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European Neurology 2023A solitary pontine lesion (SPL) is a single brainstem lesion on the trigeminal nerve pathway without any other central nervous system lesion. This research aimed to...
A solitary pontine lesion (SPL) is a single brainstem lesion on the trigeminal nerve pathway without any other central nervous system lesion. This research aimed to investigate the demographic and clinical features of nonpainful TNO patients with SPL and identify the most frequently affected anatomical areas using lesion mapping techniques. Demographic and clinical features were retrospectively reviewed from the patients' charts. Brain lesions were mapped using MRIcroGL software. The study included 6 patients (three females and three males) with an SPL. The median age of the patients was 57 (range: 46-68) years. Cranial MRI displayed lesions in the dorsolateral pons and the cerebellar peduncle. The lesion mapping revealed that the lesions were on the trigeminal nerve pathway. SPL is an uncommon cause of TNO. Nonpainful SPL patients have demographic, clinical, and radiological features similar to those of painful SPL patients. The lesion mapping showed that the same brainstem areas are affected in painful and nonpainful SPL patients.
Topics: Male; Female; Humans; Middle Aged; Aged; Retrospective Studies; Pons; Trigeminal Nerve Diseases; Trigeminal Nerve; Brain Stem; Magnetic Resonance Imaging
PubMed: 36689918
DOI: 10.1159/000528470 -
Trends in Cognitive Sciences Jun 2022Neural dynamics are shaped and constrained by the projections of a small nucleus in the pons: the noradrenergic locus coeruleus (LC). Much like a bow to the brain's... (Review)
Review
Neural dynamics are shaped and constrained by the projections of a small nucleus in the pons: the noradrenergic locus coeruleus (LC). Much like a bow to the brain's violin, activity in the LC lacks content specificity, but instead dynamically shapes the excitability and receptivity of neurons across the brain. In this review, we explain how the style of the bowing technique, which is analogous to different firing modes in the LC, affects distinct activity patterns in the rest of the brain. Through this analogical lens, we provide intuitive insights into how the complex activity of the LC acts to coordinate adaptive neural dynamics.
Topics: Humans; Locus Coeruleus; Neurons
PubMed: 35469726
DOI: 10.1016/j.tics.2022.03.006 -
Parkinsonism & Related Disorders Sep 2021This study aimed to evaluate whether novel individual voxel-based morphometry adjusting covariates (iVAC), such as age, sex, and total intracranial volume, could...
INTRODUCTION
This study aimed to evaluate whether novel individual voxel-based morphometry adjusting covariates (iVAC), such as age, sex, and total intracranial volume, could increase the accuracy of a diagnosis of multiple system atrophy (MSA) and enable the differentiation of MSA from Parkinson's disease (PD).
METHODS
We included 53 MSA patients (MSA-C: 33, MSA-P: 20), 53 PD patients, and 189 healthy controls in this study. All participants underwent high-resolution T1-weighted imaging (WI) and T2-WI with a 3.0-T MRI scanner. We evaluated the occurrence of significant atrophic findings in the pons/middle cerebellar peduncle (MCP) and putamen on iVAC and compared these findings with characteristic changes on T2-WI.
RESULTS
On iVAC, abnormal findings were observed in the pons/MCP of 96.2% of MSA patients and in the putamen of 80% of MSA patients; however, on T2-WI, they were both observed at a frequency of 60.4% in MSA patients. On iVAC, all but one MSA-P patient (98.1%) showed significant atrophic changes in the pons/MCP or putamen. By contrast, 69.8% of patients with MSA showed abnormal signal changes in the pons/MCP or putamen on T2-WI. iVAC yielded 95.0% sensitivity and 96.2% specificity for differentiating MSA-P from PD.
CONCLUSION
iVAC enabled us to recognize the morphological characteristics of MSA visually and with high accuracy compared to T2-WI, indicating that iVAC is a potential diagnostic screening tool for MSA.
Topics: Adult; Aged; Case-Control Studies; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Middle Cerebellar Peduncle; Multiple System Atrophy; Parkinson Disease; Pons; Putamen; Reproducibility of Results; Sensitivity and Specificity
PubMed: 34481140
DOI: 10.1016/j.parkreldis.2021.07.025 -
Fetal and Pediatric Pathology Feb 2018This study evaluated the feasibility of measuring the fetal mesencephalon and pons by ultrasonographic cross sectional imaging to detect fetal central nervous system...
OBJECTIVES
This study evaluated the feasibility of measuring the fetal mesencephalon and pons by ultrasonographic cross sectional imaging to detect fetal central nervous system developmental abnormalities.
MATERIALS AND METHODS
Fetal ultrasonographic measurements included: Fetal mesencephalon anteroposterior diameters (MAD), mesencephalon transverse diameters (MTD), pons anteroposterior diameter (PAD) and proximal transverse diameters (PTD).
RESULTS
Nine-hundred ninety fetuses were imaged. Thirty-eight fetuses (observation group) presented central nervous system abnormalities; 952 fetuses without imaged abnormalities were utilized as the reference (control) group. Fetal MAD, MTD, PAD, and PTD in control fetuses showed a linear correlation with gestational age. Thirty-eight fetuses had 40 abnormal measurements (8 MAD, 8 MTD, 14 PAD, and 10 PTD), 16 in mesencephalon, and 24 in pons. All data fell below the 95% confidence intervals' lower limits for the corresponding gestational age.
CONCLUSION
Using normative data based on 957 fetuses allows detection of size abnormalities of the pons and midbrain during fetal life.
Topics: Fetus; Humans; Mesencephalon; Nervous System Malformations; Neuroimaging; Pons; Ultrasonography, Prenatal
PubMed: 29336643
DOI: 10.1080/15513815.2017.1397069 -
Journal of Neuroscience Research Nov 2021The pons is one of the earliest affected regions in patients with synucleinopathies. We aimed to investigate the diagnostic value of measuring pontine damage using...
The pons is one of the earliest affected regions in patients with synucleinopathies. We aimed to investigate the diagnostic value of measuring pontine damage using diffusion tensor imaging (DTI) in these patients. We enrolled 49 patients with Parkinson's disease (PD), 16 patients with idiopathic rapid eye movement sleep behavior disorder (iRBD), 23 patients with multiple system atrophy (MSA), and 39 healthy controls in this study. All the participants underwent high-resolution T1-weighted imaging and DTI. Mean diffusivity (MD) and fraction anisotropy (FA) values in the pons were calculated to characterize structural damage. The discriminatory power of pontine MD and FA values to differentiate patients with synucleinopathies from healthy controls was examined using receiver operating characteristics (ROC) analyses. Compared to healthy controls, patients with PD, iRBD, and MSA had increased MD values and decreased FA values in the pons, although no correlation was observed between these DTI measures and disease severity. The ROC analyses showed that MD values in the pons had a fair discriminatory power to differentiate healthy controls from patients with PD (area under the curve [AUC], 0.813), iRBD (AUC, 0.779), and MSA (AUC, 0.951). The AUC for pontine FA values was smaller than that for pontine MD values when differentiating healthy controls from patients with PD (AUC, 0.713; p = 0.054) and iRBD (AUC, 0.686; p = 0.045). Our results suggest that MD values in the pons may be a useful marker of brain stem neurodegeneration in patients with synucleinopathies.
Topics: Anisotropy; Diffusion Tensor Imaging; Humans; Pons; REM Sleep Behavior Disorder; Synucleinopathies
PubMed: 34521154
DOI: 10.1002/jnr.24926 -
Journal of Neurology Aug 2022Pontine infarctions are often associated with extrapontine infarcts. We aimed to elucidate differences in clinical characteristics, mechanisms, and functional outcomes...
BACKGROUND
Pontine infarctions are often associated with extrapontine infarcts. We aimed to elucidate differences in clinical characteristics, mechanisms, and functional outcomes between isolated pontine infarction (IPI) and pontine plus infarction (PPI).
METHODS
We studied patients with acute pontine infarction between January 2019 and August 2021 and divided them into IPI and PPI according to diffusion-weighted magnetic resonance image. Vertical locations were classified into rostral, middle, and caudal, and horizontal locations were categorized as basal/tegmental and unilateral/bilateral. Factors associated with poor 90-day outcome (modified Rankin scale 3-6) were analyzed.
RESULTS
Among 241 patients, 170 (70.5%) had IPI and 71 (29.5%) had PPI. The most frequently observed extrapontine areas were cerebellar (59.1%), followed by posterior cerebral artery territory (45.1%). Mental status changes, sensory changes, and ataxia were more common, and motor dysfunction was less common in PPI patients. The PPI patients more often had rostral (P < 0.001), bilateral lesions (P < 0.001), and moderate/severe vascular stenosis and atrial fibrillation; therefore, large artery disease (LAD) and cardioembolism were more common stroke mechanisms (P < 0.001). In IPI patients, high initial National Institutes of Health Stroke Scale (NIHSS) (adjusted Odds ratio (OR) = 1.38; P = 0.001) and old age (aOR = 1.05; P = 0.049) were associated with poor functional outcome, whereas moderate/severe stenosis (Reference: no stenosis, aOR = 7.17; P = 0.014) and high initial NIHSS (aOR = 1.39; P = 0.006) were related to unfavorable outcomes in PPI patients.
CONCLUSIONS
PPI patients more often had extensive pontine lesions, LAD and cardioembolism, and their outcome was more often influenced by underlying severe vascular diseases. These differences need to be considered in the prevention and therapeutic strategies.
Topics: Brain Stem Infarctions; Constriction, Pathologic; Humans; Infarction; Pons; Prevalence; Stroke
PubMed: 35318490
DOI: 10.1007/s00415-022-11075-1 -
Brain & Development Apr 2017Down syndrome (DS) is the most common chromosomal aberration, but the characteristics of the brainstem component in this condition during childhood (from newborn to...
BACKGROUND
Down syndrome (DS) is the most common chromosomal aberration, but the characteristics of the brainstem component in this condition during childhood (from newborn to preteen stages) have not been clarified.
OBJECTIVE
To evaluate the morphological features of the brainstem in DS on magnetic resonance imaging (MRI).
MATERIALS AND METHODS
MRIs for 32 children with DS (16 boys and girls each; age range, 0-11years) without major brain insults, and 32 age-matched controls (16 boys and girls each) were retrospectively analyzed. Height, width, and area of the midbrain, pons, and medulla oblongata were measured on sagittal T1-weighted images; these were compared in children with DS and age-matched controls. The ratios of the brainstem to the size of the posterior fossa (BS/PF index) were calculated; these were also compared in the children with DS and the control group.
RESULTS
The width and area of the midbrain; height, width, area of the pons; and area of the medulla oblongata were significantly smaller in children with DS than in control children (P<0.05); the area of the pons, particularly for the ventral part, showed the largest differences in the mean relative differences. The BS/PF indices of the height, width, and area of the pons were significantly smaller in children with DS than in the control group (P<0.01). However, the BS/PF indices for the midbrain and the medulla oblongata did not differ between these two groups.
CONCLUSIONS
Children with DS may have small brainstems, particularly in the pons; this may be a characteristic morphological feature of the brainstem on MRI in childhood including neonates.
Topics: Child; Child, Preschool; Down Syndrome; Female; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Medulla Oblongata; Mesencephalon; Organ Size; Pons
PubMed: 27865668
DOI: 10.1016/j.braindev.2016.10.016 -
Multiple Sclerosis and Related Disorders Jan 2020Diagnosis of central or peripheral facial palsy (FP) is traditionally based on clinical evaluation. This study aims at investigating the relationship between clinical... (Observational Study)
Observational Study
BACKGROUND
Diagnosis of central or peripheral facial palsy (FP) is traditionally based on clinical evaluation. This study aims at investigating the relationship between clinical evaluation of FP and lesion location as visible on Magnetic Resonance Imaging (MRI) in patients with Multiple Sclerosis (MS) for the purpose of adding supporting evidence to the diagnosis of central or peripheral FP in these patients.
METHODS
A retrospective study was conducted on data from patients who underwent MS treatment between January 2016 and January 2019 at the MS Center of Wayne State University, MI, USA, and presented with at least one episode of FP during the observational period. The following data was collected from each patient: demographics, time from MS onset, side of FP, FP type (central or peripheral, as clinically evaluated), FP onset, FP treatment, amount of recovery of normal facial movements, time elapsed from beginning of FP treatment, number of FP recurrences, lesions presence/absence and location as visible on MRI. Correlation analysis was performed to assess to which extent clinical evaluation of FP correlated with presence of MRI lesions in different locations.
RESULTS
Eighteen patients were included in this study. In thirteen patients (72.2%) FP was classified as peripheral. Among them only five (38.4%) displayed one or more lesions in the pons. Correlation between presence of lesions in the pons and presence of peripheral FP was statistically significant (p = 0.02). Correlation between presence of lesions in the cortex (observed in 61.5% of patients with FP clinically evaluated as peripheral) and presence of FP clinically evaluated as peripheral was also statistically significant (p = 0.01). Finally, presence of lesions in the cortex was significantly correlated with presence of FP clinically evaluated as central (p = 0.02).
CONCLUSIONS
FP clinically classified as peripheral may be caused by central lesions in the cortex or pons and not only by peripheral facial nerve damage. In MS patients, FP may appear at the onset of the disease and be misdiagnosed as Bell 's palsy. Clinicians should carefully approach FP diagnosis and perform a brain as well as temporal bone MRI before pursuing pharmacological treatment.
Topics: Adult; Cerebral Cortex; Facial Nerve; Facial Paralysis; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pons; Retrospective Studies; Young Adult
PubMed: 31670209
DOI: 10.1016/j.msard.2019.101456 -
Cell Sep 2016Urine release (micturition) serves an essential physiological function as well as a critical role in social communication in many animals. Here, we show a combined...
Urine release (micturition) serves an essential physiological function as well as a critical role in social communication in many animals. Here, we show a combined effect of olfaction and social hierarchy on micturition patterns in adult male mice, confirming the existence of a micturition control center that integrates pro- and anti-micturition cues. Furthermore, we demonstrate that a cluster of neurons expressing corticotropin-releasing hormone (Crh) in the pontine micturition center (PMC) is electrophysiologically distinct from their Crh-negative neighbors and sends glutamatergic projections to the spinal cord. The activity of PMC Crh-expressing neurons correlates with and is sufficient to drive bladder contraction, and when silenced impairs micturition behavior. These neurons receive convergent input from widespread higher brain areas that are capable of carrying diverse pro- and anti-micturition signals, and whose activity modulates hierarchy-dependent micturition. Taken together, our results indicate that PMC Crh-expressing neurons are likely the integration center for context-dependent micturition behavior.
Topics: Animals; Corticotropin-Releasing Hormone; Female; Glutamic Acid; Mice; Mice, Inbred C57BL; Muscle Contraction; Neurons; Pons; Smell; Spinal Cord; Urinary Bladder; Urination
PubMed: 27662084
DOI: 10.1016/j.cell.2016.08.073 -
The Journal of Neuroscience : the... Jul 2020The cholinergic neurons in the pontomesencephalic tegmentum have been shown to discharge in association with and promote cortical activation during active or attentive...
The cholinergic neurons in the pontomesencephalic tegmentum have been shown to discharge in association with and promote cortical activation during active or attentive waking and paradoxical or rapid eye movement sleep. However, GABA neurons lie intermingled with the cholinergic neurons and may contribute to or oppose this activity and role. Here we investigated and the properties, activities, and role of GABA neurons within the laterodorsal tegmental and sublaterodorsal tegmental nuclei (LDT/SubLDT) using male and female transgenic mice expressing channelrhodopsin-()- in vesicular GABA transporter ()-expressing neurons. Presumed GABA (pGABA) neurons were identified by response to photostimulation and verified by immunohistochemical staining following juxtacellular labeling pGABA neurons were found to be fast-firing neurons with the capacity to burst when depolarized from a hyperpolarized membrane potential. When stimulated in urethane-anesthetized or unanesthetized mice, the pGABA neurons fired repetitively at relatively fast rates (∼40 Hz) during a continuous light pulse or phasically in bursts (>100 Hz) when driven by rhythmic light pulses at theta (4 or 8 Hz) frequencies. pNon-GABA, which likely included cholinergic, neurons were inhibited during each light pulse to discharge rhythmically in antiphase to the pGABA neurons. The reciprocal rhythmic bursting by the pGABA and pNon-GABA neurons drove rhythmic theta activity in the EEG. Such phasic bursting by GABA neurons also occurred in WT mice in association with theta activity during attentive waking and paradoxical sleep. Neurons in the pontomesencephalic tegmentum, particularly cholinergic neurons, play an important role in cortical activation, which occurs during active or attentive waking and paradoxical or rapid eye movement sleep. Yet the cholinergic neurons lie intermingled with GABA neurons, which could play a similar or opposing role. Optogenetic stimulation and recording of these GABA neurons in mice revealed that they can discharge in rhythmic bursts at theta frequencies and drive theta activity in limbic cortex. Such phasic burst firing also occurs during natural attentive waking and paradoxical sleep in association with theta activity and could serve to enhance sensory-motor processing and memory consolidation during these states.
Topics: Anesthesia; Animals; Cerebral Cortex; Electroencephalography; Electrophysiological Phenomena; Female; Male; Mesencephalon; Mice; Mice, Inbred C57BL; Mice, Transgenic; Optogenetics; Photic Stimulation; Pons; Sleep; Vesicular Inhibitory Amino Acid Transport Proteins; Wakefulness; gamma-Aminobutyric Acid
PubMed: 32576622
DOI: 10.1523/JNEUROSCI.2875-19.2020