Improved Discrimination of Visual Stimuli Following Repetitive Transcranial Magnetic Stimulation

Background

Repetitive transcranial magnetic stimulation (rTMS) at certain frequencies increases thresholds for motor-evoked potentials and phosphenes following stimulation of cortex. Consequently rTMS is often assumed to introduce a “virtual lesion” in stimulated brain regions, with correspondingly diminished behavioral performance.

Methodology/Principal Findings

Here we investigated the effects of rTMS to visual cortex on subjects'' ability to perform visual psychophysical tasks. Contrary to expectations of a visual deficit, we find that rTMS often improves the discrimination of visual features. For coarse orientation tasks, discrimination of a static stimulus improved consistently following theta-burst stimulation of the occipital lobe. Using a reaction-time task, we found that these improvements occurred throughout the visual field and lasted beyond one hour post-rTMS. Low-frequency (1 Hz) stimulation yielded similar improvements. In contrast, we did not find consistent effects of rTMS on performance in a fine orientation discrimination task.

Conclusions/Significance

Overall our results suggest that rTMS generally improves or has no effect on visual acuity, with the nature of the effect depending on the type of stimulation and the task. We interpret our results in the context of an ideal-observer model of visual perception.     

Plastic Repair Following the Removal of Large Desmoid Tumors of the Abdominal Wall

The case records of 100 patients over the age of 60 at the time of their admission to a state mental hospital in California were evaluated, using rigid criteria to determine whether the precipitating cause for their state hospitalization was due to a deterioration of their mental state or a change in their socio-environmental milieu. The results of the study indicated that 77 per cent of these patients were in hospital because of a deterioration in their own mental state while 23 per cent were there because of a deterioration in their socio-environmental milieu. The data also were indicative that the proportion of patients put in hospital because of a deterioration in their socio-environmental milieu might conceivably be higher than 23 per cent if subtle changes in family attitude towards the patient could be adequately evaluated.     

Cell Proliferation In Emt6 Tumors Treated With Single Doses of X-Rays Or Hydroxyurea. I. Experimental Results

EMT6 mouse mammary tumors were treated in vivo with 5 mg/mouse of hydroxyurea (HU) or 300 rads of X-rays. the proliferation of the tumor cells was followed for 28 hr after treatment. Changes in the ³H-TdR labeling index, the mitotic index, the specific activity of the ³H-TdR-labeled DNA, and the proportion of suspended, clonogenic cells in the S phase of the cell cycle were examined and compared. Evidence was found for reassortment of the surviving cells in treated tumors into partially synchronous cohorts. the partial synchrony in the proliferation of the surviving cells was not accurately predicted by the changes in the labeling index and the mitotic index. the changes in DNA specific activity proved unacceptable as an indicator of cell proliferation in solid EMT6 tumors treated with low doses of radiation or HU.     

Study of Thresholds of Motor Evoked Responses during Transcranial Magnetic Stimulation in Healthy Subjects and Patients with Brain Tumors

Since 1985, transcranial magnetic stimulation (TMS) has been widely used for the investigation of different processes in the human central nervous system. We studied the thresholds of the motor-evoked responses (MER) during TMS and their hemispheric differences in healthy subjects and patients with brain tumors of different localization: in the brainstem projection, left and right motor areas, and left frontal-temporal area. The obtained results testify to a lower threshold of MER in healthy subjects during TMS of the dominant hemisphere. In patients with brainstem tumors, there was a decrease in the thresholds of MER during TMS. In patients with tumors in the motor area, the thresholds of MER were increased on the lesion side, whereas in patients with tumors in the left temporal area, the thresholds were significantly decreased during TMS of the lesioned hemisphere.     

Tumors as clonal proliferation.

Cytogenetic studies indicate that most tumors are clonal (i.e. unicellular in origin) and have karyotypic alterations. These are not consistent, but non-random abnormalities are being increasingly identified by banding techniques, pointing to the sites on human chromosomes where genes important in neoplastic development are located. It is postulated that tumor progression occurs as a result of genetic lability within the neoplastic clone, leading to emergence of increasingly mutant subpopulations (often recognizable cytogenetically) with more malignant properties. In the context of this hypothesis, acute leukemia, chronic leukemia, and preleukemia can be viewed as differing only in the rate at which an abnormal hemic clone is expanding, with progression to a more aggressive phase (e.g. the "blast crisis" of chronic granulocytic leukemia) reflecting emergence of a new predominant subpopulation as the result of an additional genetic change. These concepts, and the cytogenetic data from which they have been derived, may help our understanding of basic tumor biology, and have some practical applications in the diagnosis of human neoplasms.     

Variables Affecting the Long-Term Outcome of Graves Orbitopathy Following High-Dose Intravenous Glucocorticoid Pulse Therapy in Patients not Treated with Orbital Radiotherapy

Objective: Intravenous (iv) glucocorticoids (GC) (ivGC) are used for active Graves orbitopathy (GO), but factors affecting GO outcome are poorly understood. We performed a retrospective study to investigate the variables affecting GO after ivGC.Methods: We evaluated 83 consecutive GO patients treated with ivGC but not orbital radiotherapy (ORT) and re-examined them after a median of 47 months. The endpoints were the relationships between GO outcome or additional treatments with age, sex, smoking habits, thyroid volume, thyroid treatment, time since thyroid treatment, antithyroid-stimulating hormone receptor antibodies (TRAb), GO duration, GO features, and follow-up time.Results: GO features improved after treatment, resulting in moderate and marked amelioration in ~75% and ~41% of patients respectively. By multivariate analysis, a moderate GO improvement correlated with diplopia at first observation, which was more severe in responders. A marked GO improvement correlated with time between first and last observation and time after thyroid treatment, which were longer in responders. This likely reflected the combination of an early effect of GC and a late, spontaneous improvement of GO, as shown by analyses of GO outcome at various time points. Additional treatments after ivGC correlated by multivariate analysis with eyelid aperture, diplopia and NOSPECS score (NOSPECS stands for no GO signs [N], only eyelid sign [O], soft tissue involvement [S], proptosis [P], extraocular motility restriction [E], corneal involvement [C], and sight loss [S]) at first observation, which were more severe in responders.Conclusion: Our study shows that response to ivGC increases with time, likely reflecting the known tendency of GO to improve spontaneously, and is more pronounced when GO is more severe to begin with, which is associated with more additional treatments.Abbreviations:ANOVA = analysis of varianceCAS = clinical activity scoreGC = glucocorticoidsGO = Graves orbitopathy¹³¹I = radioactive iodineiv = intravenousivGC = high-dose intravenous glucocorticoid pulse therapyMMI = methimazoleOD = orbital decompressionORT = orbital radiotherapyTRAb = antithyroid-stimulating hormone receptor antibodies