Systemic lupus erythematosus as a cause of first-episode psychosis in the second trimester of pregnancy.

A Chinese woman had a first-episode of psychosis in the second trimester of pregnancy. The sudden onset of psychotic symptoms and fluctuating mental condition with visual hallucinations suggested an organic origin for the psychosis. Antipsychotic medication was started. Ultrasound investigation at 19 weeks of gestation revealed intrauterine growth retardation and she decided to terminate the pregnancy. Positive blood test results for antiphospholipid antibodies confirmed a diagnosis of systemic lupus erythematosus with antiphospholipid syndrome. Psychosis is one of the neuropsychiatric syndromes in systemic lupus erythematosus and can sometimes be the primary manifestation, antedating other evidence of the disease. Pregnancy can exacerbate systemic lupus erythematosus. This report highlights the importance of considering an organic cause for psychosis, including systemic lupus erythematosus, especially when it occurs for the first time during pregnancy in a previously healthy woman.

Basic response determinants of single neurons to amplitude modulation in the auditory midbrain.

Amplitude-modulated (AM) signals represent important components of environmental sounds. While single-cell responses to AM tones in the central auditory system were often studied using repetitive modulation, owing to its presence in vocalization signals, the AM response has not been fully depicted in terms of receptive field in the stimulus domain. This study was aimed to characterize the receptive field of AM response with respect to nonrepetitive AM stimuli and to understand how complex acoustic signals may be coded in the brain. A novel AM stimulus was implemented with a random envelope and a systemic change in intensity across trials. From 393 single units recorded in the inferior colliculus (IC) of urethane-anesthetized rats, responses to the AM stimulus were first characterized in terms of dot-raster pattern. Three types of response were identified: type I showing a monotonic response to mainly the steady states of the AM envelope and type II to rising phases of the AM envelope with a clear intensity preference. Type III showed a mixed response of both type I and type II. A small number of units, called type IV, responded to both rising and falling phases of the modulation. Using perispike averaging, the AM receptive field, or "level temporal receptive field" (LTRF), was displayed in a "stimulus level versus perispike time" plane. The LTRF, particularly of the type II response, clearly revealed triggering features of the cell. The triggering features are consistent with the representation of the cell's response in a receptive space formed by the Cartesian axes of the velocity of amplitude modulation, the intensity of the sound, and the range of modulation. We therefore considered these stimulus parameters as the three basic determinants of the AM response in the auditory midbrain.

A novel system for simultaneous monitoring of locomotor and sound activities in animals.

This paper describes a PC-based system for simultaneous monitoring of locomotor and sound activities on small rodents. The displacement and location signals of the animal were first determined across consecutive video-frames, followed by marked data reduction to cater for long-term studies. At the same time, sounds generated by the animal were detected and the sound level was recorded as root-mean-square values at 1 s intervals. Preliminary data showed that such a multi-parametric monitor system could provide comprehensive information on the animal's activity.

Spectro-temporal receptive fields of midbrain auditory neurons in the rat obtained with frequency modulated stimulation.

Single unit responses at the auditory midbrain of the anesthetized rat were characterized in terms of spectro-temporal receptive field (STRF) using random frequency modulated (FM) tones and peri-spike averaging. STRFs were obtained from 121 FM-sensitive units covering a wide range of characteristic frequency (CF). Roughly half of the neurons showed clearly preferred stimulus time profiles that formed either a single, double or multiple bands. Neurons with a single-band STRF appeared to be sorted into positive or negative directional sensitivity for FM modulation on the basis of their CF either below or above 10 kHz. This directional selectivity is discussed in relation to the most sensitive part of the rat's audiogram.

Multiscale characterization of chronobiological signals based on the discrete wavelet transform.

To compensate for the deficiency of conventional frequency-domain or time-domain analysis, this paper presents a multiscale approach to characterize the chronobiological time series (CTS) based on a discrete wavelet transform (DWT). We have shown that the local modulus maxima and zero-crossings of the wavelet coefficients at different scales give a complete characterization of rhythmic activities. We further constructed a tree scheme to represent those interacting activities across scales. Using the bandpass filter property of the DWT in the frequency domain, we also characterized the band-related activities by calculating energy in respective rhythmic bands. Moreover, since there is a fast and easily implemented algorithm for the DWT, this new approach may simplify the signal processing and provide a more efficient and complete study of the temporal-frequency dynamics of the CTS. Preliminary results are presented using the proposed method on the locomotion of mice under altered lighting conditions, verifying its competency for CTS analysis.

Similarities of FM and AM receptive space of single units at the auditory midbrain.

Complex sounds, including human speech, contain time-varying signals like frequency modulation (FM) and amplitude modulation (AM) components. In spite of various attempts to characterize their neuronal coding in the mammalian auditory systems, a unified view of their responses has not been reached. We compared FM and AM coding in terms of receptive space with reference to the input-output relationship of the underlying neural circuits. Using extracellular recording, single unit responses to a novel stimulus (i.e. random AM or FM tone) were obtained at the auditory midbrain of the anesthetized rat. Responses could be classified into three general types, corresponding to selective sensitivity to one of the following aspects of the modulation: (a) steady state, (b) dynamic state, or (c) steady-and-dynamic states. Such response typing was basically similar between FM and AM stimuli. Furthermore, the receptive space of each unit could be characterized in a three-dimensional Cartesian co-ordinate system formed by three modulation parameters: velocity, range and intensity. This representation applies to both FM and AM responses. We concluded that the FM and AM codings are very similar at the auditory midbrain and may likely involve similar neural mechanisms.

A tracing evoked potential estimator.

The paper presents an adaptive Gaussian radial basis function neural network (RBFNN) for rapid estimation of evoked potential (EP). Usually, a recorded EP is severely contaminated by background ongoing activities of the brain. Many approaches have been reported to enhance the signal-to-noise ratio (SNR) of the recorded signal. However, non-linear methods are seldom explored due to their complexity and the fact that the non-linear characteristics of the signal are generally hard to determine. An RBFNN possesses built-in non-linear activation functions that enable the neural network to learn any function mapping. An RBFNN was carefully designed to model the EP signal. It has the advantage of being linear-in-parameter, thus a conventional adaptive method can efficiently estimate its parameters. The proposed algorithm is simple so that its convergence behaviour and performance in signal-to-noise ratio (SNR) improvement can be mathematically derived. A series of experiments carried out on simulated and human test responses confirmed the superior performance of the method. In a simulation experiment, an RBFNN having 15 hidden nodes was trained to approximate human visual EP (VEP). For detecting human brain stem auditory EP (BAEP), the approach (40 hidden nodes and convergence rate = 0.005) speeded up the estimation remarkably by using only 80 ensembles to achieve a result comparable to that obtained by averaging 1000 ensembles.

Wavelet analysis of embolic heart sound detected by precordial Doppler ultrasound during continuous venous air embolism in dogs.

UNLABELLED: The spectrum of the embolic heart sounds (EHS) detected by precordial Doppler ultrasound has been previously characterized, but only on small volumes of venous air embolism (VAE). We sought to determine whether real-time wavelet analysis is useful in analyzing the signals of EHS and whether the embolic power of the EHS for larger volumes of air is proportionate to the volume of VAE that has been reported for small volumes of VAE. A series of small air boli (0.01, 0.02, 0.05, 0.07, 0.1, 0.15, 0.2, 0.3, 0.4, and 0.8 mL), followed by continuous infusion of larger volumes of air (0.8, 1.6, 2.4, 4.8, and 9.6 mL), was injected into the external jugular vein through a central catheter in seven pentobarbital-anesthetized dogs. We measured the spectrum of the Doppler heart sound (DHS) in a real-time manner by using wavelet analysis at different scales. Wavelet analysis at scale = 1 yielded satisfactory results in distinguishing abnormal EHS from normal DHS with high sensitivity (100%) and good positive predictive value (100%) compared with the conventional method, which requires an anesthesiologist to listen to the audio DHS signals in a real-time manner. There was a linear relationship (y = 1.08x + 7.89, r = 0.75, P < 0.001) between the cumulative embolic power of the EHS and the air volume introduced in the form of either bolus or continuous infusion. The 95% confidence intervals for slope and intercept were 0.89-1.27 and 7.65-8.13, respectively. Our results suggest that wavelet analysis is effective as a real-time monitor and that it is possible to distinguish larger volumes of air emboli based on previous injections of small volumes of air. IMPLICATIONS: The real-time wavelet analysis of the heart sound detected by precordial Doppler ultrasound may be useful in estimating larger volumes of air emboli based on previous injections of small volumes of air in anesthetized dogs.

Transient frequency and intensity sensitivities of central auditory neurons determined with sweep tone.

To determine the transient frequency and intensity sensitivities of central auditory neurons, we implemented an exponential sweep tone stimulus (2 sec in period, mean sweep rate 3.3 octave/sec), intensity of which varied systematically across trials. Response of single units to the stimulus was studied at the inferior colliculus (IC) of urethane-anesthetized rats. Most IC units responded to the sweep tone by one or more transient increases in discharge rate. The area of increased discharge, or response area (RA), was delineated on the frequency-intensity plane. The tip of RA gives the best frequency (BF) and minimum threshold (MT) of the cell. We also compared the BF and MT concurrently obtained with another method, viz., the conventional 'audio-visual' method of subjective judgment. Results showed that for the same population of cells (n=130), correlation between the two methods is better for BF (r=0.91) than for MT (r=0.78). Such discrepancy was discussed in relation to the response characteristics of these central auditory neurons.

Evoked potential estimation using modified time-sequenced adaptive filter.

A method called modified time-sequenced adaptive filtering (MTSAF) is applied to estimate evoked potential (EP) signals and track the temporal variations of EPs. The MTSAF consists of a set of adaptive filters (AFs), with each processing a time segment of EP data. After convergence, each AF reaches the best estimation of EP signals over its own time segment in terms of minimum mean squared error (MMSE). Numerical results of simulated and human EP data show that the MTSAF reaches better estimation of EPs than a conventional adaptive signal enhancer (ASE). With the MTSAF, the temporal variations of EPS across trials can be estimated to reveal more subtle variations of EPs, which may be of clinical value.

Fast detection of venous air embolism in Doppler heart sound using the wavelet transform.

The introduction of air bubbles into the systemic circulation can result in significant morbidity. Real-time monitoring of continuous heart sound in patients detected by precordial Doppler ultrasound is, thus, vital for early detection of venous air embolism (VAE) during surgery. In this study, the multiscale feature of wavelet transforms (WT's) is exploited to examine the embolic Doppler heart sound (DHS) during intravenous air injections in dogs. As both humans and dogs share similar physiological conditions, our methods and results for dogs are expected to be applicable to humans. The WT of DHS at scale 2j (j = 1, 2) selectively magnified the power of embolic, but not the normal, heart sound. Statistically, the enhanced embolic power was found to be sensitive (P < 0.01 at 0.01 ml of injected air) and correlated significantly (P < 0.0005, r = 0.83) with the volume of injected air from 0.01 to 0.10 ml. A fast detection algorithm of O(N) complexity with unit complexity constant for VAE was developed (processing speed = 8 ms per heartbeat), which confirmed the feasibility of real-time processing for both humans and dogs.

Modeling of the response of midbrain auditory neurons in the rat to their vocalization sounds based on FM sensitivities.

Single units were recorded from the inferior colliculus (IC) of anaesthetized rats in response to: (a) an FM tone, the frequency of which was randomly varied, and (b) a digitized rat vocalization sound. We hypothesized that these neurons may have 'orientation-specific' spectrotemporal receptive field (STRF) that can be used to estimate their responses to complex communication signals. Based on the FM response, we first estimated the cell's STRF which was then convolved with the spectrogram of the rat's vocalization call. A simple convolution gave only crude prediction of the cell's response to the vocalization sound. When inhibitory areas were added around certain parts of the STRF, a better match was found. We conclude that for some FM-sensitive neurons of the IC, STRF with inhibitory areas may account for their responses to vocalization sounds.

Effect of cage size on ultradian locomotor rhythms of laboratory mice.

The effect of cage size on spontaneous locomotor rhythms of laboratory mice was studied under simulated light-dark (12:12) cycles. On-line image analysis of bodily displacement yielded a locomotor signal over a period of 3 days. Continuous wavelet transform was applied to the signal, and ensemble averaging of eight mice revealed in the time-frequency plot bouts of increased motor activities. Notably, there were two bouts in the dark corresponding to ultradians of periods below 5 h: a first bout at the dark onset (at 0.6-1.0 cycle/h), and a second bout during the second half of the dark period (at 0.4-0.7 cycle/h). These increases of activity were more intense and distinct when the animals were kept inside the larger cage. Furthermore, the first bout disappeared when the animals were kept in the small cage for 3 days.

Computerised infrared imaging system for studying thermal activation on the skull following somatic stimulation in small animals.

A computerised infrared imaging system has been developed to measure infrared radiation as a means of functionally mapping the cerebral cortex. In two species of small mammal, rat and gerbil, the authors localised the thermal changes at the skull overlying the somatic sensory cortex following somatic stimulation of the mystacial vibrissae. Though typically small in magnitude, a thermal response could be detected through the skull. To enhance detection sensitivity, a number of measures were taken to improve various aspects of data acquisition, stimulus delivery and control of experimental conditions. Regarding data analysis, a coordinate system based on skull landmarks was adopted to localise thermally-active regions for comparison across animals of the same species. To extract the region of weak temperature changes, a coarse-to-fine detection strategy was developed, which searched automatically for clusters of temporally- and spatially-correlated pixels above a data-driven threshold. Thus, the dynamic aspect of the thermal changes at any region of interest on the skull could be studied efficiently. The detection algorithm was tested against simulated responses in addition to empirical data obtained from animals. All of the above software was integrated in a user-friendly package.

EMG spike trains of succinylcholine-induced fasciculations in myalgic patients.

Single spike activity from the surface electromyogram (EMG) of fasciculations induced by succinylcholine (Sch) were studied from limb muscles (biceps, triceps, anterior tibialis and gastrocnemius) in 100 female patients. About 2/3 of them (n = 72) also received nondepolarizing neuromuscular pretreatment (atracurium or vecuronium). We observed from 20% of EMG records in the myalgic (but not in the nonmyalgic) patients, sustained spike trains (mean duration 1.47 s) that resembled motor units firing at physiologically high rates (mean 21.7 spikes/s). The finding reflects Sch's distal actions at the muscle spindle. The implications for myalgia and the possible involvement of micro damage at the extrafusal muscles are discussed.

Visual evoked potential enhancement by an artificial neural network filter.

The application of an artificial neural network filter (ANNF) to estimate the visual evoked potential (VEP) is presented. VEP is the gross electrical response of the brain to visual stimuli. Due to the low SNR, it is difficult to extract response from individual stimulus trials. The ANNF we used estimates the deterministic component of the signal and removes the noise uncorrelated with the stimulus, even when the noise is colored. The ANNF is trained through back-error propagation with a data set consisting of a training signal and a target signal. The training signal is the raw VEP from a single trial having a SNR of about -5 dB, while the target signal has a higher SNR which is achieved by ensemble averaging 100 stimulus trials. Simulated signals were generated to test the performance of the ANNF. Results show that the ANNF could greatly enhance the SNR of the VEP to single visual stimulus. Thus the total number of ensembles is reduced. In clinical applications, the traditional ensemble averaging method requires a hundred ensembles to determine the VEP. When ANNF is used, about 20 ensembles are sufficient for the same purpose.

Detection of brainstem auditory evoked potential by adaptive filtering.

A method of detecting brainstem auditory evoked potential (BAEP) using adaptive signal enhancement (ASE) is proposed and tested in humans and cats. The ASE in this system estimates the signal component of the primary input, which is correlated with the reference input to the adaptive filter. The reference input is carefully designed to make an optimal and rapid estimation of the signal corrupted with noise, such as ongoing EEG. With a good choice of reference input, it is possible to track the variability of BAEP efficiently and rapidly. Moreover, the number of repetitions required could be markedly reduced and the result of the system is superior to that of ensemble averaging (EA). To detect BAEP in cats, only 30 ensemble averages are needed to obtain a reasonable reference input to the adaptive filter, and, for humans, 350-750 ensemble averages are sufficient for a satisfactory result. Using the LMS adaptive algorithm, individual BAEP can be obtained in real-time.

Thermal images of somatic sensory cortex obtained through the skull of rat and gerbil.

Infrared images of the skull surface were obtained in urethane-anesthetized rats and gerbils before, during and after mechanical stimulation of the face and mystacial vibrissae on one side. Areas of increased temperature on the skull, localized mainly over the face area of the primary somatosensory cortex contralateral to the side of stimulation, appeared within 4-5 s after the onset of stimulation. Rarely, such temperature change was recorded bilaterally. Temperatures did not remain high on the intact skull in rats, but fell to baseline within minutes after stimulus onset regardless of stimulus duration. In rats in which the skull had been thinned and in gerbils with intact skull, temperatures remained elevated during the course of stimulation. We were unable to resolve the activation of individual vibrissae.

An enhanced approach to adaptive processing of the brain stem auditory evoked potential.

The present paper describes an adaptive signal enhancer (ASE) method for improving signal-to-noise ratio (SNR) and also for tracking the variation of brain-stem auditory evoked potential (BAEP). The enhancer has two inputs: a primary input which is the original data to be processed, consisting of signal badly corrupted by noise, and a reference input. A method called dynamic averaging (DA) is introduced to obtain the reference input. The improved reference signal allows closer tracking of evoked potential in each subsequent trial. For BAEP measurement in human, the SNR is typically very low. It requires about 200 ensembles to generate the reference input acceptable for ASE, and tracking of the variation of BAEP can be obtained satisfactorily. Our results show that while ensemble averaging is still needed, the total number of ensembles is greatly reduced. The adaptive method thus reduces the time of measurement for BAEP compared with the conventional method of ensemble averaging.

Simulation of free-field sound sources and its application to studies of cortical mechanisms of sound localization in the cat.

We synthesized a set of signals (clicks) for earphone delivery whose waveforms and amplitude spectra, measured at the eardrum, mimic those of sounds arriving from a free-field source. The complete stimulus set represents 1816 sound-source directions, which together surround the head to form a 'virtual acoustic space' for the cat. Virtual-space stimuli were delivered via calibrated earphones sealed into the external meatus in cats under barbiturate anesthesia. Neurons recorded in AI cortex exhibited sensitivity to the direction of sound in virtual acoustic space. The aggregation of effective sound directions formed a virtual space receptive field (VSRF). At 20 dB above minimal threshold, VSRFs fell into one of several categories based on spatial dimension and location. Most VSRFs were confined to either the contralateral (59%) or ipsilateral (10%) sound hemifield. Seven percent spanned the frontal quadrants and 16% were omnidirectional. Eight percent fit into no clear category and were termed 'complex'. The size, shape, and location of VSRFs remained stable over many hours of recording. The results are in essential agreement with free-field studies. VSRFs were found to be shaped by excitatory and inhibitory interactions of activity arriving from the two ears. Some cortical neurons were found to preserve the spectral information in the free-field sound which was generated by the acoustical properties of the head and pinna, filtered by the cochlea and transmitted by auditory nerve fibers.