Zobrazovací metody mozku mají zásadní klinický přínos nejen pro odhalení potenciálně léčitelných příčin nebo určení vaskulární etiologie demence, ale také pro diferenciální diagnostiku neurodegenerativních onemocnění, především Alzheimerovy nemoci (AN), frontotemporální demence (FTD) a demence s Lewyho tělísky (DLB), která se vyznačují odlišnými vzorci atrofie mozkové tkáně. Za tímto účelem byly vytvořeny vizuálních škály, které umožňují kvantifikovat míru atrofie jednotlivých oblastí mozku a představují tedy užitečný nástroj pro časnou a diferenciální diagnostiku neurodegenerativních onemocnění v klinické praxi. Tento článek shrnuje současné poznatky o diagnostice AN, FTD a DLB pomocí vizuálních škál a na jejich základě nabízí doporučení pro klinickou praxi.

Brain imaging methods have a major clinical benefit not only for identifying potentially treatable causes or determining the vascular aetiology of dementia, but also for the differential diagnosis of neurodegenerative diseases, especially Alzheimer's disease (AN), frontotemporal dementia (FTD) and dementia with Lewy bodies (DLB) that are characterized by different patterns of brain atrophy. Visual rating scales that allow to quantify the degree of atrophy of individual brain areas have been developed for this purpose. They thus represent a useful tool for the early and differential diagnosis of neurodegenerative diseases in clinical practice. This article summarizes current knowledge about the diagnosis of AN, FTD and DLB using visual rating scales and based on this knowledge offers recommendations for clinical practice.

• MeSH
• Alzheimer Disease diagnostic imaging   diagnosis   MeSH
• Atrophy diagnostic imaging   MeSH
• Frontal Lobe diagnostic imaging   MeSH
• Lewy Body Disease diagnostic imaging   diagnosis   MeSH
• Frontotemporal Dementia diagnostic imaging   diagnosis   MeSH
• Hippocampus diagnostic imaging   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Cerebral Cortex diagnostic imaging   MeSH
• Neurodegenerative Diseases * diagnostic imaging   diagnosis   MeSH
• Temporal Lobe diagnostic imaging   MeSH
• Parietal Lobe diagnostic imaging   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

INTRODUCTION: Hypokinetic dysarthria (HD) is common in Parkinson's disease (PD). Our objective was to evaluate articulatory networks and their reorganization due to PD pathology in individuals without overt speech impairment using a multimodal MRI protocol and acoustic analysis of speech. METHODS: A total of 34 PD patients with no subjective HD complaints and 25 age-matched healthy controls (HC) underwent speech task recordings, structural MRI, and reading task-induced and resting-state fMRI. Grey matter probability maps, task-induced activations, and resting-state functional connectivity within the regions engaged in speech production (ROIs) were assessed and compared between groups. Correlation with acoustic parameters was also performed. RESULTS: PD patients as compared Tto HC displayed temporal decreases in speech loudness which were related to BOLD signal increases in the right-sided regions of the dorsal language pathway/articulatory network. Among those regions, activation of the right anterior cingulate was increased in PD as compared to HC. We also found bilateral posterior superior temporal gyrus (STG) GM loss in PD as compared to HC that was strongly associated with diadochokinetic (DDK) irregularity in the PD group. Task-induced activations of the left STG were increased in PD as compared to HC and were related to the DDK rate control. CONCLUSIONS: The results provide insight into the neural correlates of speech production control and distinct articulatory network reorganization in PD apparent already in patients without subjective speech impairment.

• MeSH
• Speech Acoustics * MeSH
• Dysarthria * diagnosis   etiology   pathology   physiopathology   MeSH
• Connectome * MeSH
• Humans MeSH
• Magnetic Resonance Imaging * MeSH
• Multimodal Imaging MeSH
• Nerve Net * diagnostic imaging   pathology   physiopathology   MeSH
• Parkinson Disease * complications   diagnostic imaging   pathology   physiopathology   MeSH
• Gray Matter * diagnostic imaging   pathology   physiopathology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Temporal Lobe * diagnostic imaging   pathology   physiopathology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

PURPOSE: The purpose of the study was to evaluate cerebral morphological changes in temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and their relationship to the cerebellum. METHODS: The study cohort included 21 patients with intractable TLE-HS (14 left-sided, 7 right-sided) and 38 healthy controls (HC). All patients later underwent anteromedial temporal lobe resection. All subjects were examined using a 1.5-T magnetic resonance imaging (MRI). Volumes of distinct cerebral and cerebellar structures were measured using voxel-based morphometry. The structural covariance of temporal lobe structures, insula, and thalamus with cerebellar substructures was examined using partial least squares regression. RESULTS: Morphological changes were more significant in the group with left TLE-HS when comparing left-sided with right-sided structures as well as when comparing patients with controls. The gray matter volume (GMV) of the temporal lobe structures was smaller ipsilaterally to the seizure onset side in most cases. There was a significant amygdala enlargement contralateral to the side of hippocampal sclerosis in both patients with right and left TLE-HS as compared with controls. Selected vermian structures in patients with left but not right TLE-HS had significantly larger GMV than the identical substructures in controls. The structural covariance differed significantly between patients with left and right TLE-HS as compared with HC. The analysis revealed significant negative covariance between anterior vermis and mesial temporal structures in the group with left TLE-HS. No significance was observed for the group with right TLE-HS. CONCLUSION: There is significant asymmetry in the GMV of cerebral and cerebellar structures in patients with TLE-HS. Morphological changes are distinctly more pronounced in patients with left TLE-HS. The observed structural covariance between the cerebellum and supratentorial structures in TLE-HS suggests associations beyond the mesial temporal lobe structures and thalamus.

• MeSH
• Adult MeSH
• Epilepsy, Temporal Lobe diagnostic imaging   surgery   MeSH
• Hippocampus diagnostic imaging   MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Cerebellum diagnostic imaging   MeSH
• Cerebral Cortex diagnostic imaging   MeSH
• Gray Matter diagnostic imaging   MeSH
• Sclerosis diagnostic imaging   surgery   MeSH
• Temporal Lobe diagnostic imaging   surgery   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Cíl: Atrofie mediálního temporálního laloku (MTL) je jedním z anatomických znaků Alzheimerovy demence (AD). Transkraniální sonografie (transcranial sonography; TCS) je schopna vizualizovat a měřit MTL. Cílem pilotní studie bylo otestovat digitální analýzu TCS obrazu MTL u pacientů s AD a zdravých kontrol. Metody: Do studie byli zařazeni pacienti s AD a zdravé kontroly. Vyšetření TCS se zobrazením MTL a okolních struktur v koronární rovině oboustranně bylo provedeno u všech zařazených subjektů. Všechny snímky byly zakódovány a vyhodnoceny pomocí softwaru B-Mode Assist s vypočtením MTL black/white ratio. Statisticky byly vyhodnoceny křivka receiver operating characteristic, optimální hraniční hodnota, senzitivita, specifita, pozitivní a negativní prediktivní hodnota. Výsledky: Do studie bylo během 6 měsíců zařazeno celkem 78 subjektů; 31 pacientů s AD (14 mužů, průměrný věk 76,2 ± 5,8 let) a 47 zdravých kontrol (21 mužů, průměrný věk 75,5 ± 6,4 let). Významně nižší hodnota MTL black/white ratio byla zjištěna u pacientů s AD ve srovnání se zdravými kontrolami (1,63 ± 0,75 vs. 3,43 ± 1,01; p < 0,001). Optimální hraniční hodnota MTL black/white ratio pro diferenciaci mezi pacienty s AD a zdravými kontrolami byla 2,5 se senzitivitou 90,3 %, specifitou 87,2 %, pozitivní prediktivní hodnotou 82,3 % a negativní prediktivní hodnotou 93,2 %. Závěr: Digitální analýza TCS obrazu MTL umožňuje měřit black/white ratio jako marker atrofie MTL u pacientů s AD.

Aim: Atrophy of the medial temporal lobe (MTL) is one of the anatomical hallmarks of Alzheimer's disease (AD). Transcranial sonography (TCS) is able to visualize and measure the MTL. Study aimed to test the digital image analysis of the MTL TCS image in patients with AD compared to healthy controls. Methods: Patients with AD and healthy controls were enrolled to the study. MTL and the surrounding space were imaged in the coronal plane on TCS from both sides in all enrolled subjects. All images were encoded and evaluated using B-Mode Assist software by counting the black/white ratio of the MTL. The receiver operating characteristic curve, optimal cut-off value, sensitivity, specificity, and positive and negative predictive values were statistically evaluated. Results: A total of 78 subjects were enrolled to the study during 6 months; 31 patients with AD (14 males, mean age 76.2 < 5.8 years) and 47 healthy controls (21 males, mean age 75.5 < 6.4 years). A significantly lower value of MTL black/white ratio was found in patients with AD compared with healthy controls (1.63 ± 0.75 vs. 3.43 ± 1.01; P < 0.001). The optimal cut-off value of MTL black/white ratio for differentiation between patients with AD and healthy controls was 2.5 with a sensitivity of 90.3%, specificity of 87.2%, positive predictive value of 82.3% and negative predictive value of 93.2%. Conclusion: Digital image analysis of the TCS MTL images enables the measurement of the black/white ratio as a marker of MTL atrophy in patients with AD.

• Keywords
• echogenita,
• MeSH
• Alzheimer Disease * diagnosis   physiopathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Pilot Projects MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Temporal Lobe diagnostic imaging   pathology   MeSH
• Ultrasonography, Doppler, Transcranial methods   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

INTRODUCTION: Hypokinetic dysarthria (HD) is a common symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated acute effects of repetitive transcranial magnetic stimulation (rTMS) of the motor and auditory feedback area on HD in PD using acoustic analysis of speech. METHODS: We used 10 Hz and 1 Hz stimulation protocols and applied rTMS over the left orofacial primary motor area, the right superior temporal gyrus (STG), and over the vertex (a control stimulation site) in 16 PD patients with HD. A cross-over design was used. Stimulation sites and protocols were randomised across subjects and sessions. Acoustic analysis of a sentence reading task performed inside the MR scanner was used to evaluate rTMS-induced effects on motor speech. Acute fMRI changes due to rTMS were also analysed. RESULTS: The 1 Hz STG stimulation produced significant increases of the relative standard deviation of the 2nd formant (p = 0.019), i.e. an acoustic parameter describing the tongue and jaw movements. The effects were superior to the control site stimulation and were accompanied by increased resting state functional connectivity between the stimulated region and the right parahippocampal gyrus. The rTMS-induced acoustic changes were correlated with the reading task-related BOLD signal increases of the stimulated area (R = 0.654, p = 0.029). CONCLUSION: Our results demonstrate for the first time that low-frequency stimulation of the temporal auditory feedback area may improve articulation in PD and enhance functional connectivity between the STG and the cortical region involved in an overt speech control.

• MeSH
• Speech Acoustics MeSH
• Dysarthria diagnostic imaging   etiology   physiopathology   MeSH
• Parahippocampal Gyrus diagnostic imaging   physiopathology   MeSH
• Connectome * MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Motor Cortex diagnostic imaging   physiopathology   MeSH
• Nerve Net diagnostic imaging   physiopathology   MeSH
• Parkinson Disease complications   diagnostic imaging   physiopathology   MeSH
• Aged MeSH
• Feedback, Sensory physiology   MeSH
• Temporal Lobe diagnostic imaging   physiopathology   MeSH
• Transcranial Magnetic Stimulation * MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: The profile of cortical neuroanatomical abnormalities in schizophrenia is not fully understood, despite hundreds of published structural brain imaging studies. This study presents the first meta-analysis of cortical thickness and surface area abnormalities in schizophrenia conducted by the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Schizophrenia Working Group. METHODS: The study included data from 4474 individuals with schizophrenia (mean age, 32.3 years; range, 11-78 years; 66% male) and 5098 healthy volunteers (mean age, 32.8 years; range, 10-87 years; 53% male) assessed with standardized methods at 39 centers worldwide. RESULTS: Compared with healthy volunteers, individuals with schizophrenia have widespread thinner cortex (left/right hemisphere: Cohen's d = -0.530/-0.516) and smaller surface area (left/right hemisphere: Cohen's d = -0.251/-0.254), with the largest effect sizes for both in frontal and temporal lobe regions. Regional group differences in cortical thickness remained significant when statistically controlling for global cortical thickness, suggesting regional specificity. In contrast, effects for cortical surface area appear global. Case-control, negative, cortical thickness effect sizes were two to three times larger in individuals receiving antipsychotic medication relative to unmedicated individuals. Negative correlations between age and bilateral temporal pole thickness were stronger in individuals with schizophrenia than in healthy volunteers. Regional cortical thickness showed significant negative correlations with normalized medication dose, symptom severity, and duration of illness and positive correlations with age at onset. CONCLUSIONS: The findings indicate that the ENIGMA meta-analysis approach can achieve robust findings in clinical neuroscience studies; also, medication effects should be taken into account in future genetic association studies of cortical thickness in schizophrenia.

• MeSH
• Frontal Lobe diagnostic imaging   pathology   MeSH
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Linear Models MeSH
• Magnetic Resonance Imaging MeSH
• Adolescent MeSH
• Young Adult MeSH
• Brain diagnostic imaging   pathology   MeSH
• Neuroimaging MeSH
• Prefrontal Cortex diagnostic imaging   pathology   MeSH
• Schizophrenia diagnostic imaging   pathology   MeSH
• Aged MeSH
• Temporal Lobe diagnostic imaging   pathology   MeSH
• Case-Control Studies MeSH
• Severity of Illness Index MeSH
• Age of Onset MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Meta-Analysis MeSH
• Research Support, N.I.H., Extramural MeSH

OBJECTIVES: T1 relaxometry is a promising tool for the assessment of microstructural changes during brain ageing. Previous cross-sectional studies demonstrated increasing T1 values in white and decreasing T1 values in grey matter over the lifetime. However, these findings have not yet been confirmed on the basis of a longitudinal study. In this longitudinal study over 7 years, T1 relaxometry was used to investigate the dynamics of age-related microstructural changes in older healthy subjects. METHODS: T1 mapping was performed in 17 healthy subjects (range 51-77 years) at baseline and after 7 years. Advanced cortical and white matter segmentation was used to determine mean T1 values in the cortex and white matter. RESULTS: The analysis revealed a decrease of mean cortical T1 values over 7 years, the rate of T1 reduction being more prominent in subjects with higher age. T1 decreases were predominantly localized in the lateral frontal, parietal and temporal cortex. In contrast, mean white matter T1 values remained stable. CONCLUSIONS: T1 mapping is shown to be sensitive to age-related microstructural changes in healthy ageing subjects in a longitudinal setting. Data of a cohort in late adulthood and the senescence period demonstrate a decrease of cortical T1 values over 7 years, most likely reflecting decreasing water content and increased iron concentrations. KEY POINTS: • T1 mapping is sensitive to age-related microstructural changes in a longitudinal setting. • T1 decreases were predominantly localized in the lateral frontal, parietal and temporal cortex. • The rate of T1 reduction was more prominent in subjects with higher age. • These changes most likely reflect decreasing cortical water and increasing iron concentrations.

• MeSH
• White Matter diagnostic imaging   pathology   MeSH
• Evaluation Studies as Topic MeSH
• Middle Aged MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Magnetic Resonance Imaging methods   MeSH
• Brain Mapping methods   MeSH
• Brain diagnostic imaging   pathology   MeSH
• Follow-Up Studies MeSH
• Image Processing, Computer-Assisted methods   MeSH
• Cross-Sectional Studies MeSH
• Gray Matter diagnostic imaging   pathology   MeSH
• Aged MeSH
• Temporal Lobe diagnostic imaging   pathology   MeSH
• Aging pathology   physiology   MeSH
• Iron analysis   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH

OBJECTIVE: The aim of this study was to assess clinical and electrophysiological differences within a group of patients with magnetic-resonance-imaging-negative temporal lobe epilepsy (MRI-negative TLE) according to seizure onset zone (SOZ) localization in invasive EEG (IEEG). METHODS: According to SOZ localization in IEEG, 20 patients with MRI-negative TLE were divided into either having mesial SOZ-mesial MRI-negative TLE or neocortical SOZ-neocortical MRI-negative TLE. We evaluated for differences between these groups in demographic data, localization of interictal epileptiform discharges (IEDs), and the ictal onset pattern in semiinvasive EEG and in ictal semiology. RESULTS: Thirteen of the 20 patients (65%) had mesial MRI-negative TLE and 7 of the 20 patients (35%) had neocortical MRI-negative TLE. The differences between mesial MRI-negative TLE and neocortical MRI-negative TLE were identified in the distribution of IEDs and in the ictal onset pattern in semiinvasive EEG. The patients with neocortical MRI-negative TLE tended to have more IEDs localized outside the anterotemporal region (p=0.031) and more seizures without clear lateralization of ictal activity (p=0.044). No other differences regarding demographic data, seizure semiology, surgical outcome, or histopathological findings were found. CONCLUSIONS: According to the localization of the SOZ, MRI-negative TLE had two subgroups: mesial MRI-negative TLE and neocortical MRI-negative TLE. The groups could be partially distinguished by an analysis of their noninvasive data (distribution of IEDs and lateralization of ictal activity). This differentiation might have an impact on the surgical approach.

• MeSH
• Child MeSH
• Adult MeSH
• Electroencephalography MeSH
• Epilepsy, Temporal Lobe diagnostic imaging   surgery   MeSH
• Fluorodeoxyglucose F18 MeSH
• Infant MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Brain diagnostic imaging   MeSH
• Neocortex diagnostic imaging   MeSH
• Neurosurgical Procedures MeSH
• Positron-Emission Tomography MeSH
• Child, Preschool MeSH
• Radiopharmaceuticals MeSH
• Retrospective Studies MeSH
• Temporal Lobe diagnostic imaging   MeSH
• Age of Onset MeSH
• Treatment Outcome MeSH
• Seizures diagnostic imaging   physiopathology   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Déjà vu (DV) is an eerie phenomenon experienced frequently as an aura of temporal lobe epilepsy, but also reported commonly by healthy individuals. The former pathological manifestation appears to result from aberrant neural activity among brain structures within the medial temporal lobes. Recent studies also implicate medial temporal brain structures in the non-pathological experience of DV, but as one element of a diffuse neuroanatomical correlate; it remains to be seen if neural activity among the medial temporal lobes also underlies this benign manifestation. The present study set out to investigate this. Due to its unpredictable and infrequent occurrence, however, non-pathological DV does not lend itself easily to functional neuroimaging. Instead, we draw on research showing that brain structure covaries among regions that interact frequently as nodes of functional networks. Specifically, we assessed whether grey-matter covariance among structures implicated in non-pathological DV differs according to the frequency with which the phenomenon is experienced. This revealed two diverging patterns of structural covariation: Among the first, comprised primarily of medial temporal structures and the caudate, grey-matter volume becomes more positively correlated with higher frequency of DV experience. The second pattern encompasses medial and lateral temporal structures, among which greater DV frequency is associated with more negatively correlated grey matter. Using a meta-analytic method of co-activation mapping, we demonstrate a higher probability of functional interactions among brain structures constituting the former pattern, particularly during memory-related processes. Our findings suggest that altered neural signalling within memory-related medial temporal brain structures underlies both pathological and non-pathological DV.

• MeSH
• Databases as Topic MeSH
• Deja Vu * MeSH
• Adult MeSH
• Epilepsy, Temporal Lobe diagnostic imaging   physiopathology   psychology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Brain Mapping methods   MeSH
• Meta-Analysis as Topic MeSH
• Least-Squares Analysis MeSH
• Young Adult MeSH
• Neural Pathways diagnostic imaging   physiology   physiopathology   MeSH
• Caudate Nucleus diagnostic imaging   physiology   physiopathology   MeSH
• Gray Matter diagnostic imaging   physiology   physiopathology   MeSH
• Temporal Lobe diagnostic imaging   physiology   physiopathology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

This study evaluated language organization in children with intractable epilepsy caused by temporal lobe focal cortical dysplasia (FCD) alone or dual pathology (temporal lobe FCD and hippocampal sclerosis, HS). We analyzed clinical, neurological, fMRI, neuropsychological, and histopathologic data in 46 pediatric patients with temporal lobe lesions who underwent excisional epilepsy surgery. The frequency of atypical language representation was similar in both groups, but children with dual pathology were more likely to be left-handed. Atypical receptive language cortex correlated with lower intellectual capacity, verbal abstract conceptualization, receptive language abilities, verbal working memory, and a history of status epilepticus but did not correlate with higher seizure frequency or early seizure onset. Histopathologic substrate had only a minor influence on neuropsychological status. Greater verbal comprehension deficits were noted in children with atypical receptive language representation, a risk factor for cognitive morbidity.

• MeSH
• Child MeSH
• Epilepsy, Temporal Lobe diagnostic imaging   psychology   surgery   MeSH
• Language * MeSH
• Memory, Short-Term physiology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Cerebral Cortex diagnostic imaging   physiology   surgery   MeSH
• Child, Preschool MeSH
• Drug Resistant Epilepsy diagnostic imaging   psychology   surgery   MeSH
• Temporal Lobe diagnostic imaging   physiology   surgery   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH