The purpose of this work was to highlight the neurological differences between the MR resting state networks of a group of children with ADHD (pre-treatment) and an age-matched healthy group. Results were obtained using different image analysis techniques. A sample of n = 46 children with ages between 6 and 12 years were included in this study (23 per cohort). Resting state image analysis was performed using ReHo, ALFF and ICA techniques. ReHo and ICA represent connectivity analyses calculated with different mathematical approaches. ALFF represents an indirect measurement of brain activity. The ReHo and ICA analyses suggested differences between the two groups, while the ALFF analysis did not. The ReHo and ALFF analyses presented differences with respect to the results previously reported in the literature. ICA analysis showed that the same resting state networks that appear in healthy volunteers of adult age were obtained for both groups. In contrast, these networks were not identical when comparing the healthy and ADHD groups. These differences affected areas for all the networks except the Right Memory Function network. All techniques employed in this study were used to monitor different cerebral regions which participate in the phenomenological characterization of ADHD patients when compared to healthy controls. Results from our three analyses indicated that the cerebellum and mid-frontal lobe bilaterally for ReHo, the executive function regions in ICA, and the precuneus, cuneus and the clacarine fissure for ALFF, were the “hubs” in which the main inter-group differences were found. These results do not just help to explain the physiology underlying the disorder but open the door to future uses of these methodologies to monitor and evaluate patients with ADHD.
IntroductionEarly childhood is known to be a period when cortical plasticity phenomena are at a maximum. Music is a stimulus known to modulate these mechanisms. On the other hand, neurological impairments like blindness are also known to affect cortical plasticity. Here, we address how tonal and atonal musical stimuli are processed in control and blind young children. We aimed to understand the differences between the two groups when processing this physiological information.ResultsAtonal stimuli produced larger activations in cerebellum, fusiform, and temporal lobe structures than tonal. In contrast, tonal stimuli induced larger frontal lobe representations than atonal. Control participants presented large activations in cerebellum, fusiform, and temporal lobe. A correlation/connectivity study showed that the blind group incorporated larger amounts of perceptual information (somatosensory and motor) into tonal processing through the function of the anterior prefrontal cortex (APC). They also used the visual cortex in conjunction with the Wernicke's area to process this information. In contrast, controls processed sound with perceptual stimuli from auditory cortex structures (including Wernicke's area). In this case, information was processed through the dorsal posterior cingulate cortex and not the APC. The orbitofrontal cortex also played a key role for atonal interpretation in this group.DiscussionWernicke′s area, known to be involved in speech, was heavily involved for both groups and all stimuli. The two groups presented clear differences in strategies for music processing, with very different recruitment of brain regions.
274www.actapediatrica.org.mx criterio pediátrico DEFINICIÓNLa encefalitis es un desorden inflamatorio del encéfalo que deriva en un estado mental alterado, crisis convulsivas, déficits neurológicos focales, acompañado usualmente de signos de inflamación en el líquido cefalorraquídeo y hallazgos en la resonancia magnética que pueden ir desde normalidad hasta anormalidades extensas.1 La encefalitis puede ocurrir como resultado de una infección primaria del sistema nervioso central, o bien, por un proceso autoinmune desencadenado por una infección, vacuna o neoplasia oculta.2 La encefalitis autoinmune involucra varios tipos de entidades con diferentes fisiopatologías, el entender estas entidades nos ayuda a utilizar los recursos y elementos diagnósticos necesarios, así como la mejor estrategia terapéutica. 3 EPIDEMIOLOGÍAEn Estados Unidos se ha estimado que ocurren aproximadamente 20,000 casos de encefalitis por año, y que aproximadamente en 50% de los casos reportados no se identificaron agentes infecciosos como agentes causales, determinándose en la mayoría una asociación autoinmune. 4 En México no contamos con datos disponibles respecto a este padecimiento de forma específica. Algunos estudios han sugerido que existe un predomino de presentación en el sexo femenino con un aproximado de 67% y una edad promedio de 10.1 años. 5 COMORBILIDADESLa comorbilidad mayormente descrita han sido teratomas ováricos en más de 1/3 de mujeres adultas con diagnóstico de
Introduction. Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. Although lisdexamfetamine dimesylate (LDX) offers a treatment alternative, clinical evidence of LDX for ADHD has not been explored in Latin American pediatric population. Objective. To evaluate the LDX response in Mexican pediatric patients with ADHD. Method. We designed a quasi-experimental, uncontrolled before and after study to evaluate the LDX response in patients with severe ADHD. We established a diagnosis of ADHD according to DSM-5 criteria. We formed three groups: without previous treatment (group A), in treatment with stimulant drugs (group B) or in treatment with non-stimulant drugs (group C). Prior to the start of the study, letters of consent and informed consent were signed. We evaluated the effect of LDX based on the difference between ADHD-RS scores at the beginning and after six months. Results. We recruited a total of 144 patients (group A: 48 patients, group B: 57 patients, group C: 39 patients). All the groups showed a significant decrease in the mean score of ADHD-RS (Attention Deficit Hyperactivity Disorder Rating Scale) at six months (group A 37.57 vs. 22.34, p
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