The Cardiac Rhythm of the Unconscious in a Case of Panic Disorder.

The field of psychodynamic psychotherapy would benefit from a comprehensive model that integrates its constructs with neurobiology. Research on the autonomic nervous system activity during the psychotherapeutic process is necessary because it is key in affective experiences and defensive behavior. The current case study reports physiological findings on heart rate dynamics in a patient suffering from panic disorder during two therapeutic sessions in which we used Davanloo's Intensive Short-term Dynamic Psychotherapy. We looked at various metrics of heart rate variability during the therapeutic process leading to breakthrough of unconscious feelings. The measurements included sympathetic and parasympathetic indices, vagal tone, and their responses. Our results suggest that the sympathetic system activates during defensive responses associated with anxiety and during the passage of unconscious-aggressive impulses. Following the experience of unconscious guilt, there is an increased vagal tone corresponding to the phase of reunification with the attachment figure. Findings are discussed integrating developmental neurobiology and clinical psychodynamics.

Predictors of cardiovascular response to methamphetamine administration in methamphetamine-dependent individuals.

The goal of the present investigation was to determine predictors of cardiovascular response to methamphetamine administrated in the laboratory. Heart rate (HR) and blood pressure (BP) were measured at baseline and at several time points following the administration of methamphetamine or saline placebo. One-way ANOVA was used to determine the differences between female and male subjects in their cardiovascular response. In male subjects, linear regression and one-way ANOVA were used to determine the influence of potential predictors on cardiovascular response, including age, weight, drug use indicators, concurrent use of other substances, route of administration, and race. Methamphetamine administration provoked significant increases in HR and BP, as compared to placebo. Female gender was associated with larger peak change in diastolic BP following administration. Baseline HR and BP were found to be strong predictors of cardiovascular response to methamphetamine administration in male subjects. Lifetime use and recent use of methamphetamine and nicotine did not predict cardiovascular response to methamphetamine. Recent alcohol use was associated with increased peak change in diastolic BP. Also, current use of cannabis was negatively correlated with peak HR change. Male cannabis users show lower peak change in HR as compared to non-cannabis users. As compared to methamphetamine smokers, intravenous users demonstrated higher peak change in diastolic BP following drug administration. Race did not have a significant effect on cardiovascular response. Taken together, these findings may help in the prevention and treatment of cardiovascular events in a population at high risk of premature morbidity and mortality.

Compressed-sensing-based content-driven hierarchical reconstruction: Theory and application to C-arm cone-beam tomography.

PURPOSE: This paper addresses the reconstruction of x-ray cone-beam computed tomography (CBCT) for interventional C-arm systems. Subsampling of CBCT is a significant issue with C-arms due to their slow rotation and to the low frame rate of their flat panel x-ray detectors. The aim of this work is to propose a novel method able to handle the subsampling artifacts generally observed with analytical reconstruction, through a content-driven hierarchical reconstruction based on compressed sensing. METHODS: The central idea is to proceed with a hierarchical method where the most salient features (high intensities or gradients) are reconstructed first to reduce the artifacts these features induce. These artifacts are addressed first because their presence contaminates less salient features. Several hierarchical schemes aiming at streak artifacts reduction are introduced for C-arm CBCT: the empirical orthogonal matching pursuit approach with the ℓ0 pseudonorm for reconstructing sparse vessels; a convex variant using homotopy with the ℓ1-norm constraint of compressed sensing, for reconstructing sparse vessels over a nonsparse background; homotopy with total variation (TV); and a novel empirical extension to nonlinear diffusion (NLD). Such principles are implemented with penalized iterative filtered backprojection algorithms. For soft-tissue imaging, the authors compare the use of TV and NLD filters as sparsity constraints, both optimized with the alternating direction method of multipliers, using a threshold for TV and a nonlinear weighting for NLD. RESULTS: The authors show on simulated data that their approach provides fast convergence to good approximations of the solution of the TV-constrained minimization problem introduced by the compressed sensing theory. Using C-arm CBCT clinical data, the authors show that both TV and NLD can deliver improved image quality by reducing streaks. CONCLUSIONS: A flexible compressed-sensing-based algorithmic approach is proposed that is able to accommodate for a wide range of constraints. It is successfully applied to C-arm CBCT images that may not be so well approximated by piecewise constant functions.

Compressed sensing dynamic reconstruction in rotational angiography.

This work tackles three-dimensional reconstruction of tomographic acquisitions in C-arm-based rotational angiography. The relatively slow rotation speed of C-arm systems involves motion artifacts that limit the use of three-dimensional imaging in interventional procedures. The main contribution of this paper is a reconstruction algorithm that deals with the temporal variations due to intra-arterial injections. Based on a compressed-sensing approach, we propose a multiple phase reconstruction with spatio-temporal constraints. The algorithm was evaluated by qualitative and quantitative assessment of image quality on both numerical phantom experiments and clinical data from vascular C-arm systems. In this latter case, motion artifacts reduction was obtained in spite of the cone-beam geometry, the short-scan acquisition, and the truncated and subsampled data.

Compressed sensing based 3D tomographic reconstruction for rotational angiography.

In this paper, we address three-dimensional tomographic reconstruction of rotational angiography acquisitions. In clinical routine, angular subsampling commonly occurs, due to the technical limitations of C-arm systems or possible improper injection. Standard methods such as filtered backprojection yield a reconstruction that is deteriorated by sampling artifacts, which potentially hampers medical interpretation. Recent developments of compressed sensing have demonstrated that it is possible to significantly improve reconstruction of subsampled datasets by generating sparse approximations through l1-penalized minimization. Based on these results, we present an extension of the iterative filtered backprojection that includes a sparsity constraint called soft background subtraction. This approach is shown to provide sampling artifact reduction when reconstructing sparse objects, and more interestingly, when reconstructing sparse objects over a non-sparse background. The relevance of our approach is evaluated in cone-beam geometry on real clinical data.

Clustering of the human skeletal muscle fibers using linear programming and angular Hilbertian metrics.

In this paper, we present a manifold clustering method fo the classification of fibers obtained from diffusion tensor images (DTI) of the human skeletal muscle. Using a linear programming formulation of prototype-based clustering, we propose a novel fiber classification algorithm over manifolds that circumvents the necessity to embed the data in low dimensional spaces and determines automatically the number of clusters. Furthermore, we propose the use of angular Hilbertian metrics between multivariate normal distributions to define a family of distances between tensors that we generalize to fibers. These metrics are used to approximate the geodesic distances over the fiber manifold. We also discuss the case where only geodesic distances to a reduced set of landmark fibers are available. The experimental validation of the method is done using a manually annotated significant dataset of DTI of the calf muscle for healthy and diseased subjects.

Expression profiling of the developing and mature Nrl-/- mouse retina: identification of retinal disease candidates and transcriptional regulatory targets of Nrl.

The rod photoreceptor-specific neural retina leucine zipper protein Nrl is essential for rod differentiation and plays a critical role in regulating gene expression. In the mouse retina, rods account for 97% of the photoreceptors; however, in the absence of Nrl (Nrl-/-), no rods are present and a concomitant increase in cones is observed. A functional all-cone mouse retina represents a unique opportunity to investigate, at the molecular level, differences between the two photoreceptor subtypes. Using mouse GeneChips (Affymetrix), we have generated expression profiles of the wild-type and Nrl-/- retina at three time-points representing distinct stages of photoreceptor differentiation. Comparative data analysis revealed 161 differentially expressed genes; of which, 78 exhibited significantly lower and 83 higher expression in the Nrl-/- retina. Hierarchical clustering was utilized to predict the function of these genes in a temporal context. The differentially expressed genes primarily encode proteins associated with signal transduction, transcriptional regulation, intracellular transport and other processes, which likely correspond to differences between rods and cones and/or retinal remodeling in the absence of rods. A significant number of these genes may serve as candidates for diseases involving rod or cone dysfunction. Chromatin immunoprecipitation assay showed that in addition to the rod phototransduction genes, Nrl might modulate the promoters of many functionally diverse genes in vivo. Our studies provide molecular insights into differences between rod and cone function, yield interesting candidates for retinal diseases and assist in identifying transcriptional regulatory targets of Nrl.