Biomedical subjects

Leena Lauronen

Publications and source records attributed to Leena Lauronen.

6 recordsLinked to original sources

PubMed2006

Neonatal SEP - back to bedside with basic science.

Scalp-recorded somatosensory evoked potentials (SEPs) have been successfully used in neonatal assessment for several decades. The current routine SEP paradigm is markedly predictive for future cerebral palsy (CP) or other neurocognitive sequelae in brain-injured babies. Recent advances in basic science have dramatically increased our knowledge about structural-functional development of SEP-related brain mechanisms. It has thereby become apparent that preterm SEP differs from that in more mature counterparts in that it also comprises responses from transient brain structures, and hence being unique to the preterm period. It is now obvious also that several aspects in the current SEP paradigm, ranging from the type of stimulation to the methods of recording and analysis, are suboptimal for preterm babies. Recent progress in recording and analysis techniques have made it possible to combine SEP studies with EEG recordings, as well as to implement advanced analyses (e.g. time-frequency analysis) into routine practice. This review summarizes literature from relevant areas in basic science, and proposes a novel, integrated approach in neonatal SEP studies in order to significantly increase the fidelity of testing somatosensory system.

Cerebral Palsy↗

PubMed2006

Immaturity of somatosensory cortical processing in human newborns.

The development of the early component of somatosensory evoked potentials (SEPs) from the neonatal N1 to adult N20 response has previously been described. The main emphasis has been on the change in the response latency during maturation. We used magnetoencephalography (MEG) to characterize the cortical generators of the N1 and the subsequent response in healthy human newborns. Furthermore, we studied the maturation of tactile processing according to responses evoked by tactile stimulation of the index finger in newborns, 6-month-old babies and adults. This study provides evidence of specific differences in the somatosensory processing in neonates compared to that in adults. Although the initial cortical response to electrical median nerve stimulation in the newborns was similar in field distribution to the corresponding N20m in adults, the subsequent major deflection in the response waveform had the opposite polarity. Similar immaturity in cortical processing was seen in the tactile evoked fields in both the newborns and the 6-month-old infants compared with the adults. Our results indicate that although the somatosensory pathway in full-term newborns is sufficiently developed to supply the brain with tactile information, the cortical neuronal networks for processing the input may not function in the same way as in adults.

Adult↗

PubMed2006

Spatial dynamics of population activities at S1 after median and ulnar nerve stimulation revisited: an MEG study.

In a number of studies, magnetoencephalography (MEG) has been successfully employed in localizing cortical neural population activities after stimulation of peripheral nerves. Little attention has been paid, however, to the spatiotemporal dynamics of these activations within the primary somatosensory cortex (SI). Here we report on the activation sequence at the right SI after left median and ulnar nerve stimulation. The results show that at least three macroscopically separable sources within or near SI are activated within 100 ms after the stimulus, corresponding to the somatosensory evoked field (SEF) deflections N20m, P35m and P60m. As P60m was localized significantly more posteriorly and also tended to be deeper than the two earlier deflections, its underlying source may be more extensive than during N20m and P35m, and it may get contribution from the postcentral gyrus and sulcus, possibly Brodmann areas 1 and 2. The source separation between the neural populations activated by the 2 nerves was 12 mm during N20m, 6 mm during P35m and 4 mm during P60m. Thus, at longer latencies, the centers of gravity of the activations were closer to each other for the 2 nerves. We argue that this reflects spreading of the activation with time from the site of initial excitation to encompass larger and more overlapping neural populations at longer latencies.

Adult↗

PubMed2004

Somatosensory processing in healthy newborns.

Attempting to understand more about somatosensory processing in newborns, we give an overview of somatosensory potential studies in preterm and term healthy newborns conducted during the past few decades. In addition, we present some of our recent data from somatosensory studies conducted with magnetoencephalography (MEG). The reviewed studies show maturational patterns of cortical responses to median and tibial nerve stimulation within the preterm-term period. In this era, maturation is reflected mainly as shortening of the latencies and increase in the amplitude of especially the early responses. However, the actual somatosensory processing beyond the latency and amplitude analysis has not been the goal in these studies. Although the somatosensory pathways and cortex are mature enough to produce the evoked responses, difficulties in measuring the neonatal responses with similar parameters as used for adults is suggested to reflect the special characteristics of newborn processing. Possible factors behind the inconsistencies between different newborn studies are discussed.

Evoked Potentials, Somatosensory↗

PubMed2004

Somatosensory evoked potentials and magnetic fields elicited by tactile stimulation of the hand during active and quiet sleep in newborns.

OBJECTIVE: Our objective was to characterize the effects of sleep stages on tactile somatosensory evoked responses in full-term newborns. METHODS: Somatosensory evoked potentials (SEPs) and magnetic fields (SEFs) to tactile stimulation of the tip of the index finger and/or thenar eminence were measured from 14 healthy newborns. The stimulus was a gentle tap produced by a moving membrane driven by an air-pressure pulse. RESULTS: SEPs and SEFs to tactile stimulation of the skin were similar in waveform and latency to SEPs known to be produced by electrical stimulation of the fingertip of neonates. The two most distinguishable positive deflections of SEPs, P1 and P2, within 300 ms of the stimulation, and their magnetic counterparts were clearly smaller in active compared to quiet sleep. CONCLUSIONS: Our study demonstrates for the first time that it is possible to record SEFs in neonates, and that clear late cortical somatosensory responses are produced by tactile stimulation. In addition, the effect of sleep stage on these responses indicates differences in the processing of the incoming information, at least in the somatosensory modality, in active and quiet sleep. SIGNIFICANCE: Tactile stimulation may be useful as a completely non-invasive technique for studying the physiology of the somatosensory system in neonates. Methodologically, since the effect of sleep stage is profound, one must carefully monitor the sleep stages in studies of event-related responses in newborns, or else this effect may confound the phenomena being studied.

Electroencephalography↗

PubMed2002

Enlarged SI and SII somatosensory evoked responses in the CLN5 form of neuronal ceroid lipofuscinosis.

OBJECTIVES: To examine in detail the activation of the primary (SI) and secondary (SII) somatosensory cortex in CLN5, the Finnish variant of late infantile neuronal ceroid lipofuscinoses (NCL). METHODS: Somatory evoked magnetic fields were recorded with a 122-channel planar gradiometer in response to median nerve stimulation in 5 CLN5 patients (aged 8.8-16.7 years) and in 10 healthy age-matched controls. RESULTS: The first two responses from contralateral SI, N20m and P35m, were 6-20 times stronger in the patients than in the controls. The morphology of the subsequent deflections from SI was abnormal in the patients: a prominent N45m was detected, while the normally present P60m deflection was missing. In 4 patients the contra- and in two patients the ipsilateral SII responses were also enlarged. Furthermore, the SII activation was detected at shorter latency in patients than in controls. CONCLUSIONS: At SI, CLN5 is associated with a selective enhancement of the early cortical responses. We propose that the enlargement of N20m most likely reflects increased synchronous input from thalamus, whereas the altered morphology of the following responses may reflect defective interneuronal inhibition at the cortex. The enlargement of SII responses shows that the imbalance between excitation and inhibition in CLN5 extends outside the primary somatosensory areas.

Adolescent↗