Medical evaluation in road injury claims.
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Biomedical subjects
Publications and source records attributed to C Tomberg.
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1. Non-averaged scalp-recorded brain potentials were studied in humans during selective attention to randomly intermixed series of stimuli to fingers. Physiological tests were use for validating the presence or absence of the short-latency cognition-related P40 electrogeneses in parietal cortex in the response to a single-target stimulus (P40 signifies a positive polarity of about 40 ms peak latency). 2. To minimize interference from the electroencephalogram and noise we mapped single brain responses over the scalp and identified P40 topographies by an updated form of the numerical estimator Z for assessment of recorded potentials over time. We found that Z should exceed 0.96 for at least 15 ms for validation of the topographical congruity between the single P40 and an averaged P40 template. 3. Individual responses to 145 target finger stimuli correctly identified by the subject were analysed. P40 occurred only intermittently (34.5%) in a series of targets, but its voltage was unexpectedly large, exceeding the P40 voltage in averaged responses by a factor of about 10. 4. The usual assumption in the averaging method that the single brain responses combined in the average are stable but merely contaminated by unrelated noise was shown to be false for the cognition-related P40, which was considerably underestimated because of its intermittency in the averaged single trials. 5. The reaction time of the subject was on average 19% shorter in the trials in which a P40 was present, thus suggesting that P40 can influence subsequent perceptual processing by the brain in the same trial. 6. The feasibility of identifying specific cognition-related electrogeneses in single brain responses opens up the study of momentary shifts in brain processing strategies thereby allowing the neurophysiology of cognition to be based in real time.
Percutaneous magnetic stimulation in humans allows non-invasive stimulation of deeply situated nervous structures with little, if any, discomfort and has proven its utility for brain stimulation. At the level of the vertebral canal, magnetic stimulation readily elicits muscle responses through activation of the motor spinal roots, but there has been no evidence for direct stimulation of the spinal cord itself. The present results document the feasibility of directly stimulating descending systems of the cervical spinal cord which synaptically activate motoneurones. A working hypothesis is that the structure thus stimulated may be cortico-motoneuronal pyramidal axons or the propriospinal system.
Slightly suprathreshold magnetic stimuli were delivered over the left scalp while a normal human subject attended a sensory signal which called for a motor response of right fingers in a reaction time paradigm. The cortico-motoneuronal systems of the two muscles producing finger extension disclosed a remarkable physiological differentiation. Brain magnetic stimulation delivered just before the subject's motor response revealed cortico-motoneuronal facilitation for one extensor muscle and concomitant inhibition for the other, depending on the verbal instructions that had been given to the subject before the experimental trial. Thus, during the planning of specific finger manipulatory activities, the motor brain systems can achieve significant contrast in the membrane excitatory states of the motor cortical pyramidal neurones, even for synergic muscles.
Electronic averaging is currently used for displaying event-related potentials such as P300 from the electroencephalogram (EEG). However, there is a growing need for upgraded methods allowing cognitive components to be identified in single trial brain responses. The Z estimation method has been adapted for the topographic testing of non-averaged scalp recordings. Z values approximating +1 help validate a genuine P300 while failure to pass the Z test may suggest the spurious nature of a late positivity that mimicks a P300. Z testing can also identify interference from transient EEG alpha activity by showing alternations between +1 and -1 values, as expected from an oscillating alpha generator. In contrast with previous methods based on EEG recordings from a single scalp site, our topographic Z method takes into account 28 scalp sites for single trials testing.
Consciousness offers a major challenge to the neurosciences. Even though consciousness is by definition subjective and private to the organism concerned, we consider it to be an intrinsic feature of biological processes in the brain. As such, it should be viewed in the Darwinian perspective of natural selection which implies that the conscious brain function does have survival value and cannot be a mere epiphenomenon. We attempted a neurophysiological approach by assessing perceptual processing of simple somatic sensory inputs in humans. We found that short-latency cortical potentials evoked by a target finger stimulus attended by the subject are strongly enhanced, thus manifesting a remarkable potentiation of the cognitive representations in primary parietal cortex. About 80 msec later, the dorsolateral prefrontal cortex discloses enhanced electrogeneses which we believe to reflect activation of somatic representations in 'working memory'. A functional 'binding' between these critical areas has been revealed by the transient and selective synchrony of 40 Hz oscillations recorded in the cortical areas of the parietal and prefrontal cortices. We consider these re-entrant interactions at 40 Hz to be an essential part of the conscious brain mechanisms that achieve the identification of an object (in this example, a finger) and the decision to release a motor behavioral response.
Studies of scalp-recorded brain event-related potentials in humans currently depend on the electronic averaging of many responses to the stimulus. In non-averaged single responses, it is sometimes possible to see late components such as the so-called P300, but not the shorter latency components that are much smaller and masked in background noise. We tried to identify short-latency cognitive potentials evoked by finger stimulation by comparing single trial responses that are concomitantly recorded at the contralateral and ipsilateral parietal scalp respectively. We developed a single trial topographic mapping method that proved important for assessing whether any left-right difference at short latency indeed reflected genuine cognitive electrogeneses. These results make it possible to analyze on a trial-by-trial basis the short latency cognitive processing in somatic perception.
Electrical potential oscillations in the range of 35-45 Hz (gamma waves) have recently been shown to occur rather ubiquitously in the brain of awake humans. During selective somatic attention, we demonstrate a transient phase-locking of the gamma waves generated in the contralateral prefrontal and parietal cortical areas that we had previously shown to be involved in such selective attention tasks. In line with other microphysiological evidence obtained on mammalian visual cortex, this selective functional synchronization between critical human brain areas (as far as about 9 cm apart) is proposed to reflect the transient 'binding' of discrete cognitive features that are processed in distributed neuronal assemblies of the brain whereby the conscious perception of an object or event can be achieved. On this basis we emphasize that the conscious function of the brain is neither epiphenomenal nor delayed, but operates transiently to integrate relevant perceptual features at the time of target object identification and of conscious behavioural decision.
Different methods for estimating reaction times (RTs) from either finger flexion or finger extension responses have been evaluated. The onset of finger movement was recorded with a photoelectric method and the results are compared with RT measures based on microswitch closure or onset of electromyographic (EMG) activity in the prime move muscle. EMG analysis showed the voluntary motor commands to present a characteristic ballistic pattern in RTs. However, this was not true for a number of trials with unusually long RTs which involved ramp or double burst EMG patterns that were interpreted as reflecting errors in the force calibration of motor commands. RTs based on photoelectric recording of onset of finger extension were consistently related to the RTs estimated from EMG onset in the prime mover muscle. It is concluded that the EMG onset or the finger lift photoelectric method is best suited for reliable RT recording.
When recording the onset of the electromyographic (EMG) voluntary response in reaction time (RT) studies, the electrodes should be placed on the muscle which is first and foremost involved in executing the response. It is thus necessary to identify which is the prime mover muscle among active synergic muscles. This has been investigated for index finger lift or flexion RTs by delivering a magnetic stimulus to motor cortical areas prior to the subject's voluntary response. The EMG responses to the magnetic stimulus were selectively facilitated either in the extensor indicis proprius muscle (in index lift RTs) or in the first dorsal interosseous muscle (in index flexion RTs). These effects are robust and provide a method for identifying the prime mover muscle in voluntary movements.
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The average reference introduces ghost potential fields at the latencies for which the integral of scalp-recorded potentials differs from zero. These spurious effects occur because the average reference is computed from a limited number of (scalp) electrodes which do not survey the bottom half of the head. By arbitrarily re-setting the zero at each latency in the maps to be compared, it can also obliterate or even reverse topographical differences in the case of focal brain potentials enhancements thereby defeating the purpose of brain mapping.
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The dynamics of many biological systems have recently been attributed to low-dimensional chaos instead of high-dimensional noise, as previously though. Because biological data are invariably nonstationary, especially when recorded over a long interval, the conventional measures of low-dimensional chaos (e.g., the correlation dimension algorithms) cannot be applied. A new algorithm, the point correction dimension (PD2i) was developed to deal with this fundamental problem. In this article we describe the details of the algorithm and show that the local mean PD2i will accurately track dimension in nonstationary surrogate data.
Detailed procedures are described for the study of somatosensory event-related potentials (ERPs) to electric stimulation of fingers. Control responses to homogeneous (100%) series of identical stimuli (thus eliminating input mismatch) while the subject reads a novel (thus providing a distinct attention-capturing activity and maintaining vigilance level) are validated as reflecting the exogenous obligatory profiles required for assessing cognitive component in ERPs to target relevant stimuli. With these 'neutral' conditions, the control responses have a similar profile even at larger ISIs such as those separating the infrequent targets in Attention runs. Conversely, series of stimuli identical to those in control runs can elicit cognitive components in a 'Lie' experiment when the subject is induced to treat the stimuli like targets even though there is no discrimination involved. On this basis, the somatosensory P30, P40, P100 and N140 components appearing in the target profiles are considered genuine cognitive components. They have been analyzed with scatter displays, electronic subtraction, bit-mapped displays and with calculation of Z and dilation factors. The cognitive P30 and P40 reflect selective attention-related enhancements of the neural generators in receiving somatosensory cortex. The early parietal positivity P27 can thus be modulated separately from the frontal N30 component and is thought to be generated by a radial dipole in area 1. The later cognitive P100 and N140 reflect the invocation of distinct processors in conjunction with the behavioral use of the sensory input. The evolving topographical patterns of the P100 and N140 electrogeneses, revealed by bit-mapped data, suggest complex interactions between posterior parietal and prefrontal cortex whereby the sensory information is placed into spatial coordinate systems and matched with representations of relevant objects or relationships in space for target processing in the sequential tasks.
Somatosensory evoked potentials (SEPs) to mild electric stimulation of two fingers of the left hand were studied at regular interstimulus intervals (ISIs) of 450, 800, 1400, 2500 and 4000 msec. Habituation was evaluated while the subject was reading a novel so as to virtually ignore the finger stimuli while maintaining steady vigilance levels. Brain SEPs recorded from 25 scalp electrodes were assessed by scatter displays, electronic subtraction, bit-mapped potential fields, and by calculating the Z estimator and dilation factor. Similar results were obtained with randomly varying ISIs. The P14 farfield and cortical N20 did not change with ISIs. The parietal P27-P45 decreased at ISIs of 800 and 450 msec, but showed no significant habituation at ISIs of 1400, 2500 or 4000 msec. This validated the control conditions used for assessing the early cognitive P30 and P40 to attended target stimuli. The frontal N30 also decremented the shorter ISIs but still habituated up to ISIs of 2500 msec. The clear dissociation between frontal N30 and parietal P27 at the larger ISIs suggests that they involve at least in part distinct neural generators.
In brain topographic mapping, the putative location and orientation in the head space of neural generators are currently inferred from the features of negative and positive scalp potential fields. This procedure requires the use of a fairly neutral reference. The frequently advocated average reference creates problems because its effect is not merely to change a (steady) zero reference level, but to dynamically zero-center all scalp potentials at each latency. Ghost potential fields are thus created at the latencies for which the integral of scalp recorded potentials differs from zero. These distortions of brain mapping have been analyzed with a true 3-shell head model in conjunction with the emulation of SEP components. In the head model, surface potential fields generated by dipoles or dipole sheets of various depths and orientations were computed either over the north hemisphere, so as to emulate scalp recorded SEP components, or over the entire equivalent head sphere. The spurious effects of the average reference are shown to occur because it is computed from a limited number of (scalp) electrodes which fail to survey the bottom half of the head.