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In the neuroimaging workup of a suspected ischemic stroke, the involvement of more than one arterial territory without an anatomical substrate should raise the suspicion of a stroke mimic. We report the case of a 61-year-old male with a new-onset headache and transient phasic disturbances who presented a pattern of vascular abnormalities characterized by left-hemispheric leptomeningeal vessel paucity and hypoperfusion.

Humans’ extraordinary ability to understand speech in noise relies on multiple processes that develop with age. Using magnetoencephalography (MEG), we characterize the underlying neuromaturational basis by quantifying how cortical oscillations in 144 participants (aged 5–27 years) track phrasal and syllabic structures in connected speech mixed with different types of noise. While the extraction of prosodic cues from clear speech was stable during development, its maintenance in a multi-talker background matured rapidly up to age 9 and was associated with speech comprehension. Furthermore, while the extraction of subtler information provided by syllables matured at age 9, its maintenance in noisy backgrounds progressively matured until adulthood. Altogether, these results highlight distinct behaviorally relevant maturational trajectories for the neuronal signatures of speech perception. In accordance with grain-size proposals, neuromaturational milestones are reached increasingly late for linguistic units of decreasing size, with further delays incurred by noise.

The Free and Cued Selective Reminding Test (FCSRT) is a largely validated neuropsychological test for the identification of amnestic syndrome from the early stage of Alzheimer’s disease (AD). Previous electrophysiological data suggested a slowing down of the alpha rhythm in the AD-continuum as well as a key role of this rhythmic brain activity for episodic memory processes. This study therefore investigates the link between alpha brain activity and alterations in episodic memory as assessed by the FCSRT. For that purpose, 37 patients with altered FCSRT performance underwent a comprehensive neuropsychological assessment, supplemented by 18F-fluorodeoxyglucose positron emission tomography/structural magnetic resonance imaging (18FDG-PET/MR), and 10 min of resting-state magnetoencephalography (MEG). The individual alpha peak frequency (APF) in MEG resting-state data was positively correlated with patients’ encoding efficiency as well as with the efficacy of semantic cues in facilitating patients’ retrieval of previous stored word. The APF also correlated positively with patients’ hippocampal volume and their regional glucose consumption in the posterior cingulate cortex. Overall, this study demonstrates that alterations in the ability to learn and store new information for a relatively short-term period are related to a slowing down of alpha rhythmic activity, possibly due to altered interactions in the extended mnemonic system. As such, a decreased APF may be considered as an electrophysiological correlate of short-term episodic memory dysfunction accompanying pathological aging.

Functional magnetic resonance imaging (fMRI) allowed the spatial characterization of the resting-state verbal language network (vLN). While other resting-state networks (RSNs) were matched with their electrophysiological equivalents at rest and could be spectrally defined, such correspondence is lacking for the vLN. This magnetoencephalography (MEG) study aimed at defining the spatio-spectral characteristics of the neuromagnetic intrinsic functional architecture of the vLN. Neuromagnetic activity was recorded at rest in 100 right-handed healthy adults (age range: 18–41 years). Band-limited power envelope correlations were performed within and across frequency bands (θ, α, β, and low γ) from a seed region placed in the left Broca’s area, using static orthogonalization as leakage correction. K-means clustering was used to segregate spatio-spectral clusters of resting-state functional connectivity (rsFC). Remarkably, unlike other RSNs, within-frequency long-range rsFC from the left Broca’s area was not driven by one main carrying frequency but was characterized by a specific spatio-spectral pattern segregated along the ventral (predominantly θ and α) and dorsal (β and low-γ bands) vLN streams. In contrast, spatial patterns of cross-frequency vLN functional integration were spectrally more widespread and involved multiple frequency bands. Moreover, the static intrinsic functional architecture of the neuromagnetic human vLN involved clearly left-hemisphere-dominant vLN interactions as well as cross-network interactions with the executive control network and postero-medial nodes of the DMN. Overall, this study highlighted the involvement of multiple modes of within and cross-frequency power envelope couplings at the basis of long-range electrophysiological vLN functional integration. As such, it lays the foundation for future works aimed at understanding the pathophysiology of language-related disorders.

Teaching Point: To recognize MRI findings in acute hyperammonemic encephalopathy Acute hyperammonemic encephalopathy is a rare but life-threatening condition that might complicate liver disease as well as non-hepatic conditions. It can lead to coma and death, secondary to brain edema and intracranial hypertension. We present three cases of acute hyperammonemic encephalopathy of different etiologies and the observed brain MRI findings. Symmetrical extensive cortical signal abnormalities, typically involving the insular and cingulate cortices, often showing restricted diffusion, are commonly described. These specific imaging features should be recognized by the radiologist since prompt treatment of the condition is paramount.