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Biomedical subjects

Niels Birbaumer

Publications and source records attributed to Niels Birbaumer.

At least 19 recordsLinked to original sources

A brief and unobtrusive instrument to detect simulation and exaggeration in patients with whiplash syndrome.

The objective of this study was to develop and test a brief and unobtrusive instrument to detect exaggeration and simulation in whiplash syndrome. The instrument consists of eight scenarios with ten response options that have to be ordered according to how easy a behavior is to perform. Twenty-five simulating and 25 non-simulating patients with whiplash syndrome of grades 2 and 3 according to the Quebec Task Force classification as well as 25 simulating and 25 non-simulating controls completed the instrument. In a cross-validation study 20 controls and 20 patients participated. Malingering and exaggeration scores were determined for each subject and patient. The scores were summed up and compared across malingering and exaggerating subjects and controls and cut-off values were determined to classify the patients. T-tests and a discriminant analysis were used to determine classification accuracy. The instrument correctly identified 94% of the simulators and 84% of the exaggerators in both samples. This brief and unobtrusive instrument can detect exaggeration and simulation in whiplash syndrome.

Adult↗

Effects of hydration and hyperventilation on cortical complexity.

The effects of hydration and hyperventilation on cortical complexity were investigated in a sample of 19 healthy volunteers in a double-blind placebo design using magnetoencephalographic recordings. The subjects were asked to abstain from the intake of liquids 18 h before the study. Spontaneous magnetoencephalograms (MEG) were recorded before and after drinking 750 ml water (WAT group: nine subjects) or saline solution (SAL group: ten subjects) with eyes closed and open and during hyperventilation (HV) with eyes open. The MEG data were analysed using both linear (spectral power) and non-linear (pointwise dimension and largest Lyapunov exponent) algorithms. The prediction that intake of water, because of induced cell swelling, will lead to an increased synchronization and a decreased complexity of the spontaneous MEG during hyperventilation was confirmed. Hyperventilation following the drinking condition produced an increase in all power spectra with a stronger increase of delta and theta power after drinking of water. This synchronization of spontaneous MEG is accompanied by a general significant decrease of cortical complexity, especially after water drinking. Moreover, cortical complexity was inversely related to delta and theta power and partly also to alpha power. The SAL and WAT groups showed different relations between alpha power and dimensional complexity during HV: whereas in the SAL group the correlations between these measures became more negative during HV, they reversed in the WAT group to become positive. The synchronizing effect of hyperventilation, leading to a decrease of cortical complexity, is related in the SAL group to delta, theta and alpha power, whereas in the WAT group only delta and theta activity contribute to a reduction of cortical complexity.

Adult↗

Conscious perception of brain states: mental strategies for brain-computer communication.

Direct brain-computer communication utilises self-regulation of brain potentials to select letters, words or symbols from a computer menu. In this study a completely paralysed (locked-in) patient learnt to produce slow cortical potential (SCP) shifts to operate a binary spelling device. After hundreds of training sessions he gave a detailed description of his mental strategies for self-regulation. His cognitive strategies matched with the electrocortical changes perfectly. Thus he produced a contingent negative variation (CNV) with images of preparation such as an arrow being drawn on a bow. To produce a positive potential shift he imagined the arrow shooting up from the bow. To suppress potential shifts he tried to stop thinking. The study demonstrates that patients become sensitive for their brain states with increasing self-regulation practice. The use of conscious cognitive strategies may, however, be incompatible with the complete automatization of the self-regulation skill.

Amyotrophic Lateral Sclerosis↗

Combining MEG and MRI with neuronavigation for treatment of an epileptiform spike focus in the precentral region: a technical case report.

BACKGROUND: Epileptic foci are often located in the vicinity but not necessarily within the boundaries of intra-axial brain tumors. Resection of these tumors is based on two major goals: first, maximizing tumor removal without provoking new neurologic deficits, and second, minimizing epileptic seizure activity. Magnetic source imaging (MSI) depicts the generators of magnetic fields overlaid on individual magnetic resonance (MR) images. Established application areas are lesions located adjacent to or partly within the sensory and motor cortex, or in the depth of the brain, necessitating a surgical approach through functionally highly relevant cortical regions. Magnetoencephalography (MEG) is also applicable for epileptiform spike foci recording during interictal activity. CASE DESCRIPTION: A patient with a recurrent glioma close to the Rolandic cortex scheduled for epilepsy and tumor surgery was investigated with MSI. The MSI data showed an epileptiform spike focus outside the tumor boundaries. The resulting MSI images were integrated into our neuronavigation system. This procedure allowed for the preoperative identification of the sensory and motor cortex, the precise localization of the epileptiform spike focus, and careful planning of the surgical procedure. In this case, we were able to safely resect the recurrent tumor and the epileptiform spike focus under general anesthesia using MSI-based neuronavigational guidance but no conventional intraoperative mapping techniques. CONCLUSION: Magnetic source imaging can be a valuable, noninvasive method for planning and performing tumor resections in high-risk brain regions, especially if an epileptiform spike focus has to be localized and included into the resection strategy.

Brain Neoplasms↗

Gender differences in response to pictures of nudes: a magnetoencephalographic study.

The magnetic equivalent of the contingent negative variation (CMV) and visual evoked magnetic fields (VEF) in anticipation of pictures of opposite-sex nude, same-sex nude, and neutral photographs has been recorded with whole-head MEG in 12 males and 12 females. Subjective ratings of valence indicated a strong gender effect. While females rated both male and female nudes as neutral, males rated male nudes similar to neutrals but female nudes received higher scores of pleasantness. Gender differences were also found for ratings of picture-induced arousal. While females rated male and female nudes as equally arousing, males attributed more arousal to opposite-sex nudes. The CMV instead revealed, for both male and female participants, higher amplitudes for opposite-sex nudes. VEF in response to nudes revealed two components with mean latencies of 126 and 203 ms. The amplitude of the first component was stronger in males than in females, and only in males the magnetic activity was increased in response to male and female nudes compared to neutral pictures. For the second component the mean magnetic activity was higher in response to nudes than to neutral contents for both male and female participants. The results are discussed in terms of an evolutionary view of sexual selection, which predicts a greater response in male subjects to stimuli relevant for mate choice.

Adult↗

Complexity of visual stimuli and non-linear EEG dynamics in humans.

The effects of stimulus complexity on the nonlinear electrical brain (EEG) dynamics were investigated in a sample of 24 healthy volunteers. Stimuli used were either a single mechanical low-friction pendulum with a periodic movement (temporal frequency about 1 Hz) or a double-pendulum with a chaotic movement, which were observed for 2-3 min in each case. The prediction that a more complex visual stimulus (double-pendulum) increases the dimensional complexity of brain activity as compared to a simple visual stimulus (single-pendulum), was confirmed by determination of pointwise correlation dimension. Further, there was a significant decrease of alpha power in the double-pendulum compared to a single-pendulum condition. Moreover, a correlation analysis showed a positive correlation between EEG complexity and beta power over the whole cortex in the single- and, above all, in the double-pendulum condition, and also a positive correlation between dimensional complexity and alpha power in the double-pendulum condition only, particularly in the brain regions responsible for the 'bottom-up' sustained attention processes.

Adult↗

Electrocortical and behavioral effects of chronic immobility on word processing.

Neuroelectrical and subjective effects of chronic motor deficits (severe immobility) on word processing were explored. A total of ten artificially ventilated patients with end-stage amyotrophic lateral sclerosis (ALS), seven patients with tetraplegia due to a high spinal cord injury (SCI), and nine matched controls were examined. Both ALS and SCI patients were almost completely paralyzed; eye, head, and face movements were intact in SCI but not in ALS patients. Event-related brain potentials (ERPs) were recorded during presentation of verbs with strong motor-action associations and nouns with strong visual associations. Subjects estimated the subjective strength of motor and visual associations for each word using a scale from 0 to 5. No between-group difference was found for subjectively rated motor associations. All patients reported much stronger visual associations for both nouns and verbs than healthy subjects. ERPs to both word classes revealed a left occipital negativity in SCI patients at a latency of 200-300 ms, and a marked decrease of the slow positive wave in the interval of 300-800 ms in the two patient groups. Both psychophysical and electrophysiological data suggest compensatory activation of visual information processing areas in severely paralyzed patients. The more pronounced effects in the SCI group as compared with the ALS group may be attributed to somatosensory deafferentation in SCI patients, while the sensory inflow in ALS remains relatively intact.

Adult↗

Event-related brain potentials in a patient with akinetic mutism.

The clinical pattern of complete akinetic mutism (AM) was observed in a patient with a bilateral infarction of the anterior cerebral arteries extending to the rostral cingulate cortex and the supplementary motor areas. Since the patient was unable to produce any overt response, event-related brain potentials (ERPs) were used to obtain information about cortical processing of stimuli. Oddball tasks with simple acoustical stimuli and semantic categories were used. Verbal processing was further assessed by comparing event-related potentials to words compatible versus incompatible to the semantic context. Although the pattern of cortical responses was abnormal, differential responses were clearly obtained to semantically different word classes. Thus, the hypothesis about cortical non-responsivity of AM patients, drawn from several previous reports, was not supported. An ERP examination in AM patients can deliver information about their mental state, provided that the stimuli and tasks possess a wide range of informational complexity and motivational value.

Akinetic Mutism↗

A brain-computer interface (BCI) for the locked-in: comparison of different EEG classifications for the thought translation device.

OBJECTIVE: The Thought Translation Device (TTD) for brain-computer interaction was developed to enable totally paralyzed patients to communicate. Patients learn to regulate slow cortical potentials (SCPs) voluntarily with feedback training to select letters. This study reports the comparison of different methods of electroencephalographic (EEG) analysis to improve spelling accuracy with the TTD on a data set of 6,650 trials of a severely paralyzed patient. METHODS: Selections of letters occurred by exceeding a certain SCP amplitude threshold. To enhance the patient's control of an additional event-related cortical potential, a filter with two filter characteristics ('mixed filter') was developed and applied on-line. To improve performance off-line the criterion for threshold-related decisions was varied. Different types of discriminant analysis were applied to the EEG data set as well as on wavelet transformed EEG data. RESULTS: The mixed filter condition increased the patients' performance on-line compared to the SCP filter alone. A threshold, based on the ratio between required selections and rejections, resulted in a further improvement off-line. Discriminant analysis of both time-series SCP data and wavelet transformed data increased the patient's correct response rate off-line. CONCLUSIONS: It is possible to communicate with event-related potentials using the mixed filter feedback method. As wavelet transformed data cannot be fed back on-line before the end of a trial, they are applicable only if immediate feedback is not necessary for a brain-computer interface (BCI). For future BCIs, wavelet transformed data should serve for BCIs without immediate feedback. A stepwise wavelet transformation would even allow immediate feedback.

Communication Devices for People with Disabilities↗

Neurofeedback treatment for attention-deficit/hyperactivity disorder in children: a comparison with methylphenidate.

Clinical trials have suggested that neurofeedback may be efficient in treating attention-deficit/hyperactivity disorder (ADHD). We compared the effects of a 3-month electroencephalographic feedback program providing reinforcement contingent on the production of cortical sensorimotor rhythm (12-15 Hz) and betal activity (15-18 Hz) with stimulant medication. Participants were N = 34 children aged 8-12 years, 22 of which were assigned to the neurofeedback group and 12 to the methylphenidate group according to their parents' preference. Both neurofeedback and methylphenidate were associated with improvements on all subscales of the Test of Variables of Attention, and on the speed and accuracy measures of the d2 Attention Endurance Test. Furthermore, behaviors related to the disorder were rated as significantly reduced in both groups by both teachers and parents on the IOWA-Conners Behavior Rating Scale. These findings suggest that neurofeedback was efficient in improving some of the behavioral concomitants of ADHD in children whose parents favored a nonpharmacological treatment.

Attention Deficit Disorder with Hyperactivity↗

Perception and production of biological movement in patients with early periventricular brain lesions.

Recent neuroimaging and psychophysical findings suggest that perception and production of human body motion share a common representational network. In the present study, we address the issue of whether early disorders in production of biological movement correspond to impairment in biological motion perception. By using the simultaneous masking paradigm, we examined visual sensitivity to biological motion in adolescents (aged 13-16 years) who were born very preterm (at 27-33 gestational weeks). In a confidence rating procedure, the presence of a point-light walking figure embedded in a moving mask was judged. The participants differed in their locomotion ability, ranging from normal to a complete walking disability exhibiting signs of leg-dominated bilateral spastic cerebral palsy (BS-CP) caused by periventricular leukomalacia (PVL). Irrespective of an ability to produce movement, patients with a similar extent of PVL in the parieto-occipital complex exhibit nearly the same sensitivity to biological motion. Sensitivity correlates negatively with the extent of PVL over the parieto-occipital complex, whereas neither the severity of motor disorder nor the severity of pyramidal tract affection relate significantly to the sensitivity index. The data suggest that perception of biological motion is not substantially affected by an observer's early restrictions in body movement. Instead, the findings favour the assumption that the common network for perception and production of biological motion might be inherent for the brain. Motor experience per se does not appear to be necessary for the visual analysis of human movement.

Adolescent↗

Motor learning elicited by voluntary drive.

Motor training consisting of voluntary movements leads to performance improvements and results in characteristic reorganizational changes in the motor cortex. It has been proposed that repetition of passively elicited movements could also lead to improvements in motor performance. In this study, we compared behavioural gains, changes in functional MRI (fMRI) activation in the contralateral primary motor cortex (cM1) and in motor cortex excitability measured with transcranial magnetic stimulation (TMS) after a 30 min training period of either voluntarily (active) or passively (passive) induced wrist movements, when alertness and kinematic aspects of training were controlled. During active training, subjects were instructed to perform voluntary wrist flexion-extension movements of a specified duration (target window 174-186 ms) in an articulated splint. Passive training consisted of wrist flexion- extension movements elicited by a torque motor, of the same amplitude and duration range as in the active task. fMRI activation and TMS parameters of motor cortex excitability were measured before and after each training type. Motor performance, measured as the number of movements that hit the target window duration, was significantly better after active than after passive training. Both active and passive movements performed during fMRI measurements activated cM1. Active training led to more prominent increases in (i) fMRI activation of cM1; (ii) recruitment curves (TMS); and (iii) intracortical facilitation (TMS) than passive training. Therefore, a short period of active motor training is more effective than passive motor training in eliciting performance improvements and cortical reorganization. This result is consistent with the concept of a pivotal role for voluntary drive in motor learning and neurorehabilitation.

Adult↗

Brain circuits involved in emotional learning in antisocial behavior and social phobia in humans.

While psychopaths (PP) lack anticipatory fear, social phobics (SP) are characterized by excessive fear. Criminal PP, SP and healthy controls (HC) participated in differential aversive delay conditioning with neutral faces as conditioned (CS) and painful pressure as unconditioned stimuli. Functional magnetic resonance imaging revealed differential activation in the limbic-prefrontal circuit (orbitofrontal cortex, insula, anterior cingulate, amygdala) in the HC. By contrast, the PP displayed brief amygdala, but no further brain activation. The SP showed increased activity to the faces in the amygdala and orbitofrontal cortex already during habituation. Thus, a hypoactive frontolimbic circuit may represent the neural correlate of psychopathic behavior, whereas an overactive frontolimbic system may underly social fear.

Adult↗

Psychophysiological and subjective indicators of aversive pavlovian conditioning in generalized social phobia.

Aversive conditioning has been proposed as an important etiologic mechanism in social phobia; however, empirical evidence is scarce and has not relied on a detailed analysis of the acquisition and extinction of the conditioned emotional response. Fourteen men sustaining generalized social phobia and 19 healthy control subjects participated in differential aversive conditioning with two neutral faces as conditioned stimuli and an aversive odor as unconditioned stimulus. Subjective and peripheral physiological responses were obtained. Both groups were successfully conditioned as reflected by differential subjective (valence, arousal, subjective unconditioned stimulus expectancy) and peripheral physiological responses (skin conductance, startle response). There was no evidence for an enhanced conditionability in the social phobics; however, they showed an enhanced unconditioned stimulus expectancy, especially for the nonreinforced conditioned stimuli during acquisition, and a delayed extinction of the conditioned skin conductance response as well as a certain dissociation between subjective and physiological responses.The enhanced unconditioned stimulus expectancy during acquisition and the overall elevated subjective arousal suggest that, under threat, subjects with generalized social phobia may be more prone to associate neutral social cues and an aversive outcome. Furthermore, delayed extinction of the conditioned response seems to contribute to the etiology and maintenance of generalized social phobia.

Adult↗

Dynamics of gamma-band activity during an audiospatial working memory task in humans.

The representation of visual objects in short-term memory has been shown to be related to increased gamma-band activity in the electroencephalogram. Using a similar paradigm, we investigated oscillatory magnetoencephalographic activity in human subjects during a delayed matching-to-sample task requiring working memory of auditory spatial information. The memory task involved same-different judgments about the lateralization angle of pairs of filtered noise stimuli (S1 and S2) separated by 800 msec delays of background noise. This was compared with a control condition requiring the detection of a possible change in the background noise volume appearing instead of S2 (volume task). Statistical probability mapping revealed increased spectral activity at 59 Hz over left parietal cortex during the delay phase of the memory condition. In addition, 59 Hz coherence was enhanced between left parietal and right frontal sensors. During the end of the delay and during the presentation of S2, enhanced gamma-band activity at 67 Hz was observed over right frontal and later over midline parietal areas. In contrast, the volume task was characterized by increased left inferior frontotemporal 59 Hz spectral amplitude after S1. Apparently representation of the spatial position of a sound source is associated both with synchronization of networks in parietal areas involved in the auditory dorsal stream and with increased coupling between networks serving representation of audiospatial information and frontal executive systems. The comparison with S2 seemed to activate frontal and parietal neuronal ensembles. Gamma-band activity during the volume task may reflect auditory pattern encoding in auditory ventral stream areas.

Adult↗

Modulation of slow cortical potentials by transcranial magnetic stimulation in humans.

We studied the effects of transcranial magnetic stimulation (TMS) on slow cortical potentials (SCPs) of the brain elicited during performance of a feedback and reward task. Ten healthy participants were trained to self-regulate their SCP amplitude using visual feedback and reward for increased or decreased amplitudes. Subjects participated in 27 runs (each comprising 70 trials) under three different conditions: single-pulse TMS delivered with the coil centered over Cz (vertex), over a lateral scalp position (LSP), which increased task difficulty, and in the absence of stimulation. Cz stimulation led to a non-significant enhancement of negative SCPs, while LSP stimulation led to a significant increase of positive SCPs. These results are consistent with the idea that enhanced task difficulty, as in LSP stimulation, enhances cognitive processing load leading to an increase of positive SCPs. Additionally, the data raise the hypothesis that TMS delivered to bilateral midcentral regions could modulate the amplitude of negative SCPs.

Adult↗

Can humans perceive their brain states?

Although the brain enables us to perceive the external world and our body, it remains unknown whether brain processes themselves can be perceived. Brain tissue does not have receptors for its own activity. However, the ability of humans to acquire self-control of brain processes indicates that the perception of these processes may also be achieved by learning. In this study patients learned to control low-frequency components of their EEG: the so-called slow cortical potentials (SCPs). In particular "probe" sessions, the patients estimated the quality of the SCP shift they had produced in the preceding trial. The correspondence between the recorded SCP amplitudes and the subjective estimates increased with training. The ability to perceive the SCPs was related to the ability to control them; this perception was not mediated by peripheral variables such as changes in muscle tonus and cannot be reduced to simple vigilance monitoring. These data provide evidence that humans can learn to perceive the neural activity of their brain. Alternative interpretations are discussed.

Adult↗

Functional organization of primary somatosensory cortex depends on the focus of attention.

We used magnetic source imaging in human subjects to reveal within-subject variations of the homuncular hand representation within the primary somatosensory cortex modulated by attention. In one condition subjects were trained to detect sequential leftward or rightward stimulus motion across the fingers of the left hand ("hand" condition) and in a different condition to detect stimulus motion at a specific finger on this hand ("finger" condition). Afferent input was controlled by applying exactly the same stimulus pattern to the digits in the two tasks. Segregation of the somatotopic hand representation (an increase in the distance between the representations of digits 2 and 5) was observed, commencing with the onset of practice, in the finger relative to the hand condition. Subsequent training in the hand and finger conditions with feedback for correctness did not modify segregation, indicating that segregation was a task effect and not a training effect. These findings indicate that the hand representation within the primary somatosensory cortex is not statically fixed but is dynamically modulated by top-down mechanisms to support task requirements. A greater capacity for modulation of the functional cortical organization was positively correlated with superior learning and task performance.

Adult↗