patients). These patients exhibited a significant decrease in depressive symptoms but no other treatment effects. The results indicate that changes in outcome are related to changes in awareness, which underline the importance of taking into account different awareness groups with respect to treatment effects.

  4. Living with acquired brain injury: self-concept as mediating variable in the adjustment process.

    PubMed

    Doering, Bettina K; Conrad, Nico; Rief, Winfried; Exner, Cornelia

    2011-01-01

    Sequelae of acquired brain injury (ABI) require adjustment processes in which survivors must strive to regain subjective well-being (SWB) in the face of chronic impairment. The current study investigates whether the self-concept of achievement mediates this process. Thirty-five post-acute patients with ABI were assessed neuropsychologically for performance in memory, attention, concept formation and reasoning. Data concerning subjective complaints in applied cognition, self-concept, and SWB were collected. Patients rated their self-concept more negatively compared to a normative sample. Effects of subjective complaints in applied cognition on SWB were mediated by the self-concept of achievement. Contrary to expectations, objective cognitive deficits demonstrated no independent significant relationship to self-concept of achievement or SWB in multiple regression modelling when subjective complaints in applied cognition were considered simultaneously. The findings highlight the necessity of considering patients' subjective complaints and self-concepts to improve rehabilitative progress. Potential implications for neuropsychological rehabilitation are discussed.

  5. Correlation of brain Magnetic Resonance Imaging of spontaneously lead poisoned bald eagles (Haliaeetus leucocephalus) with histological lesions: A pilot study.

    PubMed

    de Francisco, Olga Nicolas; Feeney, Daniel; Armién, Anibal G; Wuenschmann, Arno; Redig, Patrick T

    2016-04-01

    Six bald eagles with severe, acute lead poisoning based on blood lead values were analyzed by Magnetic Resonance Imaging (MRI) of the brain and histopathology. The aims of the study were to use MRI to locate brain lesions and correlate the changes in MRI signal with the histological character of the lesions at necropsy. All of the bald eagles presented with neurologic and non-neurologic signs suggestive of severe lead poisoning and had blood lead levels in excess of 1.0 ppm. Areas of change in image intensity in the brainstem, midbrain and cerebellum were detected in the MRI scans. Histopathology confirmed the presence of all suspected lesions. The character of the lesions suggested vascular damage as the primary insult. MRI was useful for detecting lesions and defining their three-dimensional distribution and extent. Future studies are needed to evaluate the utility of MRI for detection of lesions in less severely lead poisoned eagles and determining prognosis for treatment.

  6. Novel brain lesions caused by Edwardsiella tarda in a red tilapia (Oreochromis spp.).

    PubMed

    Iregui, Carlos A; Guarín, Marlly; Tibatá, Victor M; Ferguson, Hugh W

    2012-03-01

    The histological lesions caused by Edwardsiella tarda in a variety of fish species, including tilapia, have been well characterized. There are apparent differences in the type of inflammatory response manifested by these different species, which may be due to the fish species itself, the phase of infection, or the virulence factors produced by different strains of E. tarda. In catfish, systemic abscesses involving muscles of the flank or caudal peduncle are the most common lesions. By contrast, infection in tilapia and red sea bream is more likely to be associated with granulomatous inflammation. Necrotic meningitis, encephalitis, and vasculitis with fibrinoid necrosis of the blood vessels walls, as well as the formation of a plaque-like structure in the brain, are described in the current study. The presence of E. tarda was confirmed by microbiological isolation and a positive nested polymerase chain reaction in paraffin wax-embedded tilapia tissues.

  7. 3D texture-based classification applied on brain white matter lesions on MR images

    NASA Astrophysics Data System (ADS)

    Leite, Mariana; Gobbi, David; Salluzi, Marina; Frayne, Richard; Lotufo, Roberto; Rittner, Letícia

    2016-03-01

    Lesions in the brain white matter are among the most frequently observed incidental findings on MR images. This paper presents a 3D texture-based classification to distinguish normal appearing white matter from white matter containing lesions, and compares it with the 2D approach. Texture analysis were based on 55 texture attributes extracted from gray-level histogram, gray-level co-occurrence matrix, run-length matrix and gradient. The results show that the 3D approach achieves an accuracy rate of 99.28%, against 97.41% of the 2D approach by using a support vector machine classifier. Furthermore, the most discriminating texture attributes on both 2D and 3D cases were obtained from the image histogram and co-occurrence matrix.

  8. The hyperactive syndrome: metanalysis of genetic alterations, pharmacological treatments and brain lesions which increase locomotor activity.

    PubMed

    Viggiano, Davide

    2008-12-01

    The large number of transgenic mice realized thus far with different purposes allows addressing new questions, such as which animals, over the entire set of transgenic animals, show a specific behavioural abnormality. In the present study, we have used a metanalytical approach to organize a database of genetic modifications, brain lesions and pharmacological interventions that increase locomotor activity in animal models. To further understand the resulting data set, we have organized a second database of the alterations (genetic, pharmacological or brain lesions) that reduce locomotor activity. Using this approach, we estimated that 1.56% of the genes in the genome yield to hyperactivity and 0.75% of genes produce hypoactivity when altered. These genes have been classified into genes for neurotransmitter systems, hormonal, metabolic systems, ion channels, structural proteins, transcription factors, second messengers and growth factors. Finally, two additional classes included animals with neurodegeneration and inner ear abnormalities. The analysis of the database revealed several unexpected findings. First, the genes that, when mutated, induce hyperactive behaviour do not pertain to a single neurotransmitter system. In fact, alterations in most neurotransmitter systems can give rise to a hyperactive phenotype. In contrast, fewer changes can decrease locomotor activity. Specifically, genetic and pharmacological alterations that enhance the dopamine, orexin, histamine, cannabinoids systems or that antagonize the cholinergic system induce an increase in locomotor activity. Similarly, imbalances in the two main neurotransmitters of the nervous system, GABA and glutamate usually result in hyperactive behaviour. It is remarkable that no genetic alterations pertaining to the GABA system have been reported to reduce locomotor behaviour. Other neurotransmitters, such as norepinephrine and serotonin, have a more complex influence. For instance, a decrease in norepinephrine

  9. Utility of fractional anisotropy imaging analyzed by statistical parametric mapping for detecting minute brain lesions in chronic-stage patients who had mild or moderate traumatic brain injury.

    PubMed

    Asano, Yoshitaka; Shinoda, Jun; Okumura, Ayumi; Aki, Tatsuki; Takenaka, Shunsuke; Miwa, Kazuhiro; Yamada, Mikito; Ito, Takeshi; Yokoyama, Kazutoshi

    2012-01-01

    Diffusion tensor imaging (DTI) has recently evolved as valuable technique to investigate diffuse axonal injury (DAI). This study examined whether fractional anisotropy (FA) images analyzed by statistical parametric mapping (FA-SPM images) are superior to T(2)*-weighted gradient recalled echo (T2*GRE) images or fluid-attenuated inversion recovery (FLAIR) images for detecting minute lesions in traumatic brain injury (TBI) patients. DTI was performed in 25 patients with cognitive impairments in the chronic stage after mild or moderate TBI. The FA maps obtained from the DTI were individually compared with those from age-matched healthy control subjects using voxel-based analysis and FA-SPM images (p < 0.001). Abnormal low-intensity areas on T2*GRE images (T2* lesions) were found in 10 patients (40.0%), abnormal high-intensity areas on FLAIR images in 4 patients (16.0%), and areas with significantly decreased FA on FA-SPM image in 16 patients (64.0%). Nine of 10 patients with T2* lesions had FA-SPM lesions. FA-SPM lesions topographically included most T2* lesions in the white matter and the deep brain structures, but did not include T2* lesions in the cortex/near-cortex or lesions containing substantial hemosiderin regardless of location. All 4 patients with abnormal areas on FLAIR images had FA-SPM lesions. FA-SPM imaging is useful for detecting minute lesions because of DAI in the white matter and the deep brain structures, which may not be visualized on T2*GRE or FLAIR images, and may allow the detection of minute brain lesions in patients with post-traumatic cognitive impairment.

  10. Attention and dual-task conditions: physical therapy implications for individuals with acquired brain injury.

    PubMed

    McCulloch, Karen

    2007-09-01

    The aim of this article is to consider how impairments in attention may affect the performance of two tasks during balance or walking in individuals recovering from acquired brain injury (ABI). Guidelines from the experimental dual-task paradigm from cognitive psychology are reviewed. In this paper, dual-task conditions are described as the use of two tasks performed simultaneously, but not necessarily following all the experimental guidelines of the dual-task paradigm. How and why dual-task costs may emerge are discussed as well as considerations for task selection. Review of literature that describes dual-task performance problems in older adults is summarized briefly as a foundation for considering how similar conditions may affect individuals with ABI. Studies of individuals with ABI of dual-task performance in balance or walking are reviewed in detail. Examination approaches including observational measures of attention as well as clinical measures of dual-task performance during walking are reviewed. Intervention concepts and approaches are described by review of intervention designs used with older adults and individuals with ABI that describe task selection and use of instructional set for dual-task training. Two intervention strategies described in the literature for treating attention problems are contrasted: (1) an explicit focus on cognitive impairments with the expectation that function will improve as a result and (2) an implicit focus on functional tasks through errorless learning with the expectation that cognition (and attention) will improve. An illustration of the use of both of these strategies in a complementary fashion to improve attention in a patient with ABI is reviewed. Current literature is limited in clearly directing assessment and intervention to improve attention after ABI, but strategies are presented and areas for future research are identified.

  11. Discourse level reading comprehension interventions following acquired brain injury: a systematic review.

    PubMed

    Watter, Kerrin; Copley, Anna; Finch, Emma

    2017-02-01

    Purpose Reading comprehension can change following acquired brain injury (ABI), impacting independence and participation. This review aims to identify and evaluate the interventions used for rehabilitation of discourse level reading in adults with ABI. Methods A systematic review was conducted of published journal articles. Methodological quality of studies was reviewed using formal and informal rating scales. Inclusion criteria involved adults with non-progressive ABI who experienced discourse level reading deficits related to aphasia or cognitive-communication disorders. Results A total of 23 studies were identified; these included randomized controlled trials, cohort and case studies. Six different types of reading interventions were found, overall results of these interventions were mixed. Reading deficits were reportedly related to language (aphasia) and/or cognitive deficits, with assessment processes varying. Questions arose regarding comparability of assessment methods and diagnostic issues across the studies. Conclusions Interventions for discourse level reading comprehension can make positive changes to reading function. However, no intervention was identified as a gold standard. A trend toward strategy-based reading was found, with these offering a potential for (comparatively) cost-effective lower-dosage reading treatments with positive-trend results. Cognitive and language features should be considered for assessment and intervention planning for discourse reading in ABI. Implications for Rehabilitation Six different types of discourse reading comprehension interventions for people with ABI were identified, with mixed evidence for each intervention. Clinicians need to consider both the linguistic and cognitive features of reading for assessment and intervention planning for discourse level reading. There is a research trend toward strategy-based reading interventions, which use a lower treatment dosage.

  12. Intelligent Therapy Assistant (ITA) for cognitive rehabilitation in patients with acquired brain injury

    PubMed Central

    2014-01-01

    Background This paper presents the design, development and first evaluation of an algorithm, named Intelligent Therapy Assistant (ITA), which automatically selects, configures and schedules rehabilitation tasks for patients with cognitive impairments after an episode of Acquired Brain Injury. The ITA is integrated in “Guttmann, Neuro Personal Trainer” (GNPT), a cognitive tele-rehabilitation platform that provides neuropsychological services. Methods The ITA selects those tasks that are more suitable for the specific needs of each patient, considering previous experiences, and improving the personalization of the treatment. The system applies data mining techniques to cluster the patients according their cognitive impairment profile. Then, the algorithm rates every rehabilitation task, based on its cognitive structure and the clinical impact of executions done by similar patients. Finally, it configures the most suitable degree of difficulty, depending on the impairment of the patient and his/her evolution during the treatment. Results The ITA has been evaluated during 18 months by 582 patients. In order to evaluate the effectiveness of the ITA, a comparison between the traditional manual planning procedure and the one presented in this paper has been done, taking into account: a) the selected tasks assigned to rehabilitation sessions; b) the difficulty level configured for the sessions; c) and the improvement of their cognitive capacities after completing treatment. Conclusions The obtained results reveal that the rehabilitation treatment proposed by the ITA is as effective as the one performed manually by therapists, arising as a new powerful support tool for therapists. The obtained results make us conclude that the proposal done by the ITA is very close to the one done by therapists, so it is suitable for real treatments. PMID:25038823

  13. Severe Traumatic Brain Injury, Frontal Lesions, and Social Aspects of Language Use: A Study of French-Speaking Adults

    ERIC Educational Resources Information Center

    Dardier, Virginie; Bernicot, Josie; Delanoe, Anaig; Vanberten, Melanie; Fayada, Catherine; Chevignard, Mathilde; Delaye, Corinne; Laurent-Vannier, Anne; Dubois, Bruno

    2011-01-01

    The purpose of this study was to gain insight into the social (pragmatic) aspects of language use by French-speaking individuals with frontal lesions following a severe traumatic brain injury. Eleven participants with traumatic brain injury performed tasks in three areas of communication: production (interview situation), comprehension (direct…

  14. Differential disruption of simple drawing movements in patients with unilateral brain lesion.

    PubMed

    Qin, Z; Lufei, H Q; Su, M F; Wang, Y X

    1991-11-01

    In examining the ability of patients with unilateral brain lesion to copy simple drawings of a house and a human face, 18 apoplectic patients confirmed by CT scanning were studied. We found that their drawing of a house was inferior to that of a face in 19 tests (90.5%) of 17 patients (94.4%). Marked differences existed in nearly 90% of these tests. No difference was found between the right-hemisphere and left-hemisphere group, except that more patients of the right-hemisphere group showed contralateral neglect, but in the house drawings only.

  15. Atypical mucocutaneous leishmaniasis caused by Leishmania braziliensis in an acquired immunodeficiency syndrome patient: T-cell responses and remission of lesions associated with antigen immunotherapy.

    PubMed

    Da-Cruz, A M; Filgueiras, D V; Coutinho, Z; Mayrink, W; Grimaldi, G; De Luca, P M; Mendonca, S C; Coutinho, S G

    1999-01-01

    An atypical case of acquired immunodeficiency syndrome-associated mucocutaneous lesions due to Leishmania braziliensis is described. Many vacuolated macrophages laden with amastigote forms of the parasite were found in the lesions. Leishmanin skin test and serology for leishmaniasis were both negative. The patient was resistant to therapy with conventional drugs (antimonial and amphotericin B). Interestingly, remission of lesions was achieved after an alternative combined therapy of antimonial associated with immunotherapy (whole promastigote antigens). Peripheral blood mononuclear cells were separated and stimulated in vitro with Leishmania antigens to test the lymphoproliferative responses (LPR). Before the combined immunochemotherapy, the LPR to leishmanial antigens was negligible (stimulation index - SI=1.4). After the first course of combined therapy it became positive (SI=4.17). The antigen responding cells were predominantly T-cells (47.5%) most of them with CD8+ phenotype (33%). Very low CD4+ cells (2.2%) percentages were detected. The increased T-cell responsiveness to leishmanial antigens after combined therapy was accompanied by interferon-g (IFN-g) production as observed in the cell culture supernatants. In this patient, healing of the leishmaniasis lesions was associated with the induction of a specific T-cell immune response, characterized by the production of IFN-g and the predominance of the CD8+ phenotype among the Leishmania-reactive T-cells.

  16. Cryptococcus gattii fungemia: report of a case with lung and brain lesions mimicking radiological features of malignancy.

    PubMed

    Oliveira, Flávio de Mattos; Severo, Cecília Bittencourt; Guazzelli, Luciana Silva; Severo, Luiz Carlos

    2007-01-01

    A 64-year-old apparently immunocompetent white man developed lung and brain lesions of disseminated cryptococcosis. The radiologic features mimicked those of lung cancer metastatic to the central nervous system. C. gattii was recovered from cultures of bronchoalveolar lavage fluid, brain biopsy, and blood. The same fungus was recovered from pulmonary and brain specimens at autopsy. Serum and cerebrospinal fluid cryptococcal antigen tests were diagnostic in our case and should be included in the diagnostic evaluation of unexplained pulmonary and cerebral lesions. A literature search showed few reports of fungemia by this species of Cryptococcus, contrasting to C. neoformans.

  17. The Effects of Exercise on Cognitive Recovery after Acquired Brain Injury in Animal Models: A Systematic Review

    PubMed Central

    Wogensen, Elise; Malá, Hana; Mogensen, Jesper

    2015-01-01

    The objective of the present paper is to review the current status of exercise as a tool to promote cognitive rehabilitation after acquired brain injury (ABI) in animal model-based research. Searches were conducted on the PubMed, Scopus, and psycINFO databases in February 2014. Search strings used were: exercise (and) animal model (or) rodent (or) rat (and) traumatic brain injury (or) cerebral ischemia (or) brain irradiation. Studies were selected if they were (1) in English, (2) used adult animals subjected to acquired brain injury, (3) used exercise as an intervention tool after inflicted injury, (4) used exercise paradigms demanding movement of all extremities, (5) had exercise intervention effects that could be distinguished from other potential intervention effects, and (6) contained at least one measure of cognitive and/or emotional function. Out of 2308 hits, 22 publications fulfilled the criteria. The studies were examined relative to cognitive effects associated with three themes: exercise type (forced or voluntary), timing of exercise (early or late), and dose-related factors (intensity, duration, etc.). The studies indicate that exercise in many cases can promote cognitive recovery after brain injury. However, the optimal parameters to ensure cognitive rehabilitation efficacy still elude us, due to considerable methodological variations between studies. PMID:26509085

  18. Brain transplantation of genetically engineered human neural stem cells globally corrects brain lesions in the mucopolysaccharidosis type VII mouse.

    PubMed

    Meng, Xing-Li; Shen, Jin-Song; Ohashi, Toya; Maeda, Hiroshi; Kim, Seung Up; Eto, Yoshikatsu

    2003-10-15

    In the present study, we investigated the feasibility of using human neural stem cells (NSCs) in the treatment of diffuse central nervous system (CNS) alterations in a murine model of mucopolysaccharidosis VII (MPS VII), a lysosomal storage disease caused by a genetic defect in the beta-glucuronidase gene. An immortalized NSC line derived from human fetal telencephalon was genetically engineered to overexpress beta-glucuronidase and transplanted into the cerebral ventricles of neonatal MPS VII mouse. Transplanted human NSCs were found to integrate and migrate in the host brain and to produce large amount of beta-glucuronidase. Brain contents of the substrates of beta-glucuronidase were reduced to nearly normal levels, and widespread clearing of lysosomal storage was observed in the MPS VII mouse brain at 25 days posttransplantation. The number of engrafted cells decreased markedly after the transplantation, and it appears that the major cause of the cell death was not the immune response of the host but apoptotic cell death of grafted human NSCs. Results showed that human NSCs would serve as a useful gene transfer vehicle for the treatment of diffuse CNS lesions in human lysosomal storage diseases and are potentially applicable in the treatment of patients suffering from neurological disorders.

  19. Size-weight illusion and anticipatory grip force scaling following unilateral cortical brain lesion.

    PubMed

    Li, Yong; Randerath, Jennifer; Goldenberg, Georg; Hermsdörfer, Joachim

    2011-04-01

    The prediction of object weight from its size is an important prerequisite of skillful object manipulation. Grip and load forces anticipate object size during early phases of lifting an object. A mismatch between predicted and actual weight when two different sized objects have the same weight results in the size-weight illusion (SWI), the small object feeling heavier. This study explores whether lateralized brain lesions in patients with or without apraxia alter the size-weight illusion and impair anticipatory finger force scaling. Twenty patients with left brain damage (LBD, 10 with apraxia, 10 without apraxia), ten patients with right brain damage (RBD), and matched control subjects lifted two different-sized boxes in alternation. All subjects experienced a similar size-weight illusion. The anticipatory force scaling of all groups was in correspondence with the size cue: higher forces and force rates were applied to the big box and lower forces and force rates to the small box during the first lifts. Within few lifts, forces were scaled to actual object weight. Despite the lack of significant differences at group level, 5 out of 20 LBD patients showed abnormal predictive scaling of grip forces. They differed from the LBD patients with normal predictive scaling by a greater incidence of posterior occipito-parietal lesions but not by a greater incidence of apraxia. The findings do not support a more general role for the motor-dominant left hemisphere, or an influence of apraxia per se, in the scaling of finger force according to object properties. However, damage in the vicinity of the parietal-occipital junction may be critical for deriving predictions of weight from size.

  20. Fine needle aspiration biopsy of cystic benign lymphoepithelial lesion of the parotid gland in patients at risk for the acquired immune deficiency syndrome.

    PubMed

    Finfer, M D; Gallo, L; Perchick, A; Schinella, R A; Burstein, D E

    1990-01-01

    Cystic benign lymphoepithelial lesion (BLL), a previously rare lesion of the parotid gland consisting of marked lymphoid hyperplasia with accompanying squamous-lined cysts, has recently been described in patients with the acquired immune deficiency syndrome (AIDS) or AIDS risk factors. Thirteen fine needle aspiration (FNA) samples of parotid gland masses from patients with AIDS (one case), AIDS risk factors (five cases) or denial of AIDS risk factors (two cases) and a histopathologic diagnosis of BLL were examined. The FNA features that correlated best with the histopathologic findings were (1) a heterogeneous lymphoid population, (2) scattered single and/or clustered foamy macrophages and (3) superficial and/or anucleated squamous cells. Most aspirates showed some combination of these three components. The differential diagnostic considerations, the clinical and radiologic correlations and the relationship of this lesion to HIV infection are discussed. Patients with parotid masses whose aspirates consist of some combination of squamous cells, lymphocytes and foamy macrophages should be questioned for possible AIDS risk factors.

  1. Neural correlates of apathy revealed by lesion mapping in participants with traumatic brain injuries.

    PubMed

    Knutson, Kristine M; Monte, Olga Dal; Raymont, Vanessa; Wassermann, Eric M; Krueger, Frank; Grafman, Jordan

    2014-03-01

    Apathy, common in neurological disorders, is defined as disinterest and loss of motivation, with a reduction in self-initiated activity. Research in diseased populations has shown that apathy is associated with variations in the volume of brain regions such as the anterior cingulate and the frontal lobes. The goal of this study was to determine the neural signatures of apathy in people with penetrating traumatic brain injuries (pTBIs), as to our knowledge, these have not been studied in this sample. We studied 176 male Vietnam War veterans with pTBIs using voxel-based lesion-symptom mapping (VLSM) and apathy scores from the UCLA Neuropsychiatric Inventory (NPI), a structured inventory of symptoms completed by a caregiver. Our results revealed that increased apathy symptoms were associated with brain damage in limbic and cortical areas of the left hemisphere including the anterior cingulate, inferior, middle, and superior frontal regions, insula, and supplementary motor area. Our results are consistent with the literature, and extend them to people with focal pTBI. Apathy is a significant symptom since it can reduce participation of the patient in family and other social interactions, and diminish affective decision-making.

  2. Impact of spot size on plan quality of spot scanning proton radiosurgery for peripheral brain lesions

    SciTech Connect

    Wang, Dongxu Dirksen, Blake; Hyer, Daniel E.; Buatti, John M.; Sheybani, Arshin; Dinges, Eric; Felderman, Nicole; TenNapel, Mindi; Bayouth, John E.; Flynn, Ryan T.

    2014-12-15

    Purpose: To determine the plan quality of proton spot scanning (SS) radiosurgery as a function of spot size (in-air sigma) in comparison to x-ray radiosurgery for treating peripheral brain lesions. Methods: Single-field optimized (SFO) proton SS plans with sigma ranging from 1 to 8 mm, cone-based x-ray radiosurgery (Cone), and x-ray volumetric modulated arc therapy (VMAT) plans were generated for 11 patients. Plans were evaluated using secondary cancer risk and brain necrosis normal tissue complication probability (NTCP). Results: For all patients, secondary cancer is a negligible risk compared to brain necrosis NTCP. Secondary cancer risk was lower in proton SS plans than in photon plans regardless of spot size (p = 0.001). Brain necrosis NTCP increased monotonically from an average of 2.34/100 (range 0.42/100–4.49/100) to 6.05/100 (range 1.38/100–11.6/100) as sigma increased from 1 to 8 mm, compared to the average of 6.01/100 (range 0.82/100–11.5/100) for Cone and 5.22/100 (range 1.37/100–8.00/100) for VMAT. An in-air sigma less than 4.3 mm was required for proton SS plans to reduce NTCP over photon techniques for the cohort of patients studied with statistical significance (p = 0.0186). Proton SS plans with in-air sigma larger than 7.1 mm had significantly greater brain necrosis NTCP than photon techniques (p = 0.0322). Conclusions: For treating peripheral brain lesions—where proton therapy would be expected to have the greatest depth-dose advantage over photon therapy—the lateral penumbra strongly impacts the SS plan quality relative to photon techniques: proton beamlet sigma at patient surface must be small (<7.1 mm for three-beam single-field optimized SS plans) in order to achieve comparable or smaller brain necrosis NTCP relative to photon radiosurgery techniques. Achieving such small in-air sigma values at low energy (<70 MeV) is a major technological challenge in commercially available proton therapy systems.

  3. MALDI imaging mass spectrometry analysis-A new approach for protein mapping in multiple sclerosis brain lesions.

    PubMed

    Maccarrone, Giuseppina; Nischwitz, Sandra; Deininger, Sören-Oliver; Hornung, Joachim; König, Fatima Barbara; Stadelmann, Christine; Turck, Christoph W; Weber, Frank

    2017-03-15

    Multiple sclerosis is a disease of the central nervous system characterized by recurrent inflammatory demyelinating lesions in the early disease stage. Lesion formation and mechanisms leading to lesion remyelination are not fully understood. Matrix Assisted Laser Desorption Ionisation Mass Spectrometry imaging (MALDI-IMS) is a technology which analyses proteins and peptides in tissue, preserves their spatial localization, and generates molecular maps within the tissue section. In a pilot study we employed MALDI imaging mass spectrometry to profile and identify peptides and proteins expressed in normal-appearing white matter, grey matter and multiple sclerosis brain lesions with different extents of remyelination. The unsupervised clustering analysis of the mass spectra generated images which reflected the tissue section morphology in luxol fast blue stain and in myelin basic protein immunohistochemistry. Lesions with low remyelination extent were defined by compounds with molecular weight smaller than 5300Da, while more completely remyelinated lesions showed compounds with molecular weights greater than 15,200Da. An in-depth analysis of the mass spectra enabled the detection of cortical lesions which were not seen by routine luxol fast blue histology. An ion mass, mainly distributed at the rim of multiple sclerosis lesions, was identified by liquid chromatography and tandem mass spectrometry as thymosin beta-4, a protein known to be involved in cell migration and in restorative processes. The ion mass of thymosin beta-4 was profiled by MALDI imaging mass spectrometry in brain slides of 12 multiple sclerosis patients and validated by immunohistochemical analysis. In summary, our results demonstrate the ability of the MALDI-IMS technology to map proteins within the brain parenchyma and multiple sclerosis lesions and to identify potential markers involved in multiple sclerosis pathogenesis and/or remyelination.

  4. DCE-MRI defined subvolumes of a brain metastatic lesion by principle component analysis and fuzzy-c-means clustering for response assessment of radiation therapy

    SciTech Connect

    Farjam, Reza; Tsien, Christina I.; Lawrence, Theodore S.; Cao, Yue

    2014-01-15

    Purpose: To develop a pharmacokinetic modelfree framework to analyze the dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) data for assessment of response of brain metastases to radiation therapy. Methods: Twenty patients with 45 analyzable brain metastases had MRI scans prior to whole brain radiation therapy (WBRT) and at the end of the 2-week therapy. The volumetric DCE images covering the whole brain were acquired on a 3T scanner with approximately 5 s temporal resolution and a total scan time of about 3 min. DCE curves from all voxels of the 45 brain metastases were normalized and then temporally aligned. A DCE matrix that is constructed from the aligned DCE curves of all voxels of the 45 lesions obtained prior to WBRT is processed by principal component analysis to generate the principal components (PCs). Then, the projection coefficient maps prior to and at the end of WBRT are created for each lesion. Next, a pattern recognition technique, based upon fuzzy-c-means clustering, is used to delineate the tumor subvolumes relating to the value of the significant projection coefficients. The relationship between changes in different tumor subvolumes and treatment response was evaluated to differentiate responsive from stable and progressive tumors. Performance of the PC-defined tumor subvolume was also evaluated by receiver operating characteristic (ROC) analysis in prediction of nonresponsive lesions and compared with physiological-defined tumor subvolumes. Results: The projection coefficient maps of the first three PCs contain almost all response-related information in DCE curves of brain metastases. The first projection coefficient, related to the area under DCE curves, is the major component to determine response while the third one has a complimentary role. In ROC analysis, the area under curve of 0.88 ± 0.05 and 0.86 ± 0.06 were achieved for the PC-defined and physiological-defined tumor subvolume in response assessment. Conclusions: The PC

  5. Same day tri-modality functional brain mapping prior to resection of a lesion involving eloquent cortex: technical feasibility.

    PubMed

    Choudhri, Asim F; Narayana, Shalini; Rezaie, Roozbeh; Whitehead, Matthew T; McAfee, Samuel S; Wheless, James W; Boop, Frederick A; Papanicolaou, Andrew C

    2013-10-01

    Non-invasive functional evaluation of the brain complements structural MRI imaging and has largely supplanted invasive techniques such as awake craniotomy. Techniques used for functional mapping of the brain include BOLD-functional MRI (fMRI), magnetoencephalography (MEG), and transcranial magnetic stimulation (TMS). We describe the case of a right-handed patient with a lesion centered in the left inferior perirolandic cortex who underwent fMRI, MEG, and TMS on a single day to facilitate maximal lesion resection while preserving eloquent cortex and eloquent white matter tracts.

  6. Anti-Hu Antibody-associated Paraneoplastic Neurological Syndrome Showing Peripheral Neuropathy and Atypical Multifocal Brain Lesions.

    PubMed

    Shibata, Makoto; Uchida, Megumi; Tsukagoshi, Setsuki; Yamaguchi, Koichi; Yamaguchi, Aya; Furuta, Natsumi; Makioka, Kouki; Maeno, Toshitaka; Fujita, Yukio; Kurabayashi, Masahiko; Ikeda, Yoshio

    2015-01-01

    A 64-year-old Japanese woman presented with a three-month history of progressive numbness and weakness of the lower extremities. A neurological examination and nerve conduction study indicated sensorimotor polyneuropathy. Since the serum anti-Hu antibody titer was remarkably elevated, paraneoplastic neurological syndrome was highly suspected. A thoracoscopic biopsy of the hilar lymph nodes, in which (18)F-fluorodeoxyglucose uptake was obviously increased, revealed pathological findings for small-cell lung cancer (SCLC). Subsequently, the patient presented with generalized tonic-clonic seizures, and cerebral MRI showed reversible multifocal brain lesions, considered to reflect paraneoplastic encephalopathy. After two courses of chemotherapy for SCLC, the brain lesions totally disappeared.

  7. Critical brain regions for action recognition: lesion symptom mapping in left hemisphere stroke.

    PubMed

    Kalénine, Solène; Buxbaum, Laurel J; Coslett, Harry Branch

    2010-11-01

    A number of conflicting claims have been advanced regarding the role of the left inferior frontal gyrus, inferior parietal lobe and posterior middle temporal gyrus in action recognition, driven in part by an ongoing debate about the capacities of putative mirror systems that match observed and planned actions. We report data from 43 left hemisphere stroke patients in two action recognition tasks in which they heard and saw an action word ('hammering') and selected from two videoclips the one corresponding to the word. In the spatial recognition task, foils contained errors of body posture or movement amplitude/timing. In the semantic recognition task, foils were semantically related (sawing). Participants also performed a comprehension control task requiring matching of the same verbs to objects (hammer). Using regression analyses controlling for both the comprehension control task and lesion volume, we demonstrated that performance in the semantic gesture recognition task was predicted by per cent damage to the posterior temporal lobe, whereas the spatial gesture recognition task was predicted by per cent damage to the inferior parietal lobule. A whole-brain voxel-based lesion symptom-mapping analysis suggested that the semantic and spatial gesture recognition tasks were associated with lesioned voxels in the posterior middle temporal gyrus and inferior parietal lobule, respectively. The posterior middle temporal gyrus appears to serve as a central node in the association of actions and meanings. The inferior parietal lobule, held to be a homologue of the monkey parietal mirror neuron system, is critical for encoding object-related postures and movements, a relatively circumscribed aspect of gesture recognition. The inferior frontal gyrus, on the other hand, was not predictive of performance in any task, suggesting that previous claims regarding its role in action recognition may require refinement.

  8. Enhancement of Contralesional Motor Control Promotes Locomotor Recovery after Unilateral Brain Lesion

    PubMed Central

    Hua, Xu-Yun; Qiu, Yan-Qun; Wang, Meng; Zheng, Mou-Xiong; Li, Tie; Shen, Yun-Dong; Jiang, Su; Xu, Jian-Guang; Gu, Yu-Dong; Tsien, JoeZ.; Xu, Wen-Dong

    2016-01-01

    There have been controversies on the contribution of contralesional hemispheric compensation to functional recovery of the upper extremity after a unilateral brain lesion. Some studies have demonstrated that contralesional hemispheric compensation may be an important recovery mechanism. However, in many cases where the hemispheric lesion is large, this form of compensation is relatively limited, potentially due to insufficient connections from the contralesional hemisphere to the paralyzed side. Here, we used a new procedure to increase the effect of contralesional hemispheric compensation by surgically crossing a peripheral nerve at the neck in rats, which may provide a substantial increase in connections between the contralesional hemisphere and the paralyzed limb. This surgical procedure, named cross-neck C7-C7 nerve transfer, involves cutting the C7 nerve on the healthy side and transferring it to the C7 nerve on the paretic side. Intracortical microstimulation, Micro-PET and histological analysis were employed to explore the cortical changes in contralesional hemisphere and to reveal its correlation with behavioral recovery. These results showed that the contralesional hemispheric compensation was markedly strengthened and significantly related to behavioral improvements. The findings also revealed a feasible and effective way to maximize the potential of one hemisphere in controlling both limbs. PMID:26732072

  9. Assessment of the best flow model to characterize diffuse correlation spectroscopy data acquired directly on the brain

    PubMed Central

    Verdecchia, Kyle; Diop, Mamadou; Morrison, Laura B.; Lee, Ting-Yim; St. Lawrence, Keith

    2015-01-01

    Diffuse correlation spectroscopy (DCS) is a non-invasive optical technique capable of monitoring tissue perfusion. The normalized temporal intensity autocorrelation function generated by DCS is typically characterized by assuming that the movement of erythrocytes can be modeled as a Brownian diffusion-like process instead of by the expected random flow model. Recently, a hybrid model, referred to as the hydrodynamic diffusion model, was proposed, which combines the random and Brownian flow models. The purpose of this study was to investigate the best model to describe autocorrelation functions acquired directly on the brain in order to avoid confounding effects of extracerebral tissues. Data were acquired from 11 pigs during normocapnia and hypocapnia, and flow changes were verified by computed tomography perfusion (CTP). The hydrodynamic diffusion model was found to provide the best fit to the autocorrelation functions; however, no significant difference for relative flow changes measured by the Brownian and hydrodynamic diffusion models was observed. PMID:26600995

  10. Individualized statistical learning from medical image databases: application to identification of brain lesions.

    PubMed

    Erus, Guray; Zacharaki, Evangelia I; Davatzikos, Christos

    2014-04-01

    This paper presents a method for capturing statistical variation of normal imaging phenotypes, with emphasis on brain structure. The method aims to estimate the statistical variation of a normative set of images from healthy individuals, and identify abnormalities as deviations from normality. A direct estimation of the statistical variation of the entire volumetric image is challenged by the high-dimensionality of images relative to smaller sample sizes. To overcome this limitation, we iteratively sample a large number of lower dimensional subspaces that capture image characteristics ranging from fine and localized to coarser and more global. Within each subspace, a "target-specific" feature selection strategy is applied to further reduce the dimensionality, by considering only imaging characteristics present in a test subject's images. Marginal probability density functions of selected features are estimated through PCA models, in conjunction with an "estimability" criterion that limits the dimensionality of estimated probability densities according to available sample size and underlying anatomy variation. A test sample is iteratively projected to the subspaces of these marginals as determined by PCA models, and its trajectory delineates potential abnormalities. The method is applied to segmentation of various brain lesion types, and to simulated data on which superiority of the iterative method over straight PCA is demonstrated.

  11. Image coregistration: quantitative processing framework for the assessment of brain lesions.

    PubMed

    Huhdanpaa, Hannu; Hwang, Darryl H; Gasparian, Gregory G; Booker, Michael T; Cen, Yong; Lerner, Alexander; Boyko, Orest B; Go, John L; Kim, Paul E; Rajamohan, Anandh; Law, Meng; Shiroishi, Mark S

    2014-06-01

    The quantitative, multiparametric assessment of brain lesions requires coregistering different parameters derived from MRI sequences. This will be followed by analysis of the voxel values of the ROI within the sequences and calculated parametric maps, and deriving multiparametric models to classify imaging data. There is a need for an intuitive, automated quantitative processing framework that is generalized and adaptable to different clinical and research questions. As such flexible frameworks have not been previously described, we proceeded to construct a quantitative post-processing framework with commonly available software components. Matlab was chosen as the programming/integration environment, and SPM was chosen as the coregistration component. Matlab routines were created to extract and concatenate the coregistration transforms, take the coregistered MRI sequences as inputs to the process, allow specification of the ROI, and store the voxel values to the database for statistical analysis. The functionality of the framework was validated using brain tumor MRI cases. The implementation of this quantitative post-processing framework enables intuitive creation of multiple parameters for each voxel, facilitating near real-time in-depth voxel-wise analysis. Our initial empirical evaluation of the framework is an increased usage of analysis requiring post-processing and increased number of simultaneous research activities by clinicians and researchers with non-technical backgrounds. We show that common software components can be utilized to implement an intuitive real-time quantitative post-processing framework, resulting in improved scalability and increased adoption of post-processing needed to answer important diagnostic questions.

  12. An innovative approach to meeting the educational needs of children following acquired brain injury in the UK.

    PubMed

    Wicks, Beth

    2012-01-01

    Children with acquired brain injury encounter problems both in terms of academic attainment and in other aspects of their lives in relation to social, behavioural and independent life skills. Many previous rehabilitation programmes for these children have been inappropriately adapted versions of adult models but there has often not been a recognition that successful current adult models of vocational rehabilitation can translate to educational rehabilitation models for children and adolescents. This article considers the historical basis of provision for these children in the UK and describes the development of a new programme of education as rehabilitation.

  13. Lesion correlates of impairments in actual tool use following unilateral brain damage.

    PubMed

    Salazar-López, E; Schwaiger, B J; Hermsdörfer, J

    2016-04-01

    To understand how the brain controls actions involving tools, tests have been developed employing different paradigms such as pantomime, imitation and real tool use. The relevant areas have been localized in the premotor cortex, the middle temporal gyrus and the superior and inferior parietal lobe. This study employs Voxel Lesion Symptom Mapping to relate the functional impairment in actual tool use with extent and localization of the structural damage in the left (LBD, N=31) and right (RBD, N=19) hemisphere in chronic stroke patients. A series of 12 tools was presented to participants in a carousel. In addition, a non-tool condition tested the prescribed manipulation of a bar. The execution was scored according to an apraxic error scale based on the dimensions grasp, movement, direction and space. Results in the LBD group show that the ventro-dorsal stream constitutes the core of the defective network responsible for impaired tool use; it is composed of the inferior parietal lobe, the supramarginal and angular gyrus and the dorsal premotor cortex. In addition, involvement of regions in the temporal lobe, the rolandic operculum, the ventral premotor cortex and the middle occipital gyrus provide evidence of the role of the ventral stream in this task. Brain areas related to the use of the bar largely overlapped with this network. For patients with RBD data were less conclusive; however, a trend for the involvement of the temporal lobe in apraxic errors was manifested. Skilled bar manipulation depended on the same temporal area in these patients. Therefore, actual tool use depends on a well described left fronto-parietal-temporal network. RBD affects actual tool use, however the underlying neural processes may be more widely distributed and more heterogeneous. Goal directed manipulation of non-tool objects seems to involve very similar brain areas as tool use, suggesting that both types of manipulation share identical processes and neural representations.

  14. Elevated brain lesion volumes in older adults who use calcium supplements: a cross-sectional clinical observational study.

    PubMed

    Payne, Martha E; McQuoid, Douglas R; Steffens, David C; Anderson, John J B

    2014-07-28

    Recent studies have implicated Ca supplements in vascular risk elevation, and therefore these supplements may also be associated with the occurrence of brain lesions (or hyperintensities) in older adults. These lesions represent damage to brain tissue that is caused by ischaemia. In the present cross-sectional clinical observational study, the association between Ca-containing dietary supplement use and lesion volumes was investigated in a sample of 227 older adults (60 years and above). Food and supplemental Ca intakes were assessed with the Block 1998 FFQ; participants with supplemental Ca intake above zero were categorised as supplement users. Lesion volumes were determined from cranial MRI (1.5 tesla) scans using a semi-automated technique; volumes were log-transformed because they were non-normal. ANCOVA models revealed that supplement users had greater lesion volumes than non-users, even after controlling for food Ca intake, age, sex, race, years of education, energy intake, depression and hypertension (Ca supplement use: β = 0.34, SE 0.10, F(1,217)= 10.98, P= 0.0011). The influence of supplemental Ca use on lesion volume was of a magnitude similar to that of the influence of hypertension, a well-established risk factor for lesions. Among the supplement users, the amount of supplemental Ca was not associated with lesion volume (β = - 0.000035, SE 0.00 015, F(1,139)= 0.06, P= 0.81). The present study demonstrates that the use of Ca-containing dietary supplements, even low-dose supplements, by older adults may be associated with greater lesion volumes. Evaluation of randomised controlled trials is warranted to determine whether this relationship is a causal one.

  15. Hand Function in Relation to Brain Lesions and Corticomotor-Projection Pattern in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Holmstrom, Linda; Vollmer, Brigitte; Tedroff, Kristina; Islam, Mominul; Persson, Jonas Ke; Kits, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2010-01-01

    Aim: To investigate relationships between hand function, brain lesions, and corticomotor projections in children with unilateral cerebral palsy (CP). Method: The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4] range 7-16y), with unilateral CP at Gross Motor Function Classification System level I and Manual Ability…

  16. Cerebellar function and ischemic brain lesions in migraine patients from the general population.

    PubMed

    Koppen, Hille; Boele, Henk-Jan; Palm-Meinders, Inge H; Koutstaal, Bastiaan J; Horlings, Corinne Gc; Koekkoek, Bas K; van der Geest, Jos; Smit, Albertine E; van Buchem, Mark A; Launer, Lenore J; Terwindt, Gisela M; Bloem, Bas R; Kruit, Mark C; Ferrari, Michel D; De Zeeuw, Chris I

    2017-02-01

    Objective The objective of this article is to obtain detailed quantitative assessment of cerebellar function and structure in unselected migraine patients and controls from the general population. Methods A total of 282 clinically well-defined participants (migraine with aura n = 111; migraine without aura n = 89; non-migraine controls n = 82; age range 43-72; 72% female) from a population-based study were subjected to a range of sensitive and validated cerebellar tests that cover functions of all main parts of the cerebellar cortex, including cerebrocerebellum, spinocerebellum, and vestibulocerebellum. In addition, all participants underwent magnetic resonance imaging (MRI) of the brain to screen for cerebellar lesions. As a positive control, the same cerebellar tests were conducted in 13 patients with familial hemiplegic migraine type 1 (FHM1; age range 19-64; 69% female) all carrying a CACNA1A mutation known to affect cerebellar function. Results MRI revealed cerebellar ischemic lesions in 17/196 (8.5%) migraine patients and 3/79 (4%) controls, which were always located in the posterior lobe except for one control. With regard to the cerebellar tests, there were no differences between migraine patients with aura, migraine patients without aura, and controls for the: (i) Purdue-pegboard test for fine motor skills (assembly scores p = 0.1); (ii) block-design test for visuospatial ability (mean scaled scores p = 0.2); (iii) prism-adaptation task for limb learning (shift scores p = 0.8); (iv) eyeblink-conditioning task for learning-dependent timing (peak-time p = 0.1); and (v) body-sway test for balance capabilities (pitch velocity score under two-legs stance condition p = 0.5). Among migraine patients, those with cerebellar ischaemic lesions performed worse than those without lesions on the assembly scores of the pegboard task ( p < 0.005), but not on the primary outcome measures of the other tasks. Compared with controls and non

  17. Improving the Quality of Staff and Participant Interaction in an Acquired Brain Injury Organization

    ERIC Educational Resources Information Center

    Guercio, John M.; Dixon, Mark R.

    2010-01-01

    Weekly observations of direct-care staff in a facility for persons with brain injury yielded less than optimal interactional style with facility residents. Following an observational baseline, staff were asked to self-rate a 15-min video sample of their interaction behavior with participants on their unit. They were then asked to compare their…

  18. "You Can't Imagine Unless You've Been There Yourself": A Report on the Concerns of Parents of Children with Acquired Brain Injury.

    ERIC Educational Resources Information Center

    Singer, George H. S.; Nixon, Charles

    This report describes a qualitative study of the experiences and perceptions of parents of children with severe acquired brain injury (ABI) and summarizes the experiences of several parents during the first year following their child's traumatic brain injury. Twenty-five parents participated in a day-long focus group, in lengthy structured…

  19. Acquired spatial dyslexia.

    PubMed

    Siéroff, E

    2015-08-10

    Acquired spatial dyslexia is a reading disorder frequently occurring after left or right posterior brain lesions. This article describes several types of spatial dyslexia with an attentional approach. After right posterior lesions, patients show left neglect dyslexia with errors on the left side of text, words, and non-words. The deficit is frequently associated with left unilateral spatial neglect. Severe left neglect dyslexia can be detected with unlimited exposure duration of words or non-words. Minor neglect dyslexia is detected with brief presentation of bilateral words, one in the left and one in the right visual field (phenomenon of contralesional extinction). Neglect dyslexia can be explained as a difficulty in orienting attention to the left side of verbal stimuli. With left posterior lesions, spatial dyslexia is also frequent but multiform. Right neglect dyslexia is frequent, but right unilateral spatial neglect is rare. Attentional dyslexia represents difficulty in selecting a stimulus, letter or word among other similar stimuli; it is a deficit of attentional selection, and the left hemisphere plays a crucial role in selection. Two other types of spatial dyslexia can be found after left posterior lesions: paradoxical ipsilesional extinction and stimulus-centred neglect dyslexia. Disconnections between left or right parietal attentional areas and the left temporal visual word form area could explain these deficits. Overall, a model of attention dissociating modulation, selection control, and selection positioning can help in understanding these reading disorders.

  20. Frameless Stereotactic Insertion of Viewsite Brain Access System with Microscope-Mounted Tracking Device for Resection of Deep Brain Lesions: Technical Report

    PubMed Central

    Chakraborty, Shamik; Lall, Rohan; Fanous, Andrew A; Boockvar, John; Langer, David J

    2017-01-01

    The surgical management of deep brain tumors is often challenging due to the limitations of stereotactic needle biopsies and the morbidity associated with transcortical approaches. We present a novel microscopic navigational technique utilizing the Viewsite Brain Access System (VBAS) (Vycor Medical, Boca Raton, FL, USA) for resection of a deep parietal periventricular high-grade glioma as well as another glioma and a cavernoma with no related morbidity. The approach utilized a navigational tracker mounted on a microscope, which was set to the desired trajectory and depth. It allowed gentle continuous insertion of the VBAS directly to a deep lesion under continuous microscopic visualization, increasing safety by obviating the need to look up from the microscope and thus avoiding loss of trajectory. This technique has broad value for the resection of a variety of deep brain lesions. PMID:28331774

  1. Random motor generation in a finger tapping task: influence of spatial contingency and of cortical and subcortical hemispheric brain lesions

    PubMed Central

    Annoni, J.; Pegna, A.

    1997-01-01

    OBJECTIVE—To test the hypothesis that, during random motor generation, the spatial contingencies inherent to the task would induce additional preferences in normal subjects, shifting their performances farther from randomness. By contrast, perceptual or executive dysfunction could alter these task related biases in patients with brain damage.
METHODS—Two groups of patients, with right and left focal brain lesions, as well as 25 right handed subjects matched for age and handedness were asked to execute a random choice motor task—namely, to generate a random series of 180 button presses from a set of 10 keys placed vertically in front of them.
RESULTS—In the control group, as in the left brain lesion group, motor generation was subject to deviations from theoretical expected randomness, similar to those when numbers are generated mentally, as immediate repetitions (successive presses on the same key) are avoided. However, the distribution of button presses was also contingent on the topographic disposition of the keys: the central keys were chosen more often than those placed at extreme positions. Small distances were favoured, particularly with the left hand. These patterns were influenced by implicit strategies and task related contingencies.
 By contrast, right brain lesion patients with frontal involvement tended to show a more square distribution of key presses—that is, the number of key presses tended to be more equally distributed. The strategies were also altered by brain lesions: the number of immediate repetitions was more frequent when the lesion involved the right frontal areas yielding a random generation nearer to expected theoretical randomness. The frequency of adjacent key presses was increased by right anterior and left posterior cortical as well as by right subcortical lesions, but decreased by left subcortical lesions.
CONCLUSIONS—Depending on the side of the lesion and the degree of cortical-subcortical involvement, the

  2. Experimental carbon dioxide laser brain lesions and intracranial dynamics. Part 2. Effect on brain water content and its response to acute therapy

    SciTech Connect

    Tiznado, E.G.; James, H.E.; Moore, S.

    1985-04-01

    Experimental brain lesions were created over the left parietooccipital cortex of the albino rabbit through the intact dura mater with high radiating carbon dioxide laser energy. The brain water content was studied 2, 6, and 24 hours after the insult. Another two groups of animals received acute therapy with either dexamethasone (1 mg/kg) or furosemide (1 mg/kg). In all groups, Evans blue extravasation uniformly extended from the impact crater into the surrounding white matter. The brain water content in the gray matter was elevated from the control value by 2 hours after impact and remained elevated at 6 and 24 hours. The white matter brain water content did not increase until 6 hours after impact and remained elevated in the 24-hour group. After dexamethasone treatment, there was a significant decrease of water in the gray matter, but not in the white matter. With furosemide therapy, there was no reduction of gray or white matter brain water.

  3. [Professional career, disability and dependence after acquired brain injury: a prospective study in the two years following the brain injury].

    PubMed

    Luna-Lario, Pilar; Blanco-Beregaña, Miriam; Tirapu-Ustárroz, Javier; Ojeda, Natalia; Mata-Pastor, Ignacio

    2013-09-16

    Objetivos. Analizar la trayectoria laboral, el grado de discapacidad y el grado de dependencia reconocidos en una muestra de sujetos con daño cerebral adquirido de diferentes etiologias y que presentan deficit de memoria como secuela cognitiva principal, durante un periodo de dos años tras la lesion original, y examinar que variables sociodemograficas, datos clinicos premorbidos y relacionados con la lesion cerebral predicen el exito en la incorporacion laboral. Pacientes y metodos. Muestra de 129 pacientes, de 18 a 80 años, atendidos en el Servicio de Neuropsicologia y Neuro­psiquiatria del Complejo Hospitalario de Navarra, con deficits de memoria objetivados con tests psicometricos. Las diferencias entre variables discretas se analizaron con el test de chi al cuadrado, para analizar las existentes entre dos grupos en cuanto a variables cuantitativas, se utilizo el test t de Stutent y para calcular la correlacion entre variables continuas, el coeficiente de correlacion de Pearson. Resultados. El 17,7% retoma la actividad laboral al año y el 25% a los dos años. Lo anterior se relaciono con un mayor nivel educativo. Se reconocio la discapacidad al 85% de los solicitantes, por factores psiquicos o fisicos y psiquicos en el 89% de los mismos. Al 77% de los solicitantes se le reconocio el nivel de dependencia. Conclusiones. El daño cerebral adquirido genera un fuerte impacto en la trayectoria laboral, la interaccion con el ambiente y el nivel de autonomia. Entre los factores que explican este impacto es reseñable el deficit de memoria.

  4. Acquired self-control of insula cortex modulates emotion recognition and brain network connectivity in schizophrenia.

    PubMed

    Ruiz, Sergio; Lee, Sangkyun; Soekadar, Surjo R; Caria, Andrea; Veit, Ralf; Kircher, Tilo; Birbaumer, Niels; Sitaram, Ranganatha

    2013-01-01

    Real-time functional magnetic resonance imaging (rtfMRI) is a novel technique that has allowed subjects to achieve self-regulation of circumscribed brain regions. Despite its anticipated therapeutic benefits, there is no report on successful application of this technique in psychiatric populations. The objectives of the present study were to train schizophrenia patients to achieve volitional control of bilateral anterior insula cortex on multiple days, and to explore the effect of learned self-regulation on face emotion recognition (an extensively studied deficit in schizophrenia) and on brain network connectivity. Nine patients with schizophrenia were trained to regulate the hemodynamic response in bilateral anterior insula with contingent rtfMRI neurofeedback, through a 2-weeks training. At the end of the training stage, patients performed a face emotion recognition task to explore behavioral effects of learned self-regulation. A learning effect in self-regulation was found for bilateral anterior insula, which persisted through the training. Following successful self-regulation, patients recognized disgust faces more accurately and happy faces less accurately. Improvements in disgust recognition were correlated with levels of self-activation of right insula. RtfMRI training led to an increase in the number of the incoming and outgoing effective connections of the anterior insula. This study shows for the first time that patients with schizophrenia can learn volitional brain regulation by rtfMRI feedback training leading to changes in the perception of emotions and modulations of the brain network connectivity. These findings open the door for further studies of rtfMRI in severely ill psychiatric populations, and possible therapeutic applications.

  5. Molecular mechanism of brain impairment caused by drinking-acquired fluorosis and selenium intervention.

    PubMed

    Zheng, Xiangren; Sun, Yan; Ke, Lulu; Ouyang, Wei; Zhang, Zigui

    2016-04-01

    This study investigated the molecular mechanism of brain impairment induced by drinking fluoridated water and selenium intervention. Results showed that the learning and memory of rats in NaF group significantly decreased. Moreover, the number of apoptotic cells, the expression levels of Cytc mRNA and protein, and the expression levels of Caspase-9 and Caspase-3 mRNA significantly increased; by contrast, Caspase-9 and Caspase-3 protein levels significantly decreased. Compared with the NaF group, the mRNA levels of Cytc and Caspase-9, as well as the protein levels of Cytc in NaF+Se group, significantly decreased. Conversely, the protein levels of Caspase-3 and Caspase-9, as well as the mRNA levels of Caspase-3, significantly increased. Thus, the mitochondrial CytC-Caspase-9-Caspase-3 apoptosis pathway in the hippocampus was one of the mechanisms leading to fluorosis-induced brain damage. Furthermore, the Cytc signaling molecules were possibly the key target molecules in fluorosis-induced apoptosis, and selenium could alleviate fluorosis-induced brain injury.

  6. Relationship of EEG sources of neonatal seizures to acute perinatal brain lesions seen on MRI: a pilot study.

    PubMed

    Despotovic, Ivana; Cherian, Perumpillichira J; De Vos, Maarten; Hallez, Hans; Deburchgraeve, Wouter; Govaert, Paul; Lequin, Maarten; Visser, Gerhard H; Swarte, Renate M; Vansteenkiste, Ewout; Van Huffel, Sabine; Philips, Wilfried

    2013-10-01

    Even though it is known that neonatal seizures are associated with acute brain lesions, the relationship of electroencephalographic (EEG) seizures to acute perinatal brain lesions visible on magnetic resonance imaging (MRI) has not been objectively studied. EEG source localization is successfully used for this purpose in adults, but it has not been sufficiently explored in neonates. Therefore, we developed an integrated method for ictal EEG dipole source localization based on a realistic head model to investigate the utility of EEG source imaging in neonates with postasphyxial seizures. We describe here our method and compare the dipole seizure localization results with acute perinatal lesions seen on brain MRI in 10 full-term infants with neonatal encephalopathy. Through experimental studies, we also explore the sensitivity of our method to the electrode positioning errors and the variations in neonatal skull geometry and conductivity. The localization results of 45 focal seizures from 10 neonates are compared with the visual analysis of EEG and MRI data, scored by expert physicians. In 9 of 10 neonates, dipole locations showed good relationship with MRI lesions and clinical data. Our experimental results also suggest that the variations in the used values for skull conductivity or thickness have little effect on the dipole localization, whereas inaccurate electrode positioning can reduce the accuracy of source estimates. The performance of our fused method indicates that ictal EEG source imaging is feasible in neonates and with further validation studies, this technique can become a useful diagnostic tool.

  7. [Study of the pre- and post-treatment functionality of unilateral acquired brain injuries].

    PubMed

    Huertas-Hoyas, Elisabet; Pedrero-Pérez, Eduardo J; Águila-Maturana, Ana M; González-Alted, Carlos

    2014-04-16

    Introduccion. La mayoria de las personas que han sobrevivido a un daño cerebral lateralizado presenta secuelas que afectan a componentes sensoriomotores, cognitivos o conductuales. Estos deficits repercuten en la correcta ejecucion de actividades de la vida diaria, antes y despues de un tratamiento multidisciplinar. El objetivo de este estudio es analizar y comparar el perfil ocupacional de las personas con daño cerebral adquirido unilateral, tanto en personas con traumatismo craneoencefalico (TCE) como accidentes cerebrovasculares (ACV), mediante la independencia funcional, la capacidad, la participacion y la calidad del desempeño de las actividades cotidianas. Pacientes y metodos. Diseño cuasi experimental de cohortes con medidas transversales pre y postratamiento con una muestra de 58 personas, 28 con TCE y 30 con ACV, en ambos casos lateralizados. Las medidas utilizadas fueron la Functional Independence Measure + Functional Assessment Measure, la clasificacion internacional del funcionamiento, la discapacidad y la salud, y el Assessment of Motor and Process Skills. Resultados. Teniendo en cuenta los grupos analizados (muestra completa lateralizada, muestra por diagnostico), los resultados del analisis apuntan hacia la existencia de diferencias significativas y un moderado tamaño del efecto en las dos estimaciones transversales, otorgando mayores niveles de independencia a las lesiones sobrevenidas en el hemisferio derecho (p < 0,001). Sin embargo, al dividir la muestra segun el diagnostico, no aparecen diferencias significativas, salvo en las habilidades motoras, donde se muestran mayores puntuaciones en los TCE (p < 0,05). Conclusiones. Se piensa que lo que justifica las diferencias no es la modalidad de la lesion (TCE o ACV), sino la localizacion hemisferica. Por ello, se sugiere que las personas con daño cerebral adquirido en el hemisferio izquierdo requeriran una intervencion mas intensa.

  8. Two Time Point MS Lesion Segmentation in Brain MRI: An Expectation-Maximization Framework

    PubMed Central

    Jain, Saurabh; Ribbens, Annemie; Sima, Diana M.; Cambron, Melissa; De Keyser, Jacques; Wang, Chenyu; Barnett, Michael H.; Van Huffel, Sabine; Maes, Frederik; Smeets, Dirk

    2016-01-01

    Purpose: Lesion volume is a meaningful measure in multiple sclerosis (MS) prognosis. Manual lesion segmentation for computing volume in a single or multiple time points is time consuming and suffers from intra and inter-observer variability. Methods: In this paper, we present MSmetrix-long: a joint expectation-maximization (EM) framework for two time point white matter (WM) lesion segmentation. MSmetrix-long takes as input a 3D T1-weighted and a 3D FLAIR MR image and segments lesions in three steps: (1) cross-sectional lesion segmentation of the two time points; (2) creation of difference image, which is used to model the lesion evolution; (3) a joint EM lesion segmentation framework that uses output of step (1) and step (2) to provide the final lesion segmentation. The accuracy (Dice score) and reproducibility (absolute lesion volume difference) of MSmetrix-long is evaluated using two datasets. Results: On the first dataset, the median Dice score between MSmetrix-long and expert lesion segmentation was 0.63 and the Pearson correlation coefficient (PCC) was equal to 0.96. On the second dataset, the median absolute volume difference was 0.11 ml. Conclusions: MSmetrix-long is accurate and consistent in segmenting MS lesions. Also, MSmetrix-long compares favorably with the publicly available longitudinal MS lesion segmentation algorithm of Lesion Segmentation Toolbox. PMID:28066162

  9. Two Time Point MS Lesion Segmentation in Brain MRI: An Expectation-Maximization Framework.

    PubMed

    Jain, Saurabh; Ribbens, Annemie; Sima, Diana M; Cambron, Melissa; De Keyser, Jacques; Wang, Chenyu; Barnett, Michael H; Van Huffel, Sabine; Maes, Frederik; Smeets, Dirk

    2016-01-01

    Purpose: Lesion volume is a meaningful measure in multiple sclerosis (MS) prognosis. Manual lesion segmentation for computing volume in a single or multiple time points is time consuming and suffers from intra and inter-observer variability. Methods: In this paper, we present MSmetrix-long: a joint expectation-maximization (EM) framework for two time point white matter (WM) lesion segmentation. MSmetrix-long takes as input a 3D T1-weighted and a 3D FLAIR MR image and segments lesions in three steps: (1) cross-sectional lesion segmentation of the two time points; (2) creation of difference image, which is used to model the lesion evolution; (3) a joint EM lesion segmentation framework that uses output of step (1) and step (2) to provide the final lesion segmentation. The accuracy (Dice score) and reproducibility (absolute lesion volume difference) of MSmetrix-long is evaluated using two datasets. Results: On the first dataset, the median Dice score between MSmetrix-long and expert lesion segmentation was 0.63 and the Pearson correlation coefficient (PCC) was equal to 0.96. On the second dataset, the median absolute volume difference was 0.11 ml. Conclusions: MSmetrix-long is accurate and consistent in segmenting MS lesions. Also, MSmetrix-long compares favorably with the publicly available longitudinal MS lesion segmentation algorithm of Lesion Segmentation Toolbox.

  10. Clinical impact of RehaCom software for cognitive rehabilitation of patients with acquired brain injury.

    PubMed

    Fernández, Elízabeth; Bringas, María Luisa; Salazar, Sonia; Rodríguez, Daymí; García, María Eugenia; Torres, Maydané

    2012-10-01

    We describe the clinical impact of the RehaCom computerized cognitive training program instituted in the International Neurological Restoration Center for rehabilitation of brain injury patients. Fifty patients admitted from 2008 through 2010 were trained over 60 sessions. Attention and memory functions were assessed with a pre- and post-treatment design, using the Mini-Mental State Examination, Wechsler Memory Scale and Trail Making Test (Parts A and B). Negative effects were assessed, including mental fatigue, headache and eye irritation. The program's clinical usefulness was confirmed, with 100% of patients showing improved performance in trained functions.

  11. Evaluation of linear registration algorithms for brain SPECT and the errors due to hypoperfusion lesions.

    PubMed

    Radau, P E; Slomka, P J; Julin, P; Svensson, L; Wahlund, L O

    2001-08-01

    The semiquantitative analysis of perfusion single-photon emission computed tomography (SPECT) images requires a reproducible, objective method. Automated spatial standardization (registration) of images is a prerequisite to this goal. A source of registration error is the presence of hypoperfusion defects, which was evaluated in this study with simulated lesions. The brain perfusion images measured by 99mTc-HMPAO SPECT from 21 patients with probable Alzheimer's disease and 35 control subjects were retrospectively analyzed. An automatic segmentation method was developed to remove external activity. Three registration methods, robust least squares, normalized mutual information (NMI), and count difference were implemented and the effects of simulated defects were compared. The tested registration methods required segmentation of the cerebrum from external activity, and the automatic and manual methods differed by a three-dimensional displacement of 1.4+/-1.1 mm. NMI registration proved to be least adversely effected by simulated defects with 3 mm average displacement caused by severe defects. The error in quantifying the patient-template parietal ratio due to misregistration was 2.0% for large defects (70% hypoperfusion) and 0.5% for smaller defects (85% hypoperfusion).

  12. Headache Following Occipital Brain Lesion: A Case of Migraine Triggered by Occipital Spikes?

    PubMed

    Vollono, Catello; Mariotti, Paolo; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazzucchi, Edoardo; Valentini, Piero; De Rose, Paola; Della Marca, Giacomo

    2015-10-01

    This study describes the case of an 8-year-old boy who developed a genuine migraine after the surgical excision, from the right occipital lobe, of brain abscesses due to selective infestation of the cerebrum by Entamoeba histolytica. After the surgical treatment, the boy presented daily headaches with typical migraine features, including right-side parieto-temporal pain, nausea, vomiting, and photophobia. Electroencephalography (EEG) showed epileptiform discharges in the right occipital lobe, although he never presented seizures. Clinical and neurophysiological observations were performed, including video-EEG and polygraphic recordings. EEG showed "interictal" epileptiform discharges in the right occipital lobe. A prolonged video-EEG recording performed before, during, and after an acute attack ruled out ictal or postictal migraine. In this boy, an occipital lesion caused occipital epileptiform EEG discharges without seizures, probably prevented by the treatment. We speculate that occipital spikes, in turn, could have caused a chronic headache with features of migraine without aura. Occipital epileptiform discharges, even in absence of seizures, may trigger a genuine migraine, probably by means of either the trigeminovascular or brainstem system.

  13. Depletion of brain histamine produces regionally selective protection against thiamine deficiency-induced lesions in the rat.

    PubMed

    Langlais, Philip J; McRee, Robert Carter; Nalwalk, Julia A; Hough, Lindsay B

    2002-09-01

    Breakdown of the blood brain barrier and the subsequent accumulation of free radicals, lactate, and glutamate appear to be the immediate causes of thiamine deficiency (TD)-induced damage to thalamus. The mechanisms triggering these events are unknown but recent evidence suggests an important role of histamine. We therefore studied the effects of histamine depletion on thalamic lesions in the pyrithiamine-induced thiamine deficient (PTD) rat. Chronic intracerebroventricular (i.c.v., 7 days) infusion of alpha-fluoromethylhistidine (FMH), combined with bilateral ibotenate destruction of the histamine-containing neurons in the tuberomammillary (TM) nucleus and bolus i.c.v. infusion of 48/80, a potent mast cell degranulating agent, was used to deplete brain histamine levels. PTD rats receiving combined FMH + 48/80 + TM lesions developed acute neurological symptoms, including spontaneous seizures, approximately 1 day earlier than PTD rats treated with i.c.v. infusion of vehicle and sham lesions of the TM. When examined 1 week after restoration of thiamine, the PTD vehicle + sham lesion animals contained severe neuronal loss and gliosis in midline, intralaminar, ventral, lateral, and posterior nuclei. PTD animals treated with FMH + 48/80 + TM lesions had little evidence of neuronal loss or microglial proliferation in thalamus except in the gelatinosus and anteroventral nuclei, in which there was complete neuronal loss. These data demonstrate a significant and regionally selective role of histamine in the development of thalamic lesions in a rat model of Wernicke's encephalopathy. Furthermore, these data suggest either a dissociation between seizures and thalamic lesions or a significant role of histamine in seizure-related damage to the thalamus.

  14. Acquired long QT syndrome and monomorphic ventricular tachycardia after alternative treatment with cesium chloride for brain cancer.

    PubMed

    Dalal, Anuj K; Harding, John D; Verdino, Ralph J

    2004-08-01

    Individuals searching for symptomatic relief or a potential cure are increasingly seeking and using nontraditional therapies for their various diseases. Little is known about the potential adverse effects that patients may encounter while undergoing these alternative treatments. Cesium chloride is an unregulated agent that has been reported to have antineoplastic properties. Cesium chloride is advertised as an alternative agent for many different types of cancers and can be purchased easily on the Internet. Recently, QT prolongation and polymorphic ventricular tachycardia were reported in several patients taking cesium chloride as alternative treatment for cancer. We report acquired QT prolongation and sustained monomorphic ventricular tachycardia in a patient who self-initiated and completed a course of cesium chloride as adjunctive treatment for brain cancer.

  15. Access to environmental stimulation via eyelid responses for persons with acquired brain injury and multiple disabilities: a new microswitch arrangement.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Ricci, Irene; Buonocunto, Francesca; Sacco, Valentina

    2012-04-01

    This study assessed a new microswitch arrangement for eyelid responses using an optic sensor placed above the cheekbone and a small sticker on the person's eyelid. This new arrangement, which was designed to avoid interference of the microswitch with the person's visual functioning, was tested on three adults with acquired brain injury and multiple (consciousness, communication, and motor) disabilities. The study was carried out according to a non-concurrent multiple baseline design across participants. Data showed the new microswitch arrangement was suitable for all three participants, who increased their responding during the intervention phase of the study when their responses allowed them to access preferred stimulation. Practical implications of the findings are discussed.

  16. Alcohol Use after Combat-Acquired Traumatic Brain Injury: What We Know and Don’t Know

    PubMed Central

    ADAMS, RACHEL SAYKO; CORRIGAN, JOHN D.; LARSON, MARY JO

    2012-01-01

    Military personnel engage in unhealthy alcohol use at rates higher than their same age, civilian peers, resulting in negative consequences for the individual and jeopardized force readiness for the armed services. Among those returning from combat deployment, unhealthy drinking may be exacerbated by acute stress reactions and injury, including traumatic brain injury (TBI). Combat-acquired TBI is common among personnel in the current conflicts. Although research suggests that impairments due to TBI leads to an increased risk for unhealthy drinking and consequences among civilians, there has been little research to examine whether TBI influences drinking behaviors among military personnel. This article examines TBI and drinking in both civilian and military populations and discusses implications for clinical care and policy. PMID:22485074

  17. Usual and virtual reality video game-based physiotherapy for children and youth with acquired brain injuries.

    PubMed

    Levac, Danielle; Miller, Patricia; Missiuna, Cheryl

    2012-05-01

    Little is known about how therapists promote learning of functional motor skills for children with acquired brain injuries. This study explores physiotherapists' description of these interventions in comparison to virtual reality (VR) video game-based therapy. Six physiotherapists employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using thematic analysis. Physiotherapists describe using interventions that motivate children to challenge performance quality and optimize real-life functioning. Intervention strategies are influenced by characteristics of the child, parent availability to practice skills outside therapy, and therapist experience. VR use motivates children to participate, but can influence therapist use of verbal strategies and complicate interventions. Physiotherapists consider unique characteristics of this population when providing interventions that promote learning of motor skills. The VR technology has advantageous features but its use with this population can be challenging; further research is recommended.

  18. Automatic segmentation of white matter lesions on magnetic resonance images of the brain by using an outlier detection strategy.

    PubMed

    Wang, Rui; Li, Chao; Wang, Jie; Wei, Xiaoer; Li, Yuehua; Hui, Chun; Zhu, Yuemin; Zhang, Su

    2014-12-01

    White matter lesions (WMLs) are commonly observed on the magnetic resonance (MR) images of normal elderly in association with vascular risk factors, such as hypertension or stroke. An accurate WML detection provides significant information for disease tracking, therapy evaluation, and normal aging research. In this article, we present an unsupervised WML segmentation method that uses Gaussian mixture model to describe the intensity distribution of the normal brain tissues and detects the WMLs as outliers to the normal brain tissue model based on extreme value theory. The detection of WMLs is performed by comparing the probability distribution function of a one-sided normal distribution and a Gumbel distribution, which is a specific extreme value distribution. The performance of the automatic segmentation is validated on synthetic and clinical MR images with regard to different imaging sequences and lesion loads. Results indicate that the segmentation method has a favorable accuracy competitive with other state-of-the-art WML segmentation methods.

  19. The neuroprotective effects of Semax in conditions of MPTP-induced lesions of the brain dopaminergic system.

    PubMed

    Levitskaya, N G; Sebentsova, E A; Andreeva, L A; Alfeeva, L Yu; Kamenskii, A A; Myasoedov, N F

    2004-05-01

    This report describes studies cf the effects of the ACTH(4-10) analog Semax (MEHFPGP) on the behavior of white rats with lesions to the brain dopaminergic system induced by the neurotoxin MPTP. Neurotoxin was given as single i.p. doses of 25 mg/kg. Neurotoxin injections were shown to decrease movement activity and increase anxiety in the animals. Daily intranasal administration of Semax at a dose of 0.2 mg/kg decreased the severity of MPTP-induced behavioral disturbances. The protective activity of Semax in MPTP-induced lesions of the brain dopaminergic system may be associated with both its modulating effect on the dopaminergic system and the neurotrophic action of the peptide.

  20. Reorganization of the cerebro-cerebellar network of language production in patients with congenital left-hemispheric brain lesions.

    PubMed

    Lidzba, K; Wilke, M; Staudt, M; Krägeloh-Mann, I; Grodd, W

    2008-09-01

    Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess if the language network is reorganized completely in these patients, i.e. including also cerebellar language functions. As compared to a group of controls matched for age, sex, and verbal IQ, the patients recruited an area not in the right but in the left cerebellar hemisphere. The extent of laterality of the cerebellar activation correlated significantly with the laterality of the frontal activation. We suggest that the developing brain reacts to early focal lesions in the left hemisphere with a mirror-image organization of the entire cerebro-cerebellar network engaged in speech production.

  1. Difficulties in using everyday technology after acquired brain injury: a qualitative analysis.

    PubMed

    Engström, Ann-Louice Lövgreen; Lexell, Jan; Lund, Maria Larsson

    2010-09-01

    The aim of this study was to identify and describe the characteristics of the difficulties using everyday technology in persons with an aquired brain injury (ABI), and their experiences of how these difficulties influenced their life. Thirteen persons with an ABI were interviewed about their difficulties in using everyday technology and were observed in their use of technology. Data were analysed qualitatively with a constant comparative method. The results showed that the persons' experiences formed two categories: “A variety of combinations of difficulties in the use of everyday technology” and “Restrictions in life”. The difficulties identified were related not only to everyday technology itself but also to the interaction between the technology, the task, the person, and the environment. These difficulties influenced their experiences of restrictions in occupational performance, personal identification, and participation in society. The results emphasize that occupational therapists who design interventions for people with an ABI need to accommodate both the technology and other interacting aspects in order to overcome difficulties in using everyday technology.

  2. Network analysis of human fMRI data suggests modular restructuring after simulated acquired brain injury.

    PubMed

    Ruiz Vargas, E; Mitchell, D G V; Greening, S G; Wahl, L M

    2016-01-01

    The pathophysiology underlying neurocognitive dysfunction following mild traumatic brain injury (TBI), or concussion, is poorly understood. In order to shed light on the effects of TBI at the functional network or modular level, our research groups are engaged in the acquisition and analysis of functional magnetic resonance imaging data from subjects post-TBI. Complementary to this effort, in this paper we use mathematical and computational techniques to determine how modular structure changes in response to specific mechanisms of injury. In particular, we examine in detail the potential effects of focal contusions, diffuse axonal degeneration and diffuse microlesions, illustrating the extent to which functional modules are preserved or degenerated by each type of injury. One striking prediction of our study is that the left and right hemispheres show a tendency to become functionally separated post-injury, but only in response to diffuse microlesions. We highlight other key differences among the effects of the three modelled injuries and discuss their clinical implications. These results may help delineate the functional mechanisms underlying several of the cognitive sequelae associated with TBI.

  3. Impact of a family-focused intervention on self-concept after acquired brain injury.

    PubMed

    Kelly, Amber; Ponsford, Jennie; Couchman, Grace

    2013-01-01

    The present study examined the impact of a family inclusive intervention on the multidimensional self-concept of individuals with traumatic brain injury (TBI). Forty one individuals with TBI and a matched control group completed the Tennessee Self-Concept Scale: Second Edition (TSCS: 2), the Rosenberg Self-Esteem Scale (RSE), the Family Assessment Device (FAD), and the Hospital Anxiety and Depression Scale (HADS) on two occasions: at immediate contact (pre-group, T1) and post-group (3 months after initial contact, T2). Controls did not attend the intervention. Total scores for the measures, as well as scores on subdomains of self-concept, taken pre- and post-intervention for the TBI sample and at the same time for matched controls were compared between groups using Multivariate Analysis of Variance (MANOVA); followed by a series of repeated measures analyses of variance (ANOVA) to determine whether significant changes occurred. Contrary to the main aim, the use of a family-focused intervention did not result in self-concept improvement, either globally or across self-concept domains. Nor did mood or family functioning improve for the TBI sample. Measures remained stable across time for the controls.

  4. Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF).

    PubMed

    Sigmundsdottir, Linda; Longley, Wendy A; Tate, Robyn L

    2016-10-01

    Computerised cognitive training (CCT) is an increasingly popular intervention for people experiencing cognitive symptoms. This systematic review evaluated the evidence for CCT in adults with acquired brain injury (ABI), focusing on how outcome measures used reflect efficacy across components of the International Classification of Functioning, Disability and Health. Database searches were conducted of studies investigating CCT to treat cognitive symptoms in adult ABI. Scientific quality was rated using the PEDro-P and RoBiNT Scales. Ninety-six studies met the criteria. Most studies examined outcomes using measures of mental functions (93/96, 97%); fewer studies included measures of activities/participation (41/96, 43%) or body structures (8/96, 8%). Only 14 studies (15%) provided Level 1 evidence (randomised controlled trials with a PEDro-P score ≥ 6/10), with these studies suggesting strong evidence for CCT improving processing speed in multiple sclerosis (MS) and moderate evidence for improving memory in MS and brain tumour populations. There is a large body of research examining the efficacy of CCT, but relatively few Level 1 studies and evidence is largely limited to body function outcomes. The routine use of outcome measures of activities/participation would provide more meaningful evidence for the efficacy of CCT. The use of body structure outcome measures (e.g., neuroimaging) is a newly emerging area, with potential to increase understanding of mechanisms of action for CCT.

  5. Comparing the Effect of Botulinum Toxin Type B Injection at Different Dosages for Patient with Drooling due to Brain Lesion

    PubMed Central

    Park, Hee Dong; Park, Sang Jun; Choi, Yong Min

    2012-01-01

    Objective To investigate Botulinum toxin type B (BNT-B) injection's effect and duration depending on dose for patients with brain lesion. Method Twenty one patients with brain lesion and severe drooling were included and divided into three groups. All patients received conventional dysphagia therapy. Group A patients (n=7) received an injection of 1,500 units and group B patients (n=7) received an injection of 2,500 units of BNT-B in submandibular gland under ultrasound guidance. Group C patients (n=7) received conventional dysphagia therapy. Saliva secretion was assessed quantitatively at baseline and at weeks 1, 2, 4, 8, and 12. The severity and frequency of drooling was assessed using the Drooling Quotient (DQ) by patients and/or caregivers. Results Group A and B reported a distinct improvement of the symptoms within 2 weeks after BNT-B injection. Compared to the baseline, the mean amount of saliva decreased significantly throughout the study. However, there was no meaningful difference between the two groups. The greatest reductions were achieved at 2 weeks and lasted up to 8 weeks after BNT-B injection. Group C did not show any differences. Conclusion Local injection of 1,500 units of BNT-B into salivary glands under ultrasonic guidance proved to be a safe and effective dose for drooling in patient with brain lesion, as did 2,500 units. PMID:23342318

  6. Acute functional reorganisation of the human motor cortex during resection of central lesions: a study using intraoperative brain mapping

    PubMed Central

    Duffau, H

    2001-01-01

    OBJECTIVES—Brain plasticity is supposed to allow the compensation of motor function in cases of rolandic lesion. The aim was to analyse the mechanisms of functional reorganisation during surgery in the central area.
METHODS—A motor brain mapping was performed in three right handed patients without any neurological deficit, operated on for a slow growing lesion near the rolandic region (two precentral resected under general anaesthesia and one retrocentral removed under local anaesthesia to allow also sensory mapping) using intraoperative direct electrical stimulations (5 mm space tips bipolar stimulator probe, biphasic square wave pulse current: 1 ms/phase, 60 Hz, 4 to 18mA).
RESULTS—For each patient, the motor areas of the hand and forearm in the primary motor cortex (M1) were identified before and after lesion removal with the same stimulation parameters: the same eloquent sites were found, plus the appearance after resection of additional sites in M1 inducing the same movement during stimulations as the previous areas.
CONCLUSIONS—Multiple cortical representations for hand and forearm movements in M1 seem to exist. In addition, the results demonstrate the short term capacity of the brain to make changes in local motor maps, by sudden unmasking after tumour resection of a second redundant site participating in the same movement. Finally, it seems not necessary for the whole of the redundant sites to be functional to provide normal movement, a concept with potential implications for surgery within the central region.

 PMID:11254775

  7. Early orientation of attention toward the half space ipsilateral to the lesion in patients with unilateral brain damage.

    PubMed Central

    Gainotti, G; D'Erme, P; Bartolomeo, P

    1991-01-01

    Posner has suggested that unilateral spatial neglect could be due to a difficulty in disengaging attention from its current focus to orient it toward the neglected half space. Clinical and experimental data suggest, however, that this disengaging difficulty could be only one aspect of a more complex disturbance also characterized by an early automatic orienting of attention toward the half space ipsilateral to the lesion. To test this hypothesis, two different investigations in unselected groups of patients with right and left brain-damage were carried out. The first investigation, to evaluate forms of lateral orienting of attention severe enough to provoke an overt gaze deviation, consisted of the systematic assessment of the phenomenon of "magnetic gaze attraction". The second investigation, to detect milder forms of automatic orienting of attention, analysed the temporal sequence followed in identifying the pictures represented in an "Overlapping Figures task", to see if patients tended to identify first figures lying in the half space ipsilateral to the lesion. In both investigations results consistently showed: a) that patients with right brain damage tend to orient attention automatically toward the ipsilateral half space more than patients with left brain damage; b) that this tendency is tightly linked to the presence of behavioural manifestations of hemi-neglect. These results are therefore consistent with the hypothesis that hemi-neglect is a multi-component syndrome with an early orienting of attention toward the half space ipsilateral to the lesion as the first of these components. Images PMID:1783922

  8. Performance of Apparent Diffusion Coefficient Values and Conventional MRI Features in Differentiating Tumefactive Demyelinating Lesions From Primary Brain Neoplasms

    PubMed Central

    Mabray, Marc C.; Cohen, Benjamin A.; Villanueva-Meyer, Javier E.; Valles, Francisco E.; Barajas, Ramon F.; Rubenstein, James L.; Cha, Soonmee

    2015-01-01

    OBJECTIVE Tumefactive demyelinating lesions (TDLs) remain one of the most common brain lesions to mimic a brain tumor, particularly primary CNS lymphoma (PCNSL) and high-grade gliomas. The purpose of our study was to evaluate the ability of apparent diffusion coefficient (ADC) values and conventional MRI features to differentiate TDLs from PCNSLs and high-grade gliomas. MATERIALS AND METHODS Seventy-five patients (24 patients with TDLs, 28 with PCNSLs, and 23 with high-grade gliomas) with 168 brain lesions (70 TDLs, 68 PCNSLs, and 30 high-grade gliomas) who underwent DWI before surgery or therapy were included in the study. Minimum ADC (ADCmin) and average ADC (ADCavg) values were calculated for each lesion. ANOVA and ROC analyses were performed. ROC analyses were also performed for the presence of incomplete rim enhancement and for the number of lesions. Multiple-variable logistic regression with ROC analysis was then performed to evaluate performance in multiple-variable models. RESULTS ADCmin was statistically significantly higher (p < 0.01) in TDLs (mean, 0.886; 95% CI, 0.802–0.931) than in PCNSLs (0.547; 95% CI, 0.496–0.598) and high-grade gliomas (0.470; 95% CI, 0.385–0.555). (All ADC values in this article are reported in units of × 10−3 mm2/s.) ADCavg was statistically significantly higher (p < 0.01) in TDLs (mean, 1.362; 95% CI, 1.268–1.456) than in PCNSLs (0.990; 95% CI, 0.919–1.061) but not in high-grade gliomas (1.216; 95% CI, 1.074–1.356). Multiple-variable models showed statistically significant individual effects and superior diagnostic performance on ROC analysis. CONCLUSION TDLs can be diagnosed on preoperative MRI with a high degree of specificity; MRI features of incomplete rim enhancement, high ADC values, and a large number of lesions individually increase the probability and diagnostic confidence that a lesion is a TDL. PMID:26496556

  9. Non-invasive transcranial high intensity focused ultrasound (HIFUS) under MRI thermometry and guidance in the treatment of brain lesions.

    PubMed

    Jääskeläinen, J

    2003-01-01

    Non-invasive transcranial high intensity focused ultrasound (HIFUS) therapy given under MRI thermometry and image guidance to awake patients lying within the bore of a 1.5 T MRI scanner (a) to thermally ablate brain lesions such as metastases, (b) to cause precise ablative brain lesions in functional disorders, or (c) to locally open the blood-brain-barrier for targeted therapeutic construct delivery--without the radiation risks of stereotactic radiotherapy--may sound science fiction. Kullervo Hynynen, a Finnish-born ultrasound and MRI physicist, and Ferenc Jolesz, a Hungarian-born neurosurgeon and visionary of image guided surgery, have joined forces at Radiology, Brigham & Women's Hospital, Boston, and they have taken every step to realize the vision above, in highly successful collaboration with the industry (GE, InSightec, TxSonics). The sophisticated transcranial HIFUS instrumentation, supported by profound research data from experimental animals and by the clinical experience from extracranial HIFUS targets (breast fibroadenoma, uterine fibroid), is now coming to a phase I clinical trial in cerebral metastases. It remains to be seen whether transcranial HIFUS will find applications in diffuse gliomas such as (a) thermal ablation of selected areas of glioma tissue, (b) opening the blood-brain-barrier for therapeutic constructs to enter selected areas, or (c) activating such constructs in desired areas. The prophecy of Dr. Jolesz, "this technology will put neurosurgeons out of business", may not fulfill during our lifetime.

  10. [Participation limitations following acquired brain damage: a pilot study on the relationship among functional disorders as well as personal and environmental context factors].

    PubMed

    Fries, W; Fischer, S

    2008-10-01

    The SGB IX, book 9 of the German social code (Sozialgesetzbuch, SGB), which is the legal basis of rehabilitation in Germany, states "participation and self-determined conduct of life" as the ultimate ambition of rehabilitation. This concept of participation and disability is based on the WHO model expressed in the International Classification of Functioning, Disability and Health (ICF). In this model, participation after the onset of a health problem may not only be infringed by disturbances in body functions and structures and the resulting activity limitations but also by contextual factors such as environmental and personal factors. In an outpatient neurological rehabilitation centre we prospectively rated for 49 patients the influence of these contextual factors as well as of objectively assessed functional/activity limitations on the overall disability. On average, functional/activity limitations were rated as contributing 58.4% (SD=17.2%), personal factors 26.4% (SD=12.7%) and environmental factors 15.1% (SD=11.2%) to the overall disability. The functional/activity limitations closely matched the expected limitations based on the underlying brain lesions. The degree of disability based on contextual factors was not related to activity limitations based on disturbances of body functions and structures. Also, demographic variables such as age, sex or chronicity were not significantly linked to contextual factors. Since contextual factors together contributed 41.6% (SD=17.2%) to the overall disability they have major relevance for the rehabilitation process, because they essentially decide on the extent to which abilities acquired by the rehabilitant during rehabilitation actually be transfered to his everyday life. Therefore, rehabilitation programmes need to include assessment and treatment of contextual factors. It hence is necessary to develop instruments to quantify contextual factors.

  11. Ivy Sign on Fluid-Attenuated Inversion Recovery Images in Moyamoya Disease: Correlation with Clinical Severity and Old Brain Lesions

    PubMed Central

    Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Kim, Ji Hwa; Ahn, Sung Jun; Kim, Dong-Seok

    2015-01-01

    Purpose Leptomeningeal collateral, in moyamoya disease (MMD), appears as an ivy sign on fluid-attenuated inversion-recovery (FLAIR) images. There has been little investigation into the relationship between presentation of ivy signs and old brain lesions. We aimed to evaluate clinical significance of ivy signs and whether they correlate with old brain lesions and the severity of clinical symptoms in patients with MMD. Materials and Methods FLAIR images of 83 patients were reviewed. Each cerebral hemisphere was divided into 4 regions and each region was scored based on the prominence of the ivy sign. Total ivy score (TIS) was defined as the sum of the scores from the eight regions and dominant hemispheric ivy sign (DHI) was determined by comparing the ivy scores from each hemisphere. According to the degree of ischemic symptoms, patients were classified into four subgroups: 1) nonspecific symptoms without motor weakness, 2) single transient ischemic attack (TIA), 3) recurrent TIA, or 4) complete stroke. Results TIS was significantly different as follows: 4.86±2.55 in patients with nonspecific symptoms, 5.89±3.10 in patients with single TIA, 9.60±3.98 in patients with recurrent TIA and 8.37±3.39 in patients with complete stroke (p=0.003). TIS associated with old lesions was significantly higher than those not associated with old lesions (9.35±4.22 vs. 7.49±3.37, p=0.032). We found a significant correlation between DHI and motor symptoms (p=0.001). Conclusion Because TIS has a strong tendency with severity of ischemic motor symptom and the presence of old lesions, the ivy sign may be useful in predicting severity of disease progression. PMID:26256975

  12. CT-Based Attenuation Correction in Brain SPECT/CT Can Improve the Lesion Detectability of Voxel-Based Statistical Analyses

    PubMed Central

    Kato, Hiroki; Shimosegawa, Eku; Fujino, Koichi; Hatazawa, Jun

    2016-01-01

    Background Integrated SPECT/CT enables non-uniform attenuation correction (AC) using built-in CT instead of the conventional uniform AC. The effect of CT-based AC on voxel-based statistical analyses of brain SPECT findings has not yet been clarified. Here, we assessed differences in the detectability of regional cerebral blood flow (CBF) reduction using SPECT voxel-based statistical analyses based on the two types of AC methods. Subjects and Methods N-isopropyl-p-[123I]iodoamphetamine (IMP) CBF SPECT images were acquired for all the subjects and were reconstructed using 3D-OSEM with two different AC methods: Chang’s method (Chang’s AC) and the CT-based AC method. A normal database was constructed for the analysis using SPECT findings obtained for 25 healthy normal volunteers. Voxel-based Z-statistics were also calculated for SPECT findings obtained for 15 patients with chronic cerebral infarctions and 10 normal subjects. We assumed that an analysis with a higher specificity would likely produce a lower mean absolute Z-score for normal brain tissue, and a more sensitive voxel-based statistical analysis would likely produce a higher absolute Z-score for in old infarct lesions, where the CBF was severely decreased. Results The inter-subject variation in the voxel values in the normal database was lower using CT-based AC, compared with Chang’s AC, for most of the brain regions. The absolute Z-score indicating a SPECT count reduction in infarct lesions was also significantly higher in the images reconstructed using CT-based AC, compared with Chang’s AC (P = 0.003). The mean absolute value of the Z-score in the 10 intact brains was significantly lower in the images reconstructed using CT-based AC than in those reconstructed using Chang’s AC (P = 0.005). Conclusions Non-uniform CT-based AC by integrated SPECT/CT significantly improved sensitivity and the specificity of the voxel-based statistical analyses for regional SPECT count reductions, compared with

  13. Excessive disgust caused by brain lesions or temporary inactivations: Mapping hotspots of nucleus accumbens and ventral pallidum

    PubMed Central

    Ho, Chao-Yi; Berridge, Kent C.

    2014-01-01

    Disgust is a prototypical type of negative affect. In animal models of excessive disgust, only a few brain sites are known in which localized dysfunction (lesions or neural inactivations) can induce intense ‘disgust reactions’ (e.g., gapes) to a normally pleasant sensation such as sweetness. Here we aimed to map forebrain candidates more precisely to identify where either local neuronal damage (excitotoxin lesions) or local pharmacological inactivation (muscimol-baclofen microinjections) caused rats to emit excessive sensory disgust reactions to sucrose. Our study compared subregions of nucleus accumbens shell, ventral pallidum, lateral hypothalamus and adjacent extended amygdala. Results indicated the posterior half of ventral pallidum to be the only forebrain site where intense sensory disgust gapes to sucrose were induced by both lesions and temporary inactivations (this site was previously identified as a hedonic hotspot for enhancements of sweetness ‘liking’). By comparison, for the nucleus accumbens, temporary GABA inactivations in the caudal half of the medial shell also generated sensory disgust but lesions never did at any site. Further, even inactivations failed to induce disgust in the rostral half of accumbens shell (which also contains a hedonic hotspot). In other structures, neither lesions nor inactivations induced disgust as long as the posterior ventral pallidum remained spared. We conclude that the posterior ventral pallidum is an especially crucial hotspot for producing excessive sensory disgust by local pharmacological/lesion dysfunction. By comparison, the nucleus accumbens appears to segregate sites for pharmacological disgust induction and hedonic enhancement into separate posterior versus rostral halves of medial shell. PMID:25229197

  14. Angiotensin-converting enzyme and progression of white matter lesions and brain atrophy--the SMART-MR study.

    PubMed

    Jochemsen, Hadassa M; Geerlings, Mirjam I; Grool, Anne M; Vincken, Koen L; Mali, Willem Ptm; van der Graaf, Yolanda; Muller, Majon

    2012-01-01

    High levels of angiotensin-converting-enzyme (ACE) may increase the risk of dementia through blood pressure elevation and subsequent development of cerebral small-vessel disease. However, high ACE levels may also decrease this risk through amyloid degradation which prevents brain atrophy. Within the SMART-MR study, a prospective cohort study among patients with symptomatic atherosclerotic disease, serum ACE levels were measured at baseline and a 1.5 Tesla brain MRI was performed at baseline and after on average (range) 3.9 (3.0-5.8) years of follow-up in 682 persons (mean age 58 ± 10 years). Brain segmentation was used to quantify total, deep, and periventricular white matter lesion (WML) volume, and total brain, cortical gray matter and ventricular volume (%ICV). Lacunar infarcts were rated visually. Regression analyses were used to examine the prospective associations between serum ACE and brain measures. Patients with the highest serum ACE levels (>43.3 U/L) had borderline significantly more progression of deep WML volumes than patients with the lowest ACE levels (<21.8 U/L); mean difference (95% CI) in change was 0.20 (-0.02; 0.43) %ICV. On the contrary, patients with the highest serum ACE levels had significantly less progression of cortical brain atrophy than patients with the lowest ACE levels; mean difference (95% CI) in change was 0.78 (0.21; 1.36) %ICV. Serum ACE was not associated with subcortical atrophy, periventricular WML, or lacunar infarcts. Our results show that higher ACE activity is associated with somewhat more progression of deep WML volume, but with less progression of cortical brain atrophy. This suggests both detrimental and beneficial effects of high ACE levels on the brain.

  15. Objectively measured physical activity, brain atrophy, and white matter lesions in older adults with mild cognitive impairment.

    PubMed

    Doi, Takehiko; Makizako, Hyuma; Shimada, Hiroyuki; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Park, Hyuntae; Suzuki, Takao

    2015-02-01

    Physical activity may help to prevent or delay brain atrophy. Numerous studies have shown associations between physical activity and age-related changes in the brain. However, most of these studies involved self-reported physical activity, not objectively measured physical activity. Therefore, the aim of this study was to examine the association between objectively measured physical activity, as determined using accelerometers, and brain magnetic resonance imaging (MRI) measures in older adults with mild cognitive impairment (MCI). We analyzed 323 older subjects with MCI (mean age 71.4 years) who were recruited from the participants of the Obu Study of Health Promotion for the Elderly. We recorded demographic data and measured physical activity using a tri-axial accelerometer. Physical activity was classified as light-intensity physical activity (LPA) or moderate-to-vigorous physical activity (MVPA). Brain atrophy and the severity of white matter lesions (WML) were determined by MRI. Low levels of LPA and MVPA were associated with severe WML. Subjects with severe WML were older, had lower mobility, and had greater brain atrophy than subjects with mild WML (all P<0.05). Multivariate analysis revealed that more MVPA was associated with less brain atrophy, even after adjustment for WML (β=-0.126, P=0.015), but LPA was not (β=-0.102, P=0.136). Our study revealed that objectively measured physical activity, especially MVPA, was associated with brain atrophy in MCI subjects, even after adjusting for WML. These findings support the hypothesis that physical activity plays a crucial role in maintaining brain health.

  16. Differentiating cognitive functions of poststroke patients with specific brain lesions: A preliminary study on the clinical utility of Cognistat-P.

    PubMed

    Chan, Sam C C; Chan, Chetwyn C H; Wu, Yi; Liu, Karen P Y; Xu, Yan-Wen

    2016-01-01

    The Cognistat is widely used to measure the cognitive profile of neurological patients. This study aimed to further obtain evidence on the construct and discriminative validity of the Putonghua version of the Cognistat (Cognistat-P) on poststroke patients with specific brain lesions. Cognistat-P was administered to poststroke patients (n = 98), as well as healthy elderly (n = 40) and adult (n = 34) participants as the control groups. Poststroke patients were further categorized into 4 lesion groups using standard brain slice templates. Exploratory factory analysis reflected a 2-factor structure for the Cognistat-P that resembles that for the original English version. The Construction, Similarities, and Judgment subtests were found to differentiate patients with frontal or parietal lesions from those with subcortical lesions (p < .01, R(2) = .48). The Construction subtest, tapping the "fluid" ability, was the most useful for differentiating patients with parietal lesions from those with subcortical lesions. The Similarities subtest together with the Construction subtest was the most useful for differentiating patients with frontal lesions from those with subcortical lesions. This study established the validity of the Cognistat-P for differentiating poststroke patients with specific brain lesions. Future studies should replicate the results on a larger sample size and test the clinical significance of the Cognistat-P profiles.

  17. Co-localization of brain-derived neurotrophic factor (BDNF) and wild-type huntingtin in normal and quinolinic acid-lesioned rat brain.

    PubMed

    Fusco, Francesca R; Zuccato, Chiara; Tartari, Marzia; Martorana, Alessandro; De March, Zena; Giampà, Carmela; Cattaneo, Elena; Bernardi, Giorgio

    2003-09-01

    Loss of huntingtin-mediated brain-derived neurotrophic factor (BDNF) gene transcription has been described in Huntington's disease (HD) [Zuccato et al. (2001) Science, 293, 493-498]. It has been shown that BDNF is synthesized in the pyramidal layer of cerebral cortex and released in the striatum [Altar et al. (1997) Nature, 389, 856-860; Conner et al. (1997) J. Neurosci., 17, 2295-2313]. Here we show the cellular localization of BDNF in huntingtin-containing neurons in normal rat brain; our double-label immunofluorescence study shows that huntingtin and BDNF are co-contained in approximately 99% of pyramidal neurons of motor cortex. In the striatum, huntingtin is expressed in 75% of neurons containing BDNF. In normal striatum we also show that BDNF is contained in cholinergic and in NOS-containing interneurons, which are relatively resistant to HD degeneration. Furthermore, we show a reduction in huntingtin and in BDNF immunoreactivity in cortical neurons after striatal excitotoxic lesion. Our data are confirmed by an ELISA study of BDNF and by a Western blot analysis of huntingtin in cortex of quinolic acid (QUIN)-lesioned hemispheres. In the lesioned striatum we describe that the striatal subpopulation of cholinergic neurons, surviving degeneration, contain BDNF. The finding that BDNF is contained in nearly all neurons that contain huntingtin in the normal cortex, along with the reduced expression of BDNF after QUIN injection of the striatum, shows that huntingtin may be required for BDNF production in cortex.

  18. Supporting Students with Invisible Disabilities: A Scoping Review of Postsecondary Education for Students with Mental Illness or an Acquired Brain Injury

    ERIC Educational Resources Information Center

    Venville, Annie; Mealings, Margaret; Ennals, Priscilla; Oates, Jennifer; Fossey, Ellie; Douglas, Jacinta; Bigby, Christine

    2016-01-01

    Students with invisible disabilities such as mental illness or acquired brain injury (ABI) experience multiple barriers that reduce their likelihood of postsecondary course completion. The present study conducted a systematic search of research reporting interventions for students experiencing mental illness or ABI to participate in postsecondary…

  19. Longitudinal changes in brain volumes and cerebrovascular lesions on MRI in patients with manifest arterial disease: the SMART-MR study.

    PubMed

    van der Veen, Pieternella H; Muller, Majon; Vincken, Koen L; Witkamp, Theo D; Mali, Willem P T M; van der Graaf, Yolanda; Geerlings, Mirjam I

    2014-02-15

    We estimated the progression of brain atrophy and cerebrovascular lesions on MRI in a prospective cohort of patients with various manifestations of arterial disease. Within the SMART-MR study, using brain MRI data from baseline and after on average 3.9 years of follow-up, intracranial volume (ICV), total brain, cortical gray matter, ventricular, white matter lesion volumes and visually rated infarcts were obtained from 663 patients (mean age 57 ± 9 years, 81% men). Global and cortical atrophy increased quadratically with age. Men showed more progression of global and cortical atrophy than women (mean difference in change (95% CI): -0.25 (-0.44; -0.06) and -0.94 (-1.35; -0.52)% ICV) and had an increased risk of new brain infarcts (OR = 2.7, 95% CI 1.2-6.1). Compared with coronary artery disease patients, cerebrovascular disease patients showed more progression of cortical and subcortical atrophy and an increased risk of new brain infarcts, and peripheral arterial disease patients showed more progression of cortical atrophy. These results were independent of cerebrovascular lesions and cardiovascular risk factors. In patients with manifest arterial disease, brain atrophy tended to accelerate with older age and men had more progression of brain atrophy and cerebrovascular lesions than women. Additionally, patients with cerebrovascular and peripheral arterial disease showed the most prominent progression of atrophy and lesions.

  20. A Case of Generalized Auditory Agnosia with Unilateral Subcortical Brain Lesion

    PubMed Central

    Suh, Hyee; Kim, Soo Yeon; Kim, Sook Hee; Chang, Jae Hyeok; Shin, Yong Beom; Ko, Hyun-Yoon

    2012-01-01

    The mechanisms and functional anatomy underlying the early stages of speech perception are still not well understood. Auditory agnosia is a deficit of auditory object processing defined as a disability to recognize spoken languages and/or nonverbal environmental sounds and music despite adequate hearing while spontaneous speech, reading and writing are preserved. Usually, either the bilateral or unilateral temporal lobe, especially the transverse gyral lesions, are responsible for auditory agnosia. Subcortical lesions without cortical damage rarely causes auditory agnosia. We present a 73-year-old right-handed male with generalized auditory agnosia caused by a unilateral subcortical lesion. He was not able to repeat or dictate but to perform fluent and comprehensible speech. He could understand and read written words and phrases. His auditory brainstem evoked potential and audiometry were intact. This case suggested that the subcortical lesion involving unilateral acoustic radiation could cause generalized auditory agnosia. PMID:23342322

  1. A case of generalized auditory agnosia with unilateral subcortical brain lesion.

    PubMed

    Suh, Hyee; Shin, Yong-Il; Kim, Soo Yeon; Kim, Sook Hee; Chang, Jae Hyeok; Shin, Yong Beom; Ko, Hyun-Yoon

    2012-12-01

    The mechanisms and functional anatomy underlying the early stages of speech perception are still not well understood. Auditory agnosia is a deficit of auditory object processing defined as a disability to recognize spoken languages and/or nonverbal environmental sounds and music despite adequate hearing while spontaneous speech, reading and writing are preserved. Usually, either the bilateral or unilateral temporal lobe, especially the transverse gyral lesions, are responsible for auditory agnosia. Subcortical lesions without cortical damage rarely causes auditory agnosia. We present a 73-year-old right-handed male with generalized auditory agnosia caused by a unilateral subcortical lesion. He was not able to repeat or dictate but to perform fluent and comprehensible speech. He could understand and read written words and phrases. His auditory brainstem evoked potential and audiometry were intact. This case suggested that the subcortical lesion involving unilateral acoustic radiation could cause generalized auditory agnosia.

  2. The Dysexecutive Questionnaire Revised (DEX-R): An extended measure of everyday dysexecutive problems after acquired brain injury.

    PubMed

    Simblett, Sara Katherine; Ring, Howard; Bateman, Andrew

    2016-01-19

    The Dysexecutive Questionnaire (DEX) is a tool for measuring everyday problems experienced with the dysexecutive syndrome. This study investigated the psychometric properties of a revised version of the measure (DEX-R), a comprehensive tool, grounded in current theoretical conceptualisations of frontal lobe function and dysexecutive problems. The aim was to improve measurement of dysexecutive problems following acquired brain injury (ABI). Responses to the DEX-R were collected from 136 men and women who had experienced an ABI (the majority of whom had experienced a stroke or subarachnoid haemorrhage) and where possible, one of their carers or family members (n = 71), who acted as an informant. Rasch analysis techniques were employed to explore the psychometric properties of four newly developed, theoretically distinct subscales based on Stuss model of frontal lobe function and to evaluate the comparative validity and reliability of self and informant ratings of these four subscales. The newly developed subscales were well targeted to the range of dysexecutive problems reported by the current sample and each displayed a good level of internal validity. Both self- and independent-ratings were found to be performing reliably as outcome measures for at least a group-level. This new version of the tool could help guide selection of interventions for different types of dysexecutive problems and provide accurate measurement in neurorehabilitation services.

  3. Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury

    PubMed Central

    Kangas, Maria; McDonald, Skye

    2011-01-01

    Behaviour therapies have a well-established, useful tradition in psychological treatments and have undergone several major revisions. Acceptance and Commitment Therapy (ACT) and mindfulness-based approaches are considered a third wave of behavioural therapies. Emerging evidence for ACT has demonstrated that this paradigm has promising effectiveness in improving functionality and well-being in a variety of populations that have psychological disturbances and/or medical problems. In this review we first evaluate traditional cognitive behavioural therapy (CBT) interventions used to manage psychological problems in distressed individuals who have sustained an acquired brain injury (ABI). We provide an overview of the ACT paradigm and the existent evidence base for this intervention. A rationale is outlined for why ACT-based interventions may have potential utility in assisting distressed individuals who have sustained a mild to moderate ABI to move forward with their lives. We also review emerging evidence that lends preliminary support to the implementation of acceptance and mindfulness-based interventions in the rehabilitation of ABI patient groups. On the basis of existent literature, we recommend that it is an opportune time for forthcoming research to rigorously test the efficacy of ACT-based interventions in facilitating ABI patient groups to re-engage in living a valued and meaningful life, in spite of their neurocognitive and physical limitations. The promising utility of testing the efficacy of the ACT paradigm in the context of multimodal rehabilitation programmes for ABI populations is also addressed. PMID:21246445

  4. The role of virtual motor rehabilitation: a quantitative analysis between acute and chronic patients with acquired brain injury.

    PubMed

    Albiol-Pérez, Sergio; Gil-Gómez, José-Antonio; Llorens, Roberto; Alcañiz, Mariano; Font, Carolina Colomer

    2014-01-01

    Acquired brain injury (ABI) is one of the main problems of disability and death in the world. Its incidence and survival rate are increasing annually. Thus, the number of chronic ABI patients is gradually growing. Traditionally, rehabilitation programs are applied to postacute and acute patients, but recent publications determine that chronic patients may benefit from rehabilitation. Also, in the last few years, the potential of virtual rehabilitation (VR) systems has been demonstrated. However, until now, no previous studies have been carried out to compare the evolution of chronic patients with acute patients in a VR program. To perform this study, we developed a VR system for ABI patients. The system, vestibular virtual rehabilitation (V2R), was designed with clinical specialists. V2R has been tested with 21 people ranging in age from 18 to 80 years old that were classified in two groups: chronic patients and acute patients. The results demonstrate a similar recovery for chronic and acute patients during the intervention period. Also, the results showed that chronic patients stop their improvement when they finish their training. This conclusion encourages us to direct our developments toward VR systems that can be easily integrated at home, allowing chronic patients to have a permanent VR training program.

  5. The nature of self-esteem and its relationship to anxiety and depression in adult acquired brain injury.

    PubMed

    Longworth, Catherine; Deakins, Joseph; Rose, David; Gracey, Fergus

    2016-08-31

    Acquired brain injury (ABI) has a negative impact on self-esteem, which is in turn associated with mood disorders, maladaptive coping and reduced community participation. The aim of the current research was to explore self-esteem as a multi-dimensional construct and identify which factors are associated with symptoms of anxiety or depression. Eighty adults with ABI aged 17-56 years completed the Robson Self-Esteem Scale (RSES), of whom 65 also completed the Hospital Anxiety and Depression Scale; 57.5% of the sample had clinically low self-esteem. The RSES had good internal consistency (α =   .89), and factor analysis identified four factors, which differed from those found previously in other populations. Multiple regression analysis revealed anxiety was differentially predicted by "Self-Worth" and "Self-Efficacy", R(2) =   .44, F(4, 58) =   9, p <   .001, and depression by "Self-Regard", R(2) =   .38, F(4, 58) =   9, p <   .001. A fourth factor, "Confidence", did not predict depression or anxiety. In conclusion, the RSES is a reliable measure of self-esteem after ABI. Self-esteem after ABI is multidimensional and differs in structure from self-esteem in the general population. A multidimensional model of self-esteem may be helpful in development of transdiagnostic cognitive behavioural accounts of adjustment.

  6. Profiles of emotional and behavioral sequelae following acquired brain injury: cluster analysis of the Personality Assessment Inventory.

    PubMed

    Velikonja, Diana; Warriner, Erin; Brum, Christine

    2010-07-01

    Due to the multidimensional nature of symptom complaints within the acquired brain injury (ABI) population, emotional and behavioral profiles obtained from using comprehensive validated measures often yield more relevant information than tools that assess for symptoms of a single diagnostic disorder. The current study used the Personality Assessment Inventory (PAI) to detect emotional and behavioral profiles in a sample of 440 adult ABI patients. Using a rigorous three-step cluster analytic approach, seven clusters were identified, indicating that half of the sample (50%) showed clinically significant affective and behavioral symptoms typified by multiple Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I and/or II features. Two of the subtypes showed severe and diverse affective symptoms but were distinguished from each other by antisocial features and substance use. Two other subtypes, with predominantly internalized presentations, were characterized by mainly depressive and somatic features, and the second by mild anxiety and cognitive disturbance. One group, predominantly externalized presentation, showed high substance use and antisocial features. The other part of the sample (50%) had no significant affective or behavioral complaints but were characterized by two profile types classified as essentially normal, but distinguishable by one having an increased tendency to minimize symptoms. Sex, age, marital status, education/preinjury, and vocation typified various subtypes. The identified profiles taken in the context of important demographic information can provide descriptive insight into the nature of postinjury affective and behavioral symptoms, facilitating more comprehensive conceptualization of the client's needs that can be addressed through more tailored interventions.

  7. Ischaemic and haemorrhagic brain lesions in newborns with seizures and normal Apgar scores.

    PubMed Central

    Mercuri, E.; Cowan, F.; Rutherford, M.; Acolet, D.; Pennock, J.; Dubowitz, L.

    1995-01-01

    Serial ultrasound scans and conventional and diffusion weighted magnetic resonance imaging (MRI) were performed on 16 neonates who presented with seizures. The Apgar scores were normal and subsequently no metabolic or infective cause could be found. The aim of the study was to evaluate the extent to which early sequential imaging can elucidate the cause of seizures in apparently neurologically normal infants. Fourteen of the infants had haemorrhagic or ischaemic lesions on MRI and these were detected by ultrasound scanning in 11. Early ultrasound scanning detected the haemorrhagic lesions but the ischaemic lesions were often not seen until the end of the first week of life. Early MRI, however, was able to detect all the ischaemic lesions. The evolution of the insult could be timed by using serial ultrasound scans and a combination of diffusion weighted and conventional MRI during the first week of life, confirming a perinatal insult even in the absence of fetal distress. Although the aetiology of these lesions remains obscure, serial ultrasound scans will detect the presence of cerebral lesions in neonates presenting with isolated seizures but additional MRI sequences will give better definition on type, site, and extent of the pathology. Images Figures 5 and 6 Figure 2 Figures 3 and 4 Figure 1 PMID:7583609

  8. Participation in contact or collision sports in athletes with epilepsy, genetic risk factors, structural brain lesions, or history of craniotomy.

    PubMed

    Miele, Vincent J; Bailes, Julian E; Martin, Neil A

    2006-10-15

    Despite a plethora of guidelines for return to play following mild head injury, a discussion of when and if an athlete should be allowed to participate in contact or collision sports if he or she sustains a structural brain lesion or after a head injury requiring craniotomy is lacking. The structural lesions discussed include arachnoid cyst, Chiari malformation Type I, cavum septum pellucidum, and the presence of ventriculoperitoneal shunts. Issues unique to this population with respect to the possibility of increased risk of head injury are addressed. The population of athletes with epilepsy and certain genetic risk factors is also discussed. Finally, the ability of athletes to participate in contact or collision sports after undergoing craniotomies for traumatic or congenital abnormalities is evaluated. Several known instances of athletes returning to contact sports following craniotomy are also reviewed.

  9. Manganese uptake and distribution in the brain after methyl bromide-induced lesions in the olfactory epithelia.

    PubMed

    Thompson, Khristy J; Molina, Ramon M; Donaghey, Thomas; Savaliya, Sandeep; Schwob, James E; Brain, Joseph D

    2011-03-01

    Manganese (Mn) is an essential nutrient with potential neurotoxic effects. Mn deposited in the nose is apparently transported to the brain through anterograde axonal transport, bypassing the blood-brain barrier. However, the role of the olfactory epithelial cells in Mn transport from the nasal cavity to the blood and brain is not well understood. We utilized the methyl bromide (MeBr) lesion model wherein the olfactory epithelium fully regenerates in a time-dependent and cell type-specific manner over the course of 6-8 weeks postinjury. We instilled (54)MnCl(2) intranasally at different recovery periods to study the role of specific olfactory epithelial cell types in Mn transport. (54)MnCl(2) was instilled at 2, 4, 7, 21, and 56 days post-MeBr treatment. (54)Mn concentrations in the blood were measured over the first 4-h period and in the brain and other tissues at 7 days postinstillation. Age-matched control rats were similarly studied at 2 and 56 days. Blood and tissue (54)Mn levels were reduced initially but returned to control values by day 7 post-MeBr exposure, coinciding with the reestablishment of sustentacular cells. Brain (54)Mn levels also decreased but returned to control levels only by 21 days, the period near the completion of neuronal regeneration/bulbar reinnervation. Our data show that Mn transport to the blood and brain temporally correlated with olfactory epithelial regeneration post-MeBr injury. We conclude that (1) sustentacular cells are necessary for Mn transport to the blood and (2) intact axonal projections are required for Mn transport from the nasal cavity to the olfactory bulb and brain.

  10. Gelastic epilepsy and hypothalamic hamartomas: neuroanatomical analysis of brain lesions in 100 patients.

    PubMed

    Parvizi, Josef; Le, Scheherazade; Foster, Brett L; Bourgeois, Blaise; Riviello, James J; Prenger, Erin; Saper, Clifford; Kerrigan, John F

    2011-10-01

    Hypothalamic hamartomas present with isolated fits of ictal laughter (gelastic epilepsy) or a combination of gelastic and other types of seizures. Many of these patients also suffer from cognitive decline, neuropsychiatric comorbidities and precocious puberty. Although there is a large body of anecdotal evidence about hypothalamic hamartomas and gelastic seizures, many questions still remain to be answered. For instance, which specific hypothalamic regions are most affected by the location of hamartomas causing laughing versus other types of seizures? Does the neuroanatomical localization of the lesions differ in cases with only gelastic seizures or a combination of gelastic and other types of seizures? Does the location of the lesions correlate with the presence of precocious puberty, and does the type of lesion influence the severity or the type of seizures? In a retrospective review of clinical and structural neuroimaging data from 100 cases of gelastic epilepsy and hypothalamic hamartoma, we aimed to address these questions by analysing the clinical presentation and the neuroanatomical features of the hypothalamic lesions in these patients. Our findings suggest that in all 100 cases, lesions were centred at the level of the mammillary bodies in the posterior hypothalamus. Compared with the patients with pure gelastic seizures (n = 32), those with gelastic and other types of seizures (n = 68) had significantly longer duration of epilepsy (P < 0.001), whereas age of seizure onset, the volume of lesions and the proximity to the mammillary bodies were not different between the two groups. In contrast, patients with cognitive or developmental impairment and those with precocious puberty had significantly larger lesions involving the anterior and posterior hypothalamus.

  11. Exercise partly reverses the effect of maternal separation on hippocampal proteins in 6-hydroxydopamine-lesioned rat brain.

    PubMed

    Dimatelis, J J; Hendricks, S; Hsieh, J; Vlok, N M; Bugarith, K; Daniels, W M U; Russell, V A

    2013-01-01

    Animals subjected to maternal separation stress during the early stages of development display behavioural, endocrine and growth factor abnormalities that mirror the clinical findings in anxiety/depression. In addition, maternal separation has been shown to exacerbate the behavioural deficits induced by 6-hydroxydopamine (6-OHDA) in a rat model of Parkinson's disease. In contrast, voluntary exercise reduced the detrimental effects of 6-OHDA in the rat model. The beneficial effects of exercise appeared to be largely due to compensation in the non-lesioned hemisphere. The aim of the present study was to investigate whether voluntary exercise for 3 weeks could reverse the effects of maternal separation in rats challenged with the neurotoxin 6-OHDA infused into the medial forebrain bundle after 1 week of exercise, at postnatal day 60. The rats were killed 2 weeks later, at postnatal day 74. Their brains were dissected and the hippocampus rapidly removed for proteomic analysis by isobaric tagging (iTRAQ) and quantification of peptides by matrix-assisted laser desorption/ionization tandem mass spectrometry (MALDI-MS/MS). Maternal separation upregulated hippocampal proteins functionally involved in energy metabolism (nucleoside diphosphate kinase B, enolase and triosephosphate isomerase) and synaptic plasticity (α-synuclein, tenascin-R, Ba1-667, brevican and neurocan core protein) in the non-lesioned hemisphere. Exercise reversed many of these changes by downregulating the levels of hippocampal proteins functionally associated with energy metabolism (nucleoside diphosphate kinase B, enolase and triosephosphate isomerase) and synaptic plasticity (α-synuclein, tenascin-R, Ba1-667, brevican and neurocan core protein) in the non-lesioned hemisphere of rats subjected to maternal separation. Exercise and maternal separation therefore appeared to have opposing effects on the hippocampus in the non-lesioned hemisphere of the rat brain. Exercise seemed partly to reverse the

  12. Remote effect of deep-seated vascular brain lesions on cerebral blood flow

    SciTech Connect

    Attig, E.; Capon, A.; Demeurisse, G.; Verhas, M. )

    1990-11-01

    We measured regional cerebral blood flow using the xenon-133 inhalation method, at approximately 1 month after onset, in 60 stroke patients who had no evidence of major carotid artery stenosis or occlusion. Their single lesions (43 infarcts and 17 hematomas) were located in the capsulothalamolenticular region, sparing the cortex. Hemispheric mean cerebral blood flow was reduced on the side of the lesion in 25 patients and on both sides in 20. Regional hypoperfusion was observed in 46 patients (ipsilaterally in 34, bilaterally in 10, and contralaterally in two). Regional hypoperfusion was observed most frequently in the frontal lobe, particularly in the motor and premotor cortices of the prerolandic area. The 46 patients with regional hypoperfusion were compared with the 14 patients without regional hypoperfusion, considering the size and location of the lesion as well as the functional and analytic motor performances. As a rule, the lesion was slightly smaller and more posterior and the functional (p less than 0.001) and analytic (p less than 0.05) motor performances were significantly better in the 14 patients without regional hypoperfusion. Since the xenon-133 inhalation method examines cortical blood flow, we can attribute blood flow reductions resulting from deep-seated lesions to a functional depression akin to diaschisis. Interpretation of the clinical consequences and pathogenesis of this phenomenon requires further sequential and pathologic studies.

  13. Dysexecutive behaviour following deep brain lesions--a different type of disconnection syndrome?

    PubMed

    Krause, Martin; Mahant, Neil; Kotschet, Katya; Fung, Victor S; Vagg, Daniel; Wong, Chong H; Morris, John G L

    2012-01-01

    The suppression of automatic prepotent behaviour in favour of more successful, more 'appropriate' behaviour is the primary function of the frontal lobe. Five frontal-subcortical circuits connect the frontal lobe to the basal ganglia and the thalamus. We report 17 patients with small lesions in the downstream structures of the frontal-subcortical circuits displaying severe dysexecutive behaviour. Positron emission tomography (PET) demonstrated hypometabolism of the frontal lobe in some of these patients. The literature on frontal lobe dysfunction after lesions in the basal ganglia and thalamus is discussed and the semiology of frontal lobe dysfunction in relation to the frontal-subcortical circuits is highlighted. Derived from our findings we suggest a disconnection syndrome of the frontal lobe caused by lesions in the downstream structures of the frontal-subcortical circuits.

  14. The functional organization of trial-related activity in lexical processing after early left hemispheric brain lesions: An event-related fMRI study.

    PubMed

    Fair, Damien A; Choi, Alexander H; Dosenbach, Yannic B L; Coalson, Rebecca S; Miezin, Francis M; Petersen, Steven E; Schlaggar, Bradley L

    2010-08-01

    Children with congenital left hemisphere damage due to perinatal stroke are capable of acquiring relatively normal language functions despite experiencing a cortical insult that in adults often leads to devastating lifetime disabilities. Although this observed phenomenon is accepted, its neurobiological mechanisms are not well characterized. In this paper we examined the functional neuroanatomy of lexical processing in 13 children/adolescents with perinatal left hemispheric damage. In contrast to many previous perinatal infarct fMRI studies, we used an event-related design, which allowed us to isolate trial-related activity and examine correct and error trials separately. Using both group and single subject analysis techniques we attempt to address several methodological factors that may contribute to some discrepancies in the perinatal lesion literature. These methodological factors include making direct statistical comparisons, using common stereotactic space, using both single subject and group analyses, and accounting for performance differences. Our group analysis, investigating correct trial-related activity (separately from error trials), showed very few statistical differences in the non-involved right hemisphere between patients and performance matched controls. The single subject analysis revealed atypical regional activation patterns in several patients; however, the location of these regions identified in individual patients often varied across subjects. These results are consistent with the idea that alternative functional organization of trial-related activity after left hemisphere lesions is in large part unique to the individual. In addition, reported differences between results obtained with event-related designs and blocked designs may suggest diverging organizing principles for sustained and trial-related activity after early childhood brain injuries.

  15. Using multiple imputation to efficiently correct cerebral MRI whole brain lesion and atrophy data in patients with multiple sclerosis.

    PubMed

    Chua, Alicia S; Egorova, Svetlana; Anderson, Mark C; Polgar-Turcsanyi, Mariann; Chitnis, Tanuja; Weiner, Howard L; Guttmann, Charles R G; Bakshi, Rohit; Healy, Brian C

    2015-10-01

    Automated segmentation of brain MRI scans into tissue classes is commonly used for the assessment of multiple sclerosis (MS). However, manual correction of the resulting brain tissue label maps by an expert reader remains necessary in many cases. Since automated segmentation data awaiting manual correction are "missing", we proposed to use multiple imputation (MI) to fill-in the missing manually-corrected MRI data for measures of normalized whole brain volume (brain parenchymal fraction-BPF) and T2 hyperintense lesion volume (T2LV). Automated and manually corrected MRI measures from 1300 patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB) were identified. Simulation studies were conducted to assess the performance of MI with missing data both missing completely at random and missing at random. An imputation model including the concurrent automated data as well as clinical and demographic variables explained a high proportion of the variance in the manually corrected BPF (R(2)=0.97) and T2LV (R(2)=0.89), demonstrating the potential to accurately impute the missing data. Further, our results demonstrate that MI allows for the accurate estimation of group differences with little to no bias and with similar precision compared to an analysis with no missing data. We believe that our findings provide important insights for efficient correction of automated MRI measures to obviate the need to perform manual correction on all cases.

  16. Evaluation of use of reading comprehension strategies to improve reading comprehension of adult college students with acquired brain injury.

    PubMed

    Griffiths, Gina G; Sohlberg, McKay Moore; Kirk, Cecilia; Fickas, Stephen; Biancarosa, Gina

    2016-01-01

    Adults with mild to moderate acquired brain injury (ABI) often pursue post-secondary or professional education after their injuries in order to enter or re-enter the job market. An increasing number of these adults report problems with reading-to-learn. The problem is particularly concerning given the growing population of adult survivors of ABI. Despite the rising need, empirical evaluation of reading comprehension interventions for adults with ABI is scarce. This study used a within-subject design to evaluate whether adult college students with ABI with no more than moderate cognitive impairments benefited from using reading comprehension strategies to improve comprehension of expository text. Integrating empirical support from the cognitive rehabilitation and special education literature, the researchers designed a multi-component reading comprehension strategy package. Participants read chapters from an introductory-level college anthropology textbook in two different conditions: strategy and no-strategy. The results indicated that reading comprehension strategy use was associated with recall of more correct information units in immediate and delayed free recall tasks; more efficient recall in the delayed free recall task; and increased accuracy recognising statements from a sentence verification task designed to reflect the local and global coherence of the text. The findings support further research into using reading comprehension strategies as an intervention approach for the adult ABI population. Future research needs include identifying how to match particular reading comprehension strategies to individuals, examining whether reading comprehension performance improves further through the incorporation of systematic training, and evaluating texts from a range of disciplines and genres.

  17. A Systematic Review of Hospital-to-School Reintegration Interventions for Children and Youth with Acquired Brain Injury

    PubMed Central

    Lindsay, Sally; Hartman, Laura R.; Reed, Nick; Gan, Caron; Thomson, Nicole; Solomon, Beverely

    2015-01-01

    Objectives We reviewed the literature on interventions that aimed to improve hospital-to-school reintegration for children and youth with acquired brain injury (ABI). ABI is the leading cause of disability among children and youth. A successful hospital-to-school reintegration process is essential to the rehabilitative process. However, little is known about the effective components of of such interventions. Methods and findings Our research team conducted a systematic review, completing comprehensive searches of seven databases and selected reference lists for relevant articles published in a peer-reviewed journal between 1989 and June 2014. We selected articles for inclusion that report on studies involving: a clinical population with ABI; sample had an average age of 20 years or younger; an intentional structured intervention affecting hospital-to-school transitions or related components; an experimental design; and a statistically evaluated health outcome. Two independent reviewers applied our inclusion criteria, extracted data, and rated study quality. A meta-analysis was not feasible due to the heterogeneity of the studies reported. Of the 6933 articles identified in our initial search, 17 articles (reporting on 350 preadolescents and adolescents, aged 4–19, (average age 11.5 years, SD: 2.21) met our inclusion criteria. They reported on interventions varying in number of sessions (one to 119) and session length (20 minutes to 4 hours). The majority of interventions involved multiple one-to-one sessions conducted by a trained clinician or educator, homework activities, and parental involvement. The interventions were delivered through different settings and media, including hospitals, schools, and online. Although outcomes varied (with effect sizes ranging from small to large), 14 of the articles reported at least one significant improvement in cognitive, social, psychological, or behavioral functioning or knowledge of ABI. Conclusions Cognitive, behavioral

  18. A retracting wire knife for cutting fiber bundles and making sheet lesions of brain tissue.

    PubMed

    Shibata, M; Russell, I S

    1979-07-01

    A retracting knife which has two cutting wires for the transection of fiber bundles is described. The knife holds the fiber bundles of the stria terminalis between the two cutting wires and transects them by a shearing movement as the wires close. In addition, the feasability of such a knife producing a sheet lesion around the n. caudatus is also described.

  19. Prefrontal Cortex Is Critical for Contextual Processing: Evidence from Brain Lesions

    ERIC Educational Resources Information Center

    Fogelson, Noa; Shah, Mona; Scabini, Donatella; Knight, Robert T.

    2009-01-01

    We investigated the role of prefrontal cortex (PFC) in local contextual processing using a combined event-related potentials and lesion approach. Local context was defined as the occurrence of a short predictive series of visual stimuli occurring before delivery of a target event. Targets were preceded by either randomized sequences of standards…

  20. [Clinical picture, diagnosis and treatment of the brain lesions in lymphosarcomas].

    PubMed

    Setdikov, R A; Kruglova, G V

    1986-01-01

    The study group included 11 patients with brain metastases of disseminated lymphosarcoma. The most common clinical course was progression of the disease which manifested itself in the advancement of general cerebral symptoms as well as focal ones indicative of hemisphere, subcortex or cerebral trunk involvement. High single intravenous doses of cyclophosphamide and rubomycin and radiotherapy or their combination appeared highly effective in cases of brain specific involvement: complete or partial regression of neurologic symptoms was observed in 7 and 3 patients, respectively. Radiation treatment was followed by COP, COAP or CAMP polychemotherapy to curb extracerebral disease progression. Low median survival of patients with brain metastases (5.1 months) was due to extracerebral tumor progression. However, brain metastases were not immediate death-causing factors.

  1. Diagnosis of non-Hodgkin's lymphoma intracerebral mass lesions. Usefulness of /sup 99m/Tc pertechnetate and /sup 67/Ga citrate brain scans

    SciTech Connect

    Zidar, B.L.; Adatepe, M.; Hryschko, F.; Hartsock, R.J.; Kessler, L.; Lyons, T.A.

    1982-11-01

    This paper summarizes the clinical and diagnostic features of five reports of patients with intracerebral, non-Hodgkin's lymphoma. In three patients the brain lesion was the only evidence of lymphoma, while two patients also had concomitant systemic involvement. Four patients had diffuse histiocytic lymphoma and one had a mixed type of malignant lymphoma. In all patients, /sup 99m/Tc and /sup 67/Ga brain scans disclosed discrete areas of increased radionuclide uptake consistent with a mass. In each case, brain blood perfusion studies were normal and brain computerized tomographic (CT) scans and cerebral angiograms produced variable nondiagnostic patterns. Craniotomies in four patients provided histologic confirmation of the non-Hodgkin's lymphoma in the areas of abnormality. The remaining patient had systemic histiocytic lymphoma with concomitant brain lesions that responded to irradiation. The combined use of the above noninvasive modalities in correlation with clinical findings may result in more accurate prebiopsy diagnoses of intracerebral lymphoma.

  2. Effects of brain-stem and thalamic lesions on the corneal reflex: an electrophysiological and anatomical study.

    PubMed

    Ongerboer de Visser, B W; Moffie, D

    1979-09-01

    In 9 patients with Wallenberg's lateral medullary syndrome, one patient with a midbrain lesion involving the right side of the tegmentum, and 2 patients with a thalamic lesion, corneal reflexes were investigated by a new electromyographic technique. The electrophysical results were compared with the results obtained by clinical observation. In the lateral medullary lesions the electrophysiologically obtained reflex responses showed four types of abnormality. Type A consisted of a bilateral delay and type B a bilateral absence of the corneal reflex response to stimulation on the affected side in combination with a normal reflex response on both sides when the cornea on the normal side was stimulated. Type C, which was present in one case, and type D which was seen in 3 cases, consisted of a bilateral absence of the corneal reflex upon stimulation on the affected side; stimulation on the unaffected side produced a normal reflex response on the intact side in combination with, respectively, a delay or absence of the corneal reflex response on the affected side. Comparison of the clinical observations with the electrophysiological findings revealed minor discrepancies in type A and B abnormalities. However, the electrophysiological type C and D abnormalities were not detected by clinical observation. These findings demonstrate that electrophysiological recording of the corneal reflex may reveal clinically undetectable abnormalities. From the electrophysiological findings it is concluded that the corneal reflex is conducted along medullary pathways running both ipsilaterally and contralaterally from the stimulated side before connecting, respectively, with the ipsilateral and contralateral facial nucleus. From the anatomical findings it is suggested that the ascending pathways from the spinal fifth nerve complex to the facial nuclei are located in the lateral reticular formation of the lower brain-stem. The normal corneal reflex responses in the presence of thalamic and

  3. Increasing the contrast of the brain MR FLAIR images using fuzzy membership functions and structural similarity indices in order to segment MS lesions.

    PubMed

    Bijar, Ahmad; Khayati, Rasoul; Peñalver Benavent, Antonio

    2013-01-01

    Segmentation is an important step for the diagnosis of multiple sclerosis (MS). This paper presents a new approach to the fully automatic segmentation of MS lesions in Fluid Attenuated Inversion Recovery (FLAIR) Magnetic Resonance (MR) images. With the aim of increasing the contrast of the FLAIR MR images with respect to the MS lesions, the proposed method first estimates the fuzzy memberships of brain tissues (i.e., the cerebrospinal fluid (CSF), the normal-appearing brain tissue (NABT), and the lesion). The procedure for determining the fuzzy regions of their member functions is performed by maximizing fuzzy entropy through Genetic Algorithm. Research shows that the intersection points of the obtained membership functions are not accurate enough to segment brain tissues. Then, by extracting the structural similarity (SSIM) indices between the FLAIR MR image and its lesions membership image, a new contrast-enhanced image is created in which MS lesions have high contrast against other tissues. Finally, the new contrast-enhanced image is used to segment MS lesions. To evaluate the result of the proposed method, similarity criteria from all slices from 20 MS patients are calculated and compared with other methods, which include manual segmentation. The volume of segmented lesions is also computed and compared with Gold standard using the Intraclass Correlation Coefficient (ICC) and paired samples t test. Similarity index for the patients with small lesion load, moderate lesion load and large lesion load was 0.7261, 0.7745 and 0.8231, respectively. The average overall similarity index for all patients is 0.7649. The t test result indicates that there is no statistically significant difference between the automatic and manual segmentation. The validated results show that this approach is very promising.

  4. Presupposition and implication of truth: linguistic deficits following early brain lesions.

    PubMed

    Eisele, J A; Lust, B; Aram, D M

    1998-02-15

    Twenty-four children (4-17 years) with unilateral left (N = 14) or right (N = 10) hemisphere damage and 24 age-matched controls were tested on their ability to presuppose the truth of factive sentences e.g., "Max knew that he locked the door," and to infer the truth or falsity of implicative sentences "Max remembered to lock the door." Experimental sentence types varied according to the type of inference, the semantic features of the verb (factive vs. implicative), the presence and type of negation (lexical or syntactic), and the syntax of the complement (tensed or infinitive). Relative to age-matched controls, left lesion subjects were deficient in both their presupposition and implication performance, particularly when such inferences required the computation of negation scope. Right lesion subjects exhibited a somewhat more selective deficit; one limited to implication, but not presupposition, and one limited to lexical but not syntactic forms of negation.

  5. [CLIPPERS syndrome with atypical distribution of lesions in magnetic resonance imaging of the brain].

    PubMed

    Canneti, Beatrice; Mosqueira, Antonio J; Gilo, Francisco; Carreras, Teresa; Barbosa, Antonio; Meca-Lallana, Virginia; Vivancos, José

    2013-10-16

    Introduccion. El sindrome CLIPPERS (chronic lymphocytic in?ammation with pontine perivascular enhancement responsive to steroids) es un proceso inflamatorio del sistema nervioso central cuyo rasgo distintivo son las lesiones puntiformes en el troncoencefalo captantes en los estudios de resonancia magnetica. Clinicamente, cursa con disartria, ataxia y diplopia, y suele responder a corticoides. Anatomopatologicamente, aparecen infiltrados de linfocitos T en los espacios perivasculares troncoencefalicos. Caso clinico. Mujer de 40 años con cuadro de instauracion subaguda de diplopia binocular, ataxia y disartria. En la resonancia magnetica cerebral presento lesiones puntiformes hipertintensas en secuencia T2 en el tronco, cerebelo, diencefalo y areas cortico-subcorticales bihemisfericas, que realzaron con contraste. Se realizo un estudio etiologico para descartar un origen infeccioso, neoplasico o inflamatorio subyacente, que resulto negativo. La paciente recibio tratamiento en dos ocasiones con metilprednisolona, con descenso progresivo de la dosis, con buena respuesta. Conclusiones. La diplopia y la ataxia, como en nuestro caso, estan presentes practicamente siempre. Los hallazgos en la RM consisten en lesiones captantes puntiformes localizadas en la protuberancia con extension hacia el cerebelo, ganglios basales y cuerpo calloso, con gradiente de captacion menor conforme se alejan rostralmente hacia la corteza, y caudalmente hacia la medula. En el caso de nuestra paciente, este gradiente no se respeta, encontrandose una densidad similar de las lesiones a nivel supratentorial. El diagnostico diferencial es amplio y justifica un estudio diagnostico extenso, y en casos seleccionados la biopsia cerebral. El curso de la enfermedad es remitente-recurrente, y el pronostico mejora cuanto mas precoz y prolongado es el tiempo de corticoterapia.

  6. [Chronic visual hallucinations and illusions following brain lesions. A single case study].

    PubMed

    Kasten, E; Müller-Oehring, E; Poggel, D; Sabel, B A

    1998-02-01

    Lesions of the visual system do not necessarily lead to deficits in visual function. In some cases, there may even occur Positive Spontaneous Visual Phenomena (PSVP) following cerebral damage. We present data from a male patient with continuous, long-term visual illusions after having experienced cerebral infarction at the age of 56. Basing on conventional Magnetic Resonance Imaging, lesions could be located in areas supported by the lateral and medial occipital artery. Initially, homonymous hemianopsia of the right visual field was found in perimetric examinations, but in the course of six months, visual function recovered completely. Ever since the incident, the patient has been suffering from permanent photopsia, intense colourful visual hallucinations and perseverations located in the former defective area which continued unabated even after the remission of his visual field defects. While many authors have published data on PSVP lasting for several seconds, usually vanishing completely within days or weeks after cerebral lesion, in our patient the symptoms continued over a period of so far nine months. Surprisingly, he was even able to make drawings of his illusions so that we were able to include some of his pictures.

  7. Behavioural alterations relevant to developmental brain disorders in mice with neonatally induced ventral hippocampal lesions.

    PubMed

    Naert, Arne; Gantois, Ilse; Laeremans, Annelies; Vreysen, Samme; Van den Bergh, Gert; Arckens, Lut; Callaerts-Vegh, Zsuzsanna; D'Hooge, Rudi

    2013-05-01

    Neonatal lesioning of the ventral hippocampus (vHc) in rats has served as a useful heuristic animal model to elucidate neurodevelopmental mechanisms of schizophrenia (SCZ). In the current study we have established that this procedure can be applied to model SCZ symptomatology in mice. Neonatal mice (postnatal day 6) were anaesthetised by hypothermia and electrolytic lesions of the vHc were induced. We observed locomotor hyperactivity at prepubertal and adult age and hypersensitivity to amphetamine. Furthermore, working memory deficits were observed in Y-maze (spontaneous alternation) and T-maze (exploration of a novel arm) test protocols. Decreased anxious behaviour in the elevated plus maze and increased sociability were also observed. These changes were dependent on lesion size. No differences were observed in prepulse inhibition of the startle reflex, latent inhibition, spatial memory (Morris water maze), problem solving capacities (syringe puzzle) and ability to discriminate between different unfamiliar mice. The presented findings might further help to identify neurobiological mechanisms of neurodevelopmental disorders.

  8. Correlation between Patent Foramen Ovale, Cerebral "Lesions" and Neuropsychometric Testing in Experienced Sports Divers: Does Diving Damage the Brain?

    PubMed

    Balestra, Costantino; Germonpré, Peter

    2016-01-01

    SCUBA diving exposes divers to decompression sickness (DCS). There has been considerable debate whether divers with a Patent Foramen Ovale of the heart have a higher risk of DCS because of the possible right-to-left shunt of venous decompression bubbles into the arterial circulation. Symptomatic neurological DCS has been shown to cause permanent damage to brain and spinal cord tissue; it has been suggested that divers with PFO may be at higher risk of developing subclinical brain lesions because of repeated asymptomatic embolization of decompression-induced nitrogen bubbles. These studies however suffer from several methodological flaws, including self-selection bias. We recruited 200 volunteer divers from a recreational diving population who had never suffered from DCS; we then randomly selected 50 of those for further investigation. The selected divers underwent brain Magnetic Resonance Imaging to detect asymptomatic brain lesions, contrast trans-oesophageal echocardiography for PFO, and extensive neuro-psychometric testing. Neuro-psychometry results were compared with a control group of normal subjects and a separate control group for subjects exposed to neurotoxic solvents. Forty two divers underwent all the tests and are included in this report. Grade 2 Patent Foramen Ovale was found in 16 (38%) of the divers; brain Unidentified Bright Objects (UBO's) were found in 5 (11.9%). There was no association between PFO and the presence of UBO's (P = 0.693) or their size (p = 0.5) in divers. Neuropsychometric testing in divers was significantly worse from controls in two tests, Digit Span Backwards (DSB; p < 0.05) and Symbol-Digit-Substitution (SDS; p < 0.01). Compared to subjects exposed to neurotoxic solvents, divers scored similar on DSB and SDS tests, but significantly better on the Simple Reaction Time (REA) and Hand-Eye Coordination (EYE) tests. There was no correlation between PFO, number of UBO's and any of the neuro-psychometric tests. We conclude that for

  9. [Cognitive functions and personality traits in patients with brain tumors: the role of lesion localization].

    PubMed

    Razumnikova, O M; Perfil'ev, A M; Stupak, V V

    2014-01-01

    Personality traits and cognitive functions were studied depending on a tumor localization in the brain in 21 neurosurgical patients and the results were compared with a control group. In patients with brain damage, mostly affected were personality traits associated with emotion regulation and social interaction (neuroticism, psychoticism and social conformity). Increases in psychoticism and decreases in neuroticism were more expressed in patients with a left-hemisphere localization of tumors. The tumor-induced decrease in cognitive abilities was more presented in performing figurative tasks and less in verbal ones. Verbal functions were more decreased in the group with frontal localization of tumor compared to that with parietal localization.

  10. Zero in the brain: A voxel-based lesion-symptom mapping study in right hemisphere damaged patients.

    PubMed

    Benavides-Varela, Silvia; Passarini, Laura; Butterworth, Brian; Rolma, Giuseppe; Burgio, Francesca; Pitteri, Marco; Meneghello, Francesca; Shallice, Tim; Semenza, Carlo

    2016-04-01

    Transcoding numerals containing zero is more problematic than transcoding numbers formed by non-zero digits. However, it is currently unknown whether this is due to zeros requiring brain areas other than those traditionally associated with number representation. Here we hypothesize that transcoding zeros entails visuo-spatial and integrative processes typically associated with the right hemisphere. The investigation involved 22 right-brain-damaged patients and 20 healthy controls who completed tests of reading and writing Arabic numbers. As expected, the most significant deficit among patients involved a failure to cope with zeros. Moreover, a voxel-based lesion-symptom mapping (VLSM) analysis showed that the most common zero-errors were maximally associated to the right insula which was previously related to sensorimotor integration, attention, and response selection, yet for the first time linked to transcoding processes. Error categories involving other digits corresponded to the so-called Neglect errors, which however, constituted only about 10% of the total reading and 3% of the writing mistakes made by the patients. We argue that damage to the right hemisphere impairs the mechanism of parsing, and the ability to set-up empty-slot structures required for processing zeros in complex numbers; moreover, we suggest that the brain areas located in proximity to the right insula play a role in the integration of the information resulting from the temporary application of transcoding procedures.

  11. IL-10 deficiency exacerbates the brain inflammatory response to permanent ischemia without preventing resolution of the lesion

    PubMed Central

    Pérez-de Puig, Isabel; Miró, Francesc; Salas-Perdomo, Angélica; Bonfill-Teixidor, Ester; Ferrer-Ferrer, Maura; Márquez-Kisinousky, Leonardo; Planas, Anna M

    2013-01-01

    Stroke induces inflammation that can aggravate brain damage. This work examines whether interleukin-10 (IL-10) deficiency exacerbates inflammation and worsens the outcome of permanent middle cerebral artery occlusion (pMCAO). Expression of IL-10 and IL-10 receptor (IL-10R) increased after ischemia. From day 4, reactive astrocytes showed strong IL-10R immunoreactivity. Interleukin-10 knockout (IL-10 KO) mice kept in conventional housing showed more mortality after pMCAO than the wild type (WT). This effect was associated with the presence of signs of colitis in the IL-10 KO mice, suggesting that ongoing systemic inflammation was a confounding factor. In a pathogen-free environment, IL-10 deficiency slightly increased infarct volume and neurologic deficits. Induction of proinflammatory molecules in the IL-10 KO brain was similar to that in the WT 6 hours after ischemia, but was higher at day 4, while differences decreased at day 7. Deficiency of IL-10 promoted the presence of more mature phagocytic cells in the ischemic tissue, and enhanced the expression of M2 markers and the T-cell inhibitory molecule CTLA-4. These findings agree with a role of IL-10 in attenuating local inflammatory reactions, but do not support an essential function of IL-10 in lesion resolution. Upregulation of alternative immunosuppressive molecules after brain ischemia can compensate, at least in part, the absence of IL-10. PMID:24022622

  12. [Selective stimulations and lesions of the rat brain nuclei as the models for research of the human sleep pathology mechanisms].

    PubMed

    Šaponjić, Jasna

    2011-01-01

    Many complex behavioral phenomena such as sleep can not be explained without multidisciplinary experimental approach, and complementay approaches in the animal models "in vivo" and human studies. Electrophysiological, pharmacological, anatomical and immunohistochemical techniques, and particularly stereotaxically guided local nanovolume microinjection technique, enable us to selectively stimulate and lesion the brain nuclei or their specific neuronal subpopulation, and to reslove the mechanisms of certain brain structure regulatory role, and its afferent-efferent connectivity within the brain. Local stereotaxically guided nanovolume microinjection technique enable us to investigate in animals the brain nulcei functional topography with a resolution of < or = 10 microM, and at a level of 300 microM of effective radius within the brain tissue "in vivo". The advantage of local glutamate or DL- homocysteic acid microinjection stimulation or local excitotoxic (glutamate, ibotenic acid, IgG saporin) microinjection lesion over electrical stimulation/lesion of the same neuronal population are that they reduces the likelihood of activation/lesion of fibers of passage. Much of our knowledge of the sleep neuronal substrates is based on animal studies primarly in cat and rat. Selective pharmacological stimulation of the pedunculopontine tegmentum (PPT) in freely moving rat, using glutamate microinjection, proved that excitation of its cholinergic part is necessary for induction of wakefulness or REM (Datta S, 2001). Local nanovolume glutamate microinjection into PPT of anesthetized rats (Saponjić et al, 2003a) additionally evidenced P-wave and respiratory regulating neuronal subpopulation within the cholinergic compartment of PPT (apneogenic neuronal zone). Local microinjection of serotonin and noradrenaline into cholinergic PPT apneogenic zone evidenced their opposed impact through PPT on breathing, in contrast to their convergent regulatory role in behavioral state control

  13. Intelligent speed adaptation as an assistive device for drivers with acquired brain injury: a single-case field experiment.

    PubMed

    Klarborg, Brith; Lahrmann, Harry; NielsAgerholm; Tradisauskas, Nerius; Harms, Lisbeth

    2012-09-01

    Intelligent speed adaptation (ISA) was tested as an assistive device for drivers with an acquired brain injury (ABI). The study was part of the "Pay as You Speed" project (PAYS) and used the same equipment and technology as the main study (Lahrmann et al., in press-a, in press-b). Two drivers with ABI were recruited as subjects and had ISA equipment installed in their private vehicle. Their speed was logged with ISA equipment for a total of 30 weeks of which 12 weeks were with an active ISA user interface (6 weeks=Baseline 1; 12 weeks=ISA period; 12 weeks=Baseline 2). The subjects participated in two semi-structured interviews concerning their strategies for driving with ABI and for driving with ISA. Furthermore, they gave consent to have data from their clinical journals and be a part of the study. The two subjects did not report any instances of being distracted or confused by ISA, and in general they described driving with ISA as relaxed. ISA reduced the percentage of the total distance that was driven with a speed above the speed limit (PDA), but the subjects relapsed to their previous PDA level in Baseline 2. This suggests that ISA is more suited as a permanent assistive device (i.e. cognitive prosthesis) than as a temporary training device. As ABI is associated with a multitude of cognitive deficits, we developed a conceptual framework, which focused on the cognitive parameters that have been shown to relate to speeding behaviour, namely "intention to speed" and "inattention to speeding". The subjects' combined status on the two independent parameters made up their "speeding profile". A comparison of the speeding profiles and the speed logs indicated that ISA in the present study was more efficient in reducing inattention to speeding than affecting intention to speed. This finding suggests that ISA might be more suited for some neuropsychological profiles than for others, and that customisation of ISA for different neuropsychological profiles may be required

  14. Effectiveness of a Very Early Stepping Verticalization Protocol in Severe Acquired Brain Injured Patients: A Randomized Pilot Study in ICU

    PubMed Central

    Bonini, Sara; Maffia, Sara; Molatore, Katia; Sebastianelli, Luca; Zarucchi, Alessio; Matteri, Diana; Ercoli, Giuseppe; Maestri, Roberto

    2016-01-01

    Background and Objective Verticalization was reported to improve the level of arousal and awareness in patients with severe acquired brain injury (ABI) and to be safe in ICU. We evaluated the effectiveness of a very early stepping verticalization protocol on their functional and neurological outcome. Methods Consecutive patients with Vegetative State or Minimally Conscious State were enrolled in ICU on the third day after an ABI. They were randomized to undergo conventional physiotherapy alone or associated to fifteen 30-minute sessions of verticalization, using a tilt table with robotic stepping device. Once stabilized, patients were transferred to our Neurorehabilitation unit for an individualized treatment. Outcome measures (Glasgow Coma Scale, Coma Recovery Scale revised -CRSr-, Disability Rating Scale–DRS- and Levels of Cognitive Functioning) were assessed on the third day from the injury (T0), at ICU discharge (T1) and at Rehab discharge (T2). Between- and within-group comparisons were performed by the Mann-Whitney U test and Wilcoxon signed-rank test, respectively. Results Of the 40 patients enrolled, 31 completed the study without adverse events (15 in the verticalization group and 16 in the conventional physiotherapy). Early verticalization started 12.4±7.3 (mean±SD) days after ABI. The length of stay in ICU was longer for the verticalization group (38.8 ± 15.7 vs 25.1 ± 11.2 days, p = 0.01), while the total length of stay (ICU+Neurorehabilitation) was not significantly different (153.2 ± 59.6 vs 134.0 ± 61.0 days, p = 0.41). All outcome measures significantly improved in both groups after the overall period (T2 vs T0, p<0.001 all), as well as after ICU stay (T1 vs T0, p<0.004 all) and after Neurorehabilitation (T2 vs T1, p<0.004 all). The improvement was significantly better in the experimental group for CRSr (T2-T0 p = 0.033, T1-T0 p = 0.006) and (borderline) for DRS (T2-T0 p = 0.040, T1-T0 p = 0.058). Conclusions A stepping verticalization

  15. Accuracy for detection of simulated lesions: comparison of fluid-attenuated inversion-recovery, proton density--weighted, and T2-weighted synthetic brain MR imaging

    NASA Technical Reports Server (NTRS)

    Herskovits, E. H.; Itoh, R.; Melhem, E. R.

    2001-01-01

    OBJECTIVE: The objective of our study was to determine the effects of MR sequence (fluid-attenuated inversion-recovery [FLAIR], proton density--weighted, and T2-weighted) and of lesion location on sensitivity and specificity of lesion detection. MATERIALS AND METHODS: We generated FLAIR, proton density-weighted, and T2-weighted brain images with 3-mm lesions using published parameters for acute multiple sclerosis plaques. Each image contained from zero to five lesions that were distributed among cortical-subcortical, periventricular, and deep white matter regions; on either side; and anterior or posterior in position. We presented images of 540 lesions, distributed among 2592 image regions, to six neuroradiologists. We constructed a contingency table for image regions with lesions and another for image regions without lesions (normal). Each table included the following: the reviewer's number (1--6); the MR sequence; the side, position, and region of the lesion; and the reviewer's response (lesion present or absent [normal]). We performed chi-square and log-linear analyses. RESULTS: The FLAIR sequence yielded the highest true-positive rates (p < 0.001) and the highest true-negative rates (p < 0.001). Regions also differed in reviewers' true-positive rates (p < 0.001) and true-negative rates (p = 0.002). The true-positive rate model generated by log-linear analysis contained an additional sequence-location interaction. The true-negative rate model generated by log-linear analysis confirmed these associations, but no higher order interactions were added. CONCLUSION: We developed software with which we can generate brain images of a wide range of pulse sequences and that allows us to specify the location, size, shape, and intrinsic characteristics of simulated lesions. We found that the use of FLAIR sequences increases detection accuracy for cortical-subcortical and periventricular lesions over that associated with proton density- and T2-weighted sequences.

  16. Arithmetic and Brain Connectivity: Mental Calculation in Adolescents with Periventricular Lesions

    ERIC Educational Resources Information Center

    Pavlova, Marina; Sokolov, Alexander N.; Krageloh-Mann, Ingeborg

    2009-01-01

    The ability for mental calculation represents a fundamental prerequisite for development of intelligence, which is predictive for educational and professional success in life. Many individuals with calculation difficulties are survivors of premature birth. The brain mechanisms of these deficits are, however, largely unknown. In this work, we…

  17. Rare and challenging extra-axial brain lesions: CT and MRI findings with clinico-radiological differential diagnosis and pathological correlation

    PubMed Central

    Demir, Mustafa Kemal; Yapıcıer, Özlem; Onat, Elif; Toktaş, Zafer Orkun; Akakın, Akın; Urgun, Kamran; Kılıç, Türker

    2014-01-01

    There are many kinds of extra-axial brain tumors and tumor-like lesions, and definitive diagnosis is complicated in some cases. In this pictorial essay, we present rare and challenging extra-axial brain lesions including neuroenteric cyst, primary leptomeningeal melanomatosis, isolated dural neurosarcoidosis, intradiploic epidermoid cyst, ruptured dermoid cyst, intraventricular cavernoma, and cavernous hemangioma of the skull with imaging findings and clinico-radiological differential diagnosis, including the pathologic correlation. Familiarity with these entities may improve diagnostic accuracy and patient management. PMID:25010368

  18. Lightning injury as a blast injury of skull, brain, and visceral lesions: clinical and experimental evidences.

    PubMed

    Ohashi, M; Hosoda, Y; Fujishiro, Y; Tuyuki, A; Kikuchi, K; Obara, H; Kitagawa, N; Ishikawa, T

    2001-12-01

    The present study attempts to better understand the mechanism of injuries associated with direct lightning strikes. We reviewed the records of 256 individuals struck by lightning between 1965 and 1999, including 56 people who were killed. Basal skull fracture, intracranial haemorrhage, pulmonary haemorrhage, or solid organ rupture was suspected in three men who died. Generally these lesions have been attributed to current flow or falling after being struck. However, examination of surface injuries sustained suggested that the true cause was concussion secondary to blast injury resulting from vaporization of water on the body surface by a surface flashover spark. To investigate this hypothesis, an experimental model of a lightning strike was created in the rat. Saline-soaked blotting paper was used to simulate wet clothing or skin, and an artificial lightning impulse was applied. The resultant lesions were consistent with our hypothesis that the blast was reinforced by the concussive effect of water vaporization. The concordance between the clinical and experimental evidence argues strongly for blast injury as an important source of morbidity and mortality in lightning strikes.

  19. Neuroprotection of cerebrolysin in tissue culture models of brain ischemia: post lesion application indicates a wide therapeutic window.

    PubMed

    Schauer, E; Wronski, R; Patockova, J; Moessler, H; Doppler, E; Hutter-Paier, B; Windisch, M

    2006-07-01

    All attempts to reduce neuronal damage after acute brain ischemia by the use of neuroprotective compounds have failed to prove efficacy in clinical trials so far. One of the main reasons might be the relatively narrow time window for intervention. In this study 2 different tissue culture models of ischemia, excitotoxic lesion by the use of glutamate and oxygen-glucose deprivation (OGD), were used to investigate the effects of delayed application of Cerebrolysin (Cere) on neuronal survival. This drug consists of low molecular weight peptides with neuroprotective and neurotrophic properties similar to naturally occurring growth factors. After both types of lesion, acute as well as delayed treatment with Cere resulted in a dose dependent and significant rescue of neurons. In the model of excitotoxic cell death significant drug effects were found even when the treatment started with a delay of 96 hours after addition of glutamate. In the OGD model pronounced effects were found after 48 hours delay of treatment, and even after 72 hours a small but significant rescue of neurons was detected. The neuroprotective effects of a single addition of Cerebrolysin to the culture medium resulted in significant protection until end of the experiments which was up to 2 weeks after the initial lesion. A shift of the efficacious dosages from low to high concentrations indicates that most likely active compounds are used up, indicating that multiple dosing might even increase the effect size. In conclusion the results indicate that Cere displays a relatively wide therapeutic time window which might be explained by a combination of acute neuroprotective properties and neurotrophic efficacy.

  20. Is the Motor System Necessary for Processing Action and Abstract Emotion Words? Evidence from Focal Brain Lesions

    PubMed Central

    Dreyer, Felix R.; Frey, Dietmar; Arana, Sophie; von Saldern, Sarah; Picht, Thomas; Vajkoczy, Peter; Pulvermüller, Friedemann

    2015-01-01

    Neuroimaging and neuropsychological experiments suggest that modality-preferential cortices, including motor- and somatosensory areas, contribute to the semantic processing of action related concrete words. Still, a possible role of sensorimotor areas in processing abstract meaning remains under debate. Recent fMRI studies indicate an involvement of the left sensorimotor cortex in the processing of abstract-emotional words (e.g., “love”) which resembles activation patterns seen for action words. But are the activated areas indeed necessary for processing action-related and abstract words? The current study now investigates word processing in two patients suffering from focal brain lesion in the left frontocentral motor system. A speeded Lexical Decision Task on meticulously matched word groups showed that the recognition of nouns from different semantic categories – related to food, animals, tools, and abstract-emotional concepts – was differentially affected. Whereas patient HS with a lesion in dorsolateral central sensorimotor systems next to the hand area showed a category-specific deficit in recognizing tool words, patient CA suffering from lesion centered in the left supplementary motor area was primarily impaired in abstract-emotional word processing. These results point to a causal role of the motor cortex in the semantic processing of both action-related object concepts and abstract-emotional concepts and therefore suggest that the motor areas previously found active in action-related and abstract word processing can serve a meaning-specific necessary role in word recognition. The category-specific nature of the observed dissociations is difficult to reconcile with the idea that sensorimotor systems are somehow peripheral or ‘epiphenomenal’ to meaning and concept processing. Rather, our results are consistent with the claim that cognition is grounded in action and perception and based on distributed action perception circuits reaching into

  1. [Amyloid beta-related angiitis: brain lesions showing leptomeningeal gadolinium enhancement on MRI and characteristic surgical pathologic features].

    PubMed

    Koike, Yuka; Ouchi, Haruka; Sato, Tomoe; Shimbo, Junsuke; Sato, Aki; Sasaki, Osamu; Shibuya, Hiroyuki; Okamoto, Kouichirou; Kakita, Akiyoshi; Igarashi, Shuichi

    2013-06-01

    Amyloid-β-related angiitis (ABRA) of the CNS occurs in association with vasculitis of small-and medium-sized leptomeningeal arteries. Here, we describe the clinicopathological features of a 76-year-old man with ABRA. The patient suffered progressive truncal oscillation, aphasia, and recent memory disturbance with a subacute disease onset. His cerebrospinal fluid showed a mild increase in protein levels (101 mg/dL) and pleocytosis (8/mm(3)). High-intensity brain lesion were detected on T(2)-weighted and FLAIR MRI scans, and prominent spread of gadolinium enhancement spreading was observed through the sulci of the left occipital and temporal lobes and left cerebellar hemisphere. A biopsy of the left temporal lesion showed a granulomatous and angiodestructive inflammation with infiltration of many CD4(+) T-lymphocytes and multinucleated giant cells and with fibrinoid necrosis of the arterial walls in the subarachnoid space. Immunolabeling for Aβ(1-40) revealed the abundant deposition of this protein in the affected arteries. On the basic of the diagnosis of ABRA, immunosuppressive therapy was conducted, and it ameliorated the clinical course.

  2. Developmental Coordination Disorder: Is Clumsy Motor Behavior Caused by a Lesion of the Brain at Early Age?

    PubMed Central

    Hadders-Algra, Mijna

    2003-01-01

    Children presenting with Developmental Coordination Disorder or clumsiness often exhibit signs of minor neurological dysfunction (MND). The data of the Groningen Perinatal Project, a long-term follow-up project .on the relations between prenatal and perinatal adversities and neurological, behavioral, and cognitive development revealed that two basic forms of MND can be distinguished: simple and complex MND. During school age children with simple MND are characterized by the presence of one or two dysfunctional clusters of MND, in adolescence by the presence of choreiform dyskinesia or hypotonia. Probably the major sources of origin of simple MND are genetic constitution and stress during early life. Simple MND might reflect the lower tail of the normal distribution of the quality of non-pathological brain function. In line with this hypothesis is the finding that simple MND is associated with only a moderately increased risk for learning and behavioral problems. Children with complex MND present at school age with at least three dysfunctional clusters of MND, in adolescence with problems in fine manipulation or coordination. Perinatal adversities play an evident etiological role in the development of complex MND, suggesting that it might be attributed to a lesion of the brain at early age. In line with this idea is the finding that complex MND shows .a strong correlation with attention and learning problems. PMID:14640306

  3. Clinical usefulness of the pendulum test using a NK table to measure the spasticity of patients with brain lesions.

    PubMed

    Kim, Yong-Wook

    2013-10-01

    . [Purpose] The purpose of the present study was to investigate the clinical usefulness (reliability and validity) of the pendulum test using a Noland-Kuckhoff (NK) table with an attached electrogoniometer to measure the spasticity of patients with brain lesions. [Subjects] The subjects were 31 patients with stroke or traumatic brain injury. [Methods] The intraclass correlation coefficient (ICC) was used to verify the test-retest reliability of spasticity measures obtained using the pendulum test. Pearson's product correlation coefficient was used to examine the validity of the pendulum test using the amplitude of the patellar tendon reflex (PTR) test, an objective and quantitative measure of spasticity. [Results] The test-retest reliability was high, reflecting a significant correlation between the test and the retest (ICCs = 0.95-0.97). A significant negative correlation was found between the amplitude of the PTR test and the four variables measured in the pendulum test (r = -0.77- -0.85). [Conclusion] The pendulum test using a NK table is an objective measure of spasticity and can be used in the clinical setting in place of more expensive and complicated equipment. Further studies are needed to investigate the therapeutic effect of this method on spasticity.

  4. Neuroanatomical substrates of action perception and understanding: an anatomic likelihood estimation meta-analysis of lesion-symptom mapping studies in brain injured patients.

    PubMed

    Urgesi, Cosimo; Candidi, Matteo; Avenanti, Alessio

    2014-01-01

    Several neurophysiologic and neuroimaging studies suggested that motor and perceptual systems are tightly linked along a continuum rather than providing segregated mechanisms supporting different functions. Using correlational approaches, these studies demonstrated that action observation activates not only visual but also motor brain regions. On the other hand, brain stimulation and brain lesion evidence allows tackling the critical question of whether our action representations are necessary to perceive and understand others' actions. In particular, recent neuropsychological studies have shown that patients with temporal, parietal, and frontal lesions exhibit a number of possible deficits in the visual perception and the understanding of others' actions. The specific anatomical substrates of such neuropsychological deficits however, are still a matter of debate. Here we review the existing literature on this issue and perform an anatomic likelihood estimation meta-analysis of studies using lesion-symptom mapping methods on the causal relation between brain lesions and non-linguistic action perception and understanding deficits. The meta-analysis encompassed data from 361 patients tested in 11 studies and identified regions in the inferior frontal cortex, the inferior parietal cortex and the middle/superior temporal cortex, whose damage is consistently associated with poor performance in action perception and understanding tasks across studies. Interestingly, these areas correspond to the three nodes of the action observation network that are strongly activated in response to visual action perception in neuroimaging research and that have been targeted in previous brain stimulation studies. Thus, brain lesion mapping research provides converging causal evidence that premotor, parietal and temporal regions play a crucial role in action recognition and understanding.

  5. Neuroanatomical substrates of action perception and understanding: an anatomic likelihood estimation meta-analysis of lesion-symptom mapping studies in brain injured patients

    PubMed Central

    Urgesi, Cosimo; Candidi, Matteo; Avenanti, Alessio

    2014-01-01

    Several neurophysiologic and neuroimaging studies suggested that motor and perceptual systems are tightly linked along a continuum rather than providing segregated mechanisms supporting different functions. Using correlational approaches, these studies demonstrated that action observation activates not only visual but also motor brain regions. On the other hand, brain stimulation and brain lesion evidence allows tackling the critical question of whether our action representations are necessary to perceive and understand others’ actions. In particular, recent neuropsychological studies have shown that patients with temporal, parietal, and frontal lesions exhibit a number of possible deficits in the visual perception and the understanding of others’ actions. The specific anatomical substrates of such neuropsychological deficits however, are still a matter of debate. Here we review the existing literature on this issue and perform an anatomic likelihood estimation meta-analysis of studies using lesion-symptom mapping methods on the causal relation between brain lesions and non-linguistic action perception and understanding deficits. The meta-analysis encompassed data from 361 patients tested in 11 studies and identified regions in the inferior frontal cortex, the inferior parietal cortex and the middle/superior temporal cortex, whose damage is consistently associated with poor performance in action perception and understanding tasks across studies. Interestingly, these areas correspond to the three nodes of the action observation network that are strongly activated in response to visual action perception in neuroimaging research and that have been targeted in previous brain stimulation studies. Thus, brain lesion mapping research provides converging causal evidence that premotor, parietal and temporal regions play a crucial role in action recognition and understanding. PMID:24910603

  6. The protocol and design of a randomised controlled study on training of attention within the first year after acquired brain injury

    PubMed Central

    2014-01-01

    Background To describe the design of the study aiming to examine intensive targeted cognitive rehabilitation of attention in the acute (<4 months) and subacute rehabilitation phases (4–12 months) after acquired brain injury and to evaluate the effects on function, activity and participation (return to work). Methods/Design Within a prospective, randomised, controlled study 120 consecutive patients with stroke or traumatic brain injury were randomised to 20 hours of intensive attention training by Attention Process Training or by standard, activity based training. Progress was evaluated by Statistical Process Control and by pre and post measurement of functional and activity levels. Return to work was also evaluated in the post-acute phase. Primary endpoints were the changes in the attention measure, Paced Auditory Serial Addition Test and changes in work ability. Secondary endpoints included measurement of cognitive functions, activity and work return. There were 3, 6 and 12-month follow ups focussing on health economics. Discussion The study will provide information on rehabilitation of attention in the early phases after ABI; effects on function, activity and return to work. Further, the application of Statistical Process Control might enable closer investigation of the cognitive changes after acquired brain injury and demonstrate the usefulness of process measures in rehabilitation. The study was registered at ClinicalTrials.gov Protocol. Trial registration NCT02091453, registered: 19 March 2014. PMID:24885585

  7. MRI heralds secondary nigral lesion after brain ischemia in mice: a secondary time window for neuroprotection

    PubMed Central

    Prinz, Vincent; Hetzer, Anna-Maria; Müller, Susanne; Balkaya, Mustafa; Leithner, Christoph; Kronenberg, Golo; Endres, Matthias

    2015-01-01

    Cerebral ischemia in the territory of the middle cerebral artery (MCA) can induce delayed neuronal cell death in the ipsilateral substantia nigra (SN) remote from the primary ischemic lesion. This exofocal postischemic neuronal degeneration (EPND) may worsen stroke outcomes. However, the mechanisms leading to EPND are poorly understood. Here, we studied the time course of EPND via sequential magnetic resonance imaging (MRI) and immunohistochemistry for up to 28 days after 30 minutes occlusion of the MCA (MCAo) and reperfusion in the mouse. Furthermore, the effects of delayed treatment with FK506 and MK-801 on the development of EPND were investigated. Secondary neuronal degeneration in the SN occurred within the first week after MCAo and was characterized by a marked neuronal cell loss on histology. Sequential neuroimaging examinations revealed transient MRI changes, which were detectable as early as day 4 after MCAo and thus heralding histologic evidence of EPND. Treatment with MK-801, an established anti-excitotoxic agent, conferred protection against EPND even when initiated days after the initial ischemic event, which was not evident with FK506. Our findings define a secondary time window for delayed neuroprotection after stroke, which may provide a promising target for the development of novel therapies. PMID:26126863

  8. Dietary cholesterol promotes repair of demyelinated lesions in the adult brain

    PubMed Central

    Berghoff, Stefan A.; Gerndt, Nina; Winchenbach, Jan; Stumpf, Sina K.; Hosang, Leon; Odoardi, Francesca; Ruhwedel, Torben; Böhler, Carolin; Barrette, Benoit; Stassart, Ruth; Liebetanz, David; Dibaj, Payam; Möbius, Wiebke; Edgar, Julia M.; Saher, Gesine

    2017-01-01

    Multiple Sclerosis (MS) is an inflammatory demyelinating disorder in which remyelination failure contributes to persistent disability. Cholesterol is rate-limiting for myelin biogenesis in the developing CNS; however, whether cholesterol insufficiency contributes to remyelination failure in MS, is unclear. Here, we show the relationship between cholesterol, myelination and neurological parameters in mouse models of demyelination and remyelination. In the cuprizone model, acute disease reduces serum cholesterol levels that can be restored by dietary cholesterol. Concomitant with blood-brain barrier impairment, supplemented cholesterol directly supports oligodendrocyte precursor proliferation and differentiation, and restores the balance of growth factors, creating a permissive environment for repair. This leads to attenuated axon damage, enhanced remyelination and improved motor learning. Remarkably, in experimental autoimmune encephalomyelitis, cholesterol supplementation does not exacerbate disease expression. These findings emphasize the safety of dietary cholesterol in inflammatory diseases and point to a previously unrecognized role of cholesterol in promoting repair after demyelinating episodes. PMID:28117328

  9. Photoacoustic imaging of an inflammatory lesion model in the neonatal rat brain

    NASA Astrophysics Data System (ADS)

    Guevara, Edgar; Berti, Romain; Londono, Irène; Xie, Ningshi; Bellec, Pierre; Lesage, Frédéric; Lodygensky, G. A.

    2014-09-01

    Periventricular leukomalacia (PVL) is a condition that may cause significant neurodevelopmental handicap in premature newborns. It is characterized by white matter injury, associated with inflammation. This work aimed to assess the impact of inflammation on cerebral oxygen saturation (sO2) using depth-sensitive photoacoustic tomography (PAT). The aspects of PVL were reproduced in a rodent model by injection of lipopolysaccharide (LPS) into the corpus callosum. The results of this exploratory work reveal lower sO2 values in LPS group, as compared to sham controls; showing decreased values in the corpus callosum and in the left cortex, ipsilateral to the injection site. Interhemispherical connectivity was not affected by LPS injection, as shown by functional connectivity analysis. This study supports the use of PAT as a non-invasive tool to assess oxygenation values in vivo in the newborn brain.

  10. Brain MRI lesion load quantification in multiple sclerosis: a comparison between automated multispectral and semi-automated thresholding computer-assisted techniques.

    PubMed

    Achiron, Anat; Gicquel, Sebastien; Miron, Shmuel; Faibel, Meir

    2002-12-01

    Brain magnetic resonance imaging (MRI) lesion volume measurement is an advantageous tool for assessing disease burden in multiple sclerosis (MS). We have evaluated two computer-assisted techniques: MSA multispectral automatic technique that is based on bayesian classification of brain tissue and NIH image analysis technique that is based on local (lesion by lesion) thresholding, to establish reliability and repeatability values for each technique. Brain MRIs were obtained for 30 clinically definite relapsing-remitting MS patients using a 2.0 Tesla MR scanner with contiguous, 3 mm thick axial, T1, T2 and PD weighted modalities. Digital (Dicom 3) images were analyzed independently by three observers; each analyzed the images twice, using the two different techniques (Total 360 analyses). Accuracy of lesion load measurements using phantom images of known volumes showed significantly better results for the MSA multispectral technique (p < 0.001). The mean intra-and inter-observer variances were, respectively, 0.04 +/- 0.4 (range 0.04-0.13), and 0.09 +/- 0.6 (range 0.01-0.26) for the multispectral MSA analysis technique, 0.24 +/- 2.27 (range 0.23-0.72) and 0.33 +/- 3.8 (range 0.47-1.36) for the NIH threshold technique. These data show that the MSA multispectral technique is significantly more accurate in lesion volume measurements, with better results of within and between observers' assessments, and the lesion load measurements are not influenced by increased disease burden. Measurements by the MSA multispectral technique were also faster and decreased analysis time by 43%. The MSA multispectral technique is a promising tool for evaluating MS patients. Non-biased recognition and delineation algorithms enable high accuracy, low intra-and inter-observer variances and fast assessment of MS related lesion load.

  11. Immunohistochemical analysis of brain lesions using S100B and glial fibrillary acidic protein antibodies in arundic acid- (ONO-2506) treated stroke-prone spontaneously hypertensive rats.

    PubMed

    Higashino, Hideaki; Niwa, Atsuko; Satou, Takao; Ohta, Yoshio; Hashimoto, Shigeo; Tabuchi, Masaki; Ooshima, Kana

    2009-10-01

    Stroke-prone spontaneously hypertensive rats (SHRSP) used as a model of essential hypertension cause a high incidence of brain stroke on the course of hypertension. Incidences and sizes of brain lesions are known to relate to the astrocyte activities. Therefore, relation between brain damage and the expression profile of the astrocytes was investigated with morphometric and immunohistochemical analyses using astrocyte marker antibodies of S100B and glial fibrillary acidic protein (GFAP) with or without arundic acid administration, a suppressor on the activation of astrocytes. Arundic acid extended the average life span of SHRSP. An increase in brain tissue weight was inhibited concomitant with a lower rate of gliosis/hemosiderin deposit/scarring in brain lesions. S100B- or GFAP-positive dot and filamentous structures were decreased in arundic acid-treated SHRSP, and this effect was most pronounced in the cerebral cortex, white matter, and pons, and less so in the hippocampus, diencephalon, midbrain, and cerebellum. Blood pressure decreased after administration of arundic acid in the high-dose group (100 mg/kg/day arundic acid), but not in the low-dose group (30 mg/kg/day). These data indicate that arundic acid can prevent hypertension-induced stroke, and may inhibit the enlargement of the stroke lesion by preventing the inflammatory changes caused by overproduction of the S100B protein in the astrocytes.

  12. Information gaps for patients requiring craniotomy for benign brain lesion: a qualitative study.

    PubMed

    Rozmovits, Linda; Khu, Kathleen Joy; Osman, Soha; Gentili, Fred; Guha, Abhijit; Bernstein, Mark

    2010-01-01

    Doctor-patient communication in the setting of a life-threatening illness poses considerable challenges. This study aimed to determine the information needs of a subset of neurosurgical patients. Qualitative case study methodology was used. Twenty-five semi-structured interviews were conducted with ambulatory adult patients who had undergone surgery for a benign brain tumor, arteriovenous malformation, or unruptured aneurysm. Interviews were digitally audio recorded and transcribed, and the data subjected to thematic analysis. Six overarching themes emerged from the data: (1) the amount of information patients want varies; (2) the type of information needed is not limited to information about treatment options and risks; (3) patients engage in independent information seeking for a variety of reasons; (4) patients consider compassion from their surgeon as important; (5) direct communication with the surgeon post-operatively is very important; and (6) patients' information needs are greatest post-operatively. Many patients felt that the amount and quality of information they received was not sufficient, particularly regarding post-operative recovery and long-term life issues, leading many to do their own research. The findings from this study emphasize the need for improved communication with patients so they can participate meaningfully in choices about their treatment, give a truly informed consent, and effectively participate in their own recovery.

  13. Frequent hemorrhagic lesions in cerebral toxoplasmosis in AIDS patients.

    PubMed

    Bhagavati, Satyakam; Choi, Jan

    2009-04-01

    Cerebral toxoplasmosis is a frequent complication in immunosuppressed patients such as AIDS (acquired immunodeficiency syndrome). Frequently, lesions are located deep in the brain which are inaccessible for biopsy making rapid diagnosis dependent on accurate interpretation of neuroimaging findings. The commonest cranial CT findings reported in toxoplasmosis are ring enhancing hypodense lesions in basal ganglia or cortical gray matter. Hemorrhage has only rarely been described and is usually seen following antitoxoplasma treatment. We reviewed the records of 11 AIDS patients with cerebral toxoplasmosis and found multiple hemorrhagic cerebral, cerebellar, or brain stem lesions in 7 of 11 patients. Six patients had hemorrhage at the time of initial clinical presentation and one developed hemorrhage following 2 weeks of antitoxoplasma treatment. We conclude that hemorrhagic lesions are frequently found on cranial MRI scans in cerebral toxoplasmosis. AIDS patients presenting with hemorrhagic cerebral lesions should be considered for a trial of presumptive antitoxoplasma treatment.

  14. [Impact of acquired brain injury towards the community integration: employment outcome, disability and dependence two years after injury].

    PubMed

    Luna-Lario, P; Ojeda, N; Tirapu-Ustarroz, J; Pena, J

    2016-06-16

    Objetivos. Analizar el impacto del daño cerebral adquirido en la integracion comunitaria (trayectoria laboral, discapacidad y dependencia) en una muestra de sujetos con daño cerebral adquirido de etiologia vascular, traumatica y tumoral, durante un periodo de dos años tras la lesion original, y examinar que variables sociodemograficas, datos clinicos premorbidos y relacionados con la lesion predicen la integracion en la comunidad. Pacientes y metodos. Muestra de 106 sujetos adultos con daño cerebral adquirido, atendidos en el Area de Neuropsicologia y Neuropsiquiatria del Complejo Hospitalario de Navarra, con deficit de memoria como secuela principal. Las diferencias entre grupos se analizan con los tests t de Student, chi al cuadrado y U de Mann-Whitney. Resultados. De los participantes que antes de la lesion se encontraban activos laboralmente, el 19% y 29% recuperaron su estatus previo al año y a los dos años, respectivamente; a un 45% de la muestra total se le reconocio la discapacidad, y a un 17%, la dependencia. No se hallo relacion entre las variables sociodemograficas y clinicas y los parametros funcionales contemplados. Conclusiones. La lesion cerebral adquirida impacta con intensidad en la trayectoria vital de los afectados, aunque no se han estudiado antes en España sus consecuencias en el ajuste sociolaboral en los dos años siguientes al daño a traves de parametros funcionales valorados con instrumentos oficiales estatales en una muestra de etiologia vascular, traumatica y tumoral.

  15. Traumatic axonal injury: the prognostic value of lesion load in corpus callosum, brain stem, and thalamus in different magnetic resonance imaging sequences.

    PubMed

    Moen, Kent G; Brezova, Veronika; Skandsen, Toril; Håberg, Asta K; Folvik, Mari; Vik, Anne

    2014-09-01

    The aim of this study was to explore the prognostic value of visible traumatic axonal injury (TAI) loads in different MRI sequences from the early phase after adjusting for established prognostic factors. Likewise, we sought to explore the prognostic role of early apparent diffusion coefficient (ADC) values in normal-appearing corpus callosum. In this prospective study, 128 patients (mean age, 33.9 years; range, 11-69) with moderate (n = 64) and severe traumatic brain injury (TBI) were examined with MRI at a median of 8 days (range, 0-28) postinjury. TAI lesions in fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), and T2*-weighted gradient echo (T2*GRE) sequences were counted and FLAIR lesion volumes estimated. In patients and 47 healthy controls, mean ADC values were computed in 10 regions of interests in the normal-appearing corpus callosum. Outcome measure was the Glasgow Outcome Scale-Extended (GOS-E) at 12 months. In patients with severe TBI, number of DWI lesions and volume of FLAIR lesions in the corpus callosum, brain stem, and thalamus predicted outcome in analyses with adjustment for age, Glasgow Coma Scale score, and pupillary dilation (odds ratio, 1.3-6.9; p = <0.001-0.017). The addition of Rotterdam CT score and DWI lesions in the corpus callosum yielded the highest R2 (0.24), compared to all other MRI variables, including brain stem lesions. For patients with moderate TBI only the number of cortical contusions (p = 0.089) and Rotterdam CT score (p = 0.065) tended to predict outcome. Numbers of T2*GRE lesions did not affect outcome. Mean ADC values in the normal-appearing corpus callosum did not differ from controls. In conclusion, the loads of visible TAI lesions in the corpus callosum, brain stem, and thalamus in DWI and FLAIR were independent prognostic factors in patients with severe TBI. DWI lesions in the corpus callosum were the most important predictive MRI variable. Interestingly, number of cortical

  16. Lower total and regional grey matter brain volumes in youth with perinatally-acquired HIV infection: Associations with HIV disease severity, substance use, and cognition.

    PubMed

    Lewis-de Los Angeles, C Paula; Williams, Paige L; Huo, Yanling; Wang, Shirlene D; Uban, Kristina A; Herting, Megan M; Malee, Kathleen; Yogev, Ram; Csernansky, John G; Nichols, Sharon; Van Dyke, Russell B; Sowell, Elizabeth R; Wang, Lei

    2017-05-01

    Despite improved survival due to combination antiretroviral therapy (cART), youth with perinatally-acquired HIV (PHIV) show cognitive deficits and developmental delay at increased rates. HIV affects the brain during critical periods of development, and the brain may be a persistent reservoir for HIV due to suboptimal blood brain barrier penetration of cART. We conducted structural magnetic resonance imaging (sMRI) and cognitive testing in 40 PHIV youth (mean age=16.7years) recruited from the NIH Pediatric HIV/AIDS Cohort Study (PHACS) who are part of the first generation of PHIV youth surviving into adulthood. Historical and current HIV disease severity and substance use measures were also collected. Total and regional cortical grey matter brain volumes were compared to a group of 334 typically-developing, HIV-unexposed and uninfected youth (frequency-matched for age and sex) from the Pediatric Imaging, Neurocognition, and Genetics (PING) study (mean age=16.1years). PHIV youth had smaller (2.8-5.1%) total and regional grey matter volumes than HIV-unexposed and uninfected youth, with smallest volumes seen among PHIV youth with higher past peak viral load (VL) and recent unsuppressed VL. In PHIV youth, worse cognitive performance correlated with smaller volumes. This pattern of smaller grey matter volumes suggests that PHIV infection may influence brain development and underlie cognitive dysfunction seen in this population. Among PHIV youth, smaller volumes were also linked to substance use (alcohol use: 9.0-13.4%; marijuana use: 10.1-16.0%). In this study, collection of substance use information was limited to the PHIV cohort; future studies should also collect substance use information in controls to further address interactions between HIV and substance use on brain volume.

  17. The contribution of the putamen to sensory aspects of pain: insights from structural connectivity and brain lesions

    PubMed Central

    Starr, Christopher J.; Sawaki, Lumy; Wittenberg, George F.; Burdette, Jonathan H.; Oshiro, Yoshitetsu; Quevedo, Alexandre S.; McHaffie, John G.

    2011-01-01

    Cerebral cortical activity is heavily influenced by interactions with the basal ganglia. These interactions occur via cortico-basal ganglia-thalamo-cortical loops. The putamen is one of the major sites of cortical input into basal ganglia loops and is frequently activated during pain. This activity has been typically associated with the processing of pain-related motor responses. However, the potential contribution of putamen to the processing of sensory aspects of pain remains poorly characterized. In order to more directly determine if the putamen can contribute to sensory aspects of pain, nine individuals with lesions involving the putamen underwent both psychophysical and functional imaging assessment of perceived pain and pain-related brain activation. These individuals exhibited intact tactile thresholds, but reduced heat pain sensitivity and widespread reductions in pain-related cortical activity in comparison with 14 age-matched healthy subjects. Using magnetic resonance imaging to assess structural connectivity in healthy subjects, we show that portions of the putamen activated during pain are connected not only with cortical regions involved in sensory-motor processing, but also regions involved in attention, memory and affect. Such a framework may allow cognitive information to flow from these brain areas to the putamen where it may be used to influence how nociceptive information is processed. Taken together, these findings indicate that the putamen and the basal ganglia may contribute importantly to the shaping of an individual subjective sensory experience by utilizing internal cognitive information to influence activity of large areas of the cerebral cortex. PMID:21616963

  18. Narrative Medicine: Suggestions for Clinicians to Help Their Clients Construct a New Identity Following Acquired Brain Injury

    ERIC Educational Resources Information Center

    Fraas, Michael R.

    2015-01-01

    Survivors of brain injury from trauma and stroke often lose their sense of identity and face a series of lifelong obstacles that challenge their ability to integrate back into their communities and live meaningful and productive lives. Their stories provide powerful accounts of these challenges, which can inform clinical decision-making. Arguably,…

  19. Comprehensive analysis of human endogenous retrovirus group HERV-W locus transcription in multiple sclerosis brain lesions by high-throughput amplicon sequencing.

    PubMed

    Schmitt, Katja; Richter, Christin; Backes, Christina; Meese, Eckart; Ruprecht, Klemens; Mayer, Jens

    2013-12-01

    Human endogenous retroviruses (HERVs) of the HERV-W group comprise hundreds of loci in the human genome. Deregulated HERV-W expression and HERV-W locus ERVWE1-encoded Syncytin-1 protein have been implicated in the pathogenesis of multiple sclerosis (MS). However, the actual transcription of HERV-W loci in the MS context has not been comprehensively analyzed. We investigated transcription of HERV-W in MS brain lesions and white matter brain tissue from healthy controls by employing next-generation amplicon sequencing of HERV-W env-specific reverse transcriptase (RT) PCR products, thus revealing transcribed HERV-W loci and the relative transcript levels of those loci. We identified more than 100 HERV-W loci that were transcribed in the human brain, with a limited number of loci being predominantly transcribed. Importantly, relative transcript levels of HERV-W loci were very similar between MS and healthy brain tissue samples, refuting deregulated transcription of HERV-W env in MS brain lesions, including the high-level-transcribed ERVWE1 locus encoding Syncytin-1. Quantitative RT-PCR likewise did not reveal differences in MS regarding HERV-W env general transcript or ERVWE1- and ERVWE2-specific transcript levels. However, we obtained evidence for interindividual differences in HERV-W transcript levels. Reporter gene assays indicated promoter activity of many HERV-W long terminal repeats (LTRs), including structurally incomplete LTRs. Our comprehensive analysis of HERV-W transcription in the human brain thus provides important information on the biology of HERV-W in MS lesions and normal human brain, implications for study design, and mechanisms by which HERV-W may (or may not) be involved in MS.

  20. In search of the hidden: an fMRI study with implications for the study of patients with autism and with acquired brain injury.

    PubMed

    Manjaly, Zina M; Marshall, John C; Stephan, Klaas E; Gurd, Jennifer M; Zilles, Karl; Fink, Gereon R

    2003-07-01

    The Embedded Figures Task involves a search for a target hidden in a more complex visual pattern. The task has been used to study local perception and visual search in a range of normal and pathological populations. After acquired brain damage, impairment on embedded figures is strongly associated with aphasia; in the context of developmental disorder, people with autism or with Asperger's syndrome are reliably found to be better than normal controls on the task. The current study employed functional MRI with healthy volunteers to elucidate the brain regions that are specifically involved in the local search aspects of the Embedded Figures Task. We did so by analyzing the neural activations that are implicated in the task over and above those involved in an easier visual search task and in a straightforward shape recognition task. Significant activations (P < 0.05, corrected) specific in the above sense to the Embedded Figures Task were found in left inferior and left superior parietal cortex and in left ventral premotor cortex (inferior frontal gyrus). By contrast, comparing the overall effect of visual search within geometric figures to pure recognition of geometric shapes revealed more widespread activations in parietal, occipital, cerebellar, and frontal areas bilaterally. The implications of these findings for some developmental and acquired pathologies of perceptual functioning are outlined. We also relate our results to studies of local/global processing in other tasks.

  1. Cutaneous malignant melanoma arising in an acquired naevus of Ota.

    PubMed

    Patterson, Clare R S; Acland, Katharine; Khooshabeh, Ramona

    2009-11-01

    Naevus of Ota is a dermal melanocytosis most commonly found in black or Asian skin and is usually a benign malformation, but with a low risk of melanoma. We describe a 32-year-old Caucasian man with an acquired naevus of Ota with subtle pigmentation, in which a melanocytic papule developed. The lesion, deceptively, had no clinically suspicious features, but investigation revealed an aggressive cutaneous malignant melanoma, extensive orbital ring melanocytosis and metastatic brain and subsequent liver disease.

  2. Effects of rehabilitative horse riding on the Sit-to-Stand action of the adolescent with brain lesions

    PubMed Central

    Lee, Jang Won; Han, A-reum; Kim, Kihong

    2014-01-01

    The purpose of this study was to investigate the balance abilities of the adolescent girl with brain lesions by Sit-to-Stand (STS) action analysis before and after the rehabilitative horse riding of 16 week program. The subject aged 16 yr old who had the disabilities of spasticity and hemiplegia was recruited with the consent approval. The equilibrium abilities of the subject were tested by Sit-to-Stand examination with Weight Transfer Time (WTT), Mean Rising Index (MRI), Mean Weight Asymmetry (MWA), Max Trunk Flexion Velocity (MTFV), and Max Trunk Extension Velocity (MTEV). Research was designed by AB single subject study with baseline of 3 times of measurement and rehabilitative horse riding treatments. In the results, the enhancement of the subject’s equilibrium ability was shown from the comparisons between baseline and treatment by the STS test that WTT was 2.37 sec faster, MRI was 6.64 N/kg higher, and MWA was 8.12% lower, and MTFV was 0.57°/sec larger than all those means of baseline. It suggested that the subject showed her enhanced balance ability while in sitting and standing after the rehabilitative horse riding treatments. PMID:24678502

  3. Interlaboratory comparison of assessments of Alzheimer disease-related lesions: a study of the BrainNet Europe Consortium.

    PubMed

    Alafuzoff, Irina; Pikkarainen, Maria; Al-Sarraj, Safa; Arzberger, Thomas; Bell, Jeanne; Bodi, Istvan; Bogdanovic, Nenad; Budka, Herbert; Bugiani, Orso; Ferrer, Isidro; Gelpi, Ellen; Giaccone, Giorgio; Graeber, Manuel B; Hauw, Jean-Jacques; Kamphorst, Wouter; King, Andrew; Kopp, Nicolas; Korkolopoulou, Penelope; Kovács, Gábor G; Meyronet, David; Parchi, Piero; Patsouris, Efstratios; Preusser, Matthias; Ravid, Rivka; Roggendorf, Wolfgang; Seilhean, Danielle; Streichenberger, Nathalie; Thal, Dietmar R; Kretzschmar, Hans

    2006-08-01

    This interlaboratory study evaluated the reproducibility of the assessments of neuritic plaques and neurofibrillary tangles (NFTs)--the hallmark lesions of Alzheimer disease--and compared the staining between the BrainNet Europe centers. To reduce the topography-related inconsistencies in assessments, we used a 2-mm tissue microarray (TMA) technique. The TMA block included 42 core samples taken from 21 paraffin blocks. The assessments were done on Bielschowsky and Gallyas silver stains using an immunohistochemical (IHC) method with antibodies directed to beta-amyloid (IHC/Abeta) and hyperphosphorylated tau (IHC/HPtau). The staining quality and the assessments differed between the participants, being most diverse with Bielschowsky (good/acceptable stain in 53% of centers) followed by Gallyas (good/acceptable stain in 57%) and IHC/Abeta (good/acceptable stain in 71%). The most uniform staining quality and assessment was obtained with the IHC/HPtau method (good/acceptable stain in 94% of centers). The neuropathologic diagnostic protocol (Consortium to Establish a Registry for Alzheimer Disease, Braak and Braak, and the National Institute of Aging and Reagan [NIA-Reagan] Institute) that was used significantly influenced the agreement, being highest with NIA-Reagan (54%) recommendations. This agreement was improved by visualization of NFTs using the IHC/HPtau method. Therefore, the IHC/HPtau methodology to visualize NFTs and neuropil threads should be considered as a method of choice in a future diagnostic protocol for Alzheimer disease.

  4. Magnetic resonance imaging and computer tomography of brain lesions in water buffaloes and cattle stunned with handguns or captive bolts.

    PubMed

    Schwenk, Barbara K; Lechner, Isabel; Ross, Steffen G; Gascho, Dominic; Kneubuehl, Beat P; Glardon, Matthieu; Stoffel, Michael H

    2016-03-01

    Owing to the demand for genuine mozzarella, some 330 water buffaloes are being slaughtered every year in Switzerland albeit a stunning procedure meeting animal welfare and occupational safety requirements remains to be established. To provide a basis for improvements, we sized anatomical specifics in water buffaloes and cattle and we assessed brain lesions after stunning with captive bolts or handguns by diagnostic imaging. In water buffaloes and cattle, the median distance from the frontal skin surface to the inner bone table was 74.0mm (56.0-100.0mm) vs 36.6mm (29.3-44.3mm) and from skin to the thalamus 144.8mm (117.1-172.0mm) vs 102.0 (101.0-121.0mm), respectively. Consequently, customary captive bolt stunners may be inadequate. Free bullets are potentially suitable for stunning buffaloes but involve occupational safety hazards. The results of the present study shall be used to develop a device allowing effective and safe stunning of water buffaloes.

  5. Progress and prospects in neurorehabilitation: clinical applications of stem cells and brain-computer interface for spinal cord lesions.

    PubMed

    Gongora, Mariana; Peressutti, Caroline; Machado, Sergio; Teixeira, Silmar; Velasques, Bruna; Ribeiro, Pedro

    2013-04-01

    Spinal cord injury (SCI) is a disease that affects millions of people worldwide, causing a temporary or permanent impairment of neuromotor functions. Mostly associated to traumatic lesions, but also to other forms of disease, the appropriate treatment is still unsure. In this review, several ongoing studies are presented that aim to provide methods of prevention that ensure quality of life, and rehabilitation trends to patients who suffer from this injury. Stem cell research, highlighted in this review, seeks to reduce damage caused to the tissue, as also provide spinal cord regeneration through the application of several types of stem cells. On the other hand, research using brain-computer interface (BCI) technology proposes the development of interfaces based on the interaction of neural networks with artificial tools to restore motor control and full mobility of the injured area. PubMed, MEDLINE and SciELO data basis analyses were performed to identify studies published from 2000 to date, which describe the link between SCI with stem cells and BCI technology.

  6. Inherited or acquired metabolic disorders.

    PubMed

    Eichler, Florian; Ratai, Eva; Carroll, Jason J; Masdeu, Joseph C

    2016-01-01

    This chapter starts with a description of imaging of inherited metabolic disorders, followed by a discussion on imaging of acquired toxic-metabolic disorders of the adult brain. Neuroimaging is crucial for the diagnosis and management of a number of inherited metabolic disorders. Among these, inherited white-matter disorders commonly affect both the nervous system and endocrine organs. Magnetic resonance imaging (MRI) has enabled new classifications of these disorders that have greatly enhanced both our diagnostic ability and our understanding of these complex disorders. Beyond the classic leukodystrophies, we are increasingly recognizing new hereditary leukoencephalopathies such as the hypomyelinating disorders. Conventional imaging can be unrevealing in some metabolic disorders, but proton magnetic resonance spectroscopy (MRS) may be able to directly visualize the metabolic abnormality in certain disorders. Hence, neuroimaging can enhance our understanding of pathogenesis, even in the absence of a pathologic specimen. This review aims to present pathognomonic brain MRI lesion patterns, the diagnostic capacity of proton MRS, and information from clinical and laboratory testing that can aid diagnosis. We demonstrate that applying an advanced neuroimaging approach enhances current diagnostics and management. Additional information on inherited and metabolic disorders of the brain can be found in Chapter 63 in the second volume of this series.

  7. Is the spatial distribution of brain lesions associated with closed-head injury predictive of subsequent development of attention-deficit/hyperactivity disorder? Analysis with brain-image database

    NASA Technical Reports Server (NTRS)

    Herskovits, E. H.; Megalooikonomou, V.; Davatzikos, C.; Chen, A.; Bryan, R. N.; Gerring, J. P.

    1999-01-01

    PURPOSE: To determine whether there is an association between the spatial distribution of lesions detected at magnetic resonance (MR) imaging of the brain in children after closed-head injury and the development of secondary attention-deficit/hyperactivity disorder (ADHD). MATERIALS AND METHODS: Data obtained from 76 children without prior history of ADHD were analyzed. MR images were obtained 3 months after closed-head injury. After manual delineation of lesions, images were registered to the Talairach coordinate system. For each subject, registered images and secondary ADHD status were integrated into a brain-image database, which contains depiction (visualization) and statistical analysis software. Using this database, we assessed visually the spatial distributions of lesions and performed statistical analysis of image and clinical variables. RESULTS: Of the 76 children, 15 developed secondary ADHD. Depiction of the data suggested that children who developed secondary ADHD had more lesions in the right putamen than children who did not develop secondary ADHD; this impression was confirmed statistically. After Bonferroni correction, we could not demonstrate significant differences between secondary ADHD status and lesion burdens for the right caudate nucleus or the right globus pallidus. CONCLUSION: Closed-head injury-induced lesions in the right putamen in children are associated with subsequent development of secondary ADHD. Depiction software is useful in guiding statistical analysis of image data.

  8. Fully automated rodent brain MR image processing pipeline on a Midas server: from acquired images to region-based statistics.

    PubMed

    Budin, Francois; Hoogstoel, Marion; Reynolds, Patrick; Grauer, Michael; O'Leary-Moore, Shonagh K; Oguz, Ipek

    2013-01-01

    Magnetic resonance imaging (MRI) of rodent brains enables study of the development and the integrity of the brain under certain conditions (alcohol, drugs etc.). However, these images are difficult to analyze for biomedical researchers with limited image processing experience. In this paper we present an image processing pipeline running on a Midas server, a web-based data storage system. It is composed of the following steps: rigid registration, skull-stripping, average computation, average parcellation, parcellation propagation to individual subjects, and computation of region-based statistics on each image. The pipeline is easy to configure and requires very little image processing knowledge. We present results obtained by processing a data set using this pipeline and demonstrate how this pipeline can be used to find differences between populations.

  9. Functional cliques in the amygdala and related brain networks driven by fear assessment acquired during movie viewing.

    PubMed

    Kinreich, Sivan; Intrator, Nathan; Hendler, Talma

    2011-01-01

    One of the greatest challenges involved in studying the brain mechanisms of fear is capturing the individual's unique instantaneous experience. Brain imaging studies to date commonly sacrifice valuable information regarding the individual real-time conscious experience, especially when focusing on elucidating the amygdala's activity. Here, we assumed that by using a minimally intrusive cue along with applying a robust clustering approach to probe the amygdala, it would be possible to rate fear in real time and to derive the related network of activation. During functional magnetic resonance imaging scanning, healthy volunteers viewed two excerpts from horror movies and were periodically auditory cued to rate their instantaneous experience of "I'm scared." Using graph theory and community mathematical concepts, data-driven clustering of the fear-related functional cliques in the amygdala was performed guided by the individually marked periods of heightened fear. Individually tailored functions derived from these amygdala activation cliques were subsequently applied as general linear model predictors to a whole-brain analysis to reveal the correlated networks. Our results suggest that by using a localized robust clustering approach, it is possible to probe activation in the right dorsal amygdala that is directly related to individual real-time emotional experience. Moreover, this fear-evoked amygdala revealed two opposing networks of co-activation and co-deactivation, which correspond to vigilance and rest-related circuits, respectively.

  10. Is the spatial distribution of brain lesions associated with closed-head injury in children predictive of subsequent development of posttraumatic stress disorder?

    NASA Technical Reports Server (NTRS)

    Herskovits, Edward H.; Gerring, Joan P.; Davatzikos, Christos; Bryan, R. Nick

    2002-01-01

    PURPOSE: To determine whether there is an association between the spatial distributions of lesions detected at magnetic resonance (MR) imaging of the brain in children, adolescents, and young adults after closed-head injury (CHI) and development of the reexperiencing symptoms of posttraumatic stress disorder (PTSD). MATERIALS AND METHODS: Data obtained in 94 subjects without a history of PTSD as determined by parental interview were analyzed. MR images were obtained 3 months after CHI. Lesions were manually delineated and registered to the Talairach coordinate system. Mann-Whitney analysis of lesion distribution and PTSD status at 1 year (again, as determined by parental interview) was performed, consisting of an analysis of lesion distribution versus the major symptoms of PTSD: reexperiencing, hyperarousal, and avoidance. RESULTS: Of the 94 subjects, 41 met the PTSD reexperiencing criterion and nine met all three PTSD criteria. Subjects who met the reexperiencing criterion had fewer lesions in limbic system structures (eg, the cingulum) on the right than did subjects who did not meet this criterion (Mann-Whitney, P =.003). CONCLUSION: Lesions induced by CHI in the limbic system on the right may inhibit subsequent manifestation of PTSD reexperiencing symptoms in children, adolescents, and young adults. Copyright RSNA, 2002.

  11. Neuroanatomical localization and quantification of amyloid precursor protein mRNA by in situ hybridization in the brains of normal, aneuploid, and lesioned mice

    SciTech Connect

    Bendotti, C.; Forloni, G.L.; Morgan, R.A.; O'Hara, B.F.; Oster-Granite, M.L.; Reeves, R.H.; Gearhart, J.D.; Coyle, J.T. )

    1988-05-01

    Amyloid precursor protein mRNA was localized in frozen sections from normal and experimentally lesioned adult mouse brain and from normal and aneuploid fetal mouse brain by in situ hybridization with a {sup 35}S-labeled mouse cDNA probe. The highest levels of hybridization in adult brain were associated with neurons, primarily in telencephalic structures. The dense labeling associated with hippocampal pyramidal cells was reduced significantly when the cells were eliminated by injection of the neurotoxin ibotenic acid but was not affected when electrolytic lesions were placed in the medial septum. Since the gene encoding amyloid precursor protein has been localized to mouse chromosome 16, the authors also examined the expression of this gene in the brains of mouse embryos with trisomy 16 and trisomy 19 at 15 days of gestation. RNA gel blot analysis and in situ hybridization showed a marked increase in amyloid precursor protein mRNA in the trisomy 16 mouse head and brain when compared with euploid littermates or with trisomy 19 mice.

  12. Multiple Meningioma in a Patient of Bipolar Disorder: The Dilemma of Detecting Structural Brain Lesions in the Backdrop of a Long Standing Psychiatric Illness

    PubMed Central

    Sood, Mamta; Khandelwal, Sudhir Kumar

    2016-01-01

    Multiple meningioma often can be clinically silent and may present with only psychiatric symptoms. We report a case of 43-year-old, right handed woman with a 23 year history of long standing bipolar affective disorder, who presented with a mixed episode with psychotic symptoms which did not respond to usual treatment and was further complicated with a different set of symptomatology. MRI brain revealed multiple dural based mass lesions identified to be multiple meningiomas. Patient’s symptoms improved after gamma knife stereotactic radiosurgery for the multiple meningioma. Our finding illustrates the need to assess for brain lesions in presence of atypical symptoms, along with unresponsiveness to traditional management with psychotropic medications in patients with bipolar affective disorders. PMID:27656537

  13. SU-E-T-542: Comparison of Stereotactic Radiosurgery (SRS) of Brain Lesions Using Gamma Knife, VMAT, IMRT, and Conformal Arcs

    SciTech Connect

    Li, S; Charpentier, P; Chan, P; Neicu, T; Miyamoto, C

    2014-06-01

    Purpose: To compare dose distributions in stereotactic radiation surgery of brain lesions using gamma Knife, VMAT, conformal arcs, and IMRT in order to provide an optimal treatment. Methods: Dose distributions from single shot of 4C model of Gamma Knife at the helmet collimation sizes of 4, 8, 14, and 18 mm in diameter were compared with full arcs with the square shapes of 4×4 (or 5×5), 8×8 (or 10×10), and spherical shapes of 16 or 20 mm in diameter using EDR3 films in the same gamma knife QA phantom. Plans for ten SRS cases with single and multiple lesions were created in gamma knife plans and Pinnacle plans. The external beam plans had enlarged field size by 2-mm and used single conformal full circle arc for solitary lesion and none coplanar arcs/beams for multiple lesions. Coverage, conformity index, dose to critical organs, and integral dose to the brain and nearby critical structures were compared on all plans. Structures and dose matrices were registered in a Velocity deformable image registration system. Results: Single full circle arc from Elekta beam-modulate MLC (4-mm leaf thickness) and agility MLC (5-mm leaf thickness) have larger penumbra and less flatness than that of Gamma Knife single shot. None-coplanar arcs or beams were required to achieve similar dose distribution. In general, Gamma Knife plans provided significant less integral dose than that of linac-based plans. Benefits of IMRT and VMAT versus gamma Knife and conformal arcs were not significant. Conclusion: Our dose measurement and treatment planning evaluation clearly demonstrated dose distribution differences amount current popular SRS modalities for small solitary and multiple brain lesions. The trend of using MLC shape beams or arcs to replace conventional cones should be revisited in order to keep lower integral dose if the late correlates with some radiation-induced side effects. Pilot grant from Elekta LLC.

  14. Permanent or transitory effects on neurocognitive components of the CNV complex induced by brain dysfunctions, lesions and ablations in humans.

    PubMed

    Zappoli, Roberto

    2003-05-01

    selected patients submitted to complete ablation of the damaged cortical areas, with uni- or bilateral lesions restricted to the prefrontal or associative parieto-temporal areas. We have always used the standard CNV paradigm (S1-S2 motor-response) which evokes a complex of neurocognitive potentials, including the P300 from S1, which are well-known, since they are certainly among the most studied ERPs in the various ages and races of normal subjects, psychiatric patients and subjects with different brain diseases. The most important results have been, (1) In normal subjects the MRI and the latency differences of CNV component measurements along the bidirectional pathways functionally interconnecting ipsilateral distant associative cortical areas (e.g. the arcuate-superior longitudinal complex bundle) were accounted for by the transcortical conduction time, which varies in our scalp recordings from 1 cm/0.74 to 1.28 ms ( approximately 9.8 m/s). (2) Constantly, no true auditory S1-elicited N1a, b, c, P2, N2, P300 components or CNV slow waves (O- and E-wave) were recordable over the whole of the ablated cortical areas, but only clearly identifiable volume-conducted EP/ERPs generated in other hemispheric structures. (3) The post-S1 ERP/CNV complexes on the intact hemisphere were found to be within the normal limits. (4) Effects of severe disruption on the S1 ERP/CNV complexes evocable on the site and on remote ipsilateral apparently normal anatomo-functionally interconnected brain regions were observed in 5 patients, 4 of whom had extensive frontocortical ablations. In two of the latter the distant disruptive action on the CNV components over the neuroradiologically normal ipsilateral two-way connected post-rolandic sensory and association areas was seen to be partially reversible, showing aspects of a probable slowly evolving diaschisis-like effect. Similar deactivation of some ERP components was observed in reverse on the ipsilateral dorsolateral frontocortical region in the

  15. [High-Definition Exoscope System for Microneurosurgery:Use of an Exoscope in Combination with Tubular Retraction and Frameless Neuronavigation for Microsurgical Resection of Deep Brain Lesions].

    PubMed

    Nagatani, Kimihiro; Takeuchi, Satoru; Feng, Dongxia; Mori, Kentaro; Day, J Diaz

    2015-07-01

    The high-definition exoscope (VITOM®, Karl Storz GmbH & Co., Tuttlingen, Germany) is a new equipment that can be used as an alternative to the operating microscope in neurosurgery. Several neurosurgeons have recently reported that the exoscope allows for long working distances and great depth of field. Herein, we review reported cases of exoscope use in neurosurgery. We also describe the advantages of the exoscope compared to the operating microscope and endoscope. Furthermore, we introduce a novel technique for microsurgical resection of deep brain lesions, in which the exoscope is used along with tubular retraction and frameless neuronavigation. Before the operation, neuronavigation is registered and the surgical trajectory is planned to avoid damaging the functional cortex and eloquent white matter tracts. By using intraoperative neuronavigation, the tubular retractor (NICO BrainPath®, NICO Corporation, Indianapolis, US), which is designed to split the white matter when gently inserted, is inserted transcortically into the brain to reach the lesion, along the preplanned trajectory. After insertion, the tubular retractor is fixed in place using a self-retaining arm. This creates a narrow corridor that enables the use of the exoscope (for optimum visualization), bimanual dissection technique, and long bayoneted surgical instruments. The large focal distance of the exoscope allows it to be placed sufficiently further away from the surgical site, permitting the passage of long surgical instruments under the scope. Although obtaining surgical access to deep-seated brain lesions is challenging, we consider that this technique facilitates a safe surgical approach for lesions in deep locations.

  16. Peripheral-type benzodiazepine receptor binding 4{prime}-IODO-PK11195: A new radioiodinated ligand for detecting lesioned brain areas

    SciTech Connect

    Saji, H.; Iida, Y.; Nakatsuka, I.

    1995-05-01

    An increase in the peripheral-type benzodiazepine binding sites (PBBS) has recently been reported in excitotoxic and ischaemic lesions in the brain. Thus, PBBS visualization has been of greater interest due to the possibility of imaging the lesioned area as positive image. In this study, our interest is focussed in the development of a radioiodinated compound for the SPECT study of PBBS function. Taking account of the environment of binding sites and the stability in vivo, we selected the 4{prime}position of C-1 phenyl moiety of the isoqunoline derivative PK11195 as the best exploitable site for the iodination. The no-carrier-added I-125 labeled 4{prime}-iodo-PK11195 (IPK) was synthesized by the bromine-iodine exchange reaction in 60% radiochemical yield and > 98% radiochemical purity. In vitro competitive binding studies with H-3-PI11195 using rat kidney membranes shows that IPK has high affinity for PBBS as much as PK11195. The in vivo biodistribution in mice showed high uptake of I-125-IPK in the kidney, lung, heart and adrenal, organs reported as containing high PBBS, which were reduced by the treatment with cold PK11195. Furthermore, autoradiographic studies in transient middle cerebral arteries occlusion in rats showed high accumulation of I-125-IPK in lesioned sites, in contrast to the decease of radioactivity of Tc-99m-HM-PAO. Gathered data indicated that the newly designed IPK holds to great potential for detecting the lesioned brain areas as positive image.

  17. Brain regions involved in subprocesses of small-space episodic object-location memory: a systematic review of lesion and functional neuroimaging studies.

    PubMed

    Zimmermann, Kathrin; Eschen, Anne

    2017-04-01

    Object-location memory (OLM) enables us to keep track of the locations of objects in our environment. The neurocognitive model of OLM (Postma, A., Kessels, R. P. C., & Van Asselen, M. (2004). The neuropsychology of object-location memory. In G. L. Allen (Ed.), Human spatial memory: Remembering where (pp. 143-160). Mahwah, NJ: Lawrence Erlbaum, Postma, A., Kessels, R. P. C., & Van Asselen, M. (2008). How the brain remembers and forgets where things are: The neurocognition of object-location memory. Neuroscience & Biobehavioral Reviews, 32, 1339-1345. doi: 10.1016/j.neubiorev.2008.05.001 ) proposes that distinct brain regions are specialised for different subprocesses of OLM (object processing, location processing, and object-location binding; categorical and coordinate OLM; egocentric and allocentric OLM). It was based mainly on findings from lesion studies. However, recent episodic memory studies point to a contribution of additional or different brain regions to object and location processing within episodic OLM. To evaluate and update the neurocognitive model of OLM, we therefore conducted a systematic literature search for lesion as well as functional neuroimaging studies contrasting small-space episodic OLM with object memory or location memory. We identified 10 relevant lesion studies and 8 relevant functional neuroimaging studies. We could confirm some of the proposals of the neurocognitive model of OLM, but also differing hypotheses from episodic memory research, about which brain regions are involved in the different subprocesses of small-space episodic OLM. In addition, we were able to identify new brain regions as well as important research gaps.

  18. Large-volume reconstruction of brain tissue from high-resolution serial section images acquired by SEM-based scanning transmission electron microscopy.

    PubMed

    Kuwajima, Masaaki; Mendenhall, John M; Harris, Kristen M

    2013-01-01

    With recent improvements in instrumentation and computational tools, serial section electron microscopy has become increasingly straightforward. A new method for imaging ultrathin serial sections is developed based on a field emission scanning electron microscope fitted with a transmitted electron detector. This method is capable of automatically acquiring high-resolution serial images with a large field size and very little optical and physical distortions. In this chapter, we describe the procedures leading to the generation and analyses of a large-volume stack of high-resolution images (64 μm × 64 μm × 10 μm, or larger, at 2 nm pixel size), including how to obtain large-area serial sections of uniform thickness from well-preserved brain tissue that is rapidly perfusion-fixed with mixed aldehydes, processed with a microwave-enhanced method, and embedded into epoxy resin.

  19. Anatomo-clinical overlapping maps (AnaCOM): a new method to create anatomo-functional maps from neuropsychological tests and structural MRI scan of subjects with brain lesions

    NASA Astrophysics Data System (ADS)

    Kinkingnehun, Serge R. J.; du Boisgueheneuc, Foucaud; Golmard, Jean-Louis; Zhang, Sandy X.; Levy, Richard; Dubois, Bruno

    2004-04-01

    We have developed a new technique to analyze correlations between brain anatomy and its neurological functions. The technique is based on the anatomic MRI of patients with brain lesions who are administered neuropsychological tests. Brain lesions of the MRI scans are first manually segmented. The MRI volumes are then normalized to a reference map, using the segmented area as a mask. After normalization, the brain lesions of the MRI are segmented again in order to redefine the border of the lesions in the context of the normalized brain. Once the MRI is segmented, the patient's score on the neuropsychological test is assigned to each voxel in the lesioned area, while the rest of the voxels of the image are set to 0. Subsequently, the individual patient's MRI images are superimposed, and each voxel is reassigned the average score of the patients who have a lesion at that voxel. A threshold is applied to remove regions having less than three overlaps. This process leads to an anatomo-functional map that links brain areas to functional loss. Other maps can be created to aid in analyzing the functional maps, such as one that indicates the 95% confidence interval of the averaged scores for each area. This anatomo-clinical overlapping map (AnaCOM) method was used to obtain functional maps from patients with lesions in the superior frontal gyrus. By finding particular subregions more responsible for a particular deficit, this method can generate new hypotheses to be tested by conventional group methods.

  20. [Analysis of the effect of physical group activities in patients with acquired brain injury in the subacute phase].

    PubMed

    García-Hernández, Juan José; Mediavilla-Saldaña, Lázaro; Pérez-Rodríguez, Pérez-Rodríguez; Pérez-Tejero, Javier; González-Alted, Carlos

    2013-07-16

    Introduccion. El daño cerebral adquirido (DCA) hace referencia a cualquier tipo de lesion no degenerativa que se produce en el cerebro. Las actividades fisicas grupales (AFG) se presentan como un tratamiento efectivo para la mejora de la capacidad funcional. Objetivo. Analizar la eficacia de un programa de AFG en personas con DCA en fase subaguda para su integracion fisica en la comunidad. Pacientes y metodos. Treinta y tres pacientes con DCA, con una edad de 33,18 ± 10,39 años, participaron en un programa de AFG (talleres de circuito, equilibrio simple, equilibrio dual, desplazamiento dual y actividades fisico-deportivas) de 10 semanas. Al comenzar y concluir el programa se evaluaron las variables de velocidad (prueba de velocidad de la marcha en 10 metros), resistencia (prueba de marcha de seis minutos), equilibrio dinamico (Step Test), capacidad funcional (Timed Up and Go), escala de percepcion de seguridad (Activities-specific Balance Confidence Scale) y Physical Activity and Disability Survey (PADS), el promedio por hora de la intensidad de la actividad y el numero de pasos fuera del centro de rehabilitacion (usando monitores de actividad fisica). La prueba t para muestras relacionadas se utilizo para evaluar las diferencias en las variables. Resultados. Se hallaron diferencias significativas (p <= 0,05) en las variables de velocidad, resistencia, equilibrio, capacidad funcional, percepcion de seguridad, percepcion de realizacion de actividad general (pregunta 3 del PADS) y numero de pasos. Conclusion. Los programas de AFG mejoran las capacidades fisicas, percepcion de seguridad, realizacion de actividad en general y numero de pasos, lo que puede conllevar una mayor participacion en la comunidad.

  1. Fos protein expression in olfactory-related brain areas after learning and after reactivation of a slowly acquired olfactory discrimination task in the rat.

    PubMed

    Roullet, Florence; Liénard, Fabienne; Datiche, Frédérique; Cattarelli, Martine

    2005-01-01

    Fos protein immunodetection was used to investigate the neuronal activation elicited in some olfactory-related areas after either learning of an olfactory discrimination task or its reactivation 10 d later. Trained rats (T) progressively acquired the association between one odor of a pair and water-reward in a four-arm maze. Two groups of pseudotrained rats were used: PO rats were not water restricted and were submitted to the olfactory stimuli in the maze without any reinforcement, whereas PW rats were water-deprived and systematically received water in the maze without any odorous stimulation. When the discrimination task was well mastered, a significantly lower Fos immunoreactivity was observed in T rats compared to PW and PO rats in most of the analyzed brain areas, which could reflect the post-acquisition consolidation process. Following memory reactivation, differences in Fos immunoreactivity between trained and some pseudotrained rats were found in the anterior part of piriform cortex, CA3, and orbitofrontal cortex. We also observed that Fos labeling was significantly higher in trained rats after memory reactivation than after acquisition of the olfactory task in most of the brain areas examined. Our results support the assumption of a differential involvement of neuronal networks after either learning or reactivation of an olfactory discrimination task.

  2. Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial.

    PubMed

    Tornås, Sveinung; Løvstad, Marianne; Solbakk, Anne-Kristin; Evans, Jonathan; Endestad, Tor; Hol, Per Kristian; Schanke, Anne-Kristine; Stubberud, Jan

    2016-04-01

    Executive dysfunction is a common consequence of acquired brain injury (ABI), causing significant disability in daily life. This randomized controlled trial investigated the efficacy of Goal Management Training (GMT) in improving executive functioning in patients with chronic ABI. Seventy patients with a verified ABI and executive dysfunction were randomly allocated to GMT (n=33) or a psycho-educative active control condition, Brain Health Workshop (BHW) (n=37). In addition, all participants received external cueing by text messages. Neuropsychological tests and self-reported questionnaires of executive functioning were administered pre-intervention, immediately after intervention, and at 6 months follow-up. Assessors were blinded to group allocation. Questionnaire measures indicated significant improvement of everyday executive functioning in the GMT group, with effects lasting at least 6 months post-treatment. Both groups improved on the majority of the applied neuropsychological tests. However, improved performance on tests demanding executive attention was most prominent in the GMT group. The results indicate that GMT combined with external cueing is an effective metacognitive strategy training method, ameliorating executive dysfunction in daily life for patients with chronic ABI. The strongest effects were seen on self-report measures of executive functions 6 months post-treatment, suggesting that strategies learned in GMT were applied and consolidated in everyday life after the end of training. Furthermore, these findings show that executive dysfunction can be improved years after the ABI.

  3. Reorganization of the Cerebro-Cerebellar Network of Language Production in Patients with Congenital Left-Hemispheric Brain Lesions

    ERIC Educational Resources Information Center

    Lidzba, K.; Wilke, M.; Staudt, M.; Krageloh-Mann, I.; Grodd, W.

    2008-01-01

    Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess…

  4. The Impact of Frontal and Non-Frontal Brain Tumor Lesions on Wisconsin Card Sorting Test Performance

    ERIC Educational Resources Information Center

    Goldstein, B.; Obrzut, J. E.; John, C.; Ledakis, G.; Armstrong, C. L.

    2004-01-01

    Several lesion and imaging studies have suggested that the Wisconsin Card Sorting Test (WCST) is a measure of executive dysfunction. However, some studies have reported that this measure has poor anatomical specificity because patients with either frontal or non-frontal focal lesions exhibit similar performance. This study examined 25 frontal, 20…

  5. Combat-acquired traumatic brain injury, posttraumatic stress disorder, and their relative associations with postdeployment binge drinking

    PubMed Central

    Adams, Rachel Sayko; Larson, Mary Jo; Corrigan, John D.; Ritter, Grant A.; Horgan, Constance M.; Bray, Robert M.; Williams, Thomas V.

    2014-01-01

    Objective To examine whether experiencing a traumatic brain injury (TBI) on a recent combat deployment was associated with postdeployment binge drinking, independent of posttraumatic stress disorder (PTSD). Methods Using the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, an anonymous survey completed by 28,546 personnel, the study sample included 6,824 personnel who had a combat deployment in the past year. Path analysis was used to examine whether PTSD accounted for the total association between TBI and binge drinking. Main Measures The dependent variable, binge drinking days, was an ordinal measure capturing the number of times personnel drank 5+ drinks on one occasion (4+ for women) in the past month. TBI-level captured the severity of TBI after a combat injury event exposure: TBI-AC (altered consciousness only), TBI-LOC≤20 (loss of consciousness up to 20 minutes), and TBI-LOC>20 (loss of consciousness greater than 20 minutes). APTSD positive screen relied on the standard diagnostic cutoff of 50+ on the PCL-C. Results The final path model found that while the direct effect of TBI (0.097) on binge drinking was smaller than that of PTSD (0.156), both were significant. Almost 70% of the total effect of TBI on binge drinking was from the direct effect; only 30% represented the indirect effect through PTSD. Conclusion Further research is needed to replicate these findings and to understand the underlying mechanisms that explain the relationship between TBI and increased postdeployment drinking. PMID:25310293

  6. Temporal and spatial discordance of programmed cell death-ligand 1 expression and lymphocyte tumor infiltration between paired primary lesions and brain metastases in lung cancer

    PubMed Central

    Mansfield, A. S.; Aubry, M. C.; Moser, J. C.; Harrington, S. M.; Dronca, R. S.; Park, S. S.; Dong, H.

    2016-01-01

    Background The dynamics of PD-L1 expression may limit its use as a tissue-based predictive biomarker. We sought to expand our understanding of the dynamics of PD-L1 expression and tumor-infiltrating lymphocytes (TILs) in patients with lung cancer-related brain metastases. Experimental design Paired primary lung cancers and brain metastases were identified and assessed for PD-L1 and CD3 expression by immunohistochemistry. Lesions with 5% or greater PD-L1 expression were considered positive. Agreement statistics and the χ2 or Fisher's exact test were used for analysis. Results We analyzed 146 paired lesions from 73 cases. There was disagreement of tumor cell PD-L1 expression in 10 cases (14%, κ = 0.71), and disagreement of TIL PD-L1 expression in 19 cases (26%, κ = 0.38). Most paired lesions with discordant tumor cell expression of PD-L1 were obtained 6 or more months apart. When specimens were categorized using a proposed tumor microenvironment categorization scheme based on PD-L1 expression and TILs, there were significant changes in the classifications because many of the brain metastases lacked either PD-L1 expression, tumor lymphocyte infiltration or both even when they were present in the primary lung cancer specimens (P = 0.009). Conclusions We identified that there are significant differences between the tumor microenvironment of paired primary lung cancers and brain metastases. When physicians decide to treat patients with lung cancer with a PD-1 or PD-L1 inhibitor, they must do so in the context of the spatial and temporal heterogeneity of the tumor microenvironment. PMID:27502709

  7. Usefulness of Stereotactic biopsy and neuroimaging in management of HIV-1 clade C associated focal brain lesions with special focus on cerebral toxoplasmosis

    PubMed Central

    Shyam Babu, C; Satishchandra, P; Mahadevan, A; Shibu Pillai, V; Ravishankar, S; Sidappa, N; Udaykumar, Ranga; Ravi, V; Shankar, SK

    2015-01-01

    Background Focal brain lesions (FBL) in HIV/AIDS frequently pose a diagnostic dilemma as the etiology varies from infective (tuberculoma, toxoplasmosis and tuberculous abscesses) to neoplastic lesions like lymphoma. For determining etiology, advanced neuroimaging techniques, serological and molecular biological tests have been evolved with varying sensitivities/specificities. Stereotactic biopsy (STB) of the lesions is reserved for lesions unresponsive to appropriate therapy. Objective & Methods In this study, the diagnostic yield of neuroimaging [Cranial CT (n=25), MRI (n=24), and Th 201/99 Tc SPECT scan (n=18)] is compared with histopathological diagnosis obtained by STB (n=21) or autopsy (n=4) in 25 HIV-1 subtype C seropositive individuals with FBL identified by neuroimaging with special reference to cerebral toxoplasmosis in an eighteen month study period (2006–2007). Results & conclusion Cerebral toxoplasmosis was the most frequent cause of FBL (21/25, 84%), followed by one case each of tuberculoma, progressive multifocal leukoencephalopathy (PML), primary central nervous system lymphoma (PCNSL) and measles inclusion body encephalitis (MIBE), the last two diagnosed at autopsy. Of the 21 cases of cerebral toxoplasmosis, definitive diagnosis with histopathological confirmation was available in 14/21 (66.6%), with indirect evidence suggesting probable toxoplasmosis in seven, all of whom responded to antitoxoplasma therapy. CT and MRI had comparable specificities (75%), while MRI had marginally higher sensitivity (85% versus 80.9%) in detecting multiple lesions. The positive predictive value of both CT and MRI were identical (94.4%), suggesting that CT maybe a cost effective screening tool in resource restricted settings, for evaluating FBL. Sensitivity of 99Tc SPECT scan for diagnosing inflammatory lesions was 75% but failed to differentiate PCNSL from toxoplasmosis. This study is the first of its kind from India analysing FBL with specific focus on cerebral

  8. Development of irreversible lesions in the brain, heart and kidney following acute and chronic murine malaria infection.

    PubMed

    Vuong, P N; Richard, F; Snounou, G; Coquelin, F; Rénia, L; Gonnet, F; Chabaud, A G; Landau, I

    1999-12-01

    Irreversible pathological lesions were noted in the organs of mice infected with 1 of 3 rodent malaria species: Plasmodium chabaudi chabaudi, P. vinckei petteri and P. yoelii nigeriensis at different times during the course of the primary parasitaemia and long after microscopical clearance of the parasites. Moreover, similar lesions were also obtained when parasite levels were kept below 1% by subcurative drug treatment. The frequency and severity of the lesions correlated with the duration of the infection. Accumulation of tissue damage during chronic low-grade malaria infections has implications for the design of control measures.

  9. Inter- and intrahemispheric dissociations in ideomotor apraxia: a large-scale lesion-symptom mapping study in subacute brain-damaged patients.

    PubMed

    Manuel, Aurelie L; Radman, Narges; Mesot, Delphine; Chouiter, Leila; Clarke, Stephanie; Annoni, Jean-Marie; Spierer, Lucas

    2013-12-01

    Pantomimes of object use require accurate representations of movements and a selection of the most task-relevant gestures. Prominent models of praxis, corroborated by functional neuroimaging studies, predict a critical role for left parietal cortices in pantomime and advance that these areas store representations of tool use. In contrast, lesion data points to the involvement of left inferior frontal areas, suggesting that defective selection of movement features is the cause of pantomime errors. We conducted a large-scale voxel-based lesion-symptom mapping analyses with configural/spatial (CS) and body-part-as-object (BPO) pantomime errors of 150 left and right brain-damaged patients. Our results confirm the left hemisphere dominance in pantomime. Both types of error were associated with damage to left inferior frontal regions in tumor and stroke patients. While CS pantomime errors were associated with left temporoparietal lesions in both stroke and tumor patients, these errors appeared less associated with parietal areas in stroke than in tumor patients and less associated with temporal in tumor than stroke patients. BPO errors were associated with left inferior frontal lesions in both tumor and stroke patients. Collectively, our results reveal a left intrahemispheric dissociation for various aspects of pantomime, but with an unspecific role for inferior frontal regions.

  10. Interleukin-17- and interleukin-22-secreting myelin-specific CD4(+) T cells resistant to corticoids are related with active brain lesions in multiple sclerosis patients.

    PubMed

    Wing, Ana Cristina; Hygino, Joana; Ferreira, Thais B; Kasahara, Taissa M; Barros, Priscila O; Sacramento, Priscila M; Andrade, Regis M; Camargo, Solange; Rueda, Fernanda; Alves-Leon, Soniza V; Vasconcelos, Claudia Cristina; Alvarenga, Regina; Bento, Cleonice A M

    2016-02-01

    Multiple sclerosis (MS) is thought to be an autoimmune disorder. It is believed that immunological events in the early stages have great impact on the disease course. Therefore, we aimed to evaluate the cytokine profile of myelin basic protein (MBP)-specific T cells from MS patients in the early phase of the disease and correlate it to clinical parameters, as well as to the effect of in vitro corticoid treatment. Peripheral T cells from MS patients were stimulated with MBP with our without hydrocortisone for 5 days. The cytokines level were determined by ELISA. The number of active brain lesions was determined by MRI scans, and the neurological disabilities were assessed by Expanded Disability Status Scale scores. Our results demonstrated that MS-derived T cells responded to MBP by producing high levels of T helper type 1 (Th1) and Th17 cytokines. Although the production of interleukin-6 (IL-6), granulocyte-macrophage colony-stimulating factor, IL-17 and IL-22 was less sensitive to hydrocortisone inhibition, only IL-17 and IL-22 levels correlated with active brain lesions. The ability of hydrocortisone to inhibit IL-17 and IL-22 production by MBP-specific CD4(+) T cells was inversely related to the number of active brain lesions. Finally, the production of both cytokines was significantly higher in cell cultures from Afrodescendant patients and it was less sensitive to hydrocortisone inhibition. In summary, our data suggest that IL-17- and IL-22-secreting CD4(+) T cells resistant to corticoids are associated with radiological activity of the MS in early stages of the disease, mainly among Afrodescendant patients who, normally, have worse prognosis.

  11. Cross-Phenotype Polygenic Risk Score Analysis of Persistent Post-Concussive Symptoms in U.S. Army Soldiers with Deployment-Acquired Traumatic Brain Injury.

    PubMed

    Polimanti, Renato; Chen, Chia-Yen; Ursano, Robert J; Heeringa, Steven G; Jain, Sonia; Kessler, Ronald C; Nock, Matthew K; Smoller, Jordan W; Sun, Xiaoying; Gelernter, Joel; Stein, Murray B

    2017-02-15

    Traumatic brain injury (TBI) contributes to the increased rates of suicide and post-traumatic stress disorder in military personnel and veterans, and it is also associated with the risk for neurodegenerative and psychiatric disorders. A cross-phenotype high-resolution polygenic risk score (PRS) analysis of persistent post-concussive symptoms (PCS) was conducted in 845 U.S. Army soldiers who sustained TBI during their deployment. We used a prospective longitudinal survey of three brigade combat teams to assess deployment-acquired TBI and persistent physical, cognitive, and emotional PCS. PRS was derived from summary statistics of large genome-wide association studies of Alzheimer's disease, Parkinson's disease, schizophrenia, bipolar disorder, and major depressive disorder (MDD); and for years of schooling, college completion, childhood intelligence, infant head circumference (IHC), and adult intracranial volume. Although our study had more than 95% of statistical power to detect moderate-to-large effect sizes, no association was observed with neurodegenerative and psychiatric disorders, suggesting that persistent PCS does not share genetic components with these traits to a moderate-to-large degree. We observed a significant finding: subjects with high IHC PRS recovered better from cognitive/emotional persistent PCS than the other individuals (R(2) = 1.11%; p = 3.37 × 10(-3)). Enrichment analysis identified two significant Gene Ontology (GO) terms related to this result: GO:0050839∼Cell adhesion molecule binding (p = 8.9 × 10(-6)) and GO:0050905∼Neuromuscular process (p = 9.8 × 10(-5)). In summary, our study indicated that the genetic predisposition to persistent PCS after TBI does not have substantial overlap with neurodegenerative and psychiatric diseases, but mechanisms related to early brain growth may be involved.

  12. IMaGe: Iterative Multilevel Probabilistic Graphical Model for Detection and Segmentation of Multiple Sclerosis Lesions in Brain MRI.

    PubMed

    Subbanna, Nagesh; Precup, Doina; Arnold, Douglas; Arbel, Tal

    2015-01-01

    In this paper, we present IMaGe, a new, iterative two-stage probabilistic graphical model for detection and segmentation of Multiple Sclerosis (MS) lesions. Our model includes two levels of Markov Random Fields (MRFs). At the bottom level, a regular grid voxel-based MRF identifies potential lesion voxels, as well as other tissue classes, using local and neighbourhood intensities and class priors. Contiguous voxels of a particular tissue type are grouped into regions. A higher, non-lattice MRF is then constructed, in which each node corresponds to a region, and edges are defined based on neighbourhood relationships between regions. The goal of this MRF is to evaluate the probability of candidate lesions, based on group intensity, texture and neighbouring regions. The inferred information is then propagated to the voxel-level MRF. This process of iterative inference between the two levels repeats as long as desired. The iterations suppress false positives and refine lesion boundaries. The framework is trained on 660 MRI volumes of MS patients enrolled in clinical trials from 174 different centres, and tested on a separate multi-centre clinical trial data set with 535 MRI volumes. All data consists of T1, T2, PD and FLAIR contrasts. In comparison to other MRF methods, such as, and a traditional MRF, IMaGe is much more sensitive (with slightly better PPV). It outperforms its nearest competitor by around 20% when detecting very small lesions (3-10 voxels). This is a significant result, as such lesions constitute around 40% of the total number of lesions.

  13. Impact of brain tumour location on emotion and personality: a voxel-based lesion-symptom mapping study on mentalization processes.

    PubMed

    Campanella, Fabio; Shallice, Tim; Ius, Tamara; Fabbro, Franco; Skrap, Miran

    2014-09-01

    Patients affected by brain tumours may show behavioural and emotional regulation deficits, sometimes showing flattened affect and sometimes experiencing a true 'change' in personality. However, little evidence is available to the surgeon as to what changes are likely to occur with damage at specific sites, as previous studies have either relied on single cases or provided only limited anatomical specificity, mostly reporting associations rather than dissociations of symptoms. We investigated these aspects in patients undergoing surgery for the removal of cerebral tumours. We argued that many of the problems described can be ascribed to the onset of difficulties in one or more of the different levels of the process of mentalizing (i.e. abstracting and reflecting upon) emotion and intentions, which impacts on everyday behaviour. These were investigated in terms of (i) emotion recognition; (ii) Theory of Mind; (iii) alexithymia; and (iv) self-maturity (personality disorder). We hypothesized that temporo/limbic areas would be critical for processing emotion and intentions at a more perceptual level, while frontal lobe structures would be more critical when higher levels of mentalization/abstraction are required. We administered four different tasks, Task 1: emotion recognition of Ekman faces; Task 2: the Eyes Test (Theory of Mind); Task 3: Toronto Alexithymia Scale; and Task 4: Temperament and Character Inventory (a personality inventory), both immediately before and few days after the operation for the removal of brain tumours in a series of 71 patients (age range: 18-75 years; 33 female) with lesions located in the left or right frontal, temporal and parietal lobes. Lobe-based and voxel-based analysis confirmed that tasks requiring interpretation of emotions and intentions at more basic (less mentalized) levels (Tasks 1 and 2) were more affected by temporo/insular lesions, with emotion recognition (Task 1) being maximally impaired by anterior temporal and amygdala

  14. Lesion Symptom Mapping of Manipulable Object Naming in Nonfluent Aphasia: Can a Brain be both Embodied and Disembodied?

    PubMed Central

    Reilly, Jamie; Harnish, Stacy; Garcia, Amanda; Hung, Jinyi; Rodriguez, Amy D.; Crosson, Bruce

    2014-01-01

    Embodied cognition offers an approach to word meaning firmly grounded in action and perception. A strong prediction of embodied cognition is that sensorimotor simulation is a necessary component of lexical-semantic representation. One semantic distinction where motor imagery is likely to play a key role involves the representation of manufactured artifacts. Many questions remain with respect to the scope of embodied cognition. One dominant unresolved issue is the extent to which motor enactment is necessary for representing and generating words with high motor salience. We investigated lesion correlates of manipulable relative to non-manipulable name generation (e.g., name a school supply; name a mountain range) in patients with nonfluent aphasia (N=14). Lesion volumes within motor (BA4) and premotor (BA6) cortices were not predictive of category discrepancies. Lesion symptom mapping linked impairment for manipulable objects to polymodal convergence zones and to projections of the left, primary visual cortex specialized for motion perception (MT/V5+). Lesions to motor and premotor cortex were not predictive of manipulability impairment. This lesion correlation is incompatible with an embodied perspective premised on necessity of motor cortex for the enactment and subsequent production of motor-related words. These findings instead support a graded or ‘soft’ approach to embodied cognition premised on an ancillary role of modality-specific cortical regions in enriching modality-neutral representations. We discuss a dynamic, hybrid approach to the neurobiology of semantic memory integrating both embodied and disembodied components. PMID:24839997

  15. Decline in attainability of communion and agency life goals over 2 years following acquired brain injury and the impact on subjective well-being.

    PubMed

    Kuenemund, Anna; Zwick, Sarah; Doering, Bettina K; Conrad, Nico; Rief, Winfried; Exner, Cornelia

    2013-01-01

    Acquired brain injury (ABI) confronts patients with sudden and possibly permanent functional impairments which disrupt or block the attainment of important life goals and reduce subjective well-being (SWB). This longitudinal study aimed at investigating changes in the importance and the attainability of communion and agency life goals and their impact on SWB. Self-report measures of life goals, functional status and SWB were assessed in 42 patients during acute rehabilitation two months following ABI (baseline) and reassessed 19 months following discharge (follow up). Results indicate a significant longitudinal decrease of the general attainability of life goals and of the present success in achieving communal and agentic life goals. Life goal importance remained stable. After controlling for baseline SWB and follow up functional status the attainability of communal life goals significantly predicted SWB at follow up whereas agentic life goals failed to predict SWB. The present findings show long-term deterioration of life goal attainability. They highlight that more emphasis should be given to realistic attainability attributions during rehabilitation processes. Moreover, the results stress the need for outpatient treatment to promote disengagement from unobtainable life goals and to offer means for the engagement in alternative life goals in order to maintain or regain SWB.

  16. Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury

    PubMed Central

    2016-01-01

    Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM—admission FIM)/(Maximum possible FIM—Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself. PMID:27780215

  17. What are the barriers and facilitators to goal-setting during rehabilitation for stroke and other acquired brain injuries? A systematic review and meta-synthesis

    PubMed Central

    Plant, Sarah E; Tyson, Sarah F; Kirk, Susan; Parsons, John

    2016-01-01

    Objective: To identify the barriers and facilitators to goal-setting during rehabilitation for stroke and other acquired brain injuries. Data sources: AMED, Proquest, CINAHL and MEDLINE. Review methods: Two reviewers independently screened, extracted data and assessed study quality using the Mixed Methods Appraisal Tool and undertook thematic content analysis for papers examining the barriers and facilitators to goal-setting during stroke/neurological rehabilitation (any design). Last searches were completed in May 2016. Results: Nine qualitative papers were selected, involving 202 participants in total: 88 patients, 89 health care professionals and 25 relatives of participating patients. Main barriers were: Differences in staff and patients perspectives of goal-setting; patient-related barriers; staff-related barriers, and organisational level barriers. Main facilitators were: individually tailored goal-setting processes, strategies to promote communication and understanding, and strategies to avoid disappointment and unrealistic goals. In addition, patients’ and staff’s knowledge, experience, skill, and engagement with goal-setting could be either a barrier (if these aspects were absent) or a facilitator (if they were present). Conclusion: The main barriers and facilitators to goal-setting during stroke rehabilitation have been identified. They suggest that current methods of goal-setting during inpatient/early stage stroke or neurological rehabilitation are not fit for purpose. PMID:27496701

  18. Using single-case experimental design methodology to evaluate the effects of the ABC method for nursing staff on verbal aggressive behaviour after acquired brain injury.

    PubMed

    Winkens, Ieke; Ponds, Rudolf; Pouwels, Climmy; Eilander, Henk; van Heugten, Caroline

    2014-01-01

    The ABC method is a basic and simplified form of behavioural modification therapy for use by nurses. ABC refers to the identification of Antecedent events, target Behaviours, and Consequent events. A single-case experimental AB design was used to evaluate the effects of the ABC method on a woman diagnosed with olivo-ponto-cerebellar ataxia. Target behaviour was verbal aggressive behaviour during ADL care, assessed at 9 time points immediately before implementation of the ABC method and at 36 time points after implementation. A randomisation test showed a significant treatment effect between the baseline and intervention phases (t = .58, p = .03; ES [Nonoverlap All Pairs] = .62). Visual analysis, however, showed that the target behaviour was still present after implementation of the method and that on some days the nurses even judged the behaviour to be more severe than at baseline. Although the target behaviour was still present after treatment, the ABC method seems to be a promising tool for decreasing problem behaviour in patients with acquired brain injury. It is worth investigating the effects of this method in future studies. When interpreting single-subject data, both visual inspection and statistical analysis are needed to determine whether treatment is effective and whether the effects lead to clinically desirable results.

  19. Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury.

    PubMed

    Franceschini, Marco; Massimiani, Maria Pia; Paravati, Stefano; Agosti, Maurizio

    2016-01-01

    Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM-admission FIM)/(Maximum possible FIM-Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself.

  20. Evaluating the usability of a single UK community acquired brain injury (ABI) rehabilitation service website: implications for research methodology and website design.

    PubMed

    Newby, Gavin; Groom, Christina

    2010-04-01

    Information provision is an important resource for those living with acquired brain injury (ABI) and their families. Web-based health information services are now common additions to health service provision. Ideally, they should be easy to use and provide useful, relevant and accurate information. ABI injuries do not affect individuals in the same way, and survivors can have a wide range of abilities and impairments. Therefore, any informational resource intended for this group should take account of their needs and help to compensate for their limitations. This pilot study recruited a group of individuals with ABI (of a median Extended Glasgow Outcome Scale rating of "lower moderate disability") who were clients of a UK National Health Service rehabilitation service and asked them to assess a specialised website provided by that service and hosted by their employing Primary Care Trust organisation. Participants completed a practical task and then gave their opinions on various aspects of website design, and content. They were also asked to suggest improvements and recommend additions. Overall the results were favourable. However, improvements in the legibility, layout and writing style were identified. There were also requests to add more information on the existing topics and add additional topics. The discussion also evaluates the utility of the methodology and the implications of the results for others considering constructing their own website.

  1. EXTENDING THE ASSESSMENT OF TECHNOLOGY-AIDED PROGRAMS TO SUPPORT LEISURE AND COMMUNICATION IN PEOPLE WITH ACQUIRED BRAIN INJURY AND EXTENSIVE MULTIPLE DISABILITIES.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'reilly, Mark F; Sigafoos, Jeff; Buonocunto, Francesca; D'amico, Fiora; Quaranta, Sara; Navarro, Jorge; Lanzilotti, Crocifissa; Colonna, Fabio

    2015-10-01

    Intervention programs for people with acquired brain injury and extensive motor and communication impairment need to be diversified according to their characteristics and environment. These two studies assessed two technology-aided programs for supporting leisure (i.e., access to songs and videos) and communication (i.e., expressing needs and feelings and making requests) in six of those people. The three people participating in Study 1 did not possess speech but were able to understand spoken and written sentences. Their program presented leisure and communication options through written phrases appearing on the computer screen. The three people participating in Study 2 did not possess any speech and were unable to understand spoken or written language. Their program presented leisure and communication options through pictorial images. All participants relied on a simple microswitch response to enter the options and activate songs, videos, and communication messages. The data showed that the participants of both studies learned to use the program available to them and to engage in leisure and communication independently. The importance of using programs adapted to the participants and their environment was discussed.

  2. Affiliative and "self-as-doer" identities: Relationships between social identity, social support, and emotional status amongst survivors of acquired brain injury (ABI).

    PubMed

    Walsh, R Stephen; Muldoon, Orla T; Gallagher, Stephen; Fortune, Donal G

    2015-01-01

    Social support is an important factor in rehabilitation following acquired brain injury (ABI). Research indicates that social identity makes social support possible and that social identity is made possible by social support. In order to further investigate the reciprocity between social identity and social support, the present research applied the concepts of affiliative and "self-as-doer" identities to an analysis of relationships between social identity, social support, and emotional status amongst a cohort of 53 adult survivors of ABI engaged in post-acute community neurorehabilitation. Path analysis was used to test a hypothesised mediated model whereby affiliative identities have a significant indirect relationship with emotional status via social support and self-as-doer identification. Results support the hypothesised model. Evidence supports an "upward spiral" between social identity and social support such that affiliative identity makes social support possible and social support drives self-as-doer identity. Our discussion emphasises the importance of identity characteristics to social support, and to emotional status, for those living with ABI.

  3. Enactive Approach and Dual-Tasks for the Treatment of Severe Behavioral and Cognitive Impairment in a Person with Acquired Brain Injury: A Case Study

    PubMed Central

    Martínez-Pernía, David; Huepe, David; Huepe-Artigas, Daniela; Correia, Rut; García, Sergio; Beitia, María

    2016-01-01

    One of the most important sequela in persons who suffer from acquired brain injury is a behavioral disorder. To date, the primary approaches for the rehabilitation of this sequela are Applied Behavior Analysis, Cognitive-Behavior Therapy, and Comprehensive-Holistic Rehabilitation Programs. Despite this theoretical plurality, none of these approaches focuses on rehabilitating behavioral disorders considering the relation between affordance and environmental adaptation. To introduce this therapeutic view to neurorehabilitation, we apply the theoretical tenets of the enactive paradigm to the rehabilitation of a woman with severe behavioral and cognitive impairment. Over seventeen sessions, her behavioral and cognitive performance was assessed in relation to two seated affordances (seated on a chair and seated on a ball 65 cm in diameter) and the environmental adaptation while she was working on various cognitive tasks. These two seated affordances allowed to incorporate the theoretical assumptions of the enactive approach and to know how the behavior and the cognition were modified based on these two postural settings and the environmental adaptation. The findings indicate that the subject exhibited better behavioral (physical and verbal) and cognitive (matching success and complex task) performances when the woman worked on the therapeutic ball than when the woman was on the chair. The enactive paradigm applied in neurorehabilitation introduces a level of treatment that precedes behavior and cognition. This theoretical consideration allowed the discovery of a better relation between a seated affordance and the environmental adaptation for the improvement behavioral and cognitive performance in our case study. PMID:27847494

  4. Outcomes of a community-based treatment programme for people with acquired brain injury in the chronic phase: a pilot study.

    PubMed

    Middag-van Spanje, Marij; Smeets, Sanne; van Haastregt, Jolanda; van Heugten, Caroline

    2017-03-28

    The objective of the study was to evaluate the outcomes of Brainz, a low intensity community-based treatment programme for people with acquired brain injury (ABI). Participants were 62 people with sustained ABI (5.2 years post-injury, SD = 4.5) and 35 family caregivers. Participants attended two to five cognitive and physical group modules and received two hours of individual home treatment every two weeks. Primary outcomes for people with ABI were participation, perceived difficulties in daily life and need of care, level of goal attainment, and self-esteem. Primary family caregiver outcome was perceived burden of care. Attrition rate of people with ABI was 24% (n = 15), and of family caregivers was 31% (n = 11). People with ABI were more satisfied with the level of their participation after completing Brainz (p < .01), but showed no change in participation frequency or in restrictions (both ps > .01). They perceived fewer difficulties in daily life and less need of care (both ps < .01). Also, in two cognitive modules people improved on their goal achievement (p < .01). However, their self-esteem was reduced (p < .01). Caregiver burden was reduced (p < .01). This study has provided preliminary evidence of the effectiveness of a combined group-based clinical and individual home-based treatment programme, but more research is needed, preferably in larger controlled studies.

  5. Parallel Olfactory Processing in the Honey Bee Brain: Odor Learning and Generalization under Selective Lesion of a Projection Neuron Tract

    PubMed Central

    Carcaud, Julie; Giurfa, Martin; Sandoz, Jean Christophe

    2016-01-01

    The function of parallel neural processing is a fundamental problem in Neuroscience, as it is found across sensory modalities and evolutionary lineages, from insects to humans. Recently, parallel processing has attracted increased attention in the olfactory domain, with the demonstration in both insects and mammals that different populations of second-order neurons encode and/or process odorant information differently. Among insects, Hymenoptera present a striking olfactory system with a clear neural dichotomy from the periphery to higher-order centers, based on two main tracts of second-order (projection) neurons: the medial and lateral antennal lobe tracts (m-ALT and l-ALT). To unravel the functional role of these two pathways, we combined specific lesions of the m-ALT tract with behavioral experiments, using the classical conditioning of the proboscis extension response (PER conditioning). Lesioned and intact bees had to learn to associate an odorant (1-nonanol) with sucrose. Then the bees were subjected to a generalization procedure with a range of odorants differing in terms of their carbon chain length or functional group. We show that m-ALT lesion strongly affects acquisition of an odor-sucrose association. However, lesioned bees that still learned the association showed a normal gradient of decreasing generalization responses to increasingly dissimilar odorants. Generalization responses could be predicted to some extent by in vivo calcium imaging recordings of l-ALT neurons. The m-ALT pathway therefore seems necessary for normal classical olfactory conditioning performance. PMID:26834589

  6. Social Brains in Context: Lesions Targeted to the Song Control System in Female Cowbirds Affect Their Social Network

    PubMed Central

    Maguire, Sarah E.; Schmidt, Marc F.; White, David J.

    2013-01-01

    Social experiences can organize physiological, neural, and reproductive function, but there are few experimental preparations that allow one to study the effect individuals have in structuring their social environment. We examined the connections between mechanisms underlying individual behavior and social dynamics in flocks of brown-headed cowbirds (Molothrus ater). We conducted targeted inactivations of the neural song control system in female subjects. Playback tests revealed that the lesions affected females' song preferences: lesioned females were no longer selective for high quality conspecific song. Instead, they reacted to all cowbird songs vigorously. When lesioned females were introduced into mixed-sex captive flocks, they were less likely to form strong pair-bonds, and they no longer showed preferences for dominant males. This in turn created a cascade of effects through the groups. Social network analyses showed that the introduction of the lesioned females created instabilities in the social structure: males in the groups changed their dominance status and their courtship patterns, and even the competitive behavior of other female group-mates was affected. These results reveal that inactivation of the song control system in female cowbirds not only affects individual behavior, but also exerts widespread effects on the stability of the entire social system. PMID:23650558

  7. Parallel Olfactory Processing in the Honey Bee Brain: Odor Learning and Generalization under Selective Lesion of a Projection Neuron Tract.

    PubMed

    Carcaud, Julie; Giurfa, Martin; Sandoz, Jean Christophe

    2015-01-01

    The function of parallel neural processing is a fundamental problem in Neuroscience, as it is found across sensory modalities and evolutionary lineages, from insects to humans. Recently, parallel processing has attracted increased attention in the olfactory domain, with the demonstration in both insects and mammals that different populations of second-order neurons encode and/or process odorant information differently. Among insects, Hymenoptera present a striking olfactory system with a clear neural dichotomy from the periphery to higher-order centers, based on two main tracts of second-order (projection) neurons: the medial and lateral antennal lobe tracts (m-ALT and l-ALT). To unravel the functional role of these two pathways, we combined specific lesions of the m-ALT tract with behavioral experiments, using the classical conditioning of the proboscis extension response (PER conditioning). Lesioned and intact bees had to learn to associate an odorant (1-nonanol) with sucrose. Then the bees were subjected to a generalization procedure with a range of odorants differing in terms of their carbon chain length or functional group. We show that m-ALT lesion strongly affects acquisition of an odor-sucrose association. However, lesioned bees that still learned the association showed a normal gradient of decreasing generalization responses to increasingly dissimilar odorants. Generalization responses could be predicted to some extent by in vivo calcium imaging recordings of l-ALT neurons. The m-ALT pathway therefore seems necessary for normal classical olfactory conditioning performance.

  8. Changes in /sup 3/H-substance P receptor binding in the rat brain after kainic acid lesion of the corpus striatum

    SciTech Connect

    Mantyh, P.W.; Hunt, S.P.

    1986-06-01

    Previous studies have indicated that the substantia nigra contains the highest concentration of substance P-like immunoreactivity (SPLI) in the brain. Paradoxically, it also appears to contain one of the lowest concentrations of substance P receptors in the brain. One possibility is that the massive amount of SPLI blocks the binding of the radioligand to the substance P receptor and/or down-regulates the number of substance P receptors present in this structure. Since greater than 95% of the SPLI within the substantia nigra originates from the corpus striatum, we have lesioned this area and measured the changes in substance P receptor concentration in the substantia nigra and other corpus striatal projection areas. A semiquantitative autoradiographic technique for measuring the binding of /sup 3/H-substance P to substance P receptors was used in conjunction with tritium-sensitive film. 3H-substance P binding was measured in both the corpus striatum and its projection areas after kainic acid lesion of the corpus striatum. At either 4 or 21 d after the lesion there was approximately a 90% loss of substance P receptors in the rostral striatum, a 74% loss in the globus pallidus, a 57% increase in receptor number in lamina I and II of the ipsilateral somatosensory cortex, and no apparent change in the number of receptors in the substantia nigra pars reticulata, superior colliculus, and central gray. These findings suggest that the low concentration of substance P receptors found within the substantia nigra is not due the massive SPLI innervation, since removal of greater than 95% of the SPLI had no measurable effect on the concentration of substance P receptors.

  9. Long-term effects of enriched environment on neurofunctional outcome and CNS lesion volume after traumatic brain injury in rats.

    PubMed

    Maegele, M; Braun, M; Wafaisade, A; Schäfer, N; Lippert-Gruener, M; Kreipke, C; Rafols, J; Schäfer, U; Angelov, D N; Stuermer, E K

    2015-01-01

    To determine whether the exposure to long term enriched environment (EE) would result in a continuous improvement of neurological recovery and ameliorate the loss of brain tissue after traumatic brain injury (TBI) vs. standard housing (SH). Male Sprague-Dawley rats (300-350 g, n=28) underwent lateral fluid percussion brain injury or SHAM operation. One TBI group was held under complex EE for 90 days, the other under SH. Neuromotor and sensorimotor dysfunction and recovery were assessed after injury and at days 7, 15, and 90 via Composite Neuroscore (NS), RotaRod test, and Barnes Circular Maze (BCM). Cortical tissue loss was assessed using serial brain sections. After day 7 EE animals showed similar latencies and errors as SHAM in the BCM. SH animals performed notably worse with differences still significant on day 90 (p<0.001). RotaRod test and NS revealed superior results for EE animals after day 7. The mean cortical volume was significantly higher in EE vs. SH animals (p=0.003). In summary, EE animals after lateral fluid percussion (LFP) brain injury performed significantly better than SH animals after 90 days of recovery. The window of opportunity may be wide and also lends further credibility to the importance of long term interventions in patients suffering from TBI.

  10. The effect of NMDA-R antagonism on simultaneously acquired local field potentials and tissue oxygen levels in the brains of freely-moving rats.

    PubMed

    Kealy, John; Commins, Sean; Lowry, John P

    2017-01-11

    Non-competitive NMDA receptor antagonists are known to induce psychosis-like symptoms in rodents. Administration of such compounds cause behavioural effects such as memory impairment and hyperlocomotion. Additionally, drugs such as phencyclidine (PCP), ketamine and MK-801 all cause distinctive increases in striatal local field potential (LFP) in the high frequency oscillation (HFO) band in the power spectrum (140-180 Hz). Amperometric sensors provide a means to measure tissue oxygen (tO2; a BOLD-like signal) in the brains of freely-moving rats while simultaneously acquiring LFP using the same electrode. Carbon paste electrodes were implanted into the striatum and hippocampus of male Wistar rats. Rats were administered with saline, ketamine (10 mg/kg), MK-801 (0.1 mg/kg) and PCP (2.5 mg/kg) and recordings were made at 1 kHz using three different potentials (-650 mV to measure tO2; 0 mV and +700 mV as control conditions). NMDA receptor antagonism caused significant increases in tO2 in both the striatum and the hippocampus. Power spectrum analysis showed significant increases in HFO power in the striatum but not in the hippocampus. Conversely, there were significant decreases in delta and alpha power along with increases in theta and gamma power in the hippocampus that were absent in the striatum. This supports findings that LFP can be obtained from an amperometric sensor signal; allowing simultaneous acquisition of two translational biomarkers of neuronal activity (LFP and tO2).

  11. Acquired hyperpigmentations*

    PubMed Central

    Cestari, Tania Ferreira; Dantas, Lia Pinheiro; Boza, Juliana Catucci

    2014-01-01

    Cutaneous hyperpigmentations are frequent complaints, motivating around 8.5% of all dermatological consultations in our country. They can be congenital, with different patterns of inheritance, or acquired in consequence of skin problems, systemic diseases or secondary to environmental factors. The vast majority of them are linked to alterations on the pigment melanin, induced by different mechanisms. This review will focus on the major acquired hyperpigmentations associated with increased melanin, reviewing their mechanisms of action and possible preventive measures. Particularly prominent aspects of diagnosis and therapy will be emphasized, with focus on melasma, post-inflammatory hyperpigmentation, periorbital pigmentation, dermatosis papulosa nigra, phytophotodermatoses, flagellate dermatosis, erythema dyschromicum perstans, cervical poikiloderma (Poikiloderma of Civatte), acanthosis nigricans, cutaneous amyloidosis and reticulated confluent dermatitis PMID:24626644

  12. Uterine Vascular Lesions

    PubMed Central

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

  13. [Micropolarization of the brain: a noninvasive method for correction of morphological and functional disturbances in acute focal brain lesions and their consequences].

    PubMed

    Sheliakin, A M; Preobrazhenskaia, I G; Tiul'kin, O N

    2006-01-01

    The paper is devoted to the use of small direct current in correction of morphological and functional disturbances of the human brain. Two hundred and one patients aged from 7 to 82 years have been studied. In patients with focal brain damages at the acute stage (1-2 days after stroke), the anode and cathode were placed in the projection of a damaged center. In patients in "autonomic status" condition, the anode was placed both in frontal and parietal projection of the right hemisphere cortex and the cathode--on a mastoid of the right hemisphere. Strength of the current used was 300-500 mcA, time of one procedure--30-40 min. The whole treatment course involved no more than 15 procedures. Before the treatment, after 3-5 procedures of micropolarization and at the end of the treatment course, patients underwent computer tomography and electroencephalographic study. Transcranial micropolarization exerts a cerebroprotective effect and has a selective-systemic character due to an increase of neuronal structures activity boht directly in the area of the impact that manifests with the absence of brain edema and the reduction of the destruction locus by 10-15% just after three procedures and as in the other brain regions that results in the decrease of intensity of general cerebral symptoms. The micropolarization promotes restoration of the broken functional connections in central regulatory systems caused by improvement of interaction between neurons, structures and systems the results finally in restoration of central regulation of body's functions.

  14. Neuronal markers expression of NGF-primed bone marrow cells (BMCs) transplanted in the brain of 6-hydroxydopamine and ibotenic acid lesioned littermate mice.

    PubMed

    Triaca, Viviana; Aloe, Luigi

    In the present study, we aim to show that non-adherent bone marrow cells (BMCs) express TrkA, the nerve growth factor (NGF) receptor, and that addition of NGF promotes the survival and neuronal commitment of BMC transplanted into the experimentally injured brain of littermates mice. Immunohistochemical analysis revealed that transplanted BMCs express tyrosine hydroxylase (TH) in proximity of the damaged dopaminergic tissues and choline acetyltransferase (ChAT) in the lesioned cholinergic regions. These results suggest that NGF supports the survival and differentiation of uncommitted BMCs and concurs with other local environmental signals to promote the expression of neuronal markers in these cells. The possible functional significance of these observations will be discussed.

  15. Diagnostic work up for language testing in patients undergoing awake craniotomy for brain lesions in language areas.

    PubMed

    Bilotta, Federico; Stazi, Elisabetta; Titi, Luca; Lalli, Diana; Delfini, Roberto; Santoro, Antonio; Rosa, Giovanni

    2014-06-01

    Awake craniotomy is the technique of choice in patients with brain tumours adjacent to primary and accessory language areas (Broca's and Wernicke's areas). Language testing should be aimed to detect preoperative deficits, to promptly identify the occurrence of new intraoperative impairments and to establish the course of postoperative language status. Aim of this case series is to describe our experience with a dedicated language testing work up to evaluate patients with or at risk for language disturbances undergoing awake craniotomy for brain tumour resection. Pre- and intra operative testing was accomplished with 8 tests. Intraoperative evaluation was accomplished when patients were fully cooperative (Ramsey < 3). Postoperative evaluation was scheduled at early (within 21 days) and long-term follow-up (3-6 months). Twenty consecutive patients were prospectively recruited. Preoperative language testings were normal in 9 patients (45%), showed mild to moderate language deficit in 8 (40%) and severe language deficit or aphasic disorders in 3 (15%). Broca's area was identified in 15 patients, in all cases by counting arrest during stimulation and in 12 cases by naming arrest. In this article we describe our experience using a language testing work up to evaluate - pre, intra and postoperatively - patients undergoing awake craniotomy for brain tumour resection with preoperative language disturbances or at risk for postoperative language deficits. This approach allows a systematic evaluation and recording of language function status and can be accomplished even when a neuropsychologist or speech therapist are not involved in the operation crew.

  16. Delayed Methylene Blue Improves Lesion Volume, Multi-Parametric Quantitative Magnetic Resonance Imaging Measurements, and Behavioral Outcome after Traumatic Brain Injury.

    PubMed

    Talley Watts, Lora; Long, Justin Alexander; Boggs, Robert Cole; Manga, Hemanth; Huang, Shiliang; Shen, Qiang; Duong, Timothy Q

    2016-01-15

    Traumatic brain injury (TBI) remains a primary cause of death and disability in both civilian and military populations worldwide. There is a critical need for the development of neuroprotective agents that can circumvent damage and provide functional recovery. We previously showed that methylene blue (MB), a U.S. Food and Drug Administration-grandfathered drug with energy-enhancing and antioxidant properties, given 1 and 3 h post-TBI, had neuroprotective effects in rats. This study aimed to further investigate the neuroprotection of delayed MB treatment (24 h postinjury) post-TBI as measured by lesion volume and functional outcomes. Comparisons were made with vehicle and acute MB treatment. Multi-modal magnetic resonance imaging and behavioral studies were performed at 1 and 3 h and 2, 7, and 14 days after an impact to the primary forelimb somatosensory cortex. We found that delaying MB treatment 24 h postinjury still minimized lesion volume and functional deficits, compared to vehicle-treated animals. The data further support the potential for MB as a neuroprotective treatment, especially when medical teatment is not readily available. MB has an excellent safety profile and is clinically approved for other indications. MB clinical trials on TBI can thus be readily explored.

  17. Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury

    PubMed Central

    2011-01-01

    Background Acquired brain injury (ABI) is the main cause of death and disability among young adults. In most cases, survivors can experience balance instability, resulting in functional impairments that are associated with diminished health-related quality of life. Traditional rehabilitation therapy may be tedious. This can reduce motivation and adherence to the treatment and thus provide a limited benefit to patients with balance disorders. We present eBaViR (easy Balance Virtual Rehabilitation), a system based on the Nintendo® Wii Balance Board® (WBB), which has been designed by clinical therapists to improve standing balance in patients with ABI through motivational and adaptative exercises. We hypothesize that eBaViR, is feasible, safe and potentially effective in enhancing standing balance. Methods In this contribution, we present a randomized and controlled single blinded study to assess the influence of a WBB-based virtual rehabilitation system on balance rehabilitation with ABI hemiparetic patients. This study describes the eBaViR system and evaluates its effectiveness considering 20 one-hour-sessions of virtual reality rehabilitation (n = 9) versus standard rehabilitation (n = 8). Effectiveness was evaluated by means of traditional static and dynamic balance scales. Results The final sample consisted of 11 men and 6 women. Mean ± SD age was 47.3 ± 17.8 and mean ± SD chronicity was 570.9 ± 313.2 days. Patients using eBaViR had a significant improvement in static balance (p = 0.011 in Berg Balance Scale and p = 0.011 in Anterior Reaches Test) compared to patients who underwent traditional therapy. Regarding dynamic balance, the results showed significant improvement over time in all these measures, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. There were no serious adverse events during treatment in either group. Conclusions The results suggest that e

  18. Toxoplasmosis of spinal cord in acquired immunodeficiency syndrome patient presenting as paraparesis: a rare entity.

    PubMed

    Agrawal, Sachin R; Singh, Vinita; Ingale, Sheetal; Jain, Ajeet Prasad

    2014-10-01

    Although brain has been the most common site for toxoplasma infection in acquired immunodeficiency syndrome patients, involvement of spinal cord by toxoplasma has been rarely found. Spinal cord toxoplasmosis can present as acute onset weakness in both lower limbs associated with sensory and bladder dysfunction. A presumptive diagnosis can be made in patients with CD4 count <100/mm(3) based on a positive serum Toxoplasma gondii IgG antibodies, no recent prophylaxis against toxoplasmosis, intramedullary ring enhancing lesion in spinal cord supported by similar lesions in brain parenchyma. Institutions of antitoxoplasma treatment in such patients result in prompt clinical response and therefore avoiding the need of unnecessary invasive diagnostic tests. Here, we report a case of toxoplasmic myelitis in immunocompromised patient presenting as myelopathy who showed significant clinical improvement after starting antitoxoplasma treatment. Hence toxoplasmic myelitis should be considered in toxoplasma seropositive immunocompromised patients presenting as myelopathy and imaging studies showing ring enhancing intramedullary lesion.

  19. Spinal cord toxoplasmosis in human immunodeficiency virus infection/acquired immunodeficiency syndrome.

    PubMed

    García-García, Concepción; Castillo-Álvarez, Federico; Azcona-Gutiérrez, José M; Herraiz, María J; Ibarra, Valvanera; Oteo, José A

    2015-05-01

    Neurological complications in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) are still common, even in the era of highly active antiretroviral therapy. Opportunistic infections, immune reconstitution, the virus itself, antiretroviral drugs and neurocognitive disorders have to be considered when establishing the differential diagnosis. Toxoplasmic encephalitis remains the major cause of space-occupying lesions in the brain of patients with HIV/AIDS; however, spinal cord involvement has been reported infrequently. Here, we review spinal cord toxoplasmosis in HIV infection and illustrate the condition with a recent case from our hospital. We suggest that most patients with HIV/AIDS and myelitis with enhanced spine lesions, multiple brain lesions and positive serology for Toxoplasma gondii should receive immediate empirical treatment for toxoplasmosis, and a biopsy should be performed in those cases without clinical improvement or with deterioration.

  20. Fluorescence spectroscopy to discriminate neoplastic human brain lesions: a study using the spectral intensity ratio and multivariate linear discriminant analysis

    NASA Astrophysics Data System (ADS)

    Nazeer, Shaiju S.; Saraswathy, Ariya; Gupta, Arun Kumar; Jayasree, Ramapurath S.

    2014-02-01

    Fluorescence spectroscopy is an emerging tool used to differentiate normal and malignant tissue based on the emission spectral profile from endogenous fluorophores. The goal of this study is to estimate the concentration of fluorophores using autofluorescence spectroscopy and try to utilize its diagnostic potential on samples of clinical importance. Brain tumor tissues from patients who received craniotomy for the removal of astrocytoma, glioma, meningioma and schwannoma were utilized in this study. Fluorescence emissions of the formalin fixed samples were recorded at excitation wavelengths of 320 and 410 nm. The emission characteristics of fluorophores such as collagen, nicotinamide adenine dinucleotide (NADH), flavin adenine dinucleotide (FAD), phospholipids and porphyrins of tumor tissue and adjacent normal tissue were elicited. Exact tissue classification was carried out using the spectral intensity ratio (SIR) and multivariate principal component analysis-linear discriminant analysis (PCA-LDA). The diagnostic algorithm based on PCA-LDA provided better classification efficiency than SIR. Moreover, the spectral data based on an excitation wavelength of 410 nm are found to be more efficient in the classification than 320 nm excitation, using PCA-LDA. Better efficacy of PCA-LDA in tissue classification was further confirmed by the receiver operator characteristic (ROC) curve method. The results of this study establish the feasibility of using fluorescence spectroscopy based real time tools for the discrimination of brain tumors from the adjacent normal tissue during craniotomies, which at present faces a huge challenge.

  1. What the locus of brain lesion tells us about the nature of the cognitive defect underlying category-specific disorders: a review.

    PubMed

    Gainotti, G

    2000-09-01

    Different models have been proposed to account for the nature of the cognitive defects underlying category-specific disorders for living and non-living things. One model assumes that the living/non-living distinction is the by-product of a more basic dichotomy, contingent upon the different weighting that visuo-perceptual and functional attributes have in the identification of members of these categories. A second model submits that evolutionary pressure resulted in the elaboration of dedicated neural mechanisms for the domains of living (animals and plants) and non-living (artefacts) things. A third model proposes that the different level of interconnections existing between perceptual and functional features in living and non living things may be more important than the weighting of these features. Each of these models makes implicit assumptions about the extent and the localization of brain lesions provoking category-specific disorders. However, it must also be considered that these disorders are heterogeneous in nature, resulting from defects located at the semantic, lexical or visual level. In the present review of the literature, we kept this distinction in mind in trying to analyze the neuroanatomical correlates of living and non-living disorders. Our findings showed that there is a correlation between the locus of lesion and the patterns of categorical impairment: (a) a bilateral injury to the antero-mesial and inferior parts of the temporal lobes was found in patients with a category-specific semantic impairment for living things; (b) a lesion of the infero-mesial parts of the temporo-occipital areas of the left hemisphere was found in a group of patients showing a specific lexical impairment for members of the 'plants' category; (c) an extensive lesion of the areas lying on the dorso-lateral convexity of the left hemisphere was found in patients with a category-specific semantic impairment for man-made artefacts. Taken together, these results seem to show

  2. L-carnitine enhances axonal plasticity and improves white-matter lesions after chronic hypoperfusion in rat brain.

    PubMed

    Ueno, Yuji; Koike, Masato; Shimada, Yoshiaki; Shimura, Hideki; Hira, Kenichiro; Tanaka, Ryota; Uchiyama, Yasuo; Hattori, Nobutaka; Urabe, Takao

    2015-03-01

    Chronic cerebral hypoperfusion causes white-matter lesions (WMLs) with oxidative stress and cognitive impairment. However, the biologic mechanisms that regulate axonal plasticity under chronic cerebral hypoperfusion have not been fully investigated. Here, we investigated whether L-carnitine, an antioxidant agent, enhances axonal plasticity and oligodendrocyte expression, and explored the signaling pathways that mediate axonal plasticity in a rat chronic hypoperfusion model. Adult male Wistar rats subjected to ligation of the bilateral common carotid arteries (LBCCA) were treated with or without L-carnitine. L-carnitine-treated rats exhibited significantly reduced escape latency in the Morris water maze task at 28 days after chronic hypoperfusion. Western blot analysis indicated that L-carnitine increased levels of phosphorylated high-molecular weight neurofilament (pNFH), concurrent with a reduction in phosphorylated phosphatase tensin homolog deleted on chromosome 10 (PTEN), and increased phosphorylated Akt and mammalian target of rapamycin (mTOR) at 28 days after chronic hypoperfusion. L-carnitine reduced lipid peroxidation and oxidative DNA damage, and enhanced oligodendrocyte marker expression and myelin sheath thickness after chronic hypoperfusion. L-carnitine regulates the PTEN/Akt/mTOR signaling pathway, and enhances axonal plasticity while concurrently ameliorating oxidative stress and increasing oligodendrocyte myelination of axons, thereby improving WMLs and cognitive impairment in a rat chronic hypoperfusion model.

  3. L-carnitine enhances axonal plasticity and improves white-matter lesions after chronic hypoperfusion in rat brain

    PubMed Central

    Ueno, Yuji; Koike, Masato; Shimada, Yoshiaki; Shimura, Hideki; Hira, Kenichiro; Tanaka, Ryota; Uchiyama, Yasuo; Hattori, Nobutaka; Urabe, Takao

    2015-01-01

    Chronic cerebral hypoperfusion causes white-matter lesions (WMLs) with oxidative stress and cognitive impairment. However, the biologic mechanisms that regulate axonal plasticity under chronic cerebral hypoperfusion have not been fully investigated. Here, we investigated whether L-carnitine, an antioxidant agent, enhances axonal plasticity and oligodendrocyte expression, and explored the signaling pathways that mediate axonal plasticity in a rat chronic hypoperfusion model. Adult male Wistar rats subjected to ligation of the bilateral common carotid arteries (LBCCA) were treated with or without L-carnitine. L-carnitine-treated rats exhibited significantly reduced escape latency in the Morris water maze task at 28 days after chronic hypoperfusion. Western blot analysis indicated that L-carnitine increased levels of phosphorylated high-molecular weight neurofilament (pNFH), concurrent with a reduction in phosphorylated phosphatase tensin homolog deleted on chromosome 10 (PTEN), and increased phosphorylated Akt and mammalian target of rapamycin (mTOR) at 28 days after chronic hypoperfusion. L-carnitine reduced lipid peroxidation and oxidative DNA damage, and enhanced oligodendrocyte marker expression and myelin sheath thickness after chronic hypoperfusion. L-carnitine regulates the PTEN/Akt/mTOR signaling pathway, and enhances axonal plasticity while concurrently ameliorating oxidative stress and increasing oligodendrocyte myelination of axons, thereby improving WMLs and cognitive impairment in a rat chronic hypoperfusion model. PMID:25465043

  4. Written Discourse and Acquired Brain Impairment: Evaluation of Structural and Semantic Features of Personal Letters from a Systemic Functional Linguistic Perspective

    ERIC Educational Resources Information Center

    Mortensen, Lynne

    2005-01-01

    This qualitative study investigated written discourse in the form of personal letters written by ten people with aphasia following stroke and ten people with cognitive-language disorder as a consequence of traumatic brain injury, and compared their performance with 15 non brain-damaged writers. Personal letters perform the dual function of…

  5. Exercise training reinstates cortico-cortical sensorimotor functional connectivity following striatal lesioning: Development and application of a subregional-level analytic toolbox for perfusion autoradiographs of the rat brain

    NASA Astrophysics Data System (ADS)

    Peng, Yu-Hao; Heintz, Ryan; Wang, Zhuo; Guo, Yumei; Myers, Kalisa; Scremin, Oscar; Maarek, Jean-Michel; Holschneider, Daniel

    2014-12-01

    Current rodent connectome projects are revealing brain structural connectivity with unprecedented resolution and completeness. How subregional structural connectivity relates to subregional functional interactions is an emerging research topic. We describe a method for standardized, mesoscopic-level data sampling from autoradiographic coronal sections of the rat brain, and for correlation-based analysis and intuitive display of cortico-cortical functional connectivity (FC) on a flattened cortical map. A graphic user interface “Cx-2D” allows for the display of significant correlations of individual regions-of-interest, as well as graph theoretical metrics across the cortex. Cx-2D was tested on an autoradiographic data set of cerebral blood flow (CBF) of rats that had undergone bilateral striatal lesions, followed by 4 weeks of aerobic exercise training or no exercise. Effects of lesioning and exercise on cortico-cortical FC were examined during a locomotor challenge in this rat model of Parkinsonism. Subregional FC analysis revealed a rich functional reorganization of the brain in response to lesioning and exercise that was not apparent in a standard analysis focused on CBF of isolated brain regions. Lesioned rats showed diminished degree centrality of lateral primary motor cortex, as well as neighboring somatosensory cortex--changes that were substantially reversed in lesioned rats following exercise training. Seed analysis revealed that exercise increased positive correlations in motor and somatosensory cortex, with little effect in non-sensorimotor regions such as visual, auditory, and piriform cortex. The current analysis revealed that exercise partially reinstated sensorimotor FC lost following dopaminergic deafferentation. Cx-2D allows for standardized data sampling from images of brain slices, as well as analysis and display of cortico-cortical FC in the rat cerebral cortex with potential applications in a variety of autoradiographic and histologic

  6. Exercise training reinstates cortico-cortical sensorimotor functional connectivity following striatal lesioning: development and application of a subregional-level analytic toolbox for perfusion autoradiographs of the rat brain

    PubMed Central

    Peng, Yu-Hao; Heintz, Ryan; Wang, Zhuo; Guo, Yumei; Myers, Kalisa G.; Scremin, Oscar U.; Maarek, Jean-Michel I.; Holschneider, Daniel P.

    2015-01-01

    Current rodent connectome projects are revealing brain structural connectivity with unprecedented resolution and completeness. How subregional structural connectivity relates to subregional functional interactions is an emerging research topic. We describe a method for standardized, mesoscopic-level data sampling from autoradiographic coronal sections of the rat brain, and for correlation-based analysis and intuitive display of cortico-cortical functional connectivity (FC) on a flattened cortical map. A graphic user interface “Cx-2D” allows for the display of significant correlations of individual regions-of-interest, as well as graph theoretical metrics across the cortex. Cx-2D was tested on an autoradiographic data set of cerebral blood flow (CBF) of rats that had undergone bilateral striatal lesions, followed by 4 weeks of aerobic exercise training or no exercise. Effects of lesioning and exercise on cortico-cortical FC were examined during a locomotor challenge in this rat model of Parkinsonism. Subregional FC analysis revealed a rich functional reorganization of the brain in response to lesioning and exercise that was not apparent in a standard analysis focused on CBF of isolated brain regions. Lesioned rats showed diminished degree centrality of lateral primary motor cortex, as well as neighboring somatosensory cortex—changes that were substantially reversed in lesioned rats following exercise training. Seed analysis revealed that exercise increased positive correlations in motor and somatosensory cortex, with little effect in non-sensorimotor regions such as visual, auditory, and piriform cortex. The current analysis revealed that exercise partially reinstated sensorimotor FC lost following dopaminergic deafferentation. Cx-2D allows for standardized data sampling from images of brain slices, as well as analysis and display of cortico-cortical FC in the rat cerebral cortex with potential applications in a variety of autoradiographic and histologic

  7. Cilostazol reduces blood brain barrier dysfunction, white matter lesion formation and motor deficits following chronic cerebral hypoperfusion.

    PubMed

    Edrissi, Hamidreza; Schock, Sarah C; Cadonic, Robert; Hakim, Antoine M; Thompson, Charlie S

    2016-09-01

    Cerebral small vessel disease (CSVD) is a pathological process leading to lacunar infarcts, leukoaraiosis and cerebral microbleeds. Dysfunction of the blood brain barrier (BBB) has been proposed as a mechanism in the progression cerebral small vessel disease. A rodent model commonly used to study some aspects of CSVD is bilateral common carotid artery occlusion (BCCAO) in the rat. In the present study it was determined that gait impairment, as determined by a tapered beam test, and BBB permeability increased following BCCAO. Cilostazol, a type III phosphodiesterase inhibitor, has been shown to have anti-apoptotic effects and prevent white matter vacuolation and rarefaction induced by BCCAO in rats. In this study the protective effect of cilostazol administration on the increase BBB permeability following BCCAO was determined as well as the effect on plasma levels of circulating microparticles (MPs), cerebral white matter rarefaction, glial activation and gait disturbance. The effect of cilostazol on in vitro endothelial barriers was also evaluated. Cilostazol treatment improved BBB permeability and reduced gait disturbance, visual impairment and microglial activation in optic tract following BCCAO in vivo. It also reduced the degree of cell death and the reduction in trans-endothelial electrical resistance (TEER) in artificial endothelial barriers in vitro induced by MP treatment of in vitro barriers.

  8. A short-term scan-rescan reliability test measuring brain tissue and subcortical hyperintensity volumetrics obtained using the lesion explorer structural MRI processing pipeline.

    PubMed

    Ramirez, Joel; Scott, Christopher J M; Black, Sandra E

    2013-01-01

    Lesion Explorer (LE) is a reliable and comprehensive MRI-derived tissue segmentation and brain region parcellation processing pipeline for obtaining intracranial tissue and subcortical hyperintensity (SH) volumetrics. The processing pipeline segments: gray (GM) and white matter (WM); sulcal (sCSF) and ventricular cerebrospinal fluid (vCSF); periventricular (pvSH) and deep white subcortical hyperintensities (dwSH); and cystic fluid filled lacunar-like infarcts (Lacunar); into 26 regions of interest. A short-term scan-rescan reliability test was performed on 20 healthy volunteers: 10 older (mean = 77.7 years, SD = 11.1) and 10 younger (mean = 29.4 years, SD = 7.1). Each participant was scanned twice with an average interscan interval of 15.4 days (range: 29 min-50 days). Results suggest low technique-related error as indicated by excellent intraclass correlation coefficient (ICC) results, with ICCs above 0.90 (p < 0.05) for GM, WM, and CSF, in all 26 regions of interest (13 per hemisphere). Ventricular and lesion sub-type (pvSH, dwSH, and Lacunar) volumes also showed high scan-rescan reliability (dwSH = 0.9998, pvSH = 0.9998, Lacunar = 0.9859, p < 0.01). As indicated by the results of this short-term scan-rescan study, the LE structural MRI processing pipeline can be applied for longitudinal volumetric analyses with confidence.

  9. Intracranial pressure changes following traumatic brain injury in rats: lack of significant change in the absence of mass lesions or hypoxia.

    PubMed

    Gabrielian, Levon; Willshire, Luke W; Helps, Stephen C; van den Heuvel, Corinna; Mathias, Jane; Vink, Robert

    2011-10-01

    Traumatic brain injury (TBI) often causes raised intracranial pressure (ICP), with >50% of all TBI- related deaths being associated with this increase in ICP. To date, there is no effective pharmacological treatment for TBI, partly because widely used animal models of TBI may not replicate many of the pathophysiological responses observed in humans, and particularly the ICP response. Generally, rodents are the animal of choice in neurotrauma research, and edema formation has been demonstrated in rat models; however, few studies in rats have specifically explored the effects of TBI on ICP. The aim of the current study was to investigate the ICP response of rats in two different, focal and diffuse, injury models of TBI. Adult male Sprague-Dawley rats were subjected to brain trauma by either lateral fluid percussion or impact-acceleration induced injury, in the presence or absence of secondary hypoxia. ICP, mean arterial blood pressure (MABP), and cerebral perfusion pressure (CPP) were monitored for 4 h after TBI. TBI alone or coupled with hypoxia did not result in any significant increase of ICP in rats unless there was an intracranial hemorrhage. At all other times, changes in CPP were the result of changes in MABP and not ICP. Our results suggest that rats may be able to compensate for the intracranial expansion associated with cerebral edema after TBI, and that they only develop a consistent post-traumatic increase in ICP in the presence of a mass lesion. Therefore, they are an inappropriate model for the investigation of ICP changes after TBI, and for the development of therapies targeting ICP.

  10. Primary central nervous system lymphoma in acquired immune deficiency syndrome mimicking toxoplasmosis.

    PubMed

    Utsuki, Satoshi; Oka, Hidehiro; Abe, Katsutoshi; Osawa, Shigeyuki; Yamazaki, Tomoya; Yasui, Yoshie; Fujii, Kiyotaka

    2011-02-01

    A 37-year-old man, a hepatitis B virus carrier due to mother-to-child transmission, had a medical examination in September 2008 in nearby hospitals due to anorexia and weight loss. He was transported to our hospital because computed tomography (CT) detected intracranial lesions, and he had a positive human immunodeficiency virus (HIV) antibody test. Head computed tomography (CT) revealed multiple hemorrhagic lesions and enhancement effect, suggesting a thin wall. Also, an enhancement effect was present in the ventricle walls and the subarachnoid space. No accumulation was found in the thallium-201 scintigraphy. The enhancement effect of the ventricle walls and the subarachnoid space disappeared after oral administration of pyrimethamine, sulfadiazine, and calcium folinate, contributing to the diagnosis of an abscess and meningitis due to toxoplasma. However, mass lesions did not reduce. A biopsy was performed on 30 October, and the pathological diagnosis was malignant lymphoma. He died from respiratory function deterioration on 8 November. Lymphoma cells were found in ventricle wall tissue and the subarachnoid space at the autopsy. Toxoplasmosis will typically occur as a brain lesion most commonly in acquired immune deficiency syndrome (AIDS), whereas malignant lymphoma commonly manifests as a brain neoplastic lesion. However, differentiating between images of these lesions is difficult, so diagnosis by early biopsy is recommended.

  11. Fos Protein Expression in Olfactory-Related Brain Areas after Learning and after Reactivation of a Slowly Acquired Olfactory Discrimination Task in the Rat

    ERIC Educational Resources Information Center

    Roullet, Florence; Lienard, Fabienne; Datiche, Frederique; Cattarelli, Martine

    2005-01-01

    Fos protein immunodetection was used to investigate the neuronal activation elicited in some olfactory-related areas after either learning of an olfactory discrimination task or its reactivation 10 d later. Trained rats (T) progressively acquired the association between one odor of a pair and water-reward in a four-arm maze. Two groups of…

  12. Acquired epidermodysplasia verruciformis.

    PubMed

    Rogers, Heather D; Macgregor, Jennifer L; Nord, Kristin M; Tyring, Stephen; Rady, Peter; Engler, Danielle E; Grossman, Marc E

    2009-02-01

    Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genodermatosis with an increased susceptibility to specific human papillomavirus (HPV) genotypes. Classically, this viral infection leads to the development of tinea versicolor-like macules on the trunk, neck, arms, and face during childhood, and over time, these lesions can progress to squamous cell carcinoma. More recently, an EV-like syndrome has been described in patients with impaired cell-mediated immunity. We describe two cases of EV-like syndrome in HIV-positive patients, review all previously reported cases of EV in patients with impaired cell-mediated immunity, introduce the term "acquired epidermodysplasia verruciformis" to describe EV developing in the immunocompromised host and examine the limited treatment options for these patients.

  13. Occupationally Acquired American Cutaneous Leishmaniasis

    PubMed Central

    Felinto de Brito, Maria Edileuza; Andrade, Maria Sandra; de Almeida, Éricka Lima; Medeiros, Ângela Cristina Rapela; Werkhäuser, Roberto Pereira; de Araújo, Ana Isabele Freitas; Brandão-Filho, Sinval Pinto; Paiva de Almeida, Alzira Maria; Gomes Rodrigues, Eduardo Henrique

    2012-01-01

    We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL): one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR) assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples) and characterized as Leishmania (Viannia) naiffi through an indirect immunofluorescence assay (IFA) with species-specific monoclonal antibodies (mAbs) and by multilocus enzyme electrophoresis (MLEE). Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis. PMID:23227369

  14. Albumin induces excitatory synaptogenesis through astrocytic TGF-β/ALK5 signaling in a model of acquired epilepsy following blood-brain barrier dysfunction

    PubMed Central

    Weissberg, Itai; Wood, Lydia; Kamintsky, Lyn; Vazquez, Oscar; Milikovsky, Dan Z.; Alexander, Allyson; Oppenheim, Hannah; Ardizzone, Carolyn; Becker, Albert; Frigerio, Federica; Vezzani, Annamaria; Buckwalter, Marion S.; Huguenard, John; Friedman, Alon; Kaufer, Daniela

    2015-01-01

    Post injury epilepsy (PIE) is a common complication following brain insults, including ischemic and traumatic brain injuries. At present there are no means to identify the patients at-risk to develop PIE or to prevent its development. Seizures can occur months or years after the insult, do not respond to anti-seizure medications in over third of the patients, and are often associated with significant neuropsychiatric morbidities. We have previously established the critical role of blood-brain barrier dysfunction in PIE, demonstrating that exposure of brain tissue to extravasated serum albumin induces activation of inflammatory transforming growth factor beta (TGF-β) signaling in astrocytes and eventually seizures. However, the link between the acute astrocytic inflammatory responses and reorganization of neural networks that underlie recurrent spontaneous seizures, remains unknown. Here we demonstrate in-vitro and in-vivo that activation of the astrocytic ALK5/TGF-β-pathway induces excitatory, but not inhibitory, synaptogenesis that precedes the appearance of seizures. Moreover, we show that treatment with SJN2511, a specific ALK5/TGF-β inhibitor, prevents synaptogenesis and epilepsy. Our findings point to astrocyte-mediated synaptogenesis as a key epileptogenic process, and highlight manipulation of the TGF-β-pathway as a potential strategy for the prevention of PIE. PMID:25836421

  15. Albumin induces excitatory synaptogenesis through astrocytic TGF-β/ALK5 signaling in a model of acquired epilepsy following blood-brain barrier dysfunction.

    PubMed

    Weissberg, Itai; Wood, Lydia; Kamintsky, Lyn; Vazquez, Oscar; Milikovsky, Dan Z; Alexander, Allyson; Oppenheim, Hannah; Ardizzone, Carolyn; Becker, Albert; Frigerio, Federica; Vezzani, Annamaria; Buckwalter, Marion S; Huguenard, John R; Friedman, Alon; Kaufer, Daniela

    2015-06-01

    Post-injury epilepsy (PIE) is a common complication following brain insults, including ischemic, and traumatic brain injuries. At present, there are no means to identify the patients at risk to develop PIE or to prevent its development. Seizures can occur months or years after the insult, do not respond to anti-seizure medications in over third of the patients, and are often associated with significant neuropsychiatric morbidities. We have previously established the critical role of blood-brain barrier dysfunction in PIE, demonstrating that exposure of brain tissue to extravasated serum albumin induces activation of inflammatory transforming growth factor beta (TGF-β) signaling in astrocytes and eventually seizures. However, the link between the acute astrocytic inflammatory responses and reorganization of neural networks that underlie recurrent spontaneous seizures remains unknown. Here we demonstrate in vitro and in vivo that activation of the astrocytic ALK5/TGF-β-pathway induces excitatory, but not inhibitory, synaptogenesis that precedes the appearance of seizures. Moreover, we show that treatment with SJN2511, a specific ALK5/TGF-β inhibitor, prevents synaptogenesis and epilepsy. Our findings point to astrocyte-mediated synaptogenesis as a key epileptogenic process and highlight the manipulation of the TGF-β-pathway as a potential strategy for the prevention of PIE.

  16. Effects at the periphery of the laser lesion in human brain and its tumors after CO/sub 2/, Nd:YAG, and CO/sub 2/ high-peak pulsed radiation

    SciTech Connect

    Fasano, V.A.; Peirone, S.M.; Ponzio, R.M.; Lanotte, M.M.; Merighi, A.

    1986-01-01

    The histological changes in various tissues irradiated with lasers are well known. Our own previous observations with the optical microscope confirm those already reported in the laser literature. If tissue is treated with various laser sources, the results are similar, with the characteristic three layers from the outside toward the inside of carbonization, coagulative necrosis, and edema. Otherwise, only the shapes and sizes of the lesions differ, with craters of different depths. In this paper, we report an ultrastructural study of the changes occurring in the periphery of the laser lesions in both normal human brain and neoplastic tissues (gliomas and meningiomas). Continuous-wave CO/sub 2/ and Nd:YAG lasers were used at different exposure times and powers and the effects of high-peak pulsed CO/sub 2/ laser radiation has also been investigated. The study, performed during neurosurgical procedures was mostly focused on microcirculation at 1.5-3 mm outside the area of coagulative necrosis, at the level of the edema zone. Only lesions of the blood brain barrier are produced in normal brain by CO/sub 2/ radiation (power ranging from 40 to 80 W; exposure time from 3 to 10 seconds). The same results were achieved by Nd:YAG radiation of short duration (3 seconds) regardless of the power used (40 and 80 W). Long-duration Nd:YAG radiation (10 sec; power: 40-80 W) produces endoluminal phenomena leading to the complete occlusion of the capillaries. In neoplastic brain tissues, microcirculation does not seem to be impaired by CO/sub 2/ radiation. More marked lesions are produced in tumors even after Nd:YAG short-time radiation. Endoluminal obliteration is observed in meningiomas and perivascular hemorrhage occurs in highly vascularized gliomas.

  17. Cognitive reserve and preinjury educational attainment: effects on outcome of community-based rehabilitation for longer-term individuals with acquired brain injury.

    PubMed

    Fortune, Dónal G; Walsh, R Stephen; Richards, Helen L

    2016-09-01

    The cognitive reserve hypothesis has been proposed to account for the mismatch between brain pathology and its clinical expression. The aim of the current research was to explore, in a longitudinal data set, the effects of level of educational attainment before brain injury (cognitive reserve) and clinical factors on the level of rehabilitation-induced changes in disability and community integration. Participants in receipt of postacute rehabilitation were assessed at induction to the service and again at between 14 and 18 months of follow-up while still in service on changes in aspects of their abilities, adjustment and participation (Mayo Portland Adaptability Indices) and community integration (Community Integration Questionnaire). Controlling for type and severity of injury, age at onset of injury and duration of time since injury, participants with higher previous educational attainment showed significantly greater changes over the course of rehabilitation on adjustment to their injury and participation, but not on abilities, or community integration following postacute rehabilitation. Level of education would appear to be an important element of cognitive reserve in brain injury that serves to aid responses to postacute rehabilitation in terms of an individual's adjustment to disability and participation.

  18. Visual hallucinations of autobiographic memory and asomatognosia: a case of epilepsy due to brain cysticercosis.

    PubMed

    Orjuela-Rojas, Juan Manuel; Ramírez-Bermúdez, Jesús; Martínez-Juárez, Iris E; Kerik, Nora Estela; Diaz Meneses, Iván; Pérez-Gay, Fernanda Juárez

    2015-01-01

    The current study describes the case of a woman with symptomatic epilepsy due to brain cysticercosis acquired during childhood. During her adolescence, she developed seizures characterized by metamorphopsia, hallucinations of autobiographic memory and, finally, asomatognosia. Magnetic brain imaging showed a calcified lesion in the right occipitotemporal cortex, and positron emission tomography imaging confirmed the presence of interictal hypometabolism in two regions: the right parietal cortex and the right lateral and posterior temporal cortex. We discuss the link between these brain areas and the symptoms described under the concepts of epileptogenic lesion, epileptogenic zone, functional deficit zone, and symptomatogenic zone.

  19. Indices of impaired self-awareness in traumatic brain injury patients with focal frontal lesions and executive deficits: implications for outcome measurement.

    PubMed

    Spikman, Jacoba M; van der Naalt, Joukje

    2010-07-01

    In patients with moderate to severe traumatic brain injury (TBI), impairments of self-awareness are frequently found and associated with worse functional outcome and poor compliance with rehabilitation. The aim of this study was to investigate whether indications of impaired self-awareness could be found in TBI patients with frontal lesions and executive function deficits. Twenty-two TBI patients with focal frontal injuries were compared to 29 TBI patients without focal frontal injuries visible on neuroimaging. No differences were found on several outcome measures, including the Glasgow Outcome Scale-Extended (GOS-E), the Differential Outcome Scale (DOS), and return to work (RTW), although the frontal injury patients were more severely injured as indicated by the Glasgow Coma Scale (GCS) and duration of post-traumatic amnesia (PTA), and had impaired performance on a neuropsychological test of executive functioning. Even more so, the frontal injury group had a significantly lower score on the Sickness Impact Profile (SIP), indicating that they had fewer complaints than the patients without frontal injury, and scored significantly higher on the percentage of recovery (PoR) score, which expresses the extent of recovery as a percentage of their previous level of functioning. In contrast to the non-frontal-injury group, their PoR scores were not related to RTW, reflecting an erroneous perception of their actual working status. The positive results on these different outcome measures, which are partly or entirely self-reported, were seen as an indication of an impaired self-evaluative ability in the frontal injury patients. To determine outcome in a patient with frontal injuries and executive dysfunction, the judgment of several relevant other persons in the patient's life (e.g., partners, therapists, and employers) of the patient's daily life functioning should be sought.

  20. Acquired Cystic Kidney Disease

    MedlinePlus

    ... They Work Kidney Disease A-Z Acquired Cystic Kidney Disease What is acquired cystic kidney disease? Acquired cystic kidney disease happens when a ... cysts. What are the differences between acquired cystic kidney disease and polycystic kidney disease? Acquired cystic kidney ...

  1. Acquired Dyslexia in Three Writing Systems: Study of a Portuguese-Japanese Bilingual Aphasic Patient

    PubMed Central

    Senaha, Mirna Lie Hosogi; de Mattos Pimenta Parente, Maria Alice

    2012-01-01

    The Japanese language is represented by two different codes: syllabic and logographic while Portuguese employs an alphabetic writing system. Studies on bilingual Portuguese-Japanese individuals with acquired dyslexia therefore allow an investigation of the interaction between reading strategies and characteristics of three different writing codes. The aim of this study was to examine the differential impact of an acquired brain lesion on the reading of the logographic, syllabic and alphabetic writing systems of a bilingual Portuguese-Japanese aphasic patient (PF). Results showed impaired reading in the logographic system and when reading irregularly spelled Portuguese words but no effects on reading regular words and nonwords in syllabic and alphabetic writing systems. These dissociations are interpreted according to a multi-route cognitive model of reading assuming selective damage in the lexical route can result in acquired dyslexia across at least three different writing codes. PMID:22713387

  2. Acquired reactive perforating collagenosis

    PubMed Central

    Fei, Chengwen; Wang, Yao; Gong, Yu; Xu, Hui; Yu, Qian; Shi, Yuling

    2016-01-01

    Abstract Background: Reactive perforating collagenosis (RPC) is a rare form of transepithelial elimination, in which altered collagen is extruded through the epidermis. There are 2 types of RPC, acquired RPC (ARPC) and inherited RPC, while the latter is extremely rare. Here we report on 1 case of ARPC. Methods: A 73-year-old female was presented with strongly itchy papules over her back and lower limbs for 3 months. She denied the history of oozing or vesiculation. A cutaneous examination showed diffusely distributed multiple well-defined keratotic papules, 4 to 10 mm in diameter, on the bilateral lower limbs and back as well as a few papules on her chest and forearm. Scratching scars were over the resolved lesions while Koebner phenomenon was negative. The patient had a history of type 2 diabetes for 15 years. Laboratory examinations showed elevated blood glucose level. Skin lesion biopsy showed a well-circumscribed area of necrosis filled with a keratotic plug. Parakeratotic cells and lymphocytic infiltration could be seen in the necrosed area. In dermis, sparse fiber bundles were seen perforating the epidermis. These degenerated fiber bundles were notarized as collagen fiber by elastic fiber stain, suggesting a diagnosis of RPC. Results: Then a diagnosis of ARPC was made according to the onset age and the history of diabetes mellitus. She was treated with topical application of corticosteroids twice a day and oral antihistamine once a day along with compound glycyrrhizin tablets 3 times a day. And the blood glucose was controlled in a satisfying range. Two months later, a significant improvement was seen in this patient. Conclusion: Since there is no efficient therapy to RPC, moreover, ARPC is considered to be associated with some systemic diseases, the management of the coexisting disease is quite crucial. The patient in this case received a substantial improvement due to the control of blood glucose and application of compound glycyrrhizin tablets. PMID

  3. Written discourse and acquired brain impairment: evaluation of structural and semantic features of personal letters from a Systemic Functional Linguistic perspective.

    PubMed

    Mortensen, Lynne

    2005-01-01

    This qualitative study investigated written discourse in the form of personal letters written by ten people with aphasia following stroke and ten people with cognitive-language disorder as a consequence of traumatic brain injury, and compared their performance with 15 non brain-damaged writers. Personal letters perform the dual function of providing information and maintaining social relationships. Using the Systemic Functional Linguistics framework for investigation, letters were examined in terms of their dual functions, and at two different strata of language--generic structure and semantic organisation. A small quantum of research suggests that the dissociation between different strata of language (i.e., macro and micro linguistic abilities), identified in the spoken discourse of people with aphasia and people with cognitive-language disorder is mirrored in written discourse. Aphasic writers largely maintain coherent text structure while writers with cognitive-language impairment demonstrate problems with global text coherence and the episodic structure of texts. Results of the generic structure analysis did not support the hypothesis. However, the semantic Move analysis revealed how diminished linguistic resources, most evident in the letters written by the subjects with aphasia, impacted upon the semantic diversity of the text, as well as the interpersonal function of the personal letter. Variable performance as a feature pathology and normality is highlighted and clinical implications discussed.

  4. Large multifocal cardiac myxoma causing the sudden unexpected death of a 2-month-old infant--a rapidly growing, acquired lesion versus a congenital process?: a case report.

    PubMed

    Kure, Kiyoe; Lingamfelter, Daniel; Taboada, Eugenio

    2011-06-01

    We report the occurrence of a clinically undiagnosed biatrial myxoma with left ventricular involvement in a 2-month-old male infant, resulting in sudden death. During a routine well-baby examination, a grade (34) holosystolic murmur was detected at the left sternal border with radiation to the axilla and back. On the following day, the patient collapsed and died suddenly. An autopsy revealed a large multifocal neoplasm diffusely involving the aortic valve while displaying mitral, tricuspid, and left ventricular extensions. The ensuing histopathologic and immunohistochemical studies were diagnostic for myxoma. We discuss the occurrence of cardiac myxoma within the pediatric population and review the literature as to theorize whether this lesion was a congenital process versus a rapidly growing tumor that developed after the child was born. Lastly, we address the potential for sudden death in patients with such tumors.

  5. [Spanish validation of the Iowa Rating Scale for Personality Change (IRSPC) for the appraisal of changes in personality in patients with acquired brain injury].

    PubMed

    Guallart-Balet, María; Jiménez-Cortés, Marta P; Tuquet-Calvo, Helena; Pelegrín-Valero, Carmelo; Olivera-Pueyo, Javier; Benabarre-Ciria, Sergio; Tirapu-Ustárroz, Javier

    2015-01-01

    Introduccion. La Iowa Rating Scale for Personality Change (IRSPC) presenta una serie de caracteristicas (enfasis en las funciones motivacionales y emocionales, evaluacion de las funciones ejecutivas 'cognitivas' en la vida cotidiana, estimacion de la personalidad premorbida, valoracion de la fiabilidad del informador) que hacen muy interesante su utilizacion tanto en la clinica como en la investigacion. Objetivo. Validar en castellano la IRSPC para la evaluacion de los 'cambios de personalidad' secundarios a las lesiones cerebrales de la corteza prefrontal en general y del area ventromedial en particular. Pacientes y metodos. Tras el proceso de traduccion y adaptacion de la guia de la escala al castellano, se realizo un estudio de validacion con 31 pacientes con daño cerebral traumatico y se obtuvieron unos resultados de fiabilidad muy adecuados. Resultados. Los resultados obtenidos al medir la consistencia interna de la IRSPC y los coeficientes de fiabilidad interobservadores y test-retest apoyan dicha afirmacion. La validez del instrumento es confirmada por la validez concurrente (comparandolo con el inventario neuropsiquiatrico) y la validez de constructo (comparando las puntuaciones de los pacientes antes y despues del traumatismo). Conclusiones. La IRSPC es un instrumento fiable y valido para la exploracion clinica, en el contexto de una evaluacion integral de los sintomas derivados de las enfermedades neurologicas en general, y en particular de aquellas en las que se encuentra involucrada la corteza prefrontal ventromedial.

  6. [Comparison of the Wechsler Memory Scale-III and the Spain-Complutense Verbal Learning Test in acquired brain injury: construct validity and ecological validity].

    PubMed

    Luna-Lario, P; Pena, J; Ojeda, N

    2017-04-16

    Objetivo. Profundizar en la validez de constructo y en la validez ecologica de la escala de memoria de Wechsler-III (WMS-III) y el test de aprendizaje verbal España-Complutense (TAVEC). Pacientes y metodos. La muestra consta de 106 adultos con daño cerebral adquirido atendidos en el Area de Neuropsicologia y Neuropsiquiatria del Complejo Hospitalario de Navarra, con deficit de memoria como secuela principal, medido a traves de test especificos de memoria. Para determinar la validez de constructo se examinan las tareas requeridas en cada prueba sobre los modelos teoricos de base, comparando el rendimiento segun los parametros ofrecidos por los tests, contrastando los indices de gravedad de cada prueba y analizando su convergencia. La validez externa se explora a traves de la correlacion entre las pruebas y mediante modelos de regresion. Resultados. De acuerdo con los resultados obtenidos, la WMS-III y el TAVEC tienen validez de constructo. El TAVEC es mas sensible y capta no solo los deficits en la consolidacion mnesica, sino en las estrategias ejecutivas implicadas en la memoria. El indice de memoria de trabajo de la WMS-III es util para predecir la reincorporacion laboral a los dos años del daño cerebral adquirido, pero ningun instrumento anticipa la discapacidad y la dependencia al menos seis meses despues de la lesion. Conclusion. Se reflexiona sobre la validez de constructo de las pruebas y su capacidad insuficiente para predecir la funcionalidad cuando las secuelas se cronifican.

  7. [Is the early brain organisation of spatial information conveyed by tactile stimuli performed in different ways in congenital and acquired blind children? A pilot study].

    PubMed

    Ortiz, Tomás; Santos, Juan M; Ortiz-Teran, Laura; Nogales, Ramón; Serrano-Marugán, Isabel; Martínez, José M; Minguito-García, Carlos; Requena, Carmen; Poch-Broto, Joaquín

    2013-02-22

    Cortical reorganization after congenital blindness is not sufficiently known yet it does offer an optimum window of opportunity to study the effects of absolute sensorial deprivation. Cross-modality in people with blindness has been documented, but it may differ in congenital blindness and in early blindness. Vibrotactile passive stimulation of lines and letters generates different electroencephalographic patterns with different source localizations in two children with blindness, aged 9 and 10, respectively with congenital blindness and early blindness with some remnants of vision. Most of the brain electrical activity is centered in auditive areas in P50 and P100 in the case of the child with congenital blindness, while the other shows activity in multiple areas. Reaction times to letters are shorter than to lines of different orientation in both children.

  8. OASIS is Automated Statistical Inference for Segmentation, with applications to multiple sclerosis lesion segmentation in MRI.

    PubMed

    Sweeney, Elizabeth M; Shinohara, Russell T; Shiee, Navid; Mateen, Farrah J; Chudgar, Avni A; Cuzzocreo, Jennifer L; Calabresi, Peter A; Pham, Dzung L; Reich, Daniel S; Crainiceanu, Ciprian M

    2013-01-01

    Magnetic resonance imaging (MRI) can be used to detect lesions in the brains of multiple sclerosis (MS) patients and is essential for diagnosing the disease and monitoring its progression. In practice, lesion load is often quantified by either manual or semi-automated segmentation of MRI, which is time-consuming, costly, and associated with large inter- and intra-observer variability. We propose OASIS is Automated Statistical Inference for Segmentation (OASIS), an automated statistical method for segmenting MS lesions in MRI studies. We use logistic regression models incorporating multiple MRI modalities to estimate voxel-level probabilities of lesion presence. Intensity-normalized T1-weighted, T2-weighted, fluid-attenuated inversion recovery and proton density volumes from 131 MRI studies (98 MS subjects, 33 healthy subjects) with manual lesion segmentations were used to train and validate our model. Within this set, OASIS detected lesions with a partial area under the receiver operating characteristic curve for clinically relevant false positive rates of 1% and below of 0.59% (95% CI; [0.50%, 0.67%]) at the voxel level. An experienced MS neuroradiologist compared these segmentations to those produced by LesionTOADS, an image segmentation software that provides segmentation of both lesions and normal brain structures. For lesions, OASIS out-performed LesionTOADS in 74% (95% CI: [65%, 82%]) of cases for the 98 MS subjects. To further validate the method, we applied OASIS to 169 MRI studies acquired at a separate center. The neuroradiologist again compared the OASIS segmentations to those from LesionTOADS. For lesions, OASIS ranked higher than LesionTOADS in 77% (95% CI: [71%, 83%]) of cases. For a randomly selected subset of 50 of these studies, one additional radiologist and one neurologist also scored the images. Within this set, the neuroradiologist ranked OASIS higher than LesionTOADS in 76% (95% CI: [64%, 88%]) of cases, the neurologist 66% (95% CI: [52%, 78

  9. [Community-based rehabilitation and outpatient care for patients with acquired brain injury and chronic neurological disability in Germany: continuing support for social participation and re-integration in the neurological care system?].

    PubMed

    Reuther, P; Hendrich, A; Kringler, W; Vespo, E

    2012-12-01

    In Germany a number of patients who are suffering from acquired brain injury and chronic neurological disability are either undersupplied or exposed to inappropriate care in their social environment. The number of these patients is increasing due to the changes in the procedures of care and due to demographic factors. While acute medical care and early rehabilitative treatment is accessible throughout the German health care system the necessary multimodal and competent care is rare or absent in the social participative sites such as life and occupational environments of the patients. The complex impairment of the brain, the central organ for sensorial, executive and other cognitive functions of human beings, renders the affected patient an exception in the system of medical and social care - this has only inadequately been considered in the past. The authors explain the necessity to disclose the status of a "human-with acquired-brain damage (Mensch-mit-erworbener-Hirnschädigung, MeH)" explicitly as severely disabled. The paper recommends a number of structural and procedural elements that have proven to overcome the insufficient or inappropriate support in integrating the patients suffering from acquired brain injury and chronic neurological disability in their social environment as well as for a demand-focused support with sustainable rehabilitative and ambulant follow-up procedures. Comparisons with other developed health care systems and international guidelines show that with organizing of early-supported-discharge, community-ambulation, shared-care and community-based-rehabilitation these problems have long since been identified elsewhere. Community-based and resident-oriented concepts have already been systematically implemented. In order to achieve the necessary support for the individual patient, a nation-wide development is necessary in Germany to perform the principles of the German social code and the principles of the Convention on the Rights of

  10. Patient- and lesion-tailored algorithm of endovascular treatment for arterial occlusive disease of extracranial arteries supplying the brain: safety of the treatment at 30-day follow-up

    PubMed Central

    Simka, Marian; Brzegowy, Paweł; Janas, Piotr; Kazibudzki, Marek; Pieniążek, Piotr; Ochała, Andrzej; Popiela, Tadeusz; Mrowiecki, Tomasz

    2017-01-01

    Introduction Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, stenting plays an important role as an alternative treatment modality, especially in high-risk patients. The actual safety profile associated with stenting procedures is probably better than that reported by randomized controlled trials. Aim To assess the safety of stent implantations in extracranial arteries supplying the brain, and also to identify risk factors associated with this procedure. Material and methods This was a post hoc analysis, with 30-day follow-up. We analyzed the results of treatment of 372 patients who underwent 408 procedures, 197 such procedures in asymptomatic, and 211 in symptomatic individuals. Stenting procedures were performed using a technique and armamentarium which were tailored to the type and anatomy of lesions. Results There were 6 (1.5%) strokes, including 2 (0.5%) major strokes, 1 ipsi- and 1 contralateral, and 4 (1.0%) minor strokes. In asymptomatic patients there was 1 (0.3%) minor stroke. Transient ischemic attacks occurred in 5 (1.2%) patients. There were 2 (0.5%) non-STEMI myocardial infarctions and 2 (0.5%) non-stroke related fatalities. Risk factors of these adverse events were diabetes mellitus, lesions localized in a tortuous segment of the artery, embolic material in the filter and bilateral stenoses of carotid arteries. Additional risk factors in asymptomatic patients were renal impairment and advanced coronary artery disease; and in symptomatic patients, grade 3 arterial hypertension, dislipidemia, cigarette smoking and lesions requiring predilatation. Conclusions Stenting procedures of extracranial arteries supplying the brain, which are tailored to the type and anatomy of lesions, seem to be relatively safe. PMID:28344618

  11. The anatomical foundations of acquired reading disorders: a neuropsychological verification of the dual-route model of reading.

    PubMed

    Ripamonti, E; Aggujaro, S; Molteni, F; Zonca, G; Frustaci, M; Luzzatti, C

    2014-07-01

    In this study we investigated the neural correlates of acquired reading disorders through an anatomo-correlative procedure of the lesions of 59 focal brain damaged patients suffering from acquired surface, phonological, deep, undifferentiated dyslexia and pure alexia. Two reading tasks, one of words and nonwords and one of words with unpredictable stress position, were used for this study. We found that surface dyslexia was predominantly associated with left temporal lesions, while in phonological dyslexia the lesions overlapped in the left insula and the left inferior frontal gyrus (pars opercularis) and that pure alexia was associated with lesions in the left fusiform gyrus. A number of areas and white matter tracts, which seemed to involve processing along both the lexical and the sublexical routes, were identified for undifferentiated dyslexia. Two cases of deep dyslexia with relatively dissimilar anatomical correlates were studied, one compatible with Coltheart's right-hemisphere hypothesis (1980) whereas the other could be interpreted in the context of Morton and Patterson's (1980), multiply-damaged left-hemisphere hypothesis. In brief, the results of this study are only partially consistent with the current state of the art, and propose new and stimulating challenges; indeed, based on these results we suggest that different types of acquired dyslexia may ensue after different cortical damage, but white matter disconnection may play a crucial role in some cases.

  12. Density abnormalities in normal-appearing gray matter in the middle-aged brain with white matter hyperintense lesions: a DARTEL-enhanced voxel-based morphometry study

    PubMed Central

    Peng, Yan; Li, Shenhong; Zhuang, Ying; Liu, Xiaojia; Wu, Lin; Gong, Honghan; Liu, Dewu; Zhou, Fuqing

    2016-01-01

    Background and purpose Little is known about the structural alterations within gray matter (GM) in middle-aged subjects with white matter hyperintense (WMH) lesions. Here, we aimed to examine the anatomical changes within the GM and their relationship to WMH lesion loads in middle-aged subjects. Participants and methods Twenty-three middle-aged subjects with WMH lesions (WMH group) and 23 demographically matched healthy control subjects participated in the study. A Diffeomorphic Anatomical Registration Through Exponentiated Liealgebra-enhanced voxel-based morphometry was used to measure the GM density, and the correlations between WMH lesion volume and extracted GM values in abnormal regions were identified by voxel-based morphometry analysis. Results Compared with the healthy control subjects, the WMH group had a significantly decreased GM density in the left middle frontal gyrus, bilateral anterior cingulate cortex, left and right premotor cortex, and left and right middle cingulate cortex and an increased GM density in the bilateral cerebellum anterior lobe, left middle temporal gyrus, right temporoparietal junction, left and right prefrontal cortex (PFC), and left inferior parietal lobule. A relationship was observed between the normalized WMH lesion volume and the decreased GM density, including the left middle frontal gyrus (ρ=−0.629, P=0.002), bilateral anterior cingulate cortex (ρ=−0.507, P=0.019), right middle cingulate cortex (ρ=−0.484, P=0.026), and right premotor cortex (ρ=−0.438, P=0.047). The WMH lesion loads also negatively correlated with increased GM density in the right temporoparietal junction (ρ=−0.484, P=0.026), left PFC (ρ=−0.469, P=0.032), and right PFC (ρ=−0.438, P=0.047). Conclusion We observed that lesion load-associated structural plasticity corresponds to bidirectional changes in regional GM density in the WMH group. PMID:27274211

  13. Long term motor function after neonatal stroke: Lesion localization above all.

    PubMed

    Dinomais, Mickael; Hertz-Pannier, Lucie; Groeschel, Samuel; Chabrier, Stéphane; Delion, Matthieu; Husson, Béatrice; Kossorotoff, Manoelle; Renaud, Cyrille; Nguyen The Tich, Sylvie

    2015-12-01

    Motor outcome is variable following neonatal arterial ischemic stroke (NAIS). We analyzed the relationship between lesion characteristics on brain MRI and motor function in children who had suffered from NAIS. Thirty eight full term born children with unilateral NAIS were investigated at the age of seven. 3D T1- and 3D FLAIR-weighted MR images were acquired on a 3T MRI scanner. Lesion characteristics were compared between patients with and without cerebral palsy (CP) using the following approaches: lesion localization either using a category-based analysis, lesion mapping as well as voxel-based lesion-symptom mapping (VLSM). Using diffusion-weighted imaging the microstructure of the cortico-spinal tract (CST) was related to the status of CP by measuring DTI parameters. Whereas children with lesions sparing the primary motor system did not develop CP, CP was always present when extensive lesions damaged at least two brain structures involving the motor system. The VLSM approach provided a statistical map that confirmed the cortical lesions in the primary motor system and revealed that CP was highly correlated with lesions in close proximity to the CST. In children with CP, diffusion parameters indicated microstructural changes in the CST at the level of internal capsule and the centrum semiovale. White matter damage of the CST in centrum semiovale was a highly reproducible marker of CP. This is the first description of the implication of this latter region in motor impairment after NAIS. In conclusion, CP in childhood was closely linked to the location of the infarct in the motor system.

  14. Pink lesions.

    PubMed

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  15. Neuronal Biomarker Ubiquitin C-Terminal Hydrolase (UCH-L1) Detects Traumatic Intracranial Lesions on CT in Children and Youth with Mild Traumatic Brain Injury.

    PubMed

    Papa, Linda; Mittal, Manoj K; Ramirez, Jose; Silvestri, Salvatore; Giordano, Philip; Braga, Carolina F; Tan, Ciara Natasha S; Ameli, Neema J; Lopez, Marco; Haeussler, Crystal A; Mendez Giordano, Diego; Zonfrillo, Mark R

    2017-02-03

    This study examined the performance of serum Ubiquitin C-terminal Hydrolase (UCH-L1) in detecting traumatic intracranial lesions on CT scan (+CT) in children and youth with mild and moderate TBI (MMTBI) and assessed its performance in trauma control patients without head trauma. This prospective cohort study enrolled children and youth presenting to three Level 1 Trauma Centers following blunt head trauma and a GCS 9-15 as well as trauma control patients with GCS 15 that did not have blunt head trauma. The primary outcome measure was the presence of intracranial lesions on initial CT scan. Blood samples were obtained in all patients within six hours of injury and measured by ELISA for UCH-L1 (ng/ml). A total of 256 children and youth were enrolled in the study and had serum samples drawn within 6 hours of injury for analysis, 196 had blunt head trauma and 60 were trauma controls. CT scan of the head was performed in 151 patients and traumatic intracranial lesions on CT scan were evident in 17 (11%), all of whom had a GCS 13-15. The area under the ROC curve (AUC) for UCH-L1 in detecting children and youth with traumatic intracranial lesions on CT was 0.83 (95%CI 0.73-0.93). In those presenting with a GCS of 15, the AUC for detecting lesions was 0.83 (95%CI 0.72-0.94). Similarly, in children under five years old the AUC was 0.79 (95%CI 0.59-1.00). Performance for detecting intracranial lesions at a UCH-L1 cutoff level of 0.18 ng/ml yielded a sensitivity of 100%, a specificity of 47% and negative predictive value of 100%.

  16. Effects of Diclofenac, L-NAME, L-Arginine, and Pentadecapeptide BPC 157 on Gastrointestinal, Liver, and Brain Lesions, Failed Anastomosis, and Intestinal Adaptation Deterioration in 24 Hour-Short-Bowel Rats.

    PubMed

    Lojo, Nermin; Rasic, Zarko; Zenko Sever, Anita; Kolenc, Danijela; Vukusic, Darko; Drmic, Domagoj; Zoricic, Ivan; Sever, Marko; Seiwerth, Sven; Sikiric, Predrag

    2016-01-01

    Stable gastric pentadecapeptide BPC 157 was previously used to ameliorate wound healing following major surgery and counteract diclofenac toxicity. To resolve the increasing early risks following major massive small bowel resectioning surgery, diclofenac combined with nitric oxide (NO) system blockade was used, suggesting therapy with BPC 157 and the nitric oxide synthase (NOS substrate) L-arginine, is efficacious. Immediately after anastomosis creation, short-bowel rats were untreated or administered intraperitoneal diclofenac (12 mg/kg), BPC 157 (10 μg/kg or 10 ng/kg), L-NG-nitroarginine methyl ester (L-NAME, 5 mg/kg), L-arginine (100 mg/kg) alone or combined, and assessed 24 h later. Short-bowel rats exhibited poor anastomosis healing, failed intestine adaptation, and gastrointestinal, liver, and brain lesions, which worsened with diclofenac. This was gradually ameliorated by immediate therapy with BPC 157 and L-arginine. Contrastingly, NOS-blocker L-NAME induced further aggravation and lesions gradually worsened. Specifically, rats with surgery alone exhibited mild stomach/duodenum lesions, considerable liver lesions, and severe cerebral/hippocampal lesions while those also administered diclofenac showed widespread severe lesions in the gastrointestinal tract, liver, cerebellar nuclear/Purkinje cells, and cerebrum/hippocampus. Rats subjected to surgery, diclofenac, and L-NAME exhibited the mentioned lesions, worsening anastomosis, and macro/microscopical necrosis. Thus, rats subjected to surgery alone showed evidence of deterioration. Furtheremore, rats subjected to surgery and administered diclofenac showed worse symptoms, than the rats subjected to surgery alone did. Rats subjected to surgery combined with diclofenac and L-NAME showed the worst deterioration. Rats subjected to surgery exhibited habitual adaptation of the remaining small intestine, which was markedly reversed in rats subjected to surgery and diclofenac, and those with surgery, diclofenac, and

  17. Effects of Diclofenac, L-NAME, L-Arginine, and Pentadecapeptide BPC 157 on Gastrointestinal, Liver, and Brain Lesions, Failed Anastomosis, and Intestinal Adaptation Deterioration in 24 Hour-Short-Bowel Rats

    PubMed Central

    Lojo, Nermin; Rasic, Zarko; Zenko Sever, Anita; Kolenc, Danijela; Vukusic, Darko; Drmic, Domagoj; Zoricic, Ivan; Sever, Marko; Seiwerth, Sven; Sikiric, Predrag

    2016-01-01

    Stable gastric pentadecapeptide BPC 157 was previously used to ameliorate wound healing following major surgery and counteract diclofenac toxicity. To resolve the increasing early risks following major massive small bowel resectioning surgery, diclofenac combined with nitric oxide (NO) system blockade was used, suggesting therapy with BPC 157 and the nitric oxide synthase (NOS substrate) L-arginine, is efficacious. Immediately after anastomosis creation, short-bowel rats were untreated or administered intraperitoneal diclofenac (12 mg/kg), BPC 157 (10 μg/kg or 10 ng/kg), L-NG-nitroarginine methyl ester (L-NAME, 5 mg/kg), L-arginine (100 mg/kg) alone or combined, and assessed 24 h later. Short-bowel rats exhibited poor anastomosis healing, failed intestine adaptation, and gastrointestinal, liver, and brain lesions, which worsened with diclofenac. This was gradually ameliorated by immediate therapy with BPC 157 and L-arginine. Contrastingly, NOS-blocker L-NAME induced further aggravation and lesions gradually worsened. Specifically, rats with surgery alone exhibited mild stomach/duodenum lesions, considerable liver lesions, and severe cerebral/hippocampal lesions while those also administered diclofenac showed widespread severe lesions in the gastrointestinal tract, liver, cerebellar nuclear/Purkinje cells, and cerebrum/hippocampus. Rats subjected to surgery, diclofenac, and L-NAME exhibited the mentioned lesions, worsening anastomosis, and macro/microscopical necrosis. Thus, rats subjected to surgery alone showed evidence of deterioration. Furtheremore, rats subjected to surgery and administered diclofenac showed worse symptoms, than the rats subjected to surgery alone did. Rats subjected to surgery combined with diclofenac and L-NAME showed the worst deterioration. Rats subjected to surgery exhibited habitual adaptation of the remaining small intestine, which was markedly reversed in rats subjected to surgery and diclofenac, and those with surgery, diclofenac, and

  18. Radiosynthesis, In Vivo Biological Evaluation, and Imaging of Brain Lesions with [123I]-CLINME, a New SPECT Tracer for the Translocator Protein

    PubMed Central

    Mattner, F.; Quinlivan, M.; Greguric, I.; Pham, T.; Liu, X.; Jackson, T.; Berghofer, P.; Fookes, C. J. R.; Dikic, B.; Gregoire, M.-C.; Dolle, F.; Katsifis, A.

    2015-01-01

    The high affinity translocator protein (TSPO) ligand 6-chloro-2-(4′-iodophenyl)-3-(N,N-methylethyl)imidazo[1,2-a]pyridine-3-acetamide (CLINME) was radiolabelled with iodine-123 and assessed for its sensitivity for the TSPO in rodents. Moreover neuroinflammatory changes on a unilateral excitotoxic lesion rat model were detected using SPECT imaging. [123I]-CLINME was prepared in 70–80% radiochemical yield. The uptake of [123I]-CLINME was evaluated in rats by biodistribution, competition, and metabolite studies. The unilateral excitotoxic lesion was performed by injection of α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid unilaterally into the striatum. The striatum lesion was confirmed and correlated with TSPO expression in astrocytes and activated microglia by immunohistochemistry and autoradiography. In vivo studies with [123I]-CLINME indicated a biodistribution pattern consistent with TPSO distribution and the competition studies with PK11195 and Ro 5-4864 showed that [123I]-CLINME is selective for this site. The metabolite study showed that the extractable radioactivity was unchanged [123I]-CLINME in organs which expresses TSPO. SPECT/CT imaging on the unilateral excitotoxic lesion indicated that the mean ratio uptake in striatum (lesion : nonlesion) was 2.2. Moreover, TSPO changes observed by SPECT imaging were confirmed by immunofluorescence, immunochemistry, and autoradiography. These results indicated that [123I]-CLINME is a promising candidate for the quantification and visualization of TPSO expression in activated astroglia using SPECT. PMID:26199457

  19. The Functional Organization of Trial-Related Activity in Lexical Processing after Early Left Hemispheric Brain Lesions: An Event-Related fMRI Study

    ERIC Educational Resources Information Center

    Fair, Damien A.; Choi, Alexander H.; Dosenbach, Yannic B. L.; Coalson, Rebecca S.; Miezin, Francis M.; Petersen, Steven E.; Schlaggar, Bradley L.

    2010-01-01

    Children with congenital left hemisphere damage due to perinatal stroke are capable of acquiring relatively normal language functions despite experiencing a cortical insult that in adults often leads to devastating lifetime disabilities. Although this observed phenomenon is accepted, its neurobiological mechanisms are not well characterized. In…

  20. Can Small Lesions Induce Language Reorganization as Large Lesions Do?

    ERIC Educational Resources Information Center

    Maestu, Fernando; Saldana, Cristobal; Amo, Carlos; Gonzalez-Hidalgo, Mercedes; Fernandez, Alberto; Fernandez, Santiago; Mata, Pedro; Papanicolaou, Andrew; Ortiz, Tomas

    2004-01-01

    Shift of the cortical mechanisms of language from the usually dominant left to the non-dominant right hemisphere has been demonstrated in the presence of large brain lesions. Here, we report a similar phenomenon in a patient with a cavernoma over the anterolateral superior temporal gyrus associated with epilepsy. Language mapping was performed by…

  1. Cortical correlates of acquired deafness to dissonance.

    PubMed

    Brattico, Elvira; Tervaniemi, Mari; Valimaki, Vesa; Van Zuijen, Titia; Peretz, Isabelle

    2003-11-01

    Patient I.R., who had bilateral lesions in the auditory cortex but intact hearing, did not distinguish dissonant from consonant musical excerpts in behavioral testing. We additionally found that the electrical brain responses did not differentiate musical intervals in terms of their dissonance/consonance, consistent with the idea that this phenomenon depends on the integrity of cortical functions.

  2. Associations between clinical outcome and navigated transcranial magnetic stimulation characteristics in patients with motor-eloquent brain lesions: a combined navigated transcranial magnetic stimulation-diffusion tensor imaging fiber tracking approach.

    PubMed

    Sollmann, Nico; Wildschuetz, Noémie; Kelm, Anna; Conway, Neal; Moser, Tobias; Bulubas, Lucia; Kirschke, Jan S; Meyer, Bernhard; Krieg, Sandro M

    2017-03-31

    OBJECTIVE Navigated transcranial magnetic stimulation (nTMS) and diffusion tensor imaging fiber tracking (DTI FT) based on nTMS data are increasingly used for preoperative planning and resection guidance in patients suffering from motor-eloquent brain tumors. The present study explores whether nTMS-based DTI FT can also be used for individual preoperative risk assessment regarding surgery-related motor impairment. METHODS Data derived from preoperative nTMS motor mapping and subsequent nTMS-based tractography in 86 patients were analyzed. All patients suffered from high-grade glioma (HGG), low-grade glioma (LGG), or intracranial metastasis (MET). In this context, nTMS-based DTI FT of the corticospinal tract (CST) was performed at a range of fractional anisotropy (FA) levels based on an individualized FA threshold ([FAT]; tracking with 50%, 75%, and 100% FAT), which was defined as the highest FA value allowing for visualization of fibers (100% FAT). Minimum lesion-to-CST distances were measured, and fiber numbers of the reconstructed CST were assessed. These data were then correlated with the preoperative, postoperative, and follow-up status of motor function and the resting motor threshold (rMT). RESULTS At certain FA levels, a statistically significant difference in lesion-to-CST distances was observed between patients with HGG who had no impairment and those who developed surgery-related transient or permanent motor deficits (75% FAT: p = 0.0149; 100% FAT: p = 0.0233). In this context, no patient with a lesion-to-CST distance ≥ 12 mm suffered from any new surgery-related permanent paresis (50% FAT and 75% FAT). Furthermore, comparatively strong negative correlations were observed between the rMT and lesion-to-CST distances of patients with surgery-related transient paresis (Spearman correlation coefficient [rs]; 50% FAT: rs = -0.8660; 75% FAT: rs = -0.8660) or surgery-related permanent paresis (50% FAT: rs = -0.7656; 75% FAT: rs = -0.6763). CONCLUSIONS This is

  3. Cognitive Function and Emotional Status of Middle-aged Chinese Hypertensive Patients Without Detectable White Matter Brain Lesions or Lacunar Infarctions

    DTIC Science & Technology

    2006-08-30

    with extremes of systolic blood pressure in older Caucasians appears to be muted in elderly African Americans (Bohannon, Fillenbaum, Pieper, Hanlon...145-151. DeCarli, C., Miller, B. L., Swan , G. E., Reed, T., Wolf, P. A., Garner, J., et al. (1999). Predictors of brain morphology for the men of

  4. Cognitive Function and Emotional Status of Middle-aged Chinese Hypertensive Patients Without Detectable White Matter Brain Lesions or Lacunar Infarctions

    DTIC Science & Technology

    2006-01-01

    extremes of systolic blood pressure in older Caucasians appears to be muted in elderly African Americans (Bohannon, Fillenbaum, Pieper, Hanlon, & Blazer...DeCarli, C., Miller, B. L., Swan , G. E., Reed, T., Wolf, P. A., Garner, J., et al. (1999). Predictors of brain morphology for the men of the NHLBI

  5. Musical anhedonia after focal brain damage.

    PubMed

    Belfi, Amy M; Evans, Erin; Heskje, Jonah; Bruss, Joel; Tranel, Daniel

    2017-03-01

    People listen to music because it is pleasurable. However, there are individual differences in the reward value of music. At the extreme low end of this continuum, individuals who derive no pleasure from music are said to have 'musical anhedonia.' Cases of acquired musical anhedonia following focal brain damage are rare, with only a handful having been reported in the scientific literature. Here, we surveyed a large sample of patients with focal brain damage to identify the frequency, specificity, and neural correlates of acquired musical anhedonia. Participants completed the Musical anhedonia Questionnaire and the Barcelona Music Reward Questionnaire (Mas-Herrero et al., 2013) to assess changes in musical enjoyment and reward following brain injury. Neuroanatomical data were analyzed with a proportional MAP-3 method to create voxelwise lesion proportion difference maps. No clear or consistent neuroanatomical correlates of musical anhedonia were identified. One patient with damage to the right-hemisphere putamen and internal capsule displayed specific and severe acquired musical anhedonia. These findings indicate that acquired musical anhedonia is very uncommon, a result which is consistent with the fact that only a small number of such cases have been reported in the literature. This rarity could have positive implications for the therapeutic potentialities of music in patients with severe neurological disorders.

  6. Effect of Treatment with Interferon Beta-1a on Changes in Voxel-Wise Magnetization Transfer Ratio in Normal Appearing Brain Tissue and Lesions of Patients with Relapsing–Remitting Multiple Sclerosis: A 24-Week, Controlled Pilot Study

    PubMed Central

    Zivadinov, Robert; Dwyer, Michael G.; Markovic-Plese, Silva; Kennedy, Cheryl; Bergsland, Niels; Ramasamy, Deepa P.; Durfee, Jacqueline; Hojnacki, David; Hayward, Brooke; Dangond, Fernando; Weinstock-Guttman, Bianca

    2014-01-01

    Background This pilot study investigated changes in remyelinating and demyelinating activity in normal appearing brain tissue (NABT) and lesions, by using voxel-wise magnetization transfer ratio (VW-MTR), in patients with relapsing–remitting multiple sclerosis (RRMS) receiving interferon beta-1a 44 mcg subcutaneously (IFN β-1a SC) three times weekly versus healthy controls (HCs) (NCT01085318). Methods Increasing (suggestive of remyelination) and decreasing (suggestive of demyelination) VW-MTR changes in NABT and in T2, T1 and gadolinium (Gd)-enhancing lesion volume were measured over 24 weeks in 23 patients treated with IFN β-1a SC and in 15 HCs (where applicable). VW-MTR changes were tested using the Wilcoxon signed–rank or Wilcoxon rank–sum test. Results A trend for greater volume of NABT with increasing VW-MTR at 24 weeks was observed for patients versus HCs (median [range] 1206 [0–15278]; 342 [0–951] mm3; p = 0.061). NABT volume with increasing VW-MTR at 12 weeks was significantly greater in patients than in HCs (852 [6–11577]; 360 [0–1755] mm3; p = 0.028). Similar findings were detected for lesion volumes. Two patients with notably high numbers of Gd-enhancing lesions at baseline had a markedly greater volume of tissue with increasing VW-MTR compared with other patients. Volume of NABT tissue with decreasing VW-MTR was significantly greater in patients versus HCs at 24 weeks (942 [0–6141]; 297 [0–852] mm3; p<0.001). Conclusions The significant change in NABT volume with increasing VW-MTR at 12 weeks suggests that active remyelination in patients with RRMS may occur during treatment with IFN β-1a SC. Findings from two patients with the highest number of Gd-enhancing lesions at baseline suggest that extensive remyelination in NABT may occur in patients with high disease activity. Tissue volume with decreasing VW-MTR was greater in patients than in HCs, despite treatment, validating the sensitivity of this technique for detecting MS

  7. Acquired Idiopathic Generalized Anhidrosis.

    PubMed

    Gangadharan, Geethu; Criton, Sebastian; Surendran, Divya

    2015-01-01

    Acquired idiopathic generalized anhidrosis is a rare condition, where the exact pathomechanism is unknown. We report a case of acquired idiopathic generalized anhidrosis in a patient who later developed lichen planus. Here an autoimmune-mediated destruction of sweat glands may be the probable pathomechanism.

  8. LABORATORY-ACQUIRED MYCOSES

    DTIC Science & Technology

    laboratory- acquired mycoses . Insofar as possible, the etiological fungus, type of laboratory, classification of personnel, type of work conducted, and other...pertinent data have been listed in this study. More than 288 laboratory- acquired mycoses are described here, including 108 cases of

  9. Brain imaging

    SciTech Connect

    Bradshaw, J.R.

    1989-01-01

    This book presents a survey of the various imaging tools with examples of the different diseases shown best with each modality. It includes 100 case presentations covering the gamut of brain diseases. These examples are grouped according to the clinical presentation of the patient: headache, acute headache, sudden unilateral weakness, unilateral weakness of gradual onset, speech disorders, seizures, pituitary and parasellar lesions, sensory disorders, posterior fossa and cranial nerve disorders, dementia, and congenital lesions.

  10. Losartan prevents acquired epilepsy via TGF-β signaling suppression

    PubMed Central

    Bar-Klein, Guy; Cacheaux, Luisa P.; Kamintsky, Lyn; Prager, Ofer; Weissberg, Itai; Schoknecht, Karl; Cheng, Paul; Kim, Soo Young; Wood, Lydia; Heinemann, Uwe; Kaufer, Daniela; Friedman, Alon

    2014-01-01

    Objective Acquired epilepsy is frequently associated with structural lesions following trauma, stroke and infections. While seizures are often difficult to treat, there is no clinically applicable strategy to prevent the development of epilepsy in patients at risk. We have recently shown that vascular injury is associated with activation of albumin-mediated transforming growth factor β (TGF-β) signaling, and followed by local inflammatory response and epileptiform activity ex vivo. Here we investigated albumin-mediated TGF-β signaling and tested the efficacy of blocking the TGF-β pathway in preventing epilepsy. Methods We addressed the role of TGF-β signaling in epiletogenesis in two different rat models of vascular injury, combining in vitro and in vivo biochemical assays, gene expression, magnetic resonance and direct optical imaging for blood-brain barrier (BBB) permeability and vascular reactivity. Long-term electrocorticographic (ECoG) recordings were acquired in freely behaving animals. Results We demonstrate that serum-derived albumin preferentially induces activation of the activin receptor-like kinase 5 (ALK5) pathway of TGF-β receptor I in astrocytes. We further show that the angiotensin II type 1 receptor antagonist (AT1), losartan, previously identified as a blocker of peripheral TGF-β signaling, effectively blocks albumin-induced TGF-β activation in the brain. Most importantly, losartan prevents the development of delayed recurrent spontaneous seizures, an effect that persists weeks after drug withdrawal. Interpretation TGF-β signaling, activated in astrocytes by serum-derived albumin, is involved in epileptogenesis. We propose losartan, an FDA-approved drug, as an efficient anti-epileptogenic therapy for epilepsy associated with vascular injury. PMID:24659129

  11. Gross morphology and morphometric sequelae in the hippocampus, fornix, and corpus callosum of patients with severe non-missile traumatic brain injury without macroscopically detectable lesions: a T1 weighted MRI study

    PubMed Central

    Tomaiuolo, F; Carlesimo, G; Di, P; Petrides, M; Fera, F; Bonanni, R; Formisano, R; Pasqualetti, P; Caltagirone, C

    2004-01-01

    Objective: The gross morphology and morphometry of the hippocampus, fornix, and corpus callosum in patients with severe non-missile traumatic brain injury (nmTBI) without obvious neuroradiological lesions was examined and the volumes of these structures were correlated with performance on memory tests. In addition, the predictability of the length of coma from the selected anatomical volumes was examined. Method: High spatial resolution T1 weighted MRI scans of the brain (1 mm3) and neuropsychological evaluations with standardised tests were performed at least 3 months after trauma in 19 patients. Results: In comparison with control subjects matched in terms of gender and age, volume reduction in the hippocampus, fornix, and corpus callosum of the nmTBI patients was quantitatively significant. The length of coma correlated with the volume reduction in the corpus callosum. Immediate free recall of word lists correlated with the volume of the fornix and the corpus callosum. Delayed recall of word lists and immediate recall of the Rey figure both correlated with the volume of the fornix. Delayed recall of the Rey figure correlated with the volume of the fornix and the right hippocampus. Conclusion: These findings demonstrate that in severe nmTBI without obvious neuroradiological lesions there is a clear hippocampal, fornix, and callosal volume reduction. The length of coma predicts the callosal volume reduction, which could be considered a marker of the severity of axonal loss. A few memory test scores correlated with the volumes of the selected anatomical structures. This relationship with memory performance may reflect the diffuse nature of the damage, leading to the disruption of neural circuits at multiple levels and the progressive neural degeneration occurring in TBI. PMID:15314123

  12. Subcortical infarction resulting in acquired stuttering.

    PubMed

    Ciabarra, A M; Elkind, M S; Roberts, J K; Marshall, R S

    2000-10-01

    Stuttering is an uncommon presentation of acute stroke. Reported cases have often been associated with left sided cortical lesions, aphasia, and difficulties with other non-linguistic tests of rhythmic motor control. Three patients with subcortical lesions resulting in stuttering are discussed. In one patient the ability to perform time estimations with a computerised repetitive time estimation task was characterised. One patient had a pontine infarct with clinical evidence of cerebellar dysfunction. A second patient had a left basal ganglionic infarct and a disruption of timing estimation. A third patient had a left subcortical infarct and a mild aphasia. These findings expand the reported distribution of infarction that can result in acquired stuttering. Subcortical mechanisms of speech control and timing may contribute to the pathophysiology of acquired stuttering.

  13. Acquired inflammatory demyelinating neuropathies.

    PubMed

    Ensrud, E R; Krivickas, L S

    2001-05-01

    The acquired demyelinating neuropathies can be divided into those with an acute onset and course and those with a more chronic course. The acute neuropathies present as Guillain-Barré syndrome and include acute inflammatory demyelinating polyradiculoneuropathy (AIDP), Miller Fisher syndrome, acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), and acute pandysautonomia. The chronic neuropathies are collectively known as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and include MADSAM (multifocal acquired demyelinating sensory and motor neuropathy, also know as Lewis-Sumner syndrome) and DADS (distal acquired demyelinating symmetric neuropathy) as variants. The clinical features, pathology, pathogenesis, diagnosis, treatment, rehabilitation, and prognosis of these neuropathies are discussed.

  14. Neuropsychiatric Symptom Clusters in Stroke and Transient Ischemic Attack by Cognitive Status and Stroke Subtype: Frequency and Relationships with Vascular Lesions, Brain Atrophy and Amyloid

    PubMed Central

    Wong, Adrian; Lau, Alexander Y. L.; Yang, Jie; Wang, Zhaolu; Liu, Wenyan; Lam, Bonnie Y. K.; Au, Lisa; Shi, Lin; Wang, Defeng; Chu, Winnie C. W.; Xiong, Yun-yun; Lo, Eugene S. K.; Law, Lorraine S. N.; Leung, Thomas W. H.; Lam, Linda C. W.; Chan, Anne Y. Y.; Soo, Yannie O. Y.; Leung, Eric Y. L.; Wong, Lawrence K. S.; Mok, Vincent C. T.

    2016-01-01

    Background The objectives of this study are 1) to examine the frequencies of neuropsychiatric symptom clusters in patients with stroke or transient ischemic attack (TIA) by cognitive level and stroke subtype; and 2) to evaluate effect of demographic, clinical, and neuroimaging measures of chronic brain changes and amyloid upon neuropsychiatric symptom clusters. Methods Hospital-based, cross-sectional study. 518 patients were administered the Neuropsychiatric Inventory (NPI) 3–6 months post index admission. NPI symptoms were classified into four symptom clusters (Behavioral Problems, Psychosis, Mood Disturbance & Euphoria) derived from a confirmatory factor analysis of the 12 NPI items. Multivariable logistic regression was used to determine independent associations between demographic, clinical and neuroimaging measures of chronic brain changes (white matter changes, old infarcts, whole brain atrophy, medial temporal lobe atrophy [MTLA] and frontal lobe atrophy [FLA]) with the presence of NPI symptoms and all symptom clusters except euphoria. 11C-Pittsburg Compound B Positron Emission Tomography (11C-PiB PET) was performed in 24 patients to measure amyloid retention for Alzheimer’s Disease (AD) pathology. Results 50.6% of the whole sample, including 28.7% cognitively normal and 66.7% of patients with mild cognitive symptoms, had ≥1 NPI symptoms. Frequencies of symptom clusters were largely similar between stroke subtypes. Compared to patients with cardioembolic stroke and intracranial haemorrhage, those with TIA had less frequent mood disturbance. Stroke severity at admission and MTLA were the most robust correlates of symptoms. FLA was associated with behavioral problems cluster only. Frequency of symptom clusters did not differ between patients with and without significant amyloid retention. Conclusion Frequency of neuropsychiatric symptoms increased with level of cognitive impairment but was largely similar between stroke subtypes. Stroke severity and MTLA

  15. Sustained production of beta-glucuronidase from localized sites after AAV vector gene transfer results in widespread distribution of enzyme and reversal of lysosomal storage lesions in a large volume of brain in mucopolysaccharidosis VII mice.

    PubMed

    Skorupa, A F; Fisher, K J; Wilson, J M; Parente, M K; Wolfe, J H

    1999-11-01

    The lysosomal storage disorders are a large group of inherited diseases that involve central nervous system degeneration. The disease in the brain has generally been refractory to treatment, which will require long-term correction of lesions dispersed throughout the central nervous system to be effective. A promising approach is somatic gene therapy but the methods have so far been inadequate because they have only achieved short-term or localized improvements. A potential approach to overcome these limitations is to obtain sustained high level expression and secretion of the missing normal enzyme from a small group of cells for export to neighboring diseased cells, which might allow the therapeutic protein to reach distal sites. We tested this in a mouse model of mucopolysaccharidosis VII (Sly disease) using an adeno-associated virus vector. After a single treatment the vector continuously produced the normal enzyme from infected cells at the injection sites. The secreted enzyme was disseminated along most of the neuraxis, resulting in widespread reversal of the hallmark pathology. An extensive sphere of correction surrounding the transduction sites was created, suggesting that a limited number of appropriately spaced sites of gene transfer may provide overlapping spheres of enzyme diffusion to cover a large volume of brain tissue.

  16. Acquired color vision deficiency.

    PubMed

    Simunovic, Matthew P

    2016-01-01

    Acquired color vision deficiency occurs as the result of ocular, neurologic, or systemic disease. A wide array of conditions may affect color vision, ranging from diseases of the ocular media through to pathology of the visual cortex. Traditionally, acquired color vision deficiency is considered a separate entity from congenital color vision deficiency, although emerging clinical and molecular genetic data would suggest a degree of overlap. We review the pathophysiology of acquired color vision deficiency, the data on its prevalence, theories for the preponderance of acquired S-mechanism (or tritan) deficiency, and discuss tests of color vision. We also briefly review the types of color vision deficiencies encountered in ocular disease, with an emphasis placed on larger or more detailed clinical investigations.

  17. Studies of the endothelial origin of cells in systemic angioendotheliomatosis and other vascular lesions of the brain and meninges using ulex europaeus lectin stains.

    PubMed

    Schelper, R L; Olson, S P; Carroll, T J; Hart, M N; Witters, E

    1986-01-01

    Ulex europaeus agglutinin I (UEA-I) is a plant lectin which binds specifically to alpha-L-fucose moieties on the surface glycoproteins of human endothelial cells. The binding is completely inhibited by preincubation of the lectin with fucose. UEA-I can be conjugated directly to fluorescein or peroxidase and can be used to stain endothelium of paraffin embedded tissues. UEA-I staining was evaluated on normal and infarcted brain, systemic angioendotheliomatosis, metastatic epidural angiosarcoma, hemangioendothelioma, hemangioblastoma, angioblastic meningioma of both the hemangioblastic and hemangiopericytic types, and vascular meningioma. The endothelium, but not neuropil of normal and infarcted brain was positive for UEA-I. The tumor cells of hemangioendothelioma and angiosarcoma also stained. However, no staining was seen in malignant intravascular cells of angioendotheliomatosis, the stromal cells of hemangioblastoma, or pericytes of angioblastic meningioma. It is concluded that the malignant cells in angioendotheliomatosis, the stromal cells of hemangioblastoma and the pericytes of angioblastic meningioma do not produce surface glycoproteins characteristic of endothelial cells.

  18. Acquired alexithymia following damage to the anterior insula

    PubMed Central

    Hogeveen, J.; Bird, G.; Chau, A.; Krueger, F.; Grafman, J.

    2016-01-01

    Alexithymia is a subclinical condition characterized by impaired awareness of one’s emotional states, which has profound effects on mental health and social interaction. Despite the clinical significance of this condition, the neurocognitive impairment(s) that lead to alexithymia remain unclear. Recent theoretical models suggest that impaired anterior insula (AI) functioning might be involved in alexithymia, but conclusive evidence for this hypothesis is lacking. We measured alexithymia levels in a large sample of brain-injured patients (N=129) and non-brain-injured control participants (N=33), to determine whether alexithymia can be acquired after pronounced damage to the AI. Alexithymia levels were first analyzed as a function of group, with patients separated into four groups based on AI damage: patients with >15% damage to AI, patients with <15% damage to AI, patients with no damage to AI, and healthy controls. An ANOVA revealed that alexithymia levels varied across groups (p=0.009), with >15% AI damage causing higher alexithymia relative to all other groups (all p<0.01). Next, a multiple linear regression model was fit with the degree of damage to AI, the degree of damage to a related region (the anterior cingulate cortex, ACC), and the degree of damage to the whole brain as predictor variables, and alexithymia as the dependent variable. Critically, increased AI damage predicted increased alexithymia after controlling for the other two regressors (ACC damage; total lesion volume). Collectively, our results suggest that pronounced AI damage causes increased levels of alexithymia, providing critical evidence that this region supports emotional awareness. PMID:26801227

  19. Empty-nest-related psychological distress is associated with progression of brain white matter lesions and cognitive impairment in the elderly

    PubMed Central

    Duan, Dandan; Dong, Yuanli; Zhang, Hua; Zhao, Yingxin; Diao, Yutao; Cui, Yi; Wang, Juan; Chai, Qiang; Liu, Zhendong

    2017-01-01

    This study evaluated the association between empty-nest-related psychological distress and the progression of white matter lesions (WMLs) and cognitive impairment in 219 elderly subjects aged 60 years or over. Psychological distress was assessed using the University of California at Los Angeles Loneliness Scale (UCLA-LS) and Geriatric Depression Scale (GDS) Short-Form. Cognitive function was evaluated using the MMSE and MoCA. White matter hyperintensities (WMH) were assessed using magnetic resonance imaging. After 5.2-year follow-up, the reductions in MMSE and MoCA scores and the increases in periventricular (P)WMH, deep (D)WMH, and total WMH volumes in the empty-nest elderly were greater than those in the non-empty-nest elderly (P < 0.05). The reduced MMSE and MoCA scores and increased volumes of PWMH and total WMH in the empty-nest elderly living alone were greater than those in the empty-nest elderly living with a spouse (P < 0.05). UCLA-LS and GDS scores were significantly and independently associated with reduced MMSE and MoCA scores and the increased volumes of PWMH, DWMH, and total WMH. The results indicate that empty-nest-related psychological distress is associated with progression of WMLs and cognitive impairment in the elderly. PMID:28256594

  20. Cardiovascular risk factors and small vessel disease of the brain: Blood pressure, white matter lesions, and functional decline in older persons

    PubMed Central

    Abraham, Hazel Mae A; Wolfson, Leslie; Moscufo, Nicola; Guttmann, Charles R G; Kaplan, Richard F

    2016-01-01

    Several potential vascular risk factors exist for the development and accumulation of subcortical white matter disease in older people. We have reported that in older people followed for up to 4 years white matter hyperintensity (WMH) lesions on magnetic resonance imaging nearly doubled in volume and were associated with alterations in mobility and cognitive function. Herein we review the genetic, metabolic, and vascular risk factors that have been evaluated in association with the development and pathogenesis of WMH in older persons. Our research efforts have focused on systemic hypertension, particularly in the out-of-office setting as 24-hour ambulatory blood pressure (BP) has proven to be a stronger indicator of the progression of WMH in older people and the associated functional decline than doctor’s office BP. Based on relations between 24-hour systolic BP levels, the accrual of WMH, and functional decline, we have designed the INFINITY trial, the first interventional study to use ambulatory BP to guide antihypertensive therapy to address this problem in the geriatric population. PMID:26036933

  1. Elementary lesions in dermatological semiology: literature review*

    PubMed Central

    Cardili, Renata Nahas; Roselino, Ana Maria

    2016-01-01

    Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology. PMID:27828637

  2. Abnormal endothelial tight junctions in active lesions and normal-appearing white matter in multiple sclerosis.

    PubMed

    Plumb, Jonnie; McQuaid, Stephen; Mirakhur, Meenakshi; Kirk, John

    2002-04-01

    Blood-brain barrier (BBB) breakdown, demonstrable in vivo by enhanced MRI is characteristic of new and expanding inflammatory lesions in relapsing-remitting and chronic progressive multiple sclerosis (MS). Subtle leakage may also occur in primary progressive MS. However, the anatomical route(s) of BBB leakage have not been demonstrated. We investigated the possible involvement of interendothelial tight junctions (TJ) by examining the expression of TJ proteins (occludin and ZO-1 ) in blood vessels in active MS lesions from 8 cases of MS and in normal-appearing white (NAWM) matter from 6 cases. Blood vessels (10-50 per frozen section) were scanned using confocal laser scanning microscopy to acquire datasets for analysis. TJ abnormalities manifested as beading, interruption, absence or diffuse cytoplasmic localization of fluorescence, or separation of junctions (putative opening) were frequent (affecting 40% of vessels) in oil-red-O-positive active plaques but less frequent in NAWM (15%), and in normal (< 2%) and neurological controls (6%). Putatively "open" junctions were seen in vessels in active lesions and in microscopically inflamed vessels in NAWM. Dual fluorescence revealed abnormal TJs in vessels with pre-mortem serum protein leakage. Abnormal or open TJs, associated with inflammation may contribute to BBB leakage in enhancing MRI lesions and may also be involved in subtle leakage in non-enhancing focal and diffuse lesions in NAWM. BBB disruption due to tight junctional pathology should be regarded as a significant form of tissue injury in MS, alongside demyelination and axonopathy.

  3. Acquired hypofibrinogenemia: current perspectives

    PubMed Central

    Besser, Martin W; MacDonald, Stephen G

    2016-01-01

    Acquired hypofibrinogenemia is most frequently caused by hemodilution and consumption of clotting factors. The aggressive replacement of fibrinogen has become one of the core principles of modern management of massive hemorrhage. The best method for determining the patient’s fibrinogen level remains controversial, and particularly in acquired dysfibrinogenemia, could have major therapeutic implications depending on which quantification method is chosen. This review introduces the available laboratory and point-of-care methods and discusses the relative advantages and limitations. It also discusses current strategies for the correction of hypofibrinogenemia. PMID:27713652

  4. Community-acquired pneumonia.

    PubMed

    Falguera, M; Ramírez, M F

    2015-11-01

    This article not only reviews the essential aspects of community-acquired pneumonia for daily clinical practice, but also highlights the controversial issues and provides the newest available information. Community-acquired pneumonia is considered in a broad sense, without excluding certain variants that, in recent years, a number of authors have managed to delineate, such as healthcare-associated pneumonia. The latter form is nothing more than the same disease that affects more frail patients, with a greater number of risk factors, both sharing an overall common approach.

  5. Medial entorhinal cortex lesions only partially disrupt hippocampal place cells and hippocampus-dependent place memory

    PubMed Central

    Hales, Jena B; Schlesiger, Magdalene I; Leutgeb, Jill K; Squire, Larry R; Leutgeb, Stefan; Clark, Robert E

    2014-01-01

    SUMMARY Entorhinal cortex provides the primary cortical projections to the hippocampus, a brain structure critical for memory. However, it remains unclear how the precise firing patterns of medial entorhinal cortex (MEC) cells influence hippocampal physiology and hippocampus-dependent behavior. We found that complete bilateral lesions of MEC resulted in a lower proportion of active hippocampal cells. The remaining active cells had place fields, but with decreased spatial precision and decreased long-term spatial stability. In addition, MEC rats were as impaired at acquiring the watermaze as hippocampus rats, while rats with combined MEC and hippocampal lesions had an even greater deficit. However, MEC rats were not impaired on other hippocampus-dependent tasks, including those in which an object location or context was remembered. Thus, MEC is not necessary for all types of spatial coding, nor for all types of hippocampus-dependent memory, but is necessary for the normal acquisition of place memory. PMID:25437546

  6. Doctors Describe First U.S. Case of Locally Acquired Zika in Pregnancy

    MedlinePlus

    ... Doctors Describe First U.S. Case of Locally Acquired Zika in Pregnancy Baby shows no signs of brain ... HealthDay News) -- The first case of locally acquired Zika virus in a pregnant woman in the United ...

  7. Method for quantitative validation of image-based correction for intraoperative brain shift

    NASA Astrophysics Data System (ADS)

    Bates, Lisa M.; Goerss, Stephan J.; Robb, Richard A.

    2000-04-01

    Stereotactic neuronavigational systems use pre-operatively acquired 3D images for procedural planning and also are employed in intraoperative navigations to help localize and resect brain lesions. Intraoperatively, multiple factors contribute to anatomic changes that limit the accuracy of navigation based solely on pre-operative images. Loss of CSF, cortical swelling, and the effect of gravity relative to the craniotomy locations are some of the factors that contribute to errors in navigation.

  8. Segmentation editing improves efficiency while reducing inter-expert variation and maintaining accuracy for normal brain tissues in the presence of space-occupying lesions.

    PubMed

    Deeley, M A; Chen, A; Datteri, R D; Noble, J; Cmelak, A; Donnelly, E; Malcolm, A; Moretti, L; Jaboin, J; Niermann, K; Yang, Eddy S; Yu, David S; Dawant, B M

    2013-06-21

    Image segmentation has become a vital and often rate-limiting step in modern radiotherapy treatment planning. In recent years, the pace and scope of algorithm development, and even introduction into the clinic, have far exceeded evaluative studies. In this work we build upon our previous evaluation of a registration driven segmentation algorithm in the context of 8 expert raters and 20 patients who underwent radiotherapy for large space-occupying tumours in the brain. In this work we tested four hypotheses concerning the impact of manual segmentation editing in a randomized single-blinded study. We tested these hypotheses on the normal structures of the brainstem, optic chiasm, eyes and optic nerves using the Dice similarity coefficient, volume, and signed Euclidean distance error to evaluate the impact of editing on inter-rater variance and accuracy. Accuracy analyses relied on two simulated ground truth estimation methods: simultaneous truth and performance level estimation and a novel implementation of probability maps. The experts were presented with automatic, their own, and their peers' segmentations from our previous study to edit. We found, independent of source, editing reduced inter-rater variance while maintaining or improving accuracy and improving efficiency with at least 60% reduction in contouring time. In areas where raters performed poorly contouring from scratch, editing of the automatic segmentations reduced the prevalence of total anatomical miss from approximately 16% to 8% of the total slices contained within the ground truth estimations. These findings suggest that contour editing could be useful for consensus building such as in developing delineation standards, and that both automated methods and even perhaps less sophisticated atlases could improve efficiency, inter-rater variance, and accuracy.

  9. Segmentation editing improves efficiency while reducing inter-expert variation and maintaining accuracy for normal brain tissues in the presence of space-occupying lesions

    NASA Astrophysics Data System (ADS)

    Deeley, M. A.; Chen, A.; Datteri, R. D.; Noble, J.; Cmelak, A.; Donnelly, E.; Malcolm, A.; Moretti, L.; Jaboin, J.; Niermann, K.; Yang, Eddy S.; Yu, David S.; Dawant, B. M.

    2013-06-01

    Image segmentation has become a vital and often rate-limiting step in modern radiotherapy treatment planning. In recent years, the pace and scope of algorithm development, and even introduction into the clinic, have far exceeded evaluative studies. In this work we build upon our previous evaluation of a registration driven segmentation algorithm in the context of 8 expert raters and 20 patients who underwent radiotherapy for large space-occupying tumours in the brain. In this work we tested four hypotheses concerning the impact of manual segmentation editing in a randomized single-blinded study. We tested these hypotheses on the normal structures of the brainstem, optic chiasm, eyes and optic nerves using the Dice similarity coefficient, volume, and signed Euclidean distance error to evaluate the impact of editing on inter-rater variance and accuracy. Accuracy analyses relied on two simulated ground truth estimation methods: simultaneous truth and performance level estimation and a novel implementation of probability maps. The experts were presented with automatic, their own, and their peers’ segmentations from our previous study to edit. We found, independent of source, editing reduced inter-rater variance while maintaining or improving accuracy and improving efficiency with at least 60% reduction in contouring time. In areas where raters performed poorly contouring from scratch, editing of the automatic segmentations reduced the prevalence of total anatomical miss from approximately 16% to 8% of the total slices contained within the ground truth estimations. These findings suggest that contour editing could be useful for consensus building such as in developing delineation standards, and that both automated methods and even perhaps less sophisticated atlases could improve efficiency, inter-rater variance, and accuracy.

  10. Optic nerve sheath diameter threshold by ocular ultrasonography for detection of increased intracranial pressure in Korean adult patients with brain lesions

    PubMed Central

    Lee, Si Un; Jeon, Jin Pyeong; Lee, Hannah; Han, Jung Ho; Seo, Mingu; Byoun, Hyoung Soo; Cho, Won-Sang; Ryu, Ho Geol; Kang, Hyun-Seung; Kim, Jeong Eun; Kim, Heung Cheol; Jang, Kyung-Sool

    2016-01-01

    Abstract Optic nerve sheath diameter (ONSD) seen on ocular US has been associated with increased intracranial pressure (IICP). However, most studies have analyzed normal range of ONSD and its optimal cut-off point for IICP in Caucasian populations. Considering ONSD differences according to ethnicity, previous results may not accurately reflect the association between IICP and ONSD in Koreans. Therefore, we conducted this study to investigate normal range of ONSD and its optimal threshold for detecting IICP in Korean patients. This prospective multicenter study was performed for patients with suspected IICP. ONSD was measured 3 mm behind the globe using a 13-MHz US probe. IICP was defined as significant brain edema, midline shift, compression of ventricle or basal cistern, effacement of sulci, insufficient gray/white differentiation, and transfalcine herniation by radiologic tests. The results of the ONSD are described as the median (25th–75th percentile). The differences of ONSD according to disease entity were analyzed. A receiver operator characteristic (ROC) curve was generated to determine the optimal cut-off point for identifying IICP. A total of 134 patients were enrolled. The patients were divided into 3 groups as follows: patients with IICP, n = 81 (60.5%); patients without IICP, n = 27 (20.1%); and control group, n = 26 (19.4%). ONSD in patients with IICP (5.9 mm [5.8–6.2]) is significantly higher than those without IICP (5.2 mm [4.8–5.4]) (P < 0.01) and normal control group (4.9 mm [4.6–5.2]) (P < 0.001). Between patients without IICP and normal control group, the difference of ONSD did not reach statistical significance (P = 0.31). ONSD >5.5 mm yielded a sensitivity of 98.77% (95% CI: 93.3%–100%) and a specificity of 85.19% (95% CI: 66.3%–95.8%). In conclusion, the optimal cut-off point of ONSD for identifying IICP was 5.5 mm. ONSD seen on ocular US can be a feasible method for detection and serial monitoring of ICP in

  11. Hospital-acquired thrombocytopenia.

    PubMed

    McMahon, Christine M; Cuker, Adam

    2014-10-01

    The development of thrombocytopenia is common in hospitalized patients and is associated with increased mortality. Frequent and important causes of thrombocytopenia in hospitalized patients include etiologies related to the underlying illness for which the patient is admitted, such as infection and disseminated intravascular coagulation, and iatrogenic etiologies such as drug-induced immune thrombocytopenia, heparin-induced thrombocytopenia, posttransfusion purpura, hemodilution, major surgery, and extracorporeal circuitry. This review presents a brief discussion of the pathophysiology, distinguishing clinical features, and management of these etiologies, and provides a diagnostic approach to hospital-acquired thrombocytopenia that considers the timing and severity of the platelet count fall, the presence of hemorrhage or thrombosis, the clinical context, and the peripheral blood smear. This approach may offer guidance to clinicians in distinguishing among the various causes of hospital-acquired thrombocytopenia and providing management appropriate to the etiology.

  12. Desmosomes in acquired disease

    PubMed Central

    Stahley, Sara N.; Kowalczyk, Andrew P.

    2015-01-01

    Desmosomes are cell-cell junctions that mediate adhesion and couple the intermediate filament cytoskeleton to sites of cell-cell contact. This architectural arrangement functions to integrate adhesion and cytoskeletal elements of adjacent cells. The importance of this robust adhesion system is evident in numerous human diseases, both inherited and acquired, that occur when desmosome function is compromised. This review focuses on autoimmune and infectious diseases that impair desmosome function. In addition, we discuss emerging evidence that desmosomal genes are often misregulated in cancer. The emphasis of our discussion is placed on how human diseases inform our understanding of basic desmosome biology, and in turn, how fundamental advances in the cell biology of desmosomes may lead to new treatments for acquired diseases of the desmosome. PMID:25795143

  13. Desmosomes in acquired disease.

    PubMed

    Stahley, Sara N; Kowalczyk, Andrew P

    2015-06-01

    Desmosomes are cell-cell junctions that mediate adhesion and couple the intermediate filament cytoskeleton to sites of cell-cell contact. This architectural arrangement integrates adhesion and cytoskeletal elements of adjacent cells. The importance of this robust adhesion system is evident in numerous human diseases, both inherited and acquired, which occur when desmosome function is compromised. This review focuses on autoimmune and infectious diseases that impair desmosome function. In addition, we discuss emerging evidence that desmosomal genes are often misregulated in cancer. The emphasis of our discussion is placed on the way in which human diseases can inform our understanding of basic desmosome biology and in turn, the means by which fundamental advances in the cell biology of desmosomes might lead to new treatments for acquired diseases of the desmosome.

  14. Difficulties with diagnosis and consequential poor outcome due to stigma of acquired immunodeficiency syndrome - a case report.

    PubMed

    Vuletic, Vladimira; Nevajda, Branimir; Spero, Martina; Chudy, Darko

    2013-09-01

    Low incidence of human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) has been detected in Croatia so far. Toxoplasmic encephalitis (TE) is the most common opportunistic cerebral infection in AIDS patients and is highly responsive to antiparasitic chemotherapy, if treated at an early stage. We present the case of the brain biopsy confirmed as TE on a 36-year-old female patient who at admission presented with unconsciousness and a right hemiplegia. A MSCT was performed and two hypodense lesions were diagnosed. The patient's family initially denied the presence or history of any medical problem or infection. An MRI showed multiple ring-enhanced mass lesions. An infectologist required a brain biopsy to exclude cerebral lymphoma and multiple metastases. Pathohistological analysis suggested TE. Meanwhile, patient's blood samples were found to be HIV positive. The patient was transferred to University Hospital for Infectious Diseases in Zagreb, where she died 2 days following admission. The patient's family terminally confessed that the patient had been HIV positive for 10 years and had refused any treatment. Family's denial of infection as well as 'hiding information' concerning patient's health from physicians involved in her treatment caused a delay in proper on-time patient treatment. We would like to emphasize that TE must be considered as a differential diagnosis in patients presenting with multiple cerebral lesions, including patients without acknowledged past history of HIV infection. A stigma towards HIV infection and ignorance of the disease still exist and therefore hinders proper treatment.

  15. Progressive multifocal leukoencephalopathy in a patient with acquired immunodeficiency syndrome (AIDS) manifesting Gerstmann's syndrome.

    PubMed

    Saito, H; Sakai, H; Fujihara, K; Fujihara, K; Itoyama, Y

    1998-11-01

    We reported a case of acquired immunodeficiency syndrome (AIDS) via multiple blood transfusions, who manifested progressive multifocal leukoencephalopathy (PML) about 18 months after the development of AIDS. PML initiated with right hemiparesis, dysphasia, and Gerstmann's syndrome and resulted in death within 2 months after the onset. Neuroimaging examinations revealed white matter lesions mainly in the left posterior parietal lobe. The cortical gray matter also showed abnormal signal intensity. Peripheral CD4+ lymphocyte count was 81/microl. Routine cerebrospinal fluid (CSF) examinations were negative. CSF antibodies against herpes simplex virus, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus as well as serum antibody against toxoplasma gondii were negative. Though autopsy or biopsy of the brain was not performed, JC virus genomes were detected in the CSF sample by a polymerase chain reaction, and their sequencing showed unique alterations of the regulatory regions, characteristic to PML-type JC virus.

  16. Acquired prosopagnosia without word recognition deficits.

    PubMed

    Susilo, Tirta; Wright, Victoria; Tree, Jeremy J; Duchaine, Bradley

    2015-01-01

    It has long been suggested that face recognition relies on specialized mechanisms that are not involved in visual recognition of other object categories, including those that require expert, fine-grained discrimination at the exemplar level such as written words. But according to the recently proposed many-to-many theory of object recognition (MTMT), visual recognition of faces and words are carried out by common mechanisms [Behrmann, M., & Plaut, D. C. ( 2013 ). Distributed circuits, not circumscribed centers, mediate visual recognition. Trends in Cognitive Sciences, 17, 210-219]. MTMT acknowledges that face and word recognition are lateralized, but posits that the mechanisms that predominantly carry out face recognition still contribute to word recognition and vice versa. MTMT makes a key prediction, namely that acquired prosopagnosics should exhibit some measure of word recognition deficits. We tested this prediction by assessing written word recognition in five acquired prosopagnosic patients. Four patients had lesions limited to the right hemisphere while one had bilateral lesions with more pronounced lesions in the right hemisphere. The patients completed a total of seven word recognition tasks: two lexical decision tasks and five reading aloud tasks totalling more than 1200 trials. The performances of the four older patients (3 female, age range 50-64 years) were compared to those of 12 older controls (8 female, age range 56-66 years), while the performances of the younger prosopagnosic (male, 31 years) were compared to those of 14 younger controls (9 female, age range 20-33 years). We analysed all results at the single-patient level using Crawford's t-test. Across seven tasks, four prosopagnosics performed as quickly and accurately as controls. Our results demonstrate that acquired prosopagnosia can exist without word recognition deficits. These findings are inconsistent with a key prediction of MTMT. They instead support the hypothesis that face

  17. Hindlimb spasticity after unilateral motor cortex lesion in rats is reduced by contralateral nerve root transfer

    PubMed Central

    Zong, Haiyang; Ma, Fenfen; Zhang, Laiyin; Lu, Huiping; Gong, Jingru; Cai, Min; Lin, Haodong; Zhu, Yizhun; Hou, Chunlin

    2016-01-01

    Lower extremity spasticity is a common sequela among patients with acquired brain injury. The optimum treatment remains controversial. The aim of our study was to test the feasibility and effectiveness of contralateral nerve root transfer in reducing post stroke spasticity of the affected hindlimb muscles in rats. In our study, we for the first time created a novel animal hindlimb spastic hemiplegia model in rats with photothrombotic lesion of unilateral motor cortex and we established a novel surgical procedure in reducing motor cortex lesion-induced hindlimb spastic hemiplegia in rats. Thirty six rats were randomized into three groups. In group A, rats received sham operation. In group B, rats underwent unilateral hindlimb motor cortex lesion. In group C, rats underwent unilateral hindlimb cortex lesion followed by contralateral L4 ventral root transfer to L5 ventral root of the affected side. Footprint analysis, Hoffmann reflex (H-reflex), cholera toxin subunit B (CTB) retrograde tracing of gastrocnemius muscle (GM) motoneurons and immunofluorescent staining of vesicle glutamate transporter 1 (VGLUT1) on CTB-labelled motoneurons were used to assess spasticity of the affected hindlimb. Sixteen weeks postoperatively, toe spread and stride length recovered significantly in group C compared with group B (P<0.001). Hmax (H-wave maximum amplitude)/Mmax (M-wave maximum amplitude) ratio of gastrocnemius and plantaris muscles (PMs) significantly reduced in group C (P<0.01). Average VGLUT1 positive boutons per CTB-labelled motoneurons significantly reduced in group C (P<0.001). We demonstrated for the first time that contralateral L4 ventral root transfer to L5 ventral root of the affected side was effective in relieving unilateral motor cortex lesion-induced hindlimb spasticity in rats. Our data indicated that this could be an alternative treatment for unilateral lower extremity spasticity after brain injury. Therefore, contralateral neurotization may exert a potential

  18. Acquired Factor V Inhibitor

    PubMed Central

    Hirai, Daisuke; Yamashita, Yugo; Masunaga, Nobutoyo; Katsura, Toshiaki; Akao, Masaharu; Okuno, Yoshiaki; Koyama, Hiroshi

    2016-01-01

    Inhibitors directed against factor V rarely occur, and the clinical symptoms vary. We herein report the case of a patient who presented with a decreased factor V activity that had decreased to <3 %. We administered vitamin K and 6 units of fresh frozen plasma, but she thereafter developed an intracerebral hemorrhage. It is unclear whether surgery >10 years earlier might have caused the development of a factor V inhibitor. The treatment of acquired factor V inhibitors is mainly the transfusion of platelet concentrates and corticosteroids. Both early detection and the early initiation of the treatment of factor V inhibitor are thus considered to be important. PMID:27746446

  19. Acquired epidermodysplasia verruciformis in an HIV-positive patient.

    PubMed

    Lau, Carmen; Acharya, Sashi; Arumainayagam, Joseph T; Kasparis, Christos; Dhesi, I

    2016-10-01

    Epidermodysplasia verruciformis (EV) is a rare dermatological manifestation of the human papillomavirus (HPV) infection, which causes distinctive skin lesions in sun-exposed areas. Both inherited and acquired forms exist. Immunocompromised individuals, such as HIV patients, are at risk of acquired EV. EV poses challenges in its management and variable responses are seen in different individuals. In addition, EV carries a significant risk of skin malignancy with certain HPV types that require skin surveillance. A case of acquired EV in a HIV-positive patient is presented in this report.

  20. [Acquired coagulant factor inhibitors].

    PubMed

    Nogami, Keiji

    2015-02-01

    Acquired coagulation factor inhibitors are an autoimmune disease causing bleeding symptoms due to decreases in the corresponding factor (s) which result from the appearance of autoantibodies against coagulation factors (inhibitor). This disease is quite different from congenital coagulation factor deficiencies based on genetic abnormalities. In recent years, cases with this disease have been increasing, and most have anti-factor VIII autoantibodies. The breakdown of the immune control mechanism is speculated to cause this disease since it is common in the elderly, but the pathology and pathogenesis are presently unclear. We herein describe the pathology and pathogenesis of factor VIII and factor V inhibitors. Characterization of these inhibitors leads to further analysis of the coagulation process and the activation mechanisms of clotting factors. In the future, with the development of new clotting examination method (s), we anticipate that further novel findings will be obtained in this field through inhibitor analysis. In addition, detailed elucidation of the coagulation inhibitory mechanism possibly leading to hemostatic treatment strategies for acquired coagulation factor disorders will be developed.

  1. Over-dose insulin and stable gastric pentadecapeptide BPC 157. Attenuated gastric ulcers, seizures, brain lesions, hepatomegaly, fatty liver, breakdown of liver glycogen, profound hypoglycemia and calcification in rats.

    PubMed

    Ilic, S; Brcic, I; Mester, M; Filipovic, M; Sever, M; Klicek, R; Barisic, I; Radic, B; Zoricic, Z; Bilic, V; Berkopic, L; Brcic, L; Kolenc, D; Romic, Z; Pazanin, L; Seiwerth, S; Sikiric, P

    2009-12-01

    We focused on over-dose insulin (250 IU/kg i.p.) induced gastric ulcers and then on other disturbances that were concomitantly induced in rats, seizures (eventually fatal), severely damaged neurons in cerebral cortex and hippocampus, hepatomegaly, fatty liver, increased AST, ALT and amylase serum values, breakdown of liver glycogen with profound hypoglycemia and calcification development. Calcium deposits were present in the blood vessel walls, hepatocytes surrounding blood vessels and sometimes even in parenchyma of the liver mainly as linear and only occasionally as granular accumulation. As an antidote after insulin, we applied the stable gastric pentadecapeptide BPC 157 (10 microg/kg) given (i) intraperitoneally or (ii) intragastrically immediately after insulin. Controls received simultaneously an equivolume of saline (5 ml/kg). Those rats that survived till the 180 minutes after over-dose application were further assessed. Interestingly, pentadecapeptide BPC 157, as an antiulcer peptide, may besides stomach ulcer consistently counteract all insulin disturbances and fatal outcome. BPC 157 rats showed no fatal outcome, they were mostly without hypoglycemic seizures with apparently higher blood glucose levels (glycogen was still present in hepatocytes), less liver pathology (i.e., normal liver weight, less fatty liver), decreased ALT, AST and amylase serum values, markedly less damaged neurons in brain and they only occasionally had small gastric lesions. BPC 157 rats exhibited mostly only dot-like calcium presentation. In conclusion, the success of BPC 157 therapy may indicate a likely role of BPC 157 in insulin controlling and BPC 157 may influence one or more causative process(es) after excessive insulin application.

  2. Isolated toxoplasmosis of the thoracic spinal cord in a patient with acquired immunodeficiency syndrome. Case report.

    PubMed

    Resnick, D K; Comey, C H; Welch, W C; Martinez, A J; Hoover, W W; Jacobs, G B

    1995-03-01

    Toxoplasmosis and lymphoma are the two most common causes of intraparenchymal cerebral mass lesions in patients with acquired immunodeficiency syndrome (AIDS). The clinical and radiographic features of the intracranial lesions have been well described. Because of the high frequency of toxoplasmosis in the AIDS population, common therapy for patients presenting with intracranial mass lesions consists of an empirical trial of anti-Toxoplasma chemotherapy, with biopsy reserved for cases demonstrating features considered to be more consistent with lymphoma, or for lesions that do not improve despite adequate anti-Toxoplasma treatment. A similar treatment algorithm does not exist for intramedullary lesions of the spinal cord. The authors describe a patient who presented with paraparesis resulting from an isolated thoracic intramedullary lesion. An open biopsy of the lesion revealed characteristic structures containing Toxoplasma tachyzoites. The clinical and radiographic presentation of the lesion is discussed, the available literature is reviewed, and a treatment strategy for spinal cord lesions in AIDS patients is proposed.

  3. AIDS: acquired immunodeficiency syndrome.

    PubMed Central

    Gilmore, N. J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1983-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of utmost importance. PMID:6342737

  4. AIDS: acquired immunodeficiency syndrome *

    PubMed Central

    Gilmore, N.J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1992-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of the utmost importance. PMID:1544049

  5. GETTING LOST: TOPOGRAPHIC SKILLS IN ACQUIRED AND DEVELOPMENTAL PROSOPAGNOSIA

    PubMed Central

    Lee, Edison; Pancaroglu, Raika; Burles, Ford; Duchaine, Brad; Iaria, Giuseppe; Barton, Jason J S

    2016-01-01

    Previous studies report that acquired prosopagnosia is frequently associated with topographic disorientation. Whether this is associated with a specific anatomic subtype of prosopagnosia, how frequently it is seen with the developmental variant, and what specific topographic function is impaired to account for this problem are not known. We studied ten subjects with acquired prosopagnosia from either occipitotemporal or anterior temporal lesions and seven with developmental prosopagnosia. Subjects were given a battery of topographic tests, including house and scene recognition, the road map test, a test of cognitive map formation, and a standardized self-report questionnaire. House and/or scene recognition were frequently impaired after either occipitotemporal or anterior temporal lesions in acquired prosopagnosia. Subjects with occipitotemporal lesions were also impaired in cognitive map formation: an overlap analysis identified right fusiform and parahippocampal gyri as a likely correlate. Only one subject with acquired prosopagnosia had mild difficulty with directional orientation on the road map test. Only one subject with developmental prosopagnosia had difficulty with cognitive map formation, and none were impaired on the other tests. Scores for house and scene recognition correlated most strongly with the results of the questionnaire. We conclude that topographic disorientation in acquired prosopagnosia reflects impaired place recognition, with a contribution from poor cognitive map formation when there is occipitotemporal damage. Topographic impairments are less frequent in developmental prosopagnosia. PMID:26874939

  6. Getting lost: Topographic skills in acquired and developmental prosopagnosia.

    PubMed

    Corrow, Jeffrey C; Corrow, Sherryse L; Lee, Edison; Pancaroglu, Raika; Burles, Ford; Duchaine, Brad; Iaria, Giuseppe; Barton, Jason J S

    2016-03-01

    Previous studies report that acquired prosopagnosia is frequently associated with topographic disorientation. Whether this is associated with a specific anatomic subtype of prosopagnosia, how frequently it is seen with the developmental variant, and what specific topographic function is impaired to account for this problem are not known. We studied ten subjects with acquired prosopagnosia from either occipitotemporal or anterior temporal (AT) lesions and seven with developmental prosopagnosia. Subjects were given a battery of topographic tests, including house and scene recognition, the road map test, a test of cognitive map formation, and a standardized self-report questionnaire. House and/or scene recognition were frequently impaired after either occipitotemporal or AT lesions in acquired prosopagnosia. Subjects with occipitotemporal lesions were also impaired in cognitive map formation: an overlap analysis identified right fusiform and parahippocampal gyri as a likely correlate. Only one subject with acquired prosopagnosia had mild difficulty with directional orientation on the road map test. Only one subject with developmental prosopagnosia had difficulty with cognitive map formation, and none were impaired on the other tests. Scores for house and scene recognition correlated most strongly with the results of the questionnaire. We conclude that topographic disorientation in acquired prosopagnosia reflects impaired place recognition, with a contribution from poor cognitive map formation when there is occipitotemporal damage. Topographic impairments are less frequent in developmental prosopagnosia.

  7. Example based lesion segmentation

    NASA Astrophysics Data System (ADS)

    Roy, Snehashis; He, Qing; Carass, Aaron; Jog, Amod; Cuzzocreo, Jennifer L.; Reich, Daniel S.; Prince, Jerry; Pham, Dzung

    2014-03-01

    Automatic and accurate detection of white matter lesions is a significant step toward understanding the progression of many diseases, like Alzheimer's disease or multiple sclerosis. Multi-modal MR images are often used to segment T2 white matter lesions that can represent regions of demyelination or ischemia. Some automated lesion segmentation methods describe the lesion intensities using generative models, and then classify the lesions with some combination of heuristics and cost minimization. In contrast, we propose a patch-based method, in which lesions are found using examples from an atlas containing multi-modal MR images and corresponding manual delineations of lesions. Patches from subject MR images are matched to patches from the atlas and lesion memberships are found based on patch similarity weights. We experiment on 43 subjects with MS, whose scans show various levels of lesion-load. We demonstrate significant improvement in Dice coefficient and total lesion volume compared to a state of the art model-based lesion segmentation method, indicating more accurate delineation of lesions.

  8. Acquired aplastic anemia.

    PubMed

    Keohane, Elaine M

    2004-01-01

    Acquired aplastic anemia (AA) is a disorder characterized by a profound deficit of hematopoietic stem and progenitor cells, bone marrow hypocellularity, and peripheral blood pancytopenia. It primarily affects children, young adults, and those over 60 years of age. The majority of cases are idiopathic; however, idiosyncratic reactions to some drugs, chemicals, and viruses have been implicated in its etiology. An autoimmune T-cell reaction likely causes the stem cell depletion, but the precise mechanism, as well as the eliciting and target antigens, is unknown. Symptoms vary from severe life-threatening cytopenias to moderate or non-severe disease that does not require transfusion support. The peripheral blood typically exhibits pancytopenia, reticulocytopenia, and normocytic or macrocytic erythrocytes. The bone marrow is hypocellular and may exhibit dysplasia of the erythrocyte precursors. First line treatment for severe AA consists of hematopoietic stem cell transplantation in young patients with HLA identical siblings, while immunosuppression therapy is used for older patients and for those of any age who lack a HLA matched donor. Patients with AA have an increased risk of developing paroxysmal nocturnal hemoglobinuria (PNH), myelodysplastic syndrome (MDS), or acute leukemia. Further elucidation of the pathophysiology of this disease will result in a better understanding of the interrelationship among AA, PNH, and MDS, and may lead to novel targeted therapies.

  9. First description of the dermatoscopic features of acquired elastotic hemangioma—a case report

    PubMed Central

    Hicks, Tristan; Katz, Ian

    2016-01-01

    We present a case of acquired elastotic hemangioma (AEH), a rare, benign vascular tumor. A Caucasian male in his 60s presented with an asymptomatic, solitary, non-pigmented and violaceous lesion of short duration on the dorsum of his hand. The lesion had unique clinical, dermatoscopic and pathological features. Dermatoscopic images of the lesion are presented for characterization and histopathological correlation that have not previously been published or described. PMID:27867745

  10. Treatment of infectious complications of acquired immunodeficiency syndrome.

    PubMed

    Furio, M M; Wordell, C J

    1985-01-01

    The infectious complications of the acquired immunodeficiency syndrome (AIDS) are discussed, and the conventional and nonconventional therapies used for these infections are reviewed. The infections most commonly encountered in patients with AIDS are Pneumocystis carinii pneumonia (58%), Candida esophagitis (31%), toxoplasmosis (21%), cytomegalovirus infections (15%), and herpes-simplex virus infections (12%). Pneumocystis carinii pneumonia is the most common life-threatening process in these patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the drug of choice for its treatment. Oral candidiasis often indicates the progression to AIDS in the high-risk populations of homosexual or bisexual men, intravenous drug abusers, and individuals with hemophilia. Nystatin suspension is commonly used to treat oral candidiasis, while Candida esophagitis demands systemic therapy with ketoconazole. Toxoplasmosis most commonly manifests itself in patients with AIDS as a cerebral mass lesion. The recommended therapy includes sulfadiazine and pyrimethamine. AIDS patients frequently experience protozoal invasion of the intestinal tract with Giardia lamblia, Isospora belli, and Cryptosporidium muris. Various drugs have been tried for these infections, including quinacrine hydrochloride, metronidazole, TMP-SMZ, and spiramycin. Cytomegalovirus (CMV) infections commonly involve the lungs, gastrointestinal tract, eyes, brain, and nervous system. Attempts to treat these disseminated CMV infections with antiviral agents, including acyclovir, have not been successful. However, acyclovir has been found beneficial in the treatment of herpes-simplex virus infections. Multiple infectious complications may occur in patients with AIDS as a result of the cellular-immune deficiency associated with this disease. Until more research is done with AIDS patients, therapy must be based on the data available from the treatment of these infections in immunosuppressed patients without AIDS.

  11. Microsporum gypseum dermatophytosis in a patient of acquired immunodeficiency syndrome: a rare case report.

    PubMed

    Bhagra, S; Ganju, S A; Sood, A; Guleria, R C; Kanga, A K

    2013-01-01

    Microsporum gypseum, a geophillic dermatophyte is rarely isolated from patients with acquired immunodeficiency syndrome. We report tinea corporis due to Microsporum gypseum, an uncommon aetiological agent, in a patient with acquired immunodeficiency syndrome from our region. The clinical presentation resembled psoriasis characterised by atypical, scaly and hyperkeratotic lesions.

  12. 16 CFR 801.2 - Acquiring and acquired persons.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Acquiring and acquired persons. 801.2 Section 801.2 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.2...

  13. 16 CFR 801.2 - Acquiring and acquired persons.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Acquiring and acquired persons. 801.2 Section 801.2 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.2...

  14. 16 CFR 801.2 - Acquiring and acquired persons.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Acquiring and acquired persons. 801.2 Section 801.2 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.2...

  15. 16 CFR 801.2 - Acquiring and acquired persons.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Acquiring and acquired persons. 801.2 Section 801.2 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.2...

  16. 16 CFR 801.2 - Acquiring and acquired persons.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Acquiring and acquired persons. 801.2 Section 801.2 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.2...

  17. Aetiology of abfraction lesions.

    PubMed

    Lyons, K

    2001-09-01

    The aetiology of abfraction lesions is complex. Most evidence indicates that physical loading forces are a major contributing factor, although they are unlikely to be entirely responsible. Intraoral chemical influences and toothbrush abrasion, combined with the dynamics of inter-occlusal activity such as chewing, swallowing, and parafunction, lead to stress corrosion and may contribute to abfraction lesions. The multifactorial aetiology that operates in the initiation and progression of these lesions has made investigation difficult. Various theories have been proposed and numerous surveys and studies conducted, but the primary causal factor has yet to be definitively determined. This review concludes that occlusal loading is the initiating factor in the development of abfraction lesions.

  18. Revealing latent value of clinically acquired CTs of traumatic brain injury through multi-atlas segmentation in a retrospective study of 1,003 with external cross-validation

    NASA Astrophysics Data System (ADS)

    Plassard, Andrew J.; Kelly, Patrick D.; Asman, Andrew J.; Kang, Hakmook; Patel, Mayur B.; Landman, Bennett A.

    2015-03-01

    Medical imaging plays a key role in guiding treatment of traumatic brain injury (TBI) and for diagnosing intracranial hemorrhage; most commonly rapid computed tomography (CT) imaging is performed. Outcomes for patients with TBI are variable and difficult to predict upon hospital admission. Quantitative outcome scales (e.g., the Marshall classification) have been proposed to grade TBI severity on CT, but such measures have had relatively low value in staging patients by prognosis. Herein, we examine a cohort of 1,003 subjects admitted for TBI and imaged clinically to identify potential prognostic metrics using a "big data" paradigm. For all patients, a brain scan was segmented with multi-atlas labeling, and intensity/volume/texture features were computed in a localized manner. In a 10-fold crossvalidation approach, the explanatory value of the image-derived features is assessed for length of hospital stay (days), discharge disposition (five point scale from death to return home), and the Rancho Los Amigos functional outcome score (Rancho Score). Image-derived features increased the predictive R2 to 0.38 (from 0.18) for length of stay, to 0.51 (from 0.4) for discharge disposition, and to 0.31 (from 0.16) for Rancho Score (over models consisting only of non-imaging admission metrics, but including positive/negative radiological CT findings). This study demonstrates that high volume retrospective analysis of clinical imaging data can reveal imaging signatures with prognostic value. These targets are suited for follow-up validation and represent targets for future feature selection efforts. Moreover, the increase in prognostic value would improve staging for intervention assessment and provide more reliable guidance for patients.

  19. Revealing Latent Value of Clinically Acquired CTs of Traumatic Brain Injury Through Multi-Atlas Segmentation in a Retrospective Study of 1,003 with External Cross-Validation.

    PubMed

    Plassard, Andrew J; Kelly, Patrick D; Asman, Andrew J; Kang, Hakmook; Patel, Mayur B; Landman, Bennett A

    2015-03-20

    Medical imaging plays a key role in guiding treatment of traumatic brain injury (TBI) and for diagnosing intracranial hemorrhage; most commonly rapid computed tomography (CT) imaging is performed. Outcomes for patients with TBI are variable and difficult to predict upon hospital admission. Quantitative outcome scales (e.g., the Marshall classification) have been proposed to grade TBI severity on CT, but such measures have had relatively low value in staging patients by prognosis. Herein, we examine a cohort of 1,003 subjects admitted for TBI and imaged clinically to identify potential prognostic metrics using a "big data" paradigm. For all patients, a brain scan was segmented with multi-atlas labeling, and intensity/volume/texture features were computed in a localized manner. In a 10-fold cross-validation approach, the explanatory value of the image-derived features is assessed for length of hospital stay (days), discharge disposition (five point scale from death to return home), and the Rancho Los Amigos functional outcome score (Rancho Score). Image-derived features increased the predictive R(2) to 0.38 (from 0.18) for length of stay, to 0.51 (from 0.4) for discharge disposition, and to 0.31 (from 0.16) for Rancho Score (over models consisting only of non-imaging admission metrics, but including positive/negative radiological CT findings). This study demonstrates that high volume retrospective analysis of clinical imaging data can reveal imaging signatures with prognostic value. These targets are suited for follow-up validation and represent targets for future feature selection efforts. Moreover, the increase in prognostic value would improve staging for intervention assessment and provide more reliable guidance for patients.

  20. Systems biology of human epilepsy applied to patients with brain tumors.

    PubMed

    Mittal, Sandeep; Shah, Aashit K; Barkmeier, Daniel T; Loeb, Jeffrey A

    2013-12-01

    Epilepsy is a disease of recurrent seizures that can be associated with a wide variety of acquired and developmental brain lesions. Current medications for patients with epilepsy can suppress seizures; they do not cure or modify the underlying disease process. On the other hand, surgical removal of focal brain regions that produce seizures can be curative. This surgical procedure can be more precise with the placement of intracranial recording electrodes to identify brain regions that generate seizure activity as well as those that are critical for normal brain function. The detail that goes into these surgeries includes extensive neuroimaging, electrophysiology, and clinical data. Combined with precisely localized tissues removed, these data provide an unparalleled opportunity to learn about the interrelationships of many "systems" in the human brain not possible in just about any other human brain disorder. Herein, we describe a systems biology approach developed to study patients who undergo brain surgery for epilepsy and how we have begun to apply these methods to patients whose seizures are associated with brain tumors. A central goal of this clinical and translational research program is to improve our understanding of epilepsy and brain tumors and to improve diagnosis and treatment outcomes of both.

  1. Acquired immunodeficiency syndrome: Ga-67 citrate imaging

    SciTech Connect

    Woolfenden, J.M.; Carrasquillo, J.A.; Larson, S.M.; Simmons, J.T.; Masur, H.; Smith, P.D.; Shelhamer, J.H.; Ognibene, F.P.

    1987-02-01

    All gallium-67 citrate scans obtained in patients with acquired immunodeficiency syndrome (AIDS) at the Clinical Center, National Institutes of Health (Bethesda, Md.) were retrospectively analyzed and correlated with the results of bronchoscopy, chest radiography, and endoscopy. There were 164 scans of 95 patients. Twenty scans were from patients with Pneumocystis carinii pneumonia; 19 were abnormal, for a sensitivity of 95%. Ga-67 uptake tended to be less in patients receiving therapy for P. carinii pneumonia. Chest radiographs were normal at least initially in three patients with abnormal scans and P. carinii pneumonia. Unusually prominent colonic activity was associated with infection in some patients. No lesions of Kaposi sarcoma showed tracer uptake. Gallium scanning is useful for detecting P. carinii pneumonia and other opportunistic infections in patients with AIDS, but it is not useful for localizing Kaposi sarcoma.

  2. Reliability of the Bony Anatomy in Image-Guided Stereotactic Radiotherapy of Brain Metastases

    SciTech Connect

    Guckenberger, Matthias Baier, Kurt; Guenther, Iris; Richter, Anne; Wilbert, Juergen; Sauer, Otto; Vordermark, Dirk; Flentje, Michael

    2007-09-01

    Purpose: To evaluate whether the position of brain metastases remains stable between planning and treatment in cranial stereotactic radiotherapy (SRT). Methods and Materials: Eighteen patients with 20 brain metastases were treated with single-fraction (17 lesions) or hypofractionated (3 lesions) image-guided SRT. Median time interval between planning and treatment was 8 days. Before treatment a cone-beam CT (CBCT) and a conventional CT after application of i.v. contrast were acquired. Setup errors using automatic bone registration (CBCT) and manual soft-tissue registration of the brain metastases (conventional CT) were compared. Results: Tumor size was not significantly different between planning and treatment. The three-dimensional setup error (mean {+-} SD) was 4.0 {+-} 2.1 mm and 3.5 {+-} 2.2 mm according to the bony anatomy and the lesion itself, respectively. A highly significant correlation between automatic bone match and soft-tissue registration was seen in all three directions (r {>=} 0.88). The three-dimensional distance between the isocenter according to bone match and soft-tissue registration was 1.7 {+-} 0.7 mm, maximum 2.8 mm. Treatment of intracranial pressure with steroids did not influence the position of the lesion relative to the bony anatomy. Conclusion: With a time interval of approximately 1 week between planning and treatment, the bony anatomy of the skull proved to be an excellent surrogate for the target position in image-guided SRT.

  3. A Common Left Occipito-Temporal Dysfunction in Developmental Dyslexia and Acquired Letter-By-Letter Reading?

    PubMed Central

    Richlan, Fabio; Sturm, Denise; Schurz, Matthias; Kronbichler, Martin; Ladurner, Gunther; Wimmer, Heinz

    2010-01-01

    Background We used fMRI to examine functional brain abnormalities of German-speaking dyslexics who suffer from slow effortful reading but not from a reading accuracy problem. Similar to acquired cases of letter-by-letter reading, the developmental cases exhibited an abnormal strong effect of length (i.e., number of letters) on response time for words and pseudowords. Results Corresponding to lesions of left occipito-temporal (OT) regions in acquired cases, we found a dysfunction of this region in our developmental cases who failed to exhibit responsiveness of left OT regions to the length of words and pseudowords. This abnormality in the left OT cortex was accompanied by absent responsiveness to increased sublexical reading demands in phonological inferior frontal gyrus (IFG) regions. Interestingly, there was no abnormality in the left superior temporal cortex which—corresponding to the onological deficit explanation—is considered to be the prime locus of the reading difficulties of developmental dyslexia cases. Conclusions The present functional imaging results suggest that developmental dyslexia similar to acquired letter-by-letter reading is due to a primary dysfunction of left OT regions. PMID:20711448

  4. Acquired epidermodysplasia verruciformis in a child with atopic dermatitis.

    PubMed

    Fernandez, Kristen H; Rady, Peter; Tyring, Steven; Stone, Mary S

    2014-01-01

    A 4-year-old girl with an established diagnosis of atopic dermatitis, previously severe and treated with cyclosporine, developed widespread papules that demonstrated changes consistent with epidermodysplasia verruciformis on biopsy. Human papilloma virus (HPV) typing was performed and was consistent with epidermodysplasia verruciformis-type HPV (type 5). These lesions rapidly resolved with a 2-week course of imiquimod. Rapid resolution and no family history of epidermodysplasia verruciformis make this most consistent with acquired epidermodysplasia verruciformis. This case is the first reported case of acquired epidermodysplasia verruciformis in a child without the human immunodeficiency virus and may be linked to cyclosporine use, which also has never been previously reported.

  5. Mycosis fungoides: an important differential diagnosis for acquired palmoplantar keratoderma.

    PubMed

    Kim, Janet; Foster, Rachael; Lam, Minh; Kumarasinghe, Sujith Prasad

    2015-02-01

    Mycosis fungoides is the most common subtype of primary cutaneous lymphoma and has several clinical variants. We report a 74-year-old man presenting with an acquired palmoplantar keratoderma initially diagnosed and treated as psoriasis with suboptimal improvement. Several months later the patient developed patches and plaques that were histologically consistent with mycosis fungoides. These lesions were ameliorated with the treatment of the underlying mycosis fungoides and the palmoplantar keratoderma resolved promptly with radiotherapy. This case highlights the importance of considering mycosis fungoides as an infrequent but serious cause of acquired palmoplantar keratoderma.

  6. Progressive multifocal leukoencephalopathy occurring with the acquired immune deficiency syndrome.

    PubMed

    England, J D; Hsu, C Y; Garen, P D; Goust, J M; Biggs, P J

    1984-08-01

    A 33-year-old homosexual man with symptoms and signs of a focal brain process was subsequently found to have an acquired immune deficiency syndrome (AIDS) with biopsy-proven progressive multifocal leukoencephalopathy. This report reemphasizes the association of progressive multifocal leukoencephalopathy with AIDS and probably is best viewed as another example of an opportunistic CNS infection complicating deficient cell-mediated immunity.

  7. Lesion Characteristics of Individuals With Upper Limb Spasticity After Stroke.

    PubMed

    Cheung, Daniel K; Climans, Seth A; Black, Sandra E; Gao, Fuqiang; Szilagyi, Gregory M; Mochizuki, George

    2016-01-01

    This study explores the relationship between lesion location and volume and upper limb spasticity after stroke. Ninety-seven stroke patients (51 with spasticity) were included in the analysis (age = 67.5 ± 13.3 years, 57 males). Lesions were traced from computed tomography and magnetic resonance images and coregistered to a symmetrical brain template. Lesion overlays from the nonspastic group were subtracted from the spastic group to determine the regions of the brain more commonly lesioned in spastic patients. Similar analysis was performed across groups of participants whose upper limb (elbow or wrist) Modified Ashworth Scale (MAS) score ranged from 1 (mild) to 4 (severe). Following subtraction analysis and Fisher's exact test, the putamen was identified as the area most frequently lesioned in individuals with spasticity. More severe spasticity was associated with a higher lesion volume. This study establishes the neuroanatomical correlates of poststroke spasticity and describes the relationship between lesion characteristics and the severity of spasticity using mixed brain imaging modalities, including computed tomography imaging, which is more readily available to clinicians. Understanding the association between lesion location and volume with the development and severity of spasticity is an important first step toward predicting the development of spasticity after stroke. Such information could inform the implementation of intervention strategies during the recovery process to minimize the extent of impairment.

  8. Imaging Pediatric Vascular Lesions

    PubMed Central

    Nguyen, Tuyet A.; Krakowski, Andrew C.; Naheedy, John H.; Kruk, Peter G.

    2015-01-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  9. Quantitative validation of a method for correction of intraoperative brain shift

    NASA Astrophysics Data System (ADS)

    Bates, Lisa M.; Goerss, Stephan J.; Robb, Richard A.

    2000-05-01

    Stereotactic neuronavigational systems have demonstrated significant clinical influence during the past decade, and are being used in an increasing number of neurosurgical procedures. Pre-operatively acquired 3D images are used for planning purposes, and also are employed in intraoperative navigations to help localize and resect brain lesions. However, as the operation progresses, multiple factors contribute the changes that limit the accuracy of the navigation based on pore-operative images alone. The opening of the dura with the associated loss of CSF and cortical swelling, the effect of gravity relative to the craniotomy location, tumor decompression, and collapse of neural tissue around the operative site are some of the factors that contribute to errors in navigation, particularly navigation based solely on pre-operatively acquired images. Neuronavigational system assume a one-to-one correlation between patient anatomy in the operating room and the pre- operatively acquired MRI images. Since the brain deforms in a non-linear manner, intraoperative brain shift can really only be corrected via intraoperative sensing methods that effectively update the pre-operatively acquired image data during surgery.