Role of operculoinsular cortices in human pain processing: converging evidence from PET,fMRI, dipole modeling,and intracerebral recordings of evoked potentials

Insular and SII cortices have been consistently shown by PET, fMRI, EPs, and MEG techniques to be activated bilaterally by a nociceptive stimulation. The aim of the present study was to refer to, and to compare within a common stereotactic space, the nociceptive responses obtained in humans by (i) PET, (ii) fMRI, (iii) dipole modeling of scalp LEPs, and (iv) intracerebral recordings of LEPs. PET, fMRI, and scalp LEPs were obtained from normal subjects during thermal pain. Operculoinsular LEPs were obtained from 13 patients using deep brain electrodes implanted for presurgical evaluation of drug-resistant epilepsy. Whatever the technique, we obtained responses which were located bilaterally in the insular and SII cortices. In electrophysiological responses (LEPs) the SII insular contribution peaked between 150 and 250 ms poststimulus and corresponded to the earliest portions of the whole cerebral response. Group analysis of PET and fMRI data showed highly consistent responses contralateral to stimulation. On single-subject analysis, LEPs and fMRI activations were concentrated in relatively restricted volumes even though spatial sampling was quite different for both techniques. Despite our multimodal approach, however, it was not possible to separate insular from SII activities. Individual variations in the anatomy and function of SII and insular cortices may explain this limitation. This multimodal study provides, however, cross-validated spatial and temporal information on the pain-related processes occurring in the operculoinsular region, which thus appears as a major site for the early cortical pain encoding in the human brain.     

Hemodynamic responses in visual, motor, and somatosensory cortices in schizophrenia

Recent advances in functional neuroimaging allow comparisons between individuals with schizophrenia and control groups. Previous studies of schizophrenia have used blocked task paradigms and, more recently, "rapid event-related" designs in which stimuli of different types are presented close together in an intermixed fashion. The validity of between-group comparisons in both of these types of paradigms depends on excluding the possibility that observed functional response differences are attributable to altered hemodynamic responses in individuals with schizophrenia. The goal of the current study was to begin a systematic examination of the hemodynamic response in schizophrenia. We administered a flashing checkerboard paradigm with a motor response to 17 individuals with schizophrenia and 24 healthy controls. Both groups showed robust activation of visual, motor, somatosensory, and supplementary motor regions. For the most part, the individuals with schizophrenia demonstrated intact peak amplitude, variance, latency, and linear summation properties in regions activated by this task. We did find some evidence for increased variability in the amplitude and latency of the hemodynamic responses in the visual and somatosensory cortices, although the magnitudes of these group differences were relatively small. These results begin to validate the interpretation of functional neuroimaging studies of schizophrenia in terms of neuronal as opposed to vascular mechanisms.     

Hemodynamic correlates of stimulus repetition in the visual and auditory cortices: an fMRI study

We examined the effects of stimulus repetition upon the evoked hemodynamic response (HDR) in auditory and visual cortices measured by magnetic resonance imaging in two experiments. Experiment 1 focused on the effects of the interval duration between two identical stimuli on HDR. Pure auditory tones (1000 Hz) of 100-ms duration were presented singly or in pairs with intrapair intervals (IPIs: onset-to-onset) of 1, 4, and 6 s. In Experiment 2, using a within-subject design, we aimed to compare the HDR refractory period in both sensory cortices as well as the HDRs to auditory and visual stimuli. Identical auditory tone as described above and visual stimuli of 500-ms high-contrast checkerboard patterns were presented singly or in identical pairs with an IPI of 1 s. Images were acquired at 1.5 T using a gradient-echo echo-planar imaging sequence sensitive to blood oxygenation level-dependent (BOLD) contrast. Experiment 1 revealed that the HDR evoked by an auditory stimulus is followed by a refractory period of 4-6 s in the auditory cortex, as indicated by smaller HDR amplitudes to the second of each pair of stimuli. Furthermore, peak latency was dependent upon IPI, with longer latencies observed for shorter IPIs. Experiment 2 revealed that the HDR evoked in both sensory cortices by paired stimulus presentations is suppressed and delayed similarly by the refractory effects imposed by the preceding stimulus, suggesting similar refractory properties of the HDR at this specific IPI. We also provide evidence for additional neural resource allocation in response to repeated stimuli.     

Attentional modulation of oscillatory activity in human visual cortex

The effects of attentional modulation on activity within the human visual cortex were investigated using magnetoencephalography. Chromatic sinusoidal stimuli were used to evoke activity from the occipital cortex, with attention directed either toward or away from the stimulus using a bar-orientation judgment task. For five observers, global magnetic field power was plotted as a function of time from stimulus onset. The major peak of each function occurred at about 120 ms latency and was well modeled by a current dipole near the calcarine sulcus. Independent component analysis (ICA) on the non-averaged data for each observer also revealed one component of calcarine origin, the location of which matched that of the dipolar source determined from the averaged data. For two observers, ICA revealed a second component near the parieto-occipital sulcus. Although no effects of attention were evident using standard averaging procedures, time-varying spectral analyses of single trials revealed that the main effect of attention was to alter the level of oscillatory activity. Most notably, a sustained increase in alpha-band (7-12 Hz) activity of both calcarine and parieto-occipital origin was evident. In addition, calcarine activity in the range of 13-21 Hz was enhanced, while calcarine activity in the range of 5-6 Hz was reduced. Our results are consistent with the hypothesis that attentional modulation affects neural processing within the calcarine and parieto-occipital cortex by altering the amplitude of alpha-band activity and other natural brain rhythms.     

Comparison of the performance of the RF cross correlation and doppler autocorrelation technique to estimate the mean velocity of simulated ultrasound signals

In pulsed Doppler systems the received RF (radio frequency) signal is multiplied by a quadrature reference signal and subsequently averaged over a short depth range to obtain a sample of the complex Doppler signal. The mean frequency of the sampled Doppler signal, obtained with the autocorrelation function, reflects the mean velocity of the scatterers moving through the sample volume. An alternative is to evaluate the two-dimensional cross correlation function of a short segment of the RF signals over subsequent lines, giving the mean velocity of the scatterers. Both methods of velocity estimation were applied to computer-generated RF signals with varying RF bandwidth, signal-to-noise ratio, and mean and width of the imposed velocity distribution. The length of the RF signal segment and the number of lines for velocity estimation (package length) affects the accuracy of the velocity estimate. It can be concluded that the cross correlation technique behaves superiorly especially for a low velocity dispersion. Furthermore, the standard deviation of the velocity estimate decreases for an increasing sample volume length and package length, while the performance of the conventional Doppler technique is rather independent of the length of the sample volume. The difference between both techniques decreases for a greater package length or for signals simulating a wide velocity distribution.     

Localizing human visual gamma-band activity in frequency, time and space

Neuronal gamma-band (30-100 Hz) synchronization subserves fundamental functions in neuronal processing. However, different experimental approaches differ widely in their success in finding gamma-band activity. We aimed at linking animal and human studies of gamma-band activity and at preparing optimized methods for an in-depth investigation of the mechanisms and functions of gamma-band activity and gamma-band coherence in humans. In the first step described here, we maximized the signal-to-noise ratio with which we can observe visually induced gamma-band activity in human magnetoencephalographic recordings. We used a stimulus and task design that evoked strong gamma-band activity in animals and combined it with multi-taper methods for spectral analysis and adaptive spatial filtering for source analysis. With this approach, we found human visual gamma-band activity very reliably across subjects and across multiple recording sessions of a given subject. While increases in gamma-band activity are typically accompanied by decreases in alpha- and beta-band activity, the gamma-band enhancement was often the spectral component with the highest signal-to-noise ratio. Furthermore, some subjects demonstrated two clearly separate visually induced gamma bands, one around 40 Hz and another between 70 and 80 Hz. Gamma-band activity was sustained for the entire stimulation period, which was up to 3 s. The sources of gamma-band activity were in the calcarine sulcus in all subjects. The results localize human visual gamma-band activity in frequency, time and space and the described methods allow its further investigation with great sensitivity.     

Sustained activation of the human SII cortices by stimulus trains

To compare the functional properties of neurons in the human primary (SI) and secondary (SII) cortices, we recorded somatosensory-evoked fields (SEFs) from seven healthy subjects to single electric stimuli and stimulus trains delivered to the median nerve at 8--12 Hz. The SI and SII cortices responded strikingly differently to stimulus trains: whereas SI followed each stimulus with a sharp transient response up to at least 12 Hz, the transient responses were much less prominent at SII, which mainly responded with a sustained field that returned to base level at 800--1000 ms. The different response patterns of SI and SII suggest that the inhibition, following the early excitatory responses, is weaker at SII than SI, or that inhibitory responses of these two areas differ in their relative timing.     

正常老化对视皮层静息状态脑活动的影响

目的利用fMRI技术初步探讨年龄对人类视皮层静息状态活动的影响。方法10名健康青年志愿者及10名老年健康志愿者参加实验。任务通过听觉呈现。任务期要求受试者听汉语真词词组并作词语属性判断(具体或抽象)。静息期要求受试者闭眼、静卧,不做任何主动思维活动。利用SPM 2软件进行数据处理,采用反减法获得负激活图。结果两组受试者负激活脑区部位基本一致,主要包括扣带回后部/楔前叶(BA 7),前额叶中内侧(BA 32/10),两侧前额叶背外侧(BA 9),两侧顶下小叶(BA 39/40),两侧枕叶视皮层(BA 18/19),左侧基底节区及两侧岛叶(BA 13)。该负激活脑区模式与Raichle等提出的脑默认活动网络基本一致。进一步组间分析发现,老年人视皮层静息期fMR信号强度明显高于青年人组。结论本研究进一步验证了静息状态人脑默认活动假说,并发现静息状态时老年人视皮层活动比青年人活跃。     

Comparison of MR imaging against physical sectioning to estimate the volume of human cerebral compartments

The purpose of this study was to compare magnetic resonance imaging (MRI) against physical sectioning techniques to estimate the volume of human cerebral hemisphere compartments (cortex, subcortex, and their union, called "total"). The volume of these compartments was estimated postmortem for six human subjects from MRI virtual sections and from physical sections using the Cavalieri design with point counting. Cursory paired t tests revealed no significant differences between the two methods for any of the three compartments considered, although P = 0.06 for the subcortex. A sharper analysis incorporating recent error prediction formulae revealed a significant discrepancy between the two methods in the estimation of subcortex and total volume for three of the specimens. Yet, none of these analyses is adequate to detect possible biases. The incorporation of an explanatory variable, namely hemisphere weight, and the adoption of a specific gravity rho = 1.04 g/cm(3) for the material, enabled us to carry out an allometric analysis for the total compartment which revealed a significant bias of the MRI data. The new error prediction formulae are illustrated by way of example, and their accuracy is checked by a resampling experiment on a data set of 274 MRI sections.     

Activation of the human posterior parietal and temporoparietal cortices during audiotactile interaction

We recorded cortical-evoked responses with a whole-scalp neuromagnetometer to study human brain dynamics associated with audiotactile interaction. The subjects received unilateral auditory (A) or tactile (T) stimuli, or both stimuli simultaneously (AT), alternating to the left and right side. Responses to AT stimuli differed significantly from the algebraic sum of responses to A and T stimuli (A + T) at 75-85 and 105-130 ms and indicated suppressive audiotactile interaction. Source modeling revealed that the earlier interaction occurred in the contralateral posterior parietal cortex and the later interaction in the contralateral parietal opercula between the SII cortex and the auditory cortex. The interaction was significantly stronger in the left than the right hemisphere. In most subjects, AT responses were far more similar to T than to A responses, suggesting suppression of auditory processing during the spatially and temporally concordant audiotactile stimuli in which the tactile component was subjectively more salient.     

State-space models of impulse hemodynamic responses over motor,somatosensory, and visual cortices

The paper presents state space models of the hemodynamic response (HR) of fNIRS to an impulse stimulus in three brain regions: motor cortex (MC), somatosensory cortex (SC), and visual cortex (VC). Nineteen healthy subjects were examined. For each cortex, three impulse HRs experimentally obtained were averaged. The averaged signal was converted to a state space equation by using the subspace method. The activation peak and the undershoot peak of the oxy-hemoglobin (HbO) in MC are noticeably higher than those in SC and VC. The time-to-peaks of the HbO in three brain regions are almost the same (about 6.76 76 ± 0.2 s). The time to undershoot peak in VC is the largest among three. The HbO decreases in the early stage (~0.46 s) in MC and VC, but it is not so in SC. These findings were well described with the developed state space equations. Another advantage of the proposed method is its easy applicability in generating the expected HR to arbitrary stimuli in an online (or real-time) imaging. Experimental results are demonstrated.OCIS codes: (170.2655) Functional monitoring and imaging, (300.0300) Spectroscopy, (170.5380) Physiology, (100.2960) Image analysis     

高仿真模拟人在呼吸系统案例综合分析中的应用

[目的]强化呼吸系统常见疾病理论知识的学习及基本操作技能训练.[方法]在呼吸系统案例分析与操作过程中应用高仿真模拟人,设计5个场景,让护生在模拟人身上进行演示、现场分析、讨论.[结果]98％护生认为该方法强化了呼吸系统常见疾病的临床表现、诊治要点及护理等相关理论知识；99％护生认为能对呼吸系统疾病病人进行护理评估与病情观察,提高了观察能力、分析能力；96％护生认为掌握了呼吸系统常见基本操作技能；99％护生认为强化了基本护理技能和临床课之间的联系;98％护生认为培养了良好的团队合作和沟通技能.[结论]在临床实验教学中,采用高仿真模拟人进行案例分析与讨论能促进护生主动参与、积极学习、乐于探究、勤于动手.     

Variational Bayesian inversion of the equivalent current dipole model in EEG/MEG

In magneto- and electroencephalography (M/EEG), spatial modelling of sensor data is necessary to make inferences about underlying brain activity. Most source reconstruction techniques belong to one of two approaches: point source models, which explain the data with a small number of equivalent current dipoles and distributed source or imaging models, which use thousands of dipoles. Much methodological research has been devoted to developing sophisticated Bayesian source imaging inversion schemes, while dipoles have received less such attention. Dipole models have their advantages; they are often appropriate summaries of evoked responses or helpful first approximations. Here, we propose a variational Bayesian algorithm that enables the fast Bayesian inversion of dipole models. The approach allows for specification of priors on all the model parameters. The posterior distributions can be used to form Bayesian confidence intervals for interesting parameters, like dipole locations. Furthermore, competing models (e.g., models with different numbers of dipoles) can be compared using their evidence or marginal likelihood. Using synthetic data, we found the scheme provides accurate dipole localizations. We illustrate the advantage of our Bayesian scheme, using a multi-subject EEG auditory study, where we compare competing models for the generation of the N100 component.     

我院护理人力资源现状调查与分析

目的分析医院临床护理人力资源配置和使用的现状。方法采用国家卫生部2002年9月在上海举办的护理研讨会上提供的综合医院护士人力编制测算的方法,对照国家卫生部1978年颁布的《综合医院组织编制原则试行草案》对护理工作量及人力编制测算进行分析。结果护理人力资源配置存在不平衡和使用不合理的情况。结论科学测算护理人力编制可以保证临床护理人力资源的合理配置。     

安徽省临床护理人力资源配置现状的调查研究

目的了解安徽省护理人力资源现状,探讨以实际护理工作量为依据的护士人力配置标准。方法采用问卷调查和观察法先后对全省的109所医院和其中60所医院的400个临床病区进行调查。结果①护士缺编严重;②需要配置护士数与实际配置差距大;③医院级别越高,规模越大,床位使用率越高,护士缺编比例越大;④聘用制护士离岗率高,护理队伍不稳定;⑤高学历、高职称人员比例偏少;⑥临床护理质量令人担忧。结论科学合理的配置护士人力、提高护士素质是护理人力资源管理的重要内容。各级医院应根据实际护理工作量,合理配置,科学管理,改变目前护士缺编现状,确保临床护理安全。     

Reciprocal modulation of neuromagnetic induced gamma activity by attention in the human visual and auditory cortex

For attentional control of behavior, the brain permanently resolves a competition between the impressions supplied by different senses. Here, using a dual-modality temporal order detection task, we studied attentional modulation of oscillatory neuromagnetic activity in the human cerebral cortex. On each trial, after simultaneous exposure to visual and auditory noise, subjects were presented with an asynchronous pair of a visual and an auditory stimulus. Either of the two stimuli could occur first equally often, their order was not cued. Subjects had to determine the leading stimulus in a pair and attentively monitor it to respond upon its offset. With the attended visual or auditory stimuli, spectral power analysis revealed marked enhancements of induced gamma activity within 250 ms post-stimulus onset over the modality-specific cortices (occipital at 64 Hz, right temporal at 53 Hz). When unattended, however, the stimuli led to a significantly decreased (beneath baseline) gamma response in these cortical regions. The gamma decreases occurred at lower frequencies ( approximately 30 Hz) than did the gamma increases. An increase in the gamma power and frequency for the attended modality and their decrease for the unattended modality suggest that attentional regulation of multisensory processing involves reciprocal changes in synchronization of respective cortical networks. We assume that the gamma decrease reflects an active suppression of the task-irrelevant sensory input. This suppression occurs at lower frequencies, suggesting an involvement of larger scale cell assemblies.     

Comparison of immunoreactive renin and plasma renin activity in human plasma

Measurement of immunoreactive plasma renin concentration (PRC) using direct radioimmunoassay (RIA) was compared with the common procedure, measurement of plasma renin activity (PRA). The sensitivity of the PRC assay was 5 pg/ml. In 67 normal subjects aged 45.2 +/- 1.2 year, the mean PRC value was 17.0 +/- 0.9 pg/ml in the recumbent position and 38.0 +/- 5.4 pg/ml in the upright position. In patients with high renin essential hypertension and renovascular hypertension, discrepancies were observed between changes in PRA and PRC at 60 min after the administration of captopril. In a patient with Bartter's syndrome PRC was markedly elevated (393 pg/ml) and the changes in PRA and in PRC after captopril were very different (452% vs. 1249%). In all 10 cases of primary hyperaldosteronism PRC was less than 5 pg/ml. The correlation coefficient between PRC and PRA was 0.85 (n = 227, p less than 0.01). The slope of the regression line between PRA and PRC decreased in proportion to PRC values. Direct RIA for PRC is likely to be useful for the determination of plasma active renin when renin levels are high or substrate concentrations are abnormal. Moreover, the combined use of PRA and PRC measurements might be useful in assessing abnormalities in renin substrate concentration as well as in PRC.     

模拟失重状态下人体焦虑状况及心理状态调查分析

[目的]了解模拟失重状态下人体的焦虑状况及心理状态。[方法]应用状态-特质焦虑量表(STAI-FormX)以及症状自评量表(SCL-90),以第四军医大学航空航天医学系12名学员为调查对象,测量他们在模拟失重状态下的焦虑状况及心理状态。[结果]测试前后学员的焦虑程度比较,差异无统计学意义(P>0.05);症状自评量表中除躯体化症状方面外,12名测试者其他因子得分均低于常模,强迫症状、抑郁、焦虑、敌对及偏执因子与常模比较差异有统计学意义(P<0.05)。[结论]模拟失重状态下航空航天医学系学员具有较高的心理承受能力。