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Biomedical subjects

C Kennard

Publications and source records attributed to C Kennard.

At least 91 records · Page 5Linked to original sources
PubMed1994

Cortical control of saccades and fixation in man. A PET study.

To identify cortical regions activated during saccades and visual fixation, regional cerebral blood flow (rCBF) was measured in eight healthy subjects using C15O2 PET during the performance of three tasks: (i) central fixation; (ii) reflexive saccades to random targets; (iii) remembered saccades to locations of recent target appearance. Significant rCBF increases were identified using analysis of covariance and the t statistic (P < 0.001). Compared with central fixation there was activation of striate and extra-striate cortex, posterior parietal cortex (PPC) and frontal eye fields (FEF) during both reflexive and remembered saccades. During remembered saccades there was additional activation of supplementary motor area (SMA), insula, cingulate, thalamus, midbrain, cerebellum and right superior temporal gyrus (Brodmann's area 22). Compared with the individual saccadic tasks, central fixation activated extensive regions of ventromedial (areas 10, 11 and 32) and anterolateral (areas 8, 9, 10, 45 and 46) prefrontal cortex, and foveal visual cortex. We conclude that FEF and PPC are associated with the generation of both reflexive and remembered saccades, with SMA additionally involved during remembered saccades. Sustained voluntary fixation is mediated by prefrontal cortex.

Adult↗
PubMed1994

Precortical dysfunction of spatial and temporal visual processing in migraine.

This paper examines spatial and temporal processing in migraineurs (diagnosed according to International Headache Society criteria, 1988), using psychophysical tests that measure spatial and temporal responses. These tests are considered to specifically assess precortical mechanisms. Results suggest precortical dysfunction for processing of spatial and temporal visual stimuli in 11 migraineurs with visual aura and 13 migraineurs without aura; the two groups could not be distinguished. As precortical dysfunction seems to be common to both groups of patients, it is suggested that symptoms that are experienced by both groups, such as blurring of vision and photophobia, may have their basis at a precortical level.

Adult↗
PubMed1993

Temozolomide: a new oral cytotoxic chemotherapeutic agent with promising activity against primary brain tumours.

Temozolomide, a new oral cytotoxic agent, has been given to 28 patients with primary brain tumours. Treatment was given at a dose of 150 mg/m2/day for 5 days (i.e. total dose 750 mg/m2) escalating, if no significant myelosuppression was noted on day 22, to 200 mg/m2/day for 5 days (i.e. total dose 1000 mg/m2) for subsequent courses at 4 week intervals. A major improvement in computer tomography (CT) scan was noted in 5/10 patients with astrocytomas recurrent after radiotherapy, with a major clinical improvement but minor improvement on CT scan in one further patient. Reduction in the size of the CT lesion was also observed in 4/7 patients with newly diagnosed high grade astrocytomas given 2-3 courses of temozolomide prior to irradiation. 1 patient with recurrent medulloblastoma had a clinical response in bone metastases. Temozolomide was well tolerated with little subjective toxicity and usually predictable myelosuppression and is a promising new drug in the treatment of primary brain tumours.

Administration, Oral↗
PubMed1993

Influence of sensory manipulation on postural control in Parkinson's disease.

Postural control was assessed on a tilting platform system in 20 patients with idiopathic Parkinson's disease and 20 age-matched controls. The amount of information provided by vision and lower limb proprioception was varied during the experiment to investigate the influence of changes in sensory cues on postural control. The patient group with clinical evidence of impaired postural control (Hoehn and Yahr III) had significantly higher sway scores over all sensory conditions than either the Hoehn and Yahr II group or controls. The pattern of sway scores indicated that no obvious deficit in the quality, or processing, of sensory information was responsible for the postural instability observed in this group. The patients in both Hoehn and Yahr groups were also able to respond appropriately to potentially destabilising sensory conflict situations and significantly improved their sway scores when provided with visual feedback of body sway. The results indicate that in Parkinson's disease, the main site of dysfunction in postural control is likely to be at a central motor level.

Adult↗
PubMed1992

Saccadic eye movements in Parkinson's disease: I. Delayed saccades.

The saccadic eye movements of nine patients with Parkinson's disease were compared to those of nine age-matched controls in two paradigms generating volitional saccades. In both paradigms, subjects had to make delayed saccades to peripheral LED targets: a peripheral target appeared 700 msec before a buzzer sounded, the buzzer being the signal to make a saccade to the target. In the first paradigm ("centre-off"), the fixation target was extinguished simultaneously with buzzer onset. In the second ("centre-remain") it was not extinguished until 1000 msec later. The results showed that for outward saccades in both paradigms, there was no difference between Parkinsonian patients and controls, but saccadic latencies were significantly shorter in the "centre-remain" paradigm. The initial outward saccades were indistinguishable from the normal, reflex saccades of the same subjects. However, saccades returning to the centre (a type of remembered target saccade) were hypometric and showed multistepping. Both effects were more pronounced in patients with Parkinson's disease. The significance of these findings in terms of current hypotheses about the nature of the Parkinsonian saccadic deficit is discussed.

Aged↗
PubMed1992

Saccadic eye movements in Parkinson's disease: II. Remembered saccades--towards a unified hypothesis?

Ten patients with mild to moderate Parkinson's disease were compared with ten age-matched normal controls in a series of saccadic paradigms in order to test various hypotheses relating to the origin of the Parkinsonian saccadic defect. The paradigms comprised a reflex saccade paradigm, a standard remembered saccade paradigm, a remembered saccade paradigm with delayed centre-offset, and a remembered saccade paradigm with a second target flash immediately prior to saccade execution. Finally, subjects executed both reflex and remembered saccades in a standard remembered paradigm (the "two-saccade" paradigm). As has been reported previously, Parkinsonian subjects demonstrated hypometria on all remembered saccade paradigms, particularly the "two-saccade" paradigm. There was, however, no significant difference between the first three remembered saccade paradigms. These studies serve to refute a simple attentional capture hypothesis, and a hypothesis that suggests that the abnormality of remembered saccades is due to concurrent reflex saccade suppression. On the basis of the results, further hypotheses are advanced in an attempt to explain all published work on Parkinsonian saccades.

Aged↗
PubMed1991

Increase in saccadic peak velocity with increased frequency of saccades in man.

Twelve normal subjects (aged 22-80 yr, mean 47 yr) performed three blocks of 20 saccades made to LED targets stepped back and forth. The first and last blocks were performed at a (slow) rate of 0.18 Hz, while the middle block was performed at the faster rate of 1.15 Hz. Mean saccadic amplitude was unaffected by saccade rate, but latency and duration became shorter at the higher frequency. Most interestingly, the peak velocity increased by approx. 6% when saccades were performed at the higher rate. This increase was statistically significant, even after normalization for saccade amplitude. That saccadic frequency may affect saccadic peak velocity must be considered as a potential variable when analysing saccades.

Adult↗
PubMed1991

A case of ocular tilt reaction and torsional nystagmus due to direct stimulation of the midbrain in man.

A case is presented of a patient who underwent insertion of a periaqueductal grey electrode for the relief of chronic pain. Shortly after insertion, the patient developed a left-sided ocular tilt reaction (OTR). The electrode tip, initially to the right of the midline, was then withdrawn slightly so that it was now on the left side. Stimulation at this point gave rise to a worsening of the tilt reaction, in addition to bilateral counter-clockwise torsional nystagmus. Computerized tomography and stereotactic coordinates indicated that the tip of the electrode was finally situated in the region of the left interstitial nucleus of Cajal (INC). The production of an OTR by stimulation in this region is similar to the phenomenon previously reported in monkeys and cats. The side of the OTR is consistent with previous evidence, suggesting that the utricular pathways cross between medulla and midbrain.

Electric Stimulation↗
PubMed1991

Scales for rating motor impairment in Parkinson's disease: studies of reliability and convergent validity.

Study 1 examined the reliability of the ratings assigned to the performance of five sign-and-symptom items drawn from tests of motor impairment in Parkinson's disease. Patients with Parkinson's disease of varying severity performed gait, rising from chair, and hand function items. Video recordings of these performances were rated by a large sample of experienced and inexperienced neurologists and by psychology undergraduates, using a four point scale. Inter-rater reliability was moderately high, being higher for gait than hand function items. Clinical experience proved to have no systematic effect on ratings or their reliability. The idiosyncrasy of particular performances was a major source of unreliable ratings. Study 2 examined the intercorrelation of several standard rating scales, comprised of sign-and-symptom items as well as activities of daily living. The correlation between scales was high, ranging from 0.70 to 0.83, despite considerable differences in item composition. Inter-item correlations showed that the internal cohesion of the tests was high, especially for the self-care scale. Regression analysis showed that the relationship between the scales could be efficiently captured by a small selection of test items, allowing the construction of a much briefer test.

Activities of Daily Living↗
PubMed1991

A direct demonstration of functional specialization in human visual cortex.

We have used positron emission tomography (PET), which measures regional cerebral blood flow (rCBF), to demonstrate directly the specialization of function in the normal human visual cortex. A novel technique, statistical parametric mapping, was used to detect foci of significant change in cerebral blood flow within the prestriate cortex, in order to localize those parts involved in the perception of color and visual motion. For color, we stimulated the subjects with a multicolored abstract display containing no recognizable objects (Land color Mondrian) and contrasted the resulting blood flow maps with those obtained when subjects viewed an identical display consisting of equiluminous shades of gray. The comparison identified a unique area (area V4) located in the lingual and fusiform gyri of the prestriate cortex. For motion, blood flow maps when subjects viewed moving or stationary black and white random-square patterns were contrasted. The comparison identified a unique area located in the region of the temporo-parieto-occipital junction (area V5). We thus provide direct evidence to show that, just as in the macaque monkey, different areas of the human prestriate visual cortex are specialized for different attributes of vision. The striate cortex (V1) and the contiguous visual area (V2), which in the monkey brain feed both the homologous areas, were active in all 4 conditions. This pattern of activity allowed us to use an extension of the approach to assess the functional relationship between the 3 areas during color and motion stimulation. This is based on an hypothesis-led analysis of the covariance structure of the blood flow maps and promises to be a powerful tool for inferring anatomical pathways in the normal human brain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Auditory-visual interaction in the generation of saccades in man.

Four normal human subjects were investigated for evidence of auditory-visual interaction in the generation of horizontal saccades. In a first experiment it was shown that the mean amplitudes of initial saccades from primary position to auditory targets were significantly affected by the simultaneous occurrence of a distracting visual stimulus. If both auditory and visual stimuli were in the same hemifield, the mean amplitude of initial saccades to a fixed buzzer position was consistently increased or decreased depending on the position of the visual stimulus. The phenomenon is felt to be analogous to the "centre-of-gravity" effect previously described for two simultaneous visual stimuli. It did not occur if visual and auditory stimuli were in opposite hemifields when a simultaneous visual stimulus caused a slight reduction of mean initial saccadic amplitude compared to the mean amplitude to buzzer alone. In this case the reduction was independent of visual stimulus position. Similar effects were seen for mean final eye positions. In a second experiment, a similar procedure was carried out, but the eyes started by looking at a point at 15 degrees eccentricity. The same pattern of auditory-visual interaction was obtained in both experiments, consistent with the concept of eye-movement related movement of modality-specific sensory "maps" which has recently been shown to occur in the superior colliculus of primates.

Acoustic Stimulation↗
PubMed1990

Saccadic eye movements in essential blepharospasm.

To provide evidence of an organic pathology for essential (idiopathic) blepharospasm, reflex saccadic eye movements in response to randomly stepped visual targets were assessed in seven affected patients and seven age-matched controls using the magnetic scleral search coil technique. The results indicate a significant prolongation in latency and a reduction in gain of horizontal saccades, and an increase in latency and reduction of peak velocity of large downward saccades. These findings suggest an organic component to the aetiology of blepharospasm, the pathology of which also appears to involve the oculomotor system. The pattern of the oculomotor disorder does not allow specific localisation but is consistent with the underlying pathology being localised in the basal ganglia.

Adult↗
PubMed1990

Antisaccades and remembered saccades in Parkinson's disease.

Antisaccades were studied in ten patients with mild to moderate Parkinson's disease and ten age-matched normal controls. Remembered saccades and reflex saccades were assessed for comparison. In the population of patients who showed the previously reported abnormalities of remembered saccades, antisaccades were indistinguishable from those of controls in latency, gain and peak velocity. This finding implies that antisaccades are mediated through pathways which are unaffected by Parkinson's disease, and which are therefore presumably distinct from pathways mediating other voluntary saccades.

Aged↗
PubMed1989

The colour centre in the cerebral cortex of man.

Anatomical and physiological studies have shown that there is an area specialized for the processing of colour (area V4) in the prestriate cortex of macaque monkey brain. Earlier this century, suggestive clinical evidence for a colour centre in the brain of man was dismissed because of the association of other visual defects with the defects in colour vision. However, since the demonstration of functional specialization in the macaque cortex, the question of a colour centre in man has been reinvestigated, based on patients with similar lesions in the visual cortex. In order to study the colour centre in normal human subjects, we used the technique of positron emission tomography (PET), which measures increases in blood flow resulting from increased activity in the cerebral cortex. A comparison of the results of PET scans of subjects viewing multi-coloured and black-and-white displays has identified a region of normal human cerebral cortex specialized for colour vision.

Cerebral Cortex↗