Understanding functional brain reorganization for naturalistic piano playing in novice pianists

Learning to play the piano is a unique complex task, integrating multiple sensory modalities and higher order cognitive functions. Longitudinal neuroimaging studies on adult novice musicians show training-related functional changes in music perception tasks. The reorganization of brain activity while actually playing an instrument was studied only on a very short time frame of a single fMRI session, and longer interventions have not yet been performed. Thus, our aim was to investigate the dynamic complexity of functional brain reorganization while playing the piano within the first half year of musical training. We scanned 24 novice keyboard learners (female, 18–23 years old) using fMRI while they played increasingly complex musical pieces after 1, 6, 13, and 26 weeks of training. Playing music evoked responses bilaterally in the auditory, inferior frontal, and supplementary motor areas, and the left sensorimotor cortex. The effect of training over time, however, invoked widespread changes encompassing the right sensorimotor cortex, cerebellum, superior parietal cortex, anterior insula and hippocampus, among others. As the training progressed, the activation of these regions decreased while playing music. Post hoc analysis revealed region-specific time-courses for independent auditory and motor regions of interest. These results suggest that while the primary sensory, motor, and frontal regions are associated with playing music, the training decreases the involvement of higher order cognitive control and integrative regions, and basal ganglia. Moreover, training might affect distinct brain regions in different ways, providing evidence in favor of the dynamic nature of brain plasticity.     

Ophthalmic changes in a spaceflight analog are associated with brain functional reorganization

Following long‐duration spaceflight, some astronauts exhibit ophthalmic structural changes referred to as Spaceflight Associated Neuro‐ocular Syndrome (SANS). Optic disc edema is a common sign of SANS. The origin and effects of SANS are not understood as signs of SANS have not manifested in previous spaceflight analog studies. In the current spaceflight analog study, 11 subjects underwent 30 days of strict head down‐tilt bed rest in elevated ambient carbon dioxide (HDBR+CO₂). Using functional magnetic resonance imaging (fMRI), we acquired resting‐state fMRI data at 6 time points: before (2), during (2), and after (2) the HDBR+CO₂ intervention. Five participants developed optic disc edema during the intervention (SANS subgroup) and 6 did not (NoSANS group). This occurrence allowed us to explore whether development of signs of SANS during the spaceflight analog impacted resting‐state functional connectivity during HDBR+CO₂. In light of previous work identifying genetic and biochemical predictors of SANS, we further assessed whether the SANS and NoSANS subgroups exhibited differential patterns of resting‐state functional connectivity prior to the HDBR+CO₂ intervention. We found that the SANS and NoSANS subgroups exhibited distinct patterns of resting‐state functional connectivity changes during HDBR+CO₂ within visual and vestibular‐related brain networks. The SANS and NoSANS subgroups also exhibited different resting‐state functional connectivity prior to HDBR+CO₂ within a visual cortical network and within a large‐scale network of brain areas involved in multisensory integration. We further present associations between functional connectivity within the identified networks and previously identified genetic and biochemical predictors of SANS. Subgroup differences in resting‐state functional connectivity changes may reflect differential patterns of visual and vestibular reweighting as optic disc edema develops during the spaceflight analog. This finding suggests that SANS impacts not only neuro‐ocular structures, but also functional brain organization. Future prospective investigations incorporating sensory assessments are required to determine the functional significance of the observed connectivity differences.     

Handedness shift as a consequence of motor cortex reorganization after early functional impairment in left temporal lobe epilepsy--an fMRI case report

The impact of epileptiform activity on the functional organization of various cortical regions is currently a widely discussed topic. Our patient, suffering from left-sided temporal lobe epilepsy with typical mesiotemporal sclerosis, had a remarkable history of a clear-cut handedness shift in early childhood. In this study, we considered the possibility of the functional reorganization of the motor cortex using functional MRI. The results reflect epileptiform activity as an important formative factor for motor cortex development in our patient.     

Cognitive and functional impairment in hypertensive brain microangiopathy

Brain microangiopathy, whose neuroimaging expression is represented by age-related white matter changes (ARWMC), is largely due to hypertension and it is, in turn, responsible for geriatric syndromes, including decline in cognitive, functional and motor/gait abilities. This review analyzes the link between hypertension and ARWMC, as well as the complex relationships between ARWMC and cognitive impairment, executive dysfunction, and movement/gait abnormalities. The available evidence supports the hypothesis that these functional consequences of ARWMC are responsible for substantial disability in the elderly. Thus, adequate treatment of hypertension may represent a feasible way to reduce the burden of disability in late life.     

Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia

Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusion. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia.     

Selection of stimulus parameters for deep brain stimulation.

OBJECTIVE: To provide an analysis of stimulation parameters for deep brain stimulation (DBS). METHODS: Synthesis of theoretical and empirical findings is used to provide guidance for the selection of stimulus parameters. Finite element modeling is used to investigate the effects of contact location and electrode geometry on the electric field, and to estimate the effects of current density distribution on the limit for non-damaging stimulation. RESULTS: Anatomical targeting of DBS electrodes is complicated by the uncertainty of which neural elements are targeted and differences in the electric field distribution in fiber tracts and nuclei. Electrical targeting by selection of electrode geometry and stimulus waveform can alter the distribution of the electric field and control neural activation. The recommended charge density limit for DBS represents a liberal estimate for non-damaging stimulation. Short duration stimulus pulses reduce charge injection and increase the therapeutic window between therapeutic effects and side effects. CONCLUSIONS: There are several challenges to developing rational methods of selecting stimulus parameters including a large number of degrees of freedom, the unknown effects of stimulation, and the complexity of the responses. SIGNIFICANCE: Understanding the fundamentals of electrical stimulation of the nervous system enables rational selection of stimulus parameters.     

Physiologic impairment of olfactory stimulus processing in schizophrenia.

BACKGROUND: Behavioral studies of olfaction have demonstrated impairments in the ability to detect and identify odors in patients with schizophrenia. These deficits appear to be independent of either symptom severity or other cognitive impairment. Only limited efforts have been made to investigate the neurophysiologic substrate of these olfactory abnormalities. This article reports the first examination of olfactory electrophysiologic responses in patients with schizophrenia. METHODS: Olfactory event-related potential responses to three different concentrations of hydrogen sulfide were recorded in a sample of 21 patients and 20 healthy control subjects. Odors were presented via an olfactometer to ensure there was no associated trigeminal nerve stimulation. RESULTS: Patients exhibited abnormalities in the amplitudes of the N1 and P2 components of the olfactory evoked potential, and delayed latency of the P2. The N1 abnormality, which denotes primary olfactory cortex activity, was related to impaired odor detection threshold sensitivity; the P2 abnormality was related to impaired odor identification. CONCLUSIONS: These data indicate the presence of a primary physiologic impairment in the olfactory cortex underlying behavioral olfactory deficits seen in patients with schizophrenia. This is consistent with postmortem and in vitro studies suggesting abnormalities in olfactory receptor neurons. Understanding the nature of these physiologic olfactory impairments could offer clues to the basic neuropathology of this disorder.     

Childhood maltreatment is associated with a sex‐dependent functional reorganization of a brain inhibitory control network

Childhood adversity represents a major risk factor for drug addiction and other mental disorders. However, the specific mechanisms by which childhood adversity impacts human brain organization to confer greater vulnerability for negative outcomes in adulthood is largely unknown. As an impaired process in drug addiction, inhibitory control of behavior was investigated as a target of childhood maltreatment (abuse and neglect). Forty adults without Axis‐I psychiatric disorders (21 females) completed a Childhood Trauma Questionnaire (CTQ) and underwent functional MRI (fMRI) while performing a stop‐signal task. A group independent component analysis identified a putative brain inhibitory control network. Graph theoretical analyses and structural equation modeling investigated the impact of childhood maltreatment on the functional organization of this neural processing network. Graph theory outcomes revealed sex differences in the relationship between network functional connectivity and inhibitory control which were dependent on the severity of childhood maltreatment exposure. A network effective connectivity analysis indicated that a maltreatment dose‐related negative modulation of dorsal anterior cingulate (dACC) activity by the left inferior frontal cortex (IFC) predicted better response inhibition and lesser attention deficit hyperactivity disorder (ADHD) symptoms in females, but poorer response inhibition and greater ADHD symptoms in males. Less inhibition of the right IFC by dACC in males with higher CTQ scores improved inhibitory control ability. The childhood maltreatment‐related reorganization of a brain inhibitory control network provides sex‐dependent mechanisms by which childhood adversity may confer greater risk for drug use and related disorders and by which adaptive brain responses protect individuals from this risk factor. Hum Brain Mapp 35:1654–1667, 2014. © 2013 Wiley Periodicals, Inc.     

Experience induces functional reorganization in brain regions involved in odor imagery in perfumers

Areas of expertise that cultivate specific sensory domains reveal the brain's ability to adapt to environmental change. Perfumers are a small population who claim to have a unique ability to generate olfactory mental images. To evaluate the impact of this expertise on the brain regions involved in odor processing, we measured brain activity in novice and experienced (student and professional) perfumers while they smelled or imagined odors. We demonstrate that olfactory imagery activates the primary olfactory (piriform) cortex (PC) in all perfumers, demonstrating that similar neural substrates were activated in odor perception and imagination. In professional perfumers, extensive olfactory practice influences the posterior PC, the orbitofrontal cortex, and the hippocampus; during the creation of mental images of odors, the activity in these areas was negatively correlated with experience. Thus, the perfumers' expertise is associated with a functional reorganization of key olfactory and memory brain regions, explaining their extraordinary ability to imagine odors and create fragrances.     

Functional brain imaging as a surrogate marker in vascular cognitive impairment

Functional brain imaging represents cerebrovascular status, neuronal status, and neuronetwork status, and plays an increasingly important role in the evaluation of vascular cognitive impairment or vascular dementia. In this article, the roles of functional brain imaging are discussed in evaluation of subcortical lesions disrupting cortico-subcortical circuits and in the study of white-matter changes in dementia. Also mentioned is an ongoing clinical trial of extracranial-intracranial artery bypass surgery for hemispheric hemodynamic misery perfusion where single-photon emission tomography is used as a surrogate measure.     

Altered functional brain networks in amnestic mild cognitive impairment: a resting-state fMRI study

Amnestic mild cognitive impairment MCI (aMCI) has a high progression to Alzheimer’s disease (AD). Recently, resting-state functional MRI (RS-fMRI) has been increasingly utilized in studying the pathogenesis of aMCI, especially in resting-state networks (RSNs). In the current study, we aimed to explore abnormal RSNs related to memory deficits in aMCI patients compared to the aged-matched healthy control group using RS-fMRI techniques. Firstly, we used ALFF (amplitude of low-frequency fluctuation) method to define the regions of interest (ROIs) which exhibited significant changes in aMCI compared with the control group. Then, we divided these ROIs into different networks in line with prior studies. The aim of this study is to explore the functional connectivity between these ROIs within networks and also to investigate the connectivity between networks. Comparing aMCI to the control group, our results showed that 1) the hippocampus (HIPP) had decreased FC with the medial prefrontal cortex (mPFC) and inferior parietal lobe (IPL), and the mPFC showed increased connectivity to IPL in the default mode network; 2) the thalamus showed decreased FC with the putamen and HIPP, and the HIPP showed increased connectivity to the putamen in the limbic system; 3) the supplementary motor area had decreased FC with the middle temporal gyrus and increased FC with the superior parietal lobe in the sensorimotor network; 4) increased connectivity between the lingual gyrus and middle occipital gyrus in the visual network; and 5) the DMN has reduced inter-network connectivities with the SMN and VN. These findings indicated that functional brain networks involved in cognition such as episodic memory, sensorimotor and visual cognition in aMCI were altered, and provided a new sight in understanding the important subtype of aMCI.     

脑死亡患者的血流动力学分析

目的对脑死亡患者进行血流动力学分析。方法纳入2015年3月至2017年3月本院重症监护室收治的拟进行器官捐献的脑死亡患者26例,应用脉搏指示性连续心排量监测(Pi CCO)测定患者0h(入组时)的脑内血容量指数(ITBVI),根据ITBVI指标进行补液治疗,使其6h内达到正常。对比0h及6h时患者的心率(HR)、平均动脉压(MAP)、心指数(CI)、每博指数(SVI)、系统血管阻力指数(SVRI)、ITBVI、去甲肾上腺素用量及血乳酸水平。6h时行心脏彩超测定患者的左室射血分数(LVEF),对LVEF50%的患者给予多巴酚丁胺5ug·kg-1·min-1持续泵入,对比6h和10h,患者的LVEF、CI、去甲肾上腺素用量及血乳酸水平;统计48h患者的胆红素及肌酐的改善率及肝肾器官捐献成功率。结果患者0h ITBVI显著低于正常值,经补液治疗,6h时HR下降,CI、SI升高,SVRI下降,去加肾上腺用量降低,乳酸水平下降,前后比较差异有统计学意义(P均0.01);6h时76.9%的患者LVEF50%,给予多巴酚丁胺泵入,10h时患者LVEF50%的比例下降至30.7%,与6h时相比LVEF、CI增高(去甲肾上腺素用量下降,乳酸水平降低(均P0.01);患者48h胆红素及肌酐水平明显下降(P0.001),肝脏及肾脏的捐赠成功率分别为92.3%及96.2%。结论脑死亡患者前负荷不足,心脏收缩功能下降,外周阻力降低,给予优化血流动力学后可明显降低去甲肾上腺素用量,改善供体肝肾功能。     

Sneezing as a fetishistic stimulus

Our understanding of the aetiology and psychopathology of fetishism is discussed in the context of a case history of a young homosexual man who was sexually aroused by observing other people sneeze.     

Pregnancy as a transference stimulus

The paper discusses the concept of transference in therapeutic relationships where the therapist is pregnant. Comparisons are made with other physical attributes of the therapist. The remarkable lack of literature to date is noted and the reasons for this discussed. Case histories illustrate some typical reactions and demonstrate the usual mixture of transference elements, those inappropriate and displaced and those which are firmly based in reality.     

Cortical reorganization of hand motor function to face somatotopy in a patient with brain injury: a functional MRI study

We report on a patient with a meningioma whose hand motor function appeared to be reorganized mainly into the face somatotopy of the primary motor cortex (M1) following meningioma removal, using functional RMI (fMRI). A 76-year-old right-handed woman showed leukomalactic lesions in the left fronto-parietal lobes and subcortical white matter, including the upper portion of the precentral knob after meningioma removal. She recovered motor function to the point that she was able to extend the affected fingers against gravity at 6 weeks and extend the affected fingers against resistance at 12 weeks. The right primary sensori-motor cortex centered on the precentral knob was activated during movement of the unaffected (left) hand. By contrast, the face somatotopy and inferior portion of the precentral knob of the left primary motor cortex were activated during movement of the right hand. Peak activations were present at the left face somatotopy of the primary motor cortex during movement of the right hand and the right precentral knob during movement of the left hand. Motor function of the affected hand appeared to be reorganized mainly into the face somatotopy of the primary motor cortex and partially into the lower portion of the precentral knob after meningioma removal.     

Mild cognitive impairment: conceptual issues and structural and functional brain correlates

Mild cognitive impairment (MCI) is a prevalent condition among older adults that carries a high risk of progression to Alzheimer's disease or other dementias. Given the potential for delaying or preventing the onset of dementia, efforts aimed at early detection and early intervention are important. The current paper reviews the conceptualization and diagnosis of MCI, assessment of memory complaints and deficits in the elderly, as well as recent research on the neurobiological basis of the disorder, including neurochemical, structural, and functional neuroimaging findings.