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The emotional brain: Combining insights from patients and basic science
Published in Howard J. Rosen, Robert W. Levenson, Neurocase, 2020
Howard J. Rosen, Robert W. Levenson
The medial frontal regions, especially the anterior cingulate cortex, also play a role in emotion. Similar to the amygdala, these regions are active during viewing of emotional faces in fMRI studies (Phan et al., 2002), and during tasks where decisions are in part mediated by the emotional content of the stimulus (Bush et al., 2000). Researchers often distinguish between the more dorsal portion the anterior cingulate cortex, which is thought to play an important role in monitoring of cognitive processing, and the more ventral anterior cingulate, which appears to subserve monitoring of internal sensations related to emotional functions (Vogt et al., 2003). Lesions to ventral and medial frontal regions impair recognition of emotions (Hornak et al., 2003). As will be discussed below, the anterior cingulate also plays an important role in mediating reactions to emotional stimuli.
Diagnosis of Chronic Fatigue Syndrome
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
PET (positron emission tomography) scans are also abnormal in a distinctive fashion, implicating limbic structures most frequently as being hypometabolic. The medial frontal lobe, the hippocampus, amygdala, and cingulate gyrus are usually involved as are the anterior caudate nucleus, superior colliculus, and areas of the parietal lobe. Sometimes the premotor cortex and anterior cerebellum are also hypometabolic. PET scans utilize radioactive fluorodeoxyglucose which is injected intravenously prior to computerized scanning. The expense of the test and duration of action of the tracer preclude doing the type of exercise testing that we do with SPECT scans. The limits of resolution of the PET scanner that I use are 6 mm, not good enough to image small structures such as the nucleus accumbens. Newer PET scanners will be able to resolve down to 2 mm, a distinct improvement. Both PET and SPECT technology will be revolutionized by the use of isotopes which label receptors. The multiple serotonin and dopamine receptors are of interest, and compounds to label them are available now. We shall start using them shortly.
Preparing the Patient for the fMRI Study and Optimization of Paradigm Selection and Delivery
Published in Andrei I. Holodny, Functional Neuroimaging, 2019
Not all patients with lesions in the perirolandic cortex are referred for motor strip localization. Many patients with medial frontal lesions are mapped to localize the supplementary motor area (SMA) in the superior frontal gyrus. The SMA is generally responsible for planning motor movements. It is divided into two major portions, the SMA proper and the pre-SMA, just anterior (Fig. 6). The SMA proper is generally responsible for planning motor movements and the pre-SMA is generally involved in linguistic planning (9). SMA localization using fMRI is important as the anatomical boundaries are vague and surgical insult can result in paresis or muteness. Interestingly, these deficits tend to resolve fairly quickly (on the order of weeks in many cases). Further, in our experience, it can be difficult to get a response in the SMA during intraoperative electrocorticography, placing even more importance on the fMRI localization.
Assessment of the Financial Capacity in the Context of Normal and Pathological Cognitive Aging. Preliminary Analysis of the Portuguese Version of the Numerical Activities of Daily- Living- Financial (NADL-F)
Published in Experimental Aging Research, 2022
Luísa Sousa, Nicole Baptista, Carina Gomes, Miguel Peixoto, Élia Baeta, J. C. Rocha, Emanuela Lopes, Bruno Peixoto
The linear regression model comprised the following predictors: arithmetic, schooling and the performance on IFS. This model accounted for most of the variance (54.1%) on NALD-F performance. Arithmetic is a measure believed to tap conceptual knowledge of numbers, counting, operations and calculations abilities and spatial organization, and it has been found that constitutes the primary predictor of FC across the dementia spectrum (Sherod, et al., 2009). Another predictor was schooling, a variable that also showed a consistent effect on the original version of NADL-F (Arcara et al., 2017) and is thought to be reacted to arithmetic abilities and cognitive revere. Performance on IFS, a measure of frontal functioning, was also a predictor of FC. Neuroanatomical correlates of FC have determined a relationship between medial frontal cortex volume and overall FC (Stoeckel et al., 2013). Measures of the central executive showed strong correlations with the performance on FCI (Earnst et al., 2001) and executive functioning was identified has a secondary predictor of FC (Sherod et al, 2009).
Postoperative Focal Lower Extremity Supplementary Motor Area Syndrome: Case Report and Review of the Literature
Published in The Neurodiagnostic Journal, 2021
Nicholas B. Dadario, Joanna K. Tabor, Justin Silverstein, Xiaonan R. Sun, Randy S. DAmico
The supplementary motor area (SMA) is found bilaterally within the posterior frontal lobe in the medial frontal gyrus. The SMA is bordered posteriorly by primary motor cortex and inferiorly by the cingulate sulcus and cingulate, and the genu of the corpus callosum. Cortical models suggest that the SMA demonstrates extensive connections within and outside of the motor network and participates in a variety of functions Briggs et al. (2021). Primarily, the SMA is involved in the initiation and coordination of internal and externally cued movements – especially speech and bilateral motor control (Sheets et al. 2021; Vergani et al. 2014). Recent data suggest that the SMA is part of a prefrontal cognitive initiation “axis” in the medial frontal lobe where it coordinates with the default mode network and salience network to execute goal-directed behavior (Poologaindran et al. 2020).
A Neuroethical Analysis of Physicians’ Dual Obligations in Clinical Research
Published in The American Journal of Bioethics, 2019
Dissonance-reduction strategies may give some personal and emotional comfort, whereas CD can foster inappropriate behavior (Zentall 2016). As such, if CD may be bad in and of itself, then the dissonance that orients preference change toward normalizing or justifying physician-researchers administering consent to their patients for research purposes without restriction calls for pause. One of the cardinal postulates of the theory of cognitive dissonance is that human actions influence preferences (Colosio et al. 2017), and this has been demonstrated at the level of prefrontal medial frontal cortex (Izuma et al. 2010). When faced with two or more valued options, people adjust their attitudes to support their decision by increasing their preference for the selected option(s) and decreasing the rejected option or options (Jarcho et al. 2011). Applied to the context of physician-researchers, resolving the moral tension elicited by DrC may involve not participating in it, convincing oneself that DrC is devoid of the ethical concerns often associated with it, or ignoring the moral quandary altogether—after all, deliberate ignorance eliminates cognitive dissonance (Hertwig and Engel 2016). Some evidence has linked this decision-related attitude change to the conflict resolution activity in brain regions such as the right inferior frontal gyrus (Jarcho et al. 2011), which plays both executive function and inhibitory function.