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Biomedical subjects

A M J Paans

Publications and source records attributed to A M J Paans.

7 recordsLinked to original sources

Medial versus lateral prefrontal dissociation in movement selection and inhibitory control.

We aimed to test the hypothesis that the cerebral selection of movement includes active suppression of unwanted movements. To that end, a cerebral activation paradigm was used in which index finger flexion was compared with similar movement, made together with fingers 3, 4, 5. Cerebral activations were assessed by positron emission tomography (PET) measurements of cerebral perfusion in 10 healthy subjects, during the two motor tasks and rest. Statistical parametric mapping (SPM) revealed significant increase of (antero)medial prefrontal activity and subtle changes in pallidum and thalamus in the condition of less movement, i.e. isolated index finger flexion contrasted to full-hand flexion. These increases indicated a mechanism of selection mediated by active suppression of unwanted movements. Suppression of all motor responses was inferred from anterolateral prefrontal activation related to rest (with only auditory cues), contrasted to both motor conditions. This segregation of inhibitory functions specifies the complementary character of response selection and inhibitory control, in such a way, that towards the medial prefrontal surface, a transition from general to increasingly selective inhibition allows the internal ordering of action.

Adult↗

Cerebral reorganisation of human hand movement following dynamic immobilisation.

Surgical treatment of a flexor tendon lesion of the hand is followed by a 6-week period of dynamic immobilisation. This is achieved by the elastic strings of a Kleinert splint, enabling only passive and no active flexor movements. After such immobilisation, the appearance of a temporary clumsy hand indicates decreased efficiency of cerebral motor control. Using PET we identified the recruitment of contralateral parietal and cingulate activations specifically related to the suboptimal character of these hand movements. After 6-8 weeks, normalised movement was related with contralateral putamen activation. Activations of the sensorimotor cortex and cerebellum were present during both scanning sessions. Changes in the pattern of cerebral activations reflect functional reorganisation. The shift from cortical to striatal involvement, observed in the group of four patients, generates the concept of unlearned movements being relearned.

Cerebellum↗

One brain, two selves.

Having a sense of self is an explicit and high-level functional specialization of the human brain. The anatomical localization of self-awareness and the brain mechanisms involved in consciousness were investigated by functional neuroimaging different emotional mental states of core consciousness in patients with Multiple Personality Disorder (i.e., Dissociative Identity Disorder (DID)). We demonstrate specific changes in localized brain activity consistent with their ability to generate at least two distinct mental states of self-awareness, each with its own access to autobiographical trauma-related memory. Our findings reveal the existence of different regional cerebral blood flow patterns for different senses of self. We present evidence for the medial prefrontal cortex (MPFC) and the posterior associative cortices to have an integral role in conscious experience.

Adult↗

Comparison of 99mTc-sestamibi-18F-fluorodeoxyglucose dual isotope simultaneous acquisition and rest-stress 99mTc-sestamibi single photon emission computed tomography for the assessment of myocardial viability.

Dual isotope simultaneous acquisition single photon emission computed tomography (DISA SPECT) offers the advantage of obtaining information on myocardial perfusion using Tc-sestamibi ( Tc-MIBI) and metabolism using F-fluorodeoxyglucose ( F-FDG) in a single study. The prerequisite is that the Tc-MIBI images are not degraded by scattered 511 keV photons or poor count statistics due to the lower efficiency of the extra high energy (EHE) collimator. Therefore, we compared the registered Tc-MIBI uptake and image quality of DISA and single isotope acquisition. Furthermore, we investigated whether DISA yields additional information for the assessment of myocardial viability in comparison with rest-stress Tc-MIBI. Nineteen patients with known coronary artery disease and irreversible perfusion defects on previous rest-stress MIBI test studies were investigated. After oral glucose loading and simultaneous injection of 600 MBq of Tc-MIBI and 185 MBq of F-FDG at rest, DISA was performed using energy windows of 140 (+/-15%), 170 (+/-20%) and 511 keV (+/-15%). Planar 140 keV images were corrected for scatter by subtraction using the 170 keV window. The single and dual isotope Tc-MIBI images were both displayed in a polar map with 128 segments normalized to maximum counts. F-FDG and Tc-MIBI images were visually scored for a perfusion-metabolism mismatch pattern using nine regions per heart. There was an excellent correlation (r =0.93, P<0.0001) between the Tc-MIBI uptake detected in the single and dual isotope acquisition. The average difference between the dual and single isotope Tc-MIBI uptake was -1.2% (not significantly different from zero) and the coefficient of variation of the difference was 8.7%. Of the 79 regions with irreversible perfusion defects on previous rest-stress Tc-MIBI, six regions in five patients showed a perfusion-metabolism mismatch pattern. We conclude that DISA does not affect the quality of the Tc-MIBI images. Furthermore, F-FDG- Tc-MIBI DISA may show viability in a small but significant (7.6%, P<0.0034) number of regions with irreversible perfusion defects on rest-stress Tc-MIBI.

Adult↗

Iterative versus filtered backprojection reconstruction for statistical parametric mapping of PET activation measurements: a comparative case study.

The significance of task-induced cerebral blood flow responses, assessed using statistical parametric mapping, depends, among other things, on the signal-to-noise ratio (SNR) of these responses. Generally, positron emission tomography sinograms of H(2)(15)O activation studies are reconstructed using filtered backprojection (FBP). Alternatively, the acquired data can be reconstructed using an iterative reconstruction procedure. It has been demonstrated that the application of iterative reconstruction methods improves image SNR as compared with FBP. The aim of this study was to compare FBP with iterative reconstruction, to assess the statistical power of H(2)(15)O-PET activation studies using statistical parametric mapping. For this case study, PET data originating from a bimanual motor task were reconstructed using both FBP and maximum likelihood expectation maximization (ML-EM), an iterative algorithm. Both resulting data sets were statistically analyzed using statistical parametric mapping. It was found, with this dataset, that the statistical analysis of the iteratively reconstructed data confirm the a priori expected physiological response. In addition, increased Z scores were obtained in the iteratively reconstructed data. In particular, for the expected task-related response, activation of the posterior border of the left angular gyrus, the Z score increased from 3.00 to 3.96. Furthermore, the number of statistically significant clusters doubled while their volume increased by more than 50%. In conclusion, iterative reconstruction has the potential to increase the statistical power in H(2)(15)O-PET activation studies as compared with FBP reconstruction.

Brain Mapping↗

Interscan displacement-induced variance in PET activation data is excluded by a scan-specific attenuation correction.

In PET activation studies, linear changes in regional cerebral blood flow may be caused by subject interscan displacements rather than by changes in cognitive state. The aim of this study was to investigate the impact of these artifacts and to assess whether they can be removed by applying a scan-specific calculated attenuation correction (CAC) instead of the default measured attenuation correction (MAC). Two independent data sets were analyzed, one with large (data I) and one with small (data II) interscan displacements. After attenuation correction (CAC or MAC), data were analyzed using SPM99. Interscan displacement parameters (IDP), obtained during scan realignment, were included as additional regressors in the General Linear Model and their impact was assessed by variance statistics revealing the affected brain volume. For data I, this volume reduced dramatically from 579 to 12 cm(3) (approximately 50-fold) at P(uncorr) </= 0.001 and from 100 to 0 cm(3) at P(corr) </= 0.05 when CAC was applied instead of MAC. Surprisingly, for data II, applying CAC instead of MAC still resulted in a substantial (approximately 10-fold) reduction of the affected volume from 23 to 2 cm(3) at P(uncorr) </= 0.001. We conclude that interscan displacement-induced variance can be prevented by applying a (realigned attenuation correction scan (e.g., CAC). With MAC data, introducing IDP covariates is not an alternative since they model only this variance. Even in data with minor interscan displacements, applying a (realigned attenuation correction method (e.g., CAC) is superior to a nonaligned MAC with IDP covariates.

Adult↗

Right parieto-premotor activation related to limb-independent antiphase movement.

In both quadrupedal and bipedal walking, cyclic movements of opposite limbs are made in antiphase, with identical frequency of all four limbs. These kinematical characteristics generated the hypothesis that, in humans, the cerebral control of this stereotypic movement pattern is associated with a common circuitry involved in antiphase movement, independent from execution by either the two upper or the two lower limbs. By means of positron emission tomography (PET), we identified cerebral activations related to limb-independent antiphase movement, distributed over the right anterior parietal and the right dorsal premotor cortex. Particularly, involvement of the right parietal cortex demonstrates a lateralized brain function for higher-order somatosensory processing, enabling the sensorimotor anchoring of stereotypic multilimb movement.

Acoustic Stimulation↗