Obsessions appear after the removal a brain tumor in the right frontal lobe

A series of case reports and neuroimaging research points to the underlying neuropathological substrate for obsessive–compulsive disorder (OCD) and the underlying associations between OCD and areas of the frontal lobe. We report a patient wherein the onset of OCD occurred after resection of meningioma of the right frontal lobe and who was treated successfully with paroxetine hydrochloride. We suggest that the onset of secondary (organic) OCD is associated with the frontal lobe, and we propose that the origin of obsessions is located in the right frontal lobe.     

Validation of a neurofeedback paradigm: Manipulating frontal EEG alpha-activity and its impact on mood

It is claimed that neurofeedback (NF) is an effective treatment for a variety of psychiatric disorders. NF, within an operant conditioning framework, helps individuals to regulate cortical electroencephalographic (EEG) activity while receiving feedback from a visual or acoustic signal. For example, changing asymmetry between left and right frontal brain alpha activity by NF, is claimed to be an efficacious treatment for major depressive disorder. However, the specificity of this intervention in occasioning electrophysiological changes at target locations and target wave-frequencies, and its relation to changes in mood, has not been established. During a single session of NF, it was tested if the balance between left and right frontal alpha-activity could be changed, regardless of direction, in 40 healthy females. Furthermore, we investigated whether this intervention was electrophysiologically specific and if it was associated with changes in mood. Participants were able to decrease or increase frontal alpha-asymmetry during the intervention. However, no changes in mood were observed. Changes in EEG activity were specific in terms of location and wave-frequency.     

Changes in whole-brain functional networks and memory performance in aging

We used resting-functional magnetic resonance imaging data from 98 healthy older adults to analyze how local and global measures of functional brain connectivity are affected by age, and whether they are related to differences in memory performance. Whole-brain networks were created individually by parcellating the brain into 90 cerebral regions and obtaining pairwise connectivity. First, we studied age-associations in interregional connectivity and their relationship with the length of the connections. Aging was associated with less connectivity in the long-range connections of fronto-parietal and fronto-occipital systems and with higher connectivity of the short-range connections within frontal, parietal, and occipital lobes. We also used the graph theory to measure functional integration and segregation. The pattern of the overall age-related correlations presented positive correlations of average minimum path length (r = 0.380, p = 0.008) and of global clustering coefficients (r = 0.454, p < 0.001), leading to less integrated and more segregated global networks. Main correlations in clustering coefficients were located in the frontal and parietal lobes. Higher clustering coefficients of some areas were related to lower performance in verbal and visual memory functions. In conclusion, we found that older participants showed lower connectivity of long-range connections together with higher functional segregation of these same connections, which appeared to indicate a more local clustering of information processing. Higher local clustering in older participants was negatively related to memory performance.     

A review of selected candidate endophenotypes for depression

Endophenotypes are proposed to occupy an intermediate position in the pathway between genotype and phenotype in genetically complex disorders such as depression. To be considered an endophenotype, a construct must meet a set of criteria proposed by Gottesman and Gould (2003). In this qualitative review, we summarize evidence for each criterion for several putative endophenotypes for depression: neuroticism, morning cortisol, frontal asymmetry of cortical electrical activity, reward learning, and biases of attention and memory. Our review indicates that while there is strong support for some depression endophenotypes, other putative endophenotypes lack data or have inconsistent findings for core criteria.     

Effect of levetiracetam on behavioral problems in pervasive developmental disorder children with epilepsy

AimsWe investigated the relationship between behavioral problems, location of electroencephalogram (EEG) paroxysmal abnormalities (PA), and treatment with levetiracetam in children with pervasive developmental disorder (PDD) and epilepsy.MethodsTwelve PDD children with epilepsy were included in the study. All patients had EEG PA (frontal spikes, 8; rolandic, 3; generalized, 1). After a 3-month baseline period, patients were given levetiracetam with an initial dose of 10 mg/kg/day for the first week, followed by increments of 5 mg/kg/day every week. Levetiracetam dosage was then adjusted up to a maximum of 60 mg/kg/day. EEG recordings were performed every 3 months, focusing on PA frequency. We counted the frequency of seizures and EEG PA, and scored instances of panic/aggressive behaviors.ResultsEight (66.7%) of the 12 patients were considered to be responders to clinical seizures and EEG findings (≥50% reduction in both seizures and PA frequency). Six (75%) of these eight patients were considered to be responders for behavioral problems (≥50% reduction in panic/aggressive behavior). These six patients had frontal EEG paroxysms, whereas the remaining two patients without behavioral responses had rolandic EEG paroxysms. Patients with frontal PA showed a significantly higher correlation between EEG/clinical seizures and behavioral improvements (p < 0.05).ConclusionThe present data indicated the usefulness of LEV in reducing behavioral problems related to the reduction of seizures and frontal spikes in PDD for some but not all of the patients. Thus, levetiracetam represents an important addition to treatment for PDD children with epilepsy presenting with frontal EEG paroxysms.     

额叶脑挫裂伤合并颅内血肿单侧开颅手术临床疗效评价

【目的】探讨单侧开颅手术治疗额叶脑挫裂伤合并颅内血肿的临床疗效。【方法】选取2015年6月至2017年6月本院手术治疗的额叶脑挫裂伤合并颅内血肿患者110例,根据手术入路分为单侧开颅手术(观察组,n=60)、双侧开颅手术(对照组,n=50),对比两组患者的手术时间、输血量、住院时间、术后不同时间的格拉斯哥昏迷(GCS)评分、格拉斯哥预后评分,手术前后患者血清神经元烯醇化酶(NSE)、S100β蛋白、乳酸水平变化。【结果】观察组患者的手术时间、输血量、住院时间均显著地低于对照组患者,差异均具有统计学意义(P<0.05)。术后1周,观察组患者的GCS评分显著地高于对照组患者,差异均具有统计学意义(P<0.05)。术后3个月进行患者预后评估,观察组患者的预后良好率66.67%显著高于对照组患者的46.00%,差异具有统计学意义(P<0.05)。术后1d,两组患者的血清NSE、S100β蛋白、血乳酸浓度差异不具有统计学意义(P>0.05);术后1周,观察组患者的血清NSE、S100β蛋白、血乳酸浓度均显著低于对照组患者,差异具有统计学意义(P<0.05)。【结论】额叶脑挫裂伤合并颅内血肿患者采用单侧开颅手术相对于双侧开颅手术其创伤更小、术后恢复效果更好。     

不同术式治疗先天性上睑下垂患者的疗效比较

目的 比较不同术式治疗先天性上睑下垂患者的效果.方法 选取我院2018年3月～2020年1月期间接收的先天性上睑下垂患者112例作为研究对象,其中接受经眶隔后隧道额肌瓣悬吊术治疗的57例患者作为悬吊组,接受上睑提肌缩短徙前矫正术治疗的55例患者作为提肌组,比较两组临床疗效、并发症状况以及术后1个月、3个月、6个月上睑回...     

Methamphetamine induces neuronal death: Evidence from rodent studies

Animal studies have consistently observed neuronal death following methamphetamine (MA) administration, however, these have not been systematically reviewed. This systematic review aims to present the evidence for MA-induced neuronal death in animals (rodents) and identify the regions affected. Locating the brain regions in which neuronal death occurs in animal studies will provide valuable insight into the linkage between MA consumption and the structural alterations observed in the human brain. The data were collected from three databases: Scopus, Ovid, and the Web of Science. Thirty-seven studies met the inclusion criteria and were divided into two sub-groups, i.e. acute and repeated administration. Twenty-six (of 27) acute and ten (of 11) repeated administration studies observed neuronal death. A meta-analysis was not possible due to different variables between studies, i.e. species, treatment regimens, withdrawal periods, methods of quantification, and regions studied. Acute MA treatment induced neuronal death in the frontal cortex, striatum, and substantia nigra, but not in the hippocampus, whereas repeated MA administration led to neuronal loss in the hippocampus, frontal cortex, and striatum. In addition, when animals self-administered the drug, neuronal death was observed at much lower doses than the doses administered by experimenters. There is some overlap in the regions where neuronal death occurred in animals and the identified regions from human studies. For instance, gray matter deficits have been observed in the prefrontal cortex and hippocampus of MA users. The findings presented in this review implicate that not only does MA induce neuronal death in animals, but it also damages the same regions affected in human users. Despite the inter-species differences, animal studies have contributed significantly to addiction research, and are still of great assistance for future research with a more relevant model of compulsive drug use in humans.     

Anterior skull base reconstruction after tumour resection using the posterior wall of the frontal sinus

IntroductionThe authors describe their experience of surgical closure of the anterior skull base after tumour resection, using the posterior wall of the frontal sinus.Material and methodThe authors describe their anterior skull base closure technique performed in three patients after tumour resection. Tumour resection via a transglabellar approach resulted in an anterior skull base defect. Reconstruction consisted of direct implantation of the posterior wall of the frontal sinus without using a bone substitute (except when nasofrontal duct obstruction is required).ResultsThree patients were operated by this surgical procedure with complete tumour resection in every case and no infectious complications. This technique was easy to perform, despite one case of persistent CSF leak. Follow-up imaging showed no displacement of the onlay bone graft.ConclusionAnterior skull base reconstruction after tumour resection using autologous frontal sinus bone graft is easy to perform with a low complication rate.     

额眶损伤的伤情特点及手术处理

目的 总结额眶损伤的伤情特点,探讨额眶损伤早期手术处理的效果。 方法 对广东医学院附属厚街医院神经外科自2001年6月至2009年5月救治的26例额眶部损伤患者的临床资料及手术治疗情况进行回顾性分析。 结果 额眶损伤患者的伤情特点为意识障碍轻、额眶塌陷畸形明显、脑脊液漏及颅神经损伤发生率高。术后随访6～12个月,根据GOS评分分为恢复良好19例,中残6例,重残1例。按面部整形评价标准,17例行额眶整复者术后12例达到整形标准优秀级,5例达到良好级。7例行颅底重建者术后均无脑脊液漏发生,2例行视神经管减压者术后视力改善明显。 结论 额眶损伤在治疗上应积极早期手术,包括颅内血肿清除、挫伤坏死脑组织清除、额眶塌陷畸形整复、颅底修复等,此有助于患者神经功能的恢复及防止颅内感染等。