NeuroImage
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Case Reports
DTI fiber tracking to differentiate demyelinating diseases from diffuse brain stem glioma.
Intrinsic diffuse brainstem tumors and demyelinating diseases primarily affecting the brainstem can share common clinical and radiological features, sometimes making the diagnosis difficult especially at the time of first clinical presentation. To explore the potential usefulness of new MRI sequences in particular diffusion tensor imaging fiber tracking in differentiating these two pathological entities, we review a series of brainstem tumors and demyelinating diseases treated at our institution. ⋯ DTI fiber tracking of the pyramid tracts in patients with suspected intrinsic brainstem tumor or demyelinating disease presents two clearly different patterns that may help in differentiating between these two pathologies when conventional MRI and clinical data are inconclusive.
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During voluntary motor acts, potential perturbations due to transient external forces are counteracted very quickly by short- and long-latency stretch reflexes (SLSR and LLSR, respectively). The LLSR, presumably linked to a transcortical loop, can be modulated by the subjects' intention. Here, we used combined TMS-EEG to study cortical mechanisms involved in this intention-related modulation both before and during the reaction to a mechanical perturbation. ⋯ Therefore, the cortical mechanisms involved in the intention-related LLSR modulation differ from those involved in the voluntary reaction. In addition, in response to a single-pulse TMS delivered during the expectation of the mechanical perturbation, the TMS-evoked N100 amplitude decreased when subjects intended to 'let-go', suggesting anticipatory decreased activity of intracortical inhibitory sensorimotor networks. Taken together, these results support the idea that anticipatory processes preset the sensorimotor cortex so as to adapt its early reaction to the perturbation relative to the subjects' intention.