Deficit of learning of posture voluntary control in patients with cortical lesions of various locations: cortical mechanisms of posture regulation

Forty two hemiparetic patients after cerebrovascular accidents were trained to change the position of the center of pressure according to a target on the screen with the visual feedback control. The learning was substantially impaired in comparison with the group of healthy subjects. Patients with the right-hemispheric lesions showed somewhat greater learning deficit than patients with lesions in the left hemisphere. Lesion localization also affected the process of learning. The learning was disturbed to a greater extent in patients with lesions involving not only motor but also premotor and parietal cortical areas. In patients with parieto-temporal lesions the learning reached a very low level after three initial days of training, possibly, because of the deficit of sensory integration and of body scheme in the extra-personal space. Patients with combined lesions of the motor, premotor, and parietal areas showed the lowest results. The learning was shown to depend on the deficit of proprioception and extent of postural disturbances (asymmetry of body weight distribution and amplitude of the center of pressure oscillations) rather than on the extent of motor deficit (paresis and spasticity). However, the learning itself improved some motor disturbances.     

Reaction time in bimanual simultaneous motions

Electromyographically determined reaction times (EMG-RTs) of the finger flexor and extensor of both forearms were measured for four different motions: inward (task 1), flexion of both wrists; outward (task 2), extension of both wrists; to the left (task 3), extension of the left wrist and flexion of the right; and to the right (task 4), flexion of the left and extension of the right. The EMG-RTs were shorter and synchronization errors in terms of left to right differences of EMG-RTs were smaller in tasks 1 and 2 than in tasks 3 and 4. Comparing the flexors and the extensors, the extent of prolongation of EMG-RTs in tasks 3 and 4 differed significantly on the left side, being larger in the flexor than in the extensor, but there was no difference in the extent of prolongation between the flexor and the extensor on the right. It was suggested that the timing of initiation of movements in simultaneous motions was primarily determined by the pattern of muscle coupling in both limbs, and not by the direction of movements. The steadiness of motor function and of the right hand in right-handed subjects was also discussed in regard to hand preference.     

Assessment of recognition of emotions by healthy persons and patients with focal brain pathology

To assess the involvement of different structures of the human brain into successive stages of the recognition of the principal emotions by facial expression, we examined 48 patients with local brain lesions and 18 healthy adult subjects. It was shown that at the first (intuitive) stage of the recognition, premotor areas of the right hemisphere and temporal areas of the left hemisphere are of considerable importance in the recognition of both positive and negative emotions. In this process, the left temporal areas are substantially involved into the recognition of anger, and the right premotor areas predominantly participate in the recognition of fear. In patients with lesions of the right and left brain hemispheres, at the second (conscious) stage of recognition, the critical attitude to the assessment of emotions drops depending on the sign of the detected emotion. We have confirmed the hypothesis about a correlation between the personality features of the recognition of facial expressions and the dominant emotional state of a given subject.     

Membrane channel properties of premotor excitatory burst neurons may underlie saccade slowing after lesions of omnipause neurons

Chemical lesions of the brain stem region containing glycinergic omnipause neurons (OPNs) cause saccade slowing with no change in latency. To explore the mechanisms responsible for this deficit, simulation studies were performed with a conductance-based model of premotor excitatory burst neurons (EBNs) that incorporated multiple membrane channels, including the T-type calcium channel. The peak speed of a normal saccade was determined by the T- and NMDA currents in EBNs after the OPNs shut off. After OPN lesions, the model made slow saccades, because the EBN activity was lower than normal due to a reduced T-current (caused by the loss of hyperpolarization), and a reduced NMDA current (caused by a reduced glycine concentration around the receptors). Thus, we propose that two biophysical mechanisms are responsible for saccade slowing after OPN lesions: reduced T-current and reduced NMDA current, both of which are caused by the loss of glycine from OPNs. Action Editor: Karen Sigvardt     

Risk of Premotor Symptoms in Patients with Newly Diagnosed PD: A Nationwide,Population-Based,Case-Control Study in Taiwan

Background

To evaluate the risk of premotor symptoms, namely rapid eye movement behavior disorder (RBD), constipation, and depression among patients with newly diagnosed Parkinson disease (PD).

Methods

A total of 705 PD patients and 2,820 control subjects were selected from the Taiwan National Health Insurance Research Database. Patients were traced back for a maximum of 14 years to determine the diagnoses of RBD, depression, and constipation. Logistic regression analysis was used to identify risk of premotor symptoms for PD. Moreover, subgroup analyses were performed by dividing the patients into a middle-age onset group (≤ 64 years) and an old-age onset group (≥ 65 years). The associations between these premotor symptoms and age of PD onset were further examined.

Results

An association was found between a history of premotor symptoms and newly diagnosed PD in which a high occurrence of premotor symptoms was identified in PD patients as compared to selected controls (4.3% vs. 1.2% for RBD, 40.4% vs. 24.0% for constipation, and 13.0% vs. 5.1% for depression). The strength of this association remained statistically significant after adjustment for potential confounders (3.69 fold risk for RBD, 2.36 for constipation, and 2.82 for depression, all p < 0.0001). The average interval between premotor symptoms and PD ranged from 4.5 to 6.2 years. RBD and depression carried higher risks for PD in the middle-age onset group than in the old-age onset group (7.20- vs. 2.24-fold risk for RBD, 6.06 vs. 1.40 for depression).

Conclusion

The prevalence of premotor symptoms was higher among the PD patients than in the controls. Premotor symptoms appeared to be associated with a higher risk for PD in subjects with an earlier age of onset.     

Specific activation of brain cortical areas in response to stimulation of the support receptors in healthy subjects and patients with focal lesions of the CNS

The space medicine data on the nature of motor disorders suggest an important role of the support inputs in the control of mammalian tonic and postural systems. Progress in functional magnetic resonance tomography (fMRT) makes it possible to perform in vivo analysis of various brain areas during stimulation of the support afferentation. Under these conditions, specific activation of the brain cortical areas was studied in 19 healthy subjects (with the mean age of 38 ± 15.13 years) and 23 patients (with the mean age of 53 ± 9.07 years) with focal CNS lesions (cortical-subcortical ischemic stroke). During scanning of subjects, the support areas of the soles of the feet were stimulated using a block design to simulate slow walking. In healthy subjects, significant activation was recorded (p < 0.05 at the cluster level) in the primary somatosensory cortex, premotor and dorsolateral prefrontal cortex, and insular lobe. In patients that had had a stroke, activation of the locomotion-controlling supraspinal systems clearly depended on the stage of the disease. In patients with a cortical-subcortical stroke, the pattern of contralateral activation of the sensorimotor locomotion predominated during motility rehabilitation.     

Demonstration of dissociation between frontal and temporal lesions in man on two versions of delayed non-matching recognition tests used in monkeys]

11 patients with frontal lobe lesions (F group), 9 patients with temporal lobe lesions (T group) and 18 normal control subjects (C group) were tested on two versions of the delayed non matching-to-sample task using either different pairs (DNMTS) or the same pairs of objects (RECURRENT) on successive test trials. The results revealed that the DNMTS task was sensitive to memory impairment but did not differentiate the two experimental groups. In contrast, the recurrent version of the task showed a dissociation between the two pathologies. Thus, whereas patients of group T exhibited an accelerated rate of forgetting as a function of the retention interval, patients of group F were impaired whatever the retention interval.     

Two cortical systems for reaching in central and peripheral vision

Parietal lesions in humans can produce a specific disruption of visually guided hand movement, termed optic ataxia. The fact that the deficit mainly occurs in peripheral vision suggests that reaching in foveal and extrafoveal vision rely on two different neural substrates. In the present study, we have directly tested this hypothesis by event-related fMRI in healthy subjects. Brain activity was measured when participants reached toward central or peripheral visual targets. Our results confirm the existence of two systems, differently modulated by the two conditions. Reaching in central vision involved a restricted network including the medial intraparietal sulcus (mIPS) and the caudal part of the dorsal premotor cortex (PMd). Reaching in peripheral vision activated in addition the parieto-occipital junction (POJ) and a more rostral part of PMd. These results show that reaching to the peripheral visual field engages a more extensive cortical network than reaching to the central visual field.     

Lipoprotein binding of crosslinked type III collagen aminopropeptide and fractions of its antigen in blood

When [125I] labelled bovine type III collagen aminopropeptide (PIIIP) is incubated with tissue transglutaminase (TGase) mixed with hyperlipemic rabbit plasma and subjected to ultracentrifugation the labelled fraction with density less than 1.2 g/ml is larger than when either lipoprotein or TGase is omitted. Chromatography of the fraction with density less than 1.2 g/ml shows the presence of peaks which are not present in the denser material. Since their elution positions indicate that they have higher molecular weights than PIIIP it is concluded that they consist of [125I]PIIIP which had been crosslinked by TGase and bound to lipoprotein. Low concentrations of similar low density, high molecular weight PIIIP antigens were found in normal human plasma and pooled sera from angiography subjects. In two out of seven infarct patients an unusually large fraction of the PIIIP antigen in the serum was found in a very high molecular weight peak containing low density material. It is speculated that this may arise from atherosclerotic lesions.     

Electro and acoustic myography for noninvasive assessment of lumbar paraspinal muscle function

In 31 normal subjects (17 male), aged 19-48 years, and 8 patients with chronic low back pain (4 male), aged 37-55 years, the repeatability of surface recordings of acoustic myography (AMG) and electromyography (EMG) were examined in the lumbar paraspinal muscles. Five isometric test positions were examined. In 21 of the normal subjects, four positions tested were: quiet standing, half extension from prone lying, full extension from prone with and without resistance. In 10 of the normal subjects and the 8 back pain patients, a standardised, unsupported horizontal position with the upper body over the end of a couch was tested. The AMG and EMG signals were full-wave rectified and integrated (iAMG and iEMG). The variability of recordings during repeated 5-s isometric contractions was assessed by analysis of variance (ANOVA) and the coefficient of variation (CV) was calculated from the ANOVA. Both recording techniques produced the most repeatable results during the unsupported, horizontal hold position. In the normal subjects, CV were, iAMG 5.6%, iEMG 4.9%; and in the patients, iAMG 4.4%, iEMG 2.6%. The CV for the other four isometric test positions ranged from 15.3% to 29.4% for iAMG, and 8% to 15.7% for iEMG. These results demonstrated that a controlled test manoeuvre for examining AMG and EMG of the paraspinal muscles was vital for repeatable recordings. The CV for the standardised, horizontal position were lower than for previously published results.(ABSTRACT TRUNCATED AT 250 WORDS)     

Neural correlates of hate

In this work, we address an important but unexplored topic, namely the neural correlates of hate. In a block-design fMRI study, we scanned 17 normal human subjects while they viewed the face of a person they hated and also faces of acquaintances for whom they had neutral feelings. A hate score was obtained for the object of hate for each subject and this was used as a covariate in a between-subject random effects analysis. Viewing a hated face resulted in increased activity in the medial frontal gyrus, right putamen, bilaterally in premotor cortex, in the frontal pole and bilaterally in the medial insula. We also found three areas where activation correlated linearly with the declared level of hatred, the right insula, right premotor cortex and the right fronto-medial gyrus. One area of deactivation was found in the right superior frontal gyrus. The study thus shows that there is a unique pattern of activity in the brain in the context of hate. Though distinct from the pattern of activity that correlates with romantic love, this pattern nevertheless shares two areas with the latter, namely the putamen and the insula.     

Differential Grey Matter Changes in Sensorimotor Cortex Related to Exceptional Fine Motor Skills

Functional changes in sensorimotor representation occur in response to use and lesion throughout life. Emerging evidence suggests that functional changes are paralleled by respective macroscopic structural changes. In the present study we used voxel-based morphometry to investigate sensorimotor cortex in subjects with congenitally malformed upper extremities. We expected increased or decreased grey matter to parallel the enlarged or reduced functional representations we reported previously. More specifically, we expected decreased grey matter values in lateral sensorimotor cortex related to compromised hand function and increased grey matter values in medial sensorimotor cortex due to compensatory foot use. We found a medial cluster of grey matter increase in subjects with frequent, hand-like compensatory foot use. This increase was predominantly seen for lateral premotor, supplementary motor, and motor areas and only marginally involved somatosensory cortex. Contrary to our expectation, subjects with a reduced number of fingers, who had shown shrinkage of the functional hand representation previously, did not show decreased grey matter values within lateral sensorimotor cortex. Our data suggest that functional plastic changes in sensorimotor cortex can be associated with increases in grey matter but may also occur in otherwise macroscopically normal appearing grey matter volumes. Furthermore, macroscopic structural changes in motor and premotor areas may be observed without respective changes in somatosensory cortex.     

Complex movements evoked by microstimulation of precentral cortex

Electrical microstimulation was used to study primary motor and premotor cortex in monkeys. Each stimulation train was 500 ms in duration, approximating the time scale of normal reaching and grasping movements and the time scale of the neuronal activity that normally accompanies movement. This stimulation on a behaviorally relevant time scale evoked coordinated, complex postures that involved many joints. For example, stimulation of one site caused the mouth to open and also caused the hand to shape into a grip posture and move to the mouth. Stimulation of this site always drove the joints toward this final posture, regardless of the direction of movement required to reach the posture. Stimulation of other cortical sites evoked different postures. Postures that involved the arm were arranged across cortex to form a map of hand positions around the body. This stimulation-evoked map encompassed both primary motor and the adjacent premotor cortex. We suggest that these regions fit together into a single map of the workspace around the body.     

Homeokinesis and short-term variability of human airway caliber.

We hypothesized that short-term variation in airway caliber could be quantified by frequency distributions of respiratory impedance (Zrs) measured at high frequency. We measured Zrs at 6 Hz by forced oscillations during quiet breathing for 15 min in 10 seated asthmatic patients and 6 normal subjects in upright and supine positions before and after methacholine (MCh). We plotted frequency distributions of Zrs and calculated means, skewness, kurtosis, and significance of differences between normal and log-normal frequency distributions. The data were close to, but usually significantly different from, a log-normal frequency distribution. Mean lnZrs in upright and supine positions was significantly less in normal subjects than in asthmatic patients, but not after MCh and MCh in the supine position. The lnZrs SD (a measure of variation), in the upright position and after MCh was significantly less in normal subjects than in asthmatic patients, but not in normal subjects in the supine position and after MCh in the supine position. We conclude that 1) the configuration of the normal tracheobronchial tree is continuously changing and that this change is exaggerated in asthma, 2) in normal lungs, control of airway caliber is homeokinetic, maintaining variation within acceptable limits, 3) normal airway smooth muscle (ASM) when activated and unloaded closely mimics asthmatic ASM, 4) in asthma, generalized airway narrowing results primarily from ASM activation, whereas ASM unloading by increasing shortening velocity allows faster caliber fluctuations, 5) activation moves ASM farther from thermodynamic equilibrium, and 6) asthma may be a low-entropy disease exhibiting not only generalized airway narrowing but also an increased appearance of statistically unlikely airway configurations.     

Recognition of emotions by facial and verbal samples in healthy humans and patients with local brain pathology

The efficiency of emotion recognition by verbal and facial samples was tested in 81 persons (25 healthy subjects and 56 patients with focal pathology of premotor and temporal areas of brain hemispheres). The involvement of some cortical structures in the recognition of the basic emotional states (joy, anger, grief, and fear) and the neutral state was compared. It was shown that the damage to both right and left hemispheres impaired the recognition of emotional states by not only facial but also verbal samples. Damage to the right premotor area and to the left temporal area impaired the efficiency of the emotion recognition by both kinds of samples to the highest degree.     

Association of endothelial microparticle with NO,eNOS, ET-1, and fractional flow reserve in patients with coronary intermediate lesions

Abstract

Endothelial microparticle (EMP) is a biomarker for endothelial dysfunction. The aim of this study is to investigate the utility of EMP in evaluating coronary intermediate lesions. Participants included 49 patients with coronary intermediate lesions and 24 subjects with normal coronary arteries. Among these subjects, 28 patients accepted fractional flow reserve (FFR). Results showed that level of EMP was significantly higher in the intermediate lesion group. No correlation was found between EMP and FFR value, suggesting that circulating EMP is a systemic marker rather than a focal one.     

Accumulation of DNA structural damages in human lymphocytes during aging

Elastoviscosometric parameters of DNA from normal subjects of different age and patients with Down syndrome were assessed. Characteristics of DNA isolated from lymphocytes trisomic for chromosome 21 were studied to compare normal and pathological rates of ageing. Increased elastoviscosity was observed in normal subjects above 60. Similar changes in this parameter were noted in aberrant lymphocytes isolated from patients above 10. The established dependence of elastoviscosity on ethidium bromide concentration led to the assumption that an increase in hydrodynamic DNA volume in human leukocytes during ageing was due to accumulation of spontaneous irreparable DNA lesions.     

The distribution of the cortical origin of the corticoreticular pathway in the human brain: A diffusion tensor imaging study

We investigated the distribution of the cortical origin of the corticoreticular pathway (CRP) in the human brain. Forty normal subjects were recruited and CRPs from four cortical areas were reconstructed. The first cortical origin area of the CRP was the premotor cortex and the next was the primary motor cortex. Although the CRP fibers also originated from the primary somatosensory cortex and prefrontal cortex, they occupied the smallest portion among four regions of interest.     

Are Normal Decision-Makers Sensitive to Changes in Value Contrast under Uncertainty? Evidence from the Iowa Gambling Task

The Iowa Gambling Task (IGT) developed by Bechara et al. in 1994 is used to diagnose patients with Ventromedial Medial Prefrontal Cortex (VMPFC) lesions, and it has become a landmark in research on decision making. According to Bechara et al., the manipulation of progressive increments of monetary value can normalize the performance of patients with VMPFC lesions; thus, they developed a computerized version of the IGT. However, the empirical results showed that patients'' performances did not improve as a result of this manipulation, which suggested that patients with VMPFC lesions performed myopically for future consequences. Using the original version of the IGT, some IGT studies have demonstrated that increments of monetary value significantly influence the performance of normal subjects in the IGT. However, other research has resulted in inconsistent findings. In this study, we used the computerized IGT (1X-IGT) and manipulated the value contrast of progressive increments (i.e., by designing the 10X-IGT, which contained 10 times of progressive increment) to investigate the influence of value contrast on the performance of normal subjects. The resulting empirical observations indicated that the value contrast (1X- vs. 10X-IGT) of the progressive increment had no effect on the performance of normal subjects. This study also provides a discussion of the issue of value in IGT-related studies. Moreover, we found the “prominent deck B phenomenon” in both versions of the IGT, which indicated that the normal subjects were guided mostly by the gain-loss frequency, rather than by the monetary value contrast. In sum, the behavioral performance of normal subjects demonstrated a low correlation with changes in monetary value, even in the 10X-IGT.     

Lesions to right posterior parietal cortex impair visual depth perception from disparity but not motion cues

The posterior parietal cortex (PPC) is understood to be active when observers perceive three-dimensional (3D) structure. However, it is not clear how central this activity is in the construction of 3D spatial representations. Here, we examine whether PPC is essential for two aspects of visual depth perception by testing patients with lesions affecting this region. First, we measured subjects'' ability to discriminate depth structure in various 3D surfaces and objects using binocular disparity. Patients with lesions to right PPC (N = 3) exhibited marked perceptual deficits on these tasks, whereas those with left hemisphere lesions (N = 2) were able to reliably discriminate depth as accurately as control subjects. Second, we presented an ambiguous 3D stimulus defined by structure from motion to determine whether PPC lesions influence the rate of bistable perceptual alternations. Patients'' percept durations for the 3D stimulus were generally within a normal range, although the two patients with bilateral PPC lesions showed the fastest perceptual alternation rates in our sample. Intermittent stimulus presentation reduced the reversal rate similarly across subjects. Together, the results suggest that PPC plays a causal role in both inferring and maintaining the perception of 3D structure with stereopsis supported primarily by the right hemisphere, but do not lend support to the view that PPC is a critical contributor to bistable perceptual alternations.This article is part of the themed issue ‘Vision in our three-dimensional world’.