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Biomedical subjects

G Lindinger

Publications and source records attributed to G Lindinger.

At least 37 records · Page 2Linked to original sources

A marker for differentiation of capabilities for processing of musical harmonies as detected by magnetoencephalography in musicians.

This investigation was designed to study the characteristics of a marker for harmonic processing and to test whether it could be used for differentiating harmonic processing capabilities. The first three chords of an ordinary musical cadenca were presented to the left ear to establish a harmonic context followed by a harmonic or non-harmonic target tone. Cadencas were presented rapidly and randomly in different keys to render the task difficult. Results showed a specific P3m (magnetic P300) effect to the non-harmonic targets which was only visible in subjects with low target recognition errors. Low resolution electro-magnetic tomography current density maps showed P3m sources in the right temporoparietal, left temporoparietal and frontocentral brain areas with right temporoparietal sources being strongest and most reliable. The results offer new possibilities to selectively study harmonic variables in music processing.

Adult↗

Implicit memory within a word recognition task: an event-related potential study in human subjects.

First, we recorded brain potentials from 15 healthy young subjects during the performance of a word/non-word discrimination task. During continuous visual presentation, some of the meaningful words were repeated after 86-94 s. We found a significant decrease of response time associated with the classification of repeated words which is an index for priming, an unconscious brain process. However, event-related potentials (ERPs) did not differ significantly between first and second presentations. Second, we recorded brain potentials during a following recognition test. Some of the meaningful words which were presented only once during the semantic discrimination task were repeated and had to be discriminated from randomly interspersed new words. We compared ERPs produced by incorrectly classified repeated words (misses) with ERPs produced by correctly classified new words (correct rejections). We found early ERP differences between 250 and 400 ms and later differences starting at about 500 ms after the stimulus onset. The early effect occurred over parietal scalp locations and the later effect over frontal, parietal and occipital scalp locations. This is evidence for unconscious brain activity related to the processing of missed repeated words. We suggest that the later frontal effect we found is due to an enhanced effort of the retrieval of item representations during word recognition and that the earlier parietal effect reflects partial recognition.

Adult↗

Clinical symptoms in psychogenic seizures.

PURPOSE: To develop a classification system of psychogenic seizures based on characteristic clinical symptom clusters and sequences in order to facilitate the correct differential diagnosis of epileptic seizures. METHODS: We analysed the symptoms: clonic movements, hypermotor movements, trembling and tonic posturing of the upper/lower extremities, pelvic thrusting, stiffening of the body, version, side-to-side-head movements, non-versive head-turning and falling to the floor. We did this in a series of 16 patients with psychogenic seizures documented with prolonged video EEG monitoring. Nine patients (7 with frontal lobe epilepsy and 2 with primary generalised epilepsy with tonic, clonic seizures) served as a control group. RESULTS: We classified psychogenic seizures into 3 groups, namely (1) atonic psychogenic seizures, (2) psychogenic motor seizures and (3) psychogenic hypermotor seizures characterised by (1) falling to the ground, (2) trembling in the upper/lower extremities and (3) pelvic thrusting in combination with beating and kicking. While version exclusively occurred in epileptic seizures (incidence = 20%) and side-to-side head movements were only observed during psychogenic seizures (incidence = 8%), all other analysed symptoms were observed in both psychogenic and epileptic seizures. CONCLUSION: Our classification scheme should be useful in terms of permitting a more comprehensive clinical assessment of psychogenic seizures and their underlying psychiatric disorders. Furthermore, the differential diagnosis of psychogenic seizures should be considerably improved.

Adult↗

Autonomic epilepsy--the influence of epileptic discharges on heart rate and rhythm.

PURPOSE: To study cardiac alterations (changes in heart rate and cardiac arrhythmias) at the transition from the pre-ictal to the ictal state during focal epileptic seizures. METHODS: We assessed ECG changes during 92 seizures recorded with scalp EEG in 30 patients and 35 seizures in 11 patients evaluated with subdural strip and/or grid electrodes. Consecutive RR intervals were analyzed with a newly developed mathematical model for a total of 90 seconds (60 seconds pre-ictal, 30 seconds ictal). RESULTS: We found an ictal tachycardia (heart rate increase > 10 bpm) in 82.5% of seizures, and an ictal bradycardia (heart rate decrease > 10 bpm) in 3.3% of seizures. Bradycardia was only observed in seizures of frontal lobe origin. Heart rate changes occurred several seconds prior to EEG seizure onset on scalp-EEG in 76.1% of seizures, but also prior to EEG seizure onset on invasive EEG in 45.7% of seizures. Early tachycardia occurred significantly more often in temporal than in frontal lobe origin seizures. We found no significant effect of the side of seizure onset on both the quality and quantity of ictal heart rate changes. The occurrence of an aura or of awakening prior to the seizure had no influence on peri-ictal heart rate changes. Low risk cardiac arrhythmias were more frequently observed in frontal lobe origin seizures. CONCLUSIONS: Epileptic discharges directly influence portions of the central autonomic network, within a brain area too small or too deep to be detected on EEG, most likely deep mesial structures such as the amygdala or portions of the hippocampus. The potential clinical applications of our results include (1) automatic seizure detection, (2) differentiation between seizures of temporal and frontal lobe origin, (3) detection of peri-ictal cardiac arrhythmias, and (4) clarification of SUDS (sudden unexplained death syndrome) in epilepsy.

Adult↗

Event-related potential correlates of false recognitions of faces.

In a recognition memory experiment we recorded event-related brain potentials (ERPs) following the presentation of faces. We compared correctly classified repetitions of faces (hits) with new faces classified as repeated (false alarms). Stimulus-related averaging yielded significantly more negative ERPs to false alarms between 750 and 900 ms after onset of stimulus presentation. With response-related averaging we found significantly more negative ERPs to false alarms within the last 100 ms before movement onset. The differential activity was distributed over central and frontal regions and was still present in the period after the response. We interpret the phenomenon as an electrophysiological manifestation of false recognition as described by Schacter et al. (Schacter, D.L., Norman, K.A. and Koutstaal, W., The cognitive neuroscience of constructive memory, Annu. Rev. Psychol., 49 (1998) 289-318). False recognition could be the result of a preliminary decision based on illusionary familiarity and be associated with post-retrieval processing.

Evoked Potentials↗

Mental representations of movements. Brain potentials associated with imagination of eye movements.

OBJECTIVE: Current research in motor imagery is focused on similarities between actual and imagined movements on a central and a peripheral level of the nervous system. The present study measured slow cortical potentials (DC-potentials) during execution and internal simulation of memorized saccadic eye movements. METHODS: In 19 healthy righthanded subjects DC-potentials were recorded from 28 electrodes during execution and during imagination of a sequence of memorized eye movements during a visual imagery condition. RESULTS: Both oculomotor conditions showed a similar global level and similar topography of performance related DC-potentials, both strongly differed from the visual imagery condition and were lateralized to the left hemisphere. CONCLUSION: This study therefore supports the hypothesis that cortical brain structures responsible for execution and imagination of memorized saccadic eye movements are similar. The observed left hemispheric lateralization is in contrast to a previous study using bimanual movements. This discrepancy is discussed in relation to recent observations in apractic patients with parietal lesions.

Adult↗

Early occipito-parietal activity in a word recognition task: an EEG and MEG study.

OBJECTIVE: We investigated early brain activity (under 200 ms after the stimulus onset) related to the encoding and the retrieval of verbal information. METHODS: First, we compared ERPs produced by words which were encoded to ERPs produced by words from following test phases (correctly identified repetitions and correctly classified new words) in two different experiments. Experiment 1 consisted of an intentional learning paradigm and experiment 2 consisted of an incidental learning paradigm. In addition, we conducted a control experiment (experiment 3), which was a continuous recognition task with two different repetition intervals. Secondly, we conducted a magnetoencephalographic (MEG) study to further investigate early brain activity (experiment 4). The same intentional learning paradigm as in experiment 1 was used. RESULTS: We found that ERPs elicited by correctly classified test words (repeated words and new words) of both experiment 1 and experiment 2 were significantly more negative going than the ERPs elicited by the study words. This effect was apparent between 100 ms and 200 ms after the stimulus onset and was distributed over occipital and parietal scalp locations. In the control task (experiment 3), these early potential differences were missing (for both repetition intervals). Early event-related fields (ERFs) were also found to depend on the situation of the study phase and the test phase. This activity difference peaked at 120 ms after the stimulus onset. The distributions of the difference magnetic fields were occipito-parietal and thus consistent with the findings of experiment 1 (EEG-experiment). CONCLUSION: Whether the effect we defined in the present study is due to an increase of activity during the test situation or due to a decrease of activity during the study situation remains unclear. However, it might reflect attentional processes within a word recognition task depending on whether a word is encoded or an effort of word retrieval has to be made.

Adult↗

Bilateral subthalamic nucleus stimulation improves frontal cortex function in Parkinson's disease. An electrophysiological study of the contingent negative variation.

Parkinson's disease involves impaired activation of frontal cortical areas, including the supplementary motor area and prefrontal cortex, resulting from impaired thalamocortical output of the basal ganglia. Electrophysiologically, such impaired cortical activation may be seen as a reduced amplitude of the contingent negative variation (CNV), a slow negative potential shift reflecting cognitive processes associated with the preparation and/or anticipation of a response. Surgical interventions aimed at increasing basal ganglia-thalamic outflow to the cortex, such as electrical stimulation of the subthalamic nucleus with chronically implanted electrodes, have been shown to be effective in improving the clinical symptoms of Parkinson's disease. This study examined changes in cortical activity, as reflected in the CNV, associated with bilateral subthalamic nucleus stimulation in Parkinson's disease. The CNV was recorded from 10 patients with Parkinson's disease when on and off bilateral subthalamic nucleus stimulation, and was compared with the CNV of 10 healthy control subjects. Without subthalamic nucleus stimulation, Parkinson's disease patients showed reduced CNV amplitudes over the frontal and frontocentral regions compared with control subjects. With bilateral subthalamic nucleus stimulation, however, CNV amplitudes over the frontal and frontocentral regions were significantly increased. Results therefore suggest that impaired cortical functioning in Parkinson's disease, particularly within the frontal and premotor areas, is improved by subthalamic nucleus stimulation.

Adult↗

Regional cerebral blood flow during temporal lobe seizures associated with ictal vomiting: an ictal SPECT study in two patients.

PURPOSE: Ictal vomiting represents a rare clinical manifestation during seizures originating from the temporal lobes of the nondominant hemisphere. The precise anatomic structures responsible for generation of ictal vomiting remain to be clarified. Ictal single photon emission computed tomography (SPECT), which allows one to visualize the three-dimensional dynamic changes of regional cerebral blood flow (rCBF) associated with the ongoing epileptic activity, should be useful to study the brain areas activated during ictal vomiting. METHODS: We performed ictal Tc-HMPAO SPECT scans in two patients with mesial temporal lobe epilepsy (MTLE) whose seizures were characterized by ictal retching and vomiting. MTLE was documented by typical clinical seizure semiology, interictal and ictal EEG findings, hippocampal atrophy on magnetic resonance imaging (MRI) scan, and a seizure-free outcome after selective amydalohippocampectomy. In both patients, seizures originated in the nondominant temporal lobe. We obtained accurate anatomic reference of rCBF changes visible on SPECT by a special coregistration technique of MRI and SPECT. We used ictal SPECT studies in 10 patients with MTLE who had seizures without ictal vomiting as controls. RESULTS: In the two patients with ictal vomiting, we found a significant hyperperfusion of the nondominant temporal lobe (inferior, medial, and lateral superior) and of the occipital region on ictal SPECT. In patients without ictal vomiting, on the contrary, these brain regions never were hyperperfused simultaneously. CONCLUSIONS: Ictal SPECT provides further evidence that activation of a complex cortical network, including the medial and lateral superior aspects of the temporal lobe, and maybe the occipital lobes, is responsible for the generation of ictal vomiting.

Adult↗

Early cortical activation indicates preparation for retrieval of memory for faces: an event-related potential study.

Event-related brain potentials (ERPs) were used to investigate the time course of memory processes following the presentation of faces. Following a phase in which subjects were asked to memorize faces presented on a computer screen (study phase) they had to distinguish the previously presented faces from others new to the experiment (test phase). We found that in a time period from 250 to 350 ms after onset of stimulus presentation ERPs show higher negativity for both repeated and novel faces in the test phase compared to the study phase. This situation dependent effect is most pronounced in occipito-temporal regions. We conclude that memory retrieval for faces is a sequential process. The early part of this process constitutes preparation for the retrieval of stored information, and a later part of the process comprises the discrimination between repeated and novel faces.

Adult↗

The mode of movement selection. Movement-related cortical potentials prior to freely selected and repetitive movements.

In two previous studies, the readiness potential (RP) has been reported to be influenced by the mode of movement selection. Freely selected movements were found to have a higher RP amplitude than fixed repetitive movements. This was attributed to the higher demands on planning for the performance of freely selected movements. However, movements in the free mode are distinct from movements in the fixed mode in more than one respect. For example, they are also associated with a higher degree of alteration of the side and/or the finger of movement execution and hence serial "novelty" across blocks of trials. The aim of our study was to establish whether the greater novelty of movements in the free mode could also contribute to the enhanced RP amplitude of movements in the free mode of movement selection by comparing free versus fixed movements performed in long and short sequences that differ in terms of serial novelty. The RP was recorded in 31 healthy young subjects with electrodes placed over Fz, C3, Cz, C4 and Pz. Two types of movement were studied: randomly chosen button presses with right or left index or middle finger (free mode), and repetitive pressing of a predetermined button (fixed mode). We found that: (1) in confirmation of previous studies, the amplitude of the RP was higher for freely selected than free movements; (2) the effect of the mode of movement selection was present over central electrodes but was most pronounced for parietal electrode Pz, with movements in the free mode showing the earliest and greatest increase in negativity at this site; (3) this parietally enhanced negativity in free compared with the fixed mode was absent after the subjects had performed a block of long movement sequences, suggesting that serial novelty of movements also contributed to the effect of mode on the RP amplitude; (4) both the latency and the magnitude of the lateralized readiness potential (LRP) were altered by the mode of movement selection. Movements in the free mode showed an earlier onset of the LRP, which had a higher peak than the LRP prior to movements in the fixed mode. This effect was mainly due to an increased amplitude of the RP over the electrode contralateral to the side of movement prior to freely selected movements. These findings are discussed in relation to previous RP and positron emission tomography studies.

Adult↗

Language-related hemispheric asymmetry in healthy subjects and patients with temporal lobe epilepsy as studied by event-related brain potentials and intracarotid amobarbital test.

There are current attempts to replace the WADA test for pre-surgical evaluation of hemispheric language capabilities by one of the methods of functional brain imaging. Recent PET and fMRI studies using verbal cognitive tasks like verb generation, semantic monitoring or semantic ('deep') encoding of words showed asymmetries of activation in the fronto-lateral cortex. In a previous ERP study subjects were required to indicate whether pronounceable non-words and abstract geometric figures were presented for the first time ('new item') or whether they had been shown before ('old item'). Group analyses of this study showed significant material-specific hemispheric asymmetries with ERPs being more negative-going in recordings of the posterior part of the left hemisphere with verbal material (CP5/6) but more negative-going in recordings of the right hemisphere with the spatial material (P7/8). The aim of the present study was to test statistically ERP lateralization effects in individual healthy subjects as well as WADA-tested patients suffering from seizures of the mesio-temporal lobe (MTL). In all subjects ERP lateralization with verbal material was tested in the electrode pair CP5/6, and ERP lateralization with figures in the electrode pair P7/8. Statistical analyses of single trials showed that in 20 out of 24 subjects ERPs with verbal material started to be more negative-going in CP5 as compared to CP6 in the period between 100 and 200 ms after stimulus onset or the subsequent time epoch (200-300 ms). In one subject not CP5/6 but the closely adjacent electrode pair P7/P8 showed this verbal material-related hemispheric effect. In patients language dominance as indicated by ERPs was not always consistent with the data of the WADA test. In one patient with left MTL seizures ERPs with verbal material and figures were found to be significantly lateralized to the right hemisphere although the WADA test assigned this patient to have a language-dominant left hemisphere.

Adult↗

Event-related potentials in patients with temporal lobe epilepsy reveal topography specific lateralization in relation to the side of the epileptic focus.

Event-related potentials (ERPs) were recorded during a continuous recognition memory paradigm in patients with left-sided (LTLE; n = 8) or right-sided temporal lobe epilepsy (RTLE; n = 6), and in healthy control subjects (n = 24). Control subjects and both patient groups exhibited consistent OLD/NEW ERP-differences from 200-600 ms after stimulus onset. ERPs did not differ significantly between LTLE and RTLE patients, with respect to OLD/NEW distinction or the type of presented material (verbal vs. non-verbal). However, ERP topography showed significant differences between LTLE and RTLE patients: in lateral fronto-temporal recordings, patients showed larger negativities contralateral to the seizure focus, whereas we found larger negativities ipsilateral to the seizure focus in parietal recordings. Differences between the groups were significant from 300 to 600 ms post-stimulus. As a consequence, the amplitude gradient from fronto-temporal to parietal recordings was higher on the right side in LTLE patients and on the left side in RTLE patients. Again, differences between LTLE and RTLE patients were highly significant. We assume that ERPs reflect disturbances of a cortico-cortical network dependent on the side of the seizure focus in temporal lobe epilepsy. Furthermore, scalp-recorded ERPs might be a useful tool in the prediction of the side of the seizure focus in patients with temporal lobe epilepsy.

Adult↗

Ictal scalp EEG in unilateral mesial temporal lobe epilepsy.

PURPOSE: We wished to determine the predictive significance of unilateral hippocampal atrophy and interictal spikes on localization of ictal scalp EEG changes and assess whether ictal EEG provides information that might change treatment or influence prognosis in patients with such characteristics of epilepsy. METHODS: We analyzed EEG seizure patterns in 118 seizures in 24 patients with unilateral mesial temporal lobe epilepsy (MTLE) defined by typical clinical seizure semiology, unilateral hippocampal atrophy on magnetic resonance imaging (MRI) and unitemporal spikes on interictal EEG. Two blinded electroencephalographers independently determined morphology, location, and time course of ictal EEG changes. RESULTS: Lateralization was possible in 88.4-92.0% of seizures and always corresponded to the side of the interictal spike focus and of hippocampal atrophy on MRI. Although only 30.4-33.9% of seizures were lateralized at onset, a later significant pattern emerged (12.6-13.3 s after EEG seizure onset) that allowed lateralization in 82.4-91.0% of seizures with nonlateralized onset. Interobserver reliability for lateralization was excellent, with a K-value of 0.85. In most patients, either all (79.2-83.3%) or >50% (8.3-16.7%) of seizures were lateralized. In only a small proportion of patients (4.2-8.3%) were <50% of seizures lateralized. In 1 patient, no seizure could be lateralized by 1 electroencephalographer. The results of ictal EEG recordings did not alter the surgical approach and did not correlate with surgical outcome. CONCLUSIONS: We conclude that unilateral hippocampal atrophy on MRI and unitemporal interictal spikes can predict localization of ictal scalp EEG changes with a high degree of reliability and that ictal EEG provides no additional localizing information in this particular patient group.

Adult↗

[Prolonged video EEG monitoring in differential diagnosis of seizures and in presurgical epilepsy diagnosis].

Prolonged video-EEG-monitoring facilitates a correlation of clinical seizure semiology and corresponding EEG changes. Indications for prolonged video-EEG-monitoring comprise differential diagnosis of epileptic and psychogenic seizures, correct classification of epileptic syndromes and presurgical evaluation of patients with medically refractory focal epilepsies. 6000 patients in Austria would benefit from epilepsy surgery with an additional 150 bis 200 new patients appearing each year. Presurgical evaluation consists of a non-invasive Phase I and an invasive Phase II. During Phase I each patient is evaluated with a prolonged video-EEG-monitoring with scalp-EEG, a MRI-scan, a SPECT- and/or PET-scan, a neuropsychological evaluation and a Wada-test. If the epileptogenic zone cannot be localized adequately with these methods, invasive electrophysiological techniques with intracranial (epidural peg-electrodes, foramen-ovale electrodes, subdural strip or grid electrodes) or intracerebral electrodes (stereotaxically implanted depth electrodes) have to be applied. Epilepsy surgery renders 70 to 80% of patients seizure free and thus can regarded an effective and safe treatment option for patients with medically refractory focal epilepsies.

Diagnosis, Differential↗

Cortical DC potential shifts accompanying the central processing of visually presented analogue and digital time displays.

According to studies in brain-lesioned patients, the cortical substrate subserving the reading of digitally presented time displays seems to differ from that of reading analogue displays. While the right hemisphere has been assumed to be important for reading analogue displays, reading digital displays is attributed to the left hemisphere. This study attempts to localize the cortical substrate of reading analogue versus digital time displays in the intact human brain using scalp-recorded event-related slow negative DC potential shifts. In the arithmetic tasks, subjects had to judge whether or not the time conveyed by the last out of three tachistoscopically presented (analogue or digital) slides was the exact difference between the time conveyed by the first and the second slide. In the control condition, subjects only had to attend to (analogue or digital) time displays. With analogue slides, frontolateral recording sites revealed a right hemispheric preponderance of DC shifts measured in the interval between the second and third slide. Anterior temporal recording sites revealed a right hemispheric preponderance only when calculations were performed. By contrast, there was no hemispheric lateralization with digital slides. The arithmetic versus control manipulation modulated waveforms, but did not influence hemispheric laterality.

Adult↗

Brain/behaviour dissociation on old/new distinction in a patient with amnesic syndrome.

Event-related potentials (ERP) were recorded in a recognition memory task in 5 healthy subjects and an amnesic patient. A list of high-imagery words with low probability in everyday language was presented visually for 200 ms each. A second list, consisting of 50% previously presented ('old') words and 50% 'new' words was presented immediately after the first list. Old/new distinction was determined by the subject's motor response. For each subject single trial analysis of ERPs was performed. In each healthy subjects, correct old/new distinction was associated with significant ERP differences from 500 to 900 ms after stimulus onset. It was, therefore, assumed that task and recording procedures were appropriate for the study of ERPs with recognition memory. The main finding is a dissociation between brain activity and behaviour with old/new distinction in the patient with amnesic syndrome. Frequently, the patient incorrectly classified previously shown words ('old' words) to be presented for the first time ('new'). But ERP showed that brain processing of 'old' words which had incorrectly been classified to be 'new' is different from correctly classified new words. ERP differences were significant between 900 and 1200 ms after stimulus presentation. These data indicate preserved memory functions which are not assessed at the behavioural level in the memory recognition task.

Adult↗