scholarly journals Frontal Dysexecutive Syndrome in Brain Tumors: A Pragmatic Insight to an Old Problem

2021 ◽  
pp. 325-332
Author(s):  
Souvik Dubey ◽  
Ritwik Ghosh ◽  
Subhankar Chatterjee ◽  
Mahua Jana Dubey ◽  
Samya Sengupta ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Psychiatric Symptoms ◽  
Detailed Examination ◽  
Secondary Effects ◽  
Dysexecutive Syndrome ◽  
Movement Assessment ◽  
Psychiatric Conditions ◽  
Rule Out

Brain tumors have long been considered one of the most prevalent causes of potentially reversible cognitive impairment. An accurate underlying cause of cognitive impairment due to brain tumor needs to be evaluated pragmatically. Patterns of cognitive impairment associated with brain tumors depend mainly on their location, lateralization, pathological classification and secondary effects of the treatment, as well as the structural plasticity and diaschisis. Hence, it is not rare that lesions with different locations and histologies may manifest with a similar pattern of cognitive impairment due to the complex interplay of determinants. We herein report 3 patients with brain tumors affecting different locations and with differing histologies, who shared a similar presentation as “frontal dysexecutive syndrome” masqueraded as psychiatric conditions. Detailed examination of saccades and pursuit along with eye movements and conventional motor examinations were essential not only to diagnose brain tumor as the potential cause of cognitive impairment, but also to rule out other coexisting etiologies with completely different underlying pathological mechanisms (i.e., Huntington’s disease in 1 of the cases). A detailed neurological examination, including eye movement assessment, in patients with psychiatric symptoms provides not only important clues to delineate the underlying anatomical substrate involved, but also helps clinicians to make an accurate diagnosis and to select appropriate therapeutic options.

scholarly journals Brain tumors and indications for brain imaging in patients with psychiatric manifestations: a case report

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Seyed Alireza Haji Seyed Javadi ◽  
Bahare Rezaei
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Psychiatric Symptoms ◽  
Relevant Information ◽  
History Of ◽  
Response To Stress ◽  
The Right ◽  
Occipital Lobes ◽  
Psychiatric Manifestations ◽  
The Relationship

Abstract Background Studies on the relationship between psychiatric symptoms and brain tumors are ambiguous, as it is not clear whether these symptoms are due to the direct effect of the tumor or a secondary psychological response to stress, resulting from the diagnosis and treatment of the disease; therefore, it is difficult to analyze and retrieve relevant information. Case presentation We present the case of a 43-year-old male patient, who was admitted to a psychiatric emergency room with psychiatric symptoms, such as restlessness and extreme talkativeness, but normal neurological examinations. He showed no response to outpatient treatment and had no history of psychiatric disorders. The onset of symptoms was 2 months before his visit. On neuroimaging, a brain tumor was observed in the right temporal and occipital lobes. Accordingly, the patient was transferred to the neurosurgery ward. Conclusion Factors, such as increased internal pressure on the brain due to a brain tumor or the effect of tumor area, contribute to the occurrence of symptoms, such as restlessness and talkativeness. However, further studies are needed to confirm these findings.

A description of clinical profile of over 65-years-old patients in acute psychiatric hospitalization unit at Hospital Universitario Central De Asturias (Oviedo, Spain)

2016 ◽  
Vol 33 (S1) ◽  
pp. S186-S186
Author(s):  
I. Abad-Acebedo ◽  
L. Gonzalez-Blanco ◽  
E. Torio-Ojea ◽  
S. Bestene-Medina ◽  
J. Rodriguez-Revuelta
Keyword(s):  
Cognitive Impairment ◽  
Hospital Stay ◽  
Psychiatric Hospitalization ◽  
Psychiatric Symptoms ◽  
Length Of Hospital Stay ◽  
Clinical Profile ◽  
Old Patients ◽  
Treatment Data ◽  
Psychiatric Conditions ◽  
Competing Interest

IntroductionOlder patients with psychiatric conditions often have other disorders that include different levels of cognitive impairment, modifying the presentation of psychiatric symptoms and requiring treatment adaptations [1].ObjectiveTo describe clinical profile of hospitalized patients > 65 years, and its relationship with the presence of cognitive impairment and the length of hospital stay.MethodsDescriptive and comparative study. Sample: 71 inpatients > 65 years (mean ± SD Age: 72.42 ± 5.96), admitted to “Hospital Universitario Central de Asturias”(Spain) from August 2014 to June 2015. Age, length of hospitalization, diagnosis, cognitive impairment and treatment data were collected (Table 1).ResultsDays of hospital stay (mean ± SD) = 15.89 ± 11.53. No variable showed significant relation except number of antipsychotics taken (r = 0.307, P = 0.009). Cognitive impairment was significantly more frequent in men than women (45.5/15.8%; χ2 = 7.46; P = 0.006). No other variable showed significant differences.ConclusionsA high percentage of psychiatric inpatients > 65 years present a cognitive impairment (29.6%) which was more frequent in males (45.5%). The length of hospital stay seems to be similar than in the rest of patients and not being affected by any of studied variables. More studies should be carried on to compare those results with similar variables in younger population and to analyze if there are differences between subgroups (65–75 vs > 75) [1].Disclosure of interestThe authors have not supplied their declaration of competing interest.

Brain Tumors, Systemic Lupus Erythematosus, HIV/AIDS, and Wilson’s Disease

2008 ◽  
Author(s):  
Constantine G. Lyketsos
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Frontal Lobe ◽  
Temporal Lobe ◽  
Psychiatric Symptoms ◽  
Language Disorders ◽  
Executive Dysfunction ◽  
Brain Regions ◽  
Generalized Seizures ◽  
Psychiatric Manifestations

This chapter deals with four diseases affecting the central nervous system (CNS) for which neurologists are primarily involved as consultants. It follows the same approach as the chapters that focus on single diseases but does so more briefly. Brain tumors are estimated to have an incidence of 12/100,000 per year (Scharre, 2000). The incidence is highest in old age, peaking between 60 and 80 years of age. Almost 50% of intracranial tumors are gliomas, 10% to 15% are meningiomas, 5% to 7% are pituitary adenomas, and 5% to 6% are metastatic tumors. Brain tumors produce signs and symptoms in a variety of ways, including direct invasion, compression, hemorrhage, and edema. Motor, sensory, visual, and gait disturbances are frequent manifestations of brain tumors. In addition, headache and focal or generalized seizures are quite common. The psychiatric manifestations of brain tumors reflect their location; the type of brain damage they produce; patients’ reactions to their symptoms or diagnosis; and the effects of treatments such as steroids, chemotherapy, and radiation. Tumors in specific brain regions have been linked to specific psychiatric manifestations. Frontal lobe tumors are most closely associated with behavioral changes,sometimes referred to as the frontal lobe syndrome or executive dysfunction syndrome. Temporal lobe tumors are most closely associated with personality change, irritability, and hallucinations (especially auditory), as well as with a variety of language disorders. Patients with language disorders associated with temporal lobe tumors can experience catastrophic reactions when their deficits interfere with communication. Parietal lobe tumors typically are associated with cognitive deficits such as apraxia, neglect syndromes of the contralateral body or space, and unformed visual hallucinations such as streaks or flashes of light. When evaluating brain tumor patients with psychiatric symptoms and signs, careful evaluation and differential diagnosis are critical. In hospitalized and seriously ill patients, it is especially important to rule out delirium, particularly when the psychiatric phenomena are intermittent and vary in intensity. Serial observations and repeated mental status examinations are the basis for the diagnosis of delirium, but an electroencephalogram (EEG) is also helpful, because in most cases of delirium it reveals generalized slowing involving brain areas far from the location of the brain tumor.

Recent advancements in Fuzzy C-means based techniques for brain MRI Segmentation

2021 ◽  
Vol 16 ◽  
Author(s):  
Ghazanfar Latif ◽  
Jaafar Alghazo ◽  
Fadi N. Sibai ◽  
D.N.F. Awang Iskandar ◽  
Adil H. Khan
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Brain Mri ◽  
Tumor Segmentation ◽  
Brain Anatomy ◽  
Mri Segmentation ◽  
Brain Tumor Segmentation ◽  
Brain Images ◽  
Low Contrast ◽  
Fuzzy C Means

Background: Variations of image segmentation techniques, particularly those used for Brain MRI segmentation, vary in complexity from basic standard Fuzzy C-means (FCM) to more complex and enhanced FCM techniques. Objective: In this paper, a comprehensive review is presented on all thirteen variations of FCM segmentation techniques. In the review process, the concentration is on the use of FCM segmentation techniques for brain tumors. Brain tumor segmentation is a vital step in the process of automatically diagnosing brain tumors. Unlike segmentation of other types of images, brain tumor segmentation is a very challenging task due to the variations in brain anatomy. The low contrast of brain images further complicates this process. Early diagnosis of brain tumors is indeed beneficial to patients, doctors, and medical providers. Results: FCM segmentation works on images obtained from magnetic resonance imaging (MRI) scanners, requiring minor modifications to hospital operations to early diagnose tumors as most, if not all, hospitals rely on MRI machines for brain imaging. In this paper, we critically review and summarize FCM based techniques for brain MRI segmentation.

Brain Tumor Detection via Asymmetry Quantification across Mid Sagittal Plane

2020 ◽  
Vol 13 ◽  
Author(s):  
Shoaib Amin Banday ◽  
Mohammad Khalid Pandit
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Sagittal Plane ◽  
Early Stage ◽  
Imaging Techniques ◽  
Complex Structure ◽  
Magnetic Resonance Images ◽  
Absolute Difference ◽  
Brain Hemispheres ◽  
The Brain

Introduction: Brain tumor is among the major causes of morbidity and mortality rates worldwide. According to National Brain Tumor Foundation (NBTS), the death rate has nearly increased by as much as 300% over last couple of decades. Tumors can be categorized as benign (non-cancerous) and malignant (cancerous). The type of the brain tumor significantly depends on various factors like the site of its occurrence, its shape, the age of the subject etc. On the other hand, Computer Aided Detection (CAD) has been improving significantly in recent times. The concept, design and implementation of these systems ascend from fairly simple ones to computationally intense ones. For efficient and effective diagnosis and treatment plans in brain tumor studies, it is imperative that an abnormality is detected at an early stage as it provides a little more time for medical professionals to respond. The early detection of diseases has predominantly been possible because of medical imaging techniques developed from past many decades like CT, MRI, PET, SPECT, FMRI etc. The detection of brain tumors however, has always been a challenging task because of the complex structure of the brain, diverse tumor sizes and locations in the brain. Method: This paper proposes an algorithm that can detect the brain tumors in the presence of the Radio-Frequency (RF) inhomoginiety. The algorithm utilizes the Mid Sagittal Plane as a landmark point across which the asymmetry between the two brain hemispheres is estimated using various intensity and texture based parameters. Result: The results show the efficacy of the proposed method for the detection of the brain tumors with an acceptable detection rate. Conclusion: In this paper, we have calculated three textural features from the two hemispheres of the brain viz: Contrast (CON), Entropy (ENT) and Homogeneity (HOM) and three parameters viz: Root Mean Square Error (RMSE), Correlation Co-efficient (CC), and Integral of Absolute Difference (IAD) from the intensity distribution profiles of the two brain hemispheres to predict any presence of the pathology. First a Mid Sagittal Plane (MSP) is obtained on the Magnetic Resonance Images that virtually divides brain into two bilaterally symmetric hemispheres. The block wise texture asymmetry is estimated for these hemispheres using the above 6 parameters.

Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

2020 ◽  
Vol 13 (12) ◽  
pp. e233179
Author(s):  
Eric Garrels ◽  
Fawziya Huq ◽  
Gavin McKay
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Potassium Channel ◽  
Limbic Encephalitis ◽  
Psychiatric Symptoms ◽  
Differential Diagnoses ◽  
Visual Hallucinations ◽  
Voltage Gated ◽  
History Of ◽  
Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

scholarly journals Genetic variants and cognitive functions in patients with brain tumors

2019 ◽  
Vol 21 (10) ◽  
pp. 1297-1309 ◽  
Author(s):  
Denise D Correa ◽  
Jaya Satagopan ◽  
Axel Martin ◽  
Erica Braun ◽  
Maria Kryza-Lacombe ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cell Cycle ◽  
Dna Repair ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Cell Cycle Regulation ◽  
Cognitive Outcome ◽  
Cholesterol Transport ◽  
Tumor Patients ◽  
Cycle Regulation

AbstractBackgroundPatients with brain tumors treated with radiotherapy (RT) and chemotherapy (CT) often experience cognitive dysfunction. We reported that single nucleotide polymorphisms (SNPs) in the APOE, COMT, and BDNF genes may influence cognition in brain tumor patients. In this study, we assessed whether genes associated with late-onset Alzheimer’s disease (LOAD), inflammation, cholesterol transport, dopamine and myelin regulation, and DNA repair may influence cognitive outcome in this population.MethodsOne hundred and fifty brain tumor patients treated with RT ± CT or CT alone completed a neurocognitive assessment and provided a blood sample for genotyping. We genotyped genes/SNPs in these pathways: (i) LOAD risk/inflammation/cholesterol transport, (ii) dopamine regulation, (iii) myelin regulation, (iv) DNA repair, (v) blood–brain barrier disruption, (vi) cell cycle regulation, and (vii) response to oxidative stress. White matter (WM) abnormalities were rated on brain MRIs.ResultsMultivariable linear regression analysis with Bayesian shrinkage estimation of SNP effects, adjusting for relevant demographic, disease, and treatment variables, indicated strong associations (posterior association summary [PAS] ≥ 0.95) among tests of attention, executive functions, and memory and 33 SNPs in genes involved in: LOAD/inflammation/cholesterol transport (eg, PDE7A, IL-6), dopamine regulation (eg, DRD1, COMT), myelin repair (eg, TCF4), DNA repair (eg, RAD51), cell cycle regulation (eg, SESN1), and response to oxidative stress (eg, GSTP1). The SNPs were not significantly associated with WM abnormalities.ConclusionThis novel study suggests that polymorphisms in genes involved in aging and inflammation, dopamine, myelin and cell cycle regulation, and DNA repair and response to oxidative stress may be associated with cognitive outcome in patients with brain tumors.

scholarly journals Molecular Imaging of Brain Tumor-Associated Epilepsy

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1049
Author(s):  
Csaba Juhász ◽  
Sandeep Mittal
Keyword(s):  
Brain Tumor ◽  
Amino Acid ◽  
Brain Tumors ◽  
Treatment Strategies ◽  
Amino Acid Uptake ◽  
Seizure Outcome ◽  
Acid Uptake ◽  
Positron Emission ◽  
Oncology Practice ◽  
Glioneuronal Tumors

Epilepsy is a common clinical manifestation and a source of significant morbidity in patients with brain tumors. Neuroimaging has a pivotal role in neuro-oncology practice, including tumor detection, differentiation, grading, treatment guidance, and posttreatment monitoring. In this review, we highlight studies demonstrating that imaging can also provide information about brain tumor-associated epileptogenicity and assist delineation of the peritumoral epileptic cortex to optimize postsurgical seizure outcome. Most studies focused on gliomas and glioneuronal tumors where positron emission tomography (PET) and advanced magnetic resonance imaging (MRI) techniques can detect metabolic and biochemical changes associated with altered amino acid transport and metabolism, neuroinflammation, and neurotransmitter abnormalities in and around epileptogenic tumors. PET imaging of amino acid uptake and metabolism as well as activated microglia can detect interictal or peri-ictal cortical increased uptake (as compared to non-epileptic cortex) associated with tumor-associated epilepsy. Metabolic tumor volumes may predict seizure outcome based on objective treatment response during glioma chemotherapy. Advanced MRI, especially glutamate imaging, can detect neurotransmitter changes around epileptogenic brain tumors. Recently, developed PET radiotracers targeting specific glutamate receptor types may also identify therapeutic targets for pharmacologic seizure control. Further studies with advanced multimodal imaging approaches may facilitate development of precision treatment strategies to control brain tumor-associated epilepsy.

scholarly journals Is There a Relationship between the Elasticity of Brain Tumors, Changes in Diffusion Tensor Imaging, and Histological Findings? A Pilot Study Using Intraoperative Ultrasound Elastography

2021 ◽  
Vol 11 (2) ◽  
pp. 271
Author(s):  
Santiago Cepeda ◽  
Sergio García-García ◽  
María Velasco-Casares ◽  
Gabriel Fernández-Pérez ◽  
Tomás Zamora ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Diffusion Tensor Imaging ◽  
Linear Regression ◽  
Brain Tumors ◽  
Diffusion Tensor ◽  
Intraoperative Ultrasound ◽  
Ultrasound Elastography ◽  
Proliferation Index ◽  
Strong Positive Correlation ◽  
Non Linear

Intraoperative ultrasound elastography (IOUS-E) is a novel image modality applied in brain tumor assessment. However, the potential links between elastographic findings and other histological and neuroimaging features are unknown. This study aims to find associations between brain tumor elasticity, diffusion tensor imaging (DTI) metrics, and cell proliferation. A retrospective study was conducted to analyze consecutively admitted patients who underwent craniotomy for supratentorial brain tumors between March 2018 and February 2020. Patients evaluated by IOUS-E and preoperative DTI were included. A semi-quantitative analysis was performed to calculate the mean tissue elasticity (MTE). Diffusion coefficients and the tumor proliferation index by Ki-67 were registered. Relationships between the continuous variables were determined using the Spearman ρ test. A predictive model was developed based on non-linear regression using the MTE as the dependent variable. Forty patients were evaluated. The pathologic diagnoses were as follows: 21 high-grade gliomas (HGG); 9 low-grade gliomas (LGG); and 10 meningiomas. Cases with a proliferation index of less than 10% had significantly higher medians of MTE (110.34 vs. 79.99, p < 0.001) and fractional anisotropy (FA) (0.24 vs. 0.19, p = 0.020). We found a strong positive correlation between MTE and FA (rs (38) = 0.91, p < 0.001). A cubic spline non-linear regression model was obtained to predict tumoral MTE from FA (R2 = 0.78, p < 0.001). According to our results, tumor elasticity is associated with histopathological and DTI-derived metrics. These findings support the usefulness of IOUS-E as a complementary tool in brain tumor surgery.

scholarly journals The Association of Human Herpesviruses with Malignant Brain Tumor Pathology and Therapy: Two Sides of a Coin

2021 ◽  
Vol 22 (5) ◽  
pp. 2250
Author(s):  
Evita Athanasiou ◽  
Antonios N. Gargalionis ◽  
Fotini Boufidou ◽  
Athanassios Tsakris
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Comprehensive Evaluation ◽  
Tumor Development ◽  
Scientific Data ◽  
Malignant Brain Tumor ◽  
Direct Role ◽  
Tumor Pathology ◽  
Human Herpesviruses

The role of certain viruses in malignant brain tumor development remains controversial. Experimental data demonstrate that human herpesviruses (HHVs), particularly cytomegalovirus (CMV), Epstein–Barr virus (EBV) and human herpes virus 6 (HHV-6), are implicated in brain tumor pathology, although their direct role has not yet been proven. CMV is present in most gliomas and medulloblastomas and is known to facilitate oncomodulation and/or immunomodulation, thus promoting cancer cell proliferation, invasion, apoptosis, angiogenesis, and immunosuppression. EBV and HHV-6 have also been detected in brain tumors and high-grade gliomas, showing high rates of expression and an inflammatory potential. On the other hand, due to the neurotropic nature of HHVs, novel studies have highlighted the engagement of such viruses in the development of new immunotherapeutic approaches in the context of oncolytic viral treatment and vaccine-based strategies against brain tumors. This review provides a comprehensive evaluation of recent scientific data concerning the emerging dual role of HHVs in malignant brain pathology, either as potential causative agents or as immunotherapeutic tools in the fight against these devastating diseases.

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