Volker Diekmann

Emotional responding in amyotrophic lateral sclerosis

AbstractAmyotrophic lateral sclerosis (ALS) is a fatal disease, leaving the patient in a partially or completely deafferented state. In an explorative study, we investigated responses to visual socio–emotional stimuli in ALS patients. Pictures from the International Affective Picture System (IAPS) were verbally judged by 12 moderately affected ALS patients with a spinal onset and a slow progression and 18 age–matched controls, and data were compared with psychophysiological responses. Verbal emotional judgments of patients were more positive than ratings of controls. Regarding arousal, patients neutralized extreme pictures, in that they rated calm pictures as more exciting than controls and exciting pictures as more calm. These changes of emotional processing were unrelated to depression or frontal lobe dysfunction. There were no major differences between patients and controls concerning physiological responses to emotional stimuli. We conclude that emotional responses of ALS patients tend to be altered towards positive valence and towards a more balanced arousal state in early stages of the disease. These findings contradict assumptions of a generally negative impact of the disease on the emotional disposition and may indicate compensatory cognitive or neuroplastic changes.

Localisation of epileptic foci with electric, magnetic and combined electromagnetic models.

We compare the localisation of epileptic foci by means of (1) EEG, (2) magnetoencephalography (MEG) and (3) combined EEG/MEG data in a group of patients suffering from pharmaco-resistant focal epilepsy. Individual epileptic events were localised by means of a moving dipole model in a 4-shell spherical head approximation. A patients epileptic activity was summarised by calculating the spatial density distribution (DD) of all localised events, and the centre of gravity of DD was considered the most likely locus of seizure generation. To verify these loci a subgroup of 6 patients was selected, in which seizures could be related to a clearly identifiable lesion in MRI. On average, the combined EEG/MEG approach resulted in the smallest error (1.8 cm distance between calculated locus and the nearest lesion border); using only MEG yielded the largest error (2.4 cm), while EEG resulted in an intermediate value (2.2 cm). In the individual patients, EEG/MEG would also rank intermediate, but never worst. In summary, combining EEG/MEG appears to be a more robust approach to localisation than using only EEG or only MEG. Finally, we also report on the use of the barbiturate methohexital as a safe method of increasing the number of spike events during an EEG/MEG recording session.

Neuroimaging of multimodal sensory stimulation in amyotrophic lateral sclerosis

Aim Structural and functional imaging techniques were combined to investigate sensory system function in amyotrophic lateral sclerosis (ALS). Methods Functional MRI (fMRI) was used to investigate cortical activity during visual, auditory and somatosensory stimulation in 14 ALS patients and 18 control subjects. Changes in amplitude, latency and duration of the blood oxygen level dependent response were modelled. Furthermore, diffusion tensor imaging was used to investigate changes in white matter networks. Results During visual stimulation, fMRI demonstrated a decreased response in secondary visual areas in ALS, possibly related to demyelination of sensory nerve fibres. Increasing brain activity in associative cortices was linked to a decrease in physical functioning and might represent a compensatory process. Additionally, reduced white matter functioning became evident for fibres projecting to the extrastriate visual cortex. For auditory stimulation, a delayed response in secondary auditory areas probably linked to prolonged nerve conductance time and an altered cortical pattern in areas involved in target processing/detection became evident in ALS patients. Structural white matter changes in the primary and secondary auditory cortices were observed. For somatosensory stimulation, a prolonged/reduced response in sensory integration areas of the parietal lobe was observed, perhaps linked to the reduced visceral inflow due to immobility. Conclusion Multiparametric MRI suggests a progressive functional deficit in secondary/higher order sensory processing areas in ALS, probably associated with reduction of re-afferent information flow due to progressive immobility. The changes described might also represent an expression of the disease process itself. Evidence for compensatory processes in multimodal associative cortices was found.

Cortical plasticity in amyotrophic lateral sclerosis: motor imagery and function.

Background. Cortical networks underlying motor imagery are functionally close to motor performance networks and can be activated by patients with severe motor disabilities. Objective. The aim of the study was to examine the longitudinal effect of progressive motoneuron degeneration on cortical representation of motor imagery and function in amyotrophic lateral sclerosis. Methods. The authors studied 14 amyotrophic lateral sclerosis patients and 15 healthy controls and a subgroup of 11 patients and 14 controls after 6 months with a grip force paradigm comprising imagery and execution tasks using functional magnetic resonance imaging. Results. Motor imagery activated similar neural networks as motor execution in amyotrophic lateral sclerosis patients and healthy subjects in the primary motor (BA 4), premotor, and supplementary motor (BA 6) cortex. Amyotrophic lateral sclerosis patients presented a stronger response within premotor and primary motor areas for imagery and execution compared to controls. After 6 months, these differences persisted with additional activity in the precentral gyrus in patients as well as in a frontoparietal network for motor imagery, in which activity increased with impairment. Conclusion. The findings suggest an ongoing compensatory process within the higher order motor-processing system of amyotrophic lateral sclerosis patients, probably to overcome loss of function in primary motor and motor imagery-specific networks. The increased activity in precentral and frontoparietal networks in motor imagery might be used to control brain-computer interfaces to drive communication and limb prosthetic devices in patients with loss of motor control such as severely disabled amyotrophic lateral sclerosis patients in a locked-in-like state.

Slower theta activity over the midfrontal cortex in schizophrenic patients

Disturbances of the topographical distribution of theta activity in the EEG spectra before and during voluntary movements were investigated in 31 neuroleptic‐treated and in 13 untreated schizophrenics and matched controls as well as in 15 normals medicated with haloperidol. All 4 groups demonstrated similar topographical distribution of theta mean power density, with highest values over the midfrontal region. In the center frequency of the theta band, however, treated and untreated schizophrenics had lower values over the midfrontal region than at parietal electrodes. In controls and normals medicated with haloperidol, this frontoparietal “gradient” demonstrated the inverse picture, with highest values at the frontal midline electrode. Patients and controls differed significantly in this gradient. The slower theta activity over the midfrontal cortex in the schizophrenic patients is related to the hypofrontality hypothesis.

Musicians versus Nonmusicians

Abstract: The ability to perceive sounds and correctly categorize them within a scale is the result of the interaction between inherited capabilities and acquired rules. If a subject listens to a melody, occasional and unexpected endings of the melody typically evoke characteristic auditory evoked responses in the latency range of 300‐400 ms (P300). Also, earlier stages of auditory information processing have been exhaustively investigated by means of mismatch negativity (MMN), a deflection that occurs in the auditory evoked response at a latency of about 200 ms, whenever a deviance is randomly inserted in a series of otherwise equal stimuli. Conceivably, perceptual deviations could also be detected against expectancies that are based on abstract rules; introspective experience suggests that such deviations may also elicit fast intuitive responses that typically initiate processes of analytical reasoning for confirmation. In music, the physical features of the stimulus are, in fact, always changing, because the melodic contour consists of a series of notes with different pitch characteristics. In such a condition, a typical mismatch negativity would not be evoked on the basis of physical deviance, but rather of criteria involving the musical contour of the stimulus. In this study, 20 healthy subjects (10 nonmusicians and 10 musicians) underwent auditory stimulation (tone, chord, chord sequence, Mozart and Bach melodies) and both electrical and magnetic recordings. Clear N1 was recorded for all paradigms, in all subjects; MMN and P300 were also recorded, and their amplitudes and latencies were significantly correlated with the musicality score and with the paradigms difficulty.

Bereitschaftspotential in amyotrophic lateral sclerosis (ALS): lower amplitudes in patients with hyperreflexia (spasticity)

In a pilot study the Bereitschaftspotential (BP) was investigated in 16 patients suffering from amyotrophic lateral sclerosis (mean age 58.6, mean severity of the illness according to Norris ALS score 76.4 points). Comparing the total ALS group (n = 16) with matched controls no significant differences in the BP amplitude parameters were found. However, a subgroup of 7 ALS patients with signs of pronounced spasticity (hyperreflexia) differed significantly at the central midline from matched controls and significantly in addition from patients with a lower degree of spasticity. Controls as well as patients with a lower degree of spasticity had significantly higher BP amplitudes at the midline (electrode positions Cz and Pz, P<0.05, H‐test). The correlation coefficient between the hyperreflexia Norris score and the various BP parameters for the total ALS sample (n = 16) revealed a significant correlation especially over the midline. Stronger signs of spasticity (hyperreflexia) are associated with lower amplitudes of the BP.

Sensor fusion by neural networks using spatially represented information.

Abstract. A neural network model based on a lateral-inhibition-type feedback layer is analyzed with regard to its capabilities to fuse signals from two different sensors reporting the same event (“multisensory convergence”). The model consists of two processing stages. The input stage holds spatial representations of the sensor signals and transmits them to the second stage where they are fused. If the input signals differ, the model exhibits two different processing modes: with small differences it produces a weighted average of the input signals, whereas with large differences it enters a decision mode where one of the two signals is suppressed. The dynamics of the network can be described by a series of two first-order low-pass filters, whose bandwidth depends nonlinearly on the level of concordance of the input signals. The network reduces sensor noise by means of both its averaging and filtering properties. Hence noise suppression, too, depends on the level of concordance of the inputs. When the networks neurons have internal noise, sensor noise suppression is reduced but still effective as long as the input signals do not differ strongly. The possibility of extending the scheme to three and more inputs is discussed.

Deriving angular displacement from optic flow : a fMRI study

Using fMRI we wished to identify brain areas subserving the conversion of velocity signals into estimates of self-displacement (velocity-to-displacement integration, VDI), a function which is a prerequisite for the ability to navigate without landmarks. As real self-motion is not feasible in an fMRI environment, we presented subjects with a ride along a circular path in virtual reality devoid of usable landmarks. We asked subjects to try and feel as if actually moving in the scene and to either detect and count changes in driving speed (V-task) or to estimate the angular displacement achieved during a ride (D-task). We examined the contrast between these two tasks with regard to two hypothesised key functions for VDI: (1) evoking an internal image of the self in space and (2) manipulating this image in proportion to perceived velocity at the pace of a time base. The BOLD-responses during both tasks were fairly similar showing activity with right hemispheric dominance in a large parieto-temporo-occipital area as well as in frontal and prefrontal areas. Contrast D–V revealed a mainly parieto-hippocampal network comprising precuneus and inferior parietal cortex, posterior parieto-occipital cortex, retrosplenial cortex and the hippocampal region, but also right superior frontal gyrus and right cerebellum. It can be viewed as a blend of networks known to be involved in mental rotation and in navigation, except for the lack of ventral premotor and prefrontal activity. A tentative interpretation proposes a scenario where precuneus, together perhaps with posterior parieto-occipital cortex, provides the postulated mental image of the self in space and uses it to interpret results computed in the hippocampal region. In the hippocampal region, VDI proper would take place based on a map of spatial orientation, with the appropriate time scale being an intrinsic property. In addition, a dedicated time keeping system in inferior parietal cortex appears to be involved.

Spectral analysis of EEG during self-paced movements: Differences between untreated schizophrenics and normal controls

Thirteen untreated schizophrenic patients, among them nine who had never been treated, were compared with a corresponding number of matched normal controls with regard to changes of the spectral composition of the electroencephalogram (EEG) accompanying voluntary movements. Triggered by self-paced movements of the right fingers (fast fist closure), the spectral composition of three epochs was analyzed: (1) rest (2,5-1,5 sec before movement), (2) movement preparation (last sec before movement onset), and (3) movement execution (1st sec following movement onset). For frequencies above 6 Hz, marked differences between schizophrenics and controls were evident, in particular over the parietal electrodes. Whereas patients exhibited a clear decrease of power density during movement as compared to rest, controls showed only a small decrease (left and mid parietal) or virtually none (only right parietal). Consequently there were significant differences over the right parietal area (P4) between patients and controls in the theta, alpha- and beta-bands with regard to the mean power density and center frequencies of these bands. Also at parietal positions, schizophrenics lacked the enhancement of theta-power during the preparatory epoch that was characteristic for normal controls at all parietal positions. The results are discussed with regard to the well-known disturbances of voluntary motor behavior in schizophrenia.