Seyed M. Mirsattari

Impaired familiarity with preserved recollection after anterior temporal-lobe resection that spares the hippocampus

It is well established that the medial-temporal lobe (MTL) is critical for recognition memory. The MTL is known to be composed of distinct structures that are organized in a hierarchical manner. At present, it remains controversial whether lower structures in this hierarchy, such as perirhinal cortex, support memory functions that are distinct from those of higher structures, in particular the hippocampus. Perirhinal cortex has been proposed to play a specific role in the assessment of familiarity during recognition, which can be distinguished from the selective contributions of the hippocampus to the recollection of episodic detail. Some researchers have argued, however, that the distinction between familiarity and recollection cannot capture functional specialization within the MTL and have proposed single-process accounts. Evidence supporting the dual-process view comes from demonstrations that selective hippocampal damage can produce isolated recollection impairments. It is unclear, however, whether temporal-lobe lesions that spare the hippocampus can produce selective familiarity impairments. Without this demonstration, single-process accounts cannot be ruled out. We examined recognition memory in NB, an individual who underwent surgical resection of left anterior temporal-lobe structures for treatment of intractable epilepsy. Her resection included a large portion of perirhinal cortex but spared the hippocampus. The results of four experiments based on three different experimental procedures (remember-know paradigm, receiver operating characteristics, and response-deadline procedure) indicate that NB exhibits impaired familiarity with preserved recollection. The present findings thus provide a crucial missing piece of support for functional specialization in the MTL.

Functional Networks in the Anesthetized Rat Brain Revealed by Independent Component Analysis of Resting-State fMRI

The rodent brain is organized into functional networks that can be studied through examination of synchronized low-frequency spontaneous fluctuations (LFFs) of the functional magnetic resonance imaging -blood-oxygen-level-dependent (BOLD) signal. In this study, resting networks of LFFs were estimated from the whole-brain BOLD signals using independent component analysis (ICA). ICA provides a hypothesis-free technique for determining the functional connectivity map that does not require a priori selection of a seed region. Twenty Long-Evans rats were anesthetized with isoflurane (1%, n = 10) or ketamine/xylazine (50/6 mg . kg(-1) . h(-1) ip, n = 10) and imaged for 5-10 min in a 9.4 T MR scanner without experimental stimulation or task requirement. Independent, synchronous LFFs of BOLD signals were found to exist in clustered, bilaterally symmetric regions of both cortical and subcortical structures, including primary and secondary somatosensory cortices, motor cortices, visual cortices, posterior and anterior cingulate cortices, hippocampi, caudate-putamen, and thalamic and hypothalamic nuclei. The somatosensory and motor cortices typically demonstrated both symmetric and asymmetric components with unique frequency profiles. Similar independent network components were found under isoflurane and ketamine/xylazine anesthesia. The report demonstrates, for the first time, 12 independent resting networks that are bilaterally synchronous in different cortical and subcortical areas of the rat brain.

Resting-state networks in the macaque at 7 T ☆

Assessment of brain connectivity has revealed that the structure and dynamics of large-scale network organization are altered in multiple disease states suggesting their use as diagnostic or prognostic indicators. Further investigation into the underlying mechanisms, organization, and alteration of large-scale brain networks requires a homologous animal model that would allow neurophysiological recordings and experimental manipulations. The current study presents a comprehensive assessment of macaque resting-state networks based on evaluation of intrinsic low-frequency fluctuations of the blood oxygen-level-dependent signal using group independent component analysis. Networks were found underlying multiple levels of sensory, motor, and cognitive processing. The results demonstrate that macaques share remarkable homologous network organization with humans, thereby providing strong support for their use as an animal model in the study of normal and abnormal brain connectivity as well as aiding the interpretation of electrophysiological recordings within the context of large-scale brain networks.

Disruptions of functional connectivity in the default mode network of comatose patients

Objective: To evaluate the possible role of the default mode network (DMN) in consciousness and assess the diagnostic or prognostic potential of DMN connectivity measures in the assessment of a patient group lacking cognitive awareness. Methods: DMN connectivity was established using independent component analysis of resting-state fMRI data in patients with reversible (n = 2) and irreversible (n = 11) coma following cardiac arrest and compared to healthy controls (n = 12). Results: A present and intact DMN was observed in controls and those patients who subsequently regained consciousness, but was disrupted in all patients who failed to regain consciousness. Conclusions: The results suggest that the DMN is necessary but not sufficient to support consciousness. Clinically, DMN connectivity may serve as an indicator of the extent of cortical disruption and predict reversible impairments in consciousness.

Transient lesion in the splenium of the corpus callosum in an epileptic patient

Pathogenesis of a rarely occurring transient, isolated focal lesion of the splenium of the corpus callosum in epilepsy patients is uncertain: frequent seizures or antiepileptic drug reduction causing ischemia or demyelination is possible. The several MRI sequences, including diffusion-weighted imaging, in this first case of occipital epilepsy suggest ischemia from rapid carbamazepine reduction, frequent seizures, or a combination of both.

Myoclonic status epilepticus following repeated oral ingestion of colloidal silver

The authors report a case of a 71-year-old man who developed myoclonic status epilepticus and coma after daily ingestion of colloidal silver for 4 months resulting in high levels of silver in plasma, erythrocytes, and CSF. Despite plasmapheresis, he remained in a persistent vegetative state until his death 5.5 months later. Silver products can cause irreversible neurologic toxicity associated with poor outcome.

MRI compatible EEG electrode system for routine use in the epilepsy monitoring unit and intensive care unit.

OBJECTIVE We report on the development of an electroencephalographic (EEG) recording system that is Magnetic Resonance Imaging (MRI) compatible and can safely be left on the scalp during anatomical imaging or used to obtain simultaneous EEG and metabolic or hemodynamic data using functional imaging techniques such as functional MRI or MR spectroscopy. METHODS We assembled a versatile EEG recording set-up with medically acceptable materials that contained no ferromagnetic components. It was tested for absence of excess heating and distortion of the image quality in a spherical phantom similar in size to average adult human head in a clinical 1.5 T GE scanner. After testing its safety in four volunteers, 100 consecutive patients from our epilepsy long-term monitoring unit were studied. RESULTS There was no change in the temperature of the EEG electrode discs during the various anatomical MRI sequences used in our routine clinical studies (maximum temperature change was -0.45 degrees C with average head SAR<==1.6 W/Kg in the selected subjects) nor were there any reported complications in the others. The brain images were not distorted by the susceptibility artifact of the EEG electrodes. CONCLUSIONS Our MRI compatible EEG set-up allows safe and artifact free brain imaging in 1.5T MR scanner with average SAR<==1.6 W/Kg. This EEG system can be used for EEG recording during anatomical MRI studies as well as functional imaging studies in patients requiring continuous EEG recordings.

Proactive Interference as a Result of Persisting Neural Representations of Previously Learned Motor Skills in Primary Motor Cortex

Learning to control movements in different dynamic environments is marked by proactive interference; learning a first skill interferes with the subsequent learning of a second one. The neural basis of this effect is poorly understood. We tested the idea that proactive interference results from persisting neural representations of previously learned skills in the primary motor cortex (M1). We used repetitive transcranial magnetic stimulation (rTMS) of M1 to disrupt retention of a recently learned motor skill. If interference results from the retention of this skill then its disruption should be associated with reduced interference. Subjects reached to targets while interacting with a robotic arm that applied force fields to the limb. Fifteen minutes of 1-Hz rTMS to M1 impaired the retention of a first force field, and more importantly, reduced proactive interference when subjects learned a second one. Our findings suggest that retention and interference are linked at the level of M1.

Prevalence of benign epileptiform variants

OBJECTIVE There are numerous distinctive benign electroencephalographic (EEG) patterns which are morphologically epileptiform but are non-epileptic. The aim of this study was to determine the prevalence of different benign epileptiform variants (BEVs) among subjects who underwent routine EEG recordings in a large EEG laboratory over 35 years. METHODS We retrospectively studied the prevalence of BEVs among 35,249 individuals who underwent outpatient EEG recordings at London Health Sciences Centre in London, Ontario, Canada between January 1, 1972 and December 31, 2007. The definitions of the Committee on Terminology of the International Federation of Societies for EEG and Clinical Neurophysiology (IFSECN) were used to delineate epileptiform patterns (Chatrian et al. A glossary of terms most commonly used by clinical electroencephlographers. Electroenceph Clin Neurophysiol 1974;37:538-48) and the descriptions of Klass and Westmoreland [Klass DW, Westmoreland BF. Nonepileptogenic epileptiform electroenephalographic activity. Ann Neurol 1985;18:627-35] were used to categorize the BEVs. RESULTS BEVs were identified in 1183 out of 35,249 subjects (3.4%). The distribution of individual BEVs were as follows: benign sporadic sleep spikes 1.85%, wicket waves 0.03%, 14 and 6 Hz positive spikes 0.52%, 6 Hz spike-and-waves 1.02%, rhythmic temporal theta bursts of drowsiness 0.12%, and subclinical rhythmic electrographic discharge of adults in 0.07%. CONCLUSION The prevalence of six types of BEVs was relatively low among the Canadian subjects when compared to the reports from other countries. SIGNIFICANCE BEVs are relatively uncommon incidental EEG findings. Unlike focal epileptic spikes and generalized spike-and-waves, BEVs do not predict the occurrence of epilepsy. Accurate identification of the BEVs can avoid misdiagnosis and unnecessary investigations.

Selective Familiarity Deficits after Left Anterior Temporal-Lobe Removal with Hippocampal Sparing Are Material Specific.

Research has firmly established a link between recognition memory and the functional integrity of the medial temporal lobes (MTL). Dual-process models of MTL organization maintain that there is a division of labour within the MTL, with the hippocampus (HC) supporting recollective processes and perirhinal cortex (PRc) supporting familiarity assessment. An older neuropsychological literature suggested a different type of division of labour within the MTL, with left-sided structures playing a critical role in memory for verbal materials and right-sided structures being differentially involved in memory for material that cannot easily be verbalized. Research that has related predictions made by these two accounts to each other is limited. Evidence from research in patients with selective recollection impairments and fMRI data in healthy individuals suggests that lateralization of recollection for verbal materials is not clear-cut. Here we examined lateralization of familiarity processes in the MTL by asking whether selective familiarity impairments after unilateral anterior temporal-lobe removal with hippocampal sparing are material specific. We examined this issue in NB, an individual who was previously shown to exhibit selective familiarity impairments with such a lesion (Bowles et al., 2007). We administered three similar recognition memory tests in combination with the same Remember-Know procedure for three different types of novel stimuli without pre-existing semantic representations. Analyses focused on discrimination and on possible differences in response criterion, and included an ROC based approach as well. We found that NB exhibited a deficit in overall recognition of aurally presented pronounceable non-words that reflected a specific impairment of familiarity assessment with preservation of recollective processes. Examination of recognition memory for visually presented abstract pictures and faces did not reveal any impairment, neither at the level of overall recognition nor, more specifically, at the level of familiarity assessment. These findings suggest that the neural mechanisms that support familiarity assessment in the temporal lobe operate in a manner that is tied to the specific stimulus class being assessed.