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Wutzl B, Golaszewski SM, Leibnitz K, Langthaler PB, Kunz AB, Leis S, Schwenker K, Thomschewski A, Bergmann J, Trinka E. Narrative Review: Quantitative EEG in Disorders of Consciousness. Brain Sci 2021; 11:brainsci11060697. [PMID: 34070647 PMCID: PMC8228474 DOI: 10.3390/brainsci11060697] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 02/06/2023] Open
Abstract
In this narrative review, we focus on the role of quantitative EEG technology in the diagnosis and prognosis of patients with unresponsive wakefulness syndrome and minimally conscious state. This paper is divided into two main parts, i.e., diagnosis and prognosis, each consisting of three subsections, namely, (i) resting-state EEG, including spectral power, functional connectivity, dynamic functional connectivity, graph theory, microstates and nonlinear measurements, (ii) sleep patterns, including rapid eye movement (REM) sleep, slow-wave sleep and sleep spindles and (iii) evoked potentials, including the P300, mismatch negativity, the N100, the N400 late positive component and others. Finally, we summarize our findings and conclude that QEEG is a useful tool when it comes to defining the diagnosis and prognosis of DOC patients.
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Affiliation(s)
- Betty Wutzl
- Graduate School of Information Science and Technology, Osaka University, Suita 565-0871, Japan; (B.W.); (K.L.)
- Symbiotic Intelligent Systems Research Center, Osaka University, Suita 565-0871, Japan
| | - Stefan M. Golaszewski
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
- Neuroscience Institute, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Kenji Leibnitz
- Graduate School of Information Science and Technology, Osaka University, Suita 565-0871, Japan; (B.W.); (K.L.)
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita 565-0871, Japan
| | - Patrick B. Langthaler
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Department of Mathematics, Paris Lodron University of Salzburg, 5020 Salzburg, Austria
- Team Biostatistics and Big Medical Data, IDA Lab Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Alexander B. Kunz
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
| | - Stefan Leis
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Kerstin Schwenker
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
- Neuroscience Institute, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, 5020 Salzburg, Austria
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Aljoscha Thomschewski
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Neuroscience Institute, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, 5020 Salzburg, Austria
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Jürgen Bergmann
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Neuroscience Institute, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, Affiliated Member of the European Reference Network EpiCARE, 5020 Salzburg, Austria; (S.M.G.); (P.B.L.); (A.B.K.); (S.L.); (K.S.); (A.T.); (J.B.)
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
- Neuroscience Institute, Christian Doppler Medical Center, and Centre for Cognitive Neuroscience, Paracelsus Medical University, 5020 Salzburg, Austria
- Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
- Correspondence: ; Tel.: +43-5-7255-34600
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Golaszewski SM, Wutzl B, Unterrainer AF, Florea C, Schwenker K, Frey VN, Kronbichler M, Rattay F, Nardone R, Hauer L, Sellner J, Trinka E. Functional Magnetic Resonance Imaging in the Final Stage of Creutzfeldt-Jakob Disease. Diagnostics (Basel) 2020; 10:diagnostics10050309. [PMID: 32429303 PMCID: PMC7277986 DOI: 10.3390/diagnostics10050309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 11/16/2022] Open
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare fatal degenerative disease of the central nervous system. The clinical course is characterized by rapid progression of neurological and neuromuscular symptoms. The late stage with loss of consciousness is not well characterized. We report a 62-year-old male patient with sCJD with the clinical picture of a vegetative state/apallic syndrome, in whom we studied cortical responses using a vibration paradigm. The functional magnetic resonance imaging (fMRI) investigation demonstrated a clear response within the sensorimotor cortex, the cerebellum, the parietal cortex, the insular, and frontal inferior region. The finding of persistent cortical activity on fMRI in a patient with CJD in a state of unconsciousness has implications for the clinical management and for ethical considerations.
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Affiliation(s)
- Stefan M. Golaszewski
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
- Neuroscience Institute, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria;
- Correspondence: ; Tel.: +43-(0)5-7255-34600; Fax: +43-(0)5-7255-34899
| | - Bettina Wutzl
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
- Institute for Analysis and Scientific Computing, Technical University of Vienna, 1040 Vienna, Austria;
| | - Axel F. Unterrainer
- Institute of Neuroanesthesiology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Cristina Florea
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
| | - Kerstin Schwenker
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
| | - Vanessa N. Frey
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
| | - Martin Kronbichler
- Neuroscience Institute, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria;
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, 5020 Salzburg, Austria
| | - Frank Rattay
- Institute for Analysis and Scientific Computing, Technical University of Vienna, 1040 Vienna, Austria;
| | - Raffaele Nardone
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
- Department of Neurology, Franz-Tappeiner-Hospital, 39012 Merano, Italy
| | - Larissa Hauer
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Johann Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, 2130 Mistelbach, Austria
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria; (B.W.); (C.F.); (K.S.); (V.N.F.); (R.N.); (J.S.); (E.T.)
- Institute for Analysis and Scientific Computing, Technical University of Vienna, 1040 Vienna, Austria;
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Florea C, Bräumann C, Mussger C, Leis S, Hauer L, Sellner J, Golaszewski SM. Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction. Brain Sci 2020; 10:E256. [PMID: 32353976 PMCID: PMC7287930 DOI: 10.3390/brainsci10050256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 11/22/2022] Open
Abstract
Dysphagia after stroke impacts quality of life and is a risk factor for respiratory infections. Patients frequently require prophylactic measures including nasogastric tube or percutaneous endoscopic gastrostomy. Until recently, therapy for dysphagia was limited to training with a speech and language specialist. Intraluminal pharyngeal electrical stimulation (PES) is a new technique that stimulates the pharyngeal sensory afferents to the higher swallowing center in cortex. The clinical trials published to date involved stimulation for 10 minutes over three days. We present a case of brainstem infarction with severe dysphagia in a 53-year-old woman with preserved cognitive functions. For airway protection, she had a surgical tracheotomy. The initial swallowing training achieved slight improvements, but stagnated after three months so PES was tried. Under good PES tube tolerance, a prolonged and repeated stimulation protocol was administered, with the main purpose of relieving her of the tracheal tube. Although the swallowing improved, she stayed tube-dependent with minimal attempts with puréed food during therapy, and could not be decannulated. Further studies are required to assess the value of this promising approach for the treatment of dysphagia.
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Affiliation(s)
- Cristina Florea
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Christine Bräumann
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Christine Mussger
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Stefan Leis
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Larissa Hauer
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Johann Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, 2130 Mistelbach, Austria
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany
| | - Stefan M. Golaszewski
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, 5020 Salzburg, Austria
- Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, 5020 Salzburg, Austria
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Pikija S, Sztriha LK, Sebastian Mutzenbach J, Golaszewski SM, Sellner J. Idarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Alteplase: A Systematic Review of the Available Evidence. CNS Drugs 2017; 31:747-757. [PMID: 28808918 PMCID: PMC5573762 DOI: 10.1007/s40263-017-0460-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSE Current guidelines do not recommend the use of intravenous recombinant tissue plasminogen activator in patients with acute ischemic stroke who receive direct oral anticoagulants. While the humanized monoclonal antibody idarucizumab can quickly reverse the anticoagulant effects of the thrombin inhibitor dabigatran, safety data for subsequent tissue plasminogen activator treatment are sparse. Here, we review current knowledge about dabigatran reversal prior to systemic reperfusion treatment in acute ischemic stroke. METHODS We performed a systematic review of all published cases of intravenous tissue plasminogen activator treatment following the administration of a dabigatran antidote up to June 2017 and added five unpublished cases of our own. We analyzed clinical and radiological outcomes, symptomatic post-thrombolysis intracranial hemorrhage, and other serious systemic bleeding. Additional endpoints were allergic reaction to idarucizumab, and venous thrombosis in the post-acute phase. RESULTS We identified a total of 21 patients (71% male) with a median age of 76 years (interquartile range 70-84). The median National Institute of Health Stroke Scale score at baseline was 10 (n = 20, interquartile range 5-11) and 18/20 patients (90%) had mild or moderate stroke severity. The time from symptom onset to start of tissue plasminogen activator was 155 min (n = 18, interquartile range 122-214). The outcome was unfavorable in 3/19 patients (16%). There was one fatality as a result of a symptomatic post-thrombolysis intracranial hemorrhage, and two patients experienced an increase in the National Institute of Health Stroke Scale compared with baseline. One patient had a recurrent stroke. No systemic bleeding, venous thrombosis, or allergic reactions were reported. CONCLUSION Experience with idarucizumab administration prior to tissue plasminogen activator treatment in acute ischemic stroke is limited. Initial clinical experience in less severe stroke syndromes and short time windows seems favorable. Larger cohorts are required to confirm safety, including bleeding complications and the risk of thrombosis.
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Affiliation(s)
- Slaven Pikija
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University Salzburg, Ignaz-Harrer-Str. 79, 5020, Salzburg, Austria
| | - Laszlo K Sztriha
- Department of Neurology, King's College Hospital, Denmark Hill, London, UK
| | - J Sebastian Mutzenbach
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University Salzburg, Ignaz-Harrer-Str. 79, 5020, Salzburg, Austria
| | - Stefan M Golaszewski
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University Salzburg, Ignaz-Harrer-Str. 79, 5020, Salzburg, Austria
| | - Johann Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University Salzburg, Ignaz-Harrer-Str. 79, 5020, Salzburg, Austria.
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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Affiliation(s)
- S M Golaszewski
- From the Department of Neurology and Neuroscience Institute, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Austria
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Nardone R, Höller Y, Thomschewski A, Bathke AC, Ellis AR, Golaszewski SM, Brigo F, Trinka E. Assessment of corticospinal excitability after traumatic spinal cord injury using MEP recruitment curves: a preliminary TMS study. Spinal Cord 2015; 53:534-8. [PMID: 25665538 DOI: 10.1038/sc.2015.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 12/30/2014] [Accepted: 01/08/2015] [Indexed: 12/20/2022]
Abstract
STUDY DESIGN Transcranial magnetic stimulation study. OBJECTIVES To further investigate the corticospinal excitability changes after spinal cord injury (SCI), as assessed by means of transcranial magnetic stimulation (TMS). SETTING Merano (Italy) and Salzburg (Austria). METHODS We studied resting motor threshold (RMT), motor evoked potential (MEP) amplitude and recruitment curve in five subjects with good recovery after traumatic incomplete cervical SCI. RESULTS RMT did not differ significantly between patients and controls, whereas the slope of MEP recruitment curve was significantly increased in the patients. CONCLUSION This abnormal finding may represent an adaptive response after SCI. The impaired ability of the motor cortex to generate proper voluntary movement may be compensated by increasing spinal excitability. The easily performed measurement of MEP recruitment curve may provide a useful additional tool to improve the assessment and monitoring of motor cortical function in subjects with SCI. Increasing our knowledge of the corticospinal excitability changes in the functional recovery after SCI may also support the development of effective therapeutic strategies.
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Affiliation(s)
- R Nardone
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Department of Neurology, Franz Tappeiner Hospital, Merano, Italy [3] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - Y Höller
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - A Thomschewski
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
| | - A C Bathke
- 1] Department of Mathematics, Paris Lodron University, Salzburg, Austria [2] Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - A R Ellis
- Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - S M Golaszewski
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria
| | - F Brigo
- 1] Department of Neurology, Franz Tappeiner Hospital, Merano, Italy [2] Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy
| | - E Trinka
- 1] Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria [2] Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria
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Marschallinger R, Golaszewski SM, Kunz AB, Kronbichler M, Ladurner G, Hofmann P, Trinka E, McCoy M, Kraus J. Usability and potential of geostatistics for spatial discrimination of multiple sclerosis lesion patterns. J Neuroimaging 2013; 24:278-86. [PMID: 23384318 DOI: 10.1111/jon.12000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 08/21/2012] [Accepted: 10/01/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE In multiple sclerosis (MS) the individual disease courses are very heterogeneous among patients and biomarkers for setting the diagnosis and the estimation of the prognosis for individual patients would be very helpful. For this purpose, we are developing a multidisciplinary method and workflow for the quantitative, spatial, and spatiotemporal analysis and characterization of MS lesion patterns from MRI with geostatistics. METHODS We worked on a small data set involving three synthetic and three real-world MS lesion patterns, covering a wide range of possible MS lesion configurations. After brain normalization, MS lesions were extracted and the resulting binary 3-dimensional models of MS lesion patterns were subject to geostatistical indicator variography in three orthogonal directions. RESULTS By applying geostatistical indicator variography, we were able to describe the 3-dimensional spatial structure of MS lesion patterns in a standardized manner. Fitting a model function to the empirical variograms, spatial characteristics of the MS lesion patterns could be expressed and quantified by two parameters. An orthogonal plot of these parameters enabled a well-arranged comparison of the involved MS lesion patterns. CONCLUSIONS This method in development is a promising candidate to complement standard image-based statistics by incorporating spatial quantification. The work flow is generic and not limited to analyzing MS lesion patterns. It can be completely automated for the screening of radiological archives.
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Wipfler P, Heikkinen A, Harrer A, Pilz G, Kunz A, Golaszewski SM, Reuss R, Oschmann P, Kraus J. Circadian rhythmicity of inflammatory serum parameters: a neglected issue in the search of biomarkers in multiple sclerosis. J Neurol 2012; 260:221-7. [PMID: 22875099 DOI: 10.1007/s00415-012-6622-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 07/11/2012] [Accepted: 07/13/2012] [Indexed: 01/21/2023]
Abstract
Inflammatory serum parameters are intensely investigated in the search of biomarkers for disease activity and treatment response in multiple sclerosis (MS). A reason for contradictory results might be the timing of blood collection for analyzing serum concentrations of inflammatory parameters which are subject to diurnal changes. We included 34 untreated patients with relapsing-remitting MS and 34 age- and sex-matched healthy controls. 12 MS patients showed acute disease activity in corresponding MRI scans. Blood samples were obtained at 7.00, 11.00 am, 2.30, 6.00 and 9.30 pm within 1 day. We determined serum levels of cortisol and inflammatory markers including soluble tumor necrosis factor-beta (sTNF-β), soluble TNF-Receptor-1 (sTNF-R1) and -2 (sTNF-2), soluble vascular adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) by ELISA. We observed significantly higher serum levels of sTNF-R1 (p < 0.001) and sTNF-R2 (p < 0.001) in the morning and a significant decline of sICAM-1 (p < 0.005) and sVCAM-1 (p < 0.001) in the afternoon in both, MS patients and healthy controls. Comparison of diurnal serum levels between MS patients with active versus with non-active disease revealed significantly higher serum levels of sVCAM-1 (p < 0.05) around noon and in the early afternoon in MS patients with active disease. A significant decline of sICAM-1 (p < 0.05) in the afternoon was seen in MS patients with active and non-active disease. Our data indicate that increased awareness of potential diurnal serum concentration changes of biomarkers can eliminate one major cause of biased data as they occur in most of the investigated immunological parameters.
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Affiliation(s)
- P Wipfler
- Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University and Salzburger Landeskliniken, Ignaz-Harrer-Strasse 79, 5020, Salzburg, Austria
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Golaszewski SM, Bergmann J, Christova M, Kunz AB, Kronbichler M, Rafolt D, Gallasch E, Staffen W, Trinka E, Nardone R. Modulation of motor cortex excitability by different levels of whole-hand afferent electrical stimulation. Clin Neurophysiol 2012; 123:193-9. [DOI: 10.1016/j.clinph.2011.06.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 06/06/2011] [Accepted: 06/14/2011] [Indexed: 11/16/2022]
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Nardone R, McCoy M, Kunz AB, Kraus J, Staffen W, Ladurner G, Golaszewski SM. Hyponatremic encephalopathy mimicking hypoxic-ischemic encephalopathy. Clin Neuroradiol 2010; 20:243-6. [PMID: 20628710 DOI: 10.1007/s00062-010-0017-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 06/04/2010] [Indexed: 11/25/2022]
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Golaszewski SM, Bergmann J, Christova M, Nardone R, Kronbichler M, Rafolt D, Gallasch E, Staffen W, Ladurner G, Beisteiner R. Increased motor cortical excitability after whole-hand electrical stimulation: a TMS study. Clin Neurophysiol 2009; 121:248-54. [PMID: 20036618 DOI: 10.1016/j.clinph.2009.09.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 09/18/2009] [Accepted: 09/26/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the neuromodulatory effect of whole-hand mesh-glove (MG) stimulation on motor cortical pathways, we explored motor cortical excitability before and after suprathreshold whole-hand MG stimulation using transcranial magnetic stimulation (TMS). METHODS Twenty-eight healthy volunteers (14 controls) were studied at baseline, immediately post and 1h post-MG stimulation for 30 min. Motor thresholds (MTs), motor evoked potentials (MEPs) recruitment curve, short intracortical inhibition (SICI) and intracortical facilitation (ICF) after paired magnetic stimuli were evaluated. RESULTS After MG stimulation the MTs were significantly reduced and slope of MEP recruitment curve significantly increased; furthermore, the stimulation led to a sustained decrease of SICI and increase of ICF in the contralateral motor cortex. These effects lasted for at least 60 min and were stronger 1h post-stimulation compared with testing immediately after stimulation. A sham group did not show any differences before and after MG stimulation. CONCLUSIONS We provide a first demonstration that MG whole-hand stimulation induces increases in motor cortical excitability lasting at least 1h. Both the strength of the corticospinal projections and the inhibitory and facilitatory intracortical mechanisms are involved. Synaptic modifications such as long-term potentiation mechanisms may underlie this stimulation-induced cortical plasticity changes. SIGNIFICANCE Present results prove the MG stimulation to be a promising tool in neurorehabilitation.
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Affiliation(s)
- Stefan M Golaszewski
- Department of Neurology and Neuroscience Institute, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria.
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12
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Kunz AB, Tschernatsch M, Blaes F, Wipfler P, Pilz G, Golaszewski SM, Lesicky O, Staffen W, Ladurner G, Kraus J. Detailed report of an overlap syndrome of Systemic lupus erythematosus with positive neuromyelitis optitica-antibodies. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Golaszewski SM, Kunz AB, McCoy M, Nardone R, Broussalis E, Ladurner G, Staffen W, Kraus J. Hyponatriemic encephalopathy which failed to present episodes of hypoxia or respiratory failure – a case report. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Koppelstaetter F, Siedentopf CM, Rhomberg P, Lechner-Steinleitner S, Mottaghy FM, Eisner W, Golaszewski SM. fMRT vor Motorkortexstimulation beim Phantomschmerz. Nervenarzt 2007; 78:1435-9. [PMID: 17846735 DOI: 10.1007/s00115-007-2323-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study deals with the diagnostic value of functional magnetic resonance imaging (fMRI) in a patient with phantom limb pain following traumatic amputation of the right arm. After failure with medication, resection of stump neurinoma, and spinal cord stimulation, fMRI with evidence of cortical reorganization was performed. Tactile stimulation of the perioral region and motor imagery with cranial, tactile stimulation of the stump led to a caudal shift in fMRI activity. Subsequent motor cortex stimulation brought relief from the pain. By detecting cortical reorganization, fMRI contributes to the indication for motor cortex stimulation for phantom pain and aids in electrode positioning.
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Affiliation(s)
- F Koppelstaetter
- Univ.-Klinik für Radiologie II, Medizinische Universität, Innsbruck, Austria
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15
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Hofer A, Siedentopf CM, Ischebeck A, Rettenbacher MA, Verius M, Golaszewski SM, Felber S, Fleischhacker WW. Neural substrates for episodic encoding and recognition of unfamiliar faces. Brain Cogn 2007; 63:174-81. [PMID: 17207899 DOI: 10.1016/j.bandc.2006.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Revised: 11/17/2006] [Accepted: 11/22/2006] [Indexed: 10/23/2022]
Abstract
Functional MRI was used to investigate brain activation in healthy volunteers during encoding of unfamiliar faces as well as during correct recognition of newly learned faces (CR) compared to correct identification of distractor faces (CF), missed alarms (not recognizing previously presented faces, MA), and false alarms (incorrectly recognizing newly presented faces, FA). Encoding was associated with frontal, occipital/fusiform, thalamic, and cerebellar activation. CR produced activation in frontal and cerebellar regions, whereas CF activated frontal and occipitotemporal regions as well as the thalamus. In contrast, MA was associated with frontal and thalamic activation, and FA with frontal activation. The CR minus CF comparison showed left lateral prefrontal and parietal activation, while no suprathreshold positive signal changes were detected when subtracting the other conditions (CR minus MA, CR minus FA, and vice versa). These results support the view that the successful episodic retrieval of newly learned faces is based on a dorsal visual stream mechanism.
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Affiliation(s)
- Alex Hofer
- Medical University Innsbruck, Department of Biological Psychiatry, Anichstrasse 35, A-6020 Innsbruck, Austria.
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16
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Hofer A, Siedentopf CM, Ischebeck A, Rettenbacher MA, Widschwendter CG, Verius M, Golaszewski SM, Koppelstaetter F, Felber S, Wolfgang Fleischhacker W. The neural regions sustaining episodic encoding and recognition of objects. Brain Cogn 2006; 63:159-66. [PMID: 17174458 DOI: 10.1016/j.bandc.2006.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Revised: 11/02/2006] [Accepted: 11/03/2006] [Indexed: 11/22/2022]
Abstract
In this functional MRI experiment, encoding of objects was associated with activation in left ventrolateral prefrontal/insular and right dorsolateral prefrontal and fusiform regions as well as in the left putamen. By contrast, correct recognition of previously learned objects (R judgments) produced activation in left superior frontal, bilateral inferior frontal, and right cerebellar regions, whereas correct rejection of distractor objects (N judgments) was associated with activation in bilateral prefrontal and anterior cingulate cortices, in right parietal and cerebellar regions, in the left putamen, and in the right caudate nucleus. The R minus N comparison showed activation in the left lateral prefrontal cortex and in bilateral cingulate cortices and precunei, while the N minus R comparison did not reveal any positive signal change. These results support the view that similar regions of the frontal lobe are involved in episodic encoding and retrieval processes, and that the successful episodic retrieval of newly learned objects is mainly based on a frontoparietal network.
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Affiliation(s)
- Alex Hofer
- Medical University Innsbruck, Department of Biological Psychiatry, Anichstrasse 35, A-6020 Innsbruck, Austria.
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17
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Siedentopf CM, Ischebeck A, Haala IA, Mottaghy FM, Schikora D, Verius M, Koppelstaetter F, Buchberger W, Schlager A, Felber SR, Golaszewski SM. Neural correlates of transmeatal cochlear laser (TCL) stimulation in healthy human subjects. Neurosci Lett 2006; 411:189-93. [PMID: 17123710 DOI: 10.1016/j.neulet.2006.08.049] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Revised: 07/24/2006] [Accepted: 08/10/2006] [Indexed: 11/21/2022]
Abstract
Transmeatal cochlear laser (TCL) treatment has recently been proposed as a therapeutic procedure for cochlear dysfunction such as chronic cochlear tinnitus or sensorineural hearing loss. The aim of this study was to investigate whether TLC has any influence on the central nervous system using functional MRI with healthy young adults. The laser stimulation device was placed on the tympanic membrane of both ears. A laser stimulation run and a placebo run were performed in random order. The participants were unable to differentiate between verum and placebo stimulation. In the comparison of verum to placebo runs, we observed significant activations within the left superior frontal gyrus, the right middle and medial frontal gyrus, the right superior parietal lobule, the left superior occipital gyrus, the precuneus and cuneus bilaterally, the right anterior and the left and right middle and posterior cingulate gyrus and the left thalamus. This network of brain areas corresponds well to results from previous PET studies of patients with tinnitus. Though TCL seems to have a clinically measurable effect on the central nervous system the neurophysiological mechanism leading to the observed activated neuronal network remains unknown.
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Affiliation(s)
- Christian M Siedentopf
- Department of Radiology II, Division of Neuroradiology, University Hospital of Innsbruck, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
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18
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Golaszewski SM, Siedentopf CM, Koppelstaetter F, Fend M, Ischebeck A, Gonzalez-Felipe V, Haala I, Struhal W, Mottaghy FM, Gallasch E, Felber SR, Gerstenbrand F. Human brain structures related to plantar vibrotactile stimulation: A functional magnetic resonance imaging study. Neuroimage 2006; 29:923-9. [PMID: 16253525 DOI: 10.1016/j.neuroimage.2005.08.052] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Revised: 07/03/2005] [Accepted: 08/23/2005] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study was to investigate the sensorimotor cortex response to plantar vibrotactile stimulation using a newly developed MRI compatible vibration device. Ten healthy subjects (20-45 years) were investigated. Vibrotactile stimulation of the sole of the foot with a frequency of 50 Hz and a displacement of 1 mm was performed during fMRI (echo-planar imaging sequence at 1.5 T) using an MRI compatible moving magnet actuator that is able to produce vibration frequencies between 0 and 100 Hz and displacement amplitudes between 0 and 4 mm. The fMRI measurement during vibrotactile stimulation of the right foot revealed brain activation contralaterally within the primary sensorimotor cortex, bilaterally within the secondary somatosensory cortex, bilaterally within the superior temporal, inferior parietal, and posterior insular region, bilaterally within the anterior and posterior cingular gyrus, bilaterally within the thalamus and caudate nucleus, contralaterally within the lentiform nucleus, and bilaterally within the anterior and posterior cerebellar lobe. The advantages of the new MRI compatible vibration device include effective transmission of the stimulus and controlled vibration amplitudes, frequencies, and intensities. The results indicate that plantar vibration can be a suitable paradigm to observe activation within the sensorimotor network in fMRI. Furthermore, the method may be used to determine the optimal responsiveness of the individual sensorimotor network.
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Gallasch E, Golaszewski SM, Fend M, Siedentopf CM, Koppelstaetter F, Eisner W, Gerstenbrand F, Felber SR. Contact force- and amplitude-controllable vibrating probe for somatosensory mapping of plantar afferences with fMRI. J Magn Reson Imaging 2006; 24:1177-82. [PMID: 17031838 DOI: 10.1002/jmri.20742] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To study cerebral responses evoked from mechanoreceptors in the human foot sole using a computer-controlled vibrotactile stimulation system. MATERIALS AND METHODS The stimulation system consisted of two stationary moving magnet actuators with indentors to gently contact and vibrate the foot sole during functional MRI (fMRI) experiments. To allow independent settings of contact force (0-20 N) and intensity of vibration (frequency range=20-100 Hz) the actuators were controlled by a digital servo loop. For fMRI experiments with complex stimulus protocols, both vibrating probes were further operated under supervisory control. RESULTS The MR compatibility of this electromagnetic system was tested in a 1.5T scanner with an actively shielded magnet (Siemens Magnetom Sonata). Blood oxygenation level-dependent (BOLD) responses were detected in the contralateral left pre- and postcentral gyrus, bilaterally within the secondary somatosensory cortex, bilaterally within the supplementary motor cortex, and bilaterally within the anterior cingular gyrus. CONCLUSION This stimulation device provides a new tool for identifying cerebral structures that convey sensory information from the foot region, which is of promising diagnostic value, particularly for assessing sensorimotor deficits resulting from brain lesions.
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Affiliation(s)
- Eugen Gallasch
- Department of Physiology, Medical University Graz, Graz, Austria.
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20
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Siedentopf CM, Koppelstaetter F, Haala IA, Haid V, Rhomberg P, Ischebeck A, Buchberger W, Felber S, Schlager A, Golaszewski SM. Laser acupuncture induced specific cerebral cortical and subcortical activations in humans. Lasers Med Sci 2005; 20:68-73. [PMID: 15990948 DOI: 10.1007/s10103-005-0340-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2005] [Revised: 04/14/2005] [Accepted: 04/27/2005] [Indexed: 10/25/2022]
Abstract
As recent studies demonstrated, acupuncture can elicit activity in specific brain areas. This study aims to explore further the central effect using laser acupuncture. We investigated the cerebral effects of laser acupuncture at both acupoints GB43 with functional magnetic resonance imaging (fMRI). As a control condition the laser was mounted at the same acupoints but without application of laser stimulation. The group results showed significant brain activations within the thalamus, nucleus subthalamicus, nucleus ruber, the brainstem, and the Brodmann areas 40 and 22 for the acupuncture condition. No significant brain activations were observed within the placebo condition. The activations we observed were laser acupuncture-specific and predominantly ipsilateral. This supports the assumption that acupuncture is mediated by meridians, since meridians do not cross to the other side. Furthermore, we could show that laser acupuncture allows one to design a pure placebo condition.
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Affiliation(s)
- Christian M Siedentopf
- Department of Radiology II, University Hospital of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
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21
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Golaszewski SM, Siedentopf CM, Koppelstaetter F, Rhomberg P, Guendisch GM, Schlager A, Gallasch E, Eisner W, Felber SR, Mottaghy FM. Modulatory effects on human sensorimotor cortex by whole-hand afferent electrical stimulation. Neurology 2004; 62:2262-9. [PMID: 15210892 DOI: 10.1212/wnl.62.12.2262] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the effect of electrical stimulation of the nerve afferents of the hand on cortical activity elicited by whole-hand subthreshold stimulation for sensation in healthy human subjects. METHODS Ten healthy volunteers were studied using BOLD-fMRI with 1) a test motor-task with finger-to-thumb tapping of the left hand, 2) a whole-hand afferent electrical stimulation of the left hand below the sensory level for sensation for 30 minutes, 3) a second fMRI run with the same paradigm as in the test motor-task immediately after electrical stimulation, and 4) a final identical fMRI run 2 hours post-stimulation to test the cortical changes induced by electrical stimulation. Experiments were carried out on a 1.5 T MR scanner and for fMRI echoplanar sequences were used. Data analysis was performed with SPM99. RESULTS An increase of movement-related responses was seen within the primary motor and primary somatosensory areas of both hemispheres when comparing the test motor-task with the motor-task after electrical stimulation relative to the baseline or sham stimulation. Two hours post-stimulation the modulatory effects of mesh-glove stimulation diminished to baseline level except within the contralateral primary motor region. CONCLUSIONS The increased BOLD response spatially localized within the sensorimotor cortex reflects an increase in neuronal activity that may provide augmented neuronal excitability.
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Affiliation(s)
- S M Golaszewski
- Department of Neurology, University Hospital of Graz, Austria.
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22
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Hofer A, Weiss EM, Golaszewski SM, Siedentopf CM, Brinkhoff C, Kremser C, Felber S, Fleischhacker WW. Neural correlates of episodic encoding and recognition of words in unmedicated patients during an acute episode of schizophrenia: a functional MRI study. Am J Psychiatry 2003; 160:1802-8. [PMID: 14514494 DOI: 10.1176/appi.ajp.160.10.1802] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Memory impairment has been well documented in schizophrenia. In a previous study, the authors investigated patterns of brain activity during episodic encoding and recognition of words in remitted, stable schizophrenia outpatients being treated with novel antipsychotics. The same procedure was used in this study to investigate unmedicated patients during an acute episode of schizophrenia. METHOD Functional magnetic resonance imaging was used to study regional brain activation in 10 unmedicated patients experiencing an acute episode of schizophrenia and 10 healthy comparison subjects during performance of a modified version of the words subtest of Warrington's Recognition Memory Test. RESULTS Despite intact recognition performance, patients with schizophrenia showed reduced activation of anterior prefrontal, posterior cingulate, and retrosplenial areas relative to comparison subjects during word encoding. During word recognition, reduced activation was found in the patients' dorsolateral prefrontal and limbic/paralimbic regions. On the other hand, higher metabolism in bilateral anterior prefrontal cortices was observed. CONCLUSIONS The results suggest that different neural pathways are engaged during episodic encoding and recognition of words in patients experiencing an acute episode of schizophrenia relative to healthy comparison subjects. Furthermore, acute psychosis may prevent practice effects, reflected in a failure to engage brain regions associated with successful episodic memory retrieval in healthy subjects.
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Affiliation(s)
- Alex Hofer
- Department of Biological Psychiatry, Innsbruck University Clinics, Austria.
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23
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Hofer A, Weiss EM, Golaszewski SM, Siedentopf CM, Brinkhoff C, Kremser C, Felber S, Fleischhacker WW. An FMRI study of episodic encoding and recognition of words in patients with schizophrenia in remission. Am J Psychiatry 2003; 160:911-8. [PMID: 12727695 DOI: 10.1176/appi.ajp.160.5.911] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Verbal memory deficits are among the most severe cognitive deficits observed in patients with schizophrenia. This study examined patterns of brain activity during episodic encoding and recognition of words in patients with schizophrenia. METHOD Functional magnetic resonance imaging (fMRI) was used to study regional brain activation in 10 healthy male comparison subjects and 10 male outpatients with schizophrenia during performance of a modified version of the words subtest of Warrington's Recognition Memory Test. RESULTS Despite having intact performance in word recognition, the patients with schizophrenia had less activation of the right dorsolateral and anterior prefrontal cortex, right anterior cingulate, and left lateral temporal cortex during word encoding, compared with the healthy comparison subjects. During word recognition, the patients had impairments in activation of the bilateral dorsolateral prefrontal and lateral temporal cortices. CONCLUSIONS Schizophrenia was associated with attenuated frontotemporal activation during episodic encoding and recognition of words. These results from an fMRI study replicate earlier findings derived from a positron emission tomography study.
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Affiliation(s)
- Alex Hofer
- Department of Biological Psychiatry and Radiology, Innsbruck University Clinics, Anichstrasse 35, A-6020 Innsbruck, Austria.
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Golaszewski SM, Siedentopf CM, Baldauf E, Koppelstaetter F, Eisner W, Unterrainer J, Guendisch GM, Mottaghy FM, Felber SR. Functional magnetic resonance imaging of the human sensorimotor cortex using a novel vibrotactile stimulator. Neuroimage 2002; 17:421-30. [PMID: 12482095 DOI: 10.1006/nimg.2002.1195] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to investigate the fMRI response of the sensorimotor cortex to a vibration paradigm produced by a novel vibrotactile stimulator. Fifteen contiguous slices covering the sensorimotor cortex parallel to the anterior (AC) and posterior commissure (PC) line were obtained with echoplanar magnetic resonance imaging at 1.5T. Cortical activity in ten healthy subjects (20-45 years) was investigated during vibration (50 Hz) of the palm of the right hand and compared to a finger-to-thumb tapping paradigm. For the vibration paradigm a mechanically driven vibration head was mounted on the palm of the right hand. The new vibration device produces vibration frequencies (1-130 Hz) and displacement amplitudes (0.5-4 mm) suitable to elicit the tonic vibratory reflex. The fMRI measurement during vibratory stimulation revealed activation in the pre- and postcentral gyrus in all subjects. These activations were comparable to the finger-to-thumb tapping paradigm. The advantages of the new MR compatible vibration device include effective transmission of the stimulus and controlled vibration frequencies and intensities. These preliminary fMRI results indicate that vibration can be an alternative paradigm for the evaluation of sensory and motor functions in patients unable to perform active motor paradigms.
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Siedentopf CM, Golaszewski SM, Mottaghy FM, Ruff CC, Felber S, Schlager A. Functional magnetic resonance imaging detects activation of the visual association cortex during laser acupuncture of the foot in humans. Neurosci Lett 2002; 327:53-6. [PMID: 12098499 DOI: 10.1016/s0304-3940(02)00383-x] [Citation(s) in RCA: 140] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of this study was to investigate the effect of laser acupuncture on cerebral activation. Using functional magnetic imaging (fMRI) cortical activations during laser acupuncture at the left foot (Bladder 67) and dummy acupuncture, were compared employing a block design in ten healthy male volunteers. All experiments were done on a 1.5 Tesla magnetic resonance scanner equipped with a circular polarized head coil. During laser acupuncture, we found activation in the cuneus corresponding to Brodmann Area (BA) 18 and the medial occipital gyrus (BA 19) of the ipsilateral visual cortex. Placebo stimulation did not show any activation. We could demonstrate that laser acupuncture of a specific acupoint, empirically related to ophthalmic disorders, leads to activation of visual brain areas, whereas placebo acupuncture does not. These results indicate that fMRI has the potential to elucidate effects of acupuncture on brain activity.
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Golaszewski SM, Zschiegner F, Siedentopf CM, Unterrainer J, Sweeney RA, Eisner W, Lechner-Steinleitner S, Mottaghy FM, Felber S. A new pneumatic vibrator for functional magnetic resonance imaging of the human sensorimotor cortex. Neurosci Lett 2002; 324:125-8. [PMID: 11988343 DOI: 10.1016/s0304-3940(02)00229-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The aim of the study was to implement a vibrotactile stimulator using functional magnetic resonance imaging (fMRI). A fMRI compatible vibration device consisting of a pneumatically driven dual membrane pump was developed. Brain activation during 50 Hz vibrotactile stimulation of the right hand-palm were compared to a right 2 Hz finger-to-thumb-tapping in ten healthy, right-handed male volunteers. The vibration paradigm showed a comparable activation pattern with respect to finger-to-thumb-tapping in the contralateral perirolandic region. The advantage of the new vibration device is the possibility to elicit the vibratory-tonic-reflex due to the higher amplitude in context with the high frequency than established devices. This reflex is considered to be responsible for the activation in the primary motor cortex and the current paradigm might prove useful in future neurosurgical planning in patients with perirolandic lesions.
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