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Preferential activation of different I waves by transcranial magnetic stimulation with a figure-of-eight-shaped coil.

Transcranial magnetic stimulation (TMS) over the human primary motor cortex (MI) evokes motor responses in the contralateral limb muscles. The latencies and amplitudes of those responses depend on the direction of induced current in the brain by the stimuli (Mills et al. 1992, Werhahn et al. 1994). This observation suggests that different neural elements might be activated by the differently directed induced currents. Using a figure-of-eight-shaped coil, which induces current with a certain direction, we analyzed the effect of direction of stimulating current on the latencies of responses to TMS in normal subjects. The latencies were measured from surface electromyographic responses of the first dorsal interosseous muscles and the peaks in the peristimulus time histograms (PSTHs) of single motor units from the same muscles. The coil was placed over the MI, with eight different directions each separated by 45 degrees. Stimulus intensity was adjusted just above the motor threshold while subjects made a weak tonic voluntary contraction, so that we can analyse the most readily elicited descending volley in the pyramidal tracts. In most subjects, TMS with medially and anteriorly directed current in the brain produced responses or a peak that occurred some 1.5 ms later than those to anodal electrical stimulation. In contrast, TMS with laterally and posteriorly directed current produced responses or a peak that occurred about 4.5 ms later. There was a single peak in most of PSTHs under the above stimulation condition, whereas there were occasionally two peaks under the transitional current directions between the above two groups. These results suggest that TMS with medially and anteriorly directed current in the brain readily elicits I1 waves, whereas that with laterally and posteriorly directed current preferentially elicits I3 waves. Functional magnetic resonance imaging studies indicated that this direction was related to the course of the central sulcus. TMS with induced current flowing forward relative to the central sulcus preferentially elicited I1 waves and that flowing backward elicited I3 waves. Our finding of the dependence of preferentially activated I waves on the current direction in the brain suggests that different sets of cortical neurons are responsible for different I waves, and are contrarily oriented. The present method using a figure-of-eight-shaped coil must enable us to study physiological characteristics of each I wave separately and, possibly, analyse different neural elements in MI, since it activates a certain I wave selectively without D waves or other I waves.

Adult↗

Lumbar cerebrospinal fluid pulse wave rising from pulsations of both the spinal cord and the brain in humans.

There are two theories regarding the origin of the lumbar cerebrospinal fluid pulse wave (L-CSFPW): that it arises from the arteries supplying the spinal cord, and that it is due to the pulsations of the brain transmitted through the subarachnoid space of the spine. We investigated L-CSFPW of 11 myelopathic patients with a complete (five patients, CB-group) or an incomplete spinal block (six, ICB-group) on myelography to determine the origin of L-CSFPW. Since arterial pressure amplitude (APA), the energy source of L-CSFPW, is not the same between individuals or between before and after operation, not only L-CSFPW itself but also the transfer function between the arterial pressure wave and the L-CSFPW calculated by the system analysis method was analyzed to eliminate the influence of hemodynamic fluctuations. In the system analysis, the arterial pressure wave, L-CSFPW and transfer function were decomposed into five harmonic waves (HW). In the CB group, L-CSFPW was observed to be 0.72 mmHg on average (range, 0.25-1.00) in spite of blocking pulsations of the brain, showing that there was a contribution to L-CSFPW unrelated to the brain, that is, the spinal cord. In the CB group, however, the preoperative transfer function value of HW1 (mean, 0.056; range, 0.012-0.170) was lower than that in the ICB group (mean, 0.137; range, 0.061-0.236) (P < 0.05), indicating that the brain pulsation also contributed to L-CSFPW. In the ICB group, there was significant reduction of HW1 (P < 0.01) and HW2 (P < 0.05) transfer function after posterior decompression surgery in spite of improvement in the subarachnoid space narrowing: preoperative HW1, mean, 0.137, range, 0.061-0.236; postoperative HW1, mean, 0.065, range, 0.021-0.153; preoperative HW2, mean, 0.092, range, 0.011-0.148; postoperative HW2, mean, 0.044, range, 0.030-0.066. It has been reported that the spinal cord blood flow is decreased 20% or more by laminectomy, therefore, L-CSFPW measurement may be sensitive enough to detect a 20% or higher decrease in this flow. This suggests that L-CSFPW could possibly be used clinically as a non-invasive method of monitoring the spinal cord blood flow. For broad clinical application of CSFPW, however, further studies are needed, especially on the direct relationship between CSFPW and spinal cord blood flow itself.

Adult↗

Inconsistency of auditory middle latency and steady-state responses in infants.

Auditory middle latency and steady-state responses (MLR/SSRs) were recorded in normal infants (aged 3 weeks to 28 months) and adults. SSR amplitudes were maximum using stimulus presentation rates near 40 Hz in adults. By contrast, the infant data showed no consistent amplitude maximum across the rates tested (9-59 Hz). With the exception of the brain-stem response wave V to MLR Na deflection, MLR components in infants' responses to 10.85 Hz clicks did not show any consistent pattern. To investigate the hypothesis that the 40 Hz SSR is derived from overlapping of the 10 Hz MLR components, 43.4 Hz SSRs were synthesized from the responses recorded at 10.85 Hz and compared with those recorded at 43.4 Hz. The predictive accuracy of the synthesized 43.4 Hz SSRs was significantly better in adults than in infants. The results of these studies indicate the presence of large age-related differences in the auditory MLR and SSR, and in the relationship between the two responses.

Acoustic Stimulation↗

Multiple independent spike foci and epilepsy, with special reference to a new epileptic syndrome of "severe epilepsy with multiple independent spike foci".

BACKGROUND: Markand and Blume first realized the specificity of the EEG pattern of multiple independent spike foci (MISF) in the late 1970s; its close relation with hypsarrhythmia and slow spike-waves, extensive bilateral brain lesion, and intractable seizures. But they did not recognize it as an epileptic syndrome. On the other hand, the authors had been taken notice of severe epilepsy with MISF (SE-MISF) as a peculiar clinico-electrical entity showing "generalized seizures", and pointed out its close relation to Lennox-Gastaut syndrome (LGS) from the long-term follow-up of LGS. SUMMARY POINTS: SE-MISF is characterized by (1) interictal EEG showing multiple independent spike foci (three or more foci in both hemisphere, i.e. at least one in each hemisphere) and diffuse slowing of the background activity. Diffuse epileptic discharges are rare. (2) The main seizure type is frequent generalized minor seizures, often tonic spasms. (3) Mutual transition is often observed between the age-dependent epileptic encephalopathies, i.e. Ohtahara syndrome, West syndrome and LGS. (4) The age at epilepsy onset is early, but the onset of SE-MISF is variable. (5) It is often associated with mental retardation and neurological abnormalities, usually severe. (6) Etiology is variable and largely nonspecific, including prenatal, perinatal, and postnatal cerebral pathologies. (7) Prognoses for seizures and psychomotor development are poor. Seizures are very intractable and may cause psychomotor deterioration. CONCLUSION: SE-MISF may be classified into symptomatic generalized epilepsy, namely a diffuse encephalopathy with mutual transition between other age-dependent epileptic encephalopathies. This characteristic entity may be acknowledged as a new epileptic syndrome.

Age of Onset↗

Stabilization of inhomogeneous patterns in a diffusion-reaction system under structural and parametric uncertainties.

Many phenomena such as neuron firing in the brain, the travelling waves which produce the heartbeat, arrythmia and fibrillation in the heart, catalytic reactions or cellular organization activities, among others, can be described by a unifying paradigm based on a class of nonlinear reaction-diffusion mechanisms. The FitzHugh-Nagumo (FHN) model is a simplified version of such class which is known to capture most of the qualitative dynamic features found in the spatiotemporal signals. In this paper, we take advantage of the dissipative nature of diffusion-reaction systems and results in finite dimensional nonlinear control theory to develop a class of nonlinear feedback controllers which is able to ensure stabilization of moving fronts for the FHN system, despite structural or parametric uncertainty. In the context of heart or neuron activity, this class of control laws is expected to prevent cardiac or neurological disorders connected with spatiotemporal wave disruptions. In the same way, biochemical or cellular organization related with certain functional aspects of life could also be influenced or controlled by the same feedback logic. The stability and robustness properties of the controller will be proved theoretically and illustrated on simulation experiments.

Diffusion↗

Event-related potentials during memorization of spatial locations in the auditory and visual modalities.

Event-related potential (ERP) studies of working memory have used delayed S1-S2 match-to-sample tasks in which S1 is held in memory for comparison with S2. ERP negativities in the S1-S2 interval have been interpreted either in terms of working memory operations, or in terms of general preparatory motor processing. Two experiments (N = 20 each) were carried out to explore the nature of ERP negativities in a visuospatial memory task and in an auditory spatial memory task, respectively. In the experimental condition, subjects had to memorize the location of S1 (S1-memorize) so as to respond whether S2 appeared in the same spatial location (S2-memorize). In the control condition, subjects were requested to ignore S1 (S1-passive), and to respond whether S2 matched or not a target location predetermined at the beginning of the trial block (S2-pressing). Results support the two main conclusions of Martin-Loeches et al. (Electroenceph. clin. Neurophysiol., 1994, 91: 363-373). Firstly, that the encoding into memory of spatial location is associated with an ERP negative wave over the brain areas putatively associated with the processing of sensory information (i.e. right parieto-occipital for the visual task; fronto-central and left temporal areas for the auditory task). Secondly, the P300 does not seem to be an important ERP feature related to spatial location encoding and retaining into memory. Despite the distinct scalp distribution of these memory-related, modality-specific ERP negativities, they also showed a considerable degree of temporal synchronicity across modalities.

Adolescent↗

Nonstationarity in epileptic EEG and implications for neural dynamics.

In this paper, we use a recently developed method to analyze the nonstationarity in time series from intracranial depth and subdural recordings of patients with temporal lobe epilepsy. We show that the nonstationarity in the signal can be accounted for by the variation of a single parameter. We then show that the various dominant nonlinear waveforms observed in different electrodes can be explained by a simple stochastic model in which the mesoscopic collection of neurons, whose potential the electrodes measure, can be on one of two states. The nonstationarity observed in our analysis is a consequence of a time-dependent transition probability between these two states. In general, this transition probability increases as a seizure is approached. The model that we propose incorporates this bistability. We find good agreement between real data and simulated data generated by our model. We understand that this mesoscopic bistability may be associated with the existence of excitation waves traversing the brain in these patients.

Electroencephalography↗

Tumor necrosis factor receptor fragment attenuates interferon-gamma-induced non-REM sleep in rabbits.

Although the somnogenic actions of interferon-alpha (IFNalpha) and IFNbeta have been reported, the sleep effects of IFNgamma remained unknown. Thus, we investigated the effects of intracerebroventricular injection of human IFNgamma on sleep in rabbits. IFNgamma dose-dependently increased nonrapid eye movement sleep (NREMS), electroencephalographic slow wave activity and brain temperature (Tbr). These effects were markedly attenuated after the heat treatment of IFNgamma. IFNgamma suppressed rapid eye movement sleep if given during the light period, but not if given at dark onset. Although a tumor necrosis factor receptor fragment did not affect any sleep parameters when given at dark onset, it significantly attenuated IFNgamma-induced NREMS and Tbr. These data suggest that IFNgamma may be involved in the sleep responses during infection. Further, IFNgamma may have a synergistic interaction with intrinsic TNFalpha in the brain.

Amino Acid Sequence↗

Is there a relationship between delta sleep at night and afternoon cerebral blood flow, assessed by HMPAO-SPECT in depressed patients and normal control subjects? Preliminary data.

We wished to explore the relationships between waking HMPAO uptake and visually scored polysomnography. We hypothesized that HMPAO activity would correlate positively with slow wave sleep measures the same night. Eight unmedicated unipolar patients with current DSM-IV major depression (17-item Hamilton Depression Rating Scale score 21.5+/-2.9) and seven control subjects received polysomnography on 2 consecutive nights. On the afternoon following the adaptation night, subjects received cerebral SPECT, with 15 mCi Tc-99m-HMPAO injected while subjects performed the Continuous Performance Task. Patients and control subjects did not significantly differ on demographic, polysomnographic, and SPECT variables. Slow wave sleep measures correlated positively (Spearman's) with global and regional tracer activity for depressed (n = 8), control (n = 7) and combined groups (n = 15); in other words, the greater the global or regional afternoon HMPAO uptake, the greater the slow wave sleep measures were the same night. In addition, the greater the waking afternoon global or regional HMPAO activity, the faster subjects fell asleep and the less Stage 2% they had. In patients, global and regional HMPAO activity correlated positively with REM density. Positive correlations between waking tracer activity and subsequent slow wave measures are consistent with previous hypotheses linking slow wave sleep with brain energy conservation and restoration. Further study is needed to determine whether these functional relationships differ in depression.

Adult↗

Electrophysiological support for strategic processing of spatial sentences.

The aims of the present EEG study were to distinguish between the various representation options of spatial sentences and to gain insight into the moment at which differences in the processing of spatial sentences arise. To examine the possible existence of different strategies, we used sentence-sentence and sentence-picture verification trials in mixed blocks, whereby the probability of a specific second stimulus was fixed within a block but varied between blocks. Brain activation (slow wave, 550-1100 ms after stimulus onset) linked to parsing spatial sentences (and not nonspatial sentences) occurred at parieto-occipital regions associated with mental image processing, and only when participants were expecting to compare verbal information to a picture. Therefore, this study provides neuroimaging evidence that different representational formats of spatial sentences arise almost directly when people are reading a spatial sentence.

Adult↗

Microglia digest Staphylococcus aureus into low molecular weight biologically active compounds.

Excess sleep and fever are central nervous system (CNS) facets of the acute phase response; these responses are induced by microbial products, such as muramyl peptides, via their ability to enhance cytokine production. Although peripheral macrophages are known to digest bacteria, thereby releasing muramyl peptides that, in turn, stimulate cytokine production, it was unknown whether CNS phagocytes such as microglia also had this capacity. Primary cultures of microglia were allowed to phagocytize and digest Staphylococcus aureus radiolabeled with a cell wall-specific marker. Radiolabeled low molecular weight substances released into the culture medium were partially purified and tested for the ability to induce excess sleep, fever, and cytokine production. These substances increased non-rapid eye movement sleep, electroencephalographic slow-wave activity, and brain temperature after intracerebroventricular injection into rabbits. They also induced interleukin-1, tumor necrosis factor, and the interleukin-1 receptor antagonist production in human monocytes. Results suggest that microglia perform fundamental macrophage functions and further implicate microglia as resident immunocompetent cells.

Animals↗

Multimodal electroneurophysiological studies of systemic lupus erythematosus.

The purpose of this study was to obtain electrophysiological documentation of possible involvement of central and peripheral nervous system (CNS and PNS) in systemic lupus erythematosus (SLE) patients even in the absence of neurological manifestations. The study included 30 consecutive patients with SLE and 25 age- and sex-matched volunteers as a control group. They were subjected to neurological and rheumatological tests and an extensive battery of neurophysiological tests, besides Wechsler adult intelligence scale. Overt neurological manifestations were observed in 14 patients (46.7%). Neurophysiological data revealed that 25 patients (83%) had at least 2 abnormal tests; 11 (68.8%) patients of the asymptomatic group and 14 patients (100%) of the symptomatic group with no significant differences between them. Seventeen patients (56.7%) had evidence of PNS dysfunction either in nerves (46.7%) or muscles (10%); 7 of them in the asymptomatic group. Twenty-four patients (80%) had evidence of CNS dysfunction. Twenty-two patients (73%) had abnormalities recorded on electroencephalography; 9 patients in the asymptomatic group and 13 patients in the symptomatic group. Eleven patients (37%) had abnormal values of P100 of visual evoked potential; 5 patients in the asymptomatic group and 6 in the symptomatic group. Eight patients (26.7%) had abnormal latency of wave I of brain stem response; 3 of them in the asymptomatic group. Abnormal prolongation of the P300 component of event-related potentials was recorded in 2 patients (12.5%) of the asymptomatic group, while low IQ was observed in 8 patients of each group. Neurophysiological abnormalities are fairly common in SLE patients whether symptomatic or asymptomatic. The use of such tests favors a true incidence of nervous system involvement, more accurate diagnosis, and may lead to better clinical care before the development of debilitating CNS and PNS changes.

Adolescent↗

Preservation of hearing in acoustic tumor surgery: audiologic indicators.

Preservation of hearing in patients with acoustic nerve tumors can be a goal when tumor size is small and residual hearing is intact. Overall success rates for preservation have been reported to be 20% to 40%. The overall success rate in this series is 30.7%. However, indicators of intact auditory brain stem response (waves I-III-V), good speech discrimination score, and intact acoustic (stapedial) reflex were associated with a 68.2% rate of success. Thus, a comprehensive audiologic evaluation is a guideline for selecting and counselling patients with acoustic tumors before hearing preservation procedures.

Adolescent↗

Treatment of chronic suppurative otitis media with topical ciprofloxacin.

To date, only ofloxacin has been approved by the US Food and Drug Administration for treatment of ears with a nonintact tympanic membrane. The purpose of this study was to determine the safety and efficacy of topical ciprofloxacin hydrochloride in the treatment of experimental chronic suppurative otitis media caused by Pseudomonas aeruginosa infection in cynomolgus monkeys. Forty adult cynomolgus monkeys were divided into 4 equal groups, and their ears were challenged with P aeruginosa, drained for 3 weeks, then treated twice daily for 4 weeks with 1 of 4 randomly assigned agents: 1) ciprofloxacin, 2) saline, 3) Cortisporin, or 4) vehicle. The animals were followed up with auditory brain stem response testing, culture, otoscopy, and histopathology. Both ciprofloxacin and Cortisporin treatment resulted in a significantly more rapid rate of clearance of P aeruginosa as compared to treatment with saline (100% versus 20%). Eradication was not associated with resolution of otorrhea after a 4-week period of treatment. There were no significant changes in auditory brain stem response wave latencies for any of the treatment groups. Histopathologic data revealed that there was no statistically significant difference in the amount of outer hair cell loss for the ciprofloxacin group as compared to the control ear and other treatment groups. We conclude, therefore, that topical ciprofloxacin is not ototoxic and is effective in sterilizing the otorrhea, but does not promote resolution of the drainage, in this animal model.

Administration, Topical↗

Triphasic waves in a patient with glioblastoma multiforme.

A 57-year-old woman with biopsy proven glioblastoma multiforme with greater left-sided involvement, presented with subacute right hemiparesis. Her EEG showed triphasic waves with a left-sided predominance. Possible metabolic causes of triphasic waves were excluded. The association between triphasic waves and primary brain tumor is extremely rare, and the pathogenesis unknown.

Brain Neoplasms↗

Topographic electroencephalographic studies in a hyperbaric environment--specific reference to high pressure nervous syndrome.

Hyperbaric chamber dives at various equivalent depths below sea level, i.e. 7, 14, 19 and 31 atmosphere absolute (ATA) with helium-oxygen or helium-nitrogen-oxygen have been performed at the Japan Marine Science and Technology Center. A two-dimensional (topographic) display of the scalp EEG was used during simulated underwater experiments to determine; 1) Whether there are any characteristic EEG patterns in high pressure nervous syndrome (HPNS), 2) the relationship between the EEG changes and the compression rate, and 3) the relationship between the EEG changes and the characteristic signs and symptoms of HPNS. A two-way analysis of variance and a distribution analysis technique revealed that the topographic brain patterns depended on the diving depth and indicated the most affected brain areas during compression and decompression. Significant correlations between the diving depth and the EEG potentials were observed at different brain locations. Alpha waves showed a diffuse cortical distribution. Theta wave activity was more localized in the frontal midline region. These waves developed paroxysmally in relatively brief bursts supplanting or intermixing with normal background EEG rhythms. In our subjects, frontal midline theta activity was associated mostly with some of the characteristic features of HPNS, such as a transient episode of laughter or euphoria at depths greater than 21 ATA. An intimate correlation between frontal midline theta wave and laughter was observed. Frontal midline theta waves may be related to emotional activities induced by helium under high pressure. There were significant individual variations in susceptibility and subjective signs and symptoms. The EEG is of great value in studying man's physiological reactions in an undersea environment and also very important in selecting divers who are relatively more tolerant of a severe hyperbaric environment.

Adult↗

Trial-to-trial variability and state-dependent modulation of auditory-evoked responses in cortex.

Recent experimental work has provided evidence that trial-to-trial variability of sensory-evoked responses in cortex can be explained as a linear superposition of random ongoing background activity and a stationary response. While studying single trial variability and state-dependent modulation of evoked responses in auditory cortex of ketamine/xylazine-anesthetized rats, we have observed an apparent violation of this model. Local field potential and unit spike trains were recorded and analyzed during different anesthesia depths-deep, medium, and light-which were defined by the pattern of ongoing cortical activity. Estimation of single trial evoked response was achieved by considering whole waveforms, rather than just one or two peak values from each wave. Principal components analysis was used to quantitatively classify waveforms on the basis of their time courses (i.e., shapes). We found that not only average response but also response variability is modulated by depth of anesthesia. Trial-to-trial variability is highest under medium levels of anesthesia, during which ongoing cortical activity exhibits rhythmic population bursting activity. By triggering the occurrence of stimuli from the spontaneously occurring burst events, we show that the observed variability can be accounted for by the background activity. In particular, the ongoing activity was found to modulate both amplitude and shape (including latency) of evoked local field potentials and evoked unit activity in a manner not predicted by linear superposition of background activity and a stereotyped evoked response. This breakdown of the linear model is likely attributable to rapid transitions between different levels of thalamocortical excitability (e.g., spike-wave discharges), although brain "state" is relatively fixed.

Acoustic Stimulation↗

[History of electrophysiological investigations of organs of hearing].

Development of electrophysiological examinations of organ of hearing was examined, starting from Luigi Galvani's discovery of electrical activity of biological tissue, through experimental research aiming at localization of cortical hearing centres. The studies by Wever and Bray, as well as, Ruben's team of Baltimore underline the significance of potentials expressing electrical activity of cochlea and acoustic nerve fibres. Pioneer studies of Hallowel Davis (called "father of ERA studies"--Electric Response Audiometry) and his first wife, Paulina. Several other studies done by his research team were mentioned. Besing on these papers and papers of some other authors, a short description of slow cortical potentials and cochlea potentials was done as they were discovered and introduced to clinical tests. The discussion covered also investigations of Sohmer and Feinmesser, as well, as, those of Jewett and Willistone on systematization of structures generating waves in auditory brain stem responses. The paper is concluded with the description of the recent classification of auditory potentials induced by an acoustic stimulus. The discussion on the development and progress of electrophysiological studies of the organ of hearing is concluded with some remarks on otoacoustic cochlea emission discovered by David Kemp of London in 1978.

Cochlea↗