Electrophysiological evidence for fast visual processing through the human koniocellular pathway when stimuli move

There is increasing evidence from cellular recordings in primates and behavioral studies in humans that motion can be processed by other than the magnocellular (M) pathway and the cortical dorsal stream. Little is known about cortical processing of moving stimuli when the information is conveyed by the third retinogeniculocortical pathway - the so-called koniocellular (K) pathway. We addressed this issue in humans by studying the spatio-temporal dynamics of the brain electrical fields evoked by tritan (S-cone isolating) and luminance-defined moving stimuli. Tritan and luminance stimuli are presumably carried by the K and M pathways respectively. We found two time intervals where significant stimulus-specific electric fields were evoked: an early period between 40 and 75 ms after stimulus onset, and a later period between 175 and 240 ms. Some of these fields were identical for tritanand luminance-motion, suggesting that the processing of moving stimuli share common cortical substrates when mediated via K and M pathway input. However, tritan-motion stimuli also evoked unique electric fields that appeared earlier in time than the common motion-specific fields, indicating very fast activation of cortical areas specific to input through the K pathway. A distributed source localization procedure revealed simultaneous activation of striate and extrastriate areas even at the early processing stages, strongly suggesting a very fast activation of the visual cerebral network.     

Decoupling of autonomic and cognitive emotional reactions after cerebellar stroke

Emotional blunting can be found after cerebellar lesions. However, the mechanism of such a modification is not clear. We present a patient with emotional flattening and increased risk taking after left cerebellar infarct who had an impaired autonomic reactivity to negative as compared with positive reinforcement. This impairment was demonstrated by the patient's undifferentiated skin conductance responses to negative and positive reinforcement, whereas controls produced larger skin conductance responses after negative feedback. The cooccurrence of emotional flattening and undifferentiated autonomic reactions to positively and negatively valenced stimuli strengthens the role of the cerebellum in the modulation of the autonomic responses.     

Medial vestibular nucleus in the guinea-pig

In the preceding paper, medial vestibular nuclei neurones (MVNn) were shown to belong to two main classes, A MVNn and B MVNn, depending on their membrane properties in brainstem slices. In the following study we attempted to confirm this segregation by studying some of the ionic conductances that these cells are endowed with. Type A MVNn demonstrated small high threshold calcium spikes that could be potentiated by barium, a 4-AP resistant A-like conductance and a calcium-dependent afterhyperpolarization. Type B MVNn, in contrast, had large high threshold calcium spikes and prolonged calcium-dependent plateau potentials. In addition, they had a calcium-dependent afterhyperpolarization as well as a subthreshold persistent sodium conductance. A subpopulation of B MVNn had also low threshold calcium spikes that gave them bursting properties. These data confirm the segregation of MVN neurones into two main classes and will be discussed with respect to the firing characteristics of vestibular neurones in vivo.     

Discriminating emotional faces without primary visual cortices involves the right amygdala

Destruction of the brain's primary visual areas leads to blindness of cortical origin. Here we report on a subject who, after bilateral destruction of his visual cortices and ensuing cortical blindness, could nevertheless correctly guess the type of emotional facial expression being displayed, but could not guess other types of emotional or non-emotional stimuli. Functional magnetic resonance imaging showed activation of the right amygdala during the unconscious processing of emotionally expressive faces.     

Variability of right hemisphere activation during semantic word processing in aphasic patients: an electrophysiologic study in three patients

After stroke, the interhemispheric reorganisation of the neural network implicated in language is hypothesized to be a function not only of the site of lesion but also of the residual impairment. With a multiple case approach, we tested this hypothesis in three chronic aphasic patients. Two patients, GE (capsulo-lenticular stroke) and JHN (fronto-temporal stroke) showed formal residual semantic difficulties, while the third patient (EG, large sylvian lesion) did not. Brain electric activity was analysed during a categorisation task of tachistoscopically presented words in the left and the right visual field. The temporal analysis of brain activity showed that both patients with semantic residual difficulties activated the right hemisphere (RH) during some steps of word processing. In the third patient, without semantic impairment, the RH was activated only during a short time period. Further more, RH activation was shown to be dependent on the visual field of word presentation. Phonological impairment was not predictive of RH activation. These results suggest that RH activation, particularly anterior regions, can occur during semantic processing of words as a function of semantic residual impairment.     

Cholinergic nucleus basalis neurons display the capacity for rhythmic bursting activity mediated by low-threshold calcium spikes.

Acetylcholine has long been known to play an important role in the cortical activation that accompanies the states of wakefulness and paradoxical sleep (for review, see Refs 17, 21) when this neurotransmitter is released from the cerebral cortex at the highest rates. The major supply of acetylcholine to the cerebral cortex arises from the cholinergic neurons of Meynert's Basal-ganglion or nucleus basalis of the forebrain. Lying in the substantia innominata within the major ascending pathway from the brain stem reticular formation, magnocellular basalis neurons project upon the cerebral cortex as the important ventral, extrathalamic relay of the ascending reticular activating system. Although the cholinergic basalis nucleus neurons have been shown to be important for cortical activation, the precise manner in which they influence cortical activity has not as yet been elucidated, in part because the cholinergic cells of this nucleus have not been identified in electrophysiological studies. Using intracellular recording in guinea-pig brain slices, we were able to record and fill with biocytin nucleus basalis neurons which were subsequently revealed by immunohistochemical staining to be choline acetyltransferase-positive and thus cholinergic. The cholinergic cells displayed rhythmic bursting activity mediated by a low-threshold calcium spike in vitro, which would endow them with a capacity for phasic (in addition to tonic) firing in vivo. By virtue of these different modes, cholinergic basalis neurons may accordingly deter or facilitate the cortical response to sensory input and may furthermore modulate the major frequencies of cortical activity across the different states of the sleep-waking cycle.     

Mild aniridia phenotype: an under-recognized diagnosis of a severe inherited ocular disease

Graefe's Archive for Clinical and Experimental Ophthalmology - Aniridia is a rare panocular disorder caused by mutations in the PAX6 gene and characterized mainly by iris hypoplasia. Here, we...     

How do small rural primary health care services sustain themselves in a constantly changing health system environment?

Background

Services for Rheumatoid Arthritis (RA) have evolved with the development of independently led outreach Rheumatology Practitioner (RP) clinics in Primary Care (PC). Their clinical and cost effectiveness, compared with Secondary Care (SC) services, has not been assessed. The RECIPROCATE study aims to evaluate their clinical and cost effectiveness. This part of the study aimed to explore health professionals?? opinions of rheumatology outreach service.

Methods

Using a qualitative design, semi-structured interviews were conducted with GPs, practice nurses, hospital doctors and RPs, from one hospital and seven PC practices in Norfolk, to elicit their opinions of the service. The interviews were analysed using thematic analysis.

Results

All participants agreed the service was supportive and valuable providing high quality personalised care, disease management, social, and educational support. Advantages identified included convenience, continuity of care and proximity of services to home. RPs helped bridge the communication gap between PC and SC. Some participants suggested having a doctor alongside RPs. The service was considered to be cost effective for patients but there was uncertainty about cost effectiveness for service providers. Few disadvantages were identified the most recurring being the lack of other onsite services when needed. It was noted that more services could be provided by RPs such as prescribing and joint injections as well as playing a more active role in knowledge transfer to PC.

Conclusions

Professionals involved in the care of RA patients recognised the valuable role of the RP outreach clinics. This service can be further developed in rheumatology and the example can be replicated for other chronic conditions.