Objective To investigate the feasibility of using navigated transcranial magnetic stimulation (nTMS) to identify Chinese eloquent language area and further reveal the distribution pattern of essential language area in Chinese.Methods Twenty volunteers (students from Graduate School,Tianjin Medical University) were given a synchronized repetitive TMS with the guidance of navigation system while accomplishing the picture naming task.The performances of volunteers were video recorded and further analyzed to identify the areas which could induce language error.Results (1) The nTMS was capable of inducing repeatable language errors in 90％ of volunteers (18/20) and all the volunteers presented a good tolerability.No side effect of nTMS was observed.(2) The distribution pattern of essential language areas of Chinese in individual level had a substantial variability;the overall distribution pattern presented aggregation in some particular brain regions;in frontal lobe,the ventral precentral gyrus (36％,17/47) and the frontal operculum (23％,11/47) went with a high concentration of essential language functions;in temporal lobe,middle and posterior part of superior temporal gyrus (58％,14/24) and middle and posterior middle temporal gyrus (25％,6/24) presented a concentration of essential language functions;in the parietal lobe,the supramarginal gyrus (83％,15/18) was the main area possessing essential language functions while angular gyrus (17％,3/18) was also responsible for a small part of essential language functions.Conclusions The nTMS is capable of mapping essential language area in Chinese which is different from alphabetic language.The variability of individual essential language area indicates the importance of individualized language mapping.The aggregation of essential language area in group level provides useful information for surgery management when dealing with lesions in these areas.

Recent studies have demonstrated that lymphocytes play a key role in ischemic brain injury. However, there is still a lack of viable approaches to non-invasively track infiltrating lymphocytes and reveal their key spatiotemporal events in the inflamed central nervous system (CNS). Here we describe an in vivo imaging approach for sequential monitoring of brain-infiltrating CD4(+) T cells in experimental ischemic stroke. We show that magnetic resonance imaging (MRI) or Xenogen imaging combined with labeling of SPIO-Molday ION Rhodamine-B (MIRB) can be used to monitor the dynamics of CD4(+) T cells in a passive transfer model. MIRB-labeled CD4(+) T cells can be longitudinally visualized in the mouse brain and peripheral organs such as the spleen and liver after cerebral ischemia. Immunostaining of tissue sections showed similar kinetics of MIRB-labeled CD4(+) T cells when compared with in vivo observations. Our results demonstrated the use of MIRB coupled with in vivo imaging as a valid method to track CD4(+) T cells in ischemic brain injury. This approach will facilitate future investigations to identify the dynamics and key spatiotemporal events for brain-infiltrating lymphocytes in CNS inflammatory diseases.

OBJECTIVE:To investigate the hodotopical organization of neural pathway of Chinese in posterior inferior frontal gyrus. Forprovide the basis for the individual protectionoflanguage functionin the operation of the language functional area.METHODS:Twenty volunteers underwentlanguage mapping using repetitive navigated transcranial magnetic stimulation(nTMS)to identify the essential language sites in posterior inferior frontal gyrus.Then, DTI tractography was used to reconstruct language-relevant fiber tracts within posterior inferior frontal lobe. Finally, the relationships between essential language sites and language-relevant fiber tracts were analyzed.RESULTS:(1)Eighteen subjects hadlanguage sites which induce repeatable language errors in posterior inferior frontal gyrus. The total number of essential language sites was 39.46% of essential language sites located in ventral precentralgyrus, 41% in parsopercularis and 13% in parstriangularis. (2)Long segment of arcuate fasciculus had the probability of 100%to project into ventral precentralgyrus. Anterior segment of arcuate fasciculus had the probability of 100%to project into ventral precentralgyrus. Inferior frontal occipital fasciculus had the probability of 94% to project into parstriangularis. Uncinate fasciculus had the probability of 67% to project into parstriangularis. Aslantfiber had the probability of 100% to project into parsopercularis.(3)When the essential language site located in ventral precentralgyrus, it had the probability of 82% to correlate with long segment of arcuate fasciculus. When the essential language site located in parsopercularis, it had the probability of 79%to correlate with aslant fiber. When the essential language site located in parstriangularis, it had the probability of 60% to correlate with inferior frontal occipital fasciculus.CONCLUSION:Essential language sites within distinct locations were conducted through different fasciculus, which enlightensour neurosurgeons thatin order to achieve both maximal lesions resection and language function protection, we shouldprotectboththe essential language cortices and language relevant subcortical connection according to each individual's hodotopical organization.

Peripheral lymphocytes entering brain ischemic regions orchestrate inflammatory responses, catalyze tissue death, and worsen clinical outcomes of acute ischemic stroke (AIS) in preclinical studies. However, it is not known whether modulating brain inflammation can impact the outcome of patients with AIS. In this open-label, evaluator-blinded, parallel-group clinical pilot trial, we recruited 22 patients matched for clinical and MRI characteristics, with anterior cerebral circulation occlusion and onset of stroke that had exceeded 4.5 h, who then received standard management alone (controls) or standard management plus fingolimod (FTY720, Gilenya, Novartis), 0.5 mg per day orally for 3 consecutive days. Compared with the 11 control patients, the 11 fingolimod recipients had lower circulating lymphocyte counts, milder neurological deficits, and better recovery of neurological functions. This difference was most profound in the first week when reduction of National Institutes of Health Stroke Scale was 4 vs. -1, respectively (P = 0.0001). Neurological rehabilitation was faster in the fingolimod-treated group. Enlargement of lesion size was more restrained between baseline and day 7 than in controls (9 vs. 27 mL, P = 0.0494). Furthermore, rT1%, an indicator of microvascular permeability, was lower in the fingolimod-treated group at 7 d (20.5 vs. 11.0; P = 0.005). No drug-related serious events occurred. We conclude that in patients with acute and anterior cerebral circulation occlusion stroke, oral fingolimod within 72 h of disease onset was safe, limited secondary tissue injury from baseline to 7 d, decreased microvascular permeability, attenuated neurological deficits, and promoted recovery.

The temporal pole (TP) is an association cortex capable of multisensory integration and participates in various high-order cognitive functions.However, an accepted parcellation of the human TP and its connectivity patterns have not yet been well established.Here, we sought to present a scheme for the parcellation of human TP based on anatomical connectivity and to reveal its subregional connectivity patterns.Three distinct subregions with characteristic fiber pathways were identified, including the dorsal (TAr), the medial (TGm), and lateral (TGl) subregions, which are located ventrally.According to the connectivity patterns, a dorsal/ventral sensory segregation of auditory and visual processing and the medial TGm involved in the olfactory processing were observed.Combined with the complementary resting-state functional connectivity analysis, the connections of the TGm with the orbitofrontal cortex and other emotion-related areas, the TGl connections with the MPFC and major default mode network regions, and the TAr connections with the perisylvian language areas were observed.To the best of our knowledge, the present study represents the first attempt to parcel the human TP based on its anatomical connectivity features, which may help to improve our understanding of its connectional anatomy and to extend the available knowledge in TP-related clinical research.

The human cerebellum is a heterogeneous structure, and the pattern of resting-state functional connectivity (rsFC) of each subregion has not yet been fully characterized. We aimed to systematically investigate rsFC pattern of each cerebellar subregion in 228 healthy young adults. Voxel-based analysis revealed that several subregions showed similar rsFC patterns, reflecting functional integration; however, different subregions displayed distinct rsFC patterns, representing functional segregation. The same vermal and hemispheric subregions showed either different patterns or different strengths of rsFCs with the cerebrum, and different subregions of lobules VII and VIII displayed different rsFC patterns. Region of interest (ROI)-based analyses also confirmed these findings. Specifically, strong rsFCs were found: between lobules I-VI and vermal VIIb-IX and the visual network; between hemispheric VI, VIIb, VIIIa and the auditory network; between lobules I-VI, VIII and the sensorimotor network; between lobule IX, vermal VIIIb and the default-mode network; between lobule Crus I, hemispheric Crus II and the fronto-parietal network; between hemispheric VIIb, VIII and the task-positive network; between hemispheric VI, VIIb, VIII and the salience network; between most cerebellar subregions and the thalamus; between lobules V, VIIb and the midbrain red nucleus; between hemispheric Crus I, Crus II, vermal VIIIb, IX and the caudate nucleus; between lobules V, VI, VIIb, VIIIa and the pallidum and putamen; and between lobules I-V, hemispheric VIII, IX and the hippocampus and amygdala. These results confirm the existence of both functional integration and segregation among cerebellar subregions and largely improve our understanding of the functional organization of the human cerebellum.

A number of researches have studied the neurophysiological bases of amblyopia, and most of these studies focused on the gray matter alterations. For the purpose of elucidating whether there would be any changes in the white matter, a combination of high-resolution anatomic MRI and vision tests were used to compare a group of children with ametropic amblyopia and control subjects. An automated and unbiased method called voxel-based morphometry (VBM) was employed to analyze the anatomical brain images. After performing two sample t-tests, decreased white matter volume were detected in ametropic amblyopic children versus controls. The involved regions were predominantly in the occipital lobes bilaterally, and a smaller region in middle frontal lobe. It indicates that visual defects in amblyopia can influence the development of white matter.

Objective To investigate white matter volume changes in children with anisometropic or ametropic amblyopia.Methods A total of fourteen anisometropic amblyopic children,eight ametropic amblyopia and twenty matched normal controls participated in this study.After high resolution T1WI images of the brain were acquired,the data were processed using voxel-based morphometry (VBM).Two sample t-test were employed to analyze the morphological changes of white matter in amblyopic groups.Results Compared to healthy controls,anisometropic amblyopic group showed decreased white matter volume in left calarine sulcus and superior parietal lobule,whereas increased white matter volume was detected in right cuneus.In ametropic amblyopia group,only reduced white matter volumes were found,and the regions predominantly located in right occipital lobe and frontal lobe.Conclusions Both anisometropic and ametropic amblyopic children undergo white matter morphologic changes in vision associated regions.These findings suggest that besides gray matter,developmental abnormalities also exist in white matter,and such morphologic changes also may contribute to visual impairment in amblyopic children as well.