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Neurosensory Assessment
Published in Golara Honari, Rosa M. Andersen, Howard Maibach, Sensitive Skin Syndrome, 2017
As the LAST is based upon the reported sensations by the subject in terms of nature and intensity, it has raised controversies owing to the use of a subjective individual pain scale hard to tackle by the investigator. Indeed, there is no consensual scale for quantifying the intensity of the sensory response experienced (23). So the experience of pain reported by a subject can never be fully confirmed or invalidated by an external observer. Nevertheless, the relevance of the stinging sensations reported by the subjects has been shown by measuring cerebral responses to the LAST with fMRI (24). According to their answers to a self-assessment questionnaire, 18 subjects were divided into two balanced groups: severe sensitive skin and completely nonsensitive skin. Inclusion criteria involved the absence of any dermatological, neurological, or vascular condition affecting the face. Event-related fMRI was used to measure cerebral activation induced by split-face application of lactic acid and its vehicle (control) (Figure 13.1). In both groups, skin discomfort due to lactic acid increased activity in the primary sensorimotor cortex contralateral to the application site and in a bilateral frontoparietal network including the parietal cortex, the prefrontal areas around the superior frontal sulcus, and the supplementary motor area. However, activity was significantly larger in the sensitive skin group. Most remarkably, in the sensitive skin group only, activity spread into the ipsilateral primary sensorimotor cortex and the bilateral peri-insular secondary somatosensory area (Figure 13.2). These results demonstrated that compared with control subjects, self-perceived sensitive skin subjects had a specific cerebral activation during LAST, which allowed the authors to hypothesize that self-perceived sensitive skin was intrinsically linked to a specific neurophysiologic pattern for these subjects. This study highly contributed to give evidence of the clinical reality of this syndrome and of the pertinence of the psychophysical approach.
Posterior reversible encephalopathy syndrome induced by intracranial hypotension in a postpartum patient
Published in International Journal of Neuroscience, 2021
A number of hormonal, physiologic, immunologic, and hemodynamic changes take place in perinatal maternal body [1,2,6]. The patients during pregnancy and the postpartum period have a relatively specific spectrum of central nervous system disorders such as eclampsia, cerebral venous thrombosis, PRES, RCVS, stroke, and Wernicke encephalopathy [7]. This patient presented with epileptic seizure and recent memory loss. The MR of brain showed patchy vasogenic edema in both hemispheres of the brain, consistent with PRES. Since the patient had no exact cause of PRES, such as blood pressure fluctuations, renal failure, autoimmune disorders, use of cytotoxic drugs, etc., it is preliminarily considered that it is related to pregnancy. Although the pathophysiologic mechanism of PRES is not well understood, the cerebral blood vessels autoregulatory failure and endothelial dysfunction are thought to be closely related to PRES [8]. PRES is characterized by a variety of neurological symptoms (disorders of consciousness, epileptic seizures, visual disturbances, headache, nausea, and vomiting) and altered consciousness presenting with radiographic evidence of reversible vasogenic edema [9,10]. Characteristic patterns were seen with brain MRI on this patient: a dominant parieto-occipital pattern and superior frontal sulcus pattern [3].
Personalising transcranial magnetic stimulation for depression using neuroimaging: A systematic review
Published in The World Journal of Biological Psychiatry, 2021
Anish Modak, Paul B. Fitzgerald
Among the studies that used neuronavigation with structural MRI to target a predetermined dlPFC location, specific treatment targets varied slightly between studies. Target coordinates in Montreal Neurological Institute (MNI) or Talaraich space, if reported in the study, are presented in Table 2. Most studies aimed to target the BA 9, BA 46, or both; if reported, this target corresponded with the middle third of the middle frontal gyrus (Dell’Osso et al. 2009; Saeki et al. 2013; Baeken et al. 2015; Duprat et al. 2016; Hayasaka et al. 2017), the junction between the middle and anterior thirds of the middle frontal gyrus (Fitzgerald et al. 2009), or the superior frontal sulcus at the point 10 mm anterior to the genu of the corpus callosum (Wall et al. 2016). One study that compared BA 9 or BA 46 targeting defined the BA 9 target as the superior frontal gyrus, so as to not overlap with the BA 46 target (Trojak et al. 2014). Two studies (Stubbeman et al. 2018; Pan et al. 2020) chose to adopt the BA 46 treatment coordinates that were previously found to have maximal functional connectivity antecorrelation with the subgenual anterior cingulate cortex (Fox et al. 2012), while another study (Blumberger et al. 2018) adopted the coordinates that were suggested to be potentially associated with better treatment outcomes in a different analysis by Fox et al. (2012). Other studies (Fitzgerald et al. 2009; Blumberger et al. 2016; Stubbeman et al. 2018) referred to a previous definition of BA 9 and 46 (Rajkowska and Goldman-Rakic 1995) to determine their target location. Response rates across studies that used structural MRI to personalise TMS for depression, in those that reported them, ranged from 15% to 83% (Table 4).
Family Members of Those with SUDs: Examining Associations between Family and PFC Functioning
Published in Alcoholism Treatment Quarterly, 2021
Hannah Agner, Spencer D. Bradshaw, Lauren Winfrey, Mazie Zielinski, Sterling T. Shumway
When examining family functioning and left and right dmPFC regional activation in response to SUD loved-one images, support was found for a positive association between family functioning and the left dmPFC region. Specifically, a positive relationship between activation of the left superior frontal sulcus, part of the dmPFC, and family functioning was found to be significant r(25) = 0.51, p = .009 (see Figures 2 and Figure 3). No other regional activation in response to SUD loved-one images showed significant associations with family functioning (see Table 2).