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Contralateral motor automatisms in neocortical temporal lobe epilepsy.

BACKGROUND: The lateralizing value of the motor automatisms is generally doubted in most patients with temporal lobe epilepsy. However, subgroup analysis of the seizures of temporal lobe origin suggests a role for motor automatisms in discriminating seizures of neocortical versus mesial temporal lobe origin. METHODS: Video-EEG of a patient with well-defined neocortical temporal lobe epilepsy was reviewed to assess the localizing value of motor automatisms. RESULTS: We report a patient with left upper extremity motor automatisms and clonic movements of the proximal left lower extremity with altered awareness as the sole manifestations of right temporal neocortical seizures. CONCLUSION: Early onset unilateral motor automatisms without dystonic posturing can localize the seizure origin to the contralateral temporal lobe neocortex.

Automatism↗

Measuring automatic retrieval.

A variety of procedures have been used to assess automatic retrieval effects on memory, including implicit memory tests and the process dissociation approach. Theoretical concerns with each are summarized prior to describing a procedure for evaluating automatic retrieval that is based on retrieval speed. Specifically, in a speeded implicit task, participants were encouraged to complete word stems using strictly automatic retrieval by presenting several practice test trials that did not allow responding based on previously studied items and by encouraging speed of responding. This speeded implicit task was compared with a condition in which conscious retrieval of studied information was not possible and a condition in which conscious retrieval was required, providing converging evidence to support the hypothesis that the speeded implicit procedure can yield pure estimates of automatic retrieval. Furthermore, evidence from a standard implicit memory task yielded comparable data that suggests that participants engaged automatic retrieval processes on this task also.

Adult↗

Prejudice from thin air: The effect of emotion on automatic intergroup attitudes.

Two experiments provide initial evidence that specific emotional states are capable of creating automatic prejudice toward outgroups. Specifically, we propose that anger should influence automatic evaluations of outgroups because of its functional relevance to intergroup conflict and competition, whereas other negative emotions less relevant to intergroup relations (e.g., sadness) should not. In both experiments, after minimal ingroups and outgroups were created, participants were induced to experience anger, sadness, or a neutral state. Automatic attitudes toward the in- and outgroups were then assessed using an evaluative priming measure (Experiment 1) and the Implicit Association Test (Experiment 2). As predicted, results showed that anger created automatic prejudice toward the outgroup, whereas sadness and neutrality resulted in no automatic intergroup bias. The implications of these findings for emotion-induced biases in implicit intergroup cognition in particular, and in social cognition in general, are considered.

Affect↗

Age-related differences in the maintenance and modification of automatic processes: arithmetic Stroop interference.

This experiment was designed to investigate whether well-learned "automatic" processes remain stable as a function of age, as well as to determine whether the ability to modify these automatic processes is disrupted for older adults. We used an arithmetic Stroop task to measure the stability of an automatic process. Nineteen young (mean age 22) and 19 old (mean age 75) adults participated in three experimental sessions, each of which consisted of 15 blocks of 30 trials. Although the young subjects had faster verification times overall than did the old adults, both young and old subjects showed significant interference effects. For the young adults, there was a decrease in the interference effect with practice, which suggested that they were learning to inhibit the automatic process of performing the arithmetical operation. However, the old adults showed no significant decrease in the associative interference effects. This implies that the older adults were impaired in their ability to inhibit automatic processes, even when those processes interfered with performance. Theoretical and practical training implications are discussed.

Adult↗

Genital automatisms in complex partial seizures.

OBJECTIVE: To determine which brain region is responsible for the generation of sexual automatisms. METHODS: Ninety consecutive patients with medically refractory focal epilepsy (74 with temporal lobe and 16 with frontal lobe epilepsy) referred to an epilepsy monitoring unit were studied. The occurrence of the following sexual automatisms was assessed during prolonged video-EEG monitoring: 1) repeatedly grabbing or fondling the genitals and 2) pelvic or truncal thrusting or similar movements. RESULTS: Five patients repeatedly fondled or grabbed their genitals during or immediately after some of their seizures. All five had temporal lobe epilepsy, as evidenced from prolonged video-EEG monitoring, high-resolution MRI, and good to excellent outcome after epilepsy surgery. Sexual automatisms did not occur with frontal lobe epilepsy. CONCLUSION: Sexual automatisms cannot be related exclusively to frontal lobe seizures. As previously proposed, apparently sexual hypermotoric pelvic or truncal movements are common in frontal lobe seizures, but this study suggests that discrete genital automatisms, like fondling and grabbing the genitals, are more common in seizures evolving from the temporal lobe.

Adult↗

Dissociation of automatic and strategic lexical-semantics: functional magnetic resonance imaging evidence for differing roles of multiple frontotemporal regions.

Behavioral research has demonstrated three major components of the lexical-semantic processing system: automatic activation of semantic representations, strategic retrieval of semantic representations, and inhibition of competitors. However, these component processes are inherently conflated in explicit lexical-semantic decision tasks typically used in functional magnetic resonance imaging (fMRI) research. Here, we combine the logic of behavioral priming studies and the neurophysiological phenomenon of fMRI priming to dissociate the neural bases of automatic and strategic lexical-semantic processes across a series of three studies. A single lexical decision task was used in all studies, with stimulus onset asynchrony or linguistic relationship between prime and target being manipulated. Study 1 demonstrated automatic semantic priming in the left mid-fusiform gyrus (mid-FFG) and strategic semantic priming in five regions: left middle temporal gyrus (MTG), bilateral anterior cingulate, anterior left inferior prefrontal cortex (aLIPC), and posterior LIPC (pLIPC). These priming effects were explored in more detail in two subsequent studies. Study 2 replicated the automatic priming effect in mid-FFG and demonstrated that automatic priming in this region is preferential for the semantic domain. Study 3 demonstrated a neural dissociation in regions contributing to the strategic semantic priming effect. Strategic semantic facilitation was observed in the aLIPC and MTG, whereas strategic semantic inhibition was observed in the pLIPC and anterior cingulate. These studies provide reproducible evidence for a neural dissociation between three well established components of the lexical-semantic processing system.

Adolescent↗

Automatisms--the current legal position related to clinical practice and medicolegal interpretation.

The interface between medicine and the law is an area which demands further investigation. There can be no criminal capability for an act unless the perpetrator had both the will to so act and the capacity to differentiate and choose whether or not to conform the particular behaviour to that dictated by the law. The capacity for choice must remain the fundamental issue. The range of conditions which can raise volition as a defence include: Somnambulism; post-traumatic syndromes; epilepsy; arteriosclerosis; or acts secondary to cerebral neoplasia. There is need to differentiate between reflex actions and automatisms and it is imperative that terms such as automatism or automatic behaviour are not perverted to allow an excuse for that which is inexcusable. Cases such as that of Cogdon, who was acquitted of murdering her daughter; Ramsbottom who was found guilty of causing a traffic accident despite having a stroke; Dennison in which a driver was found guilty despite epilepsy or Jenkins where the driver was initially found innocent of dangerous driving because of the unpredictable nature of diabetes are discussed. Special attention will be focused upon the case of Sullivan, a landmark in consideration of automatism in epilepsy. The paper examines insane verses non-insane automatism and the Australian legal system as it affects modern neurological practice. Suggestions are proffered as to how the law should be modified to better reflect justice as required within the context of modern medical knowledge. 'The social and psychological pressures that shape our criminals also shape-those who make and remake the laws which aim to control, punish or rehabilitate them, and those who try to change their behaviour.'

Australia↗

[Complex partial seizures: the localization value of automatisms].

INTRODUCTION: The clinical findings in complex partial crises may help our understanding of the different foci and vias of epileptogenesis. MATERIAL AND METHODS: We analyse automatisms and findings on EEG and neuroimaging in 151 patients with different types of partial epilepsy, seeking to establish a possible correlation between the type of automatism and cerebral localization. RESULTS AND CONCLUSIONS: The relative frequency of automatisms was: oro-alimentary 30%, mimicking 11%, gestures 35%, ambulatory 19% and verbal 13%. There was a statistically significant difference between the type of automatism and the topography of the EEG and neuroimaging findings. There were more gesture and oro-alimentary automatisms in patients with temporal anomalies, both on EEG and on neuroimaging, than in those with extratemporal alterations.

Adolescent↗

Automatic query formulations in information retrieval.

Modern information retrieval systems are designed to supply relevant information in response to requests received from the user population. In most retrieval environments the search requests consist of keywords, or index terms, interrelated by appropriate Boolean operators. Since it is difficult for untrained users to generate effective Boolean search requests, trained search intermediaries are normally used to translate original statements of user need into useful Boolean search formulations. Methods are introduced in this study which reduce the role of the search intermediaries by making it possible to generate Boolean search formulations completely automatically from natural language statements provided by the system patrons. Frequency considerations are used automatically to generate appropriate term combinations as well as Boolean connectives relating the terms. Methods are covered to produce automatic query formulations both in a standard Boolean logic system, as well as in an extended Boolean system in which the strict interpretation of the connectives is relaxed. Experimental results are supplied to evaluate the effectiveness of the automatic query formulation process, and methods are described for applying the automatic query formulation process in practice.

Computers↗

Diagnostic yield of automatic and patient-triggered ambulatory cardiac event recording in the evaluation of patients with palpitations, dizziness, or syncope.

BACKGROUND: Recent studies have shown that patient-triggered cardiac event recorders (CER) have an increased diagnostic yield and are more cost effective than conventional 24-h-Holter electrocardiograms (ECGs) for the evaluation of sporadic, potentially arrhythmia-related symptoms. HYPOTHESIS: The aim of this study was to determine the diagnostic yield of a patient-triggered CER combined with continuous automatic arrhythmia detection in the evaluation of sporadic dizziness/syncope or palpitations and its clinical relevance in assessing the further management. METHODS: We investigated 101 consecutive outpatients (54 +/- 20 years, 40 women), referred for evaluation of sporadic dizziness and syncope (36%) or palpitations (64%) of suspected rhythmogenic origin. All were monitored by patient-triggered CER with continuous automatic arrhythmia detection. RESULTS: After a mean monitoring period of 103 +/- 38 h, 83 patients registered symptoms and 57 patients had diagnostic or therapeutic relevant arrhythmias (relA). A total of 196 episodes of relA were recorded; 31 (16%) episodes were patient-triggered and 165 (84%) automatically recorded. Diagnostic relevant episodes (relA and/or typical symptoms) occurred in 94 patients, in 54% after the first 24 h of monitoring. According to the results of the CER, 80 patients needed no further diagnostic evaluation; 20 had additional diagnostic tests. CONCLUSIONS: Cardiac event recorders with a continuous automatic arrhythmia detection function are a well-tolerated device for sporadic, potentially arrhythmia-related symptoms. The patient-triggered mode alone is not sufficiently reliable; the automatic continuous arrhythmia detection function has additional diagnostic and therapeutic consequences. In 54% of all patients, the first diagnostic event would not have been recorded with a single conventional 24-h-Holter ECG.

Arrhythmias, Cardiac↗

Fully automatic chromosome segmentation.

This paper is concerned with automatic segmentation of high resolution digitized metaphases. This includes automatic detection and rejection of interphase nuclei, stain debris, and other "noise"; automatic detection and segmentation of touching and overlapping chromosome clusters; and automatic rejection of cells which are evaluated as being incomplete, or incorrectly segmented, or where the cell is otherwise unsuitable for further analysis. In this paper, a rule-based approach is described which treats the cell as a whole rather than as a series of individual chromosomes or clusters. The rules adapt classification and segmentation parameters for each cell. Initially, different sets of parameters are chosen according to the staining method of the cells, and the goal of the segmentation. A chromosome number predictor is used to guide the adaptation of the parameters and to estimate the performance. The adaptation is iterative, and the self-adjustment will stop when either a satisfactory result is achieved or if the cell is rejected. The method was implemented on both a Sun workstation and a Cytoscan, a commercial machine for chromosome analysis. Seven hundred and thirteen cells from real data have been tested. A success rate of 90-95% has been achieved. The procedure has been implemented in an automatic aberration scoring system for routine use.

Chromosome Aberrations↗

Automatic attention to emotional stimuli: neural correlates.

We investigated the capability of emotional and nonemotional visual stimulation to capture automatic attention, an aspect of the interaction between cognitive and emotional processes that has received scant attention from researchers. Event-related potentials were recorded from 37 subjects using a 60-electrode array, and were submitted to temporal and spatial principal component analyses to detect and quantify the main components, and to source localization software (LORETA) to determine their spatial origin. Stimuli capturing automatic attention were of three types: emotionally positive, emotionally negative, and nonemotional pictures. Results suggest that initially (P1: 105 msec after stimulus), automatic attention is captured by negative pictures, and not by positive or nonemotional ones. Later (P2: 180 msec), automatic attention remains captured by negative pictures, but also by positive ones. Finally (N2: 240 msec), attention is captured only by positive and nonemotional stimuli. Anatomically, this sequence is characterized by decreasing activation of the visual association cortex (VAC) and by the growing involvement, from dorsal to ventral areas, of the anterior cingulate cortex (ACC). Analyses suggest that the ACC and not the VAC is responsible for experimental effects described above. Intensity, latency, and location of neural activity related to automatic attention thus depend clearly on the stimulus emotional content and on its associated biological importance.

Adult↗

An automatic method for bone histomorphometry: assessment with reference to usual static and dynamic parameters.

To perform a fast and reproducible analysis in bone histomorphometry, we developed an automatic method for calculating static and dynamic parameters. A color automatic image analyzer (SAMBA 200) was used to obtain the usual parameters of bone histomorphometry: bone volume (Cn-BV%TV), osteoid volume (Cn-OV%BV), and osteoid surface (Cn-OS%BS). A specialized algorithm was designed for calculation of the mineral apposition rate (MAR). Eroded surface (Cn-ES%BS) was read in a semiautomatic mode using a cursor. To validate this program, we input 30 samples from patients with bone disease (20 osteoporosis, 6 renal osteodystrophy, 2 osteomalacia, and 2 hyperparathyroidism) using manual and automatic modes. The results obtained showed a highly significant correlation with the usual manual method for all parameters: OS/BS, r = 0.93; OV/BV, r = 0.98; MAR, r = 0.90. With the automatic method, larger values were found for osteoid parameters and MAR and lower values for BV/TV. There were no statistical differences for OV/BV and MAR when compared to the reference manual method. This study establishes that automatic measurements of osteoid parameters and MAR can be performed by a fast analyzer with as good reproducibility and accuracy as the manual method.

Adolescent↗

Influence of dopaminergic medication on automatic postural responses and balance impairment in Parkinson's disease.

It is still unclear why balance impairment in Parkinson's disease (PD) often responds insufficiently to dopaminergic medication. We have studied this issue in 23 patients with idiopathic PD and 24 healthy controls. Our specific purposes were (a) to investigate the contribution of abnormal automatic postural responses to balance impairment in PD and (b) to assess the influence of dopaminergic medication on abnormal automatic postural responses and balance impairment. Standing subjects received 4 degrees "toe-up" rotational perturbations of a supporting forceplate. We bilaterally recorded posturally destabilizing medium latency (ML) responses from the stretched gastrocnemius muscles and functionally corrective long latency (LL) responses from the shortened tibialis anterior (TA) muscles. We also assessed changes in the center of foot pressure (CFP) and the center of gravity (COG). All patients were tested in the "off" and "on" phases. All controls were tested and retested after 1 h. During the off phase, we found enlarged ML amplitudes and diminished LL amplitudes in patients, together with a markedly increased posterior displacement of the COG. The abnormal ML and LL responses were partially responsible for the increased body sway in patients because the initial forward (destabilizing) displacement of the CFP was increased, while the subsequent backward displacement of the CFP (a measure of the corrective braking action of LL responses) was delayed. Abnormal late automatic or possibly more voluntary postural corrections also contributed substantially to the increased body sway. During the on phase, ML amplitudes were reduced in patients but remained increased compared with controls. LL amplitudes no longer differed between both groups due to a modest, possibly dopamine-related increase in patients and a simultaneous decrease in controls. The abnormal CFP displacement was only partially improved by dopaminergic medication. The later postural corrections were not improved at all. Consequently, the increased posterior COG displacement was not ameliorated during the on phase. We conclude that (a) a combination of abnormal automatic and perhaps more voluntary postural corrections contributes to increased body sway in PD and (b) dopaminergic medication fails to improve balance impairment in PD because early automatic postural responses are only partially corrected, while later occurring postural corrections are not improved at all. These electrophysiological results support clinical observations and suggest that nondopaminergic lesions play a significant role in the pathophysiology of postural abnormalities in PD.

Adult↗

Automatic selection of arterial input function using cluster analysis.

Quantification of cerebral blood flow (CBF) using dynamic susceptibility contrast MRI requires determination of the arterial input function (AIF) representing the delivery of intravascular tracer to tissue. This is typically accomplished manually by inspection of concentration time curves (CTCs) in regions containing the ICA, VA, and MCA. This is, however, a time consuming and operator dependent procedure. We suggest a completely automatic procedure for establishing the AIF based on a cluster analysis algorithm. In 20 normal subjects CBF maps calculated in 2 slices by the automatic procedure were compared to maps obtained with AIFs selected individually by 7 experienced operators. The average manual to automatic CBF ratio was 1.03+/-0.15 in the lower slice and 1.05+/-0.12 in the upper slice, demonstrating excellent agreement between the manual and automatic method. The algorithm provides means for objectively assessing AIF candidates in local AIF search algorithms designed to reduce bias due to delay and dispersion. Given the reproducibility and speed (10 s) of the automatic method, we speculate that it will greatly improve the accuracy of perfusion images and facilitate their use in clinical diagnosis and decision-making, particularly in acute stroke but also in cerebrovascular disease in general.

Aged↗

Effects of exogenous neuropeptide Y on automaticity of isolated Purkinje fibers and atrium.

Neuropeptide Y exerts prejunctional effects on automaticity in cardiac pacemaker tissue and postjunctional effects on contractile activity of cardiomyocytes. It is uncertain whether neuropeptide Y has postjunctional effects on cardiac automaticity. This paper reports a study of the actions of exogenous neuropeptide Y (10(-10)-10(-6) M) on automaticity of isolated preparations of canine Purkinje fibers and guinea-pig right atrium. Neuropeptide Y had no effect on the rate of normal and abnormal (barium-induced) automaticity and did not modify the effect of norepinephrine on canine Purkinje fibers. Neuropeptide Y did not affect normal sinus rhythm in guinea-pig right atrium. The influence of neuropeptide Y (5 x 10(-7) M) on the response to field stimulation in guinea-pig right atrium was also studied: neuropeptide Y reduced the vagal component of response three-fold (P < 0.05) and insignificantly diminished the sympathetic component. Neuropeptide Y fragment 18-36 suppressed the vagal effect of neuropeptide Y by approximately 50% (P < 0.05). These results suggest that neuropeptide Y does not influence automaticity directly in canine Purkinje fibers and guinea-pig right atria. A prejunctional action to inhibit release of acetylcholine from parasympathetic nerve endings is implied by experiments on field-stimulated right atrium, but based on results with fragment 18-36, postjunctional actions may also occur here.

Animals↗

Automatic generation of glomerular capillary topological organization.

Glomerular structural changes are conventionally investigated by optical or electron microscopy on two-dimensional (2D) sections. To understand the relationship between functional and structural changes of glomerular capillary networks in more detail, three-dimensional (3D) investigation of the capillary tufts is required. Since confocal microscopy and scanning electron microscopy cannot completely show the 3D topological organization of the capillary tuft, we have developed an automatic method to obtain a 3D model of the glomerular capillary lumen structure and to derive its topological organization. Serial semithin sections of a glomerular tuft, from rat kidney tissue, were digitized at high resolution. Capillary lumens were digitally outlined and segmented images were automatically aligned. A 3D model of the capillary tuft was automatically generated using the Visualization Toolkit library and the Marching Cubes algorithm. We then developed an original algorithm for automatic 3D skeletonization of capillary lumen volume to identify capillary segments and bifurcations and to obtain the topological organization of the network and geometric parameters of capillary segments (length, radius, and spatial configuration). Capillary segment connectivity was graphically presented in a 2D layout with an automatic procedure, revealing the lobular organization of the network. This technique, successfully applied to serial sections of a glomerular capillary, can be used to study a population of glomerular capillaries to disclose the structural effects of pathological conditions. The methodology can be extended to other vascular structures, such as the microcirculation of neoplastic tissues.

Algorithms↗

Noninvasive, automatic 24-h ambulatory blood pressure monitoring in normotensive subjects.

The reliability of noninvasive, automatic blood pressure monitoring is not yet clearly established. A 24-h ambulatory blood pressure profile was obtained in 9 healthy, normotensive subjects with an automatic, noninvasive device. The blood pressure profile showed the typical circadian pattern with lower systolic and diastolic values during sleep, although pulse pressure was fairly constant (about 40 mm Hg). The systolic blood pressure rose steeply in the early morning hours--before waking up. The results were compared with simultaneous hourly readings using the auscultatory method. There were no statistically significant differences between the automatic and auscultatory readings, 13 of the 18 mean values at different time points being within 2 mm Hg of each other. All the auscultatory means fell within the 95% confidence limits of those measured hourly by the automatic method. Although the automatic method seemed to be reliable compared with the auscultatory method, its sensitivity to motion artifacts is a disadvantage in a truly ambulatory setting.

Adult↗