Proximal intersection syndrome
In this study, we examined the correlation between the hippocampal volume laterality index and the relative lengths of the second index finger and fourth ring finger digits 2D:4D in healthy female subjects. The 2D:4D ratio is fixed in utero, and the ratio is higher in women than in men.
Intersection Syndrome / Crossover Syndrome / Squeaker's Wrist
There is evidence that this ratio is an indicator of the intrauterine concentration of testosterone, which influences the development of different regions of the brain. Assessing the volume of different parts of the brain of 40 healthy adult female students by magnetic resonance imaging MRIwe found that the 2D:4D ratio was associated with an asymmetry in the hippocampal sub-regions.
Smaller volume on proximal intersection syndrome left side was found in the posterior part of the hippocampus in females with a low masculine type 2D:4D ratio. On the other hand, smaller volume on the left side was found in the middle part of the h; ippocampus in females with a high female type 2D:4D ratio. Thus, the development of the middle and posterior regions of proximal intersection syndrome hippocampal formation may respond in opposite ways to prenatal levels of testosterone.
Other brain regions such as the amygdala, the cerebral cortex, the total volume hippocampus, proximal intersection syndrome the head of the hippocampus did not show such a difference. D Elsevier Ireland Ltd. All rights reserved.
E-mail address: janos. Kallai et al. Introduction Recent studies support the presence of significant gender differences in several psychiatric disorders that may reflect the interplay of sex hormones as well as neurodevelopmental and psychosocial sex differences Leung and Chue, Gonadal hormones, such as androgen, act in an organizational role before birth and influence the development of different brain areas, brain and body asymmetry, handedness, sexual orientation and cognitive skills in humans Kimura, In addition to brain laterality differences, other types of sex-dependent traits have been found, such as the relative lengths of the second index finger and fourth ring finger digits proximal intersection syndrome ratio in the right and left hands in females and males Manning et al.
The ratio between the length of the second and fourth digits in the right and left hands has a sexually dimorphic pattern. In comparison to females, males tend to have longer fourth digits in relationship to their second digits.
It is thought that low 2D:4D ratios are associated with high levels of prenatal testosterone and low oestrogen, and that high 2D:4D ratios are associated with low beteg térdízület kezelése of testosterone and high levels of proximal intersection syndrome in utero because a the sex difference in the 2D:4D ratio appears as early as 2 years of age and does not change at puberty Manning et al.
This correlation between the 2D:4D ratio and hormonal levels in adults may originate from an association between the 2D:4D ratio and prenatal hormonal level, with the 2D:4D ratio in adults reflecting prenatal hormonal conditions Manning et al.
The ability of androgenic steroids to influence the 2D:4D ratio is indicated by a study of homosexual men and women. The right-hand 2D:4D ratio of homosexual women is significantly more masculine i.
The differentiation of the genital system proximal intersection syndrome the appendicular skeleton in vertebrates is controlled by Homeobox Hox genes.
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Hox-d genes play a major role in the formation of an anatomical and physiological subdivision of the gut, the ileocaecal sphincter, and the proper digits, and therefore are important for the development of the lumbosacral area as well as for proper limb and urogenital development Zákány and Duboule, The distal limbs and the genital eminence are regions of apical growth and involve epithelial—mesenchymal interactions; they represent morphogenetic ends of the body, digits at the distal end of the limbs Kondo et al.
Manning et al. However, proximal intersection syndrome exact nature of these influences on the developing brain remains unclear. The prenatal testosterone concentration is critical for the differentiation of the laterality of several parts of the nervous system, and the development of visual— spatial judgment, speed, endurance and physical proximal intersection syndrome Geschwind and Galaburda, ; Hugdahl, ; Kimura, According to the testosterone hypothesis of proximal intersection syndrome development of brain laterality formulated by Geschwind and Galaburdatestosterone in utero inhibits the normal development of the left hemisphere, thus setting the stage for symmetry a kiálló fájdalom a csípőízületre sugárzik than asymmetry as a working principle between the cerebral hemispheres.
Significant brain asymmetries in normal subjects are seen in both of the cerebral hemispheres Galaburda,as well as in the hippocampus Pruessner et al.
Volumetric differences are frequently found between the two sides of the hippocampus in magnetic resonance imaging MRI. Unilateral volume decreases or atrophy of the hippocampal formation J. MRI studies of hippocampal volume in posttraumatic stress disorder have found that subjects who underwent physical or sexual abuse in childhood show smaller left hippocampal volume relative to matched controls without showing a corresponding decrease in the volumes of the amygdala, the caudate, and the temporal lobe Bremner et al.
Chronic schizophrenic patients show a bilateral reduction in the volume of the hippocampal formation compared with matched healthy controls. The extent of the reduction has been related to the severity of functional disorganization inappropriate affect, positive formal thought disorder, proximal intersection syndrome bizarre behavior but not to psychomotor poverty apathy, asociality, alogia or reality distortion hallucinations, delusions. However, no significant correlation has been reported between the clinical symptoms on psychiatric rating scales and the rate of hippocampus asymmetry Fukuzako et al.
Shenton et al. Proximal intersection syndrome levels of cortisol during depressive episodes and posttraumatic stress could cause hippocampal damage, leading to a reduction in volume Driessen et al.
Even though the effects of epilepsy Juhász et al. There are some experimental results on the correlation between intrauterine hormonal proximal intersection syndrome, currently circulating hormonal level, verbal recall performance, chronic stress, several psychiatric illnesses, individual brain development, and volume of the hippocampal formation Bremner et al.
However the exact nature of lateral volume differences in the hippocampal formation remains unclear Sullivan et al.
In the present study, the 2D:4D ratio was considered as an indicator of intrauterine testosterone concentration. We examined the 2D:4D ratio and circulating endogenous testosterone concentrations in relation to volumetric findings in subregions of the hippocampus in healthy adult women. Methods 2. Subjects Forty female subjects from the general population of the University of Pécs were recruited through advertisements. All volunteers were interviewed to ensure that they had no history of psychiatric or neurological illness.
All subjects scored in the normal range on the SCLR, were free of chronic medical conditions, and were not taking any medications that could influence the radioimmunoassay results. A full-scale Wechsler IQ Kun and Szegedi, score below was a criterion for exclusion from the study. All subjects were right-handed as indicated by the Chapman and Chapman Handedness Proximal intersection syndrome with righthanded scores from 11 to the upper quartile of the Handedness scores.
Subjects were reimbursed for their participation. Permission for the protocol was given by the Regional Research Ethics Committee of the Pécs Medical Center, and participants gave informed consent. Procedure 2. Measurement of second to fourth digit ratio The method of assessment of the right and left hand fingers was followed as described by Manning The length of the second and fourth digits was measured on the ventral surface of the hand from the basal crease of the digit proximal to the palm to the tip of the digit Proximal intersection syndrome.
Vernier calipers were used throughout this study.
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The measurement was performed three times by the same operator. The digit ratio was calculated by dividing the length of the second digit by that of the fourth digit 2D:4D. The repeatability of similar measurements made directly on digits has been high in previous studies e.
The results of the proximal intersection syndrome measures were averaged and con- J. MR investigation MRI-based volumetry was performed in all cases using a previously described method Watson et al. All scans were performed on a 1. Standard head position was used during the measurements, and all data were saved in 8-bit grayscale DICOM format for further analysis. Image analysis Images were transferred to a Suse Linux 7.
Six regions of interest ROI were measured: hippocampus, amygdala and a 3 mm thickness of hemisphere on both sides in accordance with the anatomic boundaries described below. CSF spaces were excluded from all parenchymal measurements, except the hemisphere. All ROIs were measured sequentially, slice-by-slice 1 mmusing a mousedriven cursor, for manual tracing.
Absolute volumes of right, left, and total hippocampus and amygdala were defined independently by two observers. The volumetric procedure was carried out manually. The averaged volumes were used for further analysis. To assess volume differences in MR images of hemisphere, amygdala, entire hippocampus, and anterior headmiddle body and posterior tail portions of hippocampus see Fig. VDI indicates the percentage of the right to left volume proximal intersection syndrome see Table 1.
A positive score proximal intersection syndrome that the right side is larger than the left side, and a negative score indicates the left side is larger than the right.
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Special sub-regions of brain volume were measured to carry out relative volume calculations. Small, welldefined brain regions were drawn from the level of foramen interventrivulare Monroi in the direction of the occipital lobe. The volumes of these 3-mm-thick slices were treated as brain volume BV. The relative Fig. A schematic representation of a female and a male type left hand.
The length of the second digit 2D and the fourth digit 4D was measured from the basal crease of the digit to the tip.
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The 2D:4D ratio was calculated by dividing the length proximal intersection syndrome the second digit by that of the fourth. The 2D:4D ratio was found to be negatively related to prenatal testosterone level. Right hippocampus Left hippocampus Total hippocampus Hippocampus right—left difference index Right hippocampus head Left hippocampus head Total hippocampus head Head right—left difference index Right hippocampus body Left hippocampus body Total hippocampus body Body right—left difference index Right hippocampus tail Left hippocampus tail Total hippocampus tail Tail lateraity index Right amygdala Left amygdala Gyógyítani a lábízületi betegségeket amygdala Amygdala right—left difference index Right hemisphere Left hemisphere Total hemisphere Hemisphere right—left difference index 2.
Anatomic boundaries of the regions of interest A standard anatomic protocol was used to define the borders of the hippocampus and amygdala published by Watson et al.
The measurements included hippocampus proper, dentate gyrus, subicular complex from subiculum to entorhinal cortex, alveus and fimbria.
It is difficult to define the boundaries of the hippocampus from its most anterior portion, the hippocampal head. The most reliable structure separating the head of the hippocampus from the amygdala in this region is the inferior horn of the lateral ventricle. Hence to standardize the measurement, the hippocampus drawing began anteriorly from the first slice where the inferior horn of the lateral ventricle appeared. To outline the boundary, proximal intersection syndrome drawing progressed along the hippocampal sulcus, medially to the inferior horn of the lateral ventricle and turned up laterally along the choroidal fissure.
The most posterior section of the hippocampus was measured in the sections with the crus of fornix clearly separated from the hippocampus and its fimbria. The average length measured was 30 mm for portions of hippocampus, see Fig. Anatomical boundaries of the hippocampus were drawn on the coronal slices. When a contour of the ROI was accepted, the projection area immediately appeared on the sagittal and axial images as well, allowing us to make the appropriate corrections if they were necessary.
Separating different subregions on the hippocampal models seems to be promising Watson et al.