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T Paus

Publications and source records attributed to T Paus.

At least 37 records · Page 2Linked to original sources

Progressive cortical change during adolescence in childhood-onset schizophrenia. A longitudinal magnetic resonance imaging study.

BACKGROUND: Adolescence provides a window to examine regional and disease-specific late abnormal brain development in schizophrenia. Because previous data showed progressive brain ventricular enlargement for a group of adolescents with childhood-onset schizophrenia at 2-year follow-up, with no significant changes for healthy controls, we hypothesized that there would be a progressive decrease in volume in other brain tissue in these patients during adolescence. METHODS: To examine cortical change, we used anatomical brain magnetic resonance imaging scans for 15 patients with childhood-onset schizophrenia (defined as onset of psychosis by age 12 years) and 34 temporally yoked, healthy adolescents at a mean (SD) age of 13.17 (2.73) years at initial baseline scan and 17.46 (2.96) years at follow-up scan. Cortical gray and white matter volumes were obtained with an automated analysis system that classifies brain tissue into gray matter, white matter, and cerebrospinal fluid and separates the cortex into anatomically defined lobar regions. RESULTS: A significant decrease in cortical gray matter volume was seen for healthy controls in the frontal (2.6%) and parietal (4.1%) regions. For the childhood-onset schizophrenia group, there was a decrease in volume in these regions (10.9% and 8.5%, respectively) as well as a 7% decrease in volume in the temporal gray matter. Thus, the childhood-onset schizophrenia group showed a distinctive disease-specific pattern (multivariate analysis of variance for change X region X diagnosis: F, 3.68; P = .004), with the frontal and temporal regions showing the greatest between-group differences. Changes in white matter volume did not differ significantly between the 2 groups. CONCLUSIONS: Patients with very early-onset schizophrenia had both a 4-fold greater decrease in cortical gray matter volume during adolescence and a disease-specific pattern of change. Etiologic models for these patients' illness, which seem clinically and neurobiologically continuous with later-onset schizophrenia, must take into account both early and late disruptions of brain development.

Adolescent↗

Increased blood flow in the basal ganglia when using cues to direct attention.

We used positron emission tomography (PET) in ten subjects to study the brain regions involved in voluntary shifts of attention. For six scans, subjects performed a visual target detection task in which the location of the target was indicated in advance on some proportion of trials by the appearance of an arrow cue at fixation. The informative cues were successful in speeding reaction time to the target. Blood flow in the left putamen was correlated with the proportion of informative cues provided within a scan. We discuss this finding in terms of three possible interpretations: attentional shifts, response inhibition, and motor preparation related to the use of the right hand to respond. Blood flow in cortical regions commonly associated with attention was not related to cue ratio, a finding that may reflect automatization of the processes involved in interpreting and using the cues.

Adult↗

Imaging the brain before, during, and after transcranial magnetic stimulation.

This article provides a brief overview of current trends in combining neuroimaging and transcranial magnetic stimulation (TMS). First, I outline the utility of magnetic-resonance imaging (MRI) and frameless stereotaxy for planning, monitoring and documenting the location of the TMS coil relative to the subject's brain. Second, I describe two novel methods, based on the combination of TMS with positron emission tomography (PET) or with electroencephalography (EEG), for the assessment of connectivity and excitability of the human cerebral cortex. Finally, I point out the utility of PET and MRI for evaluating possible long-term effects of repetitive TMS.

Brain↗

Frequency-dependent changes in cerebral metabolic rate of oxygen during activation of human visual cortex.

To test the hypothesis that brain oxidative metabolism is significantly increased upon adequate stimulation, we varied the presentation of a visual stimulus to determine the frequency at which the metabolic response would be at maximum. The authors measured regional CMR(O2) in 12 healthy normal volunteers with the ECAT EXACT HR+ (CTI/Siemens, Knoxville, TN, U.S.A.) three-dimensional whole-body positron emission tomograph (PET). In seven successive activating conditions, subjects viewed a yellow-blue annular checkerboard reversing its contrast at frequencies of 0, 1, 4, 8, 16, 32, and 50 Hz. Stimulation began 4 minutes before and continued throughout the 3-minute dynamic scan. In the baseline condition, the subjects began fixating a cross hair 30 seconds before the scan and continued to do so for the duration of the 3-minute scan. At the start of each scan, the subjects inhaled 20 mCi of (15)O-O2 in a single breath. The CMR(O2) value was calculated using a two-compartment, weighted integration method. Normalized PET images were averaged across subjects and coregistered with the subjects' magnetic resonance imaging in stereotaxic space. Mean subtracted image volumes (activation minus baseline) of CMR(O2) then were obtained and converted to z statistic volumes. The authors found a statistically significant focal change of CMR(O2) in the striate cortex (x = 9; y = -89; z = -1) that reached a maximum at 4 Hz and dropped off sharply at higher stimulus frequencies.

Administration, Inhalation↗

Cerebral mechanisms of hypnotic induction and suggestion.

The neural mechanisms underlying hypnotic states and responses to hypnotic suggestions remain largely unknown and, to date, have been studied only with indirect methods. Here, the effects of hypnosis and suggestions to alter pain perception were investigated in hypnotizable subjects by using positron emission tomography (PET) measures of regional cerebral blood flow (rCBF) and electroencephalographic (EEG) measures of brain electrical activity. The experimental conditions included a restful state (Baseline) followed by hypnotic relaxation alone (Hypnosis) and by hypnotic relaxation with suggestions for altered pain unpleasantness (Hypnosis-with-Suggestion). During each scan, the left hand was immersed in neutral (35 degree C) or painfully hot (47 degrees C) water in the first two conditions and in painfully hot water in the last condition. Hypnosis was accompanied by significant increases in both occipital rCBF and delta EEG activity, which were highly correlated with each other (r = 0.70, p < 0.0001). Peak increases in rCBF were also observed in the caudal part of the right anterior cingulate sulcus and bilaterally in the inferior frontal gyri. Hypnosis-related decreases in rCBF were found in the right inferior parietal lobule, the left precuneus, and the posterior cingulate gyrus. Hypnosis-with-suggestions produced additional widespread increases in rCBF in the frontal cortices predominantly on the left side. Moreover, the medial and lateral posterior parietal cortices showed suggestion-related increases overlapping partly with regions of hypnosis-related decreases. Results support a state theory of hypnosis in which occipital increases in rCBF and delta activity reflect the alteration of consciousness associated with decreased arousal and possible facilitation of visual imagery. Frontal increases in rCBF associated with suggestions for altered perception might reflect the verbal mediation of the suggestions, working memory, and top-down processes involved in the reinterpretation of the perceptual experience. These results provide a new description of the neurobiological basis of hypnosis, demonstrating specific patterns of cerebral activation associated with the hypnotic state and with the processing of hypnotic suggestions.

Adult↗

Regional differences in the effects of task difficulty and motor output on blood flow response in the human anterior cingulate cortex: a review of 107 PET activation studies.

We reviewed 107 blood flow activation studies carried out with positron emission tomography and published between January 1993 and November 1996. These studies had reported their findings as peaks of significant difference in cerebral blood-flow (CBF) between two scans/tasks and had located the peaks in standardized stereotaxic space. We coded each task along several dimensions, including the type and rate of input and output, the types of cognitive processes, and the relative difficulty of tasks within a study. Based on this coding, a difference score (A-B) was calculated for each subtraction. Subsequently, the frequency distributions of the difference scores for subtractions yielding a peak in the anterior cingulate region (cingulate peak) were compared with those distributions obtained from subtractions without a cingulate peak (no cingulate-peak). The cingulate peak subtractions (n = 158) differed from the no cingulate peak subtractions (n = 229) in terms of difficulty level (p = 0.001) and the presence of a remote memory component (p = 0.01). Regional differences in the frequency distribution of certain task parameters, such as difficulty level, recent memory and the use of the hand for responding, were also observed when peaks found in the anterior cingulate cortex (ACC) were further classified as located in the rostral vs caudal ACC, supracallosal vs subcallosal ACC, and limbic vs paralimbic parts of the supracallosal ACC. We conclude that task difficulty plays a major role in modulating blood-flow response in the ACC, possibly interacting with other parameters such as the nature of the response and memory demands.

Animals↗

Directed attention after unilateral frontal excisions in humans.

We investigated the ability of patients with frontal-lobe lesions to benefit from advance information in a simple reaction-time task. The task involved pressing a button in response to the appearance of a peripheral target (visual angle of 11.5 degrees). A cue, presented in the centre of the screen, preceded the target onset by either a short (average 500 ms) or a long (average 3000 ms) interval. In half of the trials, the cue was an arrow indicating the location, in the left or right hemifield, of the upcoming target; in the other half, the cue was an uninformative plus sign. In addition to patients with unilateral excisions of frontal cortex, we tested patients with anterior temporal-lobe excisions and normal controls. The frontal-lobe group was mildly impaired with respect to the temporal-lobe group in using advance spatial cues to speed response to the visual target. While the size of the cueing effect changed across the range of cue-target intervals tested, there was no variation across intervals in the size of the impairment exhibited by the frontal-lobe group. The site and the volume of the lesions were determined on the basis of magnetic resonance image (MRI) scans in 10 of the 17 patients in the frontal group. There was no correlation between lesion volume and benefit score in these patients.

Adolescent↗

Dose-dependent reduction of cerebral blood flow during rapid-rate transcranial magnetic stimulation of the human sensorimotor cortex.

Rapid-rate transcranial magnetic stimulation (rTMS) was used to stimulate the primary sensorimotor cortex in six healthy volunteers while regional changes in cerebral blood flow (CBF) were simultaneously measured by means of positron emission tomography. A figure-eight TMS coil (Cadwell Corticoil) was positioned, using frameless stereotaxy, over the probabilistic location of the left primary sensorimotor cortex, and a series of brief 10-Hz trains of TMS was delivered at subthreshold intensity during each of six 60-s scans. The scans differed in the number of trains delivered, namely 5, 10, 15, 20, 25, and 30 trains/scan, respectively. In the left primary sensorimotor cortex, CBF covaried significantly and negatively with the number of stimulus trains. These CBF decreases may reflect TMS-induced activation of local inhibitory mechanisms known to play a role in TMS-related phenomena, such as the electromyographic silent period.

Adult↗

Applications of random field theory to functional connectivity.

Functional connectivity between two voxels or regions of voxels can be measured by the correlation between voxel measurements from either PET CBF or BOLD fMRI images in 3D. We propose to look at the entire 6D matrix of correlations between all voxels and search for 6D local maxima. The main result is a new theoretical formula based on random field theory for the p-value of these local maxima, which distinguishes true correlations from background noise. This can be applied to crosscorrelations between two different sets of images--such as activations under two different tasks, as well as autocorrelations within the same set of images.

Brain Mapping↗

Transcranial magnetic stimulation during PET: reaching and verifying the target site.

Transcranial magnetic stimulation (TMS) during positron emission tomography (PET) is a novel technique for in vivo measurements of connectivity and excitability of the human cerebral cortex. Here we describe tools that allow investigators to position the stimulating coil over a target region and to verify the actual position of the coil after the study. The former is achieved by coregistering the head of the subject with an MR image of his/her brain using frameless stereotaxy. The latter is accomplished by identifying the coil on a transmission scan and coregistering it, e.g., with a model of the electrical field induced in the brain.

Cerebral Cortex↗

Regional cerebral blood flow changes as a function of delta and spindle activity during slow wave sleep in humans.

In the present study, we investigated changes in regional cerebral blood flow (rCBF) in humans during the progression from relaxed wakefulness through slow wave sleep (SWS). These changes were examined as a function of spindle (12-15 Hz) and delta (1.5-4.0 Hz) electroencephalographic (EEG) activity of SWS. rCBF was studied with positron emission tomography (PET) using the H215O bolus method. A maximum of six 60 sec scans were performed per subject during periods of wakefulness and stages 1-4 of SWS, as determined by on-line EEG monitoring. Spectral analysis was performed off-line on the EEG epochs corresponding to the scans for computation of activity in specific frequency bands. The relationship between EEG frequency band activity and normalized rCBF was determined by means of a voxel-by-voxel analysis of covariance. delta activity covaried negatively with rCBF most markedly in the thalamus and also in the brainstem reticular formation, cerebellum, anterior cingulate, and orbitofrontal cortex. After the effect of delta was removed, a significant negative covariation between spindle activity and the residual rCBF was evident in the medial thalamus. These negative covariations may reflect the disfacilitation and active inhibition of thalamocortical relay neurons in association with delta and spindles, as well as the neural substrates underlying the progressive attenuation of sensory awareness, motor responsiveness, and arousal that occur during SWS. delta activity covaried positively with rCBF in the visual and auditory cortex, possibly reflecting processes of dream-like mentation purported to occur during SWS.

Adult↗

Transcranial magnetic stimulation during positron emission tomography: a new method for studying connectivity of the human cerebral cortex.

We describe a new technique permitting the mapping of neural connections in the living human brain. The method combines two well established tools of brain research: transcranial magnetic stimulation (TMS) and positron emission tomography (PET). We use TMS to stimulate directly a selected cortical area while simultaneously measuring changes in brain activity, indexed by cerebral blood flow (CBF), with PET. The exact location of the stimulation site is achieved by means of frameless stereotaxy. In the first study using this technique, we found significant positive correlations between CBF and the number of TMS pulse trains at the stimulation site, namely the left frontal eye field (FEF) and, most importantly, in the visual cortex of the superior parietal and medial parieto-occipital regions. The pattern of these distal effects was consistent with the known anatomic connectivity of the monkey FEF. We suggest that the combined TMS/PET technique offers an objective tool for assessing the state of functional connectivity without requiring the subject to engage in any specific behavior.

Adult↗

Blindsight in hemispherectomized patients as revealed by spatial summation across the vertical meridian.

The present study provides a demonstration of blindsight in two hemispherectomy patients who showed a visual spatial summation effect across the vertical meridian despite their lack of visual awareness in one hemifield. Such an effect cannot be related to light diffusion onto the sighted hemifield because it was not present when one of the stimuli fell into the retinal blind spot of control subjects. We conclude that blindsight phenomena of the simple type described in the present study can be subserved by sub-cortical mechanisms and do not necessarily require cortical processing.

Adolescent↗

In vivo morphometry of the intrasulcal gray matter in the human cingulate, paracingulate, and superior-rostral sulci: hemispheric asymmetries, gender differences and probability maps.

Volumes of the intrasulcal gray matter were measured in three cerebral sulci located on the medial wall of the human frontal lobe: cingulate sulcus (CS), paracingulate sulcus (PCS), and superior-rostral sulcus (SRS). The measurements were carried out on T1-weighted 3-D high-resolution magnetic-resonance (MR) images acquired in 105 young right-handed volunteers (42 female and 63 male). Before the measurement, the images were transformed into a standardized stereotaxic space (Talairach and Tournoux [1988] Human Brain: 3-Dimensional Proportional System. An Approach to Cerebral Imaging. Stuttgart, New York: Georg Thieme Verlag), thus removing inter-individual differences in brain size. The intrasulcal gray matter was segmented in a semi-automatic manner. Significant gender differences were found in the volume of the CS (female > male) and the PCS (male > female). Hemispheric asymmetries were observed between the left and right volumes of the intrasulcal gray matter in the anterior (right > left) and posterior (left > right) segments of the CS, as well as between the left and right volumes of the PCS (left > right). There was no interaction between the asymmetries and gender. In addition, significant positive correlations were found between the left and right gray-matter volumes in the anterior (r = 0.43) and posterior (r = 0.66) segments of the CS, whereas significant negative correlations were observed between the gray-matter volumes of the anterior segment of the CS and those of the PCS (left hemisphere: r = -0.48; right hemisphere: r = -0.42). The observed hemispheric asymmetries in the CS and PCS gray-matter volumes are consistent with the proposed role of these structures in the integration of emotions with cognition (CS) and in the control of speech/vocalization (PCS). The pattern of inter-hemispheric correlations in the sulcal gray-matter points to an increasing asynchrony in the foetal development of primary (CS), secondary (SRS), and tertiary (PCS) sulci, respectively. The presence of negative correlations between the two neighbouring sulci (CS and PCS) suggests that a process of compensation could underlie interactions between adjacent primary and tertiary sulci. Besides the above volumetric analysis, we also provide average (probability) maps of the three sulci; the use of such maps for the parcellation of the medial frontal lobe and localization of "peaks" obtained in blood-flow activation studies is discussed.

Brain Mapping↗

Imaging motor-to-sensory discharges in the human brain: an experimental tool for the assessment of functional connectivity.

We present a new approach to studying functional connectivity in the human brain. This approach is based on the observation that when we engage in motor activity, a discharge corollary to the motor command is sent from motor to sensory structures. Thus, as long as movement-related sensory input is either prevented or masked, modulation of neuronal activity in sensory structures would indicate the presence of functional connectivity between the motor and the sensory regions. Using positron emission tomography, such a central interaction between motor and sensory regions can be assessed by measuring regional changes in cerebral blood flow (CBF) in sensory regions. In this paper, we describe the experimental design and the results of two studies of corollary discharges, namely those generated during eye movements and speech. In these studies, a graded approach was used to establish the relationship between the number of eye movements or utterances and CBF in visual or auditory regions, respectively. Significant covariations between the number of movements and CBF in sensory regions were found, thus indicating the presence of functional connectivity between motor and sensory regions. In addition, interregional CBF covariations were computed and the effect of removing the intersubject variance on these covariations was evaluated. The corollary-discharge-based approach to studying functional connectivity is discussed in the context of more traditional computational approaches to network analysis in functional brain imaging.

Brain↗

Location and function of the human frontal eye-field: a selective review.

The location and possible function of the human frontal eye-field (FEF) were evaluated by reviewing results of cerebral blood-flow (CBF) and lesion studies. A remarkable consistency was found regarding the rostro-caudal (Y: from -6 to 1 mm) and dorso-ventral (Z: from 44 to 51 mm) location of the FEF, as defined by the CBF method within a standardized stereotaxic system (the zero point for all X, Y and Z coordinates coinciding with the anterior commissure, Talairach and Tournoux [Co-planar Stereotactic Atlas of the Human Brain, Georg Thieme, Stuttgart, 1988]. In contrast, there was a marked variability along the mediolateral axis (X: from -24 to -40 mm for the left hemisphere and from 21 to 40 mm for the right hemisphere). The human FEF is thus located either in the vicinity of the precentral sulcus and/or in the depth of the caudalmost part of the superior frontal sulcus. In either case, this location challenges the commonly held view of the FEF being located in Broadmann's area 8. With regard to FEF function, the results of CBF studies failed to support a role for the FEF in the cognitive aspects of oculomotor control, such as the execution of anti-saccades. Blood-flow activation data are consistent in this respect with the results of lesion studies. It is proposed that future research on FEF function in human subjects may benefit from focusing on the visuomotor rather than the cognitive aspects of oculomotor control.

Cerebrovascular Circulation↗

Modulation of cerebral blood flow in the human auditory cortex during speech: role of motor-to-sensory discharges.

To investigate mechanisms of audio-vocal interactions in the human brain, we studied the effect of speech output on modulation of neuronal activity in the auditory cortex. The modulation was assessed indirectly by measuring changes in cerebral blood flow (CBF) during unvoiced speech (whispering). Using positron emission tomography (PET), CBF was measured in eight volunteers as they uttered syllables at each of seven rates (30, 50, 70, 90, 110, 130 or 150/min) during each of the seven 60-s PET scans. Low-intensity white noise was used throughout scanning to mask auditory input contingent on the whispering. We found that, as a function of the increasing syllable rate, CBF increased in the left primary face area, the upper pons, the left planum temporale and the left posterior perisylvian cortex. The latter two regions contain secondary auditory cortex and previously have been implicated in the processing of speech sounds. We conclude that, in the absence of speech-contingent auditory input, the modulation of CBF in the auditory cortex is mediated by motor-to-sensory discharges. As such, it extends our previous findings of oculomotor corollary discharges to the audio-vocal domain.

Adult↗