Optimized activation of the primary sensorimotor cortex for clinical functional MR imaging. (41/1471)

BACKGROUND AND PURPOSE: One application of functional MR imaging is to identify the primary sensorimotor cortex (M1 and S1) around the central sulcus before brain surgery. However, it has been shown that undesirable coactivation of nonprimary motor areas, such as the supplementary motor area and the premotor area, can interfere with the identification of the primary motor cortex, especially in patients with distorted anatomic landmarks. We therefore sought to design a simple functional MR imaging paradigm for selective activation of the primary sensorimotor cortex. METHODS: Different paradigms using finger tapping for motor activation were examined and compared with respect to the distribution of activated voxels in primary and nonprimary cortical areas. Studies were conducted in 14 healthy volunteers using a blood oxygen level-dependent multislice echo-planar imaging sequence. RESULTS: The most selective activation of the primary sensorimotor cortex was obtained with a paradigm combining right-sided finger tapping as the activation condition with left-sided finger tapping as the control condition. Analysis of the signal time course of primary and nonprimary areas revealed that the highly selective primary motor activation was due to it being restricted to contralateral finger movements, as opposed to the nonprimary motor areas, which were activated by ipsilateral, contralateral, and bilateral finger movements alike. CONCLUSION: When performing functional MR imaging to determine the location of the primary sensorimotor cortex, one should compare unilateral voluntary movements as the activation condition with contralateral movements as the control condition to accentuate activation of the primary motor area and to suppress undesirable coactivation of nonprimary motor areas.  (+info)

Dynamic CT perfusion to assess the effect of carotid revascularization in chronic cerebral ischemia. (42/1471)

We present the case of a female patient who was studied with dynamic contrast-enhanced CT perfusion before and after carotid revascularization. Before treatment, there was decreased perfusion in the ipsilateral insula, which was shown to be resolved on the scan obtained 1 day after treatment, indicating the technical success of the revascularization. In the ipsilateral basal ganglia, there was delayed contrast agent clearance from the tissue, which was attributed to vasodilation; after revascularization, there remained a subtle stenotic effect. The observed changes in the dynamic CT perfusion study suggest that this technique may be a useful tool in the evaluation of patients with asymmetrical cerebral blood flow.  (+info)

Mapping the visual recognition memory network with PET in the behaving baboon. (43/1471)

By means of a novel 18F-fluoro-deoxyglucose PET method designed for cognitive activation imaging in the baboon, the large-scale neural network involved in visual recognition memory in the nonhuman primate was mapped for the first time. In this method, the tracer is injected in the awake, unanesthetized, and unrestrained baboon performing the memory task, and brain imaging is performed later under light anesthesia. Brain maps obtained during a computerized trialunique delayed matching-to-sample task (lists of meaningless geometrical patterns and delay > 9 seconds) were statistically compared pixel-by-pixel to maps obtained during a specially designed visuomotor control task. When displayed onto the baboon's own anatomic magnetic resonance images, foci of significant activation were distributed along the ventral occipitotemporal pathway, the inferomedial temporal lobe (especially the perirhinal cortex and posterior hippocampal region), and the orbitofrontal cortex, consistent with lesion, single-unit, and autoradiographic studies in monkeys, as well as with activation studies in healthy humans. Additional activated regions included the nucleus basalis of Meynert, the globus pallidus and the putamen. The results also document an unexpected left-sided advantage, suggesting hemispheric functional specialization for recognition of figural material in nonhuman primates.  (+info)

Parallel visuomotor processing in the split brain: cortico-subcortical interactions. (44/1471)

We tested nine patients with callosal pathology in a simple reaction time task with and without redundant targets in the same or opposite visual hemifield. Four patients showed large facilitation (redundancy gain) in the presence of a redundant target, exceeding probability summation models (neural summation). Five patients showed redundancy gain not exceeding probability models. Violation of probability models was not associated with a specific type of callosal lesion. Neural summation, which probably occurs at collicular level, may be modulated by cortical activity. To test this hypothesis, we used functional MRI. During detection of redundant simultaneous targets, activations in the extrastriate cortex were observed in a patient with callosal agenesis and redundancy gain violating probability models, but not in a patient with callosal agenesis and redundancy gain not exceeding probability models. We conclude that cortical activity in the extrastriate cortex may be a modulating factor in the magnitude of the redundancy gain during parallel visuomotor transforms.  (+info)

Interhemispheric switching mediates perceptual rivalry. (45/1471)

BACKGROUND: Binocular rivalry refers to the alternating perceptual states that occur when the images seen by the two eyes are too different to be fused into a single percept. Logothetis and colleagues have challenged suggestions that this phenomenon occurs early in the visual pathway. They have shown that, in alert monkeys, neurons in the primary visual cortex continue to respond to their preferred stimulus despite the monkey reporting its absence. Moreover, they found that neural activity higher in the visual pathway is highly correlated with the monkey's reported percept. These and other findings suggest that the neural substrate of binocular rivalry must involve high levels, perhaps the same levels involved in reversible figure alternations. RESULTS: We present evidence that activation or disruption of a single hemisphere in human subjects affects the perceptual alternations of binocular rivalry. Unilateral caloric vestibular stimulation changed the ratio of time spent in each competing perceptual state. Transcranial magnetic stimulation applied to one hemisphere disrupted normal perceptual alternations when the stimulation was timed to occur at one phase of the perceptual switch, but not at the other. Furthermore, activation of a single hemisphere by caloric stimulation affected the perceptual alternations of a reversible figure, the Necker cube. CONCLUSIONS: Our findings suggest that interhemispheric switching mediates perceptual rivalry. Thus, competition for awareness in both binocular rivalry and reversible figures occurs between, rather than within, each hemisphere. This interhemispheric switch hypothesis has implications for understanding the neural mechanisms of conscious experience and also has clinical relevance as the rate of both types of perceptual rivalry is slow in bipolar disorder (manic depression).  (+info)

Categorization of unilaterally presented emotional words: an ERP analysis. (46/1471)

This study is intended to clarify the functional role of different ERP components as indicators of the processing of emotions. The effect of emotional connotation of words on hemispheric lateralization is also explored. Visual ERPs were recorded to unilaterally presented positive, negative, and neutral words that should be categorized according to their emotional connotation. The P2 amplitude was larger to positive than to negative words whereas P3 amplitude was larger to positive words compared with neutral ones. The slow positive wave (SPW) was influenced by words emotionality at anterior and posterior sites differently. The amplitude of the N1 component was larger in the left hemisphere to contralaterally presented words. The P2 and P3 components were larger over the left hemisphere whereas the N3 and N4 components were larger over the right hemisphere to ipsilateral stimulation. The results support our hypotheses on the functional role of positive ERP components in the processing of an affective words connotation: the P2 wave reflects a general evaluation of emotional significance, the P3 a task-related decision, and the SPW an additional decision control in the context of the emotional experience of an individual. Neither the "right hemisphere hypothesis" nor "valence hypothesis" on lateralization of the processing of emotions were confirmed. Each hemisphere seems to exert its effect on emotion through specific hemispheric resources that are unequally allocated along the different stages of task processing and may cause alternation of hemispheric dominance.  (+info)

Compensatory strategies for reaching in stroke. (47/1471)

A major prerequisite for successful rehabilitation therapy after stroke is the understanding of the mechanisms underlying motor deficits common to these patients. Studies have shown that in stroke patients multijoint pointing movements are characterized by decreased movement speed and increased movement variability, by increased movement segmentation and by spatial and temporal incoordination between adjacent arm joints with respect to healthy subjects. We studied how the damaged nervous system recovers or compensates for deficits in reaching, and correlated reaching deficits with the level of functional impairment. Nine right-hemiparetic subjects and nine healthy subjects participated. All subjects were right-hand dominant. Data from the affected arm of hemiparetic subjects were compared with those from the arm in healthy subjects. Seated subjects made 40 pointing movements with the right arm in a single session. Movements were made from an initial target, for which the arm was positioned alongside the trunk. Then the subject lifted the arm and pointed to the final target, located in front of the subject in the contralateral workspace. Kinematic data from the arm and trunk were recorded with a three-dimensional analysis system. Arm movements in stroke subjects were longer, more segmented, more variable and had larger movement errors. Elbow-shoulder coordination was disrupted and the range of active joint motion was decreased significantly compared with healthy subjects. Some aspects of motor performance (duration, segmentation, accuracy and coordination) were significantly correlated with the level of motor impairment. Despite the fact that stroke subjects encountered all these deficits, even subjects with the most severe motor impairment were able to transport the end-point to the target. All but one subject involved the trunk to accomplish this motor task. In others words, they recruited new degrees of freedom typically not used by healthy subjects. The use of compensatory strategies may be related to the degree of motor impairment: severely to moderately impaired subjects recruited new degrees of freedom to compensate for motor deficits while mildly impaired subjects tended to employ healthy movement patterns. We discuss the possibility that there is a critical level of recovery at which patients switch from a strategy employing new degrees of freedom to one in which motor recovery is produced by improving the management of degrees of freedom characteristic of healthy performance. Our data also suggest that stroke subjects may be able to exploit effectively the redundancy of the motor system.  (+info)

Differences in control of limb dynamics during dominant and nondominant arm reaching. (48/1471)

This study compares the coordination patterns employed for the left and right arms during rapid targeted reaching movements. Six right-handed subjects reached to each of three targets, designed to elicit progressively greater amplitude interaction torques at the elbow joint. All targets required the same elbow excursion (20 degrees ), but different shoulder excursions (5, 10, and 15 degrees, respectively). Movements were restricted to the shoulder and elbow and supported on a horizontal plane by a frictionless air-jet system. Subjects received visual feedback only of the final hand position with respect to the start and target locations. For motivation, points were awarded based on final position accuracy for movements completed within an interval of 400-600 ms. For all subjects, the right and left hands showed a similar time course of improvement in final position accuracy over repeated trials. After task adaptation, final position accuracy was similar for both hands; however, the hand trajectories and joint coordination patterns during the movements were systematically different. Right hand paths showed medial to lateral curvatures that were consistent in magnitude for all target directions, whereas the left hand paths had lateral to medial curvatures that increased in magnitude across the three target directions. Inverse dynamic analysis revealed substantial differences in the coordination of muscle and intersegmental torques for the left and right arms. Although left elbow muscle torque contributed largely to elbow acceleration, right arm coordination was characterized by a proximal control strategy, in which movement of both joints was primarily driven by the effects of shoulder muscles. In addition, right hand path direction changes were independent of elbow interaction torque impulse, indicating skillful coordination of muscle actions with intersegmental dynamics. In contrast, left hand path direction changes varied directly with elbow interaction torque impulse. These findings strongly suggest that distinct neural control mechanisms are employed for dominant and non dominant arm movements. However, whether interlimb differences in neural strategies are a consequence of asymmetric use of the two arms, or vice versa, is not yet understood. The implications for neural organization of voluntary movement control are discussed.  (+info)