Pathological Laughter Prodromal to a Stroke of the Head of the Left Caudate Nucleus

A 38-year-old right-handed female with a past history of intermittent painful rash, dizzy spells, and chronic daily headaches as well as episodic migraines experienced an episode of transient involuntary pathological laughter, right arm weakness, and expressive dysphasia. She was found on MRI to have multiple strokes in multiple vascular distributions, including one in the head of the left caudate. A cardiac ECHO found an atrial myxoma, with extensive evaluation for other causes of stroke unrevealing. The differential diagnosis for pathological laughter in this patient is discussed. The most plausible cause in this patient is an infarct to the head of the left caudate nucleus caused by an embolus of the atrial myxoma.

Iron deficiency and internalizing symptom severity in unmedicated adolescents: a pilot study

Background Iron plays a key role in a broad set of metabolic processes. Iron deficiency is the most common nutritional deficiency in the world, but its neuropsychiatric implications in adolescents have not been examined. Methods Twelve- to 17-year-old unmedicated females with major depressive or anxiety disorders or with no psychopathology underwent a comprehensive psychiatric assessment for this pilot study. A T1-weighted magnetic resonance imaging scan was obtained, segmented using Freesurfer. Serum ferritin concentration (sF) was measured. Correlational analyses examined the association between body iron stores, psychiatric symptom severity, and basal ganglia volumes, accounting for confounding variables. Results Forty females were enrolled, 73% having a major depressive and/or anxiety disorder, 35% with sF < 15 ng/mL, and 50% with sF < 20 ng/mL. Serum ferritin was inversely correlated with both anxiety and depressive symptom severity (r = −0.34, p < 0.04 and r = −0.30, p < 0.06, respectively). Participants with sF < 15 ng/mL exhibited more severe depressive and anxiety symptoms as did those with sF < 20 ng/mL. Moreover, after adjusting for age and total intracranial volume, sF was inversely associated with left caudate (Spearman's r = −0.46, p < 0.04), left putamen (r = −0.58, p < 0.005), and right putamen (r = −0.53, p < 0.01) volume. Conclusions Brain iron may become depleted at a sF concentration higher than the established threshold to diagnose iron deficiency (i.e. 15 ng/mL), potentially disrupting brain maturation and contributing to the emergence of internalizing disorders in adolescents.

Distressing Belching with Chorea Induced by Caudate Infarction

Although belching is mostly associated with gastrointestinal disorders, it occasionally accompanies movement disorders such as Parkinsonism or dystonia. A woman in her 80s presented distressing belching and chorea of the right arm and leg from 3 years earlier. A brain MRI showed a left caudate infarction and atrophic change. Haloperidol significantly improved belching and chorea. Caudate infarction can cause distressing belching with chorea. It might be important to select the appropriate drug by referring to the accompanying involuntary movement to treat belching with movement disorders.

Brain network topology and personality traits: a source level magnetoencephalographic study

Personality neuroscience is focusing on the correlation between individual differences and the efficiency of large-scale networks from the perspective of the brain as an interconnected network. A suitable technique to explore this relationship is the magnetoencephalography (MEG), but little are MEG studies aimed at investigating topological properties correlated to personality traits. By using MEG, the present study is aimed at evaluating how individual differences described in Cloninger’s psychobiological model are correlated with specific cerebral structures. Fifty healthy individuals (20 males, 30 females, mean age: 27.4 ± 4.8 years) underwent Temperament and Character Inventory examination and MEG recording during a resting state condition. High harm avoidance scores were associated with a reduced centrality of the left caudate nucleus and this negative correlation was maintained in females when we analyzed gender differences. Our data suggest that the caudate nucleus plays a key role in adaptive behavior and could be a critical node in insular salience network. The clear difference between males and females allows us to suggest that topological organization correlated to personality is highly dependent on gender. Our findings provide new insights to evaluate the mutual influences of topological and functional connectivity in neural communication efficiency and disruption as biomarkers of psychopathological traits.

Effects of early energy intake on neonatal cerebral growth of preterm newborn: an observational study

Current guidelines for preterm newborns recommend high energy nutrition soon after birth in order to limit growth retardation. However, long-term effects of this nutritional approach are still debated, and it has been demonstrated that cerebral growth depends on protein intake in early life. A negative impact of early high energy intake by parenteral nutrition (PN) has been reported for patients in critically ill conditions, observed in intensive care unit. We aimed at evaluating the impact of energy intake on cerebral growth in preterm neonates early in life. We included preterm newborns with gestational age < 32 weeks or birth weight (BW) < 1500 g. Measurement of cerebral structures was performed by cranial Ultrasonography (cUS) between 3 and 7 days of life (DOL, T0) and at 28 DOL (T1). We evaluated the relation between energy intake and cerebral growth in the first 28 DOL. We observed in 109 preterm newborns a significant (p < 0.05) negative correlation between energy intake received by PN and right caudate head growth (r = − 0.243*) and a positive correlation between total energy intake and transverse cerebellum diameter (r = 0.254*). Multivariate analysis showed that energy intake administered by enteral nutrition (EN), independently increased growth of left caudate head (β = 0.227*) and height cerebellar vermis (β = 0.415*), while PN independently affected growth of both right and left caudate head (β = − 0.164* and β = − 0.228*, respectively) and cerebellum transverse diameter (β = − 0.849*). The route of energy administration may exert different effects on cerebral growth in early life. High energy intake administered through EN seems to be positively correlated to cerebral growth; conversely, PN energy intake results in a poorer cerebral growth evaluated with cUS.

Post-stroke Hemichorea Responding to Repetitive Transcranial Magnetic Stimulation Using a Parabolic Coil: A Case Report

Background: Hemichorea is a common post-stroke movement disorder. Although the general prognosis is good, permanent functional impairment remains in a substantial number of patients with post-stroke hemichorea. Anti-choreic drugs may alleviate symptoms in mild cases, but they often incur unacceptable side effects like tardive dyskinesia and parkinsonism. Surgery is rarely indicated for the treatment of vascular chorea, except in refractory cases. Case presentation: Here we reported a case of a 71-year-old man with severe choreatic movements after stroke, which caused the inability to perform the activities of daily living. Computed tomography revealed signs of former bleeding in the left caudate nucleus. Due to poor response to pharmacologic treatment, he was subjected to physical therapy and repetitive magnetic stimulation (rTMS) using a parabolic coil with 1 Hz over the left M1 area. The patient reported reduced symptoms after the 1st week of stimulation. rTMS substantially reduced choreatic movements and improved functional scores, including Brunnstrom recovery stage, Fugl–Meyer Assessment, Barthel index, Berg balance scale, and Dyskinesias scale. After 4 weeks of therapy, he was discharged with only a slight involuntary movement on the left side. No relapse occurred during the 1-year follow-up. Conclusions: Further studies are needed to reveal the mechanism of the observed effects and confirm the efficacy of rTMS as an alternative treatment for severe post-stroke hemichorea.

Resting-State Functional Connectivity of Salience Network in Schizophrenia and Depression

To explore the salience network(SN) functional alterations in schizophrenia and depression, resting-state functional magnetic resonance imaging (rs-fMRI) data from 29 patients with schizophrenia (SCH), 28 patients with depression (DEP) and 30 healthy controls(HC) were obtained. The SN was derived from data-driven group independent component analysis (gICA). ANCOVA and post hoc tests were performed to discover the FC differences of SN between groups. The ANCOVA demonstrated a significant group effect in FC with right inferior and middle temporal gyrus (ITG and MTG), left caudate, and right precentral gyrus. Post-hoc analyses revealed an opposite altered FC pattern between SN and right ITG and MTG for both patient groups. The DEP group showed a reduced FC between SN and right ITG and MTG compared with HC whereas the SCH group showed an increased FC. In addition, the SCH group showed decreased FC between SN and left caudate, and enhanced FC between SN and right precentral gyrus compared to the other two groups. Our findings suggest distinct FC of SN in schizophrenia and depression, supporting that the resting-state FC pattern of SN may be a transdiagnostic difference between depression and schizophrenia and may play a critical role in the pathogenesis of these two disorders.

Altered Functional Connectivity in the Resting State Neostriatum After Complete Sleep Deprivation: Impairment of Motor Control and Regulatory Network

Sleep loss not only compromises individual physiological functions but also induces a psychocognitive decline and even impairs the motor control and regulatory network. In this study, we analyzed whole-brain functional connectivity changes in the putamen and caudate nucleus as seed points in the neostriatum after 36 h of complete sleep deprivation in 30 healthy adult men by resting state functional magnetic resonance imaging to investigate the physiological mechanisms involved in impaired motor control and regulatory network in individuals in the sleep-deprived state. The functional connectivity between the putamen and the bilateral precentral, postcentral, superior temporal, and middle temporal gyrus, and the left caudate nucleus and the postcentral and inferior temporal gyrus were significantly reduced after 36 h of total sleep deprivation. This may contribute to impaired motor perception, fine motor control, and speech motor control in individuals. It may also provide some evidence for neurophysiological changes in the brain in the sleep-deprived state and shed new light on the study of the neostriatum in the basal ganglia.

GENDER DIFFERENCES IN THE VOLUME OF BRAIN STRUCTURES IN THE ASPECT OF PHYSIOLOGICAL AGING

Целью работы являлось уточнение гендерных и возрастных различий в строении мозговых структур у здоровых добровольцев в связи с задачей разграничения визуальных паттернов физиологического старения и патологических процессов головного мозга. Методы исследования включали проведение структурной МРТ головного мозга у 131 условно-здорового добровольца 20-70 лет (из них 72 женщины и 59 мужчин). С помощью метода магнитно-резонансной воксель-базированной морфометрии проводили измерение объёма головного мозга в целом, а также его отделов с последующим сравнением полученных данных в возрастных подгруппах и между полами. Полученные в ходе исследования данные свидетельствуют о том, что наибольшее уменьшение размеров после 60 лет претерпевают правый и левый таламусы, левое хвостатое ядро, правая скорлупа, левый бледный шар, оба гиппокампа. Наибольшие изменения в гиппокампах претерпевает объём СА3 полей Бродмана. Установлено, что процесс физиологического старения головного мозга с изменением объёма его различных отделов имеет ряд гендерных особенностей, которые необходимо учитывать на диагностическом этапе медицинской помощи. The aim of the work was to clarify the gender, age and variable differences in the structure of brain structures in healthy volunteers in connection with the task of distinguishing between physiological aging and pathological processes of the brain. The study methods included performing structural MRI of the brain in 131 conditionally healthy volunteers aged 20 to 70 years (72 of them were women and 59 men). Using the method of MR voxel-based morphometry, the total volume of the brain as a whole, as well as its segmented parts, was measured, followed by a comparison of the data obtained in age subgroups and between the sexes. The data obtained in the course of the study indicate that the right and left thalamuses, the left caudate nucleus, the right shell, the left pale ball, and both hippocampus undergo the greatest reduction in size after 60 years. The greatest changes in the hippocampus are the volumes of CA 3 Brodman fields. It is established that the process of physiological aging of the brain.

Recurrent Facial Focal Seizures With Chronic Striatopathy and Caudate Atrophy—A Double Whammy in an Elderly Woman With Diabetes Mellitus

Seizures and involuntary movements are relatively rare, but well-known neurological complications of non-ketotic hyperglycemia. While hemichorea-hemiballism secondary to diabetic striatopathy is increasingly being reported, unilateral caudate atrophy resulting from chronic vascular insufficiency/insult in a backdrop of poorly controlled diabetes mellitus is sparsely described in literature. We herein report a 75-year-old woman with poorly controlled diabetes mellitus who presented with concurrent epilepsia partialis continua involving left side of her face and hemichorea on the right side in the context of non-ketotic hyperglycemia. Neuroimaging revealed a space-occupying lesion suggestive of low-grade glioma in the right superior frontal cortex and left-sided caudate atrophy as well. Possibly, space-occupying lesion in motor cortex acted as an inciting factor for seizures and non-ketotic hyperglycemia further lowered the seizures threshold. On the other hand, atrophied left caudate had led to persistent choreiform movements secondary to chronic uncontrolled hyperglycemia. The simultaneous presence of acute and chronic neurological complications of diabetes mellitus makes this case unique. It also highlights the need for strict control of blood glucose and utility of appropriate neuroimaging to rapidly diagnose and prevent further complications.