MEG Coherence and DTI Connectivity in mTLE

Magnetoencephalography (MEG) is a noninvasive imaging method for localization of focal epileptiform activity in patients with epilepsy. Diffusion tensor imaging (DTI) is a noninvasive imaging method for measuring the diffusion properties of the underlying white matter tracts through which epileptiform activity is propagated. This study investigates the relationship between the cerebral functional abnormalities quantified by MEG coherence and structural abnormalities quantified by DTI in mesial temporal lobe epilepsy (mTLE). Resting state MEG data was analyzed using MEG coherence source imaging (MEG-CSI) method to determine the coherence in 54 anatomical sites in 17 adult mTLE patients with surgical resection and Engel class I outcome, and 17 age- and gender- matched controls. DTI tractography identified the fiber tracts passing through these same anatomical sites of the same subjects. Then, DTI nodal degree and laterality index were calculated and compared with the corresponding MEG coherence and laterality index. MEG coherence laterality, after Bonferroni adjustment, showed significant differences for right versus left mTLE in insular cortex and both lateral orbitofrontal and superior temporal gyri (p < 0.017). Likewise, DTI nodal degree laterality, after Bonferroni adjustment, showed significant differences for right versus left mTLE in gyrus rectus, insular cortex, precuneus and superior temporal gyrus (p < 0.017). In insular cortex, MEG coherence laterality correlated with DTI nodal degree laterality (\(R^{2} = 0.46; p = 0.003)\) in the cases of mTLE. None of these anatomical sites showed statistically significant differences in coherence laterality between right and left sides of the controls. Coherence laterality was in agreement with the declared side of epileptogenicity in insular cortex (in 82 % of patients) and both lateral orbitofrontal (88 %) and superior temporal gyri (88 %). Nodal degree laterality was also in agreement with the declared side of epileptogenicity in gyrus rectus (in 88 % of patients), insular cortex (71 %), precuneus (82 %) and superior temporal gyrus (94 %). Combining all significant laterality indices improved the lateralization accuracy to 94 % and 100 % for the coherence and nodal degree laterality indices, respectively. The associated variations in diffusion properties of fiber tracts quantified by DTI and coherence measures quantified by MEG with respect to epileptogenicity possibly reflect the chronic microstructural cerebral changes associated with functional interictal activity. The proposed methodology for using MEG and DTI to investigate diffusion abnormalities related to focal epileptogenicity and propagation may provide a further means of noninvasive lateralization.     

Movement Kinematics Dynamically Modulates the Rolandic ~ 20-Hz Rhythm During Goal-Directed Executed and Observed Hand Actions

This study investigates whether movement kinematics modulates similarly the rolandic α and β rhythm amplitude during executed and observed goal-directed hand movements. It also assesses if this modulation relates to the corticokinematic coherence (CKC), which is the coupling observed between cortical activity and movement kinematics during such motor actions. Magnetoencephalography (MEG) signals were recorded from 11 right-handed healthy subjects while they performed or observed an actor performing the same repetitive hand pinching action. Subjects’ and actor’s forefinger movements were monitored with an accelerometer. Coherence was computed between acceleration signals and the amplitude of α (8–12 Hz) or β (15–25 Hz) oscillations. The coherence was also evaluated between source-projected MEG signals and their β amplitude. Coherence was mainly observed between acceleration and the amplitude of β oscillations at movement frequency within bilateral primary sensorimotor (SM1) cortex with no difference between executed and observed movements. Cross-correlation between the amplitude of β oscillations at the SM1 cortex and movement acceleration was maximal when acceleration was delayed by ~?100 ms, both during movement execution and observation. Coherence between source-projected MEG signals and their β amplitude during movement observation and execution was not significantly different from that during rest. This study shows that observing others’ actions engages in the viewer’s brain similar dynamic modulations of SM1 cortex β rhythm as during action execution. Results support the view that different neural mechanisms might account for this modulation and CKC. These two kinematic-related phenomena might help humans to understand how observed motor actions are actually performed.     

Independent Sources of Spontaneous BOLD Fluctuation Along the Visual Pathway

In resting-state functional magnetic resonance imaging (fMRI) experiments, correlation analysis can be used to identify clusters of cortical regions that may be functionally connected. Although such functional connectivity is often assumed to reflect cortico-cortical connections, a potential confound is the contribution of subcortical brain regions, many of which have strong anatomical connectivity to cortical regions and may also enable cortico-cortical interactions through trans-thalamic pathways. To investigate this, we performed resting state fMRI of the human visual system, including cortical regions and subcortical nuclei of the pulvinar and lateral geniculate. Regression analysis was used to investigate the dependence of the measured inter-regional correlations upon afferents from specific retinal, thalamic and cortical regions as well as systemic global signal fluctuation. A high level of inter-hemispheric correlation (cc = 0.95) was found in the visual cortex that could not be explained by activity in the subcortical nuclei investigated; in addition a relatively low level of inter-hemispheric correlation (cc = 0.39–0.42) was found in vision-related thalamic nuclei that could not be explained by direct anatomical connections or their cortical inputs. These findings suggest that spontaneous fMRI signal correlations within the human visual system originate from a mixture of independent signal sources that may be transmitted through thalamo-cortical, cortico-thalamic, and cortico-cortical connections either trans-callosal or trans-thalamic in origin. Our findings thus call for more cautious interpretation of resting state functional connectivity in terms of any single type of anatomical connectivity.     

Combined DTI–fMRI Analysis for a Quantitative Assessment of Connections Between WM Bundles and Their Peripheral Cortical Fields in Verbal Fluency

Diffusion tensor imaging (DTI) tractography and functional magnetic resonance imaging (fMRI) are powerful techniques to elucidate the anatomical and functional aspects of brain connectivity. However, integrating these approaches to describe the precise link between structure and function within specific brain circuits remains challenging. In this study, a novel DTI–fMRI integration method is proposed, to provide the topographical characterization and the volumetric assessment of the functional and anatomical connections within the language circuit. In a group of 21 healthy elderly subjects (mean age 68.5 ± 5.8 years), the volume of connection between the cortical activity elicited by a verbal fluency task and the cortico-cortical fiber tracts associated with this function are mapped and quantified. An application of the method to a case study in neuro-rehabilitation context is also presented. Integrating structural and functional data within the same framework, this approach provides an overall view of white and gray matter when studying specific brain circuits.     

Alternative Stimulation Intensities for Mapping Cortical Motor Area with Navigated TMS

Navigated transcranial magnetic stimulation (nTMS) is becoming a popular tool in pre-operative mapping of functional motor areas. The stimulation intensities used in the mapping are commonly suprathreshold intensities with respect to the patient’s resting motor threshold (rMT). There is no consensus on which suprathreshold intensity should be used nor on the optimal criteria for selecting the appropriate stimulation intensity (SI). In this study, the left motor cortices of 12 right-handed volunteers (8 males, age 24–61 years) were mapped using motor evoked potentials with an SI of 110 and 120 % of rMT and with an upper threshold (UT) estimated by the Mills–Nithi algorithm. The UT was significantly lower than 120 % of rMT (p < 0.001), while no significant difference was observed between UT and 110 % of rMT (p = 0.112). The representation sizes followed a similar trend, i.e. areas computed based on UT (5.9 cm²) and 110 % of rMT (5.0 cm²) being smaller than that of 120 % of rMT (8.8 cm²) (p ≤ 0.001). There was no difference in representation sizes between 110 % of rMT and UT. The variance in representation size was found to be significantly lower with UT compared to 120 % of rMT (p = 0.048, uncorrected), while there was no difference between 110 % of rMT and UT or 120 % of rMT. Indications of lowest inter-individual variation in representation size were observed with UT; this is possibly due to the fact that it takes into account the individual input–output characteristics of the motor cortex. Therefore, the UT seems to be a good option for SI in motor mapping applications to outline functional motor areas with nTMS and it could potentially reduce the inter-individual variation caused by the selection of SI in motor mapping in pre-surgical applications and radiosurgery planning.     

Transcranial magnetic stimulation--a new tool for functional imaging of the brain

Recent progress in the theory and technology of transcranial magnetic stimulation (TMS) is leading to novel approaches in brain mapping. TMS becomes a powerful functional brain mapping tool when other imaging methods are used to record TMS-evoked activity or when peripheral effects are observed as a function of stimulus location. TMS-evoked activity currently can be recorded by EEG, PET, and fMRI. In addition to providing indices of cortical excitability, these methods allow one to study brain connectivity directly, without the need for behavioral activations. When the coordinate systems in the different imaging modalities are combined, anatomical structures seen in MRI and activation sites determined by PET, fMRI, or MEG/EEG can be used for the selection of target areas in the brain. PET and fMRI can be used to map the spatial distribution of TMS-evoked activity. On the other hand, the combination of TMS and high-resolution EEG may often be the method of choice for basic neuroscience and for clinical diagnosis, for example, in the assessment of brain connectivity in patients suffering from neurodegenerative diseases or head injuries.     

Changes in the functional MR signal in motor and non-motor areas during intermittent fatiguing hand exercise

The aim of this study was to determine whether there were significant changes in the time course of the functional magnetic resonance imaging (fMRI) signal in motor and non-motor regions of both cerebral hemispheres during a unilateral fatiguing exercise of the hand. Twelve subjects performed a submaximal (30%) intermittent fatiguing handgrip exercise (3 s grip, 2 s release, left hand) for ∼9 min during fMRI scanning. Regression analysis was used to measure changes in fMRI signal from primary sensorimotor cortex (SM1), premotor cortex and visual cortex (V1) in both hemispheres. Force declined to 77 ± 3.6% of prefatigue maximal force (P < 0.05). The fMRI signal from SM1 contralateral to the fatiguing hand increased by 1.2 ± 0.5% of baseline (P < 0.05). The fMRI signal from the ipsilateral SM1 did not change significantly. Premotor cortex showed a similar pattern but did not reach significance. The signal from V1 increased significantly for both hemispheres (contralateral 1.3 ± 0.9%, ipsilateral 1.5 ± 0.9% of baseline and P < 0.05). During the performance of a unimanual, submaximal fatiguing exercise there is an increase in activation of motor and non-motor regions. The results are in keeping with the notion of an increase in sensory processing and corticomotor drive during fatiguing exercise to maintain task performance as fatigue develops.     

Integrated MEG/fMRI Model Validated Using Real Auditory Data

The main objective of this paper is to present methods and results for the estimation of parameters of our proposed integrated magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI) model. We use real auditory MEG and fMRI datasets from 7 normal subjects to estimate the parameters of the model. The MEG and fMRI data were acquired at different times, but the stimulus profile was the same for both techniques. We use independent component analysis (ICA) to extract activation-related signal from the MEG data. The stimulus-correlated ICA component is used to estimate MEG parameters of the model. The temporal and spatial information of the fMRI datasets are used to estimate fMRI parameters of the model. The estimated parameters have reasonable means and standard deviations for all subjects. Goodness of fit of the real data to our model shows the possibility of using the proposed model to simulate realistic datasets for evaluation of integrated MEG/fMRI analysis methods.     

Altered cortical and subcortical local coherence in obstructive sleep apnea: a functional magnetic resonance imaging study

Obstructive sleep apnea (OSA) syndrome is the most common sleep‐related breathing disorder, characterized by excessive snoring and repetitive apneas and arousals, which leads to fragmented sleep and, most importantly, to intermittent nocturnal hypoxaemia during apneas. Considering previous studies about morphovolumetric alterations in sleep apnea, in this study we aimed to investigate for the first time the functional connectivity profile of OSA patients and age–gender–matched healthy controls, using resting‐state functional magnetic resonance imaging (fMRI). Twenty severe OSA patients (mean age 43.2 ± 8 years; mean apnea–hypopnea index, 36.3 h^?1) and 20 non‐apneic age–gender–body mass index (BMI)‐matched controls underwent fMRI and polysomnographic (PSG) registration, as well as mood and sleepiness evaluation. Cerebro‐cerebellar regional homogeneity (ReHo) values were calculated from fMRI acquisition, in order to identify pathology‐related alterations in the local coherence of low‐frequency signal (<0.1 Hz). Multivariate pattern classification was also performed using ReHo values as features. We found a significant pattern of cortical and subcortical abnormal local connectivity in OSA patients, suggesting an overall rearrangement of hemispheric connectivity balance, with a decrease of local coherence observed in right temporal, parietal and frontal lobe regions. Moreover, an increase in bilateral thalamic and somatosensory/motor cortices coherence have been found, a finding due possibly to an aberrant adaptation to incomplete sleep–wake transitions during nocturnal apneic episodes, induced by repetitive choke sensation and physical efforts attempting to restore breathing. Different hemispheric roles into sleep processes and a possible thalamus key role in OSA neurophysiopathology are intriguing issues that future studies should attempt to clarify.     

Comparison of Brain Networks During Interictal Oscillations and Spikes on Magnetoencephalography and Intracerebral EEG

Electromagnetic source localization in electroencephalography (EEG) and magnetoencephalography (MEG) allows finding the generators of transient interictal epileptiform discharges (‘interictal spikes’). In intracerebral EEG (iEEG), oscillatory activity (above 30 Hz) has also been shown to be a marker of neuronal dysfunction. Still, the difference between networks involved in transient and oscillatory activities remains largely unknown. Our goal was thus to extract and compare the networks involved in interictal oscillations and spikes, and to compare the non-invasive results to those obtained directly within the brain. In five patients with both MEG and iEEG recordings, we computed correlation graphs across regions, for (1) interictal spikes and (2) epileptic oscillations around 30 Hz. We show that the corresponding networks can involve a widespread set of regions (average of 10 per patient), with only partial overlap (38 % of the total number of regions in MEG, 50 % in iEEG). The non-invasive results were concordant with intracerebral recordings (79 % for the spikes and 50 % for the oscillations). We compared our interictal results to iEEG ictal data. The regions labeled as seizure onset zone (SOZ) belonged to interictal networks in a large proportion of cases: 75 % (resp. 58 %) for spikes and 58 % (resp. 33 %) for oscillations in iEEG (resp. MEG). A subset of SOZ regions were detected by one type of discharges but not the other (25 % for spikes and 8 % for oscillations). Our study suggests that spike and oscillatory activities involve overlapping but distinct networks, and are complementary for presurgical mapping.     

Reliability and Validity of Functional Neuroimaging Techniques for Identifying Language-Critical Areas in Children and Adults

Advances in neuroimaging technologies over the last 15 years have prompted their relatively widespread use in the study of brain mechanisms supporting language function in children and adults. We reviewed reliability and external validity studies of 3 of the most common functional imaging methods, functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), and positron emission tomography (PET). Although reliability and validity reports for fMRI are generally quite favorable, significant variability was found across studies with respect to methodology, preventing in some cases either the assessment of the reliability of individual datasets, or cross-study comparisons. Reliability and validity reports of MEG are strong, yet methodological questions regarding optimal modeling techniques remain. PET investigators report good concordance of language maps with data from more invasive brain mapping techniques, but its use of radioactive tracers and poorer spatial and temporal resolution make it the least optimal of the 3 methods for language mapping. Investigations of the cortical networks supporting language function during development and into adulthood should be viewed in the context of the validity and reliability of the methods used, with careful attention to details regarding the methodologies employed in the acquisition and analysis of statistical maps.     

Reliability and validity of functional neuroimaging techniques for identifying language-critical areas in children and adults

Advances in neuroimaging technologies over the last 15 years have prompted their relatively widespread use in the study of brain mechanisms supporting language function in children and adults. We reviewed reliability and external validity studies of 3 of the most common functional imaging methods, functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), and positron emission tomography (PET). Although reliability and validity reports for fMRI are generally quite favorable, significant variability was found across studies with respect to methodology, preventing in some cases either the assessment of the reliability of individual datasets, or cross-study comparisons. Reliability and validity reports of MEG are strong, yet methodological questions regarding optimal modeling techniques remain. PET investigators report good concordance of language maps with data from more invasive brain mapping techniques, but its use of radioactive tracers and poorer spatial and temporal resolution make it the least optimal of the 3 methods for language mapping. Investigations of the cortical networks supporting language function during development and into adulthood should be viewed in the context of the validity and reliability of the methods used, with careful attention to details regarding the methodologies employed in the acquisition and analysis of statistical maps.     

High-frequency neural activity and human cognition: Past, present and possible future of intracranial EEG research

Human intracranial EEG (iEEG) recordings are primarily performed in epileptic patients for presurgical mapping. When patients perform cognitive tasks, iEEG signals reveal high-frequency neural activities (HFAs, between around 40Hz and 150Hz) with exquisite anatomical, functional and temporal specificity. Such HFAs were originally interpreted in the context of perceptual or motor binding, in line with animal studies on gamma-band ('40Hz') neural synchronization. Today, our understanding of HFA has evolved into a more general index of cortical processing: task-induced HFA reveals, with excellent spatial and time resolution, the participation of local neural ensembles in the task-at-hand, and perhaps the neural communication mechanisms allowing them to do so. This review promotes the claim that studying HFA with iEEG provides insights into the neural bases of cognition that cannot be derived as easily from other approaches, such as fMRI. We provide a series of examples supporting that claim, drawn from studies on memory, language and default-mode networks, and successful attempts of real-time functional mapping. These examples are followed by several guidelines for HFA research, intended for new groups interested by this approach. Overall, iEEG research on HFA should play an increasing role in cognitive neuroscience in humans, because it can be explicitly linked to basic research in animals. We conclude by discussing the future evolution of this field, which might expand that role even further, for instance through the use of multi-scale electrodes and the fusion of iEEG with MEG and fMRI.     

Whole-Brain Haemodynamic After-Effects of 1-Hz Magnetic Stimulation of the Posterior Superior Temporal Cortex During Action Observation

The posterior superior temporal sulcus (pSTS) is active when observing biological motion. We investigated the functional connections of the pSTS node within the action observation network by measuring the after-effect of focal repetitive transcranial magnetic stimulation (rTMS) with whole-brain functional magnetic resonance imaging (fMRI). Participants received 1-Hz rTMS over the pSTS region for 10 min and underwent fMRI immediately after. While scanned, they were shown short video clips of a hand grasping an object (grasp clips) or moving next to it (control clips). rTMS–fMRI was repeated for four consecutive blocks. In two blocks we stimulated the left pSTS region and in the other two the right pSTS region. For each side TMS was applied with an effective intensity (95 % of motor threshold) or with ineffective intensity (50 % of motor threshold). Brain regions showing interactive effects of (clip type) × (TMS intensity) were identified in the lateral temporo-occipital cortex, in the anterior intraparietal region and in the ventral premotor cortex. Remote effects of rTMS were mostly limited to the stimulated hemisphere and consisted in an increase of blood oxygen level-dependent responses to grasp clips compared to control clips. We show that the pSTS occupies a pivotal relay position during observation of goal-directed actions.     

Localization of Broca's area using verb generation tasks in the MEG: Validation against fMRI

Functional MRI (fMRI) is routinely used to non-invasively localize language areas. Magnetoencephalography (MEG) is being explored as an alternative technique. MEG tasks to localize receptive language are well established although there are no standardized tasks to localize expressive language areas. We developed two expressive language tasks for MEG and validated their localizations against fMRI data. Ten right-handed adolescents (μ = 17.5 years) were tested with fMRI and MEG on two tasks: verb generation to pictures and verb generation to words. MEG and fMRI data were normalized and overlaid. The number of overlapping voxels activated in fMRI and MEG were counted for each subject, for each task, at different thresholding levels. For picture verb generation, there was 100% concordance between MEG and fMRI lateralization, and for word verb generation, there was 75% concordance. A count showed 79.6% overlap of voxels activated by both MEG and fMRI for picture verb generation and 50.2% overlap for word verb generation. The percentage overlap decreased with increasingly stringent activation thresholds. Our novel MEG expressive language tasks successfully identified neural regions involved in language production and showed high concordance with fMRI laterality. Percentage overlap of activated voxels was also high when validated against fMRI, but showed task-specific and threshold-related effects. The high concordance and high percentage overlap between fMRI and MEG activations confirm the validity of our new MEG task. Furthermore, the higher concordance from the picture verb generation task suggests that this is a promising task for use in the young clinical population.     

Multimodal neuroimaging in humans at 9.4 T: a technological breakthrough towards an advanced metabolic imaging scanner

The aim of this paper is twofold: firstly, to explore the potential of simultaneously acquiring multimodal MR–PET–EEG data in a human 9.4 T scanner to provide a platform for metabolic brain imaging. Secondly, to demonstrate that the three modalities are complementary, with MRI providing excellent structural and functional imaging, PET providing quantitative molecular imaging, and EEG providing superior temporal resolution. A 9.4 T MRI scanner equipped with a PET insert and a commercially available EEG device was used to acquire in vivo proton-based images, spectra, and sodium- and oxygen-based images with MRI, EEG signals from a human subject in a static 9.4 T magnetic field, and demonstrate hybrid MR–PET capability in a rat model. High-resolution images of the in vivo human brain with an isotropic resolution of 0.5 mm and post-mortem brain images of the cerebellum with an isotropic resolution of 320 µm are presented. A ¹H spectrum was also acquired from 2 × 2 × 2 mm voxel in the brain allowing 12 metabolites to be identified. Imaging based on sodium and oxygen is demonstrated with isotropic resolutions of 2 and 5 mm, respectively. Auditory evoked potentials measured in a static field of 9.4 T are shown. Finally, hybrid MR–PET capability at 9.4 T in the human scanner is demonstrated in a rat model. Initial progress on the road to 9.4 T multimodal MR–PET–EEG is illustrated. Ultra-high resolution structural imaging, high-resolution images of the sodium distribution and proof-of-principle ¹⁷O data are clearly demonstrated. Further, simultaneous MR–PET data are presented without artefacts and EEG data successfully corrected for the cardioballistic artefact at 9.4 T are presented.     

Evidence for interhemispheric processing of inputs from the hands in human S2 and PV

In the present investigation, we identified cortical areas involved in the integration of bimanual inputs in human somatosensory cortex. Using functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG), we compared the responses to unilateral versus bilateral stimulation in anterior parietal cortex and areas in the Sylvian fissure of the contralateral hemisphere. The extent of fMRI activation on the upper bank of the Sylvian fissure, in the second somatosensory (S2) and the parietal ventral (PV) areas, was significantly larger for bilateral stimulation than for unilateral stimulation. Using MEG, we were able to describe the latency of response in S1 and S2/PV to unilateral and bilateral stimulation. The MEG response had three components under both stimulus conditions. An early peak in S1 at 40 ms, a middle peak in S2/PV at 80-160 ms, and three late peaks in S2/PV at 250-420 ms. There was an increase in magnetic field strength in S2/PV to bilateral stimulation at 300-400 ms post stimulus. The fMRI results indicate that, as in monkeys, S2/PV receives inputs from both the contralateral and ipsilateral hand. The MEG data suggest that information is processed serially from S1 to S2. The very late response in S2/PV indicates that extensive intrahemispheric processing occurs before information is transferred to the opposite hemisphere. The neural substrate for the increased activation and field strength at long latencies during bilateral stimulation can be accounted for in three ways. Under bilateral stimulus conditions, more neurons may be active, neuronal firing rate may increase, and/or neural activity may be more synchronous.     

A Dedicated Tool for Presurgical Mapping of Brain Tumors and Mixed-Reality Navigation During Neurosurgery

Brain tumor surgery requires a delicate tradeoff between complete removal of neoplastic tissue while minimizing loss of brain function. Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) have emerged as valuable tools for non-invasive assessment of human brain function and are now used to determine brain regions that should be spared to prevent functional impairment after surgery. However, image analysis requires different software packages, mainly developed for research purposes and often difficult to use in a clinical setting, preventing large-scale diffusion of presurgical mapping. We developed a specialized software able to implement an automatic analysis of multimodal MRI presurgical mapping in a single application and to transfer the results to the neuronavigator. Moreover, the imaging results are integrated in a commercially available wearable device using an optimized mixed-reality approach, automatically anchoring 3-dimensional holograms obtained from MRI with the physical head of the patient. This will allow the surgeon to virtually explore deeper tissue layers highlighting critical brain structures that need to be preserved, while retaining the natural oculo-manual coordination. The enhanced ergonomics of this procedure will significantly improve accuracy and safety of the surgery, with large expected benefits for health care systems and related industrial investors.

     

脑磁图在大脑感觉运动功能区占位性病变患者中的应用

目的：探讨脑磁图（MEG）在大脑皮层感觉、运动功能区占位性病变患者中的应用价值.方法：对81例大脑皮层感觉和（或）运动功能区及其附近占位性病变患者,应用151信道全头型MEG系统,通过电流刺激正中神经和胫神经确定上、下肢体感皮层的位置,运动皮层分别通过双手食指按压键盘引起的MEG反应来定位.术前将磁源性影像（MSI）通过神经影像导航进行三维重建,了解相应功能区与病变的解剖关系,设计手术入路.感觉功能区病变患者和运动功能区不能确定的患者术中通过电刺激正中神经（或胫神经内踝）使用皮层电极于拟定的中央沟前后的皮层记录体感诱发电位（CSEP）,依据中央沟前后皮层记录到的CSEP具有极性反转的特征来确定中央沟.其中8例患者通过对指运动行功能磁共振（fMRI）检查,在术中唤醒状态下通过电刺激大脑皮层确定运动功能区.结果：81例患者全部定位出感觉功能区,75例患者定位出运动功能区,6例患者因功能障碍或配合差运动功能区不能定位.术后1例患者病变对侧肢体运动障碍加重,其余80例患者无感觉、运动功能损害.结论：术前行MEG功能区定位有助于医生选择合适的手术入路和避免术中损伤脑功能区皮质,最大限度地保护神经功能,减少手术伤残率,提高手术疗效.     

Age and aerobic training status effects on plasma and skeletal muscle tPA and PAI-1

Introduction

Reductions in fibrinolytic potential occur with both aging and physical inactivity and are associated with an increased cardiovascular disease risk. Plasmin, the enzyme responsible for the enzymatic degradation of fibrin clots, is activated by tissue plasminogen activator (tPA), while plasminogen activator inhibitor-1 (PAI-1) inhibits its activation. Currently, fibrinolysis research focuses almost exclusively on changes within the plasma. However, tPA and PAI-1 are expressed by human skeletal muscle (SM). Currently, no studies have focused on changes in SM fibrinolytic activity with regard to aging and aerobic fitness.

Purpose

The purpose of this study was to cross-sectionally evaluate effects of age and aerobic fitness on tPA and PAI-1 expressions and activity in SM.

Methods

Twenty-six male subjects were categorized into the following groups: (1) young aerobically trained (n = 8); (2) older aerobically trained (n = 6); (3) young aerobically untrained (n = 7); and (4) older aerobically untrained (n = 5). Muscle biopsies were obtained from each subject. SM tPA activity was assessed using gel zymography and SM tPA and PAI-1 expressions were assessed using RT-PCR.

Results

Trained subjects had higher SM tPA activity compared to untrained (25.3 ± 2.4 × 10³ vs. 21.5 ± 5.6 × 10³ pixels, respectively; p = 0.03) with no effect observed for age. VO_{2 max} and SM tPA activity were also significantly correlated (r = 0.42; p < 0.04). SM tPA expression was higher in older participants, but no effect of fitness level was observed. No differences were observed for PAI-1 expression in SM.

Conclusions

Higher levels of aerobic fitness are associated with increased fibrinolytic activity in SM.