Biomedical subjects

J Hornak

Publications and source records attributed to J Hornak.

13 recordsLinked to original sources

PubMed2004

Reward-related reversal learning after surgical excisions in orbito-frontal or dorsolateral prefrontal cortex in humans.

Neurophysiological studies in primates and neuroimaging studies in humans suggest that the orbito-frontal cortex is involved in representing the reward value of stimuli and in the rapid learning and relearning of associations between visual stimuli and rewarding or punishing outcomes. In the present study, we tested patients with circumscribed surgical lesions in different regions of the frontal lobe on a new visual discrimination reversal test, which, in an fMRI study (O'Doherty, Kringelbach, Rolls, Hornak, & Andrews, 2001), produced bilateral orbito-frontal cortex activation in normal subjects. In this task, touching one of two simultaneously presented patterns produced reward or loss of imaginary money delivered on a probabilistic basis to minimize the usefulness of verbal strategies. A number of types of feedback were present on the screen. The main result was that the group of patients with bilateral orbito-frontal cortex lesions were severely impaired at the reversal task, in that they accumulated less money. These patients often failed to switch their choice of stimulus after a large loss and often did switch their choice although they had just received a reward. The investigation showed that bilateral lesions were required for this deficit, since patients with unilateral orbito-frontal cortex (or medial prefrontal cortex) lesions were not impaired in the probabilistic reversal task. The task ruled out a simple motor disinhibition as an explanation of the deficit in the bilateral orbito-frontal cortex patients, in that the patients were required to choose one of two stimuli on each trial. A comparison group of patients with dorsolateral prefrontal cortex lesions was in some cases able to do the task, and in other cases, was impaired. Posttest debriefing showed that all the dorsolateral prefrontal patients who were impaired at the task had failed to pay attention to the crucial feedback provided on the screen after each trial about the amount won or lost on each trial. In contrast, all dorsolateral patients who paid attention to this crucial feedback performed normally on the reversal task. Further, it was confirmed that the bilateral orbito-frontal cortex patients had also paid attention to this crucial feedback, but in contrast had still performed poorly at the task. The results thus show that the orbital prefrontal cortex is required bilaterally for monitoring changes in the reward value of stimuli and using this to guide behavior in the task; whereas the dorsolateral prefrontal cortex, if it produces deficits in the task, does so for reasons related to executive functions, such as the control of attention. Thus, the ability to determine which information is relevant when making a choice of pattern can be disrupted by a dorsolateral lesion on either side, whereas the ability to use this information to guide behavior is not disrupted by a unilateral lesion in either the left or the right orbito-frontal cortex, but is severely impaired by a bilateral lesion in this region. Because both abilities are important in many of the tasks and decisions that arise in the course of daily life, the present results are relevant to understanding the difficulties faced by patients after surgical excisions in different frontal brain regions.

Adult↗

PubMed2003

Changes in emotion after circumscribed surgical lesions of the orbitofrontal and cingulate cortices.

To analyse the functions of different parts of the prefrontal cortex in emotion, patients with different prefrontal surgical excisions were compared on four measures of emotion: voice and face emotional expression identification, social behaviour, and the subjective experience of emotion. Some patients with bilateral lesions of the orbitofrontal cortex (OFC) had deficits in voice and face expression identification, and the group had impairments in social behaviour and significant changes in their subjective emotional state. Some patients with unilateral damage restricted to the OFC also had deficits in voice expression identification, and the group did not have significant changes in social behaviour or in their subjective emotional state. Patients with unilateral lesions of the antero-ventral part of the anterior cingulate cortex (ACC) and/or medial Brodmann area (BA) 9 were, in some cases, impaired on voice and face expression identification, had some change in social behaviour, and had significant changes in their subjective emotional state. Patients with unilateral lesions of the OFC and of the ACC and/or medial BA 9 were, in some cases, impaired on voice and face expression identification, had some changes in social behaviour, and had significant changes in their subjective emotional state. Patients with dorsolateral prefrontal cortex lesions or with medial lesions outside ACC and medial BA 9 areas (dorsolateral/other medial group) were unimpaired on any of these measures of emotion. In all cases in which voice expression identification was impaired, there were no deficits in control tests of the discrimination of unfamiliar voices and the recognition of environmental sounds. Thus bilateral or unilateral lesions circumscribed surgically within the OFC can impair emotional voice and/or face expression identification, but significant changes in social behaviour and in subjective emotional state are related to bilateral lesions. Importantly, unilateral lesions of the ACC (including some of medial BA 9) can produce voice and/or face expression identification deficits, and marked changes in subjective emotional state. These findings with surgically circumscribed lesions show that within the prefrontal cortex, both the OFC and the ACC/medial BA 9 region are involved in a number of aspects of emotion in humans including emotion identification, social behaviour and subjective emotional state, and that the dorsolateral prefrontal areas are not involved in emotion in these ways.

Adult↗

PubMed2002

The role of the vertical meridian in visual memory for objects.

It is widely believed that, in human and nonhuman primates, visual memories of objects are stored in the temporal lobe. Electrophysiological results in monkeys, however, indicate that when a visual scene contains two or more objects, with at least one object in each visual hemifield, neurons in the temporal lobe of each hemisphere respond only to the objects that are in the contralateral visual hemifield, and their activity is unaffected by the objects in the ipsilateral hemifield. Putting these two premises together predicts that object memory should fail, or at least suffer a substantial decrement, when an object is presented for learning and retention as part of such a scene, but crosses the vertical meridian between the learning trial and the retention test. The effect of this change should be much greater than the effect of an equal retinal translation that crosses the horizontal rather than the vertical meridian. An experiment with normal human subjects verified this prediction under conventional conditions of tachistoscopic viewing, with a single constant fixation spot. A further condition in the same experiment, however, tested the same retinal translations in a more naturalistic condition, where the retinal changes were produced by varying the position on the display screen of the fixation spot rather than of the objects. Here, there was no significant special effect of crossing the vertical meridian. We conclude that visual memories are not stored exclusively in the temporal lobe.

Adult↗

PubMed2001

Abstract reward and punishment representations in the human orbitofrontal cortex.

The orbitofrontal cortex (OFC) is implicated in emotion and emotion-related learning. Using event-related functional magnetic resonance imaging (fMRI), we measured brain activation in human subjects doing an emotion-related visual reversal-learning task in which choice of the correct stimulus led to a probabilistically determined 'monetary' reward and choice of the incorrect stimulus led to a monetary loss. Distinct areas of the OFC were activated by monetary rewards and punishments. Moreover, in these areas, we found a correlation between the magnitude of the brain activation and the magnitude of the rewards and punishments received. These findings indicate that one emotional involvement of the human orbitofrontal cortex is its representation of the magnitudes of abstract rewards and punishments, such as receiving or losing money.

Adult↗

PubMed2000

Differential cognitive effects of colloid cysts in the third ventricle that spare or compromise the fornix.

A series of twelve cases, all of whom had received surgery for the removal of a colloid cyst in the third ventricle, was examined on a series of memory tests. The only consistent predictor of poor memory performance that could be detected from MRIs was the presence of bilateral interruption of the fornix, which occurred in three of the subjects. Although these three cases were poor on tests of learning and recall, there was evidence that recognition was less impaired. The subjects were also tested on a set of recognition and concurrent discriminations that closely matched tests given to non-human primates. Clear parallels were found between the apparent effects of fornix damage in these clinical cases and those observed following more selective surgery in non-human primates. These findings not only indicate that fornix damage is sufficient to induce anterograde amnesia but also support the validity of recent animal tests that are thought to capture aspects of episodic memory.

Adult↗

PubMed1999

Counseling in audiology, or learning to listen: pre- and post-measures from an audiology counseling course.

Because of a "technology explosion," audiologists have more options than ever in providing for their patients' hearing needs. However, relatively few individuals with hearing loss seek out amplification, and those who do frequently report dissatisfaction with the quality of their interactions with audiologists. Most audiologists did not have coursework in counseling in their graduate programs, which may account for patient complaints. As part of a course development evaluation of an audiology counseling course, a preliminary study was conducted to examine two student learning objectives: to learn how to differentiate between content messages and affective messages and to learn how to respond to each type of message appropriately. Pre- and postcourse data collected from two cohorts of audiology graduate students indicated that (a) before taking the course, students were likely to provide informational responses to personal adjustment comments (a type of "communication mismatch"), and (b) at the end of the class, they were much more likely to match or mirror affective statements with affective responses.

Adult↗

PubMed1997

Amnesia and neglect: beyond the Delay-Brion system and the Hebb synapse.

Hippocampal damage in people causes impairments of episodic memory, but in rats it causes impairments of spatial learning. Experiments in macaque monkeys show that these two kinds of impairment are functionally similar to each other. After any lesion that interrupts the Delay-Brion system (hippocampus, fornix, mamillary bodies and anterior thalamus) monkeys are impaired in scene-specific memory, where an event takes place against a background that is specific to that event. Scene-specific memory in the monkey corresponds to human episodic memory, which is the memory of a unique event set in a particular scene, as opposed to scene-independent human knowledge, which is abstracted from many different scenes. However, interruption of the Delay-Brion system is not sufficient to explain all of the memory impairments that are seen in amnesic patients. To explain amnesia the specialized function of the hippocampus in scene memory needs to be considered alongside the other, qualitatively different functional specializations of other memory systems of the temporal lobe, including the perirhinal cortex and the amygdala. In all these specialized areas, however, including the hippocampus, there is no fundamental distinction between memory systems and perceptual systems. In explaining memory disorders in amnesia it is also important to consider them alongside the memory disorders of neglect patients. Neglect patients fail to represent in memory the side of the world that is contralateral to the current fixation point, in both short- and long-term memory retrieval. Neglect was produced experimentally by unilateral visual disconnection in the monkey, confirming the idea that visual memory retrieval is retinotopically organized; patients with unilateral medial temporal-lobe removals showed lateralized memory impairments for half-scenes in the visual hemifield contralateral to the removal. Thus, in scene-memory retrieval the Delay-Brion system contributes to the retrieval of visual memories into the retinotopically organized visual cortex. This scene memory interpretation of hippocampal function needs to be contrasted with the cognitive-map hypothesis. The cognitive-map model of hippocampal function shares some common assumptions with the Hebb-synapse model of association formation, and the Hebb-synapse model can be rejected on the basis of recent evidence that monkeys can form direct associations in memory between temporally discontiguous events. Our general conclusion is that the primate brain encompasses widespread and powerful memory mechanisms which will continue to be poorly understood if theory and experimentation continue to concentrate too much, as they have in the past, on the hippocampus and the Hebb synapse.

Amnesia↗

PubMed1997

Hemifield-specific visual recognition memory impairments in patients with unilateral temporal lobe removals.

Recent evidence on visual neglect suggests that each hemisphere maintains a retinotopically organized representation of the visual world contralateral to the current fixation point and that this representation is based not only on analysis of the current retinal input but, equally importantly, on information retrieved from memory. This idea predicts that unilateral damage to memory systems should produce a lateralized impairment of memory for the retinotopically contralateral visual world. To test this prediction we examined visual recognition memory performance in the left and right visual hemifields of patients who had undergone partial unilateral temporal lobe removals for the relief of epilepsy, either in the left hemisphere (n = 5) or the right (n = 5). The patients were given complex artificial scenes to remember, constructed of independent left and right halves, and were then tested for recognition of the left and the right halves separately. Stimuli were exposed tachistoscopically throughout and fixation was maintained on a central position. Patients made significantly more errors with half-scenes in the hemifield contralateral to their removal than in the ipsilateral hemifield, an increase of 50% in the error rate on average. The effect was seen equally in patients with left and right removals. This finding supports the idea that visual memory retrieval is retinotopically organized.

Adult↗

PubMed1997

Visual neglect in the monkey. Representation and disconnection.

Macaque monkeys were trained preoperatively in a visual search task. Neglect after a unilateral lesion was measured as the tendency to make errors (choices of non-target stimuli) ipsilateral to the lesion. Neglect was observed after optic tract section combined with forebrain commissurotomy (n = 6) and after parietal leucotomy, i.e. unilateral section of the white matter between the fundus of the intraparietal sulcus and the lateral ventricle (n = 3). Neglect was not observed after optic tract section alone, or forebrain commissurotomy alone, or posterior parietal cortical ablation, or posterior parietal ablation plus frontal eyefield ablation, or after frontal lobectomy plus forebrain commissurotomy (n = 3 in each of these groups). We propose that the cortex of each hemisphere maintains a retinotopically organized representation of the visible halfworld that is contralateral to the animal's current point of fixation, and that this representation is based not only on analysis of the current retinal input but also on memory. Visual neglect reflects an impairment in this representation. According to this proposal, the fact that neglect is not caused by optic tract section alone is explained by the ability of the blind hemisphere to build a memory-based representation of what is contralateral to the current point of fixation, using memories of visual information which arrived from the ipsilateral visual field in previous fixations that were directed contralateral to the current fixation point. However, neglect does follow when unilateral optic tract section is combined with forebrain commissurotomy, even though the cortex is intact, because then the blind hemisphere is not only deprived of information arriving from the contralateral field but it is also cut off from information arriving from the ipsilateral visual field, and therefore cannot build a memory-based representation of the currently contralateral visible world.

Animals↗

PubMed1996

Face and voice expression identification in patients with emotional and behavioural changes following ventral frontal lobe damage.

Impairments in the identification of facial and vocal emotional expression were demonstrated in a group of patients with ventral frontal lobe damage who had socially inappropriate behaviour. The expression identification impairments could occur independently of perceptual impairments in facial recognition, voice discrimination, or environmental sound recognition. The face and voice expression problems did not necessarily occur together in the same patients, providing an indication of separate processing. Poor performance on both expression tests was correlated with the degree of alteration of emotional experience reported by the patients. There was also a strong positive correlation between the degree of altered emotional experience and the severity of the behavioural problems (e.g. disinhibition) found in these patients. A comparison group of patients with brain damage outside the ventral frontal lobe region, without these behavioural problems, was unimpaired on the face expression identification test, was significantly less impaired at vocal expression identification and reported little subjective emotional change. The expression identification deficits in ventral frontal patients may contribute to the abnormal behaviour seen after frontal lesions, and have implications for rehabilitation.

Facial Expression↗

PubMed1995

Perceptual completion in patients with drawing neglect: eye-movement and tachistoscopic investigations.

A group of neglect patients was compared with control patients in the perception of complete and incomplete figures, including the patients' own incomplete drawings. Eye movements were recorded throughout. Under both tachistoscopic and free-vision conditions, the neglect patients failed to report the absence of the left side of figures only when this missing side lay in the left visual field; they always reported the absence of the left side when the right half-stimulus lay entirely within the right visual field. Thus, the position of a stimulus in the visual field is an important factor in explaining neglect.

Adult↗

PubMed1994

Emotion-related learning in patients with social and emotional changes associated with frontal lobe damage.

A group of patients with damage to the ventral part of the frontal lobes was severely impaired relative to a group of patients without damage in this area (the non-ventral group) in the reversal and in the extinction of simple visual discrimination tests. In these tests they continued to make responses to a previously rewarded stimulus. Patients often reported verbally that the contingencies had changed, but were unable to alter their behaviour appropriately. These impairments occurred independently of IQ or verbal memory impairments. The perseverative touching of a previously rewarded stimulus is consistent with work with non-human primates showing impaired reversal and extinction after orbitofrontal lesions. Performance on these reversal and extinction tests was highly correlated with scores obtained on a behaviour questionnaire, which reflected the degree of disinhibited and socially inappropriate behaviour exhibited by patients. It is suggested that a difficulty in modifying responses, especially when followed by negative consequences, as manifested in these simple laboratory tests, may contribute to the inappropriate behaviour shown in daily life by patients with frontal lobe damage.

Activities of Daily Living↗

PubMed1992

Ocular exploration in the dark by patients with visual neglect.

Eye-movements were recorded as patients with visual neglect searched in a completely darkened room to determine whether any light was present. Fixations were confined almost entirely to the right of the midline, and biased rightwards within that area. A control group with visual field defects searched equally to both sides. This shows that neglect patients have a bias to look to the right which is independent of the difficulty they also have in processing sensory information in the left visual field. Results are related to theories of the hemispheric control of attention and to the view that the representation of contralateral space is impaired in neglect.

Adult↗