Antisaccade deficit after anterior cingulate cortex resection.

Suppression of unwanted reflexive saccades is a crucial process allowing to sustain voluntary fixation, when required. This inhibition process, which is mainly controlled by the dorsolateral prefrontal cortex, may also involve other cortical and subcortical structures. We prospectively studied the effect of frontal cortical resections involving adjacent regions to the anterior cingulate cortex on the ability to inhibit reflexive saccades. This lesion study included six patients undergoing resection of frontal low grade gliomas, studied prior and after surgery with electro-oculography, using the antisaccade paradigm. Lesions were normalized and mapped in Talairach space allowing to detail the structures whose lesions were associated with antisaccade deficits. In three of the six patients significant early post-operative antisaccade errors were associated with resection of a common critical region, mainly involving the posterior part of the anterior cingulate cortex. This same region was spared in the three remaining patients with no antisaccade deficit, suggesting that the anterior cingulate cortex, known as the cingulate eye field, could play a role in suppression of unwanted saccades.

Localization of human frontal eye fields: anatomical and functional findings of functional magnetic resonance imaging and intracerebral electrical stimulation.

OBJECT: The goal of this study was to investigate the anatomical localization and functional role of human frontal eye fields (FEFs) by comparing findings from two independently conducted studies. METHODS: In the first study, 3-tesla functional magnetic resonance (fMR) imaging was performed in 14 healthy volunteers divided into two groups: the first group executed self-paced voluntary saccades in complete darkness and the second group repeated newly learned or familiar sequences of saccades. In the second study, intracerebral electrical stimulation (IES) was performed in 38 patients with epilepsy prior to surgery, and frontal regions where stimulation induced versive eye movements were identified. These studies showed that two distinct oculomotor areas (OMAs) could be individualized in the region classically corresponding to the FEFs. One OMA was consistently located at the intersection of the superior frontal sulcus with the fundus of the superior portion of the precentral sulcus, and was the OMA in which saccadic eye movements could be the most easily elicited by electrical stimulation. The second OMA was located more laterally, close to the surface of the precentral gyrus. The fMR imaging study and the IES study demonstrated anatomical and stereotactic agreement in the identification of these cortical areas. CONCLUSIONS: These findings indicate that infracentimetric localization of cortical areas can be achieved by measuring the vascular signal with the aid of 3-tesla fMR imaging and that neuroimaging and electrophysiological recording can be used together to obtain a better understanding of the human cortical functional anatomy.

Human cortical networks for new and familiar sequences of saccades.

Visual exploration is organized in sequences of saccadic eye movements that depend on both perceptual and cognitive context. Using functional magnetic resonance imaging, we studied the neural basis of sequential oculomotor behavior and its dependence on different types of memory by analyzing cerebral activity during performance of newly learned and familiar sequences of eye movements. Compared to a resting condition, both types of sequences activated a common fronto-parietal network, including frontal and supplementary eye fields, and several parietal areas. Within this network, newly learned sequences induced stronger activation than familiar sequences, probably reflecting higher attentional demands. In addition, specific regions were recruited for the performance of new sequences, including pre-supplementary eye fields, the precuneus and the caudate nucleus. This indicates that in addition to attentional modulation, novelty of saccadic sequences requires specific cortical resources, probably related to effortful sequence preparation and coordination as well as to spatial working memory. For familiar sequences, recalled from long-term memory, we observed specific right medial temporo-occipital activation in the vicinity of the boundary between the parahippocampal and lingual gyri, as well as an activation site in the parieto-occipital fissure. We conclude that neuronal resources recruited by the gaze system can change with the familiarity of the scanpath to be executed. This study is important to better understand how the brain implements memorized scanpaths for visual exploration and orienting.

The neural basis of egocentric and allocentric coding of space in humans: a functional magnetic resonance study.

The spatial location of an object can be represented in the brain with respect to different classes of reference frames, either relative to or independent of the subject's position. We used functional magnetic resonance imaging to identify regions of the healthy human brain subserving mainly egocentric or allocentric (object-based) coordinates by asking subjects to judge the location of a visual stimulus with respect to either their body or an object. A color-judgement task, matched for stimuli, difficulty, motor and oculomotor responses, was used as a control. We identified a bilateral, though mainly right-hemisphere based, fronto-parietal network involved in egocentric processing. A subset of these regions, including a much less extensive unilateral, right fronto-parietal network, was found to be active during object-based processing. The right-hemisphere lateralization and the partial superposition of the egocentric and the object-based networks is discussed in the light of neuropsychological findings in brain-damaged patients with unilateral spatial neglect and of neurophysiological studies in the monkey.

Visual perception of motion and 3-D structure from motion: an fMRI study.

Functional magnetic resonance imaging was used to study the cortical bases of 3-D structure perception from visual motion in human. Nine subjects underwent three experiments designed to locate the areas involved in (i) motion processing (random motion versus static dots), (ii) coherent motion processing (expansion/ contraction versus random motion) and (iii) 3-D shape from motion reconstruction (3-D surface oscillating in depth versus random motion). Two control experiments tested the specific influence of speed distribution and surface curvature on the activation results. All stimuli consisted of random dots so that motion parallax was the only cue available for 3-D shape perception. As expected, random motion compared with static dots induced strong activity in areas V1/V2, V5+ and the superior occipital gyrus (SOG; presumptive V3/V3A). V1/V2 and V5+ showed no activity increase when comparing coherent motion (expansion or 3-D surface) with random motion. Conversely, V3/V3A and the dorsal parieto-occipital junction were highlighted in both comparisons and showed gradually increased activity for random motion, coherent motion and a curved surface rotating in depth, which suggests their involvement in the coding of 3-D shape from motion. Also, the ventral aspect of the left occipito-temporal junction was found to be equally responsive to random and coherent motion stimuli, but showed a specific sensitivity to curved 3-D surfaces compared with plane surfaces. As this region is already known to be involved in the coding of static object shape, our results suggest that it might integrate various cues for the perception of 3-D shape.

An anatomical landmark for the supplementary eye fields in human revealed with functional magnetic resonance imaging.

Together with the frontal and parietal eye fields, the supplementary eye field (SEF) is involved in the performance and control of voluntary and reflexive saccades and of ocular pursuit. This region was first described in non-human primates and is rather well localized on the dorsal surface of the medial frontal cortex. In humans the site of the SEF is still ill-defined. Functional imaging techniques have allowed investigation of the location and function of the SEF. However, there is great variability with regard to the published standardized coordinates of this area. We used here the spatial precision of functional magnetic resonance imaging (fMRI) in order to better localize the SEF in individuals. We identified as the SEF a region on the medial wall that was significantly activated when subjects executed self-paced horizontal saccades in darkness as compared to rest. This region appeared to be predominantly activated in the left hemisphere. We found that, despite a discrepancy of >2 cm found in the standardized Talairach coordinates, the location of this SEF-region could be precisely and reliably described by referring to a sulcal landmark found in each individual: the upper part of the paracentral sulcus.

Cortical areas activated by bilateral galvanic vestibular stimulation.

The brain areas activated by bilateral galvanic vestibular stimulation (GVS) were studied using functional magnetic resonance imaging. In six human volunteers, GVS led to activation in the region of the temporoparietal junction, the central sulcus, and the anterior interior intraparietal sulcus, which may correspond to macaque areas PIVC, 3aV, and 2v, respectively. In addition, activation was found in premotor regions of the frontal lobe, presumably analogous to areas 6pa and 8a in the monkey. Since these areas were not detected in previous studies using caloric vestibular stimulation, they could be related to the modulation of otolith afferent activity by GVS. However, the simple paradigm used did not allow separation of the otolithic and semicircular canal effects of GVS. Further studies must be performed to clarify the question of cortical representation of the otolithic information in the human and monkey brain.

A fronto-parietal system for computing the egocentric spatial frame of reference in humans.

Spatial orientation is based on coordinates referring to the subject's body. A fundamental principle is the mid-sagittal plane, which divides the body and space into the left and right sides. Its neural bases were investigated by functional magnetic resonance imaging (fMRI). Seven normal subjects pressed a button when a vertical bar, moving horizontally, crossed the subjective mid-sagittal plane. In the control condition, the subjects' task was to press a button when the direction of the bar movement changed, at the end of each leftward or rightward movement. The task involving the computation of the mid-sagittal plane yielded increased signal in posterior parietal and lateral frontal premotor regions, with a more extensive activation in the right cerebral hemisphere. This direct evidence in normal human subjects that a bilateral, mainly right hemisphere-based, cortical network is active during the computation of the egocentric reference is consistent with neuropsychological studies in patients with unilateral cerebral lesions. Damage to the right hemisphere, more frequently to the posterior-inferior parietal region, may bring about a neglect syndrome of the contralesional, left side of space, including a major rightward displacement of the subjective mid-sagittal plane. The existence of a posterior parietal-lateral premotor frontal network concerned with egocentric spatial reference frames is also in line with neurophysiological studies in the monkey.

Human taste cortical areas studied with functional magnetic resonance imaging: evidence of functional lateralization related to handedness.

Whole-brain functional magnetic resonance imaging was used to detect local hemodynamic changes reflecting cortical activation in five left handed and five right handed human subjects during bilateral stimulation of the tongue with various tastes. Activation was found bilaterally in the insula and the perisylvian region. These regions correspond to the primary taste cortical areas identified with electrophysiological recordings in monkeys and suggested from former clinical observations in human subjects. Moreover, a unilateral projection was described for the first time in the inferior part of the insula of the dominant hemisphere, according to the subject's handedness.

Functional MRI of galvanic vestibular stimulation.

The cortical processing of vestibular information is not hierarchically organized as the processing of signals in the visual and auditory modalities. Anatomic and electrophysiological studies in the monkey revealed the existence of multiple interconnected areas in which vestibular signals converge with visual and/or somatosensory inputs. Although recent functional imaging studies using caloric vestibular stimulation (CVS) suggest that vestibular signals in the human cerebral cortex may be similarly distributed, some areas that apparently form essential constituents of the monkey cortical vestibular system have not yet been identified in humans. Galvanic vestibular stimulation (GVS) has been used for almost 200 years for the exploration of the vestibular system. By contrast with CVS, which mediates its effects mainly via the semicircular canals (SCC), GVS has been shown to act equally on SCC and otolith afferents. Because galvanic stimuli can be controlled precisely, GVS is suited ideally for the investigation of the vestibular cortex by means of functional imaging techniques. We studied the brain areas activated by sinusoidal GVS using functional magnetic resonance imaging (fMRI). An adapted set-up including LC filters tuned for resonance at the Larmor frequency protected the volunteers against burns through radio-frequency pickup by the stimulation electrodes. Control experiments ensured that potentially harmful effects or degradation of the functional images did not occur. Six male, right-handed volunteers participated in the study. In all of them, GVS induced clear perceptions of body movement and moderate cutaneous sensations at the electrode sites. Comparison with anatomic data on the primate cortical vestibular system and with imaging studies using somatosensory stimulation indicated that most activation foci could be related to the vestibular component of the stimulus. Activation appeared in the region of the temporo-parietal junction, the central sulcus, and the intraparietal sulcus. These areas may be analogous to areas PIVC, 3aV, and 2v, respectively, which form in the monkey brain, the "inner vestibular circle". Activation also occurred in premotor regions of the frontal lobe. Although undetected in previous imaging-studies using CVS, involvement of these areas could be predicted from anatomic data showing projections from the anterior ventral part of area 6 to the inner vestibular circle and the vestibular nuclei. Using a simple paradigm, we showed that GVS can be implemented safely in the fMRI environment. Manipulating stimulus waveforms and thus the GVS-induced subjective vestibular sensations in future imaging studies may yield further insights into the cortical processing of vestibular signals.

Somatotopical organization of striatal activation during finger and toe movement: a 3-T functional magnetic resonance imaging study.

The present study aimed at determining the distribution and somatotopical organization of striatal activation during performance of simple motor tasks. Ten right-handed healthy volunteers were studied by using a 3-T whole-body magnetic resonance unit and echo planar imaging. The tasks consisted of self-paced flexion/extension of the right fingers or toes. Motor activation was found mainly in the putamen posterior to the anterior commissure (10 of 10 subjects) and the globus pallidus (6 subjects), whereas the caudate nucleus was activated in only 3 subjects, and in a smaller area. Thus, performance of a simple motor task activated the sensorimotor territory of the basal ganglia. Within the putamen, there was a somatotopical organization of the foot and hand areas similar to that observed in nonhuman primates. These data suggest that functional magnetic resonance imaging can be used to study normal function of the basal ganglia and should therefore also allow investigation of patients with movement disorders.

Latencies in fMRI time-series: effect of slice acquisition order and perception.

In BOLD fMRI a detailed analysis of the MRI signal time course sometimes shows time differences between different activated regions. Some researchers have suggested that these latencies could be used to infer the temporal order of activation of these cortical regions. Several effects must be considered, however, before interpreting these latencies. The effect of a slice-dependent time shift (SDTS) with multi-slice acquisitions, for instance, may be important for regions located on different slices. After correction for this SDTS effect the time dispersion between activated regions is significantly decreased and the correlation between the MRI signal time course and the stimulation paradigm is improved. Another effect to consider is the latency which may exist between perception and stimulus presentation. It is shown that the control of perception can be achieved using a finger-spanning technique during the fMRI acquisition. The use of this perception profile rather than an arbitrary waveform derived from the paradigm proves to be a powerful alternative to fMRI data processing, especially with chemical senses studies, when return to baseline is not always correlated to stimulus suppression. This approach should also be relevant to other kinds of stimulation tasks, as a realistic way of monitoring the actual task performance, which may depend on attention, adaptation, fatigue or even variability of stimulus presentation.

Post-contact chronic eczema: pension or rehabilitation.

A proportion of patients who suffer from either irritant or allergic contact dermatitis, many of whom have no past or family history of atopy or of any other skin disease, evolve into chronic eczema. Workers' compensation payments are frequently suspended after about 6 to 12 months on the basis of 'endogenous dermatitis'. Patients, often healthy breadwinners in the 30 to 50 age group are deemed unemployable because of persistent active dermatitis. Expensive prolonged litigation frequently follows but the end result is usually a patient who has become a healthy, bored, pensioner/retiree with all the psychological and physical sequelae secondary to inactivity and major lifestyle change. It is now becoming recognized that there are many jobs which a person suffering from various degrees of chronic dermatitis can perform without aggravation of dermatitis. However, widespread acceptance of this tenet requires a change in attitude by all the players in the workers' compensation complex, namely the employer, the insurance company, the medical practitioner, the employee and the union. Fortunately, the emphasis is gradually changing towards multidisciplinary assessment of work potential with appropriate retraining and redeployment of injured workers rather than granting lump sum compensation payouts or pensions.