[ and Riding as Well? Case Report about the Treatment of an Infant with Unresponsive Wakefulness Syndrome]. / und jetzt auch noch reiten? Fallbericht zur Behandlung eines Kleinkindes im Syndrom reaktionsloser Wachheit.

BACKGROUND: There is a growing number of children surviving birth complications with severe, multiple disabilities. Unfortunately, this is not paralleled by equal growth in knowledge about adequate therapeutic approaches. Some publications showed that Hippotherapy could, under certain circumstances, be a very useful complimentary therapy for a range of disabilities. But it remains unclear if riding could even help a quadriplegic individual with multiple brain damage and tracheal ventilation. METHOD: In this case study we examined the effect of horse riding on the mobility of joints and heart rate in a little girl with multiple disabilities. RESULTS: We found a statistically significant increase in joint mobility and a significant decrease in the heart-rate (down to a normal resting frequency). We also had a rather unexpected effect of the hippotherapy. Namely, while on horseback, the girl demonstrated a sufficient spontaneous breathing. No additional oxygen was needed. CONCLUSION: Horse-back riding helped our patient to reduce her symptoms. Therefore, it showed clear positive effects even for a girl with severe and multiple disabilities.

People matter: Perceived sender identity modulates cerebral processing of socio-emotional language feedback.

How do human brains integrate content with social context in communication? Recent research demonstrates that the perceived communicative embedding of perceptually identical language messages alters their cortical processing. When emotional trait-adjectives are perceived as human-generated personality feedback, event-related brain potentials are considerably larger than when the same adjectives are perceived as random computer-generated feedback. Here, we investigate the unique role of ascribed sender humanness for the underlying neural mechanisms. Participants were told that they were going to receive written positive, negative, or neutral feedback from an unknown stranger or from a socially intelligent computer system while high-density EEG was recorded. In the event-related potential (ERP), feedback from the 'human sender' elicited larger P2, Early Posterior Negativity (EPN), P3, and Late Positive Potential (LPP) components. The sources of this activity were localized in extended visual cortex, but also in the right superior frontal gyri, related to mentalizing about others, and the bilateral postcentral gyri implicated in embodied language processing. For emotional feedback, larger EPN, P3 and LPP amplitudes were also observed, resulting from enhanced activity in visual and temporal regions. Finally, for the EPN an interaction between sender and emotion was found, showing substantially increased visual processing of human-generated emotional feedback. These data confirm visual amplification effects induced by motivated attention but crucially also reveal distinct effects of perceiving a communication partner as human that activate 'social brain' structures. Obviously who is perceived as saying something can be as relevant as what is said and induce specific brain activity.

Pro- and antisaccades in children elicited by visual and acoustic targets - does modality matter?

BACKGROUND: Children are able to inhibit a prepotent reaction to suddenly arising visual stimuli, although this skill is not yet as pronounced as it is in adulthood. However, up to now the inhibition mechanism to acoustic stimuli has been scarcely investigated METHODS: Reflexive (prosaccade) and inhibitory (antisaccade) responses to visual and acoustic targets were examined with an eye tracker system in 31 children between seven and twelve years of age using a gap-overlap task and two target eccentricities. RESULTS: Acoustically cued saccades had longer reaction times than visually cued saccades. A gap effect (i.e., shorter reaction time in the gap than the overlap condition) was only found for visually elicited saccades, whereas an eccentricity effect (i.e., faster saccades to more laterally presented targets - 12° vs. 6° or rather 90° vs. 45°) was only present in the acoustic condition. Longer reaction times of antisaccades compared to prosaccades were found only in the visual task. Across both tasks the typical pattern of elevated error rates in the antisaccade condition was found. Antisaccade errors declined with age, indicating an ongoing development of inhibitory functions. CONCLUSIONS: The present results lay the ground for further studies of acoustically triggered saccades in typically as well as atypically developing children and it might thus be possible to upgrade physiological diagnostic tools.

Medio-frontal and anterior temporal abnormalities in children with attention deficit hyperactivity disorder (ADHD) during an acoustic antisaccade task as revealed by electro-cortical source reconstruction.

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent disorders in children and adolescence. Impulsivity is one of three core symptoms and likely associated with inhibition difficulties. To date the neural correlate of the antisaccade task, a test of response inhibition, has not been studied in children with (or without) ADHD. METHODS: Antisaccade responses to visual and acoustic cues were examined in nine unmedicated boys with ADHD (mean age 122.44 ± 20.81 months) and 14 healthy control children (mean age 115.64 ± 22.87 months, three girls) while an electroencephalogram (EEG) was recorded. Brain activity before saccade onset was reconstructed using a 23-source-montage. RESULTS: When cues were acoustic, children with ADHD had a higher source activity than control children in Medio-Frontal Cortex (MFC) between -230 and -120 ms and in the left-hemispheric Temporal Anterior Cortex (TAC) between -112 and 0 ms before saccade onset, despite both groups performing similarly behaviourally (antisaccades errors and saccade latency). When visual cues were used EEG-activity preceding antisaccades did not differ between groups. CONCLUSION: Children with ADHD exhibit altered functioning of the TAC and MFC during an antisaccade task elicited by acoustic cues. Children with ADHD need more source activation to reach the same behavioural level as control children.

Processing of emotional adjectives: Evidence from startle EMG and ERPs.

Affective startle modulation in the electromyographic (EMG), auditory startle evoked potentials, and visually evoked potentials (VEPs) were assessed while subjects evaluated pleasant, unpleasant, and neutral adjectives. Acoustic startle probes were presented at random time points 2.5-4.0 s after word onset. The visual P2 and P3 potentials were generally larger during processing of emotional than of neutral adjectives. In contrast, the late positive component was enhanced and was correlated with larger EMG startle responses and auditory startle evoked potential P3 amplitudes for pleasant words only. During internal cognitive activity, the startle reflex represents a measure of "processing interrupt." Thus the startle tone interrupted processing of particularly pleasant adjectives and caused re-alerting to environmental stimuli. Specific effects for pleasant material may arise from a "positivity offset," favoring responses to pleasant material at lower arousal levels.

Cerebral lateralization in schizophrenia and dyslexia: neuromagnetic responses to auditory stimuli.

Many studies have shown altered hemispheric asymmetry-particularly in perisylvian regions-in schizophrenia patients as well as in individuals with dyslexia. Here we explore the similarity of these findings comparing the localization of the magnetic auditory N100m to the German syllable [ba:] in schizophrenia patients, dyslexic adults, and healthy control subjects. Control subjects showed the typical finding of more anterior sources in the right than in the left perisylvian region. In contrast, both schizophrenia patients and dyslexic subjects displayed a symmetrical N100m source configuration. While in people with dyslexia the alteration appears to originate in the right hemisphere, left-hemispheric deviations might contribute to reduced asymmetry in schizophrenia patients. Our results indicate that an absence of lateralized auditory responses in the temporal lobes may reflect a common deviance present in dyslexia and schizophrenia. The nonspecific finding of reduced cerebral laterality may be accounted for by population-specific differences in the functional organization of perisylvian sites.

Ear of stimulation determines schizophrenia-normal brain activity differences in an auditory paired-stimuli paradigm.

Schizophrenia patients have abnormalities of auditory information processing, theoretically associated with dysfunction of neuronal excitation. Auditory paired-stimuli (S1-S2) paradigms are used to evaluate the nature of these abnormalities. It is unknown whether patients' abnormalities during S1-S2 paradigms are attributable to specific hemispheric differences in cortical processing. The present studies used whole head magnetoencephalography and monaural or binaural versions of the paired-stimuli paradigm to evaluate auditory processing among 38 schizophrenia and 38 normal subjects. The strengths of auditory-evoked brain responses over time were quantified using distributed source reconstructions with L2 minimum norm constraint and realistic head models. For left ear stimuli, schizophrenia and normal groups did not differ on either left or right hemisphere activity over auditory cortex. For right ear and binaural stimuli, schizophrenia patients had less activity over left auditory cortex from 80 to 120 ms post-stimulus but did not differ from normal on activity over right auditory cortex. Additionally, in response to monaural stimulation, schizophrenia patients had significantly less activity than normal over right temporal parietal junction from 60 to 120 ms post-stimulus. These data are consistent with four propositions about schizophrenia: (i). right auditory cortex is functioning normally; (ii). processing of simple auditory stimuli is abnormal in left auditory cortex, probably specifically in supra-granular layers; (iii). auditory localization abilities are deficient; and (iv). auditory cortex abnormalities are not a function of deficient hemispheric communication because they are evident early in processing as long as stimuli are delivered directly to left hemisphere.

Source distribution of neuromagnetic slow-wave activity in schizophrenic patients--effects of activation.

When slow waves in the EEG delta and theta frequency range appear in the waking state, they may indicate pathological conditions including psychopathology. The generators of focal slow waves can be mapped using magnetic source imaging. The resulting brain maps may possibly characterize dysfunctional brain areas. The present study examined the stability of the density and distribution of MEG slow waves during three conditions-rest, mental arithmetic and imagery-in 30 schizophrenic patients and 17 healthy controls. Schizophrenic patients displayed a higher density of delta and theta generators primarily in temporal and parietal areas. The group difference was not affected by the particular conditions. The focal concentration of delta and theta slow waves did not differ between patients with and without neuroleptic medication, whereas the prominence of theta dipoles in the temporal area correlated with neuroleptic dosage. The relative amount of temporal slow waves was correlated with the negative symptoms score (PANSS-N) suggesting that temporal dysfunction may be related to negative symptomatology.Results suggest that the distribution of slow-wave activity, measured in a standardized setting, might add diagnostic information about brain abnormalities in schizophrenia.