Explore the vast range of titles available.

Depersonalization-Derealization Disorder (DD) typically manifests as a disruption of body self-awareness. Interoception -defined as the cognitive processing of body signals- has been extensively considered as a key processing for body self-awareness. In consequence, the purpose of this study was to investigate whether there are systematic differences in interoception between a patient with DD and controls that might explain the disembodiment symptoms suffered in this disease. To assess interoception, we utilized a heartbeat detection task and measures of functional connectivity derived from fMRI networks in interoceptive/exteroceptivo/mind-wandering states. Additionally, we evaluated empathic abilities to test the association between interoception and emotional experience. The results showed patient's impaired performance in the heartbeat detection task when compared to controls. Furthermore, regarding functional connectivity, we found a lower global brain connectivity of the patient relative to controls only in the interoceptive state. He also presented a particular pattern of impairments in affective empathy. To our knowledge, this is the first experimental research that assesses the relationship between interoception and DD combining behavioral and neurobiological measures. Our results suggest that altered neural mechanisms and cognitive processes regarding body signaling might be engaged in DD phenomenology. Moreover, our study contributes experimental data to the comprehension of brain-body interactions and the emergence of self-awareness and emotional feelings.

Social cognition impairments are pervasive in the frontotemporal dementias (FTD). These deficits would be triggered by (a) basic emotion and face recognition processes as well as by (b) higher level social cognition (e.g., theory of mind, ToM). Both emotional processing and social cognition impairments have been previously reported in the behavioral variant of FTD (bvFTD) and also in other versions of FTDs, including primary progressive aphasia. However, no neuroanatomic comparison between different FTD variants has been performed. We report selective behavioral impairments of face recognition, emotion recognition, and ToM in patients with bvFTD and progressive non-fluent aphasia (PNFA) when compared to controls. Voxel-based morphometry (VBM) shows a classical impairment of mainly orbitofrontal (OFC), anterior cingulate (ACC), insula and lateral temporal cortices in patients. Comparative analysis of regional gray matter related to social cognition deficits (VBM) reveals a differential pattern of fronto-insulo-temporal atrophy in bvFTD and an insulo-temporal involvement in PNFA group. Results suggest that in spite of similar social cognition impairments reported in bvFTD and PNFA, the former represents an inherent ToM affectation whereas in the PNFA these deficits could be related to more basic processes of face and emotion recognition. These results are interpreted in the frame of the fronto-insulo-temporal social context network model (SCNM).

Recent advances in neuroscience have provided new insights into the understanding of heart–brain interaction and communication. Cardiac information to the brain relies on two pathways, terminating in the insular cortex (IC) and anterior cingulate cortex (ACC), along with the somatosensory cortex (S1-S2). Interoception relying on these neuroanatomical pathways has been shown to modulate social cognition. We report the case study of C.S., a patient with an ‘external heart’ (an extracorporeal left-univentricular cardiac assist device, LVAD). The patient was assessed with neural/behavioral measures of cardiac interoception complemented by neuropsychological and social cognition measures. The patient’s performance on the interoception task (heartbeat detection) seemed to be guided by signals from the artificial LVAD, which provides a somatosensory beat rather than by his endogenous heart. Cortical activity (HEP, heartbeat-evoked potential) was found decreased in comparison with normal volunteers, particularly during interoceptive states. The patient accurately performed several cognitive tasks, except for interoception-related social cognition domains (empathy, theory of mind and decision making). This evidence suggests an imbalance in the patient’s cardiac interoceptive pathways that enhances sensation driven by the artificial pump over that from the cardiac vagal-IC/ACC pathway. A patient with two hearts, one endogenous and one artificial, presents a unique opportunity to explore models of interoception and heart–brain interaction.

Background Liver transplantation (LT) is a life-saving intervention for end-stage liver disease; however, postoperative complications, particularly neurological issues such as seizures, pose significant challenges. This study aims to identify perioperative factors associated with seizures following LT and develop a predictive risk model. By recognizing these in-hospital risk factors, clinicians may tailor perioperative management to mitigate seizure risk and improve neurological outcomes. Methodology We conducted a retrospective observational study of adult patients who underwent LT at a tertiary referral center between January 2009 and January 2019. Data were collected for the perioperative period, spanning seven days pre-LT to 30 days post-LT. Variables included demographic, clinical, neurological, and liver-related data. Statistical analyses compared patients with and without seizures using appropriate tests for categorical and continuous variables. A predictive model for seizures was developed using in-hospital factors. It was then internally validated and evaluated for accuracy, sensitivity, specificity, and receiver operating characteristic curve. From this model, a practical clinical risk score was created. Results Of 376 patients, 40 (10.6%) experienced seizures within 30 days post-LT. The median age was 54.8 years, and 41% were males. Chronic liver failure was the primary indication for LT, with alcohol abuse, hepatitis C, and hepatitis B being the most common etiologies. Patients' preoperative conditions included hepatocellular carcinoma (23%), chronic hyponatremia (22.6%), and prior kidney failure (22.1%). Portosystemic encephalopathy (PSE) was present in 46.5% of patients. Patients' preoperative blood tests revealed low hemoglobin (mean: 10.8 g/dL, SD: 2.2), hyponatremia (mean: 134 mEq/L, SD: 5), elevated international normalized ratio (mean: 2.21, SD: 1.56), high bilirubin (mean: 8.74 mg/dL, SD: 10.23), and creatinine (mean: 1.41 mg/dL, SD: 1.95). Combined liver and kidney transplantation was performed in 9.2% of cases, while 15.4% were emergency procedures. Graft complications occurred in 25% of patients, with functional delay being the most frequent (14.5%). Immunosuppressive regimens included prednisone with tacrolimus or mycophenolate. Seizures typically occurred on post-LT day seven (interquartile range: 5-13) and included uncertain onset (40%), non-convulsive status epilepticus (30%), generalized seizures (22.5%), convulsive status epilepticus (5%), and focal seizures (2.5%). Treatment was administered to 85% of seizure patients, primarily with levetiracetam (75%). Using seven acute perioperative variables, i.e., age at transplantation, history of PSE, pre-LT epilepsy diagnosis, pre-LT hemoglobin, procedure duration, graft cold ischemia time, and intraoperative blood transfusion, we developed a risk score for post-LT seizures. This score achieved an accuracy of 0.72 (95% CI: 0.63-0.80) and an area under the curve (AUC) of 0.90. Conclusions This study identifies key in-hospital factors associated with seizures following LT and presents a predictive risk model based on clinical preoperative and surgical variables. With an AUC of 0.90, the model demonstrates strong discriminative ability, suggesting it is a robust tool for predicting seizures in the immediate post-LT period. Further prospective multicenter studies are needed to externally validate the model and risk score, thereby enhancing its clinical applicability.

Background Interoception refers to the ability to sense body signals. Two interoceptive dimensions have been recently proposed: (a) interoceptive sensitivity (IS) –objective accuracy in detecting internal bodily sensations (e.g., heartbeat, breathing)–; and (b) metacognitive interoception (MI) –explicit beliefs and worries about one’s own interoceptive sensitivity and internal sensations. Current models of panic assume a possible influence of interoception on the development of panic attacks. Hypervigilance to body symptoms is one of the most characteristic manifestations of panic disorders. Some explanations propose that patients have abnormal IS, whereas other accounts suggest that misinterpretations or catastrophic beliefs play a pivotal role in the development of their psychopathology. Our goal was to evaluate these theoretical proposals by examining whether patients differed from controls in IS, MI, or both. Twenty-one anxiety disorders patients with panic attacks and 13 healthy controls completed a behavioral measure of IS motor heartbeat detection (HBD) and two questionnaires measuring MI. Findings Patients did not differ from controls in IS. However, significant differences were found in MI measures. Patients presented increased worries in their beliefs about somatic sensations compared to controls. These results reflect a discrepancy between direct body sensing (IS) and reflexive thoughts about body states (MI). Conclusion Our findings support the idea that hypervigilance to body symptoms is not necessarily a bottom-up dispositional tendency (where patients are hypersensitive about bodily signals), but rather a metacognitive process related to threatening beliefs about body/somatic sensations.

According to this hypothesis, the comprehension of meaningful actions could be supported by a more distributed neural network where visual information extracted by EBA/FBA is integrated with the contextual information processed in other parts of the brain. [...]anterior insular cortex has also shown to be recruited during motivational decision-making in uncertain contexts, suggesting that this area also mediates risk behavior when the available information is not sufficient to predict an outcome (Singer et al., 2009). In brief, we suggest that action meaning is beyond EBA and FBA through the integration of contextual information processed by a distributed fronto-insular–temporal network. [...]action meaning is not an amodal, invariant, immutable representation in a brain area, but instead a polymodal, context-sensitive, constructive, and distributed process. [...]a context–facilitation large-scale distributed neural network may process and influence the EBA/FBA activity in a top-down manner.

The ability to reappraise the emotional impact of events is related to long-term mental health. Self-focused reappraisal (REAPPself), i.e., reducing the personal relevance of the negative events, has been previously associated with neural activity in regions near right medial prefrontal cortex, but rarely investigated among brain-damaged individuals. Thus, we aimed to examine the REAPPself ability of brain-damaged patients and healthy controls considering structural atrophies and gray matter intensities, respectively. Twenty patients with well-defined cortex lesions due to an acquired circumscribed tumor or cyst and 23 healthy controls performed a REAPPself task, in which they had to either observe negative stimuli or decrease emotional responding by REAPPself. Next, they rated the impact of negative arousal and valence. REAPPself ability scores were calculated by subtracting the negative picture ratings after applying REAPPself from the ratings of the observing condition. The scores of the patients were included in a voxel-based lesion-symptom mapping (VLSM) analysis to identify deficit related areas (ROI). Then, a ROI group-wise comparison was performed. Additionally, a whole-brain voxel-based-morphometry (VBM) analysis was run, in which healthy participant's REAPPself ability scores were correlated with gray matter intensities. Results showed that (1) regions in the right superior frontal gyrus (SFG), comprising the right dorsolateral prefrontal cortex (BA9) and the right dorsal anterior cingulate cortex (BA32), were associated with patient's impaired down-regulation of arousal, (2) a lesion in the depicted ROI occasioned significant REAPPself impairments, (3) REAPPself ability of controls was linked with increased gray matter intensities in the ROI regions. Our findings show for the first time that the neural integrity and the structural volume of right SFG regions (BA9/32) might be indispensable for REAPPself. Implications for neurofeedback research are discussed.

Parkinson’s disease(PD) lacks a biomarker for disease progression. To analyze how cerebrospinal fluid (CSF), glucosylceramide (GlcCer), sphingomyelin (SM), or serum neurofilament light chain (NfL) associate with progression of PD in a retrospective cohort, we used linear mixed-model regressions between baseline biomarkers and change in dopamine transporter brain-imaging (DaTscan©), Montreal cognitive assesment (MoCA), or global composite outcome (GCO) score. In 191 PD patients, biomarkers were not associated with DaTscan or MoCA change over 2.1 years. Higher baseline GlcCer/SM ratio and serum-NfL nonsignificantly associated with increase in GCO score. Results do not support a role for CSF-sphingolipid/serum-NfL to predict cognitive and DaTscan progression in early-PD. Potential prediction of global clinical change warrants further study.