Left Occipital Cortex Research Articles

Valor de la tomogammagrafía cerebral Talio-201/Galio-67 en el diagnóstico diferencial de las lesiones cerebrales ocupantes de espacio

Central nervous system (CNS) neoplasms are 10% of all tumors. A metastasis of an unknown primary neoplasm should be suspected in an adult with a cerebral tumor. In this location, the origin of most of metastases (62%) is lung, breast, skin and kidney. However, a differentiation of CNS focal infection and brain tumor, based on clinical status and morphologic imaging, may be difficult. A positive Tl-201 next to a negative Ga-67 SPECT brain scans is entirely in accord with brain metastatic tumor. A 72-year-old man, with history of excised bladder cancer, was admitted for neurological symptoms associated with a left occipital mass demonstrated by cranial CT and brain MRI. Clinicoradiological findings suggested a neoplastic process. Two cerebral biopsies just showed inflammatory cells. Tl-201 and Ga-67 SPECT brain scans were performed and their findings, an abnormal uptake of Tl-201 in the left occipital cortex and a negative Ga-67 scan, favored a neoplastic process. Radical exeresis of the lesion showed a metastatic adenosquamous carcinoma of probably lung origin. Tl-201 in addition to Ga-67 brain SPECT scans are a valuable tool for differential diagnosis between cerebral infection and brain tumour in patients with a sole cerebral mass lesion, especially when clinicoradiological findings and biopsy results are conflicting.

Searching for face-specific long latency ERPs: a topographic study of effects associated with mismatching features

In a previous study [E. Olivares, M.A. Bobes, E. Aubert, M. Valdés-Sosa, Associative ERPs effects with memories of artificial faces, Cogn. Brain Res. 2 (1994) 39–48] we reported the presence of a negativity associated with mismatching features when subjects carried out a face-feature matching task whilst their evoked potentials were recorded. Since the stimuli used were learned faces (realistic drawings), for which the subjects possessed no semantic information or associated verbal labels, the mismatch negativity obtained was considered a face-specific N400. In this work we present a new experiment to study the topographic distribution of these mismatch effects. As in the above-mentioned study, in each trial the subjects observed previously an incomplete (without the eyes/eyebrows fragment) familiar face, which served as a structural context for the face recognition. The face was then completed by grafting either matching (learned) features or mismatching features (from another face). In line with neuropsychological studies on prosopagnosia and electrophysiological findings in humans and non-human primates, we found as one of the most relevant items of data that the most-posterior (principally, left occipital) cortices appear to be a region in which are located the possible neural generators of the negativity associated with the detection of incongruencies in the structure of familiar faces. We also reported a late positivity, distributed in more anterior regions, which follows the mismatch negativity. This complex N–P is interpreted as reflecting a dual process of retrieval and integration of information in memory.

Alterations of benzodiazepine receptors in type II alcoholic subjects measured with SPECT and [123I]iomazenil.

Alterations in cortical benzodiazepine receptor density have been described in postmortem and in vivo studies of alcoholic subjects. The authors attempted to replicate these findings using single photon emission computed tomography and the benzodiazepine receptor radiotracer [123I]iomazenil. They measured the distribution volume of benzodiazepine receptors in 11 recently detoxified patients with type II alcoholism and 11 healthy comparison subjects. The tracer was given as a bolus followed by a continuous infusion to achieve sustained binding equilibrium at the benzodiazepine receptors. Data were analyzed by using a region of interest method (regions of interest were identified on coregistered magnetic resonance imaging scans) and by a pixel-by-pixel method (distribution volume maps were analyzed with statistical parametric mapping for between-group differences). The region of interest analysis revealed that alcoholic patients had significantly lower benzodiazepine distribution volume than comparison subjects in the frontal, anterior cingulate, and cerebellar cortices. Statistical parametric mapping revealed two large excursions in which the distribution volume in alcoholic patients was significantly lower than in comparison subjects: the anterior cingulate, extending into the right middle frontal gyrus, and the left occipital cortex. Benzodiazepine receptor distribution volume is significantly lower in several cortical regions and the cerebellum in alcoholic subjects than in healthy comparison subjects. These results are consistent with previous reports and might indicate either a toxic effect of alcoholism on benzodiazepine receptors or a vulnerability factor for developing alcoholism.

Analysis of neural interactions explains the activation of occipital cortex by an auditory stimulus.

Analysis of neural interactions explains the activation of occipital cortex by an auditory stimulus. J. Neurophysiol. 80: 2790-2796, 1998. Large-scale neural interactions were characterized in human subjects as they learned that an auditory stimulus signaled a visual event. Once learned, activation of left dorsal occipital cortex (increased regional cerebral blood flow) was observed when the auditory stimulus was presented alone. Partial least-squares analysis of the interregional correlations (functional connectivity) between the occipital area and the rest of the brain identified a pattern of covariation with four dominant brain areas that could have mediated this activation: prefrontal cortex (near Brodmann area 10, A10), premotor cortex (A6), superior temporal cortex (A41/42), and contralateral occipital cortex (A18). Interactions among these regions and the occipital area were quantified with structural equation modeling to identify the strongest sources of the effect on left occipital activity (effective connectivity). Learning-related changes in feedback effects from A10 and A41/42 appeared to account for this change in occipital activity. Influences from these areas on the occipital area were initially suppressive, or negative, becoming facilitory, or positive, as the association between the auditory and visual stimuli was acquired. Evaluating the total effects within the functional models showed positive influences throughout the network, suggesting enhanced interactions may have primed the system for the now-expected visual discrimination. By characterizing both changes in activity and the interactions underlying sensory associative learning, we demonstrated how parts of the nervous system operate as a cohesive network in learning about and responding to the environment.

Visual complexity in letter-by-letter reading: Pure alexia is not pure

Standard accounts of pure alexia have favoured the view that this acquired disorder of reading arises from damage to a left posterior occipital cortex mechanism dedicated to the processing of alphanumeric symbols. We challenge these accounts in two experiments and demonstrate that patients with this reading deficit are also impaired at object identification. In the first experiment, we show that a single subject, EL, who shows all the hallmark features of pure alexia, is impaired at picture identification across a large set of stimuli. As the visual complexity of pictures increases, so ELs reaction time to identify the stimuli increases disproportionately relative to the control subjects. In the second experiment, we confirm these findings with a larger group of five pure alexic patients using a selected subset of high- and low-visual complexity pictures. These findings suggest that the deficit giving rise to pure alexia is not restricted to orthographic symbols per se but, rather, is a consequence of damage to a more general-purpose visual processing mechanism.

Convergence of neural systems processing stimulus associations and coordinating motor responses.

A sensory-sensory learning paradigm was used to measure neural changes in humans during acquisition of an association between an auditory and visual stimulus. Three multivariate partial least-squares (PLS) analyses of positron emission tomography data identified distributed neural systems related to (i) processing the significance of the auditory stimulus, (ii) mediating the acquisition of the behavioral response, and (iii) the spatial overlap between these two systems. The system that processed the significance of the tone engaged primarily right hemisphere regions and included dorsolateral prefrontal cortex, putamen, and inferior parietal and temporal cortices. Activity changes in left occipital cortex were also identified, most likely reflecting the learned expectancy of the upcoming visual event. The system related to behavior was similar to that which coded the significance of the tone, including dorsal occipital cortex. The PLS analysis of the concordance between these two systems showed substantial regional overlap, and included occipital, dorsolateral prefrontal, and limbic cortices. However, activity in dorsomedial prefrontal cortex was strictly related to processing the auditory stimulus and not to behavior. Taken together, the PLS analyses identified a system that contained a sensory-motor component (comprised of occipital, temporal association and sensorimotor cortices) and a medial prefrontallimbic component, that as a group simultaneously embodied the learning-related response to the stimuli and the subsequent change in behavior.

Radiation-associated cerebral blindness

PURPOSE: To report a case of blindness caused by a white-matter injury after whole brain irradiation for metastatic renal cell carcinoma. METHODS: Case report. We performed comprehensive serial neuro-ophthalmologic examinations. RESULTS: Four to 5 months after resection of renal cell metastasis in the left occipital cortex, interleukin-2 therapy, and whole brain irradiation with 3,000 cGy plus a 1,500-cGy boost to the posterior third of the brain, the patient developed a progressive decline in visual acuity in both eyes to hand motions. Magnetic resonance imaging disclosed signal abnormalities without mass effect in the white matter of the parietal and occipital lobes bilaterally, including the optic radiations. CONCLUSION: This case is a unique example of cortical blindness secondary to radiation injury in the occipital lobes and optic radiations.

Age-related changes in brain perfusion of normal subjects detected by 99mTc-HMPAO SPECT.

Previous functional imaging data generally show impairment in global cerebral blood flow (CBF) with age. Conflicting data, however, concerning age-related changes in regional CBF (rCBF) have been reported. We examined the relative rCBF in a sample of healthy subjects of various ages, to define and localize any age-related CBF reduction. Twenty-seven healthy subjects (17 male, 10 female; mean age 49 +/- 15, range 26-71, median 47 years) were studied by 99mTc-HMPAO brain SPECT. The younger age group consisted of subjects below, the older group above 47 years of age, respectively. Analysis was performed by applying three preformed templates, each containing delineated regions of interest (ROIs), to three transaxial brain slices at approximately 4, 6, and 7 cm above the orbitomeatal line (OML). The average number of counts for each ROI was normalized to mean uptake of the cerebellum and of the whole brain slice. Globally, 99mTc-HMPAO uptake ratio normalized to cerebellum was significantly decreased in older subjects, affecting both hemispheres. A slight left-to-right asymmetry was observed in HMPAO uptake of the whole study group. It did not, however, change with age. Regionally, both cortical and subcortical structures of older subjects were involved: uptake ratio to cerebellum was significantly lower (after correction for multiple testing) in the left basal ganglia and in the left superior temporal, right frontal and bilateral occipital cortices at 4 cm above the OML. At 6 cm above the OML, reduced uptake ratios were identified in the left frontal and bilateral parietal areas. At 7 cm, reduced uptake was detected in the right frontal and left occipital cortices. Most of these differences were reduced when uptake was normalized to whole slice, whereas an increase in uptake ratios was observed in the cingulate cortex of the elderly. An inverse correlation between age and HMPAO uptake ratios normalized to cerebellum was observed in a number of brain regions. These findings suggest that advancing age has a differential effect on cerebral perfusion reflected in brain 99mTc-HMPAO uptake.

PET study of human voluntary saccadic eye movements in darkness: effect of task repetition on the activation pattern.

Using H2(15)O 3D Positron Emission Tomography (PET), regional cerebral blood flow (rCBF) was measured in six human subjects under two different conditions: at rest and while performing self-paced horizontal saccadic eye movements in darkness. These two conditions were repeated four times each. First, the comparison between the four saccadic and four resting conditions was investigated in a group and a single subject analysis. Saccades elicited bilateral rCBF increases in the medial part of the superior frontal gyrus (supplementary eye field), precentral gyrus (frontal eye field), superior parietal lobule, anterior medial part of the occipital lobe involving striate and extrastriate cortex (lingual gyrus and cuneus), and in the right inferior parietal lobule. At the subcortical level, activations were found in the left putamen. These results mainly replicate previous PET findings on saccadic control. Second, the interaction between the experimental conditions and their repetition was examined. When activations throughout repetition of the same saccadic task are compared, the supplementary eye fields show a progressive increase of activation. On the contrary, the activation in the cerebellum, left superior parietal lobule and left occipital cortex progressively decreases during the scanning session. Given the existence of such an interaction, the pattern of activations must be interpreted as a function of task repetition. This may be a factor explaining some apparent mismatch between different studies.

Epicortical slow potential shifts and sensory-evoked potentials are related to seizure propensity in gerbils.

Gerbils were assessed for behavioral tendency by scoring seizure severity and the amount of ambulatory and rearing activities in a novel 'open-field' arena. Seizure-prone animals exhibited seizures on early open-field trials (1-2) and later performed more ambulatory activity than non-seizure-prone animals. Two weeks later, two groups of both seizure prone and non-seizure prone animals were chronically implanted with six silver/silver chloride ball electrodes for recordings during behaviour. Electrodes were on the surfaces of the frontal, parietal and occipital cortices bilaterally. In one group these were used to record slow potential shifts; in the other, visual- and acoustic-evoked responses. Larger negative and positive slow shifts occurred in seizure-prone animals. Most evident were the larger positive right frontal shifts and negative left occipital shifts. Seizure tendency was related to the amplitude of these waveforms. Visual-evoked potential amplitudes were generally larger and latencies shorter in seizure-prone animals, especially in the right occipital and left parietal cortices. Seizure susceptibility was associated with increased visual-evoked potential amplitude in the right frontal and left occipital cortices, and with reduced latency of both auditory- and visual-evoked responses in the left occipital cortex. The discussion highlights a role for glia in slow shift generation and the association of large shifts with enhanced sensory-evoked responses, especially in seizure-prone animals.

Words in Noise: Graded Visual Responses in the Left Occipital Cortex

Words in Noise: Graded Visual Responses in the Left Occipital Cortex

Brain mapping with single photon emission CT.

To investigate the feasibility of performing brain mapping studies by using cortical activation paradigms and single photon emission computed tomography (SPECT) and to evaluate methods of analysis. Twenty healthy volunteers underwent technetium-99m bicisate SPECT under baseline conditions and during either full-field or right hemifield visual stimulation with a black and white reversing checkerboard pattern. Changes in regional cerebral perfusion were measured by using regions of interest (ROIs) and statistical parametric mapping. ROI analysis identified statistically significant increases in perfusion in the occipital cortex with full-field visual stimulation (mean +/- standard error of the mean percentage change from baseline: left, 8.0 +/- 1.5; right, 6.6 +/- 2.4). With right hemifield visual stimulation, perfusion was significantly increased only in the left occipital cortex (left, 5.2 +/- 1.5; right, -0.2 +/- 1.9). Statistical parametric mapping showed areas of activation (more than 100 voxel clusters showed significant change from baseline at a threshold value of P < or = .005 or z > or = 2.58) in the left primary visual cortex (right hemifield visual stimulation) and in both right and left primary visual areas (full-field visual stimulation). Brain mapping studies were preformed with Tc-99m bicisate SPECT, and activation-induced changes were visualized and measured. These methods can be applied to develop improved methods of diagnosis and assessment of treatment outcome in patients with neuropsychiatric disorders.

Neural mechanisms involved in the processing of global and local aspects of hierarchically organized visual stimuli.

We investigated the functional anatomy involved in sustaining or switching visual attention between different perceptual levels, using functional imaging measures of neural activity. Two experiments were carried out using hierarchically organized letters (i.e. large letters made out of small letters). In a divided-attention task, subjects were required to switch attention between local and global levels. The number of successive stimuli for which subjects had to sustain attention to either the global or local level co-varied significantly with temporal-parietal activations bilaterally. Other activations were also observed in the right orbitofrontal cortex, the right dorsolateral prefrontal cortex, and the right middle temporal gyrus. The number of switches between levels co-varied significantly with activations in the left supplementary motor area and the left medial parietal cortex. In the directed-attention task, subjects were required to attend to either the global or local level of the stimuli throughout all trials; attention to the global aspect resulted in significant activation of the right lingual gyrus while attention to the local aspect significantly activated the left inferior occipital cortex. We suggest that left hemisphere activations with increasing numbers of switches between perceptual levels reflect increased demands on an executive attentional system, while sustained attention to either level activates a predominantly right hemispheric network involving temporal-parietal and dorsolateral prefrontal regions. Overall, the results provide evidence for relative hemispheric specialization for global and local processing in accordance with previous neuropsychological studies. In addition, the findings demonstrate that early visual processing mechanisms in the prestriate cortex are influenced by an attentional system in temporal-parietal areas.

Central pathway of photic reflex myoclonus.

Direct, new evidence for the cortical origin of photic reflex myoclonus in a patient with "posterior cortical atrophy" is provided. Photic stimulation elicited myoclonic jerks in the right upper limb...

The neural regions sustaining object recognition and naming.

This positron emission tomography study dissociates the neural correlates of object recognition and naming. Stimuli comprised coloured outline drawings of objects and coloured nonsense shapes. Subjects either viewed or explicitly named objects, similarly they viewed or named the colour of the shapes. Activations common to object and colour naming were identified by contrasting the explicit naming conditions (objects and colours) with the control (viewing) conditions. Activations associated with object recognition were identified by contrasting both object conditions (naming and viewing) with both shape conditions and activations specific to object or colour naming were identified by contrasting object naming (relative to object viewing) with colour naming (relative to shape viewing). The results associate: (i) object recognition with left middle occipital and bilateral anterior temporal cortices; (ii) modality independent naming with left posterior basal temporal lobe and the left prefrontal cortex; (iii) areas specific to object naming with left temporal extrasylvian regions, left anterior insula and right cerebellum; and (iv) areas specific to colour naming with left posterior lingual and fusiform gyri and midline cerebellum. These results are discussed in relation to previous neuroimaging and neuropsychological findings.

Cerebral activations during number multiplication and comparison: a PET study

Positron emission tomography was used to examine the cerebral networks underlying number comparison and multiplication in eight normal volunteers. Cerebral blood flow was measured within anatomical regions of interest defined in each subject using magnetic resonance imaging. Three conditions were used: rest with eyes closed, mental multiplication of pairs of arabic digits and larger-smaller comparison of the same pairs. Both multiplication and comparison activated the left and right lateral occipital cortices, the left precentral gyrus, and the supplementary motor area. Beyond these common activations, multiplication activated also the left and right inferior parietal gyri, the left fusiform and lingual gyri, and the right cuneus. Relative to comparison, multiplication also yielded superior activity in the left lenticular nucleus and in Brodmann's area 8, and induced a hemispheric asymmetry in the activation of the precentral and inferior frontal gyri. Conversely, relative to multiplication, comparison yielded superior activity in the right superior temporal gyrus, the left and right middle temporal gyri, the right superior frontal gyrus, and the right inferior frontal gyrus. These results underline the role of bilateral inferior parietal regions in number processing and suggest that multiplication and comparison may rest on partially distinct networks.

Where in the brain does visual attention select the forest and the trees?

The perceptual world is organized hierarchically: the forest consists of trees, which in turn have leaves. Visual attention can emphasize the overall picture (global form) or the focal details of a scene (local components). Neuropsychological studies have indicated that the left hemisphere is biased towards local and the right towards global processing. The underlying attentional and perceptual mechanisms are maximally impaired by unilateral lesions to the temporal and parietal cortex. We measured brain activity of normal subjects during two experiments using 'hierarchically' organized figures. In a directed attention task, early visual processing (prestriate) areas were activated: attention to the global aspect of the figures activated the right lingual gyrus whereas locally directed attention activated the left inferior occipital cortex. In a subsequent divided attention task, the number of target switches from local to global (and vice versa) covaried with temporal-parietal activation. The findings provide direct evidence for hemispheric specialization in global and local perception; furthermore, they indicate that temporal-parietal areas exert attentional control over the neural transformations occurring in prestriate cortex.

Network Analysis of Positron Emission Tomography Regional Cerebral Blood Flow Data: Ensemble Inhibition during Episodic Memory Retrieval

Two important objectives in the neuroscience of memory are (1) identification of neural pathways involved in memory processes; and (2) characterization of the pattern of interactions between these pathways. Functional neuroimaging can contribute to both of these goals. Using image subtraction analysis of regional cerebral blood flow data measured with positron emission tomography, we identified brain regions that changed activity during episodic memory retrieval (visual work recognition). Relative to a baseline reading task, decreased activity was observed in bilateral prefrontal, bilateral anterior and posterior temporal, and posterior cingulate cortices. Brain regions showing increased activity were the right prefrontal (different from deactivated regions), left anterior cingulate, and left occipital cortices, and vermis of cerebellum. We then performed a network analysis with structural equation modeling to test the hypothesis that regional decreases came about through active inhibition by regions showing increased activity during retrieval. This analysis demonstrated that the influence of activated regions on deactivated regions was more negative during retrieval than during reading, confirming the inhibition hypothesis. Such confirmation could not have been made from the subtraction analysis alone because decreases can come about, at the very least, through reduction of functional influences as well as by active inhibition. The concepts of ensemble excitation and inhibition, as defined through network analysis, are introduced. We argue that is is critical to examine the combined pattern of excitatory and inhibitory influences to fully appreciate the neural basis of episodic memory.

EFFECTS OF HYPOXIA (12% O2) ON CEREBRAL EDEMA AND ACUTE MOUNTAIN SICKNESS (AMS) IN MEN AND WOMEN 1212

Current theories suggest that many of the symptoms of AMS are the result of a previously undocumented “subclinical” cerebral edema brought on by hypoxia. Healthy nonsmoking young men (N=12) and women (N=8) breathed 12% O2 (4600 m) in a whole head hood for 8 hrs. Subjects had an MRI scan within 24 hrs prior to exposure and at 8 hrs of exposure. Pre and 8 hr densitometry measurements (corrected with a water phantom) were compared in a blind fashion in identical 5 mm brain slices using a GE Windows work station. The environmental symptoms questionnaire (ESQ) and Lake Louise scores were used to identify individuals with AMS. Seven subjects (3 men, 4 women) were identified with AMS. Statistical analysis identified a significant (p< 0.05) main effect due to AMS (increase in edema) and significant increases in edema in those with AMS in the following brain regions: left caudate, left putamen, left thalamus, left frontal cortex/grey and white matter, right frontal grey matter, and left and right occipital cortex grey matter. Gender also had a significant main effect with women showing a greater degree of edema than men. This difference was also evident in the vermis. These results demonstrate a significant relationship between hypoxia, AMS, and cerebral edema. Additional studies are required to determine whether hypobaria also plays a role in cerebral edema.

Cerebral activation during performance of a card sorting test.

The Wisconsin Card Sorting Test (WCST) is used clinically for evaluating frontal lobe function, but there is some controversy as to its specificity for detecting frontal lobe damage. To investigate the cerebral regions essential to the performance of the Card Sorting Test, we measured the regional cerebral blood flow (rCBF) in 18 normal subjects by PET under the three conditions: (i) during the Modified Card Sorting Test (MCST); (ii) during a matching-to-sample (MTS) task, based on the MCST, but with selective attention to one of three stimulus categories (colour, number or shape) as a control to cancel the effects of maintenance of sets in the MCST; (iii) under resting conditions as overall control. When rCBF during the MCST was compared with that during each MTS task separately, significant activations were observed during the MCST in the left or bilateral dorsolateral prefrontal cortex (DLPFC), bilateral inferior parietal lobes, left superior occipital gyrus and left cerebellum. Compared with all the MTS tasks inclusively, significant increase in rCBF was detected during the MCST in the bilateral DLPFC, inferior parietal lobes, striate cortex, cerebellum and left occipital cortex. These results suggest the involvement of the DLPFC and other related areas such as the inferior parietal cortex in the execution of the MCST, and may help explain why a variety of brain lesions can result in impaired performance on the Card Sorting Test.