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Mapping plastic brain changes after acute lesions.

The combination of different mapping techniques has yielded new insights in reorganization processes after acute lesions in humans. Recent research focused not only on lesion-induced plasticity, but also on therapy-induced reorganization of the brain. Data from animal experiments has expanded our knowledge of mechanisms that underlie plastic changes.

Acute Disease↗

Three-dimensional filtering approach to brain potential mapping.

The spatial distribution of electroencephalogram (EEG) features on the scalp surface, both in time or frequency, is of great importance in clinical applications and medical research. Traditionally, mathematical methods based on interpolation algorithms have been widely applied to obtain the EEG mappings. This paper presents an innovative approach to reconstructing the brain potential mappings from multichannel EEG's. The three-dimensional (3-D) filtering approach, differing from the numerical interpolating methods, considers the spatial distribution of brain potentials as a 3-D signal, which is processed and interpolated according to its spatial frequency characteristics. The performance of the 3-D filtering method evaluated on simulated brain potentials is shown to be comparable to the four-nearest-neighbors method. Moreover, the 3-D filtering method is superior to the spherical splines method in efficiency. Two main advantages of this method are: the prospect of developing real-time, animated EEG mappings utilizing powerful digital signal processors and its capability of processing and interpolating the brain potentials on the realistic irregular scalp surface.

Brain Mapping↗

Whole-brain T2 mapping demonstrates occult abnormalities in focal epilepsy.

OBJECTIVES: To examine the cerebral structure of 14 patients with partial seizures and acquired lesions, 20 patients with malformations of cortical development (MCDs), and 45 patients with partial seizures and normal conventional MRI using whole-brain T2 mapping and statistical parametric mapping (SPM). METHODS: T2 maps were calculated, and individual patients were compared with a group of 30 control subjects using SPM. RESULTS: T2 mapping and objective voxel-by-voxel statistical comparison identified regions of increased T2 signal in all 14 patients with acquired nonprogressive cerebral lesions and partial seizures. In all of these, the areas of increased T2 signal concurred with abnormalities identified on visual inspection of conventional MRI. In 18 of 20 patients with MCDs, SPM detected regions of increased T2 signal, all of which corresponded to abnormalities identified on visual inspection of conventional MRI. In addition, in both groups, there were areas that were normal on conventional imaging, which demonstrated abnormal T2 signal. Voxel-by-voxel statistical analysis identified increased T2 signal in 23 of the 45 patients with cryptogenic focal epilepsy. In 20 of these, the areas of increased T2 signal concurred with epileptiform EEG abnormality and clinical seizure semiology. Group analysis of MRI-negative patients with electroclinical seizure onset localizing to the left and right temporal and left and right frontal regions revealed increased T2 signal within the white matter of each respective lobe. CONCLUSIONS: T2 mapping analyzed using statistical parametric mapping was sensitive in patients with malformations of cortical development and acquired cerebral damage. Increased T2 signal in individual and grouped MRI-negative patients suggests that minor structural abnormalities exist in occult epileptogenic cerebral lesions.

Adult↗

Generic brain activation mapping in functional magnetic resonance imaging: a nonparametric approach.

We report a novel method to identify brain regions generically activated by periodic experimental design in functional magnetic resonance imaging data. This involves: 1) registering each of N individual functional magnetic resonance imaging datasets in a standard space; 2) computing the median standardised power of response to the experimental design; 3) testing median standardised power at each voxel against its nonparametrically ascertained distribution under the null hypothesis of no experimental effect; and 4) constructing a generic brain activation map. The method is validated by analysis of 6 null images, acquired under conditions when the null hypothesis was known to be true; 8 images acquired during periodic auditory-verbal stimulation; and 6 images acquired during periodic performance of a covert verbal fluency task.

Acoustic Stimulation↗

Language functional magnetic resonance imaging in preoperative assessment of language areas: correlation with direct cortical stimulation.

OBJECTIVE: The aim of this study was to analyze the usefulness of preoperative language functional magnetic resonance imaging (fMRI), by correlating fMRI data with intraoperative cortical stimulation results for patients with brain tumors. METHODS: Naming and verb generation tasks were used, separately or in combination, for 14 right-handed patients with tumors in the left hemisphere. fMRI data obtained were analyzed with SPM software, with two standard analysis thresholds (P < 0.005 and then P < 0.05). The fMRI data were then registered in a frameless stereotactic neuronavigational device and correlated with direct brain mapping results. We used a statistical model with the fMRI information as a predictor, spatially correlating each intraoperatively mapped cortical site with fMRI data integrated in the neuronavigational system (site-by-site correlation). Eight patients were also studied with language fMRI postoperatively, with the same acquisition protocol. RESULTS: We observed high variability in signal extents and locations among patients with both tasks. The activated areas were located mainly in the left hemisphere in the middle and inferior frontal gyri (F2 and F3), the superior and middle temporal gyri (T1 and T2), and the supramarginal and angular gyri. A total of 426 cortical sites were tested for each task among the 14 patients. In frontal and temporoparietal areas, poor sensitivity of the fMRI technique was observed for the naming and verb generation tasks (22 and 36%, respectively) with P < 0.005 as the analysis threshold. Although not perfect, the specificity of the fMRI technique was good in all conditions (97% for the naming task and 98% for the verb generation task). Better correlation (sensitivity, 59%; specificity, 97%) was achieved by combining the two fMRI tasks. Variation of the analysis threshold to P < 0.05 increased the sensitivity to 66% while decreasing the specificity to 91%. Postoperative fMRI data (for the cortical brain areas studied intraoperatively) were in accordance with brain mapping results for six of eight patients. Complete agreement between pre- and postoperative fMRI studies and direct brain mapping results was observed for only three of eight patients. CONCLUSION: With the paradigms and analysis thresholds used in this study, language fMRI data obtained with naming or verb generation tasks, before and after surgery, were imperfectly correlated with intraoperative brain mapping results. A better correlation could be obtained by combining the fMRI tasks. The overall results of this study demonstrated that language fMRI could not be used to make critical surgical decisions in the absence of direct brain mapping. Other acquisition protocols are required for evaluation of the potential role of language fMRI in the accurate detection of essential cortical language areas.

Adolescent↗

Mapping rat brain structures activated during ethanol withdrawal: role of glutamate and NMDA receptors.

Brain structures activated during ethanol withdrawal have been mapped by visualizing c-fos mRNA expression. The regional distribution of c-fos mRNA in brain during ethanol withdrawal can be mimicked by acute injection of N-methyl-D-aspartic acid (NMDA) and is stereospecifically blocked by the NMDA receptor antagonist, MK-801. The findings reveal that the dentate gyrus and piriform cortex are selectively activated during ethanol withdrawal and suggest that this may be mediated by glutamate activation of NMDA receptors.

Animals↗

Methodological and technical issues for integrating functional magnetic resonance imaging data in a neuronavigational system.

OBJECTIVE: The aim of this article was to analyze the technical and methodological issues resulting from the use of functional magnetic resonance image (fMRI) data in a frameless stereotactic device for brain tumor or pain surgery (chronic motor cortex stimulation). METHODS: A total of 32 candidates, 26 for brain tumor surgery and six chronic motor cortex stimulation, were studied by fMRI scanning (61 procedures) and intraoperative cortical brain mapping under general anesthesia. The fMRI data obtained were analyzed with the Statistical Parametric Mapping 99 software, with an initial analysis threshold corresponding to P < 0.001. Subsequently, the fMRI data were registered in a frameless stereotactic neuronavigational device and correlated to brain mapping. RESULTS: Correspondence between fMRI-activated areas and cortical mapping in primary motor areas was good in 28 patients (87%), although fMRI-activated areas were highly dependent on the choice of paradigms and analysis thresholds. Primary sensory- and secondary motor-activated areas were not correlated to cortical brain mapping. Functional mislocalization as a result of insufficient correction of the echo-planar distortion was identified in four patients (13%). Analysis thresholds (from P < 0.0001 to P < 10(-12)) more restrictive than the initial threshold (P < 0.001) had to be used in 25 of the 28 patients studied, so that fMRI motor data could be matched to cortical mapping spatial data. These analysis thresholds were not predictable preoperatively. Maximal tumor resection was accomplished in all patients with brain tumors. Chronic motor cortex electrode placement was successful in each patient (significant pain relief >50% on the visual analog pain scale). CONCLUSION: In brain tumor surgery, fMRI data are helpful in surgical planning and guiding intraoperative brain mapping. The registration of fMRI data in anatomic slices or in the frameless stereotactic neuronavigational device, however, remained a potential source of functional mislocalization. Electrode placement for chronic motor cortex stimulation is a good indication to use fMRI data registered in a neuronavigational system and could replace somatosensory evoked potentials in detection of the central sulcus.

Adolescent↗

Mapping of brain areas expressing RNA homologous to two different acetylcholine receptor alpha-subunit cDNAs.

We have used an in situ RNA X RNA hybridization technique to determine, in the central nervous systems of the mouse and rat, the distribution of RNA homologous to cDNA clones encoding the alpha subunit of a putative neural nicotinic acetylcholine receptor and the alpha subunit of the muscle nicotinic acetylcholine receptor. Hybridization of the neural alpha-subunit probe was strongest in the medial habenula but was also detected consistently in the compact part of the substantia nigra and ventral tegmental area, in the neocortex, and in certain parts of the thalamus and hypothalamus. The in situ hybridization technique makes it possible to compile a map of brain regions containing cell bodies expressing RNA coding for a specific receptor type and subsequently to apply the techniques of molecular biology to study these brain receptors.

Animals↗

Brain stem mapping: neurophysiological localization of motor nuclei on the floor of the fourth ventricle.

We have improved upon a brain stem mapping technique that can be used to locate cranial motor nuclei on the floor of the fourth ventricle. This technique helped to intraoperatively locate the facial colliculus and the motor nuclei of cranial nerves IX/X and XII in 14 patients undergoing removal of brain stem tumors. The motor nuclei of these cranial nerves are usually located relative to specific anatomic landmarks on the ventricular floor. These landmarks were not evident in most patients studied because of the distorting effects of the tumor. Different points of the floor of the fourth ventricle were electrically stimulated while electromyographic responses were recorded with electrodes inserted in the orbicularis oculi and orbicularis oris muscles, the lateral posterior pharyngeal wall, and the intrinsic muscles of tongue. Mapping was performed before and after tumor resection. The technique was found to be useful for locating cranial motor nuclei before tumor resection. It enabled surgeons to avoid damaging the nuclei when entering the brain stem. This technique, however, has certain limitations. Because this is a mapping technique, not a monitoring technique, continuous monitoring during tumor resection was unavailable. Also, the presence of a muscle response after tumor resection did not always indicate preservation of immediate postoperative function (7 days after surgery) because damage to the corticobulbar tract and/or the underlying neural circuitry was not detectable by mapping. Further research is needed to determine the point of stimulation in the functional motor circuitry and the relationship between intraoperative recordings and postoperative function in the long term.

Adolescent↗

A natural and broad spectrum nootropic substance for treatment of SDAT--the Ginkgo biloba extract.

The efficacy of the Ginkgo biloba extract was not only found clinically or in standardised ratings but also documented by objective data, obtained by a computerized EEG method, the DYNAMIC BRAIN MAPPING and BRAIN FUNCTION MONITORING SYSTEM (Dr. T. Itil, New York). A one year open trial comprise 25 parkinson patients with additional signs of SDAT. Data from 3 selected cases were given: The short time efficacy of the substance after the infusion and the long-term result after the oral medication. The maps showed less slower and more faster waves. Without any side effects the Ginkgo biloba extract seems to be a substance with a broad spectrum of influence. Our therapeutic findings in parkinsonian patients with SDAT and the data taken from healthy elderly volunteers revealed that the computerized EEG method may have another big advantage: It seems that the so-called anteriorisation of the Theta waves can be taken as a preclinical sign of an incipient change in brain metabolism. As a consequence--it might be that these changes are reversible by an adequate nootropic treatment. Further studies and treatment experiences must confirm these preliminary findings.

Aged↗

Mapping human brain activity in vivo.

A wide range of structural and functional techniques now exists to map the human brain in health and disease. These approaches span the gamut from external tomographic imaging devices (positron-emission tomography, single photon-emission computed tomography, magnetic resonance imaging, computed tomography), to surface detectors (electroencephalography, magnetoencephalography, transcranial magnetic stimulation), to measurements made directly on the brain's surface or beneath it (intrinsic signal imaging, electrocorticography). The noninvasive methods have been combined to provide unique and previously unavailable insights into the macroscopic organization of the functional neuroanatomy of human vision, sensation, hearing, movement, language, learning, and memory. All methods have been applied to patients with neurologic, neurosurgical, and psychiatric disease and have provided a rapidly expanding knowledge of the pathophysiology of diseases such as epilepsy, cerebrovascular disease, neoplasms, neurodegenerative diseases, mental illness, and addiction states. In addition, these new methods have become a mainstay of preoperative surgical planning and the monitoring of pharmacologic or surgical (transplantation) interventions. Most recently, the ability to observe the reorganization of the human nervous system after acute injury, such as occurs with cerebral infarction or head trauma, or in the course of a progressive degenerative process such as Alzheimer's or Parkinson's disease, may provide new insights and methods in the rapidly expanding field of neurorehabilitation. Our newfound ability to generate maps and databases of human brain development, maturation, skill acquisition, aging, and disease states is both an exciting and formidable task.

Brain↗

[Use of magnetoencephalography and functional neuronavigation in planning and surgery of brain tumors].

The role of magnetoencephalography (MEG) in neurology has been established for basic research, epilepsy, and functional brain mapping. The presurgical localization of functionally important brain areas has evolved as an important application of MEG. Both neurologists and neurosurgeons can use this method for decision-making and planning of nonsurgical or surgical treatment in brain tumors. The integration of functional brain mapping data into neuronavigation systems may help to minimize postoperative morbidity. This is especially important in low-grade gliomas, in which a potential benefit of surgery is only achieved when the tumor has been resected completely, whereas neurological deterioration means a substantial loss of quality of life during the survival time. This report addresses the utility of MEG combined with neuronavigation in the treatment of brain tumors adjacent to eloquent brain areas.

Adolescent↗

[The mapping of brain biopotentials in patients with the depressive syndrome].

By means of mapping method a study of spatial distribution of biopotentials was conducted (by alpha-rhythm power and by asymmetry of its energy). It is shown that in patients with depressive syndrome within maniac-depressive psychosis and schizophrenia main neurophysiological properties are paradoxical alpha-rhythm reaction in the frontal cortical regions in response to eyes opening, hyperactivation of the posterior areas of the left hemisphere and also dissociation between activation level of the anterior and posterior regions of the hemisphere, creating the picture of "transversal functional block". After the séance of electrostimulation the "block" disappeared both by alpha-rhythm power parameter and by the parameter of its energy asymmetry; and the activation of the left hemisphere sharply decreased being accompanied by improvement of clinic state of patients.

Alpha Rhythm↗

Attenuation of the neural response to sad faces in major depression by antidepressant treatment: a prospective, event-related functional magnetic resonance imaging study.

BACKGROUND: Depression is associated with interpersonal difficulties related to abnormalities in affective facial processing. OBJECTIVES: To map brain systems activated by sad facial affect processing in patients with depression and to identify brain functional correlates of antidepressant treatment and symptomatic response. DESIGN: Two groups underwent scanning twice using functional magnetic resonance imaging (fMRI) during an 8-week period. The event-related fMRI paradigm entailed incidental affect recognition of facial stimuli morphed to express discriminable intensities of sadness. SETTING: Participants were recruited by advertisement from the local population; depressed subjects were treated as outpatients. PATIENTS AND OTHER PARTICIPANTS: We matched 19 medication-free, acutely symptomatic patients satisfying DSM-IV criteria for unipolar major depressive disorder by age, sex, and IQ with 19 healthy volunteers. Intervention After the baseline assessment, patients received fluoxetine hydrochloride, 20 mg/d, for 8 weeks. MAIN OUTCOME MEASURES: Average activation (capacity) and differential response to variable affective intensity (dynamic range) were estimated in each fMRI time series. We used analysis of variance to identify brain regions that demonstrated a main effect of group (depressed vs healthy subjects) and a group x time interaction (attributable to antidepressant treatment). Change in brain activation associated with reduction of depressive symptoms in the patient group was identified by means of regression analysis. Permutation tests were used for inference. RESULTS: Over time, depressed subjects showed reduced capacity for activation in the left amygdala, ventral striatum, and frontoparietal cortex and a negatively correlated increase of dynamic range in the prefrontal cortex. Symptomatic improvement was associated with reduction of dynamic range in the pregenual cingulate cortex, ventral striatum, and cerebellum. CONCLUSIONS: Antidepressant treatment reduces left limbic, subcortical, and neocortical capacity for activation in depressed subjects and increases the dynamic range of the left prefrontal cortex. Changes in anterior cingulate function associated with symptomatic improvement indicate that fMRI may be a useful surrogate marker of antidepressant treatment response.

Affect↗

Cognitive processing in Chinese literate and illiterate subjects: an fMRI study.

Functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) were used to map brain activation during language tasks. While previous studies have compared performance between alphabetic literate and illiterate subjects, there have been no such data in Chinese-speaking individuals. In this study, we used fMRI to examine the effects of education on neural activation associated with silent word recognition and silent picture-naming tasks in 24 healthy right-handed Chinese subjects (12 illiterates and 12 literates). There were 30 single Chinese characters in the silent word recognition task and 30 meaningful road-signs in the silent picture-naming task. When we compared literate and illiterate subjects, we observed education-related differences in activation patterns in the left inferior/middle frontal gyrus and both sides of the superior temporal gyrus for the silent word recognition task and in the bilateral inferior/middle frontal gyrus and left limbic cingulated gyrus for the silent picture-naming task. These results indicate that the patterns of neural activation associated with language tasks are strongly influenced by education. Education appears to have enhanced cognitive processing efficiency in language tasks.

Aged↗

Spatiotemporal cortical dynamics underlying abstract and concrete word reading.

The current study used whole-head anatomically constrained magnetoencephalography (aMEG) to spatiotemporally map brain responses while subjects made abstract/concrete judgments on visually presented words. Both word types evoked a similar posterior-to-anterior sequence of cortical recruitment involving occipital, temporal, parietal, and frontal areas from approximately 100 to 900 ms poststimulus. A prominent left temporofrontal N400m was smaller to abstract words, while the right temporal N400m was smaller to concrete words, suggesting that differences may exist in their semantic representation. The left temporofrontal decrease for abstract words is consistent with EEG studies, indicating a smaller N400 for abstract words based on a more extensive or accessible lexicosemantic network. Furthermore, the N400m peaked at approximately 420 ms and was followed by a large right hemisphere medial occipitoparietal as well as lateral parietal response to concrete words peaking at approximately 550 ms, perhaps embodying imagistic processing. These data suggest that words may be initially understood using a left-lateralized (frontotemporal) verbal-linguistic system that for concrete words is supplemented after a short delay by a right parietal and medial occipital imagistic network.

Adolescent↗

Neural simulation of action: a unifying mechanism for motor cognition.

Paradigms drawn from cognitive psychology have provided new insight into covert stages of action. These states include not only intending actions that will eventually be executed, but also imagining actions, recognizing tools, learning by observation, or even understanding the behavior of other people. Studies using techniques for mapping brain activity, probing cortical excitability, or measuring the activity of peripheral effectors in normal human subjects and in patients all provide evidence of a subliminal activation of the motor system during these cognitive states. The hypothesis that the motor system is part of a simulation network that is activated under a variety of conditions in relation to action, either self-intended or observed from other individuals, will be developed. The function of this process of simulation would be not only to shape the motor system in anticipation to execution, but also to provide the self with information on the feasibility and the meaning of potential actions.

Brain Mapping↗

Neurodevelopmental aspects of spatial navigation: a virtual reality fMRI study.

Navigation in spatial contexts has been studied in diverse species, yielding insights into underlying neural mechanisms and their phylogenetic progression. Spatial navigation in humans is marked by age-related changes that may carry important implications for understanding cortical development. The emergence of "allocentric" processing, reflecting that ability to use viewer-independent spatial abstractions, represents an important developmental change. We used fMRI to map brain regions engaged during memory-guided navigation in a virtual reality environment in adolescents and adults. Blood oxygen level-dependent (BOLD) signal was monitored in eight adolescents and eight adults in a 1.5-T MRI scanner during three conditions: (1) memory-guided navigation (NAV); (2) arrow-guided navigation (ARROW); and (3) fixation (FIX). We quantified navigation ability during scanning and allocentric memory after scanning, based on subjects' ability to label a previously unseen, aerial view of the town. Adolescents and adults exhibited similar memory-guided navigation ability, but adults exhibited superior allocentric memory ability. Memory-guided navigation ability during scanning correlated with BOLD change between NAV/ARROWS in various regions, including a right frontal and right-anterior medial temporal lobe region. Age group and allocentric memory together explained significant variance in BOLD change in temporoparietal association cortex and the cerebellum, particularly in the left hemisphere. Consistent with developmental models, these findings relate maturation in the coding of spatial information to functional changes in a distributed, left-lateralized neural network.

Adolescent↗