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Biomedical subjects

Yung-Yang Lin

Publications and source records attributed to Yung-Yang Lin.

18 recordsLinked to original sources

Bilateral oscillations for lateralized spikes in benign rolandic epilepsy.

PURPOSES: To elucidate the oscillatory dynamics with respect to interictal spike occurrence in benign rolandic epilepsy (BRE). METHODS: Using a whole-scalp magnetoencephalography (MEG), we recorded scalp EEG and MEG signals in 10 BRE patients (age 8-12 years) and visually identified unilateral interictal spikes that were simultaneously present on both EEG and MEG channels. We obtained the peak timing of individual spike complex based on MEG single-dipole modeling, and then applied wavelet transform to analyze the time-frequency components of corresponding MEG signals with respect to spike occurrence. RESULTS: In the hemisphere with time-domain spike waveforms, we identified a clear increase of 0.5-40 Hz activity around the spike peak, most prominent at alpha band (8-13 Hz). Notably, at the approximate timing we also observed an increase in 0.5-25 Hz oscillations over the homotopic area in the other hemisphere where no spike signals were found. CONCLUSIONS: Our results indicate bilateral increases in 0.5-25 Hz oscillations during unilateral spike formation in BRE patients. By using wavelet transform analysis, one could be able to detect some irritative feature that would in visual analysis remain undetected.

Child↗

Neuromagnetic SII responses do not fully reflect pain scale.

To elucidate the role of somatosensory cortices in coding pain magnitude, we recorded the neuromagnetic responses of ten subjects to mild, moderate, and severe pain stimulation by delivering thulium-laser pulses on the dorsum of the left hand. The stimulus intensities for producing different pain levels were determined individually, and the mean values across subjects were 255, 365, and 490 mJ for mild, moderate, and severe pain, respectively. We obtained 40 responses for each intensity condition, and analyzed the averaged cortical signals by multi-dipole modeling. All subjects showed consistent activation over the bilateral secondary somatosensory (SII) cortices for each intensity level, peaking around 150-230 ms, with 15-ms earlier on the contralateral hemisphere. The SII dipole strength was significantly larger for the moderate than for the mild pain stimulation, but lacked further increase as the pain magnitude elevated to the severe level. In contrast, the primary somatosensory cortical response was detected in only half of our subjects, and thus it seemed difficult to evaluate its role in pain intensity coding. Our results suggest that activation strength in human SII cortices reflects the magnitude of peripheral noxious inputs only up to the moderate level, and some other cerebral correlates may get involved in sensing a further increment of pain magnitude.

Adult↗

Oscillatory characteristics of face-evoked neuromagnetic responses.

To study the oscillatory activities during face processing, we recorded magnetoencephalographic responses in 8 healthy subjects to upright and inverted human faces, and obtained the time-frequency representation by using wavelet transform. Delta to beta activities were clearly increased at 140-210 ms after stimulus onset in the bilateral occipitotemporal (OT) areas (t(7)>5.5; p<0.001), with larger power for theta, alpha and beta over the right side. Notably, more increase alpha activity for inverted than upright face condition was observed in the right OT area. Our results suggest that 4-25 Hz oscillations are involved in face information processing, and the more activation over the right OT implies the right hemisphere advantage for face perception. Moreover, the alpha activity may reflect the differential cortical demands for processing inverted and upright face images.

Adult↗

Differential generators for N20m and P35m responses to median nerve stimulation.

To study the spatial and behavioral dynamics of cortical sources for N20m and P35m at varying stimulus intensities, we measured neuromagnetic cortical responses to left electric median nerve stimulation at the wrist in 17 male healthy adults. The stimulus intensity levels were individually determined according to sensory threshold (ST) for perceiving electric pulses. Using equivalent current dipole (ECD) modeling, we analyzed the peak latencies, amplitudes, and locations of ECDs from 14 subjects for N20m and P35m elicited at 2 ST, 3 ST, and 4 ST. Compared with N20m, P35m was localized 3.3 +/- 0.6 mm more superiorly at 2-4 ST, and 2.9 +/- 1.2 mm more medially at 3-4 ST. Superimposed over subjects' own MR images, N20m ECDs were localized in the area of 3b contralateral to stimulus side in all 17 subjects at 3 ST, whereas P35m ECDs were localized either in the postcentral (in 14 subjects) or in the precentral areas (in 3 subjects). We found no clear correlation between N20m and P35m in terms of peak latencies as well as the corresponding growth of activation strengths along with stepwise increase in stimulus intensity. Our results imply that the two early SEF components, N20m and P35m, have differential cortical generators, with distinctive neurophysiological behaviors in response to varying stimulus intensity levels.

Adult↗

Hemispheric balance in coding speech and non-speech sounds in Chinese participants.

To study the role of neuromagnetic auditory approximately 100-ms responses (N100m) in phonetic processing, we recorded N100m in 24 right-handed Chinese participants using a whole-head neuromagnetometer. The stimuli included vowel /a/ and consonant-vowels /ba/ and /da/, spoken by one Chinese speaker, and a 1-kHz tone. N100m to tones was larger in the right hemisphere, whereas that to speech sounds was bilaterally similar. The amplitude ratio of speech to non-speech N100m was larger in the left hemisphere. N100m dipoles in the left hemisphere were approximately 2 mm more anterior for speech than for tone stimuli. The results suggest that N100m reflects both acoustics and phonetic processing. Moreover, the ratio of speech to non-speech activation in individual hemispheres may be useful for language lateralization.

Acoustic Stimulation↗

The effects of face spatial frequencies on cortical processing revealed by magnetoencephalography.

To study the spatial frequency (SF) effects on cortical face processing, we recorded magnetoencephalographic responses in seven healthy subjects to upright and inverted human faces. Four face types were used, including original (broad-band SF, BSF), low SF (LSF, <5 cycles/face), middle SF (MSF, 5-15 cycles/face), and high SF (HSF, >15 cycles/face) face images. Using equivalent current dipole (ECD) modeling, neuromagnetic M170 responses peaking around 160-185 ms were localized in right occipitotemporal region across subjects to BSF faces. M170 responses to LSF faces showed longer latency and smaller amplitude compared with those to BSF faces. We found no significant difference between BSF, MSF, and HSF conditions in M170 amplitude or latency. ECD locations for the four upright face conditions were close to one another, although the mean locations for MSF or HSF seemed more medial than those for BSF or LSF. Longer latencies for inverted than upright faces were observed in BSF (183.4+/-8.5 ms versus 168+/-6.9 ms, P<0.001) and LSF face conditions (223.6+/-13.1 ms versus 207.3+/-16.3 ms, P<0.01). M170 ECDs were located more medial for inverted than upright images in either BSF or LSF condition. In conclusion, the less M170 activation to LSF faces suggests that face parts information is important for early face processing. The cortical representations in right occipitotemporal region for configural and face feature processing are overlapping. Our findings on the face inversion effect suggest that inverted BSF and LSF faces may be processed as objects.

Adult↗

Optimal check size and reversal rate to elicit pattern-reversal MEG responses.

OBJECTIVE: To determine the impact of check size and interstimulus interval (ISI) on neuromagnetic visual cortical responses. METHODS: We recorded visual evoked fields to pattern-reversal stimulation with central occlusion in ten subjects. The -100 ms magnetic activation (P100m) was analyzed by single dipole modeling. RESULTS: With 1 s ISI, P100m strengths increased as check size increased from 15' up to 120' of visual arc, and larger checks elicited less P100m activation. With 120' checks, we found no P100m attenuation as ISI decreased from 4 s to 0.16 s. P100m sources around the calcarine sulcus did not vary with check size or ISI. CONCLUSIONS: The magnitude of cortical activation during visual contrast processing is check size-dependent and the 120' checks are optimum for future studies on neuromagnetic visual cortical functions using central-occluded stimulation. The corresponding neuronal activation demonstrated a short refractory period less than 0.16 s. We also found significantly overlapping cortical representation areas for different check sizes or ISIs.

Adult↗

Convulsive syncope: an unusual complication of acupuncture treatment in older patients.

Vasovagal syncope is an uncommon complication during acupuncture. However, convulsive syncope during acupuncture treatment in older individuals is seldom reported in the literature. Two older patients who experienced convulsive syncope during acupuncture treatment at Taipei Veterans Hospital, Taipei, Taiwan, from January 2000 to December 2002 are reported. These cases are instructive to acupuncturists. Although acupuncture treatment is generally safe in most situations, one needs to be cautious in delivering acupuncture to older and debilitated individuals.

Acupuncture Therapy↗

Effect of transcranial magnetic stimulation on bimanual movements.

Transcranial magnetic stimulation (TMS) of the motor cortex can interrupt voluntary contralateral rhythmic limb movements. Using the method of "resetting index" (RI), our study investigated the TMS effect on different types of bimanual movements. Six normal subjects participated. For unimanual movement, each subject tapped either the right or left index finger at a comfortable rate. For bimanual movement, index fingers of both hands tapped in the same (in-phase) direction or in the opposite (antiphase) direction. TMS was applied to each hemisphere separately at various intensities from 0.5 to 1.5 times motor threshold (MT). TMS interruption of rhythm was quantified by RI. For the unimanual movements, TMS disrupted both contralateral and ipsilateral rhythmic hand movements, although the effect was much less in the ipsilateral hand. For the bimanual in-phase task, TMS could simultaneously reset the rhythmic movements of both hands, but the effect on the contralateral hand was less and the effect on the ipsilateral hand was more compared with the unimanual tasks. Similar effects were seen from right and left hemisphere stimulation. TMS had little effect on the bimanual antiphase task. The equal effect of right and left hemisphere stimulation indicates that neither motor cortex is dominant for simple bimanual in-phase movement. The smaller influence of contralateral stimulation and the greater effect of ipsilateral stimulation during bimanual in-phase movement compared with unimanual movement suggest hemispheric coupling. The antiphase movements were resistant to TMS disruption, and this suggests that control of rhythm differs in the 2 tasks. TMS produced a transient asynchrony of movements on the 2 sides, indicating that both motor cortices might be downstream of the clocking command or that the clocking is a consequence of the 2 hemispheres communicating equally with each other.

Adult↗

Prolonged central motor conduction time of lower limb muscle in spinocerebellar ataxia 6.

We investigated the function of corticospinal tract in spinocerebellar ataxia 6 (SCA6) by measuring the central motor conduction time (CMCT). Motor evoked potentials (MEP) of tibialis anterior (TA) muscle were elicited by magnetic stimulation to motor cortex and spinal cord in 9 SCA6 patients and 10 normal height- and age-matched subjects. CMCT in lower limb of SCA6 patients (18.1+/-1.9 ms) was significantly prolonged than that of the normal subjects (15.0+/-1.0 ms) ((p < 0.001). The prolonged CMCT was well correlated with the duration of disease (p = 0.005), but MEP amplitudes and stimulation intensities were not significantly different. These results indicate that the corticospinal tract function is also impaired and correlate with the disease duration in SCA6.

Adult↗

Subtle brain dysfunction in treated 6-pyruvoyl-tetrahydropterin synthase deficiency: relationship to motor tasks and neurophysiological tests.

6-Pyruvoyl-tetrahydropterin synthase (6PTPS) deficiency is a major cause of biopterin deficiency. 6PTPS patients usually have an elevated serum phenylalanine level, a deficiency of neurotransmitters (serotonin and dopamine), and neurological symptoms, if without treatment. We herein investigated the possibility of neurological dysfunction in early-treated patients. In the study, 12 early-treated 6PTPS patients were studied. Their auditory simple reaction time, movement rhythm variation (MRV), somatosensory evoked potentials to median nerve stimulation, and hand muscle responses to transcranial magnetic stimulation, were measured. MRV is a test of repetitive voluntary movements, and was used with and without auditory cues at 0.3 Hz. The 6PTPS patients had an increased motor threshold but normal motor and sensory central conduction times. They performed very well in simple reactions (6PTPS 208.4+/-16.7 ms, control 200.3+/-11.7 ms, p=0.18), but not in continuous tasks. The continuous performance tests showed that MRV had increased in the 6PTPS patients (with cues: 6PTPS 7.35+/-0.94, control 5.47+/-0.80, p<0.0001; without cues: 6PTPS 9.87+/-1.44, control 6.59+/-0.68, p<0.0001). Without cues, MRV had increased in both the 6PTPS and control groups, but more significantly in the 6PTPS patients (6PTPS 2.51+/-0.97, control 1.25+/-0.42; p=0.0001). Our findings indicate that early-treated 6PTPS patients have subtle neurological dysfunctions. They may not maintain movement rhythm as well as normal subjects, even with external cues. Hence, MRV is a good method to assess motor control.

Acoustic Stimulation↗

Lateralisation value of lower limb behaviors in complex partial seizures of temporal lobe origin: a video-EEG analysis.

PURPOSE: To determine the lateralising value of leg behaviors in complex partial seizures (CPS) of temporal lobe onset. METHODS: Videotapes of 123 seizures from 38 patients who were seizure-free after temporal lobectomy were reviewed. Ictal behaviors including head turning, limb automatisms, tonic/dystonic postures and the latent time for ictal behavior were analysed for their lateralising value. RESULTS: Contralateral versive head turning, ipsilateral arm automatisms, contralateral arm tonic/dystonic posturing, and contralateral arm clonic posturing were found to have high predictive value of lateralisation. As for the lower limbs, meaningful leg behaviors were recorded in 38 (31%) of 123 seizures, far less than behaviors of the upper limbs (79%). The predictive value from leg behaviors were similar to that from upper limbs. Among the leg behaviors, dystonic behaviors were always contralateral to the ictal side. Tonic behaviors were 94% contralateral to the ictal side. Dystonia and clonic movement were always contralateral to the ictal side. Automatisms were 86% ipsilateral to the ictal side. CONCLUSIONS: Although incidences were low, leg behaviors could provide useful lateralising value of the seizure foci. Clinicians as well as investigators should recognize the value of lower limbs behavior in studies of ictal semiology.

Adolescent↗

Transcranial magnetic stimulation in patients with transient ischemic attacks.

BACKGROUND: By definition, transient ischemic attacks (TIAs) do not leave a neurological deficit beyond 24 hours after onset. However, a subgroup of TIA patients is characterized by persistent perfusion defect on single photon emission computed tomogram or infarction on brain computerized tomogram and magnetic resonance imaging. Here, we applied transcranial magnetic stimulation (TMS) to study whether TIA could produce persistent subclinical dysfunction for more than 24 hours. METHODS: The study included 23 TIA patients who had the criteria of hand weakness as one of their clinical manifestations. TMS was done twice in each TIA patient. The first time was during the period of 24-48 hours after onset and the second 7 days after onset. We studied the cortical motor threshold, the latencies and the amplitudes of the motor evoked potentials, the central motor conduction time, and the cortical silent period at the intensity of 1.5 times motor threshold with maximal voluntary isometric contraction. The recording was at the first dorsal interosseous muscle. RESULTS: There was no significant difference between the whole group of TIA patients and normal control. However, in the subgroup of TIA patients who had hand weakness more than 1 hour, they had increased motor threshold and prolonged cortical silent period during the first test. Both improved 1 week after onset. On the contrary, in TIA patients who had hand weakness less than 1 hour, their data were all within normal limits during the first and the second studies. CONCLUSIONS: Our results indicate that the motor function of TMS study will recover to full if the motor symptoms subside within 1 hour in TIA patients. Subclinical motor deficits may persist in TIA patients who have motor symptoms more than 1 hour.

Aged↗

Healthy-side dominance of cortical neuromagnetic responses in sudden hearing loss.

Previous brain imaging and mapping studies have reported findings indicating functional reorganization in the central auditory pathways of patients with profound unilateral hearing loss. This study reports for the first time to our knowledge, using a whole-head neuromagnetometer with monaural stimulation of both intact and affected ears, a pattern of healthy-side dominance for cortical neuromagnetic responses in adult patients in the early stage of idiopathic sudden sensorineural hearing loss, and a pattern of contralateral dominance is verified in controls.

Adult↗

Differential effects of stimulus intensity on peripheral and neuromagnetic cortical responses to median nerve stimulation.

To study the differential effects of tactile stimulus intensity on cortical and peripheral responses, we measured neuromagnetic cortical responses, compound muscle action potentials (CMAP), sensory nerve action potentials (SNAP), and the subjective estimation of tactile magnitude to electric median nerve stimulation at the wrist in 13 male healthy adults. The sensory perception threshold (ST) for electric pulses at wrist skin was determined and then various levels of stimulus intensity (1 approximately 6 ST) were given to each subject. At 1 ST, only the P50m components of the primary somatosensory (SI) cortical responses were recorded. The second somatosensory (SII) cortical responses were saturated at 2 ST, while the SI responses reached maximum at 3 ST equivalent to the subjective threshold intensity for "strong" tactility. The CMAP and SNAP were maximum at 4-5 ST. At 2 ST, >70% of maximum SI responses were produced, whereas only <40% of maximum CMAP or SNAP responses were obtained. We concluded that the stimulus intensities for activating or saturating somatosensory cortical responses were lower than those for CMAP and SNAP. The differential intensity effects on cortical and peripheral responses suggest a polysynaptic organization underlying the central amplification for somatosensory cortical activation. The optimal intensity levels for producing maximum SI and SII responses were 3 and 2 ST, respectively. Compared with the SII, the SI plays a crucial role in the coding of the tactile stimulus intensity.

Action Potentials↗

Magnetoencephalographic analysis of bilaterally synchronous discharges in benign rolandic epilepsy of childhood.

The purpose of this study was to examine the spatial and temporal relationship between bilateral foci of bilaterally synchronous discharges in benign rolandic epilepsy of childhood (BREC) using a whole-scalp neuromagnetometer. We simultaneously recorded interictal magnetoencephalographic (MEG) and electroencephalographic (EEG) signals in six children with BREC. Interictal spikes were classified into three groups: bilaterally synchronous discharges (BSDs), unilateral discharges on right side (UD-R), and unilateral discharges on left side (UD-L). We used equivalent current dipole (ECD) modelling to analyse the cortical sources of interictal spikes. Both BSDs and UDs were found in Patients 1-4, whereas only UDs were identified in Patients 5 and 6. The ECDs of interictal spikes were located in rolandic regions, 10-20mm anterior and lateral to hand somatosensory cortices. Multi-dipole analysis of BSDs showed two ECDs in homotopic motor areas of the hemispheres. During BSDs, the right-sided activation preceded the left-sided activation by 15-21 milliseconds in Patients 1 and 2. In Patients 3 and 4, the activation occurred 17-20 milliseconds earlier in the left than the right hemisphere. Within the same hemisphere, the sources of BSDs and UDs were located in similar areas. In conclusion, our results imply the cortical epileptogenicity in bilateral perirolandic areas in BREC. The sequential activation during BSDs in both hemispheres suggest the existence of synaptic connections, possibly via the corpus callosum, between bilateral irritative foci.

Brain Mapping↗

Neuromagnetic somatosensory responses to natural moving tactile stimulation.

OBJECTIVE: To explore the somatosensory cortical responses to natural moving tactile stimulation in adult subjects using magnetoencephalography. METHODS: We measured cortical somatosensory magnetic evoked fields (SEFs) to moving tactile stimuli by a brush over the right thumb once every 1.5 s in seven subjects. Electric SEFs with various intensity or simulated jitter were used for comparison. RESULTS: Tactile SEFs in primary somatosensory cortex (SI) consisted of two deflections: N24mT and P55mT. Electric SEFs consisted of N24mE, P30mE, P40mE, and P55mE. The amplitude of N24mT was only 34% +/- 12% of N24mE, whereas P55mT and P55mE were of about the same size. With increased jitter or decreased intensity, attenuation of electric SEFs was more clearly found in early deflection than late deflection. CONCLUSIONS: Natural moving tactile stimulation produced simpler cortical somatosensory waveforms in comparison with electric SEFs, partly related to less sharp intensity and stimulation jitter with moving tactile stimulation. We propose that of all the afferent fibers conveying the early deflection, the low threshold components participate the generation of the late deflection.

Adult↗

Using electrodiagnostic machine to study movement rhythm variation.

BACKGROUND: Hand movement constitutes the most common daily activities in our life. Hand dexterity is often impaired in patients with neurological disease. We developed an adjunct method, based upon the electrodiagnostic software, for study of motor control and hand dexterity. METHODS: Thirty-two normal subjects, 2 stroke patients and 2 Parkinson patients were included in the study. All of them were right-handed, and were asked to pace rhythmic finger tapping at a comfortable rate without cue or any external stimuli. A trigger kit was designed to transform the finger tapping. After using the triggering mode and adjusting the sweep speed, 2 tapping signals were simultaneously displayed on the screen. The first signal was the triggering potential, and the variation in timing of the second signal represented the variation in timing of the inter-response interval. Twenty sweeps were recorded, superimposed and measured on the screen. Movement rhythm variation (MRV) was defined as b/a x 100 (b = [maximal interval of finger tapping - minimal interval of finger tapping]; a = [maximal interval of finger tapping + minimal interval of finger tapping]/2). Each subject started with right hand and then left hand. RESULTS: MRV measurement showed excellent intrarater (r = 0.97) and interrater (r = 0.97) reliability. In normal right-handed subjects, the MRV was better in right hand than in left hand (right 16.5 +/- 4.1% and left 21.0 +/- 7.6%; p < 0.05). The MRV improved in stroke patients along with the recovery and improved in Parkinson patients after levodopa treatment. CONCLUSIONS: MRV was a good method to provide quantitative data for assessment of hand dexterity. Our study also showed the potential role of MRV in motor control study.

Adult↗