Marion Noulhiane

Where are your body parts? A pure case of heterotopagnosia following left parietal stroke.

We studied the involvement of the parietal cortex in interpersonal body representation in a left parietal stroke patient. We used tasks assessing different types of body representations and localization of object parts. The patient performed normally on all tasks of body knowledge. However, she was unable to locate body parts on another person or on body representations. In contrast, she pointed correctly to the same body parts on herself or object representations. The data support the important role of the left parietal cortex in the transformation of intrinsic spatial coding of body parts localization in extrinsic body part coordinates.

Relationships between Regional Radiation Doses and Cognitive Decline in Children Treated with Cranio-Spinal Irradiation for Posterior Fossa Tumors

Pediatric posterior fossa tumor (PFT) survivors who have been treated with cranial radiation therapy often suffer from cognitive impairments that might relate to IQ decline. Radiotherapy (RT) distinctly affects brain regions involved in different cognitive functions. However, the relative contribution of regional irradiation to the different cognitive impairments still remains unclear. We investigated the relationships between the changes in different cognitive scores and radiation dose distribution in 30 children treated for a PFT. Our exploratory analysis was based on a principal component analysis (PCA) and an ordinary least square regression approach. The use of a PCA was an innovative way to cluster correlated irradiated regions due to similar radiation therapy protocols across patients. Our results suggest an association between working memory decline and a high dose (equivalent uniform dose, EUD) delivered to the orbitofrontal regions, whereas the decline of processing speed seemed more related to EUD in the temporal lobes and posterior fossa. To identify regional effects of RT on cognitive functions may help to propose a rehabilitation program adapted to the risk of cognitive impairment.

Language plasticity after hemispherotomy of the dominant hemisphere in 3 patients: Implication of non-linguistic networks

The neural networks involved in language recovery following hemispherotomy of the dominant hemisphere after language acquisition in children remain poorly known. Twelve hemispherotomized children (mean age at surgery: 11.3years) with comparable post-operative neuropsychological patterns underwent multi-task language functional MRI. Three of them had recovered from an initial postoperative aphasia i.e., hemispherotomy was performed on the language-dominant hemisphere. Our main results revealed (1) perisylvian activations in all patients after either left or right hemispherotomy; (2) no differences in activations between groups regarding the side of hemispherotomy; (3) additional activations in pre-frontal (3/3) and hippocampal/parahippocampal and occipito-parietal (2/3) areas, when comparing language activation in each of the three subjects with hemispherotomy of the language-dominant hemisphere to the group of 9 non-dominant hemispherotomized patients. These neural networks support the stronger engagement of learning and memory during language recovery in a hemisphere that was not initially actively subserving language.

Special Issues in fMRI Involving Children

Anatomo-functional brain imaging methods have considerably developed recently, leading to new advances in noninvasive exploration of children with various neurological disorders. In addition, fMRI is a unique method to study healthy children because it does not require any exogenous tracer and has no reported side effects. It thus gives us access to normative data of functional brain development and to the assessment of networks reorganization following focal anatomical or functional abnormality, which is particularly relevant in the child’s immature and plastic brain.

Memory for fearful faces across development: specialization of amygdala nuclei and medial temporal lobe structures

Enhanced memory for emotional faces is a significant component of adaptive social interactions, but little is known on its neural developmental correlates. We explored the role of amygdaloid complex (AC) and medial temporal lobe (MTL) in emotional memory recognition across development, by comparing fMRI activations of successful memory encoding of fearful and neutral faces in children (n = 12; 8–12 years) and adolescents (n = 12; 13–17 years). Memory for fearful faces was enhanced compared with neutral ones in adolescents, as opposed to children. In adolescents, activations associated with successful encoding of fearful faces were centered on baso-lateral AC nuclei, hippocampus, enthorhinal and parahippocampal cortices. In children, successful encoding of fearful faces relied on activations of centro-mesial AC nuclei, which was not accompanied by functional activation of MTL memory structures. Successful encoding of neutral faces depended on activations in anterior MTL region (hippocampal head and body) in adolescents, but more posterior ones (hippocampal tail and parahippocampal cortex) in children. In conclusion, two distinct functional specializations emerge from childhood to adolescence and result in the enhancement of memory for these particular stimuli: the specialization of baso-lateral AC nuclei, which is associated with the expertise in processing emotional facial expression, and which is intimately related to the specialization of MTL memory network. How the interplay between specialization of AC nuclei and of MTL memory structures is fundamental for the edification of social interactions remains to be elucidated.

Dynamics of Spatio-Temporal Binding in Rats

Time and space are commonly approached as two distinct dimensions, and rarely combined together in a single task, preventing a comparison of their interaction. In this project, using a version of a timing task with a spatial component, we investigate the learning of a spatio-temporal rule in animals. To do so, rats were placed in front of a five-hole nose-poke wall in a Peak Interval (PI) procedure to obtain a reward, with two spatio-temporal combination rules associated with different to-be-timed cues and lighting contexts. We report that, after successful learning of the discriminative task, a single Pavlovian session was sufficient for the animals to learn a new spatio-temporal association. This was seen as evidence for a beneficial transfer to the new spatio-temporal rule, as compared to control animals that did not experience the new spatio-temporal association during the Pavlovian session. The benefit was observed until nine days later. The results are discussed within the framework of adaptation to a change of a complex associative rule involving interval timing processes.

Neuropsychological consequences of childhood medulloblastoma and possible interventions: A review.

BACKGROUND Children who have been treated for a medulloblastoma often suffer long-term cognitive impairments that often negatively affect their academic performance and quality of life. In this article, we will review the neuropsychological consequences of childhood medulloblastoma and discuss the risk factors known to influence the presence and severity of these cognitive impairments and possible interventions to improve their quality of life. METHODS This narrative review was based on electronic searches of PubMed to identify all relevant studies. RESULTS Although many types of cognitive impairments often emerge during a childs subsequent development, the core cognitive domains that are most often affected in children treated for a medulloblastoma are processing speed, attention and working memory. The emergence and magnitude of these deficits varies greatly among patients. They are influenced by demographic (age at diagnosis, parental education), medical and treatment-related factors (perioperative complications, including posterior fossa syndrome, radiation therapy dose, etc.), and the quality of interventions such as school adaptations provided to the child or rehabilitation programs that focus on cognitive skills, behavior and psychosocial functioning. CONCLUSION These patients require specialized and coordinated multidisciplinary rehabilitation follow-up that provides timely and adapted assessments and culminates in personalized intervention goals being set with the patient and the family. Follow-up should be continued until referral to adult services.

Recent advances in functional magnetic resonance imaging: Contribution to pediatric epilepsy

New non-invasive functional magnetic resonance imaging (fMRI) techniques are deeply changing the exploration of epileptic and functional networks in childhood epilepsies, as well as of the normally developing brain. In this review, we first briefly describe the fMRI methods and the specificity, advantages and limitations of fMRI protocols and studies in pediatric epi- lepsies. Current fMRI applications in pediatric epilepsies mostly refer to presurgical mapping that can be performed with motor, language or memory tasks, and allows to select patients, tailor resection and sometimes predict postoperative cognitive outcome. Functional connectivity studies are currently emerging from resting state fMRI acquisitions to assess the possible consequences of epileptic activity on the development of functional long distance networks. Future directions for research applications, espe- cially connectivity analysis, and new developments such as electroencephalography-fMRI, will lead to better comprehensive descriptions of functional brain networks in pediatric epilepsy.