INTRODUÇÃO: A ressonância magnética (RM) é, atualmente, uma das técnicas mais utilizadas para avaliação quantitativa do volume das estruturas cerebrais. Estudos com pessoas que preenchem critérios diagnósticos para dependência de álcool, utilizando esta técnica, demonstram atrofia cerebral nestes sujeitos, sendo que a região mais sensível e afetada pelos efeitos do álcool parece ser o córtex pré-frontal. A literatura revisada sugere que as subporções do córtex pré-frontal que podem ser mais suscetíveis aos efeitos do uso crônico do álcool são as regiões filogeneticamente mais recentes, como as áreas anterior e dorsolateral, enquanto que a área orbital, mais antiga, pode estar mais preservada. No entanto, nenhum estudo de RM morfométrica até hoje investigou possíveis diferenças no grau de comprometimento morfológico entre áreas de Brodmann (AB) distintas na região pré-frontal, em indivíduos que preenchem diagnóstico para dependência de álcool em comparação com voluntários saudáveis. OBJETIVO: O presente trabalho teve como objetivo realizar um estudo detalhado do impacto do álcool, especialmente sobre o córtex pré-frontal, parcelando-o em áreas de Brodmann, o que pode auxiliar para uma maior compreensão dos danos cerebrais subjacentes aos déficits cognitivos presentes em alcoolistas e ajudar no planejamento de estratégias terapêuticas e de reabilitação cognitiva. METODOLOGIA: A amostra foi composta por dois grupos: o grupo dependentes de álcool (DA), com 98 sujeitos que preenchiam critérios diagnósticos para dependência de álcool, e o grupo controle, com 73 sujeitos saudáveis pareados por idade, sexo e dominância cerebral. RESULTADOS: Foram encontradas diferenças estatisticamente significantes na volumetria cerebral, especialmente, no córtex frontal (substância cinzenta e líquor p<0,05) e parietal (substância cinzenta e líquor p<0,05). Quando dividido em AB, as áreas mais afetadas foram a AB 8 (SC p<0,001; L p<0,006), AB 9 (SC e L p<0,002) e AB 44 (L p=0,036 , SB p<0,005). CONCLUSÃO: Foi possível confirmar a hipótese inicial de que as áreas filogeneticamente jovens são mais sensíveis e vulneráveis à neurotoxidade do álcool, o qual, por sua vez, acelera o processo natural do envelhecimento, implicando perdas de substância cinzenta, principalmente nas áreas cognitivamente mais sofisticadas, como a anterior e a dorsolateral do córtex pré-frontal / INTRODUCTION: Magnetic resonance imaging (MRI) is currently one of the most widely used techniques for quantitative evaluation brain volume. MRI studies with people who meet diagnostic criteria for alcohol dependence show brain atrophy, especially on the prefrontal cortex, which seems to be the most sensitive and affected area by the neurotoxic effects of alcohol. The reviewed literature suggests that the sub-portions of the prefrontal cortex that may be more susceptible to the effects of chronic alcohol use are the phylogenetically newer regions such as the anterior and dorsolateral areas, while the orbital area, older than the others, may be preserved. However, no morphometric MRI study has investigated possible differences in the degree of morphological changes at Brodmann areas (BA) in prefrontal regions of people who meet the diagnosis for alcohol dependence compared with healthy volunteers. OBJECTIVE: The aim of this study was deep investigate alcohols impact, especially in the prefrontal cortex, dividing it in BA, which can contribute to a better understanding of the brain damage, underlying cognitive deficits present in alcoholics, and to help to establish treatment strategies and cognitive rehabilitation. METHODS: The sample comprised two groups: a group of alcohol dependent (AD) with 98 subjects, who met diagnostic criteria for alcohol dependence, and the control group consisted of 73 healthy subjects matched for age, sex and cerebral dominance. RESULTS: Statistically significant differences were found in the brain volume, mainly in the frontal cortex (gray matter and CSF p <0.05) and parietal cortex (gray matter, white matter and CSF p <0.05). When divided in Brodmann areas, the most affected one was: BA 8 (gray matter p <0.001; CSF p<0.006), BA 9 (gray matter and CSF p<0.002) and BA 44 (CSF p = 0.036, white matter p<0.005). CONCLUSION: It was possible to confirm the initial hypothesis that the phylogenetically younger areas are more sensitive and vulnerable to alcohol neurotoxicity, which accelerates the natural process of aging, implying loss of gray matter, especially in areas more cognitively sophisticated such as the anterior and the dorsolateral prefrontal areas

INTRODUÇÃO: A ressonância magnética (RM) é, atualmente, uma das técnicas mais utilizadas para avaliação quantitativa do volume das estruturas cerebrais. Estudos com pessoas que preenchem critérios diagnósticos para dependência de álcool, utilizando esta técnica, demonstram atrofia cerebral nestes sujeitos, sendo que a região mais sensível e afetada pelos efeitos do álcool parece ser o córtex pré-frontal. A literatura revisada sugere que as subporções do córtex pré-frontal que podem ser mais suscetíveis aos efeitos do uso crônico do álcool são as regiões filogeneticamente mais recentes, como as áreas anterior e dorsolateral, enquanto que a área orbital, mais antiga, pode estar mais preservada. No entanto, nenhum estudo de RM morfométrica até hoje investigou possíveis diferenças no grau de comprometimento morfológico entre áreas de Brodmann (AB) distintas na região pré-frontal, em indivíduos que preenchem diagnóstico para dependência de álcool em comparação com voluntários saudáveis. OBJETIVO: O presente trabalho teve como objetivo realizar um estudo detalhado do impacto do álcool, especialmente sobre o córtex pré-frontal, parcelando-o em áreas de Brodmann, o que pode auxiliar para uma maior compreensão dos danos cerebrais subjacentes aos déficits cognitivos presentes em alcoolistas e ajudar no planejamento de estratégias terapêuticas e de reabilitação cognitiva. METODOLOGIA: A amostra foi composta por dois grupos: o grupo dependentes de álcool (DA), com 98 sujeitos que preenchiam critérios diagnósticos para dependência de álcool, e o grupo controle, com 73 sujeitos saudáveis pareados por idade, sexo e dominância cerebral. RESULTADOS: Foram encontradas diferenças estatisticamente significantes na volumetria cerebral, especialmente, no córtex frontal (substância cinzenta e líquor p<0,05) e parietal (substância cinzenta e líquor p<0,05). Quando dividido em AB, as áreas mais afetadas foram a AB 8 (SC p<0,001; L p<0,006), AB 9 (SC e L p<0,002) e AB 44 (L p=0,036 , SB p<0,005). CONCLUSÃO: Foi possível confirmar a hipótese inicial de que as áreas filogeneticamente jovens são mais sensíveis e vulneráveis à neurotoxidade do álcool, o qual, por sua vez, acelera o processo natural do envelhecimento, implicando perdas de substância cinzenta, principalmente nas áreas cognitivamente mais sofisticadas, como a anterior e a dorsolateral do córtex pré-frontal / INTRODUCTION: Magnetic resonance imaging (MRI) is currently one of the most widely used techniques for quantitative evaluation brain volume. MRI studies with people who meet diagnostic criteria for alcohol dependence show brain atrophy, especially on the prefrontal cortex, which seems to be the most sensitive and affected area by the neurotoxic effects of alcohol. The reviewed literature suggests that the sub-portions of the prefrontal cortex that may be more susceptible to the effects of chronic alcohol use are the phylogenetically newer regions such as the anterior and dorsolateral areas, while the orbital area, older than the others, may be preserved. However, no morphometric MRI study has investigated possible differences in the degree of morphological changes at Brodmann areas (BA) in prefrontal regions of people who meet the diagnosis for alcohol dependence compared with healthy volunteers. OBJECTIVE: The aim of this study was deep investigate alcohols impact, especially in the prefrontal cortex, dividing it in BA, which can contribute to a better understanding of the brain damage, underlying cognitive deficits present in alcoholics, and to help to establish treatment strategies and cognitive rehabilitation. METHODS: The sample comprised two groups: a group of alcohol dependent (AD) with 98 subjects, who met diagnostic criteria for alcohol dependence, and the control group consisted of 73 healthy subjects matched for age, sex and cerebral dominance. RESULTS: Statistically significant differences were found in the brain volume, mainly in the frontal cortex (gray matter and CSF p <0.05) and parietal cortex (gray matter, white matter and CSF p <0.05). When divided in Brodmann areas, the most affected one was: BA 8 (gray matter p <0.001; CSF p<0.006), BA 9 (gray matter and CSF p<0.002) and BA 44 (CSF p = 0.036, white matter p<0.005). CONCLUSION: It was possible to confirm the initial hypothesis that the phylogenetically younger areas are more sensitive and vulnerable to alcohol neurotoxicity, which accelerates the natural process of aging, implying loss of gray matter, especially in areas more cognitively sophisticated such as the anterior and the dorsolateral prefrontal areas

Le but de cette thèse est d'étudier les corrélats comportementaux et neuronaux du transfert inter-linguistique (TIL) dans l'apprentissage d’une langue seconde (L2). Compte tenu de nos connaissances sur l'influence de la distance linguistique sur le TIL (Paradis, 1987, 2004; Odlin, 1989, 2004, 2005; Gollan, 2005; Ringbom, 2007), nous avons examiné l'effet de facilitation de la similarité phonologique à l’aide de la résonance magnétique fonctionnelle entre des langues linguistiquement proches (espagnol-français) et des langues linguistiquement éloignées (persan-français). L'étude I rapporte les résultats obtenus pour des langues linguistiquement proches (espagnol-français), alors que l'étude II porte sur des langues linguistiquement éloignées (persan-français). Puis, les changements de connectivité fonctionnelle dans le réseau langagier (Price, 2010) et dans le réseau de contrôle supplémentaire impliqué dans le traitement d’une langue seconde (Abutalebi & Green, 2007) lors de l’apprentissage d’une langue linguistiquement éloignée (persan-français) sont rapportés dans l’étude III. Les résultats des analyses d’IRMF suivant le modèle linéaire général chez les bilingues de langues linguistiquement proches (français-espagnol) montrent que le traitement des mots phonologiquement similaires dans les deux langues (cognates et clangs) compte sur un réseau neuronal partagé par la langue maternelle (L1) et la L2, tandis que le traitement des mots phonologiquement éloignés (non-clang-non-cognates) active des structures impliquées dans le traitement de la mémoire de travail et d'attention. Toutefois, chez les personnes bilingues de L1-L2 linguistiquement éloignées (français-persan), même les mots phonologiquement similaires à travers les langues (cognates et clangs) activent des régions connues pour être impliquées dans l'attention et le contrôle cognitif. Par ailleurs, les mots phonologiquement éloignés (non-clang-non-cognates) activent des régions usuellement associées à la mémoire de travail et aux fonctions exécutives. Ainsi, le facteur de distance inter-linguistique entre L1 et L2 module la charge cognitive sur la base du degré de similarité phonologiques entres les items en L1 et L2. Des structures soutenant les processus impliqués dans le traitement exécutif sont recrutées afin de compenser pour des demandes cognitives. Lorsque la compétence linguistique en L2 augmente et que les tâches linguistiques exigent ainsi moins d’effort, la demande pour les ressources cognitives diminue. Tel que déjà rapporté (Majerus, et al, 2008; Prat, et al, 2007; Veroude, et al, 2010; Dodel, et al, 2005; Coynel, et al ., 2009), les résultats des analyses de connectivité fonctionnelle montrent qu’après l’entraînement la valeur d'intégration (connectivité fonctionnelle) diminue puisqu’il y a moins de circulation du flux d'information. Les résultats de cette recherche contribuent à une meilleure compréhension des aspects neurocognitifs et de plasticité cérébrale du TIL ainsi que l'impact de la distance linguistique dans l'apprentissage des langues. Ces résultats ont des implications dans les stratégies d'apprentissage d’une L2, les méthodes d’enseignement d’une L2 ainsi que le développement d'approches thérapeutiques chez des patients bilingues qui souffrent de troubles langagiers. / The purpose of this thesis was to study the behavioral and neural correlates of Cross-linguistic Transfer effects (CLT) at the word level, in second language learning. Moreover, given that language distance has an impact on CLT, (Paradis, 1987, 2004, Odlin, 1989, 2004, 2005, Gollan, 2005, Ringbom, 2007), two distinct language pairs were examined: Close language pairs (Spanish-French) and distant language pairs (Persian-French). This thesis comprises three studies. In study I, Spanish speakers and in study II Persian speakers were trained for lexical learning until consolidation level. Cognates (phonologically and semantically similar words), Clangs (phonologically similar words with different meanings), and Non-cognate-non-clangs (semantically similar words), were presented in a picture naming task. Accuracy rates and response times as well as event-related fMRI BOLD responses to each word category were measured. Simple and direct contrasts with phonologically similar and phonologically distant words were performed. Thus, Study I reports the results of close languages (Spanish-French) and Study II, reports the results of distant languages (Persian-French). The neurocognitive processing of language learning was further investigated in terms of networks using functional connectivity analysis in distant languages (Persian-French) and the results are reported in Study III. The Results with the General Linear Model analysis show that with close language pairs (French-Spanish), the processing of phonologically similar words (cognates and clangs) relies upon a shared L1-L2 language specific neural areas, whereas processing of phonologically distant words (non-clang-non-cognates), activates L1 language processing areas, but also relies upon working memory, attentional, and processing structures. However, with distant language pairs (French-Persian), even phonologically similar words (cognates and clangs) activate areas known to be involved in attentional processing and cognitive control. Moreover, phonologically distant words (non-clang-non-cognates) also activate areas involved in working memory and executive function processing structures. Thus, the factor of L1-L2 cross-linguistic distance appears to modulate the executive load imposed to the system, on the basis of the degree of phonological overlap between L1-L2 items; thus in order to compensate for more effortful processing demands, the system recruits executive function supporting structures. The results of the connectivity analysis show that, in line with literature (Majerus, et al., 2008; Prat, et al., 2007; Veroude, et al., 2010; Dodel, et al., 2005; Coynel, et al., 2009), when the language proficiency is low, there is enhanced functional connectivity between and within language specific and other cognitive processing (working memory, attentional and cognitive control) networks. However, as proficiency increases, integration values (functional connectivity) decrease. This reflects that language tasks become less effortful and demand less cognitive resources. The results of this dissertation contribute to a better understanding of CLT effects on L2 learning, both in regards to different word types and L1-L2 language distance. These results have implications with regards to L2 learning and teaching strategies and approaches as well as with regards to the development of data-driven therapy approaches in the case of language break down in bilingual population.

Os tumores adrenocorticais (TAC) são lesões que se originam do córtex da glândula suprarrenal e ocorrem tanto em crianças quanto em adultos. Técnicas de imagem que forneçam informações quantitativas relativas à citoarquitetura desses tumores ainda não foram estabelecidas neste contexto. A difusão por ressonância magnética (DWI) é uma técnica que pode fornecer informações quantitativas dos tecidos através do valor do coeficiente aparente de difusão (ADC). O papel do ADC nas lesões tumorais adrenais tem sido estudado, porém sua relação com critérios histopatológicos e prognósticos ainda não foram descritos. O objetivo geral deste estudo é investigar a utilidade dos métodos de imagem realizando um paralelo na correlação clínica, histopatológica entre TAC em crianças e carcinoma adrenocortical (CAC) nos adultos. Os objetivos específicos são correlacionar os valores do ADC tumoral a escores histopatológicos, celularidade e Ki-67 tanto em crianças quanto em adultos, avaliando ainda a concordância entre-observadores nas medidas dos ADCs em pacientes e em controles. Este trabalho será baseado em três artigos, nos quais mostrarão a metodologia, resultados e discussões relativos à cada uma das etapas. O primeiro artigo, \"Neoplasias adrenocorticais em adultos e crianças: apresentações distintas. Revisão dos aspectos clínicos, patológicos e do diagnostico por imagem\" trata-se de uma revisão da literatura e análise comparativa sobre as características clínicas, histopatológicas e por imagem dos TAC em crianças e adultos. O segundo artigo, Estudo dos parâmetros derivados do histograma do coeficiente aparente de difusão obtido pela técnica de difusão por RM na avaliação de prognóstico do carcinoma adrenocortical\", estudou CAC em adultos e buscou associar o ADC com os critérios clínicos, histopatológicos, celularidade e o Ki-67. No terceiro artigo \"Tumores Adrenocorticais Pediátricos valores de ADC na diferenciação entre adenomas e carcinomas e sua relação com critérios histopatológicos\" foi realizado em crianças com TAC buscando uma tentativa de diferenciação pelo ADC entre tumores com comportamentos benignos e malignos seja clínica ou histopatologicamente. Os valores de ADCmínimo (ADCmín) e máximo nos adultos, demonstraram ser úteis para diferenciar controles de pacientes com CAC. O ADCmín nos pacientes adultos com CACs evidenciaram que podem ser utilizados para inferir celularidade tumoral. Este estudo ainda reafirmou em adultos com CAC, os valores do Ki-67 como marcador prognóstico e demonstrou uma boa relação da celularidade com o sistema de Weiss. Já nas crianças, houve correlação inversa de alguns dos valores do ADCs com o peso tumoral. Os valores de ADCs não demonstraram relação com a celularidade e com o comportamento clínico e histopatológico dos pacientes, reafirmando, portanto, a peculiaridade dos TAC pediátricos em relação à população adulta. Apesar de neste estudo, os valores de ADCs terem sido mais baixos nos TACs e em CACs que os valores na glândula saudável e de nos adultos ter havido correlação do ADCmín e a celularidade tumoral e em criança com o peso lesional, estas alterações não foram suficientes para predizer objetivamente, critérios preditores de agressividade tumoral ou de prognóstico, podendo eventualmente no futuro, representar uma ferramenta para tal. / Adrenocortical tumors (TAC) are lesions that originate from the cortex of the adrenal gland and occur in children and also in adults. Imaging techniques that provide quantitative information about the citoarchitecture of these tumors have not been established in this context yet. The diffusion magnetic resonance imaging (DWI) is a technique that can provide quantitative information of the tissues by the value of the apparent diffusion coefficient (ADC). The role of the ADC in adrenal tumors has been studied, however its relationship with histopathological prognostic criteria has not been described yet. The aim of this study is to investigate the usefulness of imaging methods performing a parallel in the clinical and histopathologic correlation of the TACs in children and adrenocortical carcinoma (CAC) in adults. The specific objectives are to correlate the values of tumor ADC histopathologic scores, cellularity and Ki-67 in children and also in adults, still evaluating the agreement between observers in the measurements of ADCs in patients and controls. This study will be based on three articles in which show the methodology, results and discussions relating to each of the steps. The first paper, \"Adrenocortical neoplasms in adults and children: different presentations. Review of clinical, pathological and diagnostic imaging \" is about a literature review and comparative analysis of the clinical, histopathological and imaging of CT in children and adults. The second article, \"Utility of the parameters derived from the histogram of the apparent diffusion coefficient obtained by MR diffusion technique in the assessment of adrenocortical carcinoma prognosis,\" studied CAC in adults and sought to link the ADC with the clinical, histopathological, cellularity and Ki-67 of these lesions. In the third paper \"Pediatric adrenocortical tumors: ADC values to differentiate between adenomas and carcinomas and its correlation with histopathological criteria\" was conducted in children with TAC seeking an attempt to differentiate between the ADC tumors with benign and malignant behavior either in clinical or histopathological prism. The ADCmín and max values in adults proven to be useful to differentiate patients from controls. The ADC min in adult patients with CACs showed that it could be used to infer tumor cellularity. This study also reaffirmed in adults with CAC, the values of Ki-67 as a prognostic marker and demonstrated a good relationship with Weiss score and cellularity. Also in children, there was a significant inverse correlation of some of the ADCs values with tumor weight. Some ADCs values showed no relationship to the cellularity and the clinical and histopathological behavior of patients, re-affirming therefore the peculiarity of pediatric TAC relation to the adult population. Despite this study, the ADCs values were lower in TACs and CACs than the values in healthy gland and also that in adults have been correlation the ADCmín and tumor cellularity and in children with weight, these changes were not enough to predict objectively, criteria predictive of tumor aggressiveness and prognosis possibly could in the future represent a tool for such.

Le but de cette thèse est d'étudier les corrélats comportementaux et neuronaux du transfert inter-linguistique (TIL) dans l'apprentissage d’une langue seconde (L2). Compte tenu de nos connaissances sur l'influence de la distance linguistique sur le TIL (Paradis, 1987, 2004; Odlin, 1989, 2004, 2005; Gollan, 2005; Ringbom, 2007), nous avons examiné l'effet de facilitation de la similarité phonologique à l’aide de la résonance magnétique fonctionnelle entre des langues linguistiquement proches (espagnol-français) et des langues linguistiquement éloignées (persan-français). L'étude I rapporte les résultats obtenus pour des langues linguistiquement proches (espagnol-français), alors que l'étude II porte sur des langues linguistiquement éloignées (persan-français). Puis, les changements de connectivité fonctionnelle dans le réseau langagier (Price, 2010) et dans le réseau de contrôle supplémentaire impliqué dans le traitement d’une langue seconde (Abutalebi & Green, 2007) lors de l’apprentissage d’une langue linguistiquement éloignée (persan-français) sont rapportés dans l’étude III. Les résultats des analyses d’IRMF suivant le modèle linéaire général chez les bilingues de langues linguistiquement proches (français-espagnol) montrent que le traitement des mots phonologiquement similaires dans les deux langues (cognates et clangs) compte sur un réseau neuronal partagé par la langue maternelle (L1) et la L2, tandis que le traitement des mots phonologiquement éloignés (non-clang-non-cognates) active des structures impliquées dans le traitement de la mémoire de travail et d'attention. Toutefois, chez les personnes bilingues de L1-L2 linguistiquement éloignées (français-persan), même les mots phonologiquement similaires à travers les langues (cognates et clangs) activent des régions connues pour être impliquées dans l'attention et le contrôle cognitif. Par ailleurs, les mots phonologiquement éloignés (non-clang-non-cognates) activent des régions usuellement associées à la mémoire de travail et aux fonctions exécutives. Ainsi, le facteur de distance inter-linguistique entre L1 et L2 module la charge cognitive sur la base du degré de similarité phonologiques entres les items en L1 et L2. Des structures soutenant les processus impliqués dans le traitement exécutif sont recrutées afin de compenser pour des demandes cognitives. Lorsque la compétence linguistique en L2 augmente et que les tâches linguistiques exigent ainsi moins d’effort, la demande pour les ressources cognitives diminue. Tel que déjà rapporté (Majerus, et al, 2008; Prat, et al, 2007; Veroude, et al, 2010; Dodel, et al, 2005; Coynel, et al ., 2009), les résultats des analyses de connectivité fonctionnelle montrent qu’après l’entraînement la valeur d'intégration (connectivité fonctionnelle) diminue puisqu’il y a moins de circulation du flux d'information. Les résultats de cette recherche contribuent à une meilleure compréhension des aspects neurocognitifs et de plasticité cérébrale du TIL ainsi que l'impact de la distance linguistique dans l'apprentissage des langues. Ces résultats ont des implications dans les stratégies d'apprentissage d’une L2, les méthodes d’enseignement d’une L2 ainsi que le développement d'approches thérapeutiques chez des patients bilingues qui souffrent de troubles langagiers. / The purpose of this thesis was to study the behavioral and neural correlates of Cross-linguistic Transfer effects (CLT) at the word level, in second language learning. Moreover, given that language distance has an impact on CLT, (Paradis, 1987, 2004, Odlin, 1989, 2004, 2005, Gollan, 2005, Ringbom, 2007), two distinct language pairs were examined: Close language pairs (Spanish-French) and distant language pairs (Persian-French). This thesis comprises three studies. In study I, Spanish speakers and in study II Persian speakers were trained for lexical learning until consolidation level. Cognates (phonologically and semantically similar words), Clangs (phonologically similar words with different meanings), and Non-cognate-non-clangs (semantically similar words), were presented in a picture naming task. Accuracy rates and response times as well as event-related fMRI BOLD responses to each word category were measured. Simple and direct contrasts with phonologically similar and phonologically distant words were performed. Thus, Study I reports the results of close languages (Spanish-French) and Study II, reports the results of distant languages (Persian-French). The neurocognitive processing of language learning was further investigated in terms of networks using functional connectivity analysis in distant languages (Persian-French) and the results are reported in Study III. The Results with the General Linear Model analysis show that with close language pairs (French-Spanish), the processing of phonologically similar words (cognates and clangs) relies upon a shared L1-L2 language specific neural areas, whereas processing of phonologically distant words (non-clang-non-cognates), activates L1 language processing areas, but also relies upon working memory, attentional, and processing structures. However, with distant language pairs (French-Persian), even phonologically similar words (cognates and clangs) activate areas known to be involved in attentional processing and cognitive control. Moreover, phonologically distant words (non-clang-non-cognates) also activate areas involved in working memory and executive function processing structures. Thus, the factor of L1-L2 cross-linguistic distance appears to modulate the executive load imposed to the system, on the basis of the degree of phonological overlap between L1-L2 items; thus in order to compensate for more effortful processing demands, the system recruits executive function supporting structures. The results of the connectivity analysis show that, in line with literature (Majerus, et al., 2008; Prat, et al., 2007; Veroude, et al., 2010; Dodel, et al., 2005; Coynel, et al., 2009), when the language proficiency is low, there is enhanced functional connectivity between and within language specific and other cognitive processing (working memory, attentional and cognitive control) networks. However, as proficiency increases, integration values (functional connectivity) decrease. This reflects that language tasks become less effortful and demand less cognitive resources. The results of this dissertation contribute to a better understanding of CLT effects on L2 learning, both in regards to different word types and L1-L2 language distance. These results have implications with regards to L2 learning and teaching strategies and approaches as well as with regards to the development of data-driven therapy approaches in the case of language break down in bilingual population.

Os tumores adrenocorticais (TAC) são lesões que se originam do córtex da glândula suprarrenal e ocorrem tanto em crianças quanto em adultos. Técnicas de imagem que forneçam informações quantitativas relativas à citoarquitetura desses tumores ainda não foram estabelecidas neste contexto. A difusão por ressonância magnética (DWI) é uma técnica que pode fornecer informações quantitativas dos tecidos através do valor do coeficiente aparente de difusão (ADC). O papel do ADC nas lesões tumorais adrenais tem sido estudado, porém sua relação com critérios histopatológicos e prognósticos ainda não foram descritos. O objetivo geral deste estudo é investigar a utilidade dos métodos de imagem realizando um paralelo na correlação clínica, histopatológica entre TAC em crianças e carcinoma adrenocortical (CAC) nos adultos. Os objetivos específicos são correlacionar os valores do ADC tumoral a escores histopatológicos, celularidade e Ki-67 tanto em crianças quanto em adultos, avaliando ainda a concordância entre-observadores nas medidas dos ADCs em pacientes e em controles. Este trabalho será baseado em três artigos, nos quais mostrarão a metodologia, resultados e discussões relativos à cada uma das etapas. O primeiro artigo, \"Neoplasias adrenocorticais em adultos e crianças: apresentações distintas. Revisão dos aspectos clínicos, patológicos e do diagnostico por imagem\" trata-se de uma revisão da literatura e análise comparativa sobre as características clínicas, histopatológicas e por imagem dos TAC em crianças e adultos. O segundo artigo, Estudo dos parâmetros derivados do histograma do coeficiente aparente de difusão obtido pela técnica de difusão por RM na avaliação de prognóstico do carcinoma adrenocortical\", estudou CAC em adultos e buscou associar o ADC com os critérios clínicos, histopatológicos, celularidade e o Ki-67. No terceiro artigo \"Tumores Adrenocorticais Pediátricos valores de ADC na diferenciação entre adenomas e carcinomas e sua relação com critérios histopatológicos\" foi realizado em crianças com TAC buscando uma tentativa de diferenciação pelo ADC entre tumores com comportamentos benignos e malignos seja clínica ou histopatologicamente. Os valores de ADCmínimo (ADCmín) e máximo nos adultos, demonstraram ser úteis para diferenciar controles de pacientes com CAC. O ADCmín nos pacientes adultos com CACs evidenciaram que podem ser utilizados para inferir celularidade tumoral. Este estudo ainda reafirmou em adultos com CAC, os valores do Ki-67 como marcador prognóstico e demonstrou uma boa relação da celularidade com o sistema de Weiss. Já nas crianças, houve correlação inversa de alguns dos valores do ADCs com o peso tumoral. Os valores de ADCs não demonstraram relação com a celularidade e com o comportamento clínico e histopatológico dos pacientes, reafirmando, portanto, a peculiaridade dos TAC pediátricos em relação à população adulta. Apesar de neste estudo, os valores de ADCs terem sido mais baixos nos TACs e em CACs que os valores na glândula saudável e de nos adultos ter havido correlação do ADCmín e a celularidade tumoral e em criança com o peso lesional, estas alterações não foram suficientes para predizer objetivamente, critérios preditores de agressividade tumoral ou de prognóstico, podendo eventualmente no futuro, representar uma ferramenta para tal. / Adrenocortical tumors (TAC) are lesions that originate from the cortex of the adrenal gland and occur in children and also in adults. Imaging techniques that provide quantitative information about the citoarchitecture of these tumors have not been established in this context yet. The diffusion magnetic resonance imaging (DWI) is a technique that can provide quantitative information of the tissues by the value of the apparent diffusion coefficient (ADC). The role of the ADC in adrenal tumors has been studied, however its relationship with histopathological prognostic criteria has not been described yet. The aim of this study is to investigate the usefulness of imaging methods performing a parallel in the clinical and histopathologic correlation of the TACs in children and adrenocortical carcinoma (CAC) in adults. The specific objectives are to correlate the values of tumor ADC histopathologic scores, cellularity and Ki-67 in children and also in adults, still evaluating the agreement between observers in the measurements of ADCs in patients and controls. This study will be based on three articles in which show the methodology, results and discussions relating to each of the steps. The first paper, \"Adrenocortical neoplasms in adults and children: different presentations. Review of clinical, pathological and diagnostic imaging \" is about a literature review and comparative analysis of the clinical, histopathological and imaging of CT in children and adults. The second article, \"Utility of the parameters derived from the histogram of the apparent diffusion coefficient obtained by MR diffusion technique in the assessment of adrenocortical carcinoma prognosis,\" studied CAC in adults and sought to link the ADC with the clinical, histopathological, cellularity and Ki-67 of these lesions. In the third paper \"Pediatric adrenocortical tumors: ADC values to differentiate between adenomas and carcinomas and its correlation with histopathological criteria\" was conducted in children with TAC seeking an attempt to differentiate between the ADC tumors with benign and malignant behavior either in clinical or histopathological prism. The ADCmín and max values in adults proven to be useful to differentiate patients from controls. The ADC min in adult patients with CACs showed that it could be used to infer tumor cellularity. This study also reaffirmed in adults with CAC, the values of Ki-67 as a prognostic marker and demonstrated a good relationship with Weiss score and cellularity. Also in children, there was a significant inverse correlation of some of the ADCs values with tumor weight. Some ADCs values showed no relationship to the cellularity and the clinical and histopathological behavior of patients, re-affirming therefore the peculiarity of pediatric TAC relation to the adult population. Despite this study, the ADCs values were lower in TACs and CACs than the values in healthy gland and also that in adults have been correlation the ADCmín and tumor cellularity and in children with weight, these changes were not enough to predict objectively, criteria predictive of tumor aggressiveness and prognosis possibly could in the future represent a tool for such.

L’aphasie est un trouble acquis du langage entraînant des problèmes de communication pouvant toucher la compréhension et/ou l’expression. Lorsque l’aphasie fait suite à un accident vasculaire cérébral, une régression des déficits communicatifs s'observe initialement, mais elle peut demeurer sévère pour certains et est considérée chronique après un an. Par ailleurs, l’aphasie peut aussi être observée dans l’aphasie progressive primaire, une maladie dégénérative affectant uniquement le langage dans les premières années. Un nombre grandissant d’études s’intéressent à l’impact de la thérapie dans l’aphasie chronique et ont démontré des améliorations langagières après plusieurs années. L’hémisphère gauche semble avoir un rôle crucial et est associé à de meilleures améliorations langagières, mais la compréhension des mécanismes de plasticité cérébrale est encore embryonnaire. Or, l’efficacité de la thérapie dans l’aphasie progressive primaire est peu étudiée. À l’aide de la résonance magnétique fonctionnelle, le but des présentes études consiste à examiner les mécanismes de plasticité cérébrale induits par la thérapie Semantic Feature Analysis auprès de dix personnes souffrant d’aphasie chronique et d’une personne souffrant d’aphasie progressive primaire. Les résultats suggèrent que le cerveau peut se réorganiser plusieurs années après une lésion cérébrale ainsi que dans une maladie dégénérative. Au niveau individuel, une meilleure amélioration langagière est associée au recrutement de l’hémisphère gauche ainsi qu’une concentration des activations. Les analyses de groupe mettent en évidence le recrutement du lobule pariétal inférieur gauche, alors que l’activation du gyrus précentral gauche prédit l’amélioration suite à la thérapie. D’autre part, les analyses de connectivité fonctionnelle ont permis d’identifier pour la première fois le réseau par défaut dans l’aphasie. Suite à la thérapie, l’intégration de ce réseau bien connu est comparable à celle des contrôles et les analyses de corrélation suggèrent que l’intégration du réseau par défaut a une valeur prédictive d’amélioration. Donc, les résultats de ces études appuient l’idée que l’hémisphère gauche a un rôle prépondérant dans la récupération de l’aphasie et fournissent des données probantes sur la neuroplasticité induite par une thérapie spécifique du langage dans l’aphasie. De plus, l’identification d’aires clés et de réseaux guideront de futures recherches afin d’éventuellement maximiser la récupération de l’aphasie et permettre de mieux prédire le pronostic. / Aphasia is an acquired language impairment leading to communication disorders which may affect comprehension and/or expression. When aphasia follows a stroke, major recovery of the communicative deficits is initially observed after the lesion, but for some the aphasia may remain severe and is considered to be chronic after a year. Furthermore aphasia can be observed in primary progressive aphasia, a degenerative disease only affecting language in the early years. The impact of therapy in chronic aphasia is the subject of growing literature in recent years and has shown language improvements after several years of therapy. The left hemisphere seems to have a crucial role and is associated with greater language improvements but our understanding of brain plasticity mechanisms is still lacking. In primary progressive aphasia, few studies have examined therapy effectiveness. Using functional magnetic resonance imaging, the aim of these studies was to examine therapy-induced brain plasticity mechanisms following Semantic Feature Analysis in ten participants suffering from chronic aphasia and one participant with primary progressive aphasia. The results suggest that brain reorganization is possible several years after injury and in degenerative disease. At the individual level, greater language improvement is associated with the recruitment of the left hemisphere and less activated areas. Group analysis shows the recruitment of left inferior parietal lobule, whereas the activation of left precentral gyrus predicts improved response to therapy. Functional connectivity analysis allowed for the first time the identification of the default-mode network in aphasia. Following therapy, the integration of this well-known network is comparable to that of the controls and the correlation analysis suggests that the default-mode network integration has a predictive value for improvement. Therefore, the results of these studies support the idea that the left hemisphere has a major role in the recovery of aphasia and provide evidence on therapy-induced neuroplasticity in aphasia. In addition, the identification of key areas and networks will guide future research in order to possibly maximize the recovery of aphasia and to better predict the prognosis.

L’aphasie est un trouble acquis du langage entraînant des problèmes de communication pouvant toucher la compréhension et/ou l’expression. Lorsque l’aphasie fait suite à un accident vasculaire cérébral, une régression des déficits communicatifs s'observe initialement, mais elle peut demeurer sévère pour certains et est considérée chronique après un an. Par ailleurs, l’aphasie peut aussi être observée dans l’aphasie progressive primaire, une maladie dégénérative affectant uniquement le langage dans les premières années. Un nombre grandissant d’études s’intéressent à l’impact de la thérapie dans l’aphasie chronique et ont démontré des améliorations langagières après plusieurs années. L’hémisphère gauche semble avoir un rôle crucial et est associé à de meilleures améliorations langagières, mais la compréhension des mécanismes de plasticité cérébrale est encore embryonnaire. Or, l’efficacité de la thérapie dans l’aphasie progressive primaire est peu étudiée. À l’aide de la résonance magnétique fonctionnelle, le but des présentes études consiste à examiner les mécanismes de plasticité cérébrale induits par la thérapie Semantic Feature Analysis auprès de dix personnes souffrant d’aphasie chronique et d’une personne souffrant d’aphasie progressive primaire. Les résultats suggèrent que le cerveau peut se réorganiser plusieurs années après une lésion cérébrale ainsi que dans une maladie dégénérative. Au niveau individuel, une meilleure amélioration langagière est associée au recrutement de l’hémisphère gauche ainsi qu’une concentration des activations. Les analyses de groupe mettent en évidence le recrutement du lobule pariétal inférieur gauche, alors que l’activation du gyrus précentral gauche prédit l’amélioration suite à la thérapie. D’autre part, les analyses de connectivité fonctionnelle ont permis d’identifier pour la première fois le réseau par défaut dans l’aphasie. Suite à la thérapie, l’intégration de ce réseau bien connu est comparable à celle des contrôles et les analyses de corrélation suggèrent que l’intégration du réseau par défaut a une valeur prédictive d’amélioration. Donc, les résultats de ces études appuient l’idée que l’hémisphère gauche a un rôle prépondérant dans la récupération de l’aphasie et fournissent des données probantes sur la neuroplasticité induite par une thérapie spécifique du langage dans l’aphasie. De plus, l’identification d’aires clés et de réseaux guideront de futures recherches afin d’éventuellement maximiser la récupération de l’aphasie et permettre de mieux prédire le pronostic. / Aphasia is an acquired language impairment leading to communication disorders which may affect comprehension and/or expression. When aphasia follows a stroke, major recovery of the communicative deficits is initially observed after the lesion, but for some the aphasia may remain severe and is considered to be chronic after a year. Furthermore aphasia can be observed in primary progressive aphasia, a degenerative disease only affecting language in the early years. The impact of therapy in chronic aphasia is the subject of growing literature in recent years and has shown language improvements after several years of therapy. The left hemisphere seems to have a crucial role and is associated with greater language improvements but our understanding of brain plasticity mechanisms is still lacking. In primary progressive aphasia, few studies have examined therapy effectiveness. Using functional magnetic resonance imaging, the aim of these studies was to examine therapy-induced brain plasticity mechanisms following Semantic Feature Analysis in ten participants suffering from chronic aphasia and one participant with primary progressive aphasia. The results suggest that brain reorganization is possible several years after injury and in degenerative disease. At the individual level, greater language improvement is associated with the recruitment of the left hemisphere and less activated areas. Group analysis shows the recruitment of left inferior parietal lobule, whereas the activation of left precentral gyrus predicts improved response to therapy. Functional connectivity analysis allowed for the first time the identification of the default-mode network in aphasia. Following therapy, the integration of this well-known network is comparable to that of the controls and the correlation analysis suggests that the default-mode network integration has a predictive value for improvement. Therefore, the results of these studies support the idea that the left hemisphere has a major role in the recovery of aphasia and provide evidence on therapy-induced neuroplasticity in aphasia. In addition, the identification of key areas and networks will guide future research in order to possibly maximize the recovery of aphasia and to better predict the prognosis.