Differential Associations of IL-4 With Hippocampal Subfields in Mild Cognitive Impairment and Alzheimer’s Disease

Background/Aims: We aimed to assess the association between in volumetric measures of hippocampal sub-regions – in healthy older controls (HC), subjects with mild cognitive impairment (MCI) and AD- with circulating levels of IL-4.Methods: From AddNeuroMed Project 113 HC, 101 stable MCI (sMCI), 22 converter MCI (cMCI) and 119 AD were included. Hippocampal subfield volumes were analyzed using Freesurfer 6.0.0 on high-resolution sagittal 3D-T1W MP-RAGE acquisitions. Plasmatic IL-4 was measured using ELISA assay.Results: IL-4 was found to be (a) positively associate with left subiculum volume (β = 0.226, p = 0.037) in sMCI and (b) negatively associate with left subiculum volume (β = -0.253, p = 0.011) and left presubiculum volume (β = -0.257, p = 0.011) in AD.Conclusion: Our results indicate a potential neuroprotective effect of IL-4 on the areas of the hippocampus more vulnerable to aging and neurodegeneration

Stroke in a patient with tuberculous meningitis and HIV infection

Abstract. Tuberculous meningitis (TBM) is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy

Complexity of motor sequences and cortical reorganization in Parkinson's disease: a functional MRI study.

Motor impairment is the most relevant clinical feature in Parkinson's disease (PD). Functional imaging studies on motor impairment in PD have revealed changes in the cortical motor circuits, with particular involvement of the fronto-striatal network. The aim of this study was to assess brain activations during the performance of three different motor exercises, characterized by progressive complexity, using a functional fMRI multiple block paradigm, in PD patients and matched control subjects. Unlike from single-task comparisons, multi-task comparisons between similar exercises allowed to analyse brain areas involved in motor complexity planning and execution. Our results showed that in the single-task comparisons the involvement of primary and secondary motor areas was observed, consistent with previous findings based on similar paradigms. Most notably, in the multi-task comparisons a greater activation of supplementary motor area and posterior parietal cortex in PD patients, compared with controls, was observed. Furthermore, PD patients, compared with controls, had a lower activation of the basal ganglia and limbic structures, presumably leading to the impairment in the higher levels of motor control, including complexity planning and execution. The findings suggest that in PD patients occur both compensatory mechanisms and loss of efficiency and provide further insight into the pathophysiological role of distinct cortical and subcortical areas in motor dysfunction

Multi-task analysis results.

<p>Results of whole brain fMRI between group analysis are reported. For each region with significant differences Talairach coordinates and F-score of the local maxima are reported (<i>p</i><0.001). L:left; M1: primary motor area; PPC: posterior parietal cortex; PD: Parkinson's disease; R: right; rSMA: rostral supplementary motor area.</p

Multi-task analysis Complex Scale vs Simple Scale.

<p>The over-activations of right parahippocampal (a) cortex and caudate (b) observed in controls, compared to patients, for the second level analysis (Complex Scale vs Simple Scale), are shown. Colours bar range for F-score: 2 to 18,14.</p

Single-task analysis Simple Scale.

<p>The over-activations of right hippocampus (a) and right insula (b) observed in controls, compared to patients, and of right cerebellum (c), left primary motor area, right dorsolateral prefrontal cortex and rostral supplementary motor area (d) observed in patients, compared to controls, for Simple Scale, are shown. Colours bar range for F-score: 2 to 8,63.</p

Single-task analysis Finger.

<p>The over-activations of bilateral insula (a), bilateral primary motor area and caudal supplementary motor area (b) observed in patients, compared to controls, for Finger, are shown. Colours bar range for F-score: 2 to 8.09.</p

Single-task analysis Complex Scale, Controls > PD Patients.

<p>The over-activation of right hippocampus observed in controls, compared to patients, for Complex Scale, is shown. Colours bar range for F-score: 2 to 9,47.</p

Clinical characteristics of patients and control subjects.

<p>Clinical characteristics of patients and control subjects.</p