Bilateral effects of unilateral cerebellar lesions as detected by voxel based morphometry and diffusion imaging

Over the last decades, the importance of cerebellar processing for cortical functions has been acknowledged and consensus was reached on the strict functional and structural cortico-cerebellar interrelations. From an anatomical point of view strictly contralateral interconnections link the cerebellum to the cerebral cortex mainly through the middle and superior cerebellar peduncle. Diffusion MRI (dMRI) based tractography has already been applied to address cortico-cerebellar-cortical loops in healthy subjects and to detect diffusivity alteration patterns in patients with neurodegenerative pathologies of the cerebellum. In the present study we used dMRI-based tractography to determine the degree and pattern of pathological changes of cerebellar white matter microstructure in patients with focal cerebellar lesions. Diffusion imaging and high-resolution volumes were obtained in patients with left cerebellar lesions and in normal controls. Middle cerebellar peduncles and superior cerebellar peduncles were reconstructed by multi fiber diffusion tractography. From each tract, measures of microscopic damage were assessed, and despite the presence of unilateral lesions, bilateral diffusivity differences in white matter tracts were found comparing patients with normal controls. Consistently, bilateral alterations were also evidenced in specific brain regions linked to the cerebellum and involved in higher-level functions. This could be in line with the evidence that in the presence of unilateral cerebellar lesions, different cognitive functions can be affected and they are not strictly linked to the side of the cerebellar lesion

Reconstructing the Neanderthal brain using computational anatomy

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Developmental Differences of the Major Forebrain Commissures in Lissencephalies

WOS: 000283011300010PubMed: 20522570BACKGROUND AND PURPOSE: Changes of the major forebrain commissures in lissencephaly have not been systematically studied. We investigated the developmental differences of the commissures in patients with varying types of lissencephaly to determine whether specific commissural features may help in distinguishing lissencephaly phenotypes. MATERIALS AND METHODS: MR imaging of 124 patients was retrospectively reviewed. Patients were classified as having cLIS, vLIS, and CBSC, according to cortical phenotype; few patients had genetic diagnoses. Abnormalities of the CC, AC, and HC were recorded, and the overall shape was regarded as hypogenetic, hypoplastic, dysmorphic, a thin flat callosal body with a vertical splenium, and a convex upward callosal body, compared with age-matched controls. Correlations between commissural characteristics and cortical patterns were analyzed by using the Monte Carlo simulation of x(2), extension to m x n table, and Fisher exact tests as appropriate (P < .051. RESULTS: Patients were classified as having cLIS (57.4%), vLIS (38.4%), or CBSC (4.2%). The most common callosal developmental anomaly was hypogenesis with an absent rostrum, a small inferior genu, and a small splenium. An angled (900) splenium was found to be significantly associated with cLIS, as was an excessively convex upward callosal body with VLDLR. ACC with an enlarged AC was found in all cases of ARX. CONCLUSIONS: Specific patterns of the commissure anomalies were associated with certain types of lissencephaly. Callosal anomalies were more common than those of the AC or HC. Developmental variations of commissures may be useful as an imaging criterion in differentiating the groups of lissencephalies and may give insight into the processes causing these malformations.NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [R01 NS035129]This work was supported in part by NIH grant R01 NS035129

Late diagnosis of intestinal malrotation treated with gastrojejunal bypass: A case report

We report the case of a male African patient who presented at day 8 of life with recurrent episodes of proximal small intestine occlusion, which was treated conservatively, because of misdiagnosis. Physical and cognitive development was normal throughout with, however, some episodes of stagnation. At the age of 15 years the recurrence of symptoms, not responding to the current conservative treatment, resulted in severe weight loss with BMI at 11 kg/m2. The oesogastroduodenal barium study disclosed an extrinsic duodenal compression compatible with a congenital duodenal band. Because of the major concerns related to the patient and to the medical environment, jejunostomy for feeding was first performed to improve his weight. A year later the intestinal malrotation was cured by gastrojejunal bypass. The postoperative clinical course was favorable. The patient resumed a normal life and schooling. His BMI is currently 21.5 kg/m2.SCOPUS: ar.jinfo:eu-repo/semantics/publishe