Temporal Sites Research Articles

Nasal and temporal intraconal orbital fat densities differ on computerized tomographic scans of normal orbits

AbstractBackground and AimThe anatomy and function of different areas within the intraconal fat remain poorly understood. A potential difference between nasal and temporal orbital fat densities in normal eyes may assist clinicians and radiologists in more accurately interpreting computerized tomographic (CT) scans and making more informed diagnostic and therapeutic decisions for patients with orbital pathologies.Patients and MethodsData from randomly selected patients who underwent orbital CT scans at Sheba Medical Center in 2022 were analyzed. Patients with abnormal imaging findings in either orbit were excluded. Intraconal orbital fat density was measured in six nasal and temporal sites by means of Hounsfield units (HU).ResultsThe study included 54 patients (mean age 45.3 ± 25.5 years, 29 [54%] females) who were scanned for ophthalmologic etiologies unrelated to the orbit. Non-contrast-enhanced (NCE)-CT scans were available for 36 patients (67%), CE-CT scans for 31 patients (57%), and both CE and NCE scans for 13 patients. HU values were significantly higher in the nasal orbit compared to the temporal orbit on both NCE-CT (−75.8 ± 7.5 nasal vs. −78.1 ± 8.4 temporal, P < 0.001) and CE-CT (−72.7 ± 6.7 nasal vs. −74.6 ± 8.6 temporal, P = 0.02). Age, sex, and laterality had no effect on the HU values.ConclusionsThe density of nasal intraconal fat is higher compared to temporal intraconal fat, as observed on both CE and NCE-CT scans of normal eyes.These results suggest the presence of anatomical differences between these compartments and could have significant clinical implications in the diagnosis of various orbital pathologies.

Efficacy of Bihemispheric tDCS in Rehabilitation of Non-Fluent Aphasia: A Single-subject Pilot Study

Objective: Transcranial direct current stimulation (tDCS) has emerged as a potentially effective complementary tool in rehabilitation of aphasia. However, there is no consensus regarding the optimal tDCS montage to augment language outcomes in aphasia. Against this background, the present study aimed to examine efficacy of tDCS combined with language therapy in aphasia rehabilitation and to compare two different montages. Methods: A right-handed participant suffering from chronic, non-fluent aphasia following stroke affecting the left hemisphere underwent a 5-week procedure involving tDCS coupled with language therapy. The procedure comprised two 5-day treatments of bihemispheric tDCS (over inferior frontal and posterior temporal sites determined using the international 10-20 EEG system). As part of both treatments, the left hemispheric targets were excited through anodal tDCS while simultaneously inhibiting their right-hemispheric homologues through cathodal tDCS. Baseline, post-treatment and follow-up assessments were obtained using a comprehensive language assessment tool. Results: An increase in language outcomes, particularly in repetition, was observed following the treatments. It was also found that therapy gains were more robust following bihemispheric stimulation of the posterior temporal sites compared to the inferior frontal targets. Conclusion: Bihemispheric tDCS coupled with language therapy appears to be effective in remediating language symptoms, particularly in terms of the repetition ability, in aphasia.

Theta-burst direct electrical stimulation remodels human brain networks

Theta-burst stimulation (TBS), a patterned brain stimulation technique that mimics rhythmic bursts of 3–8 Hz endogenous brain rhythms, has emerged as a promising therapeutic approach for treating a wide range of brain disorders, though the neural mechanism of TBS action remains poorly understood. We investigated the neural effects of TBS using intracranial EEG (iEEG) in 10 pre-surgical epilepsy participants undergoing intracranial monitoring. Here we show that individual bursts of direct electrical TBS at 29 frontal and temporal sites evoked strong neural responses spanning broad cortical regions. These responses exhibited dynamic local field potential voltage changes over the course of stimulation presentations, including either increasing or decreasing responses, suggestive of short-term plasticity. Stronger stimulation augmented the mean TBS response amplitude and spread with more recording sites demonstrating short-term plasticity. TBS responses were stimulation site-specific with stronger TBS responses observed in regions with strong baseline stimulation effective (cortico-cortical evoked potentials) and functional (low frequency phase locking) connectivity. Further, we could use these measures to predict stable and varying (e.g. short-term plasticity) TBS response locations. Future work may integrate pre-treatment connectivity alongside other biophysical factors to personalize stimulation parameters, thereby optimizing induction of neuroplasticity within disease-relevant brain networks.

Neural correlates of response to joint attention in 2-to-5-year-olds in relation to ASD and social-communicative abilities: An fNIRS and behavioral study.

Autism spectrum disorder (ASD) is associated with life-long challenges with social cognition, and one of its earliest and most common manifestations is atypical joint attention, which is a pivotal skill in social-cognitive and linguistic development. Early interventions for ASD children often focus on training initiation of joint attention (IJA) and response to joint attention bids (RJA), which are important for social communication and cognition. Here, we used functional near-infrared spectroscopy and behavioral measures to test typically developing (TD, n = 17) and ASD children (n = 18), to address the relationship between the neural correlates of RJA and social-communicative behavior. Group-level differences were present for RJA-specific activation over right temporal sites, where TD children showed higher levels of activation during RJA than ASD children, whereas the two groups did not differ in the control condition. Correlations between neural activation and behavioral traits suggest that, in ASD children, neural activation during RJA is related to the frequency of RJA behavior when the former is measured over left temporal sites, and to social affect symptoms when considered for right temporal sites. Possible implications of the evidenced correlations are discussed.

320 Intraoperative Angiography in Neurosurgery: Temporal Trend, Access Site, and Operative Indication Considerations From a Six-year Institutional Experience

INTRODUCTION: Historically, the transfemoral approach (TFA) has been the most common access site for cerebral intraoperative angiogram (IOA). However, in line with trends in cardiac interventional vascular access preferences, transradial approach (TRA) and transulnar approach (TUA) are gaining popularity due to favorable safety and patient satisfaction outcomes. METHODS: Between July 2016 and December 2022, 317 angiograms were included based on our case definition, comprising 59 TRA cases, 11 TUA cases, 243 TFA, and four transpopliteal cases. Fluoroscopy time, contrast dose, reference air kerma (RAK), and dose area products (DAP) per target vessel catheterized were the primary endpoints of interest. Univariate and multivariate regression analyses were conducted to evaluate predictors of elevated contrast dose and radiation exposure metrics. RESULTS: Contrast dose per vessel catheterized was significantly lower in TRA/TUA cases versus TFA cases (p = 0.001), but radiation exposure metrics did not differ between access site groups. TRA/TUA versus TFA does not significantly predict elevated levels of radiation exposure or contrast dose. Aneurysm cases were associated with significantly lower odds of elevated radiation exposure for all radiation metrics (p < 0.05) whereas AVM cases had higher odds of elevated radiation exposure across all measures (p < 0.01). There was a significant relationship between case number and operative indication over the study period (p < 0.001) with a decrease in the proportion of cases for aneurysm treatment offset by increases in total cases for the management of AVF and AVM. CONCLUSIONS: TRA and TUA are safe and effective access site options for neurointerventional procedures and are increasingly employed. Cases using wrist access may be associated with a lower contrast dosing for patients.

Temporal variability and site specificity of thermomechanical weathering in a temperate climate

Thermomechanical processes caused by short- and long-term temperature fluctuations are a prevalent weathering mechanism on exposed rock walls. While many authors have explored the potential for thermomechanical weathering in alpine and polar regions, few have examined the effects of seasonality on weathering in temperate climates. This is pertinent as seasonal climatic conditions may influence both short-term temperature oscillations which produce incipient fractures and diurnal-to annual-scale cycles which propagate pre-existing fractures via thermal fatigue. In this study, three rock outcrops located along the Niagara Escarpment in Hamilton, Canada were monitored to examine changes in the thermal regime at the rock surface and within pre-existing fractures over a 1-year period. Temperature was sampled in 1-min intervals, providing data at a fine temporal resolution. Our unique dataset demonstrates that the rock surface and fracture experience minute-scale temperature oscillations which magnify over time. Longer-term temperature cycles during the year are superimposed upon minute- and diurnal-scale fluctuations which likely augment weathering potential. This produces considerable thermal stress over the year which we estimate to be on the order of 18 GPa at the rock surface and 8 GPa in fractures. We also observed diurnal reversals of the temperature gradient between the rock surface and fracture which may further amplify crack propagation. Seasonality and site-specific characteristics interact to modify different components of the rockwall thermal regime. Vegetation shading has seasonal and diurnal-scale impacts on the temperature gradient between the surface and fracture, and the amplitude of daily warming and cooling cycles. Aspect has a stronger influence on minute-scale temperature oscillations. Estimates of diurnal thermal stress indicate that the thermomechanical weathering potential is seasonally variable, but highest in the spring. Our findings demonstrate that in a temperate climate, rockwall thermal regimes experience variability across the gradient of temporal scale with strong seasonal effects.

Population genomics of coastal Pacific Hake

AbstractObjectiveUnderstanding the genetic structure of harvested fishery species is crucial for accurate stock assessments and effective management strategies. There have been several rangewide population genetic analyses of Pacific Hake Merluccius productus; however, a thorough focus on the heavily harvested coastal stock off the west coast of North America is missing. Recent observations of spatial–temporal variability in life history and migratory patterns of the coastal population have brought into question whether this variation may be related to genetic differentiation.MethodsHere, we used restriction site‐associated DNA sequencing markers to thoroughly assess the potential for spatial–temporal genetic differentiation in the coastal stock of Pacific Hake. We sampled during different seasons from British Columbia down to the U.S.–Mexico border over multiple years on what traditionally have been thought to constitute spawning and feeding grounds, resulting in the most comprehensive assessment of coastal Pacific Hake population structure to date.ResultGenerally, our results suggest very weak to no structure among coastal spatial–temporal sites and corroborate previous findings of strong differentiation between coastal and Salish Sea populations. The lack of structure among coastal sites is likely due to significant amounts of gene flow in this highly migratory population.ConclusionThese findings align with the ongoing management strategy for coastal Pacific Hake, which is based on an annual stock assessment that considers the coastal stock homogenous and distinct from the Salish Sea population. The understanding that management units indeed match genetic populations provides managers with additional confidence in existing management strategy.

Spontaneous development and involution of a de novo pseudoaneurysm at the superficial temporal artery-middle cerebral artery bypass anastomotic site in a patient with moyamoya disease: illustrative case.

De novo pseudoaneurysm formation is a rare complication of extracranial-intracranial bypass surgery. The authors report the case of a 28-year-old male who presented with new-onset right temporal and occipital ischemia who was found to have bilateral proximal internal carotid artery occlusion with collateral vasculature formation consistent with moyamoya disease. The patient underwent bilateral superficial temporal artery-middle cerebral artery bypasses. A de novo pseudoaneurysm was found at the left-sided bypass distal anastomotic site recipient vessel 1 month after the surgery. The pseudoaneurysm demonstrated a progressive reduction in size and eventual complete involution at 6 months after surgery. Limited literature reports extracranial-intracranial bypass-associated aneurysms treated primarily with either clipping or resection and reanastomosis. The authors demonstrate, for the first time, a progressively benign natural history course of an extracranial-intracranial bypass distal anastomotic site pseudoaneurysm.

Fine-Grained Temporal Site Monitoring in EGD Streams Via Visual Time-Aware Embedding and Vision-Text Asymmetric Coworking.

Esophagogastroduodenoscopy (EGD) requires inspecting plentiful upper gastrointestinal (UGI) sites completely for a precise cancer screening. Automated temporal site monitoring for EGD assistance is thus of high demand, yet often fails if directly applying the existing methods of online action detection. The key challenges are two- fold: 1) the global camera motion dominates, invalidating the temporal patterns derived from the object optical flows, and 2) the UGI sites are fine-grained, yielding highly homogenized appearances. In this paper, we propose an EGD-customized model, powered by two novel designs, i.e., Visual Time-aware Embedding plus Vision-text Asymmetric Coworking (VTE+VAC), for real-time accurate fine-grained UGI site monitoring. Concretely, VTE learns visual embeddings by differentiating frames via classification losses, and meanwhile by reordering the sampled time-agnostic frames to be temporally coherent via a ranking loss. Such joint objective encourages VTE to capture the sequential relation without resorting to the inapplicable object optical flows, and thus to provide the time-aware frame- wise embeddings. In the subsequent analysis, VAC uses a temporal sliding window, and extracts vision-text multimodal knowledge from each frame and its corresponding textualized prediction via the learned VTE and a frozen BERT. The text embeddings help provide more representative cues, but also may cause misdirection due to prediction errors. Thus, VAC randomly drops or replaces historical predictions to increase the error tolerance to avoid collapsing onto the last few predictions. Qualitative and quantitative experiments demonstrate that the proposed method achieves superior performance compared to other state-of-the-art methods, with an average F1-score improvement of at least 7.66%.

Identifying sex differences in EEG-based emotion recognition using graph convolutional network with attention mechanism

Objective. Sex differences in emotions have been widely perceived via self-reports, peripheral physiological signals and brain imaging techniques. However, how sex differences are reflected in the electroencephalography (EEG) neural patterns of emotions remains unresolved. In this paper, we detect sex differences in emotional EEG patterns, investigate the consistency of such differences in various emotion datasets across cultures, and study how sex as a factor affects the performance of EEG-based emotion recognition models. Approach. We thoroughly assess sex differences in emotional EEG patterns on five public datasets, including SEED, SEED-IV, SEED-V, DEAP and DREAMER, systematically examine the sex-specific EEG patterns for happy, sad, fearful, disgusted and neutral emotions, and implement deep learning models for sex-specific emotion recognition. Main results. (1) Sex differences exist in various emotion types and both Western and Eastern cultures; (2) The emotion patterns of females are more stable than those of males, and the patterns of happiness from females are in sharp contrast with the patterns of sadness, fear and disgust, while the energy levels are more balanced for males; (3) The key features for emotion recognition are mainly located at the frontal and temporal sites for females and distributed more evenly over the whole brain for males, and (4) the same-sex emotion recognition models outperform the corresponding cross-sex models. Significance. These findings extend efforts to characterize sex differences in emotional brain activation, provide new physiological evidence for sex-specific emotion processing, and reinforce the message that sex differences should be carefully considered in affective research and precision medicine.

Alpha transcranial alternating current stimulation modulates auditory perception

BackgroundStudies using transcranial alternating current stimulation (tACS), a type of non-invasive brain stimulation, have demonstrated a relationship between the positive versus negative phase of both alpha and delta/theta oscillations with variable near-threshold auditory perception. These findings have not been directly compared before. Furthermore, as perception was better in the positive versus negative phase of two different frequencies, it is unclear whether changes in polarity (independent of a specific frequency) could also modulate auditory perception. ObjectiveWe investigated whether auditory perception depends on the phase of alpha, delta/theta, or polarity alone. MethodsWe stimulated participants with alpha, delta, and positive and negative direct current (DC) over temporal and central scalp sites while they identified near-threshold tones-in-noise. A Sham condition without tACS served as a control condition. A repeated-measures analysis of variance was used to assess differences in proportions of hits between conditions and polarities. Permutation-based circular-logistic regressions were used to assess the relationship between circular-predictors and single-trial behavioral responses. An exploratory analysis compared the full circular-logistic regression model to the intercept-only model. ResultsOverall, there were a greater proportion of hits in the Alpha condition in comparison to Delta, DC, and Sham conditions. We also found an interaction between polarity and stimulation condition; post-hoc analyses revealed a greater proportion of hits in the positive versus negative phase of Alpha tACS. In contrast, no significant differences were found in the Delta, DC, or Sham conditions. The permutation-based circular-logistic regressions did not reveal a statistically significant difference between the obtained RMS of the sine and cosine coefficients and the mean of the surrogate distribution for any of the conditions. However, our exploratory analysis revealed that circular-predictors explained the behavioral data significantly better than an intercept-only model for the Alpha condition, and not the other three conditions. ConclusionThese findings suggest that alpha tACS, and not delta nor polarity alone, modulates auditory perception.

Measuring auditory event-related potentials at the external ear canal: A demonstrative study using a new electrode and error-feedback paradigm.

Although ear canal electroencephalogram (EEG) recording has received interest from basic and applied research communities, evidence on how it can be implemented in practice is limited. The present study involving eight male participants including the authors presents the utility of our ear canal electrode and method by demonstrating both comparability of ear canal EEG to those at nearby sites and distinctiveness that ear canal event-related potentials (ERPs) could have. For this purpose, we used the balanced noncephalic electrode reference and an experimental paradigm with an error-feedback sound. Clear auditory ERPs were detected at the ear canal sites with a sufficiently low noise level comparable with those at conventional sites. The N1c, a temporal maximum subcomponent, spread over the bilateral temporal sites, including the ear canals and earlobes. While consecutive signals are generally highly similar between the ear canal and the earlobe, the N1c was larger at the ear canal than the earlobe, as demonstrated by the conventional frequentist and the hierarchical Bayesian modelling approaches. Although an evident caveat is that our sample was limited in terms of size and sex, the general capability indicates that the structure of our ear canal electrode provides EEG measurement that can be used in basic and applied settings. Our experimental method can also be an ERP-based test that conveniently assesses the capability of existing and future ear canal electrodes. The distinctive nature of the ERPs to the error-feedback sound may be utilized to examine the basic aspects of auditory ERPs and to test the processes involved in feedback-guided behaviour of participants.

Intraoperative angiography in neurosurgery: temporal trend, access site, and operative indication considerations from a 6-year institutional experience.

Historically, the transfemoral approach (TFA) has been the most common access site for cerebral intraoperative angiography (IOA). However, in line with trends in cardiac interventional vascular access preferences, the transradial approach (TRA) and transulnar approach (TUA) have been gaining popularity owing to favorable safety and patient satisfaction outcomes. To compare the efficacy and safety of TRA/TUA and TFA for cerebral and spinal IOA at an institutional level over a 6-year period. Between July 2016 and December 2022, 317 angiograms were included in our analysis, comprising 60 TRA, 10 TUA, 243 TFA, and 4 transpopliteal approach cases. Fluoroscopy time, contrast dose, reference air kerma, and dose-area products per target vessel catheterized were primary endpoints. Multivariate regression analyses were conducted to evaluate predictors of elevated contrast dose and radiation exposure and to assess time trends in access site selection. Contrast dose and radiation exposure metrics per vessel catheterized were not significantly different between access site groups when controlling for patient position, operative region, 3D rotational angiography use, and different operators. Access site was not a significant independent predictor of elevated radiation exposure or contrast dose. There was a significant relationship between case number and operative indication over the study period (P<0.001), with a decrease in the proportion of cases for aneurysm treatment offset by increases in total cases for the management of arteriovenous malformation, AVF, and moyamoya disease. TRA and TUA are safe and effective access site options for neurointerventional procedures that are increasingly used for IOA.

Substituting space for time: Bird responses to forest loss in space provide a general picture of responses over time.

The practice of space-for-time substitution assumes that the responses of species or communities to land-use change over space represents how they will respond to that same change over time. Space-for-time substitution is commonly used in both ecology and conservation, but whether the assumption produces reliable insights remains inconclusive. Here, we tested space-for-time substitution using data from the North American Breeding Bird Survey (BBS) and Global Forest Change (GFC) to compare the effects of landscape-scale forest cover on bird richness and abundance over time and space, for 25 space-time comparisons. Each comparison consisted of a landscape that experienced at least 20% forest loss over 19 years (temporal site) and a set of 15-19 landscapes (spatial sites) that represented the same forest cover gradient over space in 2019 as experienced over time in their corresponding temporal site. Across the 25 comparisons, the observed responses of forest and open-habitat birds to forest cover over time generally aligned with their responses to forest cover over space, but with comparatively higher variability in the magnitude and direction of effect across the 25 temporal slopes than across the 25 spatial slopes. On average, the mean differences between the spatial and temporal slopes across the 25 space-time comparisons frequently overlapped with zero, suggesting that the spatial slopes are generally informative of the temporal slopes. However, we observed high variability around these mean differences, indicating that a single spatial slope is not strongly predictive of its corresponding temporal slope. We suggest that our results may be explained by annual variability in other relevant environmental factors that combine to produce complex effects on population abundances over time that are not easily captured by snapshots in space. While not being a 1:1 proxy, measuring bird responses to changes in habitat amount in space provides an idea on how birds might be expected to eventually equilibrate to similar changes in habitat amount over time. Further, analyses such as this could be potentially used to screen for cases of regional space-time mismatches where population-limiting factors other than habitat could be playing a more important role in the population trends observed there.

Employing direct electromagnetic coupling to assess acute fracture healing: An ovine model assessment

ObjectivesThis study explored the efficacy of collecting temporal fracture site compliance data via an advanced direct electromagnetic coupling (DEC) system equipped with a Vivaldi-type antenna, novel calibration technique, and multi-antenna setup (termed maDEC) as an approach to monitor acute fracture healing progress in a translational large animal model. The overarching goal of this approach was to provide insights into the acute healing dynamics, offering a promising avenue for optimizing fracture management strategies. MethodsA sample of twelve sheep, subjected to ostectomies and intramedullary nail fixations, was divided into two groups, simulating normal and impaired healing scenarios. Sequential maDEC compliance or stiffness measurements and radiographs were taken from the surgery until euthanasia at four or eight weeks and were subsequently compared with post-sacrifice biomechanical, micro-CT, and histological findings. ResultsThe results showed that the maDEC system offered straightforward quantification of fracture site compliance via a multiantenna array. Notably, the rate of change in the maDEC-measured bending stiffness significantly varied between normal and impaired healing groups during both the 4-week (p = 0.04) and 8-week (p = 0.02) periods. In contrast, radiographically derived mRUST healing measurements displayed no significant differences between the groups (p = 0.46). Moreover, the cumulative normalized stiffness maDEC data significantly correlated with post-sacrifice mechanical strength (r2 = 0.80, p < 0.001), micro-CT measurements of bone volume fraction (r2 = 0.60, p = 0.003), and density (r2 = 0.60, p = 0.003), and histomorphometric measurements of new bone area fraction (r2 = 0.61, p = 0.003) and new bone area (r2 = 0.60, p < 0.001). ConclusionsThese data indicate that the enhanced maDEC system provides a non-invasive, accurate method to monitor fracture healing during the acute healing phase, showing distinct stiffness profiles between normal and impaired healing groups and offering critical insights into the healing process's progress and efficiency.

Children's Shyness, Frontal Brain Activity, and Anxiety in the Perioperative Context.

Although preoperative anxiety affects up to 75% of children undergoing surgery each year and is associated with many adverse outcomes, we know relatively little about individual differences in how children respond to impending surgery. We examined whether patterns of anterior brain electrical activity (i.e., a neural correlate of anxious arousal) moderated the relation between children's shyness and preoperative anxiety on the day of surgery in 70 children (36 girls, Mage = 10.4 years, SDage = 1.7, years, range 8 to 13 years) undergoing elective surgery. Shyness was assessed using self-report approximately 1 week prior to surgery during a preoperative visit (Time 1), preoperative anxiety was assessed using self-report, and regional EEG (left and right frontal and temporal sites) was assessed using a dry sensory EEG headband on the day of surgery (Time 2). We found that overall frontal EEG alpha power moderated the relation between shyness and self-reported preoperative anxiety. Shyness was related to higher levels of self-reported anxiety on the day of surgery for children with lower average overall frontal alpha EEG power (i.e., higher cortical activity) but not for children with higher average overall frontal alpha EEG power (i.e., lower cortical activity). These results suggest that the pattern of frontal brain activity might amplify some shy children's affective responses to impending surgery. Findings also extend prior results linking children's shyness, frontal brain activity, and anxiety observed in the laboratory to a real-world, ecologically salient environment.

Event related potentials to native speech contrasts predicts word reading abilities in early school-aged children

Speech perception skills have been implicated in the development of phoneme-graphene correspondence, yet the exact nature of speech perception and word reading ability remains unknown. We investigate phonological sensitivity to native (English) and nonnative (Spanish) speech syllables within an auditory oddball paradigm using event related potentials (ERPs) collected from lateral temporal electrode sites in 33 monolingual English-speaking children aged 6–8 years (N = 33). We further explore the relationship between ERPs to English word reading abilities for this group. Results revealed that language stimuli (English, Spanish), ERP condition (standard, deviant), and hemisphere (left, right) all influenced the lateral N1 component. ERPs recorded from deviant English stimuli were significantly more negative within the left hemisphere compared to all other recorded ERPs. Mean amplitude differences within the N1 in left lateral electrode sites recorded in response to English phoneme contrasts significantly predicted English word reading abilities within this sample. Results indicate that speech perception of native contrasts recorded in left temporal electrode sites for the N1 component are linked to English word reading abilities in early school-aged children.

EEG-Correlates of Emotional Memory and Seasonal Symptoms

The aim of this study was to investigate a potential all-year vulnerability of people with seasonal mood fluctuations. We compared behavioral and neurophysiological responses to emotional stimuli in summer between people who report seasonal symptoms in winter and those who do not. EEG was recorded in summer from 119 participants while they memorized 60 emotional pictures, balanced for valence and arousal. The Seasonal Pattern Assessment Questionnaire was used to determine seasonal symptoms. EEG power was analyzed in the alpha and gamma frequency bands and in early (50–150 ms) and late (300–400 ms) time-windows over frontal, temporal, and occipital sites. Positive pictures were more frequently recalled than negative and neutral pictures, and negative pictures were more frequently recalled than neutral pictures (p &lt; 0.001), but memory performance did not interact with seasonality. EEG power was overall higher in participants without elevated levels of seasonal symptoms (p = 0.043). This group difference interacted with emotional valence (p = 0.037), region of interest (p = 0.003), hemispheric differences (p = 0.027), frequency band (0.032), and time-window (0.018). This differential pattern of activation while viewing emotional pictures suggests a difference in emotional processing between the groups. The absence of behavioral effects but presence of differences in EEG activity suggests an all-year-long difference in processing of emotional contents in people who experience seasonal symptoms in winter.

P213 A COMPLICATED STEMI : POISED BETWEEN THROMBOSIS AND HEMORRHAGE

Abstract The introduction of more effective and powerful antithrombotic therapies has allowed the progressive reduction of ischemic events associated however with an increase in haemorrhagic events. What we are describing is an example of how iatrogenic and non–iatrogenic complications can add up, making routine therapeutic management difficult during and after hospital stay.We are talking about a 50–year–old male patient, a smoker and with a history of dyslipidemia under treatment, who arrived at our cath–lab with a diagnosis of anterior SCA–STEMI, after loading ticagrelor 180 mg from the spoke center where he had gone for chest pain. At coronary angiography, evidence of critical disease of the median anterior interventricular artery treated by primary angioplasty and for the high thrombotic load by thromboaspiration, DES and Tirofiban bolus and 18–hour continuous infusion. Approximately 15 hours after the event, the patient appeared confused and aphasic. A brain CT scan with and without contrast agent was performed which documented the presence of a hemorrhagic focus in the atypical left temporal site, in the absence of arteriovenous malformations not susceptible to surgical therapy (BARC–3). Therefore, in view of the high risk of bleeding, de–escalation therapy with cardioaspirin and clopidogrel was practiced. Five days after the event, the clinical picture was complicated again by the finding of apical thrombosis on the transthoracic ultrasound. For this reason, given the stability of the haemorrhagic lesion on CT scans and control MRIs, Enoxaparin sodium 4000 IU was introduced in therapy once, with resolution of the formation in the imaging control after one month. The patient was then discharged with indication for short–DAPT in consideration of the high PRECISE–DAPT score. The arduous task of managing this case led us to reflect on the importance of the pre– and post–PCI clinical picture of the patient in order to seek the appropriate antithrombotic treatment by dynamically balancing the ischemic and haemorrhagic risk during hospitalization through numerous standardized tools at our disposal.

The effects of deep transcranial magnetic stimulation on Alzheimer’s disease: a case report examining cognitive functioning, memory, and QEEG

ABSTRACT Numerous treatment options are being studied for Alzheimer’s disease (AD) given the rising prevalence of this condition worldwide. Transcranial Magnetic Stimulation (TMS) is a promising option for regulating specific neurological abnormalities pertaining to this condition. This case presents a patient with AD and co-occurring major depressive disorder that received 36 sessions of Deep TMS to the frontal and temporal lobes. This patient experienced improved general cognitive functioning and memory, remission from depression, and reduced slow-frequency theta activity in frontal and temporal sites. Following 7 months of weekly maintenance, additional improvements occurred. This report suggests that Deep TMS may be effective in mitigating AD symptoms, and maintenance sessions are advisable.