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Background: The purpose of this study was to assess impingement-free internal rotation (IR) in a virtual reverse shoulder arthroplasty simulation using a Statistical Shape Model based on scapula size. Methods: A database of over 10,000 scapulae utilized for preoperative planning for shoulder arthroplasty was analyzed with a Statistical Shape Model to obtain 5 scapula sizes including the mean and 2 standard deviations. For each scapula model, one glenosphere size (33-42 mm) was selected as the best fit based on consensus among 3 shoulder surgeons. Virtual implantation variables included 1) lateral offset (0-12 mm in 2-mm increments), 2) inferior eccentricity (0, 2.5, 5, and 7.5 mm), and 3) posterior eccentricity (0, 2.5, and 5 mm). The neck shaft angle was fixed at 135° with an inlay design humeral prosthesis. IR at the side (IR0) and in abduction (IRABD) were then simulated. Results: Maximum impingement-free IR0 was reached with increasing inferior offset in combination with increasing lateralization. Lateralization was the most important variable in increasing impingement-free IRABD. Maximum IRABD was reached at 4-6 mm of lateralization with smaller scapula (−2 to 0 standard deviation). Increasing lateralization up to 12 mm continues to increase IRABD for larger-sized scapula (+1 to +2 standard deviation). Optimal inferior offset and lateralization to maximize IR did have a small loss of external rotation in neutral abduction. There was no loss of external rotation in 60° of abduction. Conclusion: In a virtual model, the glenosphere position required to maximize IR varied by scapula size. For smaller scapulae, maximum IR0 was reached with a combination of 2.5-mm inferior offset and 0- 4 mm of lateralization. For larger scapulae, maximum IR0 was reached with a combination of 2.5 mm of inferior offset and 4 mm of lateralization. The amount of lateralization required to maximize IRABD also varies by scapula size. Maximum IRABD was reached in smaller scapula with 4-6 mm of lateralization and at least 12 mm of lateralization in larger scapula. These findings may be applied in the clinical decision-making process knowing that impingement-free IR and IRABD can be maximized with combinations of inferior offset and lateralization based on scapula size with minimal effect on external rotation and external rotation in 60° of abduction.

Background: Functional internal rotation (fIR) can be limited after reverse shoulder arthroplasty (RSA) and can result in difficulties performing activities of daily living (ADLs). The goal of this narrative review is to summarize the growing body of research on optimizing fIR after RSA that may be useful to clinical practice. Methods: A narrative review of recent literature on IR after RSA. Results: IR required for ADLs is a compound motion involving multiple joints and planes; for this reason, the term “functional internal rotation” can be used to differentiate this motion from glenohumeral IR. Measuring IR by vertebral level is limited by interobserver reliability and poor correlation with the ability to perform ADLs. IR-specific scores or questions may be more relevant. Patient-based factors that influence IR include body mass index, thoracic spine sagittal alignment, humeral torsion, preoperative humerothoracic extension, and scapulothoracic mobility. Surgically, a healed subscapularis repair appears to improve IR and anterior latissimus dorsi transfers have been described with favorable results. Tools to predict IR after RSA are emerging and may be helpful to counseling patients on implant selection. Conclusion: FIR after RSA is optimized by maximizing impingement-free arc of motion and subscapularis repair in patients with mobile scapulothoracic joints, adequate preoperative humerothoracic extension, and low body mass index.

Background: Higher bone or metal glenoid offset in reverse shoulder arthroplasty (RSA) reduces scapular notching, improves range of motion (ROM), and reduces postoperative instability. This retrospective multicenter study compared two implant designs to evaluate the short-term clinical and radiologic results of bone increased offset RSA (BIO-RSA) and metal increased offset RSA (MIO-RSA) in reverse shoulder. We hypothesized no difference between groups. Methods: This study analyzed n = 62 BIO-RSA and n = 90 MIO-RSA cases with a mean follow-up of 29.7 ± 6.0 months (BIO-RSA, range 24-49 months) and 24.0 ± 1.1 months (MIO-RSA, range 22-28 months). A 145°-onlay humeral stem was utilized in BIO-RSA cases, while a 135°-semi-inlay humeral stem was implanted in all MIO-RSA cases. Preoperative and postoperative radiologic imaging was reviewed to identify signs of scapular notching. Additionally, lateralization was evaluated according to Erickson et al. The constant score, subjective shoulder value, and ROM were evaluated during the baseline and follow-up consultations, and the findings of both groups were subsequently compared. Results: Scapular notching was observed in 7.0% (n = 8) of MIO-RSA cases and 8.1% (n = 5) of BIO-RSA cases (P = .801). MIO-group had a higher lateralization angle (P = .020) and the BIO-group had a higher distalization angle (P = .005). At baseline, mean constant score in the MIO-RSA group was higher than in the BIO-RSA group (P

Face processing dominates the right hemisphere. This lateralization can be affected by co-lateralization within the same system and influence between different systems, such as neural competition from reading acquisition. Yet, how the relationship pattern changes through development remains unknown. This study examined the lateralization of core face processing and word processing in different age groups. By comparing fMRI data from 36 school-aged children and 40 young adults, we investigated whether there are age and regional effects on lateralization, and how relationships between lateralization within and between systems change across development. Our results showed significant right hemispheric lateralization in the core face system and left hemispheric lateralization in reading-related areas for both age groups when viewing faces and texts passively. While all participants showed stronger lateralization in brain regions of higher functional hierarchy when viewing faces, only adults exhibited this lateralization when viewing texts. In both age cohorts, there was intra-system co-lateralization for face processing, whereas an inter-system relationship was only found in adults. Specifically, functional lateralization of Broca’s area during reading negatively predicted functional asymmetry in the FFA during face perception. This study initially provides neuroimaging evidence for the reading-induced neural competition theory from a maturational perspective in Chinese cohorts.

Background: Traditional brain activity monitoring via scalp electroencephalography (EEG) offers limited resolution and is susceptible to artifacts. Endovascular electroencephalography (eEEG) emerged in the 1990s. Despite early successes and potential for detecting epileptiform activity, eEEG has remained clinically unutilized. This study aimed to further test the capabilities of eEEG in detecting lateralized epileptic discharges in animal models. We hypothesized that eEEG would be able to detect lateralization. The purpose of this study was to measure epileptiform discharges with eEEG in animal models with lateralization in epileptogenicity. Materials and methods: We inserted eEEG electrodes into the transverse sinuses of three pigs, and subdural electrodes (SDs) on the surfaces of the left and right hemispheres. We induced epileptogenicity with penicillin in the left brain of pigs F00001 and F00003, and in the right brain of pig F00002. The resulting epileptiform discharges were measured by eEEG electrodes placed in the left and right transverse sinuses, and conducted comparisons with epileptiform discharges from SDs. We also had 12 neurological physicians interpret measurement results from eEEG alone and determine the side (left or right) of epileptogenicity. Results: Three pigs were evaluated for epileptiform discharge detection using eEEG: F00001 (7 months old, 14.0 kg), F00002 (8 months old, 15.6 kg), and F00003 (8 months old, 14.4 kg). The eEEG readings were compared with results from SDs, showing significant alignment across all subjects (p 0.93) and PPV (>0.95) that appear equivalent to those of subdural EEG in the three pigs. This lateralization was also discernible by neurological physicians on visual inspection.

Objective: Bilateral Vocal Fold Paralysis (BVFP) is a rare but significant resource of respiratory distress in neonates and infants. The objective of this study was to evaluate the efficacy and functional outcomes of Endoscopic Percutaneous Suture Lateralization (EPSL) for the treatment of BVFP in neonates and infants. Methods: A case series study of nine patients undergoing EPSL for BVFP between January 2019 and June 2021 was conducted. All patients were candidates for tracheostomy prior to EPSL. Demographic features including gender, age at diagnosis and surgery, main symptoms, airway comorbidities, airway support, and etiology were collected preoperatively. Patients were evaluated for breathing, swallowing and phonation postoperatively. Surgical success was defined as the ability to avoid tracheostomy. Functional Endoscopic Evaluation of Swallowing (FEES) was conducted to identify aspiration. Voice evaluation was based on clinical observation. Results: Nine patients underwent ten EPSL procedures (one in the left vocal fold, and nine in the right vocal fold). Eight patients (8/9) were able to successfully avoid tracheostomy and feed orally without aspiration after the procedure. One patient experienced clinical improvement in respiratory support requirements and underwent laparoscopic nissen and gastrostomy tube placement. At the last follow-up, two patients regained normal voice, two patients had mild dysphonia, and five patients had moderate dysphonia. Five patients showed partial return of the contralateral vocal fold function. Conclusion: EPSL is an effective and safe treatment for neonatal and infantal BVFP, which enables patients free from tracheostomy without significant impact on swallowing function or phonation. Level of evidence: Level 4.

Hemispheric asymmetry or lateralization is a fundamental principle of brain organization. However, it is poorly understood to what extent the brain asymmetries across different levels of functional organizations are evident in health or altered in brain diseases. Here, we propose a framework that integrates three degrees of brain interactions (isolated nodes, node–node, and edge–edge) into a unified analysis pipeline to capture the sliding window-based asymmetry dynamics at both the node and hemisphere levels. We apply this framework to resting-state EEG in healthy and stroke populations and investigate the stroke-induced abnormal alterations in brain asymmetries and longitudinal asymmetry changes during poststroke rehabilitation. We observe that the mean asymmetry in patients was abnormally enhanced across different frequency bands and levels of brain interactions, with these abnormal patterns strongly associated with the side of the stroke lesion. Compared to healthy controls, patients displayed significant alterations in asymmetry fluctuations, disrupting and reconfiguring the balance of inter-hemispheric integration and segregation. Additionally, analyses reveal that specific abnormal asymmetry metrics in patients tend to move towards those observed in healthy controls after short-term brain-computer interface rehabilitation. Furthermore, preliminary evidence suggests that baseline clinical and asymmetry features can predict poststroke improvements in the Fugl-Meyer assessment of the lower extremity (mean absolute error of about 2). Overall, these findings advance our understanding of hemispheric asymmetry. Our framework offers new insights into the mechanisms underlying brain alterations and recovery after a brain lesion, may help identify prognostic biomarkers, and can be easily extended to different functional modalities.

The Wada test is the gold standard for determining language-dominant hemisphere. However, the precise determination of language areas in each patient requires more invasive methods, such as electrocortical stimulation. Some studies have reported the use of anesthetic injection into selective cerebral arteries to predict postoperative function. To assess the function of the anterior and posterior language areas separately, we developed an advanced test named the “super-selective Wada test” (ssWada). The ssWada procedure is as follows: an endovascular neurosurgeon identifies the arterial branches of the middle cerebral artery (MCA) perfusing the anterior language area of the inferior frontal gyrus and the posterior language area of the posterior part of the superior temporal gyrus using angiography. Behavioral neurologists assess language symptoms before and after propofol administration using a microcatheter tip in the selected arterial branch. From 30 serial patients with epilepsy who underwent ssWada test at Tohoku University Hospital, we retrospectively reviewed patients in whom multiple areas in the bilateral MCA region was examined. Eight cases were identified in this study. All eight cases had been considered for resection of the area overlapping the classical language area. Three of the eight cases were left-dominant, and the within-hemisphere distribution was also considered typical. One case was determined to be left-dominant but atypical in the intra-hemispheric functional distribution. Two cases were right-dominant, and the intra-hemispheric functional distribution was considered a mirror image of the typical pattern. The remaining two cases were considered atypical, not only in terms of bilateral language function, but also in terms of anterior-posterior functional distribution. This case series demonstrates the potential utility of ssWada in revealing separate function of the anterior and posterior language areas. The ssWada allows simulation of local surgical brain resection and detailed investigation of language function, which potentially contributes to planning the resection area. Although indications for ssWada are quite limited, it could play a complementary role to noninvasive testing because it provides information related to resection using a different approach.

Whereas neural representations of spatial information are commonly studied in vision, olfactory stimuli might also be able to create such representations via the trigeminal system. We explored in two independent multi-method electroencephalography–functional near-infrared spectroscopy (EEG+fNIRS) experiments (n1=18, n2=14) if monorhinal odor stimuli can evoke spatial representations in the brain. We tested whether this representation depends on trigeminal properties of the stimulus, and if the retention in short-term memory follows the “sensorimotor recruitment theory”, using multivariate representational similarity analysis (RSA). We demonstrate that the delta frequency band up to 5 Hz across the scull entail spatial information of which nostril has been stimulated. Delta frequencies were localized in a network involving primary and secondary olfactory, motor-sensory and occipital regions. RSA on fNIRS data showed that monorhinal stimulations evoke neuronal representations in motor-sensory regions and that this representation is kept stable beyond the time of perception. These effects were no longer valid when the odor stimulus did not sufficiently stimulate the trigeminal nerve as well. Our results are first evidence that the trigeminal system can create spatial representations of bimodal odors in the brain and that these representations follow similar principles as the other sensory systems.

Summary: Background: Magnetic Resonance Imaging (MRI) is an indispensable tool for the diagnosis of temporal lobe epilepsy (TLE). However, about 30% of TLE patients show no lesion on structural MRI (sMRI-negative), posing a significant challenge for presurgical evaluation. This study aimed to investigate whether chemical exchange saturation transfer (CEST) MRI at 3 Tesla can lateralize the epileptic focus of TLE and study the metabolic contributors to the CEST signal measured. Methods: Forty TLE subjects (16 males and 24 females) were included in this study. An automated data analysis pipeline was established, including segmentation of the hippocampus and amygdala (HA), calculation of four CEST metrics and quantitative relaxation times (T1 and T2), and construction of prediction models by logistic regression. Furthermore, a modified two-stage Bloch–McConnell fitting method was developed to investigate the molecular imaging mechanism of 3 T CEST in identifying epileptic foci of TLE. Findings: The mean CEST ratio (CESTR) metric within 2.25–3.25 ppm in the HA was the most powerful index in predicting seizure laterality, with an area under the receiver-operating characteristic curve (AUC) of 0.84. And, the combination of T2 and CESTR further increased the AUC to 0.92. Amine and guanidinium moieties were the two leading contributors to the CEST contrast between the epileptogenic HA and the normal HA. Interpretation: CEST at 3 Tesla is a powerful modality that can predict seizure laterality with high accuracy. This study can potentially facilitate the clinical translation of CEST MRI in identifying the epileptic foci of TLE or other localization-related epilepsies. Funding: National Natural Science Foundation of China, Science Technology Department of Zhejiang Province, and Zhejiang University.

Background: Scapular notching continues to be associated with reverse shoulder arthroplasty (RSA) and is thought to lead to fewer outcomes. Decreasing the humeral neck-shaft angle (NSA) has been associated with decreased incidence of scapular notching. Lateralizing the glenosphere center of rotation (COR) has also been proposed to decrease notching; however, its effect in lower NSA RSA is less understood. The purpose of this study was to compare the impact of the medial (0 mm) and lateral (4 mm) COR on the incidence of scapular notching and clinical outcomes after RSA with a 135° NSA humeral component. Methods: We performed a multicenter retrospective comparative cohort of 82 patients with cuff tear arthropathy (41 in each cohort) who underwent RSA with a 135° NSA humeral component and a glenosphere COR of either 0 mm (medialized COR [MCOR]) or 4 mm (lateralized COR [LCOR]) of lateralization. RSA was performed using the same 135° humeral system and baseplate design. All patients had 2-year radiographic and clinical follow-up. Postoperative radiographs were evaluated for scapular notching. Clinical outcomes included American Shoulder and Elbow Surgeons scores, visual analog pain scale, Simple Assessment Numeric Evaluation, and active range of motion. Results: The overall incidence of scapular notching was 22.0%. There was no significant difference in scapular notching between cohorts: 24.4% in the MCOR and 19.5% in the LCOR (P = .625). Both cohorts had significant improvements in American Shoulder and Elbow Surgeons scores, visual analog pain scale, Simple Assessment Numeric Evaluation, and active range of motion postoperatively (P

Background: Metallic humeral and glenoid lateralized implants have been developed to prevent common problems that can emerge using Grammont’s concept (ie, medialization of center of rotation, decreased humeral offset, scapular notching) in reverse shoulder arthroplasty. The purpose of this study was to evaluate the clinical and radiological results of metallic humeral and glenoid lateralized implants for cuff tear arthropathy (CTA) and primary osteoarthritis (OA). Methods: In this prospective study, patients with CTA or OA who underwent reverse shoulder arthroplasty using augmented base plates for glenoid lateralization and a “curved stem” design for the humeral side were included. The Constant-Murley score and Subjective Shoulder Value were documented at 1- and 2-year follow-ups. Radiographs were reviewed for scapular notching, instability, loosening, osteolysis, ossification, bone resorption, or fractures. Lateralization and distalization shoulder angles were evaluated at the final follow-up. Results: There were 23 patients with CTA and 19 patients with OA (27 women; mean age, 76 years; range, 59-85) available for examination at 2 years. Both groups increased significantly in all outcome measures compared with baseline (P

There is considerable debate about whether additional fMRI-measured activity in the right prefrontal cortex readily observed in older adults represents compensatory activation that enhances cognition or whether maintenance of youthful brain activity best supports cognitive function in late adulthood. To investigate this issue, we tested a large lifespan sample of 461 adults (aged 20–89) and treated degree of left-lateralization in ventrolateral and dorsolateral prefrontal cortex during a semantic judgment fMRI task as an individual differences variable to predict cognition. We found that younger adults were highly left-lateralized, but lateralization did not predict better cognition, whereas higher left-lateralization of prefrontal cortex predicted better cognitive performance in middle-aged adults, providing evidence that left-lateralized, youth-like patterns are optimal in middle age. This relationship was reversed in older adults, with lower laterality scores associated with better cognition. The findings suggest that bilaterality in older adults facilitates cognition, but early manifestation of this pattern during middle age is characteristic of low performers. Implications of these findings for current theories of neurocognitive aging are discussed.

Introduction: Post-operative complications of corpus callosotomy (CC) in children, prolonged hospitalization due to inactivity as acute disconnection syndrome is occasionally experienced. We aimed to clarify this issue and its risk factors with a hypothesis that electroencephalogram (EEG) findings as measures of functional lateralization may be among prognostic factors for post-operative recovery., Materials and Methods: Twenty-three patients with childhood-onset drug-resistant epilepsy who underwent total CC between April 2017 and December 2023 were included in the study and they were divided into two groups based on the duration of post-operative hospitalization as an indicator of recovery of daily living activity. We compared scalp EEG findings and the other factors including clinical characteristics between the two groups., Results: Of 22 patients (14 males) without specific complications, post-operative hospitalization clustered in 9-14 days in 15 patients (Group A) with range 16-118 days in seven patients (Group B). The ratios of patients with non-lateralized spikes on pre-operative EEG and that of patients with symmetric background activity on post-operative EEG were significantly greater in Group B (7/7, 100 %; 6/7, 86 %, respectively) than in Group A (8/15, 53 %; 4/15, 27 %, respectively) (p = 0.038; p = 0.020, respectively, by Fisher's exact test), while other factors were not significantly different between the two groups., Conclusions: Delayed recovery of living activity should be anticipated, especially in patients with non-lateralized epileptic discharges on pre-operative EEG., Competing Interests: Declaration of competing interest The authors have no other conflicts of interest to disclose., (Copyright © 2024. Published by Elsevier B.V.)

Background: Mesial temporal sclerosis (MTS) is the most common pathology associated with drug-resistant mesial temporal lobe epilepsy (mTLE) in adults. Most atrophic hippocampi can be identified using MRI based on standard epilepsy protocols; however, difficulties can arise in cases where sclerotic changes in the hippocampus are subtle or non-epilepsy-specific protocols have been implemented. In such cases, quantitative methods, such as T1-weighted axial series MRIs, are valuable additional tools to complement epilepsy-specific protocols. In the current study, we applied machine learning (ML) techniques to the analysis of brain regions of interest (ROIs), including the hippocampus, thalamus, and cortical areas, to enhance the accuracy of lesion lateralization in MRI., Methods: This study included 104 patients diagnosed with mTLE, including 55 with lesions on the right side and 49 with lesions on the left side. FreeSurfer software was used to extract features from high-resolution T1-weighted axial brain MRI scans for use in computing lateralization indices (LI) for various brain regions. After using feature selection to pinpoint critical ROIs, the corresponding LI values were used as parameters in training the ML model., Results: The proposed ML model demonstrated exceptional performance in the lateralization of mTLE, achieving test accuracy of 92.38 % with an AUROC of 0.97., Conclusion: This study demonstrated the efficacy of ML in detecting instances of MTS from thin-slice T1 images. The proposed method provides valuable insights for surgical planning and treatment. Nonetheless, additional research will be required to enhance the robustness of the model and rigorously validate its effectiveness and applicability in clinical settings., Competing Interests: Declaration of competing interest There are no conflicts of interest to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Face processing dominates the right hemisphere. This lateralization can be affected by co-lateralization within the same system and influence between different systems, such as neural competition from reading acquisition. Yet, how the relationship pattern changes through development remains unknown. This study examined the lateralization of core face processing and word processing in different age groups. By comparing fMRI data from 36 school-aged children and 40 young adults, we investigated whether there are age and regional effects on lateralization, and how relationships between lateralization within and between systems change across development. Our results showed significant right hemispheric lateralization in the core face system and left hemispheric lateralization in reading-related areas for both age groups when viewing faces and texts passively. While all participants showed stronger lateralization in brain regions of higher functional hierarchy when viewing faces, only adults exhibited this lateralization when viewing texts. In both age cohorts, there was intra-system co-lateralization for face processing, whereas an inter-system relationship was only found in adults. Specifically, functional lateralization of Broca's area during reading negatively predicted functional asymmetry in the FFA during face perception. This study initially provides neuroimaging evidence for the reading-induced neural competition theory from a maturational perspective in Chinese cohorts., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Septoplasty and endoscopic sinus surgery are very often concurrently performed operations in otolaryngology practice. The most common complication of endoscopic sinus surgery is lateralization of the middle turbinate. In our practice intranasal stenting is done routinely with Doyle silicone splints. Objective: Retrospectively, we aimed to review the postoperative period and to document efficacy of endoscopy-assisted Doyle silicone splint application on prevention of middle turbinate lateralization. Methods: Patients who had failed medical therapy and who underwent elective primary endoscopic sinus surgery for chronic rhinosinusitis with septal deviation requiring septoplasty were included to the study. Doyle silicone splints were inserted to all patients at the end of the operation with nasal speculum or with endoscopic assistance. Groups were compared for position of the middle turbinate at the end of the postoperative first month regarding lateralization and for pain score recorded on the second postoperative day. Results: In the Doyle silicone splints applied with nasal speculum group, there were 46 patients with a total of 80 operated sides. In the endoscopy assisted group, there were 54 patients with a total of 88 operated sides. At the 1 month follow-up, the mean of middle turbinate position scores was 1.62 in the speculum-assisted group and 1.80 in the endoscopy-assisted group, the difference between two groups was found to be statistically significant. Mean of postoperative second day pain scores were worse in patients with the Doyle silicone splints applied with endoscopic assistance. This difference was found statistically significant. Conclusion: In our study, after concomitant endoscopic sinus surgery and septoplasty, less middle turbinate lateralization was observed when the Doyle silicone splints were inserted with endoscopic guidance. The surgical techniques or methods of sinus packing as well as nasal packing may have an impact on middle turbinate lateralization after concurrent septoplasty and endoscopic sinus surgery.

Lateralization is a fundamental characteristic of many behaviors and the organization of the brain, and atypical lateralization has been suggested to be linked to various brain-related disorders such as autism and schizophrenia. Right-handedness is one of the most prominent markers of human behavioural lateralization, yet its neurobiological basis remains to be determined. Here, we present a large-scale analysis of handedness, as measured by self-reported direction of hand preference, and its variability related to brain structural and functional organization in the UK Biobank (N = 36,024). A multivariate machine learning approach with multi-modalities of brain imaging data was adopted, to reveal how well brain imaging features could predict individual's handedness (i.e., right-handedness vs. non-right-handedness) and further identify the top brain signatures that contributed to the prediction. Overall, the results showed a good prediction performance, with an area under the receiver operating characteristic curve (AUROC) score of up to 0.72, driven largely by resting-state functional measures. Virtual lesion analysis and large-scale decoding analysis suggested that the brain networks with the highest importance in the prediction showed functional relevance to hand movement and several higher-level cognitive functions including language, arithmetic, and social interaction. Genetic analyses of contributions of common DNA polymorphisms to the imaging-derived handedness prediction score showed a significant heritability (h2=7.55%, p

Skilled reading requires specialized visual cortical processing of orthographic information and its impairment has been proposed as a potential correlate of compromised reading in dyslexia. However, which stage of orthographic information processing during natural reading is disturbed in dyslexics remains unexplored. Here we addressed this question by simultaneously measuring the eye movements and EEG of dyslexic and control young adults during natural reading. Isolated meaningful sentences were presented at five inter-letter spacing levels spanning the range from minimal to extra-large spacing, and participants were instructed to read the text silently at their own pace. Control participants read faster, performed larger saccades and shorter fixations compared to dyslexics. While reading speed peaked around the default letter spacing, saccade amplitude increased and fixation duration decreased with the increase of letter spacing in both groups. Lateralization of occipito-temporal fixation-related EEG activity (FREA) was found in three consecutive time intervals corresponding to early orthographic processing in control readers. Importantly, the lateralization in the time range of the first negative left occipito-temporal FREA peak was specific for first fixations and exhibited an interaction effect between reading ability and letter spacing. The interaction originated in the significant decrease of FREA lateralization at extra-large compared to default letter spacing in control readers and the lack of lateralization in both letter spacing conditions in the case of dyslexics. These findings suggest that expertise-driven hemispheric functional specialization for early orthographic processing thought to be responsible for letter identity extraction during natural reading is compromised in dyslexia.

Background: The biomechanical effects of joint-line medialization during shoulder surgery are poorly understood. It was therefore the purpose of this study to investigate whether medialization of the joint line especially associated with total shoulder arthroplasty leads to changes in the rotator cuff muscle forces required to stabilize the arm in space. Methods: A validated computational 3-D rigid body simulation model was used to calculate generated muscle forces, instability ratios, muscle-tendon lengths and moment arms during scapular plane elevation. Measurements took place with the anatomical and a 2 mm and 6 mm lateralized or medialized joint line. Results: When the joint line was medialized, increased deltoid muscle activity was recorded throughout glenohumeral joint elevation. The rotator cuff muscle forces increased with medialization of the joint line in the early phases of elevation. Lateralization of the joint line led to higher rotator cuff muscle forces after 52° of glenohumeral elevation and to higher absolute values in muscle activity. A maximum instability ratio of >0.6 was recorded with 6 mm of joint-line medialization. Conclusion: In this biomechanical study, medialization and lateralization of the normal joint line during total shoulder arthroplasty led to substantial load changes on the shoulder muscles used for stabilizing the arm in space. Specifically, medialization does not only lead to muscular shortening but also to increased load on the supraspinatus tendon during early arm elevation, the position which is already most loaded in the native joint.

Introduction: Mechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent. Objective: This study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms. Methods: The research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients’ preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale. Results: The mean preoperative NOSE scores were 10.3 ± 4.2 in the RF group and 10.9 ± 4.9 in the LAT group, and the mean six-month postoperative scores were 1.09 ± 1.3 in the RF group and 1.2 ± 1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p > 0.05). Conclusion: The data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).

Despite growing evidence of links between sulcation and function in the adult brain, the folding dynamics, occurring mostly before normal-term-birth, is vastly unknown. Looking into the development of cortical sulci in infants can give us keys to address fundamental questions: what is the sulcal shape variability in the developing brain? When are the shape features encoded? How are these morphological parameters related to further functional development?In this study, we aimed to investigate the shape variability of the developing central sulcus, which is the frontier between the primary somatosensory and motor cortices. We studied a cohort of 71 extremely preterm infants scanned twice using MRI – once around 30 weeks post-menstrual age (w PMA) and once at term-equivalent age, around 40w PMA –, in order to quantify the sulcus's shape variability using manifold learning, regardless of age-group or hemisphere. We then used these shape descriptors to evaluate the sulcus's variability at both ages and to assess hemispheric and age-group specificities. This led us to propose a description of ten shape features capturing the variability in the central sulcus of preterm infants. Our results suggested that most of these features (8/10) are encoded as early as 30w PMA. We unprecedentedly observed hemispheric asymmetries at both ages, and the one captured at term-equivalent age seems to correspond with the asymmetry pattern previously reported in adults. We further trained classifiers in order to explore the predictive value of these shape features on manual performance at 5 years of age (handedness and fine motor outcome). The central sulcus's shape alone showed a limited but relevant predictive capacity in both cases. The study of sulcal shape features during early neurodevelopment may participate to a better comprehension of the complex links between morphological and functional organization of the developing brain.

This study probed for structural language impairment using behavioral and functional neuroimaging methods in individuals with Autism Spectrum Disorder (ASD) and those diagnosed with ASD in childhood who no longer meet criteria for ASD, referred to as Loss of Autism Diagnosis (LAD1). Participants were drawn from Fein et al. (2013): ASD (n = 35), LAD (n = 31), and Neurotypical (NT; n = 34). Criteria for structural language impairment were: Scores ≤ 82 on Clinical Evaluation of Language Fundamentals-4 (CELF) Core Language, an omnibus measure of language; and scores ≤ 7 on CELF Recalling Sentences, a clinical marker of structural language impairment. Task-based fMRI examined lateralization of significantly activated language-related brain regions in groups with structural language impairment (LI2) versus normal-range language (LN3), collapsed across ASD, LAD1, and NT status. Results showed no ASD versus LAD group differences in the proportion of participants with structural language impairment according to either metric (Recalling Sentences or Core Language). Functional MRI results indicated greater left hemisphere lateralization within significantly activated regions in the LI2 group. Structural language abilities were not meaningfully associated with either social abilities or lifetime ADHD symptoms in LI2 subgroups, further suggesting the presence of structural language impairment. Findings indicate the presence of persistent structural language difficulty even in the absence of ASD symptoms in some individuals within the LAD1 group and unique patterns of language-related neural specialization for language function in LI2 relative to LN3.

This study explores the impact of movement-outcome congruency and motor dominance on the action-associated modulations of early visual event-related potentials (ERPs). Employing the contingent paradigm, participants with varying degrees of motor dominance were exposed to stimuli depicting left or right human hands in the corresponding visual hemifields. Stimuli were either passively observed or evoked by voluntary button-presses with the dominant or non-dominant hand, in a manner that was either congruent or incongruent with stimulus laterality and hemifield. Early occipital responses (C1 and P1 components) revealed modulations consistent with sensory attenuation (SA) for self-evoked stimuli. Our findings suggest that sensory attenuation during the initial stages of visual processing (C1 component) is a general phenomenon across all degrees of handedness and stimulus/movement combinations. However, the magnitude of C1 suppression was modulated by handedness and movement-stimulus congruency, reflecting stronger SA in right-handed participants for stimuli depicting the right hand, when elicited by actions of the corresponding hand, and measured above the contralateral occipital lobe. P1 modulation suggested concurrent but opposing influences of attention and sensory prediction, with more pronounced suppression following stimulus-congruent button-presses over the hemisphere contralateral to movement, especially in left-handed individuals. We suggest that effects of motor dominance on the degree of SA may stem from functional/anatomical asymmetries in the processing of body parts (C1) and attention networks (P1). Overall, our results demonstrate the modulating effect of hand dominance and movement-outcome congruency on SA, underscoring the need for deeper exploration of their interplay. Additional empirical evidence in this direction could substantiate a premotor account for action-associated modulation of early sensory processing in the visual domain., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Reverse shoulder arthroplasty (RSA) can treat severe rotator cuff deficiency, but its medialized design of the shoulder's center of rotation (CoR) has been associated with scapular notching. Although lateralization of CoR provides a larger impingement-free range of motion, the changes in component positioning alter the biomechanics and may cause unforeseen complications. This work quantified the muscle forces and predicted the scapula fracture risk by coupling dynamic simulation analysis with finite element modeling. To identify bone failure patterns, the results were analyzed using three common failure measures. A parametric study showed greater lateralization produced higher strain/stress concentrations in the scapular spine (Levy Region Type II), with approximately a 10% increase for the 12 ​mm lateralized scenario, compared to a neutral configuration. Significant differences in fracture risk patterns were found between the maximum principal stress/strain results and the von Mises stress results. The lateralized configurations could increase the muscle and joint reaction forces during abduction and induce scapular fracture. Studying the effects of RSA lateralization on scapular fracture risk can help guide the continued optimization of RSA performance and surgical techniques. The findings of relationships between the loading style and bone failure measures can provide valuable insight into the investigation of bone failure criteria.

The “language-ready” brain theory suggests that the infant brain is pre-wired for language acquisition prior to language exposure. As a potential brain marker of such a language readiness, a leftward structural brain asymmetry was found in human infants for the Planum Temporale (PT), which overlaps with Wernicke's area. In the present longitudinal in vivo MRI study conducted in 35 newborn monkeys (Papio anubis), we found a similar leftward PT surface asymmetry. Follow-up rescanning sessions on 29 juvenile baboons at 7-10 months showed that such an asymmetry increases across the two ages classes. These original findings in non-linguistic primate infants strongly question the idea that the early PT asymmetry constitutes a human infant-specific marker for language development. Such a shared early perisylvian organization provides additional support that PT asymmetry might be related to a lateralized system inherited from our last common ancestor with Old-World monkeys at least 25–35 million years ago.

The Extended Frontal Aslant Tract (exFAT) is a recently described tractography-based extension of the Frontal Aslant Tract connecting Broca’s territory to both supplementary and pre-supplementary motor areas, and more anterior prefrontal regions. In this study, we aim to characterize the microstructural properties of the exFAT trajectories as a means to perform a laterality analysis to detect interhemispheric structural differences along the tracts using the Human Connectome Project (HCP) dataset. To that end, the bilateral exFAT was reconstructed for 3T and 7T HCP acquisitions in 120 randomly selected subjects. As a complementary exploration of the exFAT anatomy, we performed a white matter dissection of the exFAT trajectory of two ex-vivo left hemispheres that provide a qualitative assessment of the tract profiles. We assessed the lateralization structural differences in the exFAT by performing: (i) a laterality comparison between the mean microstructural diffusion-derived parameters for the exFAT trajectories, (ii) a laterality comparison between the tract profiles obtained by applying the Automated Fiber Quantification (AFQ) algorithm, and (iii) a cross-validated Machine Learning (ML) classifier analysis using single and combined tract profiles parameters for single-subject classification. The mean microstructural diffusion-derived parameter comparison showed statistically significant differences in mean FA values between left and right exFATs in the 3T sample. The diffusion parameters studied with the AFQ technique suggest that the inferiormost half of the exFAT trajectory has a hemispheric-dependent fingerprint of microstructural properties, with an increased measure of tissue hindrance in the orthogonal plane and a decreased measure of orientational dispersion along the main tract direction in the left exFAT compared to the right exFAT. The classification accuracy of the ML models showed a high agreement with the magnitude of those differences.

While language processing is often described as lateralized to the left hemisphere (LH), the processing of emotion carried by vocal intonation is typically attributed to the right hemisphere (RH) and more specifically, to areas mirroring the LH language areas. However, the evidence base for this hypothesis is inconsistent, with some studies supporting right-lateralization but others favoring bilateral involvement in emotional prosody processing.Here we compared fMRI activations for an emotional prosody task with those for a sentence comprehension task in 20 neurologically healthy adults, quantifying lateralization using a lateralization index. We observed right-lateralized frontotemporal activations for emotional prosody that roughly mirrored the left-lateralized activations for sentence comprehension. In addition, emotional prosody also evoked bilateral activation in pars orbitalis (BA47), amygdala, and anterior insula.These findings are consistent with the idea that analysis of the auditory speech signal is split between the hemispheres, possibly according to their preferred temporal resolution, with the left preferentially encoding phonetic and the right encoding prosodic information. Once processed, emotional prosody information is fed to domain-general emotion processing areas and integrated with semantic information, resulting in additional bilateral activations.

Previous studies have found that theta activities exhibit posterior lateralized modulation as well as midfrontal event-related synchronization (ERS) during covert visual attention in adults. The present study investigated whether these theta modulations existed in children and whether they were associated with attentional problems in attention-deficit/hyperactivity disorder (ADHD). Electroencephalography signals were recorded from typically developing (TD) children and children with ADHD (TD: n = 24; ADHD: n = 22) while they performed a cued covert visual attention task. The participants responded to a target following a cue designed as human eyes that gazed to the left or right visual field (70% validity). Compared with the TD children, the children with ADHD showed increased midfrontal theta ERS and significant posterior theta lateralization in response to the cues. More importantly, we found that the stronger posterior theta lateralization in the right hemisphere exhibited a positive trial-based correlation with the larger midfrontal theta ERS and predicted lower RT variability at the trial level in the children with ADHD. We suggest that ADHD may be associated with some enhanced systems in the frontal and posterior areas via theta oscillations, which may be involved in the compensatory maturation for their attention deficits in childhood, thereby promoting the stability of behavioral responses.

Pupil size is collectively controlled by the sympathetic dilator and parasympathetic sphincter muscles. Locus coeruleus (LC) activation has been shown to evoke pupil dilation, but how the sympathetic and parasympathetic pathways contribute to this dilation remains unknown. We examined pupil dilation elicited by LC activation in lightly anesthetized rats. Unilateral LC activation evoked bilateral but lateralized pupil dilation; i.e., the ipsilateral dilation was significantly larger than the contralateral dilation. Surgically blocking the ipsilateral, but not contralateral, sympathetic pathway significantly reduced lateralization, suggesting that lateralization is mainly due to sympathetic contribution. Moreover, we found that sympathetic, but not parasympathetic, contribution is correlated with LC activation frequency. Together, our results unveil the frequency-dependent contributions of the sympathetic and parasympathetic pathways to LC activation-evoked pupil dilation and suggest that lateralization in task-evoked pupil dilations may be used as a biomarker for autonomic tone.

Recent studies have demonstrated that muscle sympathetic nerve activity (MSNA) responses to isometric exercise differs between active and inactive limbs. Whether limb-dependent responses are characteristic of responses to the cold pressor test (CPT) remains to be established. Therefore, we tested the hypothesis that CPT-induced MSNA responses differ between affected and unaffected limbs such that MSNA in the affected lower limb is greater than MSNA responses in the contralateral lower limb and the upper limb. Integrated peroneal MSNA (microneurography) was measured in young healthy individuals (n = 10) at rest and during three separate 3-min CPTs: the microneurography foot, opposite foot, and opposite hand. Peak MSNA responses were extracted for further analysis, as well as corresponding hemodynamic outcomes including mean arterial pressure (MAP; Finometer). MSNA responses were greater when the microneurography foot was immersed in ice water than when the opposite foot was immersed (38 ± 18 vs 28 ± 16 bursts/100hb: P < 0.01). MSNA responses when the opposite hand was immersed were greater than both the microneurography foot (46 ± 22 vs 38 ± 18 bursts/100hb: P < 0.01) and opposite foot (46 ± 22 vs 28 ± 16 bursts/100hb: P ≤0.01). Likewise, MAP responses were greater during the hand CPT than the microneurography foot (99 ± 9 vs 96 ± 8 mmHg: P < 0.01) and opposite foot CPT (99 ± 9 vs 96 ± 9 mmHg: P < 0.01). These data indicate that (a) upper limbs and (b) immersed limbs elicit greater MSNA responses to the CPT than lower and/or non-immersed limbs., (Copyright © 2023 Elsevier B.V. All rights reserved.)

External bilateral symmetry is a prevalent feature in vertebrates, which emerges during early embryonic development. To begin with, vertebrate embryos are largely radially symmetric before transitioning to bilaterally symmetry, after which, morphogenesis of various bilateral tissues (e.g somites, otic vesicle, limb bud), and structures (e.g palate, jaw) ensue. While a significant amount of work has probed the mechanisms behind symmetry breaking in the left-right axis leading to asymmetric positioning of internal organs, little is known about how bilateral tissues emerge at the same time with the same shape and size and at the same position on the two sides of the embryo. By discussing emergence of symmetry in many bilateral tissues and structures across vertebrate model systems, we highlight that understanding symmetry establishment is largely an open field, which will provide deep insights into fundamental problems in developmental biology for decades to come., (Copyright © 2024. Published by Elsevier Inc.)

With greater availability of hemp (Cannabis sativa L.) due to recent legislation, hempseed meal (HSM) should be evaluated as a potential feedstuff for livestock. The study objective was to evaluate the palatability of HSM in horses. Trial 1 used a modified 3 × 3 Latin Square design utilizing three geldings and three mares. Feeding periods (6d) consisted of two feedings/d with a washout phase (3d) before each treatment phase (3d). During treatment, horses were offered soybean meal pellets (SBM), rice bran pellets (RBP), or beet pulp pellets (BPP) in one bucket (500 g) and HSM in a second bucket (500 g) each feeding. In Trial 2, six geldings were offered 1 kg of HSM pellets over two 5-minute periods, 1 hour apart each day, with 1kg of Coastal Bermudagrass hay between offerings. Consumption of HSM in Trial 1 was greater than SBM (P = .005) and BPP (P < .001) but not different from RBP (P = .19). Consumption of HSM increased with each subsequent period (P < .001). In Trial 2, intake of HSM on d1, d2, and d3 were less than d6 (P < .05). Hay consumption was greater on d1 and d2 than d6 (P < .01). Hay consumption and HSM intake were not correlated (R 2  = 0.001). These findings indicate that HSM may be similar in palatability to RBP and more palatable than SBM and BPP. Consumption of HSM increases over time, but is not impacted by hay consumption. In equine rations, HSM may serve as an acceptable replacement to more common feedstuffs., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Noninvasive markers of brain function could yield biomarkers in many neurological disorders. Disease models constrained by coordinate-based meta-analysis are likely to increase this yield. Here, we evaluate a thalamic model of temporal lobe epilepsy that we proposed in a coordinate-based meta-analysis and extended in a diffusion tractography study of an independent patient population. Specifically, we evaluated whether thalamic functional connectivity (resting-state fMRI-BOLD) with temporal lobe areas can predict seizure onset laterality, as established with intracranial EEG. Twenty-four lesional and non-lesional temporal lobe epilepsy patients were studied. No significant differences in functional connection strength in patient and control groups were observed with Mann-Whitney Tests (corrected for multiple comparisons). Notwithstanding the lack of group differences, individual patient difference scores (from control mean connection strength) successfully predicted seizure onset zone as shown in ROC curves: discriminant analysis (two-dimensional) predicted seizure onset zone with 85% sensitivity and 91% specificity; logistic regression (four-dimensional) achieved 86% sensitivity and 100% specificity. The strongest markers in both analyses were left thalamo-hippocampal and right thalamo-entorhinal cortex functional connection strength. Thus, this study shows that thalamic functional connections are sensitive and specific markers of seizure onset laterality in individual temporal lobe epilepsy patients. This study also advances an overall strategy for the programmatic development of neuroimaging biomarkers in clinical and genetic populations: a disease model informed by coordinate-based meta-analysis was used to anatomically constrain individual patient analyses.

Abnormalities in cortical structure are commonly observed in children with dyslexia in key regions of the “reading network.” Whether alteration in cortical features reflects pathology inherent to dyslexia or environmental influence (e.g., impoverished reading experience) remains unclear. To address this question, we compared MRI-derived metrics of cortical thickness (CT), surface area (SA), gray matter volume (GMV), and their lateralization across three different groups of children with a historical diagnosis of dyslexia, who varied in current reading level. We compared three dyslexia subgroups with: (1) persistent reading and spelling impairment; (2) remediated reading impairment (normal reading scores), and (3) remediated reading and spelling impairments (normal reading and spelling scores); and a control group of (4) typically developing children. All groups were matched for age, gender, handedness, and IQ. We hypothesized that the dyslexia group would show cortical abnormalities in regions of the reading network relative to controls, irrespective of remediation status. Such a finding would support that cortical abnormalities are inherent to dyslexia and are not a consequence of abnormal reading experience. Results revealed increased CT of the left fusiform gyrus in the dyslexia group relative to controls. Similarly, the dyslexia group showed CT increase of the right superior temporal gyrus, extending into the planum temporale, which resulted in a rightward CT asymmetry on lateralization indices. There were no group differences in SA, GMV, or their lateralization. These findings held true regardless of remediation status. Each reading level group showed the same “double hit” of atypically increased left fusiform CT and rightward superior temporal CT asymmetry. Thus, findings provide evidence that a developmental history of dyslexia is associated with CT abnormalities, independent of remediation status.

Purpose: Identification of the seizure onset zone is critically important for outlining the surgical plan in the treatment of pharmacoresistant focal epilepsy. In patients with temporal lobe epilepsy (TLE), bilateral ictal scalp EEG changes frequently occur and can make lateralization of the seizure onset zone difficult. We investigated the incidence and clinical utility of unilateral preictal alpha rhythm attenuation as a lateralizing sign of seizure onset in TLE., Methods: Scalp EEG recordings of the seizures acquired during presurgical video-EEG monitoring of 57 consecutive patients with TLE were reviewed retrospectively. Included patients had interictal baseline recordings demonstrating symmetrical posterior alpha rhythm and seizures occurring during wakefulness., Results: We identified a total of 649 seizures in the 57 patients, of which 448 seizures in 53 patients fulfilled the inclusion criteria. Among the 53 included patients, 7 patients (13.2%) exhibited a distinct attenuation of the posterior alpha rhythm prior to the first ictal EEG changes, in 26 of 112 (23.2%) included seizures. Preictal alpha rhythm attenuation in these seizures was ipsilateral to the ultimately determined side of seizure onset (based on video-EEG or intracranial EEG findings) in 22 (84.6%) of these seizures and bilateral in 4 (15.4%), and occurred on average 5.9 ± 2.6 s prior to ictal EEG onsets., Conclusion: Our findings suggest that in some patients with TLE lateralized preictal attenuation of the posterior alpha rhythm may be a useful indicator of side of seizure onset, presumably due to early disruption of thalamo-temporo-occipital network function, likely mediated through the thalamus., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Background: The central amygdala (CeA) is a bilateral hub of pain and emotional processing with well-established functional lateralization. We reported that optogenetic manipulation of neural activity in the left and right CeA has opposing effects on bladder pain., Methods: To determine the influence of calcitonin gene-related peptide (CGRP) signaling from the parabrachial nucleus on this diametrically opposed lateralization, we administered CGRP and evaluated the activity of CeA neurons in acute brain slices as well as the behavioral signs of bladder pain in the mouse., Results: We found that CGRP increased firing in both the right and left CeA neurons. Furthermore, we found that CGRP administration in the right CeA increased behavioral signs of bladder pain and decreased bladder pain-like behavior when administered in the left CeA., Conclusions: These studies reveal a parabrachial-to-amygdala circuit driven by opposing actions of CGRP that determines hemispheric lateralization of visceral pain., (Copyright © 2022 Society of Biological Psychiatry. All rights reserved.)

Aim: To determine factors associated with the locations, types and levels of traumatic limb amputations caused by road traffic accidents., Materials and Methods: The files sent by the courts to the expert committee chaired by the authors for the determination of applicants' disability rate over the 10-year period between 2011 and 2020 were examined retrospectively., Results: Of the 27 cases with traumatic amputations caused by road traffic accidents, 63% of them were male and the mean age of the cases was 29.0 ± 20.0 years. The cases comprised 12 passengers, 10 pedestrians, and 5 drivers. Of all, 66.7% of the amputations were caused by automobile accidents, 59.3% of them were in lower limbs, 51.9% of them were on the right side, and most of them occurred below the elbow/knee levels. Amputations occurred more frequently in lower limbs that are contralateral to the side of the traffic flow, in drivers, and in front seat passengers., Conclusion: The findings in this preliminary study need to be confirmed in studies to be conducted in larger series. The findings of these studies will shed light on technological developments that can be used in the prevention of serious injuries that lead to post-accident traumatic amputations., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

This study probed for structural language impairment using behavioral and functional neuroimaging methods in individuals with Autism Spectrum Disorder (ASD) and those diagnosed with ASD in childhood who no longer meet criteria for ASD, referred to as Loss of Autism Diagnosis (LAD 1 ). Participants were drawn from Fein et al. (2013): ASD (n = 35), LAD (n = 31), and Neurotypical (NT; n = 34). Criteria for structural language impairment were: Scores ≤ 82 on Clinical Evaluation of Language Fundamentals-4 (CELF) Core Language, an omnibus measure of language; and scores ≤ 7 on CELF Recalling Sentences, a clinical marker of structural language impairment. Task-based fMRI examined lateralization of significantly activated language-related brain regions in groups with structural language impairment (LI 2 ) versus normal-range language (LN 3 ), collapsed across ASD, LAD 1 , and NT status. Results showed no ASD versus LAD group differences in the proportion of participants with structural language impairment according to either metric (Recalling Sentences or Core Language). Functional MRI results indicated greater left hemisphere lateralization within significantly activated regions in the LI 2 group. Structural language abilities were not meaningfully associated with either social abilities or lifetime ADHD symptoms in LI 2 subgroups, further suggesting the presence of structural language impairment. Findings indicate the presence of persistent structural language difficulty even in the absence of ASD symptoms in some individuals within the LAD 1 group and unique patterns of language-related neural specialization for language function in LI 2 relative to LN 3 ., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)