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PubMed2004

Multimodality image-guided surgery for the treatment of medically refractory epilepsy.

OBJECT: The aim of this study was to review seizure outcome, imaging modalities used, and complications following surgery in patients with epilepsy who had undergone multimodality image-guided surgery at our institution. METHODS: Data from patients with epilepsy who had undergone surgery between April 1999 and October 2001 were reviewed. During this time period, 116 operations were performed in 109 patients with medically refractory epilepsy. Among these patients, 22 were selected to undergo multimodality image-guided surgery primarily on the basis of whether they had no lesion visible on conventional magnetic resonance (MR) imaging sequences, multiple lesions, or one very large lesion that could not be completely resected without the risk of significant postoperative morbidity. A fourth group of patients in whom there was a single lesion in the eloquent cortex, a location associated with a significant risk of postoperative morbidity, was also included in the analysis. This latter group was assessed with the aid of intracranial grid electrodes that were coregistered to the MR image and were used intraoperatively to minimize electrode position error. Other imaging modalities used included positron emission tomography (PET), fluid-attenuated inversion recovery (FLAIR) MR imaging, and subtracted ictal-interictal single-photon positron emission computerized tomography (SPECT) coregistered with MR imaging (SISCOM). After coregistration, images were then downloaded onto an image-guided surgical system and the epileptogenic area was then resected. The mean patient age was 33 years (range 17-46 years), and there was a mean follow up of 27 months (range 14-41 months). Multimodality coregistrations used were as follows: nine PET scans, seven subdural electrode grids, four SISCOM studies, one FLAIR MR image, and one combined PET/subdural grid. Seizure outcome was excellent in 17 patients (77%) and not excellent in five (23%), or favorable in 19 (86%) and unfavorable in three (14%). Six patients (27%) had a transient neurological deficit, one patient (5%) a permanent major deficit, and three patients (15%) a permanent minor deficit. Five patients (24%) had a transient psychiatric problem postoperatively. CONCLUSIONS: Multimodality image-guided surgery offers a new perspective in surgery for epilepsy. Functional imaging modalities previously lateralized and often localized a seizure focus, but did not provide enough anatomical information to resect the epileptogenic zone confidently and safely. The coregistration of these modalities to a volumetric MR image and their incorporation into an image-guided system has allowed surgeons to offer surgery to patients who may not previously have been considered eligible, with outcomes comparable to those in patients with more straightforward lesional epilepsy.

Adolescent↗

PubMed1993

Locoregionally advanced paranasal sinus carcinoma. Favorable survival with multimodality therapy.

To determine the efficacy of multimodality treatment for stage III and IV, advanced paranasal carcinoma, we have retrospectively reviewed local control rate and disease-free survival in patients treated at the University of Chicago (Ill). Twelve consecutive patients with stage III or IV, newly diagnosed paranasal sinus carcinoma treated between 1984 and 1991 were included in this study. Multimodality therapy was composed of a sequence of fluorouracil-cisplatin-based neoadjuvant chemotherapy (in 12 of 12 patients) followed by standard surgical resection (11 of 12 patients) and radiotherapy (12 of 12 patients, 45 to 73 Gy) with or without concomitant chemotherapy. Eleven patients (92%) are currently alive and free of disease, with a median follow-up of 55 months (range, 13 to 105 months). One patient died of persistent disease. Failure was attributed to incomplete surgical resection. There was only one major irreversible treatment complication (cisplatin ototoxic reaction). Our preliminary data suggest improved local control and survival with multimodality therapy that includes systemic neoadjuvant chemotherapy and standard tumor resection in patients with advanced paranasal sinus carcinoma. These results are superior to the reported 40% survival with bimodal therapy and are better than those achieved in our institution for other head and neck primaries with the same treatment regimens.

Adult↗

PubMed2002

Electronic procedure logs: taking it further.

OBJECTIVE: To create an electronic procedural logbook with enhanced user interactivity and usefulness as an educational resource. DESCRIPTION: From our own work on electronic student logbooks and other studies, it is clear that compliance with complete and valid data entry remains a challenge. Without direct and visible benefit, students are reluctant to spend time logging all their cases. We developed an interactive procedural logbook using Microsoft Embedded Visual Basic and Metrowerks CodeWarrior. Interface design focused on rapid data entry with minimum requirement for text, and field-level automation where possible. We loaded it onto a mixed platform of personal digital assistants (PDAs)--Compaq iPaq Pocket PCs and HandEra 330 PalmOS devices. Our rural residents were supplied with the devices of their choice. Various built-in educational reference resources included: (1) contextual help options about each procedure, which contained diagrams and pictures; (2) diagnostic and fee coding so they could see how poorly some procedures pay; and (3) Quick Tips relevant to each procedure, which can be easily modified by the preceptor. Preceptor evaluations and comments can be entered rapidly. Using built-in database conduits, data are automatically collected from each device on every HotSync with the desktop. Data can then be collated and analyzed using Microsoft Access or via secure Web access. DISCUSSION: Improved compliance has been dramatic-one resident logged 250 procedures in just two months. However, not all residents have been successful in establishing seamless synchronization, and the resulting data loss has caused frustration. The evidence indicates the need to implement central data collection and backup right from the outset. Central data collection provides many advantages. The program director has better information for future applications. Preceptor evaluations are now spread over many interactions and yet can be collated and analyzed. Quick Tips have been very popular-we have been able to collect the tips and redistribute them. Focus-group feedback from the residents has shown that the rich data in the logbook's reference component improved its usefulness and popularity as an educational tool. Choice of device type is important for user acceptance because devotees of one platform are reluctant to switch to another. Cross-platform development does slow the process but is increasingly easy with the latest software design tools, such as AppForge. These new tools have enabled us to explore further improvements in data entry. Digital ink provides the ability to capture annotated diagrams and preceptor signatures. Voice input is built in with these devices, and our software now allows for voice annotation for more detailed commentary by preceptors or student. The compressed digital sound file is collected along with the data and transcribed centrally (on-device voice recognition is not feasible yet). Point-of-care accessibility has been the key attraction of using these devices for logging encounter data. This project demonstrates that it is important to explore all multimodal interactive capabilities to provide a truly rich educational tool.

Electronic Data Processing↗

PubMed2001

[Rapid recovery after colonic resection. Multimodal rehabilitation by means of Kehlet's method practiced in Vasteras].

UNLABELLED: By using a multimodal rehabilitation program professor Kehlet has shown accelerated recovery after colonic surgery with hospital stay of only two days, irrespective of open or laparoscopic technique. These results have not been confirmed in other studies. The aim of this study was to replace our traditional approach with Kehlet's multimodal regimen and try to reproduce his reported data. METHODS: 22 patients (median age 67 years) underwent right- or leftsided colectomies, 15 open (7 with midline incisions) and 7 laparoscopically. Continuous thoracic epidural, immediate mobilization and oral nutrition were used. Discharge was planned three days after surgery. On the first postoperative day all had oral intake and on the third day patients were mobilized for a median of 9.7 hours and all had resumed defecation. Pain and fatigue scores (VAS) were low. The median post-operative hospital stay was 3.5 (range 3-8) days. Two patients returned with complications. No cardiopulmonary or infectious complications were seen. The multimodal rehabilitation programme resulted in a quick recovery and a hospital stay of three days in most patients after colonic surgery.

Adult↗

PubMed2026

A Knowledge-Enhanced Multimodal Framework with Genomic Reconstruction for DLBCL Drug Response Prediction.

Diffuse large B-cell lymphoma (DLBCL) exhibits substantial biological heterogeneity, leading to pronounced variability in patient response to therapy. Accurate drug response prediction is therefore critical for precision treatment but remains challenging in clinical settings where genomic sequencing, a highly informative modality, is frequently incomplete. Existing methods, often developed from cell-line pharmacogenomic datasets or single-modality data, typically assume fully observed molecular profiles and thus show limited robustness under missing genomic data. To address this limitation, a knowledge-enhanced multimodal framework with genomic reconstruction (KeM-DRP) is proposed for individualized drug response prediction in DLBCL. The framework models the central role of genomics by integrating biological prior knowledge through a gene-pathway-biological process hierarchy, enabling robust representation learning from sparse observations. To compensate for missing genomic measurements, a cross-modal genomic compensation module reconstructs genomically informed latent features from routinely available clinical modalities. Furthermore, a genomics-guided adaptive fusion strategy dynamically integrates heterogeneous modalities conditioned on observed or reconstructed genomic representation. Experiments on a real-world DLBCL cohort demonstrate that KeM-DRP consistently outperforms competitive baselines. The reconstructed genomic representation represents most predictive utility, highlighting the robustness and practical value of the framework under incomplete genomic data.

Journal Article↗

PubMed1993

Characteristics of prostate cancers detected in a multimodality early detection program. The Investigators of the American Cancer Society-National Prostate Cancer Detection Project.

BACKGROUND: Few data are available to describe the clinical and pathologic characteristics of prostate cancers detected through early detection programs. The American Cancer Society National Prostate Cancer Detection Project (ACS-NPCDP) is a multimodality, multicenter study of the feasibility of early prostate cancer detection using digital rectal examination (DRE), transrectal ultrasound (TRUS), and prostate specific antigen (PSA). One hundred fifty-six prostate cancers are available from this project for analysis. METHODS: The ACS-NPCDP is a prospective, comparative study of a cohort of 2,999 men between 55 and 70 years of age not suspected of having prostate cancer. DRE, TRUS, and PSA are performed for each subject on an annual basis for as long as 5 years. Biopsies are performed on the basis of recommendations from DRE or TRUS results. Although elevated PSA alone was not typically a basis for biopsy, in some instances biopsies were recommended because of the degree of elevation in PSA. Diagnoses are confirmed by participating pathologists and by pathologic analysis. RESULTS: A small proportion of cancers detected were advanced in terms of the clinical stage at time of diagnosis. A total of only six cancers were stage C1 to D1, and five of these were preexisting cancers detected at the first examination. Cancers detected by DRE tended to be more advanced than those found on the basis of only TRUS or PSA. A large proportion of patients received curative therapy, involving radical prostatectomy for 67.9% and radiation therapy for 17.9%. Of 100 men presumed to have organ confined disease and treated by prostatectomy, 64 actually proved to have localized cancer, a rate of upstaging of 36.0%. PSA level and PSA density were associated with the detection of organ confined cancer, but several advanced cancers had PSA levels in the normal range, limiting the usefulness of these measures for staging. CONCLUSIONS: The cancers resulting from this multimodality detection effort represented a spectrum of pathologic findings. These data, however, suggest that early detection interventions in men not suspected to have prostate cancer will yield tumors with a favorable stage distribution that are likely to benefit from treatment. Further follow-up evaluation is needed to determine whether these benefits are reflected in long-term mortality and survival experience.

Aged↗

PubMed1997

The National Cancer Data Base report on carcinoma of the anus.

BACKGROUND: The last 15 years have seen substantial advances in the management of anal carcinoma, primarily in the use of radiochemotherapy as definitive or adjuvant treatment. This study reviews the patterns of presentation, care, and outcome reflected in data from the National Cancer Data Base representing a broad range of medical centers. METHODS: Data on patients with anal carcinoma (on 1050 patients from 1988 and 1289 patients from 1993) were reviewed for patterns of care and presentation. The 1988 cases were also reviewed for outcome data. RESULTS: There was an increase in the use of chemotherapy between 1988 and 1993 (from 61.6% to 67.2%), and substantial differences were observed in the management of epidermoid carcinomas and adenocarcinomas. The majority of epidermoid carcinomas were managed nonsurgically, principally with combined chemotherapy and radiation, whereas three-fourths of patients with adenocarcinoma underwent surgery. The most important factors for favorable 5-year survival were early stage (ranging from 71.3% for Stage I to 23.1% for Stage IV), epidermoid carcinoma histology (57.6%, compared with 41.3% for adenocarcinoma), and female gender (56.2%, compared with 49.6% for males). For Stage I-II epidermoid carcinomas, the 5-year survival for patients who received nonsurgical treatment with radiochemotherapy was equivalent to that of patients who received surgical treatment (64.0% and 65.4%, respectively). CONCLUSIONS: This study confirms a trend in patterns of care favoring nonsurgical management with radiochemotherapy for epidermoid carcinomas of the anus. For adenocarcinomas, there has been a trend toward increasing use of multimodality therapy with surgery and adjuvant radiochemotherapy. Survival data from the 1988 cases confirmed the efficacy of conservative treatment with radiation plus chemotherapy for epidermoid carcinomas.

Adult↗

PubMed2026

Multimodal features and prognostic risk assessment in locally advanced gastric cancer patients following neoadjuvant therapy based on machine learning algorithms: a multicenter study.

BACKGROUND: Neoadjuvant therapy (NAT) is recommended for locally advanced gastric cancer (LAGC), but some patients respond poorly. We aimed to construct a multimodal model integrating CT images, transcriptomic sequencing, and clinicopathological data to assess prognosis in LAGC patients receiving NAT. MATERIALS AND METHODS: This multicenter study included 505 LAGC patients who underwent NAT. Radiomic features were extracted from preoperative CT images of 505 patients. RNA-seq was performed on 277 post-NAT specimens, with additional data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases (n = 804). Patients were divided into training (168 cases), internal validation (72 cases), and external validation cohorts. Machine learning algorithms identified key radiomic, molecular, and clinical features associated with NAT response, which were then integrated into a multimodal model to predict overall survival (OS) and disease-free survival (DFS). RESULTS: Six radiomic and three molecular features significantly associated with NAT response were selected. Radiomic risk (hazard ratio [HR]: 4.0, P < 0.001) and molecular risk (HR: 7.1, P < 0.001) were independent prognostic factors. By integrating radiomic risk, molecular risk, and clinical characteristics, a multimodal model (MuMo) was constructed.The C-index results (OS, C-index = 0.855; DFS, C-index = 0.786) demonstrated that MuMo outperformed the single-modality models and ypTNM staging.Mechanistic analysis suggested that the efficacy of neoadjuvant therapy was significantly enriched in immune-inflammatory pathways. CONCLUSIONS: MuMo can effectively predict postoperative survival risk in LAGC patients receiving NAT, serving as a powerful tool for optimizing prognostic assessment.

Humans↗

PubMed2003

Parcellation of cortical afferents to three distinct sectors in the parahippocampal gyrus of the rhesus monkey: an anatomical and neurophysiological study.

The posterior parahippocampal gyrus (PHG) of the rhesus monkey (Macaca mulatta) is comprised of three distinct cortical areas based on cytoarchitecture, connectivity, and neurophysiological response properties. Fluorescent retrograde tracers placed in each PHG area demonstrated unique patterns of cortical afferent input to areas TH, TL, and TF. Area TF receives inputs from the multimodal cortices of the superior temporal sulcus including areas PGa, TPO, and MST, from the visuospatial parietal area PG-Opt, and from visual areas V3A and dorsal V4. Area TL receives afferents from the inferotemporal region including visual areas TE1 and TE2 as well as from areas TEa, IPa, and FST in the lower bank and depth of the superior temporal sulcus. In contrast, the input to area TH is from the rostral part of superior temporal gyrus, including the auditory association areas TS1-3, and from the middle sector of area TPO in the superior temporal sulcus. Frontal and cingulate areas also project to the PHG in largely differential patterns. To further investigate this a correlative electrophysiological study of the three PHG areas resulted in a confirmation of these differential cortical inputs such that visually responsive neurons were found in areas TF and TL, auditory responsive neurons or bimodal auditory/visual-responsive neurons in area TH, and somatosensory-responsive neurons at the TF/TL border. Since each PHG area also receives differential hippocampal input, these data suggest that the processing of unimodal or multimodal information may be related to memory processing functions that are largely segregated within areas TH, TL, and TF.

Afferent Pathways↗

PubMed1997

Infants' perception of expressive behaviors: differentiation of multimodal information.

The literature on infants' perception of facial and vocal expressions, combined with data from studies on infant-directed speech, mother-infant interaction, and social referencing, supports the view that infants come to recognize the affective expressions of others through a perceptual differentiation process. Recognition of affective expressions changes from a reliance on multimodally presented information to the recognition of vocal expressions and then of facial expressions alone. Face or voice properties become differentiated and discriminated from the whole, standing for the entire emotional expression. Initially, infants detect information that potentially carries the meaning of emotional expressions; only later do infants discriminate and then recognize those expressions. The author reviews data supporting this view and draws parallels between the perceptions of affective expressions and of speech.

Emotions↗

PubMed2003

A multimodality regimen for deep venous thrombosis prophylaxis in total knee arthroplasty.

Data indicate that deep venous thrombosis (DVT) occurs at the time of knee arthroplasty. Nevertheless, literature concerning DVT prophylaxis has only recently addressed this contention. This prospective study evaluated the efficacy of a perioperative prophylactic regimen. Between January 1996 and June 2001, 1,308 knees (964 surgeries) underwent total knee arthroplasty. Patients were treated routinely with intraoperative heparin (1000 units intravenous push before inflation of the tourniquet and 500 units at deflation), hypotensive epidural anesthesia (MAP 70-90), external pneumatic compression boots, and aspirin (325 mg, PO, BID for 6 weeks). Duplex venous ultrasonography was performed before discharge. DVT was detected in 4% of cases (1% proximal and 3% distal). Bleeding complications occurred in 1%, and perioperative medical complications occurred in 12%.

Aged↗

PubMed2005

Recent advances in multimodal treatment for gastric cancer: a review.

The prognosis after surgical treatment of gastric cancer remains poor. This review aims to clarify the indication for multimodal treatment of gastric cancer. A systematic literature research and evaluation of clinical data presented at important international cancer meetings were undertaken. Recently published results of large randomized phase III trials underscore the potential value of neoadjuvant chemotherapy or adjuvant chemoradiotherapy in gastric cancer. However, data from randomized controlled trials are still scarce, and it remains uncertain which subgroups of patients should routinely undergo multimodal treatment. In view of the side effects of pre- and foremost postoperative therapies, a more distinct definition of prognostic and predictive markers is warranted. Neoadjuvant chemotherapy is a rising option in locally advanced gastric cancer. Adjuvant chemoradiation has been shown to be beneficial in gastric cancer patients who have undergone suboptimal surgical resection. The benefits of adjuvant chemotherapy alone seem to be very small.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2004

Multimodal inhibition of return effects in adults with and without Down syndrome.

Data from a previous study (Welsh & Elliott, 2001) has been reanalyzed to explore inhibition of return (IOR) effects in adults with and without Down syndrome (DS). Participants were required to react and move with either the left or right hand as quickly as possible to 1 of 2 target locations based on either a visual or a verbal cue. Although persons with DS demonstrated a different pattern of information processing capabilities, they demonstrated the same magnitude of IOR across all conditions of presentation as their peers without DS. This pattern of results provides further support for the multimodal and response-based nature of IOR. Moreover, the results indicate that the inhibitory processes that underlie IOR in the average population seem to be functional in persons with DS.

Acoustic Stimulation↗

PubMed2003

A mixture model for bovine abortion and foetal survival.

The effect of spontaneous abortion on the dairy industry is substantial, costing the industry on the order of US dollars 200 million per year in California alone. We analyse data from a cohort study of nine dairy herds in Central California. A key feature of the analysis is the observation that only a relatively small proportion of cows will abort (around 10;15 per cent), so that it is inappropriate to analyse the time-to-abortion (TTA) data as if it were standard censored survival data, with cows that fail to abort by the end of the study treated as censored observations. We thus broaden the scope to consider the analysis of foetal lifetime distribution (FLD) data for the cows, with the dual goals of characterizing the effects of various risk factors on (i). the likelihood of abortion and, conditional on abortion status, on (ii). the risk of early versus late abortion. A single model is developed to accomplish both goals with two sets of specific herd effects modelled as random effects. Because multimodal foetal hazard functions are expected for the TTA data, both a parametric mixture model and a non-parametric model are developed. Furthermore, the two sets of analyses are linked because of anticipated dependence between the random herd effects. All modelling and inferences are accomplished using modern Bayesian methods.

Abortion, Veterinary↗

PubMedDate not supplied

Spatio-temporal pattern discrimination in cats with insular-temporal lesions.

Previous studies have demonstrated that cats with bilateral insular-temporal lesions are impaired in their ability to perform temporal pattern discriminations of the general form A--B--A vs B--A--B. This deficit has been seen to occur when A and B are made up of two different auditory, visual, or vibrotractile stimuli. These data suggest that insular-temporal cortex is a multimodal area concerned with the perception of temporal sequences of stimuli. The present study extends these earlier observations by testing insular-temporal lesioned cats on a spatio-temporal pattern discrimination. A spatio-temporal pattern is defined as one in which the same stimulus is presented to the animal sequentially from different spatial locations. The data indicate that insular-temporal lesions disrupt a spatio-temporal pattern discrimination just as they do auditory, visual, or vibrotactile temporal pattern discriminations. Insular-temporal cortex appears to be critical for certain higher order perceptual abilities in the cat.

Animals↗

PubMed2006

An object simulation model for modeling hypothetical disease epidemics - EpiFlex.

BACKGROUND: EpiFlex is a flexible, easy to use computer model for a single computer, intended to be operated by one user who need not be an expert. Its purpose is to study in-silico the epidemic behavior of a wide variety of diseases, both known and theoretical, by simulating their spread at the level of individuals contracting and infecting others. To understand the system fully, this paper must be read together in conjunction with study of the software and its results. EpiFlex is evaluated using results from modeling influenza A epidemics and comparing them with a variety of field data sources and other types of modeling. EpiFlex is an object-oriented Monte Carlo system, allocating entities to correspond to individuals, disease vectors, diseases, and the locations that hosts may inhabit. EpiFlex defines eight different contact types available for a disease. Contacts occur inside locations within the model. Populations are composed of demographic groups, each of which has a cycle of movement between locations. Within locations, superspreading is defined by skewing of contact distributions. RESULTS: EpiFlex indicates three phenomena of interest for public health: (1) R0 is variable, and the smaller the population, the larger the infected fraction within that population will be; (2) significant compression/synchronization between cities by a factor of roughly 2 occurs between the early incubation phase of a multi-city epidemic and the major manifestation phase; (3) if better true morbidity data were available, more asymptomatic hosts would be seen to spread disease than we currently believe is the case for influenza. These results suggest that field research to study such phenomena, while expensive, should be worthwhile. CONCLUSION: Since EpiFlex shows all stages of disease progression, detailed insight into the progress of epidemics is possible. EpiFlex shows the characteristic multimodality and apparently random variation characteristic of real world data, but does so as an emergent property of a carefully constructed model of disease dynamics and is not simply a stochastic system. EpiFlex can provide a better understanding of infectious diseases and strategies for response.

Computer Simulation↗

PubMed2003

Multimodality monitoring of transcranial electric motor and somatosensory-evoked potentials during surgical correction of spinal deformity in patients with cerebral palsy and other neuromuscular disorders.

STUDY DESIGN: This prospective, descriptive study determined the reliability of transcranial electric motor and posterior tibial nerve somatosensory-evoked potentials in children with neuromuscular scoliosis. OBJECTIVE: To assess the applicability of transcranial electric motor and posterior tibial nerve somatosensory-evoked potentials during surgical correction of neuromuscular scoliosis, particularly with cerebral palsy-related deformity. SUMMARY OF BACKGROUND DATA: During corrective spinal surgery for neuromuscular scoliosis, intraoperative multimodality spinal cord monitoring is recommended. There exist conflicting, retrospective studies regarding the reliability of spinal cord monitoring in patients with neuromuscular scoliosis. METHODS: Transcranial electric motor potentials and posterior tibial nerve somatosensory-evoked potentials were monitored in all patients presenting for spinal fusion between 2000 and 2001. Anesthesia was standardized for all patients. RESULTS: There were 68 patients subdivided into two subject groups. Group I consisted of 39 patients with neuromuscular scoliosis associated with cerebral palsy, and Group II consisted of 29 children with neuromuscular scoliosis due to a disease process other than cerebral palsy. Five of the 68 patients had significant amplitude changes in 1 or both monitoring methods during surgery relative to baseline. Of these, one had permanent neurologic deficit despite standard intervention. Somatosensory-evoked potentials were monitored successfully in 82% of the cerebral palsy and 86% of the noncerebral palsy patients. Transcranial electric motor-evoked potentials, on the other hand, were monitorable in 63% of patients with mild or moderate degrees of cerebral palsy and 39% of those with severe involvement. Eighty-six percent of those with noncerebral palsy-related neuromuscular scoliosis had recordable motor-evoked potentials at baseline. CONCLUSION: Both transcranial electric motor and posterior tibial nerve somatosensory-evoked potentials can be monitored reliably in most patients with neuromuscular scoliosis. Those with severe cerebral palsy present the greatest challenge to successful neurophysiologic monitoring.

Adolescent↗

PubMed1994

Responses of thoracic interneurons to tactile stimulation in cockroach, Periplaneta americana.

Recent findings indicate that cockroaches escape in response to tactile stimulation as well as they do in response to the classic wind puff stimulus. The thoracic interneurons that receive inputs from ventral giant interneurons also respond to tactile stimulation and, therefore, represent a potential site of convergence between wind and tactile stimulation, as well as other sensory modalities. In this article, we characterize the tactile response of these interneurons, which are referred to as type-A thoracic interneurons (TIAs). In response to tactile stimulation of the body cuticle, TIAs typically respond with a short latency biphasic depolarization which often passes threshold for action potentials. The biphasic response is not typical of responses to wind stimulation nor of tactile stimulation of the antennae. It is also not seen in tactile responses of thoracic interneurons that are not part of the TIA group. The responses of individual TIAs to stimulation of various body locations were mapped. The left-right directional properties of TIAs are consistent with their responses to wind puffs from various different directions. Cells that respond equally well to wind from the left and right side also respond equally well to tactile stimuli on the left and right side of the animal's body. In contrast, cells that are biased to wind on one side are also biased to tactile stimulation on the same side. In general, tactile responses directed at body cuticle are phasic rather than tonic, occurring both when the tactile stimulator is depressed and released. The response reflects stimulus strength and follows repeated stimulation quite well. However, the first phase of the biphasic response is more robust during high-frequency stimulation than the second phase. TIAs also respond to antennal stimulation. However, here the response characteristics are complicated by the fact that movement of either antenna evokes descending activity in both left and right thoracic connectives. The data suggest that the TIAs make up a multimodal site of sensory convergence that is capable of generating an oriented escape turn in response to any one of several sensory cues.

Animals↗