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The emerging adulthood represents a vulnerable and critical turning point for the beginning of mental illnesses and is therefore of particular interest for the study of risk and resilience. The present survey investigated the impact of sex on the associations between resilience and the perception of social support and stress in students. The Resilience Scale was used to assess resilience. Stress perception and social support perception were measured using the Perceived Stress Scale and the Social Support Questionnaire FSozU k-22, respectively. Between the ages of 18 and 30, 503 subjects (59.6% female) were included into the study. We detected a significant effect of sex with markedly lower resilience and a more pronounced perception of stress and social support among females. Significant correlations between resilience, stress perception, and social support perception were found in both sexes with women showing a stronger interrelationship between stress perception and both resilience and social support perception. Mediation analysis revealed that the relationship between the perception of social support and stress was fully mediated by resilience among men and partly mediated by resilience among women. Of note, the mediation of resilience on the interrelationship between the perception of social support and stress was much stronger in women than in men. These findings suggest that sex-specific, customized interventions focusing on the strengthening of resilience and the claiming of social support are needed to promote mental health in emerging adults.

BackgroundA brain–heart interaction has been proposed in Takotsubo syndrome (TTS). Structural changes in the limbic system and hypoconnectivity between certain brain areas in the chronic phase of the disease have been reported, but little is known concerning functional neuroimaging in the acute phase. We hypothesized anatomical and functional changes in the central nervous system and investigated whole-brain volumetric and functional connectivity alterations in the acute phase TTS patients compared to controls.MethodsAnatomical and resting-state functional magnetic resonance imaging were performed in postmenopausal females: thirteen in the acute TTS phase and thirteen healthy controls without evidence of coronary artery disease. Voxel-based morphometry and graph theoretical analysis were applied to identify anatomical and functional differences between patients and controls.ResultsSignificantly lower gray matter volumes were found in TTS patients in the right middle frontal gyrus (p = 0.004) and right subcallosal cortex (p = 0.009) compared to healthy controls. When lower threshold was applied, volumetric changes were noted in the right insular cortex (p = 0.0113), the right paracingulate cortex (p = 0.012), left amygdala (p = 0.018), left central opercular cortex (p = 0.017), right (p = 0.013) and left thalamus (p = 0.017), and left cerebral cortex (p = 0.017). Graph analysis revealed significantly (p ConclusionIn the acute phase of TTS volumetric changes in frontal regions and the central autonomic network (i.e. insula, anterior cingulate cortex, and amygdala) were noted. In particular, the right insula, associated with sympathetic autonomic tone, had both volumetric and functional changes.Graphic abstract

Segmentation of specific brain tissue from MRI volumes is of great significance for brain disease diagnosis, progression assessment, and monitoring of neurological conditions. Manual segmentation is time-consuming, laborious, and subjective, which significantly amplifies the need for automated processes. Over the last decades, the active development in the field of deep learning, especially convolutional neural networks (CNNs), and the associated performance improvements have increased the demand for the application of CNN-based methods to provide consistent measurements and quantitative analyses. In this paper, we present an efficient deep learning approach for the segmentation of brain tissue. More specifically, we address the problem of segmentation of the posterior limb of the internal capsule (PLIC) in preterm neonates. To this end, we propose a CNN-based pipeline comprised of slice-selection modules and a multi-view segmentation model, which exploits the 3D information contained in the MRI volumes to improve segmentation performance. One special feature of the proposed method is its ability to identify one desired slice out of the whole image volume, which is relevant for pediatricians in terms of prognosis. To increase computational efficiency, we apply a strategy that automatically reduces the information contained in the MRI volumes to its relevant parts. Finally, we conduct an expert rating alongside standard evaluation metrics, such as dice score, to evaluate the performance of the proposed framework. We demonstrate the benefit of the multi-view technique by comparing it with its single-view counterparts, which reveals that the proposed method strikes a good balance between exploiting the available image information and reducing the required computing power compared to 3D segmentation networks. Standard evaluation metrics as, well as expert-based assessment, confirm the good performance of the proposed framework, with the latter being more relevant in terms of clinical applicability. We demonstrate that the proposed deep learning pipeline can compete with the experts in terms of accuracy. To prove the generalisability of the proposed method, we additionally assess our deep learning pipeline to data from the Developing Human Connectome Project (dHCP).

The role of the limbic system in the acute phase and during the recovery of takotsubo syndrome needs further clarification. In this longitudinal study, anatomical and task-based functional magnetic resonance imaging of the brain was performed during an emotional picture paradigm in 19 postmenopausal female takotsubo syndrome patients in the acute and recovery phases in comparison to sex- and aged-matched 15 healthy controls and 15 patients presenting with myocardial infarction. Statistical analyses were performed based on the general linear model where aversive and positive picture conditions were included in order to reveal group differences during encoding of aversive versus positive pictures and longitudinal changes. In the acute phase, takotsubo syndrome patients showed a lower response in regions involved in affective and cognitive emotional processes (e.g., insula, thalamus, frontal cortex, inferior frontal gyrus) while viewing aversive versus positive pictures compared to healthy controls and patients presenting with myocardial infarction. In the recovery phase, the response in these brain regions normalized in takotsubo syndrome patients to the level of healthy controls, whereas patients 8–12 weeks after myocardial infarction showed lower responses in the limbic regions (mainly in the insula, frontal regions, thalamus, and inferior frontal gyrus) compared to healthy controls and takotsubo syndrome patients. In conclusion, compared to healthy controls and patients suffering from acute myocardial infarction, limbic responses to aversive visual stimuli are attenuated during the acute phase of takotsubo syndrome, recovering within three months. Reduced functional brain responses in the recovery phase after a myocardial infarction need further investigation.

Background Meditation is increasingly attracting interest among neuroimaging researchers for its relevance as a cognitive enhancement technique and several cross‐sectional studies have indicated cerebral changes. This longitudinal study applied a distinct and standardized meditative technique with a group of volunteers in a short‐term training program to analyze brain metabolic changes. Methods The effect of 7 weeks of meditation exercises (focused attention meditation, FAM) was assessed on 27 healthy volunteers. Changes in cerebral energy metabolism were investigated using 31P‐MR spectroscopy. Metabolite ratios were compared before (T1) and after training (T2). Additional questionnaire assessments were included. Results The participants performed FAM daily. Depression and anxiety scores revealed a lower level of state anxiety at T2 compared to T1. From T1 to T2, energy metabolism ratios showed the following differences: PCr/ATP increased right occipitally; Pi/ATP decreased bilaterally in the basal ganglia and temporal lobe on the right; PCr/Pi increased in occipital lobe bilaterally, in the basal ganglia and in the temporal lobe on the right side. The pH decreased temporal on the left side and frontal in the right side. The observed changes in the temporal areas and basal ganglia may be interpreted as a higher energetic state, whereas the frontal and occipital areas showed changes that may be related to a down‐regulation in ATP turnover, energy state, and oxidative capacity. Conclusions The results of the current study indicate for the first time in a longitudinal study that even short‐term training in FAM may have considerable effects on brain energy state with different local energy management in specific brain regions. Especially higher energetic state in basal ganglia may represent altered function in their central role in complex cerebral distributed networks including frontal and temporal areas. Further studies including different forms of relaxation techniques should be performed for more specific and reliable insights.

Background Meditation is increasingly attracting interest among neuroimaging researchers for its relevance as a cognitive enhancement technique and several cross‐sectional studies have indicated cerebral changes. This longitudinal study applied a distinct and standardized meditative technique with a group of volunteers in a short‐term training program to analyze brain metabolic changes. Methods The effect of 7 weeks of meditation exercises (focused attention meditation, FAM) was assessed on 27 healthy volunteers. Changes in cerebral energy metabolism were investigated using 31P‐MR spectroscopy. Metabolite ratios were compared before (T1) and after training (T2). Additional questionnaire assessments were included. Results The participants performed FAM daily. Depression and anxiety scores revealed a lower level of state anxiety at T2 compared to T1. From T1 to T2, energy metabolism ratios showed the following differences: PCr/ATP increased right occipitally; Pi/ATP decreased bilaterally in the basal ganglia and temporal lobe on the right; PCr/Pi increased in occipital lobe bilaterally, in the basal ganglia and in the temporal lobe on the right side. The pH decreased temporal on the left side and frontal in the right side. The observed changes in the temporal areas and basal ganglia may be interpreted as a higher energetic state, whereas the frontal and occipital areas showed changes that may be related to a down‐regulation in ATP turnover, energy state, and oxidative capacity. Conclusions The results of the current study indicate for the first time in a longitudinal study that even short‐term training in FAM may have considerable effects on brain energy state with different local energy management in specific brain regions. Especially higher energetic state in basal ganglia may represent altered function in their central role in complex cerebral distributed networks including frontal and temporal areas. Further studies including different forms of relaxation techniques should be performed for more specific and reliable insights., Within this MR spectroscopy study, we assessed the effect of 7 weeks of meditation exercises (focused attention meditation, FAM) from 27 healthy volunteers regarding brain metabolic changes. Our results indicate for the first time in a longitudinal study that even short‐term training in FAM has considerable effects on brain energy state in different brain regions.

Background Chronic pelvic pain, in particular dysmenorrhoea, is a significant yet unresolved healthcare problem in gynaecology. As interoceptive sensitivity and underlying neural mechanisms remain incompletely understood, this functional magnetic resonance imaging (fMRI) study assessed behavioural and neural responses to visceral stimuli in primary dysmenorrhoea (PMD). Methods Women with PMD (N = 19) without psychological comorbidity and healthy women (N = 20) were compared with respect to visceral sensory and pain thresholds, and to neural responses to individually calibrated mildly painful and painful rectal distensions implemented during scanning. Trial‐by‐trial ratings of perceived intensity were accomplished with visual analogue scales (VAS). Results Although women with dysmenorrhoea reported significantly higher chronic pain intensity and pain interference with daily life activities (p

This study provides first data about the spatial variability of fMRI sensorimotor localizations when investigating the same subjects at different fMRI sites. Results are comparable to a previous patient study. We found a median between-site variability of about 6 mm independent of task (motor or sensory) and experimental standardization (high or low). An intraclass correlation coefficient analysis using data quality measures indicated a major influence of the fMRI site on variability. In accordance with this, within-site localization variability was considerably lower (about 3 mm). We conclude that the fMRI site is a considerable confound for localization of brain activity. However, when performed by experienced clinical fMRI experts, brain pathology does not seem to have a relevant impact on the reliability of fMRI localizations. Hum Brain Mapp 37:2151-2160, 2016. © 2016 Wiley Periodicals, Inc.

To evaluate the accuracy of two different sonographic median nerve measurement calculations in predicting carpal tunnel syndrome (CTS) severity in a study population with clinically and electrophysiologically confirmed CTS.643 wrists of 427 patients (325 females and 102 males, age range: 17-90 years, mean ± SD: 57.9 ± 14.7) were included with CTS diagnosis based on clinical and nerve conduction studies (NCS). Cross-sectional area (CSA) measurement of the median nerve was performed at the carpal tunnel level (CSAc) and at the pronator quadratus muscle level (CSAp). Two parameters were calculated: delta (∆-CSA), which is the difference between proximal and distal measurements, and ratio (R-CSA), calculated by dividing distal over proximal measurements.Patients were classified into mild, moderate and severe CTS based upon NCS. The mean ∆-CSA (4.2 ± 2.6, 6.95 ± 2.2 and 10.7 ± 4.9 mm(2)) and mean R-CSA (1.5 ± 0.4, 1.95 ± 0.4 and 2.4 ± 0.7) values were significantly different between all groups (p 0.001). Optimal cut-off values for ∆-CSA and R-CSA were 6 mm(2) and 1.7, respectively, to distinguish mild from moderate disease, and 9 mm(2) and 2.2, respectively, to distinguish moderate from severe disease.Threshold values for the calculated sonographic parameters ∆-CSA and R-CSA are useful in predicting CTS severity compared to NCS.• Two proposed parameters were calculated (∆-CSA, R-CSA) and compared to NCS. • A defined sonoanatomical proximal landmark was used for the calculation. • Both parameters showed ability to detect CTS severity comparable to NCS. • Cut-off values could be determined for both parameters.

To define the stiffness of the intracarpal tunnel contents and to evaluate the effect of corticosteroid injection on the intracarpal tunnel contents by using sonoelastography.This study was conducted with the approval of the institutional review boards, and all participants provided written, informed consent. Both hands were studied in 20 healthy volunteers, including eight men (mean age, 59.6 years; range, 50-76 years) and 12 women (mean age, 61.0 years; range, 39-79 years) and 22 hands were studied in 20 patients with carpal tunnel syndrome (CTS) (five men [mean age, 49.0 years] and 15 women [mean age, 61.1 years]; range, 39-89 years) between April 2012 and August 2012. The stiffness of the intracarpal tunnel contents was estimated as the standardized acoustic coupler (AC)-to-intracarpal tunnel contents surrounding the nerve (AC/C) strain ratio, analyzed with the Mann-Whitney U test. The patients were treated with corticosteroid injections, and the strain ratio was reexamined 6 weeks later, analyzed with the Wilcoxon t test.The mean AC/C strain ratio in the CTS patients was 12.6 ± 4.7 (standard deviation), which was higher (stiffer) than that in the healthy volunteers with a mean strain ratio of 8.2 ± 3.5 (P = .0013). Six weeks after the injection, the mean AC/C strain ratio had decreased to 8.5 ± 4.1 (P = .00069, compared with the preinjection value) in the CTS patients.The stiffness of the intracarpal tunnel contents in untreated CTS patients is higher than that of healthy volunteers but decreases 6 weeks after corticosteroid injection.

To investigate intersite variability of clinical functional magnetic resonance (MR) imaging, including influence of task standardization on variability and use of various parameters to inform the clinician whether the reliability of a given functional localization is high or low.Local ethics committees approved the study; all participants gave written informed consent. Eight women and seven men (mean age, 40 years) were prospectively investigated at three experienced functional MR sites with 1.5- (two sites) or 3-T (one site) MR. Nonstandardized motor and highly standardized somatosensory versions of a frequently requested clinical task (localization of the primary sensorimotor cortex) were used. Perirolandic functional MR variability was assessed (peak activation variability, center of mass [COM] variability, intraclass correlation values, overlap ratio [OR], activation size ratio). Data quality measures for functional MR images included percentage signal change (PSC), contrast-to-noise ratio (CNR), and head motion parameters. Data were analyzed with analysis of variance and a correlation analysis.Localization of perirolandic functional MR activity differed by 8 mm (peak activity) and 6 mm (COM activity) among sites. Peak activation varied up to 16.5 mm (COM range, 0.4-16.5 mm) and 45.5 mm (peak activity range, 1.8-45.5 mm). Signal strength (PSC, CNR) was significantly lower for the somatosensory task (mean PSC, 1.0% ± 0.5 [standard deviation]; mean CNR, 1.2 ± 0.4) than for the motor task (mean PSC, 2.4% ± 0.8; mean CNR, 2.9 ± 0.9) (P.001, both). Intersite variability was larger with low signal strength (negative correlations between signal strength and peak activation variability) even if the task was highly standardized (mean OR, 22.0% ± 18.9 [somatosensory task] and 50.1% ± 18.8 [motor task]).Clinical practice and clinical functional MR biomarker studies should consider that the center of task-specific brain activation may vary up to 16.5 mm, with the investigating site, and should maximize functional MR signal strength and evaluate reliability of local results with PSC and CNR.

Caffeine has been consumed since ancient times due to its beneficial effects on attention, psychomotor function, and memory. Caffeine exerts its action mainly through an antagonism of cerebral adenosine receptors, although there are important secondary effects on other neurotransmitter systems. Recently, functional MRI (fMRI) entered the field of neuropharmacology to explore the intracerebral sites and mechanisms of action of pharmacological agents. However, as caffeine possesses vasoconstrictive properties it may interfere with the mechanisms underlying the functional contrast in fMRI. Yet, only a limited number of studies dealt with the effect of caffeine on measures in fMRI. Even fewer neuroimaging studies examined the effects that caffeine exerts on cognition: Portas and colleagues used fMRI in an attentional task under different levels of arousal (sleep deprivation or caffeine administration), concluding that the thalamus is involved in mediating the interaction of attention and arousal. Bendlin and colleagues found caffeine to stabilize the extent of neuronal activation in repetitive word stem completion, counteracting the general task practice effect. Recently, Koppelstaetter and colleagues assessed the effect of caffeine on verbal working memory demonstrating a modulatory effect of caffeine on brain regions (medial frontopolar and anterior cingulate cortex) that have been associated with attentional and executive functions. This review surveys and discusses neuroimaging findings on 1) how caffeine affects the contrast underlying fMRI techniques, particularly the blood oxygen level dependent contrast (BOLD fMRI), and 2) how caffeine operates on neuronal activity underlying cognition, to understand the effect of caffeine on behavior and its neurobiological underpinnings.

Aim of this functional magnetic resonance imaging (fMRI) study was to dissociate normal aging and minimal cognitive impairment (MCI) concerning magnitude processing and interference control. We examined the neural correlates of a numerical Stroop task in elderly individuals with and without MCI. Fifteen elderly participants (six patients with MCI and nine controls) were subjected to a numerical Stroop task requiring numerical/physical magnitude classifications while inhibiting task-irrelevant stimulus dimensions. Effects of distance and congruity were examined. Behaviourally, robust distance and congruity effects were observed in both groups and tasks. Imaging baseline conditions revealed stronger and more distributed activations in MCI patients relative to controls which could not be explained by the higher error rates committed by patients. Across tasks, conjunction analysis revealed highly significant activations in intra-parietal and prefrontal regions suggesting that both groups recruit comparable brain regions upon processing magnitude and interference, respectively. MCI patients exhibited stronger pre-/postcentral and thalamic activations, possibly reflecting more effortful response-selection processes or alternatively, deficient inhibitory control. Moreover, MCI patients exhibited additional activations in fronto-parietal (magnitude) and occipital/cerebellar (congruity) regions. To summarize, though MCI patients needed to recruit more distributed activation patterns conjunction analysis revealed common activation sites in response to magnitude processing and interference control.

To assess the effect of caffeine on the functional MRI signal during a 2-back verbal working memory task, we examined blood oxygenation level-dependent regional brain activity in 15 healthy right-handed males. The subjects, all moderate caffeine consumers, underwent two scanning sessions on a 1.5-T MR-Scanner separated by a 24- to 48-h interval. Each participant received either placebo or 100 mg caffeine 20 min prior to the performance of the working memory task in blinded crossover fashion. The study was implemented as a blocked-design. Analysis was performed using SPM2. In both conditions, the characteristic working memory network of frontoparietal cortical activation including the precuneus and the anterior cingulate could be shown. In comparison to placebo, caffeine caused an increased response in the bilateral medial frontopolar cortex (BA 10), extending to the right anterior cingulate cortex (BA 32). These results suggest that caffeine modulates neuronal activity as evidenced by fMRI signal changes in a network of brain areas associated with executive and attentional functions during working memory processes.

Months, days of the week, and numbers differ from other verbal concepts because they are ordered in a sequence, whereas no order is imposed on members of other categories, such as animals or tools. Recent studies suggest that numbers activate a representation of their quantity within the intraparietal sulcus (IPS) automatically, that is, in tasks that do not require the processing of quantity. It is unclear, however, whether ordered verbal materials in general and not only numbers activate the IPS in such tasks. In the present functional magnetic resonance imaging study word generation of months, numbers, and animals were compared. Word generation of numbers and nonnumerical materials from an ordered category (months) activated the IPS more strongly than generating items from a not‐ordered category such as animals or the verbal control conditions. An ROI analysis of three subregions within the anterior IPS revealed that the most anterior and lateral of these regions, human intraparietal area hIP2, shows a greater sensitivity to ordered materials than the other two areas, hIP1 and hIP3. Interestingly, no difference in activation was observed within the IPS between numbers and months suggesting that the activation of the IPS might not be modulated by the additional quantity information carried by numbers. Hum Brain Mapp, 2008. © 2007 Wiley‐Liss, Inc.

Transmeatal cochlear laser (TCL) treatment has recently been proposed as a therapeutic procedure for cochlear dysfunction such as chronic cochlear tinnitus or sensorineural hearing loss. The aim of this study was to investigate whether TLC has any influence on the central nervous system using functional MRI with healthy young adults. The laser stimulation device was placed on the tympanic membrane of both ears. A laser stimulation run and a placebo run were performed in random order. The participants were unable to differentiate between verum and placebo stimulation. In the comparison of verum to placebo runs, we observed significant activations within the left superior frontal gyrus, the right middle and medial frontal gyrus, the right superior parietal lobule, the left superior occipital gyrus, the precuneus and cuneus bilaterally, the right anterior and the left and right middle and posterior cingulate gyrus and the left thalamus. This network of brain areas corresponds well to results from previous PET studies of patients with tinnitus. Though TCL seems to have a clinically measurable effect on the central nervous system the neurophysiological mechanism leading to the observed activated neuronal network remains unknown.

In a previous functional magnetic resonance imaging (fMRI) study of high functioning outpatients with remitted schizophrenia, we found increased activity compared with healthy subjects across multiple areas of the brain, including the dorsolateral frontal cortex and the anterior cingulate, during a modified Stroop task. The same fMRI procedure was used in this subsequent study to investigate eight unmedicated patients during an acute episode of schizophrenia and eight healthy control subjects. Patients showed a reduced activation in dorsolateral prefrontal, anterior cingulate and parietal regions and a higher activation in temporal regions and posterior cingulate compared to healthy controls. Healthy controls showed a trend towards higher accuracy in the modified Stroop task compared to schizophrenia patients. Treatment with second generation antipsychotics may improve executive performance in patients with schizophrenia and facilitate a normalization of functional hypofrontality after symptomatic improvement.

This study provides first data about the spatial variability of fMRI sensorimotor localizations when investigating the same subjects at different fMRI sites. Results are comparable to a previous patient study. We found a median between‐site variability of about 6 mm independent of task (motor or sensory) and experimental standardization (high or low). An intraclass correlation coefficient analysis using data quality measures indicated a major influence of the fMRI site on variability. In accordance with this, within‐site localization variability was considerably lower (about 3 mm). We conclude that the fMRI site is a considerable confound for localization of brain activity. However, when performed by experienced clinical fMRI experts, brain pathology does not seem to have a relevant impact on the reliability of fMRI localizations. Hum Brain Mapp 37:2151–2160, 2016. © 2016 Wiley Periodicals, Inc.

Purpose: To evaluate the feasibility and effectiveness of US-guided sacroiliac joint injection in the treatment of sacroiliitis in children. Materials and Methods: This study was approved by the institutional review board and informed oral and written consent was obtained from the patients and their parents. In 13 patients (7 females and 6 males), 9 – 16 years (mean +/– std 11.39 +/–1.98), 18 sacroiliac joint (SI joint) injections were performed under US guidance. All patients suffered from severe sacroiliitis. US scanning was performed using a linear-array transducer operating at 5 – 18 MHz. Rating of the patients pain using a 0 – 10 dolorimetry scale on a visual analog score (VAS) was recorded before, immediately after and 3 months after injection to monitor severity and therapeutic response. Results: Injection could be performed in all patients without complication and showed good response immediately and 3 months after the injection with a decrease of the VAS (from mean +/– std 9.44 +/– 1.097 to 3.89 +/– 3.82, p Conclusion: US-guided SI joint injection was feasible in all children, relatively quick and easy to perform and appeared effective in the treatment of children with sacroiliitis.

The present functional magnetic resonance imaging (fMRI) study investigates modifications of brain activation patterns related to the training of two different arithmetic operations, multiplication and subtraction. Healthy young adults were trained in five sessions to answer multiplication and subtraction problems. In the following fMRI session, trained and new untrained problems closely matched for difficulty were presented in blocked order. Contrasts between untrained and trained operations showed stronger activation of inferior frontal and parietal regions, especially along the banks of the intraparietal sulcus. The reverse contrasts, trained minus untrained operations, yielded significantly higher activation in the left angular gyrus for multiplication but no significantly activated area for subtraction. This suggests that training leads to a reduction of general purpose processes, such as working memory and executive control in both operations, indicated by the decrease of activation in inferior frontal areas. For multiplication, however, the increase of activation in the left angular gyrus indicates a switching of cognitive processes. Trained subtraction therefore seems to lead to faster and more efficient strategies, while trained multiplication showed a shift from quantity-based processing (supported by the areas along the intraparietal sulci) to more automatic retrieval (supported by the left angular gyrus). The same training method caused changes in brain activation patterns that depended on the given operation. The effects of learning on the brain therefore seem not only to depend on the method of learning but also on its content.

In a previous fMRI study of high-functioning outpatients with remitted schizophrenia, we found that healthy subjects and schizophrenia patients showed similar patterns of activation during a verbal fluency task. However, the activation in controls was primarily in Broca's area on the left, while it was more bilateral for schizophrenia patients, implicating a reduced language lateralization in schizophrenia patients. The same fMRI procedure was used in this subsequent study to investigate unmedicated patients during an acute episode of schizophrenia. Schizophrenia patients showed reduced language lateralization in the frontal cortex, because of a more bilateral activation of Broca's area compared with a primarily left hemisphere activation in healthy controls. Furthermore decreased lateralization was correlated to the severity of hallucinations. Although patients with schizophrenia showed a significantly reduced performance on the verbal fluency task when compared with healthy subjects, we were not able to find evidence of decreased language-related activity in the left hemisphere. These results suggest that decreased language lateralization is also evident in unmedicated patients experiencing an acute episode of schizophrenia.

The purpose of this study was to investigate the sensorimotor cortex response to plantar vibrotactile stimulation using a newly developed MRI compatible vibration device. Ten healthy subjects (20-45 years) were investigated. Vibrotactile stimulation of the sole of the foot with a frequency of 50 Hz and a displacement of 1 mm was performed during fMRI (echo-planar imaging sequence at 1.5 T) using an MRI compatible moving magnet actuator that is able to produce vibration frequencies between 0 and 100 Hz and displacement amplitudes between 0 and 4 mm. The fMRI measurement during vibrotactile stimulation of the right foot revealed brain activation contralaterally within the primary sensorimotor cortex, bilaterally within the secondary somatosensory cortex, bilaterally within the superior temporal, inferior parietal, and posterior insular region, bilaterally within the anterior and posterior cingular gyrus, bilaterally within the thalamus and caudate nucleus, contralaterally within the lentiform nucleus, and bilaterally within the anterior and posterior cerebellar lobe. The advantages of the new MRI compatible vibration device include effective transmission of the stimulus and controlled vibration amplitudes, frequencies, and intensities. The results indicate that plantar vibration can be a suitable paradigm to observe activation within the sensorimotor network in fMRI. Furthermore, the method may be used to determine the optimal responsiveness of the individual sensorimotor network.

Purpose To study cerebral responses evoked from mechanoreceptors in the human foot sole using a computer-controlled vibrotactile stimulation system. Materials and Methods The stimulation system consisted of two stationary moving magnet actuators with indentors to gently contact and vibrate the foot sole during functional MRI (fMRI) experiments. To allow independent settings of contact force (0–20 N) and intensity of vibration (frequency range = 20–100 Hz) the actuators were controlled by a digital servo loop. For fMRI experiments with complex stimulus protocols, both vibrating probes were further operated under supervisory control. Results The MR compatibility of this electromagnetic system was tested in a 1.5T scanner with an actively shielded magnet (Siemens Magnetom Sonata). Blood oxygenation level-dependent (BOLD) responses were detected in the contralateral left pre- and postcentral gyrus, bilaterally within the secondary somatosensory cortex, bilaterally within the supplementary motor cortex, and bilaterally within the anterior cingular gyrus. Conclusion This stimulation device provides a new tool for identifying cerebral structures that convey sensory information from the foot region, which is of promising diagnostic value, particularly for assessing sensorimotor deficits resulting from brain lesions. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc.

This study aimed at investigating the neural correlates of a number-size congruity task. Using an event-related fMRI design, we presented one-digit number pairs to 17 participants in a number-size interference task that required subjects to focus on one stimulus property (e.g., numerical size) and to ignore the other (physical size). In different blocks, participants were asked to decide which digit of a digit pair was numerically larger (numerical comparison task) or physically larger (physical comparison task). Stimuli were classified into three categories: (a) congruent: physical and numerical comparison leads to the same response; (b) incongruent: physical and numerical comparison leads to different responses; (c) neutral: the stimuli differ only with regard to the task-relevant stimulus property. Behavioral results reflect robust distance effects (quicker reaction times for long distances relative to short ones) and size congruity effects (longer reaction times for incongruent relative to congruent stimuli) in both tasks. Imaging results reveal that–compared to congruent trials–incongruent trials led to a stronger activation in the dorsolateral prefrontal cortex and the anterior cingulate cortex, areas associated with attentional control. The distance effect (neutral condition only) led to a stronger activation in bilateral parietal areas including the intraparietal sulcus (IPS).

Zusammenfassung Grundlegende wissenschaftliche Untersuchungen in der Akupunktur sind bisher durch das Fehlen einer rigiden Kontrollbedingung schwierig. Als Kontrolle wurden Nichtakupunkturpunkte und Placebonadeln verwendet. Bei ersteren ist nicht gesichert, dass von ihnen nicht doch physiologische Wechselwirkungen ausgehen und im Ergebnis aufscheinen. Placebonadeln hingegen konnen von Verumakupunktur durch das Fehlen eines DeQi-Gefuhls unterschieden und erkannt werden. Eine Losung kann die Laserakupunktur sein. Hierbei wurden mittels funktioneller Magnetresonanztomographie (f-MRT) vergleichbare und reproduzierbare Ergebnisse wie bei Nadelakupunktur nachgewiesen. Gleichzeitig erlaubt der Laser ein Placebodesign, das vom Patienten/Probanden nicht vom Verum zu unterscheiden ist und keine physiologische Wirkung entfaltet. Durch Verwendung neuartiger Mehr-Kanal-Akupunkturlasergerate mit Computersteuerung konnte auch ein doppelt verblindetes Studiendesign ermoglicht werden.

Hintergrund: Die funktionelle Kernspintomographie (f-MRT) ermoglicht es, funktionelle Aktivierungen des Gehirns nicht-invasiv bildgebend nachzuweisen und diese Funktionen bestimmten Hirnarealen zuzuordnen. Anhand zweier Laserakupunkturstudien an den Punkten Bl 67 und Gb 43 sollte mittels f-MRT die Akupunkturwirkung auf das menschliche Gehirn untersucht werden. Methode: An den Studien nahmen 10 bzw. 11 gesunde mannliche Probanden teil. Es wurden am linken Punkt Bl 67 und an beiden Punkten Gb 43 sowohl Laserakupunktur als auch Placeboakupunktur durchgefuhrt. Weiterhin wurde ein NichtAkupunkturpunkt untersucht. Alle Versuche wurden an einem 1,5 Tesla MR-Scanner durchgefuhrt. Die Auswertung erfolgte mit der Software SPM99. Ergebnisse: Die Laserakupunktur an den Punkten Bl 67 und Gb 43 bewirkte jeweils ipsilaterale Aktivierungen in den Brodmann-Arealen (BA) 18 und 19 (Bl 67), 40 und 22 (Gb 43 re.), Nucleus ruber und Substantia nigra (Gb 43 li.) sowie Aktivierungen des ipsilateralen Hirnstamms (Gb 43 re./li.). Die Placebountersuchung und die Untersuchung an einem Nicht-Akupunkturpunkt fuhrten zu keinen Aktivierungen. Schlussfolgerung: Wir konnten zeigen, dass die Laserakupunktur an den Punkten Bl 67 und Gb 43 zu spezifischen ipsilateralen Aktivierungen von kortikalen und subkor-tikalen Hirnarealen fuhrt. Der Vergleich mit einer vorhergehenden Nadelakupunkturstudie zeigt, dass Laserakupunktur einen ahnlichen Einfluss auf den zerebralen Kortex aufweist wie Nadelakupunktur. Dies ist ein weiterer Hinweis fur die Effektivitat und das therapeutische Potenzial der Laserakupunktur. Weiterhin zeigen die Ergebnisse, dass die f-MRT ein hilfreiches Mittel ist, um die therapeutischen Wirkungen der Akupunktur zu untersuchen und besser verstehen zu konnen.

Verbal memory deficits are among the most severe cognitive deficits observed in patients with schizophrenia. This study examined patterns of brain activity during episodic encoding and recognition of words in patients with schizophrenia.Functional magnetic resonance imaging (fMRI) was used to study regional brain activation in 10 healthy male comparison subjects and 10 male outpatients with schizophrenia during performance of a modified version of the words subtest of Warrington's Recognition Memory Test.Despite having intact performance in word recognition, the patients with schizophrenia had less activation of the right dorsolateral and anterior prefrontal cortex, right anterior cingulate, and left lateral temporal cortex during word encoding, compared with the healthy comparison subjects. During word recognition, the patients had impairments in activation of the bilateral dorsolateral prefrontal and lateral temporal cortices.Schizophrenia was associated with attenuated frontotemporal activation during episodic encoding and recognition of words. These results from an fMRI study replicate earlier findings derived from a positron emission tomography study.

The purpose of this study was to investigate the fMRI response of the sensorimotor cortex to a vibration paradigm produced by a novel vibrotactile stimulator. Fifteen contiguous slices covering the sensorimotor cortex parallel to the anterior (AC) and posterior commissure (PC) line were obtained with echoplanar magnetic resonance imaging at 1.5T. Cortical activity in ten healthy subjects (20-45 years) was investigated during vibration (50 Hz) of the palm of the right hand and compared to a finger-to-thumb tapping paradigm. For the vibration paradigm a mechanically driven vibration head was mounted on the palm of the right hand. The new vibration device produces vibration frequencies (1-130 Hz) and displacement amplitudes (0.5-4 mm) suitable to elicit the tonic vibratory reflex. The fMRI measurement during vibratory stimulation revealed activation in the pre- and postcentral gyrus in all subjects. These activations were comparable to the finger-to-thumb tapping paradigm. The advantages of the new MR compatible vibration device include effective transmission of the stimulus and controlled vibration frequencies and intensities. These preliminary fMRI results indicate that vibration can be an alternative paradigm for the evaluation of sensory and motor functions in patients unable to perform active motor paradigms.

The aim of the study was to implement a vibrotactile stimulator using functional magnetic resonance imaging (fMRI). A fMRI compatible vibration device consisting of a pneumatically driven dual membrane pump was developed. Brain activation during 50 Hz vibrotactile stimulation of the right hand-palm were compared to a right 2 Hz finger-to-thumb-tapping in ten healthy, right-handed male volunteers. The vibration paradigm showed a comparable activation pattern with respect to finger-to-thumb-tapping in the contralateral perirolandic region. The advantage of the new vibration device is the possibility to elicit the vibratory-tonic-reflex due to the higher amplitude in context with the high frequency than established devices. This reflex is considered to be responsible for the activation in the primary motor cortex and the current paradigm might prove useful in future neurosurgical planning in patients with perirolandic lesions.

Introduction In the last 25 years neuromodulation by deep brain stimulation gained widely acceptance starting in the field of movement disorders and getting further indications in pain syndroms and mood disorders. Surgical interventions should only be considered being a treatment option after proving ineffectiveness of conservative therapy forms. The highly acclaimed success of deep brain stimulation in Parkinsons disease, essential tremor, dystonia, chorea huntington, tourette syndrome, cannot be translated 1:1 to neuropathic pain syndromes. The EFNS guidelines on neurostimulation therapy for neuropathic pain published in the European Journal of Neurology 2007; 14: 952–970 revealed DBS against pain to be less effective than in movement disorders. The publication identified several reviews and one meta-analysis, which conclude that DBS is more effective for nociceptive pain than for neuropathic pain (63% vs. 47% long-term success). In patients with neuropathic pain, moderately higher rates of success were seen in patients with peripheral lesions. Because neuropathic pain syndromes are a complex compilation of missing information in different pathways to and within the brain resulting in the different aspects of pain consisting of sensation, perception, mood, emotion and vegetative aspects. Material and methods We will demonstrate different neuropathic pain syndromes following neurosurgical stereotactic interventions for neuromodulation. We were able to enhance the reduced input to the consciousness of man and women by modulation of the two main input areas namely the sensory thalamus and the posterior limp of the internal capsule. We modified the implantation site in the internal capsule because of ineffectiveness of the historical target and an anatomical chaos in the literature on the anatomical construction of the posterior limp of the internal capsule. By doing so we are able to cover all essential afferent fibers to the sensori-motor and the parietal cortex. In comparison to all other methods or other implantation centers a minimum of 2 stimulation electrodes have to be implanted per cerebral hemisphere. 30 patients were treated by neuromodulation against neuropathic pain syndromes. Without motor cortex stimulation and deep brain stimulation against cluster headache we operated 18 patients against neuropathic pain syndromes with our two electrode method. 6 trigeminal neuropathia (5 analgesia dolorosa) patients, 4 peripheral nerve injury patients and 8 post stroke patients. Results All patients had at least 60% up to 100% pain reduction. Some patients developed a decrease of the stimulation effect by “overstimulation”. Intermittent stimulation and our method of intensity modulation is able to reduce habituation of stimulation effects. The anterior cingulate gyrus stimulation according to T. Aziz will complete the armentarium of deep brain stimulation against neuropathic pain syndromes. Prospective randomized double blind studies in neuromodulation against neuropathic pain are still missing and will be conducted in the near future.

The aim of the present was study to evaluate cortical and subcortical neural responses on vibrotactile stimulation of the food and to assess somatosensory evoked BOLD responses in dependence of vibration amplitude and stimulus waveform. Sixteen healthy male subjects received vibrotactile stimulation at the sole of the right foot. The vibration stimulus was delivered through a moving magnet actuator system (MMAS). In an event-related design, a series of vibration stimuli with a duration of 1 s and a variable interstimulus interval was presented. Four stimulation conditions were realized using a 2 (amplitudes 0.4 mm or 1.6 mm) x 2 (waveform sinusoidal or amplitude modulated) factorial design. Stimulating with 0.4 mm amplitude compared to 1.6 mm stimulus amplitude more strongly activated the pre- and postcentral gyrus bilaterally and the right inferior, medial and middle frontal gyrus. In the reverse comparison significant differences were observed within the left inferior parietal lobule, the left superior temporal gyrus, and the left temporal transverse gyrus. In the comparison of sinusoidal versus modulated waveform and vice versa no significant activation differences were obtained. The inter-subject variability was high but when all four stimulation conditions were jointly analyzed, a significant activation of S1 was obtained for every single subject. This study demonstrated that the BOLD response is modulated by the amplitude but not by the waveform of vibrotactile stimulation. Despite high inter-individual variability, the stimulation yielded reliable results for S1 on the single-subject level. Therefore, our results suggest that vibrotactile testing could evolve into a clinical tool in functional neuroimaging.

In this functional MRI experiment, encoding of objects was associated with activation in left ventrolateral prefrontal/insular and right dorsolateral prefrontal and fusiform regions as well as in the left putamen. By contrast, correct recognition of previously learned objects (R judgments) produced activation in left superior frontal, bilateral inferior frontal, and right cerebellar regions, whereas correct rejection of distractor objects (N judgments) was associated with activation in bilateral prefrontal and anterior cingulate cortices, in right parietal and cerebellar regions, in the left putamen, and in the right caudate nucleus. The R minus N comparison showed activation in the left lateral prefrontal cortex and in bilateral cingulate cortices and precunei, while the N minus R comparison did not reveal any positive signal change. These results support the view that similar regions of the frontal lobe are involved in episodic encoding and retrieval processes, and that the successful episodic retrieval of newly learned objects is mainly based on a frontoparietal network.

Functional MRI was used to investigate brain activation in healthy volunteers during encoding of unfamiliar faces as well as during correct recognition of newly learned faces (CR) compared to correct identification of distractor faces (CF), missed alarms (not recognizing previously presented faces, MA), and false alarms (incorrectly recognizing newly presented faces, FA). Encoding was associated with frontal, occipital/fusiform, thalamic, and cerebellar activation. CR produced activation in frontal and cerebellar regions, whereas CF activated frontal and occipitotemporal regions as well as the thalamus. In contrast, MA was associated with frontal and thalamic activation, and FA with frontal activation. The CR minus CF comparison showed left lateral prefrontal and parietal activation, while no suprathreshold positive signal changes were detected when subtracting the other conditions (CR minus MA, CR minus FA, and vice versa). These results support the view that the successful episodic retrieval of newly learned faces is based on a dorsal visual stream mechanism.

In this functional magnetic resonance imaging study, 17 children were asked to make numerical and physical magnitude classifications while ignoring the other stimulus dimension (number-size interference task). Digit pairs were either incongruent (3 8) or neutral (3 8). Generally, numerical magnitude interferes with font size (congruity effect). Moreover, relative to numerically adjacent digits far ones yield quicker responses (distance effect). Behaviourally, robust distance and congruity effects were observed in both tasks. Imaging baseline contrasts revealed activations in frontal, parietal, occipital and cerebellar areas bilaterally. Different from results usually reported for adults, smaller distances activated frontal, but not (intra-)parietal areas in children. Congruity effects became significant only in physical comparisons. Thus, even with comparable behavioural performance, cerebral activation patterns may differ substantially between children and adults.

Whether men activate different brain regions during various emotions compared to women or whether gender differences exist in transient emotional states has been the subject of only few studies. We used event-related functional magnetic resonance imaging (fMRI) to investigate gender differences during the perception of positive or negative emotions. The experiment comprised two emotional conditions (pleasant/unpleasant visual stimuli) during which fMRI data were acquired. Altogether, 38 healthy volunteers (19 males, 19 females) were investigated. When subtracting the activation values of men from those of women, suprathreshold positive signal changes were detected in the right posterior cingulate, the left putamen and the left cerebellum during positive mood induction, and in bilateral superior temporal gyri and cerebellar vermis during negative mood induction. The subtraction of activation values of women from those of men yielded no significant differences. Our findings suggest gender-related neural responses to emotional stimuli and could contribute to the understanding of mechanisms underlying gender-related vulnerability of the prevalence and severity of neuropsychiatric disorders.

Content of this study is the verification whether the direct cortical stimulation agrees with the results of fMRI and to determine of what size the deviations are. It is primary to say that neuron populations, which lead to an involuntary movement with the anesthetized and awake patient over synapses, are excited during an electric direct cortical stimulation. With fMRI (similarly like in positron emission tomography), the circulation alteration after an activation of brain areas by arbitrary, active movement or spontaneous cerebral activation by sensory stimulation is represented in sectional images. With intraoperative electrophysiology individual muscles or muscle groups can be activated directly. The exact correlation of these two methods has the goal to replace ICS in future by preoperative fMRI. Numerous authors pointed out that fMRI can play an important part in preoperative functional mapping [39]. Indeed these studies don't comprise any direct comparison with intraoperative cortical stimulation, the gold standard of intraoperative functional localisation. Aim of this study therefore was the development of a three-dimensional registration system for the transfer of preoperative functional MR-data on intraoperative electro-physiological stimulation points with high precision and to install in the neuro-surgical operating room. The preoperative neuro-functional diagnostics should be integrated directly in the neuro-surgical operation planning and the correlation of the functional localisation should be examined.

As recent studies demonstrated, acupuncture can elicit activity in specific brain areas. This study aims to explore further the central effect using laser acupuncture. We investigated the cerebral effects of laser acupuncture at both acupoints GB43 with functional magnetic resonance imaging (fMRI). As a control condition the laser was mounted at the same acupoints but without application of laser stimulation. The group results showed significant brain activations within the thalamus, nucleus subthalamicus, nucleus ruber, the brainstem, and the Brodmann areas 40 and 22 for the acupuncture condition. No significant brain activations were observed within the placebo condition. The activations we observed were laser acupuncture-specific and predominantly ipsilateral. This supports the assumption that acupuncture is mediated by meridians, since meridians do not cross to the other side. Furthermore, we could show that laser acupuncture allows one to design a pure placebo condition.

Objective: To investigate the effect of electrical stimulation of the nerve afferents of the hand on cortical activity elicited by whole-hand subthreshold stimulation for sensation in healthy human subjects. Methods: Ten healthy volunteers were studied using BOLD-fMRI with 1) a test motor-task with finger-to-thumb tapping of the left hand, 2) a whole-hand afferent electrical stimulation of the left hand below the sensory level for sensation for 30 minutes, 3) a second fMRI run with the same paradigm as in the test motor-task immediately after electrical stimulation, and 4) a final identical fMRI run 2 hours post-stimulation to test the cortical changes induced by electrical stimulation. Experiments were carried out on a 1.5 T MR scanner and for fMRI echoplanar sequences were used. Data analysis was performed with SPM99. Results: An increase of movement-related responses was seen within the primary motor and primary somatosensory areas of both hemispheres when comparing the test motor-task with the motor-task after electrical stimulation relative to the baseline or sham stimulation. Two hours post-stimulation the modulatory effects of mesh-glove stimulation diminished to baseline level except within the contralateral primary motor region. Conclusions: The increased BOLD response spatially localized within the sensorimotor cortex reflects an increase in neuronal activity that may provide augmented neuronal excitability.

The present fMRI study investigates, first, whether learning new arithmetic operations is reflected by changing cerebral activation patterns, and second, whether different learning methods lead to differential modifications of brain activation. In a controlled design, subjects were trained over a week on two new complex arithmetic operations, one operation trained by the application of back-up strategies, i.e., a sequence of arithmetic operations, the other by drill, i.e., by learning the association between the operands and the result. In the following fMRI session, new untrained items, items trained by strategy and items trained by drill, were assessed using an event-related design. Untrained items as compared to trained showed large bilateral parietal activations, with the focus of activation along the right intraparietal sulcus. Further foci of activation were found in both inferior frontal gyri. The reverse contrast, trained vs. untrained, showed a more focused activation pattern with activation in both angular gyri. As suggested by the specific activation patterns, newly acquired expertise was implemented in previously existing networks of arithmetic processing and memory. Comparisons between drill and strategy conditions suggest that successful retrieval was associated with different brain activation patterns reflecting the underlying learning methods. While the drill condition more strongly activated medial parietal regions extending to the left angular gyrus, the strategy condition was associated to the activation of the precuneus which may be accounted for by visual imagery in memory retrieval.

Sex differences in executive speech tasks, favoring women, have been noted in behavioral studies and functional imaging studies. In the present study ten female and ten male volunteers underwent functional magnetic resonance imaging in a conventional block design. All subjects were selected on the basis of high performance on the verbal fluency task. Regions of activation were detected after performance of a covert lexical verbal fluency task inside the scanner. Men and women who did not differ significantly in verbal fluency task performance showed a very similar pattern of brain activation. Our data argue against genuine between-sex differences in cerebral activation patterns during lexical verbal fluency activities when confounding factors like performance differences are excluded.

Memory impairment has been well documented in schizophrenia. In a previous study, the authors investigated patterns of brain activity during episodic encoding and recognition of words in remitted, stable schizophrenia outpatients being treated with novel antipsychotics. The same procedure was used in this study to investigate unmedicated patients during an acute episode of schizophrenia.Functional magnetic resonance imaging was used to study regional brain activation in 10 unmedicated patients experiencing an acute episode of schizophrenia and 10 healthy comparison subjects during performance of a modified version of the words subtest of Warrington's Recognition Memory Test.Despite intact recognition performance, patients with schizophrenia showed reduced activation of anterior prefrontal, posterior cingulate, and retrosplenial areas relative to comparison subjects during word encoding. During word recognition, reduced activation was found in the patients' dorsolateral prefrontal and limbic/paralimbic regions. On the other hand, higher metabolism in bilateral anterior prefrontal cortices was observed.The results suggest that different neural pathways are engaged during episodic encoding and recognition of words in patients experiencing an acute episode of schizophrenia relative to healthy comparison subjects. Furthermore, acute psychosis may prevent practice effects, reflected in a failure to engage brain regions associated with successful episodic memory retrieval in healthy subjects.

Sex differences in mental rotation tasks, favoring men, have been noted in behavioral studies and functional imaging studies. In the present study ten female and ten male volunteers underwent functional magnetic resonance imaging in a conventional block design. Regions of activation were detected after performance of a mental rotation task inside the scanner. In contrast to previous studies, confounding factors such as performance differences between genders or high error rates were excluded. Men showed significantly stronger parietal activation, while women showed significantly greater right frontal activation. Our results point to gender specific differences in the neuropsychological processes involved in mental rotation tasks.