Search

Repetitive thought about oneself, including one’s emotions, can lead to both adaptive and maladaptive effects. Construal level of repetitive self-referential thought might moderate this. During interoception, which engages areas such as the insula, the anterior and/or posterior cingulate cortex (PCC) and the somatosensory cortex, concrete low level construal self-referential thought is applied, which has been shown to lead to more positive emotions after upsetting events. Contrarily, during immersion, related to neural activity in the default mode network (DMN), abstract high level construal self-referential thought is applied, which is linked to depression. The current study investigated whether the integration of concrete and abstract self-referential thought by means of embodied mentalization leads to less subjective arousal, decreased DMN activity and increased somatosensory activity as compared to immersion, and to more DMN activity as compared to interoception. In the fMRI scanner, participants imagined stressful events while adopting immersion, interoception or embodied mentalization. After each imagined stressful event, participants rated their subjective arousal and how difficult it was to apply the mode of self-referential thought. Results showed that participants felt that immersion was easier to apply than embodied mentalization. However, no differences in subjective arousal or neural activity were found between immersion, interoception and embodied mentalization. Possible reasons for this lack of significant differences are discussed.

Magnetoencephalographic imaging (MEGI) offers a non-invasive alternative for defining preoperative language lateralization in neurosurgery patients. MEGI indeed can be used for accurate estimation of language lateralization with a complex language task – auditory verb generation. However, since language function may vary considerably in patients with focal lesions, it is important to optimize MEGI for estimation of language function with other simpler language tasks. The goal of this study was to optimize MEGI laterality analyses for two such simpler language tasks that can have compliance from those with impaired language function: a non-word repetition (NWR) task and a picture naming (PN) task. Language lateralization results for these two tasks were compared to the verb-generation (VG) task. MEGI reconstruction parameters (regions and time windows) for NWR and PN were first defined in a presurgical training cohort by benchmarking these against laterality indices for VG. Optimized time windows and regions of interest (ROIs) for NWR and PN were determined by examining oscillations in the beta band (12–30 Hz) a marker of neural activity known to be concordant with the VG laterality index (LI). For NWR, additional ROIs include areas MTG/ITG and for both NWR and PN, the postcentral gyrus was included in analyses. Optimal time windows for NWR were defined as 650–850 ms (stimulus-locked) and −350 to −150 ms (response-locked) and for PN −450 to −250 ms (response-locked). To verify the optimal parameters defined in our training cohort for NWR and PN, we examined an independent validation cohort (n = 30 for NWR, n = 28 for PN) and found high concordance between VG laterality and PN laterality (82%) and between VG laterality and NWR laterality (87%). Finally, in a test cohort (n = 8) that underwent both the intracarotid amobarbital procedure (IAP) test and MEG for VG, NWR, and PN, we identified excellent concordance (100%) with IAP for VG + NWR + PN composite LI, high concordance for PN alone (87.5%), and moderate concordance for NWR alone (66.7%). These findings provide task options for non-invasive language mapping with MEGI that can be calibrated for language abilities of individual patients. Results also demonstrate that more accurate estimates can be obtained by combining laterality estimates obtained from multiple tasks. MEGI

Structural changes in the brain take place throughout one’s life. Changes related to cognitive decline may delay the stages of the speech production process in the aging brain. For example, semantic memory decline and poor inhibition may delay the retrieval of a concept from the mental lexicon. Electroencephalography (EEG) is a valuable method for identifying the timing of speech production stages. So far, studies using EEG mainly focused on a particular speech production stage in a particular group of subjects. Differences between subject groups and between methodologies have complicated identifying time windows of the speech production stages. For the current study, the speech production stages lemma retrieval, lexeme retrieval, phonological encoding, and phonetic encoding were tracked using a 64-channel EEG in 20 younger adults and 20 older adults. Picture-naming tasks were used to identify lemma retrieval, using semantic interference through previously named pictures from the same semantic category, and lexeme retrieval, using words with varying age of acquisition. Non-word reading was used to target phonological encoding (using non-words with a variable number of phonemes) and phonetic encoding (using non-words that differed in spoken syllable frequency). Stimulus-locked and response-locked cluster-based permutation analyses were used to identify the timing of these stages in the full time course of speech production from stimulus presentation until 100 ms before response onset in both subject groups. It was found that the timing of each speech production stage could be identified. Even though older adults showed longer response times for every task, only the timing of the lexeme retrieval stage was later for the older adults compared to the younger adults, while no such delay was found for the timing of the other stages. The results of a second cluster-based permutation analysis indicated that clusters that were observed in the timing of the stages for one group were absent in the other subject group, which was mainly the case in stimulus-locked time windows. A z-score mapping analysis was used to compare the scalp distributions related to the stages between the older and younger adults. No differences between both groups were observed with respect to scalp distributions, suggesting that the same groups of neurons are involved in the four stages, regardless of the adults’ age, even though the timing of the individual stages is different in both groups.

Patients with Parkinson's disease (PD) display a variety of impairments in motor and non-motor language processes; speech is decreased on motor aspects such as amplitude, prosody and speed and on linguistic aspects including grammar and fluency. Here we investigated whether verbal monitoring is impaired and what the relative contributions of the internal and external monitoring route are on verbal monitoring in patients with PD relative to controls. Furthermore, the data were used to investigate whether internal monitoring performance could be predicted by internal speech perception tasks, as perception based monitoring theories assume. Performance of 18 patients with Parkinson's disease was measured on two cognitive performance tasks and a battery of 11 linguistic tasks, including tasks that measured performance on internal and external monitoring. Results were compared with those of 16 age-matched healthy controls. PD patients and controls generally performed similarly on the linguistic and monitoring measures. However, we observed qualitative differences in the effects of noise masking on monitoring and disfluencies and in the extent to which the linguistic tasks predicted monitoring behavior. We suggest that the patients differ from healthy subjects in their recruitment of monitoring channels.

Awake surgery with electrocorticosubcortical stimulation is the golden standard treatment for gliomas in eloquent areas. Preoperatively, mostly mild cognitive disturbances are observed with postoperative deterioration. We describe pre- and postoperative profiles of 4 patients (P1–P4) with gliomas in “critical” language areas (“Broca,” “Wernicke,” and the arcuate fasciculus) undergoing awake surgery to get insight into the underlying mechanism of neuroplasticity. Neuropsychological examination was carried out preoperatively (at T1) and postoperatively (at T2, T3). At T1, cognition of P1 was intact and remained stable. P2 had impairments in all cognitive domains at T1 with further deterioration at T2 and T3. At T1, P3 had impairments in memory and executive functions followed by stable recovery. P4 was intact at T1, followed by a decline in a language test at T2 and recovery at T3. Intraoperatively, in all patients language positive sites were identified. Patients with gliomas in “critical” language areas do not necessarily present cognitive disturbances. Surgery can either improve or deteriorate (existing) cognitive impairments. Several factors may underlie the plastic potential of the brain, for example, corticosubcortical networks and tumor histopathology. Our findings illustrate the complexity of the underlying mechanism of neural plasticity and provide further support for a “hodotopical” viewpoint.

Cerebral venous thrombosis (CVT) is a distinct cerebrovascular condition that represents 0.5–1% of all strokes in the general population. Because of its procoagulant and antifibrinolytic effects [Horne et al.: J Clin Endocrinol Metab 2004;89:4469–4473], hyperthyroidism has been proposed as a predisposing factor for CVT [Saposnik et al.: Stroke 2011;42:1158–1192]. For the first time, we describe a 22-year-old right-handed woman with a sinus sigmoideus thrombosis due to Graves’ disease. Although subclinical hyperthyroidism had been detected 2 years before the onset of neurological symptoms, she did not receive any medical follow-up. Early recognition, diagnosis and treatment are of crucial importance, as Graves’ disease is a risk factor for CVT and stroke.

Crossed aphasia in dextrals (CAD) following pure subcortical lesions is rare. This study describes a right-handed patient with an ischemic lesion in the right thalamus. In the post-acute phase of the stroke, a unique combination of ‘crossed thalamic aphasia’ was found with left visuo-spatial neglect and constructional apraxia. On the basis of the criteria used in Mariën et al. [67], this case-report is the first reliable representative of vascular CAD following an isolated lesion in the right thalamus. Furthermore, this paper presents a detailed analysis of linguistic and cognitive impairments of ‘possible’ and 'reliable' subcortical CAD-cases published since 1975. Out of 25 patients with a pure subcortical lesion, nine cases were considered as ‘possibly reliable or reliable’. A review of these cases reveals that: (1) demographic data are consistent with the general findings for the entire group of vascular CAD, (2) the neurolinguistic findings do not support the data in the general CAD-population with regard to (a) the high prevalence of transcortical aphasia and (b) the tendency towards a copresence of an oral versus written language dissociation and a ‘mirror-image’ lesion-aphasia profile, (3) subcortical CAD is not a transient phenomenon, (4) the lesion-aphasia correlations are not congruent with the high incidence of anomalous cases in the general CAD-population, (5) neuropsychological impairments may accompany subcortical CAD.

Objective: Clinical, neuropsychological, structural and functional neuroimaging results are reported in a patient who developed a unique combination of symptoms after a bi-thalamic and right putaminal stroke. The symptoms consisted of dysexecutive disturbances associated with confabulating behavior and auto-activation deficits. Background: Basal ganglia and thalamic lesions may result in a variety of motor, sensory, neuropsychological and behavioral syndromes. However, the combination of a dysexecutive syndrome complicated at the behavioral level with an auto-activation and confabulatory syndrome has never been reported. Methods: Besides clinical and neuroradiological investigations, an extensive set of standardized neuropsychological tests was carried out. Results: In the post-acute phase of the stroke, a dysexecutive syndrome was found in association with confabulating behavior and auto-activation deficits. MRI showed focal destruction of both thalami and the right putamen. Quantified ECD SPECT revealed bilateral hypoperfusions in the basal ganglia and thalamus but no perfusion deficits were found at the cortical level. Conclusion: The combination of disrupted auto-activation, dysexecutive and confabulating syndrome in a single patient following isolated subcortical damage renders this case exceptional. Although these findings do not reveal a functional disruption of the striato-ventral pallidal-thalamic-frontomesial limbic circuitry, they add to the understanding of the functional role of the basal ganglia in cognitive and behavioral syndromes.

Introduction: Deficits in cognition, i.e. language memory, attentional and executive functions are common in patients with primary brain tumors in eloquent areas (Papagno et al., 2011; Santini et al., 2012; Satoer et al., 2012). Tumor resection may aggravate these deficits, which can recover 1 year postoperatively (Satoer et al., 2014). This finding was based on group analyses, however in clinical practice individual variety is common. Pre- and postoperative neural plasticity mechanisms play an important role in brain tumor patients; substantial support is provided for a hodotopic (i.e. dynamic) approach of functional organization as opposed to a topological viewpoint (i.e. static) (Duffau, 2014). Aim: To describe the influence of plasticity on cognitive functions by means of pre- and postoperative profiles of patients with a similar brain tumor localization. Methods: We present 4 right-handed cases (P1, P2, P3, P4) originating from 2 outcome studies (De Witte et al., 2015; Satoer et al., 2014) with brain tumors in the same language areas (P1, P2: temporoparietal; P3, P4: insula) and operated awake. Language, memory, attentional and executive functions were formally examined pre- (all cases) and postoperatively (P3, P4: 3 and 12 months). Results: P1 and P2 showed opposite preoperative cognitive profiles. P1 obtained normal cognitive results and P2 had clinically significant impairments in all cognitive domains, (language, memory, attentional and executive deficits) (z-score ≥-1.50). P3 and P4 also demonstrate opposite preoperative profiles. P4 obtained intact cognitive results, whereas P3 was impaired in memory and executive functions (z-score ≥-1.50). Intraoperatively, in both P3 and P4 positive language sites were found (left inferior frontal gyrus and left parietal lobe). At 3 months postoperatively, P3 presented language deficits followed by recovery at 12 months, whereas P4 appeared to have recovered at 3 months postoperatively from the observed premorbid impairments in memory and executive functioning (z-score

INTRODUCTION: Awake surgery in eloquent brain regions is performed to preserve language and other cognitive functions. Although in general, no major permanent cognitive deficits are found after awake brain surgery, clinically relevant impairments are detected and cognitive recovery takes longer than generally assumed (3 months) (Santini et al., 2012; Satoer et al., 2014; Talacchi et al., 2012). However, as there is a lack of extensive cognitive follow-up data it is unknown when recovery takes place. In addition, the influence of critical language sites identified by direct electrical stimulation (DES) and tumour variables (e.g. left/right tumour location, tumour grade) on long-term cognitive findings remains unclear. METHODS: In this longitudinal study the short-term and long-term effects of awake surgery on cognition were investigated in 40 patients (29 patients with left and 11 with right hemisphere tumours). Language, memory, attentional, executive and visuospatial functions were assessed in the preoperative phase, at short-term follow-up (6 weeks postsurgery) and at long-term follow-up (6 months postsurgery) with a neuropsychological protocol. In addition, the effect of intraoperative critical language sites, left/right tumour location, hemispheric language dominance, extent of resection and adjuvant treatment on cognitive change was studied. RESULTS: Both pre- and postoperatively, the mean performance of the patients was worse (impairment = z-score below -2) than the performance of the normal population in the language domain, the memory domain, the attentional and executive domain (p < .05), but not in the visuospatial domain (p > .05). Awake surgery negatively affected language, attentional and executive functions but not memory and visuospatial functions. At 6 weeks postsurgery, performance on all language, attentional and executive tasks deteriorated (object/action naming, semantic/phonological fluency from DuLIP, Token test; Trail Making Test A & B, Stroop I, II, & III). At 6 months postsurgery, recovery to the normative or to the preoperative level was found for all but one language task (semantic fluency). By contrast, a 'long-term' decline was still found for most attentional and executive tasks (Trail Making Test A & B, Stroop I & II). The short-term and long-term decrease for the language tasks and the attention task Stroop I was only observed in the patients with brain tumours in critical language areas identified by DES. No influence of left/right tumour location, hemispheric dominance, tumour grade, extent of resection, or adjuvant treatment on cognitive change was found. CONCLUSION: A tumour located near or within a critical language area (identified by DES) was the only risk factor for short-term and long-term postoperative decline in the language and partly the attentional domain. Most language functions recover to normative or to preoperative levels between 6 weeks and 6 months postsurgery, whereas recovery of attentional and executive functions takes more time. Postoperative testing at 6 weeks and 6 months seem to be sensitive follow-up test-moments to detect cognitive change. Future studies should focus on intraoperative mapping of both language and attentional/ executive functions in order to avoid postoperative deficits and to preserve quality of life.

Objective. To investigate possible neurobehavioral changes secondary to a mindfulness based intervention (MBI) training for individuals living with Parkinson’s disease (PD). Background. In the context of complementary medicine, MBIs are increasingly being used for stress reduction and in patient populations coping with chronic illness. The use of alternative and complementary medicine may be higher in patients with chronic conditions such as PD. However, behavioral effects of mindfulness training in PD have not yet been reported in the literature and this points to an unmet need and warrants further examination. Methods. A total of 27 out of 30 PD patients completed a randomized controlled longitudinal trial. Questionnaires and the UPDRS I–IV were obtained at baseline and 8-week follow-up. Results. Significant changes after the MBI were found including a 5.5 point decrease on the UPDRS motor score, an increase of 0.79 points on Parkinson’s disease questionnaire (PDQ-39) pain item, and a 3.15 point increase in the Five Facet Mindfulness Questionnaire observe facet. Conclusions. To the best of our knowledge, this is the first quantitative analysis of neurobehavioral effects of MBI in PD.

Objective: The aim of this paper is to report the psychiatric, neuroradiological and linguistic characteristics in a native speaker of Dutch who developed speech symptoms which strongly resemble Foreign Accent Syndrome. Background: Foreign Accent Syndrome is a rare speech production disorder in which the speech of a patient is perceived as foreign by speakers of the same speech community. This syndrome is generally related to focal brain damage. Only in few reported cases the Foreign Accent Syndrome is assumed to be of psychogenic and/or psychotic origin. Method: In addition to clinical and neuroradiological examinations, an extensive test battery of standardized neuropsychological and neurolinguistic investigations was carried out. Two samples of the patient's spontaneous speech were analysed and compared to a 500,000-words reference corpus of 160 normal native speakers of Dutch. Results: The patient had a prominent French accent in her pronunciation of Dutch. This accent had persisted over the past eight years and has become progressively stronger. The foreign qualities of her speech did not only relate to pronunciation, but also to the lexicon, syntax and pragmatics. Structural as well as functional neuroimaging did not reveal evidence that could account for the behavioural symptoms. By contrast psychological investigations indicated conversion disorder. Conclusions: To the best of our knowledge this is the first reported case of a foreign accent like syndrome in conversion disorder.

INTRODUCTION: Awake surgery with Direct Electrical Stimulation (DES) is considered the ‘gold standard’ to resect brain tumours in the language dominant hemisphere (De Witte & Mariën, 2013). Although transient language impairments are common in the immediate postoperative phase, permanent postoperative language deficits seem to be rare (Duffau, 2007). Milian et al. (2014) stated that most patients tolerate the awake procedure well and would undergo a similar procedure again. However, postoperative psychological symptoms including recurrent distressing dreams and persistent avoidance of stimuli have been recorded following awake surgery (Goebel, Nabavi, Schubert, & Mehdorn, 2010; Milian et al., 2014). To the best of our knowledge, psychogenic language disturbances have never been described after awake surgery. In general, only a handful of non-organic, psychogenic language disorders have been reported in the literature (De Letter et al., 2012). We report three patients with left brain tumours (see table 1) who presented linguistic symptoms after awake surgery that were incompatible with the lesion location, suggesting a psychogenic origin. METHODS: Neurocognitive (language, memory, executive functions) investigations were carried out before, during and after awake surgery (6 weeks, 6 months postsurgery) on the basis of standardised tests. Pre- and postoperative (f)MRI images, DTI results and intraoperative DES findings were analysed. A selection of tasks was used to map language intraoperatively (De Witte et al., 2013). In the postoperative phase spontaneous speech and behavioural phenomena to errors were video-recorded. RESULTS: Preoperative language tests did not reveal any speech or language problems. Intraoperatively, eloquent sites were mapped and preserved enabling good language skills at the end of the awake procedure. However, assessments in the first weeks postsurgery disclosed language and behavioural symptoms that support the hypothesis of a non-organic origin: fluent and nonfluent language disorders unrelated to the documented lesions, strong variablilty in the error profile, marked fluctuations of symptoms over time and condition, atypical personal comments. All three patients had a prior history of psychiatric disease and one patient witnessed language problems in an aphasic relative. In the study of De Letter et al. (2012) similar findings were mentioned, but no comprehension problems were found. In all 3 cases the "psychogenic language problems" resolved after three to six weeks. DISCUSSION: As a possible explanation for the psychogenic linguistic manifestations the following hypotheses will be discussed: 1) psychogenic language problems as part of an acute stress disorder (the awake setting); 2) psychological decompensation as the result of the fact that the patient was clearly informed that the tumour was situated near language regions; 3) getting a lot of attention in the hospital and a feeling of anxiety to return home; 4) unintended imitation of a witnessed aphasic disorder. CONCLUSION: Careful evaluation and selection of the patients and good preoperative preparation seem to be fundamental for good tolerance during awake surgery. Moreover, in the postoperative phase, extensive assessments are necessary to differentially diagnose patients with organic and non-organic language disorders in order to develop appropriate treatment strategies.

The development of an economy and, in particular, the construction of new infrastructure as well as industrial enterprises creates demand for the road transport of oversized freight that exceeds the maximum permissible total mass of vehicle combinations with its share on the axles. Failure to comply with the defined technological processes and a deficiency in the assessment of permitting such forms of transportation can have a large adverse effect, predominantly on the lifetime of bridges in a road network, which can have international implications as well. There is no legislation adopted by the EU Member States, which would at least partially unify the authorisation procedures of these forms of transportation and, therefore, it results in problems when crossing borders and leads to differences related to the assessment of bridge passages. If there is no systematic inspection of this kind of transportation, it can lead to permanent damage of these bridges as well. Currently, and not only in Slovakia but also in other states, the assessment of bridge passage for certain routes is used for heavy and oversized transportation. It means that if we use 100 transports, 100 assessments of individual routes are needed, although some are the same routes or the same vehicles/vehicle combinations used for a number of transports. Thus, the authors designed a global assessment for bridge passage in relation to heavy and oversized road transport while verifying it in the conditions of the EU Member State from Central Europe–Slovakia. Roads are full of different types of vehicles/vehicle combinations for which the axle loads and distances of the axles (wheelbases) are important. Thus, there were vehicle/vehicle combinations parameters (big data) observed, for which the routes relating to heavy and/or oversized transportation were assessed from 1 January 2016 to 31 December 2020 in Slovakia. The global assessment of bridge passage introduces an entirely new approach within the procedure for obtaining a special permission for road use as well as within transport use itself. Given the low presence of freight with an abnormal axle load or enormous total mass, it is appropriate to define the limited conditions under which it would be possible to implement the global assessment in practice as well.

This manuscript discusses the possibilities of road carriage of pyrotechnic articles and fireworks, which are labeled as dangerous goods, which means that they are covered by the European Agreement Concerning the International Carriage of Dangerous Goods by Road (ADR). In the manuscript fireworks are identified in the first chapter, while the second chapter describes the conditions for the consignor before the transport. The third part of the article points out the possibilities of influencing such transport.

Safety is one of the key aspects of the successful transport of cargo. In the case of road transport, the dynamics of a vehicle during normal events such as braking, steering, and evasive maneuver are variable in different places in the vehicle. Several manufacturers provide different dataloggers with acceleration sensors, but the results are not comparable due to different sensor parameters, measurement ranges, sampling frequencies, data filtration, and evaluation of different periods of acceleration. The position of the sensor in the loading area is also important. The accelerations are not the same at all points in the vehicle. The article deals with the measurement of these dynamic events with MEMS sensors on selected points of a vehicle loaded with cargo and with changes in dynamics after certain events that could occur during regular road transport of cargo to analyze the possibilities for monitoring accelerations and the related forces acting on the cargo during transport. The article uses evaluation times of 80, 300, and 1000 ms for accelerations. With the measured values, it is possible to determine the places with a higher risk of cargo damage and not only to adjust the packaging and securing of the cargo, but also to modify the transport routes. Concerning the purposes of securing the cargo in relation to EN 12195-1 and the minimum values of forces for securing the cargo, we focused primarily on the places where the acceleration of 0.5 g was exceeded when analyzing the monitored route. There were 32 of these points in total, all of which were measured by a sensor located at the rear of the semi-trailer. In 31 cases, the limit of 0.5 g was exceeded for an 80-ms evaluation time, and in one case, the value of 0.51 g was reached in the transverse direction for a 300-ms evaluation time.