Medial temporal lobe involvement in an implicit memory task: evidence of collaborating implicit and explicit memory systems from FMRI and Alzheimer's disease

We used a prototype extraction task to assess implicit learning of a meaningful novel visual category. Cortical activation was monitored in young adults with functional magnetic resonance imaging. We observed occipital deactivation at test consistent with perceptually based implicit learning, and lateral temporal cortex deactivation reflecting implicit acquisition of the category's semantic nature. Medial temporal lobe (MTL) activation during exposure and test suggested involvement of explicit memory as well. Behavioral performance of Alzheimer's disease (AD) patients and healthy seniors was also assessed, and AD performance was correlated with gray matter volume using voxel-based morphometry. AD patients showed learning, consistent with preserved implicit memory, and confirming that AD patients' implicit memory is not limited to abstract patterns. However, patients were somewhat impaired relative to healthy seniors. Occipital and lateral temporal cortical volume correlated with successful AD patient performance, and thus overlapped with young adults' areas of deactivation. Patients' severe MTL atrophy precluded involvement of this region. AD patients thus appear to engage a cortically based implicit memory mechanism, whereas their relative deficit on this task may reflect their MTL disease. These findings suggest that implicit and explicit memory systems collaborate in neurologically intact individuals performing an ostensibly implicit memory task.     

Evaluation of changes in motor and visual functional activation over time following moderate-to-severe brain injury

Primary objective: Relatively little research has documented functional recovery following traumatic brain injury using neuroimaging techniques. This study aimed to examine the effects of moderate-to-severe brain injury on brain functioning over time.

Research design: Eight brain-injured participants completed motor and visual tasks during fMRI at two time points within the first year following injury. Changes in functional activation within ROIs and in dispersion of activation were evaluated across time points.

Main outcomes and results: Participants demonstrated significantly reduced activation intensity within the ROI over time for the motor task, but not the RPS task. Participants demonstrated a (non-significant) trend toward reduced functional dispersion over time. Most participants demonstrated greater activation within (vs outside) the ROI for both tasks. Variability among participants, in terms of activation intensity and dispersion, was evident.

Conclusions: The findings provide support for the occurrence of functional recovery over the first year post-injury, with fewer resources utilized during task completion over time. Additionally, results suggest that variability in functional activation and activation in brain regions typically activated among controls could be anticipated in a moderate-severe TBI group. Lastly, simple motor and visual tasks may be useful in efforts to demonstrate functional recovery over time.     

Dynamic changes in the medial temporal lobe during incidental learning of object-location associations

The role of the medial temporal lobe (MTL) in associative memory encoding has been the focus of many memory experiments. However, there has been surprisingly little investigation of whether the contributions of different MTL subregions (amygdala, hippocampus [HPC], parahippocampal [PHc], perirhinal cortex [PRc], and temporal polar cortex [TPc]) shift across multiple presentations during associative encoding. We examined this issue using event-related functional magnetic resonance imaging and a multivoxel pattern classification analysis. Subjects performed a visual search task, becoming faster with practice to locate objects whose locations were held constant across trials. The classification analysis implicated right HPC and amygdala early in the task when the speed-up from trial to trial was greatest. The same analysis implicated right PRc and TPc late in learning when speed-up was minimal. These results suggest that associative encoding relies on complex patterns of neural activity in MTL that cannot be expressed by simple increases or decreases of blood oxygenation level-dependent signal during learning. Involvement of MTL subregions during encoding of object-location associations depends on the nature of the learning phase. Right HPC and amygdala support active integration of object and location information, while right PRc and TPc are involved when object and spatial representations become unitized into a single representation.     

The neural basis of visual skill learning: an fMRI study of mirror reading

The learning of perceptual skills is thought to rely upon multiple regions in the cerebral cortex, but imaging studies have not yet provided evidence about the changes in neural activity that accompany visual skill learning. Functional magnetic resonance imaging (fMRI) was used to examine changes in activation of posterior brain regions associated with the acquisition of mirror-reading skill for novel and practiced stimuli. Multiple regions in the occipital lobe, inferior temporal cortex, superior parietal cortex and cerebellum were involved in the reading of mirror-reversed compared to normally oriented text. For novel stimuli, skilled mirror-reading was associated with decreased activation in the right superior parietal cortex and posterior occipital regions and increased activation in the left inferior temporal lobe. These results suggest that learning to read mirror- reversed text involves a progression from visuospatial transformation to direct recognition of transformed letters. Reading practiced, relative to unpracticed, stimuli was associated with decreased activation in occipital visual cortices, inferior temporal cortex and superior parietal cortex and increased activation in occipito-parietal and lateral temporal regions. By examining skill learning and item- specific repetition priming in the same task, this study demonstrates that both of these forms of learning exhibit shifts in the set of neural structures that contribute to performance.      

Longitudinal structure-function correlates in elderly reveal MTL dysfunction with cognitive decline

By integrating behavioral measures and imaging data, previous investigations have explored the relationship between biological markers of aging and cognitive functions. Evidence from functional and structural neuroimaging has revealed that hippocampal volume and activation patterns in the medial temporal lobe (MTL) may predict cognitive performance in old age. Most past demonstrations of age-related differences in brain structure-function were based on cross-sectional comparisons. Here, the relationship between 6-year intraindividual change in functional magnetic resonance imaging (fMRI) signal and change in memory performance over 2 decades was examined. Correlations between intraindividual change in fMRI signal during episodic encoding and change in memory performance measured outside of scanning were used as an estimate for relating brain-behavior changes. The results revealed a positive relationship between activation change in the hippocampus (HC) and change in memory performance, reflecting reduced hippocampal activation in participants with declining performance. Using a similar analytic approach as for the functional data, we found that individuals with declining performance had reduced HC volume compared with individuals with intact performance. These observations provide a strong link between cognitive change in older adults and MTL structure and function and thus provide insights into brain correlates of individual variability in aging trajectories.     

A case of intracerebral epidermoid associated with aspergillosis]

A case of intracerebral epidermoid associated with aspergillosis, which spread from the middle ear to the left temporal lobe, is reported. A 58-year-old woman was admitted on 6 June 1988, complaining of left temporalgia and motor aphasia. She had suffered from lt. chronic otitis media with cholesteatoma and had undergone a radical operation 11 years previously. CT scan revealed low density area with a mass effect in lt. temporal lobe. Bone image coronal CT scan revealed destruction of the roof of the pyramidal bone had resulted in communication between abscess cavity and external auditory meatus. On MRI scan lt. temporal lobe showed low signal intensity on T1WI, and high signal intensity on T2WI. In spite of strong antibiotic chemotherapy, mass effect on CT scan showed no sign of improvement. We performed total removal of the abscess on 15 July 1987. A number of characteristic aspergillus hyphae were recognized in the resected cyst. As the cyst wall consisted of keratinising squamous epithelium intermingled with granulation tissue, we had a diagnosis of epidermoid cyst. The diagnosis of epidermoid associated with aspergillosis was difficult. CT findings of epidermoid in general, show homogeneous low density without enhancement, but, in our case, CT scan showed heterogeneous low density area with capsular high dense. MRI of epidermoid usually shows a low signal intensity on T1WI, but our case showed iso-low signal intensity on T1WI. In spite of a poor prognosis of aspergillosis of the CNS, our patient has recovered well due to receiving prompt surgical treatment.     

Activation of Human Prefrontal Cortex during Spatial and Nonspatial Working Memory Tasks Measured by Functional MRI

Separate working memory domains for spatial location, and forobjects, faces, and patterns, have been identified in the prefrontalcortex (PFC) of nonhuman primates. We have used functional magneticresonance imaging to examine whether spatial and nonspatialvisual working memory processes are similarly dissociable inhuman PFC. Subjects performed tasks which required them to remembereither the location or shape of successive visual stimuli. Wefound that the mnemonic component of the working memory tasksaffected the hemispheric pattern of PFC activation. The spatial(LOCATION) working memory task preferentially activated themiddle frontal gyrus (MFG) in the right hemisphere, while thenonspatial (SHAPE) working memory task activated the NIFG inboth hemispheres. Furthermore, the area of activation in theleft hemisphere extended into the inferior frontal gyrus forthe nonspatial SHAPE task. A perceptual target (DOT) detectiontask also activated the MFG bilaterally, but at a level approximatelyhalf that of the working memory tasks. The activation in theMFG occurred within 3–6 s of task onset and declined followingtask offset. Time-course analysis revealed a different patternfor the cingulate gyrus, in which activation occurred upon taskcompletion. Cingulate activation was greatest following theSHAPE task and was greater in the left hemisphere. The presentresults support the prominent role of the PFC and, specifically,the MFG in working memory, and indicate that the mnemonic contentof the task affects the relative weighting of hemispheric activation.     

Distinct patterns of functional and effective connectivity between perirhinal cortex and other cortical regions in recognition memory and perceptual discrimination

Traditionally, the medial temporal lobe (MTL) is thought to be dedicated to declarative memory. Recent evidence challenges this view, suggesting that perirhinal cortex (PrC), which interfaces the MTL with the ventral visual pathway, supports highly integrated object representations in recognition memory and perceptual discrimination. Even with comparable representational demands, perceptual and memory tasks differ in numerous task demands and the subjective experience they evoke. Here, we tested whether such differences are reflected in distinct patterns of connectivity between PrC and other cortical regions, including differential involvement of prefrontal control processes. We examined functional magnetic resonance imaging data for closely matched perceptual and recognition memory tasks for faces that engaged right PrC equivalently. Multivariate seed analyses revealed distinct patterns of interactions: Right ventrolateral prefrontal and posterior cingulate cortices exhibited stronger functional connectivity with PrC in recognition memory; fusiform regions were part of the pattern that displayed stronger functional connectivity with PrC in perceptual discrimination. Structural equation modeling revealed distinct patterns of effective connectivity that allowed us to constrain interpretation of these findings. Overall, they demonstrate that, even when MTL structures show similar involvement in recognition memory and perceptual discrimination, differential neural mechanisms are reflected in the interplay between the MTL and other cortical regions.     

开放式肩袖修复术后0．2％与0．3％的罗哌卡因行连续肌间沟镇痛对手术后镇痛和运动功能影响的比较

背景肌间沟镇痛是一种公认的肩部大手术的术后镇痛方法,但最有效的局麻药浓度仍有争议。本研究比较术后48小时肌间沟导管连续输注0．2％和0．3％的罗哌卡因的镇痛效果及不良反应。方法80例择期开放肩袖修复术患者随机分入两组中,通过肌间沟导管以14ml／h速率连续输注0．2％或0．3％罗哌卡因,所有患者术前给予0．5％的罗哌卡因40ml作为负荷量。由对分组盲态的麻醉医师进行疼痛评分（视觉模拟评分0-100）、运动阻滞强度、术后首夜睡眠质量、吗啡用量和患者满意度等方面的评估。结果0．3％罗哌卡因组中吗啡用量明显减少（12mg和30mg）、睡眠质量更佳（术后首夜觉醒率4％和27％）,握力、视觉模拟评分以及不良反应两组间相似。结论开放式肩袖手术术后48小时,通过肌间沟导管输注0．3％罗哌卡因不增加运动阻滞强度和不良反应,且吗啡用量明显减少,术后首夜睡眠质量改善。     

Category-specific naming deficit identified by intraoperative stimulation mapping and postoperative neuropsychological testing. Case report

Category-specific naming deficits and differential brain activation patterns have been reported in patients naming living as opposed to nonliving objects. The authors report on a case in which they used preoperative functional magnetic resonance (fMR) imaging, intraoperative electrocortical stimulation mapping (ESM), and postoperative neuropsychological testing to map language function. Using the latter two modalities, the authors identified a specific locus for category-specific naming in the posterior inferior temporal lobe, presumably a part of the basal temporal language area. Preoperative fMR imaging findings revealed the presence of a language area in the inferior temporal lobe; intraoperative ESM results indicated that this cortical area may be category specific for living objects; and after resection of the area, the results of postoperative neuropsychological testing confirmed that the patient made significantly more errors while naming living objects compared with nonliving ones (p < 0.001), independent of the effects of word frequency and with an intact system of object recognition and comprehension. These authors are the first to identify a specific and well-localized area of category-specific naming in the inferior temporal lobe and to demonstrate congruence of intraoperative and postoperative category-specific naming deficits. They also emphasize the roles of preoperative and intraoperative testing in predicting clinical outcomes.     

Neuroradiological and electroencephalographic features in a case of temporal lobe status epilepticus

A patient with medically intractable status epilepticus of temporal lobe origin is presented. A computed tomogram showed a low density area adjacent to the midbrain, possibly related to atrophy of the medial temporal lobe. Cerebral angiography revealed early filling veins and an anterior temporal blush. Magnetic resonance (MR) scanning (T2 weighted images) showed increased signal intensity in the region of the amygdala and anterolateral left temporal lobe. Ictal activity was recorded from scalp electrodes over the left temporal area, and many paroxysms were recorded from cortical surface electrodes. An anterior temporal lobectomy revealed only gliosis. The cerebral blood flow changes accompanying status epilepticus of focal origin are reviewed, and a possible relation of electroencephalographic, angiographic, and MR findings is discussed.     

Nocturnal Olfactory Stimulation for Improvement of Sleep Quality in Patients With Posttraumatic Stress Disorder: A Randomized Exploratory Intervention Trial

Posttraumatic stress disorder (PTSD) is characterized by sleep impairment and nightmares. As pleasant odors presented during sleep affect the emotional tone of dreams without inducing arousal, we investigated whether sleep patterns in PTSD can be improved via nocturnal olfactory stimulation. Participants were 40 inpatients with PTSD (n = 35 women; age range: 20–59 years) who completed a randomized, patient‐blind, placebo‐controlled trial. Baseline measurement for 5 consecutive nights was followed by a 5‐night experimental intervention or placebo trial. During the intervention, patients received nocturnal stimulation with a pleasant odor (odor condition) or clean air (placebo condition) via an olfactometer that delivered inspiration‐triggered stimuli in a nasal tube or via an odorized nasal clip. After each night, the patients completed standardized questionnaires that assessed sleep parameters and dream content. Each night, sleep efficiency, sleep onset latency, and wakefulness after sleep onset were monitored with a motion biosensor. Baseline assessment revealed that PTSD severity was associated with poorer sleep outcomes. An interaction effect showed that nocturnal odorization affected dream intensity. Post hoc tests revealed an improvement in the group that used the nasal clip as compared to baseline, d = 0.68. No negative effects were observed after odorization with the nasal clip. Considering the limited sample size, the study indicates that nocturnal olfactory stimulation may serve as a low‐cost concomitant intervention to improve sleep quality in PTSD.     

Distinct causal influences of parietal versus frontal areas on human visual cortex: evidence from concurrent TMS-fMRI

It has often been proposed that regions of the human parietal and/or frontal lobe may modulate activity in visual cortex, for example, during selective attention or saccade preparation. However, direct evidence for such causal claims is largely missing in human studies, and it remains unclear to what degree the putative roles of parietal and frontal regions in modulating visual cortex may differ. Here we used transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) concurrently, to show that stimulating right human intraparietal sulcus (IPS, at a site previously implicated in attention) elicits a pattern of activity changes in visual cortex that strongly depends on current visual context. Increased intensity of IPS TMS affected the blood oxygen level-dependent (BOLD) signal in V5/MT+ only when moving stimuli were present to drive this visual region, whereas TMS-elicited BOLD signal changes were observed in areas V1-V4 only during the absence of visual input. These influences of IPS TMS upon remote visual cortex differed significantly from corresponding effects of frontal (eye field) TMS, in terms of how they related to current visual input and their spatial topography for retinotopic areas V1-V4. Our results show directly that parietal and frontal regions can indeed have distinct patterns of causal influence upon functional activity in human visual cortex.     

Modulation of ventral prefrontal cortex functional connections reflects the interplay of cognitive processes and stimulus characteristics

Emerging ideas of brain function emphasize the context-dependency of regional contributions to cognitive operations, where the function of a particular region is constrained by its pattern of functional connectivity. We used functional magnetic resonance imaging to examine how modality of input (auditory or visual) affects prefrontal cortex (PFC) functional connectivity for simple working memory tasks. The hypothesis was that PFC would show contextually dependent changes in functional connectivity in relation to the modality of input despite similar cognitive demands. Participants were presented with auditory or visual bandpass-filtered noise stimuli, and performed 2 simple short-term memory tasks. Brain activation patterns independently mapped onto modality and task demands. Analysis of right ventral PFC functional connectivity, however, suggested these activity patterns interact. One functional connectivity pattern showed task differences independent of stimulus modality and involved ventromedial and dorsolateral prefrontal and occipitoparietal cortices. A second pattern showed task differences that varied with modality, engaging superior temporal and occipital association regions. Importantly, these association regions showed nonzero functional connectivity in all conditions, rather than showing a zero connectivity in one modality and nonzero in the other. These results underscore the interactive nature of brain processing, where modality-specific and process-specific networks interact for normal cognitive operations.     

Remediation of sleep-deprivation-induced working memory impairment with fMRI-guided transcranial magnetic stimulation

Repetitive transcranial magnetic stimulation (rTMS) was applied to test the role of selected cortical regions in remediating sleep-deprivation-induced deficits in visual working memory (WM) performance. Three rTMS targets were chosen using a functional magnetic resonance imaging (fMRI)-identified network associated with sleep-deprivation-induced WM performance impairment: 2 regions from the network (upper left middle occipital gyrus and midline parietal cortex) and 1 nonnetwork region (lower left middle occipital gyrus). Fifteen participants underwent total sleep deprivation for 48 h. rTMS was applied at 5 Hz during a WM task in a within-subject sham-controlled design. The rTMS to the upper-middle occipital site resulted in a reduction of the sleep-induced reaction time deficit without a corresponding decrease in accuracy, whereas stimulation at the other sites did not. Each subject had undergone fMRI scanning while performing the task both pre- and postsleep deprivation, and the degree to which each individual activated the fMRI network was measured. The degree of performance enhancement with upper-middle occipital rTMS correlated with the degree to which each individual failed to sustain network activation. No effects were found in a subset of participants who performed the same rTMS procedure after recovering from sleep deprivation, suggesting that the performance enhancements seen following sleep deprivation were state dependent.     

Muscle functional MRI as an imaging tool to evaluate muscle activity

Muscle functional magnetic resonance imaging (mfMRI) is an innovative technique that offers a noninvasive method to quantify changes in muscle physiology following the performance of exercise. The mfMRI technique is based on signal intensity changes due to increases in the relaxation time of tissue water. In contemporary practice, mfMRI has proven to be an excellent tool for assessing the extent of muscle activation following the performance of a task and for the evaluation of neuromuscular adaptations as a result of therapeutic interventions. This article focuses on the underlying mechanisms and methods of mfMRI, discusses the validity and advantages of the method, and provides an overview of studies in which mfMRI is used to evaluate the effect of exercise and exercise training on muscle activity in both experimental and clinical studies.     

Repetition suppression and reactivation in auditory-verbal short-term recognition memory

The neural response to stimulus repetition is not uniform across brain regions, stimulus modalities, or task contexts. For instance, it has been observed in many functional magnetic resonance imaging (fMRI) studies that sometimes stimulus repetition leads to a relative reduction in neural activity (repetition suppression), whereas in other cases repetition results in a relative increase in activity (repetition enhancement). In the present study, we hypothesized that in the context of a verbal short-term recognition memory task, repetition-related "increases" should be observed in the same posterior temporal regions that have been previously associated with "persistent activity" in working memory rehearsal paradigms. We used fMRI and a continuous recognition memory paradigm with short lags to examine repetition effects in the posterior and anterior regions of the superior temporal cortex. Results showed that, consistent with our hypothesis, the 2 posterior temporal regions consistently associated with working memory maintenance, also show repetition increases during short-term recognition memory. In contrast, a region in the anterior superior temporal lobe showed repetition suppression effects, consistent with previous research work on perceptual adaptation in the auditory-verbal domain. We interpret these results in light of recent theories of the functional specialization along the anterior and posterior axes of the superior temporal lobe.     

Face-selective neurons during passive viewing and working memory performance of rhesus monkeys: evidence for intrinsic specialization of neuronal coding.

The functional organization of prefrontal cortex (PFC) is a central issue in cognitive neuroscience. Previous physiological investigations have often failed to reveal specialization within the PFC. However, these studies have generally not been designed to examine this issue. Methodological issues such as statistical criteria for specificity, the number of neurons sampled, the extent of cortex sampled, and the number, location and nature of the stimuli used are among the variables that need to be considered in evaluating the results of studies on functional localization. In the present study, we have examined neurons in macaque monkeys trained to fixate while viewing visual stimuli, including faces, or to use them as memoranda on a working memory task. Visual responses of over 1500 neurons were recorded throughout a wide expanse of the PFC (areas 12, 9, 46, 8 and 45). Neurons were considered selective for faces if the best response to a face was over twice as strong as that to any of a wide variety of non-face stimuli. Full electrode track reconstructions in three monkeys revealed in each that neurons which met this criterion were concentrated almost exclusively in three distinct subregions within the projection region of the temporal lobe visual areas. We further show that for all neurons, the most visually selective neurons (for faces, objects or color patterns) were also the most concentrated in the temporal lobe recipient PFC. Similar face selectivity, regional specialization, and delay or delay-like activity were observed in monkeys whether trained on memory tasks or not, which suggests that these are naturally occurring properties of prefrontal neurons. These results confirm neuronal and regional specialization for information processing in PFC and elucidate how heretofore unexamined experimental variables have a strong influence on the detection of regional specialization.     

Impairment of attentional networks after 1 night of sleep deprivation

Here, we assessed the effects of sleep deprivation (SD) on brainactivation and performance to a parametric visual attentiontask. Fourteen healthy subjects underwent functional magneticresonance imaging of ball-tracking tasks with graded levelsof difficulty during rested wakefulness (RW) and after 1 nightof SD. Self-reports of sleepiness were significantly higherand cognitive performance significantly lower for all levelsof difficulty for SD than for RW. For both the RW and the SDsessions, task difficulty was associated with activation inparietal cortex and with deactivation in visual and insularcortices and cingulate gyrus but this pattern of activation/deactivationwas significantly lower for SD than for RW. In addition, thalamicactivation was higher for SD than for RW, and task difficultywas associated with increases in thalamic activation for theRW but not the SD condition. This suggests that thalamic resources,which under RW conditions are used to process increasingly complextasks, are being used to maintain alertness with increasinglevels of fatigue during SD. Thalamic activation was also inverselycorrelated with parietal and prefrontal activation. Thus, thethalamic hyperactivation during SD could underlie the reducedactivation in parietal and blunted deactivation in cingulatecortices, impairing the attentional networks that are essentialfor accurate visuospatial attention performance.     

Contralateral coding of imagined body parts in the superior parietal lobe

In monkeys, neurons in the superior parietal lobe (area 5) code for spatial position of contralateral body parts by combining visual and somatosensory signals. Using a modified version of the classical mental rotation task, we were able to demonstrate that in humans activation in the contralateral superior parietal lobe could be evoked when mental rotation was combined with motor imagery of hands. These findings show that even in the absence of visual and somatosensory input, information provided by motor imagery suffices to induce contralateral superior parietal lobe monitoring of the imagined limb configuration. This constitutes an important prerequisite for effective imagined motor practice that can be used to improve actual motor performance.