Dense sensor array topography of the event-related potential to task-relevant auditory stimuli

High spatial density recording and better topographic mapping algorithms have improved the spatial resolving power of the event-related potential (ERP), adding to its already excellent temporal resolution. This study used a 64 channel recording array and spherical spline interpolation to create topographic descriptions of the voltage and current density scalp distributions of the ERP in an auditory oddball paradigm. Frequent (standard) and infrequent (target) tones were presented at a rate of one every approximately 2500 ms to a group of 20 college undergraduates in passive listening and active (count the infrequent tones) task blocks. ANOVAs and topographic analyses were performed on the primary deflections in the 'late' portion of the ERP: the P1, N1, P2, N2 and P3. A target minus standard difference wave was also created for each task. The difference wave contained a mismatch negativity (MMN), an N2b and a P3d. The MMN did not differ between the passive and active tasks and had a topography similar to the N1; also the difference wave P3d was topographically similar to the target P3. The N2b, which occurred only to targets in the active condition, and was the first index of target detection, had a scalp distribution consistent with generation in frontal and superior temporal cortex, suggesting activity in cortical areas of selective attention and auditory stimulus representation.

Health effects of diesel emissions

We have reviewed the literature relating to the health effects of diesel emissions with particular reference to acute and chronic morbidity and to carcinogenicity. It is apparent that exposure to diesel fumes in sufficient concentrations may lead to eye and nasal irritation but there is no evidence of any permanent effect. A transient decline of ventilatory capacity has been noted following such exposures. There is also some evidence that the chronic inhalation of diesel fumes leads to the development of cough and sputum, that is chronic bronchitis, however, it is usually impossible to show a cause and effect relationship because of the concomitant and confounding exposures to mine dust and cigarette smoke. Although there have been a number of papers suggesting that diesel fumes may act as an carcinogen, the weight of the evidence is against this hypothesis. Finally, the role of small particles, less than 10 microns, which are frequently present in diesel emissions requires further study since there is some limited evidence that they may be partly responsible for some of the exacerbations of asthma.

EEG coherency. I: Statistics, reference electrode, volume conduction, Laplacians, cortical imaging, and interpretation at multiple scales

Several methodological issues which impact experimental design and physiological interpretations in EEG coherence studies are considered, including reference electrode and volume conduction contributions to erroneous coherence estimates. A new measure, 'reduced coherency', is introduced as the difference between measured coherency and the coherency expected from uncorrelated neocortical sources, based on simulations and analytic-statistical studies with a volume conductor model. The concept of reduced coherency is shown to be in semi-quantitative agreement with experimental EEG data. The impact of volume conduction on statistical confidence intervals for coherence estimates is discussed. Conventional reference, average reference, bipolar, Laplacian, and cortical image coherencies are shown to be partly independent measures of neocortical dynamic function at different spatial scales, due to each method's unique spatial filtering of intracranial source activity.

A digital imaging and communications in medicine (DICOM) print service for chest imaging

Large-scale picture archiving and communication systems (PACS) have not been widely implemented in this or other countries. In almost all radiology departments film remains the medium for diagnostic interpretation and image archive. Chest imaging is the dominant screening examination performed within most imaging departments and as such, is an extremely high-volume, low-margin examination. Digital technologies are being applied to chest imaging to overcome limitations of screen-film receptors (limited latitude) and current film management systems (single-image copy). Efficient management of images and information is essential to the success of a chest imaging program. In this article we report on a digital imaging and communications in medicine (DICOM)-based centralized printing network for chest imaging. The system components and their operational characteristics are described. Our experience integrating DICOM-compliant equipment supplied by several vendors is described. We conclude that the print model supported by DICOM is adequate for cross-sectional (eg, computed tomography and magnetic resonance) imaging but is too simplistic to be generally applied to projection radiography.

The relationship between pixel value and beam quality in photostimulable phosphor imaging

Direct digital capture systems are relatively new in diagnostic imaging. Full utilization of these devices requires a thorough understanding of the image formation process. The conversion of x-ray photon energy to a digital pixel value in a commercially available photostimulable phosphor (PSP) imaging system is investigated in this paper. Pixel values measured at 16 different combinations of 4 x-ray beam peak voltages (60, 80, 100, and 120 kVp) and 4 beam qualities are reported. At 60 and 80 kVp exposures were made at 2.58 x 10(-7) C/kg (1 mR); at 100 and 120 kVp exposures were made at 5.16 x 10(-7) C/kg (2 mR). Analysis of variance was used to determine the statistical significance of the relationship between pixel value and beam quality for a given kVp and exposure. A computer model accounting for x-ray spectral effects that accurately predicts pixel value is presented. Calculated pixel value agree within 5.0% of measured values over the range of beam energies, exposures, and qualities.

Tourette syndrome

This survey of recent literature addressing Tourette syndrome reflects clinical and laboratory findings of investigations of behavioral, neuropsychological, imaging, genetic, neurobiological and treatment considerations. Tourette syndrome is a prototypic neuropsychiatric disorder manifesting a full range of objectively describable phenomena from different scientific vantage points and serves as a model for study and integrative understanding of brain and behavior.

Canal wall planning by engine-driven nickel-titanium instruments, compared with stainless-steel hand instrumentation

Twenty-two mesial roots of extracted human mandibular molars were divided into two groups based on root curvature and length. The mesiolingual canals were instrumented using either Flexofiles in a step-back anticurvature filing method, or they were instrumented with engine-driven 0.02 taper nickel-titanium files. Ground sections were prepared at 1-, 2.5-, and 5-mm levels from the working length. The mesiobuccal canal was used as an uninstrumented control for predentin character. Digitizing software was used to calculate the instrumented portion as a percentage of the total canal perimeter. The results indicated no significant difference in overall canal wall planning between the two groups and no significant difference at each of the three levels.

A putative poststreptococcal case of OCD with chronic tic disorder, not otherwise specified

A 12-year-old girl presented with an atypical, recurrent, increasingly treatment-resistant case of obsessive-compulsive disorder and chronic tic disorder associated with profound separation anxiety, learning difficulty, and intermittent upper respiratory symptoms. In addition to detailed reviews of history and findings from many clinical caretakers from the prior 7 years, current pediatric, psychiatric, neuropsychological, neuroimaging, and clinical laboratory data were also available. Treatment options were considered from multiple perspectives: psychoanalytically oriented psychotherapy, conventional pharmacotherapy, family interventions, cognitive-behavioral therapy, and learning-supportive strategies. Psychological, neuropsychiatric, and neuroimmunological formulations of etiology were considered. Subsequent treatments included supportive psychotherapy, neuroleptic augmentation of selective serotonin reuptake inhibitors, prophylactic penicillin, and a course of six sessions of plasmapheresis over a 2-week period. The case raises questions for ongoing consideration that juxtapose dynamic, neuropsychiatric, and neuroimmunological perspectives.

Spatial sampling and filtering of EEG with spline laplacians to estimate cortical potentials

The electroencephalogram (EEG) is recorded by sensors physically separated from the cortex by resistive skull tissue that smooths the potential field recorded at the scalp. This smoothing acts as a low-pass spatial filter that determines the spatial bandwidth, and thus the required spatial sampling density, of the scalp EEG. Although it is better appreciated in the time domain, the Nyquist frequency for adequate discrete sampling is evident in the spatial domain as well. A mathematical model of the low-pass spatial filtering of scalp potentials is developed, using a four concentric spheres (brain, CSF, skull, and scalp) model of the head and plausible estimates of the conductivity of each tissue layer. The surface Laplacian estimate of radial skull current density or cortical surface potential counteracts the low-pass filtering of scalp potentials by shifting the spatial spectrum of the EEG, producing a band-passed spatial signal that emphasizes local current sources. Simulations with the four spheres model and dense sensor arrays demonstrate that progressively more detail about cortical potential distribution is obtained as sampling is increased beyond 128 channels.

Emotional expectancy: brain electrical activity associated with an emotional bias in interpreting life events

University students in either an optimistic or pessimistic mood state read brief stories of daily life events as event-related brain potentials were collected during the final word of each story. For subjects in a pessimistic mood, a bias to expect negative outcomes was seen as an N400/P300 effect over posterior scalp regions. For subjects in an optimistic mood, a differentiation between good and bad outcomes was also observed, but it was specific to medial frontal areas. Analysis of single-trial P300 latencies suggested that semantically incongruent and mood-incongruent outcome words resulted in increased median latency of the late positive complex (LPC) and resulted in increased variability of LPC latency across trials.

Social and emotional self-regulation

In humans, frontal lesions result in deficits of social and emotional behavior that are often surprising in the presence of intact language and other cognitive skills. The connections between the motivation and memory functions of limbic cortex and the motor planning functions of frontal neocortex must be fundamental to meeting the daily challenges of self-regulation. The connectional architecture of limbic and neocortical networks suggests a model of function. The densely interconnected paralimbic cortices may serve to maintain a global motivational context within which specific actions are articulated and sequenced within frontal neocortical networks. The paralimbic networks represent the visceral and kinesthetic information that is integral to the representation of the bodily self. In a general sense, the implicit self-representation within paralimbic networks may shape the significance of perceptions and the motivational context for developing actions. The network architecture of the frontal lobe reflects the dual limbic origins of frontal cortex, in the dorsal archicortical and ventral paleocortical structures. In this paper, we speculated that these two limbic-cortical pathways apply different motivational biases to direct the frontal lobe representation of working memory. The dorsal limbic mechanisms projecting through the cingulate gyrus may be influenced by hedonic evaluations, social attachments, and they may initiate a mode of motor control that is holistic and impulsive. In contrast, the ventral limbic pathway from the amygdala to orbital frontal cortex may implement a tight, restricted mode of motor control that reflects adaptive constraints of self-preservation. In the human brain, hemispheric specialization appears to have led to asymmetric elaborations of the dorsal and ventral pathways. Understanding the inherent asymmetries of corticolimbic architecture may be important in interpreting the increasing evidence that the left and right frontal lobes contribute differently to normal and pathological forms of self-regulation.

Quality assurance and quality control of an intensive care unit picture archiving and communication system

Most radiology departments have established quality assurance (QA) and quality control (QC) programs for conventional film-based image management systems. At many institutions, digital image management systems, or picture archiving and communication systems (PACS), are replacing part or all of the film management system. In these situations, it is important to control the quality of the digital images that are produced. The observed frequency of eight types of image-related errors occurring on an image viewing station located in a medical intensive care unit is reported. Images on the viewing station were checked for 12 consecutive weeks. Film images available in the radiology reading room and digital images on the viewing station were compared with a list of completed examinations produced by the radiological information system. Overall, 1,082 patient examinations were encountered. Seventy-six images (7.02% of all images) were observed with errors. In addition, four previously unencountered types of errors were observed in 11 images (1.01% of all images). The majority of the errors are attributed to interfaces either between information systems or between the PACS and the user. It is concluded that QA-QC procedures are necessary for PACS, and that good interfaces, both between information systems and between humans and computer systems, are essential for successful PACS implementations.

Picture archiving communication systems in the intensive care unit

The authors review the potential of picture archiving and communication systems (PACS) in the critical care environment. Presented and analyzed is a university hospital intensive care unit (ICU) PACS project. The objective of the project is to provide reliable, timely viewing of bedside radiographs in selected ICUs within the hospital. Key features include redundancy of critical hardware components and viewing stations that are simple to operate. The system was implemented in phases with incremental evaluation of performance and goals. PACS subsystems are discussed. On the basis of this experience, ICU PACS specifications and general considerations are presented. Also presented is a comparison of 10-year cost projections for conventional screen-film radiography and an ICU PACS that incorporates computed radiography. The costs of the two alternatives are comparable. PACS is a viable alternative to conventional screen-film imaging in the ICU setting and offers improved and more efficient patient care.

Digital chest radiography: comparison of unprocessed and processed images in the detection of solitary pulmonary nodules

PURPOSE

To compare the accuracy with which simulated solitary pulmonary nodules can be identified on digital images of the chest that are unprocessed, processed with adaptive spatial filtering, or processed with global filtering.

MATERIALS AND METHODS

Six experienced chest radiologists evaluated 408 test radiographs (136 from each of the three types, half with simulated nodules) and judged whether a nodule was present. Data from the 2,448 observations were evaluated by means of a receiver operating characteristic curve with location methods.

RESULTS

Accuracy was significantly better with the adaptive filter technique than with the global technique (P < .05), and it was better with adaptive filtering than with no processing in the detection of pulmonary nodules in the mediastinal-subdiaphragmatic areas (P < .05). No significant difference was found between no processing and global filtering.

CONCLUSION

Adaptive filtration is superior to global filtration in the identification of solitary pulmonary nodules and is superior to no processing in nodules projected over the radiopaque areas of the thorax on digital images.

Normalized average glandular dose in molybdenum target-rhodium filter and rhodium target-rhodium filter mammography

PURPOSE

To determine the normalized glandular dose (DgN) for molybdenum target-rhodium filter (Mo-Rh) and rhodium target-rhodium filter (Rh-Rh) mammography and compare the average glandular doses (Dg) that resulted with a conventional molybdenum target-molybdenum filter (Mo-Mo) source assembly.

MATERIALS AND METHODS

X-ray spectra models for Mo-Rh and Rh-Rh were developed and used to calculate DgN values for these target-filter combinations as a function of x-ray tube potential, half-value layer, and breast thickness for three breast compositions. For the average glandular dose comparisons, 50/50 phantoms were imaged for the three target-filter source assemblies at three tube potentials.

RESULTS

For the same parameters, DgN values for Mo-Rh and Rh-Rh were higher than for Mo-Mo. At the same voltage, the exposures required to image breast phantoms are substantially lower, and as a result, Dgs are also less with Mo-Rh and Rh-Rh than with Mo-Mo.

CONCLUSION

DgN values presented permit practical evaluations of average glandular doses for Mo-Rh and Rh-Rh mammography. At a given potential, dose savings are realized with Mo-Rh and Rh-Rh source assemblies.

Computed radiography: user-programmable features and capabilities

Digital or computed radiography (CR) using photostimulable storage phosphor plate technology is becoming increasingly popular in certain clinical applications, such as bedside radiography, where it possesses clear advantages over conventional screen-film imaging. The majority of CR systems in clinical use have been manufactured by Fuji Medical Systems USA, Inc (Stamford, CT) and provide a surprising degree of flexibility. Fuji CR units are delivered with preset menus, hardcopy format, and image-processing parameters for each examination. Of practical importance is that users may change the exam menu and printed film format as well as the image-processing parameters for each examination. There is, however, a lack of documentation describing these features and how they are programmed. This paper addresses these issues. Examples are given on how to change: 1) the printed film format, 2) the contrast and gray-scale processing, 3) spatial frequency enhancement, and 4) the appearance of the operator interface menus.

Spatial sampling of head electrical fields: the geodesic sensor net

In studying brain electrical activity from scalp sensors (electrodes), the optimal measurement would sample the potential field over the entire surface of the braincase, with a sufficient density to avoid spatial aliasing of the surface electrical fields. The geodesic sensor net organizes an array of sensors, each enclosed in a saline sponge, in a geodesic tension structure comprised of elastic threads. By fixing a sensor pedestal at each geodesic vertex, the geometry of the tension structure insures insures that the sensor array is distributed evenly across the accessible head surface. Furthermore, the tension of the network is translated into compression that is divided equally among the sensor pedestals and directed along head-radial vectors. Various geodesic partitioning frequencies may be selected to provide an even surface distribution of the dense sensor arrays (e.g., 64, 128, or 256) that appear to be necessary to provide adequate spatial sampling of brain electrical events.

Scatter in computed radiography

The effects of scatter radiation on images obtained with storage phosphor computed radiography (CR) were evaluated. The scatter degradation factor was extended to account separately for forward scatter and backscatter. Values for the ratios of forward scatter to primary radiation (sf/p) and backscatter to primary radiation (sb/p) were measured for various x-ray tube potentials, phantom thicknesses, and field sizes for CR imaging plates (IPs). Similar measurements were made for a common screen-film system. The sb/p values for the IPs were 0.05-3.80. Standard CR cassettes do not have lead foil behind the IP to control backscatter; the results of this study indicate that such control is needed. The sf/p values were 40%-70% higher in IPs (50%-120% higher when backscatter was included) than those in the conventional screen-film system. This difference is attributed to the differences in the K-absorption edges of barium and gadolinium and the fact that scatter has lower effective energy than the primary beam as they exit the patient.

Topography of the N400: brain electrical activity reflecting semantic expectancy

When subjects read an semantically unexpected word, the brain electrical activity shows a negative deflection at about 400 msec in comparison with the response to an expected word. In order to study the brain systems related to this effect we mapped it with a dense (64-channel) electrode array and two reference-independent measures, one estimating the average potential gradients and the other radial current density. With these measures, the event-related brain potential (ERP) begins at about 70 msec with the P1, reflecting bilateral current sources over occipitoparietal areas. A strongly left-lateralized N1 then follows, peaking at about 180 msec, accompanied by an anterior positivity, the P2. A separate posterior positive pattern then emerges that seems to repeat the topography of the P1. Next, at about 350 msec, the ERP for the congruous word develops a P300 or LPC, characterized by a diffuse positivity over the superior surface of the head and several negativities over inferior regions. This superior source/inferior sink pattern of the LPC is greater over the left hemisphere. In contrast, the ERP for the incongruous word in this interval displays the N400 as a period in which topographic features are absent. At about 400 msec the ERP for the incongruous word begins to develop an LPC, which then remains relatively symmetric over the two hemispheres.

Neural mechanisms of emotion

When viewed from an evolutionary perspective, the neural mechanisms of emotion can be seen to be distributed across the brainstem, limbic, paralimbic, and neocortical regions. Descending and ascending connections among these levels are discussed in relation to three types of emotional processes: peripheral effects on patterned bodily responses, central effects on cognitive processing, and subjective emotional experience. Descending influences from the higher to the lower levels allow for an increasing coordination and flexibility of emotional responses, culminating in patterned activity across the peripheral endocrine, autonomic, and motor systems. Ascending influences from lower to higher levels provide preparatory modulation of cortical pathways, thus enabling perceptual and cognitive processing that is adaptive given the current emotional state. The bodily feelings of emotion are a function of cortical interoceptive sensory fields, activated by centrally generated signals or peripheral inputs from the body.

Right hemisphere sensitivity to arousal and depression

Several lines of evidence show impaired right hemisphere function in depression. Lateralized simple reaction time tasks show impaired left visual field responses both in normals experiencing a depressed mood and in patients with mild unipolar depression. One interpretation for these findings is that depression impairs right hemisphere function by interfering with right hemisphere arousal and vigilance mechanisms. In order to test this hypothesis, subjects receiving either depression or relaxation mood suggestions performed an uncued reaction time task that has been shown to be sensitive to right posterior brain damage. Level of alertness was varied by contrasting uncued blocks with blocks in which targets were preceded by a warning tone. The results showed the predicted slowing of left visual field responses in the depressed mood, but only in women. The effect was significant only for the uncued blocks. The left visual field impairment was significantly larger during depression than in the relaxation state, but a smaller left visual field slowing was present in women in the relaxed state as well. These results may be consistent with the notion that depression interferes with right hemisphere function in part by influencing right hemisphere arousal mechanisms.