Imaging the Spatiotemporal Dynamics of Cognitive Processes at High Temporal Resolution.

This letter presents a noninvasive imaging technique that captures the exact timing and locations of cortical activity sequences that are specific to a cognitive process. These precise spatiotemporal sequences can be detected in the human brain as specific time-position pattern associated with a cognitive task. They are consistent with direct measurements of population activity recorded in nonhuman primates, thus suggesting that specific time-position patterns associated with a cognitive task can be identified. This imaging technique is based on estimating the amplitude of cortical current dipoles from MEG recordings. Although the spatial resolution of these estimations is poor (approximately 2 cm), the temporal resolution is high (milliseconds). We show that within these cortical current dipoles, time points of cortical activation can be identified as brief amplitude undulations and that sequences of these transients repeat with millisecond accuracy, hence making it possible to treat the timing of these transients as point processes. We illustrate the feasibility of finding spatiotemporal templates specific to the cognitive processes associated with following the rhythm of drumbeats that involve the activation at multiple cortical and cerebellar loci. These templates evolve at an accuracy of a few milliseconds. This approach can thus pave the way for new perspectives on the relationships between brain dynamics and cognition.

Revealing instances of coordination among multiple cortical areas.

Cognitive functions must involve interactions between several (perhaps many) cortical regions. The instances of such interactions may not be tightly time locked to any external cue. Thus averaging over repeated trials of brain activity or its spectrograms may miss these instances. Here, coordinated activity among multiple cortical locations is revealed in ongoing activity with millisecond accuracy without the need for averaging over time or frequencies. This is based on reconstructions of the cortical current dipole amplitudes at multiple points from MEG recordings. In these current dipole traces, instances of brief activity undulations (BAUs) are automatically detected and used to reveal where and when cortical points interact. The article shows that these BAUs truly represent the reorganization of activity at the cortex and are strongly connected to behavior.

Extracting cortical current dipoles from MEG recordings.

A novel way of using synthetic aperture magnetometry to extract local current dipoles is proposed. This method is used to extract the current-dipoles at multiple points in the cortex. It is shown that in this way the correlation between cortical points is lower and falls faster with distance when compared to the original MEG and other methods. Evoked auditory responses are well localized. They show higher signal to noise ratio and are more reproducible then the MEG evoked fields.

Cleaning MEG artifacts using external cues.

Using EEG, ECoG, MEG, and microelectrodes to record brain activity is prone to multiple artifacts. The main power line (mains line), video equipment, mechanical vibrations and activities outside the brain are the most common sources of artifacts. MEG amplitudes are low, and even small artifacts distort recordings. In this study, we show how these artifacts can be efficiently removed by recording external cues during MEG recordings. These external cues are subsequently used to register the precise times or spectra of the artifacts. The results indicate that these procedures preserve both the spectra and the time domain wave-shapes of the neuromagnetic signal, while successfully reducing the contribution of the artifacts to the target signals without reducing the rank of the data.

Sensitivity of global network dynamics to local parameters versus motif structure in a cortexlike neuronal model.

In the field of network dynamics it has been suggested that statistical information of motifs, small subnetworks, can help in understanding global activity of the entire network. We present a counterexample where the relation between the stable synchronized activity modes and network connectivity was studied using the Hodgkin-Huxley brain dynamics model. Simulations indicate that small motifs of three nodes exhibit different synchronization modes depending on their local parameters such as delays, synaptic strength, and external drives. Thus the activity of a complex network composed of interconnected motifs cannot be extracted from the activity mode of each individual motif and is governed by local parameters. Finally, we exemplify how local dynamics ultimately enriches the ability of a network to generate diverse modes with a given motif structure.

Minimally important difference in diffuse systemic sclerosis: results from the D-penicillamine study.

OBJECTIVE: To estimate minimally important differences (MIDs) in scores for the modified Rodnan Skin Score (mRSS) and Health Assessment Questionnaire-Disability Index (HAQ-DI) in a clinical trial on diffuse systemic sclerosis (SSc). PARTICIPANTS AND METHODS: 134 people participated in a 2-year, double-blind, randomised clinical trial comparing efficacy of low-dose and high-dose D-penicillamine in diffuse SSc. At 6, 12, 18 and 24 months, the investigator was asked to rate the change in the patient's health since entering the study: markedly worsened, moderately worsened, slightly worsened, unchanged, slightly improved, moderately improved or markedly improved. Patients who were rated as slightly improved were defined as the minimally changed subgroup and compared with patients rated as moderately or markedly improved. RESULTS: The MID estimates for the mRSS improvement ranged from 3.2 to 5.3 (0.40-0.66 effect size) and for the HAQ-DI from 0.10 to 0.14 (0.15-0.21 effect size). Patients who were rated to improve more than slightly were found to improve by 6.9-14.2 (0.86-1.77 effect size) on the mRSS and 0.21-0.55 (0.32-0.83 effect size) on the HAQ-DI score. CONCLUSION: MID estimates are provided for improvement in the mRSS and HAQ-DI scores, which can help in interpreting clinical trials on patients with SSc and be used for sample size calculation for future clinical trials on diffuse SSc.

On embedding synfire chains in a balanced network.

We investigate the formation of synfire waves in a balanced network of integrate-and-fire neurons. The synaptic connectivity of this network embodies synfire chains within a sparse random connectivity. This network can exhibit global oscillations but can also operate in an asynchronous activity mode. We analyze the correlations of two neurons in a pool as convenient indicators for the state of the network. We find, using different models, that these indicators depend on a scaling variable. Beyond a critical point, strong correlations and large network oscillations are obtained. We looked for the conditions under which a synfire wave could be propagated on top of an otherwise asynchronous state of the network. This condition was found to be highly restrictive, requiring a large number of neurons for its implementation in our network. The results are based on analytic derivations and simulations.

Trial to trial variability in either stimulus or action causes apparent correlation and synchrony in neuronal activity.

In this report we show that the observed inter-neuronal correlation reflects a superposition of correlations associated with the intrinsic correlation between neurons, and correlations associated with variability in the stimuli presented to, or the actions performed by, the subject. We argue that the effects of either stimulus or action variability on the observed correlation, though generally ignored, can be substantial. Specifically, we demonstrate how observed correlations are effected by trial to trial variability in either stimulus or action. In addition, assuming that all relevant stimuli and actions are known, we outline a method for eliminating their effects on the observed correlation. It is also shown that tuning of correlations to a stimulus or an action might be a direct consequence of variability in that stimulus or action, even in the absence of any modulation of direct inter-neuronal interaction. The effects of stimulus and action variability should therefore be carefully considered when designing and interpreting experiments involving multi-neuronal recordings.

Women's pursuit of personal goals in daily life with fibromyalgia: a value-expectancy analysis.

Eighty-nine women with fibromyalgia completed the Life Orientation Test, identified health and social goals, and answered questions from the Goal Systems Assessment Battery (P. Karoly & L. Ruehlman, 1995) about their valuation of, and self-efficiency in attaining, each goal. For 30 days, they responded to palm-top computer interviews about their pain and fatigue and rated their goal effort, goal progress, and pain- and fatigue-related goal barriers. Goal barriers increased and goal efforts and progress decreased on days with greater pain and fatigue; goals valued more highly were pursued more effortfully and successfully; more optimistic individuals were less likely to perceive goal barriers and, on days that were more fatiguing than usual, were less likely to reduce their effort and to retreat from progress in achieving their health goal; and more pessimistic individuals perceived greater goal barriers on days that were less painful than usual.

Effects of the American College of Rheumatology systemic sclerosis trial guidelines on the nature of systemic sclerosis patients entering a clinical trial.

OBJECTIVES: To compare the systemic sclerosis (SSc) patients entered into the d-penicillamine trial with SSc patients entered into previous controlled SSc trials. It was hypothesized that the d-penicillamine trial patients, who conformed to the American College of Rheumatology (ACR) guidelines for clinical trials in SSc were different from patients entered into previous trials. METHODS: Patients entering a double-blind, randomized trial of low- vs high-dose d-penicillamine were described carefully and completely. Their characteristics were then compared with previously published data on SSc and its treatment. RESULTS: One hundred and thirty-four patients had early [mean duration 9.5 (s.d. 4.2) months], diffuse [skin score 21 (8)] disease. Organ involvement in the patients was as follows: pulmonary 54%, cardiac 20%, joints 38%, muscular 20%. Thirty-three per cent had mild proteinuria and 13% were hypertensive when first seen. Compared with patients in most previous studies, these SSc patients had earlier disease and uniformly had diffuse disease. They had less muscular involvement, less dyspnoea, less abnormal pulmonary function and less cardiac and less renal involvement than patients in earlier studies. CONCLUSIONS: The use of the new ACR guidelines for SSc trials may change the nature of patient populations entering future studies.

Detecting precise firing sequences in experimental data.

A precise firing sequence (PFS) is defined here as a sequence of three spikes with fixed delays (up to some time accuracy Delta), that repeat excessively. This paper provides guidelines for detecting PFSs, verifying their significance through surrogate spike trains, and identifying existing PFSs. The method is based on constructing a three-fold correlation among spikes, estimating the expected shape of the correlation by smoothing, and detecting points for which the correlations significantly protrude above the expected correlation. Validation is achieved by generating surrogate spike trains in which the time of each of the real spikes is randomly jittered within a small time window. The method is extensively tested through application to simulated spike trains, and the results are illustrated with recordings of single units in the frontal cortex of behaving monkeys. Pitfalls which may cause false detection of PFSs, or loss of existing PFSs, include searching for PFSs in which the same neuron participates more than once, and attempting to produce a surrogate with some fixed statistical property.

The Disability Index of the Health Assessment Questionnaire is a predictor and correlate of outcome in the high-dose versus low-dose penicillamine in systemic sclerosis trial.

OBJECTIVE: To explore the clinical implications of a score of > or =1.0 on the Disability Index of the Health Assessment Questionnaire (HAQ DI) at the first patient visit, and to examine the implications of improvement in HAQ DI score over 2 years in a cohort of systemic sclerosis (SSc) patients with diffuse cutaneous scleroderma. METHODS: SSc skin and visceral involvement was assessed in 134 SSc patients with diffuse scleroderma (mean +/- SD disease duration of 10 +/- 4 months) when they entered a multicenter drug trial and again 2 years later. Mortality and the occurrence of scleroderma renal crisis were assessed for a mean +/- SD of 4.0 +/- 1.1 years. Logistic and linear regression analyses were used to examine the relationship of the baseline HAQ DI score to morbidity, mortality, and visceral involvement, as well as the relationship of changes in the HAQ DI score to changes in physical examination, laboratory, and functional variables over 2 years. RESULTS: A baseline HAQ DI score of > or =1.0 was predictive of mortality (odds ratio 3.22, 95% confidence interval 1.097-9.468) over 4 years. Multivariate linear regression demonstrated that a model which included the erythrocyte sedimentation rate at baseline (P = 0.005) and changes at 2 years in the swollen joint count (P = 0.002), total skin score (P = 0.005), and white blood cell count (P = 0.005) best explained the change in HAQ DI score over 2 years (R2 = 0.528). The HAQ DI score and total skin score at baseline were highly correlated (correlation coefficient 0.368), as were changes in the HAQ DI score and the total skin score over 2 years (correlation coefficient 0.492). Although the HAQ DI score was heavily influenced by hand dysfunction at baseline and at 2 years, improvement (reduction) in the HAQ DI score over 2 years was related to factors other than hand dysfunction. CONCLUSION: A baseline HAQ DI score of > or =1.0 predicted mortality over 4 years. Improvement in the HAQ DI score in these patients with diffuse scleroderma was associated with improvement in skin thickening, hand function, oral aperture, lung function, signs of arthritis, serum creatinine level, and the investigator's global assessment of improvement. The HAQ DI is a self-administered questionnaire that SSc patients can complete easily and rapidly and that gives the practicing physician important information about prognosis, patient status, and changes in disease course over time.

Activity of pallidal and striatal tonically active neurons is correlated in mptp-treated monkeys but not in normal monkeys.

The goal of this study is to assess the function of tonically active neurons (TANs) of the striatum and their malfunction in the parkinsonian state. We recorded multiple spike trains of striatal TANs and pallidal neurons, which are the main target of striatal projections. Recordings were performed in two vervet monkeys before and after the induction of tremulous parkinsonism by systemic injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP). We then calculated cross-correlograms between TANs and pallidal neurons to evaluate the interactions between them. In the normal monkeys, only 1.3% (2/152) of the cross-correlograms displayed significant peaks, and 8.6% (13/152) displayed significant oscillations. After MPTP treatment, 42.8% (83/194) of the cross-correlograms displayed significant peaks or troughs, or both, and 58.8% (114/194) displayed significant 3-19 Hz periodic oscillations. The frequency content of the coherent oscillations matched the frequency content of the activity of individual TANs, but was only weakly related to that of individual pallidal cells. These results confirm the notion that in the normal state neurons in the basal ganglia tend to fire independently, whereas in the parkinsonian state they exhibit synchronized oscillatory activity. The low level of correlated activity in the normal state demonstrates that TANs have only a slight effect on pallidal activity during execution of familiar behavior. The high level of oscillatory correlated activity in the parkinsonian state further suggests that coherent oscillations of the whole basal ganglia circuitry underlie the clinical features of Parkinson's disease.

Skin thickness score as a predictor and correlate of outcome in systemic sclerosis: high-dose versus low-dose penicillamine trial.

OBJECTIVE: To study the clinical implications of a skin thickness score > or =20 at first visit and of softening of sclerodermatous skin in a cohort of systemic sclerosis (SSc) patients with diffuse cutaneous scleroderma. METHODS: Skin and visceral involvement were assessed in 134 SSc patients with diffuse scleroderma (mean +/- SD duration of SSc 10 +/- 4 months) as they entered a multicenter drug trial and again at 2 years of followup. Advent of mortality and scleroderma renal crisis (SRC) were assessed during a followup of 4.0 +/- 1.1 years (mean +/- SD). Logistic and linear regression were used to examine the relationship of baseline skin score to morbidity, mortality, and visceral involvement and the relationship of changes in skin score to changes in physical examination, laboratory, and functional variables over 2 years. RESULTS: A baseline skin score > or =20 was associated with heart involvement at baseline (odds ratio [OR] 3.10, 95% confidence interval [95% CI] 1.25-7.70) and was predictive of mortality (OR 3.59, 95% CI 1.23-10.55) and SRC (OR 10.00, 95% CI 2.21-45.91) over 4 years. Multivariate linear regression demonstrated that a model with skin score at baseline (P = 0.0078) and changes in large joint contractures (P = 0.0072), tender joint counts (P = 0.0119), handspread (P = 0.0242), and Health Assessment Questionnaire disability index (HAQ-DI) (P = 0.0244) explained the change in skin score over 2 years (R2 = 0.567). Multivariate logistic regression demonstrated that the investigator's global assessment of improvement was best explained by a model with skin score and HAQ-DI (R2 = 0.455). CONCLUSION: A baseline skin score > or =20 was associated with heart involvement at baseline and predicted mortality and SRC over the subsequent 4 years. Improvement in skin score in these patients with diffuse cutaneous scleroderma was associated with improvement in hand function, inflammatory indices, joint contractures, arthritis signs, overall functional ability, and the examining investigator's global assessment of improvement.

Correlates of the disability index of the health assessment questionnaire: a measure of functional impairment in systemic sclerosis.

OBJECTIVE: To evaluate functional impairment in systemic sclerosis (SSc) patients with diffuse cutaneous scleroderma at the time of entry into a trial of a therapeutic intervention (D-penicillamine). METHODS: The 20-item Disability Index of the Health Assessment Questionnaire (HAQ-DI) was administered to 134 patients as they entered a multicenter trial of high-dose versus low-dose D-penicillamine. All patients had diffuse SSc of < 18 months' duration. SSc patients who had severe organ system involvement and recent renal crisis and who were receiving prednisone > 10 mg/day were excluded from entry. Logistic regression modeling was used to examine the relationship of HAQ-DI scores to SSc skin and organ system involvement. Odds ratios (OR) and 95% confidence intervals (95% CI) were used to estimate effects. RESULTS: The mean (+/-SD) HAQ-DI score at entry was 1.04 +/- 0.67. Fifty-three percent of patients had HAQ-DI scores > or = 1.0 (signifying moderate-to-severe functional impairment). Multivariate logistic regression demonstrated that impaired fist closure > or = 23 mm (OR 4.24, 95% CI 1.68-10.70), reduced handspread < or = 175 mm (OR 4.5, 95% CI 1.80-11.24), joint tenderness count > or = 1.0 (OR 2.93, 95% CI 1.16-7.40), age > or = 43 years (OR 2.44, 95% CI 1.01-5.95), platelet count > or = 330,000/mm3 (OR 2.30, 95% CI 0.96-5.57), and female sex (OR 2.43, 95% CI 0.77-7.73) were the most important correlates of HAQ-DI scores > or = 1.0. CONCLUSION: Increased HAQ-DI scores at baseline were correlated with reduced fist closure, reduced hand-spread, elevated platelet count, presence of tender joints, older age, and female sex. The most important contributor to functional impairment was hand dysfunction. Even within the first 18 months after SSc onset, moderate-severe functional impairment (HAQ-DI scores > or = 1.0) was frequent (53%) in this group of diffuse SSc patients. In early diffuse SSc, the self-administered HAQ-DI is therefore a valuable assessment of function that correlates with objective physical and laboratory measures of SSc disease involvement. Abnormal HAQ-DI scores may support patient claims of functional impairment, help to focus physician attention on implementing measures to reduce functional impairment, and be useful in reflecting the disease course over time.

Sensory-motor transformation and motor planning in the primate frontal cortex.

To examine the role of the frontal cortex in sensory-motor processing, we trained a Rhesus monkey to perform a behavioral task with alternations between localization (LOC) and non-localization (NL) paradigms. In the LOC block, the monkey had to remember the modality and location of two sequential cues. Two different GO signals instructed the monkey to touch the memorized location of either auditory or visual spatial cues (GO-AUD or GO-VIS, respectively). In the NL paradigm the monkey received the same stimuli, but was instructed to touch a fixed target, disregarding the location and modality of the spatial and GO signals. Reaction time was significantly longer after GO-AUD signals in the LOC mode compared to the reaction time following GO-VIS signals, or in the NL mode. We examined 961 neurons in the frontal cortex and 427 parietal neurons. A group of frontal task-related neurons (72/430; 16.7%) showed evoked activity both after the visual and the GO-AUD stimuli in the LOC mode. The units did not respond to the GO-VIS signal that instructed the monkey to move to the same location, or to the identical stimuli in the NL mode. No such neurons were found in the sampled areas of the parietal cortex. Our findings suggest that the monkey initially planned a default response towards the location of the visual stimulus and immediately updated his motor plans when instructed to touch the memorized location of the auditory stimulus. We suggest that frontal activity may also be related to such modifications of sensory-motor associations.

High-dose versus low-dose D-penicillamine in early diffuse systemic sclerosis: analysis of a two-year, double-blind, randomized, controlled clinical trial.

OBJECTIVE: To test the hypothesis that systemic sclerosis (SSc) patients taking high-dose D-penicillamine (D-Pen) would have greater softening of skin, lower frequency of renal crisis, and better survival than patients taking low-dose D-Pen. METHODS: Seventeen centers enrolled 134 SSc patients with early (< or =18 months) diffuse cutaneous scleroderma into a 2-year, double-blind, randomized comparison of high-dose D-Pen (750-1,000 mg/day) versus low-dose D-Pen (125 mg every other day). All 134 patients were followed up for a mean+/-SD of 4.0+/-1.1 years to assess the frequencies of new-onset scleroderma renal crisis (SRC) and mortality. RESULTS: Sixty-eight patients completed 24 months of drug treatment. The course of the modified Rodnan skin thickness score in the 32 high-dose and the 36 low-dose D-Pen completers was not different at 24 months: the skin score dropped 4.8+/-10.3 (mean+/-SD) units in the high-dose group and 6.9+/-8.4 units in the low-dose group (P = 0.384 by t-test; favoring low-dose D-Pen) from 20.4+/-10.3 in the high-dose and 19.9+/-6.6 in the low-dose D-Pen group at study entry. The incidences of SRC and mortality were not different (P > 0.38 by Cox proportional hazards and by chi-square test) in the 66 high-dose patients (8 developed SRC and 8 died) compared with the 68 low-dose patients (10 developed SRC and 12 died). Of the 20 adverse event-related withdrawals, 80% occurred in the high-dose D-Pen group. CONCLUSION: The course of the skin score and the frequencies of SRC and mortality in the high-dose D-Pen group were not different from those in the low-dose D-Pen group. Eighty percent of the adverse event-related withdrawals occurred in the high-dose D-Pen patients. Although this study cannot answer the question of whether low-dose D-Pen is effective, it does suggest that there is no advantage to using D-Pen in doses higher than 125 every other day.

Frontal cognitive impairments and saccadic deficits in low-dose MPTP-treated monkeys.

There is considerable overlap between the cognitive deficits observed in humans with frontal lobe damage and those described in patients with Parkinson's disease. Similar frontal impairments have been found in the 1-methyl-4-phenyl-1,2,3, 6-tetrahydropyridine (MPTP) primate model of Parkinsonism. Here we provide quantitative documentation of the cognitive, oculomotor, and skeletomotor dysfunctions of monkeys trained on a frontal task and treated with low-doses (LD) of MPTP. Two rhesus monkeys were trained to perform a spatial delayed-response task with frequent alternations between two behavioral modes (GO and NO-GO). After control recordings, the monkeys were treated with one placebo and successive LD MPTP courses. Monkey C developed motor Parkinsonian signs after a fourth course of medium-dose (MD) MPTP and later was treated with combined dopaminergic therapy (CDoT). There were no gross motor changes after the LD MPTP courses, and the average movement time (MT) did not increase. However, reaction time (RT) increased significantly. Both RT and MT were further increased in the symptomatic state, under CDoT. Self-initiated saccades became hypometric after LD MPTP treatments and their frequency decreased. Visually triggered saccades were affected to a lesser extent by the LD MPTP treatments. All saccadic parameters declined further in the symptomatic state and improved partially during CDoT. The number of GO mode (no-response, location, and early release) errors increased after MPTP treatment. The monkeys made more perseverative errors while switching from the GO to the NO-GO mode. Saccadic eye movement patterns suggest that frontal deficits were involved in most observed errors. CDoT had a differential effect on the behavioral errors. It decreased omission errors but did not improve location errors or perseverative errors. Tyrosine hydroxylase immunohistochemistry showed moderate ( approximately 70-80%) reduction in the number of dopaminergic neurons in the substantia nigra pars compacta after MPTP treatment. These results show that cognitive and motor disorders can be dissociated in the LD MPTP model and that cognitive and oculomotor impairments develop before the onset of skeletal motor symptoms. The behavioral and saccadic deficits probably result from the marked reduction of dopaminergic neurons in the midbrain. We suggest that these behavioral changes result from modified neuronal activity in the frontal cortex.

Hebbian-like functional plasticity in the auditory cortex of the behaving monkey.

In this study, the necessary conditions, including those related to behavior, for lasting modifications to occur in correlated activity ('functional plasticity') were examined in the behaving monkey. Previously, in-vitro studies of neuronal plasticity yielded important information about possible mechanisms of synaptic plasticity, but could not be used to test their functionality in the intact, behaving brain. In-vivo studies usually focused on analysis of the responsiveness of single cells, but did not examine interactions between pairs of neurons. In this study, we combined the two approaches. This was achieved by recording extracellularly and simultaneously the spike activity of several single cells in the auditory cortex of the behaving monkey. The efficacy of neuronal interactions was estimated by measuring the correlation between firing times of pairs of single neurons. Using acoustic stimuli, a version of cellular conditioning was applied when the monkey performed an auditory discrimination task and when it did not. We found that: (i) functional plasticity is a function of the change in correlation, and not of the correlation or covariance per se, and (ii) functional plasticity depends critically on behavior. During behavior, an increase in the correlation caused a short-lasting strengthening of the neuronal coupling efficacy, and a decrease caused a short-lasting weakening. These findings indicate that neuronal plasticity in the auditory cortex obeys a version of Hebb's associative rule under strong behavioral control, as predicted by Thorndike's "Law of Effect".