Improvement of Speech Function in Patients with Aphasia: The Right Hemisphere,an Enemy or a Friend?

The purpose of our research is to investigate interhemispheric language functional reorganization in patients with gliomas of the left hemisphere using functional magnetic resonance tomography (fMRI) in comparison with the dynamics of speech disorders. A total of 20 patients with a glioma in the left hemisphere underwent fMRI examination and Luria’s neuropsychological testing. The age of patients varied from 26 to 67 years; the mean age was 40 years (median, interquartile range; 13 women and 7 men). The glioma was located in the frontal lobe (12 patients) 34.50–49.75 years; or in the temporal lobe (8 patients). All patients underwent both fMRI scanning and neuropsychological testing on the same day before the surgery and then 3–10 days and 3, 5–7, 12 months after tumor surgery. The handedness was determined by using self-assessment and the Annett Hand Preference Questionnaire. Almost all the subjects were right-handed, and one was ambidexter. On the basis of the analysis of fMRI data in dynamics, all subjects were divided into two groups: (1) patients with no signs of activation of the right hemisphere homologues of Broca’s and Wernicke’s areas (even in 4 patients with severe aphasia) during the follow-up period (at least one year), and (2) patients with signs of activation in the right-sided Broca’s and Wernicke’s areas, which were found in at least several tests (16 patients; 3 of them had normal speech function during the whole follow-up period). We conclude that the lack of consistency between the presence/absence of aphasia and the activation of homologous speech areas in the right hemisphere in fMRI results from individual differences in the involvement of the right hemisphere in speech processes. Thus, we should be very cautious about the hypothesis of reciprocal relationships of the hemispheres in speech function and the use of this hypothesis in speech rehabilitation.     

Disorders of System Brain Activity in Children with Motor (Expressive) Alalia

Motor alalia refers to a number of disorders of expressive speech that are caused by the dysfunction of cerebral structures in the period when the formation of the speech system is not complete. This form of speech disorder is considered as a language disorder characterized by a persistent disturbance of the assimilation of a system of linguistic units. The possible cause of deviations in the development of speech function in children is a disproportion in the levels of development of speech structures in the left and right hemispheres, and this temporary dominance is often associated with an increased activity in the right hemisphere. According to the results of electroencephalographic studies, in children aged five to six years, there are two types of changes of the bioelectric potential system interaction of the brain cortex. The disorders of the spatial organization of interregional EEG correlations are more pronounced in either the left or right hemispheres of the brain. Thus, motor alalia can be accompanied either by disturbances in the interaction between Broca’s and Wernicke’s areas of the left hemisphere, or between symmetrical areas of the right hemisphere.     

Systemic Interaction of the Cortical Areas during Performance of Verbal–Mnestic Activity

The dynamics of the interregional interaction of cortical areas was studied in adult test subjects who accomplished the tasks of listening to and memorizing a poem and of mental arithmetic. Analysis of the spatial and temporal relations of the oscillations of the brain biopotentials showed the participation of many regions of the left and right hemispheres in the verbal–mnestic activity. The interaction was most expressed between the posterior regions of the left hemisphere and the anterior regions of the right one. To find out whether these data agree with the classical concepts on the leading role of the left hemisphere in speech activity, the authors examined 3- and 4-year-old children with motor alalia. A comparison of 3-year-old alalics with the control group of healthy children of the same age demonstrated a marked weakening of the distant interaction of the activity of the ipsilateral antero- and posterotemporal regions of the left hemisphere (i.e., those that correspond to the Broca area and Wernicke zone) both between themselves and with the activity of other cortical regions of both hemispheres. These results confirm the important role of both the inter- and intrahemispheric relations, especially those between the Broca area and the Wernicke zone, in realizing verbal–mnestic functions. A significant weakening of the systemic interaction between EEG oscillations in these areas in alalic children suggests that the auditory feedback plays a special role during speech production in the ontogenetic development of the neurophysiological mechanisms that are responsible for speech function formation.     

Organization of Regional Interactions of the Brain Cortical Activity during the Common-root Word Derivation Task

This study analyzed specificities in the activity of the neurophysiological mechanisms underlying the organization of active word-derivation processes. The regularities in the reorganization of the spatial structure for the systemic interaction of bioelectrical activity between different cortical areas of the cerebral hemispheres were studied in adult subjects during the test for mental derivation of common root words (i.е., using the modern methods of the so-called “functional connectome” investigations). Сross-correlation and coherent analysis of EEG has shown that the ipsilateral statistical EEG interactions in the left hemisphere, including Broca’s and Wernicke’s areas, were significantly increased in adults during mental derivation of common root words and, simultaneously, the interhemispheric connectivity and the EEG interactions in the right hemisphere were reduced. Comparison of our results with the previous data of verbal activity associated with speech perception and production has revealed significant differences in the degree of involvement of the left and right hemisphere cortical activity in verbal processing. For example, unlike the data of current study, an equal involvement of both hemispheres cortical activity was recorded during the phoneme recognition in auditory perceived words, grammatical and semantic errors in sentences, as well as during mental formation of words from a set of phonemes and sentences from a set of words, which was particularly manifested in the increased of hemispheric interactions, predominantly, in the inferior frontal and temporal areas and the overlapped areas of the temporal, parietal, and occipital cortical zones (TPO) of both hemispheres. Thus, the data obtained in this study indicate the presence of expressed specificities in the lateralization of activity in the neurophysiological mechanisms underlying the processes of active word derivation and inflexion.     

Form and content: dissociating syntax and semantics in sentence comprehension

The distinction between syntax (sentence form) and semantics (sentence meaning) is fundamental to our thinking about language. Whether and where this distinction is represented at the neural level is still a matter of considerable debate. In the present fMRI study, we examined the neural correlates of syntactic and semantic functions using an innovative activation paradigm specifically designed to unequivocally disentangle syntactic from lexicosemantic aspects of sentence processing. Our findings strongly indicate that a part of Broca's area (BA 44, pars opercularis) is critically implicated in processing syntactic information, whereas the lower portion of the left inferior frontal gyrus (BA 47, pars orbitalis) is selectively involved in processing the semantic aspects of a sentence.     

A Global Multiregional Proteomic Map of the Human Cerebral Cortex

The Brodmann area(BA)-based map is one of the most widely used cortical maps for studies of human brain functions and in clinical practice; however, the molecular architecture of BAs remains unknown. The present study provided a global multiregional proteomic map of the human cerebral cortex by analyzing 29 BAs. These 29 BAs were grouped into 6 clusters based on similarities in proteomic patterns: the motor and sensory cluster, vision cluster, auditory and Broca’s area cluster, Wernicke’s area c...     

汉字字形认知研究的刺激源设计及在fMRI研究中的应用

目的:评估汉字字形刺激源在汉字认知fMRI研究中的有效性,并对参与汉字处理的脑皮层区域进行定位及初步的量化分析。方法:选择母语为汉语、经利手测试后为右利手且裸眼视力正常(大于等于1．0)的在校大学生10例(男6例,女4例)作为被试。试验任务采用组块设计,将汉字(非字、假字、真字)投射到屏幕上,受试者接受汉字字形图片的视觉刺激,按非字-假字-真字-非字-假字-真字顺序呈现,共6个block。数据处理及统计分析采用国际通用的AFNI软件。结果:左额叶上、中、下回(包括Broca's area)、左中央前回(BA6)、左顶上小叶及顶下小叶(包括缘上回及角回)及双侧枕叶、楔前叶显著激活;左颞叶梭状回(BA37)、右额下回及双侧颞中、上回及扣带回显著激活,左大脑半球的激活体积明显大于右侧大脑半球。结论:本研究设计的汉字字形刺激源结合功能磁共振成像技术可以对汉字处理的相关大脑皮层区域进行定位,为研究人脑加工处理汉字的神经机制提供了一种有效的无创性影像学方法,并应用fMRI技术进一步证实其优势半球为左半球,且需要多种脑区共同参与完成。本试验模式可望成为一种对语言障碍病人进行脑功能检查的有效手段,从而为指导临床治疗和评价预后提供更丰富的信息。     

Pain Modulation in Waking and Hypnosis in Women: Event-Related Potentials and Sources of Cortical Activity

Using a strict subject selection procedure, we tested in High and Low Hypnotizable subjects (HHs and LHs) whether treatments of hypoalgesia and hyperalgesia, as compared to a relaxation-control, differentially affected subjective pain ratings and somatosensory event-related potentials (SERPs) during painful electric stimulation. Treatments were administered in waking and hypnosis conditions. LHs showed little differentiation in pain and distress ratings between hypoalgesia and hyperalgesia treatments, whereas HHs showed a greater spread in the instructed direction. HHs had larger prefrontal N140 and P200 waves of the SERPs during hypnotic hyperalgesia as compared to relaxation-control treatment. Importantly, HHs showed significant smaller frontocentral N140 and frontotemporal P200 waves during hypnotic hypoalgesia. LHs did not show significant differences for these SERP waves among treatments in both waking and hypnosis conditions. Source localization (sLORETA) method revealed significant activations of the bilateral primary somatosensory (BA3), middle frontal gyrus (BA6) and anterior cingulate cortices (BA24). Activity of these contralateral regions significantly correlated with subjective numerical pain scores for control treatment in waking condition. Moreover, multivariate regression analyses distinguished the contralateral BA3 as the only region reflecting a stable pattern of pain coding changes across all treatments in waking and hypnosis conditions. More direct testing showed that hypnosis reduced the strength of the association of pain modulation and brain activity changes at BA3. sLORETA in HHs revealed, for the N140 wave, that during hypnotic hyperalgesia, there was an increased activity within medial, supramarginal and superior frontal gyri, and cingulated gyrus (BA32), while for the P200 wave, activity was increased in the superior (BA22), middle (BA37), inferior temporal (BA19) gyri and superior parietal lobule (BA7). Hypnotic hypoalgesia in HHs, for N140 wave, showed reduced activity within medial and superior frontal gyri (BA9,8), paraippocampal gyrus (BA34), and postcentral gyrus (BA1), while for the P200, activity was reduced within middle and superior frontal gyri (BA9 and BA10), anterior cingulate (BA33), cuneus (BA19) and sub-lobar insula (BA13). These findings demonstrate that hypnotic suggestions can exert a top-down modulatory effect on attention/preconscious brain processes involved in pain perception.     

Alterations of Regional Cerebral Blood Flow in Tinnitus Patients as Assessed Using Single-Photon Emission Computed Tomography

Tinnitus is the perception of phantom sound without an external auditory stimulus. Using neuroimaging techniques, such as positron emission tomography, electroencephalography, magnetoencephalography, and functional magnetic resonance imaging (fMRI), many studies have demonstrated that abnormal functions of the central nervous system are closely associated with tinnitus. In our previous research, we reported using resting-state fMRI that several brain regions, including the rectus gyrus, cingulate gyrus, thalamus, hippocampus, caudate, inferior temporal gyrus, cerebellar hemisphere, and medial superior frontal gyrus, were associated with tinnitus distress and loudness. To reconfirm these results and probe target regions for repetitive transcranial magnetic stimulation (rTMS), we investigated the regional cerebral blood flow (rCBF) between younger tinnitus patients (<60 years old) and the age-matched controls using single-photon emission computed tomography and easy Z-score imaging system. Compared with that of controls, the rCBF of tinnitus patients was significantly lower in the bilateral medial superior frontal gyri, left middle occipital gyrus and significantly higher in the bilateral cerebellar hemispheres and vermis, bilateral middle temporal gyri, right fusiform gyrus. No clear differences were observed between tinnitus patients with normal and impaired hearing. Regardless of the assessment modality, similar brain regions were identified as characteristic in tinnitus patients. These regions are potentially involved in the pathophysiology of chronic subjective tinnitus.     

Neuroanatomical circuitry associated with exploratory eye movement in schizophrenia: a voxel-based morphometric study

Schizophrenic patients present abnormalities in a variety of eye movement tasks. Exploratory eye movement (EEM) dysfunction appears to be particularly specific to schizophrenia. However, the underlying mechanisms of EEM dysfunction in schizophrenia are not clearly understood. To assess the potential neuroanatomical substrates of EEM, we recorded EEM performance and conducted a voxel-based morphometric analysis of gray matter in 33 schizophrenic patients and 29 well matched healthy controls. In schizophrenic patients, decreased responsive search score (RSS) and widespread gray matter density (GMD) reductions were observed. Moreover, the RSS was positively correlated with GMD in distributed brain regions in schizophrenic patients. Furthermore, in schizophrenic patients, some brain regions with neuroanatomical deficits overlapped with some ones associated with RSS. These brain regions constituted an occipito-tempro-frontal circuitry involved in visual information processing and eye movement control, including the left calcarine cortex [Brodmann area (BA) 17], the left cuneus (BA 18), the left superior occipital cortex (BA 18/19), the left superior frontal gyrus (BA 6), the left cerebellum, the right lingual cortex (BA 17/18), the right middle occipital cortex (BA19), the right inferior temporal cortex (BA 37), the right dorsolateral prefrontal cortex (BA 46) and bilateral precentral gyri (BA 6) extending to the frontal eye fields (FEF, BA 8). To our knowledge, we firstly reported empirical evidence that gray matter loss in the occipito-tempro-frontal neuroanatomical circuitry of visual processing system was associated with EEM performance in schizophrenia, which may be helpful for the future effort to reveal the underlying neural mechanisms for EEM disturbances in schizophrenia.     

Weight Gain following Pallidal Deep Brain Stimulation: A PET Study

The mechanisms behind weight gain following deep brain stimulation (DBS) surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focusing on GPi target, our objective was to analyze correlations between changes in brain metabolism (measured with PET) and weight gain following GPi-DBS in patients with Parkinson’s disease (PD). Body mass index was calculated and brain activity prospectively measured using 2-deoxy-2[18F]fluoro-D-glucose PET four months before and four months after the start of GPi-DBS in 19 PD patients. Dopaminergic medication was included in the analysis to control for its possible influence on brain metabolism. Body mass index increased significantly by 0.66 ± 1.3 kg/m2 (p = 0.040). There were correlations between weight gain and changes in brain metabolism in premotor areas, including the left and right superior gyri (Brodmann area, BA 6), left superior gyrus (BA 8), the dorsolateral prefrontal cortex (right middle gyrus, BAs 9 and 46), and the left and right somatosensory association cortices (BA 7). However, we found no correlation between weight gain and metabolic changes in limbic and associative areas. Additionally, there was a trend toward a correlation between reduced dyskinesia and weight gain (r = 0.428, p = 0.067). These findings suggest that, unlike STN-DBS, motor improvement is the major contributing factor for weight gain following GPi-DBS PD, confirming the motor selectivity of this target.     

Control of breathing and brain activation in human subjects seen by functional magnetic resonance imaging.

Functional magnetic resonance imaging (fMRI) was used to demonstrate the brain activation during transition from unconscious to conscious breathing in seven healthy human subjects. In right-handed volunteers, the activated areas were found in both hemispheres. The medial part of the precentral gyrus (area 4) was constantly activated in the left hemisphere. Additional activated areas were demonstrated in the premotor cortex and in the posterior parietal cortex. The activated cortical sites exhibited analogous distribution in the right hemisphere. In two out of the seven subjects. activated sites were also observed in the cerebellar hemispheres, and in the lentiform and caudate nuclei.     

Evaluation of Diffusion-Tensor Imaging-Based Global Search and Tractography for Tumor Surgery Close to the Language System

Pre-operative planning and intra-operative guidance in neurosurgery require detailed information about the location of functional areas and their anatomo-functional connectivity. In particular, regarding the language system, post-operative deficits such as aphasia can be avoided. By combining functional magnetic resonance imaging and diffusion tensor imaging, the connectivity between functional areas can be reconstructed by tractography techniques that need to cope with limitations such as limited resolution and low anisotropic diffusion close to functional areas. Tumors pose particular challenges because of edema, displacement effects on brain tissue and infiltration of white matter. Under these conditions, standard fiber tracking methods reconstruct pathways of insufficient quality. Therefore, robust global or probabilistic approaches are required. In this study, two commonly used standard fiber tracking algorithms, streamline propagation and tensor deflection, were compared with a previously published global search, Gibbs tracking and a connection-oriented probabilistic tractography approach. All methods were applied to reconstruct neuronal pathways of the language system of patients undergoing brain tumor surgery, and control subjects. Connections between Broca and Wernicke areas via the arcuate fasciculus (AF) and the inferior fronto-occipital fasciculus (IFOF) were validated by a clinical expert to ensure anatomical feasibility, and compared using distance- and diffusion-based similarity metrics to evaluate their agreement on pathway locations. For both patients and controls, a strong agreement between all methods was observed regarding the location of the AF. In case of the IFOF however, standard fiber tracking and Gibbs tracking predominantly identified the inferior longitudinal fasciculus that plays a secondary role in semantic language processing. In contrast, global search resolved connections in almost every case via the IFOF which could be confirmed by probabilistic fiber tracking. The results show that regarding the language system, our global search is superior to clinically applied conventional fiber tracking strategies with results similar to time-consuming global or probabilistic approaches.     

带状疱疹后遗神经痛患者脑基础活动改变的功能核磁共振研究

带状疱疹后遗神经痛(postherpetic neuralgia,PHN)是临床上一种慢性顽固性神经病理性疼痛,然而,对于其潜在的中枢机制还知之甚少.为了进一步探讨带状疱疹后遗神经痛患者的相关脑区活动,利用功能核磁共振成像低频振幅振荡(ALFF)技术观察带状疱疹后遗神经痛患者的基础脑区活动.8名带状疱疹后遗神经痛患者与8名性别、年龄相匹配的健康者行静息态功能磁共振(f MRI)成像扫描,用SPM8中的多重回归分析,在控制被试年龄、性别、教育年限的影响下,将每个体素的ALFF值同每个被试的病程、视觉模拟评分(visual analog scale,VAS)进行相关分析.与健康志愿者相比,PHN组与VAS评分相关的ALFF值增高的脑区有:右侧小脑后叶、前额叶背外侧区域(BA11/46/47)、右侧顶叶(BA40)、右侧舌回(BA17/18/19);与VAS评分相关的ALFF值降低的脑区有:右侧颞中回(BA21)、左侧舌回(BA17/18)、右侧小脑前叶、左侧后扣带回(BA30/19)和右侧中央前回(BA3/4/6);PHN组与病程相关的ALFF值增高的脑区有:右侧小脑后叶、前额叶背外侧区域(BA9/10/11/47)、左侧颞上回(BA38)、右侧顶叶和右侧舌回(BA17/18/19);与病程相关ALFF值降低的脑区有:左侧海马旁回(BA28)、右侧小脑前叶、左侧扣带回(BA24)、右侧颞上回(BA13)、左侧中央前回和右侧顶下小叶(BA39/40).研究结果提示,涉及疼痛的情绪、警觉行为、注意的脑区在带状疱疹后遗痛慢性疼痛的产生和维持中发挥重要作用.     

Subthalamic Nucleus Stimulation Affects Theory of Mind Network: A PET Study in Parkinson's Disease

Background

There appears to be an overlap between the limbic system, which is modulated by subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson''s disease (PD), and the brain network that mediates theory of mind (ToM). Accordingly, the aim of the present study was to investigate the effects of STN DBS on ToM of PD patients and to correlate ToM modifications with changes in glucose metabolism.

Methodology/Principal Findings

To this end, we conducted ¹⁸FDG-PET scans in 13 PD patients in pre- and post-STN DBS conditions and correlated changes in their glucose metabolism with modified performances on the Eyes test, a visual ToM task requiring them to describe thoughts or feelings conveyed by photographs of the eye region. Postoperative PD performances on this emotion recognition task were significantly worse than either preoperative PD performances or those of healthy controls (HC), whereas there was no significant difference between preoperative PD and HC. Conversely, PD patients in the postoperative condition performed within the normal range on the gender attribution task included in the Eyes test. As far as the metabolic results are concerned, there were correlations between decreased cerebral glucose metabolism and impaired ToM in several cortical areas: the bilateral cingulate gyrus (BA 31), right middle frontal gyrus (BA 8, 9 and 10), left middle frontal gyrus (BA 6), temporal lobe (fusiform gyrus, BA 20), bilateral parietal lobe (right BA 3 and right and left BA 7) and bilateral occipital lobe (BA 19). There were also correlations between increased cerebral glucose metabolism and impaired ToM in the left superior temporal gyrus (BA 22), left inferior frontal gyrus (BA 13 and BA 47) and right inferior frontal gyrus (BA 47). All these structures overlap with the brain network that mediates ToM.

Conclusion/Significance

These results seem to confirm that STN DBS hinders the ability to infer the mental states of others and modulates a distributed network known to subtend ToM.     

Implicit Target Substitution and Sequencing for Lexical Tone Production in Chinese: An fMRI Study

In this study, we examine the neural substrates underlying Tone 3 sandhi and tone sequencing in Mandarin Chinese using fMRI. Tone 3 sandhi is traditionally described as the substitution of Tone 3 with Tone 2 when followed by another Tone 3 (i.e., 33→23). According to current speech production models, target substitution is expected to engage the posterior inferior frontal gyrus. Since Tone 3 sandhi is, to some extent, independent of segments, which makes it more similar to singing, right-lateralized activation in this region was predicted. As for tone sequencing, based on studies in sequencing, we expected the involvement of the supplementary motor area. In the experiments, participants were asked to produce twelve four-syllable sequences with the same tone assignment (the repeated sequences) or a different tone assignment (the mixed sequences). We found right-lateralized posterior inferior frontal gyrus activation for the sequence 3333 (Tone 3 sandhi) and left-lateralized activation in the supplementary motor area for the mixed sequences (tone sequencing). We proposed that tones and segments could be processed in parallel in the left and right hemispheres, but their integration, or the product of their integration, is hosted in the left hemisphere.     

Neural network development in late adolescents during observation of risk-taking action

Emotional maturity and social awareness are important for adolescents, particularly college students beginning to face the challenges and risks of the adult world. However, there has been relatively little research into personality maturation and psychological development during late adolescence and the neural changes underlying this development. We investigated the correlation between psychological properties (neuroticism, extraversion, anxiety, and depression) and age among late adolescents (n?=?25, from 18 years and 1 month to 22 years and 8 months). The results revealed that late adolescents became less neurotic, less anxious, less depressive and more extraverted as they aged. Participants then observed video clips depicting hand movements with and without a risk of harm (risk-taking or safe actions) during functional magnetic resonance imaging (fMRI). The results revealed that risk-taking actions elicited significantly stronger activation in the bilateral inferior parietal lobule, temporal visual regions (superior/middle temporal areas), and parieto-occipital visual areas (cuneus, middle occipital gyri, precuneus). We found positive correlations of age and extraversion with neural activation in the insula, middle temporal gyrus, lingual gyrus, and precuneus. We also found a negative correlation of age and anxiety with activation in the angular gyrus, precentral gyrus, and red nucleus/substantia nigra. Moreover, we found that insula activation mediated the relationship between age and extraversion. Overall, our results indicate that late adolescents become less anxious and more extraverted with age, a process involving functional neural changes in brain networks related to social cognition and emotional processing. The possible neural mechanisms of psychological and social maturation during late adolescence are discussed.     

Decreased Functional Connectivity of Homotopic Brain Regions in Chronic Stroke Patients: A Resting State fMRI Study

The recovery of motor functions is accompanied by brain reorganization, and identifying the inter-hemispheric interaction post stroke will conduce to more targeted treatments. However, the alterations of bi-hemispheric coordination pattern between homologous areas in the whole brain for chronic stroke patients were still unclear. The present study focuses on the functional connectivity (FC) of mirror regions of the whole brain to investigate the inter-hemispheric interaction using a new fMRI method named voxel-mirrored homotopic connectivity (VMHC). Thirty left subcortical chronic stroke patients with pure motor deficits and 37 well-matched healthy controls (HCs) underwent resting-state fMRI scans. We employed a VMHC analysis to determine the brain areas showed significant differences between groups in FC between homologous regions, and we explored the relationships between the mean VMHC of each survived area and clinical tests within patient group using Pearson correlation. In addition, the brain areas showed significant correlations between the mean VMHC and clinical tests were defined as the seed regions for whole brain FC analysis. Relative to HCs, patients group displayed lower VMHC in the precentral gyrus, postcentral gyrus, inferior frontal gyrus, middle temporal gyrus, calcarine gyrus, thalamus, cerebellum anterior lobe, and cerebellum posterior lobe (CPL). Moreover, the VMHC of CPL was positively correlated with the Fugl–Meyer Score of hand (FMA-H), while a negative correlation between illness duration and the VMHC of this region was also detected. Furthermore, we found that when compared with HCs, the right CPL exhibited reduced FC with the left precentral gyrus, inferior frontal gyrus, inferior parietal lobule, middle temporal gyrus, thalamus and hippocampus. Our results suggest that the functional coordination across hemispheres is impaired in chronic stroke patients, and increased VMHC of the CPL is significantly associated with higher FMA-H scores. These findings may be helpful in understanding the mechanism of hand deficit after stroke, and the CPL may serve as a target region for hand rehabilitation following stroke.     

Regional Grey Matter Structure Differences between Transsexuals and Healthy Controls—A Voxel Based Morphometry Study

Gender identity disorder (GID) refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individuals to better understand both the neuroanatomical features of transsexualism and the background of gender identity. So far, results are inconclusive but in general, transsexualism has been associated with a distinct neuroanatomical pattern. Studies mainly focused on male to female (MTF) transsexuals and there is scarcity of data acquired on female to male (FTM) transsexuals. Thus, our aim was to analyze structural MRI data with voxel based morphometry (VBM) obtained from both FTM and MTF transsexuals (n = 17) and compare them to the data of 18 age matched healthy control subjects (both males and females). We found differences in the regional grey matter (GM) structure of transsexual compared with control subjects, independent from their biological gender, in the cerebellum, the left angular gyrus and in the left inferior parietal lobule. Additionally, our findings showed that in several brain areas, regarding their GM volume, transsexual subjects did not differ significantly from controls sharing their gender identity but were different from those sharing their biological gender (areas in the left and right precentral gyri, the left postcentral gyrus, the left posterior cingulate, precuneus and calcarinus, the right cuneus, the right fusiform, lingual, middle and inferior occipital, and inferior temporal gyri). These results support the notion that structural brain differences exist between transsexual and healthy control subjects and that majority of these structural differences are dependent on the biological gender.