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Biomedical subjects

H Flor

Publications and source records attributed to H Flor.

At least 37 records · Page 2Linked to original sources
PubMed2000

The thought translation device (TTD) for completely paralyzed patients.

The thought translation device trains locked-in patients to self-regulate slow cortical potentials (SCP's) of their electroencephalogram (EEG). After operant learning of SCP self-control, patients select letters, words or pictograms in a computerized language support program. Results of five respirated, locked-in-patients are described, demonstrating the usefulness of the thought translation device as an alternative communication channel in motivated totally paralyzed patients with amyotrophic lateral sclerosis.

Biofeedback, Psychology↗
PubMed1999

Plasticity in the motor system related to therapy-induced improvement of movement after stroke.

Neuroplasticity might play a beneficial role in the recovery of function after stroke but empirical evidence for this is lacking thus far. Constraint-induced (CI) therapy was used to increase the use of a paretic upper extremity in four hemiparetic stroke patients. Dipole modeling of steady-state movement-related cortical potentials was applied before and after training and 3 months later. The source locations associated with affected hand movement were unusual at follow-up because activation of the ipsilateral hemisphere was found in the absence of mirror movements of the unaffected hand. This long-term change may be considered as an initial demonstration of large-scale neuroplasticity associated with increased use of the paretic limb after application of CI therapy.

Aged↗
PubMed1999

Constraint-induced movement therapy for motor recovery in chronic stroke patients.

OBJECTIVE: Assessment of the effectiveness of constraint-induced (CI) movement therapy and quantitative evaluation of the effects of CI therapy. DESIGN: Intervention study; case series; pretreatment to posttreatment measures and follow-up 3 months after intervention. SETTING: An outpatient department. PATIENTS: Five chronic stroke patients with moderate motor deficit; convenience sample. INTERVENTIONS: CI therapy consisting of restraint of the unaffected upper extremity in a sling for 14 days combined with 6 hours of training per weekday of the affected upper extremity. MAIN OUTCOME MEASURES: Actual Amount of Use Test (AAUT), Motor Activity Log (MAL), Wolf Motor Function Test (WMFT), and Arm Motor Ability Test (AMAT) RESULTS: There was a substantial improvement in the performance times of the laboratory tests (AMAT, WMFT, p < or = .039) and in the quality of movement (AMAT, WMFT, p < or = .049; MAL, p = .049), particularly in the use of the extremity in "real world" environments (AAUT, p = .020), supported by results of quantitative evaluation. The effect sizes were large and comparable to those found in previous studies of CI therapy. CONCLUSIONS: CI therapy is an efficacious treatment for chronic stroke patients, especially in terms of real world outcome.

Aged↗
PubMed1999

Localization of somatosensory evoked potentials in primary somatosensory cortex: a comparison between PCA and MUSIC.

The aim of this study was to test source modeling strategies for EEG-data from a clinical group of amputees. The experimental conditions (measuring time, age and condition of the patients) resulted in low quality EEG-data. Noise reduction was achieved by a principal component analysis (PCA) and a multiple signal classification (MUSIC). A comparison of the results of these two methods with traditional signal handling yielded superior results for the MUSIC algorithm.

Aged↗
PubMed1999

Applied psychophysiology and learned physiological regulation.

This commentary emphasizes the importance of including animal research and basic human research, contrasts the present state of affairs for biofeedback in the United States versus Europe, and proposes an alternative, more expanded definition of applied psychophysiology, which includes research, diagnostics, and education, as well as interventions.

Animals↗
PubMed1999

Deficient discrimination of EMG levels and overestimation of perceived tension in chronic pain patients.

Twenty chronic low back pain patients (CBP), twenty tension headache (THA) patients, and twenty healthy controls (HC) participated in a tension production task where subjects had to attain four levels (4, 8, 12, 16 microV) of muscle tension at the m. frontalis and the m. erector spinae. Ratings of perceived tension, pain, and aversiveness as well as EMG, heart rate, and skin conductance levels were recorded. Signal detection and correlational methods revealed that the patients were deficient in muscle tension discrimination at high tension levels in both muscles. They generally overestimated low and underestimated high levels of muscle tension, especially in the CBP group. At low muscle tension levels, both healthy controls and patients showed deficient discrimination ability. Perceived muscle tension, aversiveness, and pain ratings during the tasks were higher in the patient groups. These data confirm and clarify previous reports of deficient tension perception and show concurrent overestimation of bodily symptoms in chronic musculoskeletal pain patients.

Adult↗
PubMed1999

Conditioned stress-induced analgesia in humans.

The purpose of this experiment was the demonstration of conditioned stress-induced analgesia in humans. Following a baseline day (day 1), two groups of 10 subjects were each exposed to green light as the conditioned stimulus (CS) and mental arithmetic plus noise as the unconditioned stimulus (US) for 5 days (days 2-6), a third group of 10 subjects was only exposed to the US. On the test day (day 7), pain threshold and pain tolerance were tested, while groups 1 and 3 received the green light CS and group 2 received no CS. Group 1 showed a significantly higher pain threshold and higher pain tolerance on the test day, whereas the two control groups did not have altered pain perception. Heart rate data confirmed successful stress induction. Heart rate and blood pressure were unaltered on the test day, thus making cardiovascular mediation of the conditioning effect unlikely. Conditioned stress analgesia might be useful in the understanding of chronic pain-syndromes. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗
PubMed1999

Activation of cortical and cerebellar motor areas during executed and imagined hand movements: an fMRI study.

Brain activation during executed (EM) and imagined movements (IM) of the right and left hand was studied in 10 healthy right-handed subjects using functional magnetic resonance imagining (fMRI). Low electromyographic (EMG) activity of the musculi flexor digitorum superficialis and high vividness of the imagined movements were trained prior to image acquisition. Regional cerebral activation was measured by fMRI during EM and IM and compared to resting conditions. Anatomically selected regions of interest (ROIs) were marked interactively over the entire brain. In each ROI activated pixels above a t value of 2.45 (p<0.01) were counted and analyzed. In all subjects the supplementary motor area (SMA), the premotor cortex (PMC), and the primary motor cortex (M1) showed significant activation during both EM and IM; the somatosensory cortex (S1) was significantly activated only during EM. Ipsilateral cerebellar activation was decreased during IM compared to EM. In the cerebellum, IM and EM differed in their foci of maximal activation: Highest ipsilateral activation of the cerebellum was observed in the anterior lobe (Larsell lobule H IV) during EM, whereas a lower maximum was found about 2-cm dorsolateral (Larsell lobule H VII) during IM. The prefrontal and parietal regions revealed no significant changes during both conditions. The results of cortical activity support the hypothesis that motor imagery and motor performance possess similar neural substrates. The differential activation in the cerebellum during EM and IM is in accordance with the assumption that the posterior cerebellum is involved in the inhibition of movement execution during imagination.

Adult↗
PubMed1999

Learned maintenance of pain: muscle tension reduces central nervous system processing of painful stimulation in chronic and subchronic pain patients.

The effect of level of muscle tension on the perception of painful stimuli was assessed in 13 chronic back pain patients, 14 subjects at high risk for chronic back pain, and 14 matched healthy controls. Subjects received painful intracutaneous electric stimuli to the forearm or the lower back while they produced either high or low muscle tension levels. Visual analog scale (VAS) ratings of acute pain were obtained after each trial. Electroencephalograms, electromyograms, skin conductance levels, and blood pressure were measured during the trials. Although subjective pain ratings were not significantly affected by muscle tension levels, the chronic pain patients displayed elevated N150 and N150/P260 amplitudes of the somatosensory-evoked potentials in the low as compared to the high muscle tension condition. The high risk group showed a trend toward higher N150 amplitudes in the low as compared to the high tension condition. The results of this study partially support the hypothesis that increases in muscle tension might serve as a pain-reducing mechanism in chronic pain patients and those at risk for chronicity, thus leading to a vicious pain-tension cycle.

Adult↗
PubMed1998

Reorganization of auditory cortex in tinnitus.

Magnetic source imaging was used to determine whether tonotopy in auditory cortex of individuals with tinnitus diverges from normative functional organization. Ten tinnitus subjects and 15 healthy controls were exposed to four sets of tones while magnetoencephalographic recordings were obtained from the two cortical hemispheres in sequence. A marked shift of the cortical representation of the tinnitus frequency into an area adjacent to the expected tonotopic location was observed. The Euclidean distance of the tinnitus frequency from the trajectory of the tonotopic map was 5.3 mm (SD = 3.1) compared with a distance of 2.5 mm (SD = 1.3) of a corresponding frequency in the healthy controls (t = 3.13, P < 0.01). In addition, a strong positive correlation was found between the subjective strength of the tinnitus and the amount of cortical reorganization (r = 0.82, P < 0.01). These results demonstrate that tinnitus is related to plastic alterations in auditory cortex. Similarities between these data and the previous demonstrations that phantom limb pain is highly correlated with cortical reorganization suggest that tinnitus may be an auditory phantom phenomenon.

Acoustic Stimulation↗
PubMed1998

fMRI reveals amygdala activation to human faces in social phobics.

Functional magnetic resonance imaging was used to determine the activation of the amygdala while seven social phobics and five healthy controls were exposed to slides of neutral faces as well as aversive odor stimuli. The amygdala was selectively activated in the social phobics during presentation of the face stimuli. The data show for the first time that the amygdala is active in human phobics when they are exposed to potentially fear-relevant stimuli. Further research is needed to determine the extent to which overactivation of the amygdala precedes or is a consequence of phobia.

Adult↗
PubMed1998

Cortical reorganization and phantom phenomena in congenital and traumatic upper-extremity amputees.

The relationship between phantom limb phenomena and cortical reorganization was examined in five subjects with congenital absence of an upper limb and nine traumatic amputees. Neuromagnetic source imaging revealed minimal reorganization of primary somatosensory cortex in the congenital amputees (M=0.69 cm, SD 0.24) and the traumatic amputees without phantom limb pain (M=0.27 cm, SD 0.25); the amputees with phantom limb pain showed massive cortical reorganization (M=2.22 cm, SD 0.78). Phantom limb pain and nonpainful phantom limb phenomena were absent in the congenital amputees. Whereas phantom limb pain was positively related to cortical reorganization (r=0.87), nonpainful phantom phenomena were not significantly correlated with cortical reorganization (r=0.34). Sensory discrimination was normal and mislocalization (referral of stimulation-induced sensation to a phantom limb) was absent in the congenital amputees. The role of peripheral and central factors in the understanding of phantom limb pain and phantom limb phenomena is discussed in view of these findings.

Adult↗
PubMed1998

The cortical somatotopic map and phantom phenomena in subjects with congenital limb atrophy and traumatic amputees with phantom limb pain.

The extent of the cortical somatotopic map and its relationship to phantom phenomena was tested in five subjects with congenital absence of an upper limb, four traumatic amputees with phantom limb pain and five healthy controls. Cortical maps of the first and fifth digit of the intact hand, the lower lip and the first toe (bilaterally) were obtained using neuroelectric source imaging. The subjects with congenital upper limb atrophy showed symmetric positions of the left and right side of the lower lip and the first toe, whereas the traumatic amputees with pain showed a significant shift (about 2.4 cm) of the cortical representation of the lower lip towards the hand region contralateral to the amputation side but no shift for the toe representation. In healthy controls, no significant hemispheric differences between the cortical representation of the digits, lower lip or first toe were found. Phantom phenomena were absent in the congenital but extensive in the traumatic amputees. These data confirm the assumption that congenital absence of a limb does not lead to cortical reorganization or phantom limbs whereas traumatic amputations that are accompanied by phantom limb pain show shifts of the cortical areas adjacent to the amputation zone towards the representation of the deafferented body part.

Adult↗
PubMed1998

Plasticity of plasticity? Changes in the pattern of perceptual correlates of reorganization after amputation.

We report a follow-up study on seven arm amputees in whom magnetic source imaging had originally revealed a strong correlation between the amount of cortical invasion of the deafferented cortex and the amount of pain evoked sensation mislocalized to the phantom limb. This re-examination was performed in order to corroborate the phenomenon of mislocalization. On follow-up examination for mislocalization 4 weeks later, a close correlation had remained between the original amount of cortical representational reorganization of the amputation zone (at the first examination) and the number of sites from where painful stimuli evoked sensations referred to the phantom limb, i.e. the amount of perceptual mislocalization, at the second examination. However, contrary to our expectation, the topography of referred sensation had completely changed in every patient. These results suggest that while the overall extent of reorganization is a rather stable phenomenon, the concomitant changes in the pattern of sensory processing are not. This may be due to the fact that alterations of sensory processing are not hardwired, but are rather mediated by an extensive and interconnected neural network with fluctuating synaptic strengths. This mechanism may be of importance for neurological rehabilitation.

Accidents↗