Asymmetry Index Research Articles

Superior Gait Symmetry and Postural Stability among Yoga Instructors-Inertial Measurement Unit-Based Evaluation.

This study investigates gait symmetry and single-leg stance balance of professional yoga instructors versus age-matched typically developed controls using inertial measurement unit (IMU)-based evaluation. We recruited twenty-five yoga instructors and twenty-five healthy control subjects to conduct the walking experiments and single-leg stance tests. Kinematic data were measured by attaching IMUs to the lower limbs and trunk. We assessed the asymmetry of swing phases during the normal-walk and tandem-walk tests with eyes open and closed, respectively. The subjects subsequently conducted four single-leg stance tests, including a single-leg stance on both legs with eyes open and closed. Two balance indexes regarding the angular velocities of the waist and chest were defined to assess postural stability. The gait asymmetry indexes of yoga instructors were significantly lower than those of the typically developed controls. Similarly, the yoga instructors had better body balance in all four single-leg stance tests. This study's findings suggest that yoga improves gait asymmetry and balance ability in healthy adults. In the future, further intervention studies could be conducted to confirm the effect of yoga training.

Smile Reanimation with Masseteric-to-Facial Nerve Transfer plus Cross-Face Nerve Grafting in Patients with Segmental Midface Paresis: 3D Retrospective Quantitative Evaluation

Facial paresis involves functional and aesthetic problems with altered and asymmetric movement patterns. Surgical procedures and physical therapy can effectively reanimate the muscles. From our database, 10 patients (18–50 years) suffering from unilateral segmental midface paresis and rehabilitated by a masseteric-to-facial nerve transfer combined with a cross-face facial nerve graft, followed by physical therapy, were retrospectively analyzed. Standardized labial movements were measured using an optoelectronic motion capture system. Maximum teeth clenching, spontaneous smiles, and lip protrusion (kiss movement) were detected before and after surgery (21 ± 13 months). Preoperatively, during the maximum smile, the paretic side moved less than the healthy one (23.2 vs. 28.7 mm; activation ratio 69%, asymmetry index 18%). Postoperatively, no differences in total mobility were found. The activity ratio and the asymmetry index differed significantly (without/with teeth clenching: ratio 65% vs. 92%, p = 0.016; asymmetry index 21% vs. 5%, p = 0.016). Postoperatively, the mobility of the spontaneous smiles significantly reduced (healthy side, 25.1 vs. 17.2 mm, p = 0.043; paretic side 16.8 vs. 12.2 mm, p = 0.043), without modifications of the activity ratio and asymmetry index. Postoperatively, the paretic side kiss movement was significantly reduced (27 vs. 19.9 mm, p = 0.028). Overall, the treatment contributed to balancing the displacements between the two sides of the face with more symmetric movements.

Using a 3D asymmetry index as a novel form for capturing complex three-dimensionality in positional plagiocephaly

Positional plagiocephaly (PP) is the most common skull deformity in infants. Different classification systems exist for graduating the degree of PP, but all of these systems are based on two-dimensional (2D) parameters. This limitation leads to several problems stemming from the fact that 2D parameters are used to classify the three-dimensional (3D) shape of the head. We therefore evaluate existing measurement parameters and validate a newly developed 3D parameter for quantifying PP. Additionally, we present a new classification of PP based on a 3D parameter. 210 patients with PP and 50 patients without PP were included in this study. Existing parameters (2D and 3D) and newly developed volume parameters based on a 3D stereophotogrammetry scan were validated using ROC curves. Additionally, thresholds for the new 3D parameter of a 3D asymmetry index were assessed. The volume parameter 3D asymmetry index quantifies PP equally as well as the gold standard of 30° diagonal difference. Moreover, a 3D asymmetry index allows for a 3D-based classification of PP. The 3D asymmetry index can be used to define the degree of PP. It is easily applicable in stereophotogrammetric datasets and allows for comparability both intra- and inter-individually as well as for scientific analysis.

REAL‐TIME AI‐BASED VOLUMETRIC ANALYSIS OF THE HIPPOCAMPUS IN PATIENTS WITH ALZHEIMER DISEASE

AbstractBackgroundPatients suffering from a neurodegenerative condition such as Alzheimer's disease are more likely to experience hippocampal atrophy. Unfortunately, manually segmenting the hippocampus on a brain MRI scan is a time‐consuming procedure. Delineating the structure on several slices can consume a significant amount of radiologists' valuable time. We aim to use the real‐time AI method for hippocampal segmentation in patients with Alzheimer diseaseMethodThe study involved 65 participants in total, with a mean age of 72.65 5.35 years. The hippocampus volumes and asymmetry index (AI) were calculated using a 3D T1 isotropic sequence on United Imaging Healthcare 1.5 T scanner. Volumes were determined automatically using uAI‐Discovery Brain software. We used the T1‐3D sequence (voxel size [mm3]: 0.8 × 0.8 × 1; time [ms]: TE = 2.6; TR = 2000; TI = 900; duration [min]: 9:19) for manual and automatic segmentation of the hippocampus.ResultThe study revealed a high degree of concordance (ICC = 0.95) for both hippocampi. As a result, no major disparities existed between them. The subjects' mean right (2985.65344.25 mm3) and left (2898.69 225.2 mm3) volume was determined. These volumes and the asymmetry index were significantly different from those found in a sample of healthy participants (p = 0.00001 and p = 0.003, respectively), but were comparable to those obtained in a sample of subjects with ADConclusionTo emphasize, precise segmentation of the hippocampus via AI‐method can provide critical diagnostic information and open a new path in clinical settings

Comparison of Electroencephalogram Power Spectrum Characteristics of Left and Right Dragon Boat Athletes after 1 km of Rowing.

This study aimed to detect differences in post-exercise brain activity between the left and right paddlers due to exercise by analyzing the resting-state electroencephalogram (EEG) power spectrum before and after exercise. Twenty-one right paddlers and twenty-two left paddlers completed a 1 km all-out test on a dragon boat ergometer, and their heart rate and exercise time were recorded. EEG signals were collected from superficial brain layers before and after exercise; then, the EEG power spectrum was extracted and compared in different frequency bands. In addition, the degree of lateralization in each brain region was assessed by the asymmetry index. There was no significant difference in the power spectrum values and asymmetry indices between the left and right paddlers before rowing (p ˃ 0.05). However, after rowing, the left-paddlers group had significantly higher spectral power values in θ and α bands than the right-paddlers group (p < 0.05), and brain lateralization in both groups of athletes occurred mainly in the ipsilateral hemisphere of the frontal and central regions. The 1 km of rowing induced more brain activation in the left paddlers, and both left and right paddlers showed functional aggregation of hemispheric lateralization.

Five Species of Taxus Karyotype Based on Oligo-FISH for 5S rDNA and (AG3T3)3

As a relict plant, Taxus is used in a variety of medicinal ingredients, for instance to treat a variety of cancers. Taxus plants are difficult to distinguish from one another due to their similar morphology; indeed, some species of Taxus cytogenetic data still are unclear. Oligo-FISH can rapidly and efficiently provide insight into the genetic composition and karyotype. This is important for understanding the organization and evolution of chromosomes in Taxus species. We analysed five Taxus species using two oligonucleotide probes. (AG3T3)3 signals were distributed at the chromosome ends and the centromere of five species of Taxus. The 5S rDNA signal was displayed on two chromosomes of five species of Taxus. In addition to Taxus wallichiana var. mairei, 5S rDNA signals were found proximal in the remaining four species, which signals a difference in its location. The karyotype formula of Taxus wallichiana was 2n = 2x = 24m, its karyotype asymmetry index was 55.56%, and its arm ratio was 3.0087. Taxus × media's karyotype formula was 2n = 2x = 24m, its karyotype asymmetry index was 55.09%, and its arm ratio was 3.4198. The karyotype formula of Taxus yunnanensis was 2n = 2x = 24m, its karyotype asymmetry index was 55.56%, and its arm ratio was 2.6402. The karyotype formula of Taxus cuspidate was 2n = 2x = 24m, its karyotype asymmetry index was 54.67%, its arm ratio was 3.0135, and two chromosomes exhibited the 5S rDNA signal. The karyotype formula of T. wallichiana var. mairei was 2n= 2x = 22m + 2sm, its karyotype asymmetry index was 54.33%, and its arm ratio was 2.8716. Our results provide the karyotype analysis and physical genetic map of five species of Taxus, which contributes to providing molecular cytogenetics data for Taxus.

Nordic walking with an integrated resistance shock absorber affects the femur strength and muscles torques in postmenopausal women

Deterioration of the structure and function of the musculoskeletal system represents a significant problem during aging and intervention with a suitable load of physical activity may improve the quality of life. Nordic walking (NW) has become a popular and easily accessible form of activity, especially for older adults people around the world. Thus, the purpose of the study was to evaluate the influence of an Nordic walking training program with classic poles (NW) and with integrated resistance shock absorber (RSA) on bone mineral density and the peak torques of upper limb muscles and to compare the effects of both intervention programs. 25 women were randomly assigned to two training groups: 10 subjects using RSA (68 ± 4.19 years) and 15 subjects using NW poles (65 ± 3.40 years), which completed 8 weeks of training program. The hip, spine and forearm areal bone mineral density, torques of the flexors and extensors at the elbow and shoulder joints were measured before starting the training programs and after their completion. The most significant effect was found in differences between the two groups of women with respect to the femur strength index (p = 0.047) and the ratio of the flexors to extensors in the elbow (p = 0.049) and shoulder (p = 0.001) joints and peak torque of flexors in the shoulder joint (p = 0.001) for the left arm. A significant difference was also found in the index of torque asymmetry of flexors in the shoulder joint (p = 0.002). The study shows that Nordic walking with RSA poles for postmenopausal women led to beneficial changes in the femur strength index. However, we found no significant influence on bone mineral density values measured on the whole body, the femoral neck, forearm or lumbar spine regions. The occurrence of asymmetry in biomechanical muscle parameters, which was observed using RSA poles, may suggest the necessity of systematic controlling the gait technique to avoid the adverse consequences of asymmetrical rotation of the lumbar spine.

Condylar Asymmetry in Children with Unilateral Posterior Crossbite Malocclusion: A Comparative Cross-Sectional Study.

Unilateral posterior crossbite (UXB) is a common, severely asymmetric malocclusion, characterized by maxillary hypoplasia and masticatory dysfunction. The aim of this research is to evaluate the asymmetry of mandibular condyles and rami in children with UXB. This comparative cross-sectional study included 33 children with UXB (girls = 15, boys = 18; mean age ± SD = 8.0 ± 1.3 years.months]) and 33 age- and gender-matched controls (girls = 15, boys = 18; mean age ± SD = 8.4 ± 1.3 years.months]). Pre-treatment OPGs were analyzed by comparing the height of condyles and rami between the sides using the method by Habets et al. (1988); the result was considered significant if the degree of asymmetry was >6%. Children with UXB showed a significantly increased asymmetry of mandibular condyles (mean ± SD = 10.7% ± 9, p < 0.001), but not of rami (mean ± SD = 1.9% ± 2.3), compared to controls. The rami did not show significant asymmetry in either group. The presence of an increased condylar asymmetry index in a developing patient with unilateral posterior crossbite is a sign of altered skeletal growth and should be considered in the diagnostic process and treatment plan.

Scarcity Enhances Outcome Evaluation in the Present: Electroencephalography Evidence.

Scarcity goods have generally been perceived as high in value in real-world and empirical studies. However, few studies have investigated this value over time, such as performance in intertemporal decision making. This study's chief objective was to determine how scarcity evaluation changes temporally. We used the electroencephalogram technique and an outcome evaluation task with the valuation of scarcity and ordinary rewards delivered at different times to explore the effect of scarcity on delay discounting. The feedback-related negativity (FRN) results show that ordinary goods were associated with a more negative amplitude than scarcity goods, and that rewards delivered in the future evoked more negative deflection compared to those delivered immediately. The prominent FRN effect was derived mainly from ordinary trials rather than scarcity trials in the immediate condition and in the future rather than only in the immediate condition. The Frontal Asymmetry Index (FAI) results show that the scarcity condition was associated with greater relative left frontal cortical activity than the ordinary condition when delivered immediately. The frontal asymmetry indicated greater approach motivation. Our electrophysiology data indicate that scarcity goods have a perceived high value, particularly when delivered immediately.

Handgrip strength asymmetry cut points to identify slow gait speed in six low- and middle-income countries: A cross-sectional analysis with 12,669 older adults

BackgroundHandgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness. MethodsA cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0–10.0% (reference group), 10.1–20.1%, 20.1–30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index “[(HGS asymmetry*HGS)/(BMI*Age)]*100” cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%). ResultsCompared to HGS reference group, those with HGS asymmetry of 10.1–20%, 20.1–30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men). ConclusionsHGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity.

Dual-phase 18 F-FP-CIT positron emission tomography and cardiac 123 I-MIBG scintigraphy of Parkinson's disease patients with GBA mutations: evidence of the body-first type?

Parkinson's disease (PD) with glucocerebrosidase (GBA) gene mutation (GBA-PD) is known to show more rapid clinical progression than sporadic PD without GBA mutation (sPD). This study was performed to delineate the specific patterns of cortical hypoperfusion, dopamine transporter uptake and cardiac meta-iodobenzylguanidine (MIBG) uptake of GBA-PD in comparison to sPD. Through next-generation sequencing analysis targeting 41 genes, a total of 16 GBA-PD and 24 sPD patients (sex, age matched) were enrolled in the study, and the clinical, dual-phase [18 F]-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane (1 8 F-FP-CIT) positron emission tomography (PET)and cardiac 123 I-MIBG scintigraphy results were compared between the two groups. The GBA-PD group had higher rates of rapid eye movement sleep behavior disorder, orthostatic hypotension and neuropsychiatric symptoms than the sPD group. Early-phase 18 F-FP-CIT PETshowed significantly lower standard uptake value ratio on bilateral posterior parietal cortex (0.94 ± 0.05 vs. 1.02 ± 0.04, p=0.011) and part of the occipital cortex (p < 0.05) in the GBA-PD group than the sPD group. In striatal dopamine transporter uptake, the regional standard uptake value ratio, asymmetry index and caudate-to-putamen ratio were similar between the two groups. The GBA-PD group had a lower heart-to-mediastinum uptake ratio in 123 I-MIBG scintigraphy than the sPD group. The GBA-PD patients showed decreased regional perfusion in the bilateral posterior parietal and occipital cortex. Cardiac sympathetic denervation and non-motor symptoms (orthostatic hypotension, rapid eye movement sleep behavior disorder) were more common in GBA-PD than sPD. These findings suggest that GBA-PD patients have more widespread peripheral (extranigral) α-synuclein accumulation, representing a body-first PD subtype.

Evaluating Cranial Growth in Japanese Infants Using a Three-dimensional Scanner: Relationship between Growth-related Parameters and Deformational Plagiocephaly.

In this study, we aimed to evaluate the longitudinal changes in the cranial shape of healthy Japanese infants using a three-dimensional scanner and construct a normal values database for the growth process. Preterm infants (gestational age < 37 weeks), infants with neonatal asphyxia (5-minute Apgar score of <7), and patients who started helmet therapy for deformational plagiocephaly were excluded from this study. The first scan was performed at approximately 1 month of age, followed by two scans conducted at 3 and 6 months of age. The parameters considered were as follows: cranial length, width, height, circumference, volume, cranial vault asymmetry index, and cephalic index. A cranial vault asymmetry index >5% was defined as deformational plagiocephaly. Changes in each parameter were examined using repeated-measures analysis of variance classified by sex and deformational plagiocephaly status. The rate of increase in each parameter was also examined. In total, 88 infants (45 boys and 43 girls) were included in this study. All growth-related parameters were noted to increase linearly with time. Sex differences were observed in all parameters except cranial length. Deformational plagiocephaly was found to have no effect on growth-related parameters. Cranial volume increased by 60% from 1 to 6 months of age. The growth almost uniformly influenced the rate of increase in volume in each coordinate axis direction. Overall, the mean trends in three-dimensional parameters in infants up to 6 months of age were obtained using a three-dimensional scanner. These trends could be used as a guide by medical professionals involved in cranioplasty.

Can the subject reliably reproduce maximum voluntary contraction of temporalis and masseter muscles in surface EMG?

ABSTRACT Objective To evaluate the repeatability of the surface EMG variables of myoelectric signals from the masseter and temporalis muscles according to three methods to induce maximum voluntary contraction (MVC) in healthy adults. Methods Thirty healthy young subjects performed the following three MVC tasks three times each in three sessions on the same day without replacing surface electrodes: clenching the teeth (MVCIC) and biting down on two cotton rolls bilaterally with the posterior teeth (MVCBP) or first molars (MVCB6). Results The intra-class correlation coefficient (ICC) of the amplitudes during the three MVC tasks ranged from 65 to 79%. The ICCs of the spectral variables ranged from 78 to 86%. The ICCs of the asymmetry index of the masseter ranged from 77 to 86%, and those of the activity index ranged from 68 to 90%. Conclusion The surface EMG measurements according to the three MVC methods exhibited good to excellent reproducibility.

Early Electroencephalographic Features Predicting Cerebral Physiology and Functional Outcomes After Pediatric Traumatic Brain Injury.

We investigated whether early electroencephalographic features predicted intracranial pressure (ICP), cerebrovascular pressure reactivity, brain tissue oxygenation, and functional outcomes in patients with pediatric traumatic brain injury (TBI). This was a retrospective analysis of a prospective data set of 63 patients with pediatric TBI. Electroencephalographic features were collected in the first 24h of recording to predict values of ICP, pressure reactivity index (PRx), and brain tissue oxygenation (PbtO2) through the initial 7days of critical care monitoring, in addition to Glasgow Outcome Scale Extended-Pediatric Revision (GOSE-Peds) scores at 12months. Electroencephalographic features were averaged over all surface electrodes and included seizures, interictal epileptiform discharges, suppression percentage, complexity, the alpha/delta power ratio, and both absolute asymmetry indices and power in beta (13-20Hz), alpha (8-13Hz), theta (4-7Hz) and delta (0-4Hz) bands. Demographic data and injury severity scores, such as the Glasgow Coma Scale (GCS) and Pediatric Risk of Mortality III (PRISM III) scores, at presentation were also assessed. Univariate and multiple linear regression with guided stepwise variable selection was used to find combinations of risk factors that best explain variability in ICP, PRx, PbtO2, and GOSE-Peds values, and best fit models were applied to pediatric age strata. We hypothesized that suppression percentage and the alpha/delta power ratio in the first 24h of recording predict ICP, PRx, PbtO2, and GOSE-Peds values. Best subset model selection identified that increased suppression percentage and PRISM III scores predicted increased ICP (R2 = 79%, Akaike information criterion [AIC] = 332.30, root mean square error [RMSE] = 6.62), with suppression percentages < 5% (slope = - 5687.0, p = 0.0001) and ≥ 45% (slope = 9825.9, p = 0.0000) being predictive of dose of intracranial hypertension. When accounting for age and GCS score, increased suppression percentage predicted increased PRx values, suggestive of inefficient cerebrovascular pressure reactivity (R2 = 53%, AIC = 3.93, RMSE = 0.23), with suppression percentages ≥ 5% (p = 0.0033) and ≥ 45% (p = 0.0027) being predictive of median PRx values ≥ 0.3. Lower GCS scores, the presence of seizures, and increased suppression percentages each were independently associated with higher GOSE-Peds scores (R2 = 52%, AIC = 194.04, RMSE = 1.58), suggestive of unfavorable outcomes, with suppression percentages ≥ 5% (p = 0.0005) and ≥ 45% (p = 0.0000) being predictive of GOSE-Peds scores ≥ 5. At the univariate level, no electroencephalographic or clinical feature was associated with differences in PbtO2 values. Increased electroencephalographic suppression percentage on the initial day of monitoring may identify patients with pediatric TBI at risk of increased ICP, inefficient cerebrovascular pressure reactivity, and unfavorable outcomes.

A New Method for Quantifying the Asymmetry of Biological Elements by Means of a Photogrammetric Technique Using a Parametric Computer-Aided Design System

In the area of zoology, it is of great interest to determine the degree of asymmetry existing in the different animal structures in order to establish it as a variable (biomarker). In this study, a new methodology is proposed for obtaining this variable ‘Asymmetry Index’. Forty-eight Iberian red deer antlers (Cervus elaphus hispanicus) from hunting reserves in the province of Jaen (Spain) have been used. The degree of asymmetry of their antlers between homologous points considered in the two right and left sides of each antler was obtained. The methodology is applied within a parametric Computer-Aided Design system from the photogrammetric restitution of the antler from two photographs. The procedure compares the degree of asymmetry in which the points of each of the right and left sides of the antler are found by means of lengths and angles with respect to an established reference plane based on the geometry of the specimen’s skull. As a result of the study, it has been observed that the Asymmetry Index obtained is lower in those specimens that have a high score in their hunting valuation, so it is considered that this factor can be taken into account as an objective and quantifiable indicator (biomarker).

Play fighting versus real fighting in piglets (Sus scrofa): Similar patterns, different structure

When animals engage in ‘non-serious’ fighting (play-fighting) they ‘borrow’ motor patterns especially from the aggressive context. It may be difficult to distinguish play- and real-fighting. This is particularly true for piglets (Sus scrofa), which can use play-fighting as a substitute for aggression. To check for the structural differences between play- and real-fighting in piglets, we: i) video recorded 496 interactions from three litters (at Parva-Domus extensive ethical farm; Turin, Italy); ii) extracted (by video analyses) duration, patterns, and data on involved individuals; iii) calculated session structural/ecological indices; and iv) compared the indices (play- vs real-fighting). Compared to real-fighting – play-fighting was longer (informing its rewarding nature), more symmetrical (lower asymmetry index) and variable (higher Shannon index). Moreover, play-fighting showed less pattern repetition (lower Repetition Index) and was not more polyadic and evenly distributed (comparable polyadic and Pielou indices). By being longer, and more variable and symmetrical than real-fighting, play-fighting could serve some of its functions such as motor training, social assessment and training for the unexpected. However, play-fighting in piglets did not comply with all the expected play features, possibly because play is a fluid behavioural system that under certain circumstances may escalate into or replace aggression.

Corticobasal syndrome and Parkinson’s disease at the beginning: asymmetrical patterns of MRI and Blink Reflex for early diagnosis

Differential diagnosis between Parkinson’s disease (PD) and corticobasal syndrome (CBS) could be challenging at the early stage, due to the asymmetric onset of both diseases. Despite the clinical overlap, the anatomical circuits involved in these disorders are different. We evaluated R2 Blink Reflex Recovery Cycle (R2BRRC) and cortical thickness (CTh) in drug-naïve PD and CBS patients for characterizing pathophysiological mechanisms underlying these conditions. Patients with a clinically probable diagnosis of PD and possible CBS were recruited. R2BRRC was evaluated bilaterally at interstimulus intervals (ISIs) of 100–150–200–300–400–500–750 ms. Asymmetry index (AI) of R2BRRC for each ISI was computed. Patients underwent a structural brain MRI and hemisphere CTh and AI of MRI was calculated. Fourteen drug-naïve PD patients and 10 patients with early CBS diagnosis were enrolled. R2BRRC of PD patients showed an increased brainstem excitability for less affected side (LAS) stimulation at ISIs of 100 and 150 ms (p < 0.001) compared to most affected side (MAS), whereas no differences between LAS and MAS were found in CBS. AI of R2BRRC at ISI-100 ms showed significant difference, being higher in PD. CTh analysis showed significant differences between groups in hemisphere cortical volume contralateral to MAS, and, conversely, AI of MRI was significantly higher in CBS. PD patients exhibited an asymmetric pattern of brainstem excitability, compared to CBS. Conversely, CBS patients showed an asymmetric pattern of cortical atrophy. This opposite pattern of neurophysiological and structural abnormalities involving cortical and subcortical brain structures could highlight the different pathophysiological mechanisms underlying these disorders.

Pectus excavatum in motion: dynamic evaluation using real-time MRI

ObjectivesThe breathing phase for the determination of thoracic indices in patients with pectus excavatum is not standardized. The aim of this study was to identify the best period for reliable assessments of morphologic indices by dynamic observations of the chest wall using real-time MRI.MethodsIn this prospective study, patients with pectus excavatum underwent morphologic evaluation by real-time MRI at 3 T between January 2020 and June 2021. The Haller index (HI), correction index (CI), modified asymmetry index (AI), and modified eccentricity index (EI) were determined during free, quiet, and forced breathing respectively. Breathing-related differences in the thoracic indices were analyzed with the Wilcoxon signed-rank test. Motion of the anterior chest wall was analyzed as well.ResultsA total of 56 patients (11 females and 45 males, median age 15.4 years, interquartile range 14.3–16.9) were included. In quiet expiration, the median HI in the cohort equaled 5.7 (4.5–7.2). The median absolute differences (Δ) in the thoracic indices between peak inspiration and peak expiration were ΔHI = 1.1 (0.7–1.6, p < .001), ΔCI = 4.8% (1.3–7.5%, p < .001), ΔAI = 3.0% (1.0–5.0%, p < .001), and ΔEI = 8.0% (3.0–14.0%, p < .05). The indices varied significantly during different inspiratory phases, but not during expiration (p > .05 each). Furthermore, the dynamic evaluation revealed three distinctive movement patterns of the funnel chest.ConclusionsReal-time MRI reveals patterns of chest wall motion and indicate that thoracic indices of pectus excavatum should be assessed in the end-expiratory phase of quiet expiration.Key Points• The thoracic indices in patients with pectus excavatum depend on the breathing phase.• Quiet expiration represents the best breathing phase for determining thoracic indices.• Real-time MRI can identify different chest wall motion patterns in pectus excavatum.

A subtle connection between crossed cerebellar diaschisis and supratentorial collateral circulation in subacute and chronic ischemic stroke

ObjectivesIt has not been reported whether collateral circulation, a factor closely related to the prognosis of patients with cerebral infarction, is related to the occurrence of crossed cerebellar diaschisis(CCD) or not. Our research attempts to verify the relationship between the collateral circulation grade and the occurrence of CCD, mainly by means of CTA and CTP. Materials and methodsA total of 47 patients were divided into a CCD-positive (Kim et al., 2019) or a CCD-negative group Furlanis et al. (2018) by calculating the asymmetry index (AI) value (<10%) of bilateral cerebellar cerebral blood flow (CBF). A 4-scale grading method was used to evaluate collateral circulation in the supratentorial infarct area, and the four perfusion parameters of the supratentorial and subtentorial brain regions were analyzed and compared between the two groups. The extent of vascular lesions was evaluated by MR sequences including DWI and MRA. ResultsAmong the four perfusion parameters, except for CBV, were significantly different between the bilateral cerebellum in the CCD-positive group, but only TTP in the supratentorial cerebral infarction area was statistically different in the two groups. Moreover, the collateral circulation sore in the CCD-positive group was significantly lower than that in the CCD-negative group. But no statistical difference was found in the comparison of DWI positive rates between the two groups. ConclusionThe collateral score in the supratentorial infarct area is correlated with the occurrence of CCD,which may be used to explain the effect of CCD on the prognosis of patients.

A questionnaire measure of adult attachment anxiety correlates with frontal hemispheric asymmetry in sleep spindle activity

Subjects with high levels of attachment anxiety and neuroticism were proposed to be characterized by higher relative right rather than left frontal activity. Since sleep spindles are argued to reflect enhanced offline neuroplasticity, higher spindle activity measured over the right frontal areas relative to the corresponding left frontal ones could index higher attachment anxiety and neuroticism. Our aim was to explore the relationship between the lateralization patterns of frontally dominant slow sleep spindles and questionnaire measures of adult attachment anxiety and neuroticism. Thirty-four healthy subjects (male = 19; Mage = 31.64; SDage = 9.5) were enrolled in our preliminary study. Second night EEG/polysomnography records and questionnaire measures of personality (Zuckerman–Kuhlman Personality Questionnaire) and adult attachment (Relationship Scales Questionnaire) were collected. Frontal slow sleep spindles were measured by the Individual Adjustment Method (IAM), whereas hemispheric asymmetry indexes of spindle occurrence rate, duration, and amplitude were derived as normalized left–right differences (electrode pairs: Fp1–Fp2, F3–F4, and F7–F8). Relative right lateralization of frontolateral and frontopolar slow sleep spindle density and mid-frontal slow spindle duration were associated with attachment anxiety, but spindle lateralization was less closely related to neuroticism. The relationships between frontal slow spindle laterality and attachment anxiety remained statistically significant even after controlling for the effect of neuroticism, whereas attachment avoidance–independence was not correlated with frontal slow spindle lateralization. Right frontal lateralization of slow sleep spindle activity might indicate attachment status in terms of the negative view of the self.