caa a22 4500 606203222 CHVBK 20210128105229.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00429-013-0684-6 doi (NATIONALLICENCE)springer-10.1007/s00429-013-0684-6 Insular and caudate lesions release abnormal yawning in stroke patients [Elektronische Daten] [Heinz Krestel, Christian Weisstanner, Christian Hess, Claudio Bassetti, Arto Nirkko, Roland Wiest] Abnormal yawning is an underappreciated phenomenon in patients with ischemic stroke. We aimed at identifying frequently affected core regions in the supratentorial brain of stroke patients with abnormal yawning and contributing to the anatomical network concept of yawning control. Ten patients with acute anterior circulation stroke and ≥3 yawns/15min without obvious cause were analyzed. The NIH stroke scale (NIHSS), Glasgow Coma Scale (GCS), symptom onset, period with abnormal yawning, blood oxygen saturation, glucose, body temperature, blood pressure, heart rate, and modified Rankin scale (mRS) were assessed for all patients. MRI lesion maps were segmented on diffusion-weighted images, spatially normalized, and the extent of overlap between the different stroke patterns was determined. Correlations between the period with abnormal yawning and the apparent diffusion coefficient (ADC) in the overlapping regions, total stroke volume, NIHSS and mRS were performed. Periods in which patients presented with episodes of abnormal yawning lasted on average for 58h. Average GCS, NIHSS, and mRS scores were 12.6, 11.6, and 3.5, respectively. Clinical parameters were within normal limits. Ischemic brain lesions overlapped in nine out of ten patients: in seven patients in the insula and in seven in the caudate nucleus. The decrease of the ADC within the lesions correlated with the period with abnormal yawing (r=−0.76, Bonferroni-corrected p=0.02). The stroke lesion intensity of the common overlapping regions in the insula and the caudate nucleus correlates with the period with abnormal yawning. The insula might be the long sought-after brain region for serotonin-mediated yawning. The Author(s), 2013 Chasm nationallicence Disconnection syndrome nationallicence Neurotransmitter release nationallicence Anterior cerebral circulation nationallicence MRI nationallicence Krestel Heinz Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut Weisstanner Christian University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland aut Hess Christian Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut Bassetti Claudio Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut Nirkko Arto Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut Wiest Roland University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland aut Brain Structure and Function Springer Berlin Heidelberg 220/2(2015-03-01), 803-812 1863-2653 220:2<803 2015 220 429 https://doi.org/10.1007/s00429-013-0684-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00429-013-0684-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Krestel Heinz Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Weisstanner Christian University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland aut NATIONALLICENCE 700 1- Hess Christian Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Bassetti Claudio Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Nirkko Arto Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Wiest Roland University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland aut NATIONALLICENCE 773 0- Brain Structure and Function Springer Berlin Heidelberg 220/2(2015-03-01), 803-812 1863-2653 220:2<803 2015 220 429 SWISSBIB 33451343X