Browsing by Author "Stecher, Ximena"
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Publication Association between spontaneous internal carotid artery dissection and perivascular adipose tissue attenuation on computed tomography angiography(2023) Cheng, Kevin; Lin, Andrew; Stecher, Ximena; Bernstein, Tomas; Zuñiga, Paulo; Mazzon, Enrico; Brunse, Alejandro; Diaz, Violeta; Martinez, Gonzalo; Cameron, William; Nicholls, Stephen; Patel, Sanjay; Dey, Damini; Wong, Dennis; Muñoz Venturelli, PaulaBackground: Spontaneous cervical artery dissection (sCAD) is a leading cause of ischemic stroke in young patients. Studies using high-resolution magnetic resonance imaging and positron emission tomography have suggested vessel wall inflammation to be a pathogenic factor in sCAD. Computed tomography (CT) attenuation of perivascular adipose tissue (PVAT) is an established non-invasive imaging biomarker of inflammation in coronary arteries, with higher attenuation values reflecting a greater degree of vascular inflammation. Objectives: We evaluate the CT attenuation of PVAT surrounding the internal carotid artery (PVATcarotid) with and without spontaneous dissection. Methods: Single-centre prospective observational study of 56 consecutive patients with CT-verified spontaneous dissection of the internal carotid artery (ICA) admitted between 2011 and 2018. Of these patients, 6 underwent follow-up CTA. 22 patients who underwent CTA for acute neurological symptoms but did not have dissection formed the control group. Using semiautomated research software, PVATcarotid was measured as the mean Hounsfield Unit (HU) attenuation of adipose tissue within a defined volume of interest surrounding the ICA. Results: PVATcarotid was significantly higher around dissected ICA compared with non-dissected contralateral ICA in the same patients (-58.7±10.2 vs. -68.9±8.1 HU, P<0.0001) and ICA of patients without dissection (-58.7±10.2 vs. -69.3±9.3 HU, P<0.0001). After a median follow-up of 89 days, there was a significant reduction in PVATcarotid around dissected ICA (from -57.5±13.4 to -74.3±10.5 HU, P<0.05); while no change was observed around non-dissected contralateral ICA (from -71.0±4.4 to -74.1±4.1 HU, P=0.19). ICA dissection was an independent predictor of PVATcarotid following multivariable adjustment for age and the presence of ICA occlusion.Publication Cervical artery dissection in postpartum women after cesarean and vaginal delivery(2022) Urrutia, Francisca; Mazzon, Enrico; Brunser, Alejandro; Díaz, Violeta; Calderon, Juan; Stecher, Ximena; Bernstein, Tomas; Zuñiga, Paulo; Schilling, Andrea; Muñoz, PaulaBackground and aims: Cervical artery dissection (CAD) is an infrequent but potentially disabling and fatal disease, accounting for up to 25 % of strokes in young adults. Pregnancy-related hormonal changes and increased hemodynamic stress on artery walls during vaginal delivery have been associated to CAD. We aim to describe a series of women presenting CAD during postpartum (PP) after cesarean and vaginal delivery. Methods: CAD women admitted to one hospital in Santiago, Chile, between July 2018 and October 2020 were included in a prospective cohort. Demographic, clinical and imaging data were registered for the PP group. Results: Sixty-seven women were diagnosed with CAD, from which 10 were PP. Seven women had cesarean section and 3 had vaginal delivery. They presented CAD related symptoms after a median of 10.5 (IQR 5-15) days from delivery. All of them had headache as initial symptom, 9 presented cervical pain and 8 had a family history of stroke. Four patients presented preeclampsia during pregnancy. Acute treatment consisted mostly in antiplatelet agents and analgesics. None of these patients had a CAD related stroke. Demographic, clinical and imaging characteristics of these women with CAD during PP are described. Conclusions: This case series underpins the importance of clinical suspicion of CAD after delivery, highlighting the fact that CAD is not limited to women with vaginal delivery, thus alternative causes beyond acute hemodynamic stress could be involved. Further research is required to determine genetic components, along with deeper knowledge of modulating factors related to CAD in this setting.Item Cervical Artery Dissections with and without stroke, risk factors and prognosis: a Chilean prospective cohort(2020) Mazzon, Enrico; Rocha, D.; Brunser, Alejandro; Barra, C. de la; Stecher, Ximena; Bernstein, T.; Zúñiga, P.; Díaz, V.; Martínez, G.; Muñoz Venturelli, PaulaWe aimed to characterize spontaneous cervical artery dissection (CeAD) patients with and without stroke and describe risk factors for cerebrovascular complications in a Chilean prospective cohort. Methods: Consecutive CeAD patients admitted to a Chilean center confirmed by neuroimaging. Logistic regression was used. Results: 168 patients were included, median follow-up time was 157 days. Stroke occurred in 49 (29.2%) cases, 4 (2%) patients died, all of whom had a stroke, and 10 (6%) presented CeAD recurrence. In univariate analyses, men (odds ratio [OR] 3.97, 95% confidence interval [CI] 1.97-8.00, P < 0.001), internal carotid artery CeAD (OR 2.82, 95% CI 1.38-5.78, P = 0.005) and vessel occlusion (OR 4.45, 95% CI 1.38-14.38, P = 0.035) increased stroke risk. Conversely, vertebral artery dissection (OR 0.35, 95% CI 0.16-0.74, P = 0.006) and longer symptom onset to admission (O-A) time (OR 0.79, 95% CI 0.70-0.90, P < 0.001) were associated to decreased stroke risk. After multivariate analysis, men (OR 2.88, 95% CI 1.32-6.27, P = 0.008) and O-A time (OR 0.80, 95% CI 0.69-0.92, P = 0.002) remained independently associated with stroke. Conclusion: CeAD presented commonly as a non-stroke entity, with favorable prognosis. Albeit to a higher frequency of CeAD in women, stroke occurred predominantly in men, who were admitted earlier.Item Children with epilepsy demonstrate macro- and microstructural changes in the thalamus, putamen, and amygdala(2020) MacEachern, Sarah J; Santoro, Jonathan D; Hahn, Kara J; Medress, Zachary A; Stecher, Ximena; D Li, Matthew; Hahn, Jin S; Yeom, Kristen W; Forkert, Nils DPurpose: Despite evidence for macrostructural alteration in epilepsy patients later in life, little is known about the underlying pathological or compensatory mechanisms at younger ages causing these alterations. The aim of this work was to investigate the impact of pediatric epilepsy on the central nervous system, including gray matter volume, cerebral blood flow, and water diffusion, compared with neurologically normal children. Methods: Inter-ictal magnetic resonance imaging data was obtained from 30 children with epilepsy ages 1-16 (73% F, 27% M). An atlas-based approach was used to determine values for volume, cerebral blood flow, and apparent diffusion coefficient in the cerebral cortex, hippocampus, thalamus, caudate, putamen, globus pallidus, amygdala, and nucleus accumbens. These values were then compared with previously published values from 100 neurologically normal children using a MANCOVA analysis. Results: Most brain volumes of children with epilepsy followed a pattern similar to typically developing children, except for significantly larger putamen and amygdala. Cerebral blood flow was also comparable between the groups, except for the putamen, which demonstrated decreased blood flow in children with epilepsy. Diffusion (apparent diffusion coefficient) showed a trend towards higher values in children with epilepsy, with significantly elevated diffusion within the thalamus in children with epilepsy compared with neurologically normal children. Conclusion: Children with epilepsy show statistically significant differences in volume, diffusion, and cerebral blood flow within their thalamus, putamen, and amygdala, suggesting that epilepsy is associated with structural changes of the central nervous system influencing brain development and potentially leading to poorer neurocognitive outcomes.Publication Functional Dizziness as a Spatial Cognitive Dysfunction(2024) Breinbauer, Hayo; Stecher, Ximena; Zamorano, Francisco; Billeke, Pablo; Arévalo, Camilo; Villarroel, Karen; Lavin, Claudio; Faúndez, Felipe; Garrido, Rosario; Alarcón, Kevin; Delano, Paul(1) Background: Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve disrupted spatial cognition processes as a core feature. (2) Methods: A cohort of 19 PPPD patients underwent psycho-cognitive testing, including assessments for anxiety, depression, memory, attention, planning, and executive functions, with an emphasis on spatial navigation via a virtual Morris water maze. These patients were compared with 12 healthy controls and 20 individuals with other vestibular disorders but without PPPD. Vestibular function was evaluated using video head impulse testing and vestibular evoked myogenic potentials, while brain magnetic resonance imaging was used to exclude confounding pathology. (3) Results: PPPD patients demonstrated unique impairments in allocentric spatial navigation (as evidenced by the virtual Morris water maze) and in other high-demand visuospatial cognitive tasks that involve executive functions and planning, such as the Towers of London and Trail Making B tests. A factor analysis highlighted spatial navigation and advanced visuospatial functions as being central to PPPD, with a strong correlation to symptom severity. (4) Conclusions: PPPD may broadly impair higher cognitive functions, especially in spatial cognition. We discuss a disruption in the creation of enriched cognitive spatial maps as a possible pathophysiology for PPPDItem Lateral prefrontal activity as a compensatory strategy for deficits of cortical processing in Attention Deficit Hyperactivity Disorder(2017) Zamorano, Francisco; Aboitiz, Francisco; Carrasco, Ximena; López, Vladimir; Hurtado, José M.; Stecher, Ximena; Larraín, Josefina; Kausel, Leonie; Billeke, PabloAttention Deficit Hyperactivity Disorder (ADHD) is the most common neuropsychiatric disorder in childhood and is characterized by a delay of cortical maturation in frontal regions. In order to investigate interference control, which is a key function of frontal areas, a functional MRI study was conducted on 17 ADHD boys and 17 typically developing (TD) boys, while solving the multi source interference task (MSIT). This task consists of two conditions, a "congruent condition" and an "incongruent condition". The latter requires to inhibit information that interferes with task-relevant stimuli. Behavioral results showed that ADHD subjects committed more errors than TD children. In addition, TD children presented a larger MSIT effect -a greater difference in reaction times between the incongruent and the congruent conditions- than ADHD children. Associated to the MSIT effect, neuroimaging results showed a significant enhancement in the activation of the right lateral prefrontal cortex (rlPFC) in ADHD than in TD subjects. Finally, ADHD subjects presented greater functional connectivity between rlPFC and bilateral orbitofrontal cortex than the TD group. This difference in connectivity correlated with worse performance in both groups. Our results could reflect a compensatory strategy of ADHD children resulting from their effort to maintain an adequate performance during MSIT.Item Lateral Prefrontal Theta Oscillations Reflect Proactive Cognitive Control Impairment in Males With Attention Deficit Hyperactivity Disorder(2020-06) Zamorano, Francisco; Kausel, Leonie; Albornoz, Carlos; Lavin, Claudio; Figueroa-Vargas, Alejandra; Stecher, Ximena; Aragón-Caqueo, Diego; Carrasco, Ximena; Aboitiz, Francisco; Billeke, Pablottention Deficit Hyperactivity Disorder (ADHD) is a common neuropsychiatric disorder in which children present prefrontal cortex (PFC) related functions deficit. Proactive cognitive control is a process that anticipates the requirement of cognitive control and crucially depends on the maturity of the PFC. Since this process is important to ADHD symptomatology, we here test the hypothesis that children with ADHD have proactive cognitive control impairments and that these impairments are reflected in the PFC oscillatory activity. We recorded EEG signals from 29 male children with ADHD and 25 typically developing (TD) male children while they performed a Go-Nogo task, where the likelihood of a Nogo stimulus increased while a sequence of consecutive Go stimuli elapsed. TD children showed proactive cognitive control by increasing their reaction time (RT) concerning the number of preceding Go stimuli, whereas children with ADHD did not. This adaptation was related to modulations in both P3a potential and lateral prefrontal theta oscillation for TD children. Children with ADHD as a group did not demonstrate either P3a or theta modulation. But, individual variation in theta activity was correlated with the ADHD symptomatology. The results depict a neurobiological mechanism of proactive cognitive control impairments in children with ADHD.Item Morphometric analysis program: Detection of epileptic foci in young children using an adult normative database: Initial experience(2021) Stecher, Ximena; Schonstedt, Valeria; Manterola, Carla; Velásquez, Álvaro; Zamorano, Francisco; Carreño, Fernando; Castillo, MauricioObjective: To report our initial experience using an adult-template MAP in drugresistant focal epilepsy in five children with apparently normal MRI. Methods: Patients selected were highly suspicious of harboring focal structural lesions and had negative brain MRI studies. MAP was performed using a locally obtained adult database as a template. Results were reviewed by two neuroradiologists. Pertinence of MAP-positive areas was confirmed by the focal epileptic hypothesis or by pathology when possible (J Neuroradiol, 39, 2012, 87). Visual analysis was performed using Mango Software. MRI studies were reanalyzed at the workstation with knowledge of the clinical suspicion to confirm or discard the possibility of FCD. Results: Five patients aged 19-48 months were studied, all with initial 3T MRI studies interpreted as normal. All had focal epileptic hypothesis with coherence of clinical seizure characterization and electroencephalographic findings. In two patients, histology showed type 1 FCD. Due to the age of our subjects, the junction map always highlighted the subcortical white matter in relationship to maturity differences. FCD was identified as asymmetric U-shaped highlighted regions in the junction map. Significance: FCD is the most frequent pathology reported in pediatric epilepsy surgery series (Epileptic Disord, 18, 2016, 240). Significant number of FCDs may be overlooked on MRIs, reducing the odds of seizure freedom after surgery (Epilepsy Res, 89, 2010, 310). MAP is an image postprocessing method for enhanced visualization of FCD; however, when using an adult template in developing brains, normal subcortical regions may be highlighted as pathological. Creating a pediatric template is difficult, due to the need for general anesthesia to acquire the MRI database. Here, we were able to show that MAP identified FCDs as asymmetric “U-” shaped highlighted regions in the junction maps of all five patients, which may indicate that obtaining childhood databases for this purpose may not be necessary and that adult ones suffice for diagnosis of FCD.Item Neonatal brain microstructure correlates of neurodevelopment and gait in preterm children 18-22 mo of age: an MRI and DTI study(Karger, 2015) Rose, Jessica; Cahill-Rowley, Katelyn; Vassar, Rachel; Yeom, Kristen; Stecher, Ximena; Stevenson, David; Hintz, Susan; Barnea-Goraly, NaamaBACKGROUND: Near-term brain structure was examined in preterm infants in relation to neurodevelopment. We hypothesized that near-term macrostructural brain abnormalities identified using conventional magnetic resonance imaging (MRI), and white matter (WM) microstructure detected using diffusion tensor imaging (DTI), would correlate with lower cognitive and motor development and slower, less-stable gait at 18-22 mo of age. METHODS: One hundred and two very-low-birth-weight preterm infants (≤1,500 g birth weight; ≤32 wk gestational age) were recruited prior to routine near-term brain MRI at 36.6 ± 1.8 wk postmenstrual age. Cerebellar and WM macrostructure was assessed on conventional structural MRI. DTI was obtained in 66 out of 102 and WM microstructure was assessed using fractional anisotropy and mean diffusivity (MD) in six subcortical brain regions defined by DiffeoMap neonatal atlas. Neurodevelopment was assessed with Bayley-Scales-of-Infant-Toddler-Development, 3rd-Edition (BSID-III); gait was assessed using an instrumented mat. RESULTS: Neonates with cerebellar abnormalities identified using MRI demonstrated lower mean BSID-III cognitive composite scores (89.0 ± 10.1 vs. 97.8 ± 12.4; P = 0.002) at 18-22 mo. Neonates with higher DTI-derived left posterior limb of internal capsule (PLIC) MD demonstrated lower cognitive and motor composite scores (r = -0.368; P = 0.004; r = -0.354; P = 0.006) at 18-22 mo; neonates with higher genu MD demonstrated slower gait velocity (r = -0.374; P = 0.007). Multivariate linear regression significantly predicted cognitive (adjusted r(2) = 0.247; P = 0.002) and motor score (adjusted r(2) = 0.131; P = 0.017). CONCLUSION: Near-term cerebellar macrostructure and PLIC and genu microstructure were predictive of early neurodevelopment and gait.Item Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants.(Elsevier, 2014) Rose, Jessica; Vassar, Rachel; Cahill-Rowley, Katelyn; Stecher, Ximena; Hintz, Susan; Stevenson, David; Barnea-Goraly, NaamaStructural brain abnormalities identified at near-term age have been recognized as potential predictors of neurodevelopment in children born preterm. The aim of this study was to examine the relationship between neonatal physiological risk factors and early brain structure in very-low-birth-weight (VLBW) preterm infants using structural MRI and diffusion tensor imaging (DTI) at near-term age. Structural brain MRI, diffusion-weighted scans, and neonatal physiological risk factors were analyzed in a cross-sectional sample of 102 VLBW preterm infants (BW ≤ 1500 g, gestational age (GA) ≤ 32 weeks), who were admitted to the Lucile Packard Children's Hospital, Stanford NICU and recruited to participate prior to routine near-term brain MRI conducted at 36.6 ± 1.8 weeks postmenstrual age (PMA) from 2010 to 2011; 66/102 also underwent a diffusion-weighted scan. Brain abnormalities were assessed qualitatively on structural MRI, and white matter (WM) microstructure was analyzed quantitatively on DTI in six subcortical regions defined by DiffeoMap neonatal brain atlas. Specific regions of interest included the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, the thalamus, and the globus pallidus. Regional fractional anisotropy (FA) and mean diffusivity (MD) were calculated using DTI data and examined in relation to neonatal physiological risk factors including gestational age (GA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis, as well as serum levels of C-reactive protein (CRP), glucose, albumin, and total bilirubin. Brain abnormalities were observed on structural MRI in 38/102 infants including 35% of females and 40% of males. Infants with brain abnormalities observed on MRI had higher incidence of BPD (42% vs. 25%) and sepsis (21% vs. 6%) and higher mean and peak serum CRP levels, respectively, (0.64 vs. 0.34 mg/dL, p = .008; 1.57 vs. 0.67 mg/dL, p= .006) compared to those without. The number of signal abnormalities observed on structural MRI correlated to mean and peak CRP (rho = .316, p = .002; rho = .318, p= .002). The number of signal abnormalities observed on MRI correlated with thalamus MD (left: r= .382, p= .002; right: r= .400, p= .001), controlling for PMA-at-scan. Thalamus WM microstructure demonstrated the strongest associations with neonatal risk factors. Higher thalamus MD on the left and right, respectively, was associated with lower GA (r = −.322, p = .009; r= −.381, p= .002), lower mean albumin (r = −.276, p= .029; r= −.385, p= .002), and lower mean bilirubin (r = −.293, p= .020; r= −.337 p= .007). Results suggest that at near-term age, thalamus WM microstructure may be particularly vulnerable to certain neonatal risk factors. Interactions between albumin, bilirubin, phototherapy, and brain development warrant further investigation. Identification of physiological risk factors associated with selective vulnerability of certain brain regions at near-term age may clarify the etiology of neurodevelopmental impairment and inform neuroprotective treatment for VLBW preterm infants.Item Neural Dynamics of Improved Bimodal Attention and Working Memory in Musically Trained Children(2020-10) Kausel, Leonie; Zamorano, Francisco; Billeke, Pablo; Sutherland, Mary E.; Larraín-Valenzuela, Josefina; Stecher, Ximena; Schlaug, Gottfried; Aboitiz, FranciscoAttention and working memory (WM) are core components of executive functions, and they can be enhanced by training. One activity that has shown to improve executive functions is musical training, but the brain networks underlying these improvements are not well known. We aimed to identify, using functional MRI (fMRI), these networks in children who regularly learn and play a musical instrument. Girls and boys aged 10-13 with and without musical training completed an attention and WM task while their brain activity was measured with fMRI. Participants were presented with a pair of bimodal stimuli (auditory and visual) and were asked to pay attention only to the auditory, only to the visual, or to both at the same time. The stimuli were afterward tested with a memory task in order to confirm attention allocation. Both groups had higher accuracy on items that they were instructed to attend, but musicians had an overall better performance on both memory tasks across attention conditions. In line with this, musicians showed higher activation than controls in cognitive control regions such as the fronto-parietal control network during all encoding phases. In addition, facilitated encoding of auditory stimuli in musicians was positively correlated with years of training and higher activity in the left inferior frontal gyrus and the left supramarginal gyrus, structures that support the phonological loop. Taken together, our results elucidate the neural dynamics that underlie improved bimodal attention and WM of musically trained children and contribute new knowledge to this model of brain plasticity.Publication Patients recovering from COVID-19 who presented with anosmia during their acute episode have behavioral, functional, and structural brain alterations(2024) Kausel, Leonie; Figueroa-Vargas, Alejandra; Zamorano, Francisco; Stecher, Ximena; Aspé-Sánchez, Mauricio; Carvajal-Paredes, Patricio; Márquez-Rodríguez, Víctor; Martínez-Molina, María Paz; Román, Claudio; Soto-Fernández, Patricio; Valdebenito-Oyarzo, Gabriela; Manterola, Carla; Uribe-San-Martín, Reinaldo; Silva, Claudio; Henríquez-Ch, Rodrigo; Aboitiz, Francisco; Polania, Rafael; Guevara, Pamela; Muñoz-Venturelli, Paula; Soto-Icaza, Patricia; Billeke, PabloPatients recovering from COVID-19 commonly exhibit cognitive and brain alterations, yet the specific neuropathological mechanisms and risk factors underlying these alterations remain elusive. Given the significant global incidence of COVID-19, identifying factors that can distinguish individuals at risk of developing brain alterations is crucial for prioritizing follow-up care. Here, we report findings from a sample of patients consisting of 73 adults with a mild to moderate SARS-CoV-2 infection without signs of respiratory failure and 27 with infections attributed to other agents and no history of COVID-19. The participants underwent cognitive screening, a decision-making task, and MRI evaluations. We assessed for the presence of anosmia and the requirement for hospitalization. Groups did not differ in age or cognitive performance. Patients who presented with anosmia exhibited more impulsive alternative changes after a shift in probabilities (r = − 0.26, p = 0.001), while patients who required hospitalization showed more perseverative choices (r = 0.25, p = 0.003). Anosmia correlated with brain measures, including decreased functional activity during the decision-making task, thinning of cortical thickness in parietal regions, and loss of white matter integrity. Hence, anosmia could be a factor to be considered when identifying at-risk populations for follow-upPublication Radiología en el estudio de la macrocefalia. ¿Por qué?, ¿cuándo?, ¿cómo?(2022) Schonstedt, V.; Stecher, Ximena; Manterola, Carla; Roviraf, À.Macrocephaly is a clinical term defined as an occipitofrontal circumference more than two standard deviations above the mean. It is present in 5% of children and is a common indication for imaging studies. There are multiple causes of macrocephaly; most of them are benign. Nevertheless, in some cases, macrocephaly is the clinical manifestation of a condition that requires timely medical and/or surgical treatment. The importance of imaging studies lies in identifying the patients who would benefit from treatment. Children with macrocephaly associated with neurologic alterations, neurocutaneous stigmata, delayed development, or rapid increase of the circumference have a greater risk of having disease. By contrast, parental macrocephaly is predictive of a benign condition. Limiting imaging studies to patients with increased risk makes it possible to optimize resources and reduce unnecessary exposure to tests. Macrocefalia es un término clínico definido como el incremento de la circunferencia occipitofrontal por encima de dos desviaciones estándar. Se presenta en el 5% de los niños y es una indicación frecuente de estudios radiológicos. Existen múltiples causas de macrocefalia, que corresponden mayoritariamente a condiciones benignas. Sin embargo, en algunos casos es la manifestación clínica de una patología que requiere una oportuna intervención médico-quirúrgica. La relevancia del estudio radiológico radica en la identificación de estos pacientes. Aquellos niños que se presentan con macrocefalia asociada a alteraciones neurológicas, estigmas neurocutáneos, retraso del desarrollo o rápido aumento de la circunferencia craneal poseen un riesgo aumentado de presentar patología. Por el contrario, el antecedente de macrocefalia parenteral es predictivo de una condición benigna. Acotar el estudio radiológico a los pacientes de mayor riesgo permite optimizar recursos y disminuir la exposición innecesaria a exámenes.Item RM de encéfalo sin anestesia en pacientes recién nacidos. Experiencia inicial en Clínica Alemana de Santiago(2014) Sánchez D., Nicolás; Castoldi L., María Francesca; Stecher, XimenaIntroducción: Dado casos de hipotermia en recién nacidos (RN) posterior a resonancia magnética (RM) con anestesia y reproduciendo lo observado en centros extranjeros visitados, implementamos protocolo supervisado para evaluar los resultados de RM encefálicas realizadas sin anestesia o sedación en pacientes hospitalizados en nuestra institución. Objetivo: Mostrar resultados del protocolo para realización de RM encefálica sin anestesia en nuestros pacientes RN. Materiales y métodos: Estudio retrospectivo, evaluamos RM encefálicas realizadas en RN entre septiembre 2012 - julio 2013. Se aplicó protocolo para realización de RM sin anestesia en pacientes institucionalizados. Se comparan variables con RM realizadas con anestesia en ese periodo. Resultados: Se realizaron 22 RM encefálicas, 14 sin anestesia. La duración del estudio sin anestesia fue de 48 minutos promedio, obteniendo imágenes adecuadas en 13 estudios, reprogramando el examen con anestesia en un caso. Conclusiones: el protocolo implementado permite obtener RM encefálicas de calidad diagnóstica, obviando la anestesiaPublication The parietal cortex has a causal role in ambiguity computations in humans(2024) Valdebenito-Oyarzo, Gabriela; Martínez-Molina, María Paz; Soto-Icaza, Patricia; Zamorano, Francisco; Figueroa-Vargas, Alejandra; Larraín-Valenzuela, Josefina; Stecher, Ximena; Salinas, César; Bastin, Julien; Valero-Cabré, Antoni; Polania, RafaelHumans often face the challenge of making decisions between ambiguous options. The level of ambiguity in decision-making has been linked to activity in the parietal cortex, but its exact computational role remains elusive. To test the hypothesis that the parietal cortex plays a causal role in computing ambiguous probabilities, we conducted consecutive fMRI and TMS-EEG studies. We found that participants assigned unknown probabilities to objective probabilities, elevating the uncertainty of their decisions. Parietal cortex activity correlated with the objective degree of ambiguity and with a process that underestimates the uncertainty during decision-making. Conversely, the midcingulate cortex (MCC) encodes prediction errors and increases its connectivity with the parietal cortex during outcome processing. Disruption of the parietal activity increased the uncertainty evaluation of the options, decreasing cingulate cortex oscillations during outcome evaluation and lateral frontal oscillations related to value ambiguous probability. These results provide evidence for a causal role of the parietal cortex in computing uncertainty during ambiguous decisions made by humans.Item Us versus them mentality in football fans: Significant social defeat engages the mentalization network and disengages cognitive control areas [version 1; peer review: awaiting peer review](2022) Zamorano, Francisco; Carvajal-Paredes, Patricio; Soto-Icaza, Patricia; Stecher, Ximena; Salinas, César; Muñuz-Reyes, José Antonio; López, Vladimir; Méndez, Valdemar; Barrera, Joel; Aragón-Caqueo, Gonzalo; Billeke, PabloBackground: Social affiliation is one of the building blocks that shapes cultures and communities. This motivation contributes to the development of social bonding among individuals within a group, enjoying rights, assuming obligations, and strengthening its identity. Evidence has shown that social affiliation has inspired different social phenomena, such as wars, political movements, social struggles, among others, based on two human motivations: the ingroup love and the outgroup hate. One contemporary group to study as a proxy of social affiliation, and ingroup and outgroup motivations is the sports competition. However, this affiliation model has been poorly considered in social neuroscience research. This research aimed to shed light on the neurobiological networks that are related to social affiliation in football fans of two of the most popular Chilean football teams. Methods: To this end, 43 male fans of two football rival teams watched videos of winning and losing goals of their favorite team while their brain activity was measured with functional magnetic resonance imaging (fMRI). Results: The results showed that while the activation of the reward system was observed in fans when their team scores goals against the rival, both the activation of the mentalization network and the inhibition of the dorsal anterior cingulate cortex were associated with the emotional correlates of defeat in football fans. Conclusions: Taking these findings together could contribute to a deeper understanding of social affiliation, and more importantly, of extreme affiliation phenomena, and fanaticismPublication Us versus them mentality in football fans: Significant social defeat engages the mentalization network and disengages cognitive control areas [version 1; peer review: awaiting peer review](2023) Zamorano, Francisco; Patricio Carvajal-Paredes; Soto-Icaza, Patricia; Stecher, Ximena; Salinas, César; Muñoz Reyes, José Antonio; López, Vladimir; Méndez, Waldemar; Barrera, Joel; Aragón-Caqueo, Gonzalo; Billeke, Pablo; Carvajal Paredes, FranciscoBackground: Social affiliation is one of the building blocks that shapes cultures and communities. This motivation contributes to the development of social bonding among individuals within a group, enjoying rights, assuming obligations, and strengthening its identity. Evidence has shown that social affiliation has inspired different social phenomena, such as wars, political movements, social struggles, among others, based on two human motivations: the ingroup love and the outgroup hate. One contemporary group to study as a proxy of social affiliation, and ingroup and outgroup motivations is the sports competition. However, this affiliation model has been poorly considered in social neuroscience research. This research aimed to shed light on the neurobiological networks that are related to social affiliation in football fans of two of the most popular Chilean football teams. Methods: To this end, 43 male fans of two football rival teams watched videos of winning and losing goals of their favorite team while their brain activity was measured with functional magnetic resonance imaging (fMRI). Results: The results showed that while the activation of the reward system was observed in fans when their team scores goals against the rival, both the activation of the mentalization network and the inhibition of the dorsal anterior cingulate cortex were associated with the emotional correlates of defeat in football fans. Conclusions: Taking these findings together could contribute to a deeper understanding of social affiliation, and more importantly, of extreme affiliation phenomena, and fanaticism.Item Vigabatrin-induced MRI changes associated with extrapyramidal symptoms in a child with infantile spasms(Sage Publications, 2015) Schonstedt, Valeria; Stecher, Ximena; Venegas, Viviana; Silva, ClaudioVigabatrin is an antiepileptic drug used for treatment of infantile spasms. We present a female patient with infantile spasms in treatment with vigabatrin who developed ataxic movements. MRI demonstrated a symmetrical pattern of thalamic and globi pallidi diffusion restriction. While these image features have been widely described to be related to the use of vigabatrin, this case highlights the development of movement disorders in association with MRI signal changes. Awareness of the reversible nature of this condition is reassuring for the treating team and avoids unjustified studies.