A new three-dimensional method of assessing facial volumetric changes after orthognathic treatment.

OBJECTIVE: To validate a new method of facial volumetric assessment that is dependent on the use of stereophotogrammetric models and a software-based Facial Analysis Tool. DESIGN: The method was validated in vitro with three-dimensional (3D) models of a lifelike plastic female dummy head and in vivo with a male-subject head. METHODS: Thirty facial silicone explants were added in the nasal and perioral regions of each head, and their volumes were obtained by three different algorithms. These were compared with the actual values obtained by a "water displacement" method. RESULTS: The least mean error was found with the "tetrahedron formation" method followed by the "projection" method and the "back-plane construction" method. The error with the tetrahedron formation method was 0.071 cm(3) (95% confidence interval [CI]: -0.074 to 0.2161 cm3) with the in vitro models and 0.314 cm3 (95% CI: -0.080 to 0.708 cm3) with the in vivo models. The increased volumetric assessment error observed in vivo was attributed to the registration procedure and possible changes in facial expression. CONCLUSIONS: These results encourage the use of this method in the 3D assessment of orthognathic surgical outcome, provided a standardized facial expression is used for image acquisition.     

Effects of unconditioned and conditioned aversive stimuli in an intense fear conditioning paradigm on synaptic plasticity in the hippocampal CA1 area in vivo

Repeated vivid recalls or flashbacks of traumatic memories and memory deficits are the cardinal features of post-traumatic stress disorder (PTSD). The underlying mechanisms are not fully understood yet. Here, we examined the effects of very strong fear conditioning (20 pairings of a light with a 1.5-mA, 0.5-s foot shock) and subsequent reexposure to the conditioning context (chamber A), a similar context (chamber B), and/or to the fear conditioned stimulus (CS) (a light) on synaptic plasticity in the hippocampal CA1 area in anesthetized Sprague-Dawley rats. The conditioning procedure resulted in very strong conditioned fear, as reflected by high levels of persistent freezing, to both the contexts and to the CS, 24 h after fear conditioning. The induction of long-term potentiation (LTP) was blocked immediately after fear conditioning. It was still markedly impaired 24 h after fear conditioning; reexposure to the conditioning chamber A (CA) or to a similar chamber B (CB) did not affect the impairment. However, presentation of the CS in the CA exacerbated the impairment of LTP, whereas the CS presentation in a CB ameliorated the impairment so that LTP induction did not differ from that of control groups. The induction of long-term depression (LTD) was facilitated immediately, but not 24 h, after fear conditioning. Only reexposure to the CS in the CA, but not reexposure to either chamber A or B alone, or the CS in chamber B, 24 h after conditioning, reinstated the facilitation of LTD induction. These data demonstrate that unconditioned and conditioned aversive stimuli in an intense fear conditioning paradigm can have profound effects on hippocampal synaptic plasticity, which may aid to understand the mechanisms underlying impairments of hippocampus-dependent memory by stress or in PTSD.     

Attentional modulation of perceptual grouping in human visual cortex: ERP studies

We sought to identify the neural substrates underlying perceptual grouping, and examined whether the grouping-related neural activities are modulated by task relevance and attention by recording high-density event-related potentials (ERPs). Participants were presented with stimulus arrays, in which local elements were either evenly distributed or grouped into rows or columns by proximity or similarity, and had to discriminate orientations of the perceptual groups, or to identify the colors of dots around stimulus displays or of the fixation cross. We found that proximity grouping was indexed by a positive activity over the medial occipital cortex with a peak latency of about 100 ms after stimulus onset (Pd100), whereas grouping by similarity of shape was reflected in a negative activity with longer latency over the occipito-temporal areas. Dipole modeling based on a realistic boundary element head model localized the Pd100 to the right calcarine cortex. Moreover, we showed that the grouping-related activities were weakened when stimulus arrays were of low task relevance and fell outside an attended area of field. The results suggest that human calcarine cortex is engaged in early grouping operations defined by proximity, reinforcing the previous fMRI findings. Moreover, our ERP results indicate that the neural bases underlying perceptual grouping in human visual cortex can be modulated by task relevance and attention as early as 100 ms after sensory stimulation. Hum Brain Mapp, 2005. (c) 2005 Wiley-Liss, Inc.     

Attentional modulation of perceptual grouping in human visual cortex: functional MRI studies

When presented with a complex visual scene, our visual system has to organize the discrete entities present into useful perceptual units. The current work investigated the neural substrates of perceptual grouping defined by Gestalt laws of proximity and similarity of shape, and whether the neural substrates underlying perceptual grouping are modulated by task relevance and spatial attention. In visual discrimination tasks, subjects identified the orientations of perceptual groups formed by proximity or similarity of local elements or alternatively identified colors of either dots around the grouped stimuli or the fixation cross. Using functional magnetic resonance imaging (fMRI), we identified that the calcarine cortex was involved in proximity grouping but not in the grouping process defined by similarity of shape. Moreover, we showed evidence that the neural correlates of proximity grouping in the calcarine cortex were weakened when the elements were of low task relevance and fell outside an attended area of field. The findings reveal the neural basis for basic grouping operations, as well as illustrating how attention and proximity grouping interact in human visual cortex.     

Combination treatment of clozapine and topiramate in resistant rapid-cycling bipolar disorder

Several open-label studies or case reports have suggested the effectiveness of clozapine or topiramate in the treatment of resistant rapid-cycling bipolar patients, but none of these publications report the long-term effectiveness of these two agents in combination. The authors present a 38-year-old woman with a 22-year history of rapid-cycling bipolar I disorder who failed to respond satisfactorily to various somatic therapies, including combination therapy for complex regimens and a course of bilateral electroconvulsive therapy, but finally responded well to a combination treatment of clozapine and topiramate. Such a combination therapy led the patient to a complete remission for more than 3 years without inducing side effects such as weight gain, hyperglycemia, type II diabetes mellitus, or hyperlipidemia. In addition, she had a weight loss of 12 kg over the past 3 years. This case suggests that the combination treatment of clozapine and topiramate can be safe and effective in some resistant rapid-cycling bipolar patients.