Influence of stimulus cross talk on results of the twitch-interpolation technique at the biceps brachii muscle

Biceps brachii muscles of five healthy volunteers were tested with a high-resolution twitch-interpolation technique. Parameters of the electrical surface stimulation were varied. It was found that a supramaximal stimulus strength activates both biceps and triceps brachii motor units simultaneously severely affecting twitch-interpolation results. Crosstalk contamination of twitches, however, can be avoided, if submaximal stimuli are used yielding twitch-interpolation results for the biceps-brachii that are similar to those of the quadriceps muscle. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20:1187–1190, 1997     

Decoding Object-Based Auditory Attention from Source-Reconstructed MEG Alpha Oscillations

How do we attend to relevant auditory information in complex naturalistic scenes? Much research has focused on detecting which information is attended, without regarding underlying top-down control mechanisms. Studies investigating attentional control generally manipulate and cue specific features in simple stimuli. However, in naturalistic scenes it is impossible to dissociate relevant from irrelevant information based on low-level features. Instead, the brain has to parse and select auditory objects of interest. The neural underpinnings of object-based auditory attention remain not well understood. Here we recorded MEG while 15 healthy human subjects (9 female) prepared for the repetition of an auditory object presented in one of two overlapping naturalistic auditory streams. The stream containing the repetition was prospectively cued with 70% validity. Crucially, this task could not be solved by attending low-level features, but only by processing the objects fully. We trained a linear classifier on the cortical distribution of source-reconstructed oscillatory activity to distinguish which auditory stream was attended. We could successfully classify the attended stream from alpha (8–14 Hz) activity in anticipation of repetition onset. Importantly, attention could only be classified from trials in which subjects subsequently detected the repetition, but not from miss trials. Behavioral relevance was further supported by a correlation between classification accuracy and detection performance. Decodability was not sustained throughout stimulus presentation, but peaked shortly before repetition onset, suggesting that attention acted transiently according to temporal expectations. We thus demonstrate anticipatory alpha oscillations to underlie top-down control of object-based auditory attention in complex naturalistic scenes.SIGNIFICANCE STATEMENT In everyday life, we often find ourselves bombarded with auditory information, from which we need to select what is relevant to our current goals. Previous research has highlighted how we attend to specific highly controlled aspects of the auditory input. Although invaluable, it is still unclear how this relates to attentional control in naturalistic auditory scenes. Here we used the high precision of magnetoencephalography in space and time to investigate the brain mechanisms underlying top-down control of object-based attention in ecologically valid sound scenes. We show that rhythmic activity in auditory association cortex at a frequency of ∼10 Hz (alpha waves) controls attention to currently relevant segments within the auditory scene and predicts whether these segments are subsequently detected.     

Attitudes towards gamete donation among IVF doctors in the Nordic countries—are they in line with national legislation?

Purpose  To compare attitudes towards gamete donation between IVF doctors in the Nordic countries, and to determine whether attitudes are in correspondence with national legislation. Materials and methods  A study-specific questionnaire was used to study attitudes of 108 IVF doctors (92% response). Participants constituted 78% of all IVF doctors in Sweden, Denmark and Norway and 15% of IVF doctors in Finland. Results  Despite similar legislation regarding offspring right to learn his/her donor’s identity, IVF doctors from Norway reported significantly more negative attitudes towards disclosure than did Swedish physicians. A majority from all countries demonstrated positive attitudes towards embryo donation and allowing sperm donation for lesbian couples. Physicians reported strong support for anonymous donation but less support for ‘known’ donation. Conclusion  There are discrepancies between IVF doctors’ attitudes towards gamete donation and national legislation in four Nordic countries. Negative attitudes towards disclosure to offspring may counteract legislative intentions. Capsule   There are discrepancies between IVF doctors’ attitudes towards gamete donation and national legislation in four Nordic countries.     

Toward a refined genotype–phenotype classification scheme for the international consensus classification of Focal Cortical Dysplasia

Focal Cortical Dysplasia (FCD) is the most common cause of drug‐resistant focal epilepsy in children and young adults. The diagnosis of currently defined FCD subtypes relies on a histopathological assessment of surgical brain tissue. The many ongoing challenges in the diagnosis of FCD and their various subtypes mandate, however, continuous research and consensus agreement to develop a reliable classification scheme. Advanced neuroimaging and genetic studies have proven to augment the diagnosis of FCD subtypes and should be considered for an integrated clinico‐pathological and molecular classification. In this review, we will discuss the histopathological foundation of the current FCD classification and potential advancements when using genetic analysis of somatic brain mutations in neurosurgically resected brain specimens and postprocessing of presurgical neuroimaging data. Combining clinical, imaging, histopathology, and molecular studies will help to define the disease spectrum better and finally unveil FCD‐specific treatment options.     

Prenatal diagnosis of juvenile granulosa cell tumor of the testis

Juvenile granulosa cell tumor is a rare benign neoplasm of the testicular stroma that accounts for 1-5% of all prepubertal testis tumors [Metcalfe PD, Farivar-Mohseni H, Farhat W, McLorie G, Khoury A, Bagli DJ. Pediatric testicular tumors: contemporary incidence and efficacy of testicular preserving surgery. J Urol 2003;170:2412-2416; Ross JH, Rybicki L, Kay R. Clinical behavior and a contemporary management algorithm for prepubertal testis tumors: a summary of the prepubertal testis tumor registry. J Urol 2002;168:1675-1679]. A prior case series retrospectively identified a cystic testis tumor on prenatal ultrasound images which was subsequently diagnosed as a juvenile granulosa cell tumor [Bryan DE, Cain MP, Casale AJ. Juvenile granulosa-theca cell (sex cord-stromal) tumor of the infant testis. J Urol 2003;169:1497-1498]. We report a case of a prenatally diagnosed testis tumor which was subsequently diagnosed as a juvenile granulosa cell tumor.     

Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force

Structural magnetic resonance imaging (MRI) is of fundamental importance to the diagnosis and treatment of epilepsy, particularly when surgery is being considered. Despite previous recommendations and guidelines, practices for the use of MRI are variable worldwide and may not harness the full potential of recent technological advances for the benefit of people with epilepsy. The International League Against Epilepsy Diagnostic Methods Commission has thus charged the 2013‐2017 Neuroimaging Task Force to develop a set of recommendations addressing the following questions: (1) Who should have an MRI? (2) What are the minimum requirements for an MRI epilepsy protocol? (3) How should magnetic resonance (MR) images be evaluated? (4) How to optimize lesion detection? These recommendations target clinicians in established epilepsy centers and neurologists in general/district hospitals. They endorse routine structural imaging in new onset generalized and focal epilepsy alike and describe the range of situations when detailed assessment is indicated. The Neuroimaging Task Force identified a set of sequences, with three‐dimensional acquisitions at its core, the harmonized neuroimaging of epilepsy structural sequences—HARNESS‐MRI protocol. As these sequences are available on most MR scanners, the HARNESS‐MRI protocol is generalizable, regardless of the clinical setting and country. The Neuroimaging Task Force also endorses the use of computer‐aided image postprocessing methods to provide an objective account of an individual's brain anatomy and pathology. By discussing the breadth and depth of scope of MRI, this report emphasizes the unique role of this noninvasive investigation in the care of people with epilepsy.     

A comprehensive clinico‐pathological and genetic evaluation of bottom‐of‐sulcus focal cortical dysplasia in patients with difficult‐to‐localize focal epilepsy

Aims. We comprehensively studied the clinical presentation, stereo‐EEG and MRI findings, histopathological diagnosis, and brain somatic mutations in a retrospective series of drug‐resistant patients with difficult‐to‐localize epilepsy due to focal cortical dysplasia at the bottom of a sulcus (BOS‐FCD). Methods. We identified 10 patients with BOS‐FCD from the Cleveland Clinic epilepsy surgery database submitted for intracranial video‐EEG monitoring. Brain MRI, including voxel‐based morphometric analysis and surgical tissue submitted for histopathology, was reviewed. Paraffin tissue samples from five patients were made available for targeted next‐generation sequencing. Postsurgical follow‐up was available in nine patients. Results. BOS‐FCD was identified in the superior frontal sulcus in six patients, inferior frontal sulcus in one patient, central sulcus in one patient, and intraparietal sulcus in two patients. All patients had stereotyped seizures. Intracranial EEG recordings identified ictal onset at the BOS‐FCD in all 10 patients, whereas ictal scalp EEG had a localizing value in only six patients. Complete resection was achieved by lesionectomy or focal corticectomy in nine patients. Histopathologically, six patients had FCD type IIb and three had FCD type IIa. Next‐generation sequencing analysis of DNA extracted from lesion‐enriched (micro‐dissected) tissue from five patients with FCD type II led to the identification of a germline frameshift insertion in DEPDC5, introducing a premature stop in one patient. Eight out of nine patients with available follow‐up were completely seizure‐free (Engel Class IA) after a mean follow‐up period of six years. Conclusion. Our results confirm previous studies classifying difficult‐to‐localize BOS‐FCD into the emerging spectrum of FCD ILAE type II mTORopathies. Further studies with large patient numbers and ultra‐deep genetic testing may help to bridge the current knowledge gap in genetic aetiologies of FCD.