Cortical Matter Research Articles

Comparative analysis of micrometric parameters in the ovaries of adolescent, elderly and senile women

Aging is a systemic process affecting all tissues of the body. In this study, the choice of scientific interest fell on the paired gland, the key structure of the female reproductive system – the ovary.Objective: to carry out a comparative analysis of the parameters of the thickness of the cerebral and cortical layers, as well as the protein membrane of the ovaries in women in adolescence, the elderly and senile age. Materials and methods. The analysis of the results of a study of 60 women with normal pelvic dimensions and without pathology of the reproductive system organs was carried out. Group I included 28 victims of adolescent age (16-20 years old), group II consisted of 29 elderly victims (56-74 years old), group III included 27 elderly victims (75-90 years old). The thickness of the cerebral and cortical layers, as well as the albumen of both ovaries, were determined in histological samples.Results. A decrease in the thickness of the cortical and medulla and an increase in the thickness parameters of the albuminous membrane of both ovaries in the period from adolescence to old age were revealed. The thickness of the medulla of the right ovary is thinned by 3.76%, the left by 4.46%; the cortical substance of the right ovary by 29.9%, the left by 29.64% (p < 0,01). The thickness of the albumen of the right ovary, on the contrary, increases by 48.23%, of the left – by 50.21% (p < 0,01). From old age to senile age, there is a tendency to decrease the thickness of the cerebral and cortical matter of the ovary. The medulla is thinned by 0.95% on the right and 0.24% on the left (p > 0,05), the cortical substance – by 1.5% on the right and 1.21% on the left (p > 0,05). At the same time, the protein shell on the right becomes thicker by 14.08%, on the left – by 13.57% (p < 0,01). Conclusion. The results obtained can become a conditional "morphological standard" for certain age norms in the diagnosis of various diseases, as well as expand the understanding of changes in the morphological picture of a woman's ovaries with age.

Microsurgical anatomy and the inner architecture of the retrocommissural portion of the hippocampal formation demonstrated through fiber microdissection.

An understanding of the complex nomenclature and 3D spatial relations between the cortical and white matter components of the retrocommissural portion of the hippocampal formation is essential for a successful outcome when performing surgery in the mediobasal temporal region. The goal of this study was to clarify the nomenclature related to the retrocommissural portion of the hippocampal formation and to provide a detailed description of its topography and inner structure from a relevant surgical perspective. This description can serve as an anatomical reference for approaching lesions in the mediobasal temporal region. Fiber microdissection was performed from the superolateral and inferior aspects on 20 previously frozen, formalin-fixed human brains. Three formalin-fixed plastinated brain specimens were then sectioned in the coronal, axial, and sagittal planes, and the relevant sections were studied. Based on its relationship with the corpus callosum, the hippocampal formation is subdivided into precommissural, supracommissural, and retrocommissural sections. The retrocommissural portion of the hippocampal formation, a structure in the mediobasal temporal region, is a component of both the floor of the temporal horn and the medial surface of the cerebral hemisphere. It includes the hippocampus (Ammon's horn and the dentate gyrus), subiculum, and related white matter fibers. Step-by-step microdissection revealed the complex ventricular and cisternal relationships of the retrocommissural portion of the hippocampal formation in the mediobasal temporal region. This further allowed clear distinction of each component of this formation in order to understand their complex reciprocal relationships that comprise a unique internal architecture and external morphology. The fiber microdissection technique provides a valuable perspective for understanding the complex structure and relations of the components of the retrocommissural portion of the hippocampal formation. This study clarifies and supplements the information presently available in the literature by offering an anatomical reference essential for differentiating the topographic diagnosis and safer surgical planning for any lesion within this formation or the mediobasal temporal region.

Embryonic origins of forebrain oligodendrocytes revisited by combinatorial genetic fate mapping.

Multiple embryonic origins give rise to forebrain oligodendrocytes (OLs), yet controversies and uncertainty exist regarding their differential contributions. We established intersectional and subtractional strategies to genetically fate map OLs produced by medial ganglionic eminence/preoptic area (MGE/POA), lateral/caudal ganglionic eminences (LGE/CGE), and dorsal pallium in the mouse brain. We found that, contrary to the canonical view, LGE/CGE-derived OLs make minimum contributions to the neocortex and corpus callosum, but dominate piriform cortex and anterior commissure. Additionally, MGE/POA-derived OLs, instead of being entirely eliminated, make small but sustained contribution to cortex with a distribution pattern distinctive from those derived from the dorsal origin. Our study provides a revised and more comprehensive view of cortical and white matter OL origins, and established valuable new tools and strategies for future OL studies.

Clinical, Cortical, Subcortical, and White Matter Features of Right Temporal Variant FTD.

Eight patients with right temporal variant FTD were prospectively recruited and underwent a standardised neuropsychological assessment, clinical MRI, and quantitative neuroimaging. Our voxelwise grey analyses captured bilateral anterior and mesial temporal grey matter atrophy with a clear right-sided predominance. Bilateral hippocampal involvement was also observed, as well as disease burden in the right insular and opercula regions. White matter integrity alterations were also bilateral in anterior temporal and sub-insular regions with a clear right-hemispheric predominance. Extra-temporal white matter alterations have also been observed in orbitofrontal and parietal regions. Significant bilateral but right-predominant thalamus, putamen, hippocampus, and amygdala atrophy was identified based on subcortical segmentation. The clinical profile of our patients was dominated by progressive indifference, decline in motivation, loss of interest in previously cherished activities, incremental social withdrawal, difficulty recognising people, progressive language deficits, increasingly rigid routines, and repetitive behaviours. Right temporal variant FTD has an insidious onset and may be mistaken for depression at symptom onset. It manifests in a combination of apathy, language, and behavioural features. Quantitative MR imaging captures a characteristic bilateral but right-predominant temporal imaging signature with extra-temporal frontal and parietal involvement.

Safety and efficacy of phacoemulsification and intraocular lens implantation through a small pupil using iris retractors

Objectives: The objectives of this study were to study the postoperative (postop) outcome of phacoemulsification using iris retractors in patients with small pupils and compare it with well dilating pupils by comparing the final visual acuity, intra- and post-operative complications, endothelial cell count, and anterior chamber (AC) depth of patients with small pupil with those of well-dilated pupil. Materials and Methods: This was a prospective cross-sectional study for December 2020–March 2022 which included 86 eyes of 86 patients. For study purposes eyes were divided into two groups, Group 1 consisted of 43 subjects with post-mydriatic dilatation (≤5 mm), and Group 2 consisted of 43 cases with well-dilated pupils ≥6 mm. Results: Group 1 intraoperatively difficulties faced – incomplete rhexis or runoff (41.86%, n = 43), incomplete nucleus chopping (32.55%, n = 43) and retained cortical matter (46.51%, n = 43) noted, managed by applying iris retractors while group 2 faced no difficulties during surgery. In group 1, 33 patients (76.74%) had no complications. Retained cortex was seen in 5 patients (11.62%) and was the most common complication. In group 2, 41 patients (95.34%) had uneventful cataract surgery while 2 patients (4.64%) had minimally retained cortex on post op day 1. Best-corrected visual acuity (BCVA) – 3 months follow-up was good (Snellen-6/6–6/18, logMar 0.00–0.48) in 90.7% in group 1 and 97.7% in group 2. BCVA was borderline (Snellen 6/24–6/60, logMar 0.60–1.00) in 9.30% in group 1 and 2.32% in group 2. Group 1 mean pre-operative endothelial cell density (2528.44 ± 61.26) in group 2 (2457.05 ± 91.17) was significant. On postop day 1 ,1 week and at 3 months endothelial cell density decreased by 4.27%,7.75%,11.92% respectively compared to preoperative values in group 1 while in group 2 it decreased by 2.20%,3.84%,5.40% respectively compared to preoperative values. AC depth was shallower (2.49 ± 0.39) in patients in which complication was noted compared to AC depth (2.72 ± 0.41) in which there was no complication, P value being 0.010 is significant. Conclusion: Small pupil poses some difficulty in cataract surgery which can be overcome by timely intervention by expert surgeons and complication rates can be minimised.

Timing and cortical region matter: theta power differences between teenagers affected by Major Depression and healthy controls

In adults affected by Major Depressive Disorder (MDD), most findings point to higher electroencephalographic (EEG) theta power during wake compared to healthy controls (HC) as a potential biomarker aiding the diagnostic process or subgrouping for stratified treatment. Besides these group differences, theta power is modulated by time of day, sleep/wake history, and age. Thus, we aimed at assessing if the time of recording alters theta power in teenagers affected by MDD or HC. Standardized wake EEG power was assessed with high-density EEG in 15 children and adolescents with MDD and in 15 age- and sex-matched HC in the evening and morning. Using a two-way ANOVA, group, time, and their interaction were tested. In patients, the current severity of depression was rated using the Children’s Depression Rating Scale. Broadband EEG power was lower in the morning after sleep, with a significant interaction (group x time) in central regions in the 4-6 Hz range. In MDD relative to HC, theta power was decreased over occipital areas in the evening and increased over frontal areas in the morning. A higher frontal theta power was correlated with more severe depressive mood in the morning but not in the evening. This was a cross-sectional study design, including patients on antidepressant medication. In conclusion, depending on time of recording, region-specific opposite differences of theta power were found between teenagers with MDD and HC. These findings stress the importance of the time of the recording when investigating theta power’s relationship to psychopathology.

Limbic Network and Papez Circuit Involvement in ALS: Imaging and Clinical Profiles in GGGGCC Hexanucleotide Carriers in C9orf72 and C9orf72-Negative Patients.

Background: While frontotemporal involvement is increasingly recognized in Amyotrophic lateral sclerosis (ALS), the degeneration of limbic networks remains poorly characterized, despite growing evidence of amnestic deficits, impaired emotional processing and deficits in social cognition. Methods: A prospective neuroimaging study was conducted with 204 individuals with ALS and 111 healthy controls. Patients were stratified for hexanucleotide expansion status in C9orf72. A deep-learning-based segmentation approach was implemented to segment the nucleus accumbens, hypothalamus, fornix, mammillary body, basal forebrain and septal nuclei. The cortical, subcortical and white matter components of the Papez circuit were also systematically evaluated. Results: Hexanucleotide repeat expansion carriers exhibited bilateral amygdala, hypothalamus and nucleus accumbens atrophy, and C9orf72 negative patients showed bilateral basal forebrain volume reductions compared to controls. Both patient groups showed left rostral anterior cingulate atrophy, left entorhinal cortex thinning and cingulum and fornix alterations, irrespective of the genotype. Fornix, cingulum, posterior cingulate, nucleus accumbens, amygdala and hypothalamus degeneration was more marked in C9orf72-positive ALS patients. Conclusions: Our results highlighted that mesial temporal and parasagittal subcortical degeneration is not unique to C9orf72 carriers. Our radiological findings were consistent with neuropsychological observations and highlighted the importance of comprehensive neuropsychological testing in ALS, irrespective of the underlying genotype.

EVALUATION OF DEMOGRAPHIC PROFILE AND VISUAL OUTCOMES OF CATARACT PATIENTS OPERATED IN A CHARITABLE CAMP HOSPITAL IN CENTRAL INDIA

Aim: To Study the Demographic Profile and visual Outcomes of Cataract Patients Operated in a Charitable Camp in Central India Introduction Cataract is a leading cause of preventable blindness globally. Developing countries account for three quarters of cataract blindness worldwide. Despite the large number of corrective surgeries being performed globally cataract blindness is believed to be increasing by1–2 million/year. The present study was conducted in the patients residing in a peripheral rural area of Indore division (central India) to study the demographic and clinical profile of patients with cataract. This study supplements to understand the outcomes of such patients who were operated in camp at a tertiary care center. Study Design: It is a prospective descriptive study conducted on camp patients at a charitable tertiary eye care hospital (Central India) from December 2019 to February 2020.Wirtten informed consent was taken from patients for participation in this study. Setting: Department of Ophthalmology Choithram Netralaya, Indore from December 2019 to February 2020. Material and Methods: During the study period 139 surgeries were performed by the surgeon. All patients above 40 years of age having senile cataract with stable systemic condition were included. Patients with age less than 40 years of age, uncontrolled systemic condition, Patients with other ocular comorbidities, undergone previously any ocular surgery in the selected eye or not giving written informed consent were excluded.All the patients were screened for cataracts in the camps in the periphery by the trained optometrist and referred to the base hospital. Detailed pre-operative ocular examination of all the patients was performed and medical checkup with routine pre-operative profile was also done. Patients medically fit for cataract surgery underwent small incision cataract surgery with Posterior capsular IOL implantation (PCIOL) under local anesthesia. All the cataract surgeries were performed by a single surgeon using the same technique to avoid any bias. Results: It was observed that the mean age of presentation was 61.5 years with female preponderance of nearly (56.8%) . out of 139 patients 63 patients (45.3,%) had systemic comorbidities, which included ,33 patients (23.74%) with hypertension and 28 patients(20.14%) with Diabetes mellitus. Majority of patients i.e.101 (72.66%) patients had onset of ocular symptoms between 3 to 6 months . In this study bilateral immature nuclear cataract was commonly encountered cataract in 88.48% of patients and only 8 patients had mature cataract and 7 patients presented with hyper mature cataract respectively .On post-operative day one, 19 patients and 8 patients had blood clot in anterior hamber,5 patients had cortical matter in Anterior chamber On follow up at one week, majority of patients i.e 110 (79.13%) had visual acuity between 6/9-6/12.Patients after re-surgery had visual acuity of minimum up to 6/24 with possibility of getting better on further visits. Conclusion: In our study, increasing age and female gender were commonly associated with cataract. Most of the patients had bilateral cataract and low vision at presentation. Hypertension and type 2 diabetes mellitus were commonly associated systemic disorders with cataract.This study highlights that high quality cataract surgery with a low intra-operative complication rate and good visual outcome can be attained even in camp patients operated in the base hospitals with standard protocols.

Brain and cervical spinal cord MRI correlates of sensorimotor impairment in patients with multiple sclerosis.

Cervical spinal cord (cSC) lesions and atrophy contribute to disability in multiple sclerosis (MS), but associations with specific sensorimotor dysfunction require further exploration. To investigate the associations of brain and cSC magnetic resonance imaging (MRI) measures with sensorimotor impairment in MS. One hundred fifty-one MS patients and 69 healthy controls underwent 3T MRI and clinical assessments including Expanded Disability Status Scale (EDSS), 9-hole peg test (9-HPT), finger tapping test (FTT), timed 25-foot walk test (T25FWT), and vibration detection threshold (VDT). Random forest ranked brain (T2-hyperintense lesion volume (T2-LV) and normalized deep gray matter (GM), cortical and white matter (WM) volumes) and cSC (T2-LV and total, GM, and WM cross-sectional areas (CSAs) at C2/C3 level) MRI measures relevance in explaining EDSS milestones (EDSS ⩾3.0, ⩾4.0, and ⩾6.0), VDT, pyramidal and sensory functional systems (P-FS and S-FS ⩾2), and motor tests impairment. Various combinations of brain and cSC MRI measures explained EDSS milestones (area under the curve (AUC) =0.879-0.900), VDT (R2 = 0.194), and impaired P-FS (AUC = 0.820), S-FS (AUC = 0.795), 9-HPT (AUC = 0.793), FTT (AUC = 0.740), and T25FWT (AUC = 0.825). cSC GM CSA was the most informative feature for all outcomes, except 9-HPT. cSC MRI measures, especially GM CSA, explain EDSS and sensorimotor dysfunction better than brain measures in MS.

Midperipheral mini-capsulorhexis as an additional step for safe phacoemulsification in white intumescent cataracts.

The present article describes a novel surgical technique of a primary mini-capsulorhexis in midperiphery to minimize surgical complications in white intumescent cataracts. Patients with white mature cataracts with a convex anterior capsule or swollen lens fibers were selected. An initial puncture was made 3-4 mm away from the center, in the midperipheral anterior capsule, with a conventional cystitome. A mini-capsulorhexis (2-2.5 mm) was created. Loose cortical matter and fluidic contents were aspirated to reduce the intralenticular pressure. Two cuts were made at the margin of the mini-capsulorhexis, and an adequately sized secondary rhexis was completed, after which phacoemulsification was done. A circular curvilinear capsulorhexis was successfully achieved in all cases, including those with a small pupil. Rhexis could be completed in a patient where an initial extension occurred due to head movement. This refined technique aims to enhance the safety and precision of capsulorhexis in intumescent cataracts, thereby reducing the risk of complications such as the Argentinian flag sign. Further exploration and validation of this approach through clinical trials are warranted to establish its efficacy and safety profile.

Cortical Lesions as an Early Hallmark of Multiple Sclerosis: Visualization by 7 T MRI.

Compelling evidence indicates a significant involvement of cortical lesions in the progressive phase of multiple sclerosis (MS), significantly contributing to late-stage disability. Despite the promise of ultra-high-field magnetic resonance imaging (MRI) in detecting cortical lesions, current evidence falls short in providing insights into the existence of such lesions during the early stages of MS or their underlying cause. This study delineated, at the early stage of MS, (1) the prevalence and spatial distribution of cortical lesions identified by 7 T MRI, (2) their relationship with white matter lesions, and (3) their clinical implications. Twenty individuals with early-stage relapsing-remitting MS (disease duration <1 year) underwent a 7 T MRI session involving T1-weighted MP2RAGE, T2*-weighted multiGRE, and T2-weighted FLAIR sequences for cortical and white matter segmentation. Disability assessments included the Expanded Disability Status Scale, the Multiple Sclerosis Functional Composite, and an extensive evaluation of cognitive function. Cortical lesions were detected in 15 of 20 patients (75%). MP2RAGE revealed a total of 190 intracortical lesions (median, 4 lesions/case [range, 0-44]) and 216 leukocortical lesions (median, 2 lesions/case [range, 0-75]). Although the number of white matter lesions correlated with the total number of leukocortical lesions (r = 0.91, P < 0.001), no correlation was observed between the number of white matter or leukocortical lesions and the number of intracortical lesions. Furthermore, the number of leukocortical lesions but not intracortical or white-matter lesions was significantly correlated with cognitive impairment (r = 0.63, P = 0.04, corrected for multiple comparisons). This study highlights the notable prevalence of cortical lesions at the early stage of MS identified by 7 T MRI. There may be a potential divergence in the underlying pathophysiological mechanisms driving distinct lesion types, notably between intracortical lesions and white matter/leukocortical lesions. Moreover, during the early disease phase, leukocortical lesions more effectively accounted for cognitive deficits.

Dual Inversion Recovery Magnetic Resonance Imaging's Diagnostic Value for Estimating the Overall Load of Multiple Sclerosis Lesions and its Anatomical Distribution

B Background: In young adults, multiple sclerosis is a prevalent chronic inflammatory demyelinating condition. It is characterized by white matter affection, but many individuals also have significant gray matter involvement. A double inversion recovery pulse pattern was recently proposed to improve the detectability of multiple sclerosis lesions. Objectives: To evaluate the diagnostic value of double inversion recovery sequence in the detection of cortical and white matter multiple sclerosis plaques in different brain anatomical locations. Subjects and methods: A total of 37 patients with an established diagnosis of multiple sclerosis were included in this cross-sectional study. Brain MRI was done using double inversion recovery, T2 and FLAIR sequences. The number of lesions was counted and compared in the three sequences. Results: Dual Inversion Recovery sequence was highly significant and superior to both T2 and FLAIR sequences (P &lt; 0.001) in depicting the lesions regardless of anatomical distribution. Dual Inversion Recovery was significantly superior to T2 (P =&lt;0.001) and FLAIR (P =&lt;0.001) in detecting lesions in cortical and juxtacortical. However, Dual Inversion Recovery shows less periventricular and deep white matter lesions in comparison to T2 and FLAIR sequences. Conclusion: The Dual Inversion Recovery sequence detected more multiple sclerosis lesions in cortical, subcortical and infratentorial than the traditional T2W and FLAIR sequences. It also demonstrated greater delineation between the white matter, grey matter, and multiple sclerosis lesions, which became more easily visualized.

Cortical and white matter substrates supporting visuospatial working memory

ObjectiveIn tasks involving new visuospatial information, we rely on working memory, supported by a distributed brain network. We investigated the dynamic interplay between brain regions, including cortical and white matter structures, to understand how neural interactions change with different memory loads and trials, and their subsequent impact on working memory performance. MethodsPatients undertook a task of immediate spatial recall during intracranial EEG monitoring. We charted the dynamics of cortical high-gamma activity and associated functional connectivity modulations in white matter tracts. ResultsElevated memory loads were linked to enhanced functional connectivity via occipital longitudinal tracts, yet decreased through arcuate, uncinate, and superior-longitudinal fasciculi. As task familiarity grew, there was increased high-gamma activity in the posterior inferior-frontal gyrus (pIFG) and diminished functional connectivity across a network encompassing frontal, parietal, and temporal lobes. Early pIFG high-gamma activity was predictive of successful recall. Including this metric in a logistic regression model yielded an accuracy of 0.76. ConclusionsOptimizing visuospatial working memory through practice is tied to early pIFG activation and decreased dependence on irrelevant neural pathways. SignificanceThis study expands our knowledge of human adaptation for visuospatial working memory, showing the spatiotemporal dynamics of cortical network modulations through white matter tracts.

Associations between low-moderate prenatal alcohol exposure and brain development in childhood

BackgroundThe effects of low-moderate prenatal alcohol exposure (PAE) on brain development have been infrequently studied. AimTo compare cortical and white matter structure between children aged 6 to 8 years with low-moderate PAE in trimester 1 only, low-moderate PAE throughout gestation, or no PAE. MethodsWomen reported quantity and frequency of alcohol consumption before and during pregnancy. Magnetic resonance imaging was undertaken for 143 children aged 6 to 8 years with PAE during trimester 1 only (n = 44), PAE throughout gestation (n = 58), and no PAE (n = 41). T1-weighted images were processed using FreeSurfer, obtaining brain volume, area, and thickness of 34 cortical regions per hemisphere. Fibre density (FD), fibre cross-section (FC) and fibre density and cross-section (FDC) metrics were computed for diffusion images. Brain measures were compared between PAE groups adjusted for age and sex, then additionally for intracranial volume. ResultsAfter adjustments, the right caudal anterior cingulate cortex volume (pFDR = 0.045) and area (pFDR = 0.008), and right cingulum tract cross-sectional area (pFWE < 0.05) were smaller in children exposed to alcohol throughout gestation compared with no PAE. ConclusionThis study reports a relationship between low-moderate PAE throughout gestation and cingulate cortex and cingulum tract alterations, suggesting a teratogenic vulnerability. Further investigation is warranted.

Creation of a microsurgical neuroanatomy laboratory and virtual operating room: a preliminary study.

A comprehensive understanding of microsurgical neuroanatomy, familiarity with the operating room environment, patient positioning in relation to the surgery, and knowledge of surgical approaches is crucial in neurosurgical education. However, challenges such as limited patient exposure, heightened patient safety concerns, a decreased availability of surgical cases during training, and difficulties in accessing cadavers and laboratories have adversely impacted this education. Three-dimensional (3D) models and augmented reality (AR) applications can be utilized to depict the cortical and white matter anatomy of the brain, create virtual models of patient surgical positions, and simulate the operating room and neuroanatomy laboratory environment. Herein, the authors, who used a single application, aimed to demonstrate the creation of 3D models of anatomical cadaver dissections, surgical approaches, patient surgical positions, and operating room and laboratory designs as alternative educational materials for neurosurgical training. A 3D modeling application (Scaniverse) was employed to generate 3D models of cadaveric brain specimens and surgical approaches using photogrammetry. It was also used to create virtual representations of the operating room and laboratory environment, as well as the surgical positions of patients, by utilizing light detection and ranging (LiDAR) sensor technology for accurate spatial mapping. These virtual models were then presented in AR for educational purposes. Virtual representations in three dimensions were created to depict cadaver specimens, surgical approaches, patient surgical positions, and the operating room and laboratory environment. These models offer the flexibility of rotation and movement in various planes for improved visualization and understanding. The operating room and laboratory environment were rendered in three dimensions to create a simulation that could be navigated using AR and mixed reality technology. Realistic cadaveric models with intricate details were showcased on internet-based platforms and AR platforms for enhanced visualization and learning. The utilization of this cost-effective, straightforward, and readily available approach to generate 3D models has the potential to enhance neuroanatomical and neurosurgical education. These digital models can be easily stored and shared via the internet, making them accessible to neurosurgeons worldwide for educational purposes.

Cortical gray-white matter contrast abnormalities in male children with attention deficit hyperactivity disorder.

Presently, research concerning alterations in brain structure among individuals with attention deficit hyperactivity disorder (ADHD) predominantly focuses on entire brain volume and cortical thickness. In this study, we extend our examination to the cortical microstructure of male children with ADHD. To achieve this, we employ the gray-white matter tissue contrast (GWC) metric, allowing for an assessment of modifications in gray matter density and white matter microstructure. Furthermore, we explore the potential connection between GWC and the severity of disorder in male children by ADHD. We acquired 3DT1 sequences from the public ADHD-200 database. In this study, we conducted a comparative analysis between 43 male children diagnosed with ADHD and 50 age-matched male controls exhibiting typical development trajectories. Our investigation entailed assessing differences in GWC and cortical thickness. Additionally, we explored the potential correlation between GWC and the severity of ADHD. To delineate the cerebral landscape, each hemisphere was subdivided into 34 cortical regions using freesurfer 7.2.0. For quantification, GWC was computed by evaluating the intensity contrast of non-normalized T1 images above and below the gray-white matter interface. Our findings unveiled elevated GWC within the bilateral lingual, bilateral insular, left transverse temporal, right parahippocampal and right pericalcarine regions in male children with ADHD when contrasted with their healthy counterparts. Moreover, the cortical thickness in the ADHD group no notable distinctions that of control group in all areas. Intriguingly, the GWC of left transverse temporal demonstrated a negative correlation with the extent of inattention experienced by male children with ADHD. Utilizing GWC as a metric facilitates a more comprehensive assessment of microstructural brain changes in children with ADHD. The fluctuations in GWC observed in specific brain regions might serve as a neural biomarker, illuminating structural modifications in male children grappling with ADHD. This perspective enriches our comprehension of white matter microstructure and cortical density in these children. Notably, the inverse correlation between the GWC of the left transverse temporal and inattention severity underscores the potential role of structural and functional anomalies within this region in ADHD progression. Enhancing our insight into ADHD-related brain changes holds significant promise in deciphering potential neuropathological mechanisms.

Peripheral immunity and risk of incident brain disorders: a prospective cohort study of 161,968 participants

Whether peripheral immunity prospectively influences brain health remains controversial. This study aims to investigate the longitudinal associations between peripheral immunity markers with incident brain disorders. A total of 161,968 eligible participants from the UK Biobank were included. We investigated the linear and non-linear effects of peripheral immunity markers including differential leukocytes counts, their derived ratios and C-reactive protein (CRP) on the risk of dementia, Parkinson’s disease (PD), stroke, schizophrenia, bipolar affective disorder (BPAD), major depressive disorder (MDD) and anxiety, using Cox proportional hazard models and restricted cubic spline models. Linear regression models were used to explore potential mechanisms driven by brain structures. During a median follow-up of 9.66 years, 16,241 participants developed brain disorders. Individuals with elevated innate immunity markers including neutrophils, monocytes, platelets, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) had an increased risk of brain disorders. Among these markers, neutrophils exhibited the most significant correlation with risk of dementia (hazard ratio 1.08, 95% confidence interval 1.04–1.12), stroke (HR 1.06, 95% CI 1.03–1.09), MDD (HR 1.13, 95% CI 1.10–1.16) and anxiety (HR 1.07, 95% CI 1.04–1.10). Subgroup analysis revealed age-specific and sex-specific associations between innate immunity markers with risk of dementia and MDD. Neuroimaging analysis highlighted the associations between peripheral immunity markers and alterations in multiple cortical, subcortical regions and white matter tracts, typically implicated in dementia and psychiatric disorders. These findings support the hypothesis that neuroinflammation is important to the etiology of various brain disorders, offering new insights into their potential therapeutic approaches.

Distinct manifestations and potential mechanisms of seizures due to cortical versus white matter injury in children

PurposeTo study seizure manifestations and outcomes in children with cortical versus white matter injury, differences potentially explaining variability of epilepsy in children with cerebral palsy. MethodsIn this population-based retrospective cohort study, MRIs of children with cerebral palsy due to ischemia or haemorrhage were classified according to presence or absence of cortical injury. MRI findings were then correlated with history of neonatal seizures, seizures during childhood, epilepsy syndromes, and seizure outcomes. ResultsOf 256 children studied, neonatal seizures occurred in 57 and seizures during childhood occurred in 93. Children with neonatal seizures were more likely to develop seizures during childhood, mostly those with cortical injury. Cortical injury was more strongly associated with (1) developing seizures during childhood, (2) more severe epilepsy syndromes (infantile spasms syndrome, focal epilepsy, Lennox-Gastaut syndrome), and (3) less likelihood of reaching > 2 years without seizures at last follow-up, compared to children without cortical injury. Children without cortical injury, mainly those with white matter injury, were less likely to develop neonatal seizures and seizures during childhood, and when they did, epilepsy syndromes were more commonly febrile seizures and self-limited focal epilepsies of childhood, with most achieving > 2 years without seizures at last follow-up. The presence of cortical injury also influenced seizure occurrence, severity, and outcome within the different predominant injury patterns of the MRI Classification System in cerebral palsy, most notably white matter injury. ConclusionsEpileptogenesis is understood with cortical injury but not well with white matter injury, the latter potentially related to altered postnatal white matter development or myelination leading to apoptosis, abnormal synaptogenesis or altered thalamic connectivity of cortical neurons. These findings, and the potential mechanisms discussed, likely explain the variability of epilepsy in children with cerebral palsy and epilepsy following early-life brain injury in general.

Evolution of neuron firing and connectivity in neuronal plasticity with application to Parkinson’s disease

We unify different modeling structures for neuron state evolution showing how they can be derived from an invariance requirement imposed to a dissipation inequality under diffeomorphism-based changes of observer in the physical space. This is a completely non-standard way of using the second law of thermodynamics, although in isothermal setting, a law otherwise commonly used for determining constitutive restrictions and admissibility conditions as those pertaining to shock waves. In this setting, we also consider a time-varying neuronal connectivity and derive the consistent structure of its evolution equation from the same invariance principle. In the case of Parkinson, the connectivity depends also on the distribution of calcium channels that bring dopamine excess. Under special conditions, we show how the connectivity probability distribution changes in time and is influenced by the one of calcium channels. We account for memory effects in the cortical matter, namely dependence on firing and connectivity histories.

SURG-13. PEDIATRIC PRIMARY CENTRAL NERVOUS SYSTEM NEOPLASMS: RELATIVE UTILITY OF OPEN, MULTI-STAGE CRANIAL SURGERY

Abstract OBJECTIVE Staged surgery for skull base lesions has been utilized to facilitate maximal safe resection and optimize outcomes in pediatric patients. Despite its extensive applications, there is a paucity of information regarding open multi-stage resection of intrinsic, intra-axial neoplasms. We reviewed the literature in order to shed light on relevant considerations including the timing between surgeries, indications for staged approaches, and clinical outcomes following staged resection of pediatric intra-axial neoplasms. METHODS We conducted a literature search using PubMed, Web of Science, and Cochrane databases according to PRISMA recommendations. RESULTS Of 115 results, 7 articles were included for final analysis and consisted of 17 pediatric patients, including 6 (35%) male, 5 (29%) female, and 6 (35%) unspecified sex patients. Age ranged from 18 months to 17 years (mean 9 years). Tumor pathologies consisted of 5 (29%) astrocytomas, 2 (12%) ependymomas, 2 (12%) teratoid rhabdoid tumors, 2 (12%) oligodendromas, 1 (6%) glioma, 1 (6%) dysembryoplastic neuroepithelial tumor, 1 (6%) meningioangiomatosis, 1 (6%) pleomorphic xanthoastrocytoma, 1 (6%) ganglioglioma, and 1 (6%) germ cell tumor. Primary sites of the tumor included 4 (24%) temporal lobe, 3 (18%) thalamic, 3 (18%) thalamopeduncular, 3 (18%) frontal lobe, 2 (12%) posterior fossa, 1 (6%) cerebral hemisphere, and 1 (6%) frontoparietal lobe. Three studies reported complications, which included subtle hemiparesis, hydrocephalus, cranial nerve (CN) VI and VII palsies, truncal ataxia, and cerebellar mutism. Timing between surgeries varied from 5 days to several weeks CONCLUSION Indications for performing multi-stage resections included large tumor volume requiring multiple long stages of debulking, significant tumor vascularity, multicompartmental lesions, and planned staging due to presence of large tumors requiring resection around eloquent speech and motor cortical and white matter tract lesions that enabled use of awake functional mapping after a primary debulking performed in proximity to less eloquent regions.