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Cerebral responses evoked by peripheral stimuli are known to depend critically on the interstimulus interval (ISI). Here we report on the effects of ISI on somatosensory evoked magnetic fields (SEFs) to right median nerve stimulation, obtained in 9 healthy adults with ISIs of 0.15, 0.3, 1, 3 and 5 s. At the contralateral (left) primary sensorimotor cortex (SMI), the first cortical response, N20m, was stable between the ISIs 0.3 and 5 s, but slightly attenuated at the shortest ISI of 0.15 s. In contrast, the P35m and P60m deflections were very sensitive to changes of the ISI, declining steadily with shortening of the ISI throughout the entire range. These deflections were frequently undetectable at the shortest ISI of 0.15 s. Concomitant with the reductions of P35m and P60m, an N45m deflection was enhanced toward the short ISIs. Responses from second somatosensory cortex (SII) and posterior parietal cortex (PPC) were seen only with ISIs of 1 s or greater, being strongest at the 5 s ISI. Based on known effects of the ISI on intracellular evoked potentials, we present the following tentative model for the generation mechanism of the SMI response: N20m represents early excitatory postsynaptic potentials (EPSPs), P35m early inhibitory postsynaptic potentials (IPSPs), N45m secondary EPSPs and P60m late IPSPs in pyramidal neurones of area 3b. For practical purposes, SEFs from SMI can be obtained with short ISIs, while responses from SII and PPC require an ISI of at least 1 s.

In this article, we present a novel approach to create single subject fMRI (functional magnetic resonance imaging) activation maps by utilizing the group data of several subjects on the individual level. Classification of a voxel as either activated or non-activated is based on its z-value and classification in the neighborhood. We defined the neighborhood of a voxel to consist of corresponding and neighboring voxels in two subjects in addition to the neighbourhood voxels within the subject itself. Determination of the two neighboring subjects was based on kappa-statistics between single subject activation maps calculated without data from other subjects. This approach was taken using multi-subject contextual clustering. Both fully simulated and real subject null data with simulated activations were used. ROC (receiver operator characteristics) analysis showed increased classification accuracy of activated and non-activated voxels when using the described approach.

Musical competence may confer cognitive advantages that extend beyond processing of familiar musical sounds. Behavioural evidence indicates a general enhancement of both working memory and attention in musicians. It is possible that musicians, due to their training, are better able to maintain focus on task-relevant stimuli, a skill which is crucial to working memory. We measured the blood oxygenation-level dependent (BOLD) activation signal in musicians and non-musicians during working memory of musical sounds to determine the relation among performance, musical competence and generally enhanced cognition. All participants easily distinguished the stimuli. We tested the hypothesis that musicians nonetheless would perform better, and that differential brain activity would mainly be present in cortical areas involved in cognitive control such as the lateral prefrontal cortex. The musicians performed better as reflected in reaction times and error rates. Musicians also had larger BOLD responses than non-musicians in neuronal networks that sustain attention and cognitive control, including regions of the lateral prefrontal cortex, lateral parietal cortex, insula, and putamen in the right hemisphere, and bilaterally in the posterior dorsal prefrontal cortex and anterior cingulate gyrus. The relationship between the task performance and the magnitude of the BOLD response was more positive in musicians than in non-musicians, particularly during the most difficult working memory task. The results confirm previous findings that neural activity increases during enhanced working memory performance. The results also suggest that superior working memory task performance in musicians rely on an enhanced ability to exert sustained cognitive control. This cognitive benefit in musicians may be a consequence of focused musical training. Public Library of Science

Single-lung ventilation using a double-lumen endobronchial tube is often performed for surgical procedures involving the thorax. Tracheobronchial rupture during use of an endobronchial tube is an uncommon and serious complication. We present the case of a patient undergoing a right pneumonectomy who experienced a bronchial rupture due to a double-lumen endobronchial tube. Institution of veno-venous extracorporeal membrane oxygenation allowed removal of the endobronchial tube, and the repair was successfully performed. We hope that this information can provide further insight into the management of such a complication.

Goal-directed behavior lowers activity in brain areas that include the medial frontal cortex, the medial and lateral parietal cortex, and limbic and paralimbic brain regions, commonly referred to as the “default network.” These activity decreases are believed to reflect the interruption of processes that are ongoing when the mind is in a restful state. Previously, the nature of these processes was probed by varying cognitive task parameters, but the presence of emotional processes, while often assumed, was little investigated. With fMRI, we studied the effect of systematic variations of both cognitive load and emotional stimulus connotation on task-related decreases in the default network by employing an auditory working memory (WM) task with musical sounds. The performance of the WM task, compared to passive listening, lowered the activity in medial and lateral, prefrontal, parietal, temporal, and limbic regions. In a subset of these regions, the magnitude of decrease depended on the memory load; the greater the cognitive load, the larger the magnitude of the observed decrease. Furthermore, in the right amygdala and the left precuneus, areas previously associated with processing of unpleasant dissonant musical sounds, there was an interaction between the experimental condition and the stimulus type. The current results are consistent with the previously reported effect of task difficulty on task-related brain activation decreases. The results also indicate that task-related decreases may be further modulated by the emotional stimulus connotation.

Using functional magnetic resonance imaging (fMRI) and n-back tasks we investigated whether, in 11-13-year-old children, spatial (location) and nonspatial (color) information is differentially processed during visual attention (0-back) and working memory (WM) (2-back) tasks and whether such cognitive task performance, compared to a resting state, results in regional deactivation. The location 0-back task, compared to the color 0-back task, activated segregated areas in the frontal, parietal and occipital cortices whereas no differentially activated voxels were obtained when location and color 2-back tasks were directly contrasted. Several midline cortical areas were less active during 0- and 2-back task performance than resting state. The task-induced deactivation increased with task difficulty as demonstrated by larger deactivation during 2-back than 0-back tasks. The results suggest that, in 11-13-year-old children, the visual attentional network is differently recruited by spatial and nonspatial information processing, but the functional organization of cortical activation in WM in this age group is not based on the type of information processed. Furthermore, 11-13-year-old children exhibited a similar pattern of cortical deactivation that has been reported in adults during cognitive task performance compared to a resting state.

MEG directly measures the neuronal events and has greater temporal resolution than fMRI, which has limited temporal resolution mainly due to the larger timescale of the hemodynamic response. On the other hand fMRI has advantages in spatial resolution, while the localization results with MEG can be ambiguous due to the non-uniqueness of the electromagnetic inverse problem. Thus, these methods could provide complementary information and could be used to create both spatially and temporally accurate models of brain function. We investigated the degree of overlap, revealed by the two imaging methods, in areas involved in sensory or motor processing in healthy subjects and neurosurgical patients. Furthermore, we used the spatial information from fMRI to construct a spatiotemporal model of the MEG data in order to investigate the sensorimotor system and to create a spatiotemporal model of its function. We compared the localization results from the MEG and fMRI with invasive electrophysiological cortical mapping. We used a recently introduced method, contextual clustering, for hypothesis testing of fMRI data and assessed the the effect of neighbourhood information use on the reproducibility of fMRI results. Using MEG, we identified the ipsilateral primary sensorimotor cortex (SMI) as a novel source area contributing to the somatosensory evoked fields (SEF) to median nerve stimulation. Using combined MEG and fMRI measurements we found that two separate areas in the lateral fissure may be the generators for the SEF responses from the secondary somatosensory cortex region. The two imaging methods indicated activation in corresponding locations. By using complementary information from MEG and fMRI we established a spatiotemporal model of somatosensory cortical processing. This spatiotemporal model of cerebral activity was in good agreement with results from several studies using invasive electrophysiological measurements and with anatomical studies in monkey and man concerning the connections between somatosensory areas. In neurosurgical patients, the MEG dipole model turned out to be more reliable than fMRI in the identification of the central sulcus. This was due to prominent activation in non-primary areas in fMRI, which in some cases led to erroneous or ambiguous localization of the central sulcus. Magnetoenkefalografia (MEG) mittaa suoraan aivojen hermosolujen sähköistä toimintaa ja sillä on parempi ajallinen erotuskyky kuin aivojen aktivaation aiheuttamia paikallisen verenkierron muutoksia kuvaava toiminnallinen magneettikuvaus (TMK). TMK:lla on toisaalta etuja paikannuksessa MEG:hen nähden ja MEG:llä saadut paikannustulokset ovat monikäsitteisiä. Nämä menetelmät voivat täydentää toisiaan ja yhdessä niillä voidaan saada tarkempi ajallinen ja paikallinen kuva aivojen toiminnasta. Käytimme näitä kahta menetelmää aivojen tunto- ja liikejärjestelmän toiminnan kuvantamisessa terveillä koehenkilöillä ja neurokirurgisilla potilailla. Tutkimme menetelmillä saatavan paikannustuloksen yhteneväisyyttä ja käytimme TMK:sta saatavaa paikannustietoa MEG:llä mitattujen aivojen magneetisten vasteiden mallinuksessa luoden mallin aivojen tuntojärjestelmän toiminnasta. Neurokirurgisilla potilailla vertasimme kuvantamismenetelmien tuloksia leikkauksenaikaiseen sähköiseen liikeaivokuoren paikannukseen. Tutkimuksessa testattiin ja sovellettin kehittämiämme uusia kuva-analyysimenetelmiä. MEG:llä ja TMK:lla havaitsimme viitteitä aktivaatiosta tuntoärsykkeen kanssa samanpuoleisella primäärillä tuntoaivokuorella. Tuloksemme viittaavat lisäksi siihen että aivojen lateraalisessa fissuurassa on ainakin kaksi erillistä lähdealuetta jotka tuottavat magneettisia tuntoherätevasteita. Mallimme aivojen toiminnasta tuntoarsykkeen käsittelyn aikana vastasi hyvin kirjallisuudessa raportoituja suoraan aivoista mitattuja eri alueiden aktivaatioaikoja. TMK-analyysimenetelmiä vertailtaessa todettiin kuva-alkion naapurustoinformaatiota käyttävien menetelmien tuottavan paremmin toistettavia tuloksia. Kehittämämme menetelmä rajasi tarkemmin aivojen aktivaatioalueen ja oli muita menetelmiä herkempi havaitsemaan heikkoja aktivaatioita. Paikannettaessa aivojen keskusuurretta leikkauksen suunnittelua ja riskien arviointia varten MEG tuotti luotettavamman tuloksen kuin TMK jossa osalla potilaista aktivaatiot muilla kuin primäärillä liikeaivokuorella olivat voimakkaimpia vaikeuttaen tulosten tulkintaa.

To prospectively evaluate magnetoencephalography (MEG) and functional magnetic resonance (MR) imaging, as compared with intraoperative cortical mapping, for identification of the central sulcus.Fifteen patients (six men, nine women; age range, 25-58 years) with a lesion near the primary sensorimotor cortex (13 gliomas, one cavernous hemangioma, and one meningioma) were examined after institutional review board approval and written informed consent from each patient were obtained. At MEG, evoked magnetic fields to median nerve stimulation were recorded; at functional MR imaging, hemodynamic responses to self-paced palmar flexion of the wrist were imaged. General linear model analysis with contextual clustering (P.01) was used to analyze functional MR imaging data, and dipole modeling was used to analyze MEG data. MEG and functional MR localizations were compared with intraoperative cortical mappings. The distance from the area of functional MR imaging activation to the tumor margin was compared between the patients with discordant and those with concordant intraoperative mapping findings by using unpaired t testing.MEG depicted the central sulcus correctly in all 15 patients, as verified at intraoperative mapping. The functional MR imaging localization results agreed with the intraoperative mappings in 11 patients. In all four patients with a false localization, the primary activation was in the postcentral sulcus region, but it did not differ significantly from the primary activation in the patients with correct localization with respect to proximity to the tumor (P = .38). Furthermore, at functional MR imaging, multiple nonprimary areas were activated, with considerable interindividual variation.Although both MEG and functional MR imaging can provide useful information for neurosurgical planning, in the present study, MEG proved to be superior for locating the central sulcus. Activation of multiple nonprimary cerebral areas may confound the interpretation of functional MR imaging results.

Visuospatial working memory mechanisms have been studied extensively at single cell level in the dorsolateral prefrontal cortex (PFCd) in nonhuman primates. Despite the importance of short-term memory of sound location for behavioral orientation, there are only a few studies on auditory spatial working memory. The purpose of this study was to investigate neuronal mechanisms underlying working memory processing of auditory and visual location information at single cell level in the PFCd. Neuronal activity was recorded in monkeys performing a delayed matching-to-sample task (DMTS). The location of a visual or auditory stimulus was used as a memorandum. The majority of the neurons that were activated during presentation of the cue memorandum were selective either for visual or auditory spatial information. A small group of cue related bimodal neurons were sensitive to the location of the cue regardless of whether the stimulus was visual or auditory, suggesting modality independent processing of spatial information at cellular level in the PFCd. Most neurons that were activated during the delay period were modality specific, responding either during visual or auditory trials. All bimodal delay related neurons that responded during both visual and auditory trials were spatially nonselective. The results of the present study suggest that in addition to the modality specific parallel mechanism, working memory of auditory and visual space also involves modality independent processing at cellular level in the PFCd.

Gaussian random field (GRF)-based methods are commonly used for statistical inference and to control the family-wise error rate (FWE) in neuroimaging. They require that the error fields are reasonable lattice approximations to an underlying continuous multivariate Gaussian random field and have differentiable and invertible spatial autocorrelation function. Permutation test estimates the distribution of the test statistic from the data and adjusts automatically for the FWE. Here we present a new analysis procedure, the cluster mass permutation test with contextual enhancement (CMPCE), and compare it to GRF. In CMPCE, the data are first pre-whitened to remove temporal autocorrelations. The FWE rates, the cluster detection probability and delineation accuracy of CMPCE and GRF were compared using measured null data and null data containing simulated activations. We also applied both methods to an fMRI experiment where tactile somatosensory stimulation into the right hand was used. When analyzing the FWE using null data, both CMPCE and GRF gave significantly higher FWEs (CMPCE up to 0.12, GRF up to 0.18) than the nominal significance level 0.05, indicating that the pre-whitening, motion correction or high-pass filtering partially failed. In the simulated activation data, CMPCE gave less falsely classified voxels for the same cluster detection probability level than GRF. The maximal cluster detection probability was on the other hand higher in the GRF-based method. Both methods gave qualitatively similar results in the tactile fMRI data. CMPCE seems to be a promising fMRI analysis method, especially if high delineation accuracy is required.

Udgivelsesdato: 2005-Dec Musicians and nonmusicians listened to major, minor, and dissonant musical chords while their BOLD brain responses were registered with functional magnetic resonance imaging. In both groups of listeners, minor and dissonant chords, compared with major chords, elicited enhanced responses in several brain areas, including the amygdala, retrosplenial cortex, brain stem, and cerebellum, during passive listening but not during memorization of the chords. The results indicate that (1) neural processing in emotion-related brain areas is activated even by single chords, (2) emotion processing is enhanced in the absence of cognitive requirements, and (3) musicians and nonmusicians do not differ in their neural responses to single musical chords during passive listening.

Objective Slow evoked responses have been extensively studied using electrophysiological and neuroimaging methods, but there is no consensus regarding their generators. We investigated the generators of the P3 and positive slow wave (PSW) in the evoked responses to probes recorded during auditory working memory tasks to find out whether there is dissociation between functional networks involved in the generation of the P3 and PSW and between spatial and nonspatial auditory processing within this time window. Methods Whole-head magneto-(MEG) and electroencephalography (EEG); analysis of MEG data using minimum-norm current estimates. Results The associative temporal, occipito-temporal and parietal areas contributed to the generation of the slow evoked responses. The temporal source increased while the occipito-temporal source diminished activity during transition from the P3 to PSW. The occipito-temporal generator of the P3 was activated more during the spatial than nonspatial task, and the left temporal generator of the PSW tended to be more strongly activated during the nonspatial task. Conclusions These findings indicate that partially distinct functional networks generate the P3 and PSW and provide evidence for segregation of spatial and nonspatial auditory information processing in associative areas beyond the supratemporal auditory cortex. Significance The present results support the dual-stream model for auditory information processing.

Early diagnosis of postoperative perfusion failure is essential in microsurgical tissue transfer. In order to determine if microdialysis could be used in diagnosing flap ischemia, we tested this method in an experimental pig model. Sixty-six flaps (34 myocutaneous and 29 cutaneous) were created in 18 anesthetized pigs. During the experiment, secondary ischemia was induced for 5 h by selective clamping of the artery (20 flaps) or vein (21 flaps). Glucose, lactate, and pyruvate concentrations were measured hourly from the muscular and dermal layers. We found that decreasing glucose levels and increasing lactate concentrations were associated with arterial and venous occlusions from the first hour of ischemia. In venous ischemia, lactate concentrations remained lower than those in arterial ischemia. The increase in lactate-to-pyruvate and lactate-to-glucose ratios was related to ischemia and also discriminated arterial occlusion from venous occlusion. In conclusion, microdialysis can be used to facilitate early detection of ischemia.

Publication in the conference proceedings of EUSIPCO, Tampere, Finland, 2000

Somatosensory evoked fields (SEFs) following median nerve stimulation can be recorded from the contralateral primary sensorimotor cortex (SMI), from the second somatosensory cortex (SII) bilaterally and from contralateral posterior parietal cortex (PPC) [1],[2]. At SMI, the response can be divided into distinct N20m, P35m and P60m deflections, while SII responses are biphasic with peaks at 80–100 ms and about 150 ms. The latency of the PPC response is usually 80–100 ms.

Ascending sensory impulses play an important role in providing feedback information necessary for the programming of movements. Therefore, it could be expected that sensory input to the cortex is facilitated from a moving limb, as demonstrated in monkeys [1].

To evaluate the inconvenience caused by an external prosthesis and the desire for breast reconstruction among Finnish breast cancer patients.A questionnaire was sent to 345 mastectomized women 2-58 months after surgery between 1989 and 1993; 176 questionnaires were eliglible for review. Response rate was 63%.Mean age of the patients was 58 years, and 91% wore an external prosthesis. Of the patients under 65 years old, 46% wished to have reconstruction, but only one patient in the group 65 years old or older was interested in reconstructive surgery. In this study, interest in reconstructive surgery did not decrease with time. Younger patients had more difficulties and inconvenience with the prosthesis in every-day life while working, enjoying leisure time pursuits and wearing clothing.Breast cancer patients under 65 years have considerable problems with external prosthesis in every-day life. This is the group of patients therefore, that should be considered when evaluating the need for breast reconstruction in the community. Of new breast cancer patients in Finland, 40% per cent are between 45 and 59; about 50-70% of them will have a mastectomy. Our study suggests that breast reconstruction is needed for about half of these patients. Therefore, the annual need for breast reconstruction in Finland involves about 370 women.

The present study evaluated neurophysiologic function of the primary sensorimotor cortex in juvenile neuronal ceroid lipofuscinosis. A 122-channel magnetometer, which allowed studies of the somatosensory system in millimeter and millisecond precision, was used to record somatosensory evoked magnetic fields to median nerve stimulation from 10 patients and their matched control subjects. In both patients and controls, the somatosensory evoked magnetic fields from primary sensorimotor area typically consisted of N20m, P35m, and P60m deflections. In the patients, N20m was significantly delayed, whereas P35m peaked earlier than in the control subjects. The source strengths for N20m and P35m were greater in the patients than in the controls. Both deflections showed a significant positive correlation with the disease duration: the sources were stronger in the older patients than in the younger ones. P60m deflections were normal or reduced in the patients. The results indicated increased thalamocortical excitability in the sensorimotor cortex in juvenile neuronal ceroid lipofuscinosis. (J Child Neurol 1997;12:355-360).

Cerebral responses evoked by peripheral stimuli are known to depend critically on the interstimulus interval (ISI). Here we report on the effects of ISI on somatosensory evoked magnetic fields (SEFs) to right median nerve stimulation, obtained in 9 healthy adults with ISIs of 0.15 0.3, 1,3 and 5 s. At the contralateral (left) primary sensorimotor cortex (SMI), the first cortical response, N20m, was stable between the ISIs 0.3 and 5 s, but slightly attenuated at the shortest ISI of 0.15 s. In contrast, the P35m and P60m deflections were very sensitive to changes of the ISI, declining steadily with shortening of the ISI throughout the entire range. These deflections were frequently undetectable at the shortest ISI of 0.15 s. Concomitant with the reductions of P35m and P60m, an N45m deflection was enhanced toward the short ISIs. Responses from second somatosensory cortex (SII) and posterior parietal cortex (PPC) were seen only with ISIs of 1 s or greater, being strongest at the 5 s ISI. Based on known effects of the ISI on intracellular evoked potentials, we present the following tentative model for the generation mechanism of the SMI response: N20m represents early excitatory postsynaptic potentials (EPSPs), P35m early inhibitory postsynaptic potentials (IPSPs), N45m secondary EPSPs and P60m late IPSPs in pyramidal neurones of area 3b. For practical purposes, SEFs from SMI can be obtained with short ISIs, while responses from SII and PPC require an ISI of at least 1 s.

OBJECTIVE: To present applications of magnetoencephalography (MEG) in studies of neurosurgical patients. METHODS: MEG maps magnetic fields generated by electric currents in the brain, and allows the localization of brain areas producing evoked sensory responses and spontaneous electromagnetic activity. The identified sources can be integrated with other imaging modalities, e.g., with magnetic resonance imaging scans of individual patients with brain tumors or intractable epilepsy, or with other types of brain imaging data. RESULTS: MEG measurements using modern whole-scalp instruments assist in tailoring individual therapies for neurosurgical patients by producing maps of functionally irretrievable cortical areas and by identifying cortical sources of interictal and ictal epileptiform activity. The excellent time resolution of MEG enables tracking of complex spaciotemporal source patterns, helping, for example, with the separation of the epileptic pacemaker from propagated activity. The combination of noninvasive mapping of subcortical pathways by magnetic resonance imaging diffusion tensor imaging with MEG source localization will, in the near future, provide even more accurate navigational tools for preoperative planning. Other possible future applications of MEG include the noninvasive estimation of language lateralization and the follow-up of brain plasticity elicited by central or peripheral neural lesions or during the treatment of chronic pain. CONCLUSION: MEG is a mature technique suitable for producing preoperative “road maps” of eloquent cortical areas and for localizing epileptiform activity.