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PubMed1991

A multimodal neurophysiological assessment in terminal renal failure.

A prospective multimodal neurophysiological study was conducted on 36 patients with end-stage renal failure, 16 of whom subsequently underwent renal transplantation (TR). Nerve conduction study and somatosensory evoked potentials revealed that peripheral conduction deficit, often subclinical, was the commonest abnormality, and TR resulted in substantial improvement. Visual evoked potentials demonstrated subclinical impairment, which did not improve after TR. The brainstem auditory evoked potentials were essentially normal and unaffected by TR.

Brain Stem↗
PubMed1991

Multimodal evoked potentials in progressive external ophthalmoplegia with mitochondrial myopathy.

Multimodal evoked potentials were studied in 13 patients affected by progressive external ophthalmoplegia with histologically proven mitochondrial myopathy. Progressive external ophthalmoplegia occurred with craniosomatic spreading in all the patients and with a varying degree of nervous and/or other system involvement in most of them. In all but one of the subjects, at least one evoked potential modality was abnormal; 11 of them demonstrated an abnormal visual evoked potential, but this finding might have been influenced by concurrent retinal dysfunction. Abnormalities in brainstem auditory evoked potentials and/or somatosensory evoked potentials, revealing an impairment of central sensory pathways, were detected in 7 subjects, 5 of whom lacked clinical evidence of central nervous system involvement. Thus, evoked potentials represent an useful tool for the detection of subclinical central nervous system involvement in patients affected by progressive external ophthalmoplegia with mitochondrial myopathy.

Adult↗
PubMed1992

Multimodal sensory and motor evoked potentials in a two-year follow-up study of MS patients with relapsing course.

Serial recording of multimodal sensory (pattern reversal visual, brainstem auditory, median and tibial somatosensory) and motor evoked potentials during a 2-year period was performed on a group of 25 patients with relapsing multiple sclerosis. A new, 10-degree evoked potentials abnormality scale was introduced. In contrast to the insignificant common trend of both the mean individual EP latency parameters and the mean expanded disability status scale and evoked potentials abnormality scale to deteriorate the changes in both expanded disability status scale (p less than 0.05) and evoked potentials abnormality scale (p less than 0.01) were significant using a 1-point criterion for change and non-parametric testing. Changes in both scales differed in about 50% of patients; contrary to bidirectional changes in the clinical scale, no improvement in the evoked potential scale was found. The introduction of an evoked potentials abnormality scale based on separate cut-off step-like criteria may increase the robustness of evoked potential changes due to the activity of the disease in longitudinal studies.

Adult↗
PubMed1996

Multimodal evoked potentials in HIV-1-seropositive patients: relationship between the immune impairment and the neurophysiological function.

Multimodal evoked potentials (PRVEP, BAEP, mSEP) were recorded in 56 HIV-1 seropositive outpatients free from opportunistic CNS pathologies and/or overt HIV-1 encephalopathy. EPs were altered in 17 of 39 (43.6%) seropositive subjects without AIDS (group A) and in 13 of 17 (76.5%) patients with AIDS (group B). A high incidence of subclinical alterations (30.8%) were found in group A patients. Significant BAEP (I-III, III-V, I-V) interpeak latency and mSEP (N9-N13, N9-N20) conduction time prolongations were found in group A and B patients. PRVEP P100 was significantly prolonged only in group B. An inverse relationship between BAEP interpeak latencies and CD4 count was found. Our findings support the hypothesis of an important role of immunodepression in the development of neurophysiologic abnormalities, together with a preferential involvement of acoustic pathways, in the course of HIV-1 infection.

AIDS Dementia Complex↗
PubMed1995

Characteristics of multimodal co-aggregation between Fusobacterium nucleatum and streptococci.

The co-aggregation characteristics between Fusobacterium nucleatum and streptococci were examined to clarify the adherence factors participating in the co-aggregation. Nineteen strains of F. nucleatum were classified into 8 groups according to co-aggregation titer and inhibition by L-arginine, L-lysine and N-acetyl-D-galactosamine (or lactose). The inhibition activity was, however, very different from strain to strain. With two fusobacterial strains, two inhibitors, which were both inhibition negative on their own, completely inhibited the co-aggregation when used together in a mixture. In some co-aggregation pairs, the protease treatment of F. nucleatum inactivated one of the adherence factors, and resulted in the change of inhibition characteristics. These results indicate the multimodal co-aggregation of F. nucleatum with streptococci mediated by L-arginine-sensitive, L-lysine-sensitive, N-acetyl-D-galactosamine-sensitive and in some resistant factors, and that the adherence factor or factors participating the co-aggregation change according to the co-aggregation partners.

Acetylgalactosamine↗
PubMedDate not supplied

Multimodality image fusion to facilitate anatomic localization of 99mTC-pertechnetate uptake in the feline head.

99mTc-pertechnetate is excreted in humans by the thyroid glands, gastric mucosa, salivary glands, choroid plexus, and sweat glands. Uptake attributed to the zygomatic and molar salivary glands is used commonly as a reference to assess thyroid uptake and differentiate euthyroid from hyperthyroid cats. However, the exact location and origin of uptake of 99mTc-pertechnetate in the head during thyroid scintigraphy in cats remains uncertain. The purpose of this study was to localize uptake of 99mTc-pertechnetate in the head of the cat using multimodality image fusion. Computed tomography (CT), magnetic resonance (MR), and single photon emission tomography (SPECT) imaging were performed successively in two cats during the same anesthesia procedure. Transverse, dorsal, and sagittal images were reconstructed for each modality. Images were rescaled and fused manually. The anatomic location of focal 99mTc activity in SPECT images was identified in CT and MR images. Four major and four minor focal areas of uptakes were identified in the head in both cats. A rostral conical-shaped activity was identified in the nasal cavity. Two symmetric focal areas of uptakes seen in the soft tissues in the ventro-caudal retro-bulbar region, and rostro-medial to the vertical ramus of the mandible were attributed to zygomatic salivary glands. A central focal activity located ventral and caudal to the zygomatic uptake was located in the nasopharynx and soft palate. Minor symmetric areas of uptake identified in the retromandibular region were attributed to parotid and mandibular salivary glands. Minor symmetric areas of uptake identified in the region of the mandible were attributed to molar salivary glands. No focal area of uptake was identified in the brain.

Animals↗
PubMed2000

Cortical reorganization in linear nevus sebaceous syndrome: a multimodality neuroimaging study.

The authors report the findings of multimodal structural, functional, and metabolic imaging in a patient with linear nevus sebaceous syndrome, intractable seizures, and right megalencephaly. Despite nearly continuous paroxysmal electrical activity from the megalencephalic region, imaging studies suggested nonfunctional tissue in this region with reorganization of cortical function to the unaffected ipsilateral hemisphere. Hemispherectomy has been successfully performed in previous patients; however, it could have led to marked left hemiparesis with significant functional morbidity in this patient because of ipsilateral reorganization of the primary motor cortex.

Adult↗
PubMed1996

Multimodal distribution of amplitudes of miniature and spontaneous EPSPs recorded in rat trigeminal motoneurones.

1. The whole-cell variant of the patch recording method has been used to obtain voltage recordings from trigeminal motoneurones in tissue slices (500 microns thick) taken from rats aged 8 days. Membrane properties (input resistance, membrane time constant and rheobase, i.e. threshold current required to elicit an action potential) of the motoneurones were determined and recordings made of the (untriggered) EPSP activity. 2. Untriggered EPSP activity was recorded in standard artificial cerebrospinal fluid (ACSF), ACSF with added tetrodotoxin (TTX) and in nominally Ca(2+)-free ACSF with added TTX. In each case the amplitude distributions of single EPSPs were peaky and could be fitted by a model consisting of the sum of equidistant Gaussians (n = 7/9 cells). In contrast, the amplitude distribution of the noise was always unimodal. 3. All EPSP activity recorded in the presence of TTX was abolished by addition of 6-cyano-7-nitroquinoxaline-2-3-dione (CNQX; 10 microM), suggesting the activity was all mediated by glutamate acting primarily at AMPA/kainate receptors. 4. In the majority of cases, there was no correlation between the amplitude of EPSPs underlying each Gaussian and the EPSP rise time but there was a positive correlation between the EPSP half-width and EPSP rise time. The rise times of EPSPs underlying the first, and all, fitted Gaussians were similar to that for the total sample of EPSPs in each motoneurone. Taken together, this suggests that the EPSPs underlying each Gaussian arise from inputs to different dendritic compartments, and that the range of compartments is similar for EPSPs underlying successive Gaussians. 5. Two conclusions are drawn. First, EPSPs of different dendritic origin have similar amplitudes at the soma. Second, the multimodal distribution of EPSP amplitudes recorded in the presence of TTX raises the possibility that individual boutons may contain multiple release sites, with each perhaps operating on a separate functional group of postsynaptic receptors.

Animals↗
PubMed2006

Cerebellar Golgi cells in the rat receive multimodal convergent peripheral inputs via the lateral funiculus of the spinal cord.

We recently showed that the activity of cerebellar Golgi cells can be powerfully modulated by stimulation of peripheral afferents, in a pattern different to local Purkinje cells. Here we have examined the pathways underlying these responses. Graded electrical stimulation of muscle and cutaneous nerves revealed that long-lasting depressions and short-lasting excitations of Golgi cells were evoked by stimulation of cutaneous nerves at stimulus intensities that activated large mechanoreceptive afferents, and grew as additional afferents were recruited. In contrast, none of the neurones responded to stimulation of muscle nerves at intensities that activated group I afferents, although about half responded with long-lasting depressions, but not excitations, to stimuli that recruited group II and III afferents. Selective lesions of the spinal dorsal columns did not affect either of these types of response. After lesions of one lateral funiculus in the lumbar cord the responses evoked by stimulation of the hindlimb contralateral to the lesion were reduced or abolished, leaving responses evoked by ipsilateral hindlimb afferents unaltered. Since both ipsi- and contralateral afferents generate responses in Golgi cells, the convergence from the two sides must occur supraspinally. It is difficult to reconcile these properties with any of the direct spinocerebellar pathways or spinoreticulocerebellar pathways that have been described. Instead, it is likely that the responses are evoked via the multimodal 'wide dynamic range' neurones of the anterolateral system. Golgi cell activity may thus be powerfully enhanced or depressed during arousal via the anterolateral system.

Action Potentials↗
PubMedDate not supplied

Detection of morphological markers of vulnerable atherosclerotic plaque using multimodal spectroscopy.

Vulnerable plaques, which are responsible for most acute ischemic events, are presently invisible to x-ray angiography. Their primary morphological features include a thin or ulcerated fibrous cap, a large necrotic core, superficial foam cells, and intraplaque hemorrhage. We present evidence that multimodal spectroscopy (MMS), a novel method that combines diffuse reflectance spectroscopy (DRS), intrinsic fluorescence spectroscopy (IFS), and Raman spectroscopy (RS), can detect these markers of plaque vulnerability. To test this concept, we perform an MMS feasibility study on 17 human carotid artery specimens. Following the acquisition of spectra, each specimen is histologically evaluated. Two parameters from DRS, hemoglobin concentration and a scattering parameter, are used to detect intraplaque hemorrhage and foam cells; an IFS parameter that relates to the amount of collagen in the topmost layers of the tissue is used to detect the presence of a thin fibrous cap; and an RS parameter related to the amount of cholesterol and necrotic material is used to detect necrotic core. Taken together, these spectral parameters can generally identify the vulnerable plaques. The results indicate that MMS provides depth-sensitive and complementary morphological information about plaque composition. A prospective in vivo study will be conducted to validate these findings.

Algorithms↗
PubMed1996

Three-dimensional multimodality medical image registration using a parameter accumulation approach.

A parameter accumulation method based on the Hough transformation is proposed to register three-dimensional (3-D) multimodality medical images. The estimation of registration parameters is decomposed into separate estimations of rotation, using directional vectors, and translation, using positional vectors. Similarly, the rotation parameters are decomposed into the rotation axis and angle, which are then estimated separately. This kind of decomposition reduces the parametric dimension and improves the computing efficiency which has been a major concern in implementing the Hough transformation. When 3-D rotation is involved, evaluating registration error is not straightforward. This paper introduces an equivalent error angle as a criterion to evaluate the performance of 3-D registration methods. Experimental results indicate that a least-squares fitting is superior to the parameter accumulation with data contaminated by additive noise only. When mismatched feature points (outliers) exist in the data set, however, the parameter accumulation approach is more accurate. The application of the proposed approach to the registration of 3-D PET and CT images is demonstrated.

Algorithms↗
PubMed2004

Multimodal signals: enhancement and constraint of song motor patterns by visual display.

Many birds perform visual signals during their learned songs, but little is known about the interrelationship between visual and vocal displays. We show here that male brown-headed cowbirds (Molothrus ater) synchronize the most elaborate wing movements of their display with atypically long silent periods in their song, potentially avoiding adverse biomechanical effects on sound production. Furthermore, expiratory effort for song is significantly reduced when cowbirds perform their wing display. These results show a close integration between vocal and visual displays and suggest that constraints and synergistic interactions between the motor patterns of multimodal signals influence the evolution of birdsong.

Abdominal Muscles↗
PubMed2000

Dispersive multiplexing in multimode optical fiber

Recently developed ideas in the field of wireless communications suggest that the presence of scattering can be used to enhance, rather than degrade, the total information capacity of a transmission system. This concept is applied to data transmission over multimode optical fiber, and the result is an optical multiplexing that can increase the capacity of such fiber. Experimental results demonstrate the feasibility of this approach. The technique may play an important role in future high-bandwidth local area networking applications.

Journal Article↗
PubMed1981

Multimodal treatment in operable breast cancer: five-year results of the CMF programme.

The five-year results of a prospective randomised trial of radical mastectomy (179 patients) versus radical mastectomy followed by adjuvant chemotherapy (207 patients) were analysed. Chemotherapy consisted of 12 monthly cycles of cyclophosphamide, methotrexate, and fluorouracil (CMF). Both relapse-free survival (controls 44.6%, CMF group 59.5%) and total survival (controls 66.2%, CMF group 78.4%) were significantly improved. The findings were related to the number of diseased axillary nodes and amount of drug administered, and were independent of CMF-induced amenorrhoea. Menopausal state alone appeared to affect the five-year results only when the amount of drug administered was not taken into account. Salvage treatment at first relapse failed to improve total survival in the controls compared with the CMF group. Acute toxic manifestations were moderate and reversible. Chronic organ damage and increased incidence of second neoplasms (controls 1.7%, CMF group 1.4%) were not observed. The multimodality approach to treatment of primary breast cancer is a new and important advance. This and other studies are continuing.

Adult↗
PubMed2006

Multimodal evoked potentials to assess the evolution of multiple sclerosis: a longitudinal study.

BACKGROUND: Evoked potentials are used in the functional assessment of sensory and motor pathways. Their usefulness in monitoring the evolution of multiple sclerosis has not been fully clarified. OBJECTIVE: The aim of this longitudinal study was to examine the usefulness of multimodal evoked potential in predicting paraclinical outcomes of disease severity and as a prognostic marker in multiple sclerosis. METHODS: Eighty four patients with clinically definite multiple sclerosis underwent Expanded Disability Status Scale (EDSS) and functional system scoring at study entry and after a mean (standard deviation) follow-up of 30.5 (11.7) months. Sensory and motor evoked potentials were obtained in all patients at study entry and at follow-up in 64 of them, and quantified according to a conventional score. RESULTS: Cross-sectionally, the severity of each evoked potential score significantly correlated with the corresponding functional system (0.32 < R < 0.60, p < 0.01, for all but follow-up visual evoked potential) and with EDSS (0.34 < R < 0.61; p < 0.001 for all but brain stem evoked potential). EDSS significantly correlated with global evoked potential score severity (baseline R = 0.60, follow-up R = 0.46, p < 0.001). Using longitudinal analysis, only changes in somatosensory evoked potential scores were significantly correlated with changes of sensory functional system (R = 0.34, p = 0.006). However, patients with multiple sclerosis with disability progression at follow-up had more severe baseline evoked potential scores than patients who remained stable. Patients with severe baseline global evoked potential score (higher than the median value) had a risk of 72.5% to progress on disability at follow-up, whereas patients with multiple sclerosis with lower scores had a risk of only 36.3%. CONCLUSIONS: These results suggest that evoked potential is a good marker of the severity of nervous damage in multiple sclerosis and may have a predictive value regarding the evolution of disability.

Adult↗
PubMed1988

Multimodality evoked potentials in HTLV-I associated myelopathy.

Multimodality evoked potentials (EPs) consisting of somatosensory EPs (SEPs), visual EPs (VEPs) and brainstem auditory EPs (BAEPs) were studied in 16 cases with HTLV-I associated myelopathy (HAM). Median nerve SEPs were normal in all cases. In posterior tibial nerve SEPs, the potential recorded at the 12th thoracic spinal process was normal in every case but cortical components were significantly prolonged in 10 cases, although five of these showed no sensory impairment. BAEPs were normal in every case whose hearing was intact, but VEPs were abnormal in two cases whose visual acuities were normal. The present results in HAM indicate predominant lesion in the thoracic cord, and might also suggest some subclinical lesion in the visual pathway.

Adult↗
PubMed1994

Multimodal electrophysiological studies including motor evoked potentials in patients with locked-in syndrome: report of six patients.

Clinical and electrophysiological findings in six patients with locked-in syndrome are reported. Motor evoked potentials (MEPs) after magnetic stimulation of the motor cortex were absent in four patients, none of whom recovered clinically. In two patients, MEPs could be obtained from the severely paretic limbs and almost full motor recovery followed. Somatosensory evoked potentials were altered in four of the patients, and brainstem auditory evoked potentials were altered in two of four patients examined, showing a clinically unsuspected tegmental involvement. The EEG showed a predominance of reactive alpha activity in all patients, documenting a preserved consciousness. It is concluded that a multimodal electrophysiological approach, in addition to clinical assessment, can be helpful in diagnosing locked-in syndrome, estimating the extension of the underlying brainstem dysfunction, and predicting functional outcome.

Adolescent↗
PubMed2003

Differences in the diagnostic accuracy of acute stroke clinical subtypes defined by multimodal magnetic resonance imaging.

BACKGROUND: Despite its importance for acute stroke management, little is known about the underlying pathophysiology when patients with acute stroke are classified using clinical methods. OBJECTIVE: To examine the relation between the magnetic resonance defined stroke subtype and clinical stroke classifications using diffusion weighted imaging (DWI), perfusion weighted imaging (PWI), and angiographic magnetic resonance techniques. METHODS: Consecutive patients with clinical syndromes consistent with acute anterior circulation stroke were assessed clinically within six hours of onset and scanned as soon as possible using multimodal magnetic resonance imaging (MRI). Patients were classified clinically into total or partial anterior circulation syndromes using the Oxford classification, or according the severity of the National Institutes of Health stroke scale (NIHSS) (severe > 15; mild/moderate 15). There were 42 with partial anterior circulation syndromes (PACS) and 42 with total anterior circulation syndromes (TACS). Patients with TACS or severe stroke were more likely to have actually suffered a stroke (Fischer's exact test, p = 0.01), to have a correctly classified stroke (chi(2) 28.2, p < 0.01), to have persisting occlusion (chi(2) 30.6, p < 0.01), and to have a large DWI-PWI mismatch (chi(2) 17.1, p < 0.01). CONCLUSIONS: There is more inaccuracy in patients presenting with acute PACS or clinically mild to moderate anterior circulation stroke than in those with TACS or severe acute stroke syndromes. The latter appear more likely to be the targets for acute stroke interventions, as they include a significantly higher proportion of patients with persisting occlusion and diffusion/perfusion mismatch.

Acute Disease↗