Association of inferior division MCA stroke location with populations with atrial fibrillation incidence

ABSTRACTBackground and AimAnatomical features of Middle Cerebral Artery (MCA) bifurcation favors larger emboli entering the inferior rather than superior division. As cardiac source emboli are on average larger than arterial source emboli, we hypothesize that patients with atrial fibrillation have infarcts that involve more temporal and parietal lobes than frontal lobes.MethodsFrom 1,849 patients admitted with evidence of acute or early subacute ischemic stroke on diffusion-weighted MRI (DWI), 482 affected exclusively the “lobar” MCA (sparing the lenticulostriates). They were classified as “frontal predominant” (n=105) or “temporoparietal predominant” (n=197) if at least 75% of the infarct affected the frontal lobe or the temporal and parietal lobes, respectively. Differences between stroke location (frontal or temporoparietal), sex, and race were analyzed by Chi-square test. Results: Men were more likely than women, and white people were more likely than black people to have temporoparietal strokes versus frontal strokes. Patients with confirmed diagnosis of atrial fibrillation have more temporoparietal strokes, compared to frontal strokes.ConclusionMCA ischemic strokes occur more often in temporoparietal areas in men and in white patients, populations with known elevated incidence of atrial fibrillation. Patients with confirmed diagnosis of atrial fibrillation have more temporoparietal strokes, compared to frontal strokes. Results align with the hypothesis that large emboli (mostly from cardiac source) are more likely to cause temporoparietal strokes in the MCA territory, compared to frontal strokes. This association can help guide search for the most likely etiology of infarcts.

The structure of the superior and inferior parietal lobes predicts inter-individual suitability for virtual reality

The global virtual reality (VR) market is significantly expanding and being challenged with an increased demand owing to COVID-19. Unfortunately, VR is not useful for everyone due to large interindividual variability existing in VR suitability. To understand the neurobiological basis of this variability, we obtained neural structural and functional data from the participants using 3T magnetic resonance imaging. The participants completed one of two tasks (sports training or cognitive task) using VR, which differed in the time scale (months/minutes) and domain (motor learning/attention task). Behavioral results showed that some participants improved their motor skills in the real world after 1-month training in the virtual space or obtained high scores in the 3D attention task (high suitability for VR), whereas others did not (low suitability for VR). Brain structure analysis revealed that the structural properties of the superior and inferior parietal lobes contain information that can predict an individual’s suitability for VR.

Outcome Analysis and Prognostic Factors in Patients of Glioblastoma Multiforme: An Indonesian Single Institution Experience

Aims: This study was done to assess the survival of patients with glioblastoma multiform and to identify factors that can affect patient survival. Materials and methods: From January 2015 to December 2019, 55 patients with histopathologically confirmed glioblastoma multiform and received adjuvant radiation/chemoradiation in our department were retrospectively analyzed. Results: The median overall survival (OS) for entire cohort was 13 months and 1-year OS and 2-year OS rate were 52.7% and 3.6% with the mean follow-up period was 12 months. In univariate analysis, age (≤50 years vs >50 years, p=0.02), performance status (≥90 vs 70-80 vs <70, p<0.001), RTOG RPA classification (class III vs class IV vs class V-VI, p<0.001), parietal lobes tumor site (vs others, p=0.02), residual tumor volume (≤20.4cm3 vs >20.4cm3, p=0.001) and time to initiate adjuvant therapy (<4 weeks vs 4-6 weeks vs >6 weeks, p=0.01) were significantly affect overall survival. In multivariate analysis, RTOG RPA classification and involvement of parietal lobes were independent prognostic factors for overall survival. Conclusions: RTOG RPA classification that consisted of age and performance status is an independent prognostic factor for the clinical outcome of GBM. Besides this well-known factor, we also identified the involvement of parietal lobe gives a strong negative influence on survival of GBM patients.

Cognitive Archaeology and the Cognitive Sciences

Cognitive archaeology uses cognitive and psychological models to interpret the archaeological record. This chapter outlines several components that may be essential in building effective cognitive archaeological arguments. It also presents a two-stage perspective for the development of modern cognition, primarily based upon the work of Coolidge and Wynn. The first describes the transition from arboreal to terrestrial life in later Homo and the possible cognitive repercussions of terrestrial sleep. The second stage proposes that a genetic event may have enhanced working memory in Homo sapiens (specifically in terms of Baddeley’s multicomponent working memory model). The present chapter also reviews the archaeological and neurological bases for modern thinking, and the latter arguments are primarily grounded in the significance of the morphometric rescaling of the parietal lobes, which appears to have distinguished Homo sapiens from Neandertals.

Numerosity, Abstraction, and the Emergence of Symbolic Thinking

In this paper we tentatively propose that one of the feral cognitive bases for modern symbolic thinking may be numerosity, that is, the ability to appreciate and understand numbers. We proffer that numerosity appears to be an inherently abstractive process, which is supported by numerous human infant and monkey studies. We also review studies that demonstrate that the neurological substrate for numerosity is primarily the intraparietal sulcus of the parietal lobes, the angular and supramarginal gyri in the inferior parietal lobes, and areas of the prefrontal cortex. We also speculate that the lower level of abstraction involved in numerosity may serve as a basis for higher-level symbolic thinking, such as number and letter symbolism and sequencing. We further speculate that these two levels of abstraction may give rise to highly sophisticated characteristics of modern human language, such as analogizing and metaphorizing.

Dopamine, Serotonin, and Structure/Function Brain Defects as Biological Bases for Treatment Response in Delusional Disorder: A Systematic Review of Cases and Cohort Studies

Although blockade of dopamine receptors D2 and D3 appears to be the main mechanism of antipsychotic action, treatment response variability calls for an examination of other biological systems. Our aim is to systematically review reports of treatment response in delusional disorder (DD) in order to help determine its biological bases. Computerized searches of ClinicalTrials.gov, PubMed, and Scopus databases (from 1999 to September 2021) were systematically reviewed, in keeping with PRISMA directives. We used the search terms: (treat * OR therap * AND (delusional disorder)). We included all studies that explored the biological mechanisms of treatment response in DD, as diagnosed by ICD or DSM criteria. A total of 4344 records were initially retrieved, from which 14 papers were included: case reports, case series, and cohort studies. Findings point to (1) dopaminergic dysfunction (based on biochemical and genetic studies), (2) serotonergic dysfunction (based on partial agonism/antagonism of drugs), and (3) brain structure/function impairment, especially in the temporal and parietal lobes, as crucial factors in treatment response. Further studies with higher levels of evidence are needed to help clinicians determine treatment.

Magnetoencephalography reveals differences in brain activations for fast and slow responses to simple multiplications

Despite decades of studies, it is still an open question on how and where simple multiplications are solved by the brain. This fragmented picture is mostly related to the different tasks employed. While in neuropsychological studies patients are asked to perform and report simple oral calculations, neuroimaging and neurophysiological studies often use verification tasks, in which the result is shown, and the participant must verify the correctness. This MEG study aims to unify the sources of evidence, investigating how brain activation unfolds in time using a single-digit multiplication production task. We compared the participants' brain activity—focusing on the parietal lobes—based on response efficiency, dividing their responses in fast and slow. Results showed higher activation for fast, as compared to slow, responses in the left angular gyrus starting after the first operand, and in the right supramarginal gyrus only after the second operand. A whole-brain analysis showed that fast responses had higher activation in the right dorsolateral prefrontal cortex. We show a timing difference of both hemispheres during simple multiplications. Results suggest that while the left parietal lobe may allow an initial retrieval of several possible solutions, the right one may be engaged later, helping to identify the solution based on magnitude checking.

Clinical Speech fMRI in Children and Adolescents

Purpose In patients with drug-resistant focal epilepsy, surgical resection is often the only treatment option to achieve long-term seizure control. Prior to brain surgery involving potential language areas, identification of hemispheric language dominance is crucial. Our group developed and validated a functional magnetic resonance imaging (fMRI) battery of four pediatric language tasks. The present study aimed at optimizing fMRI data acquisition and analysis using these tasks. Methods We retrospectively analyzed speech fMRI examinations of 114 neuropediatric patients (age range 5.8–17.8 years) who were examined prior to possible epilepsy surgery. In order to evaluate hemispheric language dominance, 1–4 language tasks (vowel identification task VIT, word-chain task WCT, beep-story task BST, synonym task SYT) were measured. Results Language dominance was classified using fMRI activation in the 13 validly lateralizing ROIs (VLR) in frontal, temporal and parietal lobes and cerebellum of the recent validation study from our group: 47/114 patients were classified as left-dominant, 34/114 as bilateral and 6/114 as right-dominant. In an attempt to enlarge the set of VLR, we then compared for each task agreement of these ROI activations with the classified language dominance. We found four additional task-specific ROIs showing concordant activation and activation in ≥ 10 sessions, which we termed validly lateralizing (VLRnew). The new VLRs were: for VIT the temporal language area and for SYT the middle frontal gyrus, the intraparietal sulcus and cerebellum. Finally, in order to find the optimal sequence of measuring the different tasks, we analyzed the success rates of single tasks and all possible task combinations. The sequence 1) VIT 2) WCT 3) BST 4) SYT was identified as the optimal sequence, yielding the highest chance to obtain reliable results even when the fMRI examination has to be stopped, e.g., due to lack of cooperation. Conclusion Our suggested task order together with the enlarged set of VLRnew may contribute to optimize pediatric speech fMRI in a clinical setting.

Performance Analysis Between Feature Extraction and Fusion in Familiar and Unfamiliar Typing Biometric Authentication

The brain signals recorded by EEG devices are largely developed in for biometric authentication purposes. Those signals are very informative and reliable to be classified using signal processing. In this paper, the feature extraction and feature fusion are further studied to observe their performance towards the typing tasks. The signals are pre-processed to eliminate the unwanted noise present in the signals. The feature extraction method such as Welch’s method, Burg’s method and Yule Walk’s method are applied to extract the mean, median, standard deviation and variance in the data. Nonlinear feature such as fuzzy entropy is also been extracted. The extracted features are further classified by using k-Nearest Neighbour (k-NN), Random Forest (RF) and Ensemble Bagged Tree (EBT). The performance of feature extraction and feature fusion through concatenation are recorded and compared. For comparison, the feature fusion shows a better performance accuracy rather than feature extraction. The highest percentage accuracy was produced by Burg’s method for frontal-parietal lobes feature fusion which is 95.94% using Ensemble Bagged Tree (EBT).

Design and Verbal Fluency in Alzheimer’s Disease and Frontotemporal Dementia: Clinical and Metabolic Correlates

Objective: Cognitive processes underlying verbal and design fluency, and their neural correlates in patients with Alzheimer’s disease (AD) and behavioural variant Frontotemporal Dementia (bvFTD) remain unclear. We hypothesised that verbal and design fluency may be associated with distinct neuropsychological processes in AD and FTD, showing different patterns of impairment and neural basis. Methods: We enrolled 142 participants including patients with AD (n = 80, mean age = 74.71), bvFTD (n = 34, mean age = 68.18), and healthy controls (HCs) (n = 28, mean age = 71.14), that underwent cognitive assessment and 18F-fluorodeoxyglucose positron emission tomography imaging. Results: Semantic and phonemic fluency showed the largest effect sizes between groups, showing lower scores in bvFTD than AD and HCs, and lower scores in AD than HC. Both AD and bvFTD showed a lower number of unique designs in design fluency in comparison to HC. Semantic fluency was correlated with left frontotemporal lobe in AD, and with left frontal, caudate, and thalamus in bvFTD. Percentage of unique designs in design fluency was associated with the metabolism of the bilateral fronto-temporo-parietal cortex in AD, and the bilateral frontal cortex with right predominance in bvFTD. Repetitions in AD were correlated with bilateral frontal, temporal, and parietal lobes, and with left prefrontal cortex in bvFTD. Conclusions: Our findings demonstrate differential underlying cognitive processes in verbal and design fluency in AD and bvFTD. While memory and executive functioning associated with fronto-temporo-parietal regions were key in AD, attention and executive functions correlated with the frontal cortex and played a more significant role in bvFTD during fluency tasks.