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Biomedical subjects

F Tomaiuolo

Publications and source records attributed to F Tomaiuolo.

At least 19 recordsLinked to original sources

Gross anatomy of the corpus callosum in Alzheimer's disease: regions of degeneration and their neuropsychological correlates.

BACKGROUND/AIMS: Differences in the gross shape of the corpus callosum (CC) and its subregional areas were investigated on brain MRI of patients with probable Alzheimer's disease (AD) and age- and gender-matched healthy normal control subjects. The AD patients differed from the normal control subjects in terms of a more convex shape and a reduced area of the CC. METHODS: As for the comparisons of the subregional areas of the CC, we adapted a splitting method which takes into account the modification of the global shape of the CC, and we implemented it by normalizing the CC, to avoid the bias introduced by the observed callosal shape variability. RESULTS: The application of this method unveiled that the regional CC reductions were located in the anterior and posterior third of the CC, i.e. where small myelinated fibers are more frequent. None of the neuropsychological scores collected at the time of the MRI investigation of AD could predict a regional and/or overall callosal area reduction. The only measure that correlated with area of the isthmus of the CC was the MMSE that was administered to all participants. CONCLUSIONS: This latter result may be used as an in vivo indicator of the progress of neocortical disintegration in AD.

Aged↗

Gross morphology and morphometric sequelae in the hippocampus, fornix, and corpus callosum of patients with severe non-missile traumatic brain injury without macroscopically detectable lesions: a T1 weighted MRI study.

OBJECTIVE: The gross morphology and morphometry of the hippocampus, fornix, and corpus callosum in patients with severe non-missile traumatic brain injury (nmTBI) without obvious neuroradiological lesions was examined and the volumes of these structures were correlated with performance on memory tests. In addition, the predictability of the length of coma from the selected anatomical volumes was examined. METHOD: High spatial resolution T1 weighted MRI scans of the brain (1 mm3) and neuropsychological evaluations with standardised tests were performed at least 3 months after trauma in 19 patients. RESULTS: In comparison with control subjects matched in terms of gender and age, volume reduction in the hippocampus, fornix, and corpus callosum of the nmTBI patients was quantitatively significant. The length of coma correlated with the volume reduction in the corpus callosum. Immediate free recall of word lists correlated with the volume of the fornix and the corpus callosum. Delayed recall of word lists and immediate recall of the Rey figure both correlated with the volume of the fornix. Delayed recall of the Rey figure correlated with the volume of the fornix and the right hippocampus. CONCLUSION: These findings demonstrate that in severe nmTBI without obvious neuroradiological lesions there is a clear hippocampal, fornix, and callosal volume reduction. The length of coma predicts the callosal volume reduction, which could be considered a marker of the severity of axonal loss. A few memory test scores correlated with the volumes of the selected anatomical structures. This relationship with memory performance may reflect the diffuse nature of the damage, leading to the disruption of neural circuits at multiple levels and the progressive neural degeneration occurring in TBI.

Adult↗

Loss of spatial learning in a patient with topographical disorientation in new environments.

The case is described of a patient who, following cerebral hypoxia, developed severe difficulty in orienting himself in new environments in the context of a mild global amnesic syndrome. Some episodes he related suggested that his main difficulty was remembering the spatial/directional value of landmarks he recognised. A neuroradiological examination documented severe bilateral atrophy of the hippocampi associated with atrophic changes in the cerebral hemispheres, most marked in the dorsal regions. Neuropsychological and experimental evaluation showed a severe deficit of spatial learning with substantially preserved ability to learn verbal and visual-object information. He was also virtually unable to learn a route in a maze task based exclusively on spatial data, but the availability of visual cues substantially improved his learning. Finally, he performed within normal limits on various tests investigating knowledge acquired premorbidly regarding famous buildings, routes in the town he had been living in since childhood, and geography. Topographical disorientation may be subtended by a specific difficulty in storing the spatial/directional value of visual landmarks in novel environments. The hippocampus appears to be involved in the acquisition of new topographical spatial knowledge.

Adult↗

Morphology and morphometry of the corpus callosum in Williams syndrome: a T1-weighted MRI study.

Williams syndrome (WS) is characterised by a defined genetic aetiology and a specific cognitive profile. It provides an opportunity to examine associations between neuroanatomy, behaviour, and genetics. High-resolution T1-weighted MRI of the brain of 12 patients with WS and 12 normal control subjects were used to estimate the shape and volume of the corpus callosum (CC), as well as the voxel intensity values as a measure its water content. The CC of patients with WS was more convex than that of normal control subjects and overall smaller in volume, particularly in the splenium and in the caudal part of the callosal body. In addition, there were higher ratio values of voxel intensity (i.e. less water content) in the mid-section of the body and the caudal part of the body of the CC. These combined features indicate an aberrant development of the CC in patients with WS and document some of the anatomical abnormalities that may underlie some of the cognitive impairments observed in subjects with WS.

Adolescent↗

Interhemispheric transfer time in a patient with a partial lesion of the corpus callosum.

The interhemispheric transfer time (ITT) of basic visuo-motor integration was investigated in a patient who had a lesion of the corpus callosum that spared the splenium and rostrum. Overall, 4291 simple reaction times were collected during unimanual responses to tachistoscopically presented lateralized simple visual stimuli at 4 degrees, 6 degrees and 10 degrees. Despite retaining some abilities that typically require the integration of information between hemispheres (e.g. haptic naming, tachistoscopic lateralized consonant reading) the patient performed similarly to completely callosotomized patients in a basic visuo-motor ITT task (overall 25.5 ms) at any eccentricity. These findings suggest that specific callosal channels mediate the basic visuo-motor ITT and these do not include the rostrum and/or the splenium of the corpus callosum.

Brain Injuries↗

Remembering what but not where: independence of spatial and visual working memory in the human brain.

We report the neuropsychological and MRI investigation of a patient (MV) who developed a selective impairment of visual-spatial working memory (WM) with preservation not only of verbal, but also of visual shape WM, following an ischemic lesion in the cerebral territory supplied by one of the terminal branches of the right anterior cerebral artery. MV was defective in visual-spatial WM whether the experimental procedure involved arm movement for target pointing or not. Also, in agreement with the role generally assigned to visual-spatial WM in visual imagery, MV was extremely slow in the mental rotation of visually and verbally presented objects. In striking contrast with the WM deficit, MV's visual-spatial long-term memory was intact. The behavioral and neuroanatomical investigation of MV provides support for the hypothesis that the superior frontal gyrus (BA 6) and the dorsomedial cortex of the parietal lobe (BA 7) are part of the neural circuitry underlying visual-spatial WM in humans.

Brain↗

The dissociation of color from form and function knowledge.

We report on two brain-damaged subjects who exhibit the uncommon pattern of loss of object color knowledge, but spared color perception and naming. The subject P.C.O., as in previously reported patients, is also impaired in processing other perceptual and functional properties of objects. I.O.C., in contrast, is the first subject on record to have impaired object color knowledge, but spared knowledge of object form, size and function. This pattern of performance is consistent with the view that semantic information about color and other perceptual properties of objects is grounded in modality-specific systems. Lesion analysis suggests that such grounding requires the integrity of the mesial temporal regions of the left hemisphere.

Adult↗

Parieto-frontal interactions in visual-object and visual-spatial working memory: evidence from transcranial magnetic stimulation.

This study aimed to investigate whether transcranial magnetic stimulation (TMS) can induce selective working memory (WM) deficits of visual-object versus visual-spatial information in normal humans. Thirty-five healthy subjects performed two computerized visual n-back tasks, in which they were required to memorize spatial locations or abstract patterns. In a first series of experiments, unilateral or bilateral TMS was delivered on posterior parietal and middle temporal regions of both hemispheres after various delays during the WM task. Bilateral temporal TMS increased reaction times (RTs) in the visual-object, whereas bilateral parietal TMS selectively increased RTs in the visual-spatial WM task. These effects were evident at a delay of 300 ms. Response accuracy was not affected by bilateral or unilateral TMS of either cortical region. In a second group of experiments, bilateral TMS was applied over the superior frontal gyrus (SFG) or the dorsolateral prefrontal cortex (DLPFC). TMS of the SFG selectively increased RTs in the visual-spatial WM task, whereas TMS of the DLPFC interfered with both WM tasks, in terms of both accuracy and RTs. These effects were evident when TMS was applied after a delay of 600 ms, but not one of 300 ms. These findings confirm the segregation of WM buffers for object and spatial information in the posterior cortical regions. In the frontal cortex, the DLPFC appears to be necessary for WM computations regardless of the stimulus material.

Adult↗

Selective sparing of face learning in a global amnesic patient.

OBJECTIVE: To test the hypothesis that visual memory for faces can be dissociated from visual memory for topographical material. METHOD: A patient who developed a global amnesic syndrome after acute carbon monoxide poisoning is described. A neuroradiological examination documented severe bilateral atrophy of the hippocampi. RESULTS: Despite a severe anterograde memory disorder involving verbal information, abstract figures, concrete objects, topographical scenes, and spatial information, the patient was still able to learn previously unknown human faces at a normal (and, in some cases, at a higher) rate. CONCLUSIONS: Together with previous neuropsychological evidence documenting selective sparing of topographical learning in otherwise amnesic patients, this case is indicative of the fact that the neural circuits involved in face recognition are distinct from those involved in the recognition of other visuoperceptual material (for example, topographical scenes).

Acute Disease↗

Depression and school functioning in non-referred adolescents: a pilot study.

Self-image and self-perceived competencies have been considered to be related to depression in childhood and adolescence. Data from literature points to school functioning as one of the most important factors in self-esteem and self-worth during adolescence. Academic self image, defined as the way adolescents represent themselves as students, directly affects the global self-image; for this reason it has important psychopathological implications. The major aim of this preliminary report is to specifically analyze the relationship between academic self-image (assessed with a specific questionnaire), and self-reported depressive symptoms (assessed with the Children's Depression Inventory) in a school sample 150 adolescents. Our data indicate that the emotional beliefs about schooling and learning were significantly related to depressive symptomatology. Females scored higher in CDI and school anxiety. A real school failure did not affect the academic self image. These data seem to suggest that different components of the academic self-image can be differently associated with depressive feelings.

Adolescent↗

Spatial stimulus-response compatibility and coding of tactile motor events: influence of distance between stimulated and responding body parts, spatial complexity of the task and sex of subject.

We studied spatial stimulus response compatibility in the somatosensory modality by instructing 16 men and 16 women to press a key using the left or the right thumb in response to a nonnoxious electric stimulation delivered either to the left or to the right little finger or, in different blocks, to the left or to the right malleolar region. The task was performed in compatible (stimulus and key-response on the same side of the corporeal midline) and in incompatible conditions (stimulus and key-response on opposite sides of the corporeal midline). In Exp. 1 subjects were tested while keeping their limbs in anatomic position; in Exp. 2 subjects performed the task while keeping the left upper and lower limbs on the right side and the right limbs on the left side of the bodily midline (crossed position). The compatibility effect was observed in both experiments and was higher for stimuli delivered to the little finger than to the malleolar region. This suggests that the cost of inhibiting compatible responses is maximal when stimulated and responding body parts are contiguous. Moreover, in the spatially most demanding task (Exp. 2) men outperformed women for both speed and accuracy suggesting a sex related specialisation in the spatial processing of somatosensory information.

Adult↗

Demyelinating plaques in relapsing-remitting and secondary-progressive multiple sclerosis: assessment with diffusion MR imaging.

BACKGROUND AND PURPOSE: Conventional MR imaging does not provide specific information that can be reliably associated with the pathologic substrate and clinical status of patients with multiple sclerosis (MS). Our goals were 1) to determine whether the orientationally averaged water diffusion coefficient ( ) can be used to distinguish between plaques of different severity in these patients and 2) to assess possible correlations between values and disease duration, Expanded Disability Status Scale (EDSS) score, and signal intensity on T1-weighted MR images. METHODS: Twenty patients (10 with relapsing-remitting MS and 10 with secondary-progressive MS) and 11 healthy volunteers underwent a combined conventional and diffusion-weighted MR study of the brain. , a parameter that is proportional to the trace of the diffusion tensor, was computed by averaging the apparent diffusion coefficients measured in the x, y, and z directions. measurements were obtained for selected areas of white matter plaques. Differences in among the three groups were tested using analysis of variance. RESULTS: was significantly higher (1.445 +/- 0.129 x 10(-3) mm2/s) in secondary-progressive lesions than in relapsing-remitting lesions (0.951 +/- 0.08), and both values were higher than in normal white matter (0.732 +/- 0.02). There was a significant negative correlation between and the degree of hypointensity on T1-weighted images, and a positive correlation between and both EDSS score and disease duration. CONCLUSION: Our findings suggest that is useful for distinguishing MS lesions of different severities, which are associated with different degrees of clinical disability.

Adolescent↗

Morphology, morphometry and probability mapping of the pars opercularis of the inferior frontal gyrus: an in vivo MRI analysis.

The pars opercularis occupies the posterior part of the inferior frontal gyrus. Electrical stimulation or damage of this region interferes with language production. The present study investigated the morphology and morphometry of the pars opercularis in 108 normal adult human cerebral hemispheres by means of magnetic resonance imaging. The brain images were transformed into a standardized proportional steoreotaxic space (i.e. that of Talairach and Tournoux) in order to minimize interindividual brain size variability. There was considerable variability in the shape and location of the pars opercularis across brains and between cerebral hemispheres. There was no significant difference or correlation between left and right hemisphere grey matter volumes. There was also no significant difference between sex and side of asymmetry of the pars opercularis. A probability map of the pars opercularis was constructed by averaging its location and extent in each individual normalized brain into Talairach space to aid in localization of activity changes in functional neuroimaging studies.

Adult↗

Interhemispheric asymmetries in the perception of unimanual and bimanual cutaneous stimuli. A study using transcranial magnetic stimulation.

Previous studies have shown that transcranial magnetic stimulation (TMS) of the sensorimotor cortex can induce a suppression of cutaneous perception from the fingers of the contralateral hand. In this work, 17 normal subjects were submitted to focal TMS of frontal and parietal scalp sites of each hemisphere. TMS was delivered at two interstimulus intervals (20 and 40 ms) following a cutaneous electrical stimulation of the first, third and fifth digits of either hand or both hands near the subjective threshold of perception. The aim of our study was to investigate whether TMS could detect an asymmetrical hemispheric specialization in the sensory perception of unimanual and bimanual, ipsilateral and contralateral sensory stimuli. At each interpulse interval, the right parietal cortex was significantly more sensitive to TMS interference with stimulus detection for both contralateral and ipsilateral stimuli compared with the left parietal cortex. These effects were mainly evident during bimanual discrimination tasks. Our results are indicative of an interhemispheric difference in the detection of cutaneous sensation, showing right hemispheric prevalence in the perception of contralateral as well as of ipsilateral stimuli. They provide neurophysiological support in normal humans to the clinical evidence which indicates that right hemisphere lesions can indeed produce deficits in the perception of ipsilateral sensory stimuli.

Adult↗

Left frontal transcranial magnetic stimulation reduces contralesional extinction in patients with unilateral right brain damage.

It has been demonstrated previously that transcranial magnetic stimulation (TMS) of the sensorimotor cortex can induce transient suppression of the perception of cutaneous near-threshold stimuli from fingers of the contralateral hand in normal individuals. One explanation accounting for deficits in the exploration of contralateral space following a unilateral hemispheric lesion refers to a loss of the normal interhemispheric balance, with a resultant hyperactivation of the unaffected hemisphere due to the release of reciprocal inhibition by the affected one. In order to verify this hypothesis, we investigated the effects of a TMS-induced transient dysfunction of the normal hemisphere upon contralateral tactile extinctions in two groups: (i) 14 right brain-damaged patients and (ii) 14 left brain-damaged control patients. Single-pulse TMS was delivered to frontal and parietal scalp sites of the unaffected hemisphere after an interval of 40 ms from an electrical unimanual or bimanual digit stimulation. In right brain-damaged patients, left frontal TMS significantly reduced the rate of contralateral extinctions compared with controls. After left parietal TMS, the number of extinctions was comparable to the baseline. This pattern of increased sensitivity to cutaneous stimulation ipsilateral to TMS was not observed in left brain-damaged control patients. In this group, right hemisphere TMS did not significantly alter the recognition of bimanual stimuli delivered to the space contralateral to the lesion. The suggestion is made that extinctions produced by right brain damage may be dependent on a breakdown in the balance of hemispheric rivalry in directing spatial attention to contralateral hemispace, so that the unaffected hemisphere generates an unopposed orienting response to the side of the lesion. The mechanisms whereby the left frontal TMS transiently ameliorates these deficits may involve stimulus-induced removal of a left frontal-right parietal transcallosal inhibitory flow, although interactions at subcortical levels cannot be excluded.

Aged↗

Blindsight in hemispherectomized patients as revealed by spatial summation across the vertical meridian.

The present study provides a demonstration of blindsight in two hemispherectomy patients who showed a visual spatial summation effect across the vertical meridian despite their lack of visual awareness in one hemifield. Such an effect cannot be related to light diffusion onto the sighted hemifield because it was not present when one of the stimuli fell into the retinal blind spot of control subjects. We conclude that blindsight phenomena of the simple type described in the present study can be subserved by sub-cortical mechanisms and do not necessarily require cortical processing.

Adolescent↗

In vivo morphometry of the intrasulcal gray matter in the human cingulate, paracingulate, and superior-rostral sulci: hemispheric asymmetries, gender differences and probability maps.

Volumes of the intrasulcal gray matter were measured in three cerebral sulci located on the medial wall of the human frontal lobe: cingulate sulcus (CS), paracingulate sulcus (PCS), and superior-rostral sulcus (SRS). The measurements were carried out on T1-weighted 3-D high-resolution magnetic-resonance (MR) images acquired in 105 young right-handed volunteers (42 female and 63 male). Before the measurement, the images were transformed into a standardized stereotaxic space (Talairach and Tournoux [1988] Human Brain: 3-Dimensional Proportional System. An Approach to Cerebral Imaging. Stuttgart, New York: Georg Thieme Verlag), thus removing inter-individual differences in brain size. The intrasulcal gray matter was segmented in a semi-automatic manner. Significant gender differences were found in the volume of the CS (female > male) and the PCS (male > female). Hemispheric asymmetries were observed between the left and right volumes of the intrasulcal gray matter in the anterior (right > left) and posterior (left > right) segments of the CS, as well as between the left and right volumes of the PCS (left > right). There was no interaction between the asymmetries and gender. In addition, significant positive correlations were found between the left and right gray-matter volumes in the anterior (r = 0.43) and posterior (r = 0.66) segments of the CS, whereas significant negative correlations were observed between the gray-matter volumes of the anterior segment of the CS and those of the PCS (left hemisphere: r = -0.48; right hemisphere: r = -0.42). The observed hemispheric asymmetries in the CS and PCS gray-matter volumes are consistent with the proposed role of these structures in the integration of emotions with cognition (CS) and in the control of speech/vocalization (PCS). The pattern of inter-hemispheric correlations in the sulcal gray-matter points to an increasing asynchrony in the foetal development of primary (CS), secondary (SRS), and tertiary (PCS) sulci, respectively. The presence of negative correlations between the two neighbouring sulci (CS and PCS) suggests that a process of compensation could underlie interactions between adjacent primary and tertiary sulci. Besides the above volumetric analysis, we also provide average (probability) maps of the three sulci; the use of such maps for the parcellation of the medial frontal lobe and localization of "peaks" obtained in blood-flow activation studies is discussed.

Brain Mapping↗

Left-right asymmetry of callosal transfer in normal human subjects.

Interhemispheric transfer (IT) of visuomotor information can be assessed by measuring the crossed-uncrossed difference (CUD) in the Poffenberger paradigm [14]. We report a series of experiments aimed at casting light on two aspects of IT: the importance of motor response variables and the nature of the left-right asymmetries found in a recent meta-analysis of studies using the Poffenberger paradigm [10]. In Experiments 1 and 2 we found no effect of varying the finger used for response while there was a larger CUD when using the left hand in comparison to the right hand. In Experiment 3, which employed visual stimuli different from the two preceding experiments, CUD asymmetries were related to hemifields rather than to hands with a CUD larger for the right than for the left visual hemifield. These findings suggests that both motor and visual variables are important for CUD asymmetries to occur and are in keeping with a horse race model according to which overall speed of IT is determined by whichever signal (visual or pre-motor) is more rapid in crossing from one side to the other. As to the issue of lateral asymmetries in the CUD, the results of Expt. 3 have also shown that asymmetries arise only in tasks requiring an IT and therefore cannot depend upon additive hemispheric effects.

Adult↗