Functional heterogeneity of the supplementary motor area

BACKGROUND AND PURPOSE: The purpose of this study was to assess supplementary motor area (SMA) activation during motor, sensory, word generation, listening comprehension, and working memory tasks by using functional MR imaging (fMRI). Human supplementary motor area (SMA) has been shown to play roles in motor control and other various functions such as sensory, speech expression, and memory. However, topographical localizations of these functions in the SMA remain unclear. The purpose of this study was to assess SMA activation during motor, sensory, word generation, listening comprehension, and working memory tasks by using functional MR imaging (fMRI). METHODS: Sixteen healthy right-handed subjects (nine men and seven women) were imaged on a Siemens 1.5T system. Whole-brain functional maps were acquired by using blood oxygenation level-dependent echo-planar imaging sequences in the axial plane. Each paradigm consisted of five epochs of activation versus the control condition. The activation tasks consisted of left-finger complex movement, heat sensory stimulation of the left hand, word generation, listening comprehension, and working memory. The reference function was a boxcar waveform. Activation maps were thresholded at an uncorrected P = .0001. The thresholded activation maps were placed into MNI (Montreal Neurologic Institute) stereotactic coordinates, and the anatomic localization of activation within the SMA was compared across tasks. RESULTS: SMA activation was observed in 16 volunteers for the motor task, 11 for the sensory task, 15 for the word generation task, five for the listening comprehension task, and 15 for the working memory task. Although not statistically significant, qualitative differences in the location of activation within the SMA were present by task. The rostral aspects of the SMA tended to activate during word generation and working memory tasks, and the caudal aspect of the SMA tended to activate during the motor and sensory tasks. Right (contralateral) SMA activation was observed during the motor and sensory tasks, and left SMA activation during the word generation and memory tasks. CONCLUSION: Our results suggest that SMA is involved in a variety of functional tasks, including motor, sensory, word generation, and working memory. Some are tasks that are traditionally associated with this area (such as motor and sensory), and others are not (such as word generation and working memory). Qualitatively, the anterior and posterior portions of the SMA appeared to be engaged by different types of tasks.     

Multirater agreement of arthroscopic grading of knee articular cartilage

BACKGROUND: Acute and chronic cartilage injury of the knee has an important impact on prognosis. The validity of the classification of such injuries is critical for prospective multicenter studies. The agreement among multiple surgeons at different institutions for articular cartilage lesions has not been established. HYPOTHESIS: Arthroscopic classification of articular cartilage lesions is reliable and reproducible and can be used for multicenter studies involving multiple surgeons. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 1. METHODS: A total of 6 surgeons from 5 centers reviewed 31 videos of articular cartilage lesions. With grade 2 and grade 3 combined for the analysis, observed agreement ranged from 81% to 94%, and kappa ranged from 0.34 to 0.87. An additional 22 videos comprising grade 2 and grade 3 lesions were analyzed, and the observed agreement was 80%, with an overall kappa of 0.47. CONCLUSION: Arthroscopic grading of articular cartilage lesions is reproducible among surgeons at different centers. CLINICAL RELEVANCE: Articular cartilage lesions can be reliably classified among surgeons at different sites. Such reliability is important for multicenter clinical research studies involving arthroscopic knee surgery.     

Exercise-induced arterial hypoxemia is not different during cycling and running in triathletes

This study examined the effect of running and cycling on exercise-induced arterial hypoxemia (EIAH) in individuals well trained in each modality. Thirteen male triathletes (X+/-SD: age=36+/-5 years, mass=69+/-8 kg, body fat=12+/-1%) performed progressive exercise to exhaustion during cycle ergometry and treadmill running. Gas exchange was determined, while oxyhemoglobin saturation (SaO(2)) was measured with an ear oximeter. At maximal exercise, the respiratory exchange ratio (1.15+/-0.06 vs. 1.10+/-0.05) and the ventilatory equivalent for oxygen uptake (37.6+/-3.8 vs. 34.2+/-2.7) were greater during cycling vs. running (P<0.05). However, there were no differences at maximal exercise in oxygen uptake (64.4+/-3.2 vs. 67.0+/-4.6 mL kg(-1) min(-1)), SaO(2) (93.4+/-2.8% vs. 92.6+/-2.2%), or the ventilatory equivalent for carbon dioxide (V(E)/VCO(2); 33.1+/-3.1 vs. 31.0+/-3.1), during cycling vs. running, respectively. During submaximal exercise, the V(E)/VCO(2) was less for cycling (26.0+/-1.0) compared with running (29.1+/-0.4; P<0.05), but this had no apparent effect on the SaO(2) response. In conclusion, EIAH was not significantly different during cycling and running in athletes who were well trained in both exercise modalities.     

Regulation of auditory responses in the central nucleus of the inferior colliculus by tetraethylammonium-sensitive potassium channels

The role of potassium channels in regulating spontaneous firing and sound-evoked responses in the central nucleus of the inferior colliculus was studied by recording single-unit activity before and during iontophoretic application of a nonspecific potassium channel blocker, tetraethylammonium (TEA). Tone bursts and sinusoidal amplitude-modulated tones were used to evoke auditory responses. Our results show that release of TEA increased the width of spikes for all neurons tested. There was an increase in spontaneous firing for most of the neurons. There was also an increase in responses to tone bursts for most of the neurons, although in some cases there was a reduction in the evoked responses. TEA also increased the firing rate in responses to sinusoidal amplitude-modulated sounds in the majority of the neurons tested. For some neurons, the change in firing reduced the selectivity of responses for particular rates of modulation. There was also a reduction in the synchrony of action potentials to the modulation envelope in many cells. Our results show that potassium channels are important for regulating the strength of sound-evoked responses and the level of spontaneous activity, and determining the temporal properties of responses to amplitude-modulated sounds.     

Specific reading disability (dyslexia): what have we learned in the past four decades?

We summarize some of the most important findings from research evaluating the hypothesized causes of specific reading disability ('dyslexia') over the past four decades. After outlining components of reading ability, we discuss manifest causes of reading difficulties, in terms of deficiencies in component reading skills that might lead to such difficulties. The evidence suggests that inadequate facility in word identification due, in most cases, to more basic deficits in alphabetic coding is the basic cause of difficulties in learning to read. We next discuss hypothesized deficiencies in reading-related cognitive abilities as underlying causes of deficiencies in component reading skills. The evidence in these areas suggests that, in most cases, phonological skills deficiencies associated with phonological coding deficits are the probable causes of the disorder rather than visual, semantic, or syntactic deficits, although reading difficulties in some children may be associated with general language deficits. Hypothesized deficits in general learning abilities (e.g., attention, association learning, cross-modal transfer etc.) and low-level sensory deficits have weak validity as causal factors in specific reading disability. These inferences are, by and large, supported by research evaluating the biological foundations of dyslexia. Finally, evidence is presented in support of the idea that many poor readers are impaired because of inadequate instruction or other experiential factors. This does not mean that biological factors are not relevant, because the brain and environment interact to produce the neural networks that support reading acquisition. We conclude with a discussion of the clinical implications of the research findings, focusing on the need for enhanced instruction.     

Biomaterials, biomechanics, tissue healing, and immediate-function dental implants

Selected factors and opinions are reviewed specific to immediate function of dental implants in terms of biomaterial and biomechanical properties and how they might influence postsurgical tissue healing. Comparisons are made among plate, rod, and screw vs plateau, finn, and porous geometry endosteal dental-implant designs with and without alterations in device body-surface microchemistry and microtopography. Available information introduces more questions than answers, and recommendations are made for ongoing studies of bone responses specific to the implant fit and fill parameters focused on the kinetics of postsurgical osteotomy healing and applied loading. The clinical literature supports opportunities for immediate function; however, proposals about pathways for bone healing need further investigation. The current trends within the discipline of implant dentistry offer opportunities to reevaluate current vs previous immediate-function systems.