Correlation of functional magnetic source imaging with intraoperative cortical stimulation in neurosurgical patients

This study compared noninvasive preoperative functional imaging by using magnetoencephalography (MEG) with intraoperative direct cortical stimulation in ten patients undergoing neurosurgery. The goal was to assess the accuracy and reliability of MEG-based functional imaging in these patients as a possible replacement or adjunct for direct cortical stimulation with electrocorticography. Objective comparison of intraoperative mapping with preoperative MEG procedures was achieved by intraoperative recording of mapped cortical locations for motor responses using an interactive image-guided surgical device, the ISG viewing wand, with which mapping points could be marked on a previously acquired (MRI) set. In all ten patients, at least one stimulation site elicited a response during both MEG and intraoperative mapping. The central sulcus ipsilateral to the lesion was only directly visible on high-resolution MRIs in 3/10 cases and equivocally in 2/10. Coregistered with MRI to form magnetic source images (MSIs), MEG predictions of the postcentral gyrus were possible in all 10 cases. In all 10 cases, these were in agreement with intraoperative estimation of the precentral gyrus. Functional mapping of somatosensory cortex was achieved noninvasively in surgical patients by using MSI. The accuracy, compared with cortical stimulation, was always sufficient to define motor and somatosensory strips.     

Deficits and recovery of first- and second-order motion perception in patients with unilateral cortical lesions

Unilateral lesions in the posterior parietal cortex can degrade motion perception in the contralesional visual hemifield. Our aim was to investigate whether deficits caused by cortical lesions may be different for first- and second-order motion perception, and to study the time scale of any potential recovery. In nine patients with circumscribed lesions mainly in the parietal and fronto-parietal cortex, thresholds for direction discrimination were measured for stimuli presented peripherally in their ipsi- and contralesional hemifield. Subjects had to identify the direction of a vertically moving object embedded in a background of dynamic random dot noise. The object consisted of various proportions of signal and noise dots. Signal dots were either (a) coherently moving in the same direction as the object (first-order), (b) stationary (second-order: drift-balanced), or (c) coherently moving in the opposite direction (second-order: theta). Noise dots were flickering. Two patients showed significant threshold elevations for all three types of motion stimuli presented in their contralesional hemifield, while thresholds for ipsilesional targets were unaffected. Neither showed any selective deficit of first- versus second-order motion perception, but second-order motion was more impaired. Their lesions probably included the motion area V5-MT, which was spared in the other seven patients. One of the patients, who was retested several times during a 27-month postlesional period, showed complete recovery for first- and second-order motion direction discrimination, as well as for the detection of speed differences.     

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].     

The early component of the visual evoked magnetic field

Several EEG studies have reported an early component of the visual evoked potential. However, it is controversial whether this component is cortical or subcortical. Our study has aimed to clarify this problem using MEG and EEG in nine normal volunteers. A total of 4000 stimuli were presented to the monocular visual hemifield through a light-proof stimulating goggle and the visual evoked magnetic field and visual evoked potential was measured above the occipital lobe. The early component was observed in three of the nine subjects. The latency ranged from 40 to 45 ms in MEG and from 39 to 47 ms in EEG. The result of dipole localization analysis showed that its origin was cortical, and specifically, the striate cortex.     

Magnetoencephalographic mapping: basic of a new functional risk profile in the selection of patients with cortical brain lesions

OBJECTIVE: Surgical management of cortical lesions adjacent to or within the eloquent cerebral cortex requires a critical risk: benefit analysis of the procedure before intervention. This study introduced a measure of surgical risk, based on preoperative magnetoencephalographic (MEG) sensory and motor mapping, and tested its value in predicting surgical morbidity. METHODS: Forty patients (21 men and 19 women; mean age, 36.5 yr) with cortical lesions (12 arteriovenous malformations and 28 tumors) in the vicinity of the sensorimotor cortex were classified into high-, medium-, or low-risk categories by using the MEG-defined functional risk profile (FRP). This was based on the minimal distance between the lesion margin and the sensory and motor MEG sources, superimposed on a magnetic resonance imaging scan. Case management decisions were based on the MEG mapping-derived FRP in combination with biopsy pathological findings, radiographic findings, and anatomic characteristics of the lesion. A recently developed protocol was used to transform MEG source locations into the stereotactic coordinate system. This procedure provided intraoperative access to MEG data in combination with stereotactic anatomic data displays routinely available on-line during surgery. RESULTS: It was determined that 11 patients diagnosed as having gliomas had high FRPs. The margin of the lesion was less than 4 mm from the nearest MEG dipole or involved the central sulcus directly. A nonoperative approach was used for six patients of this group, based on the MEG mapping-derived FRP. In the group with arteriovenous malformations, 6 of 12 patients with high or medium FRPs underwent nonoperative therapy. The remaining 28 patients, whose lesions showed satisfactory FRPs, underwent uneventful lesion resection, without postoperative neurological deficits. CONCLUSION: Our results suggest that MEG mapping-derived FRPs can serve as powerful tools for use in presurgical planning and during surgery.     

Visual form discrimination from texture cues: a PET study

With the purpose of localising the cerebral cortical areas participating in the discrimination of visual form generated exclusively by texture cues, we measured changes in regional cerebral blood flow (rCBF) with positron emissions tomography (PET) and 15O-butanol as the tracer. The subjects performed two odd-one-out discrimination tasks: a form-from-texture discrimination task (in which a visual form was defined by differences in texture) and its reference task, the discrimination of texture. During task performance, activated fields were present bilaterally in the primary visual cortex and its immediate extrastriate cortex, the right lateral occipital gyrus, bilaterally in the fusiform and superior temporal gyri and posterior parts of the superior parietal lobules, along the medial bank of the right intraparietal sulcus, and in the right supramarginal gyrus. Other fields were found in the cingulate and prefrontal cortex. The findings demonstrate that the discrimination of visual form as defined by texture engages cortical fields that are widely distributed ion the human brain. In the visual cortex, the activated fields are present in both the occipito-temporal and occipito-parietal visual areas. These results suggest that the perception and discrimination of forms in the visual system requires the joint-activation of neuronal populations in the visual cortex.     

Psychophysical judgment: electro-cortical and heart rate correlates of accuracy and uncertainty

The relationship between perceptual accuracy and physiological response amplitude was investigated in an auditory pitch discrimination experiment. Confidence ratings were obtained from all subjects following each trial. The stimulus set consisted of three tones of different frequencies spaced in a manner to provide both easy and difficult discriminations. Heart rate, EEG and vertical eye movement were recorded throughout the experiment. The results of the experiment indicated that the largest evoked cardiac rate response was elicited by the stimulus which produced the fewest errors in judgment; larger auditory evoked potentials, particularly the late positive component (P300), were associated with the 'easy' stimulus; greater cortical negativity was associated with the difficult stimuli. Eye activity was found to covary with judgmental accuracy; cortical slow wave activity was particularly sensitive to the confidence, or 'uncertainty' parameter. A 'decision tree' model was hypothesized to describe the processing mechanism involved in solving the discrimination problem.     

Masking by object substitution: Dissociation of masking and cuing effects.

In a newly discovered form of visual masking, a target stimulus is masked by 4 flanking dots if their offset is delayed relative to the target (V. Di Lollo, J. T. Enns, & R. A. Rensink, 2000). In Di Lollo et al. (2000), the dot pattern also cued the relevant target and therefore required deliberate attention. In the present Experiments 2-6, a central arrow cued 1 of 2 letters for an E/F discrimination, with dots flanking both letters. Masking was reduced compared with the mask-cue procedure but was still robust. Delayed-offset dots flanking the nontarget also impaired performance, indicating competition for attention. Masking was unaffected by brightness of the dots relative to the target. Masking was attenuated not only by precuing attention to the target location but also by preview of an uninformative dot mask. Theories of masking by object substitution must therefore accommodate the prior context into which the target stimulus is introduced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cellular biology of human intimal hyperplastic stenosis

We studied the topographic distribution of scalp-recorded, averaged movement-related cortical potentials occurring immediately before and after the onset of voluntary movements in six patients with cerebellar degenerative disease. We placed 26 electrodes on the scalp overlying the sensorimotor area and recorded cortical potentials related to abduction of the index finger. The amplitudes and latencies of the potentials were normal in all patients except two, in whom the negative slope (NS') was absent. All patients had an abnormal topographic pattern of potentials compared with normal subjects. The initial slope of motor potential (isMP), which was focal and contralateral in the normal subjects, was diffuse and bilateral in the patients. The topography of the frontal peak of motor potential (fpMP) was more posterior in the patients than in normal subjects. The patterns found in this preliminary study indicate a derangement of sensorimotor cortex activity in voluntary movement as a consequence of cerebellar dysfunction.     

Introduction of magnetoencephalography to stereotactic techniques

Magnetoencephalography (MEG), a noninvasive functional brain mapping technique, was used for preoperative localization of the sensorimotor cortex in patients harboring lesions involving these eloquent regions. Prior to surgery, MEG source locations were transferred onto high-resolution MRI pictures which were then used for preoperative evaluation, risk analysis, and planning. We have developed a process to transform the MEG-derived sensorimotor localization coordinates into the COMPASS stereotactic coordinate system. Thus the MEG-derived functional information is incorporated into the stereotactic database, enabling the simultaneous visualization of functional and anatomical data. This information can be used for the selection of cases and in planning safe approaches for computer-assisted volumetric resections. The integration of MEG and stereotactic neurosurgery also allows a more precise comparison between MEG and intraoperative direct electrocorticographic mapping (ECoG). Seven patients were studied with good correlation between MEG and intraoperative mapping. In 4, the correlation was only based on gross visual comparison between intraoperative identification of the gyrus pattern and MEG photographs. The availability of the MEG coordinates in the stereotactic system, however, allows a more precise correlation between MEG and ECoG. In all 3 patients studied in this manner, the MEG coordinates (pinpointed to a precise cortical representation of a few millimeters) overlapped with ECoG results. In summary, we compared functional MEG data to intraoperative ECoG and conclude that the introduction of MEG into stereotactic neurosurgery can provide precise functional and anatomic information for image-guided surgical planning and resection.     

Studies on integrative functions of the human frontal association cortex with MEG

Our MEG studies on the human frontal association cortex are briefly reviewed. (1) The no-go potential was first found at go/no-go reaction-time hand movement task with discrimination between different colour light stimuli in the prefrontal cortex of monkeys. The potential was recorded in human subjects with EEG over the scalp, but its current dipoles could be localized only by use of MEG, in the dorsolateral part of the frontal association cortex in both cerebral hemispheres. The function for no-go decision and subsequent suppressor action was thus substantiated in the human frontal cortex. (2) Utterance of a short noun in Japanese was found to be initially preceded by an activity in the lower lateral part of the frontal lobe and then by that around the central sulcus. The area of the former, often in both hemispheres, appears to correspond to Broca's motor speech centre and that of the latter, always in both hemispheres, to correspond to the motor-somatosensory cortices. (3) Intensive and continuous concentration on mental calculation and some 'abstract' thinking for a few minutes were often associated with magnetic theta (5-7 Hz) wave bursts in the frontal part of the scalp. Dipole fitting suggested that the electrical current dipoles occur successively and scattered in wide areas of the frontal lobe on both sides. They are to be called "frontal mental theta wave", revealing dynamic and active participation of the frontal lobe in mental functions.     

Activation of multi-modal cortical areas underlies short-term memory

We wanted to examine whether there are cortical fields active in short-term retention of sensory information, independent of the sensory modality. To control for selective attention, response selection and motor output, the cortical activity during short-term memory (STM) tasks was compared with that during detection (DT) tasks. Using positron emission tomography and [15O]-butanol as a tracer, we measured the regional cerebral blood flow in ten subjects during three STM tasks in which the subjects had to keep in mind: (i) the pitch of tones; (ii) frequencies of a vibrating stylus; and (iii) luminance levels of a monochrome light. Another group of ten subjects undertook three tasks in which subjects detected changes in similar stimuli. Six cortical fields were significantly more activated during STM than during DT. These fields were activated irrespective of sensory modality, and were located in the left inferior frontal gyrus, right superior frontal gyrus, right inferior parietal cortex, anterior cingulate, left frontal operculum and right ventromedial prefrontal cortex. Since the DT tasks and the STM tasks differed only with respect to the STM component, we conclude that the neuronal activity specifically related to retention of the stimuli during the delays was located in these six multi-modal cortical areas. Since no differences were observed in the sensory-specific association cortices, the results indicate further that the activity in the sensory-specific association cortices due to selective attention is not different from the activity underlying short-term retention of sensory information.     

Neural correlates of working memory in a visual letter monitoring task: an fMRI study

Complex mental operations rely on the coordinated activity of widely distributed brain regions constituting neurocognitive networks. Using multislice echoplanar functional magnetic resonance imaging (fMRI) we have contrasted regional brain activity during a control and an experimental condition which differed with respect to the demands placed on verbal working memory. Subjects were seven right-handed healthy male volunteers. Analysis of group and individual data revealed activation in the anterior and posterior parasagittal cortex in all subjects, left parietal cortex (six subjects) and left dorsolateral prefontal cortex (five subjects). These results suggest that verbal working memory is subserved by a neurocognitive network comprising cortical regions involved in attention, executive function and short term mnemonic processes.     

A comparison of spatial prediction techniques for an exploratory analysis of human cortical motor representations

We compare the use of two-dimensional Laplacian smoothing splines and median polish kriging for an exploratory analysis of spatial data sets. Splines were developed originally for modelling a process with determinstic mean structure, while median polish kriging was developed for predicting a spatial random process. We review the fundamentals of both methods, including smoothing parameter selection for splines and variogram estimation and solving the kriging equations for median polish kriging. We demonstrate application of the methods on maps of muscle representations on the human motor cortex (cortical maps). After applying both methods to 20 cortical maps (left and right hemispheres on each of 10 subjects), we compare the fitted surfaces on the basis of predictive ability, aesthetic appeal, and ease of computation.     

Optimum letter size for a given display area.

"Visual acuity determinations were made on two groups of 20 subjects each at two luminance levels with three conditions of surround, or field clearance, above and below the line of letters… . It is concluded that, when space limitations are a consideration, letters should be made as large as possible up to the point of very nearly filling the available space (margin less than the stroke width of the letters), in order to permit discrimination at a maximum distance." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Molecular cloning and characterization of a recombinant Histoplasma capsulatum antigen for antibody-based diagnosis of human histoplasmosis

We recorded simultaneous multichannel electroencephalogram (EEG) and magnetoencephalogram (MEG) in four children with partial epilepsy. Sources of averaged spikes were modelled with current dipoles. Of 10 spike averages obtained, three peaked simultaneously in MEG and EEG, and in seven averages, the MEG peak preceded the main EEG peak by 9-40 ms. A small positive early EEG signal coincided with the MEG peak in six asynchronous spikes. The simultaneous MEG and EEG spikes originated within 5-23 mm, while sources of asynchronous peaks were 12-67 mm apart. We conclude that non-identical neurone currents underlie the MEG and EEG signals, and emphasize the importance of modelling early phases of EEG spikes when localizing interictal epileptic zones.     

Adult age differences in regional cerebral blood flow during visual world identification: evidence from H215O PET

We used H215O PET to investigate adult age differences in regional cerebral blood flow (rCBF) during the performance of a visual word identification task. The study participants were 20 healthy, right-handed men: 10 young adults between 18 and 27 years of age, and 10 older adults between 63 and 75 years of age. The word identification task comprised six blocks of test trials representing four task conditions; subjects responded manually. The task conditions varied with regard to whether semantic retrieval was required (e.g., word/nonword discrimination vs simple response to each stimulus) and with regard to the difficulty of visual encoding (e.g., words presented normally vs words with asterisks inserted between adjacent letters). Each subject performed all six trial blocks, concurrently with each of six H215O PET scans. Analyses of quantitative CBF data obtained from the arterial time-activity curve demonstrated a significant age-related decline in global CBF rate. Analyses of the changes in rCBF between task conditions indicated that retrieval of semantic information sufficient to distinguish words from nonwords is mediated by a ventral occipitotemporal cortical pathway. Specific areas within this pathway were also associated with visual encoding processes. Several rCBF activations were significantly greater for young adults than for older adults, indicating an age-related decline in processing efficiency within this ventral occipitotemporal pathway. Although the performance data demonstrated a greater age-related slowing for visual encoding than for semantic retrieval, these age-related performance changes were not associated with corresponding changes in rCBF activation.     

The ontogeny of interstimulus interval (ISI) discrimination of the conditioned eyeblink response in rats.

Discrimination of the eyeblink conditioned response (CR) between conditioned stimuli (CSs) of different durations and modalities was examined across development in rats. Interstimulus interval (ISI) discrimination was evident at Postnatal Days 23-34 in Experiment 1, and earlier CR peak latencies and enhanced CR amplitudes were seen to the long CS in the ISI discrimination group relative to a control group receiving the short CS without reinforcement. Experiment 2 showed that early CR peak latencies and enhanced CR amplitudes to the long CS in the ISI discrimination group were due to associative pairing of the short CS and unconditioned stimulus. Experiment 3 demonstrated ISI discrimination in adults that was improved relative to younger subjects, but with no enhancement of CR amplitude to the long CS in the ISI discrimination group. Cerebellar cortical maturation may influence the ontogeny of CR timing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human auditory cortical mechanisms of sound lateralization: II. Interaural time differences at sound onset

Neuromagnetic responses were recorded over the right temporal cortex using a 24-channel gradiometer. Stimuli were binaural click trains, presented with six separate interaural time differences (ITDs). N100m to sound onset was larger and earlier for stimuli presented with left- than with right-leading ITDs. With stimulus lateralization taken into account, monaural and binaural stimuli evoked responses of roughly equal amplitude. In selective adaptation and oddball experiments, stimuli presented with different ITDs excited overlapping neuronal populations, but the amount of overlap decreased as the ITD between the stimuli increased. There were no systematic differences in the cortical source locations of the N100m as a function of ITD, however. Thus it appears that ITD-sensitive neurons in the human auditory cortex are not organized into a large-scale, orderly representation, which could be resolved by MEG.     

Motion integration with dot patterns: effects of motion noise and structural information

To better understand how local motion detectors merge their responses so as to permit the global determination of objects' movements in the visual field, direction discrimination of performance was measured using a flexible class of moving dots--two sets of dots translating sinusoidally 90 deg out of phase along orthogonal axes. When dots' velocities are combined, a global motion along a circular trajectory emerges, clockwise or counter-clockwise depending on the sign of the phase lag. However, the results of the present experiments indicate that dot patterns are segregated into distinct, but interacting, streams when each dot motion can be accurately determined. In contrast, perceptual coherence of the global motion occurs when each local motion signal is "blurred" by a "motion noise". Direction discrimination performance then increases regularly with both noise amplitude and noise frequency, i.e., noise speed. Performance also increases when relative motion between dots is added. Testing different dot configurations indicates that performance is better for spatial arrangements that display structural properties (a square shape), as compared to overlapping random distributions. Interestingly, when the delay between stimulus onset and motion onset increases up to 300 msec, performance improves when dot patterns convey come form of structural organization but not when the dots are distributed at random. Relations of these results to existing models of motion integration are considered.