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Biomedical subjects

Ian Law

Publications and source records attributed to Ian Law.

At least 19 recordsLinked to original sources
PubMed2006

Kawasaki disease: role of coronary CT angiography.

Invasive coronary angiography is considered to be the gold standard for diagnosis and follow-up of coronary artery aneurysms, thrombosis and stenosis in patients with Kawasaki Disease. However, the availability of multi-detector CT coronary angiography provides a viable alternative as a non-invasive imaging modality for sequential follow-up of patients with Kawasaki disease. High quality multidetector CT angiography images of coronary arterial anatomy can be obtained after adequate heart rate control using beta blockers.

Child↗
PubMed2006

Self-reported fatigue common among optimally treated HIV patients: no correlation with cerebral FDG-PET scanning abnormalities.

OBJECTIVE: It was the aim of this study to determine the prevalence and severity of fatigue among optimally treated HIV patients and to investigate the potential association with systemic inflammation and abnormalities of the distribution of cerebral glucose metabolism. METHODS: A cohort of HIV patients (n = 95), known to be HIV positive for 5 years, on anti-retroviral therapy for a minimum of 3 years and with CD4 counts above 0.2 x 10(9) cells/l, completed a validated fatigue inventory, and plasma was analysed for pro-inflammatory markers including tumour necrosis factor-alpha, interleukin 6 and soluble urokinase receptor (suPAR) levels. The distribution of the regional cerebral metabolic rate of glucose was measured in a sub-group of patients suffering from severe fatigue (n = 9) and a group with no fatigue (n = 7) using fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) scanning. RESULTS: Fifteen percent suffered from severe fatigue, but no association with pro-inflammatory markers was found. About 50% of the FDG-PET-scanned patients showed minor abnormalities in the relative cerebral metabolic rate of glucose. These abnormalities were not associated with fatigue but tended to correlate with a short HIV history (p = 0.058), a low CD4 nadir (p = 0.082) and elevated tumour necrosis factor-alpha levels (p = 0.074). CONCLUSION: Fatigue is common among optimally treated HIV patients. FDG-PET-described signs of imminent neurodegeneration among HIV patients who had a low CD4 nadir may illustrate an aspect of HIV neuropathogenicity.

AIDS Dementia Complex↗
PubMed2006

Motor activation in SPG4-linked hereditary spastic paraplegia.

OBJECTIVE: The aim of this study was to investigate the extent of motor cortical functional reorganisation in patients with SPG4-linked hereditary spastic paraplegia by exploring cortical motor activation related to movements of clinically affected (lower) and unaffected (upper) limbs. METHODS: Thirteen patients and 13 normal controls matched for age, gender and handedness underwent O15-labelled water positron emission tomography during (1) right ankle flexion-extension, (2) right shoulder flexion-extension and (3) rest. Within-group comparisons of movement vs. rest (simple main effects) and between-group comparisons of movement vs. rest (group x behavioural state interaction) were performed using a random effects approach and statistical parametric mapping (SPM99). RESULTS: Patterns of motor activation were generally comparable between groups during both tasks, although patients had a tendency towards more widespread activation in sensorimotor cortical and cerebellar regions. Statistically significant differences were restricted to the ankle movement response, however, where patients showed significantly increased regional cerebral blood flow in the right and left primary motor cortices, the supplementary motor areas and the right premotor cortex compared to controls. CONCLUSIONS: Motor cortical reorganisation may explain this result, but as no significant differences were recognised in the motor response of the unaffected limb, differences in functional demands should also be considered.

Adenosine Triphosphatases↗
PubMed2006

Similar brain networks for detecting visuo-motor and visuo-proprioceptive synchrony.

The ability to recognize feedback from own movement as opposed to the movement of someone else is important for motor control and social interaction. The neural processes involved in feedback recognition are incompletely understood. Two competing hypotheses have been proposed: the stimulus is compared with either (a) the proprioceptive feedback or with (b) the motor command and if they match, then the external stimulus is identified as feedback. Hypothesis (a) predicts that the neural mechanisms or brain areas involved in distinguishing self from other during passive and active movement are similar, whereas hypothesis (b) predicts that they are different. In this fMRI study, healthy subjects saw visual cursor movement that was either synchronous or asynchronous with their active or passive finger movements. The aim was to identify the brain areas where the neural activity depended on whether the visual stimulus was feedback from own movement and to contrast the functional activation maps for active and passive movement. We found activity increases in the right temporoparietal cortex in the condition with asynchronous relative to synchronous visual feedback from both active and passive movements. However, no statistically significant difference was found between these sets of activated areas when the active and passive movement conditions were compared. With a posterior probability of 0.95, no brain voxel had a contrast effect above 0.11% of the whole-brain mean signal. These results do not support the hypothesis that recognition of visual feedback during active and passive movement relies on different brain areas.

Adult↗
PubMed2005

Shape configuration and category-specificity.

We examined the neural correlates of visual shape configuration, the binding of local shape characteristics into wholistic object descriptions, by comparing the regional cerebral blood flow associated with recognition of outline drawings and fragmented drawings. We found no areas that responded more to fragmented drawings than to outline drawings even though fragmentation had a clear impact on recognition performance. Instead, a region extending from the inferior occipital gyri to the middle parts of the fusiform gyri was activated during shape configuration of both outline drawings and fragmented drawings. We also examined whether fragmentation had different impact on the recognition of natural objects and artefacts and found that recognition of artefacts was more affected by fragmentation than recognition of natural objects. Thus, the usual finding of an advantage for artefacts in difficult object decision tasks, which is also found in the present experiments with outlines, is reversed when the stimuli are fragmented. This interaction between category (natural versus artefacts) and stimulus type (outlines versus fragmented forms) is in accordance with predictions derived from a recent account of category-specificity and lends support to the notion that category-specific impairments can occur for both natural objects and artefacts following damage to pre-semantic stages in visual object recognition. The implications of the present findings are discussed in relation to theories of perceptual organization, visual object recognition and category-specificity.

Adult↗
PubMed2005

Reduced regional cerebral blood flow in SPG4-linked hereditary spastic paraplegia.

Hereditary spastic paraplegia (HSP) linked to the spastic gait gene 4 (SPG4) is controversial, as the "pure" form traditionally has been considered confined to the long axons of the spinal cord. However, recent immunolabeling experiments have demonstrated extensive Spastin expression in the cortex and striatum. This could indicate a more widespread neuropathology from mutations in the SPG4 gene than previously assumed. The aim of this study was therefore to ascertain the extent of cerebral involvement in SPG4 linked HSP by neuropsychological examination and measurement of the regional cerebral blood flow (rCBF) as an indirect marker of regional neuronal activity. Eighteen SPG4 patients and 18 matched control subjects were studied. Resting state rCBF was measured using Positron Emission Tomography (PET) and the (15)O-labelled water bolus technique and relative group differences were explored using Statistical Parametric Mapping (SPM 99). Neuropsychological assessment was performed using established and nationally validated tests (RH Basic Battery). Compared to healthy controls, the patient group had significantly decreased rCBF in the left fronto-temporal cortex (P<0.05), and more extensive changes were observed in a separate analysis of the most disabled individuals. The neuropsychological assessment revealed only significantly impaired recognition memory for faces. In summary, the findings support cerebral pathology in SPG4-linked HSP, although the decreased rCBF in fronto-temporal cortex was not associated with severe cognitive impairment.

Adenosine Triphosphatases↗
PubMed2005

Activation in the MT-complex during visual perception of apparent motion and temporal succession.

Previous studies have shown that MT (i.e., the MT-complex) is activated during visual perception of apparent motion. To further explore the function of MT, we measured activation in MT by positron emission tomography (PET) using a broad range of stroboscopic stimulus events in which (a) the frame rate was so fast that observers perceived stimulus frames as simultaneous, (b) the frame rate was slower and generated compelling impressions of apparent motion, or (c) the frame rate was so slow that observers perceived temporal succession (successive views of the same objects at different locations) instead of motion. As expected, the simultaneity condition showed no activation (reliable increase in regional cerebral blood flow, rCBF) in MT whereas the motion condition showed activation in both left and right MT. However, the succession condition showed even stronger activation in left and right MT than did the motion condition. MT seems implicated in perception of retinal stimuli as successive views of the same object at different locations whether or not the views are connected by apparent motion.

Adult↗
PubMed2005

The relationship between cerebral blood flow and volume in humans.

The purpose of this study was to establish the relationship between regional CBF and CBV at normal, resting cerebral metabolic rates. Eleven healthy volunteers were investigated with PET during baseline conditions, and during hyper- and hypocapnia. Values for rCBF and rCBV were obtained using 15O-labelled water and carbon monoxide, respectively. The mean value of rCBF using PET was 62 +/- 18 ml 100 g(-1) min(-1) during baseline conditions, with an average increase of 46% during hypercapnia, and a decrease of 29% during hypocapnia; baseline rCBV was 7.7 ml/100 g, with 27% increase during hypercapnia and no significant decrease during hypocapnia. A regionally uniform exponential relationship was confirmed between PaCO2 and rCBF as well as rCBV. It is shown that the theoretical implication of this is that the rCBV vs. rCBF relationship should be modelled by a power function; however, due to pronounced intersubject variability, the goodness of fit for linear and nonlinear models were not significantly different. The results of the study are applied to a numerical estimation of regional brain deoxy-haemoglobin content. Independently of the choice of model for the rCBV vs. rCBF relationship, a nonlinear deoxy-haemoglobin vs. rCBF relationship was predicted, and the implications for the BOLD response are discussed.

Adult↗
PubMed2004

Enhanced accuracy in novel mirror drawing after repetitive transcranial magnetic stimulation-induced proprioceptive deafferentation.

When performing visually guided actions under conditions of perturbed visual feedback, e.g., in a mirror or a video camera, there is a spatial conflict between visual and proprioceptive information. Recent studies have shown that subjects without proprioception avoid this conflict and show a performance benefit. In this study, we tested whether deafferentation induced by repetitive transcranial magnetic stimulation (rTMS) can improve mirror tracing skills in normal subjects. Hand trajectory error during novel mirror drawing was compared across two groups of subjects that received either 1 Hz rTMS over the somatosensory cortex contralateral to the hand or sham stimulation. Mirror tracing was more accurate after rTMS than after sham stimulation. Using a position-matching task, we confirmed that rTMS reduced proprioceptive acuity and that this reduction was largest when the coil was placed at an anterior parietal site. It is thus possible, with rTMS, to enhance motor performance in tasks involving a visuoproprioceptive conflict, presumably by reducing the excitability of somatosensory cortical areas that contribute to the sense of hand position.

Adolescent↗
PubMed2004

Right temporoparietal cortex activation during visuo-proprioceptive conflict.

The conflict between vision and proprioception has been proposed to explain why healthy subjects perform worse than proprioceptively deafferented patients in conditions with optical displacement, e.g. novel mirror drawing. It is not known which brain processes depend upon the successful integration of visual and proprioceptive information and are therefore impaired when these modalities disagree. With fMRI in healthy subjects we compared brain activity across two conditions with similar visual and proprioceptive stimulation and similar task demands that differed by the congruence of movement showed by the two modalities. Subjects felt the passive movement of the right index finger on a rectangular field and watched a cursor moving on a computer screen. Cursor and finger locations either mapped onto each other (congruent condition) or did not (incongruent condition). Monitoring incongruent compared with congruent movement activated the premotor area bilaterally and the right temporoparietal junction. These brain areas have previously been associated with shifts in the attended location in the visual space. These findings suggest an interaction between vision and proprioception in orienting to spatial locations.

Adult↗
PubMed2004

Structural similarity and category-specificity: a refined account.

It has been suggested that category-specific recognition disorders for natural objects may reflect that natural objects are more structurally (visually) similar than artefacts and therefore more difficult to recognize following brain damage. On this account one might expect a positive relationship between blood flow and structural similarity in areas involved in visual object recognition. Contrary to this expectation we report a negative relationship in that identification of articles of clothing cause more extensive activation than identification of vegetables/fruit and animals even though items from the categories of animals and vegetables/fruit are rated as more structurally similar than items from the category of articles of clothing. Given that this pattern cannot be explained in terms of a tradeoff between activation and accuracy, we interpret these findings within a model where the matching of visual forms to memory incorporates two operations: (i) the integration of stored object features into whole object representations (integral units), and (ii) the competition between activated integral units for selection (i.e. identification). In addition, we suggest that these operations are differentially affected by structural similarity in that high structural similarity may be beneficial for the integration of stored features into integral units, thus explaining the greater activation found with articles of clothing, whereas it may be harmful for the selection process proper because a greater range of candidate integral units will be activated and compete for selection, thus explaining the higher error rate associated with animals. We evaluate the model based on previous evidence from both normal subjects and patients with category-specific disorders and argue that this model can help reconcile otherwise conflicting data.

Adult↗
PubMed2004

Parieto-occipital areas involved in efficient filtering in search: a time course analysis of visual marking using behavioural and functional imaging procedures.

Search for a colour-form conjunction target can be facilitated by presenting one set of distractors prior to the second set of distractors and the target: the preview benefit (Watson & Humphreys, 1997). The early presentation of one set of distractors enables them to be efficiently filtered from search. We report two studies investigating the time course of the preview benefit. In Experiment 1 we use a standard reaction time analysis to show that the benefit has a relatively slow time course; old items need to precede the new set by 600 ms or more in order to be fully filtered from search. Furthermore, the reductions in reaction time across time in the preview condition varied nonlinearly with the display size, suggesting that old items were discounted from search in parallel. In Experiment 2 we examined the neural locus of this filtering effect over time, using positron emission tomography (PET). We show that regions of parieto-occipital cortex are selectively activated in a preview search condition relative to a detection baseline. These regions also increase in activation as the preview interval increases (and search then becomes easier), consistent with them modulating the parallel filtering of distractors from targets in spatial search. Interestingly, the same areas as those activated in preview search were also active in conjunction search relative to its own detection baseline. Thus these regions either modulate parallel filtering in conjunction search too, or they modulate different behavioural functions according to task constraints.

Adult↗
PubMed2003

Efficacy of atrial antitachycardia pacing using the Medtronic AT500 pacemaker in patients with congenital heart disease.

Patients with congenital heart disease are vulnerable to atrial tachyarrhythmias, especially after atrial surgeries. We evaluated the efficacy of atrial arrhythmia detection and antitachycardia pacing (ATP) using the Medtronic AT500 pacemaker in 28 patients with congenital heart disease (age 30 +/- 18 years). Of 15 patients with atrial arrhythmias, 14 had atrial tachycardia events that were appropriately detected. ATP was enabled for 167 treatable episodes, successfully converting 90 (54%). Rhythms classified as ventricular tachycardia were detected 127 times, yet most were actually atrial or sinus tachycardia with 1:1 atrioventricular conduction. Atrial tachycardias in congenital heart disease are amenable to ATP algorithms in the AT500 pacemaker.

Adolescent↗
PubMed2003

Maximal rowing has an acute effect on the blood-gas barrier in elite athletes.

The purpose of the study was to evaluate the effects of maximal exercise on the integrity of the alveolar epithelial membrane using the clearance rate of aerosolized 99mTc-labeled diethylenetriaminepentaacetic acid as an index for the permeability of the lung blood-gas barrier. Ten elite rowers (24.3 +/- 4.6 yr of age) completed two 20-min pulmonary clearance measurements immediately after and 2 h after 6 min of all-out rowing (initial and late, respectively). All subjects participated in resting control measurements on a separate day. For each 20-min measurement, lung clearance was calculated for 0-7 and 10-20 min. Furthermore, scintigrams were processed from the initial and late measurements of diethylenetriaminepentaacetic acid clearance. Compared with control levels, the pulmonary clearance measurement after rowing was increased from 1.2 +/- 0.5 to 2.4 +/- 1.0%/min (SD) at 0-7 min (P < 0.01) and from 0.8 +/- 0.3 to 1.5 +/- 0.4%/min at 10-20 min (P < 0.0005), returning to resting levels within 2 h. In 6 of 10 subjects, ventilation distribution on the lung scintigrams was inhomogeneous at the initial measurement. The study demonstrates an acute increased pulmonary clearance after maximal rowing. The ventilation defects identified on the lung scintigrams may represent transient interstitial edema secondary to increased blood-gas barrier permeability induced by mechanical stress.

Adult↗
PubMed2002

When action turns into words. Activation of motor-based knowledge during categorization of manipulable objects.

Functional imaging studies have demonstrated that processing of man-made objects activate the left ventral premotor cortex, which is known to be concerned with motor function. This has led to the suggestion that the comprehension of man-made objects may rely on motor-based knowledge of object utilization (action knowledge). Here we show that the left ventral premotor cortex is activated during categorization of "both" fruit/vegetables and articles of clothing, relative to animals and nonmanipulable man-made objects. This observation suggests that action knowledge may not be important for the processing of man-made objects per se, but rather for the processing of manipulable objects in general, whether natural or man-made. These findings both support psycholinguistic theories suggesting that certain lexical categories may evolve from, and the act of categorization rely upon, motor-based knowledge of action equivalency, and have important implications for theories of category specificity. Thus, the finding that the processing of vegetables/fruit and articles of clothing give rise to similar activation is difficult to account for should knowledge representations in the brain be truly categorically organized. Instead, the data are compatible with the suggestion that categories differ in the weight they put on different types of knowledge.

Concept Formation↗
PubMed2002

Cerebral hemodynamics measured with simultaneous PET and near-infrared spectroscopy in humans.

Near-infrared spectroscopy (NIRS) enables continuous non-invasive quantification of blood and tissue oxygenation, and may be useful for quantification of cerebral blood volume (CBV) changes. In this study, changes in cerebral oxy- and deoxyhemoglobin were compared to corresponding changes in CBF and CBV as measured by positron emission tomography (PET). Furthermore, the results were compared using a physiological model of cerebral oxygenation. In five healthy volunteers changes in CBF were induced in a randomized order by hyperventilation or inhalation of 6% CO(2). Arterial content of O(2) and CO(2) was measured several times during each scanning. Changes in deoxyhemoglobin (deltaHb), oxyhemoglobin (deltaHbO(2)) and total hemoglobin (deltaHb(tot)) were continuously recorded with NIRS equipment. CBF and CBV was also determined in MRI-coregistered PET-slices in regions determined by the placement of the two optodes, as localized from the transmission scan. The PET-measurements showed an average CBV of 5.5+/-0.74 ml 100 g(-1) in normoventilation, with an increase of 29% during hypercapnia, whereas no significant changes were seen during hyperventilation. CBF was 51+/-10 in normoventilation, increased by 37% during 6% CO(2) and decreased by 25% during hyperventilation. NIRS showed significant increases in oxygenation during hypercapnia, and a trend towards decreases during hyperventilation. Changes in CBV measured with both techniques were significantly correlated to CO(2) levels. However, deltaCBV(NIRS) was much smaller than deltaCBV(PET), and measured NIRS parameters smaller than those predicted from the model. It is concluded that while qualitatively correct, NIRS measurements of CBV should be used with caution when quantitative results are needed.

Adult↗
PubMed2002

Attentional effects in the visual pathways: a whole-brain PET study.

Attentional effects in the visual pathways were investigated by contrasting the distribution of regional cerebral blood flow (rCBF) measured by H(2)(15)O positron emission tomography (PET) during performance of a shape-matching task with the distribution of rCBF during a less demanding color-matching task. The two tasks were performed using the same stimuli: pairs of colored random shapes shown at a fixed rate (2 s per pair). In the shape-matching task, the subjects determined whether the two stimuli were the same in shape regardless of differences in size or color. In the color-matching task, the subjects determined whether the two stimuli were the same in color regardless of differences in size or shape. Mean reaction time for shape-matching exceeded mean reaction time for color-matching by nearly 200 ms. The corresponding shape-color comparison showed extensive bilateral increases in rCBF in visual areas in the occipital and parietal lobes, including the primary visual cortex. Subcortical activations were found in cerebellum (particularly the vermis) and in the thalamus with the focus in a region comprising the lateral geniculate nucleus, the pulvinar, and adjacent parts of the reticular nucleus. Frontal activations were found in a region that seems implicated in visual short-term memory (posterior parts of the superior sulcus and the middle gyrus). The reverse, color-shape comparison showed bilateral increases in rCBF in the anterior cingulate gyri, superior frontal gyri, and superior and middle temporal gyri. The attentional effects found by the shape-color comparison in the thalamus and the primary visual cortex may have been generated by feedback signals preserving visual representations of selected stimuli in short-term memory.

Adult↗