Haemodynamic changes during high frequency oscillation for respiratory distress syndrome

In a crossover trial left ventricular output (LVO), cerebral blood flow velocity (CBFV), and resistance index (RI) of the anterior cerebral artery were compared using Doppler ultrasonography, in eight preterm infants with respiratory distress syndrome (RDS) during conventional mechanical ventilation and high frequency oscillation. LVO was 14% to 18% lower with high frequency oscillation. There were no significant changes in CBFV. On the first day of life there was a trend towards lower RI on high frequency oscillation; the fall in LVO on high frequency oscillation was not related to lung hyperinflation. Changes in ventilation type (from conventional mechanical ventilation to high frequency oscillation, or vice versa) can induce significant LVO changes in preterm infants with RDS.     

Different release of cytokines into the cerebrospinal fluid following surgery for intra- and extra-axial brain tumours

BACKGROUND: Abnormal pregnancies are usually associated with an impairment of maternal cerebral circulation which is mainly a consequence of generalized vasospasm and cerebral edema. The pathogenesis of vasospasm has still been a matter of controversy. The aim of this study was to evaluate maternal cerebral blood flow velocity (CBFV) changes in normal and abnormal pregnancies, and to correlate CBFV findings with the severity of symptoms in abnormal pregnancies. METHODS: A group of 40 gravidas (aged between 25 and 32 years) with pre-eclampsia were analyzed by Transcranial Doppler (TCD), Color Doppler Flow Imaging of carotid arteries and Transcranial Color Coded System once a week, starting from 32nd week of pregnancy and followed 2 months after delivery. The study was performed from the January 1996 to June 1996. RESULTS: The results showed 70% of abnormal pregnancies to have impaired TCD findings, mostly increased CBFV. The degree of toxemia measured by Goecke's index significantly correlated with abnormal CBFV Nine gravidas with increased CBFV on the first examination developed vasospasm during 34 to 36 weeks of gravidity. No statistically significant difference of the M1 segment of MCA diameters was found between normal (3.8 +/- 0.7 mm) and abnormal pregnancies (4.1 +/- 0.9 mm). CONCLUSIONS: The increase in the maternal CBFV was the most frequent observation in abnormal pregnancies. It was progressive during late pregnancy, when vasospasm may develop, although the presence of vasospasm is still the matter of controversy. The most important observation was that significant changes in CBFV preceded neurologic symptoms, emphasizing the predictive role of TCD in abnormal pregnancies.     

Receptor tyrosine kinase expression in human bone marrow stromal cells

A case of crossed aphasia is presented in a strongly right-handed 77-year-old white female without history of familial sinistrality or prior neurological illness. She developed a right middle cerebral artery infarction documented by CT and accompanied by obvious clinical signs of a conduction aphasia with some resolution but continuing obvious language defect after 9 weeks in rehabilitation. Comprehensive neuropsychological and aphasia testing suggested anomalous lateralization of phonologic-output aspects of language, emotional prosody, motor planning and body schema modules with usual lateralization of lexical-semantic aspects of language and visuo-spatial functions. Experimental validation of the uncrossed lexical-semantic aspects of language using tachistoscope methods found support for the Alexander-Annett theory that different aspects of language can be dissociated in their lateralization. The subject had difficulty identifying a semantic associate of a picture presented to the left visual field (7 errors out of 10) relative to right visual field presentation (2 errors out of 10). Bilateral free naming errors (6 and 5 errors in the left and right visual fields, respectively) occurred consistent with the aphasic presentation, suggesting phonologic-output dysfunction from the right cerebral vascular accident. Implications of the results for aphasia classification are discussed.     

Functional MR of frontal lobe activation: comparison with Wada language results

PURPOSE: Our purpose was to determine the utility of functional MR imaging in conjunction with a word-generation paradigm in the assessment of language lateralization. METHODS: Functional MR imaging and Wada testing for language lateralization was performed in patients with complex partial seizures during the performance of word-generation tasks. A language lateralization quotient was calculated from the number of activated pixels in the right and left hemispheres. A language laterality score was derived from the Wada results as the percentage of correct responses during right internal carotid artery injection minus the percentage of correct responses during left internal carotid injection. A correlation coefficient between the functional MR imaging results and the Wada language laterality scores was calculated. RESULTS: In 13 patients, hemispheric dominance based on Wada testing was confirmed by functional MR imaging during silent word generation. The Wada laterality scores varied from 100 to -100 and the functional MR imaging scores varied from 100 to -10. The language lateralization scores determined by functional MR imaging correlated significantly with the language lateralization scores derived from Wada testing. CONCLUSION: Functional MR imaging performed during word generation is an accurate method for lateralizing language function in patients with complex partial epilepsy.     

The morbid anatomy of the human genome: chromosomal location of mutations causing disease (update 1 December 1993)

Bound-morphine skills of school-age, language-impaired (LI) children were explored with three tasks designed to assess multiple dimensions of this component of language. Ten English-speaking, school-age LI children (Mean age: 10:3) and ten children with normal language (Mean age: 9:9) served as subjects. A two-way analysis of variance revealed significant group differences. Fisher a priori testing documented significant group differences for a measure of English bound-morpheme skill levels, a measure of ability to generalize English bound-morphemes to novel words, and a measure of ability to learn novel bound-morphemes attached to novel words. The findings indicate that core features of developmental language impairment in preschool children--poor ability to learn, to use, and to generalize bound-morphemes--are also present in school-age, LI children.     

Differential effects of prenatal testosterone on lateralization of handedness and language.

Objective: Handedness is the most noticeable functional expression of cerebral lateralization in humans. However, its developmental process and plasticity remain elusive. It has been postulated that prenatal testosterone (pT) has an effect on human lateralization development. In the present study we examined the relationship between pT and handedness and compared the outcome to previously published data on language lateralization in the same children. Method: pT was assessed from amniotic fluid of healthy pregnant women using radioimmunoassay. Strength and direction of handedness of the children (n = 65 [31 girls, 34 boys], mean age [years]: 6.43, range: 5.97–7.53) was assessed based on hand choice during performance of age appropriate tasks. Regression procedures and the Olkin & Siotani Z-statistic were used. Results: Results demonstrate that higher pT exposure was related to a decrease in strength of handedness (R2 = .11, p = .01). The analysis shows that pT has quite stronger explanatory power than sex by itself, although there may be an additional effect of sex independent from pT. In a subgroup of these children we recently reported that higher levels of pT are related to increased left hemisphere dominance for language. Analyses show that pT is differentially related to handedness and language lateralization in these children (Z > 2.75, p     

Functional MRI lateralization of memory in temporal lobe epilepsy

OBJECTIVE: To determine the feasibility of using functional magnetic resonance imaging (fMRI) to detect asymmetries in the lateralization of memory activation in patients with temporal lobe epilepsy (TLE). BACKGROUND: Assessment of mesial temporal lobe function is a critical aspect of the preoperative evaluation for epilepsy surgery, both for predicting postoperative memory deficits and for seizure lateralization. fMRI offers several potential advantages over the current gold standard, intracarotid amobarbital testing (IAT). fMRI has already been successfully applied to language lateralization in TLE. METHODS: fMRI was carried out in eight normal subjects and 10 consecutively recruited patients with TLE undergoing preoperative evaluation for epilepsy surgery. A complex visual scene encoding task known to activate mesial temporal structures was used during fMRI. Asymmetry ratios for mesial temporal activation were calculated, using regions of interest defined in normals. Patient findings were compared with the results of IAT performed as part of routine clinical evaluation. RESULTS: Task activation was nearly symmetric in normal subjects, whereas in patients with TLE, significant asymmetries were observed. In all nine patients in whom the IAT result was interpretable, memory asymmetry by fMRI concurred with the findings of IAT including two patients with paradoxical IAT memory lateralization ipsilateral to seizure focus. CONCLUSIONS: fMRI can be used to detect asymmetries in memory activation in patients with TLE. Because fMRI studies are noninvasive and provide excellent spatial resolution for functional activation, these preliminary results suggest a promising role for fMRI in improving the preoperative evaluation for epilepsy surgery.     

Variations in writing posture and cerebral organization

Two tachistoscopic tests of cerebral lateralization were administered to 73 subjects classified by handedness, sex, and hand orientation in writing. The results indicated that the direction of cerebral lateralization could be indexed from a subject's handedness and hand posture during writing. In subjects with a normal writing posture, the linguistically specialized hemisphere was contralateral to the dominant hand, and the visuospatially specialized hemisphere was ipsilateral; the reverse was true in subjects with an "inverted" hand position during writing. Females and subjects having an inverted hand posture manifested smaller degrees of lateral differentiation than males and subjects with a typical hand posture.     

Topical versus peribulbar anesthesia, without sedation, for clear corneal phacoemulsification

Electroconvulsive therapy (ECT) is an appropriate clinical model to investigate blood flow during seizures. In this study cerebral blood flow velocity (CBFV) was measured during 40 ECTs in 10 patients by means of transcranial Doppler sonography. EEG was recorded continuously. Under general anesthesia, the pre-convulsive blood flow velocity (Vmean) decreased significantly. After ECT, we measured a dramatic increase in Vmean which was significantly greater in the left MCA than in the right MCA. After termination of seizures, flow velocities returned to baseline levels. The striking increase in cerebral blood flow velocity reflects excessive cerebral metabolism during convulsive neuronal activation. The left hemisphere seems to be more sensitive to electrical stimuli as was indicated by its predominant augmentation of CBFVs.     

Left planum temporale surface correlates with functional dominance during story listening

The relationship between anatomical asymmetry of the planum temporale (PT) and functional lateralization for language comprehension was studied in 14 normal volunteers, including five left-handers (LH). PT surfaces and asymmetry were measured in each subject using structural MRI, while functional lateralization was assessed on individual regional cerebral blood flow (rCBF) difference images of a PET-H2(15)O activation protocol in which a story listening condition was contrasted with a control state. Significant positive correlations were found between the left PT surface and the amount of NrCBF increase during the story listening in the left superior temporal gyrus as well as with the left-right activation index in the superior temporal and the temporal pole. Functional imaging data were correlated neither with the right PT surface nor with the right-left PT surface asymmetry index. However the latter index was correlated with handedness scores. The present results indicate that the size of the left PT is the relevant anatomical landmark for language dominance, and demonstrate that anatomical asymmetries are part of the functional variability for language.     

Suppressed UDP-galactose: ceramide galactosyltransferase and myelin protein mRNA in twitcher mouse brain

To investigate the role of temporal processing in language lateralization, we monitored asymmetry of cerebral activation in human volunteers using positron emission tomography (PET). Subjects were scanned during passive auditory stimulation with nonverbal sounds containing rapid (40 msec) or extended (200 msec) frequency transitions. Bilateral symmetric activation was observed in the auditory cortex for slow frequency transitions. In contrast, left-biased asymmetry was observed in response to rapid frequency transitions due to reduced response of the right auditory cortex. These results provide direct evidence that auditory processing of rapid acoustic transitions is lateralized in the human brain. Such functional asymmetry in temporal processing is likely to contribute to language lateralization from the lowest levels of cortical processing.     

Language processing in aphasia: changes in lateralization patterns during recovery reflect cerebral plasticity in adults

During single word processing the negative cortical DC-potential reveals a left frontal preponderance in normal right-handers as well as in patients with a history of transient aphasia. Lateralization of DC-negativity therefore provides a reliable and robust method for the assessment of language dominance. In 11 stroke patients with permanent aphasia this physiological pattern changed to bilateral activation reflecting an additional right-hemispheric involvement in compensatory mechanisms in aphasia. Along with complete clinical recovery the classical aphasic syndromes revealed specific differences in changes of their lateralization patterns. In Broca's aphasia the initial right-hemispheric preponderance changed to a left frontal lateralization while in Wernicke's aphasia a presumably permanent shift towards the right hemisphere occurred. Differences in lateralization patterns might reflect different mechanisms of recovery such as the initial disinhibition of homologous areas contralaterally and subsequent collateral sprouting and synaptic modulation. The assessment of changes in lateralization of the cortical DC-potential during language tasks in a non-invasive, safe method with excellent time resolution that might provide further insights in the neural basis of recovery from aphasia.     

Bilateral hemispheric activation in the early recovery of motor function after stroke

BACKGROUND AND PURPOSE: Functional recovery after cerebral infarction is a complex phenomenon that depends on various factors. The aim of this study was to investigate changes in cerebral perfusion during motor activity in stroke patients with very early recovery of motor function. METHODS: We included 9 consecutive patients hospitalized for acute-onset hemiparesis who showed complete functional recovery within 24 hours. CT of the brain showed an ischemic or hemorrhagic cerebral lesion in areas compatible with the symptomatology. Within 36 hours (range, 28 to 36) all patients were examined for the effects of a thumb-to-finger opposition task on cerebral blood flow in the middle cerebral arteries, evaluated by means of bilateral transcranial Doppler ultrasonography. Data were compared with those of 9 healthy subjects matched for age and sex. In patients, the evaluation was repeated 2 to 4 months later. RESULTS: A comparable increase in flow velocity (% mean+/-SD) was observed with respect to baseline in the contralateral middle cerebral artery during motor activity with patients' normal (8.8+/-2.0%) and recovered hand (9.7+/-4.1%) and with both hands of control subjects (10.6+/-1.4%). In the middle cerebral artery ipsilateral to the hand performing the motor task, the increase in flow velocity was significantly higher (P<0.0001) during movement of the recovered hand in patients (8.6+/-2.7%) than during movement of the normal hand in both patients (2.6+/-1.6%) and control subjects (1.4+/-0.7%). In patients, pattern of changes in flow velocity during motor performance remained the same in the second evaluation. CONCLUSIONS: These observations suggest that areas of the healthy hemisphere can be activated soon after a focal injury and contribute to the positive evolution of a functional deficit in some patients. This phenomenon of ipsilateral activation cannot be considered transient because it is evident months after stroke onset.     

Metrics for cortical map organization and lateralization

Cerebral lateralization refers to the poorly understood fact that some functions are better controlled by one side of the brain than the other (e.g. handedness, language). Of particular concern here are the asymmetries apparent in cortical topographic maps that can be demonstrated electrophysiologically in mirror-image locations of the cerebral cortex. In spite of great interest in issues surrounding cerebral lateralization, methods for measuring the degree of organization and asymmetry in cortical maps are currently quite limited. In this paper, several measures are developed and used to assess the degree of organization, lateralization, and mirror symmetry in topographic map formation. These measures correct for large constant displacements as well as curving of maps. The behavior of the measures is tested on several topographic maps obtained by self-organization of an initially random artificial neural network model of a bihemispheric brain, and the results are compared with subjective assessments made by humans.     

Relations between prenatal testosterone and cerebral lateralization in children.

Several theorists have proposed that the sex steroid testosterone acts on the fetal brain during a critical period of development to influence cerebral lateralization (N. Geschwind & A. M. Galaburda, 1987; M. Hines & C. Shipley, see PA, Vol 71:8996; S. F. Witelson, see PA, Vol 79:26441. In the present study. relations were examined between prenatal testosterone levels in 2nd trimester amniotic fluid and lateralization of speech, affect, and handedness at age 10. Girls with higher prenatal testosterone levels were more strongly right-handed and had stronger left-hemisphere speech representation. Boys with higher prenatal testosterone levels had stronger right-hemisphere specialization for the recognition of emotion. This pattern of results is most consistent with Witelson's (1991) claim that prenatal testosterone leads to greater lateralization of function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cerebral blood flow velocity decreases during cognitive stimulation in Huntington's disease

OBJECTIVE: To examine whether activation of cerebral blood flow velocity during cognitive stimulation, as measured by transcranial Doppler ultrasonography (TCD), is altered in patients with Huntington's Disease (HD). BACKGROUND: Previous research suggests that resting cerebral blood flow in symptomatic and asymptomatic HD patients is reduced from expected premorbid levels. The effects of cognitive activation on this relative hypoperfusion in HD has not been studied extensively. METHODS: We measured TCD flow velocity during rest and cognitive testing with the Porteus Maze Test and the Trails Test in 12 normal control subjects and 10 gene-positive HD patients. Percent change (i.e., flow during testing/resting) of flow velocity in the anterior and middle cerebral arteries were compared between groups. Correlations among percent flow velocity change, a disability rating scale, and cognitive test scores were calculated. RESULTS: In control subjects, anterior cerebral artery flow velocity and middle cerebral artery velocity increased during cognitive testing (p=0.001). HD patients showed a smaller blood flow velocity increase in the anterior cerebral arteries during the Porteus Maze Test (p < 0.001) and the Trails Test, Part B (p < 0.001). In the left anterior cerebral artery, flow velocity fell an average of 4.2% below resting baseline levels during the Porteus Maze Test, and 1.2% below resting levels during the Trails Test. The magnitude of the cerebral blood flow velocity changes in the anterior cerebral artery correlated with a number of cognitive test scores and with a rating scale of functional disability. In addition, logistic regression was able to discriminate the HD patients from the control group based on blood flow velocity changes (p=0.0025). When HD patients were divided into more (i.e., HD with chorea; n=4) and less impaired (i.e., without chorea; n=6) groups, both showed significant decreases in left anterior cerebral artery flow velocity during visual spatial executive cognition testing compared with control subjects. CONCLUSIONS: These results suggest that activation of visual spatial executive functions cause decreased flow velocity in the anterior cerebral artery, but not the middle cerebral artery, in HD patients. These changes are related to test performance and functional capabilities.     

Examining the relationship between degree of handedness and degree of cerebral lateralization for processing facial emotion.

This paper examines the relationship between degree of handedness and degree of cerebral lateralization on a task of processing positive facial emotion in right-handed individuals. Three hundred and thirteen right-handed participants (157 women) were given two behavioral tests of lateralization: a handedness questionnaire and a chimeric faces test. Two further handedness measures were taken: familial lefthandedness and writing posture. Regression analysis showed that both degree of handedness and sex were predictive of degree of lateralization. Individuals who were strongly right-handed were also more strongly lateralized to the right hemisphere for the task. Men were more strongly lateralized than women. Data were reanalyzed for men and women separately. The relationship between handedness and lateralization remained for men only. Neither familial left-handedness nor writing posture were associated with cerebral lateralization for men or women. The results suggest a positive relationship between degree of handedness and degree of cerebral lateralization, and further that there is a sex difference in this relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Atypical laterality and retardation.

Empirical evidence is reviewed to examine whether retarded groups are characterized by reduced cerebral lateralization as predicted by theoretical accounts. There is clear evidence for atypical hand preferences and also for less congruency across hand, foot, eye, and ear preferences for retarded groups. However, these observations cannot be interpreted as indicative of reduced asymmetry in cerebral representation of function. Dichotic-listening studies provide little support for a general association between reduced cerebral asymmetry and retardation, although they indicate that Down's syndrome children, as well as autistic children, are characterized by atypical specialization for language. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Left-handedness.

Reviews the phenomenon of left-handedness from prehistoric man through contemporary studies of lateralization of cerebral function. The following conclusions seem warranted: Handedness is most appropriately regarded as a continuum ranging from strong right-handedness across mixed-handedness to strong left-handedness. Left-handedness, ranging from moderate through strongly left-handed, is found in approximately 10% of the population. Evidence for a genetic basis of handedness remains positive, but with no direct link established. There is remarkably little evidence for any association of left-handedness with deficit. The familial left-handed show greater recovery of functioning following unilateral cerebral insult than do nonfamilial right-handed and nonfamilial left-handed. Both behavioral and clinical lesion studies indicate systematic differences in lateralization of cerebral function between the right- and left-handed and the familial and nonfamilial left-handed. A classification of handedness and lateralization of cerebral function is suggested. The possibilities exist that bilaterality of cerebral functioning either is stable in the human race or is changing at an extremely slow rate. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physiological and neuropsychological correlates of hostility

This experiment tested two hypotheses linking right cerebral arousal to hostility and physiological arousal. A replication of previous research supporting heightened physiological (systolic blood pressure, diastolic blood pressure and heart rate) reactivity among high-hostility subjects was partially successful. Hemispheric lateralization of cerebral activity in response to stress was also measured. Low- and high-hostility subjects were identified using the Cook-Medley Hostility Scale (CMHS). Physiological measures (systolic blood pressure, diastolic blood pressure and heart rate) were recorded and dichotic listening procedures were administered before and after administration of the cold-pressor paradigm. The primary finding of this research was greater right cerebral activation to stress among high-hostility subjects, as indicated by their enhanced ability to identify syllables presented to the left ear. Data further supported previous findings of heightened physiological reactivity to stress among high-hostility subjects and suggest a positive relationship between right cerebral activity and cardiovascular arousal.