Oscillatory changes in cognitive networks activated during a three-stimulus visual paradigm: An intracerebral study

Scoliosis Causing Cervical Dystonia in a Chiropractic Office

Cervical dystonia is a movement disorder characterized by continuous and involuntary muscular contractions that result in aberrant head and neck motions or postures. A recent study indicates that persons with a history of scoliosis may be at a higher risk of acquiring cervical dystonia later in life. Although muscular tension and contraction abnormalities are linked in both illnesses, the pathophysiological pathways linking these two ailments are not entirely understood. A 13-year-old boy previously diagnosed with adolescent idiopathic scoliosis developed symptoms of cervical dystonia, including moderate neck pain, left-sided migraines, and tingling in the neck and shoulders. During the course of three months, the patient attended 16 chiropractic therapy sessions. He reported slow but considerable improvements in his symptoms, such as the recovery of normal cervical range of motion, decreases in neck discomfort and accompanying headaches as well as paresthesia, and enhancements in sleep quality, daily functioning, and learning capacities. The patient's clinical and radiographic improvements show that chiropractic spinal manipulation may assist in reducing pain and improving spine alignment and mobility in these circumstances. To further investigate the efficacy and safety of chiropractic therapy for the treatment of cervical dystonia, particularly in the setting of associated scoliosis, more study with bigger patient populations is required.

EEG theta and alpha oscillations in early versus late mild cognitive impairment during a semantic Go/NoGo task

Amnestic mild cognitive impairment (aMCI) is marked by episodic memory deficits, which can be used to classify individuals into early MCI (EMCI) and late MCI (LMCI). Although mounting evidence suggests that individuals with aMCI have additional cognitive alterations including deficits in cognitive control, few have examined if EMCI and LMCI differ on processes other than episodic memory. Using a semantic Go/NoGo task, we examined differences in cognitive control between EMCI and LMCI on behavioral (accuracy and reaction time) and neural (scalp-recorded event-related oscillations in theta and alpha band) measures. Although no behavioral differences were observed between the EMCI and LMCI groups, differences in neural oscillations were observed. The LMCI group had higher theta synchronization on Go trials at central electrodes compared to the EMCI group. In addition, the EMCI group showed differences in theta power at central electrodes and alpha power at central and centro-parietal electrodes between Go and NoGo trials, while the LMCI group did not exhibit such differences. These findings suggest that while behavioral differences may not be observable, neural changes underlying cognitive control processes may differentiate EMCI and LMCI stages and may be useful to understand the trajectory of aMCI in future studies.

Cortical network organization reflects clinical response to subthalamic nucleus deep brain stimulation in Parkinson's disease

The degree of response to subthalamic nucleus deep brain stimulation (STN‐DBS) is individual and hardly predictable. We hypothesized that DBS‐related changes in cortical network organization are related to the clinical effect. Network analysis based on graph theory was used to evaluate the high‐density electroencephalography (HDEEG) recorded during a visual three‐stimuli paradigm in 32 Parkinson's disease (PD) patients treated by STN‐DBS in stimulation “off” and “on” states. Preprocessed scalp data were reconstructed into the source space and correlated to the behavioral parameters. In the majority of patients (n = 26), STN‐DBS did not lead to changes in global network organization in large‐scale brain networks. In a subgroup of suboptimal responders (n = 6), identified according to reaction times (RT) and clinical parameters (lower Unified Parkinson's Disease Rating Scale [UPDRS] score improvement after DBS and worse performance in memory tests), decreased global connectivity in the 1–8 Hz frequency range and regional node strength in frontal areas were detected. The important role of the supplementary motor area for the optimal DBS response was demonstrated by the increased node strength and eigenvector centrality in good responders. This response was missing in the suboptimal responders. Cortical topologic architecture is modified by the response to STN‐DBS leading to a dysfunction of the large‐scale networks in suboptimal responders.

Cognitive task-related functional connectivity alterations in temporal lobe epilepsy

OBJECTIVE

We investigated cognitive task-related functional connectivity (FC) in patients with temporal lobe epilepsy (TLE). Using a visual three-stimulus paradigm (VTSP), we studied cognitive large-scale networks and the impact of TLE on connectivity outside the temporal lobe.

METHODS

High-density electroencephalography (EEG) was recorded during the paradigm from nineteen patients with epilepsy with hippocampal sclerosis (HS) and ten healthy controls (HCs). Scalp data were reconstructed into the source space, and FC was computed. Correlating with the neuropsychological data, possible compensatory mechanisms were investigated.

RESULTS

Significant changes were found in the FC of regions outside the epileptogenic network, particularly in the attentional network. These changes were more widespread in left TLE (LTLE). There were no significant differences in task performance (accuracy, time response) in comparison with HCs, implying that there must be some mechanism reducing the impact of connectivity changes on brain functions. When correlated with neuropsychological data, we found stronger compensatory mechanisms in right TLE (RTLE).

SIGNIFICANCE

Our findings confirm the hypothesis that LTLE is the more pervasive form of the disease. Even though the network alterations in TLE are severe, some mechanisms reduce the impact of epilepsy on cognitive functions; these mechanisms are more potent in RTLE. We also suggest that there are maladaptive mechanisms in LTLE.

Different patterns of movement-related cortical oscillations in patients with myoclonus and in patients with spinocerebellar ataxia

OBJECTIVE

To assess whether different patterns of EEG rhythms during a Go/No-go motor task characterize patients with cortical myoclonus (EPM1) or with spinocerebellar ataxia (SCA).

METHODS

We analyzed event-related desynchronization (ERD) and synchronization (ERS) in the alpha and beta-bands during visually cued Go/No-go task in 22 patients (11 with EPM1, 11 with SCA) and 11 controls.

RESULTS

In the Go condition, the only significant difference was a reduced contralateral beta-ERS in the EPM1 patients compared with controls; in the No-go condition, the EPM1 patients showed prolonged alpha-ERD in comparison with both controls and SCA patients, and reduced or delayed alpha- and beta-ERS in comparison with controls. In both conditions, the SCA patients, unlike EPM1 patients and controls, showed minimal or absent lateralization of alpha- and beta-ERD.

CONCLUSIONS

EPM1 patients showed abnormal ERD/ERS dynamics, whereas SCA patients mainly showed defective ERD lateralization.

SIGNIFICANCE

A different behavior of ERS/ERD distinguished the two patient groups: the pattern observed in EPM1 suggests a prominent defect of inhibition occurring in motor cortex contralateral to activated segment, whereas the pattern observed in SCA suggested a defective lateralization attributable to the damage of cerebello-cortical network, which is instead marginal in patients with cortical myoclonus.

Visual deviant stimuli produce mismatch responses in the amplitude dynamics of neuronal oscillations

OBJECTIVES

Auditory and visual deviant stimuli evoke mismatch negativity (MMN) responses, which can be recorded with electroencephalography (EEG) and magnetoencephalography (MEG). However, little is known about the role of neuronal oscillations in encoding of rare stimuli. We aimed at verifying the existence of a mechanism for the detection of deviant visual stimuli on the basis of oscillatory responses, so-called visual mismatch oscillatory response (vMOR).

METHODS

Peripheral visual stimuli in an oddball paradigm, standard vs. deviant (7:1), were presented to twenty healthy subjects. The oscillatory responses to an infrequent change in the direction of moving peripheral stimuli were recorded with a 60-channel EEG system. In order to enhance the detection of oscillatory responses, we used the common spatial pattern (CSP) algorithm, designed for the optimal extraction of changes in the amplitude of oscillations.

RESULTS

Both standard and deviant visual stimuli produced Event-Related Desynchronization (ERD) and Synchronization (ERS) primarily in the occipito-parietal cortical areas. ERD and ERS had overlapping time-courses and peaked at about 500-730 ms. These oscillatory responses, however, were significantly stronger for the deviant than for the standard stimuli. A difference between the oscillatory responses to deviant and standard stimuli thus reflects the presence of vMOR.

CONCLUSIONS

The present study shows that the detection of visual deviant stimuli can be reflected in both synchronization and desynchronization of neuronal oscillations. This broadens our knowledge about the brain mechanisms encoding deviant sensory stimuli.

Chiropractic management of an 81-year-old man with Parkinson disease signs and symptoms

OBJECTIVE

The purpose of this case report is to describe the chiropractic management of a patient with Parkinson disease.

CLINICAL FEATURES

An 81-year-old male with a 12-year history of Parkinson disease sought chiropractic care. He had a stooped posture and a shuffling gait. He was not able to ambulate comfortably without the guidance of his walker. The patient had a resting tremor, most notably in his right hand. Outcome measures were documented using the Parkinson's Disease Questionaire-39 (PDQ-39) and patient subjective reports.

INTERVENTION AND OUTCOME

The patient was treated with blue-lensed glasses, vibration stimulation therapy, spinal manipulation, and eye-movement exercises. Within the first week of treatment, there was a reduction in symptoms, improvement in ambulation, and tremor.

CONCLUSION

For this particular patient, the use of alternative treatment procedures appeared to help his Parkinson disease signs and symptoms.

Chiropractic care using a functional neurologic approach for idiopathic cervical dystonia in a 59-year-old woman

OBJECTIVE

The purpose of this case report is to describe the care and outcomes of a patient with cervical dystonia who was treated using chiropractic and other alternative medicine interventions.

CLINICAL FEATURES

A 59-year-old woman had an 11-year history of cervical dystonia. She had an uncontrollable 60° leftward head rotation upon shutting her eyes and had spasmodic contractions that caused fatigue.

INTERVENTION AND OUTCOME

The management consisted of blue-lensed glasses, vibration stimulation, spinal manipulation, and eye-movement exercises. Within the first week of treatment, she had a reduction in symptoms, which was documented using a functional numeric scale, and improved posture, which was assessed using measurements from her midsternal line to the center of her chin.

CONCLUSION

This patient with cervical dystonia responded to the use of conservative, nonpharmacological treatment procedures that consisted of chiropractic care using a functional neurologic approach aimed at improving her spasmodic contractions and function.