Resting-state Compensatory Remapping in Patients with Brain Tumour Before and After Surgery

Older adults typically exhibit decline in language production. However, how the brain supports or fails to support these processes is unclear. Moreover, there are competing hypotheses about the nature of age-related neural changes and whether age-related increases in neural activity reflect compensation or a decline in neural efficiency. In the current study, we investigated the neural bases of language production focusing on resting state functional connectivity. We hypothesized that language production performance, functional connectivity, and their relationship would differ as a function of age. Consistent with prior work, older age was associated with worse language production performance. Functional connectivity analyses showed that network segregation within the left hemisphere language network was maintained across adulthood. However, increased age was associated with lower whole brain network segregation. Moreover, network segregation was related to language production ability. In both network analyses, there were significant interactions with age-higher network segregation was associated with better language production abilities for younger and middle-aged adults, but not for older adults. Interestingly, there was a stronger relationship between language production and the whole brain network segregation than between production and the language network. These results highlight the utility of network segregation measures as an index of brain function, with higher network segregation associated with better language production ability. Moreover, these results are consistent with stability in the left hemisphere language network across adulthood and suggest that dedifferentiation among brain networks, outside of the language network, is a hallmark of aging and may contribute to age-related language production difficulties.

Background: Among the recovery phases, patient achieve their cognitive and psychomotor skills in intermediate phase. Rapid clearance drug like Sevoflurane has beneficial effect on early cognitive recovery which allows early mobilization and reduce post operative complication but Halothane with delayed recovery profile is still commonly used in our country. Objective: So the study was done to compare the post operative cognitive recovery in adult patients receiving sevoflurane and halothane anaesthesia and with a view to increase the use of sevoflurane over halothane. Settings and study design: This prospective randomized comparative study was done in Anaesthesia, analgesia and intensive care medicine department of BSMMU Hospital between September 2009 to June 2011. A total 60 patients[30 in sevoflurane group (Group-S) and 30 in halothane group(Group-H)]of either sex, 18-50 years, ASA-I and II, elective surgery under general anaesthesia, lasting more than 1 hour and remaining 24 hours after surgery were the study population. Cognitive recovery was assessed using Bangla adaptation mini-mental state examination (BAMSE) and paper pencil test-Trail making test part- A (TMT-A) one day prior to surgery (baseline value) and 30 minutes after recovery then at hourly interval up to 3.5 hours postoperatively and compared. Results: Emergence time was significantly shorter in Group-S compared to Group-H (10.85 min & 15.13 min respectively, P<0.001). The mean BAMSE score Group-S was 29 at baseline and demonstrated no change at the end of the observation, while the Group-H experienced a fall and rise in BAMSE score. Time taken by the patients of Group-S to complete (TMT-A) at 30 minutes after recovery was significantly less (40.9 sec. Vs 55.8 sec, P <0.001) than patients of Group-H. And no significant difference was observed between groups at 1.5 hrs, 2.5 hrs and 3.5 hrs. Conclusion: So the study concludes that adult patient of sevoflurane group experienced an early post operative cognitive recovery than halothane group. Though sevoflurane is costly, considering the benefits of patients in terms of early cognitive recovery that causes less postoperative complications and shorter hospital stay, sevoflurane should be used instead of halothane Journal of Bangladesh Society of Anaesthesiologists 2015; 28(1): 5-11

IntroductionCardiopulmonary complications and cognitive impairment following craniotomy have a significantly impact on the general health of individuals with brain tumours. Observational research indicates that engaging in walking is linked to...

Published results of our Phase I safety and feasibility trial of accelerated intermittent theta burst stimulation (a-iTBS) in mild cognitive impairment (MCI) due to Alzheimer's disease showed a large effect-size improvement in cognition. Further demonstrate target engagement by identifying whether changes in local and network-level functional connectivity relate to the observed cognitive improvement. Eighteen patients with MCI received 3-day a-iTBS (8 sessions/day) to the left dorsolateral prefrontal cortex at Beam F3 (14,400 total pulses) and completed MRI and cognitive testing at pre- and post-treatment. Based on electric field models, we selected 3 stimulated target regions of interest (ROIs) which belonged to the frontoparietal (FPN), default mode (DMN), and ventral attention (VAT) networks (3 target networks). Metrics of resting-state functional connectivity were computed at the ROI level (within-network degree: number of connections) and network level (segregation: strength of connectivity within-network relative to other networks). We correlated changes in cognition and connectivity of the target ROIs and networks; off-target ROI (primary visual) and networks served as negative controls. Improvements in cognition were associated with connectivity changes in the target ROIs and networks, but not in off-target negative controls. Positive associations were observed for degree of the l-DMN and segregation of target networks overall, with significant effects for DMN and VAT. Cognitive improvement following a-iTBS in MCI may be attributable to local and network-level reconfigurations in functional connectivity. These findings will inform larger trials designed to further evaluate the neural mechanisms of a-iTBS for cognition in MCI.

While esketamine shows promise as an adjunct in procedural sedation, its impact on postoperative cognitive recovery remains incompletely characterized. This study investigated the effects of esketamine on multiple dimensions of recovery, particularly cognition, in patients undergoing colonoscopy with propofol-based sedation. We conducted this randomized, double-blinded, placebo-controlled trial from January 6, 2023, to May 20, 2024, at two hospitals in China. Patients were randomized in a 1:1 ratio to receive either esketamine 0.2 mg/kg (n = 126) or placebo (n = 126), followed by propofol 1 mg/kg. We administered additional propofol boluses (0.5 mg/kg) to maintain sedation. The study assessed cognitive recovery on postoperative day 3 as the primary outcome, measured by the Postoperative Quality of Recovery Scale (PostopQRS). Secondary outcomes included overall recovery, recovery in other PostopQRS domains, time to discharge, and adverse events. Esketamine significantly enhanced cognitive recovery compared to placebo on postoperative day 3 (95.2% vs 83.3%, relative risk = 1.14; 95% confidence interval: 1.05-1.25, P = 0.002). Discharge times were comparable between groups (odds ratio = 0.70; 95% confidence interval: 0.43-1.16, P = 0.163). The esketamine group demonstrated higher satisfaction (P = 0.003) and significantly reduced incidences of hypotension (14.3% vs 36.5%, P < 0.001), bradycardia (5.6% vs 15.1%, P = 0.013), hypoxemia (2.4% vs 8.7%, P = 0.028), and injection site pain (21.4% vs 48.4%, P < 0.001). Adding esketamine 0.2 mg/kg to propofol for colonoscopy sedation improved postoperative cognitive recovery, enhanced patient satisfaction, and reduced cardiopulmonary adverse events without prolonging discharge time. These findings establish low-dose esketamine as a beneficial adjunct to propofol in procedural sedation for colonoscopy.

To compare intraoperative cardiac function, postoperative cognitive recovery, and surgical performance of laparoscopic cholecystectomy with abdominal wall lift (AWL) versus positive-pressure capnoperitoneum (PPCpn). AWL has been proposed as an alternative approach to PPCpn to avoid adverse cardio-respiratory changes. However, the workspace obtained with the AWL is less optimal than PPCpn and previous studies documenting delayed postoperative recovery of consciousness following PPCpn have not assessed mental alertness despite its importance. Forty operations were randomized into AWL and PPCpn. A standard anesthetic protocol was followed. Cardiac indices were measured with an esophageal Doppler machine. An auditory vigilance test was used to measure alertness level following extubation. All operations were videotaped and human reliability assessment techniques were used to identify surgical errors. There was a significant reduction in cardiac output during the first 20 minutes following CO2 insufflation in the PPCpn group, whereas in the AWL group it did not exhibit any significant change. Patients in AWL arm had better vigilance scores at 90 and 180 minutes following extubation compared with the PPn group (P < 0.05). Significantly more surgical errors were observed during surgery with AWL than with PPCpn (7.1 +/- 1.1; versus 2.9 +/- 0.4; P = 0.001). The AWL approach avoids fall in cardiac output associated with PPCpn during laparoscopic surgery and is associated with a more rapid recovery of postoperative cognitive function compared with PPCpn. However, AWL increases the level of difficulty in the execution of the operation.

Post-stroke aphasia (PSA) is a prevalent complication of left-hemispheric stroke, yet cerebellar contributions to language and cognition remain insufficiently characterized at the network level. We investigated cerebellar functional network topology in PSA and its associations with language and cognitive performance. Seventy-three right-handed PSA patients and 75 matched healthy controls underwent 3T resting-state functional magnetic resonance imaging (rs-fMRI). The cerebellum was parcellated using the Seitzman-27 atlas, which assigns cerebellar ROIs to canonical large-scale networks, allowing network-specific characterization and interpretable comparisons across functional systems. Global and nodal topological metrics and ROI-to-ROI functional connectivity were quantified, and their relationships with language and non-language cognition were assessed. Small-world organization was preserved in both groups, but PSA patients showed significant reductions in the small-world index, clustering coefficient, and local efficiency, indicating impaired network segregation and local processing. Nodal analysis revealed decreased degree centrality in the frontoparietal network and increased degree centrality in the dorsal somatomotor network. Functional connectivity was reduced within the default mode and frontoparietal networks, while connectivity between frontoparietal and dorsal somatomotor regions increased (FDR-corrected). Lower clustering coefficient and local efficiency were associated with poorer auditory comprehension, memory, and reasoning. Lesion volume was associated with worse language and cognitive outcomes but was not associated with global cerebellar network measures after covariate adjustment. These findings provide novel network-level evidence of altered cerebellar topology in PSA, extending prior cortical-focused models. The results suggest that cerebellar network disruption is associated with language and cognitive deficits and may inform the development of network-based imaging markers and motivate future longitudinal and intervention studies in aphasia.

Brief interventions for alcohol use disorder (AUD) are generally efficacious, albeit with variability in response. Resting state functional connectivity (rsFC) may characterize neurobiological indicators that predict the response to brief interventions and is the focus of the current investigation. Forty-six individuals with AUD (65.2% female) completed a resting state functional magnetic resonance imaging (fMRI) scan immediately followed by a brief intervention aimed at reducing alcohol consumption. Positive clinical response was defined as a reduction in alcohol consumption by at least one World Health Organization (WHO) risk drinking level at 3-month follow-up. rsFC was analyzed using seed-to-voxel analysis with seed regions from four networks: salience network, reward network, frontoparietal network, and default mode network. At baseline, responders had greater rsFC between the following seed regions in relation to voxel-based clusters than non-responders: (i) anterior cingulate cortex (ACC) in relation to left postcentral gyrus and right supramarginal gyrus (salience network); (ii) right posterior parietal cortex in relation to right ventral ACC (salience network); (iii) right interior frontal gyrus (IFG) pars opercularis in relation to right cerebellum and right occipital fusiform gyrus (frontoparietal); and (iv) right primary motor cortex in relation to left thalamus (default mode). Lower rsFC in responders vs. nonresponders was seen between the (i) right rostral prefrontal cortex in relation to left IFG pars triangularis (frontoparietal); (ii) right IFG pars triangularis in relation to right cerebellum (frontoparietal); (iii) right IFG pars triangularis in relation to right frontal eye fields and right angular gyrus (frontoparietal); and (iv) right nucleus accumbens in relation to right orbital frontal cortex and right insula (reward). Resting state functional connectivity in the frontoparietal, salience, and reward networks predicts the response to a brief intervention in individuals with AUD and could reflect greater receptivity or motivation for behavior change.

Dysfunctional resting state network connectivity predicts postoperative delirium after major surgery.

The relationship between recent PTSD secondary to sexual assault, hippocampal volume and resting state functional connectivity in adolescent girls

How is psychological stress linked to sleep quality? The mediating role of functional connectivity between the sensory/somatomotor network and the cingulo-opercular control network

Iron deposition has been observed in Parkinsonism and is emerging as a diagnostic marker for movement disorders. Brain functional network disruption has also been detected in parkinsonism, and is believed to be accountable for specific symptoms in parkinsonism. However, how iron deposition influences brain network remains to be elucidated. We recruited 16 Parkinson's disease (PD), 8 multiple system atrophy (MSA) and 7 progressive supranuclear palsy (PSP) patients. T1-weighted, susceptibility weighted images and resting-state functional MRI (rs-fMRI) were acquired. Quantitative susceptibility mapping (QSM) analysis was performed to quantify iron deposition in substantia nigra, putamen and dentate nucleus. Cerebellar network, sensorimotor network, default mode network and language networks were segregated using independent analysis. Network and iron deposition status were evaluated in relation to diagnostic groups, motor and non-motor symptoms. The relationship between quantitative iron deposition and brain network status was further interrogated. To further validate the findings, 13 healthy controls and 37 PD patients who had available T1 and rs-fMRI scans were selected from Parkinson's progression markers initiative (PPMI) database, and network analysis was performed. In local cohort, compared to PD, MSA patients showed greater iron deposition in putamen, while PSP patients had greater iron deposition in caudate nucleus and thalamus. Cerebellar and language networks showed significant difference across diagnostic groups, while default mode network and sensorimotor network did not. MSA patients had significantly impaired cerebellar network and language networks compared to PD patients. Cerebellar network was positively associated with motor symptom scores while language network was positively associated with MoCA scores in the patients. Iron deposition was negatively associated with both networks' activity in the patients. In PPMI cohort, impairment was found in both cerebellar and language networks in PD. Cerebellar and language networks correlated with motor and cognitive impairment, respectively. Cerebellar network and language networks are differently influenced in MSA, PD and PSP, which can serve as potential diagnostic marker. Impairment of cerebellar network and language network are associated with motor symptoms and cognitive impairment, respectively. Moreover, dysfunction of the networks is associated with iron deposition in deep nuclei (SN, DN, Putamen).

Neuropsychological studies reported that shift workers show reduced cognitive performance and circadian dysfunctions which may impact structural and functional brain networks. Here we tested the hypothesis whether night shift work is associated with resting-state functional connectivity (RSFC), cortical thickness and gray matter volume in participants of the 1000BRAINS study for whom information on night shift work and imaging data were available. 13 PRESENT and 89 FORMER night shift workers as well as 430 control participants who had never worked in shift (NEVER) met these criteria and were included in our study. No associations between night shift work, three graph-theoretical measures of RSFC of 7 functional brain networks and brain morphology were found after multiple comparison correction. Preceding multiple comparison correction, our results hinted at an association between more years of shift work and higher segregation of the visual network in PRESENT shift workers and between shift work experience and lower gray matter volume of the left thalamus. Extensive neuropsychological investigations supplementing objective imaging methodology did not reveal an association between night shift work and cognition after multiple comparison correction. Our pilot study suggests that night shift work does not elicit general alterations in brain networks and affects the brain only to a limited extent. These results now need to be corroborated in studies with larger numbers of participants.

Recurrent episodes in major depressive disorder (MDD) are common but the neuroimaging features predictive of recurrence are not established. Participants in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study who achieved remission after 12 weeks of treatment withcognitive behavior therapy, duloxetine, or escitalopram were prospectively monitored for up to 21 months for recurrence. Neuroimaging markers predictive of recurrence were identified from week 12 functional magnetic resonance imaging scans by analyzing whole-brain resting state functional connectivity (RSFC) using seeds for four brain networks that are altered in MDD. Neuroimaging correlates of established clinical predictors of recurrence, including the magnitude of depressive (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale) symptom severity at time of remission, and a comorbid anxiety disorder were examined for their similarity to the neuroimaging predictors of recurrence. Of the 344 patients randomized in PReDICT, 61 achieved remission and had usable scans for analysis, 9 of whom experienced recurrence during follow-up. Recurrence was predicted by: 1) increased RSFC between subcallosal cingulate cortex (SCC) and right anterior insula, 2) decreased RSFC between SCC and bilateral primary visual cortex, and 3) decreased RSFC between insula and bilateral caudate. Week 12 depression and anxiety scores were negatively correlated with RSFC strength between executive control and default mode networks, but they were not correlated with the three RSFC patterns predicting recurrence. We conclude that altered RSFC in SCC and anterior insula networks are prospective risk factors associated with MDD recurrence, reflecting additional sources of risk beyond clinical measures.

Resilience to childhood maltreatment is associated with increased resting-state functional connectivity of the salience network with the lingual gyrus