Editorial: Neuroimaging and neuropsychology of meditation states

2noopenopenTomasino, Barbara; Fabbro, FrancoTomasino, Barbara; Fabbro, Franc

Parietal/premotor lesions effects on visuomotor cognition in neuro-oncology patients: A multimodal study

Background: Assessing prior to surgery the functionality of brain areas exposed near the tumor requires a multimodal approach that combines the use of neuropsychological testing and fMRI tasks. Paradigms based on motor imagery, which corresponds to the ability to mentally evoke a movement, in the absence of actual action execution, can be used to test sensorimotor areas and the functionality of mental motor representations. Methods: The most commonly used paradigm is the Limb Laterality Recognition Task (LLRT), requiring judgments about whether a limb belongs to the left or right side of the body. The group studied included 38 patients with high-grade (N = 21), low-grade (N = 11) gliomas and meningiomas (N = 6) in areas anterior (N = 21) and posterior (N = 17) to the central sulcus. Patients before surgery underwent neuropsychological assessment and fMRI. They performed the LLRT as an fMRI task. Accuracy, and neuroimaging data were collected and combined in a multimodal study. Structural MRI data analyses were performed by subtracting the overlap of volumes of interest (VOIs) plotted on lesions from the impaired patient group vs the overlap of VOIs from the spared group. The fMRI analyses were performed comparing the impaired patients and spared group. Results: In general, patients were within normal limits on many neuropsychological screening tests. Compared with the control group, 17/38 patients had significantly different performance. The subtraction between the VOIs overlay of the impaired patients' group vs. the VOIs overlay of the spared group revealed that the areas maximally involved by lesions in the impaired patients' group were the right postcentral gyrus, right inferior parietal lobe, right supramarginal gyrus, right precentral gyrus, paracentral lobule, left postcentral gyrus, right superior parietal lobe, left inferior parietal lobe, and left superior and middle frontal gyrus. Analysis of the fMRI data showed which of these areas contributes to a correct LLRT performance. The task (vs. rest) in the group comparison (spared vs. impaired patients) activated a cluster in the left inferior parietal lobe. Conclusion: Underlying the altered performance at LLRT in patients with lesions to the parietal and premotor areas of the right and left hemispheres is a difference in activation of the left inferior parietal lobe. This region is involved in visuomotor processes and those related to motor attention, movement selection, and motor planning

Brain Mapping: Real-Time Neuropsychological Testing Experience during Low-Grade Tumor Resection

ABSTRACT Awake surgery and direct electrical stimulation are performed to maximize the extent of resection while minimizing the risk of neurological and cognitive deficits. Direct electrical stimulation is a highly reliable method for monitoring simple brain functions when stimulating the sensorimotor cortex, or areas involved in speech articulation; however, negative mapping increases when testing higher functions related to language or cognition. By using DES alone, when resection involves areas supporting higher level cognition, the surgeon may receive poor feedback on the patient's cognitive status. To collect more information on the patient's cognitive status during resection, we developed real-time neuropsychological testing, an intensive neuropsychological monitoring method which is performed in addition to direct electrical stimulation. The technique includes a large number of tests that are administered in a continuously rotating and repeating pattern at different stages per anatomical area. The aim is to have a continuous feedback on the patient's cognitive status by reducing the risk of negative mapping. This chapter discusses this novel real-time neuropsychological test and presents the cognitive functional dynamics during surgery and recovery brought to light by the testing

Age-dependent changes of thinking about verbs

We investigated the knowledge of emotional and motor verbs in children andadolescents from three age ranges (8\u201311, 12\u201315, 16\u201319 years). Participants estimatedthe verbs familiarity, age of acquisition, valence, arousal, imageability, and motor- andemotion-relatedness. Participants were familiar with theverbs in our dataset. The younger(8\u201311) attributed an emotional character to the verbs less frequently than the middle(12\u201315) and the older (16\u201319) groups. In the 8\u201311 group malesrated the verbs asemotion-related less frequently than females. Results indicate that processing verbalconcepts as emotion-related develops gradually, and after12\u201315 is rather stable. The ageof acquisition (AoA) develops late: the older (16\u201319) had a higher awareness in reportingthat they learnt the verbs earlier as compared to the estimations made by the younger(8\u201311 and 12\u201315). AoA positively correlated with attribution of emotion relatednessmeaning that emotion-related verbs were learned later. Arousal was comparable acrossages. Also it increased when attributing motor relatednessto verbs and decreasedwhen attributing emotion relatedness. Reporting the verbs\u2019 affective valence (happy vs.unhappy) changes with age: younger (8\u201311) judged the verbs generally more \u201chappy\u201dthan both the older groups. Instead the middle and the older group did not showdifferences. Happiness increased when processing the verbs as motor related anddecreased when processing the verbs as emotion related. Ageaffected imageability:the younger (8\u201311) considered the verbs easier to be imagined than the two oldergroups, suggesting that at this age vividness estimation isstill rough, while after 12\u201315 isstable as the 12\u201315 and 15\u201319 group did not differ. Imageability predicted arousal, AoA,emotion- and motor-relatedness indicating that this indexinfluences the way verbs areprocessed. Imageability was positively correlated to emotion relatedness, indicating thatsuch verbs were harder to be imagined, and negatively to motor relatedness. Imageablitypositively correlated with valence meaning that verbs receiving positive valence were alsothose that were hard to be imagined, and negatively correlated with arousal, meaning thatverbs that were harder to be imagined elicited low physiological activation. Our resultsgive an insight in the development of emotional and motor-related verbs representations

Language Brain Representation in Bilinguals With Different Age of Appropriation and Proficiency of the Second Language: A Meta-Analysis of Functional Imaging Studies

Language representation in the bilingual brain is the result of many factors, of which age of appropriation (AoA) and proficiency of the second language (L2) are probably the most studied. Many studies indeed compare early and late bilinguals, although it is not yet clear what the role of the so-called critical period in L2 appropriation is. In this study, we carried out coordinate-based meta-analyses to address this issue and to inspect the role of proficiency in addition to that of AoA. After the preliminary inspection of the early (also very early) and late bilinguals’ language networks, we explored the specific activations associated with each language and compared them within and between the groups. Results confirmed that the L2 language brain representation was wider than that associated with L1. This was observed regardless of AoA, although differences were more relevant in the late bilinguals’ group. In particular, L2 entailed a greater enrollment of the brain areas devoted to the executive functions, and this was also observed in proficient bilinguals. The early bilinguals displayed many activation clusters as well, which also included the areas involved in cognitive control. Interestingly, these regions activated even in L1 of both early and late bilingual groups, although less consistently. Overall, these findings suggest that bilinguals in general are constantly subjected to cognitive effort to monitor and regulate the language use, although early AoA and high proficiency are likely to reduce this

Effects of age and gender on neural correlates of emotion imagery

Mental imagery is part of people's own internal processing and plays an important role in everyday life, cognition and pathology. The neural network supporting mental imagery is bottom-up modulated by the imagery content. Here, we examined the complex associations of gender and age with the neural mechanisms underlying emotion imagery. We assessed the brain circuits involved in emotion mental imagery (vs. action imagery), controlled by a letter detection task on the same stimuli, chosen to ensure attention to the stimuli and to discourage imagery, in 91 men and women aged 14-65 years using fMRI. In women, compared with men, emotion imagery significantly increased activation within the right putamen, which is involved in emotional processing. Increasing age, significantly decreased mental imagery-related activation in the left insula and cingulate cortex, areas involved in awareness of ones' internal states, and it significantly decreased emotion verbs-related activation in the left putamen, which is part of the limbic system. This finding suggests a top-down mechanism by which gender and age, in interaction with bottom-up effect of type of stimulus, or directly, can modulate the brain mechanisms underlying mental imagery

Identifying environmental sounds: a multimodal mapping study

Our environment is full of auditory events such as warnings or hazards, and their correct recognition is essential. We explored environmental sound (ES) recognition in a series of studies. In study 1 we performed an Activation Likelihood Estimation (ALE) meta-Analysis of neuroimaging studies addressing ES processing to delineate the network of areas consistently involved in ES processing. In study 2 we reported a series of 7 neurosurgical patients with lesions involving the areas found consistently activated by the ALE meta-analysis and tested their ES recognition abilities. In study 3 we investigated how the areas involved in ES might be functionally deregulated as an effect of lesion by performing an fMRI study on patients (in comparison to healthy controls). Areas found to be consistently activated in the ALE quantitative meta-analysis involved the STG/MTG, insula/rolandic operculum, parahippocampal gyrus and inferior frontal gyrus complex bilaterally. Some of these areas were found modulated by design choices, e.g., type of task, type of control condition, type of stimuli. Patients with lesions in these areas of the left and the right hemisphere had an impaired ES recognition. The most frequently lesioned area corresponded to the hippocampus/insula/superior temporal gyrus. For the most part, the patients’ responses were unrelated to the target sounds or were semantically related to the target sounds. The other type of responses were: auditorily related, semantically and auditorily related, and I don't Know answers. The fMRI evidenced deregulations of the activation reported in the right IFG and in the STG bilaterally and in the left insula. We showed that some of these clusters of activation truly reflect ES processing, whereas others are related to design choices. Our results allowed a parcelization of the activation found along the MTG/STG are

Pre- and Post-surgical Poor Seizure Control as Hallmark of Malignant Progression in Patients With Glioma?

BackgroundRegarding brain tumor-related epilepsy (BTRE), there is an increasing number of evidence about a relationship between epileptogenesis and oncogenesis. A recent study suggests a role of post-surgery seizure outcome on the survival of patients with low-grade glioma (LGG), underlying the need for a targeted and aggressive epilepsy treatment. ObjectiveThis study aims at investigating the possible correlation between pre- and post-surgical seizure control and tumor progression in patients who underwent surgery for LGG. MethodsWe performed a retrospective analysis of patients affected by LGGs and BTRE, in a single high-volume neurosurgical center. Seizure control was assessed before surgery and at 3 years of follow-up. Patients with histological progression in high-grade glioma (HGG) have been evaluated. Clinical features, pre-surgical electroencephalograms (EEGs), and electrocorticography (ECoG) have been analyzed. ResultsAmong 154 subjects, we collected 32 patients who presented a tumor progression in HGG during the follow-up period. The majority had poor seizure control both pre- and post-surgery, never being in Engel class Ia throughout the whole history of their disease. Almost all patients with poor seizure control had pathological ECoG recording. Clinical features of seizures did not correlate with seizure outcome. On the univariate analysis, the age, the post-operative Engel class, and the extent of resection (EOR) were the prognostic factors significantly associated with oncological outcome; nevertheless, on multivariate analysis, Engel class significance was not confirmed, and the only predicting factor were age and EOR. ConclusionsAlthough not confirmed on multivariate analysis, post-surgical seizure control could be a relevant factor to consider during follow-up of BRTE, in particular, when gross total resection is not achieved. Pathological findings on the ECoG may suggest a "hidden" propensity to malignant progression, strictly related to the persistent neuronal hyper-excitability. Further studies with longer follow-up period are needed to confirm our observations

recovering and worsening at design fluency in 22 neurosurgical patients preimmediately post surgery and follow up testing

The five-point test (FPT) measures the ability to voluntarily generate non-verbal novel patterns. We investigated how this ability can be impaired or improved before immediately after brain surgery, and at follow-up. Twenty-two patients undergoing neurosurgery in the right hemisphere performed the FPT at T0 (pre-), T1 (1 week post-), and T2 (follow-up at 5 months after surgery). Significant improvements at T1 (in patients who had a deficit at T0) measured recovering (N=3/22); in addition there were patients who become pathological (8/22) and subjects who presented with the same degree of impairment as observed at T0 (stable, 1/22). Similarly, at T2 (4-5 months after surgery) we measured the effect of post-op reorganization: there were patients (5/22) who had been pathological at T1 and recovered at T2. Lesions overlapped in the right body of the corpus callosum/anterior cingulum reflecting the overcome of the deficit. Amelioration can be an effect of edema reduction. In addition, there were those who become pathological (4/22). Lesions overlapped in the right supramarginal gyrus. Lastly, there were subjects who presented with the same degree of impairment as observed at T1 (stable, 4/22) and those who remained spared (9/22). Multiple regression analysis was used to test if the number of strategies (CSs) used to solve the task or the perseverative behaviour (ErrI) significantly predicted participants' stratification, namely patients who worsened those who improved and patients who remained spared. It was found that the use of strategies significantly predicted participants' stratification, whereas perseverative behaviour was not a significant predictor