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Consciousness, EEG, Sleep and Emotions
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The limbic system is a large complex of brain structures composed of subcortical and cortical components. The subcortical components include the hypothalamus, septum, hippocampus, amygdala and parts of the basal ganglia. Surrounding the subcortical structures is the limbic cortex, which is composed of the cingulated gyrus, orbitofrontal cortex, subcallosal gyrus and parahippocampal gyrus (Figure 11.3).
Chronic Fatigue Syndrome: Limbic Encephalopathy in a Dysregulated Neuroimmune Network
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
Remembering that the limbic system amplifies and refines the control and function of the hypothalamus, just as the hypothalamus does for the brain stem, we can appreciate its role in PMS.78 The limbic system permits primitive cognitive functions and primary emotions. The heteromodal and paralimbic areas amplify and regulate the control of the limbic system in a more complex and sophisticated manner, so that state variables (cognition and attitude) have more of an influence. Temporolimbic structures do not have their primary effect in the reverberating circuit proposed by Papez. This concept proposes that the “limbic” cortex, which “rims around” the medical aspect of the telencephalon is a largely self-contained functional system.79 Rather, they directly innervate structures downstream in the neuraxis: the diencephalon, brain stem, and even the spinal cord. All of these structures have feedback or feedforward relationships with one another, but if the concept of limbic derangement of normal physiology were integrated into general medical thinking, many disorders (not just CFS, although CFS incorporates many of them) would be better understood.
Heart and soul: the feeling body
Published in Anthony Korner, Communicative Exchange, Psychotherapy and the Resonant Self, 2020
Feeling is an integration of cross-modal sensory and contextual information, translated into the “language” of affect, involving deep structures of the limbic cortex. There has been interest in the role of the amygdala in relation to the experience of affect. While the role of the amygdala in mediating fear has been well-studied (Le Doux, 2000), it is also important in facial recognition, social responsiveness and appraisal of the valence of situations, thereby “updating representations of value” (Morrison & Salzman, 2010). This suggests a role in the process of apperception, in relation to the environment. However, the amygdala does not generate affect by itself. While important in the detection of environmental dangers, its role in the “generation of affect.… has been vastly exaggerated” (Panksepp, 2008, p. 48).
Neuroimaging with PET/CT in chronic traumatic encephalopathy: what nuclear medicine can do to move the field forward
Published in Expert Review of Molecular Diagnostics, 2022
Luca Filippi, Orazio Schillaci, Barbara Palumbo
A further report on the use of Tau-PET was performed by Barrio et al. on a cohort of 14 professional football players with suspected CTE: the authors compared the pattern of 18F-FDDNP uptake in players’ brain with respect to that obtained in patients affected by AD (n = 24) and healthy controls (n = 28) [37]. It is worth mentioning that the authors identified four patterns of tracers uptake in patients with suspected CTE, ranging from T1 (mild uptake in midbrain and amygdala) to T4 (intense signal in cortical, subcortical, and limbic medial temporal lobe associated with brain atrophy). In particular, the analysis of brain PET (T1-T4) identified dorsal midbrain and amygdala as the two core regions clearly discriminating subjects with suspected CTE from healthy controls. Of note, pattern of 18F-FDDNP uptake meaningfully differed between CTE subjects and AD patients: in professional players tracer incorporation resulted highest in midbrain and limbic area, with a dorsal-ventral gradient, while in AD patients pathological tracer uptake was predominantly located in cortical areas. 18F-FDDNP PET’s findings in patients with suspected CTE were strongly concordant with neuropathological alterations detected in patients with CTE confirmed at post mortem examination and consistent with the biomechanical mechanisms of concussive trauma. Noteworthy, the involvement of midbrain and limbic cortex supports CTE clinical spectrum, since these structures are deeply interconnected in the complex network controlling mood and behavior.
Seizure and cognitive outcomes of posterior quadrantic disconnection: a series of 12 pediatric patients
Published in British Journal of Neurosurgery, 2020
Yao Wang, Chao Zhang, Xiu Wang, Lin Sang, Feng Zhou, Jian-Guo Zhang, Wen-Han Hu, Kai Zhang
After this procedure, the fibres mentioned in 1)–3) above were disconnected with remaining fibres as follows: 5) hippocampal efferent fibres; 6) projection fibres from the amygdala; 7) fibres through the anterior commissure between the anterior temporal lobe and limbic cortex; and 8) projection fibres from the insula to the basal ganglia, thalamus, hypothalamus and brain stem.(3) Stage III: Mesial temporal resection: After the opening of the temporal horn, the amygdala was revealed in the anteromedial part. The amygdala was removed along with resection of the subdural uncinate gyrus. The superior boundary of the amygdala resection was located at the top of the temporal horn of the lateral ventricle. The hippocampus was exposed and resected along the temporal horn and choroid fissure.
Atypical presentation of an elderly male with autoimmune encephalitis: anti-LG1 limbic encephalitis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Binita Bhandari, Bikash Basyal, Selin Sendil, Resha Khanal, Sunita Neupane, Vinod Nookala
Limbic encephalitis is an inflammatory process in the limbic area of the brain (hippocampus, amygdala, hypothalamus, cingulate gyrus, limbic cortex) which can present with acute or subacute short-term memory loss, cognitive dysfunction, and seizures. Classically, limbic encephalitis is considered a paraneoplastic syndrome with some underlying malignancy [1,2]. There have been few case reports of non-paraneoplastic limbic encephalitis (NPLE) that have not been associated with any underlying malignancy. NPLE has been shown to have a better prognosis than paraneoplastic limbic encephalitis since early diagnosis and treatment with immunotherapy helps achieve a quick return to baseline mental status. We present a case of an elderly male with anti-LG1 limbic encephalitis involving hypothalamus with acute changes in mental status and persistent hyperthermia, who improved with treatment with steroids, plasmapheresis, and rituximab infusion.