Clinical Characteristics and Follow-Up of Seizures in Children With Anti-NMDAR Encephalitis

Objective: To analyze the seizure characteristics of children with anti-NMDAR encephalitis.Methods: This was a retrospective analysis of 50 children with anti-NMDAR encephalitis between July 1, 2013, and July 1, 2019.Results: Fifty children with anti-NMDAR encephalitis were included in this study, of which 34 (68.0%) had seizures. During the follow-up, three patients with anti-NMDAR encephalitis secondary to herpes simplex virus encephalitis had persistent seizures. The average duration of seizures in the remaining patients was 14.6 days (range 1–47 days). Compared to patients without seizures, those with seizures were more likely to experience consciousness disturbances (p = 0.008) and epileptic form discharge on electroencephalograms (p = 0.002). The Glasgow coma scale scores (p = 0.014), and Rankin scale scores (p = 0.019) were also different. The cranial MRI findings of children were reviewed, and clinical characteristics were compared between children without cranial lesions and those with lesions in the limbic system and neocortex. Compared to children in the non-lesion group, children with lesions in the limbic system and neocortex had a higher incidence of status epilepticus. Further, children in the limbic system and neocortical lesions groups were more likely to be taking anti-seizure medications (ASMs) and receive second-line drugs.Conclusion: Long-term oral ASMs are not recommended for most children with anti-NMDAR encephalitis. Children with involvement of the limbic system and neocortex are prone to status epilepticus, and sequelae of epilepsy may remain when the neocortex is involved.

THE ROLE OF NEURO LINGUISTICS IN CREATIVE WRITING SHORT STORIES THROUGH AN INTERDISCIPLINARY APPROACH

This study aims to explore the role of neurolinguistics in writing creative short stories for students through an interdisciplinary approach. neurolinguistics is a field of study consisting of linguistics and medicine which studies the relationship between language and the human brain which is linked to cognitive neuroscience and sensory and cellular movement. The method used in this research is literature review or literature review. There are four stages or four phases in conducting this research (1) designing a review, (2) conducting a review, (3) analyzing and (4) writing a review. In neurolinguistics, the parts of the human brain are also studied. The brain has 3 main parts, namely the cerebrum (cerebrum), cerebellum (cerebellum), and brainstem (brainstem). There are six factors that must be considered in creative writing, namely general knowledge and cognition, creative cognition, process, motivation and conative, linguistics and literacy, and psychomotor. There are also four-pillar factors of neurolinguistics, namely outcome, rapport, sensory acuity, and flexibility. Neurolinguistics also studies the structure and parts of the human brain, including the cerebrum (large brain), cerebellum (cerebellum), brainstem (brain stem) and limbic system (limbic system). The part that is closely related to writing is the cerebellum (cerebellum).

Baseline Neuroimaging Predicts Decline to Dementia From Amnestic Mild Cognitive Impairment

Background and Objectives: Prediction of decline to dementia using objective biomarkers in high-risk patients with amnestic mild cognitive impairment (aMCI) has immense utility. Our objective was to use multimodal MRI to (1) determine whether accurate and precise prediction of dementia conversion could be achieved using baseline data alone, and (2) generate a map of the brain regions implicated in longitudinal decline to dementia.Methods: Participants meeting criteria for aMCI at baseline (N = 55) were classified at follow-up as remaining stable/improved in their diagnosis (N = 41) or declined to dementia (N = 14). Baseline T1 structural MRI and resting-state fMRI (rsfMRI) were combined and a semi-supervised support vector machine (SVM) which separated stable participants from those who decline at follow-up with maximal margin. Cross-validated model performance metrics and MRI feature weights were calculated to include the strength of each brain voxel in its ability to distinguish the two groups.Results: Total model accuracy for predicting diagnostic change at follow-up was 92.7% using baseline T1 imaging alone, 83.5% using rsfMRI alone, and 94.5% when combining T1 and rsfMRI modalities. Feature weights that survived the p < 0.01 threshold for separation of the two groups revealed the strongest margin in the combined structural and functional regions underlying the medial temporal lobes in the limbic system.Discussion: An MRI-driven SVM model demonstrates accurate and precise prediction of later dementia conversion in aMCI patients. The multi-modal regions driving this prediction were the strongest in the medial temporal regions of the limbic system, consistent with literature on the progression of Alzheimer’s disease.

Limbic System

Unlike the lobes of the cortex, which are regionally defined, the limbic “lobe” includes highly interconnected circuits that span cortical, subcortical, and brainstem components. The major functions of the limbic system include mediating emotional and behavioral responses, memory, and learning. From a functional standpoint, the limbic system can be conceptualized as including an anterior circuit, centered in the amygdala and primarily involved in emotion and behavioral drive, and a posterior circuit, centered in the hippocampus and crucial for encoding and retrieving declarative (explicit) memory.

Wnt1 Role in the Development of the Habenula and the Fasciculus Retroflexus

Wnt1 is one of the morphogenes that controls the specification and differentiation of neuronal populations in the developing central nervous system. The habenula is a diencephalic neuronal complex located in the most dorsal aspect of the thalamic prosomere. This diencephalic neuronal population is involved in the limbic system and its malfunction is related with several psychiatric disorders. Our aim is to elucidate the Wnt1 role in the habenula and its main efferent tract, the fasciculus retroflexus, development. In order to achieve these objectives, we analyzed these structures development in a Wnt1 lack of function mouse model. The habenula was generated in our model, but it presented an enlarged volume. This alteration was due to an increment in habenular neuroblasts proliferation rate. The fasciculus retroflexus also presented a wider and disorganized distribution and a disturbed final trajectory toward its target. The mid-hindbrain territories that the tract must cross were miss-differentiated in our model. The specification of the habenula is Wnt1 independent. Nevertheless, it controls its precursors proliferation rate. Wnt1 expressed in the isthmic organizer is vital to induce the midbrain and rostral hindbrain territories. The alteration of these areas is responsible for the fasciculus retroflexus axons misroute.

The Aversion Function of the Limbic Dopaminergic Neurons and Their Roles in Functional Neurological Disorders

The Freudian theory of conversion suggested that the major symptoms of functional neurological disorders (FNDs) are due to internal conflicts at motivation, especially at the sex drive or libido. FND patients might behave properly at rewarding situations, but they do not know how to behave at aversive situations. Sex drive is the major source of dopamine (DA) release in the limbic area; however, the neural mechanism involved in FND is not clear. Dopaminergic (DAergic) neurons have been shown to play a key role in processing motivation-related information. Recently, DAergic neurons are found to be involved in reward-related prediction error, as well as the prediction of aversive information. Therefore, it is suggested that DA might change the rewarding reactions to aversive reactions at internal conflicts of FND. So DAergic neurons in the limbic areas might induce two major motivational functions: reward and aversion at internal conflicts. This article reviewed the recent advances on studies about DAergic neurons involved in aversive stimulus processing at internal conflicts and summarizes several neural pathways, including four limbic system brain regions, which are involved in the processing of aversion. Then the article discussed the vital function of these neural circuits in addictive behavior, depression treatment, and FNDs. In all, this review provided a prospect for future research on the aversion function of limbic system DA neurons and the therapy of FNDs.