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Cephalalgia. 2016 Feb;36(2):162-71. doi: 10.1177/0333102415585085. Epub 2015 May 1.

Reversible alterations of the neuronal activity in spontaneous intracranial hypotension.

Author information

1
Department of Radiology, Graduate School of Medicine, University of Tokyo, Japan amemiya-tky@umin.ac.jp.
2
Department of Neurosurgery, Sanno Hospital, Japan.
3
Department of Radiology, Sanno Hospital, Japan.
4
22nd Century Medical and Research Center, University of Tokyo, Japan.
5
Department of Radiology, Graduate School of Medicine, University of Tokyo, Japan.

Abstract

AIM:

The aim of this article is to investigate the pathophysiology underlying the alternation of the cognitive function and neuronal activity in spontaneous intracranial hypotension (SIH).

METHODS:

Fifteen patients with SIH underwent resting-state functional magnetic resonance imaging and working-memory (WM) test one day before and one month after a surgical operation. Alternation of the cognitive function and spontaneous neuronal activity measured as amplitude of the low-frequency fluctuations (ALFF) and the functional connectivity of the default-mode network (DMN) and frontoparietal networks (FPNs) were evaluated.

RESULTS:

WM performance significantly improved post-operatively. Whole-brain linear regression analysis of the ALFF revealed a positive correlation between cognitive performance change and ALFF change in the precuneus while a negative correlation was found in the bilateral orbitofrontal cortices (OFCs) and right medial frontal cortex (MFC). The ALFF changes normalised with the WM performance improvement post-operatively. The FPN activity in the right OFC was also increased pre-operatively. Partial correlation analysis revealed a significant correlation between WM performance and right OFC activity controlled for right FPN activity.

CONCLUSIONS:

The abnormal activity of the OFCs and MFC that is not originating from the synchronous intrinsic network activity, together with the decreased activity of the central node of the DMN, could lead to cognitive impairment in SIH that is reversible through restoration of the cerebrospinal fluid.

KEYWORDS:

Spontaneous intracranial hypotension; fMRI; spontaneous neuronal activity; working memory

PMID:
25934316
DOI:
10.1177/0333102415585085
[Indexed for MEDLINE]

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