[Magneto-encephalographic (MEG) brain recordings during traumatic memory recall in women with post-traumatic stress disorder: A pilot study]. / Enregistrement magnéto-encéphalographique (MEG) de réminiscences du trauma chez des femmes souffrant de stress post-traumatique : une étude pilote.

AIM OF THE STUDY: The experiment studied the effects of a short duration exposure to traumatic memories using magneto-encephalography (MEG). PATIENTS: Nine right-handed DSM-4 PTSD patients were recruited from a unit for anxiety disorders and an organisation supporting victims of violence. In order to have a homogeneous sample, we included only women who suffered from civilian PTSD. Exclusion criteria were co-morbid major medical illness, metallic dental prostheses that would interfere in the magnetic measurement, and current drug treatment. All participants were free from neurological disease and had normal hearing. They signed a written informed consent form. An ethics committee accepted the study. METHOD: A tape-recorded voice administered a script-driven imagery. The patients had to imagine, successively, a neutral image, a traumatic memory and rest, while MEG measured brain activities across delta, theta, alpha and beta bands. Each condition lasted three minutes. Heart rate (HR), anxiety and the vividness of mental images were recorded at the end of each phase. MEG power analysis was carried out with Statistical Parametric Mapping (SPM) 8. The signals were averaged for each of the three conditions of threeminutes duration. The dependent variable was a subtracted value: (trauma - rest) - (neutral - rest). The significance threshold was set at P<0.01. RESULTS: Anxiety and HR significantly increased during the trauma condition and returned to the neutral level during rest. The vividness of the mental imagery remained stable across the three conditions. The left-brain demonstrated a statistically significant power decrease in the secondary visual cortex (BA 18-19) in the delta band, the insula (BA13) in the beta band, the insula (BA13), premotor cortex (BA 6), Broca area (BA 44), and BA 43, in the alpha band. DISCUSSION: The symptom provocation protocol was successful in eliciting subjective anxiety and HR response in relation to traumatic memories. Our MEG results are in keeping with previous neuro-imagery studies showing decreased activities in the insula and Broca area during PTSD symptom provocation. However, we did not replicate the activation in the amygdala and the cingulate and prefrontal cortex found in some studies. Moreover, the within-group design, the small sample, and the inclusion of only female patients with milder dissociative symptoms limit our conclusions. The MEG protocol we used may also explain some partial discrepancies with previous MEG studies. However, our aim was to provoke a specific autobiographic recall of a traumatic event unfolding several sequential mental images along three minutes as in exposure therapy for PTSD. CONCLUSION: Despite its limitations, this pilot study is the first to provide MEG data during trauma recall. It suggests that recalling a specific traumatic event along three minutes results in hypo-activations of the brain regions regulating language and emotions. This paves the way to recording whole sessions of specific therapies for PTSD, with MEG using the millisecond resolution. MEG might be of interest to study the suppression of traumatic memories and their activation and habituation through prolonged graduated exposure in imagination across several sessions. MEG could also be used to study the effects of medication on PTSD symptoms. A controlled replication in a larger sample including male and female patients with various traumatic experiences is needed.

Neuroplasticity of prehensile neural networks after quadriplegia.

Targeting cortical neuroplasticity through rehabilitation-based practice is believed to enhance functional recovery after spinal cord injury (SCI). While prehensile performance is severely disturbed after C6-C7 SCI, subjects with tetraplegia can learn a compensatory passive prehension using the tenodesis effect. During tenodesis, an active wrist extension triggers a passive flexion of the fingers allowing grasping. We investigated whether motor imagery training could promote activity-dependent neuroplasticity and improve prehensile tenodesis performance. SCI participants (n=6) and healthy participants (HP, n=6) took part in a repeated measurement design. After an extended baseline period of 3 weeks including repeated magnetoencephalography (MEG) measurements, MI training was embedded within the classical course of physiotherapy for 5 additional weeks (three sessions per week). An immediate MEG post-test and a follow-up at 2 months were performed. Before MI training, compensatory activations and recruitment of deafferented cortical regions characterized the cortical activity during actual and imagined prehension in SCI participants. After MI training, MEG data yielded reduced compensatory activations. Cortical recruitment became similar to that in HP. Behavioral analysis evidenced decreased movement variability suggesting motor learning of tenodesis. Data suggest that MI training participated to reverse compensatory neuroplasticity in SCI participants, and promoted the integration of new upper limb prehensile coordination in the neural networks functionally dedicated to the control of healthy prehension before injury.

Early signs of visual categorization for biological and non-biological stimuli in humans.

In a previous experiment aimed at studying gender processing from faces, we had found unexpected early ERP differences (45-85 ms) in task-irrelevant stimuli between a condition in which the stimuli of each gender were delivered in separate runs, and a condition in which the stimuli of both genders were mixed. Similar effects were observed with hand stimuli. These early ERP differences were tentatively related to incidental categorization processes between male and female stimuli. The present study was designed to test the robustness of these early effects for faces, and to examine whether similar effects can also be generated between two classes of non-biological stimuli. We replicated the previous findings for faces, and found similar early differential effects (50-65 ms) for non-biological stimuli (grey and hatched geometrical shapes) only, however, when the two shape categories were separated by conspicuous visual characteristics. While these results can partly be explained by phenomena related to neuronal habituation in the visual cortex, they may also suggest the existence of coarse and automatic categorization processes for rapid distinction between two wide classes of stimuli with strong psychosocial significance for humans.

Time course evolution of ventilatory responses to inspiratory unloading in patients.

Inspiratory muscle unloading decreases ventilatory drive. In this study, we examined the time course of this effect in patients with chronic obstructive pulmonary disease receiving two modes of ventilatory support: pressure support ventilation (PSV), during which each cycle was assisted, and biphasic positive airway pressure (BIPAP), set up in such a manner that one spontaneous breath took place between two consecutive pressure-assisted breaths. The first breath following the switch from spontaneous breathing to PSV was associated with an increase in tidal volume (VT) and a drop in mean transdiaphragmatic pressure (mean Pdi) and inspiratory work (WI) performed per liter but with unchanged values of esophageal occlusion pressure at 100 ms (Pes 0.1), diaphragmatic electrical activity (EMGdi), and WI performed by breath. The same phenomena were observed for the assisted breath of BIPAP as compared with the preceding spontaneous breath. During the subsequent breaths of PSV, Pes 0.1, EMGdi, and WI performed per breath decreased progressively up to the sixth to eighth breaths, and VT returned to pre-PSV values. We conclude that in patients with chronic obstructive pulmonary disease the decrease in ventilatory drive associated with PSV takes place from the first breath onwards but requires six to eight breaths to be fully achieved. During BIPAP, as a consequence of the kinetics of the PSV-induced downregulation of ventilatory drive, assisted breaths following spontaneous breaths are characterized by an enhanced inspiratory efficiency.

Oscillatory gamma-band (30-70 Hz) activity induced by a visual search task in humans.

The coherent representation of an object in the visual system has been suggested to be achieved by the synchronization in the gamma-band (30-70 Hz) of a distributed neuronal assembly. Here we measure variations of high-frequency activity on the human scalp. The experiment is designed to allow the comparison of two different perceptions of the same picture. In the first condition, an apparently meaningless picture that contained a hidden Dalmatian, a neutral stimulus, and a target stimulus (twirled blobs) are presented. After the subject has been trained to perceive the hidden dog and its mirror image, the second part of the recordings is performed (condition 2). The same neutral stimulus is presented, intermixed with the picture of the dog and its mirror image (target stimulus). Early (95 msec) phase-locked (or stimulus-locked) gamma-band oscillations do not vary with stimulus type but can be subdivided into an anterior component (38 Hz) and a posterior component (35 Hz). Nonphase-locked gamma-band oscillations appear with a latency jitter around 280 msec after stimulus onset and disappear in averaged data. They increase in amplitude in response to both target stimuli. They also globally increase in the second condition compared with the first one. It is suggested that this gamma-band energy increase reflects both bottom-up (binding of elementary features) and top-down (search for the hidden dog) activation of the same neural assembly coding for the Dalmatian. The relationships between high- and low-frequency components of the response are discussed, and a possible functional role of each component is suggested.

Stimulus specificity of phase-locked and non-phase-locked 40 Hz visual responses in human.

Considerable interest has been raised by non-phase-locked episodes of synchronization in the gamma-band (30-60 Hz). One of their putative roles in the visual modality is feature-binding. We tested the stimulus specificity of high-frequency oscillations in humans using three types of visual stimuli: two coherent stimuli (a Kanizsa and a real triangle) and a noncoherent stimulus ("no-triangle stimulus"). The task of the subject was to count the occurrences of a curved illusory triangle. A time-frequency analysis of single-trial EEG data recorded from eight human subjects was performed to characterize phase-locked as well as non-phase-locked high-frequency activities. We found in early phase-locked 40 Hz component, maximal at electrodes Cz-C4, which does not vary with stimulation type. We describe a second 40 Hz component, appearing around 280 msec, that is not phase-locked to stimulus onset. This component is stronger in response to a coherent triangle, whether real or illusory: it could reflect, therefore, a mechanism of feature binding based on high-frequency synchronization. Because both the illusory and the real triangle are more target-like, it could also correspond to an oscillatory mechanism for testing the match between stimulus and target. At the same latencies, the low-frequency evoked response components phase-locked to stimulus onset behave differently, suggesting that low- and high-frequency activities have different functional roles.

Ventilatory adjustments during sustained resistive unloading in exercising humans.

Effect of He-O2-breathing (79.1%:20.9%) compared to air-breathing on inspiratory ventilation (VI) and its different components [tidal volume (VT), the duration of the phases of each respiratory cycle (tI, tTOT)] as well as on inspiratory mouth occlusion pressure (P0.1) were studied in six normal men at rest and during 72 constant-load exercises (90 W) over a much longer period than in previous studies. Results showed that, irrespective of the order of administration of the two gases (7 min air----7 min He-O2 or vice versa): at rest, P0.1 decreased during He-O2 inhalation but no changes in VI and breathing pattern were detectable; during exercise, sustained He-induced hyperventilation was observed without any change in the absolute value of P0.1; increase in P0.1 between the resting period and exercise (delta P0.1) was significantly higher during He-O2-breathing than during air breathing; this He-induced hyperventilation was associated with a sustained increase in VT/tI, but with constant tI/tTOT. Helium-breathing during exercise cannot be a simple situation of resistance unloading, as has been suggested. We conclude that He-O2-breathing, after the initial compensation period, induces reflex changes in ventilatory control with an increase in inspiratory neural drive. Moreover, it appears that exercise P0.1 is not a legitimate index of inspiratory neural drive whenever rest P0.1 changes according to the nature of the inhaled gas mixture.

Transverse images of the human thoracic trachea during forced expiration.

The thoracic trachea and the proximal portion of the major bronchi were imaged in five normal volunteers during a forced expiration maneuver using a cine-computer-tomography system. Sixteen images of two contiguous slices were obtained in less than 1 is while expiratory flow was recorded at the mouth. The area of the thoracic trachea decreased rapidly as flow rate rose to its maximum and the wave of collapse propagated distally. The compressive narrowing of both the pars membranacea and the ventrolateral wall was asymmetric. A contact area appeared between the posterior and the left lateral walls. In one subject the trachea was imaged during the entire maneuver with a lower scan frequency. By 725 ms after the beginning of the forced expiration, the area had first decreased to 15% of its initial value and then reincreased to 46% of its initial value. It stayed constant for the remainder of the maneuver. The measured maximum air velocity was greater than the estimated local wave velocity.

A finite-element model of tracheal collapse.

The trachea has been approximated by an appropriate finite-element model. The three-dimensional equilibrium problems set by the tracheal deformation under various stresses have been solved using a convenient augmented Lagrangian functional. The dimensions were obtained from human tracheae. Mechanical constants for the anatomic components were calculated from the stress-strain relationships. The compressive narrowing is essentially due to the invagination of the posterior membrane in the tracheal lumen for transmural pressures down to -7 kPa. A surface of contact between the membranous wall and the lateral walls appears when the transmural pressure equals -6 kPa. The transmural pressure-area relationship is sigmoidal with a compliance equal to 0.08 kPa-1 for a transmural pressure of -2 kPa. The tracheal collapse is greater when the material constants of the membranous wall decrease or when the tracheal segment is subjected to a longitudinal tension. A slight flexion of the trachea induces an asymmetric deformation.

A transducer for measuring high frequency oscillatory flow rates.

Recent systems proposed in the literature to accurately measure flow rates at high frequency, such as the wave tube technique or the loudspeaker technique, are not adequate for large amplitude oscillations. Other standard pneumotachometer systems require analytical or numerical correction procedures. In this study, we propose a low cost, rapid response flowmeter for high and low flow rates, made up of a standard screen pneumotachometer coupled with a piezoresistive differential pressure transducer of recent conception. By reference to a gas capacitance, the frequency response of this device is compared to the frequency response obtained with the same screen pneumotachometer coupled with a standard low range medical pressure transducer. Contrary to the standard device, the new device has a flat amplitude response up to 70 Hz and introduces a minimal phase delay up to 90 Hz (9 degrees), both with a 1.51.s-1 constant peak flow and a peak flow rate two times greater. The authors suggest that this improved flowmeter can be advantageously used in physiological studies requiring accurate high frequency flow measurements over short periods of time.

Dependence of central airway resistance on frequency and tidal volume: a model study.

The resistance of a hollow cast of human central airways was measured during true sinusoidal airflow oscillations over a wide range of frequencies (0.5-40 Hz) and for various flow amplitudes up to 8 l/s. Pressure and flow were measured in the trachea with high-performance transducers, digitized and averaged over 100 cycles. Data were studied at two points in the flow cycle: at peak inspiratory and expiratory flows and in the two neighborhoods around zero flow where airway resistance (Rv approximately equal to o) was taken as the average slope of the pressure-flow (P-V) curve in each zone. When data obtained near peak flow were plotted in terms of dimensionless pressure drop vs. peak Reynolds number (Rem) and compared with steady-state data, we found no difference up to 2 Hz as previously reported (Isabey and Chang, J. Appl. Physiol. 51: 1338-1348, 1981), a slight decay in pressure drop between 4 and 8 Hz, a frequency-dependent increase in peak flow resistance at high frequencies (10-40 Hz) governed by the Strouhal number alpha 2/Rem beyond alpha 2/Rem = 0.5. On the other hand RV approximately equal to o was found to increase relative to steady state as local acceleration increases, e.g., as peak flow increases at a fixed frequency; this differs from the classical linear theory of oscillatory flow in a long straight tube. To explain these results, we had to use, as in our previous study, an alternative expression for the Strouhal number, i.e., epsilon = L X A X (dV/dt)/V2 (where L and A are the length and cross-sectional area of the trachea and V is a constant flow range over which resistance around flow reversal was computed), which accurately reflects the ratio of local acceleration [d(V/A)/dt)] to convective acceleration [(V/A)2/L] in developing branching flow. Finally, to delineate the regions of dominance of each of the dimensionless parameters, we compiled frequency-tidal volume diagrams for peak flows as well as for reversal. Epsilon, which is negligible near peak flows, appeared to govern the oscillatory P-V relationship near flow reversal in a transitional region of the diagram located between regions of steadiness, or moderate unsteadiness, and a region of dominant unsteadiness governed by alpha.

[A macrotome for the sampling of frozen or fixated tissues]. / Un macrotome pour l'échantillonnage des tissus congelés ou fixés.

The tool presented here is a cutter for systematized random sampling. The cutting by the means of parallel blades provides 2,3 mm thick sections, which are dropped automatically, avoiding any further handling for gathering them. In addition to its use in stereology, this cutter yields specimens suitable for incubation in histochemical studies.