Bilateral Middle Cingulate Cortex Research Articles

Cerebral blood flow changes in schizophrenia patients with auditory verbal hallucinations during low-frequency rTMS treatment.

Auditory verbal hallucinations (AVH) are a prominent symptom of schizophrenia. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been evidenced to improve the treatment of AVH in schizophrenia. Although abnormalities in resting-state cerebral blood flow (CBF) have been reported in schizophrenia, the perfusion alterations specific to schizophrenia patients with AVH during rTMS require further investigation. In this study, we used arterial spin labeling (ASL) to investigate changes in brain perfusion in schizophrenia patients with AVH, and their associations with clinical improvement following low-frequency rTMS treatment applied to the left temporoparietal junction area. We observed improvements in clinical symptoms (e.g., positive symptoms and AVH) and certain neurocognitive functions (e.g., verbal learning and visual learning) following treatment. Furthermore, at baseline, the patients showed reductions in CBF in regions associated with language, sensory, and cognition compared to controls, primarily located in the prefrontal cortices (e.g., left inferior frontal gyrus and left middle frontal gyrus), occipital lobe (e.g., left calcarine cortex), and cingulate cortex (e.g., bilateral middle cingulate cortex), compared to controls. Conversely, we observed increased CBF in the left inferior temporal gyrus and bilateral putamen in patients relative to controls, regions known to be involved in AVH. However, the hypoperfusion or hyperperfusion patterns did not persist and instead were normalized, and were related to clinical response (e.g., AVH) in patients during low-frequency rTMS treatment. Importantly, the changes in brainperfusion were related to clinical response (e.g., AVH) in patients. Our findings suggest that low-frequency rTMS can regulate brain perfusion involving critical circuits by its remote effect in schizophrenia, and may play an important mechanistic role in the treatment of AVH.

Trigeminal nerve stimulation for prolonged disorders of consciousness: A randomized double-blind sham-controlled study

BackgroundTrigeminal nerve stimulation (TNS) has been proposed as a promising intervention for coma awakening. However, the effect of TNS on patients with prolonged disorders of consciousness (pDoC) is still unclear. ObjectiveThis study aimed to investigate the therapeutic effects of TNS in pDoC caused by stroke, trauma, and anoxia. MethodsA total of 60 patients (male =25, female =35) aged over 18 who were in a vegetative state or minimally conscious state were randomly assigned to the TNS (N = 30) or sham TNS (N = 30) groups. 4 weeks of intervention and a followed up for 8 weeks were performed. The Glasgow Coma Scale (GCS) and Coma Recovery Scale-Revised (CRS-R) scores as primary outcomes were assessed at baseline and at 2, 4, 8, and 12 weeks. ResultsThe score changes in the TNS group over time for CRS-R (2-week: mean difference = 0.9, 95% CI = [0.3, 1.5], P = 0.006; 4-week: 1.6, 95% CI = [0.8, 2.5], P < 0.001; 8-week: mean difference = 2.4, 95% CI = [1.3, 3.5], P < 0.001; 12-week: mean difference = 2.3, 95% CI = [1.1, 3.4], P < 0.001) and GCS (4-week: mean difference = 0.7, 95% CI = [0.3, 1.2], P = 0.002; 8-week: mean difference = 1.1, 95% CI = [0.6, 1.7], P < 0.001; 12-week: 1.1, 95% CI = [0.5, 1.7], P = 0.003) were higher than those in the sham group. 18-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) revealed that the metabolism of the right parahippocampal cortex, right precuneus, and bilateral middle cingulate cortex was significantly increased in TNS group. ConclusionThe results of this study indicate that TNS could increase local brain metabolism and may promote functional recovery in patients with prolonged disorders of consciousness. Registration informationName of the registry: Chinese Clinical Trial Registry. Registration number: ChiCTR1900025573. The date that the study was submitted to a registry: 2019-09-01. The date when the first patient was enrolled was 2021-01-20.

Neurofunctional mapping of reward anticipation and outcome for major depressive disorder: a voxel-based meta-analysis.

Aberrations in how people form expectations about rewards and how they respond to receiving rewards are thought to underlie major depressive disorder (MDD). However, the underlying mechanism linking the appetitive reward system, specifically anticipation and outcome, is still not fully understood. To examine the neural correlates of monetary anticipation and outcome in currently depressed subjects with MDD, we performed two separate voxel-wise meta-analyses of functional neuroimaging studies using the monetary incentive delay task. During reward anticipation, the depressed patients exhibited an increased response in the bilateral middle cingulate cortex (MCC) extending to the anterior cingulate cortex, the medial prefrontal cortex, the left inferior frontal gyrus (IFG), and the postcentral gyrus, but a reduced response in the mesolimbic circuit, including the left striatum, insula, amygdala, right cerebellum, striatum, and IFG, compared to controls. During the outcome stage, MDD showed higher activity in the left inferior temporal gyrus, and lower activity in the mesocortical pathway, including the bilateral MCC, left caudate nucleus, precentral gyrus, thalamus, cerebellum, right striatum, insula, IFG, middle frontal gyrus, and temporal pole. Our findings suggest that cMDD may be characterised by state-dependent hyper-responsivity in cortical regions during the anticipation phase, and hypo-responsivity of the mesocortico-limbic circuit across the two phases of the reward response. Our study showed dissociable neural circuit responses to monetary stimuli during reward anticipation and outcome, which help to understand the dysfunction in different aspects of reward processing, particularly motivational v. hedonic deficits in depression.

Effect of Moxibustion Treatment on Degree Centrality in Patients With Mild Cognitive Impairment: A Resting-State Functional Magnetic Resonance Imaging Study

BackgroundMild cognitive impairment (MCI) is a common neurological disorder. Moxibustion has been shown to be effective in treating MCI, but its therapeutic mechanisms still remain unclear. This study mainly aimed to investigate the modulation effect of moxibustion treatment for patients with MCI by functional magnetic resonance imaging (fMRI).MethodsA total of 47 patients with MCI and 30 healthy controls (HCs) participated in resting-state fMRI imaging (rs-fMRI) scans. Patients with MCI were randomly divided into true moxibustion group (TRUE, n = 30) and sham moxibustion group (SHAM, n = 17). The degree centrality (DC) approach was applied to distinguish altered brain functions. Correlation analysis was then performed to examine the relationships between the neuroimaging findings and clinical symptoms.ResultsCompared with HCs, patients with MCI mainly showed decreased DC in the left middle frontal cortex (MFC) and bilateral middle cingulate cortex (MCC). After moxibustion treatment, the SHAM group had no significant DC findings, while TRUE group mainly showed significant increased DC in the bilateral MFC and MCC, as well as decreased DC in the left middle occipital cortex (MOC). Repeated measures analysis of variance (ANOVA) showed significant interactions between the two groups of patients with MCI. In addition, the higher Mini-Mental State Examination (MMSE) score was significantly positively correlated with increased DC in the right MFC and left MCC after moxibustion treatment.ConclusionOur findings demonstrate that the potential value of moxibustion treatment on MCI, which adds new insights into the popular view that moxibustion treatment may slow cognitive decline in patients with MCI.

Decreased gray matter volume of the anterior insular cortex in patients with psychogenic erectile dysfunction: A voxel-based morphometry study

This study aimed to explore the gray matter morphological alteration and its correlation with the severity of symptoms in patients with psychogenic erectile dysfunction (pED). Fifty patients with pED and 50 healthy controls (HCs) were included. The whole-brain voxel-based morphometry analysis was conducted to compare the differences in gray matter volume (GMV) between patients with pED and HCs. And then, the region-of-interest-based correlation analyses were performed between the GMV of these regions with the most pronounced between-group differences and clinical symptoms in patients. The results demonstrated that patients with pED manifested decreased GMV in the bilateral anterior insula (aINS), bilateral precentral gyrus, left postcentral gyrus, bilateral anterior cingulate cortex, bilateral middle cingulate cortex, bilateral fusiform gyrus, and cerebellum when compared to HCs. Taking the bilateral aINS as the region-of-interest, the results of voxel-based correlation analyses showed that the GMV of the bilateral aINS were positively correlated with the International Index of Erectile Function 5 (IIEF-5) and Quality of Erection Questionnaire score, and the GMV of right aINS was positively associated with duration and sexual craving score in patients with pED. Furthermore, the significant correlations between the total GMV of the right aINS and IIEF-5 and sexual craving score, as well as between the total GMV of the left aINS and sexual craving score were also detected. In conclusion, these results suggested that the decreased GMV of aINS might be a critical neuropathological characteristic of pED, which provided new evidence for understanding the neurobiological basis of pED from the perspective of brain structure alterations.

Different modulation effects of 1\xa0Hz and 20\xa0Hz transcutaneous auricular vagus nerve stimulation on the functional connectivity of the periaqueductal gray in patients with migraine

BackgroundA growing body of evidence suggests that transcutaneous auricular vagus nerve stimulation (taVNS) may relieve symptoms of migraineurs. Frequency is one of the key stimulation parameters. The aim of this study is to investigate the modulation effect of taVNS frequency on the descending pain modulation system (DPMS) in patients with migraine.MethodsTwenty-four episodic migraineurs without aura (21 females) were recruited for the single-blind, crossover, functional magnetic resonance imaging (fMRI) study. Each participant attended two separate fMRI scan sessions, one for 1 Hz and another for 20 Hz taVNS, in a random order. Seed-based functional connectivity analysis was applied using the ventrolateral periaqueductal gray (PAG) as the region of interest.ResultsCompared with the pre-taVNS resting state, continuous 1 Hz taVNS (during) produced a significant increase in functional connectivity between the PAG and the bilateral middle cingulate cortex (MCC), right precuneus, left middle frontal gyrus (MFG), and left cuneus. Compared with 20 Hz taVNS, 1 Hz taVNS produced greater PAG connectivity increases with the MCC, right precuneus/posterior cingulate cortex, left insula, and anterior cingulate cortex (ACC). A significant negative correlation was observed between the number of migraine attacks in the previous 4 weeks and the PAG-MCC functional connectivity in the pre-taVNS resting-state before 1 Hz taVNS.ConclusionsOur findings suggest that taVNS with different frequencies may produce different modulation effects on the descending pain modulation system, demonstrating the important role of stimulation frequency in taVNS treatment.

Disrupted Asymmetry of Inter- and Intra-Hemispheric Functional Connectivity at Rest in Medication-Free Obsessive-Compulsive Disorder.

Disrupted functional asymmetry of cerebral hemispheres may be altered in patients with obsessive-compulsive disorder (OCD). However, little is known about whether anomalous brain asymmetries originate from inter- and/or intra-hemispheric functional connectivity (FC) at rest in OCD. In this study, resting-state functional magnetic resonance imaging was applied to 40 medication-free patients with OCD and 38 gender-, age-, and education-matched healthy controls (HCs). Data were analyzed using the parameter of asymmetry (PAS) and support vector machine methods. Patients with OCD showed significantly increased PAS in the left posterior cingulate cortex, left precentral gyrus/postcentral gyrus, and right inferior occipital gyrus and decreased PAS in the left dorsolateral prefrontal cortex (DLPFC), bilateral middle cingulate cortex (MCC), left inferior parietal lobule, and left cerebellum Crus I. A negative correlation was found between decreased PAS in the left DLPFC and Yale–Brown Obsessive-compulsive Scale compulsive behavior scores in the patients. Furthermore, decreased PAS in the bilateral MCC could be used to distinguish OCD from HCs with a sensitivity of 87.50%, an accuracy of 88.46%, and a specificity of 89.47%. These results highlighted the contribution of disrupted asymmetry of intra-hemispheric FC within and outside the cortico-striato-thalamocortical circuits at rest in the pathophysiology of OCD, and reduced intra-hemispheric FC in the bilateral MCC may serve as a potential biomarker to classify individuals with OCD from HCs.

The Association Between Insular Subdivisions Functional Connectivity and Suicide Attempt in Adolescents and Young Adults with Major Depressive Disorder.

Previous studies demonstrated the possible involvement of insula in suicide owing to depression. However, the function of insula in young depressed patients with suicide attempt (SA) remains to be revealed. This study aimed to explore the association between resting-state functional connectivity (FC) of insula and SA in young depressed patients. Fifty-eight adolescents and young adults with major depressive disorder, including 22 with a history of at least one SA (SA group) and 36 without a history of SA (NSA group) were scanned with a 3.0T functional magnetic resonance imaging system, and the resting-state functional magnetic resonance imaging data was extracted. Whole brain resting-state FC of insular subdivisions were compared between the two groups. Significantly increased FC of the left posterior insula withthe orbital part of left inferior frontal gyrus, the right supplementary motor area and the bilateral paracentral lobule extending to the bilateral middle cingulate cortex was observed in the SA group compared with the NSA group. In addition, the orbital part of left superior frontal gyrus in the SA group exhibited significantly increased FC with the right posterior insula compared with the NSA group. However, no significant correlation was found between the insular subdivisions FC and different clinical variables in two groups. The present study highlighted the disruptions of the resting-state FC of the posterior insula with the orbitofrontal cortex and a series of motor cortices, and added incremental value to the knowledge of the neural mechanism underlying SA in young depressed patients.

Echolalia in patients with primary progressive aphasia.

This study aimed to examine echolalia and its related symptoms and brain lesions in primary progressive aphasia (PPA). Forty-five patients with PPA were included: 19 nonfluent/agrammatic variant PPA (nfvPPA), 5 semantic variant PPA, 7 logopenic variant PPA, and 14 unclassified PPA patients. We detected echolalia in unstructured conversations. An evaluation of language function and the presence of parkinsonism, grasp reflex, imitation behaviour, and disinhibition were assessed. We also measured regional cerebral blood flow (rCBF) using single-photon emission computed tomography. Echolalia was observed in 12 nfvPPA and 2 unclassified PPA patients. All patients showed mitigated echolalia. We compared nfvPPA patients with echolalia (echolalia group) to those without echolalia (non-echolalia group). The median age of the echolalia group was significantly lower than that of the non-echolalia group, and the echolalia group showed a significantly worse auditory comprehension performance than the non-echolalia group. In contrast, the performance of repetition tasks was not different between the two groups. The prevalence of imitation behaviour in the echolalia group was significantly higher than that in the non-echolalia group. The rCBFs in the bilateral pre-supplementary motor area and bilateral middle cingulate cortex in the echolalia group were significantly lower than those in the non-echolalia group. These findings suggest that echolalia is characteristic of nfvPPA patients with impaired comprehension. Reduced inhibition of the medial frontal cortex with release activity of the anterior perisylvian area account for the emergence of echolalia.

Convergent and divergent functional connectivityalterations of hippocampal subregions between short-term and chronic insomnia disorder

Insomnia disorder (ID) is reclassified into short-term and chronic subtypes based on recent etiological advances, however, neural mechanisms underlying the subtypes are rarely examined. In this study, we investigated gray matter volume and resting-state functional connectivity (RSFC) alterations of hippocampal subregions in short-term and chronic ID using multimodal MRI. We found convergent and divergent alterations between both ID groups in specific hippocampal subregions [right cornu ammonis 1 (CA1), subicular complex (Subc), and caudal hippocampus, (cHipp)] with prefrontal cortex [bilateral medial prefrontal cortex (MPFC), and right middle frontal gyrus] and limbic/paralimbic regions (bilateral middle cingulate cortex and left parahippocampal gyrus). Intriguingly, the RSFC of the right CA1/cHipp, particularly the intersection between these two subregions, with bilateral MPFC exhibited gradual increases from healthy controls to short-term ID and from short-term ID to chronic ID. Moreover, a negative correlation between the right CA1-left parahippocampal gyrus RSFC and Epworth Sleepiness Scale scores, and a positive correlation between the right CA1-bilateral MPFC RSFC and Insomnia Severity Index scores were found in the chronic ID group (P < 0.05). Our findings suggest convergent and divergent RSFC alterations of specific hippocampal subregions with the prefrontal cortex and limbic/paralimbic regions between short-term and chronic ID. These findings suggest that the hippocampus is a key node in establishing diagnostic and categorical biomarkers in ID and developing more effective treatment strategies.

Structural and Functional Thalamic Changes in Parkinson's Disease With Mild Cognitive Impairment.

The thalamus is a key node of deep gray matter and previous studies have demonstrated that it is involved in the modulation of cognition. To investigate the volume changes of the thalamus and its subregions and altered thalamus functional connectivity patterns in Parkinson's disease (PD) patients with and without mild cognitive impairment (MCI). Prospective. Thirty-three patients with MCI (PD-MCI), 36 PD patients having no cognitive impairment (PD-NCI), 21 healthy controls (HCs). 3.0T MRI scanner; 3D T1 -weighted fast spoiled gradient recalled echo (3D T1 -FSPGR); resting-state fMRI ASSESSMENT: Voxel-based morphometry (VBM) was performed to calculate the volume of the thalamus and its subregions. The left and right total thalamus were considered seeds and seed-based functional connectivity (FC) was analyzed. Additionally, correlations between volumes and cognitive performance and between FC values and cognitive performance were examined separately. Analysis of covariance (ANCOVA); two-sample t-tests; partial correlation analysis. The volumes of the total thalamus (PD-MCI vs. PD-NCI vs. HCs: 18.39 ± 1.67 vs. 19.63 ± 1.79 vs. 19.47 ± 1.35) and its subregions were significantly reduced in PD-MCI as compared to PD-NCI (total thalamus: P = 0.002) and HCs (total thalamus: P = 0.012). Compared with PD-NCI, PD-MCI showed increased FC between the thalamus and bilateral middle cingulate cortex and left posterior cingulate cortex, and decreased FC between thalamus and the left superior occipital gyrus, left cuneus, left precuneus, and left middle occipital gyrus. Volumes of thalamus and the subregions, as well as the FC of thalamus with the identified regions, were significantly correlated (P < 0.05, FDR-corrected) with neuropsychological scores in PD patients. We noted volume loss and altered FC of thalamus in PD-MCI patients, and these changes were correlated with global cognitive performance. 2 TECHNICAL EFFICIENCY: Stage 2 J. Magn. Reson. Imaging 2020;52:1207-1215.

Preoperative Altered Spontaneous Brain Activity and Functional Connectivity Were Independent Risk Factors for Delayed Neurocognitive Recovery in Older Adults Undergoing Noncardiac Surgery.

Objectives Recently, it has been demonstrated that patients with subtle preexisting cognitive impairment were susceptible to delayed neurocognitive recovery (DNR). This present study investigated whether preoperative alterations in gray matter volume, spontaneous activity, or functional connectivity (FC) were associated with DNR. Methods This was a nested case-control study of older adults (≥60 years) undergoing noncardiac surgery. All patients received MRI scan at least 1 day prior to surgery. Cognitive function was assessed prior to surgery and at 7-14 days postsurgery. Preoperative gray matter volume, amplitude of low-frequency fluctuation (ALFF), and FC were compared between the DNR patients and non-DNR patients. The independent risk factors associated with DNR were identified using a multivariate logistic regression model. Results Of the 74 patients who completed assessments, 16/74 (21.6%) had DNR following surgery. There were no differences in gray matter volume between the two groups. However, the DNR patients exhibited higher preoperative ALFF in the bilateral middle cingulate cortex (MCC) and left fusiform gyrus and lower preoperative FC between the bilateral MCC and left calcarine than the non-DNR patients. The multivariate logistic regression analysis showed that higher preoperative spontaneous activity in the bilateral MCC was independently associated with a higher risk of DNR (OR = 3.11, 95% CI, 1.30-7.45; P = 0.011). A longer education duration (OR = 0.57, 95% CI, 0.41-0.81; P = 0.001) and higher preoperative FC between the bilateral MCC and left calcarine (OR = 0.40, 95% CI, 0.18-0.92; P = 0.031) were independently correlated with a lower risk of DNR. Conclusions Preoperative higher ALFF in the bilateral MCC and lower FC between the bilateral MCC and left calcarine were independently associated with the occurrence of DNR. The present fMRI study identified possible preoperative neuroimaging risk factors for DNR. This trial is registered with Chinese Clinical Trial Registry ChiCTR-DCD-15006096.

Abnormal Functional Connectivity in Cognitive Control Network, Default Mode Network, and Visual Attention Network in Internet Addiction: A Resting-State fMRI Study.

Internet addiction (IA) has become a global mental and social problem, which may lead to a series of psychiatric symptoms including uncontrolled use of internet, and lack of concentration. However, the exact pathophysiology of IA remains unclear. Most of functional connectivity studies were based on pre-selected regions of interest (ROI), which could not provide a comprehensive picture of the communication abnormalities in IA, and might lead to limited or bias observations. Using local functional connectivity density (lFCD), this study aimed to explore the whole-brain abnormalities of functional connectivity in IA. We evaluated the whole-brain lFCD resulting from resting-state fMRI data in 28 IA individuals and 30 demographically matched healthy control subjects (HCs). The correlations between clinical characteristics and aberrant lFCD were also assessed. Compared with HCs, subjects with IA exhibited heightened lFCD values in the right dorsolateral prefrontal cortex (DLPFC), left parahippocampal gyrus (PHG), and cerebellum, and the bilateral middle cingulate cortex (MCC) and superior temporal pole (STP), as well as decreased lFCD values in the right inferior parietal lobe (IPL), and bilateral calcarine and lingual gyrus. Voxel-based correlation analysis revealed the significant correlations between the Young's Internet Addiction Test (IAT) score and altered lFCD values in the left PHG and bilateral STP. These findings revealed the hyper-connectivity in cognitive control network and default mode network as well as the hypo-connectivity in visual attention network, verifying the common mechanism in IA and substance addiction, and the underlying association between IA, and attention deficit/hyperactivity disorder in terms of neurobiology.

Microstructural damage pattern of vascular cognitive impairment: a comparison between moyamoya disease and cerebrovascular atherosclerotic disease

Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease (age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease (age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls (age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitive impairment. This study was approved by the Institutional Review Board in Huashan Hospital, China (approval No. 2014-278). This study was registered with ClinicalTrials.gov on December 2, 2014 with the identifier NCT02305407.

Altered Brain Fraction Amplitude of Low Frequency Fluctuation at Resting State in Patients With Early Left and Right Bell’s Palsy: Do They Have Differences?

Purpose: Bell’s palsy refers to acute idiopathic unilateral facial nerve palsy. It is a common disorder of the main motor pathway to the facial muscles. This study aimed to investigate the abnormal fraction amplitude of low frequency fluctuation (fALFF) of the brain in patients with early left and right Bell’s palsy.Materials and Methods: Sixty-seven patients (left 33, right 34) and 37 age- and sex-matched healthy controls underwent resting-state functional magnetic resonance imaging (R-fMRI) examination. The fALFF values were measured from all subjects and were compared among the left palsy, right palsy, and control groups. Then, correlations between the Toronto Facial Grading System (TFGS) scores of the patients and the fALFF values of abnormal brain regions were analyzed.Results: Significant group differences in fALFF values among the three groups were observed mainly in the cerebral cortical, subcortical, and deep gray matter regions. Compared with the right Bell’s palsy group, the left Bell’s palsy group showed significantly decreased fALFF values in the left temporal pole of the superior temporal gyrus (TPOsup), right supramarginal, left and right middle cingulate cortex (MCC), left superior frontal gyrus (SFG), and left precentral gyrus (PreCG), and increased fALFF values were observed in the right SFG and PreCG. Furthermore, altered fALFF values correlated positively with the TFGS scores in the left superior TPO, bilateral MCC, and right PreCG, and correlated negatively with the TFGS scores in the right SFG of the left Bell’s palsy group. Altered fALFF values correlated positively with the TFGS scores in the bilateral MCC and right PreCG and correlated negatively with the TFGS scores in the left superior TPO and SFG of the right Bell’s palsy group.Conclusion: Regulatory mechanisms seem to differ between patients with left and right early Bell’s palsy. The severity of the disease is associated with these functional alterations.

Functional insights into aberrant brain responses and integration in patients with lifelong premature ejaculation

Even though lifelong premature ejaculation (PE) is highly prevalent, few studies have investigated the neural mechanisms underlying PE. The extent and pattern of brain activation can be determined through a version of functional magnetic resonance imaging (fMRI) with erotic picture stimuli (task fMRI) and a resting-state fMRI (rs fMRI). We showed that the brain activity in the left inferior frontal gyrus and left insula was decreased both during the task and in the resting state, while there was higher activation in the right middle temporal gyrus during the task. Higher functional connectivity was found in PE between those three brain areas and the bilateral middle cingulate cortex, right middle frontal gyrus and supplementary motor area. Moreover, the brain activity had positive correlation with clinical rating scales, such as intravaginal ejaculatory latency time (IELT) and the Chinese Index of Premature Ejaculation (CIPE). These findings revealed that brain responses and functional integration in certain brain areas are impaired in cases of PE, which was consistently supported by multiple measurements obtained using a task and rs fMRI approach.

Mediation of episodic memory performance by the executive function network in patients with amnestic mild cognitive impairment: a resting-state functional MRI study.

Deficits in episodic memory (EM) are a hallmark clinical symptom of patients with amnestic mild cognitive impairment (aMCI). Impairments in executive function (EF) are widely considered to exacerbate memory deficits and to increase the risk of conversion from aMCI to Alzheimer's disease (AD). However, the specific mechanisms underlying the interaction between executive dysfunction and memory deficits in aMCI patients remain unclear. Thus, the present study utilized resting-state functional magnetic resonance imaging (fMRI) scans of the EF network and the EM network to investigate this relationship in 79 aMCI patients and 119 healthy controls (HC). The seeds were obtained from the results of a regional homogeneity (ReHo) analysis. Functional connectivity (FC) within the EM network was determined using a seed in the right retrosplenial cortex (RSC), and FC within EF network was assessed using seeds in the right dorsolateral prefrontal cortex (DLPFC). There was a significant negative correlation between EM scores and EF scores in both the aMCI and HC groups. Compared to the HC group, aMCI patients had reduced right RSC connectivity but enhanced right DLPFC connectivity. The overlapping brain regions between the EM and EF networks were associated with FC in the right inferior parietal lobule (IPL) in the right RSC network, and in the bilateral middle cingulate cortex (MCC) and left IPL in the right DLPFC network. A mediation analysis revealed that the EF network had an indirect positive effect on EM performance in the aMCI patients. The present findings provide new insights into the neural mechanisms underlying the interaction between impaired EF and memory deficits in aMCI patients and suggest that the EF network may mediate EM performance in this population.

Gray Matter Loss and Related Functional Connectivity Alterations in A Chinese Family With Benign Adult Familial Myoclonic Epilepsy.

Benign adult familial myoclonic epilepsy (BAFME) is a non-progressive monogenic epilepsy syndrome. So far, the structural and functional brain reorganizations in BAFME remain uncharacterized. This study aims to investigate gray matter atrophy and related functional connectivity alterations in patients with BAFME using magnetic resonance imaging (MRI).Eleven BAFME patients from a Chinese pedigree and 15 matched healthy controls were enrolled in the study. Optimized voxel-based morphometric and resting-state functional MRI approaches were performed to measure gray matter atrophy and related functional connectivity, respectively. The Trail-Making Test-part A and part B, Digit Symbol Test (DST), and Verbal Fluency Test (VFT) were carried out to evaluate attention and executive functions.The BAFME patients exhibited significant gray matter loss in the right hippocampus, right temporal pole, left orbitofrontal cortex, and left dorsolateral prefrontal cortex. With these regions selected as seeds, the voxel-wise functional connectivity analysis revealed that the right hippocampus showed significantly enhanced connectivity with the right inferior parietal lobule, bilateral middle cingulate cortex, left precuneus, and left precentral gyrus. Moreover, the BAFME patients showed significant lower scores in DST and VFT tests compared with the healthy controls. The gray matter densities of the right hippocampus, right temporal pole, and left orbitofrontal cortex were significantly positively correlated with the DST scores. In addition, the gray matter density of the right temporal pole was significantly positively correlated with the VFT scores, and the gray matter density of the right hippocampus was significantly negatively correlated with the duration of illness in the patients.The current study demonstrates gray matter loss and related functional connectivity alterations in the BAFME patients, perhaps underlying deficits in attention and executive functions in the BAFME.

Age-related Increase in Activation of Effort-related Brain Areas During a Sustained Fatiguing Contraction.

Fatiguing contractions result in an overall increase in activation of the motor cortical areas. Older adults activate additional, ipsilateral areas during a non-fatiguing motor task. The activity pattern in older adults during a fatiguing motor task is not well studied. PURPOSE: To examine the effects of age on brain activation during a sustained fatiguing contraction with the right index finger abductor. METHODS: Thirty subjects (age-range: 19-64 years) performed a fatiguing maximal force task with their right first dorsal interosseous (FDI) in a 3 Tesla MR scanner during which the blood oxygen level dependent (BOLD) signal was recorded. The age-related changes in brain activation were determined using a one-sample t-test with age square as a covariate. RESULTS: The left inferior and superior parietal lobe, left rolandic operculum, left precuneus, left middle occipital gyrus, right hippocampus, bilateral parahippocampal gyrus, bilateral middle temporal gyrus, bilateral fusiform gyrus, bilateral insula and bilateral middle cingulate cortex were significantly more active with age (t>3.41, p<0.001 uncorrected). CONCLUSION: There is an age-related increase in brain activation, including the activation of several structures ipsilateral to the contracting hand, during a sustained fatiguing contraction. Most areas are thought to be involved in sensory-motor integration, effort- or cost-benefit analysis.

Cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia.

To investigate the similarities and differences in cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia (FD). Twenty right-handed FD patients were enrolled and randomized divided into two groups. Each patient received 20 sessions' electro-acupuncture treatment. The acupoints used in Group A were four acupoints on the Stomach Meridian, and the acupoints used in Group B were four acupoints on the Gallbladder Meridian. PET-CT scans were performed before and after acupuncture treatment to record the changes of cerebral glycometabolism. After treatment, the dyspepsia symptoms and the quality of life (QOL) of the patients in each group were significantly improved (p < 0.05) and there was insignificant difference in efficacy between the two groups (p > 0.05). In Group A, deactivation in brainstem, bilateral anterior cingulate cortex (ACC) and cerebellum, left superior medial frontal gyrus, orbital frontal cortex (OFC), and thalamus, etc., and activation in bilateral middle cingulate cortex (MCC), precuneus and lingual gyrus, etc. were observed. In Group B, deactivation in brainstem, bilateral thalamus, putamen, ACC, postterior cingulate cortex, hippocampus and cerebellum, etc., and activation in bilateral MCC, precuneus, left OFC, etc. were observed (p < 0.05, Family-wise error corrected). Different acupoints have similar clinical efficacy but relatively different cerebral responses. The influence on the sensory transduction regions (brainstem and thalamus) and visceral modulation regions might be the common mechanism of different acupoints treating for FD, and the modulation on some emotion/cognition-related areas (e.g., prefrontal cortex) is the potential difference between the different acupoints.