Comparison of magnetoencephalography, functional MRI, and motor evoked potentials in the localization of the sensory-motor cortex

To clarify the topographical relationship between peri-Rolandic lesions and the central sulcus, we carried out presurgical functional mapping by using magnetoencephalography (MEG), functional magnetic resonance imaging (f-MRI), and motor evoked potentials (MEPs) on 5 patients. The sensory cortex was identified by somatosensory evoked magnetic fields using MEG (magnetic source imaging (MSI)). The motor area of the hand region was identified using f-MRI, during a hand squeezing task. In addition, transcranial magnetic stimulation localized the hand motor area on the scalp, which was mapped onto the MRI. In all cases, the sensory cortex was easily identified by MSI and the results of MSI correlated well with the findings obtained by the intraoperative recording of somatosensory evoked potentials. In contrast, the motor cortex could not be localized by f-MRI due to either the activated signal of the large cortical vein or the lack of any functional activation in the area of peri-lesional edema. MEPs were also unable to localize the entire motor strip. Therefore, at present, MSI is considered to be the most reliable method to localize peri-Rolandic lesions [corrected].     

Correlation between evoked motor response of the sciatic nerve and sensory blockade

OBJECTIVE: The development of collateral microvessels following therapeutic angiogenesis with vascular endothelial growth factor (VEGF) was investigated using a new system of microangiography that employs monochromatic synchrotron radiation (SR) and a high definition video system to visualize arteries with a spatial resolution of 30 microns. METHODS: Ischemia was induced in the hindlimb of 20 rats by excision of the femoral artery, followed by transfection of the plasmid (400 micrograms) encoding VEGF or beta-galactosidase (control) into limb muscles. Microangiography was used to assess the development of collaterals in the ischemic limb four weeks after treatment. RESULTS: Gene transfer of VEGF produced morphologically similar, but significantly more extensive, collateral networks at the microvascular level as compared with the naturally occurring collateral arteries in the control animals (angiographic score: 0.88 +/- 0.08 versus 0.54 +/- 0.05, p < 0.01). No adverse vascular effects such as hemangiomas and/or arteriovenous (AV) fistulae were observed following VEGF treatment. The vasodilator effect of papaverine was evident in relatively large vessels in both groups. At the microvascular level (diameter < 100 microns), however, papaverine induced significant vasodilation in the VEGF-treated animals, and almost no vasodilation in the controls. CONCLUSIONS: SR microangiography allowed us to assess the development of small collateral arteries following VEGF-gene transfer. The information obtained may provide new insights regarding the collateral microcirculation and therapeutic angiogenesis.     

Correlations of evoked potentials with MR imaging and MR spectroscopy in multiple sclerosis

The current state-of-the-art imaging technique in multiple sclerosis (MS) is magnetic resonance (MR) imaging. With improved imaging technology, MR spectroscopy offers the capacity to identify those chemical changes associated with MS and promises to enhance our ability to understand this disease. Physiologic function in the central nervous system can be measured using evoked potentials. This article analyzes the correlation between these two techniques.     

The value of somatosensory and motor evoked evoked potentials in pre-clinical spondylotic cervical cord compression

This review focuses on the biomaterials used in urology, in particular, the properties of urethral catheters and ureteral stents currently being used in clinical practice. The importance of biomaterial type, biocompatibility, and encrustations are discussed and explained. Current management of bacterial infection and the importance of biofilms are presented, with recommendations based on published information.     

Normal postexercise facilitation and depression of motor evoked potentials in postpolio patients

We studied the effects of exercise on motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation in healthy subjects and postpolio patients. Subjects performed repeated sets of isometric exercise until the muscle fatigued. In both groups, the mean MEP amplitude immediately after each exercise set was approximately twice that of the baseline amplitude, indicating similar postexercise facilitation, and after fatigue was approximately half that of the baseline amplitude, indicating similar postexercise depression. We conclude that the intracortical component of central fatigue is normal in postpolio patients.     

Visual evoked potentials in phenylketonuria: association with brain MRI, dietary state, and IQ

Tumor-associated glycoprotein 72 is a high-molecular-weight sialomucin that is expressed selectively in various adenocarcinomas, including those of the prostate. We utilized the monoclonal antibodies B72.3 and CC49 to examine the expression of TAG-72 in high-grade prostatic intraepithelial neoplasia (PIN), localized adenocarcinomas (pathologic stages B and C), as well as matching primary and nodal lesions from patients with stage D adenocarcinomas. Immunoreactivity within PIN lesions was detected within 20 (87%) and 17 (74%) of 23 specimens immunostained with B72.3 and CC49, respectively. Benign epithelium and stromal tissue did not immunostain with either antibody at the concentrations tested. Immunostaining was detected within the malignant cells in 30 (77%) and 35 (90%) of 39 localized adenocarcinomas using B72.3 and CC49, respectively. Immunostaining was localized to the cytoplasm and cellular membranes of the malignant cells and within the lumen of malignant glands. Seven of 17 (41%) primary lesions from patients with stage D adenocarcinomas demonstrated immunoreactivity when stained with B72.3. Immunoreactivity was detected in 8 of 10 (80%) of these tissues immunostained with CC49. Within nodal lesions obtained from these patients, immunostaining was observed in 3 of 17 (18%) and 6 of 10 (60%) of the specimens immunostained with B72.3 and CC49, respectively. We used a semiquantitative technique to compare the extent of immunoreactivity among well-differentiated (Gleason score < 6), moderately differentiated (Gleason 6-7), and poorly differentiated (Gleason score > 7) tumors. We observed an inverse correlation of TAG-72 expression to Gleason scores. Furthermore, TAG-72 expression was reduced in the matching primary and metastatic lesions of stage D adenocarcinomas as compared to localized lesions.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of phenytoin and carbamazepine on evoked potentials in patients with newly diagnosed epilepsy. Part I. Visual evoked potentials

Pattern-reversal visual evoked potentials (VEPs) were recorded in 64 patients with newly diagnosed epilepsy. Before starting medication the patients with partial and primary generalized epilepsy, had prolonged latencies of the VEPs component P100, as compared with controls. VEPs were repeated after 3 months in 43 patients with focal epilepsy, during carbamazepine (22 cases) or phenytoin (21 cases) treatment. The plasma concentration of the drugs were within therapeutic levels. Carbamazepine but not phenytoin, was associated with prolongation of the P100 peak latency and induced increase of its amplitude, as compared with the baseline condition. The VEPs abnormality was most pronounced in patients whose seizures were poorly controlled. We conclude, that administration of carbamazepine or phenytoin, at therapeutic serum level, have minimal effect on the VEPs.     

Effects of long-term exposure to volatile irritants on sensory thresholds, negative mucosal potentials, and event-related potentials.

This study examined whether repetitive exposure to an irritant stimulant leads to desensitization and whether such modulation influences the psychological or the physiological response to that chemical. Subjects were exposed to acetic acid vapor in their home environment. Before, during, and after 3 weeks of daily exposure, the authors obtained electrophysiological recordings at peripheral and central levels in combination with psychophysical responses to acetic acid and acetone. Responses to acetic acid decreased during and following exposure. This did not generalize to the control irritant. Thresholds measured 1 year following exposure returned to baseline levels. In summary, repetitive exposure to an irritant vapor results in a specific desensitization to irritancy from that chemical, which appears to originate at a peripheral level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MRI of optic nerve and postchiasmal visual pathways and visual evoked potentials in secondary progressive multiple sclerosis

We studied the relationship between abnormalities shown by MRI and functional disturbances in the visual pathway as assessed by the visual evoked potential (VEP) in 25 patients with established multiple sclerosis (MS); only 4 of whom had a history of acute optic neuritis. Optic nerve MRI was abnormal in 19 (76%) and is thus useful in detecting subclinical disease. Optic nerve total lesion length and area on the STIR sequence was found to correlate significantly with prolongation of the VEP latency. This may reflect a predominantly demyelinating rather than inflammatory origin for the signal change in the optic nerve.     

Contribution of initial median-nerve somatosensory evoked potentials and brainstem auditory evoked potentials to prediction of clinical outcome in cerebrovascular critical care patients: a statistical evaluation

OBJECTIVE: To analyze the pathological and clinical features of a variant of renal carcinoma: sarcomatoid renal carcinoma. METHODS: Of 316 patients diagnosed as having a renal tumor from 1975 to 1995, 11 (3.5%) with a pathological diagnosis of sarcomatoid renal carcinoma were analyzed. The clinical history, biological data and diagnostic imaging findings of these patients were reviewed. All patients had undergone surgical exploration. RESULTS: All the tumors showed a double cellular population, with a fusiform component. Histological analysis showed a high grade and stage tumor. Ten patients died from the disease, the mean survival rate was 9 months (range 2-48) following diagnosis. CONCLUSIONS: Sarcomatoid carcinoma of the kidney is uncommon and can be occasionally difficult to distinguish from sarcoma. It has a worse prognosis than other variants of renal carcinoma.     

Prognostic significance of electrophysiological investigations in stroke patients: somatosensory and motor evoked potentials and sympathetic skin response

A prospective 3-month follow-up examination was carried out in 12 patients with supratentorial stroke. Motor evoked potentials (MEP), somatosensory evoked potentials (SEP) and sympathetic skin responses (SSR) were performed 1-7 days, 30 days and 3 months after stroke. The functional outcome measured by a daily activity index (Barthel index) was assessed 3 months after the stroke. There was a significant correlation between SEP and MEP results obtained for the first week and recovery of sensation and motility 3 months later. When initially normal, motor potentials evoked by transcranial magnetic stimulation had a significant predictive value for long-term functional outcome, whereas SEP and SSR did not. SSR present at the initial stage was correlated with the state of consciousness.     

MRI of skeletal muscles in autosomal recessive hereditary motor and sensory neuropathy with focally folded myelin sheaths

A 33-day-old male infant who developed central diabetes insipitus as a complication of congenital toxoplasmosis is presented. He had polyuria and hypernatremia on admission and responded to Intranasal desmopressin acetate with the normalization of above mentioned findings. Computed tomographic (CT) scan of the brain showed obstructive hydrocephaly with periventricular and right basal ganglion calcification. CT scan of the pituitary gland, thyroid function tests, and serum cortisol levels were all normal. This is the first report of isolated diabetes insipitus with congenital toxoplasmosis in literature and central diabetes insipitus should be remembered if polyuria and hypernatremia develops in a patient with congenital toxoplasmosis.     

Dimensions of schizophrenia in the elderly. Correlations with cognitive and motor symptoms

Wound contraction is thought to be independent of site, and circular full-thickness skin wounds are though not to contract completely. To verify these statements four circular full-thickness skin wounds were created on each side of eight pigs and randomised to treatment with either split-thickness skin grafts, or healing by secondary intention under a hydrocolloid dressing. Time to healing, contraction, and final scar shape were evaluated. The median healing time was 12 days (range 6-18) in the grafted wounds and 30 days (range 15-45) in the secondarily healing wounds. There were significant differences in healing time between the different sites on the pigs. In the secondarily healing group, medial-caudal wounds healed in 21 (15-21) days compared with lateral wounds which healed in 36 (21-45) days (p < 0.005), while no differences were found in the grafted group. There was a clear relationship between site and contractility and shape of the scars in both treatment groups. Scars located on the lateral-caudal aspect of the pig were predominantly round and contracted only slightly. Scars located on the lateral aspect of the pig tended to be oval. Contraction was greatest in the medial scars and least in the lateral scars. Median contraction was 33% (range -2-63) in skin grafted wounds and 64% (range 42-82) in secondarily healed wounds. This randomised experiment showed that extent of wound contraction is dependent of site, and that circular wounds do heal with contraction.     

Relation between the size of motor units and the spectral characteristics of their action potentials. kazuseki@iname.com

Cis and trans isomers of two dinuclear platinum complexes, [cis-?Pt(NH3)2Cl?2 mu-(NH2(CH2)nNH2)](NO3)2 (1,1/c,c) and [trans-?Pt(NH3)2Cl?2 mu-(NH2(CH2)nNH2)](NO3)2 (1,1/t,t), where the diamine was 1,4-butanediamine (n = 4) or 1,6-hexanediamine (n = 6), were studied using electrospray ionization surface-induced dissociation (ESI/SID) tandem mass spectrometry (MS/MS). The same fragment ions were observed for both the cis and trans isomers of each complex (n = 4 or 6), but the relative intensities were dependent on the isomer studied. The ESI/SID data and energy-resolved mass spectra show that the position of the chloride plays a significant role in the fragmentation of these ions. Two major fragmentation pathways were detected for the complexes. The cleavage of the Pt-N bond trans to chloride was the most favorable pathway for both isomers of the complexes following the ion-surface collision. The differences in the ESI/SID spectra between the cis and trans isomers can be explained by the trans effect, namely that the Pt-N bond trans to chloride is the most labile bond.     

Behavioral reactivity, appetitive behavior, and visual evoked potentials to photic stimuli following amygdaloid lesions in rats.

Found that, while amygdaloid lesions did not affect locomotor reactivity to photic stimuli under nonappetitive conditions, such lesions markedly increased distractibility to flashes when male Holtzman albino rats (N = 100) were engaged in appetitive behavior. The enhanced distractibility would seem to reflect dysfunctions in appetitive behavior. Concurrent analysis of visual evoked responses (VERs) revealed evidence of heightened electrophysiological arousal in amygdaloid preparations with conditions of intensified photic stimulation, but no altered VERs that could be related to heightened distractibility. Analysis of appetitive dysfunctions by means of VERs to flash probe stimuli during different segments of the behavior indicated reduced electrophysiological reactivity by amygdaloid preparations to conditions of frustration instituted by intermittent withholding of reinforcement. Results are contrasted with those of septal lesions. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional analysis of the sensory motor pathway of resistance reflex in crayfish. I. Multisensory coding and motor neuron monosynaptic responses

The in vitro preparation of the fifth thoracic ganglion of the crayfish was used to analyze the connections supporting the monosynaptic reflex responses recorded from the depressor motor neurons (Dep MNs). Dep MNs are directly connected by the release-sensitive afferents from a proprioceptor, the coxo-basipodite chordotonal organ (CBCO), which is released by upward movements of the leg. Sine-wave movements, applied to the CBCO strand from the most released position, allowed us to stimulate the greatest part of release-sensitive CBCO fibers. Systematic intracellular recordings from all Dep MNs performed in high divalent cation saline allowed us to determine the connections between CBCO afferents and their postsynaptic Dep MNs: it highlighted the sequential activation of the different Dep MNs involved in the monosynaptic reflex. The convergence of different sensory afferents onto a given Dep MN, and the divergence of a given sensory afferent onto several Dep MNs illustrates the complexity of the sensory-motor reflex loops involved in the control of locomotion and posture. Electrophysiological experiments and simulations were performed to analyze the mechanisms by which Dep MNs integrate the large amount of sensory input that they receive. Paired intracellular recording experiments demonstrated that postsynaptic response shapes characteristic of both phasic and phaso-tonic afferents could be induced by varying the presynaptic firing frequency, whatever the postsynaptic Dep MN. Compartment model simulations were used to analyze the role of the sensory-motor synapse characteristics in the summation properties of postsynaptic MN. They demonstrated the importance of the postsynaptic compartment geometry, because large postsynaptic compartments allowed to generate greater excitatory postsynaptic potential (EPSP) summations than small ones. The results presented show that velocity information is the most effective to elicit large compound EPSPs in MNs. We therefore suggest that the negative feedback reflex is mainly based on the detection of leg movements.     

Effects of regional striatal lesions on motor, motivational, and executive aspects of progressive-ratio performance in rats.

The striatum is implicated in response selection and performance, the dorsal striatum in sensorimotor control and habit learning, and the ventral striatum in motivation and rewarded behaviors. Ventral striatal lesions produce performance changes on food-reinforced, progressive-ratio (PR) schedules, but the effects of dorsal striatal lesions on this task are not known. In this study, neither medial nor lateral dorsal striatal lesions produced deficits on the main motivational indices of PR performance. In contrast, significant impairments were observed in motoric or "executive" aspects of performance. Motivationally related manipulations of the task (food deprivation and reward magnitude) produced some subtle lesion-specific changes in behavior on these motoric or executive aspects of performance. Findings are discussed in relation to the roles of the dorsal and ventral striatum in reward-related behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Context-processing deficits in schizophrenia: Diagnostic specificity, 4-week course, and relationships to clinical symptoms.

Previous research on schizophrenia suggests that context-processing disturbances are one of the core cognitive deficits present in schizophrenia. However, it is not clear whether such deficits are specific to schizophrenia as compared with other psychotic disorders. To address this question, the authors administered a version of the AX Continuous Performance Test designed to assess context processing in a sample of healthy controls, patients with schizophrenia, and patients with other psychotic disorders. Participants were tested at index (when medication naive and experiencing their first contact with psychiatric services) and 4 weeks later, following medication treatment. At index, patients with schizophrenia and the psychotic comparison group demonstrated similar impairments in context processing. However, context-processing deficits improved in the psychotic comparison group at 4 weeks but did not improve in patients with schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Surgical treatment of extratemporal epilepsy: clinical, radiologic, and histopathologic findings in 60 patients

PURPOSE AND METHODS: The aim of this study was to analyze clinical, radiologic, and histopathologic findings in 60 consecutive patients with medically intractable extratemporal epilepsy who were operated on between November 1987 and May 1993. RESULTS: Histologically, there were distinct structural abnormalities in 50 (83%) of the surgical specimens. Signal abnormalities on magnetic resonance imaging (MRI) were present in all patients with neoplastic lesions (n = 17) and in 94% of patients with nonneoplastic focal lesions (n = 32). Overall, structural abnormalities were detected by MRI in 47 (96%) of 49 patients with focal lesions. During a mean follow-up of 4 years, 30 (54%) patients remained completely seizure free, 11 (20%) had < or = 2 seizures per year, seven (12%) showed a seizure reduction of > or = 75%, and eight (14%) had < 75% reduction in seizure frequency. The fraction of seizure-free patients was 12 (80%) of 15 in patients with neoplastic lesions, 16 (52%) of 31 in patients with nonneoplastic focal lesions, and two (20%) of 10 for those without histopathologic abnormalities. The differences in seizure outcome between patients with and without focal lesions were statistically significant (p < 0.05), if seizure-free outcome was compared with persistent seizures. CONCLUSIONS: Focal lesions and particularly neoplasms are associated with improved postoperative seizure control compared with patients without histopathologic abnormalities. We advise caution in considering surgery to treat extratemporal epilepsy in patients who have normal MRI scans, because the outcome with the approach described in this study is poor in such cases.     

Atrial arrhythmias in adults after repair of tetralogy of Fallot. Correlations with clinical, exercise, and echocardiographic findings

BACKGROUND: The long-term success of intracardiac repair of tetralogy of Fallot is hampered by the occurrence of arrhythmias. Numerous studies have stressed the potential role of ventricular arrhythmias. However, the importance of other arrhythmias in the morbidity of these patients appears to be underestimated. Furthermore, most follow-up studies have been limited to children or adolescents, whereas many patients have reached adulthood after earlier repair of tetralogy of Fallot. The aim of the present study was to determine the incidence of atrial fibrillation, atrial flutter, and other supraventricular arrhythmias in adult patients after intracardiac repair for tetralogy of Fallot and their correlation with surgical and clinical findings. METHODS AND RESULTS: The study group consisted of 53 consecutive patients referred to the Thoraxcenter adult congenital heart disease clinic. They underwent repair at a mean age of 9.1 years (range, 0.7 to 55 years). The median age at the time of study was 23.2 years (range, 15 to 57 years; mean age, 26.6 years), and the mean duration of follow-up of 17.5 years (range, 1.4 to 32 years) after surgery. Records were reviewed extensively for evidence of arrhythmias. The follow-up study included routine 12-lead ECG, 24-hour continuous ambulatory monitoring, and echocardiography, and 46 patients underwent exercise testing. Sinus node dysfunction was recorded in 19 patients (36%), of whom 4 required a permanent pacemaker. Atrial fibrillation or flutter was found in 12 patients, and other supraventricular tachycardias were found in 6. The former were more frequently of older age at follow-up. Antiarrhythmic therapy and cardioversion were typically directed at control of atrial (and not ventricular) tachyarrhythmias. Ten patients (19%) showed nonsustained ventricular tachycardia; they were older at initial surgery and older at follow-up and had more intracardiac repairs and longer cardiopulmonary bypass times. CONCLUSIONS: Despite an emphasis on ventricular ectopy in past series, the main sources of morbidity in adult patients after surgical correction of tetralogy of Fallot emanated from atrial arrhythmias, which were present in one third of the patients.