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Biomedical subjects

J Lagopoulos

Publications and source records attributed to J Lagopoulos.

7 recordsLinked to original sources

Cerebral vasomotor reactivity testing in head injury: the link between pressure and flow.

BACKGROUND: It has been suggested that a moving correlation index between mean arterial blood pressure and intracranial pressure, called PRx, can be used to monitor and quantify cerebral vasomotor reactivity in patients with head injury. OBJECTIVES: To validate this index and study its relation with cerebral blood flow velocity and cerebral autoregulation; and to identify variables associated with impairment or preservation of cerebral vasomotor reactivity. METHODS: The PRx was validated in a prospective study of 40 head injured patients. A PRx value of less than 0.3 indicates intact cerebral vasomotor reactivity, and a value of more than 0.3, impaired reactivity. Arterial blood pressure, intracranial pressure, mean cerebral perfusion pressure, and cerebral blood flow velocity, measured bilaterally with transcranial Doppler ultrasound, were recorded. Dynamic cerebrovascular autoregulation was measured using a moving correlation coefficient between arterial blood pressure and cerebral blood flow velocity, the Mx, for each cerebral hemisphere. All variables were compared in patients with intact and impaired cerebral vasomotor reactivity. RESULTS: No correlation between arterial blood pressure or cerebral perfusion pressure and cerebral blood flow velocity was seen in 19 patients with intact cerebral vasomotor reactivity. In contrast, the correlation between these variables was significant in 21 patients with impaired cerebral vasomotor reactivity, whose cerebral autoregulation was reduced. There was no correlation with intracranial pressure, arterial blood pressure, cerebral perfusion pressure, or interhemispheric cerebral autoregulation differences, but the values for these indices were largely within normal limits. CONCLUSIONS: The PRx is valid for monitoring and quantifying cerebral vasomotor reactivity in patients with head injury. This intracranial pressure based index reflects changes in cerebral blood flow and cerebral autoregulatory capacity, suggesting a close link between blood flow and intracranial pressure in head injured patients. This explains why increases in arterial blood pressure and cerebral perfusion pressure may be useful for reducing intracranial pressure in selected head injured patients (those with intact cerebral vasomotor reactivity).

Adolescent↗

Arousal dissociates amygdala and hippocampal fear responses: evidence from simultaneous fMRI and skin conductance recording.

The experience and appraisal of threat is essential to human and animal survival. Lesion evidence suggests that the subjective experience of fear relies upon amygdala-medial frontal activity (as well as autonomic arousal), whereas the factual context of threat stimuli depends upon hippocampal-lateral frontal activity. This amygdala-hippocampus dissociation has not previously been demonstrated in vivo. To explore this differentiation, we employed functional magnetic resonance imaging (fMRI) and simultaneous skin conductance response (SCR) measures of phasic arousal, while subjects viewed fearful versus neutral faces. fMRI activity was subaveraged according to whether or not the subject evoked an arousal SCR to each discrete face stimulus. The fMRI-with arousal and fMRI-without arousal data provided a distinct differentiation of amygdala and hippocampal networks. Amygdala-medial frontal activity was observed only with SCRs, whereas hippocampus-lateral frontal activity occurred only in the absence of SCRs. The findings provide direct evidence for a dissociation between human amygdala and hippocampus networks in the visceral experience versus declarative fact processing of fear.

Adult↗

Late components of the event-related potentials and their topography in Parkinson's disease.

Late components of the event-related potential (ERP; N100, P200, N200, and P300) were elicited using an auditory oddball paradigm (with a button-press response to target stimuli) in 15 Parkinson's disease (PD) patients and 50 normal control subjects. Compared with control subjects, PD subjects showed a significant decrease in N200 amplitude. Between-group topographical differences in N200 amplitude were evident at central (C3, Cz, C4) and temporal (T5, T3, T4, T6) regions. The results may reflect a deficit in response selection in PD possibly resulting from a dysfunction associated with the abnormalities in the central and temporal regions found to have a decreased N200 amplitude compared with normal control subjects in this study.

Acoustic Stimulation↗

Dysfunctions of automatic (P300a) and controlled (P300b) processing in Parkinson's disease.

P300 Event Related Potentials components (P300a and P300b) were investigated using an auditory oddball paradigm (with a button press response to target stimuli) in 15 Parkinson's disease patients and 50 normal controls whilst simultaneously measuring electrodermal activity. Cluster analysis showed that the first 10 target stimuli generated the largest skin conductance responses. The first 10 single-trial ERP epochs were therefore analysed as an ERP sub-average for each individual. The P300a component (associated with the automatic 'Orienting Reflex') was expected to be most prevalent in this sub-average (compared with sub-averages of subsequent blocks of 10 target stimuli). Twenty-nine out of 50 normal controls (58%) elicited a P300a in the first 10 target sub-average, compared with only 2 out of 15 Parkinson's disease subjects (13%). The conventional P300b component (associated with controlled processing) was found to be significantly delayed for all sub-averages for the Parkinson's disease group when compared with controls. These preliminary findings suggest a possible dysfunction in both automatic and controlled processing in this disorder.

Adult↗

Evoked related potentials associated with and without an orienting reflex.

Late component event related potentials (ERP) and concomitant electrodermal activity (EDA) measures of the orienting reflex (OR) were undertaken in 50 normal subjects. Our group recently developed a model to quantify electrodermal activity in conventional ERP paradigms (auditory oddball) with short interstimulus intervals (ISI). The method was used to classify the presence or absence of skin conductance response following each auditory target stimulus. Using a conventional paradigm in which data is traditionally averaged, single-trial target ERPs were sorted into those with a skin conductance response OR (ERP[+OR]) and those without (ERP[-OR]) an OR, and ERP sub-averages of the two groups were derived. The ERP(+OR) showed significantly larger P300 amplitudes and relatively earlier N200 and P300 latency than those of the ERP(-OR). These findings suggest that using concomitant SCR-ERP measures, separate ERP related processes can be determined, that are complementary to the traditional average measure.

Adolescent↗

Automatic processing dysfunction in Parkinson's disease.

Simultaneous measures of Event Related Potentials (ERP) and electrodermal activity (EDA) allow the delineation of ERPs that did, and did not, evoke an electrodermal 'Orienting Reflex' (OR). The OR is an automatic reflex invoked by novel or significant stimuli. Our group have developed a model to quantify electrodermal OR activity acquired in conventional late component ERP paradigms with short interstimulus intervals. Target late component (N100, P200, N200, P300) ERPs (acquired in an auditory oddball paradigm) and EDA was examined in 15 Parkinson's disease (PD) subjects and 50 normal controls. Single-trial target ERPs were averaged according to whether or not they elicited an electrodermal OR. Compared with controls, the PD group showed significantly decreased N100 and N200 amplitudes in the OR related ERPs ('Orienting ERPs'). These preliminary findings suggest that conventional late component ERPs can be delineated according to whether or not they evoked an OR. The 'orienting ERPs' in PD showed more significant disturbances compared with controls, than ERPs that did not evoke an OR.

Acoustic Stimulation↗

The effects of age on late components of the ERP and reaction time.

The effects of age on late component (N100, P200, N200, and P300) event-related potentials (ERP) and reaction time (RT) were investigated in 50 normal subjects, 18 to 70 years of age. A conventional auditory oddball paradigm was employed. An equal number of subjects, as well as an equal number of males and females, were examined in each decade. There were no significant associations found between ERP amplitude and age. A significant positive correlation was found between age and N200/P300 latency. There were no significant effects of age on RT in the overall group. However, females had slower RT and decreased P200 and N200 amplitude as compared with males. Moreover, males had significant correlations between N200 latency and RT, whereas females showed significant correlations between P300 amplitude and RT. ERP/RT effects should be further explicated between gender, as well as across age.

Adolescent↗