Xuchu Weng

Cerebral response to patient's own name in the vegetative and minimally conscious states

Background: A challenge in the management of severely brain-damaged patients with altered states of consciousness is the differential diagnosis between the vegetative state (VS) and the minimally conscious state (MCS), especially for the gray zone separating these clinical entities. Objective: To evaluate the differences in brain activation in response to presentation of the patients own name spoken by a familiar voice (SON-FV) in patients with VS and MCS. Methods: By using fMRI, we prospectively studied residual cerebral activation to SON-FV in seven patients with VS and four with MCS. Behavioral evaluation was performed by means of standardized testing up to 3 months post-fMRI. Results: Two patients with VS failed to show any significant cerebral activation. Three patients with VS showed SON-FV induced activation within the primary auditory cortex. Finally, two patients with VS and all four patients with MCS not only showed activation in primary auditory cortex but also in hierarchically higher order associative temporal areas. These two patients with VS showing the most widespread activation subsequently showed clinical improvement to MCS observed 3 months after their fMRI scan. Conclusion: The cerebral responses to patients own name spoken by a familiar voice as measured by fMRI might be a useful tool to preclinically distinguish minimally conscious state–like cognitive processing in some patients behaviorally classified as vegetative.

Modulation of functional connectivity during the resting state and the motor task

Quite a few studies in functional magnetic resonance imaging (fMRI) have tested that, even in a resting state, motor cortices constitute a network. It has never been investigated how the network modulates from the resting state to the motor task state. In this report, by a newly developed approach taking into account n‐to‐1 connectivity using 1‐to‐1 connectivity measures instead of conventional pairwise connectivity, we show the existence of a large organized functional connectivity network related to motor function in the resting brain with fMRI. More importantly, we found that such a network can be modulated from a conscious resting state to planning, initiation, coordination, guidance, and termination of voluntary movement state, exhibited by significant changes of functional connectivity of some brain regions in different brain activity. Moreover, a quantitative description of such a functional modulation has also been presented. Hum. Brain Mapp. 22:65–73, 2004.

Functional MRI in attention-deficit hyperactivity disorder: evidence for hypofrontality.

Using event-related functional magnetic resonance imaging to study the Stroop effect on both behavioral and brain activation of ADHD children off or on methylphenidate (MPH). Nine ADHD boys (aged 9.8-14.5 years) and 9 age-matched normal controls were included. A Stroop-like paradigm was used. AFNI (Analysis of Functional NeuroImaging) and its Deconvolution Analysis were used in a descriptive comparison between ADHD and control groups. (1) Both behavioral reaction time and brain activation showed Stroop effect in controls but neither was found in ADHD children off MPH. When MPH was administered, the Stroop effect tended to appear. (2) The activation volume (AV) of prefrontal cortex (PFC) in both the neutral (NC) and interference conditions (IC) in ADHD children off MPH was smaller than in controls. AV of anterior cingulate cortex in the IC in ADHD children off MPH was smaller than that in controls, but was similar in the NC to that in controls. AV of the basal ganglia, insula and cerebellum was also smaller in the IC, but was larger in the NC for ADHD children off MPH compared with controls. These findings are consistent with prior findings of hypofrontality in ADHD children and implicate a compensatory network including basal ganglia, insula and cerebellum for relative lower cognitive load tasks.

Reward and motivation systems: A brain mapping study of early-stage intense romantic love in Chinese participants

Early‐stage romantic love has been studied previously in the United States and United Kingdom (Aron et al. [ 2005 ]: J Neurophysiol 94:327–337; Bartels and Zeki [ 2000 ]: Neuroreport 11:3829–3834; Ortigue et al. [ 2007 ]: J Cogn Neurosci 19:1218–1230), revealing activation in the reward and motivation systems of the brain. In this study, we asked what systems are activated for early‐stage romantic love in Easterners, specifically Chinese participants? Are these activations affected by individual differences within a cultural context of Traditionality and Modernity? Also, are these brain activations correlated with later satisfaction in the relationship? In Beijing, we used the same procedure used by Aron et al. (Aron et al. [ 2005 ]: J Neurophysiol 94:327–337). The stimuli for 18 Chinese participants were a picture of the face of their beloved, the face of a familiar acquaintance, and a countback task. We found significant activations specific to the beloved in the reward and motivation systems, particularly, the ventral tegmental area and the caudate. The mid‐orbitofrontal cortex and cerebellum were also activated, whereas amygdala, medial orbitofrontal, and medial accumbens activity were decreased relative to the familiar acquaintance. Self‐reported Traditionality and Modernity scores were each positively correlated with activity in the nucleus accumbens, although in different regions and sides of the brain. Activity in the subgenual area and the superior frontal gyrus was associated with higher relationship happiness at 18‐month follow‐up. Our results show that midbrain dopamine‐rich reward/motivation systems were activated by early‐stage romantic love in Chinese participants, as found by other studies. Neural activity was associated with Traditionality and Modernity attitudes as well as with later relationship happiness for Chinese participants. Hum Brain Mapp, 2011.

Gray matter density negatively correlates with duration of heroin use in young lifetime heroin-dependent individuals

Numerous studies have documented cognitive impairments and hypoactivity in the prefrontal and anterior cingulate cortices in drug users. However, the relationships between opiate dependence and brain structure changes in heroin users are largely unknown. In the present study, we measured the density of gray matter (DGM) with voxel-based morphometry in 30 lifetime heroin-dependent individuals who had abstained from drug use for 5 months, and 34 healthy participants. The DGM of the prefrontal, temporal and cingulate cortices significantly decreased in heroin addicts relative to the healthy group. Critically, partial correlation analysis, which controlled for age, education and gender factors as well as nicotine use and heroin abstinence duration, showed that the duration of heroin use negatively correlated with the DGM in heroin-dependent individuals. These results provide compelling evidence for structural abnormality in heroin-dependent individuals and further suggest that duration of heroin use is a critical factor leading to brain damage.

Neural activity associated with cognitive regulation in heroin users : A fMRI study

Previous research has found heroin addicts to be impulsive. This study employed functional magnetic resonance imaging technology to investigate the differences between heroin addicts and normal controls in neural activity associated with cognitive regulation of behavior. Twenty-one Chinese men participated in this study, 11 of whom were newly admitted heroin-addicted patients and 10 of whom were healthy volunteers. In the experimental task, the subjects were required to first identify the correct directions of arrowheads and then give the opposite answers. Behaviorally, the heroin-dependent patients took a much shorter time to complete the more demanding second part of the task but committed more errors than the normal controls. This pattern of behavior, characteristic of people who are disinhibited and who tend to be impulsive, was consistent with previous reports of impulsivity observed in people who have abused heroin. The neural activity of the patients that was associated with performing the experimental task of cognitive regulation was different to that of the normal controls in terms of the pattern of prefrontal activation, the attenuation of activity in the anterior cingulate, and the additional recruitment of the right inferior parietal region. This study is the first that seeks to understand the neural activity associated with impulsive behavior in people who abuse heroin. The pattern of imaging data obtained resembled the pattern of data observed in immature brains attempting to exercise cognitive control of behavior. Further theoretical and clinical implications of the findings are discussed.

Involvement of the cerebellum in semantic discrimination: an fMRI study.

We investigated, using functional magnetic resonance imaging (fMRI), whether semantic discrimination, an inner linguistic task without overt articulation, can elicit activation in the cerebellum. Six subjects performed three semantic tasks with different loads of discrimination while being scanned. All three semantic tasks activated distributed brain areas, including the right posterior inferior cerebellum. Much stronger activation was found in the cerebellum in more difficult tasks, in terms of the activation volume and signal intensity. These results suggest that the cerebellum activation is involved in semantic discrimination and is modulated by discrimination difficulty. Hum. Brain Mapping 18:208–214, 2003.

Differential activity in left inferior frontal gyrus for pseudowords and real words: An event-related fMRI study on auditory lexical decision

After Newman and Twieg ([ 2001 ]: Hum Brain Mapp 14:39–47) and others, we used a fast event‐related functional magnetic resonance imaging (fMRI) design and contrasted the lexical processing of pseudowords and real words. Participants carried out an auditory lexical decision task on a list of randomly intermixed real and pseudo Chinese two‐character (or two‐syllable) words. The pseudowords were constructed by recombining constituent characters of the real words to control for sublexical code properties. Processing of pseudowords and real words activated a highly comparable network of brain regions, including bilateral inferior frontal gyrus, superior, middle temporal gyrus, calcarine and lingual gyrus, and left supramarginal gyrus. Mirroring a behavioral lexical effect, left inferior frontal gyrus (IFG) was significantly more activated for pseudowords than for real words. This result disconfirms a popular view that this area plays a role in grapheme‐to‐phoneme conversion, as such a conversion process was unnecessary in our task with auditory stimulus presentation. An alternative view was supported that attributes increased activity in left IFG for pseudowords to general processes in decision making, specifically in making positive versus negative responses. Activation in left supramarginal gyrus was of a much larger volume for real words than for pseudowords, suggesting a role of this region in the representation of phonological or semantic information for two‐character Chinese words at the lexical level. Hum Brain Mapp 25:212–221, 2005.

Anterior cingulate activity and the self in disorders of consciousness

Objectives: The aim of this study was to investigate the relationship between medial cortical activation and the presence of self and consciousness in healthy subjects and patients with vegetative state and minimally conscious state using functional magnetic resonance imaging (fMRI). Experiment design: We first conducted two fMRI experiments in healthy subjects to identify brain regions specifically associated with self‐perception through the use of different auditory stimuli that had different grades of self‐relatedness. We then applied these regions as functional localizers to examine the relationship between neural activity changes during self‐relatedness and consciousness level in the patients with disorders of consciousness (DOC). Principal observations: We demonstrated recruitment of various anterior medial cortical regions including the anterior cingulate cortex (ACC) in healthy subjects during auditory perception of self‐related stimuli. We further showed that patients with DOC showed signal changes in the ACC during auditory perception of self‐related stimuli. Finally, it was shown that these signal changes correlate with the level of consciousness in the patients with DOC. Conclusion: The degree of consciousness in patients with DOC was correlated with neural activity in the ACC induced by self‐related stimuli. Our results not only shed light on the pathophysiology of DOC, but may also suggest a useful neural, and thus diagnostic, marker of the dysfunction of consciousness in vegetative patients. Hum Brain Mapp, 2010.

Mismatch negativity to the patient's own name in chronic disorders of consciousness

Previous studies implicated potential value of mismatch negativity (MMN) in predicting recovery of consciousness in patients with disorders of consciousness (DOC). We have adopted a novel MMN evoked by subjects own name (SON), a self-referential stimulus thought to be powerful in evoking residual brain activity, and examined the correlation between the MMN and recovery of consciousness in patients with chronic (>1 month) DOC. Twelve patients and 12 age-matched healthy controls were investigated. The patients were diagnosed as coma (n=4), vegetative state (VS, n=6), and minimally conscious state (MCS, n=2), mainly based on the JFK Coma Recovery Scale-Revised. The SON-evoked MMN (SON-MMN) was present in seven patients. Critically, the presence of SON-MMN was significantly correlated with recovery of consciousness. While four of the five patients (three VS and two coma) showing SON-MMN changed to MCS 3 months later, the rest of the patients (three VS and two coma) without SON-MMN failed to show any clinical improvement. Our study thus illustrates that the subjects own name is effective in evoking MMN in patients with DOC, and that SON-MMN has potential prognostic values in predicting recovery of consciousness.