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Biomedical subjects

Nobukazu Nakasato

Publications and source records attributed to Nobukazu Nakasato.

16 recordsLinked to original sources
PubMed2006

Spike orientation may predict epileptogenic side across cerebral sulci containing the estimated equivalent dipole.

OBJECTIVE: To evaluate whether the orientation of interictal spikes, localized in major sulci by magnetoencephalography (MEG), predicts the epileptogenic side of the sulcal wall. METHODS: Sixteen epilepsy patients were analyzed in whom equivalent current dipoles (ECDs) of MEG spikes were localized on the central (four patients), interhemispheric (4), or sylvian fissure (8); and the epileptogenic side across the sulci had been confirmed by seizure semiology, structural lesions, or intracranial electroencephalography (EEG). ECD was classified as epileptogenic side or normal side oriented and correlated to the scalp EEG map. RESULTS: All central (n=50) and interhemispheric (n=83) spike ECDs were oriented toward the epileptogenic side at peak latency. In scalp EEG, 91% of the spikes showed radial pattern of broad negativity above the sulcus whereas 9% showed tangential pattern with positive maximum above the epileptogenic side. Sylvian spikes were only found in patients with temporal lobe epilepsy (TLE). In sylvian spikes (n=220), 73% of ECDs were oriented toward the epileptogenic side, whereas 27% were oriented toward the normal side. CONCLUSIONS: In central and interhemispheric spikes, epileptogenic side cortex may be gross surface negative through the sulcal wall to the adjacent gyrus. Inconsistent orientation of the sylvian spikes suggests a complex pattern of spike propagation in TLE. SIGNIFICANCE: ECD orientation of central and interhemispheric spikes in MEG may predict the epileptogenic side.

Brain↗
PubMed2006

Evaluation of interhemispheric time difference by magnetoencephalography before and after total callosotomy. Two case reports.

Interhemispheric time difference (ITD) measured by electroencephalography (EEG) and magnetoencephalography (MEG) was compared to seizure outcome after callosotomy. Two patients with frequent drop attacks underwent simultaneous EEG and MEG before and after total callosotomy. ITDs in 30 bilateral synchronized (BS) discharges were calculated independently by EEG and MEG. As minimum transcallosal conduction time was suggested to be approximately 20 msec, BS discharges were classified into five categories according to ITD and side: left- or right-leading long (300 to 80 msec), left- or right-leading moderate (80 to 20 msec), and negligible (<20 msec). In Case 1 before callosotomy, EEG detected 77% negligible and 23% right-leading moderate BS discharges, whereas MEG detected 30% and 63%, respectively. After callosotomy, drop attacks reduced remarkably and EEG and MEG detected no BS discharges. In Case 2 before callosotomy, EEG detected 77% negligible and 23% moderate BS discharges, whereas MEG detected 80% and 20%, respectively. After callosotomy, drop attacks recurred 2 months later and EEG and MEG detected left- and right-leading long BS discharges (63% by EEG and 56% by MEG). MEG detected a large number of BS discharges with moderate ITD before surgery in Case 1, suggesting that the transcallosal pathway was the main pathway for the synchronization, whereas the negligible ITD in Case 2 excludes transcallosal propagation. BS discharges with longer ITD after surgery in Case 2 suggest a persistent poly-synaptic non-transcallosal pathway. MEG with higher spatial resolution than EEG may provide surgical indications for callosotomy.

Adolescent↗
PubMed2005

Neuromagnetic evaluation of binaural unmasking.

Binaural unmasking refers to the improvement in intelligibility under conditions of masking when a tone is presented out of phase rather than in phase. In the present study, binaural unmasking was evaluated using auditory-evoked magnetoencephalography (MEG) in eight healthy right-handed volunteers (7 males and 1 female, mean age 25.9 years). Peak latency and amplitude of the N1m response to tone bursts of 250 Hz (n = 8), 1000 Hz (n = 3), and 4000 Hz (n = 3) were measured under S0N0 (binaural phase difference was zero radian (in phase) for both stimulus sound and masker noise) and SpiN0 (binaural phase difference was pi radian (out of phase) for stimulus sound and zero radian for masker noise) conditions. The level of tone bursts was swept by 5 or 10 dB steps from the level of 20 dB above the psychophysical threshold under the S0N0 condition until no significant auditory-evoked field could be observed. Identical background noise was presented to both ears continuously at 50 dB SPL. N1m responses to stimuli at or above the psychophysical threshold were found bilaterally in all subjects except one who had only right hemispheric N1m. N1m response for the SpiN0 stimulus had larger amplitude and shorter latency than that for the S0N0 stimulus in each hemisphere and at each sound level. Neuromagnetic binaural unmasking was greatest around the threshold level, corresponding to psychophysical binaural unmasking; became smaller with greater stimuli, indicating the suprathreshold unmasking effect; and disappeared at around 15-20 dB above the threshold. Psychophysical binaural unmasking can be quantitatively evaluated by MEG in the auditory cortex level of the bilateral hemispheres.

Adult↗
PubMed2005

Opercular to interhemispheric source distribution of benign rolandic spikes of childhood.

We evaluated the source distribution of benign rolandic spikes of childhood along and across the central sulcus in 15 patients, aged between 7 and 15 years, who suffered from seizure disorders. Previous routine EEG showed centrotemporal spikes, but none of them had major abnormalities on brain magnetic resonance imaging or neurological deficits. The equivalent current dipoles (ECDs) of the spikes measured by whole-head magnetoencephalography (MEG) were compared to the spike distributions detected by simultaneous scalp EEG according to the international 10-20 system. Locations and orientations of the MEG spikes corresponded to the EEG spike distribution as follows: superiorly oriented spike MEG dipoles in the opercular area corresponded to T3/4 negative peaks (8 spike groups in 6 patients); anteriorly oriented spike dipoles in the rolandic area corresponded to C3/4 or P3/4 negative peaks (17 spike groups in 13 patients); laterally oriented spike dipoles in the interhemispheric area corresponded to Cz/Pz negative peaks (4 spike groups in 3 patients); and others (4 spike groups in 4 patients). Rolandic spikes include three main types according to the ECD location from the opercular to the interhemispheric areas. The functional anatomy of benign rolandic spikes was correlated with partial seizure semiology. All three rolandic spike types can be explained by a precentral origin, assuming that the surface negative potential is continuous from the gyral to fissural cortices.

Adolescent↗
PubMed2005

High-frequency gamma-band activity in the basal temporal cortex during picture-naming and lexical-decision tasks.

Gamma-band activity (GBA) in electroencephalograms (EEGs) has been shown to reflect various cognitive processes. GBA has typically been recorded in the 30-60 Hz range in scalp EEGs. Recently, task-related "high GBA" (HGBA) with frequencies up to 100 Hz has been observed in studies with invasive electrocorticograms (ECoGs). In the present study, we recorded ECoGs from the bilateral basal temporal cortices in a patient with epilepsy and evaluated the task-related HGBA (most prominently in the 80-120 Hz range) accompanying picture-naming and lexical-decision tasks. We examined picture naming using two categories (line drawings of animals and tools). The lexical-decision task was performed using words and pseudowords of two distinct Japanese writing forms, kanji (morphograms) and kana (syllabograms). Task-related HGBA was observed bilaterally during the naming task. Recordings from some electrodes revealed significant differences in HGBA between animal and tool pictures. In contrast to the naming task, there was apparent left dominance in the lexical-decision task. Furthermore, significant differences in HGBA were observed between the Japanese kanji and kana words and between the kanji words and kanji pseudowords. A number of differences in the HGBA observed in the recordings from the basal temporal area were consistent with previous findings from neuroimaging and patient studies and suggest that HGBA is a good correlate of visual cognitive functions.

Acoustic Stimulation↗
PubMed2005

Neuromagnetic measurement of unilateral temporo-parietal theta rhythm in patients with internal carotid artery occlusive disease.

Rhythmic theta activity detected by electroencephalography (EEG) may be correlated with cerebrovascular brain diseases. Magnetoencephalography (MEG) has higher sensitivity and spatial resolution than conventional scalp EEG, so may be a better method to detect theta rhythm in patients with internal carotid artery (ICA) occlusive disease. Simultaneous EEG and MEG were performed in the awake state in 48 patients with unilateral (n = 42) or bilateral (n = 6) stenotic lesions (more than 60% occlusion) of the ICA (n = 47) or middle cerebral artery (n = 7), and in 27 age-matched healthy normal subjects. No subject had severe neurological deficits. MEG detected the theta rhythm (6-8 Hz) in 14 of 48 patients: ipsilateral to the stenotic or occluded side in 13 hemispheres and bilaterally in one patient with unilateral lesion. The source of the MEG theta rhythm was estimated in the dorsolateral temporo-parietal area, regardless of the location of infarct foci or the stenotic portion of the ICA system. The temporo-parietal theta rhythm was separated from the occipital alpha rhythm by frequency and distribution in MEG. The theta rhythm was found in only two patients by EEG, as well as by MEG. MEG provided better separation of this theta rhythm from the occipital alpha rhythm. Neither MEG nor EEG detected this theta rhythm in the normal subjects. Unilateral temporo-parietal theta rhythm is correlated with the hemisphere with ICA occlusive disease. This rhythm may indicate mild or subclinical abnormalities in the ICA system. MEG is superior to EEG for the detection and localization of theta rhythm.

Adult↗
PubMed2005

Abnormal primary somatosensory function in unilateral polymicrogyria: an MEG study.

The purpose of this study is to investigate the primary somatosensory function in patients with unilateral polymicrogyria. Somatosensory evoked fields (SEFs) due to median and posterior tibial nerve stimulation were compared in the normal and dysplastic cortices of five patients with unilateral polymicrogyria. SEFs were observed in all five normal hemispheres and three dysplastic hemispheres. Latencies of N20m and P38m, the first cortical components of and SEFs for median nerve and tibial nerve stimulation, were all within the normal range in both normal and dysplastic hemispheres. The amplitudes of the N20m and P38m in the dysplastic hemispheres were smaller in one patient and larger in two patients compared to the normal hemispheres. Equivalent current dipoles of N20m and P38m were localized on the anatomical central sulcus of the normal hemispheres and over the central area of the dysplastic hemispheres. P38m dipoles were localized medial and upward to the N20m dipole in both normal and dysplastic hemispheres. N20m dipole orientation was normal in all normal hemispheres and in one dysplastic hemisphere, but abnormally inferior in two dysplastic hemispheres. P38m dipole had normal medial orientation in all hemispheres except one dysplastic hemisphere. Abnormality of the primary somatosensory function in the dysplastic cortex of patients with unilateral polymicrogyria was clearly demonstrated by magnetoencephalography with high resolution in time and space. The normal somatotopic arrangement was preserved.

Adolescent↗
PubMed2005

Detection of epileptiform activity by human interpreters: blinded comparison between electroencephalography and magnetoencephalography.

PURPOSE: Objectively to evaluate whether independent spike detection by human interpreters is clinically valid in magnetoencephalography (MEG) and to characterize detection differences between MEG and scalp electroencephalography (EEG). METHODS: We simultaneously recorded scalp EEG and MEG data from 43 patients with intractable focal epilepsy. Raw EEG and MEG waveforms were reviewed independently by two experienced epileptologists, one for EEG and one for MEG, blinded to the other modality and to the clinical information. The number and localization of spikes detected by EEG and/or MEG were compared in relation to clinical diagnosis based on postoperative seizure freedom. RESULTS: Interictal spikes were captured in both EEG and MEG in 31, in MEG alone in eight, in EEG alone in one, and in neither modality in three patients. The number of detections ranged widely with no statistical difference between modalities. A median of 25.7% of total spikes was detectable by both modalities. Spike localization was similarly consistent with the epilepsy diagnosis in 85.2% (EEG) and 78.1% (MEG) of the patients. Inaccurate localization occurred only in those cases with very few spikes detected, especially when the detections were in one modality alone. CONCLUSIONS: Interictal epileptiform discharges are easily perceived in MEG. Independent spike identification in MEG can provide clinical results comparable, but not superior, to EEG. Many spikes were seen in only one modality or the other; therefore the use of both EEG and MEG may provide additional information.

Adolescent↗
PubMed2005

Neuromagnetic evidence that gingiva area is adjacent to tongue area in human primary somatosensory cortex.

The somatotopic organization of the human primary somatosensory (SI) area in the cerebral cortex has been intensively studied for the hand, lip, and tongue, but little is known about the gingiva. Penfield concluded that the gingival SI area was above the tongue area, as shown in his famous homunculus map. However, our recent study suggested that the lingual gingiva area was not so different to the tongue area. To delineate the fine SI somatotopy of the gingiva area, evoked magnetic fields were measured in 6 healthy subjects for the stimulus of the anterior or posterior and upper or lower parts of the lip, buccal and lingual gingiva, and tongue. Source position was estimated by a current dipole model at the first peak of the posterior-oriented current in a total of 12 cerebral hemispheres contralateral to the stimulation side. No significant difference was found between the positions of anterior and posterior or upper and lower parts of each structure. Both buccal and lingual gingiva areas were localized adjacent to the tongue area, but significantly lower than the lip area. We believe that the fine SI somatotopy of the human oral structures should be reconsidered.

Adult↗
PubMed2004

Comparison of magnetoencephalographic spikes with and without concurrent electroencephalographic spikes in extratemporal epilepsy.

Interictal spikes in patients with epilepsy may be detected by either electroencephalography (EEG) (E-spikes) or magnetoencephalography (MEG) (M-spikes), or both MEG and EEG (E/M-spikes). Localization and amplitude were compared between E/M-spikes and M-spikes in 7 adult patients with extratemporal epilepsy to evaluate the clinical significance of MEG spikes. MEG and EEG were simultaneously measured using a helmet-shaped MEG system with planar-type gradiometers and scalp electrodes of the international 10-20 system. Sources of E/M-spikes and M-spikes were estimated by an equivalent current dipole (ECD) model for MEG at peak latency. Each subject showed 9 to 20 (mean 13.4) E/M-spikes and 9 to 31 (mean 16.3) M-spikes. No subjects showed significant differences in the ECD locations between E/M- and M-spikes. ECD moments of the E/M-spikes were significantly larger in 2 patients and not significantly different in the other 5 patients. The similar localizations of E/M-spikes and M-spikes suggest that combination of MEG and EEG is useful to detect more interictal spikes in patients with extratemporal epilepsy. The smaller tendency of ECD amplitude of the M-spikes than E/M-spikes suggests that scalp EEG may overlook small tangential spikes due to background brain noise. Localization value of M-spikes is clinically equivalent to that of E/M-spikes.

Adolescent↗
PubMed2003

Ipsilateral area 3b responses to median nerve somatosensory stimulation.

Magnetoencephalography investigation of the somatosensory evoked fields for median nerve stimulation detected ipsilateral area 3b responses in 18 hemispheres of 14 (1 normal subject and 13 patients with brain diseases) among 482 consecutive subjects. The major three peaks in the ipsilateral response were named iP50m, iN75m, and iP100m, based on the current orientation in the posterior, anterior, and posterior directions and the latency of 52.7 +/- 6.2, 74.1 +/- 9.4, and 100.2 +/- 15.8 ms (mean +/- standard deviation), respectively. The moment of the iP50m dipole (9.4 +/- 5.7 nAm) was significantly smaller than that of the N20m dipole of the contralateral response (cN20m, 27.5 +/- 10.5 nAm, P < 0.0001). Dipoles of iP50m and cN20m were similarly localized on the posterior bank of the central sulcus. iP50m in the present study had the same current orientation as and peak latency similar to that of the first ipsilateral primary somatosensory response to lip stimulation in our previous report. Therefore, the somatosensory afferent pathway from the hand may reach directly to the ipsilateral area 3b at least in part of the human population.

Adult↗
PubMed2003

Focal magnetoencephalographic spikes in the superior temporal plane undetected by scalp EEG.

Temporal lobe spikes were detected by magnetoencephalography (MEG), but not by standard scalp electroencephalography (EEG), in a patient with intractable complex partial seizures. Simultaneous recording of scalp EEG and MEG revealed 2 different types of spike discharges: sporadic single spikes detected by both EEG and MEG which were localised diffusely in the right temporal lobe; and rhythmic MEG spike discharges that were not detected by scalp EEG, focally localised in the posterior part of the superior temporal plane. The tangential current orientation to the scalp may explain the different sensitivity of scalp EEG and MEG to rhythmic discharges. This study shows the unique sensitivity of MEG to epileptic activity in the superior temporal plane.

Adult↗
PubMed2002

Surgical implications of neuromagnetic spike localization in temporal lobe epilepsy.

PURPOSE: To investigate the clinical usefulness of magnetoencephalography (MEG) as a guide to the surgical treatment of temporal lobe epilepsy (TLE). METHODS: Preoperative spike localization by MEG was compared with seizure outcome and postoperative spike localization at 12 months after resective surgery in 16 patients with TLE. Spike localization was classified into anterior temporal (AT) and non-AT localization in 11 patients without neocortical lesion treated with anterior temporal lobectomy (ATL); and lesion and lobar localization in five patients with neocortical lesion treated with lesionectomy (n = 3) or lesionectomy with medial temporal resection (n = 2). RESULTS: All five patients with AT localization became seizure free and spike free after surgery. Among the six patients with non-AT localization, two became seizure free and spike free, two became seizure free with residual spikes, one had residual seizures but no spikes, and one had both residual seizures and spikes. All three patients with lesion localization and two with lobar localization had favorable seizure outcome and became spike free after surgery. CONCLUSIONS: MEG spike localization can identify neocortical sources remote from the presumed epileptogenic area. Favorable seizure outcome can be expected in patients with AT localization after ATL and patients with lesion localization after lesionectomy. In contrast, non-AT localization indicates either nonmedial TLE or spike propagation to the posterior and extratemporal neocortex. Similarly, lobar localization indicates spike propagation from an epileptogenic lesion or extensive epileptogenicity. Patients with non-AT localization or lobar localization should undergo intensive evaluations, such as intracranial EEG, for improved seizure outcome.

Action Potentials↗
PubMed2002

[Magnetoencephalographic localization of multiple seizure foci for surgical treatment of intractable frontal lobe epilepsy: confirmation with intra-operative electrocorticography].

A successfully treated case of intractable FLE, of which preoperative magnetoencephalography (MEG) provided multiple spike localization and intraoperative corticogram (ECoG) confirmed the resection area. A 22-year-old male patient, with a history of subdural abscess at the age of 14 years, had suffered frequent simple (SPSs) and complex partial seizures (CPSs) and falling attacks since the age of 16 years. Although he underwent corpus callosotomy at the age of 17 years, additional surgical treatment was considered because of intractable and more frequent SPSs and CPSs. Magnetic resonance (MR) imaging demonstrated diffuse lesions in the right frontal lobe. Although, both interictal and ictal electroencephalography (EEG) failed to show focal epileptogenic localization, interictal MEG localized several clusters over the multiple anatomical lesions in the right prefrontal and frontal opercular regions. The patient underwent right fronto-temporal craniotomy, and anterior frontal lobectomy, followed by lesionectomy of the premotor area based on the intraoperative ECoG findings. The ECoG localized frequent spike discharges over the right prefrontal, frontal operculum and premotor cortices, which showed good correspondence with the MEG findings. MEG can be a useful noninvasive method for presurgical evaluation of intractable FLE.

Adult↗