The Cumulative Therapeutic Effect of Acupuncture Treatment in Patients with Migraine without Aura: Evidence from Dynamic Alterations of Intrinsic Brain Activity and Effective Connectivity Analysis

We explored the dynamic alterations of intrinsic brain activity and effective connectivity after acupuncture treatment to investigate the underlying neurological mechanism of acupuncture treatment in patients with migraine without aura (MwoA). The fMRI scans were separately obtained at baseline, after the first and after the 12th acupuncture sessions in 40 patients with MwoA. Compared with HCs, patients with MwoA showed mostly decreased dynamic amplitude of low-frequency fluctuation (dALFF) variability in regions with differences. After acupuncture treatment, the decreased dALFF variability of the rostral ventromedial medulla (RVM), the superior lobe of left cerebellum (Cerebelum_Crus1_L), and the right precuneus (PCUN.R) progressively recovered. The RVM revealed gradually increased dynamic effective connectivity (DEC) variability outflow to the right middle frontal gyrus, the left insula, the right precentral gyrus, and the right supramarginal gyrus, and enhanced DEC variability from the right fusiform gyrus inflow to RVM. Furthermore, the increased DEC variability were found from Cerebelum_Crus1_L outflow to the left middle occipital gyrus and the left precentral gyrus, from PCUN.R outflow to the right thalamus. These dALFF variabilities were positive correlated with frequency of migraine attack and negative correlated with disease duration, dynamic GCA coefficients were positive correlated with Migraine-Specific Quality of Life Questionnaire score, negative correlated with frequency of migraine attack and visual analog scale score postacupuncture treatment. Our results provide insight into dynamic alterations from the perspective of dynamic local brain activity and effective connectivity for the understanding mechanisms of cumulative therapeutic effect of acupuncture in patients with MwoA.

Region-specific complexity of the intracranial EEG in the sleeping human brain

As the brain is a complex system with occurrence of self-similarity at different levels, a dedicated analysis of the complexity of brain signals is of interest to elucidate the functional role of various brain regions across the various stages of vigilance. We exploited intracranial electroencephalogram data from 38 cortical regions using the Higuchi fractal dimension (HFD) as measure to assess brain complexity, on a dataset of 1772 electrode locations. HFD values depended on sleep stage and topography. HFD increased with higher levels of vigilance, being highest during wakefulness in the frontal lobe. HFD did not change from wake to stage N2 in temporo-occipital regions. The transverse temporal gyrus was the only area in which the HFD did not differ between any two vigilance stages. Interestingly, HFD of wakefulness and stage R were different mainly in the precentral gyrus, possibly reflecting motor inhibition in stage R. The fusiform and parahippocampal gyri were the only areas showing no difference between wakefulness and N2. Stages R and N2 were similar only for the postcentral gyrus. Topographical analysis of brain complexity revealed that sleep stages are clearly differentiated in fronto-central brain regions, but that temporo-occipital regions sleep differently.

Pain-Related Abnormal Neuronal Synchronization of the Nucleus Accumbens in Parkinson’s Disease

Patients with Parkinson’s disease (PD) often experience pain, which fluctuates in “on” and “off” states, but the underlying mechanism is unclear. The nucleus accumbens (NAc) is a central component of the mesolimbic dopaminergic pathway involved in pain processing. We conducted resting-state functional magnetic resonance imaging (rsfMRI) analysis to explore the relationship between the neuronal synchronization of NAc with pain-related brain regions and pain intensity in “on” and “off” states. We assessed 23 patients with sporadic PD based on rsfMRI and pain intensity using the revised Short-Form McGill Pain Questionnaire. Patients with PD displayed higher pain intensity scores in the “off” state than in the “on” state. The pain intensity in the “off” state was substantially correlated with the functional connectivity (FC) between the NAc and primary motor/sensory cortices and contralateral NAc. Changes in pain intensity from the “on” to “off” state displayed correlations with those between the right (rNA) and left NAc (lNAc) and the right precentral gyrus (rPreCG) /right insular cortex (rIC) from the “off” to “on” state. Aberrant bilateral NAc and rNAc–rPreCG/rIC FC in the “off” state were closely related to pain symptoms developed from the “on” to “off” states. These results suggest that the NAc in the mesolimbic pathway is related to pain in PD and may help understand the mechanism of pain development in patients with PD.

Transcriptomic Signatures Associated With Gray Matter Volume Changes in Patients With Functional Constipation

Functional constipation, which belongs to the functional gastrointestinal disorder (FGID), is a common disease and significantly impacts daily life. FGID patients have been progressively proven with functional and structural alterations in various brain regions, but whether and how functional constipation affects the brain gray matter volume (GMV) remains unclear; besides, which genes are associated with the GMV changes in functional constipation is largely unknown. On account of the structural MRI image from the 30 functional constipation patients and 30 healthy controls (HCs), GMV analysis showed that functional constipation patients had significantly decreased GMV in the right orbital prefrontal cortex (OFC), left precentral gyrus (PreG), and bilateral thalamus (THA). Correlation analysis showed that the self-rating depressive scale, patient assessment of constipation quality of life (PAC-QOL), and Wexner constipation scores were negatively correlated with GMV of the OFC and negative correlations between PAC-QOL score and GMV of the bilateral THA. Based on the Allen Human Brain Atlas, a cross-sample spatial correlation was conducted and found that 18 genes’ expression values showed robust correlations with GMV changes in functional constipation patients. These outcomes highlight our recognition of the transcriptional features related to GMV changes in functional constipation and could be regarded as candidates to detect biological mechanisms of abnormality in functional constipation patients.

Surgical strategy for tuberculous brain abscess with dural infiltration: A case report

Background: Tuberculosis is one of the top 10 leading causes of death worldwide. Although tuberculous central complications account for 1% of all tuberculosis patients, there are many cases of medical resistance; and early surgical treatment is required for brain abscess. Reports on tuberculous brain abscesses with dural infiltration are rare, and there are no reports on surgical treatment methods. Case Description: An 81-year-old man was presented with the right arm paresis. His recent medical history included a 6-month course of immunosuppressants, and steroids prescribed for ulcerative colitis, and four antituberculosis drugs had been started 2 months before for relapse of pulmonary tuberculosis at an early age. Head T1-weighted magnetic resonance imaging with administration of gadolinium showed two ring-enhanced lesions in the left precentral gyrus and continuous with the dura mater. Surgery was performed and he was pathologically diagnosed with a tuberculous brain abscess. Since the pathological diagnosis revealed dura mater invasion, we removed the dura mater and reconstructed by periosteum. After the surgery, the symptoms gradually improved, and the abscess and edema improved when viewed on the image. Despite the administration of steroids for ulcerative colitis without antituberculosis drugs, no recurrence was observed for 1 year. Recurrence of tuberculous brain abscess is a major problem in immunosuppressed patients, but it is considered that the relapse could be prevented by removing the dural infiltration. Conclusion: In cases of tuberculous brain abscess with dural infiltration, it is considered that the recurrence can be prevented even in an immunosuppressed state by removing the dura.

Wearing a KN95/FFP2 Facemask Has Subtle Effects on Functional Salience Network Interaction

BackgroundWide use of wearing a facemask is one of the many consequences of the COVID-19 pandemic. We used resting-state fMRI to search for subtle changes in brain functional connectivity, expected notably related to the high-level salience (SN) and default mode networks (DMN).Materials and MethodsProspective crossover design resting fMRI study with/without wearing a tight FFP2/KN95 facemask, including 24 consecutive male participants (mean age ± SD = 29.9 ± 6.9 years) at 3T. As physiological parameters, respiration frequency and heart rate were monitored. Data analysis was performed using the CONN toolbox.ResultsWearing an FFP2/KN95 facemask did not impact respiration or heart rate but resulted in a significant reduction in functional connectivity between the SN as the seed region and the left middle frontal and precentral gyrus. No difference was found when the DMN, sensorimotor, visual, dorsal attention or language networks were used as seed regions.ConclusionsThe wearing of tight FFP2/KN95 facemasks in men decreases the functional connectivity of the SN, which is known to be involved in communication, social behavior and self-awareness. This phenomenon was confined to the left frontal and precentral gyrus. Our results imply that the wearing of a facemask could impact our ability to detect and react appropriately to salient stimuli by altering the functional connectivity of the SN.

Children with Strabismus and Amblyopia Presented Abnormal Spontaneous Brain Activities Measured through Fractional Amplitude of Low-frequency Fluctuation (fALFF)

Purpose: Based on fMRI technology, we explored whether children with strabismus and amblyopia (SA) showed significant change in fractional amplitude of low-frequency fluctuation (fALFF) values in specific brain regions compared with healthy controls, and whether this change could point to the clinical manifestations and pathogenesis of children with strabismus to a certain extent.Methods: We enrolled 23 children with SA and same number matched healthy control in the ophthalmology department of the First Affiliated Hospital of Nanchang University, and the whole brain was scanned by rs-fMRI. The fALFF value of each brain area was derived to examine whether there is a statistical difference in the two groups. Meanwhile, ROC curve was made in a view to evaluate whether this difference proves useful as a diagnostic index. Finally, analyze whether changes in the fALFF value of some specific brain regions are related to clinical manifestations.Results: report to HCs children with SA presented a decreased fALFF values in left temporal pole: the superior temporal gyrus, right middle temporal gyrus, right superior frontal gyrus, right supplementary motor area. Meanwhile, they also showed higher fALFF values in specific brain areas, which included left precentral gyrus, left inferior Parietal, left Precuneus.Conclusion: Children with SA showed abnormal fALFF values in different brain regions. Most of these regions were allocated to the visual formation pathway. The eye movement-related pathway or other visual-related pathways, suggesting the pathological mechanism of the patient.

The neurobiology of smartphone addiction in emerging adults evaluated using brain morphometry and resting-state functional MRI

The characteristics of smartphone addiction (SPA) can be evaluated by neuroimaging studies. Information on the brain structural alterations, and effects on psychosocial wellbeing, however, have not been concurrently evaluated. The aim of this study was to identify abnormalities in gray matter volume using voxel-based morphometry (VBM) and neuronal functional alterations using resting-state functional MRI (rs-fMRI) in emerging adults with SPA. We correlated the neuroimaging parameters with indices for psychosocial wellbeing such as depression, anxiety, stress, and impulsivity. Forty participants (20 SPA and 20 age-matched healthy controls) were assessed using VBM and rs-fMRI. The smartphone addiction scale – Malay version (SAS-M) questionnaire scores were used to categorize the SPA and healthy control groups. DASS-21 and BIS-11 questionnaires were used to assess for psychosocial wellbeing and impulsivity, respectively. VBM identified the SPA group to have reduced gray matter volume in the insula and precentral gyrus; and increased grey matter volume in the precuneus relative to controls. Moderate correlation was observed between the precuneus volume and the SAS-M scores. Individuals with SPA showed significant rs-fMRI activations in the precuneus, and posterior cingulate cortex (FWE uncorrected, p<0.001). The severity of SPA was correlated with depression. Anxiety score was moderately correlated with reduced GMV at the precentral gyrus. Collectively, these results can be used to postulate that the structural and neuronal functional changes in the insula are linked to the neurobiology of SPA that shares similarities with other behavioural addictions.

Temporal Lobe Spikes Affect Distant Intrinsic Connectivity Networks

Objective: To evaluate local and distant blood oxygen level dependent (BOLD) signal changes related to interictal epileptiform discharges (IED) in drug-resistant temporal lobe epilepsy (TLE).Methods: Thirty-three TLE patients undergoing EEG–functional Magnetic Resonance Imaging (fMRI) as part of the presurgical workup were consecutively enrolled. First, a single-subject spike-related analysis was performed: (a) to verify the BOLD concordance with the presumed Epileptogenic Zone (EZ); and (b) to investigate the Intrinsic Connectivity Networks (ICN) involvement. Then, a group analysis was performed to search for common BOLD changes in TLE.Results: Interictal epileptiform discharges were recorded in 25 patients and in 19 (58%), a BOLD response was obtained at the single-subject level. In 42% of the cases, BOLD changes were observed in the temporal lobe, although only one patient had a pure concordant finding, with a single fMRI cluster overlapping (and limited to) the EZ identified by anatomo-electro-clinical correlations. In the remaining 58% of the cases, BOLD responses were localized outside the temporal lobe and the presumed EZ. In every patient, with a spike-related fMRI map, at least one ICN appeared to be involved. Four main ICNs were preferentially involved, namely, motor, visual, auditory/motor speech, and the default mode network. At the single-subject level, EEG–fMRI proved to have high specificity (above 65%) in detecting engagement of an ICN and the corresponding ictal/postictal symptom, and good positive predictive value (above 67%) in all networks except the visual one. Finally, in the group analysis of BOLD changes related to IED revealed common activations at the right precentral gyrus, supplementary motor area, and middle cingulate gyrus.Significance: Interictal temporal spikes affect several distant extra-temporal areas, and specifically the motor/premotor cortex. EEG–fMRI in patients with TLE eligible for surgery is recommended not for strictly localizing purposes rather it might be useful to investigate ICNs alterations at the single-subject level.