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Biomedical subjects

W R Goff

Publications and source records attributed to W R Goff.

At least 19 recordsLinked to original sources

Localization of human sensorimotor cortex during surgery by cortical surface recording of somatosensory evoked potentials.

The traditional means of localizing sensorimotor cortex during surgery is Penfield's procedure of mapping sensory and motor responses elicited by electrical stimulation of the cortical surface. This procedure can accurately localize sensorimotor cortex but is time-consuming and best carried out in awake, cooperative patients. An alternative localization procedure is presented that involves cortical surface recordings of somatosensory evoked potentials (SEP's), providing accurate and rapid localization in patients under either local or general anesthesia. The morphology and amplitude of median nerve SEP's recorded from the cortical surface varied systematically as a function of spatial location relative to the sensorimotor hand representation area. These results were validated in 18 patients operated on under local anesthesia in whom the sensorimotor cortex was independently localized by electrical stimulation mapping; the two procedures were in agreement in all cases. Similar SEP results were demonstrated in an additional 27 patients operated on under general anesthesia without electrical stimulation mapping. The following three spatial relationships between SEP's and the anatomy of the sensorimotor cortex permit rapid and accurate localization of the sensorimotor hand area: 1) SEP's with approximately mirror-image waveforms are recorded at electrode sites in the hand area on opposite sides of the central sulcus (P20-N30 precentrally and N20-P30 postcentrally); 2) the P25-N35 is recorded from the postcentral gyrus as well as a small region of the precentral gyrus in the immediate vicinity of the central sulcus: this waveform is largest on the postcentral gyrus about 1 cm medial to the focus of the 20- and 30-msec potentials; and 3) regardless of component identification, maximum SEP amplitudes are recorded from the hand representation area on the precentral and postcentral gyri.

Anesthesia, General

Modification of median nerve somatic evoked potentials by prior median nerve, peroneal nerve, and auditory stimulation.

In a recovery function design, changes were measured in the somatic evoked potential (SEP) to right median nerve (RMN) shocks preceded by stimulation of: the same nerve (RMN-RMN); the left median nerve having primary input to the homologous sensory area in the contralateral hemisphere (LMN-RMN); the right peroneal nerve having primary input to a different region of the same hemisphere (RPN-RMN); and the auditory nerve with primary input to a different sensory modality (AUD-RMN). Eight inter-stimulus intervals ranged from zero (simultaneous) to 2.5 sec. It was assumed that the degree of interaction between evoked potentials would be related to the degree to which common neural structures are activated or modulated in response to the stimuli. Results were: (a) the primary somatosensory response N20-P30 was little influenced by other somatic or auditory stimulation, interaction occurring predominantly in the RMN-RMN condition; (b) with increasing latency, components showed increasing interaction across modalities; (c) preceding homolateral stimulation (RPN-RMN) showed no greater interaction than preceding contralateral stimulation (LMN-RMN); (d) N55-P100 differed from the primary somatosensory response N20-P30 by showing greater interaction with other somatic stimuli; and (e) N140-P190 showed similarly shaped recovery functions across stimulus pairs but significant differences in magnitude of interaction. These results show that components with similar wave form and topographical characteristics can have different neurophysiological properties.

Acoustic Stimulation

Developmental and aging changes in somatosensory, auditory and visual evoked potentials.

To assess developmental and aging changes in human sensory systems, components of short-latency somatosensory, brain-stem auditory and pattern-reversal visual evoked potentials, thought to originate in specific structures of these systems, were recorded in 286 normal subjects ranging in age from 4 to 95 years. Analysis was primarily restricted to peak and interpeak latencies; visual evoked potential amplitudes were also analyzed. Major results and conclusions are: (1) 'Developmental' changes (that is, decreases in latency attributable to decreased conduction time in younger subjects) were not seen in the median nerve, in brain-stem auditory pathways, or in some portions of visual cortex. Small developmental changes were seen in the somatosensory afferent pathway from the cervical spinal cord to thalamus, and large changes were seen in somatosensory and visual cortex. Cortical developmental changes appeared not to be complete until 17 years of age or later. (2) 'Aging' changes (that is, increases in latency attributable to increased conduction time in older subjects) were observed in the median nerve, cervical spinal cord, brain-stem auditory pathways, and somatosensory and visual cortex. (3) Visual evoked potential amplitudes tended to decrease with age, particularly during development; amplitude and latency effects were dissimilar for most components. (4) Males tended to show larger aging effects than females. (5) The results suggest that age-related changes in human sensory systems are not uniform, but rather are different in specific portions of these systems, different at particular epochs of the life span, and stronger in males than in females.

Adolescent

Somatic evoked potential evaluation of cerebral status in Reye syndrome.

Median nerve somatic evoked potentials (SEPs) were serially recorded in 12 Reye syndrome patients from shortly after admission to discharge. Recovery was clinically satisfactory in nine, unsatisfactory in two, and one died. All SEP components were absent or markedly depressed in initial recordings. Early progressive recovery of primary cortical components was associated with patient survival; lack of it was associated with death. Progressive recovery of SEP components later than 100 msec was associated with satisfactory clinical recovery; failure of recovery of these components was associated with residual neuropsychological deficit. Evaluation of late component recovery required comparison with age-dependent SEP configurations in normal children which differ from adults. We conclude that serial SEP recording is of significant value and superior to the EEG in early prognosis for survival, prognosis for clinically satisfactory or unsatisfactory recovery, and general evaluation of neurologic status in Reye syndrome.

Adolescent

Brain stem auditory, pattern-reversal visual, and short-latency somatosensory evoked potentials: latencies in relation to age, sex, and brain and body size.

To determine standards of normality for auditory, somatosensory and visual evoked potentials commonly used in the assessment of neurological disease, 8 AEP, 1 VEP and 12 SEP components were recorded to stimulation of left and right ears, eyes, and median nerves in 286 normal subjects ranging in age from 4 to 95 years. Peak and interpeak latencies, and left-right differences in latency, were analyzed as a function of age, sex, and estimates of brain and body size. Major features of the results were: (1) Peak latencies of all components showed statistically significant increases in latency with age except that VEP P100 latency decreased significantly between 4 and 19 years and did not change between 20 and 59 years. (2) In adults the peak latencies of all components were significantly later in males than in females. For AEPs and VEPs these differences were explained by sex differences in brain size, and for adult SEPs were explained by sex differences in arm and shoulder dimensions. No significant sex differences in VEP and SEP latencies were seen in children. (3) Most interpeak latencies showed significant differences in relation to age or sex. (4) Age and sex are useful predictors of latency for nearly all peak and interpeak latencies; in addition, height is a useful predictor of SEP peak latencies. (5) Left-right latency differences showed little age-related, and no sex-related, change. The interlaboratory use of these or other normative data was discussed. It was concluded that these AEP and SEP norms can probably be used in other laboratories if stimulating and recording conditions are similar. However, VEP results are difficult to transfer due to the poorly understood effects of variation in stimulus conditions. Some issues regarding the optimal characterization of norms were also discussed.

Adolescent

On-line statistical detection of average evoked potentials: application to evoked response audiometry (ERA).

An objective method of EP detection in averaged EEG epochs is described which is based on the statistical properties of the averaged EEG in the absence of time-locked EP activity. The statistical properties of the subject's averaged background EEG are summarized by making a set of comparisons between two consecutive EEG epochs immediately preceding each stimulus presentation. After every stimulus presentation, a second set of comparisons is made between the post-stimulus EEG epoch and the immediately preceding pre-stimulus EEG epoch. These two sets of comparisons are then examined to determine whether the latter differ significantly from the former. The technique has been programmed for on-line use on a 12-bit minicomputer, validated on cooperative adult subjects and used for ERA threshold determinations in young children. Using response detection criteria yielding an empirically determined false positive error rate of between 1 and 4%, threshold estimates averaged about 10 dB higher than psychophysical thresholds. The efficiency with which such ERA thresholds may be obtained with this method is substantially greater than that of conventional ERA procedures employing subjective evaluation of averages. Further, the technique allows variation of detection criteria to suit non-audiometric needs and empirical determination of the false-positive error rate under any set of conditions.

Adult

The scalp topography of human somatosensory and auditory evoked potentials.

The waveform and topography of components of the scalp recorded somatosensory evoked poal (AEP) to click stimulation of the right ear, were determined for scalp electrode locations of the 10-20 system and for locations at the eye, mastoids, and posterior neck. Twenty-one SEP and twenty-two AEP components were analyzed. Differentiation of neurogenic and myogenic components was attempted on the basis of localization and variability. Some components of extracranial origin, apparently originating in frontal musculature, were small in most experienced subjects and large in most experimentally naive subjects. These and other presumptive myogenic potentials can distort adjacent neurogenic components. These data should aid in predicting SEP and AEP characteristics and in assessing myogenic distortion of neurogenic components.

Adolescent

Auditory evoked potentials during speech perception.

Neural responses evoked by the same binaural speech signal were recorded from ten right-handed subjects during two auditory identification tasks. One task required analysis of acoustic parameters important for making a linguistic distinction, while the other task required analysis of an acoustic parameter which provides no linguistic information at the phoneme level. In the time interval between stimulus onset and the subjects' identification responses, evoked potentials from the two tasks were significantly different over the left hemisphere but identical over the right hemisphere. These results indicate that different neural events occur in the left hemisphere during analysis of linguistic versus nonlinguistic parameters of the same acoustic signal.

Adolescent

Attention-related increases in cortical responsivity dissociated from the contingent negative variation.

Certain tasks which increase attention to stimuli also elicit the contingent negative variation and increase the amplitude of the P300 component of the sensory evoked response. Therefore it appeared possible that the contingent negative variation and attention-related increases in P300 are either confounded by artifact or generated by common neural mechanisms. The fact that we have recorded attention-related increases in P300 amplitude independent of corresponding systematic changes in contingent negative variation indicates that neither of these possibilities is correct. The two phenomena are independently variable modulations of cortical activity.

Analysis of Variance