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Purpose: Advances in intraoperative imaging and neuronavigation techniques have positively affected glioma surgery. The desire to reduce brain-shift-related problems while achieving the real-time identification of lesions and residual and anatomical relationships has strongly supported the introduction of intraoperative ultrasound (ioUS) in neuro-oncological surgery. This paper presents tips based on our experience with ioUS in neurosurgery., Methods: We retrospectively analyzed 264 patients who underwent high-grade glioma (HGG) resection at the University of Turin and 60 patients who were treated at the University of Rome., Results: The main issues are the correct choice of the probe and how to evaluate the anatomy to understand how the information from the three common US planes (axial, sagittal and coronal plane) can be used in each case. It is also important to correctly identify anatomical structures in ioUS imaging. In a normal brain, the sulci, sickle, tentorium, choroid plexus, ependyma and the walls of the vessels are all hyperechoic. In addition, some structures are hypoechoic with a homogeneous acoustic gradient: ventricles, cysts and everything that contains liquor. Tumors are usually hyperechoic in ioUS because of their higher cellularity. Conversely, acute edema that contains fluid is hypoechoic, while chronic edema is hyperechoic., Conclusions: IoUS is a real-time, accurate and inexpensive imaging method. The difficulties of interpretation can be overcome by experience in US imaging and a better understanding of the interaction between navigation and imaging fusion techniques. Training on a large number of cases is important for the correct assessment of ioUS information to obtain valuable, real-time information during HGG surgery.

In this study, concentrations of free amino acids (FAA) and amino group containing compounds (AGCC) following graded diffuse traumatic brain injury (mild TBI, mTBI; severe TBI, sTBI) were evaluated. After 6, 12, 24, 48 and 120 hr aspartate (Asp), glutamate (Glu), asparagine (Asn), serine (Ser), glutamine (Gln), histidine (His), glycine (Gly), threonine (Thr), citrulline (Cit), arginine (Arg), alanine (Ala), taurine (Tau), γ-aminobutyrate (GABA), tyrosine (Tyr), S-adenosylhomocysteine (SAH), l-cystathionine (l-Cystat), valine (Val), methionine (Met), tryptophane (Trp), phenylalanine (Phe), isoleucine (Ile), leucine (Leu), ornithine (Orn), lysine (Lys), plus N-acetylaspartate (NAA) were determined in whole brain extracts (n = 6 rats at each time for both TBI levels). Sham-operated animals (n = 6) were used as controls. Results demonstrated that mTBI caused modest, transient changes in NAA, Asp, GABA, Gly, Arg. Following sTBI, animals showed profound, long-lasting modifications of Glu, Gln, NAA, Asp, GABA, Ser, Gly, Ala, Arg, Citr, Tau, Met, SAH, l-Cystat, Tyr and Phe. Increase in Glu and Gln, depletion of NAA and Asp increase, suggested a link between NAA hydrolysis and excitotoxicity after sTBI. Additionally, sTBI rats showed net imbalances of the Glu-Gln/GABA cycle between neurons and astrocytes, and of the methyl-cycle (demonstrated by decrease in Met, and increase in SAH and l-Cystat), throughout the post-injury period. Besides evidencing new potential targets for novel pharmacological treatments, these results suggest that the force acting on the brain tissue at the time of the impact is the main determinant of the reactions ignited and involving amino acid metabolism., (© 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.)

Background: Famous face and voice recognition is reported to be impaired both in semantic dementia (SD) and in Alzheimer's Disease (AD), although more severely in the former. In AD a coexistence of perceptual impairment in face and voice processing has also been reported and this could contribute to the altered performance in complex semantic tasks. On the other hand, in SD both face and voice recognition disorders could be related to the prevalence of atrophy in the right temporal lobe (RTL)., Objective: The aim of the present study was twofold: (1) to investigate famous faces and voices recognition in SD and AD to verify if the two diseases show a differential pattern of impairment, resulting from disruption of different cognitive mechanisms; (2) to check if face and voice recognition disorders prevail in patients with atrophy mainly affecting the RTL., Materials: To avoid the potential influence of primary perceptual problems in face and voice recognition, a pool of patients suffering from early SD and AD were administered a detailed set of tests exploring face and voice perception. Thirteen SD (8 with prevalence of right and 5 with prevalence of left temporal atrophy) and 25 CE patients, who did not show visual and auditory perceptual impairment, were finally selected and were administered an experimental battery exploring famous face and voice recognition and naming. Twelve SD patients underwent cerebral PET imaging and were classified in right and left SD according to the onset modality and to the prevalent decrease in FDG uptake in right or left temporal lobe respectively. Correlation of PET imaging and famous face and voice recognition was performed., Results: Results showed a differential performance profile in the two diseases, because AD patients were significantly impaired in the naming tests, but showed preserved recognition, whereas SD patients were profoundly impaired both in naming and in recognition of famous faces and voices. Furthermore, face and voice recognition disorders prevailed in SD patients with RTL atrophy, who also showed a conceptual impairment on the Pyramids and Palm Trees test more important in the pictorial than in the verbal modality. Finally, in 12SD patients in whom PET was available, a strong correlation between FDG uptake and face-to-name and voice-to-name matching data was found in the right but not in the left temporal lobe., Discussion: The data support the hypothesis of a different cognitive basis for impairment of face and voice recognition in the two dementias and suggest that the pattern of impairment in SD may be due to a loss of semantic representations, while a defect of semantic control, with impaired naming and preserved recognition might be hypothesized in AD. Furthermore, the correlation between face and voice recognition disorders and RTL damage are consistent with the hypothesis assuming that in the RTL person-specific knowledge may be mainly based upon non-verbal representations., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The domestic bovine Bos taurus is raised worldwide for meat and milk production, or even for field work. However the functional anatomy of its central nervous system has received limited attention and most of the reported data in textbooks and reviews are derived from single specimens or relatively old literature. Here we report information on the brain of Bos taurus obtained by sampling 158 individuals, 150 of which at local abattoirs and 8 in the dissecting room, these latter subsequently formalin-fixed. Using body weight and fresh brain weight we calculated the Encephalization Quotient (EQ), and Cerebellar Quotient (CQ). Formalin-fixed brains sampled in the necropsy room were used to calculate the absolute and relative weight of the major components of the brain. The data that we obtained indicate that the domestic bovine Bos taurus possesses a large, convoluted brain, with a slightly lower weight than expected for an animal of its mass. Comparisons with other terrestrial and marine members of the order Cetartiodactyla suggested close similarity with other species with the same feeding adaptations, and with representative baleen whales. On the other hand differences with fish-hunting toothed whales suggest separate evolutionary pathways in brain evolution. Comparison with the other large domestic herbivore Equus caballus (belonging to the order Perissodactyla) indicates that Bos taurus underwent heavier selection of bodily traits, which is also possibly reflected in a comparatively lower EQ than in the horse. The data analyzed suggest that the brain of domestic bovine is potentially interesting for comparative neuroscience studies and may represents an alternative model to investigate neurodegeneration processes.

In this study, the metabolic, enzymatic and gene changes causing cerebral glucose dysmetabolism following graded diffuse traumatic brain injury (TBI) were evaluated. TBI was induced in rats by dropping 450g from 1 (mild TBI; mTBI) or 2m height (severe TBI; sTBI). After 6, 12, 24, 48, and 120h gene expressions and enzymatic activities of glycolysis and pentose phosphate pathway (PPP) enzymes, and levels of lactate, ATP, ADP, ATP/ADP (indexing mitochondrial phosphorylating capacity), NADP(+), NADPH and GSH were determined in whole brain extracts (n=9 rats at each time for both TBI levels). Sham-operated animals (n=9) were used as controls. Results demonstrated that mTBI caused a late increase (48-120h post injury) of glycolytic gene expression and enzymatic activities, concomitantly with mitochondrial functional recovery (ATP and ATP/ADP normalization). No changes in lactate and PPP genes and enzymes, were accompanied by transient decrease in GSH, NADP(+), NADPH and NADPH/NADP(+). Animals following sTBI showed early increase (6-24h post injury) of glycolytic gene expression and enzymatic activities, occurring during mitochondrial malfunctioning (50% decrease in ATP and ATP/ADP). Higher lactate and lower GSH, NADP(+), NADPH, NADPH/NADP(+) than controls were recorded at anytime post injury (p<0.01). Both TBI levels caused metabolic and gene changes affecting glucose metabolism. Following mTBI, increased glucose flux through glycolysis is coupled to mitochondrial glucose oxidation. "True" hyperglycolysis occurs only after sTBI, where metabolic changes, caused by depressed mitochondrial phosphorylating capacity, act on genes causing net glycolytic flux increase uncoupled from mitochondrial glucose oxidation., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Nerve growth factor (NGF) is essential for the survival and functional maintenance of forebrain cholinergic neurons projecting mainly to the cortex and hippocampus. NGF is produced in these brain areas but while mature NGF (mNGF) has a survival/differentiative effect its precursor proNGF elicits apoptosis in cholinergic neurons. Impaired neurotransmission, loss of cholinergic phenotype and abnormal NGF content characterize the cholinergic circuitries in animal models of diabetic encephalopathy (DE). It is not known whether defective production or maturation of NGF could play a key role in cholinergic neurodegeneration in DE. Quantification of the mNGF/proNGF ratio is therefore needed to characterize the development and progression of NGF-related neuronal diseases. In our work, we aimed at developing ELISA methods to measure either mNGF or proNGF tissue concentration; and to define the mNGF/proNGF ratio in the rat cortex and hippocampus during the early stage of streptozotocin-induced type 1 diabetes. Using commercially available NGF ELISA kits and antibodies, we set up ELISAs for human and rat mNGF and proNGF. We then analyzed the mNGF/proNGF ratio in the cortex and hippocampus of DE rats and found that it decreased in both tissues starting from the fourth week after diabetes induction. In diabetic brain the increase in proNGF involves accumulation of the isoforms with molecular weights of 50 and 34 kDa. Our study for the first time specifically quantifies the absolute content of mature and proNGF and the mNGF/proNGF ratio in brain tissues, suggesting that early progression of experimental DE is characterized by defective maturation of NGF., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Almost 10% of the world's population is affected by alcohol use disorder (AUD). The combination between psychosocial intervention and pharmacological treatment seems to be the most effective approach for patients affected by AUD. Among effective drugs useful in the treatment of AUD, GABAB-ergic medications have been tested with encouraging results (i.e. sodium oxybate, baclofen, gabapentin, pregabalin and tiagabine). The present review will summarize available data on these medications.

The present survey develops a previous position paper, in which I suggested that the multimodal semantic impairment observed in advanced stages of semantic dementia is due to the joint disruption of pictorial and verbal representations, subtended by the right and left anterior temporal lobes, rather than to the loss of a unitary, amodal semantic system. The main goals of the present review are (a) to survey a larger set of data, in order to confirm the differences in conceptual representations at the level of the right and left hemispheres, (b) to examine if language-mediated information plays a greater role in left hemisphere semantic knowledge than sensory-motor information in right hemisphere conceptual knowledge, and (c) to discuss the models that could explain both the differences in conceptual representations at the hemispheric level and the prevalence of the left hemisphere language-mediated semantic knowledge over the right hemisphere perceptually based conceptual representations.

The aim of the present review consists in reviewing data inconsistent with assumptions made by modular cognitive models of familiar people recognition. In particular, some of these inconsistencies are due to the failure to consider hemispheric specialization as an important variable in familiar people recognition. Indeed, hemispheric asymmetries exist between familiar faces and voices, underpinned by the right hemisphere, and names, subsumed by the left hemisphere. Furthermore, before the level of the person identity nodes (PINs), cross-communication exists between the perceptual channels for faces and voices, but not the channel for faces. Additionally, familiarity judgements are generated at the level of the modality-specific recognition units, with a right hemisphere dominance in the generation of face and voice familiarity feelings and PINs should not be considered as a simple gateway to a semantic system, storing information about people, but as structures involved in person-specific information retrieval processes. These data show that person-specific representations are mainly based on perceptual (face and voice) information in the right hemisphere and on verbal information in the left hemisphere.

The gene expression pattern of glioblastoma (GBM) is well documented but the expression profile of brain adjacent to tumor is not yet analysed. This may help to understand the oncogenic pathway of GBM development. We have established the genome-wide expression profiles of samples isolated from GBM tumor mass, white matter adjacent to tumor (apparently free of tumor cells), and white matter controls by using the Affymetrix HG-U133 arrays. Array-CGH (aCGH) was also performed to detect genomic alterations. Among genes dysregulated in peritumoral white matter, 15 were over-expressed, while 42 were down-regulated when compared to white matter controls. A similar expression profile was detected in GBM cells. Growth, proliferation and cell motility/adhesion-associated genes were up-regulated while genes involved in neurogenesis were down-regulated. Furthermore, several tumor suppressor genes along with the KLRC1 (a member of natural killer receptor) were also down-regulated in the peritumoral brain tissue. Several mosaic genomic lesions were detected by aCGH, mostly in tumor samples and several GBM-associated mosaic genomic lesions were also present in the peritumoral brain tissue, with a similar mosaicism pattern. Our data could be explained by a dilution of genes expressed from tumor cells infiltrating the peritumour tissue. Alternatively, these findings could be substained by a relevant amount of "apparently normal" cells presenting a gene profile compatible with a precancerous state or even "quiescent" cancer cells. Otherwise, the recurrent tumor may arise from both infiltrating tumor cells and from an interaction and recruitment of apparently normal cells in the peritumor tissue by infiltrating tumor cells.

Background: Cholinergic deficits have been largely correlated to behavioral disorders in dementia. However, cholinergic deficits are not homogeneous and they are distributed differently in the basal forebrain and brainstem among Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). The different cholinergic networks involved suggest different patterns of behavior symptomatology in the two groups., Objective: To correlate the deficit of cholinergic activity, measured in vivo by the short latency afferent inhibition (SAI) technique, with the behavioral symptoms in patients affected by DLB and AD., Methods: Behavioral and neuropsychologic tests including Neuropsychiatric Inventory (NPI), mini-mental status examination (MMSE), and an extensive neuropsychologic investigation were administered to 18 DLB patients and 18 one-to-one matched AD patients. SAI data were compared with those from a control group of age-matched healthy individuals and the level of SAI in patients was correlated with behavioral measures., Results: AD tended to be more impaired than DLB on long-term memory, whereas DLB were more impaired than AD on constructional praxis tasks. NPI total score was similar but with a different behavioural pattern in DLB and AD. In particular, delusions and hallucinations prevailed in DLB patients, whereas affective disturbances prevailed in AD patients. SAI was significantly reduced both in AD and DLB patients when compared with controls; SAI correlated with hallucinations in DLB patients and with euphoric manic state and disinhibition in AD patients., Conclusions: Reduction of cholinergic activity as evaluated by SAI measurement correlates with different behavior disorders in AD and DLB patients., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: Every year 300,000 children with accidental head trauma are admitted to Italian emergency departments. Our aims were: (1) to describe patients with minor traumatic brain injury who were admitted to pediatric departments and underwent CT, and (2) to analyze the appropriateness of management according to current guidelines., Methods: We retrospectively analyzed patients with minor head injury (median age 4.5 years, range 1 month to 16 years) who were admitted to the pediatric department of the Catholic Medical School of Rome, from January 2005 to September 2010, who performed head CT. Univariate analysis was performed using the Fisher's exact test. Multivariate analysis was performed by logistic regression., Results: One hundred and seventy-four patients were enrolled in the study. Fifty-four patients (31%) had pathological CT findings. Eight patients underwent neurosurgical treatments. Vomiting was the only symptom significantly prevalent in the infant group, compared to the children group (10.7% vs. 38.9%, p = 0.007), while loss of consciousness in the children group (50.0% vs. 25.0%, p = 0.040). The relationship between scalp swelling and CT abnormalities was statistically significant in the entire population. The incidence of head abnormalities was significantly higher in children with abnormal CT (92.6% vs. 72.5%)., Conclusions: The best way to manage children with minor head trauma is still matter of debate. Loss of consciousness and scalp swelling are risk factors predicting brain injury that deserve CT control. The radiation risks posed by CT scanning in children must be balanced by the benefits. We believe that even though CT scans may be clinically unnecessary in many cases, the rate of scanning is justified by the even limited number of abnormalities which require neurosurgical treatment.

MR-spectroscopy (MRS) is a multiparameter diagnostic tool and modification of each parameter results in spectrum morphology changes. In particular, changing the echo time (TE) represents a useful tool to highlight different diagnostic elements, but also has significant impact on the spectrum morphology. Diagnostic errors can result if the role of TE is not properly considered. This article reviews the four most common TE-related pitfalls of MRS interpretation. Clinical practical methods to avoid such pitfalls are also suggested., (Published by Elsevier Masson SAS.)

In recent years, the anatomical and functional bases of conceptual activity have attracted a growing interest. In particular, Patterson and Lambon-Ralph have proposed the existence, in the anterior parts of the temporal lobes, of a mechanism (the 'amodal semantic hub') supporting the interactive activation of semantic representations in all modalities and for all semantic categories. The aim of then present paper is to discuss this model, arguing against the notion of an 'amodal' semantic hub, because we maintain, in agreement with the Damasio's construct of 'higher-order convergence zone', that a continuum exists between perceptual information and conceptual representations, whereas the 'amodal' account views perceptual informations only as a channel through which abstract semantic knowledge can be activated. According to our model, semantic organization can be better explained by two orthogonal higher-order convergence systems, concerning, on one hand, the right vs. left hemisphere and, on the other hand, the ventral vs. dorsal processing pathways. This model posits that conceptual representations may be mainly based upon perceptual activities in the right hemisphere and upon verbal mediation in the left side of the brain. It also assumes that conceptual knowledge based on the convergence of highly processed visual information with other perceptual data (and mainly concerning living categories) may be bilaterally represented in the anterior parts of the temporal lobes, whereas knowledge based on the integration of visual data with action schemata (namely knowledge of actions, body parts and artefacts) may be more represented in the left fronto-temporo-parietal areas., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Background and Purpose: Subtle linguistic dysfunction and reorganization of the language network were described in patients with epilepsy, suggesting the occurrence of plasticity changes. We used resting state FC-MRI to investigate the effects induced by chronic epilepsy on the connectivity of the language-related brain regions and correlated it with language performance., Materials and Methods: FC-MRI was evaluated in 22 right-handed patients with drug-resistant epilepsy (11 with LE and 11 with RE) and in 12 healthy volunteers. Neuropsychological assessment of verbal IQ was performed. Patients and controls underwent BOLD fMRI with a verb-generation task, and language function was lateralized by an LI. Intrinsic activity fluctuations for FC analysis were extracted from data collected during the task. Six seeding cortical regions for speech in both hemispheres were selected to obtain a measure of the connectivity pattern among the language networks., Results: Patients with LE presented atypical language lateralization and an overall reduced connectivity of the language network with respect to controls. In patients with both LE and RE, the mean FC was significantly reduced within the left (dominant) hemisphere and between the 2 hemispheres. In patients with LE, there was a positive correlation between verbal IQ scores and the left intrahemispheric FC., Conclusions: In patients with intractable epilepsy, FC-MRI revealed an overall reduction and reorganization of the connectivity pattern within the language network. FC was reduced in the left hemisphere regardless of the epileptogenic focus side and was positively correlated with linguistic performance only in patients with LE.

The aim of the present survey was to review scientific articles dealing with the non-visual (auditory and tactile) forms of neglect to determine: (a) whether behavioural patterns similar to those observed in the visual modality can also be observed in the non-visual modalities; (b) whether a different severity of neglect can be found in the visual and in the auditory and tactile modalities; (c) the reasons for the possible differences between the visual and non-visual modalities. Data pointing to a contralesional orienting of attention in the auditory and the tactile modalities in visual neglect patients were separately reviewed. Results showed: (a) that in patients with right brain damage manifestations of neglect for the contralesional side of space can be found not only in the visual but also in the auditory and tactile modalities; (b) that the severity of neglect is greater in the visual than in the non-visual modalities. This asymmetry in the severity of neglect across modalities seems due to the greater role that the automatic capture of attention by irrelevant ipsilesional stimuli seems to play in the visual modality., (Copyright 2009 Elsevier Srl. All rights reserved.)

Cloninger proposed a neurochemical model of alcoholism suggesting that type 2 alcoholics have serotonergic deficits with intact dopaminergic system, whereas the type 1 alcoholics have defected dopaminergic system. The work by Storvik and colleagues recently published on Alcohol and Alcoholism shows some interesting differences on the SERT brain density between the type I and type II alcoholic subtypes. Critically, these findings on different serotonergic role in subtypes of alcohol-dependence revive the concept that alcohol addiction is a heterogeneous disorder associated with varying neurochemical abnormalities. Studies testing serotonergic medications in alcohol-dependent patients classified according to subtypes have shown interesting findings. Accordingly, the identification and standardization of alcoholic subtypes could be useful in guiding research on treatment. New developments in the neurobiological understanding of subtypes of alcoholic patients, could led to get the basis for a more personalized pharmacological therapy.

Objective: In the present study, we investigated the occurrence of oxidative and nitrosative stresses in rats undergoing repeat mild traumatic brain injury (mTBI) delivered with increasing time intervals., Methods: Rats were subjected to two diffuse mTBIs (450 g/1 m height), with the second mTBI delivered after 1 (n = 6), 2 (n = 6), 3 (n = 6), 4 (n = 6), or 5 days (n = 6). The rats were sacrificed 48 hours after the last mTBI. Sham-operated animals were used as controls (n = 6). Concentrations of biochemical indices of oxidative stress (malondialdehyde, ascorbic acid, reduced and oxidized glutathione) and nitrosative stress (nitrite, nitrate) were synchronously measured by high-performance liquid chromatography in deproteinized tissue extracts (three right + three left hemispheres for each group of animals)., Results: Increase of malondialdehyde, reduced/oxidized glutathione ratio, nitrite, nitrate, and decrease of ascorbic acid and glutathione were dependent on the interval between impacts with maximal changes recorded when mTBIs were spaced by 3 days. Biochemical markers of oxidative and nitrosative stresses were near control levels only in animals receiving mTBIs 5 days apart., Conclusion: This study shows the remarkable negative contribution of reactive oxygen species overproduction and activation of inducible nitric oxide synthase in repeat mTBI. Because these effects were maximal when mTBIs were spaced by 3 days, it can be inferred that occurrence of a second mTBI within the temporal window of brain vulnerability not only causes profound derangement of mitochondrial functions, but also induces sustained oxidative and nitrosative stresses. Both phenomena certainly play a major role in the overall brain tissue damage occurring under these pathological conditions.

In this short critical review, I will take first into account the cognitive defects usually observed in multiple sclerosis (MS) patients, the neuropsychological batteries constructed to measure these defects and the main objections that can be addressed to these batteries. I will then pass to consider the problem of the model of brain dysfunction corresponding to the pattern of neuropsychological impairment typical of MS patients, stressing the main differences between anatomical progression and across subjects consistency of the cognitive defects observed in Alzheimer's disease and MS patients. In the last part of my review, I will shortly consider the issues of the emotional changes observed in MS patients, of the interpretation of these emotional disorders and of the scales used to measure them.

Contemporary debates on the 'semantic memory' construct revolve around three main topics: (1) the functional and anatomical relationships between episodic and semantic memory; (2) the format of semantic representations and their relationships with the underlying sensory-motor processes; (3) the categorical organization of semantic memory. The aim of the present review is to demonstrate that there is a common thread linking these different aspects of semantic memory. This thread is represented by the interdependence of mechanisms involved in the construction of semantic memory and the content of semantic representations. In particular, I suggest there is a continuity between: (a) the mechanisms of acquisition of episodic and semantic memory; (b) semantic representations and sensory-motor processes preliminary to the acquisition of these representations. This continuity has important implications for the format of semantic representations and the brain structures subserving the organisation of various categories of knowledge.

Objective: The combined effect of traumatic brain injury (TBI) and secondary insult on biochemical changes of cerebral tissue is not well known. For this purpose, we studied the time-course changes of parameters reflecting ROS-mediated oxidative stress and modifications of cell energy metabolism determined in rats subjected to cerebral insult of increasing severity., Methods: Rats were divided into four groups: 1) sham-operated, 2) subjected to 10 minutes of hypoxia and hypotension (HH), 3) subjected to severe diffuse TBI, and 4) subjected to severe diffuse TBI + HH. Rats were killed at different times after injury, and analyses of malondialdehyde, ascorbate, high-energy phosphates, nicotinic coenzymes, oxypurines, nucleosides, and N-acetylaspartate (NAA) were made by high-performance liquid chromatography on whole-brain tissue extracts., Results: Data indicated a close relationship between degree of oxidative stress and severity of brain insult, as evidenced by the highest malondialdehyde values and lowest ascorbate levels in rats subjected to TBI + HH. Similarly, modifications of parameters related to cell energy metabolism were modulated by increasing severity of brain injury, as demonstrated by the lowest values of energy charge potential, nicotinic coenzymes, and NAA and the highest levels of oxypurines and nucleosides recorded in TBI + HH rats. Both the intensity of oxidative stress-mediated cerebral damage and perturbation of energy metabolism were minimally affected in rats subjected to HH only., Conclusion: These results showed that the severity of brain insult can be graded by measuring biochemical modifications, specifically, reactive oxygen species-mediated damage, energy metabolism depression, and NAA, thereby validating the rodent model of closed-head diffuse TBI coupled with HH and proposing NAA as a marker with diagnostic relevance to monitor the metabolic state of postinjured brain.

The aim of this systematic review of single case studies of patients showing a category-specific disorder was to evaluate the influence of gender and lesion location on category-specific disorders for biological versus artefact categories and, within the former, for animals versus plant life categories. Two complementary studies were made, taking into account all the available single case reports of category-specific disorders found in the literature. The first study consisted of an overall statistical evaluation of the influence that gender and lesion location can have upon naming scores obtained with these different categories in patients selected only because they showed some kind of category-specific disorder. The second study assessed the influence of these variables on more selected groups of patients, contrasting those showing a categorical impairment for living things versus artefacts and, respectively, for animals versus plant life categories. Results of these studies consistently showed that: (a) Lesion location has a strong influence on the distinction between biological and artefacts categories, but not on that between animals and plant life domains. In patients with a prevalent impairment either for animals or for plant life items, lesions usually encroach upon the anterior or the posterior parts of the ventral stream of visual processing, whereas in patients with a prevalent impairment for artefacts they are located elsewhere (usually on more dorsal structures of the brain). (b) Gender, on the contrary, does not influence the distinction between living and non-living things, but, within the living entities, has a strong influence on the distinction between animals and plant life. Consistent with data obtained in normal people, which show that men are more familiar with animals and women with fruit and vegetables, men were, indeed, more impaired with plant life categories, whereas women were more impaired with animals.

The study of the neuroanatomical correlates of category-specific semantic disorders has strongly supported the 'sensory/motor model of semantic knowledge,' which assumes that the cortical areas that have critically contributed to the development of various categories are also implicated in their semantic representation. However, if the anatomo-clinical correlates are consistent with the model, less clearcut results have been obtained by functional neuroimaging experiments. In the present metanalysis, I addressed the question from a different viewpoint, shifting attention from the anatomical lesion in patients with category-specific semantic disorders to the pattern of naming impairment shown by patients suffering from a disconnection between visual areas and lexical output mechanisms. According to the model, living entities should be particularly impaired, since their semantic representations are mainly based upon visual perceptual attributes. On the contrary, actions and body parts (and to a lesser extent artefacts) should be relatively spared, as their semantic representations are mainly based upon motor, somato-sensory or functional attributes. These predictions were checked by reviewing the categorical pattern of naming impairment shown by patients with a visuo-verbal disconnection and a category-specific naming impairment published in the last 20 years. The pattern of impaired and spared categories observed in these patients was consistent with the hypothesis, since: (1) 'actions' and 'body parts' were systematically spared in comparison to all the other categories; (2) 'artefacts' were relatively spared with respect to the 'living categories'; and (3) within the biological categories, 'plants' were usually more impaired than animals.

Background: Prevention of meningeal recurrence achieved by intrathecal methotrexate (MTX) and systemic chemotherapy is part of standard acute lymphoblastic leukemia (ALL) treatment. Cranial irradiation has been a routine part of past protocol treatment but is currently reserved only for select subsets of patients. Central nervous system (CNS) prophylaxis may cause brain abnormalities such as intracerebral calcifications, cerebral atrophy, and white matter alterations. In addition, long-term neuropsychologic sequelae following CNS prophylaxis have been investigated marginally in children cured for ALL., Methods: To explore possible correlations between neuroimaging findings and neuropsychologic outcome, we used detailed cognitive tests to evaluate 21 children with ALL who received cranial irradiation (range, 18-24 Gy) plus intrathecal MTX as CNS prophylaxis. All children were followed prospectively once a year by cerebral computed tomographic scan and magnetic resonance imaging. All patients had continuous complete disease remission for at least 4 years and cognitive tests were performed after neuroradiologic examinations., Results: White matter abnormalities were associated with poor performance only in a task exploring visual motor integration in about 50% of patients. Intracerebral calcifications correlate with the number of intrathecal MTX doses and with low scores in total intellectual quotient, performance intellectual quotient, and significant impairment in attention and visual motor integration tests. Girls are more vulnerable to the effects of CNS prophylaxis, whereas age at treatment and radiotherapy dose are not relevant to neuropsychologic outcome., Conclusions: Our results indicate the need for careful follow-up of children's cognitive abilities because global intellectual measures often fail to detect specific disorders that may cause learning difficulties. Moreover, as the clinical implications of neuroimaging findings are often limited, periodic extensive evaluation by specific neurocognitive tests of mental abilities is recommended to detect early signs of cognitive impairment., (Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10997)

It is still controversial whether verbal and pictorial stimuli are independently processed and stored in memory, as assumed by the dual code hypothesis, or a single code is used both for verbal and for pictorial stimuli, as assumed by the verbal loop hypothesis and by the propositional code hypothesis. According to the first hypothesis, verbal and pictorial memory are independently disrupted by brain damage, whereas according to the second hypothesis a co-occurrence of verbal and pictorial memory disorders are usually observed. To test these contrasting predictions, we constructed a verbal and a pictorial memory task very similar with respect to testing procedures and to material to be memorized and we administered them to 33 left and 27 right brain-damaged patients and to 21 normal controls. The following results were obtained: 1) Disorders of verbal and of pictorial memory were dissociated by brain injury in about one-third of our patients; 2) A consistent relationship was observed between laterality of lesion and type of selective memory impairment, since word recognition was selectively impaired by left and picture recognition by right brain injury; 3) However, only on the test of verbal memory was a significant difference between right and left brain-damaged patients obtained, whereas on the test of pictorial memory only a nonsignificant trend in the opposite direction was observed. These data are in favor of the dual code hypothesis and suggest that the links between left hemisphere and verbal code may be stronger than the relationship between right hemisphere and pictorial code.

Although it is generally acknowledged that the right hemisphere plays some role in the recovery of language in aphasic patients, the exact nature of this role is still controversial. According to the model of right hemisphere language proposed by Zaidel, the right hemisphere should selectively contribute to the recovery of language comprehension (and in particular of lexical comprehension) but not to the recovery of language production. According to the model of right hemisphere language proposed by Gazzaniga, on the contrary, no language function is selectively supported by the right hemisphere, but the contribution of this hemisphere to the recovery of language varies widely from one individual to another. The aim of this paper is to try and clarify this problem, starting from the basic clinical observations which have given a preliminary shape to the whole issue, and passing then to a survey of results obtained following more recent and specific lines of research. The following conclusions are reached: (1) although the right hemisphere plays (at least in some patients) a definite role in the recovery from aphasia, a greater role is usually played by the undamaged areas of the left hemisphere; (2) the right hemisphere's contribution to the recovery of language seems to concern more the receptive than the expressive components of speech; and (3) the extent of the right hemisphere's contribution varies widely from one individual to another, probably due to individual differences in the hemispheric representation of language.