Deep brain stimulation for Parkinson's disease dissociates mood and motor circuits: a functional MRI case study.

Behavioral disturbances have been reported with subthalamic (STN) deep brain stimulation (DBS) treatment in Parkinson's disease (PD). We report correlative functional imaging (fMRI) of mood and motor responses induced by successive right and left DBS. A 36-year-old woman with medically refractory PD and a history of clinically remitted depression underwent uncomplicated implantation of bilateral STN DBS. High-frequency stimulation of the left electrode improved motor symptoms. Unexpectedly, right DBS alone elicited several reproducible episodes of acute depressive dysphoria. Structural and functional magnetic resonance imaging (fMRI) imaging was carried out with sequential individual electrode stimulation. The electrode on the left was within the inferior STN, whereas the right electrode was marginally superior and lateral to the intended STN target within the Fields of Forel/zona incerta. fMRI image analysis (Analysis of Functional NeuroImages, AFNI) contrasting OFF versus ON stimulation identified significant lateralized blood oxygen level-dependent (BOLD) signal changes with DBS (P < 0.001). Left DBS primarily showed changes in motor regions: increases in premotor and motor cortex, ventrolateral thalamus, putamen, and cerebellum as well as decreases in sensorimotor/supplementary motor cortex. Right DBS showed similar but less extensive change in motor regions. More prominent were the unique increases in superior prefrontal cortex, anterior cingulate (Brodmann's area [BA] 24), anterior thalamus, caudate, and brainstem, and marked widespread decreases in medial prefrontal cortex (BA 9/10). The mood disturbance resolved spontaneously in 4 weeks despite identical stimulation parameters. Transient depressive mood induced by subcortical DBS stimulation was correlated with changes in mesolimbic cortical structures. This case provides new evidence supporting cortical segregation of motor and nonmotor cortico-basal ganglionic systems that may converge in close proximity at the level of the STN and the adjacent white matter tracts (Fields of Forel/zona incerta).     

Saccharin's rewarding, conditioned reinforcing, and memory-improving properties: mediation by isomorphic or independent processes?

Unconditioned reward and conditioned reinforcing effects may reflect an isomorphic motivational process because increased conditioned reinforcing effects were seen with increased amounts of saccharin consumed in taste and place conditioning. Reinforcing effects in place conditioning leveled off as saccharin unconditioned consumption reached maximum amounts of approximately 140 mg/rat. Posttrial consumption, but not intraperitoneal injection, of saccharin significantly enhanced conditioned place and taste preferences as well as conditioned taste aversions. Saccharin's memory-improving effects in both aversive and appetitive conditioning suggest a process separate from the reward-reinforcement process. Independent of effects on blood glucose, the motivational property of saccharin's sweet taste undergoes differential central processing to mediate reward-reinforcement versus memory improvement processes.     

The time-course of rod-cone interaction

The time-course of rod-cone interaction (change of scotopic sensitivity caused by photopic background stimulation) was measured in the presence of briskly exchanged, scotopically matched, 490- and 630-nm background disks. In all conditions, interaction rose and fell quickly with changes of photopic stimulation. When the background was a small 0.6 degree-diameter disk, photopic stimulation produced relatively constant maintained interaction of about 0.6 log units. When the background was a large 7.8 degree-dia disk, photopic stimulation produced larger initial (0.6-1.0 log unit) than maintained (0.2 log unit) interaction. When a 0.6 degree by 7.8 degree annulus was used instead of a background, photopic stimulation produced substantial interaction only at offset, a transitory interaction. Thus, the spatial dependence of transitory interactions differs from that of maintained interaction: transitory interactions can be large even when maintained interaction is small or absent. The results are discussed in terms of a simple center-surround model of rod-cone interaction that unifies both maintained and transient interaction.     

A method for sleep depriving rats

A method is described for sleep depriving up to 12 rats at a time by placing them in two large rotating cylinders. EEG data, previously unavailable for rats treated in this manner, show that total sleep time was significantly reduced from 47.0 percent to 3.8 percent of a 24-hr period. There was no selective reduction of REM or non-REM sleep.     

Progress in clinical neurosciences: cognitive markers of progression in Alzheimer's disease

The objective of this review is to summarize the literature on Alzheimer's disease progression utilizing cognitive batteries to track change over time. Studies published in English and obtained through PubMed searches (1983-2004) were included (i) if they had a longitudinal design and followed probable Alzheimer's patients diagnosed by National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association or Diagnostic and Statistical Manual III/IV criteria, and (ii) if the techniques used for serial assessment were well-established in terms of validity and reliability. Longitudinal studies examining Alzheimer's disease progression report highly variable annual rates of change in decline rate. It remains unclear if this reflects disease subgroups or stage-related rate of decline. In conclusion a combination of stage-appropriate cognitive tests such as the Mattis Dementia Rating Scale and the Severe Impairment Battery, along with appropriate statistical methods to account for individual variability in decline rates, can capture the progression of Alzheimer disease and may be useful in further investigation.     

Influence of order of stimulus presentation on speech motor learning: A principled approach to treatment for apraxia of speech

The present study was designed to examine whether applying principles of motor learning to a commonly used treatment approach for acquired apraxia of speech (AOS) would enhance relearning of speech production skills. In particular, we examined one main principle, random practice, and compared it to blocked practice. Of importance is the fact that many speech treatments utilize blocked practice, but the literature on motor learning clearly shows that blocked practice facilitates acquisition of target behaviours, but not retention and transfer. The latter two are considered true indices of learning. In two subjects with severe AOS, results showed that random practice facilitated retention whereas blocked practice did not. The present study provides preliminary evidence that these principles may have a similar effect on learning of skilled speech motor acts as they do on learning of limb movements. The results reported here are encouraging and provide justification and focus for further investigation.     

Vasculitic polyradiculopathy in systemic lupus erythematosus

A 22 year old woman with recently diagnosed systemic lupus erythematosus presented with subacute progressive areflexic paraparesis, electrophysiologically identified as a pure axonal polyradiculopathy. Sural nerve biopsy disclosed necrotising vasculitis. A striking radiological feature was marked enhancement of the cauda equina with gadolinium.