Altruistic decisions following penetrating traumatic brain injury

Abstract The cerebral correlates of altruistic decisions have increasingly attracted the interest of neuroscientists. To date, investigations on the neural underpinnings of altruistic decisions have primarily been conducted in healthy adults undergoing functional neuroimaging as they engaged in decisions to punish third parties. The chief purpose of the present study was to investigate altruistic decisions following focal brain damage with a novel altruistic decision task. In contrast to studies that have focused either on altruistic punishment or donation, the Altruistic Decision Task allows players to anonymously punish or donate to 30 charitable organizations involved with salient societal issues such as abortion, nuclear energy and civil rights. Ninety-four Vietnam War veterans with variable patterns of penetrating traumatic brain injury and 28 healthy veterans who also served in combat participated in the study as normal controls. Participants were asked to invest $1 to punish or reward real societal organizations, or keep the money for themselves. Associations between lesion distribution and performance on the task were analysed with multivariate support vector regression, which enables the assessment of the joint contribution of multiple regions in the determination of a given behaviour of interest. Our main findings were: (i) bilateral dorsomedial prefrontal lesions increased altruistic punishment, whereas lesions of the right perisylvian region and left temporo-insular cortex decreased punishment; (ii) altruistic donations were increased by bilateral lesions of the dorsomedial parietal cortex, whereas lesions of the right posterior superior temporal sulcus and middle temporal gyri decreased donations; (iii) altruistic punishment and donation were only weakly correlated, emphasizing their dissociable neuroanatomical associations; and (iv) altruistic decisions were not related to post-traumatic personality changes. These findings indicate that altruistic punishment and donation are determined by largely non-overlapping cerebral regions, which have previously been implicated in social cognition and moral experience such as evaluations of intentionality and intuitions of justice and morality. 10.1093/brain/awy064_video1 awy064media1 5758316955001</jats:p

Avaliação do Nível de Maturidade no Gerenciamento de Projetos em uma Instituição de Pesquisa Clínica

Abstract During the last decade there has been a considerable growth in the number of research projects conducted in Brazil in several areas of knowledge. Much of this growth is due to the increase of private investment initiatives in research, by creating centers and specialized research institutes, such as clinical research institutes. Due to the increasing competition in this field and the search for better results and success, private financial institutions now requires a higher level of efficiency in their projects. However, many of these new institutions do not use systematic methodologies and practices in project management (PM), leading to unsatisfactory results. This methodological deficiency is accompanied by a low level of maturity in PM. Digite um texto ou endereço de um site ou traduza um documento. Thus, it is necessary the implementation and use of chained and systematized management actions, including restatements of its processes, and the creation of specific management indicators for research institutions. Using this methodology and the implementation of its main techniques, it may be possible to increase the degree of maturity in PM, incorporating streamlined processes that lead to better results in clinical research projects, contributing to the development of a new application in PM methodology.   Keywords: Clinical Research and Development; Maturity Level in Project Management; Project Management Methodology.   DOI:10.5585/gep.v4i1.124No decorrer da última década, houve um crescimento considerável no número de pesquisas realizadas no Brasil nas mais diversas áreas do conhecimento. Muito deste crescimento se deve a iniciativas de empresas privadas em aumentar os investimentos em pesquisas, criando núcleos, centros e institutos de pesquisa especializados, como no caso de um instituto de pesquisa clínica. Em razão da crescente concorrência neste setor e na busca por melhores resultados, as instituições financiadoras privadas passaram a exigir um nível de eficiência em projetos cada vez maior. Entretanto, muitas destas novas instituições não fazem uso de metodologias e práticas sistematizadas em gerenciamento de projetos (GP), gerando resultados insatisfatórios. Esta carência metodológica vem acompanhada de um baixo nível de maturidade em GP. Desta forma, faz-se necessário a implementação e uso de ações gerenciais encadeadas e sistematizadas, incluindo reformulações dos seus processos, além da criação de indicadores gerenciais específicos para instituições de pesquisa. Espera-se que, por meio do uso de uma metodologia adequada e da implementação das suas principais técnicas, possa-se elevar o grau de maturidade em GP, incorporando processos otimizados que conduzam à obtenção de melhores resultados nos projetos de pesquisa clínica, contribuindo com o desenvolvimento de uma nova aplicação para a metodologia de GP.DOI:10.5585/gep.v4i1.12

Avaliação do Nível de Maturidade no Gerenciamento de Projetos em uma Instituição de Pesquisa Clínica

<p>No decorrer da última década, houve um crescimento considerável no número de pesquisas realizadas no Brasil nas mais diversas áreas do conhecimento. Muito deste crescimento se deve a iniciativas de empresas privadas em aumentar os investimentos em pesquisas, criando núcleos, centros e institutos de pesquisa especializados, como no caso de um instituto de pesquisa clínica. Em razão da crescente concorrência neste setor e na busca por melhores resultados, as instituições financiadoras privadas passaram a exigir um nível de eficiência em projetos cada vez maior. Entretanto, muitas destas novas instituições não fazem uso de metodologias e práticas sistematizadas em gerenciamento de projetos (GP), gerando resultados insatisfatórios. Esta carência metodológica vem acompanhada de um baixo nível de maturidade em GP. Desta forma, faz-se necessário a implementação e uso de ações gerenciais encadeadas e sistematizadas, incluindo reformulações dos seus processos, além da criação de indicadores gerenciais específicos para instituições de pesquisa. Espera-se que, por meio do uso de uma metodologia adequada e da implementação das suas principais técnicas, possa-se elevar o grau de maturidade em GP, incorporando processos otimizados que conduzam à obtenção de melhores resultados nos projetos de pesquisa clínica, contribuindo com o desenvolvimento de uma nova aplicação para a metodologia de GP.</p><p><strong>DOI:10.5585/gep.v4i1.124</strong></p

The cerebral correlates of set-shifting: an fMRI study of the trail making test

The trail making test (TMT) pertains to a family of tests that tap the ability to alternate between cognitive categories. However, the value of the TMT as a localizing instrument remains elusive. Here we report the results of a functional magnetic resonance imaging (fMRI) study of a verbal adaptation of the TMT (vTMT). The vTMT takes advantage of the set-shifting properties of the TMT and, at the same time, minimizes the visuospatial and visuomotor components of the written TMT. Whole brain BOLD fMRI was performed during the alternating execution of vTMTA and vTMTB in seven normal adults with more than 12 years of formal education. Brain activation related to the set-shifting component of vTMTB was investigated by comparing performance on vTMTB with vTMTA, a simple counting task. There was a marked asymmetry of activation in favor of the left hemisphere, most notably in dorsolateral prefrontal cortex (BA 6 lateral, 44 and 46) and supplementary motor area/cingulate sulcus (BA 6 medial and 32). The intraparietal sulcus (BA 7 and 39) was bilaterally activated. These findings are in line with clinico-anatomic and functional neuroimaging data that point to a critical role of the dorsolateral and medial prefrontal cortices as well as the intraparietal sulci in the regulation of cognitive flexibility, intention, and the covert execution of saccades/anti-saccades. Many commonly used neuropsychological paradigms, such as the Stroop, Wisconsin Card Sorting, and go - no go tasks, share some patterns of cerebral activation with the TMT

White matter tract damage in the behavioral variant of frontotemporal and corticobasal dementia syndromes

The phenotypes of the behavioral variant of frontotemporal dementia and the corticobasal syndrome present considerable clinical and anatomical overlap. The respective patterns of white matter damage in these syndromes have not been directly contrasted. Beyond cortical involvement, damage to white matter pathways may critically contribute to both common and specific symptoms in both conditions. Here we assessed patients with the behavioral variant of frontotemporal dementia and corticobasal syndrome with whole-brain diffusion tensor imaging to identify the white matter networks underlying these pathologies. Twenty patients with the behavioral variant of frontotemporal dementia, 19 with corticobasal syndrome, and 15 healthy controls were enrolled in the study. Differences in tract integrity between (i) patients and controls, and (ii) patients with the corticobasal syndrome and the behavioral variant of frontotemporal dementia were assessed with whole brain tract-based spatial statistics and analyses of regions of interest. Behavioral variant of frontotemporal dementia and the corticobasal syndrome shared a pattern of bilaterally decreased white matter integrity in the anterior commissure, genu and body of the corpus callosum, corona radiata and in the long intrahemispheric association pathways. Patients with the behavioral variant of frontotemporal dementia showed greater damage to the uncinate fasciculus, genu of corpus callosum and forceps minor. In contrast, corticobasal syndrome patients had greater damage to the midbody of the corpus callosum and perirolandic corona radiata. Whereas several compact white matter pathways were damaged in both the behavioral variant of frontotemporal dementia and corticobasal syndrome, the distribution and degree of white matter damage differed between them. These findings concur with the distinctive clinical manifestations of these conditions and may improve the in vivo neuroanatomical and diagnostic characterization of these disorders

Comparison of human brain metabolite levels using 1H MRS at 1.5T and 3.0T

Proton magnetic resonance spectroscopy (MRS) of the human brain has proven to be a useful technique in\ud several neurological and psychiatric disorders and benefits from higher field scanners as signal intensity and spectral\ud resolution are proportional to the magnetic field strength. Objective: To investigate the effects of the magnetic field on\ud the measurement of brain metabolites in a typical routine clinical setting. Methods: Single voxel spectra were acquired\ud from the posterior cingulate cortex in 26 healthy subjects. Each subject was scanned consecutively at 1.5T and 3.0T in\ud a randomly distributed order. Results: SNR and peak width improvements were observed at higher fields. However, SNR\ud improvement was lower than the theoretical two-fold improvement. Other than the values obtained for creatine (Cre) and\ud myo-Inositol (mI), which were both higher at 3.0T, all metabolite concentrations obtained were roughly the same at both\ud field strengths. All the metabolite concentrations were estimated with a Cramer Rao lower bounds (CRLB) lower than 15%\ud of the calculated concentrations. Conclusions: Even though the present study supports the expected benefits of higher\ud field strength for MRS, there are several factors that can lead to different quantitative results when comparing 1.5T to 3.0T\ud MRS. Future comparative studies are necessary to refine the metabolite thresholds for early detection and quantification of\ud distinct neurological and psychiatric disorders using 3.0T MRS.\ud Key words: brain, magnetic resonance spectroscopy, 1.5T, 3.0T.Espectroscopia de prótons por ressonância magnética (MRS) tem se mostrado uma técnica bastante útil em\ud diversas doenças neurológicas e psiquiátricas. A utilização de sistemas de mais alto campo magnético favorece essa\ud técnica uma vez que a intensidade do sinal e a resolução espectral são proporcionais à intensidade do campo. Objetivo:\ud Avaliar o efeito do campo magnético sobre a medida dos níveis dos metabólitos cerebrais em uma típica rotina clínica.\ud Métodos: Os dados foram obtidos em 26 indivíduos saudáveis nos sistemas de 1.5T e 3.0T. As aquisições foram feitas\ud sequencialmente e a ordem foi distribuida randomicamente. Resultados: Foram observadas melhoras na relação sinal-ruído\ud (SNR) e na largura de linha dos picos nos dados obtidos em campo maior. No entanto, a melhoria na SNR foi menor que o\ud esperado teoricamente que seria o dobro da obtida em 1.5T. Exceto pelos valores obtidos para creatina e mio-inositol, que\ud foram maiores em 3.0T, todas as concentrações de metabólitos obtidas foram aproximadamente a mesmo em ambos os\ud campos. Todas as concentrações de metabólitos foram estimadas com Cramer Rao lower bounds (CRLB) inferior a 15% das\ud concentrações calculadas. Conclusões: Apesar de o presente estudo dar suporte aos benefícios gerados pelo aumento do\ud campo para a técnica de MRS, existem fatores que podem levar a diferentes resultados quantitativos quando se compara\ud espectroscopia em 1.5T e 3.0T. Estudos comparativos serão necessários para refinar os limiares dos níveis de metabólitos\ud para melhorar a acurácia da detecção de doenças neurológicas utilizando espectroscopia em 3.0T.\ud Palavras-chave: cérebro, espectroscopia por ressonância magnética, 1.5T, 3.0T

Comparison of human brain metabolite levels using 1H MRS at 1.5T and 3.0T

ABSTRACT Proton magnetic resonance spectroscopy (MRS) of the human brain has proven to be a useful technique in several neurological and psychiatric disorders and benefits from higher field scanners as signal intensity and spectral resolution are proportional to the magnetic field strength. Objective: To investigate the effects of the magnetic field on the measurement of brain metabolites in a typical routine clinical setting. Methods: Single voxel spectra were acquired from the posterior cingulate cortex in 26 healthy subjects. Each subject was scanned consecutively at 1.5T and 3.0T in a randomly distributed order. Results: SNR and peak width improvements were observed at higher fields. However, SNR improvement was lower than the theoretical two-fold improvement. Other than the values obtained for creatine (Cre) and myo-Inositol (mI), which were both higher at 3.0T, all metabolite concentrations obtained were roughly the same at both field strengths. All the metabolite concentrations were estimated with a Cramer Rao lower bounds (CRLB) lower than 15% of the calculated concentrations. Conclusions: Even though the present study supports the expected benefits of higher field strength for MRS, there are several factors that can lead to different quantitative results when comparing 1.5T to 3.0T MRS. Future comparative studies are necessary to refine the metabolite thresholds for early detection and quantification of distinct neurological and psychiatric disorders using 3.0T MRS

Clusters of voxels that differ significantly (<i>p</i><0.05, corrected for multiple comparisons across space (FWE) using TFCE (Threshold-Free Cluster Enhancement) between CBS and bvFTD patients for measures of MD in blue and FA in red in the axial slices (A and B), and selected coronal and sagittal slices (C and D).

<p>MNI coordinates shown in the axial slices.</p

Mean MD and FA values, statistical significance of group comparisons (α = 0.05, two-tailed), effect sizes (<i>η</i>²)^a and statistical power (1−β)^b.

<p>ROI: regions of interest; DTI: diffusion tensor imaging; NC: normal controls; bvFTD: behavioral variant fronto-temporal dementia; CBS: corticobasal syndrome; Genu (CC_genu) and splenium (CC_spl) of the corpus callosum; bilateral posterior limb of internal capsule (IC); bilateral corona radiata (Cor_RAD); bilateral frontal (UF_front) and temporal (UF_temp) sectors of the uncinate fasciculus; anterior and mid-cingulate bundle (CB_ant and CBmid); Fractional anisotropy (FA); mean diffusivity (MD); <i>η</i>²: effect size; MD in mm³/s.</p