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C H Lücking

Publications and source records attributed to C H Lücking.

At least 73 records · Page 4Linked to original sources
PubMed1998

A comparison between electric source localisation and fMRI during somatosensory stimulation.

The present study investigates the electric source localisation of somatosensory evoked potentials (SEPs) using high-resolution EEG (61 scalp electrodes) considering the individual brain morphology as obtained from magnetic resonance images (MRI). A comparison with the activation maps in fMRI under the same somatosensory stimulation paradigm was done. The somatosensory evoked potentials (SEPs) to electrical stimulation of the right median nerve were collected from the scalp of 8 healthy right-handed subjects. The source reconstruction for the 20 ms SEP component was performed by using a single moving dipole model as a source model and a spherical three-shell model as a head model. In 6 of the subjects fMRI was performed using the same electric stimulation of the right median nerve. The source location of the 20 ms SEP component was found to be within the postcentral gyrus. The fMRI activation maps were also located in the postcentral gyrus when using the same somatosensory stimulation paradigm. The appropriateness of using high-resolution EEG and fMRI in the functional localisation of the primary somatosensory cortex is discussed.

Adult↗
PubMed1998

Estimation of the accuracy of a surface matching technique for registration of EEG and MRI data.

OBJECTIVES: We developed a method to register EEG and MRI data used for the source reconstruction of electric brain activity. METHODS: The method is based on matching of the head surfaces as obtained by 3D scanning after the EEG recording, and by segmentation of MRI data. The registration accuracy was estimated by calculating the residual error of the surface matching and its intra-individual and inter-individual variability. In addition, the test-retest reliability concerning the transformation of electrode positions was studied, to estimate how inaccuracies resulting from the 3D scanning of the head surface translate into registration uncertainty. RESULTS: For 61 measurements, performed on 20 subjects, the average root mean square of the Euclidean distances between the 3D-scanned and the MRI-derived head surfaces amounted to 3.4 mm. An inter-individual standard deviation of 0.24 mm, and an intraindividual standard deviation of 0.003-0.31 mm proved a high inter- and intra-subject stability of the surface matching technique. The variation of transformation results when studying the test-retest reliability amounted to 1.6 mm on average. The maximum error of transformation was smaller than the diameter of the electrodes. CONCLUSIONS: The findings suggest that the surface matching technique is a precise method for determination of the transformation of electrode positions and MRI data into a single co-ordinate system and can successfully be used in a routine laboratory setting.

Brain↗
PubMed1998

Hemifacial spasm due to posterior fossa tumors: the impact of tumor location on electrophysiological findings.

Ephaptic transmission is one of the electrophysiological hallmarks of hemifacial spasm. It is generally accepted that in the majority of patients with idiopathic hemifacial spasm, microvascular compression of the facial nerve at the site where the nerve exits the brain stem is the underlying cause. Whether the actual site of the ephapse is at the site of the lesion or at a nuclear level due to hyperexcitability of the facial motor nucleus is still controversial. Rarely, hemifacial spasm may be due to space occupying lesions in the cerebellopontine angle or in the brain stem. We report the electrophysiological findings of four patients with hemifacial spasm due to extra-axial tumors in different locations of the posterior fossa. The location of the tumor was intrameatal in one patient, in the cerebellopontine angle in two patients and in the brain stem in another patient. Facial nerve motor neurographies including transcranial magnetic stimulation revealed abnormal findings in two patients. Selective stimulation of facial nerve branches demonstrated delayed (ephaptic) responses in all but one patient whose hemifacial spasm had disappeared after treatment with carbamazepine. The latencies of the delayed responses did not correlate with the tumor location. In sum, the site of ephaptic transmission cannot be reliably determined by latency measurements of the delayed response because of its variability which is probably caused by the different size and diameter of the axons participating in ephaptic transmission as well as by the extent of focal demyelination at the site of the lesion. A neuroradiological work up including MR imaging should be mandatory in all patients with hemifacial spasm because electrophysiological studies fail to differentiate between idiopathic and symptomatic hemifacial spasm.

Adult↗
PubMed1998

What is straight ahead to a patient with torticollis?

Vestibular and neck proprioceptive signals are known to be used in judging the locations of objects in space and relative to the body. Given that these signals are asymmetric in patients with spasmodic torticollis, one would expect such patients to have abnormal spatial perception. We tested this idea by measuring patients' perception of visual straight ahead (VSA) under various conditions: with the body in its primary position, i.e. with the head and trunk as closely aligned as possible, and after well defined passive rotations of the head and/or trunk. In the primary body position, patients' VSA direction showed considerable variations which were similar, however, to those of normal subjects; it was independent of torticollis direction, of the head torque it produced, and of the weak spontaneous nystagmus recorded in seven of the 10 patients. After whole-body rotations, i.e. where head and trunk underwent the same motion, the VSA was shifted in both patients and normal subjects, and in both groups the shift was symmetrical after rotations to the right or left. After motions where the trunk rotated under the stationary head (neck proprioceptive stimulation) or the head on the stationary trunk (combined vestibular and neck stimulus), the VSAs of normal subjects coincided rather well with their head midsagittal planes, whereas the VSAs of patients were shifted considerably towards the trunk, again in a symmetrical way. We suggest two mechanisms to explain the findings in patients: (i) a central compensation which restores symmetry of the afferent inflow in the patients (unlike the motor efference); (ii) shifting of the reference for the VSA from the head towards the trunk, because the trunk is a more reliable egocentric reference than the head in the patients. Our findings do not support the assumption that asymmetries in afferent inflow are responsible for the asymmetry of motor output in spasmodic torticollis.

Adult↗
PubMed1998

Impaired cardiac uptake of meta-[123I]iodobenzylguanidine in Parkinson's disease with autonomic failure.

OBJECTIVE: To selectively investigate postganglionic sympathetic cardiac neurons in patients with Parkinson's disease and autonomic failure. MATERIAL AND METHODS: Metaiodobenzylguanidine (MIBG) is a pharmacologically inactive analogue of noradrenaline, which is similarly metabolized in noradrenergic neurons. Therefore the uptake of radiolabelled MIBG represents not only the localization of postganglionic sympathetic neurons but also their functional integrity. Ten patients with Parkinson's disease and autonomic failure underwent standardized autonomic testing, assessment of catecholamine plasma levels and scintigraphy with [123I]MIBG. RESULTS: The cardiac uptake of MIBG, as demonstrated by the heart/mediastinum ratio, was significantly lower in patients in comparison with controls. Scintigraphy with MIBG allowed the selective in-vivo investigation of postganglionic sympathetic cardiac efferents in patients with autonomic failure, a procedure which was previously confined to post-mortem examination. CONCLUSION: These findings point to a relevant postganglionic pattern of involvement of the autonomic nervous system (ANS) in Parkinson's disease and autonomic failure.

3-Iodobenzylguanidine↗
PubMed1998

Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings.

OBJECTIVE: Vitamin B12 deficiency is a systemic disease that often affects the nervous system. One of the most prevalent manifestations is subacute combined degeneration (SCD) of the spinal cord. To access the clinical, electrophysiological, and structural abnormalities associated with SCD, a study was conducted in nine patients. METHODS: Clinical, electrophysiological (electroneurography, somatosensory and motor evoked potentials), and MRI evaluations were performed in patients before and after treatment. RESULTS: The most prominent clinical and electrophysiological findings in all patients were dysfunctions of the posterior column. Corresponding hyperintense lesions in the posterior column of the spinal cord were found in two patients by T2 weighted MRI. Damage to the central motor pathway was identified in four patients. Demyelinating neuropathy was present in one patient and axonal neuropathy in four. All patients showed improvement of their symptoms after treatment with cobalamin. Abnormalities of the spinal cord on MRI disappeared early in recovery. Motor evoked potentials and median somatosensory evoked potentials typically normalised after treatment, whereas tibial somatosensory evoked potentials remained abnormal in most patients. CONCLUSIONS: Clinical, electrophysiological, and MRI findings associated with SCD in vitamin B12 deficiency are diverse. Thus vitamin B12 deficiency should be considered in the differential diagnosis of all spinal cord, peripheral nerve, and neuropsychiatric disorders.

Acute Disease↗
PubMed1997

Hand tremor in patients with spasmodic torticollis.

The occurrence of hand tremors in patients with spasmodic torticollis (ST) was investigated in 55 patients by clinical and quantitative measurements. Ten patients had first-order or second-order relatives affected with postural tremor. Although 40% of the patients had a medical history and clinical findings for mild postural and action tremor of the hands, only four had moderate tremor amplitudes. One patient had a severe tremor, including resting tremor, and two had mild voice tremor. A positive correlation was found between hand and head tremor. Patients with hand tremor were younger at the onset of ST than were those without. The mean amplitudes of postural tremor were only slightly higher than for the controls and much smaller than those found in classic essential tremor. The tremor caused only mild disabilities. The tremor frequencies were indistinguishable from physiologic tremor. Further analysis of the tremor records showed evidence for physiologic tremor mechanisms only. We conclude that slightly enhanced postural hand tremors are common in ST but have a low amplitude and are only rarely clinically relevant for ST patients. Although the present data support the notion of an enhanced risk of postural tremor in families of patients affected with ST, none of the criteria allowed the separation of the hand tremor of ST from other postural/action tremors and especially from enhanced physiologic tremor. Thus, the present data do not support the classification of hand tremor in ST as either "dystonic" or essential tremor.

Adolescent↗
PubMed1997

Stimulation of sympathetic activity by carbon dioxide in patients with autonomic failure compared to normal subjects.

In vivo studies selectively assessing preganglionic and central autonomic nervous system activity in patients with autonomic failure have so far been limited to testing pituitary function. In animal experiments carbon dioxide (CO2) selectively stimulates central sympathetic nuclei in the ventrolateral medulla and preganglionic sympathetic neurons in the cervical trunk. This central stimulation seems to overrule less pronounced peripheral vasodilatatory effects. This study addressed the question of whether hypercapnea is a suitable challenge procedure to test preganglionic and central autonomic activity in healthy subjects and in patients with autonomic failure of preganglionic and central origin. Seven patients with multiple system atrophy (MSA) and 30 age-matched healthy volunteers underwent a protocol including a Valsalva manoeuvre (VM) under normo- and hypercapnic conditions and exposure to hypercapnea under supine resting conditions. Blood pressure (BP), heart rate (HR) and end-tidal CO2 partial pressure were measured continuously and non-invasively. In normal controls hypercapnea induced significantly higher BP values in phases II, IIe, III and IV of the VM compared to the normocapnic VM and a significant increase in BP during steady-state supine exposure compared to normocapnic baseline. HR increased significantly only after 40 s of steady-state hypercapnea during the latter challenge. In patients with MSA and autonomic failure, in whom a predominantly preganglionic lesion of the autonomic nervous system is established, no significant effects of hypercapnea on the cardiovascular parameters were found. Although this non-invasive challenge procedure cannot differentiate between pre- and postganglionic autonomic failure, exposure to hypercapnea enables the investigation of efferent autonomic activity to vasoconstrictors generated from autonomic centres in the brainstem and cervical trunk.

Aged↗
PubMed1997

[Stereotactic treatment of movement disorders].

Stereotactic surgery for movement disorders is currently undergoing a re-evaluation. A new understanding of the pathophysiology makes the surgical lesion a logical step for the aleviation of both hyperkinetic symptoms such as tremor and hypokinetic symptoms like bradykinesia. Advances in imaging and electrophysiological control render these procedures more accurate and safer. Indications are medically refractory, Parkinsonean tremor, essential tremor, cerebellar tremor, bradykinesia and L-Dopa induced dyskinesis. The standard procedure is ablative surgery, i.e. thalamotomy for tremors and pallidotomy for bradykinesia, dystonia and L-Dopa induced dyskinesias. Deep brain stimulation is a novel alternative for selected patients which is currently evaluated. Neural transplantation of autologus, fetal or genetically manipulated cell suspensions into the striatum for the time being is experimental.

Brain Mapping↗
PubMed1997

Reproducibility and validity of electric source localisation with high-resolution electroencephalography.

The present study investigates the reproducibility and validity of the EEG source localisation of somatosensory evoked potentials (SEPs) using high-resolution EEG (61 scalp electrodes) and a source reconstruction on the basis of the individual brain morphology as obtained from magnetic resonance images (MRIs). The somatosensory evoked potentials (SEPs) to electrical stimulation of the right median nerve were repeatedly collected from the scalp of one healthy subject in 9 replications run on 9 different days. The source reconstruction for the 19 ms SEP component was performed by using a single moving dipole model as a source model. Two different head models were used: a spherical 3 shell model and a more realistically shaped 3 compartment model computed using the boundary element method (BEM). The source locations of the 19 ms SEP component were found to be highly reproducible using both head models: the mean standard deviation of the dipole locations was found to be 2.6 mm for the 3 shell model and 4 mm for the more realistically shaped head model. By projection into the individual MRI, the dipoles resulting from either head models were found to be located within the postcentral gyrus. The electric source locations were consistent with the maximum of the task-specific changes seen in a functional magnetic resonance imaging (fMRI) experiment when using the same somatosensory stimulation protocol.

Brain Mapping↗
PubMed1997

The bereitschaftspotential paradigm in investigating voluntary movement organization in humans using magnetoencephalography (MEG).

In 1965, Kornhuber and Deecke first described the bereitschaftspotential (BP), a paradigm for investigating the organization of voluntary movement in humans, using electroencephalography (EEG). This paradigm has since been used in many studies for investigating motor control in healthy humans and patients. Over the last years, the advantages of magnetoencephalography (MEG) have been applied to the BP paradigm by a number of researchers. The main advantage of magnetoencephalography over electroencephalography is that MEG has a higher localization accuracy. This is due to the fact that the different structures of the head (brain, liquor cerebrospinalis, skull and scalp) influence the magnetic fields less than the volume current flow that causes the EEG. Additionally, the MEG is reference free, so that the localization of sources with a given precision is easier for MEG than it is for EEG. The present protocol shows in detail how the bereitschaftspotential paradigm can be applied using MEG. Some additional paradigms for investigating motor plasticity, somatosensory gating, Parkinson disease, and the efference copy theory are suggested as well.

Adult↗
PubMed1997

Contrast detection, discrimination and adaptation in patients with Parkinson's disease and multiple system atrophy.

Visual spatial contrast thresholds and suprathreshold contrast matches were measured before and after adaptation to high-contrast sinewave gratings in patients with Parkinson's disease (n = 27), patients with multiple system atrophy (n = 6) and a group of age-matched control patients without CNS disease (n = 27). Contrast thresholds were higher in the Parkinson's disease patients than in either the multiple system atrophy patients or control patients. The effect of contrast adaptation on both contrast thresholds and matches was approximately equal in the three groups. This suggests that contrast adaptation is not affected by these CNS disorders and is consistent with the hypothesis that the loss in contrast sensitivity in Parkinson's disease is mediated by retinal effects. The results are discussed in terms of the underlying pathology of the visual deficits in Parkinson's disease and the possible diagnostic implications for differentiating Parkinson's disease and multiple system atrophy.

Adaptation, Ocular↗
PubMed1996

Retest variation of cardiovascular parameters in autonomic testing.

Little information is available on the methodological and physiological limits of repeatedly testing changes of blood pressure (BP) and heart rate (HR) during autonomic testing. The retest variation determines the value of follow-up investigations for the assessment of the natural course of patients with autonomic failure or the efficacy of treatment. 34 healthy volunteers between 18 and 85 years of age were tested twice within a mean period of one year (75-637 days). BP and HR were measured continuously with a Finapress device during active change of posture, passive tilt, deep breathing, Valsalva manoeuvre, isometric muscle exercise and mental arithmetic. The differences to baseline resting values before each manoeuvre were analysed. Although differences between the two occasions were comparatively small with mostly 1-7 mmHg for BP and 0.3-4 bpm for HR, the high standard deviations did not allow the calculation of useful normal ranges, as they would exceed meaningful (patho-) physiological changes over time. Therefore, a single repetition of a series of standard autonomic function tests did not appear to be suitable for follow-up observations. The calculation of the components of the coefficients of variation showed a predominance of the within variance as the cause of the poor reproducibility for the BP measurements, while changes in HR were more influenced by the between variation. The combination of the selection of some tests with a high between variance and the reduction of the within variance by performing 4, 5 retest runs can increase the reliability of standard autonomic function tests regarding follow-up assessments.

Adolescent↗
PubMed1996

5-HT1D-like receptors inhibit the release of endogenously formed [3H]GABA in human, but not in rabbit, neocortex.

Both human and rabbit brain contain the 5-hydroxytryptamine (5-HT)1D subtype of 5-HT1 receptors. We studied the effects of 5-HT1D receptor stimulation on neocortical [3H] gamma-aminobutyric acid (GABA) release from GABAergic neurons in these species. The 5-HT1D receptor agonist sumatriptan depressed [3H]GABA release in human neocortex and the 5-HT1 receptor antagonist metitepin prevented this depression with potencies suggesting mediation by 5-HT1D-like receptors. In rabbit neocortex, however, 5-HT1D agonists did not affect the release of [3H]GABA. Since 5-HT and GABA seem to function antagonistically in anxiety disorders their neocortical interaction may be (patho)physiologically relevant.

3-Mercaptopropionic Acid↗
PubMed1996

Bilateral myoclonus of the trapezius muscles after distal lesion of an accessory nerve.

Observations of rhythmic or semirhythmic myoclonus due to a peripheral nerve lesion are exceptional. We report on a patient with thorax trauma with multiple bilateral hematomas of the paravertebral musculature. Eight years later he developed rhythmic myoclonus of both trapezius muscles and thoracic pain. Infiltration of a paramedially located scar at the level of D5-6 with a local anesthetic agent led to an intermittent relief of the myoclonus as did anesthetic blockade of the left accessory nerve. Surgical excision of the scar, which contained multiple dystrophic axons on histological examination, cured the patient's symptoms as illustrated in a videotape. This indicates that peripheral afferents contributed to the myoclonus. Ephaptic transmission, ectopic excitation, or misdirected neuronal sprouting secondary to the trauma are possible peripheral mechanisms responsible for the movement disorder. Successful blockade of the left accessory nerve with bilateral relief of the symptoms suggests a secondary, more centrally located mechanism, e.g., in the brain stem, probably driven by an altered afferent input. It is concluded that rhythmic or semirhythmic and focal myoclonus need a careful workup to look for a peripheral cause because such a condition would be accessible for surgical treatment.

Accessory Nerve↗
PubMed1996

Cardiovascular parameters: sensitivity to detect autonomic dysfunction and influence of age and sex in normal subjects.

In 137 healthy volunteers between 18 and 85 years of age, blood pressure (BP) and heart rate (HR) were measured continuously with the Finapres device during active change of posture (ACP), i.e. standing upright, passive tilt (PT, i.e. head-up tilt), Valsalva manoeuvre (VM), deep breathing (DB), isometric muscle exercise (IME) and a mental arithmetic task (MA). Mean HR activation was attenuated with increasing age in all manoeuvres, but was unrelated to sex. In non-orthostatic challenge procedures like MA and IME mean BP increases were independent of age and sex, despite lower increases in HR in the elderly. This points to a preserved sympathetic efferent activity. Following a forced fall in BP during ACP, PT and VM, the initial responses and maintenance values of BP showed a significant age-related decrease. This finding was strongly related to lower BP values in males compared with females, which became more pronounced with increasing age. Further studies to investigate age-related changes in the activation of the various components of the cardiovascular regulation need to consider the mode of activation of the autonomic nervous system and sex as factors of influence. Normal ranges, and also some new points in time not previously measurable, were calculated for all standard autonomic tests based on the continuous measurement of BP and HR. The minimum length of time necessary to assess the cardiovascular responses during ACP and PT was found to be 60 s. The upper time limits for reaching maximum activation during IME and MA were 3.5 min and 1 min, respectively. Age had a relevant influence on the lower limits of normal of all HR parameters and of some BP measurements during PT, ACP and VM. Sex was found to have no relevant impact on normal ranges. Over 65 years of age the normal values for HR activation during VM and DB hardly exceeded baseline values. The possibility of increasing the sensitivity of detection of autonomic dysfunction by measuring BP continuously must be approached with caution, as sufficient sensitivity was only reached at the lower limits of normal during late phase II of the VM. The initial increase of HR after ACP and the BP values after 60 s standing time proved to be the parameters with the best sensitivity for detecting an affection of the regulation of HR and BP over the whole range of age.

Adolescent↗
PubMed1996

Topography and sources of electromagnetic cerebral responses to electrical and air-puff stimulation of the hand.

SEPs and SEFs after air-puff stimulation of index and little fingers have been studied and compared to the responses following electrical stimulation of the same digits and of the median nerve at the wrist in 5 subjects. The differences in morphology of the evoked signals are described and the generator characteristics are analysed for SEFs by means of a moving dipole model inside a homogeneous sphere. In our measurements the magnetic fields following electrical finger stimulation show a 30 msec component, which was absent following air-puff stimulation. This could not be seen in the electric field activity. The generators of the first component of SEFs after air-puff finger stimulation proved to be deeper (8 mm on average across all subjects and for both fingers) than in the case of electrically evoked SEFs. A similar behaviour was also observed for the second component of SEFs for the 2 stimulus modalities.

Adult↗