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- Abé, Christoph, et al.
(författare)
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Manic episodes are related to changes in frontal cortex: a longitudinal neuroimaging study of bipolar disorder 1.
- 2015
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Ingår i: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 138:Pt 11, s. 3440-8
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Tidskriftsartikel (refereegranskat)abstract
- Higher numbers of manic episodes in bipolar patients has, in cross-sectional studies, been associated with less grey matter volume in prefrontal brain areas. Longitudinal studies are needed to determine if manic episodes set off progressive cortical changes, or if the association is better explained by premorbid brain conditions that increase risk for mania. We followed patients with bipolar disorder type 1 for 6 years. Structural brain magnetic resonance imaging scans were performed at baseline and follow-up. We compared patients who had at least one manic episode between baseline and follow-up (Mania group, n = 13) with those who had no manic episodes (No-Mania group, n = 18). We used measures of cortical volume, thickness, and area to assess grey matter changes between baseline and follow-up. We found significantly decreased frontal cortical volume (dorsolateral prefrontal and inferior frontal cortex) in the Mania group, but no volume changes in the No-Mania group. Our results indicate that volume decrease in frontal brain regions can be attributed to the incidence of manic episodes.
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| 2. |
- Abu-Rumeileh, Samir, et al.
(författare)
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The multifaceted role of neurofilament light chain protein in non-primary neurological diseases.
- 2023
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Ingår i: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 146:2
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Tidskriftsartikel (refereegranskat)abstract
- The advancing validation and exploitation of cerebrospinal fluid and blood neurofilament light chain protein as a biomarker of neuroaxonal damage has deeply changed the current diagnostic and prognostic approach to neurological diseases. Further, recent studies have provided evidence of potential new applications of this biomarker also in non-primary neurological diseases. In the present review we summarise the current evidence, future perspectives, but also limitations, of neurofilament light chain protein as a cerebrospinal fluid and blood biomarker in several medical fields, including intensive care, surgery, internal medicine and psychiatry. In particular, neurofilament light chain protein is associated with the degree of neurologic impairment and outcome in patients admitted to intensive care units or in the perioperative phase and it seems to be highly interconnected with cardiovascular risk factors. Beyond that, interesting diagnostic and prognostic insights have been provided by the investigation of neurofilament light chain protein in psychiatric disorders as well as in the current coronavirus disease 19 (COVID-19) pandemic and in normal aging. Altogether, current data outline a multifaceted applicability of cerebrospinal fluid and blood neurofilament light chain protein ranging from the critical clinical setting to the development of precision medicine models suggesting a strict interplay between the nervous system pathophysiology and the health-illness continuum.
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| 3. |
- Al-Diwani, A, et al.
(författare)
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Cervical lymph nodes and ovarian teratomas as germinal centres in NMDA receptor-antibody encephalitis
- 2022
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Ingår i: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 145:8, s. 2742-2754
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Tidskriftsartikel (refereegranskat)abstract
- Autoantibodies against the extracellular domain of the N-methyl-d-aspartate receptor (NMDAR) NR1 subunit cause a severe and common form of encephalitis. To better understand their generation, we aimed to characterize and identify human germinal centres actively participating in NMDAR-specific autoimmunization by sampling patient blood, CSF, ovarian teratoma tissue and, directly from the putative site of human CNS lymphatic drainage, cervical lymph nodes. From serum, both NR1-IgA and NR1-IgM were detected more frequently in NMDAR-antibody encephalitis patients versus controls (both P < 0.0001). Within patients, ovarian teratoma status was associated with a higher frequency of NR1-IgA positivity in serum (OR = 3.1; P < 0.0001) and CSF (OR = 3.8, P = 0.047), particularly early in disease and before ovarian teratoma resection. Consistent with this immunoglobulin class bias, ovarian teratoma samples showed intratumoral production of both NR1-IgG and NR1-IgA and, by single cell RNA sequencing, contained expanded highly-mutated IgA clones with an ovarian teratoma-restricted B cell population. Multiplex histology suggested tertiary lymphoid architectures in ovarian teratomas with dense B cell foci expressing the germinal centre marker BCL6, CD21+ follicular dendritic cells, and the NR1 subunit, alongside lymphatic vessels and high endothelial vasculature. Cultured teratoma explants and dissociated intratumoral B cells secreted NR1-IgGs in culture. Hence, ovarian teratomas showed structural and functional evidence of NR1-specific germinal centres. On exploring classical secondary lymphoid organs, B cells cultured from cervical lymph nodes of patients with NMDAR-antibody encephalitis produced NR1-IgG in 3/7 cultures, from patients with the highest serum NR1-IgG levels (P < 0.05). By contrast, NR1-IgG secretion was observed neither from cervical lymph nodes in disease controls nor in patients with adequately resected ovarian teratomas. Our multimodal evaluations provide convergent anatomical and functional evidence of NMDAR-autoantibody production from active germinal centres within both intratumoral tertiary lymphoid structures and traditional secondary lymphoid organs, the cervical lymph nodes. Furthermore, we develop a cervical lymph node sampling protocol that can be used to directly explore immune activity in health and disease at this emerging neuroimmune interface.
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| 5. |
- Anders, Silke, et al.
(författare)
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When seeing outweighs feeling : a role for prefrontal cortex in passive control of negative affect in blindsight
- 2009
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Ingår i: Brain. - Oxford : Oxford University Press. - 0006-8950 .- 1460-2156. ; 132:11, s. 3021-3031
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Tidskriftsartikel (refereegranskat)abstract
- Affective neuroscience has been strongly influenced by the viewthat a ‘feeling’ is the perception of somatic changesand has consequently often neglected the neural mechanisms thatunderlie the integration of somatic and other information inaffective experience. Here, we investigate affective processingby means of functional magnetic resonance imaging in nine corticallyblind patients. In these patients, unilateral postgeniculatelesions prevent primary cortical visual processing in part ofthe visual field which, as a result, becomes subjectively blind.Residual subcortical processing of visual information, however,is assumed to occur in the entire visual field. As we have reportedearlier, these patients show significant startle reflex potentiationwhen a threat-related visual stimulus is shown in their blindvisual field. Critically, this was associated with an increaseof brain activity in somatosensory-related areas, and an increasein experienced negative affect. Here, we investigated the patients’response when the visual stimulus was shown in the sighted visualfield, that is, when it was visible and cortically processed.Despite the fact that startle reflex potentiation was similarin the blind and sighted visual field, patients reported significantlyless negative affect during stimulation of the sighted visualfield. In other words, when the visual stimulus was visibleand received full cortical processing, the patients’ phenomenalexperience of affect did not closely reflect somatic changes.This decoupling of phenomenal affective experience and somaticchanges was associated with an increase of activity in the leftventrolateral prefrontal cortex and a decrease of affect-relatedsomatosensory activity. Moreover, patients who showed strongerleft ventrolateral prefrontal cortex activity tended to showa stronger decrease of affect-related somatosensory activity.Our findings show that similar affective somatic changes canbe associated with different phenomenal experiences of affect,depending on the depth of cortical processing. They are in linewith a model in which the left ventrolateral prefrontal cortexis a relay station that integrates information about subcorticallytriggered somatic responses and information resulting from in-depthcortical stimulus processing. Tentatively, we suggest that theobserved decoupling of somatic responses and experienced affect,and the reduction of negative phenomenal experience, can beexplained by a left ventrolateral prefrontal cortex-mediatedinhibition of affect-related somatosensory activity.
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