额叶癫癎的致癎灶定位与手术治疗

目的 探讨额叶癫癎的致痴灶定位和手术治疗的策略。方法 分析29例额叶癫癎患者的术前综合定位、术中皮层脑电图监测、术式选择及术后效果的临床资料。结果 影像学检查结合长程视频脑电图监测,可以为12例定位致癎灶;而结合颅内脑电图长程记录,24例可以定位致癎灶,其中包括10例影像学检查阴性的病例。随访1年以上,按照Engel’s效果分级:Ⅰ级13例,Ⅱ级7例,Ⅲ级4例,Ⅳ级5例。结论 影像学检查、长程视频脑电图监测以及颅内脑电图长程记录和术中皮层脑电图监测相结合的综合定位方法,可以提高额叶癫癎的致癎灶定位效果和手术疗效,其中颅内电极记录尤其有助于定位影像学检查阴性病例的致癎灶。     

Emotional responsiveness in fish from lines artificially selected for a high or low degree of laterality

Evidence showing that cerebral asymmetries exist in a wide range of animals has prompted investigation into the advantages and disadvantages of brain lateralization. In the teleost fish Girardinus falcatus individuals selected for a high degree of lateralization (LAT) performed better than those fish selected for reduced lateralization (NL) in several tasks, including schooling, foraging and spatial orientation. These findings were interpreted as evidence of hemispheric specialization allowing more efficient parallel processing and thus better cognitive performance under conditions that require multitasking, but the possibility that the results may simply reflect line differences in behavioral/physiological coping styles (i.e. in their emotional responsiveness during the tests) could not be ruled out. To test the hypothesis that NL and LAT fish differ in coping style, the present study examined differences in response in these lines to a novel situation in four different conditions. NL and LAT fish did not differ in a behavioral measure of emotional response: their readiness to explore a new environment. After being isolated in a tight space they showed a similar increase in opercular beating rates, suggesting that their physiological response to an acute stressor was comparable. The overall tendency to remain close to a shoalmate after being moved to an unfamiliar place was similar in the two groups but a significant difference was found in the temporal pattern; LAT fish swam closer than NL to their mirror image in the initial stages but this difference was later reversed. NL and LAT males placed in a new, unfamiliar environment did not differ in the number of sexual acts performed but LAT males resumed sexual behavior earlier signifying that cerebral lateralization has some influence on the trade-off between predator surveillance and mating behavior. Although this study found some differences between NL and LAT lines in their response to novelty, present evidence does not seem sufficient to justify the rejection of the hypothesis that the better scores in complex tasks shown by LAT fish in previous studies were primarily due to a cognitive advantage associated with cerebral specialization.     

Bone-Conducted Sound Lateralization of Interaural Time Difference and Interaural Intensity Difference in Children and a Young Adult with Bilateral Microtia and Atresia of the Ears

Objective—We used multi-slice helical computerized tomography (MSHCT) to evaluate the 3D characteristics of the laryngeal structures in patients with unilateral vocal fold paralysis (UVFP) during phonation, and compared the results with those obtained using an aerodynamic vocal function test. Material and methods—The subjects were 37 patients with UVFP. The region over the larynx was scanned during quiet phonation and again during inspiration using MSHCT, and 3D endoscopic and coronal reconstruction images were produced. Maximum phonation time (MPT) and mean airflow rate (MFR) during phonation were measured. Results—During phonation, the affected fold was thinner than the healthy fold in 30 subjects and located at a higher position than the healthy fold in 21 subjects. Abduction or thinning of the affected fold during phonation (paradoxical movement) was seen in seven subjects. MFR was significantly greater when the affected fold was thinner than the healthy fold during phonation, and MPT was significantly shorter when the affected fold showed paradoxical movement. Over-adduction of the healthy fold during phonation was present in 15 subjects. There were no significant differences in MPT or MFR between subjects with and without over-adduction. Conclusion—The combination of MSHCT endoscopic and coronal reconstruction images enables the 3D characteristics of the unilaterally paralyzed larynx to be visualized during phonation, and some of these characteristics are significantly correlated with vocal function in patients with UVFP.     

皮层脑电图辅助立体定向下手术治疗颅内钙化灶引起的难治性癫痫

目的研究立体定向下开放式手术联合术中皮层脑电图(ECoG)监测治疗颅内钙化灶性癫痫的手术方法、注意事项及效果。方法 21例颅内单发钙化灶引起的癫痫患者(其中主要功能区钙化灶9例),在立体定向仪导向下,开放直视手术,ECoG监测钙化灶周围皮层脑电活动情况,切除钙化灶后再次ECoG监测,确定致痫灶的范围及处理方式。结果所有钙化灶均被顺利切除。钙化灶区域ECoG监测无明显异常5例,表现为阵发性与动脉搏动相一致的单发性棘慢复合波发放9例,表现为明显癫痫样放电7例。单纯钙化灶切除术14例,钙化灶+周边增生组织+致痫皮层切除术4例,钙化灶切除+功能区致痫皮层低功率电凝热灼术3例。术后ECoG监测发现异常放电消失11例,仍残存轻中度痫样放电5例。无严重并发症。随访6个月～8年,EngelⅠ级16例,EngelⅡ级5例,总有效率100%。结论 ECoG监测是立体定向下手术治疗颅内钙化灶性癫痫的重要辅助手段,能够指导术中采取相应的手术方式切除钙化灶,妥善处理致痫灶,避免过多损伤脑皮层。     

皮层电极描记配合立体定向切除癫痫灶

目的 评价皮层电极描记在立体定向切除癫痫灶手术中的应用和价值。方法 对25例以癫痫为首发症状的继发性癫痫患者采用MRI导向下，立体定向环钻开颅，切除病灶前行皮层电极描记，记录有无癫痫波和范围，切除病灶后再次描记，如仍有癫痫波，则在不影响神经功能的基础上将有癫痫波的皮层尽可能切除。结果 25例患者中有19例在切除病灶前记录到棘波、棘-慢波、尖波或尖-慢波，切除后有15例上述癫痫波完全消失，4例仍有散在的少许癫痫波；另有6例患者未记录到癫痫波，但表现为基本的节律异常，切除病灶后好转。25例患者中胶质瘤6例，脑囊虫病5例，蛛网膜囊肿3例，软化灶3例，皮层发育不全2例，血管畸形2例，转移癌2例，炎症1例，胶质细胞增生1例，病灶直径在0．8～4．7cm。手术后24例癫痫发作消失，1例仍偶有癫痫发作，比例能够被口服抗癫痫药物控制。手术后患者无神经功能损害加重。结论 皮层电极描记和立体定向方法相结合，既能明确癫痫灶的范围，又能以微侵袭的方法切除癫痫灶，尤其适用于直径小于4cm的癫痫灶的切除。     

Laterality of 40 Hz EEG and EMG During Cognitive Performance

Task-dependent lateralization of the 40 Hz EEG rhythm was investigated in 15 right-handed male adults during the performance of verbal analogy and geometric figure rotation tasks. Forty Hz EMG recorded from the temporal and splenius muscles was similarly examined. Results indicate that 40 Hz EEG is asymmetrically distributed during cognitive performance, varying as a function of cognitive processsing. The range of laterality scores also varied by condition, with the largest variation present during baseline conditions and smallest recorded during the presentation of the verbal analogies task, suggesting that individual cognitive styles tend to vary more during less structured situations. No relationship between 40 Hz EMG and task was obtained.     

Serial changes of the susceptibility of epileptogenic focus during hippocampal kindling induced with low-frequency electrical stimulation in cats

Cats were stimulated in the dorsal hippocampus with low-frequency square wave pulses. All subjects were kindled until generalized convulsion occurred. In the early stage of the kindling process, an increase in the interpulse interval and a decrease in the number of stimulating pulses required for the provocation of epileptic afterdischarge were observed, but in the late stage a decrease in the former and an increase in the latter were observed. It appears from these data that completion of hippocampal kindling is accompanied by a decrease in excitability at the site of stimulation subsequent to an increase in the same.     

Differences in micronutrients content found in cereals from various parts of Mali

Food samples were collected from four different regions (Mopti, Ségou, Timbuktu and Bamako) in Mali. The cereals, analyzed for iron, zinc, thiamine, riboflavin and niacin, were millet (Pennisetum glaucum), sorghum (Sorghum bicolor), rice (Oryza sativa), wheat (Triticum aestivum) and fonio (Digitaria exilis). For millet the lowest coefficient of variation (CV %) between the regions was found in thiamine (15%) and the highest variation in niacin (126%). For sorghum it was the same nutrients that gave the lowest and highest CV, 34% in thiamine and 98% in niacin. For rice, however, the main variations were for zinc (lowest, CV 20%) and iron (highest, 141%). For wheat the lowest CV was in thiamine (47%) and highest in iron (115%), while for fonio the lowest CV was in zinc (9%) and highest in iron (61%). Even though the variation was very high for all nutrients except zinc in fonio, it was thiamine and zinc that differed the least and iron and niacin that differed the most. The use of different methods and laboratories could not explain the variation between different regions. The variation between ecological zones seems rather important. This raises the question of whether we can defend borrowing data on food composition from one country or area to another, with different ecological and climatic conditions. The globalization process impacting all countries actualize this question even more than before. Finally this has consequences for the design and use of the food composition table for Mali, which contain one main table giving average values, and separated tables from each region giving regional data when they are available.     

Ambiguous Language in Wada Evaluations

Summary:  A case is presented with ambiguous cerebral language lateralization, as determined by the intracarotid amobarbital test. Reasons for ambiguous language findings for this test are discussed.