Early bilateral and massive compromise of the frontal lobes.

Early bilateral and massive compromise of the frontal lobes.
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DOI:
10.1016/j.nicl.2018.02.026
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发表时间:
2018
期刊:
NeuroImage. Clinical
影响因子:
--
通讯作者:
Manes F
Manes F
中科院分区:
其他
文献类型:
--
作者:
Ibáñez A;Zimerman M;Sedeño L;Lori N;Rapacioli M;Cardona JF;Suarez DMA;Herrera E;García AM;Manes F

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额叶是最复杂的大脑结构之一,涉及一般和特定功能。这项工作的目的是评估解剖和认知的影响,从一个独特的情况下,大量的双边额叶的影响。我们报告的情况下,GC,一个八岁的孩子几乎完全的影响,双边额叶结构和备用的颞,顶叶,枕叶和小脑区域。我们进行了行为,神经心理学和成像(MRI,DTI,fMRI)评估。神经系统和神经心理学检查显示了一种混合模式的影响(执行控制/抽象能力)和相当保留(意识,语言,记忆,空间定向和社会情感)的功能。结构(DTI)和功能(fMRI)的连接证明异常的杏仁核和顶叶网络的前连接。此外,大脑结构连接分析显示,额叶连接几乎完全丧失,具有非典型的颞后通路。同样,功能连接显示异常的额顶叶网络和相对保存的默认模式网络和视觉网络的后部。我们讨论这种多层次的模式的行为,结构和功能的连接结果。由于其独特的受损和保留的结构和功能模式,这种特殊情况为神经认知理论提供了新的限制和挑战。
The frontal lobes are one of the most complex brain structures involved in both domain-general and specific functions. The goal of this work was to assess the anatomical and cognitive affectations from a unique case with massive bilateral frontal affectation. We report the case of GC, an eight-year old child with nearly complete affectation of bilateral frontal structures and spared temporal, parietal, occipital, and cerebellar regions. We performed behavioral, neuropsychological, and imaging (MRI, DTI, fMRI) evaluations. Neurological and neuropsychological examinations revealed a mixed pattern of affected (executive control/abstraction capacity) and considerably preserved (consciousness, language, memory, spatial orientation, and socio-emotional) functions. Both structural (DTI) and functional (fMRI) connectivity evidenced abnormal anterior connections of the amygdala and parietal networks. In addition, brain structural connectivity analysis revealed almost complete loss of frontal connections, with atypical temporo-posterior pathways. Similarly, functional connectivity showed an aberrant frontoparietal network and relative preservation of the posterior part of the default mode network and the visual network. We discuss this multilevel pattern of behavioral, structural, and functional connectivity results. With its unique pattern of compromised and preserved structures and functions, this exceptional case offers new constraints and challenges for neurocognitive theories.
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