Changes In Regional Blood Flow Research Articles

Changes of motor symptoms and regional cerebral blood flow after transcranial direct current stimulation in Parkinson's disease

Changes of motor symptoms and regional cerebral blood flow after transcranial direct current stimulation in Parkinson's disease

Neurobiological mechanisms and therapeutic impact of electroconvulsive therapy (ECT).

Electroconvulsive therapy (ECT) is an efficient therapeutic resource for psycho-pharmacotherapeutic resistant forms of depression. ECT is a form of electrical brain stimulation involving the induction of a controlled seizure, clinically similar to an epileptic seizure, that is initiated in the prefrontal region of the brain and spreads to the cortex and subcortex, including the diencephalic structures. This is achieved by creating a transcranial electric field and synchronously depolarizing neuronal membranes. The mechanisms of action of ECT are not yet fully understood, but several hypotheses have been proposed to explain how it affects the brain: neurotransmitter changes, neuroplasticity, network connectivity, endocrine system regulation and changes in regional cerebral blood flow and regional metabolism.

Ultrasound Duplex Scanning of Vessels in the Diagnosis of Limb Length Discrepancy in Pediatric Patients with Congenital Vascular Malformations

Ultrasound Duplex Scanning of Vessels in the Diagnosis of Limb Length Discrepancy in Pediatric Patients with Congenital Vascular Malformations

Automated brain segmentation for guidance of ultrasonic transcranial tissue pulsatility image analysis

Background and ObjectiveTissue pulsatility imaging is an ultrasonic technique that can be used to map regional changes in blood flow in the brain. Classification of regional differences in pulsatility signals can be optimized by restricting the analysis to brain tissue. For 2D transcranial ultrasound imaging, we have implemented an automated image analysis procedure to specify a region of interest in the field of view that corresponds to brain. MethodsOur segmentation method applies an initial K-means clustering algorithm that incorporates both echo strength and tissue displacement to identify skull in ultrasound brain scans. The clustering step is followed by processing steps that use knowledge of the scan format and anatomy to create an image mask that designates brain tissue. Brain regions were extracted from the ultrasound data using different numbers of K-means clusters and multiple combinations of ultrasound data. Masks generated from ultrasound data were compared with reference masks derived from Computed Tomography (CT) data. ResultsA segmentation algorithm based on ultrasound intensity with two K-means clusters achieves an accuracy better than 80% match with the CT data. Some improvement in the match is found with an algorithm that uses ultrasound intensity and displacement data, three K-means clusters, and addition of an algorithm to identify shallow sources of ultrasound shadowing. ConclusionsSeveral segmentation algorithms achieve a match of over 80% between the ultrasound and Computed Tomography brain masks. A final tradeoff can be made between processing complexity and the best match of the two data sets.

Changes of regional cerebral blood flow after repeated transcranial direct current stimulation in healthy participants: a pilot study.

Transcranial direct current stimulation (tDCS) can potentially enhance brain function and cognition in healthy individuals as well as in patients with cognitive impairment. However, neural correlates of repeated tDCS remain relatively unexplored in a healthy population. To assess the effects of repeated tDCS on regional cerebral blood flow (rCBF) in healthy volunteers in a pilot investigation. Five healthy adults received bifrontal tDCS to the dorsolateral prefrontal cortex (F3-F4 montage, 1 mA intensity, 30 minutes/session, five sessions/week) over four weeks. All participants underwent brain single-photon emission computed tomography (SPECT) scans at baseline and one week after the last tDCS session. Changes in rCBF were examined using Statistical Parametric Mapping. Resting rCBF was significantly improved in the right superior frontal gyrus at the follow-up (P < 0.001). Adverse events were not reported and the stimulation was well-tolerated. Repeated tDCS may be effective for enhancing brain function in healthy participants. Larger sham-controlled studies should be performed to confirm our preliminary findings.

Acute psychological stress-induced progenitor cell mobilization and cardiovascular events

ObjectiveCertain brain activation responses to psychological stress are associated with worse outcomes in CVD patients. We hypothesized that elevated acute psychological stress, manifesting as greater activity within neural centers for emotional regulation, mobilizes CPC from the bone marrow to the peripheral blood and predicts future cardiovascular events. MethodsIn 427 patients with stable CAD undergoing a laboratory-based mental stress (MS) test, CPCs were enumerated using flow cytometry as CD34-expressing mononuclear cells (CD34+) before and 45 min after stress. Changes in brain regional blood flow with MS were measured using high resolution-positron emission tomography (HR-PET). Association between the change in CPC with MS and the risk of cardiovascular death or myocardial infarction (MI) during a 5-year follow-up period was analyzed. ResultsMS increased CPC counts by a mean of 150 [630] cells/mL (15%), P < 0.001. Greater limbic lobe activity, indicative of activation of emotion-regulating centers, was associated with greater CPC mobilization (P < 0.005). Using Fine and Gray models after adjustment for demographioc, clinical risk factors and medications use, greater CPC mobilization was associated with a higher adjusted risk of adverse events; a rise of 1000 cells/mL was associated with a 50% higher risk of cardiovascular death/MI [hazards ratio, 1.5, 95% confidence interval, 1.1–2.2). ConclusionGreater limbic lobe activity, brain areas involved in emotional regulation, is associated with MS-induced CPC mobilization. This mobilization isindependently associated with cardiovascular events. These findings provide novel insights into mechanisms through which psychological stressors modulate cardiovascular risk.

Neuroprotective effects of pravastatin in cerebral venous infarction in a rat model.

Pravastatin sodium is reported to have multiple beneficial effects in cerebral atherosclerosis and neuronal injury; however, the preventive effects on cerebral venous ischemia are still unknown. Herein, we aimed to examine the neuroprotective effects of transoral prior administration of pravastatin sodium against cerebral cortical venous ischemia with suppression of apoptosis. Thirty 8-week-old male Wistar rats were divided equally into two study groups (n=15 vs. n=15); the pravastatin group was fed 1% pravastatin sodium with their usual diet for 2 weeks, while the control group only received the usual diet. Two-vein occlusion (2VO) model was applied for this study, and two adjacent cortical veins in each animal were permanently occluded photochemically with rose bengal dye. During photo-thrombosis, regional changes of the cerebral blood flow (CBF) in area of the venous ischemia were recorded. At 48-h after 2VO, animals were euthanized using perfusion fixation, and we histologically measured ratios of infarcted area to contralateral hemisphere, and counted Bax- and Bcl-2-positive cells in the penumbra to investigate the implications for apoptosis. The ratio of infarcted area was significantly decreased in the pravastatin group compared to the control group (P<0.01). The number of Bax-positive cells also decreased significantly in the pravastatin group (P<0.01). In contrast, immunolabeling for Bcl-2 was essentially negative in all areas in both groups. There were also no significant differences in regional CBF changes after 2VO between the two groups (P=0.13). Pre-emptive administration of pravastatin sodium mixed in the food has neuroprotective effects against cerebral cortical venous ischemia with suppression of apoptosis associated with inhibition of Bax expression but has little influence on regional CBF.

Anesthetic aspects of robot-assisted surgery (a review)

The introduction of modern robot-assisted and laparoscopic methods of surgical interventions have extended the range of surgical indications, at the same time as raising a number of specific problems related to the technical features of minimally invasive treatment. This fact makes us consider the effect of surgical aggression on the patient from a new perspective. In particular, the influence of pneumoperitoneum and the patient’s position on venous return, regional blood flow changes, and concomitant shifts of some homeokinetic systems require elucidation. This article reviews the available literature to describe the main features of anesthesia during robot-assisted surgical interventions. Recommendations from systematic reviews and meta-analyses were used. The search depth comprised the period of 12 years (2011–2022). Such factors as antiphysiological position on the operating table, tense carboxyperitoneum, and carboxythorax affect almost all organs and many regulatory mechanisms, thus having a pathological effect on the cardiovascular and respiratory systems, kidney, liver, intestines, blood coagulation system, immune system, and thermoregulation mechanisms. These effects are particularly pronounced in patients with concomitant diseases. In addition to knowledge in the field of pathophysiology, surgeons should be capable of predicting the course of events to take actions aimed at preventing the development of complications. Robot-assisted surgical interventions, although being less traumatic, are characterized by specific features that should be taken into account when preparing a patient to undergo surgery, selecting an optimal method of surgical intervention, and managing the patient in the intra- and postoperative period with rehabilitation.

Two decades of astrocytes in neurovascular coupling.

The brain is a highly energy demanding organ, which accounts in humans for the 20% of total energy consumption at resting state although comprising only 2% of the body mass. The necessary delivery of nutrients to brain parenchyma is ensured by the cerebral circulatory system, through the exchange of glucose and oxygen (O2) at the capillary level. Notably, a tight spatial and temporal correlation exists between local increases in neuronal activity and the subsequent changes in regional cerebral blood flow. The recognized concept of neurovascular coupling (NVC), also named functional hyperemia, expresses this close relationship and stands at the basis of the modern functional brain imaging techniques. Different cellular and molecular mechanisms have been proposed to mediate this tight coupling. In this context, astrocytes are ideally positioned to act as relay elements that sense neuronal activity through their perisynaptic processes and release vasodilator agents at their endfeet in contact with brain parenchymal vessels. Two decades after the astrocyte involvement in neurovascular coupling has been proposed, we here review the experimental evidence that contributed to unraveling the molecular and cellular mechanisms underlying cerebral blood flow regulation. While traveling through the different controversies that moved the research in this field, we keep a peculiar focus on those exploring the role of astrocytes in neurovascular coupling and conclude with two sections related to methodological aspects in neurovascular research and to some pathological conditions resulting in altered neurovascular coupling.

Association between the results of neuropsychological testing and indicators of regional cerebral blood flow according to SPECT data of cardiac surgical patient

Highlights. The article provides new data on the association between changes in regional cerebral blood flow during SPECT and cognitive impairment in patients who underwent coronary artery bypass grafting and combined carotid endarterectomy and coronary artery bypass grafting with cardiopulmonary bypass. The possibilities of using SPECT as a diagnostic tool in localization of areas with a similar association, in assessing the dynamics in brain perfusion and cognitive functions in the pre- and postoperative period are shown.Aim. To determine the presence of an association between the indicators of regional cerebral blood flow according to single-photon emission computed tomography (SPECT) data and the data of neuropsychological testing in cardiac surgery patients.Methods. We studied the parameters of regional cerebral blood flow (rCBF) and the data of neuropsychological testing in 34 cardiac surgical patients who underwent coronary artery bypass grafting (CABG, n = 13) and combined carotid endarterectomy and CABG (n = 21). The state of the brain was assessed by SPECT using a radiopharmaceutical 99mTc-HMPAO (Ceretek). Assessment of cognitive functions before surgery, 2–3 days before, and in the early postoperative period, on days 5–7, was carried out using a hardware-software complex Status-PF.Results. A statistically significant relationship was found between the indices of rCBF according to neuropsychological testing data in the pre- and postoperative period. We noted a moderate correlation with the Beck Depression Scale indicators in the 1st (p = 0.010943) and 2nd (p = 0.000604) groups before surgery. There was a high correlation with visual-motor response time (VMR) before (p = 0.003878) and after the procedure (p = 0.001251), a moderate correlation with the number of errors (VMR) before the procedure (p = 0.042911) and a high correlation after the procedure (p = 0.003521) in the 1st group; in the 2nd group, there was a moderate correlation before (p = 0.004625) and after the procedure (p = 0 .005689). A moderate correlation with the indicators of attention after the procedure (p = 0.049611) was noted in the 1st group, in the 2nd group, we noted a moderate correlation before (p = 0.021969) and after the procedure (p = 0.008905). In the 2nd group there was a moderate correlation with the number of processed symbols (the Bourdon test) during the 1st minute before the procedure (p = 0.016491), a high correlation after the procedure (p = 0.007920), and a high correlation with the number of processed symbols during the 4th minute before the procedure (p = 0.001473). There was a moderate correlation with a total with number of processed symbols in the 2nd group before (p = 0.029073) and after the procedure (p = 0.024164), and a high correlation with the number of errors made after the procedure in the 1st (p = 0.006367) and 2nd (p = 0.013780) groups. A high correlation with indicators of attention after surgery (p = 0.000153) was noted as wellConclusion. The indicators of regional cerebral blood flow obtained by SPECT in patients undergoing isolated CABG and combined CAE and CABG were associated with the data of neuropsychological testing and reflect changes in the cognitive status of patients.

BIAN: A Multilayer Microfluidic-Based Tissue-Mimicking Phantom for Near-Infrared Imaging.

Near-infrared spectroscopy (NIRS) is a non-invasive optical method for monitoring cerebral oxygenation. Changes in regional blood flow and oxygenation due to neurovascular coupling are important biomarkers of neuronal activation. So far, there has been little research on multilayer tissue phantoms with tuneable blood flow, blood volume, and optical properties to simulate local changes in oxygenation at different depths. The aim of this study is to design, fabricate and characterize a complex dynamic phantom based on multilayer microfluidics with controllable blood flow, blood volume, and optical properties for testing NIRS instruments. We developed a phantom prototype with two microfluidic chips embedded at two depths inside a solid silicone phantom to mimic the vessels in the scalp and in the cortex. To simulate the oxygenation and perfusion of tissue, a solution with blood-like optical properties was sent into the microchannels by a pump with a programmable pressure controller. The pressure adjusted the volume of the microfluidic chips representing a distension of blood vessels. The optical changes in the superficial and deep layers were measured by a commercially available frequency domain NIRS instrument. The NIRS successfully detected the changes in light intensity elicited by the changes in the pressure input to the two layers. In conclusion, the microfluidics-based imaging phantom was successfully designed and fabricated and mimics brain functional activity. This technique has great potential for testing other optical devices, e.g., diffuse correlation spectroscopy, pulse oximetry, and optical coherence tomography.

Cerebral Metabolic Stress Improves after Voxelotor Treatment in Pediatric Sickle Cell Disease

Introduction In sickle cell disease (SCD), hemoglobin S rapidly forms intracellular polymers in the deoxygenated state, resulting in red blood cell sickling, hemolysis, and vaso-occlusion. These changes alter cerebral perfusion and dramatically increase risk for neurocognitive deficits and stroke (Bush et al., 2014; Wang et al., 2021). Voxelotor (Oxbryta®) is an inhibitor of HbS polymerization that has been shown to significantly improve anemia and reduce hemolysis in sickle cell disease. However, it is unknown whether these changes are accompanied by improvements in perfusion and reductions in cerebral metabolic stress. Here we employ two novel optical techniques known as frequency-domain near-infrared spectroscopy (FDNIRS) and diffuse correlation spectroscopy (DCS) to non-invasively monitor regional changes in oxygen extraction fraction (OEF), cerebral blood flow (CBF), and cerebral metabolic rate of oxygen (CMRO2) as markers of cerebral metabolic stress in a pilot cohort of children with SCD beginning voxelotor. Our primary objective was to test the hypothesis that voxelotor decreases CBF, OEF, and CMRO2 from pre-treatment levels. We also explored the relationship between CBF, OEF, and CMRO2 and hemoglobin. Methods Children ages 4 to 17 years old with SCD (HbSS or HbS-thalassemia) were enrolled at Children's Healthcare of Atlanta. Participants who met study criteria started open label voxelotor at recommended dose. Participants were monitored prior to treatment initiation, as well as at weeks 4, 8, and 12 weeks. At each study visit, laboratory measurements of anemia (CBC, Retic) and FDNIRS/DCS measurements of regional cerebral blood flow, oxygen extraction fraction, and oxygen metabolism were made (Lee et al., 2022). Transcranial Doppler ultrasound (TCD, middle cerebral artery, internal carotid artery, and carotid bifurcations) along with markers of hemolysis (LDH, T.Bili) were performed at weeks 0 and 12. Paired Wilcoxon signed-rank tests were used to test whether all measures were significantly different from pre-treatment levels. Linear mixed-effects regression models with random-intercept at the patient level were used to examine the association of the relative change in each outcome measure (OEF, CBF, and CMRO2) from pre-treatment levels and delta changes in laboratory data. These models were two-level and accounted for repeated measures nested within each patient. Results Ten of the 12 recruited patients met study criteria. All patients were HbSS on stable dose of hydroxyurea (Table 1). Following initiation of voxelotor, the median (interquartile range, IQR) blood hemoglobin levels increased by 1.2 (0.4, 1.5) g/dL at week 4 (p=0.023); these increases persisted at weeks 8 and 12. Bilirubin was significantly decreased at week 12 (p=0.008), and LDH increased, although the trend was not statistically significant (p=0.24). While TCD velocities were unchanged at week 12, significant decreases in OEF, CBF, and CMRO2 were observed by week 4 (all p < 0.05) that persisted at weeks 8 and 12 (Table 2). Across all time points, relative changes in OEF, CBF, and CMRO2 from pre-treatment levels were inversely associated with changes in hemoglobin (p = 0.0015, 0.071, and 0.020, respectively). Discussion Non-invasive FDNIRS/DCS was used to successfully measure changes in regional cerebral blood flow and oxygen utilization in response to treatment with voxelotor. Results suggest that voxelotor treatment in children with SCD reduces cerebral metabolic stress by improving oxygen delivery to the tissue. Work is ongoing to validate these measurements with MRI. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The effects of acute high-intensity aerobic exercise on cognitive performance: A structured narrative review.

It is well established that acute moderate-intensity exercise improves cognitive performance. However, the effects of acute high-intensity aerobic exercise on cognitive performance have not been well characterized. In this review, we summarize the literature investigating the exercise-cognition interaction, especially focusing on high-intensity aerobic exercise. We discuss methodological and physiological factors that potentially mediate cognitive performance in response to high-intensity exercise. We propose that the effects of high-intensity exercise on cognitive performance are primarily affected by the timing of cognitive task (during vs. after exercise, and the time delay after exercise). In particular, cognitive performance is more likely to be impaired during high-intensity exercise when both cognitive and physiological demands are high and completed simultaneously (i.e., the dual-task paradigm). The effects may also be affected by the type of cognitive task, physical fitness, exercise mode/duration, and age. Second, we suggest that interactions between changes in regional cerebral blood flow (CBF), cerebral oxygenation, cerebral metabolism, neuromodulation by neurotransmitters/neurotrophic factors, and a variety of psychological factors are promising candidates that determine cognitive performance in response to acute high-intensity exercise. The present review has implications for recreational, sporting, and occupational activities where high cognitive and physiological demands are required to be completed concurrently.

Multimodal MRI of myalgic encephalomyelitis/chronic fatigue syndrome: A cross-sectional neuroimaging study toward its neuropathophysiology and diagnosis.

IntroductionMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), is a debilitating illness affecting up to 24 million people worldwide but concerningly there is no known mechanism for ME/CFS and no objective test for diagnosis. A series of our neuroimaging findings in ME/CFS, including functional MRI (fMRI) signal characteristics and structural changes in brain regions particularly sensitive to hypoxia, has informed the hypothesis that abnormal neurovascular coupling (NVC) may be the neurobiological origin of ME/CFS. NVC is a critical process for normal brain function, in which glutamate from an active neuron stimulates Ca2+ influx in adjacent neurons and astrocytes. In turn, increased Ca2+ concentrations in both astrocytes and neurons trigger the synthesis of vascular dilator factors to increase local blood flow assuring activated neurons are supplied with their energy needs.This study investigates NVC using multimodal MRIs: (1) hemodynamic response function (HRF) that represents regional brain blood flow changes in response to neural activities and will be modeled from a cognitive task fMRI; (2) respiration response function (RRF) represents autoregulation of regional blood flow due to carbon dioxide and will be modeled from breath-holding fMRI; (3) neural activity associated glutamate changes will be modeled from a cognitive task functional magnetic resonance spectroscopy. We also aim to develop a neuromarker for ME/CFS diagnosis by integrating the multimodal MRIs with a deep machine learning framework.Methods and analysisThis cross-sectional study will recruit 288 participants (91 ME/CFS, 61 individuals with chronic fatigue, 91 healthy controls with sedentary lifestyles, 45 fibromyalgia). The ME/CFS will be diagnosed by consensus diagnosis made by two clinicians using the Canadian Consensus Criteria 2003. Symptoms, vital signs, and activity measures will be collected alongside multimodal MRI.The HRF, RRF, and glutamate changes will be compared among four groups using one-way analysis of covariance (ANCOVA). Equivalent non-parametric methods will be used for measures that do not exhibit a normal distribution. The activity measure, body mass index, sex, age, depression, and anxiety will be included as covariates for all statistical analyses with the false discovery rate used to correct for multiple comparisons.The data will be randomly divided into a training (N = 188) and a validation (N = 100) group. Each MRI measure will be entered as input for a least absolute shrinkage and selection operator—regularized principal components regression to generate a brain pattern of distributed clusters that predict disease severity. The identified brain pattern will be integrated using multimodal deep Boltzmann machines as a neuromarker for predicting ME/CFS fatigue conditions. The receiver operating characteristic curve of the identified neuromarker will be determined using data from the validation group.Ethics and study registryThis study was reviewed and approved by University of the Sunshine Coast University Ethics committee (A191288) and has been registered with The Australian New Zealand Clinical Trials Registry (ACTRN12622001095752).Dissemination of resultsThe results will be disseminated through peer reviewed scientific manuscripts and conferences and to patients through social media and active engagement with ME/CFS associations.

Neurotransmitter receptor densities are associated with changes in regional Cerebral blood flow during clinical ongoing pain.

Arterial spin labelling (ASL) plays an increasingly important role in neuroimaging pain research but does not provide molecular insights regarding how regional cerebral blood flow (rCBF) relates to underlying neurotransmission. Here, we integrate ASL with positron emission tomography (PET) and brain transcriptome data to investigate the molecular substrates of rCBF underlying clinically relevant pain states. Two data sets, representing acute and chronic ongoing pain respectively, were utilised to quantify changes in rCBF; one examining pre-surgical versus post-surgical pain, and the second comparing patients with painful hand Osteoarthritis to a group of matched controls. We implemented a whole-brain spatial correlation analysis to explore associations between change in rCBF (ΔCBF) and neurotransmitter receptor distributions derived from normative PET templates. Additionally, we utilised transcriptomic data from the Allen Brain Atlas to inform distributions of receptor expression. Both datasets presented significant correlations of ΔCBF with the μ-opioid and dopamine-D2 receptor expressions, which play fundamental roles in brain activity associated with pain experiences. ΔCBF also correlated with the gene expression distributions of several receptors involved in pain processing. Overall, this is the first study illustrating the molecular basis of ongoing pain ASL indices and emphasises the potential of rCBF as a biomarker in pain research.

Effects of a multicomponent day-care program on cerebral blood flow in patients with mild cognitive impairment.

Mild cognitive impairment (MCI) is a prodromal phase of dementia and is considered an important period for intervention to prevent conversion to dementia. It has been well established that multicomponent day-care programs including exercise training, cognitive intervention and music therapy have beneficial effects on cognition, but the effects on cerebral blood flow (CBF) in MCI remain unknown. This study examined whether a multicomponent day-care program would have beneficial effects on the longitudinal changes of CBF in MCI patients. Participants were 24 patients with MCI attending a day-care program; they underwent two 99 mTc-ethyl cysteinate dimer single photon emission computed tomography scans during the study period. We evaluated the association between the changes of regional cerebral blood flow and the attendance rate. There was a significant negative correlation between the reduction of regional CBF in the right parietal region and the attendance rate. We found no significant relation between the baseline CBF images and the attendance rate. Our results suggest that continuous participation in a multicomponent day-care program might prevent reduction in brain activity in patients with MCI.

"Less is more": A dose-response account of intranasal oxytocin pharmacodynamics in the human brain.

Intranasal oxytocin is attracting attention as a potential treatment for several brain disorders due to promising preclinical results. However, translating findings to humans has been hampered by remaining uncertainties about its pharmacodynamics and the methods used to probe its effects in the human brain. Using a dose-response design (9, 18 and 36 IU), we demonstrate that intranasal oxytocin-induced changes in local regional cerebral blood flow (rCBF) in the amygdala at rest, and in the covariance between rCBF in the amygdala and other key hubs of the brain oxytocin system, follow a dose-response curve with maximal effects for lower doses. Yet, the effects on local rCBF might vary by amygdala subdivision, highlighting the need to qualify dose-response curves within subregion. We further link physiological changes with the density of the oxytocin receptor gene mRNA across brain regions, strengthening our confidence in intranasal oxytocin as a valid approach to engage central targets. Finally, we demonstrate that intranasal oxytocin does not disrupt cerebrovascular reactivity, which corroborates the validity of haemodynamic neuroimaging to probe the effects of intranasal oxytocin in the human brain. DATA AVAILABILITY: Participants did not consent for open sharing of the data. Therefore, data can only be accessed from the corresponding author upon reasonable request.

Differential Brain Perfusion Changes Following Two Mind\u2013Body Interventions for Fibromyalgia Patients: an Arterial Spin Labelling fMRI Study

ObjectivesFurther mechanistic insight on mind–body techniques for fibromyalgia (FMS) is needed. Arterial spin labelling (ASL) imaging can capture changes in regional cerebral blood flow (rCBF) that relate to spontaneous pain.MethodsWe recruited FMS patients undergoing either mindfulness-based stress reduction training (MBSR, n = 14) or a psychoeducational programme (FibroQoL, n = 18), and a control FMS group with no add-on treatment (n = 14). We acquired whole-brain rCBF maps and self-report measures at baseline and following treatment and explored interaction effects in brain perfusion between the treatment group and session with a focus on the amygdala, the insula and the anterior cingulate cortex (ACC).ResultsWe identified a significant interaction effect in the amygdala, which corresponded with rCBF decreases following FibroQoL specifically. At baseline, rCBF in the amygdala for the FibroQoL group correlated with pain catastrophizing and anxiety scores, but not after treatment, suggesting a decoupling between activity in the amygdala and negative emotional symptoms of FMS as a consequence of treatment. Baseline rCBF correlated positively with pain symptoms in the ACC and the anterior insula across all patients; moreover, the correlation between rCBF changes post intervention in the insula and pain improvement was negative for both treatments and significantly different from the control group. We suggest that there is disruption of the typical relationship between clinical pain and activity as a product of these two nonpharmacological therapies.ConclusionsWe have demonstrated that different mind-to-body treatments correspond to differential changes in clinical symptoms and brain activity patterns, which encourages future research investigating predictors of treatment response.Trial Registration NCT02561416.

Editorial: Neuroimaging: How Can Clues from the Brain Help Pain Management?

Editorial: Neuroimaging: How Can Clues from the Brain Help Pain Management?

Cerebral hemodynamics and executive functioning in patients with alcohol use disorders

To study the cerebral hemodynamics and executive functioning in patients with alcohol use disorders. We studied 58 patients with alcohol use disorders aged 30 to 55 years and 40 healthy controls. Rheoencephalography was used to detect cerebrovascular changes. Executive functioning was assessed using the Go-No-Go, Corsi, and Color Stroop tests. Patients with alcohol use disorders have higher values of the tone of resistive vessels and medium - caliber arteries, as well as lower indicators of volumetric pulse blood filling and elastic properties of the main arteries in both right and left leads compared with the controls (p≤0.003). Patients with alcohol dependence had lower rates in all studied cognitive tests compared to the norm (p≤0.011). We also found statistically significant correlations between the studied parameters in patients with alcohol use disorders: a decrease in volumetric pulse blood filling correlated with impaired psychomotor response in the Go-No-Go task (errors on the Go signal) (rs=-0.36; p=0.048), as well as cognitive flexibility in the Stroop test (rs=-0.40; p=0.024). Disturbances of the psychomotor reaction and cognitive flexibility in alcohol dependence are due to the regional changes (decrease) in cerebral blood flow, as well as to a decrease in the elasticity of the wall of cerebral vessels.