Prognostic performance of proteomic testing in advanced non-small cell lung cancer: a systematic literature review and meta-analysis

Abstract

Objective

Timely assessment of patient-specific prognosis is critical to oncology care involving a shared decision-making approach, but clinical prognostic factors traditionally used in NSCLC have limitations. We examine a proteomic test to address these limitations.     

Real-time imaging of human cortical activity evoked by painful esophageal stimulation

BACKGROUND & AIMS: Current models of visceral pain processing derived from metabolic brain imaging techniques fail to differentiate between exogenous (stimulus-dependent) and endogenous (non-stimulus-specific) neural activity. The aim of this study was to determine the spatiotemporal correlates of exogenous neural activity evoked by painful esophageal stimulation. METHODS: In 16 healthy subjects (8 men; mean age, 30.2 +/- 2.2 years), we recorded magnetoencephalographic responses to 2 runs of 50 painful esophageal electrical stimuli originating from 8 brain subregions. Subsequently, 11 subjects (6 men; mean age, 31.2 +/- 1.8 years) had esophageal cortical evoked potentials recorded on a separate occasion by using similar experimental parameters. RESULTS: Earliest cortical activity (P1) was recorded in parallel in the primary/secondary somatosensory cortex and posterior insula (approximately 85 ms). Significantly later activity was seen in the anterior insula (approximately 103 ms) and cingulate cortex (approximately 106 ms; P=.0001). There was no difference between the P1 latency for magnetoencephalography and cortical evoked potential (P=.16); however, neural activity recorded with cortical evoked potential was longer than with magnetoencephalography (P=.001). No sex differences were seen for psychophysical or neurophysiological measures. CONCLUSIONS: This study shows that exogenous cortical neural activity evoked by experimental esophageal pain is processed simultaneously in somatosensory and posterior insula regions. Activity in the anterior insula and cingulate-brain regions that process the affective aspects of esophageal pain-occurs significantly later than in the somatosensory regions, and no sex differences were observed with this experimental paradigm. Cortical evoked potential reflects the summation of cortical activity from these brain regions and has sufficient temporal resolution to separate exogenous and endogenous neural activity.     

Realistic spatial sampling for MEG beamformer images

The spatial resolution achievable using magnetoencephalography (MEG) beamformer techniques is inhomogeneous across the brain and is related directly to the amplitude of the underlying electrical sources [Barnes and Hillebrand, Hum Brain Mapp 2003;18:1-12; Gross et al., Proc Natl Acad Sci USA 2001;98:694-699; Van Veen et al., IEEE Trans Biomed Eng 1997;44:867-860; Vrba and Robinson, Proc 12th Int Conf Biomagn 2001]. We set out to examine what an adequate level of spatial sampling of the brain volume is in a realistic situation, and what implications these inhomogeneities have for region-of-interest analysis. As a basis for these calculations, we used a simple retinotopic mapping experiment where stimuli were 17-Hz reversing gratings presented in either left or right visual hemifield. Beamformer weights were calculated based on the covariance of the MEG data in a 0-80 Hz bandwidth. We then estimated volumetric full-width half-maximum (FWHM) maps at a range of sampling levels. We show that approximately 10% of the 1 mm cubic voxels in the occipital volume have a FWHM smoothness of <5 mm, and 80% <10 mm in three subjects. This was despite relatively low mean signal-to-noise ratios (SNR) values of 1.5. We demonstrate how visualization of these FWHM maps can be used to avoid some of the pitfalls implicit in beamformer region-of-interest analysis.     

The spatial distribution and temporal dynamics of brain regions activated during the perception of object and non-object patterns

Both animal and human studies suggest that the efficiency with which we are able to grasp objects is attributable to a repertoire of motor signals derived directly from vision. This is in general agreement with the long-held belief that the automatic generation of motor signals by the perception of objects is based on the actions they afford. In this study, we used magnetoencephalography (MEG) to determine the spatial distribution and temporal dynamics of brain regions activated during passive viewing of object and non-object targets that varied in the extent to which they afforded a grasping action. Synthetic Aperture Magnetometry (SAM) was used to localize task-related oscillatory power changes within specific frequency bands, and the time course of activity within given regions-of-interest was determined by calculating time-frequency plots using a Morlet wavelet transform. Both single subject and group-averaged data on the spatial distribution of brain activity are presented. We show that: (i) significant reductions in 10-25 Hz activity within extrastriate cortex, occipito-temporal cortex, sensori-motor cortex and cerebellum were evident with passive viewing of both objects and non-objects; and (ii) reductions in oscillatory activity within the posterior part of the superior parietal cortex (area Ba7) were only evident with the perception of objects. Assuming that focal reductions in low-frequency oscillations (<30 Hz) reflect areas of heightened neural activity, we conclude that: (i) activity within a network of brain areas, including the sensori-motor cortex, is not critically dependent on stimulus type and may reflect general changes in visual attention; and (ii) the posterior part of the superior parietal cortex, area Ba7, is activated preferentially by objects and may play a role in computations related to grasping.