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Although neurocognitive dysfunction has been observed after infection by SARS-CoV-2, few studies have detailed these alterations or demonstrated their impact on daily life activities and work. Here, I describe the sequence of events following a mild COVID-19 infection in August 2020 (which now is described as “post-COVID syndrome”) and comment on my ensuing limitations associated with cognitive difficulties, headache, fatigue and sleepiness. Furthermore, I discuss the efforts that I have made to recover from my infection since its beginning and the strategies adopted for living with persistent restrictions in terms of cognitive performance. RESUMO Embora a disfunção neurocognitiva tenha sido observada após a infecção por SARS-Cov2, poucos estudos detalharam essas alterações ou demonstraram seu impacto nas atividades de vida diária e trabalho. Aqui eu descrevo a sequência de eventos após uma infecção leve por COVID-19 em agosto de 2020 (agora considerada Síndrome pós-COVID) e comento as limitações associadas às dificuldades cognitivas, dor de cabeça, fadiga e sonolência. Além disso, eu caracterizo o esforço de recuperação desde o início e as estratégias para conviver com restrições persistentes em termos de desempenho cognitivo.

Although neurocognitive dysfunction has been observed after infection by SARS-CoV-2, few studies have detailed these alterations or demonstrated their impact on daily life activities and work. Here, I describe the sequence of events following a mild COVID-19 infection in August 2020 (which now is described as “post-COVID syndrome”) and comment on my ensuing limitations associated with cognitive difficulties, headache, fatigue and sleepiness. Furthermore, I discuss the efforts that I have made to recover from my infection since its beginning and the strategies adopted for living with persistent restrictions in terms of cognitive performance.

Epilepsy is a common and serious neurological disorder, with many different constituent conditions characterized by their electro clinical, imaging, and genetic features. MRI has been fundamental in advancing our understanding of brain processes in the epilepsies. Smaller‐scale studies have identified many interesting imaging phenomena, with implications both for understanding pathophysiology and improving clinical care. Through the infrastructure and concepts now well‐established by the ENIGMA Consortium, ENIGMA‐Epilepsy was established to strengthen epilepsy neuroscience by greatly increasing sample sizes, leveraging ideas and methods established in other ENIGMA projects, and generating a body of collaborating scientists and clinicians to drive forward robust research. Here we review published, current, and future projects, that include structural MRI, diffusion tensor imaging (DTI), and resting state functional MRI (rsfMRI), and that employ advanced methods including structural covariance, and event‐based modeling analysis. We explore age of onset‐ and duration‐related features, as well as phenomena‐specific work focusing on particular epilepsy syndromes or phenotypes, multimodal analyses focused on understanding the biology of disease progression, and deep learning approaches. We encourage groups who may be interested in participating to make contact to further grow and develop ENIGMA‐Epilepsy.

Orientadores: Fernando Cendes, Helder Tedeschi Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas Resumo: Objetivo: A cirurgia para pacientes com epilepsia de lobo temporal mesial refratária oferece um controle de crises para aproximadamente 70% dos pacientes. Neste estudo comparamos a eficácia entre o tratamento clínico e cirúrgico e investigamos a relação entre as alterações estruturais (atrofia de substância branca, SB e cinzenta, SC) nas imagens de ressonância magnética (RM) pré-operatórias e o resultado cirúrgico; bem como evidências estruturais de neuroplasticidade nas imagens de RM pós-operatórias. Métodos: Realizamos uma curva de sobrevivência de Kaplan-Meier para comparar a eficácia entre os dois tipos de tratamento, para o grupo clínico (85 pacientes, 30 mulheres) e grupo cirúrgico (46 pacientes, 16 mulheres). Avaliamos as imagens de RM através da técnica de Morfometria Baseada em Voxel com o software SPM2 (Statistical Parametric Mapping)/MATLAB 7.0, comparando pacientes com indivíduos normais através de um Teste-T. Para essa análise dividimos os pacientes operados em grupos de acordo com o controle de crises obtido. Para investigar as alterações plásticas pós-operatórias realizamos um teste-T pareado entre as imagens pré e pós-operatórias. Resultados: A análise de sobrevivência confirmou a superioridade do tratamento cirúrgico (84% de pacientes controlados) em longo razo em comparação ao tratamento medicamentoso (7% de pacientes controlados), p< 0,001. Os pacientes com melhor resultado cirúrgico apresentavam um padrão restrito de atrofia de SC em comparação aos pacientes com crises após a cirurgia. Apenas os pacientes controlados tiveram evidências de recuperação de SB e SC após a cirurgia. Conclusão: A cirurgia oferece um melhor controle de crises que o tratamento medicamentoso e a chance de recuperar áreas com atrofia de SB e SC. Abstract: Objective: Surgery for refractory mesial temporal lobe epilepsy (MTLE) generally offers good seizure control for approximately 70% of patients. In this study we compared the efficacy between surgical and clinical treatments and investigated the relationship between pre-operative structural abnormalities (white matter and grey matter atrophy) and surgical outcome. We also investigated the structural evidences of brain plasticity on post-operative MRI scans. Methods: We performed Kaplan-Meier survival analysis to compare the efficacy between surgical and medical groups. Clinical group included 85 patients (30 women) and the surgical group included 46 patients (16 women). We applied Voxel Based Morphometry technique on SPM2 (Statistical Parametric Mapping)/MATLAB 7.0 and compared patients with normal individuals with T-Test. For this analysis we separated patients according to post-operative surgical control. In order to investigate plastic changes after surgery we performed paired T-Test between pre and postoperative MR scans. Results: Survival analysis confirmed the superiority of surgical treatment for long-term seizure control (seizure control in 84% of patients) compared to medical treatment (seizure control in 7% of patients), p

The cognitive dysfunction caused by antiepileptic drugs (AEDs) has been extensively described, although the mechanisms underlying such collateral effects are still poorly understood. The combination of functional magnetic resonance imaging (fMRI) studies with pharmacological intervention (pharmaco-MRI or ph-MRI) offers the opportunity to investigate the effect of drugs such as AEDs on brain activity, including cognitive tasks. Here we review the studies that investigated the effects of AEDs [topiramate (TPM), lamotrigine (LMT), carbamazepine (CBZ), pregabalin (PGB), valproate (VPA) and levetiracetam (LEV)] on cognitive fMRI tasks. Despite the scarcity of fMRI studies focusing on the impact of AEDs on cognitive task, the results of recent work have provided important information about specific drug-related changes of brain function.

Agradecimentos: This study was supported by the Canadian Institute of Health Research (DWG, CB, and CLY); CEPID–FAPESP: "The Brazilian Institute of Neuroscience and Neurotechnology (BRAINN)," grant 2013/07559-3; and Brazilian National Council for Scientific and Technological Development (CNPq)–(GCB) Abstract: Objective: Although altered large-scale brain network organization in patients withtemporal lobe epilepsy (TLE) has been shown using morphologic measurements suchas cortical thickness, these studies, have not included critical subcortical structures(such as hippocampus and amygdala) and have had relatively small sample sizes. Here,we investigated differences in topological organization of the brain volumetric net-works between patients with right TLE (RTLE) and left TLE (LTLE) with unilateral hip-pocampal atrophy. Methods: We performed a cross-sectional analysis of 86 LTLE patients, 70 RTLEpatients, and 116 controls. RTLE and LTLE groups were balanced for gender(p=0.64), seizure frequency (Mann-WhitneyUtest, p=0.94), age (p=0.39), age ofseizure onset (p=0.21), and duration of disease (p=0.69). Brain networks were con-structed by thresholding correlation matrices of volumes from 80 cortical/subcorticalregions (parcellated with Freesurfer v5.3 https://surfer.nmr.mgh.harvard.edu/) thatwere then analyzed using graph theoretical approaches. Results: We identified reduced cortical/subcortical connectivity including bilateral hip-pocampus in both TLE groups, with the most significant interregional correlationincreases occurring within the limbic system in LTLE and contralateral hemisphere inRTLE. Both TLE groups demonstrated less optimal topological organization, withdecreased global efficiency and increased local efficiency and clustering coefficient.LTLE also displayed a more pronounced network disruption. Contrary to controls,hub nodes in both TLE groups were not distributed across whole brain, but ratherfound primarily in the paralimbic/limbic and temporal association cortices. Regionswith increased centrality were concentrated in occipital lobes for LTLE and contralat-eral limbic/temporal areas for RTLE.Significance:These findings provide first evidence of altered topological organizationof the whole brain volumetric network in TLE, with disruption of the coordinated pat-terns of cortical/subcortical morphology FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ Aberto

Objective To evaluate white matter (WM) integrity of distinct groups of patients with antiepileptic drug (AED)-resistant localization-related epilepsies. Methods We used diffusion tensor imaging (DTI) fiber-tractography and voxel-based morphometry (VBM) to investigate differences of WM micro- and macrostructural integrity in patients with different drug-resistant localization-related epilepsies: 17 with temporal lobe epilepsy with magnetic resonance imaging (MRI) signs of hippocampal sclerosis (TLE-HS), 17 with TLE and normal MRI (TLE-NL), 14 with frontal lobe epilepsy and subtle MRI signs of focal cortical dysplasia (FLE-FCD), and 112 healthy controls. We performed fiber-tractography using a semiautomatic deterministic method to yield average fractional anisotropy (FA), axial (AD), and radial (RD) diffusivity ipsilateral and contralateral to the epileptogenic zone of the following tracts based on their functional and anatomic relevance: body of fornix (BoF), body of cingulum (BoC), inferior frontal occipital (IFO), and uncinate fasciculi (UF). In addition, we performed VBM of the WM maps to assess macrostructural integrity differences among groups. Results TLE-HS had ipsilateral and contralateral decreased FA and increased RD for all tracts. VBM showed WM alterations mainly in the ipsilateral parahippocampal region and contralateral superior temporal gyrus. FLE-FCD showed bilateral FA decreases only in the BoC and ipsilateral RD increases also in the BoC. VBM showed WM reduction mainly in the ipsilateral precuneus and posterior and anterior cingulum. No significant WM alterations were found in the TLE-NL in DTI or VBM analysis. Significance WM abnormalities differ in distinct AED-resistant localization-related epilepsies. The diverse distribution of the WM damage in these patients suggests that the localization of the epileptic networks may play a role in the WM burden. However, the distinct degree of this damage, more accentuated in TLE-HS, also suggests that the underlying cause of the epilepsy is probably an additional factor to explain this WM damage FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP Aberto

Purpose: To compare relative N-acetylaspartate (NAA) measurements in temporal lobe epilepsy (TLE) patients with good response to the first trial of antiepileptic drugs (AEDs) (an important prognostic factor) to TLE patients who failed the first AED monotherapy and required further AED trials with monotherapy or polytherapy. We studied 25 consecutive TLE patients who responded to first AED (responders) and 21 who did not (failure-group), as well as 27 controls. Patients were seen regularly in our Epilepsy Service and underwent electroencephalography (EEG) investigation, high-resolution magnetic resonance imaging (MRI), and single-voxel proton MR spectroscopy. Voxels were tailored to the medial temporal region on each side and involved the anterior hippocampus. Analysis of variance (ANOVA) demonstrated significant variation of NAA/creatine (NAA/Cr) values in both hippocampi, ipsilateral and contralateral to the EEG focus (p < 0.001 and p = 0.021) across the groups. Pairwise post hoc comparisons showed reduced NAA/Cr in both hippocampi of failure-group compared to controls (p < 0.001) and compared to responders (p < 0.05), but not between the controls and responders. Individual analyses showed NAA/Cr ratios lower than 2 SDs (standard deviations) below the mean of controls in 9 of 21 patients (42.8%) in the failure-group (6 with unilateral and 3 with bilateral reduction) but in none of the responders. These results indicate that patients with TLE who respond well to the first AED have significantly less evidence of neuronal and axonal damage/dysfunction compared to those who are refractory to the first AED trial FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP Fechado

OBJECTIVES: To study pre and postoperative WMA in MTLE patients. METHODS: We performed Voxel-Based Morphometry (VBM) with volume of interest (VOI) in 69 controls (mean age, 34.3±11.1 years) and 67 operated patients (mean age, 34.1±10.4 years) with unilateral MTLE. 34 became seizure-free (SzFree-Group), 23 improved (Engel IB-IIA [Partial recovery-group]) and 10 did not improve (Engel III-IV [Failure-Group]). All had pre and postoperative MRIs (one year minimum). We flipped MRIs of right MTLE patients in order to avoid right-to-left analysis cancelation. VBM was performed on SPM2/MATLAB7.0 with individual masks for surgical lacunae and 1% false-discovery-rate to control for multiple comparisons. We used MARSbar routine to select ROIs and t-test for statistical analyses. RESULTS: Mean postoperative follow-up was 60.2 (±SD 30.7) months. On baseline MRI, SzFree-Group showed White Matter Atrophy (WMA) involving temporal lobes [TL], ipsilateral occipital, parietal and frontal regions, with areas of significant recovery of WMA on postoperative MRI. Partial recovery-Group presented a more restricted pattern of WMA, involving ipsilateral temporal lobe, contralateral superior temporal gyrus and few areas in bilateral cingulated and orbitofrontal areas. In this group we also identified areas with relative increase of WM after surgery. By contrast, Failure-Group showed more widespread bi-hemispheric areas of WMA on baseline MRI without postoperative improvement. CONCLUSIONS: Although we have identified some differences in baseline WMA, we were unable to correlate a more widespread pattern with a worse prognosis, as SzFree-Group, also presented a bilateral distribution of WMA. The recovery of WMA in SzFree-Group and Partial recovery-group is in agreement with previous MRS and PET studies and suggests that a network of neuronal dysfunction in MTLE can be, at least in part, reversible after successful postoperative seizure control.

Objective: Artifacts caused by metallic objects, such as dental crowns, dental implants and metallic orthodontic appliances, are a common problem in head and neck MRI. The aim of this retrospective study was to identify the main metal dental objects that produce artifacts on brain MRIs.Study design: Imaged metallic artifacts and their sources were identifi ed. Artifact image plane was rated on a score of 0 or 1 (0 - distinguishable for diagnosis and 1 - not distinguishable for diagnosis).Results: Seventy-eight percent of the artifacts appearing in images were caused by orthodontic appliances, followed by dental titanium implants (18%) and metallic crowns (4%). Orthodontic appliances obtained the highest scores in all planes.Conclusions: We concluded that is diffi cult to avoid the effect of metallic artifacts in the maxillofacial regions on brain scan. Removing metallic parts of the orthodontic appliance should ensure diagnostically useful quality scans.

OBJECTIVE: To characterize clinical and interictal electroencephalographic aspects of children and adults with temporal lobe epilepsy (TLE) due to tumoral lesions. METHOD: We performed a retrospective analysis of the clinical and interictal electroencephalographic aspects of 16 children (64 exams) and 12 adults (78 exams) with lesions in the temporal lobe. RESULTS: The most frequent etiologies were gangliogliomas, DNETs, followed by astrocytomas. Auras occurred in both groups, the most common being epigastric sensation. Other findings such as myoclonias, behavioral arrest and vomiting were more frequent in children. Temporal epileptiform and nonepileptiform activities, mostly unilateral, were found in both groups. Extratemporal epileptiform activities (frontal, parietal, central, occipital and generalized) were also found equally in both groups. CONCLUSION: Our data show that children and adults with TLE due to expansive lesions present with similar EEG findings. OBJETIVO: Avaliar os aspectos eletrencefalográficos interictais e clínicos de crianças e adultos com epilepsia do lobo temporal secundária a lesões tumorais. MÉTODO: Análise retrospectiva dos aspectos clínicos e eletrencefalográficos interictais de 16 crianças (64 exames) e 12 adultos (78 exames) com lesões tumorais no lobo temporal. RESULTADOS: As etiologias mais freqüentes foram gangliogliomas e DNETs, seguidos por astrocitomas. As auras ocorreram em ambos os grupos, sendo a sensação epigástrica a mais comum. Outros achados tais como mioclonias, parada comportamental e vômitos foram mais freqüentes em crianças. Atividade epileptiforme e não epileptiforme temporal, principalmente unilateral, foi encontrada nos dois grupos. Atividade epileptiforme extra temporal (frontal, parietal, central, occipital e generalizada) foi também igualmente detectada em ambos os grupos. CONCLUSÃO: Crianças e adultos com epilepsia do lobo temporal secundária a lesões tumorais apresentam padrão eletrencefalográfico semelhante.

Orientador: Fernando Cendes, Clarissa Lin Yasuda Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas Resumo: Introdução: A Epilepsia de Lobo Temporal Mesial (ELTM) é o tipo mais frequente de epilepsia focal em adultos. A esclerose mesial temporal é o substrato patológico encontrado em 50-70% dos casos. Os pacientes, geralmente, são refratários ao tratamento clínico e candidatos ao tratamento cirúrgico para controle das crises epilépticas. Déficits de memória material-específica são achados comuns na avaliação neuropsicológica (ANP). Entretanto, poucos estudos avaliaram longitudinalmente a influência da frequência de crises nos principais achados clínicos da ELTM. Objetivos: Avaliar a espessura cortical, a progressão do volume hipocampal (VH), do sinal T2 e da memória episódica em pacientes com ELTM e atrofia hipocampal (AH) apresentando crises frequentes (CF) ou crises infrequentes (CI) e pacientes submetidos à cirurgia (CX). Metodologia: Consideramos CF como, pelo menos, uma crise discognitiva por mês e CI como, até 3 crises discognitivas por ano e ausência de eventos secundariamente generalizados. Todas as imagens foram adquiridas em um aparelho de ressonância magnética (RM) de alta resolução (3 Tesla, Philips Achieva System). O VH foi obtido através do software FreeSurfer em 17 pacientes com CF, 26 pacientes com CI, 20 pacientes CX e 55 controles. A relaxometria T2 foi realizada através do programa Aftervoxel em 18 pacientes com CF, 26 pacientes com CI, 19 pacientes CX e 23 controles. A espessura cortical foi comparada entre 67 pacientes e 57 controles segundo a frequência de crises, a lateralidade da AH e o desempenho de memória. A ANP foi composta por subtestes da Escala de Memória de Wechsler Revisada, por subtestes da Escala de Inteligência para Adultos de Wechsler Revisada e pelo Teste de Aprendizagem Auditivo Verbal de Rey. Duas ANPs foram realizadas em 20 pacientes com CF, 23 pacientes com CI e 21 pacientes CX. Resultados: Não observamos alterações no VH ipsilateral ao longo do tempo, entretanto houve uma diminuição no VH contralateral do CX (p=0,007). Quanto à relaxometria T2, observamos um aumento de sinal no hipocampo ipsilateral do CI (p=0,034), porém a quantificação do sinal T2 foi maior no CF desde a primeira aquisição de RM. Nenhum grupo apresentou alterações progressivas no sinal do hipocampo contralateral. Observamos um afilamento cortical do lobo parietal ipsilateral nos pacientes com AHD e do lobo occipital bilateral nos pacientes com AHE. Observamos, também, um afilamento cortical do lobo parietal e occipital no hemisfério ipsilateral à AH e do lobo frontal e occipital no hemisfério contralateral à AH, principalmente no CF e nos pacientes com comprometimento de memória. Em relação à ANP, longitudinalmente, o CI apresentou melhores escores em Memória Geral (p=0,01) e Reprodução Visual I (p=0,045) e o CX apresentou melhores escores em Memória Lógica II (p=0,008) e Reprodução Visual I (p=0,021) em relação ao CF. Conclusão: Crises recorrentes podem estar associadas à extensão de alterações corticais extratemporais. Entretanto, a progressão das alterações no hipocampo parece ocorrer independentemente da frequência de crises. Em pacientes com ELTM - AH, déficits de memória parecem estar mais associados à extensão de alterações corticais extratemporais do que à frequência de crises. Entretanto, o adequado controle de crises parece ajudar no desempenho de memória dos pacientes ao longo do tempo Abstract: Rationale: Mesial Temporal Lobe Epilepsy (MTLE) is the most frequent form of focal epilepsy in adults. Mesial temporal sclerosis is the underlying pathology in 50-70% of cases. Patients are often refractory to clinical treatment and targeted to surgery for seizure control. Material-specific memory impairment is a common finding on neuropsychological assessment (NPA). However, few studies evaluated the influence of seizure frequency in these main clinical findings. Purpose: To assess cortical thickness, progression of hippocampal volume (HV), T2 signal and episodic memory in MTLE patients with hippocampal atrophy (HA) having frequent (FS) or infrequent seizures (IS) and patients who underwent surgery (SUR). Methods: We considered FS as, at least, one dyscognitive seizure per month. IS were considered as, three or less dyscognitive seizures per year and no event evolving to a bilateral convulsive seizure. All had high resolution MRIs acquired on a 3 Tesla - Philips Achieva System. HVs were obtained in 17 patients with FS, 26 patients with IS, 20 SUR patients and 55 controls by FreeSurfer software. T2 relaxometry was performed in 18 patients with FS, 26 patients with IS, 19 SUR patients and 23 controls through Aftervoxel program. Cortical thickness was compared between 67 MTLE patients and 57 controls according to the HA laterality, seizure frequency and memory performance. NPA consisted of subtests from Wechsler Memory Scale Revised, subtests from Wechsler Adult Intelligence Scale Revised and the Rey Auditory Learning Test Verbal. Two NPAs were performed in 20 patients with FS, 23 patients with IS and 21 SUR patients. Results: We did not observe changes in the ipsilateral HV over time, however, there was a decrease of contralateral VH in SUR patients (p=0.007). Regarding to T2 relaxometry, we found an increase of signal in the ipsilateral hippocampus of IS patients (p=0.034), however, T2 signal was higher in FS patients since the first MRI acquisition. There were no changes in the contralateral hippocampal signal. We observed cortical thinning of ipsilateral parietal lobe in patients with Right-HA and bilateral cortical thinning of occipital lobe in patients with Left-HA. We also observed cortical thinning of parietal and occipital lobe regions on the hemisphere ipsilateral to the HA and cortical thinning of frontal and occipital lobe regions on the hemisphere contralateral to the HA, particularly in FS and patients with memory impairment. Regarding the NPA, longitudinally, patients with IS had better scores in General Memory (p=0.01) and Visual Reproduction I (p=0.045) than FS. Finally, SUR patients showed better scores on Logical Memory II (p=0.008) and Visual Reproduction I (p=0.021). Conclusions: Recurrent seizures may be associated with extratemporal cortical damage. However, changes in the hippocampus appear to occur regardless of seizure frequency. In patients with MTLE and HA, memory impairment may be more associated with extratemporal cortical damage than the seizure frequency. However, good seizure control seems to help on memory performance of MTLE patients over time Doutorado Fisiopatologia Médica Doutora em Ciências FAPESP 2011/20856-1

Orientadores: Shin-Ting Wu, Clarissa Lin Yasuda Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação Resumo: Com o aumento da qualidade das neuroimagens estruturais torna-se possível uma investigação detalhada da neuroanatomia. Contudo, a utilização de ferramentas computacionais que ajudem no realce e na exploração de neuroimagens ainda é de extrema importância para a identificação de lesões corticais e para a localização pré-operatória de referências anatômicas. A reformatação curvilínea e o janelamento (windowing) são dois exemplos. A reformatação curvilínea permite refatiar curvilinearmente um volume reconstruído a partir de uma imagem 3D e o janelamento, alterar o brilho e o contraste das neuroimagens. No estado da arte, os métodos de reformatação curvilínea são aplicados no diagnóstico para propiciar uma melhor visualização dos giros e sulcos cerebrais, já o janelamento está presente em diversos aplicativos de renderização de neuroimagens por facilitar ajustes interativos dos parâmetros de renderização à percepção subjetiva. Este trabalho foi motivado pela nossa hipótese da existência de uma correspondência entre a neuroanatomia e os padrões de sinais em imagens de ressonância magnética ponderadas em T1 e do potencial uso deste conhecimento no aprimoramento das ferramentas já existentes. Mostramos como essa correspondência pode ser usada para caracterizar estruturas neuroanatômicas que possibilitam a construção de um algoritmo capaz de localizar a região das meninges e de estimar medidas estatísticas, como a média e o desvio-padrão, da substância cinzenta e branca de um cérebro. Uma vez que a reformatação curvilínea é realizada com preservação das meninges, a técnica se torna útil na localização pré-operatória de referências anatômicas (como as estruturas vasculares), para preservação de áreas eloquentes durante uma intervenção cirúrgica. Uma nova forma de janelamento baseada na correspondência identificada pode também realçar a interface substância cinzenta¿branca e, consequentemente, revelar lesões sutis. A análise visual com uso das ferramentas em conjunto se mostrou útil no suporte à localização de lesões corticais e na exposição pré-operatória dos marcadores fiduciais intra-operatórios em imagens anatômicas com contraste Abstract: As the quality of structural neuroimage improves, a more accurate neuroanatomy investiga- tion becomes feasible. However, computational tools to aid in the enhancement and explo- ration of these neuroimages are still extremely useful for the identification of subtle cortical lesions and pre-operative localization of anatomical landmarks. Curvilinear reformatting and windowing are two examples. Curvilinear reformatting allows reslicing curvilinearly a volume reconstructued from a 3D image, while windowing allows changing the brightness and the contrast of neuroimages. In the current state-of-the-art, curvilinear reformatting is applied to diagnosis for providing a better visualization of complex cerebral cortical folding patterns, and the windowing is used in medical visualization software for facilitating fine adjustments of rendering parameters according to the subjective perception. This work was driven by the hypothesis that there would be a correspondence between the neuroanatomy and the signal patterns from T1-weighted magnetic resonance images, and that the knowledge of this cor- respondence might improve the existing tools. We showed how this correspondence could be used to characterize the anatomical structures that made possible the design of an algorithm for locating the neighborhood of meninges and for computing the statistical measures, such as mean and standard deviation, of grey and white matter. Assuring that the curvilinear reformatting can be performed preserving the meninges, the technique is useful to preopera- tively localize the anatomical landmarks , such as superficial veins. A new way of windowing based on our finding of the neuroanatomy¿imaging signal correspondence can enhance the interface between gray matter and white matter and reveal subtle lesions. Visual analytics using both tools has proven to be helpful in supporting the localization of cortical lesions and in revealing preoperatively the intraoperative fiducial landmarks, such as superficial veins, on contrast-enhanced anatomical images Doutorado Engenharia de Computação Doutor em Engenharia Elétrica CNPQ 165777/2014-1