Biological and psychosocial factors in recovery from brain damage in humans.

Explores biological and psychosocial factors relevant to recovery of function following brain damage, with emphasis on neurorehabilitation programs. Possible mechanisms of brain plasticity that are related to synaptic reorganization include neurotransmitters and other neuroactive substances, memory, volume transmission, and receptor plasticity. Discussion of psychosocial factors beyond the early phases of rehabilitation focuses on environmental considerations, support systems, and cognitive appraisal. Future directions for neurorehabilitation are offered. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cerebellar dysfunctions of temporal processing in the seconds range in humans

The roles of the basal ganglia and cerebellum in timing remain subject to debate. It has been suggested that temporal range may dissociate them, since cerebellar research has focused on intervals of < 1 s, compared with many seconds used in much basal ganglia research. Here we show increased but scalar variability of time estimates in patients with focal lesions of the lateral cerebellar cortex and nuclei when trained to remember durations in the seconds range, compared with patients with lesions of the mesial cerebellum and vermis. This distortion is discussed on the basis of previously reported cerebellar deficits in different time ranges and contrasted to distortions occurring in patients with basal ganglia lesions performing similar tasks over similar time ranges.     

Evidence for effects of insulin on sensory processing in humans

Lessons learned from environmental and occupational hazard risk management practices over the past 30 years have led the Department of Defense to explore alternative risk management approaches. Policies for cleanup of environmentally hazardous waste sites are undergoing examination and are being reframed. A Demonstration Risk Communication Program is described which incorporates principles that integrate risk-based scientific information as well as community values, perceptions, and needs in a democratic process that includes the public as an active participant from the earliest stages. A strong scientific foundation for assessment and characterization of risk is viewed as necessary but not sufficient; the public's values must be actively integrated into the negotiated criteria. The Demonstration Program uses a model to prepare the participants and to guide them through the process. A five-step process is presented: (1) create risk communications process action team including at least one member of the specific site audience; (2) professionally train participants on team dynamics including interpersonal communication skills; (3) train risk communicators to deliver a cogent presentation of the message to secure a decision acceptable to both the government and the public; (4) identify existing biases, perceptions, and values held by all participants; and (5) develop risk message incorporating science and values. The process action team approach assumes the participants enter into the effort with the goal of improved environment and safeguarded public health. The team approach avoids confrontational or adversarial interactions and focuses on a dialogue from which a negotiated team response develops. Central to the program is the recognition that communication is only effective when the dialogue is two-way.     

Neuronal generators of visual evoked potentials in humans: visual processing in the human cortex

PURPOSE: We wished to define the localization of cortical generators of visual (pattern) evoked potentials (VEP) and the temporal sequence of activation in the occipital region. METHODS: In 4 candidates for epilepsy surgery, a large array of subdural electrodes was placed over occipital areas. Checkerboard pattern reversal stimuli were generated and the epileptogenic focus was localized and functionally mapped. Magnetic resonance imaging did not show any occipital lesions in any of the 4 patients. RESULTS: The area first activated was the lingual gyrus in the mesial occipital lobe (negative potential peaks at approximately 70 ms), followed by an area superior to the calcarine fissure (negative peaks at approximately 80 ms). Later (starting at approximately 90 ms), there were positive potentials over the occipital pole and lingual gyrus, followed by potentials at the lateral occipital lobe. CONCLUSIONS: These data support the idea that VEP are generated in the mesial and lateral occipital cortex by different circumscribed neuronal generators with different latencies of activation. The scalp-recorded N1 and P1 potential peaks most likely derive from the progressive activation of neuronal masses in different regions of the occipital lobe.     

Pitch processing in the human brain is influenced by language experience

Positron emission tomography (PET) was used in a cross-linguistic study to compare pitch processing in native speakers of English, a nontone language, with those of Thai, a tone language. When discriminating pitch patterns in Thai words, only the Thai subjects showed activation in the left frontal operculum. Activation of this region near the classically defined Broca's area suggests that the brain recognizes functional properties, rather than simply acoustic properties, of complex auditory cues in accessing language-specific mechanisms in pitch perception.     

Purification and properties of blood group A-active glycoprotein from oyster viscera

A blood group A active substance was isolated from an acetone-dried powder of oyster viscera by extraction with 0.1 M NaCl after heating a homogenate with extraction medium, in boiling water. After the removal of the acidic fraction with cetylpyridinium chloride, the separated neutral fraction was digested successively with alpha-amylase and amyloglucosidase to remove glycogen. The blood group A-active portion was eluted from a Sepharose 4B column and purified by DEAE-Sephadex column chromatography. The purified active substance was homogeneous by polyacrylamide gel electrophoresis, and its molecular weight was estimated as 100 000 by sedimentation equilibrium. The sugar content of the purified active substance, expressed in percentage of dry weight, was galactosamine, 16.6; galactose, 12.5; fucose, 9.9; glucosamine, 4.6; and glucose, 3.3. Sialic acid was not detected. Total amino acid content was 23.0% and the main constituents were threonine, proline and serine. The ORD spectrum indicated that the hexosamines were N-acetylated. Absence of glycolipid was confirmed by the analysis of fatty acid and sphingosine base. This active substance had a strong blood group A activity (0.04 mug/ml) but neither B nor H activity; it interacted with lima bean lectin but not with concanavalin A.     

Effects of insulin and hypoglycemia on the auditory brain stem response in humans

1. This study aimed to differentiate effects of insulin and hypoglycemia on sensory brain stem functions in humans. Auditory brain stem responses (ABR) were examined in 30 healthy men during euglycemia and after 20 and 50 min of steady-state hypoglycemia of 2.6 mM induced with human insulin (HI) in one session and porcine insulin (PI) in another session. 2. Levels of blood glucose and serum insulin were identical in both sessions during HI and PI infusion. 3. Hypoglycemia increased interpeak latencies III-V (+71 microseconds; P < 0.001) and I-V (+123 microseconds; P < 0.001), whereas changes in the latency of wave I were not significant. 4. After 20 min of constant hypoglycemia, increases in the interpeak latencies I-V and III-V were significantly more pronounced during infusion of PI than HI. These differences disappeared with time spent in hypoglycemia, i.e., after 50 min of hypoglycemia. 5. Apart from the delaying effect of hypoglycemia on neuronal transmission within the sensory brain stem, the results provide evidence for a separate influence of insulin on these functions.     

Comparison of brain tissue oxygen tension to microdialysis-based measures of cerebral ischemia in fatally head-injured humans

This study investigated the relationship between brain tissue oxygen tension (PbtO2) and cerebral microdialysate concentrations of several compounds in five patients with refractory intracranial hypertension after severe head injury. The following substances were assayed: lactate and glucose; the excitatory amino acids glutamate and aspartate; and the cations potassium, calcium, and magnesium. Glucose concentrations did not correlate with PbtO2, but lactate increased as PbtO2 decreased. The lactate/glucose ratio exhibited a close relationship to PbtO2, increasing sharply only when oxygen tension reached zero. Although glucose and oxygen eventually reached very low levels and zero, respectively, in these fatally head-injured patients, the terminal decrease in PbtO2 slightly preceded that of glucose in four of the five patients. This time lag is the cause of the poor correlation between glucose and PbtO2. Glutamate and aspartate concentrations both demonstrated a close relationship to PbtO2, with sharp increases not occurring until PbtO2 was zero. Concentrations of these amino acids exhibited a similar pattern in response to decreasing glucose concentrations. Potassium concentrations began increasing at a PbtO2 of 35 mm Hg, which is not generally considered indicative of hypoxia. Sharper increases began occurring once PbtO2 dropped below 15 mm Hg, with a slight rise in the minimum potassium concentrations recorded at these low PbtO2 values. Calcium and magnesium concentrations did not vary in response to PbtO2. In summary, the most robust biochemical indicators of cerebral anoxia were elevations in the lactate/glucose ratio and in the concentrations of lactate and of the excitatory amino acids glutamate and aspartate. Furthermore, the fact that glucose concentrations continue to decrease for a short period after oxygen levels reach zero suggests that cells continue to utilize glucose anaerobically for such functions as maintenance of cellular integrity, with collapse of the cell membrane as evidenced by increases of extracellular glutamate and aspartate not occurring until both oxygen and glucose concentrations reach zero.     

Semantic processing in the right hemisphere may contribute to drawing inferences from discourse

After listening to multiple-episode stories that promoted coherence inferences, right hemisphere-damaged patients answered Inference questions about the stories less accurately than Explicit questions, whereas normal elderly subjects answered both question types equally well. In addition, while subjects listened to the stories they made lexical decisions to tests words that were related to the promoted inferences or were unrelated to the stories. Right hemisphere-damaged patients responded more slowly to inference-related words than to unrelated words, whereas normal elderly subjects responded more quickly to interference-related words than to unrelated words. Furthermore, the episode boundaries did not affect either group's accuracy on Inference questions, and the boundaries equally affected both groups' lexical decision latencies, suggesting that the patients' inferencing deficit was not due to an impairment in organizing the mental substructures used to represent discourse. These results suggest that the right hemisphere-damaged patients lacked activation of semantic information necessary for drawing coherence inferences.     

Vasopressin processing defects in the Brattleboro rat: implications for hereditary central diabetes insipidus in humans?

The arginine vasopressin (AVP) precursor gene of mammals contains three exons encoding the principal domains of the polyprotein precursor, including vasopressin (exon A), neurophysin (exon B), and glycopeptide (exon C). The AVP precursor (preprohormone) is processed and transported through the endoplasmic reticulum (ER), Golgi apparatus, and secretory vesicles, and finally, mature AVP is secreted from the posterior pituitary into the circulation. The exact steps of these processes during AVP translation and posttranslation events are not yet well elucidated. Defects in peptide processing are associated with several genetic disorders, including central diabetes insipidus (CDI). In the Brattleboro rat with CDI, the mRNA and protein of AVP are present in the hypothalamus, but no circulating AVP is detectable, thus suggesting a processing defect, transport defect, or both. The mutated AVP gene precursor of Brattleboro rat has a deletion of a single base, guanine, in the neurophysin coding region that leads to a frameshift resulting in the loss of the normal stop codon. It has been reported that the mutated precursor is trapped in the ER and does not reach the Golgi apparatus. Recent studies examined AVP secretion in cultured COS cells transfected with various constructs from wild-type and mutated Brattleboro AVP gene precursors. The wild-type in vitro studies demonstrated that intact neurophysin, but not the glycoprotein coding region, is necessary for normal AVP processing and secretion. Next, the results demonstrated that the guanine defect in the neurophysin coding region and the prolonged C-terminus accounted for the processing defect in the Brattleboro rat with CDI. These defects no doubt impair the folding and configuration necessary for normal processing of the AVP gene precursor in the ER. In hereditary CDI in humans, the majority of the mutations have also been shown to occur in the neurophysin coding region. However, in contrast to the recessive defect in the Brattleboro rat, in human CDI, neurotoxicity and denigration of the magnocellular neurons have been observed, and dominant inheritance occurs. Moreover, all mutations are missense, nonsense, or deletions in human CDI rather than the shift in reading frame and preserved neurons that is observed with the Brattleboro rat. Thus, the results from studies in the Brattleboro rat may only be partially applicable to hereditary CDI in humans.     

Memory in food-storing birds: from behaviour to brain

As a result of natural history studies, it has been hypothesized that food-storing birds may develop a special kind of memory to cope with the demand imposed by their food-storing behaviour (i.e. the ability to retrieve food from a wide variety of stores over varying amounts of time after storage). Recent studies on food-storing birds suggest that, at a relatively late stage in their development, the specific memories associated with food-storing behaviour can stimulate growth of the hippocampus, an area of the brain concerned with memory processing.     

Interactions of focal cortical lesions with error processing: Evidence from event-related brain potentials.

Electrophysiological and hemodynamic studies have suggested that structures in the vicinity of the anterior cingulate cortex are involved in performance monitoring, particularly in detection of errors. Bidirectional interactions between the frontomedian system involved in performance monitoring and the lateral prefrontal cortex as well as the orbitofrontal cortex have been proposed, but few studies have directly addressed this issue. The authors used a speeded flankers task to investigate error-related event-related potentials in 3 patient groups with different focal cortical lesions. Whereas bilateral frontopolar lesions involving the orbitofrontal cortex as well as temporal lesions did not alter the error-related negativity (ERN), lesions of the lateral frontal cortex resulted in an abolition of the ERN and in a reduction of the error positivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Event-related brain activity associated with auditory pattern processing

One of the basic properties of the auditory system is the ability to analyse complex temporal patterns. Here, we investigated the neural activity associated with auditory pattern processing using event-related brain potentials. Participants were presented with a continuously repeating sequence of four tones with rare changes in either the frequency or timing of one of the tones. Both frequency- and time-deviant sounds generated mismatch negativity (MMN) waves that peaked at midline central electrode sites and inverted in polarity at inferior temporal and occipital sites, consistent with generators in the supratemporal plane. The MMN scalp topography was similar for the frequency- and time-deviant stimuli, suggesting that both spectral and temporal relations among elements of an auditory pattern are encoded in a unified memory trace.     

Fiber-type caffeine sensitivities in skinned muscle fibers from humans susceptible to malignant hyperthermia

BACKGROUND: The response to contracture tests may depend upon the relative proportion of muscle fiber types within the muscle specimen. To determine whether a difference in fiber-type caffeine sensitivities exists between malignant hyperthermia susceptible (MHS) and malignant hyperthermia-nonsusceptible (MHN) skeletal muscle, we compared the fiber-type caffeine sensitivities in chemically skinned muscle fibers dissected from vastus lateralis muscle from 15 MHS and 16 MHN patients. METHODS: Muscle fiber type was determined in each fiber by the difference in strontium-induced tension measurements and in 36 fibers, after contracture testing, by ATPase enzyme histochemistry. Caffeine sensitivity was defined as the threshold concentration inducing more than 10% of the maximal tension obtained with a calcium 1.6 x 10(-2) mM solution. RESULTS: Significant difference in the mean (+/- SD) caffeine sensitivity was found between type I MHS fibers (2.63 +/- 0.85 mM) versus type II MHS fibers (3.47 +/- 1.2 mM) and between type I MHN fibers (5.89 +/- 1.8 mM) versus type II MHN fibers (10.46 +/- 2.6 mM). The mean (+/- SD) caffeine sensitivities for a given muscle fiber type (I or II) were different between groups of MHS and MHN patients. Both type I and II MHS fibers had significantly lower caffeine sensitivities, and this increase in caffeine sensitivity was significantly smaller in type I than in type II fiber. CONCLUSIONS: The current study indicates that a truly MHS patient cannot have a false-negative result solely related to abnormal type II fibers contained in a given muscle strip. Although the occurrence of a very high proportion of type I fibers in MHN human muscle could result in a false-positive contracture outcome, such an occurrence is expected to be rare.     

Changing from isoflurane to desflurane toward the end of anesthesia does not accelerate recovery in humans

BACKGROUND: In an attempt to combine the advantage of the lower solubilities of new inhaled anesthetics with the lesser cost of older anesthetics, some clinicians substitute the former for the latter toward the end of anesthesia. The authors tried to determine whether substituting desflurane for isoflurane in the last 30 min of a 120-min anesthetic would accelerate recovery. METHODS: Five volunteers were anesthetized three times for 2 h using a fresh gas inflow of 2 l/min: 1.25 minimum alveolar concentration (MAC) desflurane, 1.25 MAC isoflurane, and 1.25 MAC isoflurane for 90 min followed by 30 min of desflurane concentrations sufficient to achieve a total of 1.25 MAC equivalent ("crossover"). Recovery from anesthesia was assessed by the time to respond to commands, by orientation, and by tests of cognitive function. RESULTS: Compared with isoflurane, the crossover technique did not accelerate early or late recovery (P > 0.05). Recovery from isoflurane or the crossover anesthetic was significantly longer than after desflurane (P < 0.05). Times to response to commands for isoflurane, the crossover anesthetic, and desflurane were 23 +/- 5 min (mean +/- SD), 21 +/- 5 min, and 11 +/- 1 min, respectively, and to orientation the times were 27 +/- 7 min, 25 +/- 5 min, and 13 +/- 2 min, respectively. Cognitive test performance returned to reference values 15-30 min sooner after desflurane than after isoflurane or the crossover anesthetic. Isoflurane cognitive test performance did not differ from that with the crossover anesthetic at any time. CONCLUSIONS: Substituting desflurane for isoflurane during the latter part of anesthesia does not improve recovery, in part because partial rebreathing through a semiclosed circuit limits elimination of isoflurane during the crossover period. Although higher fresh gas flow during the crossover period would speed isoflurane elimination, the amount of desflurane used and, therefore, the cost would increase.     

Digital computer processing of brain scans using principal components

Most of the scan processing methods used to date are unable to distinguish between normal and abnormal features. This paper describes a method of constructing a particular orthogonal transform from a set of normal images, the method of principal components, which may be used selectively to filter out normal features, leaving behind abnormal features. The method has been applied to brain scans and has been implemented on a small digital computer system with magnetic disc.     

Effects of localized pontine lesions on auditory brain-stem evoked potentials and binaural processing in humans

Potassium channels are involved in the control of neuronal excitability by fixing the membrane potential, shaping the action potential, and setting firing rates. Recently, attention has been focused on identifying the factors influencing excitability in second-order auditory and vestibular neurons. Located in the brainstem, second-order auditory and vestibular neurons are sites for convergence of inputs from first-order auditory or vestibular ganglionic cells with other sensory systems and also motor areas. Typically, second-order auditory neurons exhibit two distinct firing patterns in response to depolarization: tonic, with a repetitive firing of action potentials, and phasic, characterized by only one or a few action potentials. In contrast, all mature vestibular second-order neurons fire tonically on depolarization. Already, certain fundamental roles have emerged for potassium currents in these neurons. In mature auditory and vestibular neurons, I(K), the delayed rectifier, is required for the fast repolarization of action potentials. In tonically firing auditory neurons, I(A), the transient outward rectifier, defines the discharge pattern. I(DS), a delayed rectifier-like current distinguished by its low threshold of activation, is found in phasically firing auditory and some developing vestibular neurons where it limits firing to one or a few spikes, and also may contribute to forming short-duration excitatory postsynaptic potential (EPSPs). Also, I(DS) sets the threshold for action potential generation rather high, which may prevent spontaneous discharge in phasically firing cells. During development, there is a gradual acquisition and loss of some potassium conductances, suggesting developmental regulation. As there are similarities in membrane properties of second-order auditory and vestibular neurons, investigations on firing pattern and its underlying mechanisms in one system should help to uncover fundamental properties of the other.