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Sample records for acute left hemisphere

  1. Right Hemispatial Neglect: Frequency and Characterization Following Acute Left Hemisphere Stroke

    PubMed Central

    Kleinman, Jonathan T.; Newhart, Melissa; Davis, Cameron; Heidler-Gary, Jennifer; Gottesman, Rebecca F.; Hillis, Argye E.

    2007-01-01

    The frequency of various types of unilateral spatial neglect and associated areas of neural dysfunction after left hemisphere stroke are not well characterized. Unilateral spatial neglect (USN) in distinct spatial reference frames have been identified after acute right, but not left hemisphere stroke. We studied 47 consecutive right handed patients within 48 hours of left hemisphere stroke to determine the frequency and distribution of types of right USN using cognitive testing and MRI imaging. The distribution of USN types was different from the previously reported distribution following acute right hemisphere stroke. In this left hemisphere stroke population, allocentric neglect was more frequent than egocentric neglect. PMID:17174459

  2. Neuroanatomical Correlates of Oral Reading in Acute Left Hemispheric Stroke

    PubMed Central

    Cloutman, Lauren L.; Newhart, Melissa; Davis, Cameron L.; Heidler-Gary, Jennifer; Hillis, Argye E.

    2010-01-01

    Oral reading is a complex skill involving the interaction of orthographic, phonological, and semantic processes. Functional imaging studies with non-impaired adult readers have identified a widely distributed network of frontal, inferior parietal, posterior temporal, and occipital brain regions involved in the task. However, while functional imaging can identify cortical regions engaged in the process under examination, it cannot identify those brain regions essential for the task. The current study aimed to identify those neuroanatomical regions critical for successful oral reading by examining the relationship between word and nonword oral reading deficits and areas of tissue dysfunction in acute stroke. We evaluated 91 patients with left hemisphere ischemic stroke with a test of oral word and nonword reading, and magnetic resonance diffusion-weighted and perfusion-weighted imaging, within 24–48 hours of stroke onset. A voxel-wise statistical map showed that impairments in word and nonword reading were associated with a distributed network of brain regions, including the inferior and middle frontal gyri, the middle temporal gyrus, the supramarginal and angular gyri, and the middle occipital gyrus. In addition, lesions associated with word deficits were found to be distributed more frontally, while nonword deficits were associated with lesions distributed more posteriorly. PMID:20889196

  3. Right Hemispatial Neglect: Frequency and Characterization Following Acute Left Hemisphere Stroke

    ERIC Educational Resources Information Center

    Kleinman, Jonathan T.; Newhart, Melissa; Davis, Cameron; Heidler-Gary, Jennifer; Gottesman, Rebecca F.; Hillis, Argye E.

    2007-01-01

    The frequency of various types of unilateral spatial neglect and associated areas of neural dysfunction after left hemisphere stroke are not well characterized. Unilateral spatial neglect (USN) in distinct spatial reference frames have been identified after acute right, but not left hemisphere stroke. We studied 47 consecutive right handed…

  4. Right Hemispatial Neglect: Frequency and Characterization Following Acute Left Hemisphere Stroke

    ERIC Educational Resources Information Center

    Kleinman, Jonathan T.; Newhart, Melissa; Davis, Cameron; Heidler-Gary, Jennifer; Gottesman, Rebecca F.; Hillis, Argye E.

    2007-01-01

    The frequency of various types of unilateral spatial neglect and associated areas of neural dysfunction after left hemisphere stroke are not well characterized. Unilateral spatial neglect (USN) in distinct spatial reference frames have been identified after acute right, but not left hemisphere stroke. We studied 47 consecutive right handed…

  5. Left Hemisphere Dysfunction and Left Hemisphere Overactivation in Schizophrenia

    ERIC Educational Resources Information Center

    Gur, Raquel E.

    1978-01-01

    Reports two studies relating schizophrenia to functional brain asymmetry. The first study found support for the hypothesis of left hemisphere dysfunction in schizophrenia, occurring at a rather early stage of information processing; the second study, using eye directionality as a measure of hemispheric activation, found that schizophrenics…

  6. Mutism following left hemisphere infarction.

    PubMed Central

    David, A S; Bone, I

    1984-01-01

    A case of mutism due to left hemisphere infarction is described. Recovery revealed mild motor dysphasia. Review of the literature showed that the case resembles aphemia but is unique by virtue of its duration, and the absence of associated apraxia and paresis. Images PMID:6210346

  7. Left hemisphere dominance for movement.

    PubMed

    Haaland, Kathleen Y

    2006-12-01

    Clinical neuropsychology's dependence upon a core scientific background in clinical neuropsychology, and clinical psychology, neurology, and neuroanatomy, as well as biopsychology, cognitive neuroscience, and cognitive science is the basis of its designation as an APA-approved clinical specialty. This dependence highlights the importance of these scientific underpinnings and the scientist-practitioner model of training, detailed in the Houston Guidelines. This presentation is meant to demonstrate that cognitive neuroscience research should influence our conception of brain behavior relationships, which, in turn, should influence our clinical work. In addition, I want to illustrate how the utilization of converging methods, which is an increasingly popular approach to research, can ensure more valid conclusions about the neuroanatomical substrates for complex skills. Limb apraxia will be used as an example of a deficit that has functional implications and whose cognitive mechanisms and neuroanatomical correlates are better understood as a result of research that combines neuroanatomical imaging of brain damaged patients, functional imaging, and cognitive paradigms. This work demonstrates that left frontoparietal circuits control limb praxis and motor sequencing, suggesting that these complex motor skills should be examined in patients with such damage.

  8. Civilisations of the Left Cerebral Hemisphere?

    ERIC Educational Resources Information Center

    Racle, Gabriel L.

    Research conducted by Tadanobu Tsunoda on auditory and visual sensation, designed to test and understand the functions of the cerebral hemispheres, is discussed. Tsunoda discovered that the Japanese responses to sounds by the left and the right sides of the brain are very different from the responses obtained from people from other countries. His…

  9. Civilisations of the Left Cerebral Hemisphere?

    ERIC Educational Resources Information Center

    Racle, Gabriel L.

    Research conducted by Tadanobu Tsunoda on auditory and visual sensation, designed to test and understand the functions of the cerebral hemispheres, is discussed. Tsunoda discovered that the Japanese responses to sounds by the left and the right sides of the brain are very different from the responses obtained from people from other countries. His…

  10. Homotopic Language Reorganization in the Right Hemisphere after Early Left Hemisphere Injury

    ERIC Educational Resources Information Center

    Tivarus, Madalina E.; Starling, Sarah J.; Newport, Elissa L.; Langfitt, John T.

    2012-01-01

    To determine the areas involved in reorganization of language to the right hemisphere after early left hemisphere injury, we compared fMRI activation patterns during four production and comprehension tasks in post-surgical epilepsy patients with either left (LH) or right hemisphere (RH) speech dominance (determined by Wada testing) and healthy…

  11. Homotopic Language Reorganization in the Right Hemisphere after Early Left Hemisphere Injury

    ERIC Educational Resources Information Center

    Tivarus, Madalina E.; Starling, Sarah J.; Newport, Elissa L.; Langfitt, John T.

    2012-01-01

    To determine the areas involved in reorganization of language to the right hemisphere after early left hemisphere injury, we compared fMRI activation patterns during four production and comprehension tasks in post-surgical epilepsy patients with either left (LH) or right hemisphere (RH) speech dominance (determined by Wada testing) and healthy…

  12. Right hemispheric reversible cerebral vasoconstriction syndrome in a patient with left hemispheric partial seizures

    PubMed Central

    Perez, Gina S.; McCaslin, Justin

    2017-01-01

    We report a right-handed 19-year-old girl who developed reversible cerebral vasoconstriction syndrome (RCVS) lateralized to the right hemisphere with simultaneous new-onset left hemispheric seizures. RCVS, typically more diffuse, was lateralized to one of the cerebral hemispheres. PMID:28405089

  13. Fantasy Door Approach: Merging the Left-Right Hemispheres.

    ERIC Educational Resources Information Center

    Gunnison, Hugh

    1982-01-01

    Describes a specific fantasy technique. In several client examples, speculates on the technique's effectiveness and suggests that techniques such as the Fantasy Door Approach serve as correcting and connecting bridges between right and left hemisphere brain functioning. (Author)

  14. Competition for Left Hemisphere Resources: Right Hemisphere Superiority at Abstract Verbal Information Processing.

    ERIC Educational Resources Information Center

    Polson, Martha C.; And Others

    A study tested a multiple-resources model of human information processing wherein the two cerebral hemispheres are assumed to have separate, limited-capacity pools of undifferentiated resources. The subjects were five right-handed males who had demonstrated right visual field-left hemisphere (RVF-LH) superiority for processing a centrally…

  15. Characteristics of verbal semantic impairment in left hemisphere epilepsy.

    PubMed

    Giovagnoli, Anna Rita

    2005-07-01

    Fifty-two patients with partial epilepsy of left (n=30) or right (n=22) hemisphere origin were compared with 23 healthy subjects to explore the characteristics and mechanisms of verbal semantic deficits. Picture Naming, Picture Pointing, and the Semantic Questionnaire assessed semantic retrieval, comprehension, and judgment, respectively. In comparison with the controls and right hemisphere patients, the left hemisphere patients showed impairments on Picture Naming and the Semantic Questionnaire. On Picture Naming, the left hemisphere patients made significant omissions and intracategorical errors; on the Semantic Questionnaire, they made errors at superordinate and subordinate levels of information, they made more errors in relation to living than nonliving things, and there were significant associations between their Picture Naming and Semantic Questionnaire scores. In this population, the mixed profiles of semantic deficits suggests the coexistence of altered retrieval and information loss. ((c) 2005 APA, all rights reserved).

  16. Right hemisphere grey matter structure and language outcomes in chronic left hemisphere stroke.

    PubMed

    Xing, Shihui; Lacey, Elizabeth H; Skipper-Kallal, Laura M; Jiang, Xiong; Harris-Love, Michelle L; Zeng, Jinsheng; Turkeltaub, Peter E

    2016-01-01

    The neural mechanisms underlying recovery of language after left hemisphere stroke remain elusive. Although older evidence suggested that right hemisphere language homologues compensate for damage in left hemisphere language areas, the current prevailing theory suggests that right hemisphere engagement is ineffective or even maladaptive. Using a novel combination of support vector regression-based lesion-symptom mapping and voxel-based morphometry, we aimed to determine whether local grey matter volume in the right hemisphere independently contributes to aphasia outcomes after chronic left hemisphere stroke. Thirty-two left hemisphere stroke survivors with aphasia underwent language assessment with the Western Aphasia Battery-Revised and tests of other cognitive domains. High-resolution T1-weighted images were obtained in aphasia patients and 30 demographically matched healthy controls. Support vector regression-based multivariate lesion-symptom mapping was used to identify critical language areas in the left hemisphere and then to quantify each stroke survivor's lesion burden in these areas. After controlling for these direct effects of the stroke on language, voxel-based morphometry was then used to determine whether local grey matter volumes in the right hemisphere explained additional variance in language outcomes. In brain areas in which grey matter volumes related to language outcomes, we then compared grey matter volumes in patients and healthy controls to assess post-stroke plasticity. Lesion-symptom mapping showed that specific left hemisphere regions related to different language abilities. After controlling for lesion burden in these areas, lesion size, and demographic factors, grey matter volumes in parts of the right temporoparietal cortex positively related to spontaneous speech, naming, and repetition scores. Examining whether domain general cognitive functions might explain these relationships, partial correlations demonstrated that grey matter

  17. Right hemisphere grey matter structure and language outcomes in chronic left hemisphere stroke.

    PubMed

    Xing, Shihui; Lacey, Elizabeth H; Skipper-Kallal, Laura M; Jiang, Xiong; Harris-Love, Michelle L; Zeng, Jinsheng; Turkeltaub, Peter E

    2015-10-31

    The neural mechanisms underlying recovery of language after left hemisphere stroke remain elusive. Although older evidence suggested that right hemisphere language homologues compensate for damage in left hemisphere language areas, the current prevailing theory suggests that right hemisphere engagement is ineffective or even maladaptive. Using a novel combination of support vector regression-based lesion-symptom mapping and voxel-based morphometry, we aimed to determine whether local grey matter volume in the right hemisphere independently contributes to aphasia outcomes after chronic left hemisphere stroke. Thirty-two left hemisphere stroke survivors with aphasia underwent language assessment with the Western Aphasia Battery-Revised and tests of other cognitive domains. High-resolution T1-weighted images were obtained in aphasia patients and 30 demographically matched healthy controls. Support vector regression-based multivariate lesion-symptom mapping was used to identify critical language areas in the left hemisphere and then to quantify each stroke survivor's lesion burden in these areas. After controlling for these direct effects of the stroke on language, voxel-based morphometry was then used to determine whether local grey matter volumes in the right hemisphere explained additional variance in language outcomes. In brain areas in which grey matter volumes related to language outcomes, we then compared grey matter volumes in patients and healthy controls to assess post-stroke plasticity. Lesion-symptom mapping showed that specific left hemisphere regions related to different language abilities. After controlling for lesion burden in these areas, lesion size, and demographic factors, grey matter volumes in parts of the right temporoparietal cortex positively related to spontaneous speech, naming, and repetition scores. Examining whether domain general cognitive functions might explain these relationships, partial correlations demonstrated that grey matter

  18. Right hemisphere grey matter structure and language outcomes in chronic left hemisphere stroke

    PubMed Central

    Xing, Shihui; Lacey, Elizabeth H.; Skipper-Kallal, Laura M.; Jiang, Xiong; Harris-Love, Michelle L.; Zeng, Jinsheng

    2016-01-01

    The neural mechanisms underlying recovery of language after left hemisphere stroke remain elusive. Although older evidence suggested that right hemisphere language homologues compensate for damage in left hemisphere language areas, the current prevailing theory suggests that right hemisphere engagement is ineffective or even maladaptive. Using a novel combination of support vector regression-based lesion-symptom mapping and voxel-based morphometry, we aimed to determine whether local grey matter volume in the right hemisphere independently contributes to aphasia outcomes after chronic left hemisphere stroke. Thirty-two left hemisphere stroke survivors with aphasia underwent language assessment with the Western Aphasia Battery-Revised and tests of other cognitive domains. High-resolution T1-weighted images were obtained in aphasia patients and 30 demographically matched healthy controls. Support vector regression-based multivariate lesion-symptom mapping was used to identify critical language areas in the left hemisphere and then to quantify each stroke survivor’s lesion burden in these areas. After controlling for these direct effects of the stroke on language, voxel-based morphometry was then used to determine whether local grey matter volumes in the right hemisphere explained additional variance in language outcomes. In brain areas in which grey matter volumes related to language outcomes, we then compared grey matter volumes in patients and healthy controls to assess post-stroke plasticity. Lesion–symptom mapping showed that specific left hemisphere regions related to different language abilities. After controlling for lesion burden in these areas, lesion size, and demographic factors, grey matter volumes in parts of the right temporoparietal cortex positively related to spontaneous speech, naming, and repetition scores. Examining whether domain general cognitive functions might explain these relationships, partial correlations demonstrated that grey matter

  19. Associations and Dissociations of Transitive and Intransitive Gestures in Left and Right Hemisphere Stroke Patients

    ERIC Educational Resources Information Center

    Stamenova, Vessela; Roy, Eric A.; Black, Sandra E.

    2010-01-01

    The study investigated performance on pantomime and imitation of transitive and intransitive gestures in 80 stroke patients, 42 with left (LHD) and 38 with right (RHD) hemisphere damage. Patients were also categorized in two groups based on the time that has elapsed between their stroke and the apraxia assessment: acute-subacute (n = 42) and…

  20. Associations and Dissociations of Transitive and Intransitive Gestures in Left and Right Hemisphere Stroke Patients

    ERIC Educational Resources Information Center

    Stamenova, Vessela; Roy, Eric A.; Black, Sandra E.

    2010-01-01

    The study investigated performance on pantomime and imitation of transitive and intransitive gestures in 80 stroke patients, 42 with left (LHD) and 38 with right (RHD) hemisphere damage. Patients were also categorized in two groups based on the time that has elapsed between their stroke and the apraxia assessment: acute-subacute (n = 42) and…

  1. Caffeine improves left hemisphere processing of positive words.

    PubMed

    Kuchinke, Lars; Lux, Vanessa

    2012-01-01

    A positivity advantage is known in emotional word recognition in that positive words are consistently processed faster and with fewer errors compared to emotionally neutral words. A similar advantage is not evident for negative words. Results of divided visual field studies, where stimuli are presented in either the left or right visual field and are initially processed by the contra-lateral brain hemisphere, point to a specificity of the language-dominant left hemisphere. The present study examined this effect by showing that the intake of caffeine further enhanced the recognition performance of positive, but not negative or neutral stimuli compared to a placebo control group. Because this effect was only present in the right visual field/left hemisphere condition, and based on the close link between caffeine intake and dopaminergic transmission, this result points to a dopaminergic explanation of the positivity advantage in emotional word recognition.

  2. Apraxia and spatial inattention dissociate in left hemisphere stroke.

    PubMed

    Timpert, David C; Weiss, Peter H; Vossel, Simone; Dovern, Anna; Fink, Gereon R

    2015-10-01

    Theories of lateralized cognitive functions propose a dominance of the left hemisphere for motor control and of the right hemisphere for spatial attention. Accordingly, spatial attention deficits (e.g., neglect) are more frequently observed after right-hemispheric stroke, whereas apraxia is a common consequence of left-hemispheric stroke. Clinical reports of spatial attentional deficits after left hemisphere (LH) stroke also exist, but are often neglected. By applying parallel analysis (PA) and voxel-based lesion-symptom mapping (VLSM) to data from a comprehensive neuropsychological assessment of 74 LH stroke patients, we here systematically investigate the relationship between spatial inattention and apraxia and their neural bases. PA revealed that apraxic (and language comprehension) deficits loaded on one common component, while deficits in attention tests were explained by another independent component. Statistical lesion analyses with the individual component scores showed that apraxic (and language comprehension) deficits were significantly associated with lesions of the left superior longitudinal fascicle (SLF). Data suggest that in LH stroke spatial attention deficits dissociate from apraxic (and language comprehension) deficits. These findings contribute to models of lateralised cognitive functions in the human brain. Moreover, our findings strongly suggest that LH stroke patients should be assessed systematically for spatial attention deficits so that these can be included in their rehabilitation regime.

  3. Choosing words: left hemisphere, right hemisphere, or both? Perspective on the lateralization of word retrieval.

    PubMed

    Riès, Stéphanie K; Dronkers, Nina F; Knight, Robert T

    2016-04-01

    Language is considered to be one of the most lateralized human brain functions. Left hemisphere dominance for language has been consistently confirmed in clinical and experimental settings and constitutes one of the main axioms of neurology and neuroscience. However, functional neuroimaging studies are finding that the right hemisphere also plays a role in diverse language functions. Critically, the right hemisphere may also compensate for the loss or degradation of language functions following extensive stroke-induced damage to the left hemisphere. Here, we review studies that focus on our ability to choose words as we speak. Although fluidly performed in individuals with intact language, this process is routinely compromised in aphasic patients. We suggest that parceling word retrieval into its subprocesses-lexical activation and lexical selection-and examining which of these can be compensated for after left hemisphere stroke can advance the understanding of the lateralization of word retrieval in speech production. In particular, the domain-general nature of the brain regions associated with each process may be a helpful indicator of the right hemisphere's propensity for compensation.

  4. Choosing words: left hemisphere, right hemisphere, or both? Perspective on the lateralization of word retrieval

    PubMed Central

    Ries, Stephanie K.; Dronkers, Nina F.; Knight, Robert T.

    2015-01-01

    Language is considered to be one of the most lateralized human brain functions. Left hemisphere dominance for language has been consistently confirmed in clinical and experimental settings and constitutes one of the main axioms of neurology and neuroscience. However, functional neuroimaging studies are finding that the right hemisphere also plays a role in diverse language functions. Critically, the right hemisphere may also compensate for the loss or degradation of language functions following extensive stroke-induced damage to the left hemisphere. Here, we review studies that focus on our ability to choose words as we speak. Although fluidly performed in individuals with intact language, this process is routinely compromised in aphasic patients. We suggest that parceling word retrieval into its sub-processes—lexical activation and lexical selection—and examining which of these can be compensated for after left hemisphere stroke can advance the understanding of the lateralization of word retrieval in speech production. In particular, the domain-general nature of the brain regions associated with each process may be a helpful indicator of the right hemisphere's propensity for compensation. PMID:26766393

  5. Do temporal processes underlie left hemisphere dominance in speech perception?

    PubMed Central

    Scott, Sophie K; McGettigan, Carolyn

    2014-01-01

    It is not unusual to find it stated as a fact that the left hemisphere is specialized for the processing of rapid, or temporal aspects of sound, and that the dominance of the left hemisphere in the perception of speech can be a consequence of this specialisation. In this review we explore the history of this claim and assess the weight of this assumption. We will demonstrate that instead of a supposed sensitivity of the left temporal lobe for the acoustic properties of speech, it is the right temporal lobe which shows a marked preference for certain properties of sounds, for example longer durations, or variations in pitch. We finish by outlining some alternative factors that contribute to the left lateralization of speech perception. PMID:24125574

  6. Left face matching bias: right hemisphere dominance or scanning habits?

    PubMed

    Megreya, Ahmed M; Havard, Catriona

    2011-01-01

    A large body of work report a leftward bias in face processing. However, it is not clear whether this leftward bias purely reflects the dominance of the right hemisphere or is influenced by scanning habits developed by reading directions. Here, we report two experiments examining how well native readers of right to left Arabic scripts (Egyptians) could match (for identity) a target face that appeared with a companion to a line-up of 10 faces. There was a significant advantage for matching faces that appeared on the left. However, Experiment 2 found that the magnitude of this left face matching bias was almost three times weaker than the magnitude of the leftward bias shown by native readers of left to right English scripts (British). Accordingly, we suggest that the right hemisphere dominance for face processing underlies the leftward face perception bias, but with the interaction of scanning habits.

  7. Do temporal processes underlie left hemisphere dominance in speech perception?

    PubMed

    Scott, Sophie K; McGettigan, Carolyn

    2013-10-01

    It is not unusual to find it stated as a fact that the left hemisphere is specialized for the processing of rapid, or temporal aspects of sound, and that the dominance of the left hemisphere in the perception of speech can be a consequence of this specialization. In this review we explore the history of this claim and assess the weight of this assumption. We will demonstrate that instead of a supposed sensitivity of the left temporal lobe for the acoustic properties of speech, it is the right temporal lobe which shows a marked preference for certain properties of sounds, for example longer durations, or variations in pitch. We finish by outlining some alternative factors that contribute to the left lateralization of speech perception.

  8. Neurolinguistic Deficits and the Left Hemisphere in the Reading Disabled.

    ERIC Educational Resources Information Center

    Leavell, Carol; Lewandowski, Lawrence

    This study addressed the left hemisphere deficiency hypothesis, associated with reading disability, by accounting for attention and examining the relationship between dichotic listening results and neuropsychological deficits. Twenty reading-disabled (RD) and 20 non-reading-disabled (NRD) boys, aged 8-12, were administered the Verbal Dichotic…

  9. Does Categorical Perception in the Left Hemisphere Depend on Language?

    ERIC Educational Resources Information Center

    Holmes, Kevin J.; Wolff, Phillip

    2012-01-01

    Categorical perception (CP) refers to the influence of category knowledge on perception and is revealed by a superior ability to discriminate items across categories relative to items within a category. In recent years, the finding that CP is lateralized to the left hemisphere in adults has been interpreted as evidence for a kind of CP driven by…

  10. Does Categorical Perception in the Left Hemisphere Depend on Language?

    ERIC Educational Resources Information Center

    Holmes, Kevin J.; Wolff, Phillip

    2012-01-01

    Categorical perception (CP) refers to the influence of category knowledge on perception and is revealed by a superior ability to discriminate items across categories relative to items within a category. In recent years, the finding that CP is lateralized to the left hemisphere in adults has been interpreted as evidence for a kind of CP driven by…

  11. Left Hemisphere Regions Are Critical for Language in the Face of Early Left Focal Brain Injury

    ERIC Educational Resources Information Center

    Beharelle, Anjali Raja; Dick, Anthony Steven; Josse, Goulven; Solodkin, Ana; Huttenlocher, Peter R.; Levine, Susan C.; Small, Steven L.

    2010-01-01

    A predominant theory regarding early stroke and its effect on language development, is that early left hemisphere lesions trigger compensatory processes that allow the right hemisphere to assume dominant language functions, and this is thought to underlie the near normal language development observed after early stroke. To test this theory, we…

  12. Left Hemisphere Regions Are Critical for Language in the Face of Early Left Focal Brain Injury

    ERIC Educational Resources Information Center

    Beharelle, Anjali Raja; Dick, Anthony Steven; Josse, Goulven; Solodkin, Ana; Huttenlocher, Peter R.; Levine, Susan C.; Small, Steven L.

    2010-01-01

    A predominant theory regarding early stroke and its effect on language development, is that early left hemisphere lesions trigger compensatory processes that allow the right hemisphere to assume dominant language functions, and this is thought to underlie the near normal language development observed after early stroke. To test this theory, we…

  13. Testing the Language of German Cerebral Palsy Patients with Right Hemispheric Language Organization after Early Left Hemispheric Damage

    ERIC Educational Resources Information Center

    Schwilling, Eleonore; Krageloh-Mann, Ingeborg; Konietzko, Andreas; Winkler, Susanne; Lidzba, Karen

    2012-01-01

    Language functions are generally represented in the left cerebral hemisphere. After early (prenatally acquired or perinatally acquired) left hemispheric brain damage language functions may be salvaged by reorganization into the right hemisphere. This is different from brain lesions acquired in adulthood which normally lead to aphasia. Right…

  14. Testing the Language of German Cerebral Palsy Patients with Right Hemispheric Language Organization after Early Left Hemispheric Damage

    ERIC Educational Resources Information Center

    Schwilling, Eleonore; Krageloh-Mann, Ingeborg; Konietzko, Andreas; Winkler, Susanne; Lidzba, Karen

    2012-01-01

    Language functions are generally represented in the left cerebral hemisphere. After early (prenatally acquired or perinatally acquired) left hemispheric brain damage language functions may be salvaged by reorganization into the right hemisphere. This is different from brain lesions acquired in adulthood which normally lead to aphasia. Right…

  15. Lesion characteristics driving right-hemispheric language reorganization in congenital left-hemispheric brain damage.

    PubMed

    Lidzba, Karen; de Haan, Bianca; Wilke, Marko; Krägeloh-Mann, Ingeborg; Staudt, Martin

    2017-10-01

    Pre- or perinatally acquired ("congenital") left-hemispheric brain lesions can be compensated for by reorganizing language into homotopic brain regions in the right hemisphere. Language comprehension may be hemispherically dissociated from language production. We investigated the lesion characteristics driving inter-hemispheric reorganization of language comprehension and language production in 19 patients (7-32years; eight females) with congenital left-hemispheric brain lesions (periventricular lesions [n=11] and middle cerebral artery infarctions [n=8]) by fMRI. 16/17 patients demonstrated reorganized language production, while 7/19 patients had reorganized language comprehension. Lesions to the insular cortex and the temporo-parietal junction (predominantly supramarginal gyrus) were significantly more common in patients in whom both, language production and comprehension were reorganized. These areas belong to the dorsal stream of the language network, participating in the auditory-motor integration of language. Our data suggest that the integrity of this stream might be crucial for a normal left-lateralized language development. Copyright © 2017. Published by Elsevier Inc.

  16. Left hemisphere regions are critical for language in the face of early left focal brain injury.

    PubMed

    Raja Beharelle, Anjali; Dick, Anthony Steven; Josse, Goulven; Solodkin, Ana; Huttenlocher, Peter R; Levine, Susan C; Small, Steven L

    2010-06-01

    A predominant theory regarding early stroke and its effect on language development, is that early left hemisphere lesions trigger compensatory processes that allow the right hemisphere to assume dominant language functions, and this is thought to underlie the near normal language development observed after early stroke. To test this theory, we used functional magnetic resonance imaging to examine brain activity during category fluency in participants who had sustained pre- or perinatal left hemisphere stroke (n = 25) and in neurologically normal siblings (n = 27). In typically developing children, performance of a category fluency task elicits strong involvement of left frontal and lateral temporal regions and a lesser involvement of right hemisphere structures. In our cohort of atypically developing participants with early stroke, expressive and receptive language skills correlated with activity in the same left inferior frontal regions that support language processing in neurologically normal children. This was true independent of either the amount of brain injury or the extent that the injury was located in classical cortical language processing areas. Participants with bilateral activation in left and right superior temporal-inferior parietal regions had better language function than those with either predominantly left- or right-sided unilateral activation. The advantage conferred by left inferior frontal and bilateral temporal involvement demonstrated in our study supports a strong predisposition for typical neural language organization, despite an intervening injury, and argues against models suggesting that the right hemisphere fully accommodates language function following early injury.

  17. Left-hemisphere processing of emotional connotation during word generation.

    PubMed

    Crosson, B; Radonovich, K; Sadek, J R; Gökçay, D; Bauer, R M; Fischler, I S; Cato, M A; Maron, L; Auerbach, E J; Browd, S R; Briggs, R W

    1999-08-20

    Areas of the brain's left hemisphere involved in retrieving words with emotional connotations were studied with fMRI. Participants silently generated words from different semantic categories which evoked either words with emotional connotations or emotionally neutral words. Participants repeated emotionally neutral words as a control task. Compared with generation of emotionally neutral words, generation of words with emotional connotations engaged cortices near the left frontal and temporal poles which are connected to the limbic system. Thus, emotional connotations of words are processed in or near cortices with access to emotional experience.

  18. Left hemisphere specialization for the control of voluntary movement rate.

    PubMed

    Agnew, John A; Zeffiro, Thomas A; Eden, Guinevere F

    2004-05-01

    Although persuasive behavioral evidence demonstrates the superior dexterity of the right hand in most people under a variety of conditions, little is known about the neural mechanisms responsible for this phenomenon. As this lateralized superiority is most evident during the performance of repetitive, speeded movement, we used parametric rate variations to compare visually paced movement of the right and left hands. Twelve strongly right-handed subjects participated in a functional magnetic resonance imaging (fMRI) experiment involving variable rate thumb movements. For movements of the right hand, contralateral rate-related activity changes were identified in the precentral gyrus, thalamus, and posterior putamen. For left-hand movements, activity was seen only in the contralateral precentral gyrus, consistent with the existence of a rate-sensitive motor control subsystem involving the left, but not the right, medial premotor corticostriatal loop in right-handed individuals. We hypothesize that the right hemisphere system is less skilled at controlling variable-rate movements and becomes maximally engaged at a lower movement rate without further modulation. These findings demonstrate that right- and left-hand movements engage different neural systems to control movement, even during a relatively simple thumb flexion task. Specialization of the left hemisphere corticostriatal system for dexterity is reflected in asymmetric mechanisms for movement rate control.

  19. Left hemispheric advantage for numerical abilities in the bottlenose dolphin.

    PubMed

    Kilian, Annette; von Fersen, Lorenzo; Güntürkün, Onur

    2005-02-28

    In a two-choice discrimination paradigm, a bottlenose dolphin discriminated relational dimensions between visual numerosity stimuli under monocular viewing conditions. After prior binocular acquisition of the task, two monocular test series with different number stimuli were conducted. In accordance with recent studies on visual lateralization in the bottlenose dolphin, our results revealed an overall advantage of the right visual field. Due to the complete decussation of the optic nerve fibers, this suggests a specialization of the left hemisphere for analysing relational features between stimuli as required in tests for numerical abilities. These processes are typically right hemisphere-based in other mammals (including humans) and birds. The present data provide further evidence for a general right visual field advantage in bottlenose dolphins for visual information processing. It is thus assumed that dolphins possess a unique functional architecture of their cerebral asymmetries.

  20. Agents with left and right dominant hemispheres and quantum statistics

    NASA Astrophysics Data System (ADS)

    Ezhov, Alexandr A.; Khrennikov, Andrei Yu.

    2005-01-01

    We present a multiagent model illustrating the emergence of two different quantum statistics, Bose-Einstein and Fermi-Dirac, in a friendly population of individuals with the right-brain dominance and in a competitive population of individuals with the left-brain hemisphere dominance, correspondingly. Doing so, we adduce the arguments that Lefebvre’s “algebra of conscience” can be used in a natural way to describe decision-making strategies of agents simulating people with different brain dominance. One can suggest that the emergence of the two principal statistical distributions is able to illustrate different types of society organization and also to be used in order to simulate market phenomena and psychic disorders, when a switching of hemisphere dominance is involved.

  1. Beyond Hemispheric Dominance: Brain Regions Underlying the Joint Lateralization of Language and Arithmetic to the Left Hemisphere

    ERIC Educational Resources Information Center

    Pinel, Philippe; Dehaene, Stanislas

    2010-01-01

    Language and arithmetic are both lateralized to the left hemisphere in the majority of right-handed adults. Yet, does this similar lateralization reflect a single overall constraint of brain organization, such an overall "dominance" of the left hemisphere for all linguistic and symbolic operations? Is it related to the lateralization of specific…

  2. Beyond Hemispheric Dominance: Brain Regions Underlying the Joint Lateralization of Language and Arithmetic to the Left Hemisphere

    ERIC Educational Resources Information Center

    Pinel, Philippe; Dehaene, Stanislas

    2010-01-01

    Language and arithmetic are both lateralized to the left hemisphere in the majority of right-handed adults. Yet, does this similar lateralization reflect a single overall constraint of brain organization, such an overall "dominance" of the left hemisphere for all linguistic and symbolic operations? Is it related to the lateralization of specific…

  3. Reorganization of syntactic processing following left-hemisphere brain damage: does right-hemisphere activity preserve function?

    PubMed Central

    Wright, Paul; Randall, Billi; Marslen-Wilson, William D.; Stamatakis, Emmanuel A.

    2010-01-01

    The extent to which the human brain shows evidence of functional plasticity across the lifespan has been addressed in the context of pathological brain changes and, more recently, of the changes that take place during healthy ageing. Here we examine the potential for plasticity by asking whether a strongly left-lateralized system can successfully reorganize to the right-hemisphere following left-hemisphere brain damage. To do this, we focus on syntax, a key linguistic function considered to be strongly left-lateralized, combining measures of tissue integrity, neural activation and behavioural performance. In a functional neuroimaging study participants heard spoken sentences that differentially loaded on syntactic and semantic information. While healthy controls activated a left-hemisphere network of correlated activity including Brodmann areas 45/47 and posterior middle temporal gyrus during syntactic processing, patients activated Brodmann areas 45/47 bilaterally and right middle temporal gyrus. However, voxel-based morphometry analyses showed that only tissue integrity in left Brodmann areas 45/47 was correlated with activity and performance; poor tissue integrity in left Brodmann area 45 was associated with reduced functional activity and increased syntactic deficits. Activity in the right-hemisphere was not correlated with damage in the left-hemisphere or with performance. Reduced neural integrity in the left-hemisphere through brain damage or healthy ageing results in increased right-hemisphere activation in homologous regions to those left-hemisphere regions typically involved in the young. However, these regions do not support the same linguistic functions as those in the left-hemisphere and only indirectly contribute to preserved syntactic capacity. This establishes the unique role of the left hemisphere in syntax, a core component in human language. PMID:20870779

  4. Reorganization of syntactic processing following left-hemisphere brain damage: does right-hemisphere activity preserve function?

    PubMed

    Tyler, Lorraine K; Wright, Paul; Randall, Billi; Marslen-Wilson, William D; Stamatakis, Emmanuel A

    2010-11-01

    The extent to which the human brain shows evidence of functional plasticity across the lifespan has been addressed in the context of pathological brain changes and, more recently, of the changes that take place during healthy ageing. Here we examine the potential for plasticity by asking whether a strongly left-lateralized system can successfully reorganize to the right-hemisphere following left-hemisphere brain damage. To do this, we focus on syntax, a key linguistic function considered to be strongly left-lateralized, combining measures of tissue integrity, neural activation and behavioural performance. In a functional neuroimaging study participants heard spoken sentences that differentially loaded on syntactic and semantic information. While healthy controls activated a left-hemisphere network of correlated activity including Brodmann areas 45/47 and posterior middle temporal gyrus during syntactic processing, patients activated Brodmann areas 45/47 bilaterally and right middle temporal gyrus. However, voxel-based morphometry analyses showed that only tissue integrity in left Brodmann areas 45/47 was correlated with activity and performance; poor tissue integrity in left Brodmann area 45 was associated with reduced functional activity and increased syntactic deficits. Activity in the right-hemisphere was not correlated with damage in the left-hemisphere or with performance. Reduced neural integrity in the left-hemisphere through brain damage or healthy ageing results in increased right-hemisphere activation in homologous regions to those left-hemisphere regions typically involved in the young. However, these regions do not support the same linguistic functions as those in the left-hemisphere and only indirectly contribute to preserved syntactic capacity. This establishes the unique role of the left hemisphere in syntax, a core component in human language.

  5. Differentiating hemispheric contributions to syntax and semantics in patients with left-hemisphere lesions.

    PubMed

    Wright, Paul; Stamatakis, Emmanuel A; Tyler, Lorraine K

    2012-06-13

    Understanding the relationship between brain and cognition critically depends on data from brain-damaged patients since these provide major constraints on identifying the essential components of brain-behavior systems. Here we relate structural and functional fMRI data with behavioral data in 21 human patients with chronic left hemisphere (LH) lesions and a range of language impairments to investigate the controversial issue of the role of the hemispheres in different language functions. We address this issue within a dual neurocognitive model of spoken language comprehension in which core linguistic functions, e.g., syntax, depend critically upon an intact left frontotemporal system, whereas more general communicative abilities, e.g., semantics, are supported by a bilateral frontotemporal system and may recover from LH damage through normal or enhanced activity in the intact right hemisphere. The fMRI study used a word-monitoring task that differentiated syntactic and semantic aspects of sentence comprehension. We distinguished overlapping interactions between structure, neural activity, and performance using joint independent components analysis, identifying two structural-functional networks, each with a distinct relationship with performance. Syntactic performance correlated with tissue integrity and activity in a left frontotemporal network. Semantic performance correlated with activity in right superior/middle temporal gyri regardless of tissue integrity. Right temporal activity did not differ between patients and controls, suggesting that the semantic network is degenerately organized, with regions in both hemispheres able to perform similar computations. Our findings support the dual neurocognitive model of spoken language comprehension and emphasize the importance of linguistic specificity in investigations of language recovery in patients.

  6. Right hemisphere restitution of language and memory functions in right hemisphere language-dominant patients with left temporal lobe epilepsy.

    PubMed

    Helmstaedter, C; Kurthen, M; Linke, D B; Elger, C E

    1994-08-01

    Concomitant with the right hemispheric restitution of language functions after early left hemisphere lesions, suppression effects on originally right hemispheric visuospatial/constructional functions have repeatedly been reported. The present study evaluated this issue in 10 right hemisphere language-dominant patients with temporal lobe epilepsy. Left hemisphere language-dominant patients with left (n = 10) or right (n = 10) temporal lobe epilepsy served as controls. The following results were obtained: in all but one of the right dominant patients, left hemisphere lesions, left hemisphere foci and histories of early left brain damage indicated that secondary language transfer rather than a genetically determination is the more likely cause of the right hemisphere dominance. Despite this transfer, the language functions (comprehension, fluency, reasoning) of the right dominant patients remained significantly impaired. Language generally appeared to be better preserved in patients with an onset of epilepsy before the third year of life or a circumscribed left hemisphere lesion. No suppression effects could be detected on the level of complex cortical language and non-language functions. In contrast, on the level of temporo-limbic memory functions, verbal learning and recognition were left largely intact, albeit mostly at the expense of visuo-spatial learning and memory. The findings of the study thus indicate that the cerebral plasticity of the right hemisphere differs according to the extent of the left-hemisphere lesion, the onset of structural/functional damage and the complexity of the functions requiring restitution. Assuming that language and memory represent neocortical and palaeocortical functions, respectively, the restitution process is seemingly governed by their status in a phylogenetically determined hierarchy of functional importance.

  7. Gesture imitation with lower limbs following left hemisphere stroke.

    PubMed

    Ambrosoni, Elena; Della Sala, Sergio; Motto, Cristina; Oddo, Silvia; Spinnler, Hans

    2006-05-01

    Ideomotor apraxia (IMA) of lower limbs has rarely been investigated systematically. This is the aim of the current study. Thirty-five patients with a unilateral stroke in the left hemisphere were tested within 30 days from onset with an upper limb IMA test and with a newly devised test assessing leg IMA. Seventeen patients presented with arm apraxia, six of them also showed severe leg apraxia. Results suggest that IMA of lower limbs emerges in association with severe arm IMA in patients with large lesions, and is a sign of general severity of the patient's conditions.

  8. Neural correlates supporting sensory discrimination after left hemisphere stroke

    PubMed Central

    Borstad, Alexandra; Schmalbrock, Petra; Choi, Seongjin; Nichols-Larsen, Deborah S.

    2012-01-01

    Background Nearly half of stroke patients have impaired sensory discrimination, however, the neural structures that support post-stroke sensory function have not been described. Objectives 1) To evaluate the role of the primary somatosensory (S1) cortex in post-stroke sensory discrimination and 2) To determine the relationship between post-stroke sensory discrimination and structural integrity of the sensory component of the superior thalamic radiation (sSTR). Methods 10 healthy adults and 10 individuals with left hemisphere stroke participated. Stroke participants completed sensory discrimination testing. An fMRI was conducted during right, impaired hand sensory discrimination. Fractional anisotropy and volume of the sSTR were quantified using diffusion tensor tractography. Results Sensory discrimination was impaired in 60% of participants with left stroke. Peak activation in the left (S1) did not correlate with sensory discrimination ability, rather a more distributed pattern of activation was evident in post-stroke subjects with a positive correlation between peak activation in the parietal cortex and discrimination ability (r=.70, p=.023). The only brain region in which stroke participants had significantly different cortical activation than control participants was the precuneus. Region of interest analysis of the precuneus across stroke participants revealed a positive correlation between peak activation and sensory discrimination ability (r=.77, p=.008). The L/R ratio of sSTR fractional anisotropy also correlated with right hand sensory discrimination (r=.69, p=.027). Conclusions Precuneus cortex, distributed parietal lobe activity, and microstructure of the sSTR support sensory discrimination after left hemisphere stroke. PMID:22592076

  9. Left inferior frontal cortex and syntax: function, structure and behaviour in patients with left hemisphere damage

    PubMed Central

    Marslen-Wilson, William D.; Randall, Billi; Wright, Paul; Devereux, Barry J.; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A.

    2011-01-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left hemisphere damage and healthy participants to ask whether the left inferior frontal gyrus is essential for syntactic processing. In a functional neuroimaging study, participants listened to spoken sentences that either contained a syntactically ambiguous or matched unambiguous phrase. Behavioural data on three tests of syntactic processing were subsequently collected. In controls, syntactic processing co-activated left hemisphere Brodmann areas 45/47 and posterior middle temporal gyrus. Activity in a left parietal cluster was sensitive to working memory demands in both patients and controls. Exploiting the variability in lesion location and performance in the patients, voxel-based correlational analyses showed that tissue integrity and neural activity—primarily in left Brodmann area 45 and posterior middle temporal gyrus—were correlated with preserved syntactic performance, but unlike the controls, patients were insensitive to syntactic preferences, reflecting their syntactic deficit. These results argue for the essential contribution of the left inferior frontal gyrus in syntactic analysis and highlight the functional relationship between left Brodmann area 45 and the left posterior middle temporal gyrus, suggesting that when this relationship breaks down, through damage to either region or to the connections between them, syntactic processing is impaired. On this view, the left inferior frontal gyrus may not itself be specialized for syntactic processing, but plays an essential role in the neural network that carries out syntactic computations. PMID:21278407

  10. Left inferior frontal cortex and syntax: function, structure and behaviour in patients with left hemisphere damage.

    PubMed

    Tyler, Lorraine K; Marslen-Wilson, William D; Randall, Billi; Wright, Paul; Devereux, Barry J; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A

    2011-02-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left hemisphere damage and healthy participants to ask whether the left inferior frontal gyrus is essential for syntactic processing. In a functional neuroimaging study, participants listened to spoken sentences that either contained a syntactically ambiguous or matched unambiguous phrase. Behavioural data on three tests of syntactic processing were subsequently collected. In controls, syntactic processing co-activated left hemisphere Brodmann areas 45/47 and posterior middle temporal gyrus. Activity in a left parietal cluster was sensitive to working memory demands in both patients and controls. Exploiting the variability in lesion location and performance in the patients, voxel-based correlational analyses showed that tissue integrity and neural activity-primarily in left Brodmann area 45 and posterior middle temporal gyrus-were correlated with preserved syntactic performance, but unlike the controls, patients were insensitive to syntactic preferences, reflecting their syntactic deficit. These results argue for the essential contribution of the left inferior frontal gyrus in syntactic analysis and highlight the functional relationship between left Brodmann area 45 and the left posterior middle temporal gyrus, suggesting that when this relationship breaks down, through damage to either region or to the connections between them, syntactic processing is impaired. On this view, the left inferior frontal gyrus may not itself be specialized for syntactic processing, but plays an essential role in the neural network that carries out syntactic computations.

  11. Hemispheric Contributions to Lexical Ambiguity Resolution in a Discourse Context: Evidence from Individuals with Unilateral Left and Right Hemisphere Lesions

    ERIC Educational Resources Information Center

    Grindrod, C.M.; Baum, S.R.

    2005-01-01

    In the present study, a cross-modal semantic priming task was used to investigate the ability of left-hemisphere-damaged (LHD) nonfluent aphasic, right-hemisphere-damaged (RHD) and non-brain-damaged (NBD) control subjects to use a discourse context to resolve lexically ambiguous words. Subjects first heard four-sentence discourse passages ending…

  12. Hemispheric Contributions to Lexical Ambiguity Resolution in a Discourse Context: Evidence from Individuals with Unilateral Left and Right Hemisphere Lesions

    ERIC Educational Resources Information Center

    Grindrod, C.M.; Baum, S.R.

    2005-01-01

    In the present study, a cross-modal semantic priming task was used to investigate the ability of left-hemisphere-damaged (LHD) nonfluent aphasic, right-hemisphere-damaged (RHD) and non-brain-damaged (NBD) control subjects to use a discourse context to resolve lexically ambiguous words. Subjects first heard four-sentence discourse passages ending…

  13. A dual task priming investigation of right hemisphere inhibition for people with left hemisphere lesions

    PubMed Central

    2012-01-01

    Background During normal semantic processing, the left hemisphere (LH) is suggested to restrict right hemisphere (RH) performance via interhemispheric suppression. However, a lesion in the LH or the use of concurrent tasks to overload the LH's attentional resource balance has been reported to result in RH disinhibition with subsequent improvements in RH performance. The current study examines variations in RH semantic processing in the context of unilateral LH lesions and the manipulation of the interhemispheric processing resource balance, in order to explore the relevance of RH disinhibition to hemispheric contributions to semantic processing following a unilateral LH lesion. Methods RH disinhibition was examined for nine participants with a single LH lesion and 13 matched controls using the dual task paradigm. Hemispheric performance on a divided visual field lexical decision semantic priming task was compared over three verbal memory load conditions, of zero-, two- and six-words. Related stimuli consisted of categorically related, associatively related, and categorically and associatively related prime-target pairs. Response time and accuracy data were recorded and analyzed using linear mixed model analysis, and planned contrasts were performed to compare priming effects in both visual fields, for each of the memory load conditions. Results Control participants exhibited significant bilateral visual field priming for all related conditions (p < .05), and a LH advantage over all three memory load conditions. Participants with LH lesions exhibited an improvement in RH priming performance as memory load increased, with priming for the categorically related condition occurring only in the 2- and 6-word memory conditions. RH disinhibition was also reflected for the LH damage (LHD) group by the removal of the LH performance advantage following the introduction of the memory load conditions. Conclusions The results from the control group are consistent with

  14. Selective atrophy of left hemisphere and frontal lobe of the brain in old men.

    PubMed

    Shan, Zu Y; Liu, Jing Z; Sahgal, Vinod; Wang, Bin; Yue, Guang H

    2005-02-01

    In this study, volumes of the whole brain, hemispheres, and frontal lobes of young and elderly adults were quantified by an automated method. Effects of age, sex, and side on absolute and relative volumes of the brain structures were evaluated. Compared with the young group, elderly participants showed a 15% volume loss in the whole brain and hemispheres, and a 22% volume loss in the frontal lobes. The relative volume of the left hemisphere in the elderly group decreased more than that of the right hemisphere. Elderly men showed significantly greater left hemisphere and left frontal lobe volume losses than did elderly women, indicating that the larger left hemisphere relative volume reduction is largely contributed to by selective atrophy of the left frontal lobe volume in elderly men. These results may reflect age- and sex-related functional deterioration in the left brain.

  15. Network dysfunction predicts speech production after left hemisphere stroke

    PubMed Central

    Leech, Robert; Wise, Richard J.S.

    2016-01-01

    Objective: To investigate the role of multiple distributed brain networks, including the default mode, fronto-temporo-parietal, and cingulo-opercular networks, which mediate domain-general and task-specific processes during speech production after aphasic stroke. Methods: We conducted an observational functional MRI study to investigate the effects of a previous left hemisphere stroke on functional connectivity within and between distributed networks as patients described pictures. Study design included various baseline tasks, and we compared results to those of age-matched healthy participants performing the same tasks. We used independent component and psychophysiological interaction analyses. Results: Although activity within individual networks was not predictive of speech production, relative activity between networks was a predictor of both within-scanner and out-of-scanner language performance, over and above that predicted from lesion volume, age, sex, and years of education. Specifically, robust functional imaging predictors were the differential activity between the default mode network and both the left and right fronto-temporo-parietal networks, respectively activated and deactivated during speech. We also observed altered between-network functional connectivity of these networks in patients during speech production. Conclusions: Speech production is dependent on complex interactions among widely distributed brain networks, indicating that residual speech production after stroke depends on more than the restoration of local domain-specific functions. Our understanding of the recovery of function following focal lesions is not adequately captured by consideration of ipsilesional or contralesional brain regions taking over lost domain-specific functions, but is perhaps best considered as the interaction between what remains of domain-specific networks and domain-general systems that regulate behavior. PMID:26962070

  16. Reorganization of the Cerebro-Cerebellar Network of Language Production in Patients with Congenital Left-Hemispheric Brain Lesions

    ERIC Educational Resources Information Center

    Lidzba, K.; Wilke, M.; Staudt, M.; Krageloh-Mann, I.; Grodd, W.

    2008-01-01

    Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess…

  17. Reorganization of the Cerebro-Cerebellar Network of Language Production in Patients with Congenital Left-Hemispheric Brain Lesions

    ERIC Educational Resources Information Center

    Lidzba, K.; Wilke, M.; Staudt, M.; Krageloh-Mann, I.; Grodd, W.

    2008-01-01

    Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess…

  18. Semantic processing in the left versus right cerebral hemispheres following unilateral hand contractions.

    PubMed

    Turner, Casey E; Hahn, Michael E; Kellogg, Ronald T

    2017-03-01

    Unilateral hand contractions increase activation in the motor cortex of the contralateral hemisphere, providing a means to alter the relative degree of activation in the right hemisphere versus the left hemisphere through spreading activation. Prior research reported enhanced verbal creativity as measured by performance on remote associate problems in Hebrew from left-hand contractions (right-hemisphere activation). We sought to extend the previous findings to English problems and to homograph interpretation. In Experiment 1, unilateral hand contractions in fact altered performance on the English remote associates, but in the direction of improved performance following right-hand contractions and left-hemisphere activation. In Experiment 2, the probability of retrieving atypical interpretations of homographs with multiple meanings was least likely for left-hemisphere dominant strong right handers, but the hand contraction manipulation had no effect.

  19. A comparison of driving errors in patients with left or right hemispheric lesions after stroke

    PubMed Central

    Park, Myoung-Ok

    2015-01-01

    [Purpose] The aim of this study was to compare the incidence of driving errors among patients with left or right hemispheric lesions due to stroke. [Subjects and Methods] Thirty stroke patients participated in the study. Driving errors were assessed using a virtual reality driving simulator. [Results] Significant differences were shown in center line crossing frequency, accident rate, brake reaction time, total driving error scores, and overall driving safety between participants with left or right hemispheric lesions. [Conclusion] Driving rehabilitation specialists should consider hemispheric function when teaching driving skills to stroke survivors, because patients with lesions in the left or right hemispheres after stroke show differences in driving skills. PMID:26696720

  20. Right hemisphere structural adaptation and changing language skills years after left hemisphere stroke

    PubMed Central

    Leff, Alex P.; Prejawa, Susan; Bruce, Rachel; Haigh, Zula; Lim, Louise; Ramsden, Sue; Oberhuber, Marion; Ludersdorfer, Philipp; Crinion, Jenny; Seghier, Mohamed L.; Price, Cathy J.

    2017-01-01

    Abstract Stroke survivors with acquired language deficits are commonly thought to reach a ‘plateau’ within a year of stroke onset, after which their residual language skills will remain stable. Nevertheless, there have been reports of patients who appear to recover over years. Here, we analysed longitudinal change in 28 left-hemisphere stroke patients, each more than a year post-stroke when first assessed—testing each patient’s spoken object naming skills and acquiring structural brain scans twice. Some of the patients appeared to improve over time while others declined; both directions of change were associated with, and predictable given, structural adaptation in the intact right hemisphere of the brain. Contrary to the prevailing view that these patients’ language skills are stable, these results imply that real change continues over years. The strongest brain–behaviour associations (the ‘peak clusters’) were in the anterior temporal lobe and the precentral gyrus. Using functional magnetic resonance imaging, we confirmed that both regions are actively involved when neurologically normal control subjects name visually presented objects, but neither appeared to be involved when the same participants used a finger press to make semantic association decisions on the same stimuli. This suggests that these regions serve word-retrieval or articulatory functions in the undamaged brain. We teased these interpretations apart by reference to change in other tasks. Consistent with the claim that the real change is occurring here, change in spoken object naming was correlated with change in two other similar tasks, spoken action naming and written object naming, each of which was independently associated with structural adaptation in similar (overlapping) right hemisphere regions. Change in written object naming, which requires word-retrieval but not articulation, was also significantly more correlated with both (i) change in spoken object naming; and (ii

  1. Right hemisphere structural adaptation and changing language skills years after left hemisphere stroke.

    PubMed

    Hope, Thomas M H; Leff, Alex P; Prejawa, Susan; Bruce, Rachel; Haigh, Zula; Lim, Louise; Ramsden, Sue; Oberhuber, Marion; Ludersdorfer, Philipp; Crinion, Jenny; Seghier, Mohamed L; Price, Cathy J

    2017-06-01

    Stroke survivors with acquired language deficits are commonly thought to reach a 'plateau' within a year of stroke onset, after which their residual language skills will remain stable. Nevertheless, there have been reports of patients who appear to recover over years. Here, we analysed longitudinal change in 28 left-hemisphere stroke patients, each more than a year post-stroke when first assessed-testing each patient's spoken object naming skills and acquiring structural brain scans twice. Some of the patients appeared to improve over time while others declined; both directions of change were associated with, and predictable given, structural adaptation in the intact right hemisphere of the brain. Contrary to the prevailing view that these patients' language skills are stable, these results imply that real change continues over years. The strongest brain-behaviour associations (the 'peak clusters') were in the anterior temporal lobe and the precentral gyrus. Using functional magnetic resonance imaging, we confirmed that both regions are actively involved when neurologically normal control subjects name visually presented objects, but neither appeared to be involved when the same participants used a finger press to make semantic association decisions on the same stimuli. This suggests that these regions serve word-retrieval or articulatory functions in the undamaged brain. We teased these interpretations apart by reference to change in other tasks. Consistent with the claim that the real change is occurring here, change in spoken object naming was correlated with change in two other similar tasks, spoken action naming and written object naming, each of which was independently associated with structural adaptation in similar (overlapping) right hemisphere regions. Change in written object naming, which requires word-retrieval but not articulation, was also significantly more correlated with both (i) change in spoken object naming; and (ii) structural adaptation in

  2. Integration of Perceptual and Mnemonic Dysfunction: Sensory Auras Are Associated with Left Hemispheric Memory Impairment.

    PubMed

    Weinand, Martin E.; Labiner, David M.; Ahern, Geoffrey L.

    2001-10-01

    Memory function during the intracarotid amobarbital test was studied to test the hypothesis that left hemisphere memory impairment is associated with sensory auras. In a series of 37 patients undergoing preoperative evaluation for epilepsy surgery, the quantitative memory scores during amobarbital inactivation of right and left hemisphere were analyzed for correlation with habitual epileptic auras classified as either (a) experiential, forced emotion, or whole-body dysphoria or (b) sensory hallucinations and/or illusions or localized dysesthesias. The left hemispheric memory score impairment was significantly worse in association with auras classified as sensory hallucinations and/or illusions or localized dysesthesias compared with auras classified as experiential, forced emotion, or whole-body dysphoria (P < 0.05). This finding may assist in predicting left-sided hemispheric memory dysfunction in patients with seizures beginning as auras involving sensory material. The results suggest an integration of perceptual and mnemonic dysfunction in which sensory auras are associated with left hemispheric memory impairment.

  3. Associations and dissociations of transitive and intransitive gestures in left and right hemisphere stroke patients.

    PubMed

    Stamenova, Vessela; Roy, Eric A; Black, Sandra E

    2010-04-01

    The study investigated performance on pantomime and imitation of transitive and intransitive gestures in 80 stroke patients, 42 with left (LHD) and 38 with right (RHD) hemisphere damage. Patients were also categorized in two groups based on the time that has elapsed between their stroke and the apraxia assessment: acute-subacute (n=42) and chronic (n=38). In addition, patterns of performance in apraxia were examined. We expected that acute-subacute patients would be more impaired than chronic patients and that LHD patients would be more impaired than RHD patients, relative to controls. The hemisphere prediction was confirmed, replicating previous findings. The frequency of apraxia was also higher in all LHD time post-stroke groups. The most common impairment after LHD was impairment in both pantomime and imitation in both transitive and intransitive gestures. Selective deficits in imitation were more frequent after RHD for transitive gestures but for intransitive gestures they were more frequent after LHD. Patients were more impaired on imitation than pantomime, relative to controls. In addition, after looking at both gesture types concurrently, we have described cases of patients who suffered deficits in pantomime of intransitive gestures with preserved performance on transitive gestures. Such cases show that the right hemisphere may be in some cases critical for the successful pantomime of intransitive gestures and the neural networks subserving them may be distinct. Chronic patients were also less impaired than acute-subacute patients, even though the difference did not reach significance. A longitudinal study is needed to examine the recovery patterns in both LHD and RHD patients. Copyright 2010 Elsevier Inc. All rights reserved.

  4. The left hemisphere learns what is right: Hemispatial reward learning depends on reinforcement learning processes in the contralateral hemisphere.

    PubMed

    Aberg, Kristoffer Carl; Doell, Kimberly Crystal; Schwartz, Sophie

    2016-08-01

    Orienting biases refer to consistent, trait-like direction of attention or locomotion toward one side of space. Recent studies suggest that such hemispatial biases may determine how well people memorize information presented in the left or right hemifield. Moreover, lesion studies indicate that learning rewarded stimuli in one hemispace depends on the integrity of the contralateral striatum. However, the exact neural and computational mechanisms underlying the influence of individual orienting biases on reward learning remain unclear. Because reward-based behavioural adaptation depends on the dopaminergic system and prediction error (PE) encoding in the ventral striatum, we hypothesized that hemispheric asymmetries in dopamine (DA) function may determine individual spatial biases in reward learning. To test this prediction, we acquired fMRI in 33 healthy human participants while they performed a lateralized reward task. Learning differences between hemispaces were assessed by presenting stimuli, assigned to different reward probabilities, to the left or right of central fixation, i.e. presented in the left or right visual hemifield. Hemispheric differences in DA function were estimated through differential fMRI responses to positive vs. negative feedback in the left vs. right ventral striatum, and a computational approach was used to identify the neural correlates of PEs. Our results show that spatial biases favoring reward learning in the right (vs. left) hemifield were associated with increased reward responses in the left hemisphere and relatively better neural encoding of PEs for stimuli presented in the right (vs. left) hemifield. These findings demonstrate that trait-like spatial biases implicate hemisphere-specific learning mechanisms, with individual differences between hemispheres contributing to reinforcing spatial biases.

  5. Qualitatively different organizational structures of lexical knowledge in the left and right hemisphere.

    PubMed

    Drews, E

    1987-01-01

    The present study investigates and discusses the organization of lexical knowledge in the intact left and right hemisphere within the framework of hemisphere-specific cognitive modes of processing. Using a divided visual field technique, word pairs of concrete nouns had to be judged. Semantic relation was either intraconceptual (coordinates) or interconceptual (locative). The results suggest that the left hemisphere, lexical structures are predominantly based on intraconceptual relationships corresponding to its analytic sequential processing mechanism, whereas in the right hemisphere, lexical entries are exclusively associated by means of interconceptual relationships in accordance with its "gestalthaft" holistic processor.

  6. Selective feeding in birds depends on combined processing in the left and right brain hemisphere.

    PubMed

    Prior, Helmut; Wilzeck, Christiane

    2008-01-15

    During visually guided foraging birds tend to select certain types of food from a mixed diet. This selectivity is ecologically relevant. During scanning for food birds spot the surroundings mainly with the monocular lateral visual field of the one or other eye and then control pecking with their small binocular frontal visual field. As the visual systems of the avian left and right brain hemisphere are supposed to work largely independently in the short term, the problem arises of how the avian brain handles a task that requires coordinated activity of the left and right brain hemisphere for efficient processing. Here we report that chicks exhibit strong selective feeding when both of the brain hemispheres are involved. With the left or right hemisphere alone selectivity is reduced or completely absent. Our findings reveal a marked qualitative difference between unilateral and bilateral processing. They highlight an important but so far unexplored selection pressure for the evolution of hemispheric cooperation.

  7. Lack of hemispheric dominance for consciousness in acute ischaemic stroke

    PubMed Central

    Cucchiara, B; Kasner, S; Wolk, D; Lyden, P; Knappertz, V; Ashwood, T; Odergren, T; Nordlund, A

    2003-01-01

    Background: Previous reports have suggested left hemispheric dominance for maintaining consciousness, although there is controversy over this claim. Objective: To compare early impairment of level of consciousness between patients with right and left hemispheric stroke. Methods: Data from 564 patients with ischaemic stroke enrolled in the placebo arm of a trial of a putative neuroprotectant were analysed. All patients had major hemispheric stroke with cortical dysfunction, visual field deficit, and limb weakness, with symptom onset within 12 hours of enrolment. Patients were prospectively evaluated on a predefined scale (1–6; 1 = fully awake, higher scores representing greater impairment) to measure level of consciousness at multiple time points over the initial 24 hours after presentation. The National Institutes of Health (NIH) stroke scale score at presentation and infarct volume at 30 days were determined. Results: Some degree of impairment in level of consciousness was observed in 409 of the 564 patients (73%). Median maximum sedation score was 2 for both right and left hemispheric stroke (p = 0.91). Mean sedation score over 24 hours was 1.5 for both right and left stroke (p = 0.75). There was no difference between level of consciousness scores in right and left stroke at any individual time point during the 24 hour monitoring period. No association between side and impairment in level of consciousness was seen after adjustment for stroke severity and infarct volume. Conclusions: In contrast to previous reports, there was no evidence for hemispheric dominance for consciousness in the setting of a major hemispheric stroke. PMID:12810773

  8. Priming vs. Rhyming: Orthographic and Phonological Representations in the Left and Right Hemispheres

    ERIC Educational Resources Information Center

    Lindell, Annukka K.; Lum, Jarrad A. G.

    2008-01-01

    The right cerebral hemisphere has long been argued to lack phonological processing capacity. Recently, however, a sex difference in the cortical representation of phonology has been proposed, suggesting discrete left hemisphere lateralization in males and more distributed, bilateral representation of function in females. To evaluate this…

  9. Word Recognition in Individuals with Left and Right Hemisphere Damage: The Role of Lexical Stress.

    ERIC Educational Resources Information Center

    Baum, Shari R.

    2002-01-01

    Employed a lexical decision task to asses whether left hemisphere damaged (LHD) and right hemisphere damaged (RHD) patients are similarly sensitive to stress patterns in lexical access. Results confirmed that individuals without brain damage are influenced by stress patterns, as indicated by increased lexical decision latencies to incorrectly…

  10. Priming vs. Rhyming: Orthographic and Phonological Representations in the Left and Right Hemispheres

    ERIC Educational Resources Information Center

    Lindell, Annukka K.; Lum, Jarrad A. G.

    2008-01-01

    The right cerebral hemisphere has long been argued to lack phonological processing capacity. Recently, however, a sex difference in the cortical representation of phonology has been proposed, suggesting discrete left hemisphere lateralization in males and more distributed, bilateral representation of function in females. To evaluate this…

  11. Remembering 1500 Pictures: The Right Hemisphere Remembers Better than the Left

    ERIC Educational Resources Information Center

    Laeng, Bruno; Overvoll, Morten; Ole Steinsvik, Oddmar

    2007-01-01

    We hypothesized that the right hemisphere would be superior to the left hemisphere in remembering having seen a specific picture before, given its superiority in perceptually encoding specific aspects of visual form. A large set of pictures (N=1500) of animals, human faces, artifacts, landscapes, and art paintings were shown for 2 s in central…

  12. Remembering 1500 Pictures: The Right Hemisphere Remembers Better than the Left

    ERIC Educational Resources Information Center

    Laeng, Bruno; Overvoll, Morten; Ole Steinsvik, Oddmar

    2007-01-01

    We hypothesized that the right hemisphere would be superior to the left hemisphere in remembering having seen a specific picture before, given its superiority in perceptually encoding specific aspects of visual form. A large set of pictures (N=1500) of animals, human faces, artifacts, landscapes, and art paintings were shown for 2 s in central…

  13. The Left-Right Hemisphere Model for Information Processing: Possible Implications for Education.

    ERIC Educational Resources Information Center

    Rubenzer, Ronald L.

    The paper, part of an all-day workshop, reviews research and theory on left-right hemisphere information processing and psychophysiological models on the functional organization of the brain. Hemisphericity is considered in terms of language, cognitive styles, role in education, verbal and non-verbal processing, affective concomitants, and…

  14. Left and Right Memory Revisited: Electrophysiological Investigations of Hemispheric Asymmetries at Retrieval

    ERIC Educational Resources Information Center

    Evans, Karen M.; Federmeier, Kara D.

    2009-01-01

    Hemispheric differences in the use of memory retrieval cues were examined in a continuous recognition design, using visual half-field presentation to bias the processing of test words. A speeded recognition task revealed general accuracy and response time advantages for items whose test presentation was biased to the left hemisphere. A second…

  15. Beyond hemispheric dominance: brain regions underlying the joint lateralization of language and arithmetic to the left hemisphere.

    PubMed

    Pinel, Philippe; Dehaene, Stanislas

    2010-01-01

    Language and arithmetic are both lateralized to the left hemisphere in the majority of right-handed adults. Yet, does this similar lateralization reflect a single overall constraint of brain organization, such an overall "dominance" of the left hemisphere for all linguistic and symbolic operations? Is it related to the lateralization of specific cerebral subregions? Or is it merely coincidental? To shed light on this issue, we performed a "colateralization analysis" over 209 healthy subjects: We investigated whether normal variations in the degree of left hemispheric asymmetry in areas involved in sentence listening and reading are mirrored in the asymmetry of areas involved in mental arithmetic. Within the language network, a region-of-interest analysis disclosed partially dissociated patterns of lateralization, inconsistent with an overall "dominance" model. Only two of these areas presented a lateralization during sentence listening and reading which correlated strongly with the lateralization of two regions active during calculation. Specifically, the profile of asymmetry in the posterior superior temporal sulcus during sentence processing covaried with the asymmetry of calculation-induced activation in the intraparietal sulcus, and a similar colateralization linked the middle frontal gyrus with the superior posterior parietal lobule. Given recent neuroimaging results suggesting a late emergence of hemispheric asymmetries for symbolic arithmetic during childhood, we speculate that these colateralizations might constitute developmental traces of how the acquisition of linguistic symbols affects the cerebral organization of the arithmetic network.

  16. Hydrallazine alone in acute left ventricular failure

    PubMed Central

    Clark, A. J. L.; McMichael, H. B.

    1981-01-01

    A patient presented with severe acute left ventricular failure and was treated with hydrallazine and oxygen alone. He made a rapid and full recovery as judged by clinical, radiological and blood gas evidence. ImagesFig. 1 PMID:7329902

  17. Measurements of right / left hemisphere activation using functional near-infrared spectroscopy during incongruent Stroop test.

    PubMed

    Hiroyasu, Tomoyuki; Fukuhara, Michihiro; Yokouchi, Hisatake; Miki, Mitsunori; Yoshimi, Masato

    2011-01-01

    The human brain automatically processes information at multiple sites when recognizing various types of information at the same time, such as color, shape, etc. Cognitive conflict may occur when conflicting information is recognized at the same time. Functional near-infrared spectroscopy (fNIRS) is often used to examine the brain activity associated with this phenomenon. To examine activation of the visual system, we measured brain activity in the right / left hemispheres during cognitive conflict in the Stroop test. Consistent with the results reported previously by Ehlis, the brain activity in the near inferior-frontal gyrus of the left hemisphere was increased during the incongruent task. The brain activity also increased in the near inferior-frontal gyrus of the right hemisphere during the incongruent task. These results indicated that fNIRS can be used to detect brain activity in the inferior-frontal gyrus of the right / left hemispheres during the Stroop test.

  18. The right hemisphere supports but does not replace left hemisphere auditory function in patients with persisting aphasia

    PubMed Central

    Barnes, Gareth R.; Penny, William D.; Iverson, Paul; Woodhead, Zoe V. J.; Griffiths, Timothy D.; Leff, Alexander P.

    2013-01-01

    In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) and acoustic (same word) oddballs using dynamic causal modelling. We found stronger modulation of self-connections as a function of phonemic differences for control subjects versus aphasics in left primary auditory cortex and bilateral superior temporal gyrus. The patients showed stronger modulation of connections from right primary auditory cortex to right superior temporal gyrus (feed-forward) and from left primary auditory cortex to right primary auditory cortex (interhemispheric). This differential connectivity can be explained on the basis of a predictive coding theory which suggests increased prediction error and decreased sensitivity to phonemic boundaries in the aphasics’ speech network in both hemispheres. Within the aphasics, we also found behavioural correlates with connection strengths: a negative correlation between phonemic perception and an inter-hemispheric connection (left superior temporal gyrus to right superior temporal gyrus), and positive correlation between semantic performance and a feedback connection (right superior temporal gyrus to right primary auditory cortex). Our results suggest that aphasics with impaired speech comprehension have less veridical speech representations in both temporal lobes, and rely more on the right hemisphere auditory regions, particularly right superior temporal gyrus, for processing speech. Despite this presumed compensatory shift in network connectivity, the patients remain significantly impaired. PMID:23715097

  19. The right hemisphere supports but does not replace left hemisphere auditory function in patients with persisting aphasia.

    PubMed

    Teki, Sundeep; Barnes, Gareth R; Penny, William D; Iverson, Paul; Woodhead, Zoe V J; Griffiths, Timothy D; Leff, Alexander P

    2013-06-01

    In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) and acoustic (same word) oddballs using dynamic causal modelling. We found stronger modulation of self-connections as a function of phonemic differences for control subjects versus aphasics in left primary auditory cortex and bilateral superior temporal gyrus. The patients showed stronger modulation of connections from right primary auditory cortex to right superior temporal gyrus (feed-forward) and from left primary auditory cortex to right primary auditory cortex (interhemispheric). This differential connectivity can be explained on the basis of a predictive coding theory which suggests increased prediction error and decreased sensitivity to phonemic boundaries in the aphasics' speech network in both hemispheres. Within the aphasics, we also found behavioural correlates with connection strengths: a negative correlation between phonemic perception and an inter-hemispheric connection (left superior temporal gyrus to right superior temporal gyrus), and positive correlation between semantic performance and a feedback connection (right superior temporal gyrus to right primary auditory cortex). Our results suggest that aphasics with impaired speech comprehension have less veridical speech representations in both temporal lobes, and rely more on the right hemisphere auditory regions, particularly right superior temporal gyrus, for processing speech. Despite this presumed compensatory shift in network connectivity, the patients remain significantly impaired.

  20. A Fluent Language Disorder Following Antepartum Left-Hemisphere Brain Injury.

    ERIC Educational Resources Information Center

    Feldman, Heidi M.; And Others

    1992-01-01

    This article describes the language development in a left-handed young child with a left middle cerebral artery infarction. Patterns of development observed between 36 and 60 months of age are described as a transient jargon or fluent aphasia possibly resulting from initial reliance on an uninjured right hemisphere. (Author/DB)

  1. A Fluent Language Disorder Following Antepartum Left-Hemisphere Brain Injury.

    ERIC Educational Resources Information Center

    Feldman, Heidi M.; And Others

    1992-01-01

    This article describes the language development in a left-handed young child with a left middle cerebral artery infarction. Patterns of development observed between 36 and 60 months of age are described as a transient jargon or fluent aphasia possibly resulting from initial reliance on an uninjured right hemisphere. (Author/DB)

  2. Competition for Left Hemisphere Resources: Right Hemisphere Superiority at Abstract Verbal Information Processing.

    DTIC Science & Technology

    1981-06-01

    CENTER 1 Dr . William L. Maloy SAN DIEGO, CA 92152 Principal Civilian Advisor for Education and Training Mr. Paul Foley Naval Training Command, Code OOA...hemisphere is incapable of speech production per se (e.g., Broca , 1861, 1865; Sperry, 1974) Consequently, when a word to be named is presented to the...of controlled and automatic detection. University of Delaware Research Report Series, Report No. 8001, 1979. ib 36 REFERENCES Broca , P. Remarques sur

  3. Moral judgement by the disconnected left and right cerebral hemispheres: a split-brain investigation

    PubMed Central

    Hamlin, J. Kiley; Miller, Michael B.; King, Danielle; Kingstone, Alan

    2017-01-01

    Owing to the hemispheric isolation resulting from a severed corpus callosum, research on split-brain patients can help elucidate the brain regions necessary and sufficient for moral judgement. Notably, typically developing adults heavily weight the intentions underlying others' moral actions, placing greater importance on valenced intentions versus outcomes when assigning praise and blame. Prioritization of intent in moral judgements may depend on neural activity in the right hemisphere's temporoparietal junction, an area implicated in reasoning about mental states. To date, split-brain research has found that the right hemisphere is necessary for intent-based moral judgement. When testing the left hemisphere using linguistically based moral vignettes, split-brain patients evaluate actions based on outcomes, not intentions. Because the right hemisphere has limited language ability relative to the left, and morality paradigms to date have involved significant linguistic demands, it is currently unknown whether the right hemisphere alone generates intent-based judgements. Here we use nonlinguistic morality plays with split-brain patient J.W. to examine the moral judgements of the disconnected right hemisphere, demonstrating a clear focus on intent. This finding indicates that the right hemisphere is not only necessary but also sufficient for intent-based moral judgement, advancing research into the neural systems supporting the moral sense. PMID:28791143

  4. Moral judgement by the disconnected left and right cerebral hemispheres: a split-brain investigation.

    PubMed

    Steckler, Conor M; Hamlin, J Kiley; Miller, Michael B; King, Danielle; Kingstone, Alan

    2017-07-01

    Owing to the hemispheric isolation resulting from a severed corpus callosum, research on split-brain patients can help elucidate the brain regions necessary and sufficient for moral judgement. Notably, typically developing adults heavily weight the intentions underlying others' moral actions, placing greater importance on valenced intentions versus outcomes when assigning praise and blame. Prioritization of intent in moral judgements may depend on neural activity in the right hemisphere's temporoparietal junction, an area implicated in reasoning about mental states. To date, split-brain research has found that the right hemisphere is necessary for intent-based moral judgement. When testing the left hemisphere using linguistically based moral vignettes, split-brain patients evaluate actions based on outcomes, not intentions. Because the right hemisphere has limited language ability relative to the left, and morality paradigms to date have involved significant linguistic demands, it is currently unknown whether the right hemisphere alone generates intent-based judgements. Here we use nonlinguistic morality plays with split-brain patient J.W. to examine the moral judgements of the disconnected right hemisphere, demonstrating a clear focus on intent. This finding indicates that the right hemisphere is not only necessary but also sufficient for intent-based moral judgement, advancing research into the neural systems supporting the moral sense.

  5. Brain activity underlying tool-related and imitative skills after major left hemisphere stroke.

    PubMed

    Martin, Markus; Nitschke, Kai; Beume, Lena; Dressing, Andrea; Bühler, Laura E; Ludwig, Vera M; Mader, Irina; Rijntjes, Michel; Kaller, Christoph P; Weiller, Cornelius

    2016-05-01

    Apraxia is a debilitating cognitive motor disorder that frequently occurs after left hemisphere stroke and affects tool-associated and imitative skills. However, the severity of the apraxic deficits varies even across patients with similar lesions. This variability raises the question whether regions outside the left hemisphere network typically associated with cognitive motor tasks in healthy subjects are of additional functional relevance. To investigate this hypothesis, we explored regions where functional magnetic resonance imaging activity is associated with better cognitive motor performance in patients with left hemisphere ischaemic stroke. Thirty-six patients with chronic (>6 months) large left hemisphere infarcts (age ± standard deviation, 60 ± 12 years, 29 male) and 29 control subjects (age ± standard deviation, 72 ± 7, 15 male) were first assessed behaviourally outside the scanner with tests for actual tool use, pantomime and imitation of tool-use gestures, as well as for meaningless gesture imitation. Second, functional magnetic resonance imaging activity was registered during the passive observation of videos showing tool-associated actions. Voxel-wise linear regression analyses were used to identify areas where behavioural performance was correlated with functional magnetic resonance imaging activity. Furthermore, lesions were delineated on the magnetic resonance imaging scans for voxel-based lesion-symptom mapping. The analyses revealed two sets of regions where functional magnetic resonance imaging activity was associated with better performance in the clinical tasks. First, activity in left hemisphere areas thought to mediate cognitive motor functions in healthy individuals (i.e. activity within the putative 'healthy' network) was correlated with better scores. Within this network, tool-associated tasks were mainly related to activity in supramarginal gyrus and ventral premotor cortex, while meaningless gesture imitation depended more on the

  6. When Left Means Right: An Explanation of the Left Cradling Bias in Terms of Right Hemisphere Specializations

    ERIC Educational Resources Information Center

    Bourne, Victoria J.; Todd, Brenda K.

    2004-01-01

    Previous research has indicated that 70-85% of women and girls show a bias to hold infants, or dolls, to the left side of their body. This bias is not matched in males (e.g. deChateau, Holmberg & Winberg, 1978; Todd, 1995). This study tests an explanation of cradling preferences in terms of hemispheric specialization for the perception of facial…

  7. When Left Means Right: An Explanation of the Left Cradling Bias in Terms of Right Hemisphere Specializations

    ERIC Educational Resources Information Center

    Bourne, Victoria J.; Todd, Brenda K.

    2004-01-01

    Previous research has indicated that 70-85% of women and girls show a bias to hold infants, or dolls, to the left side of their body. This bias is not matched in males (e.g. deChateau, Holmberg & Winberg, 1978; Todd, 1995). This study tests an explanation of cradling preferences in terms of hemispheric specialization for the perception of facial…

  8. Left hemispheric breakdown of LTP-like cortico-cortical plasticity in schizophrenic patients.

    PubMed

    Ribolsi, Michele; Lisi, Giulia; Ponzo, Viviana; Siracusano, Alberto; Caltagirone, Carlo; Niolu, Cinzia; Koch, Giacomo

    2017-10-01

    Altered cortical connectivity and plasticity seems to be asymmetrical between the hemispheres in patients with schizophrenia (SCZ). We evaluated long-term potentiation (LTP) in parietal-frontal circuits of both hemispheres using a cortico-cortical Paired Associative Stimulation (cc-PAS) protocol testing the rules of Hebbian-like spike timing dependent plasticity (SPTD). 12 SCZ and 12 healthy subjects (HS) underwent a cc-PAS protocol to activate, by means of paired pulses of transcranial magnetic stimulation (TMS), the short-latency connection between posterior parietal cortex (PPC) and primary motor cortex (M1) of both hemispheres. Motor-evoked potentials (MEPs) were collected to assess the time course of the after effects of cc-PAS protocol measuring MEP amplitude as index of cortico-cortical associative plasticity. While HS showed a similar time course of LTP-like plasticity in the two hemispheres, SCZ revealed a weaker late-LTP-like plasticity in the left compared to the right hemisphere after cc-PAS protocol. SCZ failed to show the typical long-lasting increase of M1 excitability observed after cc-PAS protocol in both hemispheres, with a greater reduction in the left one. Our findings provide novel neurophysiological evidence for an asymmetric impairment of the left parietal-frontal network in SCZ patients. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  9. LEFT VERSUS RIGHT HEMISPHERE DIFFERENCES IN BRAIN CONNECTIVITY: 4-TESLA HARDI TRACTOGRAPHY IN 569 TWINS.

    PubMed

    Daianu, Madelaine; Jahanshad, Neda; Dennis, Emily L; Toga, Arthur W; McMahon, Katie L; de Zubicaray, Greig I; Martin, Nicholas G; Wright, Margaret J; Hickie, Ian B; Thompson, Paul M

    2012-05-01

    Diffusion imaging can map anatomical connectivity in the living brain, offering new insights into fundamental questions such as how the left and right brain hemispheres differ. Anatomical brain asymmetries are related to speech and language abilities, but less is known about left/right hemisphere differences in brain wiring. To assess this, we scanned 457 young adults (age 23.4±2.0 SD years) and 112 adolescents (age 12-16) with 4-Tesla 105-gradient high-angular resolution diffusion imaging. We extracted fiber tracts throughout the brain with a Hough transform method. A 70×70 connectivity matrix was created, for each subject, based on the proportion of fibers intersecting 70 cortical regions. We identified significant differences in the proportions of fibers intersecting left and right hemisphere cortical regions. The degree of asymmetry in the connectivity matrices varied with age, as did the asymmetry in network topology measures such as the small-world effect.

  10. Left hemisphere and male sex dominance of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome).

    PubMed

    Unal, Ozkan; Tombul, Temel; Cirak, Bayram; Anlar, Omer; Incesu, Lütfi; Kayan, Mustafa

    2004-01-01

    Although radiological findings of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome) are well known, there is no systematic study about the gender and the affected side in this syndrome. Brain images in 26 patients (mean aged 11) with cerebral hemiatrophy were retrospectively reviewed. Nineteen patients (73.5%) were male and seven patients (26.5%) were female. Left hemisphere involvement was seen in 18 patients (69.2%) and right hemisphere involvement was seen in eight patients (30.8%). We conclude that male gender and left side involvement are frequent in cerebral hemiatrophy disease.

  11. The role of the right hemisphere in semantic control: A case-series comparison of right and left hemisphere stroke

    PubMed Central

    Thompson, Hannah E.; Henshall, Lauren; Jefferies, Elizabeth

    2016-01-01

    Semantic control processes guide conceptual retrieval so that we are able to focus on non-dominant associations and features when these are required for the task or context, yet the neural basis of semantic control is not fully understood. Neuroimaging studies have emphasised the role of left inferior frontal gyrus (IFG) in controlled retrieval, while neuropsychological investigations of semantic control deficits have almost exclusively focussed on patients with left-sided damage (e.g., patients with semantic aphasia, SA). Nevertheless, activation in fMRI during demanding semantic tasks typically extends to right IFG. To investigate the role of the right hemisphere (RH) in semantic control, we compared nine RH stroke patients with 21 left-hemisphere SA patients, 11 mild SA cases and 12 healthy, aged-matched controls on semantic and executive tasks, plus experimental tasks that manipulated semantic control in paradigms particularly sensitive to RH damage. RH patients had executive deficits to parallel SA patients but they performed well on standard semantic tests. Nevertheless, multimodal semantic control deficits were found in experimental tasks involving facial emotions and the ‘summation’ of meaning across multiple items. On these tasks, RH patients showed effects similar to those in SA cases – multimodal deficits that were sensitive to distractor strength and cues and miscues, plus increasingly poor performance in cyclical matching tasks which repeatedly probed the same set of concepts. Thus, despite striking differences in single-item comprehension, evidence presented here suggests semantic control is bilateral, and disruption of this component of semantic cognition can be seen following damage to either hemisphere. PMID:26945505

  12. The role of the right hemisphere in semantic control: A case-series comparison of right and left hemisphere stroke.

    PubMed

    Thompson, Hannah E; Henshall, Lauren; Jefferies, Elizabeth

    2016-05-01

    Semantic control processes guide conceptual retrieval so that we are able to focus on non-dominant associations and features when these are required for the task or context, yet the neural basis of semantic control is not fully understood. Neuroimaging studies have emphasised the role of left inferior frontal gyrus (IFG) in controlled retrieval, while neuropsychological investigations of semantic control deficits have almost exclusively focussed on patients with left-sided damage (e.g., patients with semantic aphasia, SA). Nevertheless, activation in fMRI during demanding semantic tasks typically extends to right IFG. To investigate the role of the right hemisphere (RH) in semantic control, we compared nine RH stroke patients with 21 left-hemisphere SA patients, 11 mild SA cases and 12 healthy, aged-matched controls on semantic and executive tasks, plus experimental tasks that manipulated semantic control in paradigms particularly sensitive to RH damage. RH patients had executive deficits to parallel SA patients but they performed well on standard semantic tests. Nevertheless, multimodal semantic control deficits were found in experimental tasks involving facial emotions and the 'summation' of meaning across multiple items. On these tasks, RH patients showed effects similar to those in SA cases - multimodal deficits that were sensitive to distractor strength and cues and miscues, plus increasingly poor performance in cyclical matching tasks which repeatedly probed the same set of concepts. Thus, despite striking differences in single-item comprehension, evidence presented here suggests semantic control is bilateral, and disruption of this component of semantic cognition can be seen following damage to either hemisphere. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Left and right hemispheric contributions to discourse coherence and cohesion.

    PubMed

    Bloom, R L; Borod, J C; Santschi-Haywood, C; Pick, L H; Obler, L K

    1996-11-01

    Linguistic coherence and cohesion were examined in patients with unilateral left brain damage (LBD), unilateral right brain damage (RBD), and normal control (NC) right-handed adults. Groups were matched for age, gender, occupation, and education. Brain-damaged groups did not differ for months post onset or intrahemispheric lesion site. Contrary to previous literature, results indicated that LBDs, all of whom were aphasic, demonstrated impairments in coherence but not cohesion, relative to NCs and RBDs. Surprisingly, among RBDs, overall coherence and cohesion were spared. When the relationship between measures of coherence and cohesion was examined, there were few significant correlations and no systematic patterns. Results support the notion that coherence and cohesion represent coexisting and independent linguistic systems. Further, the findings suggest that descriptions of discourse integrity need to account for the perspective of both the speaker and listener.

  14. Increased inter-hemispheric resting-state functional connectivity in acute lacunar stroke patients with aphasia.

    PubMed

    Yang, Haiqing; Bai, Lin; Zhou, Yi; Kang, Shan; Liang, Panpan; Wang, Lihua; Zhu, Yifei

    2017-03-01

    Aphasia is a devastating neurological condition affecting a person's ability to communicate and reintegrate into the society. It may occur in 20% or more of patients after stroke. The recovery of language function is accompanied by brain reorganization, and identifying the inter-hemispheric interaction post-stroke will conduce to more targeted treatments. Previous studies suggested that robust homotopic resting-state functional connectivity is a key characteristic of the brain's intrinsic functional architecture, and communication between the left and right cerebral hemispheres is important for language processing. In this study, voxel-mirrored homotopic connectivity (VMHC) was used to examine the inter-hemispheric resting-state functional connectivity (RSFC) differences between 37 patients with acute lacunar stroke in the left hemisphere and 28 healthy controls. Besides, correlation analyses were carried out to investigate the relationship between VMHC values of brain regions showing abnormal inter-hemispheric RSFC and clinical variables [i.e., aphasia quotient (AQ) scores, National Institutes of Health Stroke Scale (NIHSS) and Mini-Mental State Examination of patients]. Compared with healthy controls, patients showed significantly increased VMHC in the pars orbitalis of the inferior frontal gyrus, anterior part of the superior temporal gyrus (STG) and lingual gyrus. No brain region showed decreased VMHC in the patient group than in the healthy control group. The AQ scores were negatively correlated with VMHC values in the STG. NIHSS scores were positively correlated with VMHC values in the lingual gyrus. We hope these results could shed new insights into the pathology of aphasia in patients with acute lacunar stroke.

  15. Left hemispheric dominance of vestibular processing indicates lateralization of cortical functions in rats.

    PubMed

    Best, Christoph; Lange, Elena; Buchholz, Hans-Georg; Schreckenberger, Mathias; Reuss, Stefan; Dieterich, Marianne

    2014-11-01

    Lateralization of cortical functions such as speech dominance, handedness and processing of vestibular information are present not only in humans but also in ontogenetic older species, e.g. rats. In human functional imaging studies, the processing of vestibular information was found to be correlated with the hemispherical dominance as determined by the handedness. It is located mainly within the right hemisphere in right handers and within the left hemisphere in left handers. Since dominance of vestibular processing is unknown in animals, our aim was to study the lateralization of cortical processing in a functional imaging study applying small-animal positron emission tomography (microPET) and galvanic vestibular stimulation in an in vivo rat model. The cortical and subcortical network processing vestibular information could be demonstrated and correlated with data from other animal studies. By calculating a lateralization index as well as flipped region of interest analyses, we found that the vestibular processing in rats follows a strong left hemispheric dominance independent from the "handedness" of the animals. These findings support the idea of an early hemispheric specialization of vestibular cortical functions in ontogenetic older species.

  16. Left-side infant holding: a test of the hemispheric arousal-attentional hypothesis.

    PubMed

    Harris, L J; Almerigi, J B; Carbary, T J; Fogel, T G

    2001-01-01

    When asked to hold a young infant in their arms, most adults hold on the left side (Harris, 1997). In a prior study, we found the same bias when we asked adults merely to imagine holding an infant in their arms (Harris, Almerigi, & Kirsch, 1999). It has been hypothesized that the left-side bias is the product of right-hemisphere arousal accompanying certain aspects of the act, causing attention to be driven to the contralateral, or left, side of personal space. Left-side holding, whether actual or imagined, thus would be consistent with the direction to which the holder's attention has been endogenously directed. We tested this hypothesis by giving 250 college students the "imagine-holding" task and then, as an independent measure of lateralized hemispheric arousal, a 34-item Chimeric Faces Test (CFT). On the "imagine" test, a significant majority reported a left-side hold, and, on the CFT, left-side holders had a significantly stronger left-hemispace bias than right-side holders, although both left- and right side holders had left-hemispace CFT biases. The results thus support the attentional-arousal hypothesis but indicate that other factors are contributing as well.

  17. Reorganization of the cerebro-cerebellar network of language production in patients with congenital left-hemispheric brain lesions.

    PubMed

    Lidzba, K; Wilke, M; Staudt, M; Krägeloh-Mann, I; Grodd, W

    2008-09-01

    Patients with congenital lesions of the left cerebral hemisphere may reorganize language functions into the right hemisphere. In these patients, language production is represented homotopically to the left-hemispheric language areas. We studied cerebellar activation in five patients with congenital lesions of the left cerebral hemisphere to assess if the language network is reorganized completely in these patients, i.e. including also cerebellar language functions. As compared to a group of controls matched for age, sex, and verbal IQ, the patients recruited an area not in the right but in the left cerebellar hemisphere. The extent of laterality of the cerebellar activation correlated significantly with the laterality of the frontal activation. We suggest that the developing brain reacts to early focal lesions in the left hemisphere with a mirror-image organization of the entire cerebro-cerebellar network engaged in speech production.

  18. Production of Korean Idiomatic Utterances Following Left- and Right-Hemisphere Damage: Acoustic Studies

    ERIC Educational Resources Information Center

    Yang, Seung-yun; Van Lancker Sidtis, Diana

    2016-01-01

    Purpose: This study investigates the effects of left- and right-hemisphere damage (LHD and RHD) on the production of idiomatic or literal expressions utilizing acoustic analyses. Method: Twenty-one native speakers of Korean with LHD or RHD and in a healthy control (HC) group produced 6 ditropically ambiguous (idiomatic or literal) sentences in 2…

  19. Production of Korean Idiomatic Utterances Following Left- and Right-Hemisphere Damage: Acoustic Studies

    ERIC Educational Resources Information Center

    Yang, Seung-yun; Van Lancker Sidtis, Diana

    2016-01-01

    Purpose: This study investigates the effects of left- and right-hemisphere damage (LHD and RHD) on the production of idiomatic or literal expressions utilizing acoustic analyses. Method: Twenty-one native speakers of Korean with LHD or RHD and in a healthy control (HC) group produced 6 ditropically ambiguous (idiomatic or literal) sentences in 2…

  20. Left and Right Hemisphere Brain Functions and Symbolic vs. Spontaneous Communication Processes.

    ERIC Educational Resources Information Center

    Buck, Ross

    Recent findings on the communicative functions of the left versus the right hemisphere of the brain may suggest that there is a distinction between the intentional use of symbols for the sending of specific messages or propositions (language, signing, pantomime) and spontaneous expressive behaviors that signal their meaning through a natural…

  1. Mental Number Line Disruption in a Right-Neglect Patient after a Left-Hemisphere Stroke

    ERIC Educational Resources Information Center

    Pia, Lorenzo; Corazzini, Luca Latini; Folegatti, Alessia; Gindri, Patrizia; Cauda, Franco

    2009-01-01

    A right-neglect patient with focal left-hemisphere damage to the posterior superior parietal lobe was assessed for numerical knowledge and tested on the bisection of numerical intervals and visual lines. The semantic and verbal knowledge of numbers was preserved, whereas the performance in numerical tasks that strongly emphasize the visuo-spatial…

  2. Research Synthesis on Right and Left Hemispheres: We Think with Both Sides of the Brain.

    ERIC Educational Resources Information Center

    Levy, Jerre

    1983-01-01

    Simplified interpretations of brain function portraying rationality solely in the left hemisphere and creativity solely in the right are incorrect, but the two sides of the brain do differ in important ways. Conclusive implications of brain research cannot yet be drawn for educational practices, but certain inferences can be made. (Author/JM)

  3. Is the Left Hemisphere Specialized for Speech, Language and/or Something Else?

    ERIC Educational Resources Information Center

    Papcun, George; And Others

    1974-01-01

    Morse code signals were presented dichotically to Morse code operators and to naive subjects with no knowledge of Morse code. The operators showed right ear superiority, indicating left hemisphere dominance for the perception of dichotically presented Morse code letters. Naive subjects showed the same right ear superiority when presented with a…

  4. Mental Number Line Disruption in a Right-Neglect Patient after a Left-Hemisphere Stroke

    ERIC Educational Resources Information Center

    Pia, Lorenzo; Corazzini, Luca Latini; Folegatti, Alessia; Gindri, Patrizia; Cauda, Franco

    2009-01-01

    A right-neglect patient with focal left-hemisphere damage to the posterior superior parietal lobe was assessed for numerical knowledge and tested on the bisection of numerical intervals and visual lines. The semantic and verbal knowledge of numbers was preserved, whereas the performance in numerical tasks that strongly emphasize the visuo-spatial…

  5. Knowledge and Strategies for Processing Lexical Metaphor after Right or Left Hemisphere Brain Damage.

    ERIC Educational Resources Information Center

    Tompkins, Connie A.

    1990-01-01

    The study assessed how unilateral right hemisphere brain damage (RHD) affects processing of metaphoric aspects of word meaning. RHD stroke patients (N=25) performed similarly to left-brain-damaged and normal subjects in the automatic condition and when provided with processing strategies. Both brain-damaged groups had difficulty developing…

  6. Functional characteristics of developmental dyslexia in left-hemispheric posterior brain regions predate reading onset

    PubMed Central

    Raschle, Nora Maria; Zuk, Jennifer; Gaab, Nadine

    2012-01-01

    Individuals with developmental dyslexia (DD) show a disruption in posterior left-hemispheric neural networks during phonological processing. Additionally, compensatory mechanisms in children and adults with DD have been located within frontal brain areas. However, it remains unclear when and how differences in posterior left-hemispheric networks manifest and whether compensatory mechanisms have already started to develop in the prereading brain. Here we investigate functional networks during phonological processing in 36 prereading children with a familial risk for DD (n = 18, average age = 66.50 mo) compared with age and IQ-matched controls (n = 18; average age = 65.61 mo). Functional neuroimaging results reveal reduced activation in prereading children with a family-history of DD (FHD+), compared with those without (FHD−), in bilateral occipitotemporal and left temporoparietal brain regions. This finding corresponds to previously identified hypoactivations in left hemispheric posterior brain regions for school-aged children and adults with a diagnosis of DD. Furthermore, left occipitotemporal and temporoparietal brain activity correlates positively with prereading skills in both groups. Our results suggest that differences in neural correlates of phonological processing in individuals with DD are not a result of reading failure, but are present before literacy acquisition starts. Additionally, no hyperactivation in frontal brain regions was observed, suggesting that compensatory mechanisms for reading failure are not yet present. Future longitudinal studies are needed to determine whether the identified differences may serve as neural premarkers for the early identification of children at risk for DD. PMID:22308323

  7. Hand movements with a phase structure and gestures that depict action stem from a left hemispheric system of conceptualization.

    PubMed

    Helmich, I; Lausberg, H

    2014-10-01

    The present study addresses the previously discussed controversy on the contribution of the right and left cerebral hemispheres to the production and conceptualization of spontaneous hand movements and gestures. Although it has been shown that each hemisphere contains the ability to produce hand movements, results of left hemispherically lateralized motor functions challenge the view of a contralateral hand movement production system. To examine hemispheric specialization in hand movement and gesture production, ten right-handed participants were tachistoscopically presented pictures of everyday life actions. The participants were asked to demonstrate with their hands, but without speaking what they had seen on the drawing. Two independent blind raters evaluated the videotaped hand movements and gestures employing the Neuropsychological Gesture Coding System. The results showed that the overall frequency of right- and left-hand movements is equal independent of stimulus lateralization. When hand movements were analyzed considering their Structure, the presentation of the action stimuli to the left hemisphere resulted in more hand movements with a phase structure than the presentation to the right hemisphere. Furthermore, the presentation to the left hemisphere resulted in more right and left-hand movements with a phase structure, whereas the presentation to the right hemisphere only increased contralateral left-hand movements with a phase structure as compared to hand movements without a phase structure. Gestures that depict action were primarily displayed in response to stimuli presented in the right visual field than in the left one. The present study shows that both hemispheres possess the faculty to produce hand movements in response to action stimuli. However, the left hemisphere dominates the production of hand movements with a phase structure and gestures that depict action. We therefore conclude that hand movements with a phase structure and gestures that

  8. TIMING VARIABILITY OF REACH TRAJECTORIES IN LEFT VERSUS RIGHT HEMISPHERE STROKE

    PubMed Central

    Freitas, Sandra Maria Sbeghen Ferreira; Gera, Geetanjali; Scholz, John Peter

    2011-01-01

    This study investigated trajectory timing variability in right and left stroke survivors and healthy controls when reaching to a centrally located target under a fixed target condition or when the target could suddenly change position after reach onset. Trajectory timing variability was investigated with a novel method based on dynamic programming that identifies the steps required to time warp one trial’s acceleration time series to match that of a reference trial. Greater trajectory timing variability of both hand and joint motions was found for the paretic arm of stroke survivors compared to their non-paretic arm or either arm of controls. Overall, the non-paretic left arm of the LCVA group and the left arm of controls had higher timing variability than the non-paretic right arm of the RCVA group and right arm of controls. The shoulder and elbow joint warping costs were consistent predictors of the hand’s warping cost for both left and right arms only in the LCVA group, whereas the relationship between joint and hand warping costs was relatively weak in control subjects and less consistent across arms in the RCVA group. These results suggest that the left hemisphere may be more involved in trajectory timing, although the results may be confounded by skill differences between the arms in these right hand dominant participants. On the other hand, arm differences did not appear to be related to differences in targeting error. The paretic left arm of the RCVA exhibited greater trajectory timing variability than the paretic right arm of the LCVA group. This difference was highly correlated with the level of impairment of the arms. Generally, the effect of target uncertainty resulted in slightly greater trajectory timing variability for all participants. The results are discussed in light of previous studies of hemispheric differences in the control of reaching, in particular, left hemisphere specialization for temporal control of reaching movements. PMID:21920508

  9. Timing variability of reach trajectories in left versus right hemisphere stroke.

    PubMed

    Freitas, Sandra Maria Sbeghen Ferreira; Gera, Geetanjali; Scholz, John Peter

    2011-10-24

    This study investigated trajectory timing variability in right and left stroke survivors and healthy controls when reaching to a centrally located target under a fixed target condition or when the target could suddenly change position after reach onset. Trajectory timing variability was investigated with a novel method based on dynamic programming that identifies the steps required to time warp one trial's acceleration time series to match that of a reference trial. Greater trajectory timing variability of both hand and joint motions was found for the paretic arm of stroke survivors compared to their non-paretic arm or either arm of controls. Overall, the non-paretic left arm of the LCVA group and the left arm of controls had higher timing variability than the non-paretic right arm of the RCVA group and right arm of controls. The shoulder and elbow joint warping costs were consistent predictors of the hand's warping cost for both left and right arms only in the LCVA group, whereas the relationship between joint and hand warping costs was relatively weak in control subjects and less consistent across arms in the RCVA group. These results suggest that the left hemisphere may be more involved in trajectory timing, although the results may be confounded by skill differences between the arms in these right hand dominant participants. On the other hand, arm differences did not appear to be related to differences in targeting error. The paretic left arm of the RCVA exhibited greater trajectory timing variability than the paretic right arm of the LCVA group. This difference was highly correlated with the level of impairment of the arms. Generally, the effect of target uncertainty resulted in slightly greater trajectory timing variability for all participants. The results are discussed in light of previous studies of hemispheric differences in the control of reaching, in particular, left hemisphere specialization for temporal control of reaching movements. Copyright © 2011

  10. Illness Denial in Schizophrenia Spectrum Disorders: A Function of Left Hemisphere Dominance

    PubMed Central

    Gerretsen, Philip; Menon, Mahesh; Chakravarty, M. Mallar; Lerch, Jason P; Mamo, David C.; Remington, Gary; Pollock, Bruce G; Graff-Guerrero, Ariel

    2014-01-01

    Impaired illness awareness or anosognosia is a common, but poorly understood feature of schizophrenia that contributes to medication nonadherence and poor treatment outcomes. Here we present a functional imaging study to measure brain activity at the moment of illness denial. To accomplish this, participants with schizophrenia (n = 18) with varying degrees of illness awareness were confronted with their illness beliefs while undergoing functional MRI. To link structure with function, we explored the relationships among impaired illness awareness and brain activity during the illness denial task with cortical thickness (CT). Impaired illness awareness was associated with increased brain activity in the left temporoparietooccipital junction (TPO) and left medial prefrontal cortex (mPFC) at the moment of illness denial. Brain activity in the left mPFC appeared to be a function of participants’ degree of self-reflectiveness, while the activity in the left TPO was associated with cortical thinning in this region and more specific to illness denial. Participants with impaired illness awareness had slower response times to illness related stimuli than those with good illness awareness. Increased left hemisphere brain activity in association with illness denial is consistent with the literature in other neuropsychiatric conditions attributing anosognosia or impaired illness awareness to left hemisphere dominance. The TPO and mPFC may represent putative targets for non-invasive treatment interventions, such as transcranial magnetic or direct current stimulation. PMID:25209949

  11. Do left and right asymmetries of hemispheric preference interact with attention to predict local and global performance in applied tasks?

    PubMed

    Jackson, Chris J; Hobman, Elizabeth V; Jimmieson, Nerina L; Martin, Robin

    2012-01-01

    Many cognitive neuroscience studies show that the ability to attend to and identify global or local information is lateralised between the two hemispheres in the human brain; the left hemisphere is biased towards the local level, whereas the right hemisphere is biased towards the global level. Results of two studies show attention-focused people with a right ear preference (biased towards the left hemisphere) are better at local tasks, whereas people with a left ear preference (biased towards the right hemisphere) are better at more global tasks. In a third study we determined if right hemisphere-biased followers who attend to global stimuli are likely to have a stronger relationship between attention and globally based supervisor ratings of performance. Results provide evidence in support of this hypothesis. Our research supports our model and suggests that the interaction between attention and lateral preference is an important and novel predictor of work-related outcomes.

  12. Left hemispheric lateral preference and high neuroticism predict disinhibition in two go/no-go experiments.

    PubMed

    Gardiner, Elliroma; Jackson, Chris J; Loxton, Natalie J

    2015-02-01

    Although disinhibition is widely implicated in impulse-control-related psychopathologies, debate remains regarding the underlying approach and avoidance processes of this construct. In two studies, we simultaneously tested three competing models in which varying levels of extraversion, neuroticism, and hemispheric lateral preference are associated with disinhibition. In both studies (Study 1, N = 92; Study 2, N = 124), undergraduate students were randomly allocated to one of two versions of the go/no-go task: one where participants were primed through reward to make more "go" responses and another where no such priming occurred. Neuroticism, extraversion, and hemispheric lateral preference measures were also collected. Across both studies, disinhibition was greatest in individuals who reported both a left hemispheric lateral preference and high neuroticism. This pattern was only found for those who were primed through reward to make more "go" responses. There was no association with extraversion. Contrary to previous research, our results suggest that left hemispheric asymmetry and neuroticism and not extraversion drive disinhibited approach, following the establishment of a prepotent approach response set. This has salient implications for the theoretical understanding of disinhibited behavior, as well as for the study of continued maladaptive approach behavior.

  13. Haptic processing by the left hemisphere in a split-brain patient.

    PubMed

    Badan, M; Caramazza, A

    1997-09-01

    We report the case of a patient who suffered an ischemic accident resulting in damage to the anterior part of the corpus callosum and to the white matter in the posterior right hemisphere. Recognition of two-dimensional haptic stimuli explored with the right hand was severely impaired. The deficit was not specific to the type of stimuli, since letters, digits and geometrical shapes were not correctly recognized. Poor performance was not due to a specific mode of haptic exploration, since deficits were also observed without active manipulation of the stimuli. In contrast, the patient correctly named visual letters presented in the right visual hemifield (left hemisphere), and recognized three-dimensional common objects palpated with the right hand. Comparable results were observed in a surgical split-brain patient tested as a control. We conclude that (i) the construction of spatial representations of haptic stimuli, such as two-dimensional stimuli or three-dimensional block letters, cannot be fully realized in the intact left hemisphere, this ability requiring the contribution of both hemispheres, and (ii) tests for correct naming of common objects do not provide sufficient evidence to establish the integrity of the system involved in the identification of haptic information processed by the right hand of split-brain patients.

  14. Whose side are you on: does serotonin preferentially activate the right hemisphere and norepinephrine the left?

    PubMed

    Fitzgerald, Paul J

    2012-08-01

    Serotonin (5-HT) and norepinephrine (NE) innervate both the left and right hemispheres of the brain, but whether they affect lateralization of function is unknown. This paper concisely examines evidence that these two neurotransmitters differentially affect the two hemispheres, and puts forth the novel hypothesis 5-HT preferentially activates the right hemisphere (RH) and NE the left hemisphere (LH). The principal lines of evidence comprise studies of: (1) 5-HT and NE level measurement, (2) receptor binding, (3) functional brain imaging, (4) dichotic listening, and (5) electroencephalography and evoked potentials. In assessing these 5 lines, emphasis is placed on studies of pharmaceutical drugs that affect the 5-HT and NE systems. While all of the data do not support the hypothesis, they are generally consistent with it, or a variant of the hypothesis that there is a bias toward 5-HT preferentially activating a majority of brain areas or functions in the RH, and NE a majority of LH areas or functions. If this hypothesis, or a variant of it, is correct, it may be relevant to understanding the physiological basis of neuropsychiatric disorders that could involve dysfunction in brain monoaminergic systems, as well as understanding potential lateralization of the effects of drugs that act on these systems.

  15. Right and Left Hemisphere Cooperation for Drawing Predictive and Coherence Inferences during Normal Story Comprehension

    PubMed Central

    Beeman, Mark Jung; Bowden, Edward M.; Gernsbacher, Morton Ann

    2015-01-01

    In three experiments, healthy young participants listened to stories promoting inferences and named inference-related test words presented to the right visual field-Left Hemisphere (rvf-LH) or to the left visual field-Right Hemisphere (lvf-RH). Participants showed priming for predictive inferences only for target words presented to the lvf-RH; in contrast, they showed priming for coherence inferences only for target words presented to the rvf-LH. These results, plus the fact that patients with RH brain damage have difficulty drawing coherence inferences and do not show inference-related priming, suggest that information capable of supporting predictive inferences is more likely to be initially activated in the RH than the LH, but following coherence breaks these concepts (now coherence inferences) are completed in the LH. These results are consistent with the theory that the RH engages in relatively coarse semantic coding, which aids full comprehension of discourse. PMID:10716864

  16. Semantic priming increases left hemisphere theta power and inter-trial phase synchrony

    PubMed Central

    Salisbury, Dean F; Taylor, Grantley

    2011-01-01

    Information is stored in distributed cortical networks, but it is unclear how distributed stores are synthesized into a unified percept. Activation of local circuits in the gamma range (30<>80 Hz), and distributed stores in the low theta range (3–5 Hz) may underlie perceptual binding. Words have a crucial role in semantic memory. Within memory the activation of distributed semantic stores is facilitated by conceptually related previous items, termed semantic priming. We sought to detect event-related brain oscillations (EROs) sensitive to semantic activation and priming. Here we show that low theta evoked power and inter-trial phase locking (4–5 Hz) from 250–350 msec over left hemisphere language areas was greater to related than to unrelated words. Theta band event-related oscillations over left hemisphere language areas may provide a brain signature for semantic activation across distributed stores being facilitated by semantic priming. PMID:22176140

  17. Marc Dax and the discovery of the lateralisation of language in the left cerebral hemisphere.

    PubMed

    Manning, L; Thomas-Antérion, C

    2011-12-01

    In 1836, Marc Dax presented a revolutionary conclusion based on both his clinical observations and reports from the literature: the localisation of language in the left hemisphere. Twenty-seven years later, his son, Gustave Dax, extended and enriched his work. Their involvement in 19th century neuropsychology is impressive and recognition should have been considerable. However, according to the vast majority of historians of neurology, neuropsychology and aphasiology, the priority in establishing the dominance of the left brain hemisphere for speech goes to Paul Broca in an undivided way. Is it possible that Marc Dax's and his son, Gustave Dax's works were entirely unknown? Were they known and utterly forgotten? Were they ignored? How did we get to know that they existed? The aim of the present paper is to try to answer those and other questions and to demonstrate that there is abundance of data pointing out that the priority of the discovery of left hemisphere dominance for speech ought to be, at least, shared by Dax and Broca.

  18. Left Inferior Frontal Cortex and Syntax: Function, Structure and Behaviour in Patients with Left Hemisphere Damage

    ERIC Educational Resources Information Center

    Tyler, Lorraine K.; Marslen-Wilson, William D.; Randall, Billi; Wright, Paul; Devereux, Barry J.; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A.

    2011-01-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left…

  19. Left Inferior Frontal Cortex and Syntax: Function, Structure and Behaviour in Patients with Left Hemisphere Damage

    ERIC Educational Resources Information Center

    Tyler, Lorraine K.; Marslen-Wilson, William D.; Randall, Billi; Wright, Paul; Devereux, Barry J.; Zhuang, Jie; Papoutsi, Marina; Stamatakis, Emmanuel A.

    2011-01-01

    For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left…

  20. Ipsilesional trajectory control is related to contralesional arm paralysis after left hemisphere damage.

    PubMed

    Haaland, Kathleen Y; Schaefer, Sydney Y; Knight, Robert T; Adair, John; Magalhaes, Alvaro; Sadek, Joseph; Sainburg, Robert L

    2009-06-01

    We have recently shown ipsilateral dynamic deficits in trajectory control are present in left hemisphere damaged (LHD) patients with paresis, as evidenced by impaired modulation of torque amplitude as response amplitude increases. The purpose of the current study is to determine if these ipsilateral deficits are more common with contralateral hemiparesis and greater damage to the motor system, as evidenced by structural imaging. Three groups of right-handed subjects (healthy controls, LHD stroke patients with and without upper extremity paresis) performed single-joint elbow movements of varying amplitudes with their left arm in the left hemispace. Only the paretic group demonstrated dynamic deficits characterized by decreased modulation of peak torque (reflected by peak acceleration changes) as response amplitude increased. These results could not be attributed to lesion volume or peak velocity as neither variable differed across the groups. However, the paretic group had damage to a larger number of areas within the motor system than the non-paretic group suggesting that such damage increases the probability of ipsilesional deficits in dynamic control for modulating torque amplitude after left hemisphere damage.

  1. Contralateral somatosensory neglect in unrestrained rats after lesion of the parietal cortex of the left hemisphere.

    PubMed

    Holm, S; Mogensen, J

    1993-01-01

    Three groups of rats were studied: a sham operated control group and two groups in which the parietal "association" cortex had been ablated in the left and right hemispheres respectively. Twenty-four hours and 8 days postoperatively the animals were subjected to a test in which their responsiveness to lateralized somatosensory stimuli was measured while the rats were left unrestrained. Additionally, an activity cage locomotion test followed immediately upon both tests of somatosensory responsiveness. Twenty-four hours postoperatively the animals in which the parietal cortex of the left hemisphere had been ablated demonstrated a significant contralateral neglect of somatosensory stimuli while the group in which the right parietal cortex had been ablated only exhibited a non-significant tendency to a contralateral neglect. While the activity cage test did not reveal an overall difference in the activity level of the three groups the latency to initiate locomotion in the activity cage was found to be significantly decreased in both ablated groups. Eight days postoperatively both ablated groups appeared fully recovered. It is concluded that ablations of the parietal "association" cortex of the rat are associated with a syndrome of contralateral somatosensory neglect that can even be demonstrated if the animals are left unrestrained during testing.

  2. Hemispheric specificity for proprioception: Postural control of standing following right or left hemisphere damage during ankle tendon vibration.

    PubMed

    Duclos, Noémie C; Maynard, Luc; Abbas, Djawad; Mesure, Serge

    2015-11-02

    Right brain damage (RBD) following stroke often causes significant postural instability. In standing (without vision), patients with RBD are more unstable than those with left brain damage (LBD). We hypothesised that this postural instability would relate to the cortical integration of proprioceptive afferents. The aim of this study was to use tendon vibration to investigate whether these changes were specific to the paretic or non-paretic limbs. 14 LBD, 12 RBD patients and 20 healthy subjects were included. Displacement of the Centre of Pressure (CoP) was recorded during quiet standing, then during 3 vibration conditions (80 Hz - 20s): paretic limb, non-paretic limb (left and right limbs for control subjects) and bilateral. Vibration was applied separately to the peroneal and Achilles tendons. Mean antero-posterior position of the CoP, variability and velocity were calculated before (4s), during and after (24s) vibration. For all parameters, the strongest perturbation was during Achilles vibrations. The Achilles non-paretic condition induced a larger backward displacement than the Achilles paretic condition. This condition caused specific behaviour on the velocity: the LBD group was perturbed at the onset of the vibrations, but gradually recovered their stability; the RBD group was significantly perturbed thereafter. After bilateral Achilles vibration, RBD patients required the most time to restore initial posture. The reduction in use of information from the paretic limb may be a central strategy to deal with risk-of-fall situations such as during Achilles vibration. The postural behaviour is profoundly altered by lesions of the right hemisphere when proprioception is perturbed.

  3. To the other side of the neglected brain: the hyperexcitability of the left intact hemisphere.

    PubMed

    Koch, Giacomo; Veniero, Domenica; Caltagirone, Carlo

    2013-04-01

    The human brain is characterized by the lateralization of cognitive functions. Multiple lines of evidence suggest the deployment of visuospatial attention is controlled by a frontoparietal network, with a right hemisphere dominance. Among cortical areas included in the network, the right posterior parietal cortex (PPC) has been proposed to be a crucial node and has also been implicated on clinical grounds. Here, the authors provide an overview of the existent literature giving evidence to a functional asymmetry of the parietal cortices in directing visuospatial attention, focusing on those studies seeking to characterize the causal role of PPC, applying transcranial magnetic stimulation and its combination with imaging techniques, such as electroencephalography and fMRI. First, the role of PPC and how this region exerts its control over remote areas of both hemispheres is discussed. The second part discusses studies involving neglect patients shedding light on the complex interplay between left and right PPC, strongly supporting the hemispheric rivalry theory. Finally, studies demonstrating changes of neglect disorders following the manipulation of the unaffected hemisphere activation will be discussed.

  4. Visconti and Fellini: from left social neorealism to right-hemisphere stroke.

    PubMed

    Dieguez, Sebastian; Assal, Gil; Bogousslavsky, Julien

    2007-01-01

    The acclaimed Italian directors Luchino Visconti and Federico Fellini had very different life trajectories that led them to become major figures in the history of cinema. Similarities, however, can be found in their debuts with the neorealist genre, their personalities, creative styles and politicocultural involvement, and ultimately in the neurological disease that struck them at the end of their careers. Both suffered a right-hemispheric stroke that left them hemiplegic on the left side. We review their life and career to put that event into perspective, and then discuss its aftermath for both artists in the light of our current knowledge of right-hemispheric functions. Visconti showed a tremendous resilience following the accident and managed to direct several films and plays as an infirm, whereas Fellini had to put an end to his career but still was able to display his talents to the neuropsychologists that treated him. A speculative account is given of the links between right-hemispheric symptomatology and the premorbid personality of these highly prolific patients.

  5. Left hemisphere lateralization for lexical and acoustic pitch processing in Cantonese speakers as revealed by mismatch negativity.

    PubMed

    Gu, Feng; Zhang, Caicai; Hu, Axu; Zhao, Guoping

    2013-12-01

    For nontonal language speakers, speech processing is lateralized to the left hemisphere and musical processing is lateralized to the right hemisphere (i.e., function-dependent brain asymmetry). On the other hand, acoustic temporal processing is lateralized to the left hemisphere and spectral/pitch processing is lateralized to the right hemisphere (i.e., acoustic-dependent brain asymmetry). In this study, we examine whether the hemispheric lateralization of lexical pitch and acoustic pitch processing in tonal language speakers is consistent with the patterns of function- and acoustic-dependent brain asymmetry in nontonal language speakers. Pitch contrast in both speech stimuli (syllable /ji/ in Experiment 1) and nonspeech stimuli (harmonic tone in Experiment 1; pure tone in Experiment 2) was presented to native Cantonese speakers in passive oddball paradigms. We found that the mismatch negativity (MMN) elicited by lexical pitch contrast was lateralized to the left hemisphere, which is consistent with the pattern of function-dependent brain asymmetry (i.e., left hemisphere lateralization for speech processing) in nontonal language speakers. However, the MMN elicited by acoustic pitch contrast was also left hemisphere lateralized (harmonic tone in Experiment 1) or showed a tendency for left hemisphere lateralization (pure tone in Experiment 2), which is inconsistent with the pattern of acoustic-dependent brain asymmetry (i.e., right hemisphere lateralization for acoustic pitch processing) in nontonal language speakers. The consistent pattern of function-dependent brain asymmetry and the inconsistent pattern of acoustic-dependent brain asymmetry between tonal and nontonal language speakers can be explained by the hypothesis that the acoustic-dependent brain asymmetry is the consequence of a carryover effect from function-dependent brain asymmetry. Potential evolutionary implication of this hypothesis is discussed. © 2013.

  6. Differential Impact of Posterior Lesions in the Left and Right Hemisphere on Visual Category Learning and Generalization to Contrast Reversal

    ERIC Educational Resources Information Center

    Langguth, Berthold; Juttner, Martin; Landis, Theodor; Regard, Marianne; Rentschler, Ingo

    2009-01-01

    Hemispheric differences in the learning and generalization of pattern categories were explored in two experiments involving sixteen patients with unilateral posterior, cerebral lesions in the left (LH) or right (RH) hemisphere. In each experiment participants were first trained to criterion in a supervised learning paradigm to categorize a set of…

  7. Differential Impact of Posterior Lesions in the Left and Right Hemisphere on Visual Category Learning and Generalization to Contrast Reversal

    ERIC Educational Resources Information Center

    Langguth, Berthold; Juttner, Martin; Landis, Theodor; Regard, Marianne; Rentschler, Ingo

    2009-01-01

    Hemispheric differences in the learning and generalization of pattern categories were explored in two experiments involving sixteen patients with unilateral posterior, cerebral lesions in the left (LH) or right (RH) hemisphere. In each experiment participants were first trained to criterion in a supervised learning paradigm to categorize a set of…

  8. Prosodic facilitation in the resolution of syntactic ambiguities in subjects with left and right hemisphere damage.

    PubMed

    Walker, J P; Fongemie, K; Daigle, T

    2001-08-01

    The purpose of this study was to determine if prosody facilitates the comprehension of sentences containing temporary syntactic ambiguities in control, and left (LHD) and right hemisphere damaged (RHD) subjects. To test for effects of prosodic facilitation, sentences were created where prosodic boundaries coincided with (cooperating), were absent (baseline), or conflicted (conflicting) with syntactic boundaries in three response times (RTs) experiments. Despite differences in overall RTs and response accuracy for each group, all three groups responded faster and more accurately to sentences in the cooperating than in the baseline and conflicting conditions across experiments, indicating that prosody facilitates syntactic parsing in brain-damaged subjects just as it does with normal control subjects. Results are discussed in relation to psycholinguistic theories of syntactic parsing and neurolinguistic theories of hemispheric specialization in processing the acoustic properties of prosodic structures.

  9. Neuroanatomical Correlates of Oral Reading in Acute Left Hemispheric Stroke

    ERIC Educational Resources Information Center

    Cloutman, Lauren L.; Newhart, Melisssa; Davis, Cameron L.; Heidler-Gary, Jennifer; Hillis, Argye E.

    2011-01-01

    Oral reading is a complex skill involving the interaction of orthographic, phonological, and semantic processes. Functional imaging studies with nonimpaired adult readers have identified a widely distributed network of frontal, inferior parietal, posterior temporal, and occipital brain regions involved in the task. However, while functional…

  10. Neuroanatomical Correlates of Oral Reading in Acute Left Hemispheric Stroke

    ERIC Educational Resources Information Center

    Cloutman, Lauren L.; Newhart, Melisssa; Davis, Cameron L.; Heidler-Gary, Jennifer; Hillis, Argye E.

    2011-01-01

    Oral reading is a complex skill involving the interaction of orthographic, phonological, and semantic processes. Functional imaging studies with nonimpaired adult readers have identified a widely distributed network of frontal, inferior parietal, posterior temporal, and occipital brain regions involved in the task. However, while functional…

  11. Reading on the right when there's nothing left? Probabilistic tractography reveals hemispheric asymmetry in pure alexia.

    PubMed

    Veldsman, Michele; Loetscher, Tobias; Wood, Amanda; Brodtmann, Amy

    2017-08-09

    We present a patient with reading inexpertise and right hemianopia following left posterior cerebral artery (PCA) stroke. We examine the extent of disruption to reading performance and the extent of white matter tract damage relative to a patient with more limited PCA infarction and isolated right hemianopia. We show white matter disconnection of the temporal occipital fusiform cortex in our pure alexia patient. Connectivity-based laterality indices revealed right hemisphere laterality in the alexia patient; this was not associated with improved reading function. We speculate that the degree of premorbid laterality may be a critical factor affecting the extent of reading dysfunction in alexia.

  12. Mapping nouns and finite verbs in left hemisphere tumors: a direct electrical stimulation study.

    PubMed

    Rofes, Adrià; Spena, Giannantonio; Talacchi, Andrea; Santini, Barbara; Miozzo, Antonio; Miceli, Gabriele

    2017-03-27

    Neurosurgical mapping studies with nouns and finite verbs are scarce and subcortical data are nonexistent. We used a new task that uses finite verbs in six Italian-speaking patients with gliomas in the left language-dominant hemisphere. Language-relevant positive areas were detected only with nouns in four patients, with both tasks yet in distinct cortical areas in one patient, and only with finite verbs in another patient. Positive areas and types of errors varied across participants. Finite verbs provide complementary information to nouns, and permit more accurate mapping of language production when nouns are unaffected by electrical stimulation.

  13. A distributed left hemisphere network active during planning of everyday tool use skills.

    PubMed

    Johnson-Frey, Scott H; Newman-Norlund, Roger; Grafton, Scott T

    2005-06-01

    Determining the relationship between mechanisms involved in action planning and/or execution is critical to understanding the neural bases of skilled behaviors, including tool use. Here we report findings from two fMRI studies of healthy, right-handed adults in which an event-related design was used to distinguish regions involved in planning (i.e. identifying, retrieving and preparing actions associated with a familiar tools' uses) versus executing tool use gestures with the dominant right (experiment 1) and non-dominant left (experiment 2) hands. For either limb, planning tool use actions activates a distributed network in the left cerebral hemisphere consisting of: (i) posterior superior temporal sulcus, along with proximal regions of the middle and superior temporal gyri; (ii) inferior frontal and ventral premotor cortices; (iii) two distinct parietal areas, one located in the anterior supramarginal gyrus (SMG) and another in posterior SMG and angular gyrus; and (iv) dorsolateral prefrontal cortex (DLFPC). With the exception of left DLFPC, adjacent and partially overlapping sub-regions of left parietal, frontal and temporal cortex are also engaged during action execution. We suggest that this left lateralized network constitutes a neural substrate for the interaction of semantic and motoric representations upon which meaningful skills depend.

  14. Hemispheric differences between left and right supramarginal gyrus for pitch and rhythm memory

    PubMed Central

    Schaal, Nora K.; Pollok, Bettina; Banissy, Michael J.

    2017-01-01

    Functional brain imaging studies and non-invasive brain stimulation methods have shown the importance of the left supramarginal gyrus (SMG) for pitch memory. The extent to which this brain region plays a crucial role in memory for other auditory material remains unclear. Here, we sought to investigate the role of the left and right SMG in pitch and rhythm memory in non-musicians. Anodal or sham transcranial direct current stimulation (tDCS) was applied over the left SMG (Experiment 1) and right SMG (Experiment 2) in two different sessions. In each session participants completed a pitch and rhythm recognition memory task immediately after tDCS. A significant facilitation of pitch memory was revealed when anodal stimulation was applied over the left SMG. No significant effects on pitch memory were found for anodal tDCS over the right SMG or sham condition. For rhythm memory the opposite pattern was found; anodal tDCS over the right SMG led to an improvement in performance, but anodal tDCS over the left SMG had no significant effect. These results highlight a different hemispheric involvement of the SMG in auditory memory processing depending on auditory material that is encoded. PMID:28198386

  15. A Distributed Left Hemisphere Network Active During Planning of Everyday Tool Use Skills

    PubMed Central

    Newman-Norlund, Roger; Grafton, Scott T.

    2005-01-01

    Determining the relationship between mechanisms involved in action planning and/or execution is critical to understanding the neural bases of skilled behaviors, including tool use. Here we report findings from two fMRI studies of healthy, right-handed adults in which an event-related design was used to distinguish regions involved in planning (i.e. identifying, retrieving and preparing actions associated with a familiar tools′ uses) versus executing tool use gestures with the dominant right (experiment 1) and non-dominant left (experiment 2) hands. For either limb, planning tool use actions activates a distributed network in the left cerebral hemisphere consisting of: (i) posterior superior temporal sulcus, along with proximal regions of the middle and superior temporal gyri; (ii) inferior frontal and ventral premotor cortices; (iii) two distinct parietal areas, one located in the anterior supramarginal gyrus (SMG) and another in posterior SMG and angular gyrus; and (iv) dorsolateral prefrontal cortex (DLFPC). With the exception of left DLFPC, adjacent and partially overlapping sub-regions of left parietal, frontal and temporal cortex are also engaged during action execution. We suggest that this left lateralized network constitutes a neural substrate for the interaction of semantic and motoric representations upon which meaningful skills depend. PMID:15342430

  16. Damage to white matter bottlenecks contributes to language impairments after left hemispheric stroke.

    PubMed

    Griffis, Joseph C; Nenert, Rodolphe; Allendorfer, Jane B; Szaflarski, Jerzy P

    2017-01-01

    Damage to the white matter underlying the left posterior temporal lobe leads to deficits in multiple language functions. The posterior temporal white matter may correspond to a bottleneck where both dorsal and ventral language pathways are vulnerable to simultaneous damage. Damage to a second putative white matter bottleneck in the left deep prefrontal white matter involving projections associated with ventral language pathways and thalamo-cortical projections has recently been proposed as a source of semantic deficits after stroke. Here, we first used white matter atlases to identify the previously described white matter bottlenecks in the posterior temporal and deep prefrontal white matter. We then assessed the effects of damage to each region on measures of verbal fluency, picture naming, and auditory semantic decision-making in 43 chronic left hemispheric stroke patients. Damage to the posterior temporal bottleneck predicted deficits on all tasks, while damage to the anterior bottleneck only significantly predicted deficits in verbal fluency. Importantly, the effects of damage to the bottleneck regions were not attributable to lesion volume, lesion loads on the tracts traversing the bottlenecks, or damage to nearby cortical language areas. Multivariate lesion-symptom mapping revealed additional lesion predictors of deficits. Post-hoc fiber tracking of the peak white matter lesion predictors using a publicly available tractography atlas revealed evidence consistent with the results of the bottleneck analyses. Together, our results provide support for the proposal that spatially specific white matter damage affecting bottleneck regions, particularly in the posterior temporal lobe, contributes to chronic language deficits after left hemispheric stroke. This may reflect the simultaneous disruption of signaling in dorsal and ventral language processing streams.

  17. Neuroplasticity of language in left-hemisphere stroke: Evidence linking subsecond electrophysiology and structural connections.

    PubMed

    Piai, Vitória; Meyer, Lars; Dronkers, Nina F; Knight, Robert T

    2017-03-27

    The understanding of neuroplasticity following stroke is predominantly based on neuroimaging measures that cannot address the subsecond neurodynamics of impaired language processing. We combined behavioral and electrophysiological measures and structural-connectivity estimates to characterize neuroplasticity underlying successful compensation of language abilities after left-hemispheric stroke. We recorded the electroencephalogram from patients with stroke lesions to the left temporal lobe and from matched controls during context-driven word retrieval. Participants heard lead-in sentences that either constrained the final word ("He locked the door with the") or not ("She walked in here with the"). The last word was shown as a picture to be named. Individual-participant analyses were conducted, focusing on oscillatory power as a subsecond indicator of a brain region's functional neurophysiological computations. All participants named pictures faster following constrained than unconstrained sentences, except for two patients, who had extensive damage to the left temporal lobe. Left-lateralized alpha-beta oscillatory power decreased in controls pre-picture presentation for constrained relative to unconstrained contexts. In patients, the alpha-beta power decreases were observed with the same time course as in controls but were lateralized to the intact right hemisphere. The right lateralization depended on the probability of white-matter connections between the bilateral temporal lobes. The two patients who performed poorly behaviorally showed no alpha-beta power decreases. Our findings suggest that incorporating direct measures of neural activity into investigations of neuroplasticity can provide important neural markers to help predict language recovery, assess the progress of neurorehabilitation, and delineate targets for therapeutic neuromodulation. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

  18. The differential effects of acute right- vs. left-sided vestibular failure on brain metabolism.

    PubMed

    Becker-Bense, Sandra; Dieterich, Marianne; Buchholz, Hans-Georg; Bartenstein, Peter; Schreckenberger, Mathias; Brandt, Thomas

    2014-07-01

    The human vestibular system is represented in the brain bilaterally, but it has functional asymmetries, i.e., a dominance of ipsilateral pathways and of the right hemisphere in right-handers. To determine if acute right- or left-sided unilateral vestibular neuritis (VN) is associated with differential patterns of brain metabolism in areas representing the vestibular network and the visual-vestibular interaction, patients with acute VN (right n = 9; left n = 13) underwent resting state (18)F-FDG PET once in the acute phase and once 3 months later after central vestibular compensation. The contrast acute vs. chronic phase showed signal differences in contralateral vestibular areas and the inverse contrast in visual cortex areas, both more pronounced in VN right. In VN left additional regions were found in the cerebellar hemispheres and vermis bilaterally, accentuated in severe cases. In general, signal changes appeared more pronounced in patients with more severe vestibular deficits. Acute phase PET data of patients compared to that of age-matched healthy controls disclosed similarities to these patterns, thus permitting the interpretation that the signal changes in vestibular temporo-parietal areas reflect signal increases, and in visual areas, signal decreases. These data imply that brain activity in the acute phase of right- and left-sided VN exhibits different compensatory patterns, i.e., the dominant ascending input is shifted from the ipsilateral to the contralateral pathways, presumably due to the missing ipsilateral vestibular input. The visual-vestibular interaction patterns were preserved, but were of different prominence in each hemisphere and more pronounced in patients with right-sided failure and more severe vestibular deficits.

  19. Left hemisphere structural connectivity abnormality in pediatric hydrocephalus patients following surgery.

    PubMed

    Yuan, Weihong; Meller, Artur; Shimony, Joshua S; Nash, Tiffany; Jones, Blaise V; Holland, Scott K; Altaye, Mekibib; Barnard, Holly; Phillips, Jannel; Powell, Stephanie; McKinstry, Robert C; Limbrick, David D; Rajagopal, Akila; Mangano, Francesco T

    2016-01-01

    Neuroimaging research in surgically treated pediatric hydrocephalus patients remains challenging due to the artifact caused by programmable shunt. Our previous study has demonstrated significant alterations in the whole brain white matter structural connectivity based on diffusion tensor imaging (DTI) and graph theoretical analysis in children with hydrocephalus prior to surgery or in surgically treated children without programmable shunts. This study seeks to investigate the impact of brain injury on the topological features in the left hemisphere, contratelateral to the shunt placement, which will avoid the influence of shunt artifacts and makes further group comparisons feasible for children with programmable shunt valves. Three groups of children (34 in the control group, 12 in the 3-month post-surgery group, and 24 in the 12-month post-surgery group, age between 1 and 18 years) were included in the study. The structural connectivity data processing and analysis were performed based on DTI and graph theoretical analysis. Specific procedures were revised to include only left brain imaging data in normalization, parcellation, and fiber counting from DTI tractography. Our results showed that, when compared to controls, children with hydrocephalus in both the 3-month and 12-month post-surgery groups had significantly lower normalized clustering coefficient, lower small-worldness, and higher global efficiency (all p < 0.05, corrected). At a regional level, both patient groups showed significant alteration in one or more regional connectivity measures in a series of brain regions in the left hemisphere (8 and 10 regions in the 3-month post-surgery and the 12-month post-surgery group, respectively, all p < 0.05, corrected). No significant correlation was found between any of the global or regional measures and the contemporaneous neuropsychological outcomes [the General Adaptive Composite (GAC) from the Adaptive Behavior Assessment System, Second Edition (ABAS

  20. Early Left-Hemispheric Dysfunction of Face Processing in Congenital Prosopagnosia: An MEG Study

    PubMed Central

    Dobel, Christian; Putsche, Christian; Zwitserlood, Pienie; Junghöfer, Markus

    2008-01-01

    Background Congenital prosopagnosia is a severe face perception impairment which is not acquired by a brain lesion and is presumably present from birth. It manifests mostly by an inability to recognise familiar persons. Electrophysiological research has demonstrated the relevance to face processing of a negative deflection peaking around 170 ms, labelled accordingly as N170 in the electroencephalogram (EEG) and M170 in magnetoencephalography (MEG). The M170 was shown to be sensitive to the inversion of faces and to familiarity-two factors that are assumed to be crucial for congenital prosopagnosia. In order to locate the cognitive dysfunction and its neural correlates, we investigated the time course of neural activity in response to these manipulations. Methodology Seven individuals with congenital prosopagnosia and seven matched controls participated in the experiment. To explore brain activity with high accuracy in time, we recorded evoked magnetic fields (275 channel whole head MEG) while participants were looking at faces differing in familiarity (famous vs. unknown) and orientation (upright vs. inverted). The underlying neural sources were estimated by means of the least square minimum-norm-estimation (L2-MNE) approach. Principal Findings The behavioural data corroborate earlier findings on impaired configural processing in congenital prosopagnosia. For the M170, the overall results replicated earlier findings, with larger occipito-temporal brain responses to inverted than upright faces, and more right- than left-hemispheric activity. Compared to controls, participants with congenital prosopagnosia displayed a general decrease in brain activity, primarily over left occipitotemporal areas. This attenuation did not interact with familiarity or orientation. Conclusions The study substantiates the finding of an early involvement of the left hemisphere in symptoms of prosopagnosia. This might be related to an efficient and overused featural processing strategy

  1. Are there right hemisphere contributions to visually-guided movement? Manipulating left hand reaction time advantages in dextrals

    PubMed Central

    Carey, David P.; Otto-de Haart, E. Grace; Buckingham, Gavin; Dijkerman, H. Chris; Hargreaves, Eric L.; Goodale, Melvyn A.

    2015-01-01

    Many studies have argued for distinct but complementary contributions from each hemisphere in the control of movements to visual targets. Investigators have attempted to extend observations from patients with unilateral left- and right-hemisphere damage, to those using neurologically-intact participants, by assuming that each hand has privileged access to the contralateral hemisphere. Previous attempts to illustrate right hemispheric contributions to the control of aiming have focussed on increasing the spatial demands of an aiming task, to attenuate the typical right hand advantages, to try to enhance a left hand reaction time advantage in right-handed participants. These early attempts have not been successful. The present study circumnavigates some of the theoretical and methodological difficulties of some of the earlier experiments, by using three different tasks linked directly to specialized functions of the right hemisphere: bisecting, the gap effect, and visuospatial localization. None of these tasks were effective in reducing the magnitude of left hand reaction time advantages in right handers. Results are discussed in terms of alternatives to right hemispheric functional explanations of the effect, the one-dimensional nature of our target arrays, power and precision given the size of the left hand RT effect, and the utility of examining the proportions of participants who show these effects, rather than exclusive reliance on measures of central tendency and their associated null hypothesis significance tests. PMID:26379572

  2. Meta-analyzing left hemisphere language areas: phonology, semantics, and sentence processing.

    PubMed

    Vigneau, M; Beaucousin, V; Hervé, P Y; Duffau, H; Crivello, F; Houdé, O; Mazoyer, B; Tzourio-Mazoyer, N

    2006-05-01

    The advent of functional neuroimaging has allowed tremendous advances in our understanding of brain-language relationships, in addition to generating substantial empirical data on this subject in the form of thousands of activation peak coordinates reported in a decade of language studies. We performed a large-scale meta-analysis of this literature, aimed at defining the composition of the phonological, semantic, and sentence processing networks in the frontal, temporal, and inferior parietal regions of the left cerebral hemisphere. For each of these language components, activation peaks issued from relevant component-specific contrasts were submitted to a spatial clustering algorithm, which gathered activation peaks on the basis of their relative distance in the MNI space. From a sample of 730 activation peaks extracted from 129 scientific reports selected among 260, we isolated 30 activation clusters, defining the functional fields constituting three distributed networks of frontal and temporal areas and revealing the functional organization of the left hemisphere for language. The functional role of each activation cluster is discussed based on the nature of the tasks in which it was involved. This meta-analysis sheds light on several contemporary issues, notably on the fine-scale functional architecture of the inferior frontal gyrus for phonological and semantic processing, the evidence for an elementary audio-motor loop involved in both comprehension and production of syllables including the primary auditory areas and the motor mouth area, evidence of areas of overlap between phonological and semantic processing, in particular at the location of the selective human voice area that was the seat of partial overlap of the three language components, the evidence of a cortical area in the pars opercularis of the inferior frontal gyrus dedicated to syntactic processing and in the posterior part of the superior temporal gyrus a region selectively activated by

  3. Auditory agnosia and auditory spatial deficits following left hemispheric lesions: evidence for distinct processing pathways.

    PubMed

    Clarke, S; Bellmann, A; Meuli, R A; Assal, G; Steck, A J

    2000-01-01

    Auditory recognition and auditory spatial functions were studied in four patients with circumscribed left hemispheric lesions. Patient FD was severely deficient in recognition of environmental sounds but normal in auditory localisation and auditory motion perception. The lesion included the left superior, middle and inferior temporal gyri and lateral auditory areas (as identified in previous anatomical studies), but spared Heschl's gyrus, the acoustic radiation and the thalamus. Patient SD had the same profile as FD, with deficient recognition of environmental sounds but normal auditory localisation and motion perception. The lesion comprised the postero-inferior part of the frontal convexity and the anterior third of the temporal lobe; data from non-human primates indicate that the latter are interconnected with lateral auditory areas. Patient MA was deficient in recognition of environmental sounds, auditory localisation and auditory motion perception, confirming that auditory spatial functions can be disturbed by left unilateral damage; the lesion involved the supratemporal region as well as the temporal, postero-inferior frontal and antero-inferior parietal convexities. Patient CZ was severely deficient in auditory motion perception and partially deficient in auditory localisation, but normal in recognition of environmental sounds; the lesion involved large parts of the parieto-frontal convexity and the supratemporal region. We propose that auditory information is processed in the human auditory cortex along two distinct pathways, one lateral devoted to auditory recognition and one medial and posterior devoted to auditory spatial functions.

  4. Mental visual synthesis is originated in the fronto-temporal network of the left hemisphere.

    PubMed

    Yomogida, Yukihito; Sugiura, Motoaki; Watanabe, Jobu; Akitsuki, Yuko; Sassa, Yuko; Sato, Teruyuki; Matsue, Yoshihiko; Kawashima, Ryuta

    2004-12-01

    Mental visual synthesis is the capacity for experiencing, constructing, or manipulating 'mental imagery'. To investigate brain networks involved in mental visual synthesis, brain activity was measured in right-handed healthy volunteers during mental imagery tasks, in which the subjects were instructed to imagine a novel object, that does not exist in the real world, by composing it from two visually presented words associated with a real object or two achromatic line drawings of a real object, using functional magnetic resonance imaging (fMRI). Both tasks activated the same areas in the inferior frontal and inferior temporal cortices of the left hemisphere. Our results indicate that the source of mental visual synthesis may be formed by activity of a brain network consisting of these areas, which are also involved in semantic operations and visual imagery.

  5. Greater left cerebral hemispheric metabolism in bulimia assessed by positron emission tomography

    SciTech Connect

    Wu, J.C.; Hagman, J.; Buchsbaum, M.S.; Blinder, B.; Derrfler, M.; Tai, W.Y.; Hazlett, E.; Sicotte, N. )

    1990-03-01

    Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using (18F)-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance task during FDG uptake. In control subjects, the metabolic rate was higher in the right hemisphere than in the left, but patients with bulimia did not have this normal asymmetry. Lower metabolic rates in the basal ganglia, found in studies of depressed subjects, and higher rates in the basal ganglia, reported in a study of anorexia nervosa, were not found. This is consistent with the suggestion that bulimia is a diagnostic grouping distinct from these disorders.

  6. Left-hemisphere activation is associated with enhanced vocal pitch error detection in musicians with absolute pitch.

    PubMed

    Behroozmand, Roozbeh; Ibrahim, Nadine; Korzyukov, Oleg; Robin, Donald A; Larson, Charles R

    2014-02-01

    The ability to process auditory feedback for vocal pitch control is crucial during speaking and singing. Previous studies have suggested that musicians with absolute pitch (AP) develop specialized left-hemisphere mechanisms for pitch processing. The present study adopted an auditory feedback pitch perturbation paradigm combined with ERP recordings to test the hypothesis whether the neural mechanisms of the left-hemisphere enhance vocal pitch error detection and control in AP musicians compared with relative pitch (RP) musicians and non-musicians (NM). Results showed a stronger N1 response to pitch-shifted voice feedback in the right-hemisphere for both AP and RP musicians compared with the NM group. However, the left-hemisphere P2 component activation was greater in AP and RP musicians compared with NMs and also for the AP compared with RP musicians. The NM group was slower in generating compensatory vocal reactions to feedback pitch perturbation compared with musicians, and they failed to re-adjust their vocal pitch after the feedback perturbation was removed. These findings suggest that in the earlier stages of cortical neural processing, the right hemisphere is more active in musicians for detecting pitch changes in voice feedback. In the later stages, the left-hemisphere is more active during the processing of auditory feedback for vocal motor control and seems to involve specialized mechanisms that facilitate pitch processing in the AP compared with RP musicians. These findings indicate that the left hemisphere mechanisms of AP ability are associated with improved auditory feedback pitch processing during vocal pitch control in tasks such as speaking or singing. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Left-hemisphere activation is associated with enhanced vocal pitch error detection in musicians with absolute pitch

    PubMed Central

    Behroozmand, Roozbeh; Ibrahim, Nadine; Korzyukov, Oleg; Robin, Donald A.; Larson, Charles R.

    2014-01-01

    The ability to process auditory feedback for vocal pitch control is crucial during speaking and singing. Previous studies have suggested that musicians with absolute pitch (AP) develop specialized left-hemisphere mechanisms for pitch processing. The present study adopted an auditory feedback pitch perturbation paradigm combined with ERP recordings to test the hypothesis whether the neural mechanisms of the left-hemisphere enhance vocal pitch error detection and control in AP musicians compared with relative pitch (RP) musicians and non-musicians (NM). Results showed a stronger N1 response to pitch-shifted voice feedback in the right-hemisphere for both AP and RP musicians compared with the NM group. However, the left-hemisphere P2 component activation was greater in AP and RP musicians compared with NMs and also for the AP compared with RP musicians. The NM group was slower in generating compensatory vocal reactions to feedback pitch perturbation compared with musicians, and they failed to re-adjust their vocal pitch after the feedback perturbation was removed. These findings suggest that in the earlier stages of cortical neural processing, the right hemisphere is more active in musicians for detecting pitch changes in voice feedback. In the later stages, the left-hemisphere is more active during the processing of auditory feedback for vocal motor control and seems to involve specialized mechanisms that facilitate pitch processing in the AP compared with RP musicians. These findings indicate that the left hemisphere mechanisms of AP ability are associated with improved auditory feedback pitch processing during vocal pitch control in tasks such as speaking or singing. PMID:24355545

  8. Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients.

    PubMed

    Blini, Elvio; Romeo, Zaira; Spironelli, Chiara; Pitteri, Marco; Meneghello, Francesca; Bonato, Mario; Zorzi, Marco

    2016-11-01

    Unilateral Spatial Neglect, the most dramatic manifestation of contralesional space unawareness, is a highly heterogeneous syndrome. The presence of neglect is related to core spatially lateralized deficits, but its severity is also modulated by several domain-general factors (such as alertness or sustained attention) and by task demands. We previously showed that a computer-based dual-task paradigm exploiting both lateralized and non-lateralized factors (i.e., attentional load/multitasking) better captures this complex scenario and exacerbates deficits for the contralesional space after right hemisphere damage. Here we asked whether multitasking would reveal contralesional spatial disorders in chronic left-hemisphere damaged (LHD) stroke patients, a population in which impaired spatial processing is thought to be uncommon. Ten consecutive LHD patients with no signs of right-sided neglect at standard neuropsychological testing performed a computerized spatial monitoring task with and without concurrent secondary tasks (i.e., multitasking). Severe contralesional (right) space unawareness emerged in most patients under attentional load in both the visual and auditory modalities. Multitasking affected the detection of contralesional stimuli both when presented concurrently with an ipsilesional one (i.e., extinction for bilateral targets) and when presented in isolation (i.e., left neglect for right-sided targets). No spatial bias emerged in a control group of healthy elderly participants, who performed at ceiling, as well as in a second control group composed of patients with Mild Cognitive Impairment. We conclude that the pathological spatial asymmetry in LHD patients cannot be attributed to a global reduction of cognitive resources but it is the consequence of unilateral brain damage. Clinical and theoretical implications of the load-dependent lack of awareness for contralesional hemispace following LHD are discussed.

  9. Impairments of trunk movements following left or right hemisphere lesions: dissociation between apraxic errors and postural instability.

    PubMed

    Spinazzola, Lucia; Cubelli, Roberto; Della Sala, Sergio

    2003-12-01

    Stroke patients present with apraxic or postural deficits involving trunk movements. Praxis and posture control have been associated with the functions of the left and the right hemisphere, respectively. For the first time, in this study the occurrence of apraxic and postural components in trunk movement deficits following right and left hemisphere lesions were investigated in the same participants. Twenty-three patients with left (L/pt), 12 with right (R/pt) hemisphere lesion, and 30 healthy controls were evaluated with a 21-item test assessing the imitation of meaningless, symbolic and reaching movements presented twice on visual or proprioceptive modality. Erroneous, motor responses of the trunk were classified as postural (compensations to overcome stability or asymmetry deficits) or apraxic (execution errors not due to biomechanical constraints). Postural instability reactions were significantly more frequent among the R/pts, whilst apraxic responses were overwhelming within the L/pts. The findings are consistent with the view that the left hemisphere is dominant for praxis and suggest that this dominance be extended to trunk praxis. The results also support the hypothesis that trunk postures are coded in relation to the environment by a representational system. A widespread network, mainly sitting in the right hemisphere, subserves this postural system. The distinction between praxic and postural deficits in executing trunk movements should be kept in mind when evaluating trunk movement difficulties shown by stroke patients, in following up their recovery or when tailoring rehabilitation programmes.

  10. Embedded words in visual word recognition: does the left hemisphere see the rain in brain?

    PubMed

    McCormick, Samantha F; Davis, Colin J; Brysbaert, Marc

    2010-09-01

    To examine whether interhemispheric transfer during foveal word recognition entails a discontinuity between the information presented to the left and right of fixation, we presented target words in such a way that participants fixated immediately left or right of an embedded word (as in gr*apple, bull*et) or in the middle of an embedded word (grapp*le, bu*llet). Categorization responses to target words were faster and more accurate in a congruent condition (in which the embedded word was associated with the same response; e.g., Does bullet refer to an item of clothing?) than in an incongruent condition (e.g., Does bullet refer to a type of animal?). However, the magnitude of this effect did not vary as a function of position of fixation, relative to the embedded word, as might be expected if information from the 2 visual fields was initially split over the cerebral hemispheres and integrated only late in the word identification process. Equivalent results were observed in Experiment 1 (long stimulus duration) and Experiment 2 (in which stimulus duration was 200 ms; i.e., less than the time required to initiate a refixation).

  11. A comparison of EEG activity in the left and right cerebral hemispheres by power-spectrum analysis during language and non-language tasks.

    PubMed

    Grabow, J D; Aronson, A E; Greene, K L; Offord, K P

    1979-10-01

    In 10 female subjects, power-spectrum analysis was performed on the alpha activity elicted during the resting state, 4 right hemispheric tasks, and 3 left hemispheric tasks. The data were treated in 3 ways: approach 1, comparing the right and left hemispheric alpha activity; approach 2, comparing the right and left hemispheric alpha activity adjusted for the resting state; and approach 3, comparing the right and left hemispheric alpha activity adjusted for the previous task. Approaches 1 and 2 revealed few significant differences in the alpha activity of the hemispheres, but approach 3 provided data that better fit the theory of decreased power spectrum of attenuation of activity in the activated hemisphere. Thus, approach 3 may be useful in developing an electroencephalographic test for determining cerebral dominance for language.

  12. Dissociations of action means and outcome processing in left hemisphere stroke

    PubMed Central

    Kalénine, Solène; Shapiro, Allison D.; Buxbaum, Laurel J.

    2013-01-01

    Previous evidence suggests that distinct fronto-parietal regions may be involved in representing action kinematics (means) and action results (outcome) during action observation. However, the evidence is contradictory with respect to the precise regions that are critical for each type of representation. Additionally unknown is the degree to which ability to detect action means and outcome during observation is related to action production performance. We used a behavioral task to evaluate the ability of healthy and left-hemisphere stroke participants to detect differences between pairs of videos that dissociated object-related action means (e.g., wiping with circular or straight movement) and/or outcome (e.g., applying or removing detergent). We expected that deficits in detecting action means would be associated with spatiomotor gesture production deficits, whereas deficits in detecting action outcome would predict impairments in complex naturalistic action. We also hypothesized a posterior to anterior gradient in the regions critical for each type of representation, disproportionately affecting means and outcome encoding, respectively. Results indicated that outcome – but not means – detection predicted naturalistic action performance in stroke participants. Regression and voxel lesion-symptom mapping analyses of lesion data revealed that means – but not outcome – coding relies on the integrity of the left inferior parietal lobe, whereas no selective critical brain region could be identified for outcome detection. Thus, means and outcome representations are dissociable at both the behavioral and neuroanatomical levels. Furthermore, the data are consistent with a degree of parallelism between action perception and production tasks. Finally, they reinforce the evidence for a critical role of the left inferior parietal lobule in the representation of action means, whereas action outcome may rely on a more distributed neural circuit. PMID:23566892

  13. A Left Cerebral Hemisphere's Superiority in Processing Spatial-Categorical Information in a Non-Verbal Semantic Format

    ERIC Educational Resources Information Center

    Suegami, Takashi; Laeng, Bruno

    2013-01-01

    It has been shown that the left and right cerebral hemispheres (LH and RH) respectively process qualitative or "categorical" spatial relations and metric or "coordinate" spatial relations. However, categorical spatial information could be thought as divided into two types: semantically-coded and visuospatially-coded categorical information. We…

  14. A Left Cerebral Hemisphere's Superiority in Processing Spatial-Categorical Information in a Non-Verbal Semantic Format

    ERIC Educational Resources Information Center

    Suegami, Takashi; Laeng, Bruno

    2013-01-01

    It has been shown that the left and right cerebral hemispheres (LH and RH) respectively process qualitative or "categorical" spatial relations and metric or "coordinate" spatial relations. However, categorical spatial information could be thought as divided into two types: semantically-coded and visuospatially-coded categorical information. We…

  15. Wholetheme Constructivism and Whole-Brain Education: Educational Implications of the Research on Left and Right Brain Hemispheres.

    ERIC Educational Resources Information Center

    Saleh, Amany; Iran-Nejad, Asghar

    The left side of the brain has been said to process speech along with logical, rational, convergent, objective, and sequential tasks. The right side of the brain is thought to process nonverbal, spatial, musical, and analogical information. This paper discusses the research on brain hemisphericity from the perspectives of traditional and…

  16. Cerebral infarction in the left hemisphere compared with the right hemisphere increases the risk of aspiration pneumonia.

    PubMed

    Yamamoto, Keiichi; Koh, Hideo; Shimada, Hiroyuki; Takeuchi, Jun; Yamakawa, Yoshihiro; Kawamura, Mayumi; Miki, Takami

    2014-12-01

    Aspiration pneumonia (AP) following cerebral infarction (CI) has been considered as one of its most serious complications. Nevertheless, there are no reports on the association between the type or location of CI and the incidence of AP. In addition, the association between dysphagia, which leads to aspiration, and the type or location of CI has never been investigated. Therefore we hypothesized that the laterality of CI affects the development of both dysphagia and AP. We performed a retrospective cohort study to examine the association between the laterality of CI and the incidence of dysphagia and AP in 133 patients. AP was found in 6.0% of the group with left CI and in 0.8% of the group with right CI. A univariate logistic regression analysis revealed that left CI was a significant predictor of AP (hazard ratio, 8.81; 95% confidence interval, 1.07-72.59; p = 0.043). Left CI was a significant predictor of AP even after adjusting for age, sex, CI type, or presence of diabetes mellitus. In addition, although the frequency of dysphagia as the direct cause of AP did not differ according to laterality, the frequency of AP that ensued from dysphagia in the left CI group was greater than that observed in the right CI group. The group with left CI from the motor cortex to the internal capsule complicated by dysphagia exhibited a high risk of AP.

  17. Critical brain regions for action recognition: lesion symptom mapping in left hemisphere stroke.

    PubMed

    Kalénine, Solène; Buxbaum, Laurel J; Coslett, Harry Branch

    2010-11-01

    A number of conflicting claims have been advanced regarding the role of the left inferior frontal gyrus, inferior parietal lobe and posterior middle temporal gyrus in action recognition, driven in part by an ongoing debate about the capacities of putative mirror systems that match observed and planned actions. We report data from 43 left hemisphere stroke patients in two action recognition tasks in which they heard and saw an action word ('hammering') and selected from two videoclips the one corresponding to the word. In the spatial recognition task, foils contained errors of body posture or movement amplitude/timing. In the semantic recognition task, foils were semantically related (sawing). Participants also performed a comprehension control task requiring matching of the same verbs to objects (hammer). Using regression analyses controlling for both the comprehension control task and lesion volume, we demonstrated that performance in the semantic gesture recognition task was predicted by per cent damage to the posterior temporal lobe, whereas the spatial gesture recognition task was predicted by per cent damage to the inferior parietal lobule. A whole-brain voxel-based lesion symptom-mapping analysis suggested that the semantic and spatial gesture recognition tasks were associated with lesioned voxels in the posterior middle temporal gyrus and inferior parietal lobule, respectively. The posterior middle temporal gyrus appears to serve as a central node in the association of actions and meanings. The inferior parietal lobule, held to be a homologue of the monkey parietal mirror neuron system, is critical for encoding object-related postures and movements, a relatively circumscribed aspect of gesture recognition. The inferior frontal gyrus, on the other hand, was not predictive of performance in any task, suggesting that previous claims regarding its role in action recognition may require refinement.

  18. Dissociation between Semantic Representations for Motion and Action Verbs: Evidence from Patients with Left Hemisphere Lesions

    PubMed Central

    Taylor, Lawrence J.; Evans, Carys; Greer, Joanna; Senior, Carl; Coventry, Kenny R.; Ietswaart, Magdalena

    2017-01-01

    This multiple single case study contrasted left hemisphere stroke patients (N = 6) to healthy age-matched control participants (N = 15) on their understanding of action (e.g., holding, clenching) and motion verbs (e.g., crumbling, flowing). The tasks required participants to correctly identify the matching verb or associated picture. Dissociations on action and motion verb content depending on lesion site were expected. As predicted for verbs containing an action and/or motion content, modified t-tests confirmed selective deficits in processing motion verbs in patients with lesions involving posterior parietal and lateral occipitotemporal cortex. In contrast, deficits in verbs describing motionless actions were found in patients with more anterior lesions sparing posterior parietal and lateral occipitotemporal cortex. These findings support the hypotheses that semantic representations for action and motion are behaviorally and neuro-anatomically dissociable. The findings clarify the differential and critical role of perceptual and motor regions in processing modality-specific semantic knowledge as opposed to a supportive but not necessary role. We contextualize these results within theories from both cognitive psychology and cognitive neuroscience that make claims over the role of sensory and motor information in semantic representation. PMID:28261070

  19. Post-stroke acquired amusia: A comparison between right- and left-brain hemispheric damages.

    PubMed

    Jafari, Zahra; Esmaili, Mahdiye; Delbari, Ahmad; Mehrpour, Masoud; Mohajerani, Majid H

    2017-01-01

    Although extensive research has been published about the emotional consequences of stroke, most studies have focused on emotional words, speech prosody, voices, or facial expressions. The emotional processing of musical excerpts following stroke has been relatively unexplored. The present study was conducted to investigate the effects of chronic stroke on the recognition of basic emotions in music. Seventy persons, including 25 normal controls (NC), 25 persons with right brain damage (RBD) from stroke, and 20 persons with left brain damage (LBD) from stroke between the ages of 31-71 years were studied. The Musical Emotional Bursts (MEB) test, which consists of a set of short musical pieces expressing basic emotional states (happiness, sadness, and fear) and neutrality, was used to test musical emotional perception. Both stroke groups were significantly poorer than normal controls for the MEB total score and its subtests (p < 0.001). The RBD group was significantly less able than the LBD group to recognize sadness (p = 0.047) and neutrality (p = 0.015). Negative correlations were found between age and MEB scores for all groups, particularly the NC and RBD groups. Our findings indicated that stroke affecting the auditory cerebrum can cause acquired amusia with greater severity in RBD than LBD. These results supported the "valence hypothesis" of right hemisphere dominance in processing negative emotions.

  20. Timing independent spatial motor sequence learning is preserved in left hemisphere stroke.

    PubMed

    Dovern, Anna; Niessen, Eva; Ant, Jana M; Saliger, Jochen; Karbe, Hans; Fink, Gereon R; Koch, Iring; Weiss, Peter H

    2017-09-26

    During neurorehabilitation, the re-learning of motor sequences is crucial for patients with motor deficits, enabling them to master again complex movements. A recent study showed that patients with left hemisphere (LH) stroke exhibited preserved motor sequence learning (as assessed by the serial reaction time (SRT) task) when the timing of the stimuli was comparable in the training and later test phase. However, patients showed significantly smaller learning scores as compared to healthy controls when the temporal delay between the patient's motor response and the following stimulus was randomized in the test phase. We here investigated whether LH stroke patients were able to learn spatial motor sequences even if no predictable temporal information was provided (i.e., adopting random response-stimulus intervals, RSIs) already during the training phase. Twelve right-handed LH stroke patients and 18 right-handed healthy controls performed a SRT task with random RSIs to test incidental learning of a complex spatial motor sequence. Results indicate that, although the learning condition with random RSIs was more difficult than learning with predictable RSIs, LH stroke patients performed as well as healthy controls regarding sequence specific learning. Thus, data show for the first time that LH stroke patients are able to incidentally learn a spatial sequence even when no predictable temporal information is available. Copyright © 2017. Published by Elsevier Ltd.

  1. Use of the Faces Pain Scale by left and right hemispheric stroke patients.

    PubMed

    Benaim, Charles; Froger, Jerome; Cazottes, Claire; Gueben, Delphine; Porte, Melanie; Desnuelle, Claude; Pelissier, Jacques Yvon

    2007-03-01

    No pain scale is available for stroke patients due to the presence of language or cognitive disorders. However, the Faces Pain Scale (FPS), which was initially developed for children, has been used with success in adults with cognitive impairments. The aim of this study is to test whether the FPS could be used in left or right hemispheric stroke patients (LHSP, RHSP). One hundred twenty-seven stoke patients and 21 controls were recruited in 2 rehabilitation units. Construct validity of FPS was assessed by rating and ranking facial expressions. FPS was correlated to a Visual Analog Scale (VAS) and to a Verbal Rating Scale (VRS) for the assessment of shoulder pain. Reliability was determined by test-retest procedures. Performances of RHSP in the ranking and rating procedures were very poor compared to LHSP and to controls. However, in the assessment of patients' shoulder pain, FPS scores were highly correlated with VAS and VRS in both stroke groups (r=0.65-0.82, p<10(-3)). FPS was more reliable in LHSP than in RHSP. It was preferred to VAS and VRS in LHSP, while in RHSP VAS was the preferred scale. The present study provides preliminary support for the validity and the reliability of FPS in LHSP. However, we do not recommend its sole use in stroke patients. Further studies are needed to determine whether FPS can be used in stroke patients for assessing changes in severity of pain over time.

  2. Dissociation between Semantic Representations for Motion and Action Verbs: Evidence from Patients with Left Hemisphere Lesions.

    PubMed

    Taylor, Lawrence J; Evans, Carys; Greer, Joanna; Senior, Carl; Coventry, Kenny R; Ietswaart, Magdalena

    2017-01-01

    This multiple single case study contrasted left hemisphere stroke patients (N = 6) to healthy age-matched control participants (N = 15) on their understanding of action (e.g., holding, clenching) and motion verbs (e.g., crumbling, flowing). The tasks required participants to correctly identify the matching verb or associated picture. Dissociations on action and motion verb content depending on lesion site were expected. As predicted for verbs containing an action and/or motion content, modified t-tests confirmed selective deficits in processing motion verbs in patients with lesions involving posterior parietal and lateral occipitotemporal cortex. In contrast, deficits in verbs describing motionless actions were found in patients with more anterior lesions sparing posterior parietal and lateral occipitotemporal cortex. These findings support the hypotheses that semantic representations for action and motion are behaviorally and neuro-anatomically dissociable. The findings clarify the differential and critical role of perceptual and motor regions in processing modality-specific semantic knowledge as opposed to a supportive but not necessary role. We contextualize these results within theories from both cognitive psychology and cognitive neuroscience that make claims over the role of sensory and motor information in semantic representation.

  3. Language lateralization in children with pre- and postnatal epileptogenic lesions of the left hemisphere: an fMRI study.

    PubMed

    Hadac, Jan; Brozová, Katerina; Tintera, Jaroslav; Krsek, Pavel

    2007-12-01

    Functional MRI was used to evaluate factors influencing hemispheric dominance for language in 34 children suffering from intractable focal epilepsy due to left hemispheric lesion of pre- (n = 19) or postnatal (n = 15) origin. Nineteen children (56%) exhibited pronounced left-hemispheric language dominance. Significant co-activation of the right hemisphere or a complete language shift to this hemisphere was present in 15 children (44%). Atypical language representation was detected in 6 children (31,6%) with developmental pathology and in 9 patients (60%) with acquired epileptogenic lesion. Younger age at epilepsy onset and longer duration of epilepsy correlated significantly with atypical language presentation (p < 0,017 and p < 0,025). Whereas lesser tendency of prenatal lesions to displace cortical language centers did not reach statistical significance in simple paired tests, multiple logistic regression analysis viewed positive interaction between language shift, etiology and age at epilepsy onset. In conclusion, the language network reorganization was strongly influenced by both, the age at epilepsy onset and duration of epilepsy, and to a lesser degree by the character of the epileptogenic lesion, either developmental or acquired postnatally.

  4. Asymmetry of temporal auditory T-complex: right ear-left hemisphere advantage in Tb timing in children.

    PubMed

    Bruneau, Nicole; Bidet-Caulet, Aurélie; Roux, Sylvie; Bonnet-Brilhault, Frédérique; Gomot, Marie

    2015-02-01

    To investigate brain asymmetry of the temporal auditory evoked potentials (T-complex) in response to monaural stimulation in children compared to adults. Ten children (7 to 9 years) and ten young adults participated in the study. All were right-handed. The auditory stimuli used were tones (1100 Hz, 70 dB SPL, 50 ms duration) delivered monaurally (right, left ear) at four different levels of stimulus onset asynchrony (700-1100-1500-3000 ms). Latency and amplitude of responses were measured at left and right temporal sites according to the ear stimulated. Peaks of the three successive deflections (Na-Ta-Tb) of the T-complex were greater in amplitude and better defined in children than in adults. Amplitude measurements in children indicated that Na culminates on the left hemisphere whatever the ear stimulated whereas Ta and Tb culminate on the right hemisphere but for left ear stimuli only. Peak latency displayed different patterns of asymmetry. Na and Ta displayed shorter latencies for contralateral stimulation. The original finding was that Tb peak latency was the shortest at the left temporal site for right ear stimulation in children. Amplitude increased and/or peak latency decreased with increasing SOA, however no interaction effect was found with recording site or with ear stimulated. Our main original result indicates a right ear-left hemisphere timing advantage for Tb peak in children. The Tb peak would therefore be a good candidate as an electrophysiological marker of ear advantage effects during dichotic stimulation and of functional inter-hemisphere interactions and connectivity in children. Copyright © 2014. Published by Elsevier B.V.

  5. A case of expressive-vocal amusia in a right-handed patient with left hemispheric cerebral infarction.

    PubMed

    Uetsuki, Shizuka; Kinoshita, Hiroshi; Takahashi, Ryuichi; Obata, Satoshi; Kakigi, Tatsuya; Wada, Yoshiko; Yokoyama, Kazumasa

    2016-03-01

    A 53-year-old right-handed woman had an extensive lesion in the left hemisphere due to an infarction caused by vasospasm secondary to subarachnoid bleeding. She exhibited persistent expressive-vocal amusia with no symptoms of aphasia. Evaluation of the patient's musical competence using the Montreal Battery for Evaluation of Amusia, rhythm reproduction tests, acoustic analysis of pitch upon singing familiar music, Japanese standard language tests, and other detailed clinical examinations revealed that her amusia was more dominantly related to pitch production. The intactness of her speech provided strong evidence that the right hemisphere played a major role in her linguistic processing. Data from functional magnetic resonance imaging while she was singing a familiar song, a scale, and reciting lyrics indicated that perilesional residual activation in the left hemisphere was associated with poor pitch production, while right hemispheric activation was involved in linguistic processing. The localization of infarction more anterior to the left Sylvian fissure might be related to the dominant deficits in expressive aspects of the singing of the patient. Compromised motor programming producing a single tone may have made a major contribution to her poor singing. Imperfect auditory feedback due to borderline perceptual ability or improper audio-motor associations might also have played a role.

  6. You may now kiss the bride: Interpretation of social situations by individuals with right or left hemisphere injury.

    PubMed

    Baldo, Juliana V; Kacinik, Natalie A; Moncrief, Amber; Beghin, Francesca; Dronkers, Nina F

    2016-01-08

    While left hemisphere damage (LHD) has been clearly shown to cause a range of language impairments, patients with right hemisphere damage (RHD) also exhibit communication deficits, such as difficulties processing prosody, discourse, and social contexts. In the current study, individuals with RHD and LHD were directly compared on their ability to interpret what a character in a cartoon might be saying or thinking, in order to better understand the relative role of the right and left hemisphere in social communication. The cartoon stimuli were manipulated so as to elicit more or less formulaic responses (e.g., a scene of a couple being married by a priest vs. a scene of two people talking, respectively). Participants' responses were scored by blind raters on how appropriately they captured the gist of the social situation, as well as how formulaic and typical their responses were. Results showed that RHD individuals' responses were rated as significantly less appropriate than controls and were also significantly less typical than controls and individuals with LHD. Individuals with RHD produced a numerically lower proportion of formulaic expressions than controls, but this difference was only a trend. Counter to prediction, the pattern of performance across participant groups was not affected by how constrained/formulaic the social situation was. The current findings expand our understanding of the roles that the right and left hemispheres play in social processing and communication and have implications for the potential treatment of social communication deficits in individuals with RHD.

  7. Affective speech prosody perception and production in stroke patients with left-hemispheric damage and healthy controls.

    PubMed

    Leung, Joan H; Purdy, Suzanne C; Tippett, Lynette J; Leão, Sylvia H S

    2017-03-01

    'Affective prosody' defines the supra-segmental features of speech that, when manipulated, can change the type and intensity of emotion conveyed by the speaker. Although the right hemisphere is predominantly linked to the processing of affective prosodic cues, existing literature also suggests that damage to the left hemisphere can result in similar deficits. This study aims to demonstrate, and add to the evidence, that patients with left-hemisphere injury experience difficulties with affective prosodic perception and production, measured via a new combination of assessments and analyses. It is also hypothesised that aphasia severity will be correlated with impaired processing of affective prosody. Stroke and control participants differed significantly on prosody perception tests of matching auditory affective cues to visual images. Prosodic production was measured by participants vocalising different affective expressions of words and monosyllables - from which significant differences were found in perceptual judgements of emotion accuracy and intensity, and acoustic analyses of pitch range and variance. There were significant correlations between participants' Western Aphasia Battery (WAB) scores, quality of life, and prosody production. Individuals with left-hemisphere damage after stroke have impaired affective prosodic perception and production that may be associated with reduced quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Damage of left temporal lobe resulting in conversion of speech to Sutra, a Buddhist prayer stored in the right hemisphere.

    PubMed

    Shinoura, Nobusada; Onodera, Toshiyuki; Kurokawa, Kotoyo; Tsukada, Masanobu; Yamada, Ryozi; Tabei, Yusuke; Koizumi, Tomoyuki; Yagi, Kazuo

    2010-08-01

    The present study describes a case of a right-handed 74-year-old woman with a brain tumor who showed conversion of speech to Sutra, a Buddhist prayer, which was stored in the right hemisphere according to the Wada test. After surgery, relative improvement in the speech disorder was observed, and frequency of speech production of simple normal words with normal phonology increased. These observations indicate that damage to left temporal lobe resulted in conversion of speech to Sutra, and that Sutra was stored in this patient's right hemisphere.

  9. Left Hemispheric Imbalance and Reward Mechanisms Affect Gambling Behavior: The Contribution of the Metacognition and Cortical Brain Oscillations.

    PubMed

    Balconi, Michela; Finocchiaro, Roberta; Canavesio, Ylenia

    2015-07-01

    The present research used the Iowa Gambling Task to test the effect of the reward-sensitivity Behavioral Activation System-Reward (BAS-Reward) construct on the ability to distinguish between high- and low-risk decisions. To elucidate the individual differences that influence the decisional processes, making the strategies more or less advantageous, we considered the impact of the BAS motivational system and the frontal left and right cortical activity on subjects' decisions. More specifically, the lateralization effect, which is related to the increased activation of the left (BAS-Reward-related) hemisphere, was explored by using frequency band analysis. Specifically, behavioral responses (gain/loss options), metacognition, and delta, theta, alpha, and beta band modulation (asymmetry index) were considered. Thirty subjects were divided into high-BAS and low-BAS groups. In comparison with low-BAS, the high-BAS group showed an increased tendency to opt in favor of the immediate reward (losing strategy) instead of the long-term option (winning strategy), and members of this group were more impaired in metacognitive monitoring of their strategies and showed an increased left hemisphere activation when they responded to losing choices. A "reward bias" effect was hypothesized to act for high BAS, based on a left-hemisphere hyperactivation.

  10. Atypical conduction aphasia and the right hemisphere: Cross-hemispheric plasticity of phonology in a developmentally dyslexic and dysgraphic patient with early left frontal damage.

    PubMed

    Berthier, Marcelo L; Dávila, Guadalupe; García-Casares, Natalia; Green, Cristina; Juárez, Rocío; Ruiz-Cruces, Rafael; Pablo Lara, J; Barbancho, M A

    2011-01-01

    We report the rare case of a patient, JNR, with history of mixed handedness, developmental dyslexia, dysgraphia, and attentional deficits associated with a Klippel-Trenaunay syndrome and a small subcortical frontal lesion involving the left arcuate fasciculus. In adulthood, he suffered a large right perisylvian stroke and developed atypical conduction aphasia with deficits in input and output phonological processing and poor auditory-verbal short-term memory. Lexical-semantic processing for single words was intact, but he was unable to access meaning in sentence comprehension and repetition. Reading and writing deficits worsened after the stroke and he presented a combination of developmental and acquired dysgraphia and dyslexia with mixed lexical and phonological processing deficits. This case suggest that a small lesion sustained prenatally or early in life could induce a selective rightward shift of phonology sparing the standard left hemisphere lateralisation of lexical-semantic functions.

  11. Left acute scrotum associated with appendicitis.

    PubMed

    Yasumoto, R; Kawano, M; Kawanishi, H; Shindow, K; Hiura, A; Kim, E; Ikehara, T

    1998-01-01

    A 10-year-old boy, who had a mild inguinal hernia in his left scrotum, was referred to our clinic because of redness of the scrotal skin and tenderness of the left scrotal contents. Scrotal echography showed a hypoechoic lesion around the normal testis and epididymis. Because torsion of either the testis or testicular appendage was suspected, the scrotum was opened and 1.5 mL of purulent fluid was observed in the tunica vaginalis with inflammatory tissue around the testis and epididymis. On the first postoperative day, a low grade fever and abdominal tenderness persisted, however, the abdomen was flat and soft. There was no marked tenderness over McBurney's point, but there was moderate tenderness over Lanz's point on deep palpation. Abdominal sonography and magnetic resonance imaging revealed abscess formation between the bladder and the sacrum. With a diagnosis of perforation of the appendix, a laparotomy was performed. The inguinal hernia sac could not be observed on inspection, and it was not possible to palpate the left side because of severe adhesion due to infection. Also, the neck of the right inguinal sac could not be seen. The appendix specimen was gangrenous. On the second postsurgical day, all symptoms and signs disappeared. We present this rare condition and discuss the difficulty in establishing a diagnosis.

  12. Tool-use and the left hemisphere: what is lost in ideomotor apraxia?

    PubMed

    Sunderland, Alan; Wilkins, Leigh; Dineen, Rob; Dawson, Sophie E

    2013-03-01

    Impaired tool related action in ideomotor apraxia is normally ascribed to loss of sensorimotor memories for habitual actions (engrams), but this account has not been tested against a hypothesis of a general deficit in representation of hand-object spatial relationships. Rapid reaching for familiar tools was compared with reaching for abstract objects in apraxic patients (N=9) and in a control group with right hemisphere posterior stroke. The apraxic patients alone showed an impairment in rotating the wrist to correctly grasp an inverted tool but not when inverting the hand to avoid a barrier and grasp an abstract object, and the severity of the impairment in tool reaching correlated with pantomime of tool-use. A second experiment with two apraxic patients tested whether barrier avoidance was simply less spatially demanding than reaching for a tool. However, the patient with damage limited to the inferior parietal lobe still showed a selective problem for tools. These results demonstrate that some apraxic patients are selectively impaired in their interaction with familiar tools, and this cannot be explained by the demands of the task on postural or spatial representation. However, traditional engram theory cannot account for associated problems with imitation of novel actions nor the absence of any correlated deficit in recognition of the methods of grasp of common tools. A revised theory is presented which follows the dorsal and ventral streams model (Milner & Goodale, 2008) and proposes preservation of motor control by the dorsal stream but impaired modulating input to it from the conceptual systems of the left temporal lobe.

  13. Patterns of apraxia associated with the production of intransitive limb gestures following left and right hemisphere stroke.

    PubMed

    Heath, M; Roy, E A; Westwood, D; Black, S E

    2001-01-01

    The model of apraxia proposed by Roy (1996) states that three patterns of apraxia should be observed across pantomime and imitation conditions. In the present analysis the frequency and severity of each pattern of apraxia were examined in a consecutive sample of left-(LHD) and right-hemisphere-damaged (RHD) patients during the production of intransitive limb gestures. The results indicated that a significant proportion of LHD and RHD patients were selectively impaired in formulating the ideational component of intransitive limb gestures.

  14. Is a lone right hemisphere enough? Neurolinguistic architecture in a case with a very early left hemispherectomy.

    PubMed

    Danelli, Laura; Cossu, Giuseppe; Berlingeri, Manuela; Bottini, Gabriella; Sberna, Maurizio; Paulesu, Eraldo

    2013-01-01

    We studied the linguistic profile and neurolinguistic organization of a 14-year-old adolescent (EB) who underwent a left hemispherectomy at the age of 2.5 years. After initial aphasia, his language skills recovered within 2 years, with the exception of some word finding problems. Over the years, the neuropsychological assessments showed that EB's language was near-to-normal, with the exception of lexical competence, which lagged slightly behind for both auditory and written language. Moreover, EB's accuracy and speed in both reading and writing words and non-words were within the normal range, whereas difficulties emerged in reading loan words and in tasks with homophones. EB's functional magnetic resonance imaging (fMRI) patterns for several linguistic and metalinguistic tasks were similar to those observed in the dominant hemisphere of controls, suggesting that his language network conforms to a left-like linguistic neural blueprint. However, a stronger frontal recruitment suggests that linguistic tasks are more demanding for him. Finally, no specific reading activation was found in EB's occipitotemporal region, a finding consistent with the surface dyslexia-like behavioral pattern of the patient. While a lone right hemisphere may not be sufficient to guarantee full blown linguistic competences after early hemispherectomy, EB's behavioral and fMRI patterns suggest that his lone right hemisphere followed a left-like blueprint of the linguistic network.

  15. Prevalence and length of recovery of pusher syndrome based on cerebral hemispheric lesion side in patients with acute stroke.

    PubMed

    Abe, Hiroaki; Kondo, Takeo; Oouchida, Yutaka; Suzukamo, Yoshimi; Fujiwara, Satoru; Izumi, Shin-Ichi

    2012-06-01

    The aim of this study was to determine if side of cerebral hemisphere lesion affects the prevalence and time course of pushing behavior (PB) after stroke. A total of 1660 patients with acute stroke were investigated. PB was assessed using the standardized Scale for Contraversive Pushing. Risk ratios were used to evaluate the differences in the prevalence of PB between right cerebral hemisphere-damaged (RCD) and left cerebral hemisphere-damaged (LCD) patients. The differences in the time course among 35 (27 RCD and 8 LCD) patients were evaluated by analyzing Scale for Contraversive Pushing scores with the Kaplan-Meier method using a log-rank test. PB was observed in 156 (9.4%) patients. The prevalence of PB was significantly higher in RCD (97 of 556 [17.4%]) than in LCD (57 of 599 [9.5%]) patients; risk ratio was 1.83 (95% CI, 1.35-2.49). The log-rank test indicated that RCD patients exhibited a significantly slower recovery than LCD patients (P=0.027). The number of RCD patients who exhibited PB was higher than that of LCD patients. The duration of recovery from PB was longer in RCD patients than in LCD patients.

  16. Successful percutaneous management of acute left ventricular assist device stoppage.

    PubMed

    Chrysant, George S; Horstmanshof, Douglas A; Snyder, Trevor; Chaffin, John S; Elkins, C Craig; Kanaly, Paul J; Long, James W

    2010-01-01

    The HeartMate II left ventricular assist device (LVAD) is a small axial-flow next-generation pump. Acute stoppage of this device is a potentially lethal complication. As these devices proliferate, many patients will be in areas remote to their implant center. Therefore, percutaneous stabilization of these patients before definitive surgical replacement could be potentially life saving. We present two cases of acute LVAD stoppage managed successfully using percutaneous means.

  17. Development of a selective left-hemispheric fronto-temporal network for processing syntactic complexity in language comprehension

    PubMed Central

    Xiao, Yaqiong; Friederici, Angela D.; Margulies, Daniel S.; Brauer, Jens

    2016-01-01

    The development of language comprehension abilities in childhood is closely related to the maturation of the brain, especially the ability to process syntactically complex sentences. Recent studies proposed that the fronto-temporal connection within left perisylvian regions, supporting the processing of syntactically complex sentences, is still immature at preschool age. In the current study, resting state functional magnetic resonance imaging data were acquired from typically developing 5-year-old children and adults to shed further light on the brain functional development. Children additionally performed a behavioral syntactic comprehension test outside the scanner. The amplitude of low-frequency fluctuations was analyzed in order to identify the functional correlation networks of language-relevant brain regions. Results showed an intrahemispheric correlation between left inferior frontal gyrus (IFG) and left posterior superior temporal sulcus (pSTS) in adults, whereas an interhemispheric correlation between left IFG and its right-hemispheric homolog was predominant in children. Correlation analysis between resting-state functional connectivity and sentence processing performance in 5-year-olds revealed that local connectivity within the left IFG is associated with competence of processing syntactically simple canonical sentences, while long-range connectivity between IFG and pSTS in left hemisphere is associated with competence of processing syntactically relatively more complex non-canonical sentences. The present developmental data suggest that a selective left fronto-temporal connectivity network for processing complex syntax is already in functional connection at the age of 5 years when measured in a non-task situation. The correlational findings provide new insight into the relationship between intrinsic functional connectivity and syntactic language abilities in preschool children. PMID:26352468

  18. Development of a selective left-hemispheric fronto-temporal network for processing syntactic complexity in language comprehension.

    PubMed

    Xiao, Yaqiong; Friederici, Angela D; Margulies, Daniel S; Brauer, Jens

    2016-03-01

    The development of language comprehension abilities in childhood is closely related to the maturation of the brain, especially the ability to process syntactically complex sentences. Recent studies proposed that the fronto-temporal connection within left perisylvian regions, supporting the processing of syntactically complex sentences, is still immature at preschool age. In the current study, resting state functional magnetic resonance imaging data were acquired from typically developing 5-year-old children and adults to shed further light on the brain functional development. Children additionally performed a behavioral syntactic comprehension test outside the scanner. The amplitude of low-frequency fluctuations was analyzed in order to identify the functional correlation networks of language-relevant brain regions. Results showed an intrahemispheric correlation between left inferior frontal gyrus (IFG) and left posterior superior temporal sulcus (pSTS) in adults, whereas an interhemispheric correlation between left IFG and its right-hemispheric homolog was predominant in children. Correlation analysis between resting-state functional connectivity and sentence processing performance in 5-year-olds revealed that local connectivity within the left IFG is associated with competence of processing syntactically simple canonical sentences, while long-range connectivity between IFG and pSTS in left hemisphere is associated with competence of processing syntactically relatively more complex non-canonical sentences. The present developmental data suggest that a selective left fronto-temporal connectivity network for processing complex syntax is already in functional connection at the age of 5 years when measured in a non-task situation. The correlational findings provide new insight into the relationship between intrinsic functional connectivity and syntactic language abilities in preschool children.

  19. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction.

    PubMed

    Elsheshtawy, Moustafa; Sriganesh, Priatharsini; Virparia, Vasudev; Patel, Falgun; Khanna, Ashok

    2016-01-01

    Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools.

  20. Co-speech hand movements during narrations: What is the impact of right vs. left hemisphere brain damage?

    PubMed

    Hogrefe, Katharina; Rein, Robert; Skomroch, Harald; Lausberg, Hedda

    2016-10-27

    Persons with brain damage show deviant patterns of co-speech hand movement behaviour in comparison to healthy speakers. It has been claimed by several authors that gesture and speech rely on a single production mechanism that depends on the same neurological substrate while others claim that both modalities are closely related but separate production channels. Thus, findings so far are contradictory and there is a lack of studies that systematically analyse the full range of hand movements that accompany speech in the condition of brain damage. In the present study, we aimed to fill this gap by comparing hand movement behaviour in persons with unilateral brain damage to the left and the right hemisphere and a matched control group of healthy persons. For hand movement coding, we applied Module I of NEUROGES, an objective and reliable analysis system that enables to analyse the full repertoire of hand movements independent of speech, which makes it specifically suited for the examination of persons with aphasia. The main results of our study show a decreased use of communicative conceptual gestures in persons with damage to the right hemisphere and an increased use of these gestures in persons with left brain damage and aphasia. These results not only suggest that the production of gesture and speech do not rely on the same neurological substrate but also underline the important role of right hemisphere functioning for gesture production.

  1. Bilateral Transcranial Direct Current Stimulation Language Treatment Enhances Functional Connectivity in the Left Hemisphere: Preliminary Data from Aphasia.

    PubMed

    Marangolo, Paola; Fiori, Valentina; Sabatini, Umberto; De Pasquale, Giada; Razzano, Carmela; Caltagirone, Carlo; Gili, Tommaso

    2016-05-01

    Several studies have already shown that transcranial direct current stimulation (tDCS) is a useful tool for enhancing recovery in aphasia. However, no reports to date have investigated functional connectivity changes on cortical activity because of tDCS language treatment. Here, nine aphasic persons with articulatory disorders underwent an intensive language therapy in two different conditions: bilateral anodic stimulation over the left Broca's area and cathodic contralesional stimulation over the right homologue of Broca's area and a sham condition. The language treatment lasted 3 weeks (Monday to Friday, 15 sessions). In all patients, language measures were collected before (T0) and at the end of treatment (T15). Before and after each treatment condition (real vs. sham), each participant underwent a resting-state fMRI study. Results showed that, after real stimulation, patients exhibited the greatest recovery not only in terms of better accuracy in articulating the treated stimuli but also for untreated items on different tasks of the language test. Moreover, although after the sham condition connectivity changes were confined to the right brain hemisphere, real stimulation yielded to stronger functional connectivity increase in the left hemisphere. In conclusion, our data provide converging evidence from behavioral and functional imaging data that bilateral tDCS determines functional connectivity changes within the lesioned hemisphere, enhancing the language recovery process in stroke patients.

  2. Phonological memory in sign language relies on the visuomotor neural system outside the left hemisphere language network.

    PubMed

    Kanazawa, Yuji; Nakamura, Kimihiro; Ishii, Toru; Aso, Toshihiko; Yamazaki, Hiroshi; Omori, Koichi

    2017-01-01

    Sign language is an essential medium for everyday social interaction for deaf people and plays a critical role in verbal learning. In particular, language development in those people should heavily rely on the verbal short-term memory (STM) via sign language. Most previous studies compared neural activations during signed language processing in deaf signers and those during spoken language processing in hearing speakers. For sign language users, it thus remains unclear how visuospatial inputs are converted into the verbal STM operating in the left-hemisphere language network. Using functional magnetic resonance imaging, the present study investigated neural activation while bilinguals of spoken and signed language were engaged in a sequence memory span task. On each trial, participants viewed a nonsense syllable sequence presented either as written letters or as fingerspelling (4-7 syllables in length) and then held the syllable sequence for 12 s. Behavioral analysis revealed that participants relied on phonological memory while holding verbal information regardless of the type of input modality. At the neural level, this maintenance stage broadly activated the left-hemisphere language network, including the inferior frontal gyrus, supplementary motor area, superior temporal gyrus and inferior parietal lobule, for both letter and fingerspelling conditions. Interestingly, while most participants reported that they relied on phonological memory during maintenance, direct comparisons between letters and fingers revealed strikingly different patterns of neural activation during the same period. Namely, the effortful maintenance of fingerspelling inputs relative to letter inputs activated the left superior parietal lobule and dorsal premotor area, i.e., brain regions known to play a role in visuomotor analysis of hand/arm movements. These findings suggest that the dorsal visuomotor neural system subserves verbal learning via sign language by relaying gestural inputs to

  3. Words, Hemispheres, and Dissociable Subsystems: The Effects of Exposure Duration, Case Alternation, Priming, and Continuity of Form on Word Recognition in the Left and Right Visual Fields

    ERIC Educational Resources Information Center

    Ellis, Andrew W.; Ansorge, Lydia; Lavidor, Michal

    2007-01-01

    Three experiments explore aspects of the dissociable neural subsystems theory of hemispheric specialisation proposed by Marsolek and colleagues, and in particular a study by [Deason, R. G., & Marsolek, C. J. (2005). A critical boundary to the left-hemisphere advantage in word processing. "Brain and Language," 92, 251-261]. Experiment 1A showed…

  4. Words, Hemispheres, and Dissociable Subsystems: The Effects of Exposure Duration, Case Alternation, Priming, and Continuity of Form on Word Recognition in the Left and Right Visual Fields

    ERIC Educational Resources Information Center

    Ellis, Andrew W.; Ansorge, Lydia; Lavidor, Michal

    2007-01-01

    Three experiments explore aspects of the dissociable neural subsystems theory of hemispheric specialisation proposed by Marsolek and colleagues, and in particular a study by [Deason, R. G., & Marsolek, C. J. (2005). A critical boundary to the left-hemisphere advantage in word processing. "Brain and Language," 92, 251-261]. Experiment 1A showed…

  5. Regional brain blood flow and cerebral hemispheric oxygen consumption during acute hypoxaemia in the llama fetus

    PubMed Central

    Llanos, Aníbal J; Riquelme, Raquel A; Sanhueza, Emilia M; Herrera, Emilio; Cabello, Gertrudis; Giussani, Dino A; Parer, Julian T

    2002-01-01

    Unlike fetal animals of lowland species, the llama fetus does not increase its cerebral blood flow during an episode of acute hypoxaemia. This study tested the hypothesis that the fetal llama brain maintains cerebral hemispheric O2 consumption by increasing cerebral O2 extraction rather than decreasing cerebral oxygen utilisation during acute hypoxaemia. Six llama fetuses were surgically instrumented under general anaesthesia at 217 days of gestation (term ca 350 days) with vascular and amniotic catheters in order to carry out cardiorespiratory studies. Following a control period of 1 h, the llama fetuses underwent 3 × 20 min episodes of progressive hypoxaemia, induced by maternal inhalational hypoxia. During basal conditions and during each of the 20 min of hypoxaemia, fetal cerebral blood flow was measured with radioactive microspheres, cerebral oxygen extraction was calculated, and fetal cerebral hemispheric O2 consumption was determined by the modified Fick principle. During hypoxaemia, fetal arterial O2 tension and fetal pH decreased progressively from 24 ± 1 to 20 ± 1 Torr and from 7.36 ± 0.01 to 7.33 ± 0.01, respectively, during the first 20 min episode, to 16 ± 1 Torr and 7.25 ± 0.05 during the second 20 min episode and to 14 ± 1 Torr and 7.21 ± 0.04 during the final 20 min episode. Fetal arterial partial pressure of CO2 (Pa,CO2, 42 ± 2 Torr) remained unaltered from baseline throughout the experiment. Fetal cerebral hemispheric blood flow and cerebral hemispheric oxygen extraction were unaltered from baseline during progressive hypoxaemia. In contrast, a progressive fall in fetal cerebral hemispheric oxygen consumption occurred during the hypoxaemic challenge. In conclusion, these data do not support the hypothesis that the fetal llama brain maintains cerebral hemispheric O2 consumption by increasing cerebral hemispheric O2 extraction. Rather, the data show that in the llama fetus, a reduction in cerebral hemispheric metabolism occurs during acute

  6. Listeners' identification and evaluation of Korean idiomatic utterances produced by persons with left- or right-hemisphere damage.

    PubMed

    Yang, Seung-Yun; Sidtis, Diana; Yang, Seung Nam

    2017-01-01

    This study investigates the effects of left- (LHD) or right-hemisphere damage (RHD) on the production of matched idiomatic or literal expressions by examining healthy listeners' abilities to identify, evaluate and perceptually characterize the utterances. Native speakers of Korean with LHD or RHD and healthy controls (HCs) produced six ditropically ambiguous (idiomatic or literal) sentences in an elicitation and a repetition task. Healthy listeners identified the sentence types and indicated how well each utterance represented the intended meaning. Perceptual ratings of voice quality were performed by expert listeners. The results indicate a negative effect of RHD on listeners' identification and goodness ratings of utterance type. Repetition yielded better speech exemplars than elicitation. Sentence type was associated with selected voice qualities. These findings support previous reports of prosodic information serving to signal idiomatic versus literal meanings as well as a right-hemisphere involvement in formulaic language and the dual process model of language.

  7. Lexical Competition is Enhanced in the Left Hemisphere: Evidence from Different Types of Orthographic Neighbors

    ERIC Educational Resources Information Center

    Perea, Manuel; Acha, Joana; Fraga, Isabel

    2008-01-01

    Two divided visual field lexical decision experiments were conducted to examine the role of the cerebral hemispheres in orthographic neighborhood effects. In Experiment 1, we employed two types of words: words with many substitution neighbors (high-"N") and words with few substitution neighbors (low-"N"). Results showed a facilitative effect of…

  8. Hemispheric dominance for emotions, empathy and social behaviour: evidence from right and left handers with frontotemporal dementia.

    PubMed

    Perry, R J; Rosen, H R; Kramer, J H; Beer, J S; Levenson, R L; Miller, B L

    2001-01-01

    Although evidence from primates suggests an important role for the anterior temporal cortex in social behaviour, human research has to date concentrated almost solely on the orbitofrontal cortex and amygdala. By describing four cases of the temporal variant of frontotemporal dementia we show how this degenerative condition provides an excellent model for investigating the role of the anterior temporal lobe, especially the right, in emotions, empathy and social behaviour. Assessments of semantic memory, processing of emotional facial expression and emotional prosody were made, empathy was measured, and facial expressions of emotion were coded. Of the two right handers described, one subject with predominantly left temporal lobe atrophy had severe semantic impairment but normal performance on all emotional tasks. In contrast, the subject with right temporal lobe atrophy showed severely impaired recognition of emotion from faces and voices that was not due to semantic or perceptual difficulties. Empathy was lost, interpersonal skills were severely affected and facial expression of emotion was characterized by a fixed expression that was unresponsive to situations. Additionally, two left handers with right temporal lobe atrophy are described. One demonstrated the same pattern of hemispheric lateralization as the right handers and had emotional impairment. The other left hander showed the opposite pattern of deficits, suggesting a novel presentation of anomalous dominance with reversed hemispheric specialization of semantic memory and emotional processing.

  9. Understanding Actions of Others: The Electrodynamics of the Left and Right Hemispheres. A High-Density EEG Neuroimaging Study

    PubMed Central

    Ortigue, Stephanie; Sinigaglia, Corrado; Rizzolatti, Giacomo; Grafton, Scott T.

    2010-01-01

    Background When we observe an individual performing a motor act (e.g. grasping a cup) we get two types of information on the basis of how the motor act is done and the context: what the agent is doing (i.e. grasping) and the intention underlying it (i.e. grasping for drinking). Here we examined the temporal dynamics of the brain activations that follow the observation of a motor act and underlie the observer's capacity to understand what the agent is doing and why. Methodology/Principal Findings Volunteers were presented with two-frame video-clips. The first frame (T0) showed an object with or without context; the second frame (T1) showed a hand interacting with the object. The volunteers were instructed to understand the intention of the observed actions while their brain activity was recorded with a high-density 128-channel EEG system. Visual event-related potentials (VEPs) were recorded time-locked with the frame showing the hand-object interaction (T1). The data were analyzed by using electrical neuroimaging, which combines a cluster analysis performed on the group-averaged VEPs with the localization of the cortical sources that give rise to different spatio-temporal states of the global electrical field. Electrical neuroimaging results revealed four major steps: 1) bilateral posterior cortical activations; 2) a strong activation of the left posterior temporal and inferior parietal cortices with almost a complete disappearance of activations in the right hemisphere; 3) a significant increase of the activations of the right temporo-parietal region with simultaneously co-active left hemispheric sources, and 4) a significant global decrease of cortical activity accompanied by the appearance of activation of the orbito-frontal cortex. Conclusions/Significance We conclude that the early striking left hemisphere involvement is due to the activation of a lateralized action-observation/action execution network. The activation of this lateralized network mediates the

  10. The role of left and right hemispheres in the comprehension of idiomatic language: an electrical neuroimaging study.

    PubMed

    Proverbio, Alice M; Crotti, Nicola; Zani, Alberto; Adorni, Roberta

    2009-09-15

    The specific role of the two cerebral hemispheres in processing idiomatic language is highly debated. While some studies show the involvement of the left inferior frontal gyrus (LIFG), other data support the crucial role of right-hemispheric regions, and particularly of the middle/superior temporal area. Time-course and neural bases of literal vs. idiomatic language processing were compared. Fifteen volunteers silently read 360 idiomatic and literal Italian sentences and decided whether they were semantically related or unrelated to a following target word, while their EEGs were recorded from 128 electrodes. Word length, abstractness and frequency of use, sentence comprehensibility, familiarity and cloze probability were matched across classes. Participants responded more quickly to literal than to idiomatic sentences, probably indicating a difference in task difficulty. Occipito/temporal N2 component had a greater amplitude in response to idioms between 250-300 ms. Related swLORETA source reconstruction revealed a difference in the activation of the left fusiform gyrus (FG, BA19) and medial frontal gyri for the contrast idiomatic-minus-literal. Centroparietal N400 was much larger to idiomatic than to literal phrases (360-550 ms). The intra-cortical generators of this effect included the left and right FG, the left cingulate gyrus, the right limbic area, the right MTG (BA21) and the left middle frontal gyrus (BA46). Finally, an anterior late positivity (600-800 ms) was larger to idiomatic than literal phrases. ERPs also showed a larger right centro-parietal N400 to associated than non-associated targets (not differing as a function of sentence type), and a greater right frontal P600 to idiomatic than literal associated targets. The data indicate bilateral involvement of both hemispheres in idiom comprehension, including the right MTG after 350 ms and the right medial frontal gyrus in the time windows 270-300 and 500-780 ms. In addition, the activation of left and

  11. The role of left and right hemispheres in the comprehension of idiomatic language: an electrical neuroimaging study

    PubMed Central

    Proverbio, Alice M; Crotti, Nicola; Zani, Alberto; Adorni, Roberta

    2009-01-01

    Background The specific role of the two cerebral hemispheres in processing idiomatic language is highly debated. While some studies show the involvement of the left inferior frontal gyrus (LIFG), other data support the crucial role of right-hemispheric regions, and particularly of the middle/superior temporal area. Time-course and neural bases of literal vs. idiomatic language processing were compared. Fifteen volunteers silently read 360 idiomatic and literal Italian sentences and decided whether they were semantically related or unrelated to a following target word, while their EEGs were recorded from 128 electrodes. Word length, abstractness and frequency of use, sentence comprehensibility, familiarity and cloze probability were matched across classes. Results Participants responded more quickly to literal than to idiomatic sentences, probably indicating a difference in task difficulty. Occipito/temporal N2 component had a greater amplitude in response to idioms between 250-300 ms. Related swLORETA source reconstruction revealed a difference in the activation of the left fusiform gyrus (FG, BA19) and medial frontal gyri for the contrast idiomatic-minus-literal. Centroparietal N400 was much larger to idiomatic than to literal phrases (360-550 ms). The intra-cortical generators of this effect included the left and right FG, the left cingulate gyrus, the right limbic area, the right MTG (BA21) and the left middle frontal gyrus (BA46). Finally, an anterior late positivity (600-800 ms) was larger to idiomatic than literal phrases. ERPs also showed a larger right centro-parietal N400 to associated than non-associated targets (not differing as a function of sentence type), and a greater right frontal P600 to idiomatic than literal associated targets. Conclusion The data indicate bilateral involvement of both hemispheres in idiom comprehension, including the right MTG after 350 ms and the right medial frontal gyrus in the time windows 270-300 and 500-780 ms. In addition

  12. When left-hemisphere reading is compromised: Comparing reading ability in participants after left cerebral hemispherectomy and participants with developmental dyslexia.

    PubMed

    Katzir, Tami; Christodoulou, Joanna A; de Bode, Stella

    2016-10-01

    We investigated reading skills in individuals who have undergone left cerebral hemispherectomy and in readers with developmental dyslexia to understand diverse characteristics contributing to reading difficulty. Although dyslexia is a developmental disorder, left hemispherectomy requires that patients (re)establish the language process needed to perform the language-based tasks in the nondominant (right) hemisphere to become readers. Participants with developmental dyslexia (DD; n = 11) and participants who had undergone left hemispherectomy (HEMI; n = 11) were matched on age and gender, and were compared on timed and untimed measures of single word and pseudo-word reading. The hemispherectomy group was subdivided into prenatal (in utero) and postnatal (>3 years) insult groups, indicating the timing of the primary lesion that ultimately required surgical intervention. On an untimed reading measure, the readers with DD were comparable to individuals who had undergone left hemispherectomy due to prenatal insult, but both scored higher than the postnatal hemispherectomy group. Timed word reading differed across groups. The hemispherectomy prenatal subgroup had low average scores on both timed and untimed tests. The group with dyslexia had average scores on untimed measures and below average scores on timed reading. The hemispherectomy postnatal group had the lowest scores among the groups by a significant margin, and the most pronounced reading difficulty. Patients with prenatal lesions leading to an isolated right hemisphere (RH) have the potential to develop reading to a degree comparable to that in persons with dyslexia for single word reading. This potential sharply diminishes in individuals who undergo hemispherectomy due to postnatal insult. The higher scores of the prenatal hemispherectomy group on timed reading suggest that under these conditions, individuals with an isolated RH can compensate to a significant degree. Wiley Periodicals, Inc. © 2016

  13. Embedded Words in Visual Word Recognition: Does the Left Hemisphere See the Rain in Brain?

    ERIC Educational Resources Information Center

    McCormick, Samantha F.; Davis, Colin J.; Brysbaert, Marc

    2010-01-01

    To examine whether interhemispheric transfer during foveal word recognition entails a discontinuity between the information presented to the left and right of fixation, we presented target words in such a way that participants fixated immediately left or right of an embedded word (as in "gr*apple", "bull*et") or in the middle…

  14. Embedded Words in Visual Word Recognition: Does the Left Hemisphere See the Rain in Brain?

    ERIC Educational Resources Information Center

    McCormick, Samantha F.; Davis, Colin J.; Brysbaert, Marc

    2010-01-01

    To examine whether interhemispheric transfer during foveal word recognition entails a discontinuity between the information presented to the left and right of fixation, we presented target words in such a way that participants fixated immediately left or right of an embedded word (as in "gr*apple", "bull*et") or in the middle…

  15. Acute Appendicitis Presenting as Unusual Left Upper Quadrant Pain

    PubMed Central

    Chuang, Tsung-Ju; Chen, Chun-Wen; Lin, Hsin-Yuan; Hsu, Wen-Hsiu; Wang, Shou-Cheng; Tu, Chuan-Chou

    2013-01-01

    Appendicitis is the most common abdominal disease that requires surgery in the emergency ward. It usually presents as right lower quadrant pain, but may rarely present as left upper quadrant (LUQ) pain due to congenital anatomical abnormalities of the intestine. We report a patient who complained of persistent LUQ abdominal pain and was finally diagnosed by computed tomography (CT) as congenital intestinal malrotation complicated with acute appendicitis. It is important to include acute appendicitis in the differential diagnosis of patients who complain of LUQ abdominal pain. Abdominal CT can provide significant information that is useful in preoperative diagnosis and determination of proper treatment. PMID:24348602

  16. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction

    PubMed Central

    Sriganesh, Priatharsini; Virparia, Vasudev; Patel, Falgun; Khanna, Ashok

    2016-01-01

    Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools. PMID:27119030

  17. Left inferior frontal gyrus mediates morphosyntax: ERP evidence from verb processing in left-hemisphere damaged patients.

    PubMed

    Regel, Stefanie; Kotz, Sonja A; Henseler, Ilona; Friederici, Angela D

    2017-01-01

    Neurocognitive models of language comprehension have proposed different mechanisms with different neural substrates mediating human language processing. Whether the left inferior frontal gyrus (LIFG) is engaged in morpho-syntactic information processing is currently still controversially debated. The present study addresses this issue by examining the processing of irregular verb inflection in real words (e.g., swim > swum > swam) and pseudowords (e.g., frim > frum > fram) by using event-related brain potentials (ERPs) in neurological patients with lesions in the LIFG involving Broca's area as well as healthy controls. Different ERP patterns in response to the grammatical violations were observed in both groups. Controls showed a biphasic negativity-P600 pattern in response to incorrect verb inflections whereas patients with LIFG lesions displayed a N400. For incorrect pseudoword inflections, a late positivity was found in controls, while no ERP effects were obtained in patients. These findings of different ERP patterns in the two groups strongly indicate an involvement of LIFG in morphosyntactic processing, thereby suggesting brain regions' specialization for different language functions.

  18. Speech perception, rapid temporal processing, and the left hemisphere: A case study of unilateral pure word deafness

    PubMed Central

    Slevc, L. Robert; Martin, Randi C.; Hamilton, A. Cris; Joanisse, Marc F.

    2010-01-01

    The mechanisms and functional anatomy underlying the early stages of speech perception are still not well understood. One way to investigate the cognitive and neural underpinnings of speech perception is by investigating patients with speech perception deficits but with preserved ability in other domains of language. One such case is reported here: patient NL shows highly impaired speech perception despite normal hearing ability and preserved semantic knowledge, speaking, and reading ability, and is thus classified as a case of pure word deafness (PWD). NL has a left temporoparietal lesion without right hemisphere damage and DTI imaging suggests that he has preserved cross-hemispheric connectivity, arguing against an account of PWD as a disconnection of left lateralized language areas from auditory input. Two experiments investigated whether NL’s speech perception deficit could instead result from an underlying problem with rapid temporal processing. Experiment 1 showed that NL has particular difficulty discriminating sounds that differ in terms of rapid temporal changes, be they speech or non-speech sounds. Experiment 2 employed an intensive training program designed to improve rapid temporal processing in language impaired children (Fast ForWord; Scientific Learning Corporation, Oakland, CA) and found that NL was able to improve his ability to discriminate rapid temporal differences in non-speech sounds, but not in speech sounds. Overall, these data suggest that patients with unilateral PWD may, in fact, have a deficit in (left lateralized) temporal processing ability, however they also show that a rapid temporal processing deficit is, by itself, unable to account for this patient’s speech perception deficit. PMID:21093464

  19. Speech perception, rapid temporal processing, and the left hemisphere: a case study of unilateral pure word deafness.

    PubMed

    Slevc, L Robert; Martin, Randi C; Hamilton, A Cris; Joanisse, Marc F

    2011-01-01

    The mechanisms and functional anatomy underlying the early stages of speech perception are still not well understood. One way to investigate the cognitive and neural underpinnings of speech perception is by investigating patients with speech perception deficits but with preserved ability in other domains of language. One such case is reported here: patient NL shows highly impaired speech perception despite normal hearing ability and preserved semantic knowledge, speaking, and reading ability, and is thus classified as a case of pure word deafness (PWD). NL has a left temporoparietal lesion without right hemisphere damage and DTI imaging suggests that he has preserved cross-hemispheric connectivity, arguing against an account of PWD as a disconnection of left lateralized language areas from auditory input. Two experiments investigated whether NL's speech perception deficit could instead result from an underlying problem with rapid temporal processing. Experiment 1 showed that NL has particular difficulty discriminating sounds that differ in terms of rapid temporal changes, be they speech or non-speech sounds. Experiment 2 employed an intensive training program designed to improve rapid temporal processing in language impaired children (Fast ForWord; Scientific Learning Corporation, Oakland, CA) and found that NL was able to improve his ability to discriminate rapid temporal differences in non-speech sounds, but not in speech sounds. Overall, these data suggest that patients with unilateral PWD may, in fact, have a deficit in (left lateralized) temporal processing ability, however they also show that a rapid temporal processing deficit is, by itself, unable to account for this patient's speech perception deficit. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. When Only the Right Hemisphere Is Left: Studies in Language and Communication

    ERIC Educational Resources Information Center

    Vanlancker-Sidtis, D.

    2004-01-01

    An adult of above normal intelligence, BL, underwent left hemispherectomy at age five, and subsequently graduated from college and has been regularly employed. Using standardized neuropsychological instruments, previous extensive testing had revealed optimal performance for a hemispherectomized subject. To probe communicative abilities in greater…

  1. Improved Spatial Ability Correlated with Left Hemisphere Dysfunction in Turner's Syndrome. Implications for Mechanism.

    ERIC Educational Resources Information Center

    Rovet, Joanne F.

    This study contrasts the performance of a 17-year-old female subject with Turner's syndrome before and after developing left temporal lobe seizures, as a means of identifying the mechanism responsible for the Turner's syndrome spatial impairment. The results revealed a deficit in spatial processing before onset of the seizure disorder. Results…

  2. Improved Spatial Ability Correlated with Left Hemisphere Dysfunction in Turner's Syndrome. Implications for Mechanism.

    ERIC Educational Resources Information Center

    Rovet, Joanne F.

    This study contrasts the performance of a 17-year-old female subject with Turner's syndrome before and after developing left temporal lobe seizures, as a means of identifying the mechanism responsible for the Turner's syndrome spatial impairment. The results revealed a deficit in spatial processing before onset of the seizure disorder. Results…

  3. Acute left main coronary artery thrombosis due to cocaine use.

    PubMed

    Apostolakis, Efstratios; Tsigkas, Grigorios; Baikoussis, Nikolaos G; Koniari, Ioanna; Alexopoulos, Dimitrios

    2010-08-19

    It is common knowledge that cocaine has been linked to the development of various acute and chronic cardiovascular complications including acute coronary syndromes. We present a young, male patient, drug abuser who underwent CABG due to anterolateral myocardial infarction. Our presentation is one of the very rare cases reported in literature regarding acute thrombosis of left main coronary artery related to cocaine use, in a patient with normal coronary arteries, successfully operated. Drug-abusers seem to have increased mortality and morbidity after surgery and high possibility for stent thrombosis after percutaneous coronary interventions, because of their usually terrible medical compliance and coexistent several problems of general health. There are no specific guidelines about treatment of thrombus formation in coronary arteries, as a consequence of cocaine use. So, any decision making concerning the final treatment of these patient is a unique and individualized approach. We strongly recommend that all these patients should be treated surgically, especially patients with thrombus into the left main artery.

  4. Functional magnetic resonance imaging of chronic dysarthric speech after childhood brain injury: reliance on a left-hemisphere compensatory network.

    PubMed

    Morgan, Angela T; Masterton, Richard; Pigdon, Lauren; Connelly, Alan; Liégeois, Frédérique J

    2013-02-01

    Severe and persistent speech disorder, dysarthria, may be present for life after brain injury in childhood, yet the neural correlates of this chronic disorder remain elusive. Although abundant literature is available on language reorganization after lesions in childhood, little is known about the capacity of motor speech networks to reorganize after injury. Here, we examine the structural and functional neural correlates associated with chronic dysarthria after childhood-onset traumatic brain injury. Forty-nine participants aged 12 years 3 months to 24 years 11 months were recruited to the study: (i) a group with chronic dysarthria (n = 17); matched for age and sex with two control groups of (ii) healthy control subjects (n = 17); and (iii) individuals without dysarthria after traumatic brain injury (n = 15). A high-resolution 3D T(1)-weighted whole-brain data set was acquired for voxel-based morphometry analyses of group differences in grey matter. Functional magnetic resonance imaging was used to localize activation associated with speaking single words (baseline: listening to words). Group differences on voxel-based morphometry revealed widespread grey matter reductions in the dysarthric group compared with healthy control subjects, including in numerous speech motor regions bilaterally, such as the cerebellum, the basal ganglia and primary motor cortex representation of the articulators. Relative to the non-dysarthric traumatic brain injury group, individuals with dysarthria showed reduced grey matter bilaterally in the ventral sensorimotor cortex, but this reduction was concomitant with increased functional activation only in the left-hemisphere cluster during speech. Finally, increased recruitment of Broca's area (Brodmann area 45, pars triangularis) but not its right homologue, correlated with better speech outcome, suggesting that this 'higher-level' area may be more critically involved with production when associated motor speech regions are damaged. We

  5. Activity levels in the left hemisphere caudate–fusiform circuit predict how well a second language will be learned

    PubMed Central

    Tan, Li Hai; Chen, Lin; Yip, Virginia; Chan, Alice H. D.; Yang, Jing; Gao, Jia-Hong; Siok, Wai Ting

    2011-01-01

    How second language (L2) learning is achieved in the human brain remains one of the fundamental questions of neuroscience and linguistics. Previous neuroimaging studies with bilinguals have consistently shown overlapping cortical organization of the native language (L1) and L2, leading to a prediction that a common neurobiological marker may be responsible for the development of the two languages. Here, by using functional MRI, we show that later skills to read in L2 are predicted by the activity level of the fusiform–caudate circuit in the left hemisphere, which nonetheless is not predictive of the ability to read in the native language. We scanned 10-y-old children while they performed a lexical decision task on L2 (and L1) stimuli. The subjects’ written language (reading) skills were behaviorally assessed twice, the first time just before we performed the fMRI scan (time 1 reading) and the second time 1 y later (time 2 reading). A whole-brain based analysis revealed that activity levels in left caudate and left fusiform gyrus correlated with L2 literacy skills at time 1. After controlling for the effects of time 1 reading and nonverbal IQ, or the effect of in-scanner lexical performance, the development in L2 literacy skills (time 2 reading) was also predicted by activity in left caudate and fusiform regions that are thought to mediate language control functions and resolve competition arising from L1 during L2 learning. Our findings suggest that the activity level of left caudate and fusiform regions serves as an important neurobiological marker for predicting accomplishment in reading skills in a new language. PMID:21262807

  6. Radiographic and echocardiographic assessment of left atrial size in 100 cats with acute left-sided congestive heart failure.

    PubMed

    Schober, Karsten E; Wetli, Ellen; Drost, Wm Tod

    2014-01-01

    The aims of this study were to evaluate left atrial size in cats with acute left-sided congestive heart failure. We hypothesized that left atrial size as determined by thoracic radiography can be normal in cats with acute left-sided congestive heart failure. One hundred cats with acute left-sided congestive heart failure in which thoracic radiography and echocardiography were performed within 12 h were identified. Left atrial size was evaluated using right lateral and ventrodorsal radiographs. Measurements were compared to two-dimensional echocardiographic variables of left atrial size and left ventricular size. On echocardiography, left atrial enlargement was observed in 96% cats (subjective assessment) whereas maximum left atrial dimension was increased (>15.7 mm) in 93% cats. On radiographs left atrial enlargement (subjective assessment) was found in 48% (lateral view), 53% (ventrodorsal view), and 64% (any view) of cats whereas left atrial enlargement was absent in 36% of cats in both views. Agreement between both methods of left atrial size estimation was poor (Cohen's kappa 0.17). Receiver operating characteristic curve analysis identified a maximum echocardiographic left atrial dimension of approximately 20 mm as the best compromise (Youden index) between sensitivity and specificity in the prediction of radiographic left atrial enlargement. Left atrial enlargement as assessed by thoracic radiography may be absent in a clinically relevant number of cats with congestive heart failure. Therefore, normal left atrial size on thoracic radiographs does not rule out presence of left-sided congestive heart failure in cats with clinical signs of respiratory distress.

  7. Selective attention to phonology dynamically modulates initial encoding of auditory words within the left hemisphere.

    PubMed

    Yoncheva, Yuliya; Maurer, Urs; Zevin, Jason D; McCandliss, Bruce D

    2014-08-15

    Selective attention to phonology, i.e., the ability to attend to sub-syllabic units within spoken words, is a critical precursor to literacy acquisition. Recent functional magnetic resonance imaging evidence has demonstrated that a left-lateralized network of frontal, temporal, and posterior language regions, including the visual word form area, supports this skill. The current event-related potential (ERP) study investigated the temporal dynamics of selective attention to phonology during spoken word perception. We tested the hypothesis that selective attention to phonology dynamically modulates stimulus encoding by recruiting left-lateralized processes specifically while the information critical for performance is unfolding. Selective attention to phonology was captured by manipulating listening goals: skilled adult readers attended to either rhyme or melody within auditory stimulus pairs. Each pair superimposed rhyming and melodic information ensuring identical sensory stimulation. Selective attention to phonology produced distinct early and late topographic ERP effects during stimulus encoding. Data-driven source localization analyses revealed that selective attention to phonology led to significantly greater recruitment of left-lateralized posterior and extensive temporal regions, which was notably concurrent with the rhyme-relevant information within the word. Furthermore, selective attention effects were specific to auditory stimulus encoding and not observed in response to cues, arguing against the notion that they reflect sustained task setting. Collectively, these results demonstrate that selective attention to phonology dynamically engages a left-lateralized network during the critical time-period of perception for achieving phonological analysis goals. These findings suggest a key role for selective attention in on-line phonological computations. Furthermore, these findings motivate future research on the role that neural mechanisms of attention may

  8. Selective attention to phonology dynamically modulates initial encoding of auditory words within the left hemisphere

    PubMed Central

    Yoncheva; Maurer, Urs; Zevin, Jason; McCandliss, Bruce

    2015-01-01

    Selective attention to phonology, i.e., the ability to attend to sub-syllabic units within spoken words, is a critical precursor to literacy acquisition. Recent functional magnetic resonance imaging evidence has demonstrated that a left-lateralized network of frontal, temporal, and posterior language regions, including the visual word form area, supports this skill. The current event-related potential (ERP) study investigated the temporal dynamics of selective attention to phonology during spoken word perception. We tested the hypothesis that selective atten tion to phonology dynamically modulates stimulus encoding by recruiting left-lateralized processes specifically while the information critical for performance is unfolding. Selective attention to phonology was captured by ma nipulating listening goals: skilled adult readers attended to either rhyme or melody within auditory stimulus pairs. Each pair superimposed rhyming and melodic information ensuring identical sensory stimulation. Selective attention to phonology produced distinct early and late topographic ERP effects during stimulus encoding. Data- driven source localization analyses revealed that selective attention to phonology led to significantly greater re cruitment of left-lateralized posterior and extensive temporal regions, which was notably concurrent with the rhyme-relevant information within the word. Furthermore, selective attention effects were specific to auditory stimulus encoding and not observed in response to cues, arguing against the notion that they reflect sustained task setting. Collectively, these results demonstrate that selective attention to phonology dynamically engages a left-lateralized network during the critical time-period of perception for achieving phonological analysis goals. These findings support the key role of selective attention to phonology in the development of literacy and motivate future research on the neural bases of the interaction between phonological

  9. Pulsed and continuous wave mobile phone exposure over left versus right hemisphere: effects on human cognitive function.

    PubMed

    Haarala, Christian; Takio, Fiia; Rintee, Taija; Laine, Matti; Koivisto, Mika; Revonsuo, Antti; Hämäläinen, Heikki

    2007-05-01

    The possible effects of continuous wave (CW) and pulse modulated (PM) electromagnetic field (EMF) on human cognition was studied in 36 healthy male subjects. They performed cognitive tasks while exposed to CW, PM, and sham EMF. The subjects performed the same tasks twice during each session; once with left-sided and once with right-sided exposure. The EMF conditions were spread across three testing sessions, each session separated by 1 week. The exposed hemisphere, EMF condition, and test order were counterbalanced over all subjects. We employed a double-blind design: both the subject and the experimenter were unaware of the EMF condition. The EMF was created with a signal generator connected via amplifier to a dummy phone antenna, creating a power output distribution similar to the original commercial mobile phone. The EMF had either a continuous power output of 0.25 W (CW) or pulsed power output with a mean of 0.25 W. An additional control group of 16 healthy male volunteers performed the same tasks without any exposure equipment to see if mere presence of the equipment could have affected the subjects' performance. No effects were found between the different EMF conditions, separate hemisphere exposures, or between the control and experimental group. In conclusion, the current results indicate that normal mobile phones have no discernible effect on human cognitive function as measured by behavioral tests. (c) 2007 Wiley-Liss, Inc.

  10. Hemispheric prevalence during chewing in normal right-handed and left-handed subjects: a functional magnetic resonance imaging preliminary study.

    PubMed

    Bracco, Pietro; Anastasi, Giuseppe; Piancino, Maria Grazia; Frongia, Gianluigi; Milardi, Demetrio; Favaloro, Angelo; Bramanti, Placido

    2010-04-01

    This study evaluated the activation of different cortical areas during nondeliberate chewing of soft and hard boluses in five right-handed and five left-handed subjects with normal occlusion, to determine different hemispheric prevalences. The study was conducted with a functional Magnetic Resonance Imaging (1.5 T Magnetom Vision - Siemens Medical, Germany) using a head coil. The results showed that the most frequently activated areas were Brodmann's areas four and six in the primary motor and premotor cortex, the insula and Broca's area and, overall, showed greater activity of the cortical mastication area (CMA) in the right hemisphere for right-handed and in the left hemisphere for left-handed subjects.

  11. Sound lateralisation in patients with left or right cerebral hemispheric lesions: relation with unilateral visuospatial neglect

    PubMed Central

    Tanaka, H.; Hachisuka, K.; Ogata, H.

    1999-01-01

    OBJECTIVES—To localise the brain lesion that causes disturbances of sound lateralisation and to examine the correlation between such deficit and unilateral visuospatial neglect.
METHOD—There were 29 patients with right brain damage, 15 patients with left brain damage, and 22 healthy controls, who had normal auditory and binaural thresholds. A device was used that delivered sound to the left and right ears with an interaural time difference using headphones. The amplitude (an index of ability to detect sound image shifts from the centre) and midpoint (an index of deviation of the interaural time difference range perceived as the centre) parameters of interaural time difference were analysed in each subject using 10 consecutive stable saw toothed waves.
RESULTS—The amplitude of interaural time difference was significantly higher in patients with right brain damage than in controls. The midpoint of the interaural time difference was significantly more deviated in patients with right brain damage than in those with left brain damage and controls (p<0.05). Patients with right brain damage with lesions affecting both the parietal lobe and auditory pathway showed a significantly higher amplitude and deviated midpoint than the controls, whereas right brain damage with involvement of only the parietal lobe showed a midpoint significantly deviated from the controls (p<0.05). Abnormal sound lateralisation correlated with unilateral visuospatial neglect (p<0.05).
CONCLUSIONS—The right parietal lobe plays an important part in sound lateralisation. Sound lateralisation is also influenced by lesions of the right auditory pathway, although the effect of such lesions is less than that of the right parietal lobe. Disturbances of sound lateralisation correlate with unilateral visuospatial neglect.

 PMID:10486395

  12. Another look at category effects on colour perception and their left hemispheric lateralisation: no evidence from a colour identification task.

    PubMed

    Suegami, Takashi; Aminihajibashi, Samira; Laeng, Bruno

    2014-05-01

    The present study aimed to replicate category effects on colour perception and their lateralisation to the left cerebral hemisphere (LH). Previous evidence for lateralisation of colour category effects has been obtained with tasks where a differently coloured target was searched within a display and participants reported the lateral location of the target. However, a left/right spatial judgment may yield LH-laterality effects per se. Thus, we employed an identification task that does not require a spatial judgment and used the same colour set that previously revealed LH-lateralised category effects. The identification task was better performed with between-category colours than with within-category task both in terms of accuracy and latency, but such category effects were bilateral or RH-lateralised, and no evidence was found for LH-laterality effects. The accuracy scores, moreover, indicated that the category effects derived from low sensitivities for within-blue colours and did not reflect the effects of categorical structures on colour perception. Furthermore, the classic "category effects" were observed in participants' response biases, instead of sensitivities. The present results argue against both the LH-lateralised category effects on colour perception and the existence of colour category effects per se.

  13. Left hemisphere diffusivity of the arcuate fasciculus: influences of autism spectrum disorder and language impairment.

    PubMed

    Roberts, T P L; Heiken, K; Zarnow, D; Dell, J; Nagae, L; Blaskey, L; Solot, C; Levy, S E; Berman, J I; Edgar, J C

    2014-03-01

    There has been much discussion whether brain abnormalities associated with specific language impairment and autism with language impairment are shared or are disorder specific. Although white matter tract abnormalities are observed in both specific language impairment and autism spectrum disorders, the similarities and differences in the white matter abnormalities in these 2 disorders have not been fully determined. Diffusion tensor imaging diffusion parameters of the arcuate fasciculus were measured in 14 children with specific language impairment as well as in 16 children with autism spectrum disorder with language impairment, 18 with autism spectrum disorder without language impairment, and 25 age-matched typically developing control participants. Language impairment and autism spectrum disorder both had (elevating) main effects on mean diffusivity of the left arcuate fasciculus, initially suggesting a shared white matter substrate abnormality. Analysis of axial and radial diffusivity components, however, indicated that autism spectrum disorder and language impairment differentially affect white matter microstructural properties, with a main effect of autism spectrum disorder on axial diffusivity and a main effect of language impairment on radial diffusivity. Although white matter abnormalities appear similar in language impairment and autism spectrum disorder when examining broad white matter measures, a more detailed analysis indicates different mechanisms for the white matter microstructural anomalies associated with language impairment and autism spectrum disorder.

  14. [Associative visual agnosia: role of the left hemisphere in visual perception (author's transl)].

    PubMed

    Pillon, B; Signoret, J L; Lhermitte, F

    1981-01-01

    Visual agnosia following ischaemic accidents of the left posterior cerebral artery is often associated with intellectual deficiencies, memory disorders, elementary perceptive disturbances and elements of visuoverbal disconnection, with the result that some authors reject the notion of visual agnosia. By using a relatively simple examination procedure it is, however, possible to clearly differentiate the various disturbances, as shown by the case of a right-handed 66-year-old man in whom this type of vascular accident occurred. Neither the reduced intellectual capacities nor the memory disorders can explain the differences observed in the treatment of visual stimuli, which was very disturbed, and the normal treatment of other types of stimulus. Elementary difficulties are not sufficient to prevent correct discrimination, as all tests of matching object, images, colours, and graphic signs were successfully accomplished. Identification was disturbed however: the patient could not show the use of objects presented visually, and this disorder is related to the visual characteristics of the stimuli, which excludes a simple visuogestural disconnection; results of tests of classifying types of object images, colours, and graphic signs were markedly abnormal. Naming of these stimuli was also affected, even when they were correctly identified; this results from the visuoverbal disconnection associated with the agnosia, but it is insufficient to account for it, as the patient could correctly use objects that had been wrongly named, but could not use those that had been poorly identified. This case, therefore, has enabled a visual identification disorder to be isolated independently from a discrimination problem, and visuoverbal or visuogestural disconnections. It is the significance of ths stimulus that is disturbed. In contrast, functional or categorical classification is respected in right temporo-occipital lesions. It is the individuality of a stimulus within a physical

  15. Use of Prosodic Cues in the Production of Idiomatic and Literal Sentences by Individuals with Right- and Left-Hemisphere Damage

    ERIC Educational Resources Information Center

    Belanger, Nathalie; Baum, Shari R.; Titone, Debra

    2009-01-01

    The neural bases of prosody during the production of literal and idiomatic interpretations of literally plausible idioms was investigated. Left- and right-hemisphere-damaged participants and normal controls produced literal and idiomatic versions of idioms ("He hit the books.") All groups modulated duration to distinguish the interpretations. LHD…

  16. The Memory That's Right and the Memory That's Left: Event-Related Potentials Reveal Hemispheric Asymmetries in the Encoding and Retention of Verbal Information

    ERIC Educational Resources Information Center

    Evans, Karen M.; Federmeier, Kara D.

    2007-01-01

    We examined the nature and timecourse of hemispheric asymmetries in verbal memory by recording event-related potentials (ERPs) in a continuous recognition task. Participants made overt recognition judgments to test words presented in central vision that were either novel (new words) or had been previously presented in the left or right visual…

  17. The Influence of Visual and Auditory Information on the Perception of Speech and Non-Speech Oral Movements in Patients with Left Hemisphere Lesions

    ERIC Educational Resources Information Center

    Schmid, Gabriele; Thielmann, Anke; Ziegler, Wolfram

    2009-01-01

    Patients with lesions of the left hemisphere often suffer from oral-facial apraxia, apraxia of speech, and aphasia. In these patients, visual features often play a critical role in speech and language therapy, when pictured lip shapes or the therapist's visible mouth movements are used to facilitate speech production and articulation. This demands…

  18. The Functional Organization of Trial-Related Activity in Lexical Processing after Early Left Hemispheric Brain Lesions: An Event-Related fMRI Study

    ERIC Educational Resources Information Center

    Fair, Damien A.; Choi, Alexander H.; Dosenbach, Yannic B. L.; Coalson, Rebecca S.; Miezin, Francis M.; Petersen, Steven E.; Schlaggar, Bradley L.

    2010-01-01

    Children with congenital left hemisphere damage due to perinatal stroke are capable of acquiring relatively normal language functions despite experiencing a cortical insult that in adults often leads to devastating lifetime disabilities. Although this observed phenomenon is accepted, its neurobiological mechanisms are not well characterized. In…

  19. The Memory That's Right and the Memory That's Left: Event-Related Potentials Reveal Hemispheric Asymmetries in the Encoding and Retention of Verbal Information

    ERIC Educational Resources Information Center

    Evans, Karen M.; Federmeier, Kara D.

    2007-01-01

    We examined the nature and timecourse of hemispheric asymmetries in verbal memory by recording event-related potentials (ERPs) in a continuous recognition task. Participants made overt recognition judgments to test words presented in central vision that were either novel (new words) or had been previously presented in the left or right visual…

  20. The Influence of Visual and Auditory Information on the Perception of Speech and Non-Speech Oral Movements in Patients with Left Hemisphere Lesions

    ERIC Educational Resources Information Center

    Schmid, Gabriele; Thielmann, Anke; Ziegler, Wolfram

    2009-01-01

    Patients with lesions of the left hemisphere often suffer from oral-facial apraxia, apraxia of speech, and aphasia. In these patients, visual features often play a critical role in speech and language therapy, when pictured lip shapes or the therapist's visible mouth movements are used to facilitate speech production and articulation. This demands…

  1. The Functional Organization of Trial-Related Activity in Lexical Processing after Early Left Hemispheric Brain Lesions: An Event-Related fMRI Study

    ERIC Educational Resources Information Center

    Fair, Damien A.; Choi, Alexander H.; Dosenbach, Yannic B. L.; Coalson, Rebecca S.; Miezin, Francis M.; Petersen, Steven E.; Schlaggar, Bradley L.

    2010-01-01

    Children with congenital left hemisphere damage due to perinatal stroke are capable of acquiring relatively normal language functions despite experiencing a cortical insult that in adults often leads to devastating lifetime disabilities. Although this observed phenomenon is accepted, its neurobiological mechanisms are not well characterized. In…

  2. Changes in regional cerebral blood flow in the right cortex homologous to left language areas are directly affected by left hemispheric damage in aphasic stroke patients: evaluation by Tc-ECD SPECT and novel analytic software.

    PubMed

    Uruma, G; Kakuda, W; Abo, M

    2010-03-01

    The objective of this study was to clarify the influence of regional cerebral blood flow (rCBF) changes in language-relevant areas of the dominant hemisphere on rCBF in each region in the non-dominant hemisphere in post-stroke aphasic patients. The study subjects were 27 aphasic patients who suffered their first symptomatic stroke in the left hemisphere. In each subject, we measured rCBF by means of 99mTc-ethylcysteinate dimmer single photon emission computed tomography (SPECT). The SPECT images were analyzed by the statistical imaging analysis programs easy Z-score Imaging System (eZIS) and voxel-based stereotactic extraction estimation (vbSEE). Segmented into Brodmann Area (BA) levels, Regions of Interest (ROIs) were set in language-relevant areas bilaterally, and changes in the relative rCBF as average negative and positive Z-values were computed fully automatically. To assess the relationship between rCBF changes of each ROIs in the left and right hemispheres, the Spearman ranked correlation analysis and stepwise multiple regression analysis were applied. Globally, a negative and asymmetric influence of rCBF changes in the language-relevant areas of the dominant hemisphere on the right hemisphere was found. The rCBF decrease in left BA22 significantly influenced the rCBF increase in right BA39, BA40, BA44 and BA45. The results suggested that the chronic increase in rCBF in the right language-relevant areas is due at least in part to reduction in the trancallosal inhibitory activity of the language-dominant left hemisphere caused by the stroke lesion itself and that these relationships are not always symmetric.

  3. Emergency management of malignant acute left-sided colonic obstruction.

    PubMed

    Trompetas, Vasileios

    2008-04-01

    The management of acute left-sided colonic obstruction still remains a challenging problem despite significant progress. A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes such as mortality, morbidity, long-term prognosis and cost effectiveness. Colonic stenting is the best option either for palliation or as a bridge to surgery. It reduces morbidity and mortality rate and the need for colostomy formation. Stenting is likely to be cost effective, but data are variable depending on the individual healthcare system. Nevertheless, surgical management remains relevant as colonic stenting has a small rate of failure, and it is not always available. There are various surgical options. One-stage primary resection and anastomosis is the preferred choice for low-risk patients. Intra-operative colonic irrigation has no proven benefit. Subtotal colectomy is useful in cases of proximal bowel damage or synchronous tumours. Hartmann's procedure should be reserved for high-risk patients. Simple colostomy has no role other than for use in very ill patients who are not fit for any other procedure.

  4. Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

    PubMed Central

    Trompetas, Vasileios

    2008-01-01

    INTRODUCTION The management of acute left-sided colonic obstruction still remains a challenging problem despite significant progress. METHODS A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes such as mortality, morbidity, long-term prognosis and cost effectiveness. DISCUSSION Colonic stenting is the best option either for palliation or as a bridge to surgery. It reduces morbidity and mortality rate and the need for colostomy formation. Stenting is likely to be cost effective, but data are variable depending on the individual healthcare system. Nevertheless, surgical management remains relevant as colonic stenting has a small rate of failure, and it is not always available. There are various surgical options. One-stage primary resection and anastomosis is the preferred choice for low-risk patients. Intra-operative colonic irrigation has no proven benefit. Subtotal colectomy is useful in cases of proximal bowel damage or synchronous tumours. Hartmann's procedure should be reserved for high-risk patients. Simple colostomy has no role other than for use in very ill patients who are not fit for any other procedure. PMID:18430330

  5. The Role of Left Hemispheric Structures for Emotional Processing as a Monitor of Bodily Reaction and Felt Chill – a Case-Control Functional Imaging Study

    PubMed Central

    Grunkina, Viktoria; Holtz, Katharina; Klepzig, Kai; Neubert, Jörg; Horn, Ulrike; Domin, Martin; Hamm, Alfons O.; Lotze, Martin

    2017-01-01

    Background: The particular function of the left anterior human insula on emotional arousal has been illustrated with several case studies. Only after left hemispheric insula lesions, patients lose their pleasure in habits such as listening to joyful music. In functional magnetic resonance imaging studies (fMRI) activation in the left anterior insula has been associated with both processing of emotional valence and arousal. Tight interactions with different areas of the prefrontal cortex are involved in bodily response monitoring and cognitive appraisal of a given stimulus. Therefore, a large left hemispheric lesion including the left insula should impair the bodily response of chill experience (objective chill response) but leave the cognitive aspects of chill processing (subjective chill response) unaffected. Methods: We investigated a patient (MC) with a complete left hemispheric media cerebral artery stroke, testing fMRI representation of pleasant (music) and unpleasant (harsh sounds) chill response. Results: Although chill response to both pleasant and unpleasant rated sounds was confirmed verbally at passages also rated as chilling by healthy participants, skin conductance response was almost absent in MC. For a healthy control (HC) objective and subjective chill response was positively associated. Bilateral prefrontal fMRI-response to chill stimuli was sustained in MC whereas insula activation restricted to the right hemisphere. Diffusion imaging together with lesion maps revealed that left lateral tracts were completely damaged but medial prefrontal structures were intact. Conclusion: With this case study we demonstrate how bodily response and cognitive appraisal are differentially participating in the internal monitor of chill response. PMID:28111546

  6. Spatio-temporal processing of words and nonwords: hemispheric laterality and acute alcohol intoxication

    PubMed Central

    Marinkovic, Ksenija; Rosen, Burke Q.; Cox, Brendan; Hagler, Donald J.

    2014-01-01

    This study examined neurofunctional correlates of reading by modulating semantic, lexical, and orthographic attributes of letter strings. It compared the spatio-temporal activity patterns elicited by real words (RW), pseudowords, orthographically regular, pronounceable nonwords (PN) that carry no meaning, and orthographically illegal, nonpronounceable nonwords (NN). A double-duty lexical decision paradigm instructed participants to detect RW while ignoring nonwords and to additionally respond to words that refer to animals (AW). Healthy social drinkers (N=22) participated in both alcohol (0.6 g/kg ethanol for men, 0.55 g/kg for women) and placebo conditions in a counterbalanced design. Whole-head MEG signals were analyzed with an anatomically-constrained MEG method. Simultaneously acquired ERPs confirm previous evidence. Spatio-temporal MEG estimates to RW and PN are consistent with the highly replicable left-lateralized ventral visual processing stream. However, the PN elicit weaker activity than other stimuli starting at ~230 ms and extending to the M400 (magnetic equivalent of N400) in the left lateral temporal area, indicating their reduced access to lexicosemantic stores. In contrast, the NN uniquely engage the right hemisphere during the M400. Increased demands on lexicosemantic access imposed by AW result in greater activity in the left temporal cortex starting at ~230 ms and persisting through the M400 and response preparation stages. Alcohol intoxication strongly attenuates early visual responses occipito-temporally overall. Subsequently, alcohol selectively affects the left prefrontal cortex as a function of orthographic and semantic dimensions, suggesting that it modulates the dynamics of the lexicosemantic processing in a top-down manner, by increasing difficulty of semantic retrieval. PMID:24565928

  7. Continuous theta burst stimulation (cTBS) on left cerebellar hemisphere affects mental rotation tasks during music listening.

    PubMed

    Picazio, Silvia; Oliveri, Massimiliano; Koch, Giacomo; Caltagirone, Carlo; Petrosini, Laura

    2013-01-01

    Converging evidence suggests an association between spatial and music domains. A cerebellar role in music-related information processing as well as in spatial-temporal tasks has been documented. Here, we investigated the cerebellar role in the association between spatial and musical domains, by testing performances in embodied (EMR) or abstract (AMR) mental rotation tasks of subjects listening Mozart Sonata K.448, which is reported to improve spatial-temporal reasoning, in the presence or in the absence of continuous theta burst stimulation (cTBS) of the left cerebellar hemisphere. In the absence of cerebellar cTBS, music listening did not influence either MR task, thus not revealing a "Mozart Effect". Cerebellar cTBS applied before musical listening made subjects faster (P = 0.005) and less accurate (P = 0.005) in performing the EMR but not the AMR task. Thus, cerebellar inhibition by TBS unmasked the effect of musical listening on motor imagery. These data support a coupling between music listening and sensory-motor integration in cerebellar networks for embodied representations.

  8. Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function: two case studies

    PubMed Central

    Al-Janabi, Shahd; Nickels, Lyndsey A.; Sowman, Paul F.; Burianová, Hana; Merrett, Dawn L.; Thompson, William F.

    2014-01-01

    The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia. PMID:24550864

  9. Continuous Theta Burst Stimulation (cTBS) on Left Cerebellar Hemisphere Affects Mental Rotation Tasks during Music Listening

    PubMed Central

    Picazio, Silvia; Oliveri, Massimiliano; Koch, Giacomo; Caltagirone, Carlo; Petrosini, Laura

    2013-01-01

    Converging evidence suggests an association between spatial and music domains. A cerebellar role in music-related information processing as well as in spatial-temporal tasks has been documented. Here, we investigated the cerebellar role in the association between spatial and musical domains, by testing performances in embodied (EMR) or abstract (AMR) mental rotation tasks of subjects listening Mozart Sonata K.448, which is reported to improve spatial-temporal reasoning, in the presence or in the absence of continuous theta burst stimulation (cTBS) of the left cerebellar hemisphere. In the absence of cerebellar cTBS, music listening did not influence either MR task, thus not revealing a “Mozart Effect”. Cerebellar cTBS applied before musical listening made subjects faster (P = 0.005) and less accurate (P = 0.005) in performing the EMR but not the AMR task. Thus, cerebellar inhibition by TBS unmasked the effect of musical listening on motor imagery. These data support a coupling between music listening and sensory-motor integration in cerebellar networks for embodied representations. PMID:23724071

  10. THE IMPACT OF LEFT HEMISPHERE STROKE ON FORCE CONTROL WITH FAMILIAR AND NOVEL OBJECTS: NEUROANATOMIC SUBSTRATES AND RELATIONSHIP TO APRAXIA

    PubMed Central

    Dawson, Amanda M.; Buxbaum, Laurel J.; Duff, Susan V.

    2010-01-01

    Fingertip force scaling for lifting objects frequently occurs in anticipation of finger contact. An ongoing question concerns the types of memories that are used to inform predictive control. Object-specific information such as weight may be stored and retrieved when previously encountered objects are lifted again. Alternatively, visual size and shape cues may provide estimates of object density each time objects are encountered. We reasoned that differences in performance with familiar versus novel objects would provide support for the former possibility. Anticipatory force production with both familiar and novel objects was assessed in 6 left hemisphere stroke patients, 2 of whom exhibited deficient actions with familiar objects (ideomotor apraxia; IMA), along with 5 control subjects. In contrast to healthy controls and stroke participants without IMA, participants with IMA displayed poor anticipatory scaling with familiar objects. However, like the other groups, IMA participants learned to differentiate fingertip forces with repeated lifts of both familiar and novel objects. Finally, there was a significant correlation between damage to the inferior parietal and superior and middle temporal lobes, and impaired anticipatory control for familiar objects. These data support the hypotheses that anticipatory control during lifts of familiar objects in IMA patients are based on object-specific memories, and that the ventro-dorsal stream is involved in the long-term storage of internal models used for anticipatory scaling during object manipulation. PMID:19945445

  11. Different visual exploration of tool-related gestures in left hemisphere brain damaged patients is associated with poor gestural imitation.

    PubMed

    Vanbellingen, Tim; Schumacher, Rahel; Eggenberger, Noëmi; Hopfner, Simone; Cazzoli, Dario; Preisig, Basil C; Bertschi, Manuel; Nyffeler, Thomas; Gutbrod, Klemens; Bassetti, Claudio L; Bohlhalter, Stephan; Müri, René M

    2015-05-01

    According to the direct matching hypothesis, perceived movements automatically activate existing motor components through matching of the perceived gesture and its execution. The aim of the present study was to test the direct matching hypothesis by assessing whether visual exploration behavior correlate with deficits in gestural imitation in left hemisphere damaged (LHD) patients. Eighteen LHD patients and twenty healthy control subjects took part in the study. Gesture imitation performance was measured by the test for upper limb apraxia (TULIA). Visual exploration behavior was measured by an infrared eye-tracking system. Short videos including forty gestures (20 meaningless and 20 communicative gestures) were presented. Cumulative fixation duration was measured in different regions of interest (ROIs), namely the face, the gesturing hand, the body, and the surrounding environment. Compared to healthy subjects, patients fixated significantly less the ROIs comprising the face and the gesturing hand during the exploration of emblematic and tool-related gestures. Moreover, visual exploration of tool-related gestures significantly correlated with tool-related imitation as measured by TULIA in LHD patients. Patients and controls did not differ in the visual exploration of meaningless gestures, and no significant relationships were found between visual exploration behavior and the imitation of emblematic and meaningless gestures in TULIA. The present study thus suggests that altered visual exploration may lead to disturbed imitation of tool related gestures, however not of emblematic and meaningless gestures. Consequently, our findings partially support the direct matching hypothesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. A common network in the left cerebral hemisphere represents planning of tool use pantomimes and familiar intransitive gestures at the hand-independent level.

    PubMed

    Króliczak, Gregory; Frey, Scott H

    2009-10-01

    Evidence from neuropsychology and neuroimaging implicates parietal and frontal areas of the left cerebral hemisphere in the representation of skills involving the use of tools and other artifacts. On the basis of neuropsychological data, it has been claimed that 1) independent mechanisms within the left hemisphere may support the representation of these skills (transitive actions) versus meaningful gestures that do not involve manipulating objects (intransitive actions), and 2) both cerebral hemispheres may participate in the representation of intransitive gestures. Functional magnetic resonance imaging was used to test these hypotheses in 12 healthy adults while they planned and executed tool use pantomimes or intransitive gestures with their dominant right (Exp. 1) or nondominant left (Exp. 2) hands. Even when linguistic processing demands were controlled, planning either type of action was associated with asymmetrical increases in the same regions of left parietal (the intraparietal sulcus, supramarginal gyrus, and caudal superior parietal lobule) and dorsal premotor cortices. Effects were greater for tool use pantomimes, but only when the right hand was involved. Neither group nor individual analyses revealed evidence for greater bilateral activity during intransitive gesture planning. In summary, at the hand-independent level, transitive and intransitive actions are represented in a common, left-lateralized praxis network.

  13. Changes of deceleration and acceleration capacity of heart rate in patients with acute hemispheric ischemic stroke.

    PubMed

    Xu, Yan-Hong; Wang, Xing-De; Yang, Jia-Jun; Zhou, Li; Pan, Yong-Chao

    2016-01-01

    Autonomic dysfunction is common after stroke, which is correlated with unfavorable outcome. Phase-rectified signal averaging is a newly developed technique for assessing cardiac autonomic function, by detecting sympathetic and vagal nerve activity separately through calculating acceleration capacity (AC) and deceleration capacity (DC) of heart rate. In this study, we used this technique for the first time to investigate the cardiac autonomic function of patients with acute hemispheric ischemic stroke. A 24-hour Holter monitoring was performed in 63 patients with first-ever acute ischemic stroke in hemisphere and sinus rhythm, as well as in 50 controls with high risk of stroke. DC, AC, heart rate variability parameters, standard deviation of all normal-to-normal intervals (SDNN), and square root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals (RMSSD) were calculated. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of stroke. We analyzed the changes of DC, AC, SDNN, and RMSSD and also studied the correlations between these parameters and NIHSS scores. The R-R (R wave to R wave on electrocardiogram) intervals, DC, AC, and SDNN in the cerebral infarction group were lower than those in controls (P=0.003, P=0.002, P=0.006, and P=0.043), but the difference of RMSSD and the D-value and ratio between absolute value of AC (|AC|) and DC were not statistically significant compared with those in controls. The DC of the infarction group was significantly correlated with |AC|, SDNN, and RMSSD (r=0.857, r=0.619, and r=0.358; P=0.000, P=0.000, and P=0.004). Correlation analysis also showed that DC, |AC|, and SDNN were negatively correlated with NIHSS scores (r=-0.279, r=-0.266, and r=-0.319; P=0.027, P=0.035, and P=0.011). Both DC and AC of heart rate decreased in patients with hemispheric infarction, reflecting a decrease in both vagal and sympathetic modulation. Both DC and AC were correlated

  14. Shift-back of right into left hemisphere language dominance after control of epileptic seizures: evidence for epilepsy driven functional cerebral organization.

    PubMed

    Helmstaedter, C; Fritz, N E; González Pérez, P A; Elger, C E; Weber, B

    2006-08-01

    Atypical, i.e. right hemisphere language dominance is frequently observed in early onset left hemisphere epilepsies. In left mesial temporal lobe epilepsy, where eloquent cortex is not directly involved, it is a matter of debate, to which degree atypical language dominance is driven not only by morphological lesions but also by epileptic dysfunction, and whether atypical dominance is hardwired or not. Taking this as the background this study evaluated the hypothesis that epilepsy driven atypical dominancy might be reversible when seizures are successfully controlled. This was evaluated in patients with left mesial temporal lobe epilepsy, who were atypically language dominant by means of language fMRI before surgery, and became seizure free after left selective amygdalo-hippocampectomy. Three out of 53 consecutive atypically dominant patients with chronic epilepsy fulfilled these criteria. Postoperative follow-up language fMRI indicated reversal of right into left dominance in one patient going along with unexpected losses in verbal memory performance. The two other patients experienced unchanged or even enhancement of the pre-existing dominance pattern, going along with consistent postoperative performance changes in cognition. The data thus provide supporting evidence that atypical language dominance can indeed be functionally driven and moreover that in at least some patients, right hemispheric language can shift-back to the left hemisphere when the driving factor, i.e. seizures, becomes successfully controlled. The results have clinical implications for outcome prediction after brain surgery in atypically dominant patients with epilepsy. However, further research in larger groups of atypically dominant patients is required to identify the conditions under which atypical dominance becomes hardwired and when not.

  15. Right: Left:: East: West. Evidence that individuals from East Asian and South Asian cultures emphasize right hemisphere functions in comparison to Euro-American cultures.

    PubMed

    Rozin, Paul; Moscovitch, Morris; Imada, Sumio

    2016-09-01

    We present evidence that individuals from East or South Asian cultures (Japanese college students in Japan and East or South Asian born and raised college students in the USA) tend to exhibit default thinking that corresponds to right hemisphere holistic functions, as compared to Caucasian individuals from a Western culture (born and raised in the USA). In two lateralized tasks (locating the nose in a scrambled face, and global-local letter task), both Asian groups showed a greater right hemisphere bias than the Western group. In a third lateralized task, judging similarity in terms of visual form versus functional/semantic categorizations, there was not a reliable difference between the groups. On a classic, ambiguous face composed of vegetables, both Eastern groups displayed a greater right hemisphere (holistic face processing) bias than the Western group. These results support an "East - Right Hemisphere, West - Left Hemisphere" hypothesis, as originally proposed by Ornstein (1972). This hypothesis is open as to the degree to which social-cultural forces were involved in hemispheric specialization, or the opposite, or both. Our aim is to encourage a more thorough analysis of this hypothesis, suggesting both lateralization studies corresponding to documented East-West differences, and East-West studies corresponding to lateralization differences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. [Effectiveness of semax in acute period of hemispheric ischemic stroke (a clinical and electrophysiological study)].

    PubMed

    Gusev, E I; Skvortsova, V I; Miasoedov, N F; Nezavibat'ko, V N; Zhuravleva, E Iu; Vanichkin, A V

    1997-01-01

    Efficiency of Semax (synthetic derivative of ACTH-4-10) was studied in 30 patients in acute period of hemispherical ischemic stroke. Control group consisted of 80 patients with the strokes analogous in severity and location of the damages and which were treated by conventional therapy. Different clinical rating scales were used for both objectivization of the severity of the patients' state and estimation of the degree of neurological defect. The control of Semax influence on the functional state of the brain included monitoring of EEG with mapping, repeated analysis of somatosensory evoked potentials and their mapping. It was established that including of Semax in combined intensive therapy of acute ischemic stroke had some influence on the rate of restoration of the damaged neurological functions in terms of increasing the regress of general cerebral and focal, especially motor disorders. The most effective daily doses were 12 mg for patients with strokes of moderate severity and 18 mg for patients with severe strokes (treatment course--5 and 10 days).

  17. [Correlations of activity of neurons of sensorimotor cortex of the right and left brain hemispheres of rabbits during defensive dominant and "animal hypnosis"].

    PubMed

    Bogdanov, A V; Galashina, A G; Karamysheva, N N

    2009-01-01

    A hidden excitation focus of the rhythmic nature (a rhythmic defensive dominant focus) was produced in the rabbit's CNS. The focus was formed by means of threshold electrodermal stimulation of the left forelimb by series of pulses consisting of 15-20 stimuli with 2 s intervals between the pulses. Correlated activity of cells in the sensorimotor cortex of the right and left brain hemispheres was analyzed. In cases when crosscorrelation histograms were constructed by the results of the analysis of discharges of the left-side cortical of neurons regarding high- and middle-amplitude pulses in a right hemisphere, 15 and 23 % of correlated neural pairs, respectively, revealed the prevalence of the rhythm identical or close to the initial rhythm of stimulation that formed the hidden excitation focus. In contrast, in cases when the same analysis was applied to the right-side cortical neurons regarding high- and middle-amplitude discharges in the left hemisphere, prevalence of the dominant 2-second rhythm was revealed in correlated activity of only 3 and 10% of neural pairs, respectively. After the exposure to "animal hypnosis" procedure, the distinctions between the brain in this parameter were eliminated.

  18. Effects of mental rotation on acalculia: differences in the direction of mental rotation account for the differing characteristics of acalculia induced by right and left hemispheric brain injury.

    PubMed

    Asada, Tomohiko; Takayama, Yoshihiro; Oita, Jiro; Fukuyama, Hidenao

    2014-04-01

    We observed a 59-year-old right-handed man with an infarction in his right-middle cerebral artery that included the parietal lobe, who abnormally manipulated mental images in the horizontal direction, resulting in calculation disturbances. Three years later, the patient suffered an infarction in the left parietal lobe and displayed abnormalities during the creation of mental images; i.e., he rotated them in the vertical direction, which again resulted in calculation disturbances. These mental imagery disturbances might indicate that a common acalculia mechanism exists between the right and left hemispheres.

  19. Left ventricular muscle and fluid mechanics in acute myocardial infarction.

    PubMed

    Nucifora, Gaetano; Delgado, Victoria; Bertini, Matteo; Marsan, Nina Ajmone; Van de Veire, Nico R; Ng, Arnold C T; Siebelink, Hans-Marc J; Schalij, Martin J; Holman, Eduard R; Sengupta, Partho P; Bax, Jeroen J

    2010-11-15

    Left ventricular (LV) diastolic filling is characterized by the formation of intraventricular rotational bodies of fluid (termed "vortex rings") that optimize the efficiency of LV ejection. The aim of the present study was to evaluate the morphology and dynamics of LV diastolic vortex ring formation early after acute myocardial infarction (AMI), in relation to LV diastolic function and infarct size. A total of 94 patients with a first ST-segment elevation AMI (59 ± 11 years; 78% men) were included. All patients underwent primary percutaneous coronary intervention. After 48 hours, the following examinations were performed: 2-dimensional echocardiography with speckle-tracking analysis to assess the LV systolic and diastolic function, the vortex formation time (VFT, a dimensionless index for characterizing vortex formation), and the LV untwisting rate; contrast echocardiography to assess LV vortex morphology; and myocardial contrast echocardiography to identify the infarct size. Patients with a large infarct size (≥ 3 LV segments) had a significantly lower VFT (p <0.001) and vortex sphericity index (p <0.001). On univariate analysis, several variables were significantly related to the VFT, including anterior AMI, LV end-systolic volume, LV ejection fraction, grade of diastolic dysfunction, LV untwisting rate, and infarct size. On multivariate analysis, the LV untwisting rate (β = -0.43, p <0.001) and infarct size (β = -0.33, p = 0.005) were independently associated with VFT. In conclusion, early in AMI, both the LV infarct size and the mechanical sequence of diastolic restoration play key roles in modulating the morphology and dynamics of early diastolic vortex ring formation.

  20. Mechanics of the left ventricular myocardial interstitium: effects of acute and chronic myocardial edema.

    PubMed

    Desai, Ketaki V; Laine, Glen A; Stewart, Randolph H; Cox, Charles S; Quick, Christopher M; Allen, Steven J; Fischer, Uwe M

    2008-06-01

    Myocardial interstitial edema forms as a result of several disease states and clinical interventions. Acute myocardial interstitial edema is associated with compromised systolic and diastolic cardiac function and increased stiffness of the left ventricular chamber. Formation of chronic myocardial interstitial edema results in deposition of interstitial collagen, which causes interstitial fibrosis. To assess the effect of myocardial interstitial edema on the mechanical properties of the left ventricle and the myocardial interstitium, we induced acute and chronic interstitial edema in dogs. Acute myocardial edema was generated by coronary sinus pressure elevation, while chronic myocardial edema was generated by chronic pulmonary artery banding. The pressure-volume relationships of the left ventricular myocardial interstitium and left ventricular chamber for control animals were compared with acutely and chronically edematous animals. Collagen content of nonedematous and chronically edematous animals was also compared. Generating acute myocardial interstitial edema resulted in decreased left ventricular chamber compliance compared with nonedematous animals. With chronic edema, the primary form of collagen changed from type I to III. Left ventricular chamber compliance in animals made chronically edematous was significantly higher than nonedematous animals. The change in primary collagen type secondary to chronic left ventricular myocardial interstitial edema provides direct evidence for structural remodeling. The resulting functional adaptation allows the chronically edematous heart to maintain left ventricular chamber compliance when challenged with acute edema, thus preserving cardiac function over a wide range of interstitial fluid pressures.

  1. Acute myocardial infarction caused by left atrial myxoma: Role of intracoronary catheter aspiration.

    PubMed

    Al-Fakhouri, Ahmad; Janjua, Muhammad; DeGregori, Michele

    2017-01-01

    Acute ST-segment elevation myocardial infarction (STEMI) caused by left atrial myxoma is very rare. Catheter-based approaches or thrombolytic therapy are mostly the first step in the management of STEMI with less time delay. We report a case of acute anterior/lateral STEMI caused by a left atrial myxoma. The patient was successfully treated by intracoronary aspiration with an Export aspiration catheter, with excellent distal coronary flow. Intracoronary catheter aspiration in acute myocardial infarction caused by a left atrial myxoma may help to salvage the infarcting myocardium with less time delay.

  2. The functional organization of trial-related activity in lexical processing after early left hemispheric brain lesions: An event-related fMRI study.

    PubMed

    Fair, Damien A; Choi, Alexander H; Dosenbach, Yannic B L; Coalson, Rebecca S; Miezin, Francis M; Petersen, Steven E; Schlaggar, Bradley L

    2010-08-01

    Children with congenital left hemisphere damage due to perinatal stroke are capable of acquiring relatively normal language functions despite experiencing a cortical insult that in adults often leads to devastating lifetime disabilities. Although this observed phenomenon is accepted, its neurobiological mechanisms are not well characterized. In this paper we examined the functional neuroanatomy of lexical processing in 13 children/adolescents with perinatal left hemispheric damage. In contrast to many previous perinatal infarct fMRI studies, we used an event-related design, which allowed us to isolate trial-related activity and examine correct and error trials separately. Using both group and single subject analysis techniques we attempt to address several methodological factors that may contribute to some discrepancies in the perinatal lesion literature. These methodological factors include making direct statistical comparisons, using common stereotactic space, using both single subject and group analyses, and accounting for performance differences. Our group analysis, investigating correct trial-related activity (separately from error trials), showed very few statistical differences in the non-involved right hemisphere between patients and performance matched controls. The single subject analysis revealed atypical regional activation patterns in several patients; however, the location of these regions identified in individual patients often varied across subjects. These results are consistent with the idea that alternative functional organization of trial-related activity after left hemisphere lesions is in large part unique to the individual. In addition, reported differences between results obtained with event-related designs and blocked designs may suggest diverging organizing principles for sustained and trial-related activity after early childhood brain injuries.

  3. The functional organization of trial-related activity in lexical processing after early left hemispheric brain lesions: An event-related fMRI study

    PubMed Central

    Fair, Damien A.; Choi, Alexander H.; Dosenbach, Yannic B.L.; Coalson, Rebecca S.; Miezin, Francis M.; Petersen, Steven E.; Schlaggar, Bradley L.

    2009-01-01

    Children with congenital left hemisphere damage due to perinatal stroke are capable of acquiring relatively normal language functions despite experiencing a cortical insult that in adults often leads to devastating lifetime disabilities. Although this observed phenomenon accepted, its neurobiological mechanisms are not well characterized. In this paper we examined the functional neuroanatomy of lexical processing in 13 children/adolescents with perinatal left hemispheric damage. In contrast to many previous perinatal infarct fMRI studies, we use an event-related design, which allowed us to isolate trial related activity and examine correct and error trials separately. Using both group and single subject analysis techniques we attempt to address several methodological factors that may contribute to some discrepancies in the perinatal lesion literature. These methodological factors include making direct statistical comparisons, using common stereotactic space, using both single-subject and group analyses, and accounting for performance differences. Our group analysis, investigating correct trial related activity (separately from error trials), showed very few statistical differences in the non-involved right hemisphere between patients and performance matched controls. The single subject analysis revealed atypical regional activation patterns in several patients; however, the location of these regions identified in individual patients often varied across subjects. These results are consistent with the idea that alternative functional organization of trial-related activity after left hemisphere lesions is in large part unique to the individual. In addition, reported differences between results obtained with event-related designs and blocked designs may suggest diverging organizing principles for sustained and trial-related activity after early childhood brain injuries. PMID:19819000

  4. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting.

    PubMed

    Sartelli, Massimo; Catena, Fausto; Ansaloni, Luca; Coccolini, Federico; Griffiths, Ewen A; Abu-Zidan, Fikri M; Di Saverio, Salomone; Ulrych, Jan; Kluger, Yoram; Ben-Ishay, Ofir; Moore, Frederick A; Ivatury, Rao R; Coimbra, Raul; Peitzman, Andrew B; Leppaniemi, Ari; Fraga, Gustavo P; Maier, Ronald V; Chiara, Osvaldo; Kashuk, Jeffry; Sakakushev, Boris; Weber, Dieter G; Latifi, Rifat; Biffl, Walter; Bala, Miklosh; Karamarkovic, Aleksandar; Inaba, Kenji; Ordonez, Carlos A; Hecker, Andreas; Augustin, Goran; Demetrashvili, Zaza; Melo, Renato Bessa; Marwah, Sanjay; Zachariah, Sanoop K; Shelat, Vishal G; McFarlane, Michael; Rems, Miran; Gomes, Carlos Augusto; Faro, Mario Paulo; Júnior, Gerson Alves Pereira; Negoi, Ionut; Cui, Yunfeng; Sato, Norio; Vereczkei, Andras; Bellanova, Giovanni; Birindelli, Arianna; Di Carlo, Isidoro; Kok, Kenneth Y; Gachabayov, Mahir; Gkiokas, Georgios; Bouliaris, Konstantinos; Çolak, Elif; Isik, Arda; Rios-Cruz, Daniel; Soto, Rodolfo; Moore, Ernest E

    2016-01-01

    Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.

  5. Hemispheric specialization in selective attention and short-term memory: a fine-coarse model of left- and right-ear disadvantages

    PubMed Central

    Marsh, John E.; Pilgrim, Lea K.; Sörqvist, Patrik

    2013-01-01

    Serial short-term memory is impaired by irrelevant sound, particularly when the sound changes acoustically. This acoustic effect is larger when the sound is presented to the left compared to the right ear (a left-ear disadvantage). Serial memory appears relatively insensitive to distraction from the semantic properties of a background sound. In contrast, short-term free recall of semantic-category exemplars is impaired by the semantic properties of background speech and is relatively insensitive to the sound's acoustic properties. This semantic effect is larger when the sound is presented to the right compared to the left ear (a right-ear disadvantage). In this paper, we outline a speculative neurocognitive fine-coarse model of these hemispheric differences in relation to short-term memory and selective attention, and explicate empirical directions in which this model can be critically evaluated. PMID:24399988

  6. The effects of left or right hemispheric epilepsy on language networks investigated with semantic decision fMRI task and independent component analysis.

    PubMed

    Karunanayaka, Prasanna; Kim, Kwang Ki; Holland, Scott K; Szaflarski, Jerzy P

    2011-04-01

    Chronic and progressive brain injury, as seen in epilepsy, may alter brain networks that underlie cognitive functions. To evaluate the effect of epilepsy on language functions we investigated the neuroanatomical basis of semantic processing in patients with left (LHE) or right (RHE) hemispheric onset epilepsy using semantic decision fMRI paradigm and group independent component analysis (ICA); we then compared the results of our investigations with language networks in healthy subjects examined with the same language task (Kim K, Karunanayaka P, Privitera M, Holland S, Szaflarski J. Semantic association investigated with fMRI and independent component analysis. In press). Group ICA is a data-driven technique capable of revealing the functional organization of the human brain based on fMRI data. In addition to providing functional connectivity information, ICA can also provide information about the temporal dynamics of underlying networks subserving specific cognitive functions. In this study, we implemented two complementary analyses to investigate group differences in underlying network dynamics based on associated independent component (IC) time courses (a priori defined criterion or a posteriori identified maximum likelihood descriptor). We detected several differences between healthy controls and patients with epilepsy not previously observed with standard fMRI analysis methods. Our analyses confirmed the presence of different effects of LHE or RHE on the behavior of the language network. In particular, a major difference was noted in the nodes subserving verbal encoding and retrieval in the bilateral medial temporal regions. These effects were dependent on the side of the epilepsy onset; that is, effects were different with left or right hemispheric epilepsy. These findings may explain the differences in verbal and nonverbal memory abilities between patients with left and those with right hemispheric epilepsy. Further, although the effects on other nodes of

  7. [Acute cerebral ischemia: an unusual clinical presentation of isolated left ventricular noncompaction in an adult patient].

    PubMed

    Fiorencis, Andrea; Quadretti, Laura; Bacich, Daniela; Chiodi, Elisabetta; Mele, Donato; Fiorencis, Roberto

    2013-01-01

    Isolated left ventricular noncompaction in adults is uncommon. The most frequent clinical manifestations are heart failure due to left ventricular systolic dysfunction and supraventricular and ventricular arrhythmias, which may be sustained and associated with sudden death. Thromboembolic complications are also possible. We report the case of an adult patient with isolated left ventricular noncompaction who came to our observation because of acute cerebral ischemia, an initial presentation of the disease only rarely described.

  8. The Visual Word Form Area remains in the dominant hemisphere for language in late-onset left occipital lobe epilepsies: A postsurgery analysis of two cases.

    PubMed

    Lopes, Ricardo; Nunes, Rita Gouveia; Simões, Mário Rodrigues; Secca, Mário Forjaz; Leal, Alberto

    2015-05-01

    Automatic recognition of words from letter strings is a critical processing step in reading that is lateralized to the left-hemisphere middle fusiform gyrus in the so-called Visual Word Form Area (VWFA). Surgical lesions in this location can lead to irreversible alexia. Very early left hemispheric lesions can lead to transfer of the VWFA to the nondominant hemisphere, but it is currently unknown if this capability is preserved in epilepsies developing after reading acquisition. In this study, we aimed to determine the lateralization of the VWFA in late-onset left inferior occipital lobe epilepsies and also the effect of surgical disconnection from the adjacent secondary visual areas. Two patients with focal epilepsies with onset near the VWFA underwent to surgery for epilepsy, with sparing of this area. Neuropsychology evaluations were performed before and after surgery, as well as quantitative evaluation of the speed of word reading. Comparison of the surgical localization of the lesion, with the BOLD activation associated with the contrast of words-strings, was performed, as well as a study of the associated main white fiber pathways using diffusion-weighted imaging. Neither of the patients developed alexia after surgery (similar word reading speed before and after surgery) despite the fact that the inferior occipital surgical lesions reached the neighborhood (less than 1cm) of the VWFA. Surgeries partly disconnected the VWFA from left secondary visual areas, suggesting that pathways connecting to the posterior visual ventral stream were severely affected but did not induce alexia. The anterior and superior limits of the resection suggest that the critical connection between the VWFA and the Wernicke's Angular Gyrus cortex was not affected, which is supported by the detection of this tract with probabilistic tractography. Left occipital lobe epilepsies developing after reading acquisition did not produce atypical localizations of the VWFA, even with foci in the

  9. Predictors of Percutaneous Endoscopic Gastrostomy Tube Placement in Patients with Severe Dysphagia from an Acute-Subacute Hemispheric Infarction

    PubMed Central

    Kumar, Sandeep; Langmore, Susan; Goddeau, Richard P.; Alhazzani, Adel; Selim, Magdy; Caplan, Louis R.; Zhu, Lin; Safdar, Adnan; Wagner, Cynthia; Frayne, Colleen; Searls, David E.; Schlaug, Gottfried

    2011-01-01

    This study investigated the influence of age, National Institutes of Health Stroke Scale (NIHSS) score, time from stroke onset, infarct location and volume in predicting placement of a percutaneous endoscopic gastrostomy (PEG) tube in patients with severe dysphagia from an acute-subacute hemispheric infarction. We performed a retrospective analysis of a hospital-based patient cohort to analyze the effect of the aforementioned variables on the decision of whether or not to place a PEG tube. Consecutive patients were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes for acute ischemic stroke, Current Procedural Terminology (CPT)-4 codes for a formal swallowing evaluation by a speech pathologist, and procedure codes for PEG placement over a 5-year period from existing medical records at our institution. Only patients with severe dysphagia were enrolled. A total of 77 patients met inclusion criteria; 20 of them underwent PEG placement. The relationship between age (dichotomized; < and ≥75 years), time from stroke onset (days), NIHSS score, acute infarct lesion volume (dichotomized; < and ≥100 cc), and infarct location (ie, insula, anterior insula, periventricular white matter, inferior frontal gyrus, motor cortex, or bilateral hemispheres) with PEG tube placement were analyzed using logistic regression analysis. In univariate analysis, NIHSS score (P =.005), lesion volume (P =.022), and presence of bihemispheric infarction (P =.005) were found to be the main predictors of interest. After multivariate adjustment, only NIHSS score (odds ratio [OR], 1.15; 90% confidence interval [CI], 1.02–1.29; P = .04) and presence of bihemispheric infarcts (OR, 4.67; 90% CI, 1.58–13.75; P =.018) remained significant. Our data indicates that baseline NIHSS score and the presence of bihemispheric infarcts predict PEG placement during hospitalization from an acute-subacute hemispheric infarction in patients with severe dysphagia. These results

  10. Thirty Years Later: Evolution of Treatment for Acute Left Main Coronary Artery Occlusion

    PubMed Central

    Ben-Dov, Nissan; Karkabi, Basheer; Jaffe, Ronen

    2016-01-01

    Acute occlusion of left main coronary artery is a catastrophic event. We describe two patients with acute occlusion of the left main coronary artery treated thirty years apart. The first patient was treated in 1982 and survived the event without revascularization but developed severe heart failure. His survival was so unusual that it merited a case report at that time. The second patient was treated at the end of 2015. Early revascularization resulted in myocardial reperfusion and near normal left ventricular function. These patients exemplify the progress in therapeutic cardiology over the last 30 years. PMID:28078145

  11. Let thy left brain know what thy right brain doeth: Inter-hemispheric compensation of functional deficits after brain damage.

    PubMed

    Bartolomeo, Paolo; Thiebaut de Schotten, Michel

    2016-12-01

    Recent evidence revealed the importance of inter-hemispheric communication for the compensation of functional deficits after brain damage. This review summarises the biological consequences observed using histology as well as the longitudinal findings measured with magnetic resonance imaging methods in brain damaged animals and patients. In particular, we discuss the impact of post-stroke brain hyperactivity on functional recovery in relation to time. The reviewed evidence also suggests that the proportion of the preserved functional network both in the lesioned and in the intact hemispheres, rather than the simple lesion location, determines the extent of functional recovery. Hence, future research exploring longitudinal changes in patients with brain damage may unveil potential biomarkers underlying functional recovery.

  12. Left:right differences in psychophysical and electrodermal measures of olfactory thresholds and their relation to electrodermal indices of hemispheric asymmetries.

    PubMed

    Brand, Gérard; Millot, Jean-Louis; Jacquot, Laurence; Thomas, Stéphanie; Wetzel, Sonia

    2004-06-01

    The study of lateralization processes in olfaction in human subjects has given rise to many contradictory findings. Indeed, sensorial cerebral asymmetry in olfaction depends on several factors (nature of task, quality of stimulus, characteristics of subjects, etc.) and could be also related to differences between the nostrils. In this field, few studies have assessed simultaneously the left-right nostril differences and the hemispheric asymmetry. The present work dealt with this question in the same population with the same odorants, procedures, and stimulations. Seven different concentrations of four specific odorants (two pleasant and two unpleasant) were used by single nostril stimulation with 30 dextral subjects (20 women and 10 men). Threshold detection in unilateral stimulation was investigated using electrodermal response to confirm the first psychophysic measure. Moreover, bilateral recordings of electrodermal activity (EDA) with unilateral stimulation were used as a measure of functional hemispheric asymmetry. Analysis showed no differences between the two nostrils for the threshold detection regardless of the method used (psychophysic or EDA response). However, most subjects presented a constant direction of electrodermal asymmetry whichever nostril was stimulated and whichever odorant stimulus used. The constant bilateral differences in EDA recordings are discussed in terms of asymmetrical activation of the hemispheres.

  13. The influence of visual and auditory information on the perception of speech and non-speech oral movements in patients with left hemisphere lesions.

    PubMed

    Schmid, Gabriele; Thielmann, Anke; Ziegler, Wolfram

    2009-03-01

    Patients with lesions of the left hemisphere often suffer from oral-facial apraxia, apraxia of speech, and aphasia. In these patients, visual features often play a critical role in speech and language therapy, when pictured lip shapes or the therapist's visible mouth movements are used to facilitate speech production and articulation. This demands audiovisual processing both in speech and language treatment and in the diagnosis of oral-facial apraxia. The purpose of this study was to investigate differences in audiovisual perception of speech as compared to non-speech oral gestures. Bimodal and unimodal speech and non-speech items were used and additionally discordant stimuli constructed, which were presented for imitation. This study examined a group of healthy volunteers and a group of patients with lesions of the left hemisphere. Patients made substantially more errors than controls, but the factors influencing imitation accuracy were more or less the same in both groups. Error analyses in both groups suggested different types of representations for speech as compared to the non-speech domain, with speech having a stronger weight on the auditory modality and non-speech processing on the visual modality. Additionally, this study was able to show that the McGurk effect is not limited to speech.

  14. Deficit in automatic sound-change detection may underlie some music perception deficits after acute hemispheric stroke.

    PubMed

    Kohlmetz, C; Altenmüller, E; Schuppert, M; Wieringa, B M; Münte, T F

    2001-01-01

    Music perception deficits following acute neurological damage are thought to be rare. By a newly devised test battery of music-perception skills, however, we were able to identify among a group of 12 patients with acute hemispheric stroke six patients with music perception deficits (amusia) while six others had no such deficits. In addition we recorded event-related brain potentials (ERPs) in a passive listening task with frequent standard and infrequent pitch deviants designed to elicit the mismatch negativity (MMN). The MMN in the patients with amusia was grossly reduced, while the non-amusic patients and control subjects had MMNs of equal size. These data show that amusia is quite common in unselected stroke patients. The MMN reduction suggests that amusia is related to unspecific automatic stimulus classification deficits in these patients.

  15. Subclavian steal syndrome presenting as recurrent pulmonary oedema associated with acute left ventricular diastolic dysfunction.

    PubMed

    Mangialavori, Giuseppe; Ballo, Piercarlo; Michelagnoli, Stefano; Ercolini, Leonardo; Barbanti, Enrico; Passuello, Franco; Abbondanti, Alessandro; Consoli, Lorenzo; Chechi, Tania; Fibbi, Veronica; Nannini, Marco; Chiodi, Leandro; Zuppiroli, Alfredo

    2013-01-01

    Subclavian steal syndrome typically presents as angina in patients with internal mammary artery grafts. Atypical clinical presentations have been rarely described. We report an unusual case of subclavian steal syndrome presenting as pulmonary oedema with acute left ventricular diastolic dysfunction and preserved ejection fraction in a patient with internal mammary artery graft and severe stenosis of the proximal left subclavian artery. After successful angioplasty and stenting of subclavian artery, the patient remained asymptomatic for six months, but then experienced acute diastolic dysfunction and recurrent pulmonary oedema associated with critical subclavian in-stent restenosis with stent deformation. This report points out that, in patients with internal mammary-to-LAD grafts, subclavian steal syndrome may present as acute left ventricular diastolic dysfunction and pulmonary oedema even in the presence of normal ejection fraction.

  16. [Acute amnestic syndrome: left thalamo-polar infarct].

    PubMed

    Ghika, Joseph

    2012-04-11

    An 80-year old American patient was found wandering in a mountain village of Switzerland, with an anterograde, prospective, retrograde, dyschronologic amnesic syndrome without confabulation, paramnesia or false recognitions, disoriented, slightly confused, with no focal sensory, motor, ataxic or visual field deficit, with a mild dysexecutive syndrome. The MR imaging showed an acute thalamo-polar artery infarct. A dysconnection of the mamillo-othalamic and thalamo-temporal pathways is felt at the origin of the amnesic syndrome. A brief review of the other presentation of this chamelon syndrome is presented, together the main etiologies at its origin.

  17. [Early left ventricular remodelling following acute coronary accident].

    PubMed

    Gaertner, Roger; Logeart, Damien; Michel, Jean-Baptiste; Mercadier, Jean-Jacques

    2004-01-01

    Ventricular remodelling following acute coronary syndromes is both complex and multiform. It is due to the response of the myocardium to the different agressions associated with these syndromes, in particular the ischemia and necrosis downstream of the occluded artery. We must not however neglect the role of the remodelling of the lesions resulting from spontaneous reperfusion or provoked by the cells and tissues associated with coronary microcirculation embolisms and the no-reflow phenomenon. Acute post-infarct remodelling is dominated by early ventricular dilatation which largely affects late prognosis, necrosis elimination and its replacement by a fibrotic scar in parallel with a compensatory hypertrophy of the non-infarcted myocardium. The diverse cellular and molecular components of this remodelling are increasingly well-known, allowing us to better explain the beneficial effects of the currently available medications and providing us with new potential therapeutic targets. A grading of this knowledge associated with the identification of new risk factors and early therapeutic interventions should help us to further limit the deleterious aspects of this remodelling in the goal of preventing, or at least delaying, the devolution towards heart failure.

  18. Emotion Recognition in Stroke Patients with Left and Right Hemispheric Lesion: Results with a New Instrument-The Feel Test

    ERIC Educational Resources Information Center

    Braun, M.; Traue, H.C.; Frisch, S.; Deighton, R.M.; Kessler, H.

    2005-01-01

    The aim of this study was to investigate the effect of a stroke event on people's ability to recognize basic emotions. In particular, the hypothesis that right brain-damaged (RBD) patients would show less of emotion recognition ability compared with left brain-damaged (LBD) patients and healthy controls, was tested. To investigate this the FEEL…

  19. Shared and Distinct Neuroanatomic Regions Critical for Tool-related Action Production and Recognition: Evidence from 131 Left-hemisphere Stroke Patients.

    PubMed

    Tarhan, Leyla Y; Watson, Christine E; Buxbaum, Laurel J

    2015-12-01

    The inferior frontal gyrus and inferior parietal lobe have been characterized as human homologues of the monkey "mirror neuron" system, critical for both action production (AP) and action recognition (AR). However, data from brain lesion patients with selective impairment on only one of these tasks provide evidence of neural and cognitive dissociations. We sought to clarify the relationship between AP and AR, and their critical neural substrates, by directly comparing performance of 131 chronic left-hemisphere stroke patients on both tasks--to our knowledge, the largest lesion-based experimental investigation of action cognition to date. Using voxel-based lesion-symptom mapping, we found that lesions to primary motor and somatosensory cortices and inferior parietal lobule were associated with disproportionately impaired performance on AP, whereas lesions to lateral temporo-occipital cortex were associated with a relatively rare pattern of disproportionately impaired performance on AR. In contrast, damage to posterior middle temporal gyrus was associated with impairment on both AP and AR. The distinction between lateral temporo-occipital cortex, critical for recognition, and posterior middle temporal gyrus, important for both tasks, suggests a rough gradient from modality-specific to abstract representations in posterior temporal cortex, the first lesion-based evidence for this phenomenon. Overall, the results of this large patient study help to bring closure to a long-standing debate by showing that tool-related AP and AR critically depend on both common and distinct left hemisphere neural substrates, most of which are external to putative human mirror regions.

  20. Left Atrial Expansion Index Predicts Left Ventricular Filling Pressure and Adverse Events in Acute Heart Failure With Severe Left Ventricular Dysfunction.

    PubMed

    Hsiao, Shih-Hung; Chu, Kuo-An; Wu, Chieh-Jen; Chiou, Kuan-Rau

    2016-04-01

    The power of left atrial (LA) parameters for predicting left ventricular (LV) filling pressure and adverse events in acute heart failure (HF) with severe LV dysfunction, either sinus rhythm or atrial fibrillation (AF), is not fully understood. Echocardiography was performed in 141 patients with acute decompensated congestive HF and LV ejection fraction <35%, including 42 with permanent AF. The LA expansion index was calculated as (Volmax - Volmin) × 100%/Volmin, where Volmax was defined as maximal and Volmin as minimal LA volume. Of 141 patients, invasive LV filling pressures within 12 hours of LA expansion index measurement were available in 109. The end points were 3-year frequencies of HF hospitalization and all-cause mortality. Over a median follow-up of 3.1 years, 74 participants (52.5%) reached the end points (sinus vs AF group: 48.5% vs 61.9%, respectively; P = .047). Multivariate analysis revealed that adverse events of both groups were only independently associated with age and LA expansion index. Rates of adverse events were proportional to LA expansion index. There was a good logarithmic relationship between LA expansion index and LV filling pressure, regardless of presence or absence of AF. LV filling pressure can be estimated well by LA expansion index, with or without AF. The LA expansion index predicts adverse events in HF patients with severe systolic dysfunction. (ClinicalTrials.gov number: NCT01307722). Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Acute Korsakoff-like amnestic syndrome resulting from left thalamic infarction following a right hippocampal hemorrhage.

    PubMed

    Rahme, R; Moussa, R; Awada, A; Ibrahim, I; Ali, Y; Maarrawi, J; Rizk, T; Nohra, G; Okais, N; Samaha, E

    2007-04-01

    Korsakoff-like amnestic syndromes have been rarely described following structural lesions of the central nervous system. In this report, we describe a case of acute Korsakoff-like syndrome resulting from the combination of a left anteromedian thalamic infarct and a right hippocampal hemorrhage. We also review the literature relevant to the neuropathology and pathophysiology of Korsakoff syndrome and anterograde amnesia.

  2. Acute left ventricular failure in a patient with hydroxychloroquine-induced cardiomyopathy.

    PubMed

    Hartmann, M; Meek, I L; van Houwelingen, G K; Lambregts, H P C M; Toes, G J; van der Wal, A C; von Birgelen, C

    2011-11-01

    We present the case of a 75-year-old woman with a medical history of rheumatoid arthritis treated with hydroxychloroquine, who was admitted with acute left-sided heart failure due to a hydroxychloroquine-induced cardiomyopathy as supported by endomyocardial biopsy.

  3. Bilingualism yields language-specific plasticity in left hemisphere's circuitry for learning to read in young children.

    PubMed

    Jasińska, K K; Berens, M S; Kovelman, I; Petitto, L A

    2017-04-01

    How does bilingual exposure impact children's neural circuitry for learning to read? Theories of bilingualism suggests that exposure to two languages may yield a functional and neuroanatomical adaptation to support the learning of two languages (Klein et al., 2014). To test the hypothesis that this neural adaptation may vary as a function of structural and orthographic characteristics of bilinguals' two languages, we compared Spanish-English and French-English bilingual children, and English monolingual children, using functional Near Infrared Spectroscopy neuroimaging (fNIRS, ages 6-10, N =26). Spanish offers consistent sound-to-print correspondences ("phonologically transparent" or "shallow"); such correspondences are more opaque in French and even more opaque in English (which has both transparent and "phonologically opaque" or "deep" correspondences). Consistent with our hypothesis, both French- and Spanish-English bilinguals showed hyperactivation in left posterior temporal regions associated with direct sound-to-print phonological analyses and hypoactivation in left frontal regions associated with assembled phonology analyses. Spanish, but not French, bilinguals showed a similar effect when reading Irregular words. The findings inform theories of bilingual and cross-linguistic literacy acquisition by suggesting that structural characteristics of bilinguals' two languages and their orthographies have a significant impact on children's neuro-cognitive architecture for learning to read. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Hemodynamic effects of left atrial or left ventricular cannulation for acute circulatory support in a bovine model of left heart injury.

    PubMed

    Kapur, Navin K; Paruchuri, Vikram; Pham, Duc Thinh; Reyelt, Lara; Murphy, Barbara; Beale, Corinna; Bogins, Courtney; Wiener, Daniel; Nilson, James; Esposito, Michele; Perkins, Scott; Perides, George; Karas, Richard H

    2015-01-01

    Our objective was to examine the hemodynamic effects of a trans-aortic axial flow catheter (Impella CP) in the left ventricle (LV) versus left atrial (LA) to femoral artery bypass using a centrifugal pump (TandemHeart: TH) in a bovine model of acute LV injury. In three male calves, we performed sequential activation of a CP then TH device in each animal. After 60 minutes of left anterior descending artery ligation, a CP was activated at maximal power. The CP was then removed and the TH activated at 5,500 then a maximum of 7,500 rotations per minute (RPM). The CP generated a maximum 3.1 ± 0.2 L/minute (LPM) of flow, whereas the TH at 5,500 and 7,500 RPM generated 3.1 ± 0.4 and 4.4 ± 0.3 LPM. At 3.1 LPM, the CP and TH reduced LV stroke work (LVSW) similarly. The TH reduced stroke volume, whereas the CP did not. The CP reduced end-systolic pressure, whereas the TH did not. At a maximum flow of 4.4 LPM, the TH provided a greater reduction in LVSW than maximal CP activation. This is the first report to compare the hemodynamic effects of trans-aortic LV unloading versus LA-to-femoral artery (FA) bypass.

  5. Scuba diving, acute left anterior descending artery occlusion and normal ECG.

    PubMed

    Doll, Sébastien Xavier; Rigamonti, Fabio; Roffi, Marco; Noble, Stéphane

    2013-01-31

    We report the case of an acute proximal occlusion of the left anterior descending coronary (LAD) artery following a scuba diving decompression accident and associated with normal ECG. Following uneventful thromboaspiration and coronary stenting, the patient was discharged on day 4 with secondary preventative therapies. A transthoracic echocardiography performed at this point showed a complete recovery compared with an initial localised akinesia involving the anterior and apical portion of the left ventricle upon admission. This case highlights that significant acute coronary lesions involving the LAD can occur without any ECG anomaly. The presence of acute and persistent angina associated with troponin elevation should prompt physicians to consider coronary angiography without delay, independently of the ECG results.

  6. [Association between biochemical markers and left ventricular dysfunction in the ST-elevation acute myocardial infarction].

    PubMed

    de Abreu, Maximiliano; Mariani, Javier; Guridi, Cristian; González-Villa-Monte, Gabriel; Gastaldello, Natalio; Potito, Mauricio; Reyes, Graciela; Antonietti, Laura; Tajer, Carlos

    2014-01-01

    The association between biochemical markers and left ventricular ejection fraction in patients with myocardial infarction was not completely studied. Our goal is to study the association between biochemical markers and left ventricular dysfunction in patients with ST-elevation acute myocardial infarction. With an observational and prospective design we included patients with less than 24h ST-elevation myocardial infarction. Leukocytes, glucose, B-type natriuretic peptide and T troponin were measured at admission, and creatine-phosphokinase and creatine-phosphokinase-MB were measured at admission and serially, and correlated with the ejection fraction estimated by echocardiography. A total of 108 patients were included. The median left ventricular ejection fraction was 48% (interquartile range 41-57). Simple linear regression analysis showed that B-type natriuretic peptide (P=.005), peak creatine-phosphokinase-MB (P=.01), leukocyte count (P=.001) and glucose (P=.033) were inversely and significantly associated with the left ventricular ejection fraction. The other parameters showed no association. B-type natriuretic peptide (P=.01) and peak creatine-phosphokinase-MB (P=.02) were the only two variables significantly associated with the left ventricular ejection fraction in the multiple linear regression analysis. Both markers were significantly associated with a left ventricular ejection fraction < 50%, independently of other clinical variables. B-type natriuretic peptide and peak creatine-phosphokinase-MB showed significant association with left ventricular ejection fraction in the acute phase of ST elevation acute myocardial infarction. This association was independent of the presence of other biochemical markers and clinical variables related to ventricular dysfunction. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  7. Manifestation of Latent Left Ventricular Outflow Tract Obstruction in the Acute Phase of Takotsubo Cardiomyopathy

    PubMed Central

    Ozaki, Kazuyuki; Okubo, Takeshi; Tanaka, Komei; Hosaka, Yukio; Tsuchida, Keiichi; Takahashi, Kazuyoshi; Oda, Hirotaka; Minamino, Tohru

    2016-01-01

    Objective Left ventricular outflow tract (LVOT) obstruction is a complication in 15-25% of patients with Takotsubo cardiomyopathy and sometimes leads to catastrophic outcomes, such as cardiogenic shock or cardiac rupture. However, the underlying mechanisms have not been clarified. Methods and Results We experienced 22 cases of Takotsubo cardiomyopathy during 3 years, and 4 of these 22 cases were complicated with LVOT obstruction in the acute phase (mean age 79±5 years, 1 man, 21 women). The LVOT pressure gradient in the acute phase was 100±17 mmHg. Transthoracic echocardiogram (TTE) revealed left ventricular hypertrophy (LVH) in one case and sigmoid-shaped septum without LVH in three cases. The complete resolution of the LVOT obstruction was achieved in a few days with normalization of the left ventricular wall motion following administration of beta-blockers. A dobutamine provocation test after normalization of the left ventricular wall motion reproduced the LVOT obstruction in all cases and revealed the presence of latent LVOT obstruction. Conclusion The manifestation of latent LVOT obstruction in the acute phase of Takotsubo cardiomyopathy is one potential reason for the complication of LVOT obstruction with Takotsubo cardiomyopathy. PMID:27904102

  8. Manifestation of Latent Left Ventricular Outflow Tract Obstruction in the Acute Phase of Takotsubo Cardiomyopathy.

    PubMed

    Ozaki, Kazuyuki; Okubo, Takeshi; Tanaka, Komei; Hosaka, Yukio; Tsuchida, Keiichi; Takahashi, Kazuyoshi; Oda, Hirotaka; Minamino, Tohru

    Objective Left ventricular outflow tract (LVOT) obstruction is a complication in 15-25% of patients with Takotsubo cardiomyopathy and sometimes leads to catastrophic outcomes, such as cardiogenic shock or cardiac rupture. However, the underlying mechanisms have not been clarified. Methods and Results We experienced 22 cases of Takotsubo cardiomyopathy during 3 years, and 4 of these 22 cases were complicated with LVOT obstruction in the acute phase (mean age 79±5 years, 1 man, 21 women). The LVOT pressure gradient in the acute phase was 100±17 mmHg. Transthoracic echocardiogram (TTE) revealed left ventricular hypertrophy (LVH) in one case and sigmoid-shaped septum without LVH in three cases. The complete resolution of the LVOT obstruction was achieved in a few days with normalization of the left ventricular wall motion following administration of beta-blockers. A dobutamine provocation test after normalization of the left ventricular wall motion reproduced the LVOT obstruction in all cases and revealed the presence of latent LVOT obstruction. Conclusion The manifestation of latent LVOT obstruction in the acute phase of Takotsubo cardiomyopathy is one potential reason for the complication of LVOT obstruction with Takotsubo cardiomyopathy.

  9. Acute pulmonary edema in patients with reduced left ventricular ejection fraction is associated with concentric left ventricular geometry.

    PubMed

    Imanishi, Junichi; Kaihotsu, Kenji; Yoshikawa, Sachiko; Nishimori, Makoto; Sone, Naohiko; Honjo, Tomoyuki; Iwahashi, Masanori

    2017-08-02

    Although acute pulmonary edema (APE) is common in patients with heart failure (HF) with preserved ejection fraction (EF), its pathogenesis in patients with HF with reduced EF (HFrEF) is not completely understood. The purpose of our study was to explore the contributions of left ventricular (LV) geometry to understand the difference between HFrEF patients with or without APE. We studied 122 consecutive acute decompensated HF patients with HFrEF (≤40%). APE was defined as acute-onset dyspnea and radiographic alveolar edema requiring immediate airway intervention. LV geometry was determined from a combination of the LV mass index and relative wall thickness (RWT). Long-term unfavorable outcome events were tracked during a follow-up of a median of 21 months (interquartile range, 10-28 months), during which APE was observed in 29 patients (24%). Compared to those without APE, hospitalized patients with APE had a higher systolic blood pressure, RWT, and LVEF and lower end-diastolic dimension. Among echocardiographic variables, a multivariate logistic regression analysis identified RWT as the only independent determinant of APE (hazard ratio: 2.46, p < 0.001). Those with concentric geometry (n = 25; RWT > 0.42) had a higher incidence of APE relative to those with non-concentric geometry. Furthermore, among patients with APE, mortality was significantly higher among those with concentric geometry (log-rank, p = 0.008). Compared with non-concentric geometry, concentric geometry (increased RWT, not LV mass) was strongly associated with APE onset and a poorer outcome among APE patients. An easily obtained echocardiographic RWT index may facilitate the risk stratification of patients.

  10. Prediction of acute cardiac rejection by changes in left ventricular volumes

    SciTech Connect

    Novitzky, D.; Cooper, D.K.; Boniaszczuk, J.

    1988-11-01

    Sixteen patients underwent heart transplantation (11 orthotopic, five heterotopic). Monitoring for acute rejection was by both endomyocardial biopsy (EMB) and multigated equilibrium blood pool scanning with technetium 99m-labelled red blood cells. From the scans information was obtained on left ventricular volumes (stroke, end-diastolic, and end-systolic), ejection fraction, and heart rate. Studies (208) were made in the 16 patients. There was a highly significant correlation between the reduction in stroke volume and end-diastolic volume (and a less significant correlation in end-systolic volume) and increasing acute rejection seen on EMB. Heart rate and ejection fraction did not correlate with the development of acute rejection. Correlation of a combination of changes in stroke volume and end-diastolic volume with EMB showed a sensitivity of 85% and a specificity of 96%. Radionuclide scanning is therefore a useful noninvasive tool for monitoring acute rejection.

  11. Hypnosis in the Right Hemisphere

    PubMed Central

    Kihlstrom, John F.; Glisky, Martha L.; McGovern, Susan; Rapcsak, Steven Z.; Mennemeier, Mark S.

    2012-01-01

    Speculations about the neural substrates of hypnosis have often focused on the right hemisphere, implying that right-hemisphere damage should impair hypnotic responsiveness more than left-hemisphere damage. The present study examined the performance of a patient who suffered a stroke destroying most of his left hemisphere, on slightly modified versions of two hypnotizability scales. This patient was at least modestly hypnotizable, as indicated in particular by the arm rigidity and age regression items, suggesting that hypnosis can be mediated by the right hemisphere alone -- provided that the language capacities normally found in the left hemisphere remain available. A further study of 16 patients with unilateral strokes of the left or right hemisphere found no substantial differences in hypnotizability between the two groups. Future neuropsychological studies of hypnosis might explore the dorsal/ventral or anterior/posterior dichotomies, with special emphasis on the role of prefrontal cortex. PMID:22705266

  12. Lateral left ventricular wall rupture following acute myocardial infarction: pathophysiological interpretation by multimodality imaging approach.

    PubMed

    Avegliano, Gustavo; Conde, Diego; González Ruiz, María Isabel; Kuschnir, Paola; Sciancalepore, Agustina; Castro, Florencia; Ronderos, Ricardo

    2014-11-01

    Lateral left ventricular wall rupture (LVWR) is a rare complication following acute myocardial infarction (AMI) less than 1%. After cardiogenic shock, LVWR constitutes the most common cause of in-hospital death in AMI patients. Around 40% of all LVWR occurred during the first 24 hours and 85% within the first week. In the present case, 76 hours following the intervention, LVWR was observed likely due to a small infarction at the lateral left ventricular wall possibly due to the marginal lesion. Our patient refused surgery and was followed clinically. Eighteen months later, real time three-dimensional echocardiography showed a pseudoaneurysm.

  13. The Marc Dax (1770-1837)/Paul Broca (1824-1880) Controversy over Priority in Science: Left Hemisphere Specificity for Seat of Articulate Language and for Lesions that Cause Aphemia

    ERIC Educational Resources Information Center

    Buckingham, Hugh W.

    2006-01-01

    One of the most fascinating and frustrating issues in the priority of discovery in science is over just who, for the first time, went on record in the public forum, either orally at a conference or through a published communication, proclaiming that the faculty of articulate human speech was located in the left, not the right, cortical hemisphere.…

  14. The Marc Dax (1770-1837)/Paul Broca (1824-1880) Controversy over Priority in Science: Left Hemisphere Specificity for Seat of Articulate Language and for Lesions that Cause Aphemia

    ERIC Educational Resources Information Center

    Buckingham, Hugh W.

    2006-01-01

    One of the most fascinating and frustrating issues in the priority of discovery in science is over just who, for the first time, went on record in the public forum, either orally at a conference or through a published communication, proclaiming that the faculty of articulate human speech was located in the left, not the right, cortical hemisphere.…

  15. Effects of increasing left ventricular filling pressure in patients with acute myocardial infarction

    PubMed Central

    Russell, Richard O.; Rackley, Charles E.; Pombo, Jaoquin; Hunt, David; Potanin, Constantine; Dodge, Harold T.

    1970-01-01

    Left ventricular performance in 19 patients with acute myocardial infarction has been evaluated by measuring left ventricular response in terms of cardiac output, stroke volume, work, and power to progressive elevation of filling pressure accomplished by progressive expansion of blood volume with rapid infusion of low molecular weight dextran. Such infusion can elevate the cardiac output, stroke volume, work, and power and thus delineate the function of the left ventricle by Frank-Starling function curves. Left ventricular filling pressure in the range of 20-24 mm Hg was associated with the peak of the curves and when the filling pressure exceeded this range, the curves became flattened or decreased. An increase in cardiac output could be maintained for 4 or more hr. Patients with a flattened function curve had a high mortality in the ensuing 8 wk. The function curve showed improvement in myocardial function during the early convalescence. When left ventricular filling pressure is monitored directly or as pulmonary artery end-diastolic pressure, low molecular weight dextran provides a method for assessment of left ventricular function. Images PMID:5431663

  16. Swimming exercise training prior to acute myocardial infarction attenuates left ventricular remodeling and improves left ventricular function in rats.

    PubMed

    Dayan, Anat; Feinberg, Micha S; Holbova, Radka; Deshet, Naamit; Scheinowitz, Mickey

    2005-01-01

    The effect of exercise training prior to acute myocardial infarction (AMI) on left ventricular (LV) remodeling is poorly understood. This study investigated the protective effect of 3 weeks of swimming exercise training prior to AMI on cardiac morphology and function. Male Sprague-Dawley rats (n = 35) were randomly assigned to 3 groups: swimming training (n = 14, 90 min, 5 days/wk, 3 wk), sedentary (n =14), and controls (n = 7, no exercise, no MI). At the end of the training/sedentary period, rats were subjected to AMI (ExMI and SedMI) induced by surgical ligation of the left coronary artery. Thereafter, the rats remained sedentary for a 4-wk recovery period. Trans-thoracic echocardiography was performed in each group at the end of the exercise/sedentary period (pre-AMI), 24 hr after AMI, and following recovery (4 wk after AMI). No differences were observed in LV dimensions and function pre-AMI among the 3 groups; however, LV-end systolic diameter (LVESD) and LV-end systolic area (LVES-area) were significantly lower in the prior trained rats, 24 hr post-AMI with no additional change 4 wk post-AMI, during remodeling. Both LV-shortening fraction (SF%) and fractional area change (FAC%) were higher in the trained animals 4 wk post-AMI (39+/-12% vs 23+/-8%; p 0.002, and 48+/-14% vs. 38+/-9%; p 0.07, respectively). In conclusion, 3 wk of swimming exercise training prior to AMI significantly attenuated LV remodeling and improved LV function, despite no changes in LV dimensions or systolic function at the end of the exercise session. The data suggest that even a short-term training period is sufficient to induce cardiac protection.

  17. Left ventricular aneurysm and prognosis in patients with first acute transmural anterior myocardial infarction and isolated left anterior descending artery disease.

    PubMed

    Shen, W F; Tribouilloy, C; Mirode, A; Dufossé, H; Lesbre, J P

    1992-01-01

    To determine the clinical and angiographic factors responsible for left ventricular aneurysm formation and the prognosis of patients with aneurysm, 79 patients with a first acute transmural anterior myocardial infarction and angiographically documented isolated left anterior descending artery disease were retrospectively evaluated. Presence of large infarct size and left ventricular volumes, reduced left ventricular function, and evidence of clinical functional impairment were more common in patients with aneurysm (n = 31) than in those without (n = 48). Patients with aneurysm often had total occlusion of the proximal left anterior descending artery without collateral vessels on angiography. During a mean follow-up of 53 months, 10 patients with and three without aneurysm died (P less than 0.01). Compared to survivors with or without aneurysm, the nonsurvivors were older, had significantly larger infarct size and left ventricular volumes and poor systolic function. The incidence of total occlusion of the left anterior descending artery without collaterals was higher in nonsurvivors. In patients with aneurysm, stepwise multivariate analysis revealed that left ventricular ejection fraction and the status of left anterior descending artery obstruction and collaterals were independent predictors of mortality. The study indicates that in patients with a first acute transmural anterior myocardial infarction and isolated anterior descending artery disease, left ventricular aneurysm often results from a large infarct caused by total occlusion of the proximal left anterior descending artery without collateral supply to the infarct region. The reduced survival rate for patients with aneurysm is primarily related to severe global left ventricular dysfunction which may be determined by assessing the residual flow to the infarct region.

  18. Horizontal portion of arcuate fasciculus fibers track to pars opercularis, not pars triangularis, in right and left hemispheres: A DTI study

    PubMed Central

    Kaplan, Elina; Naeser, Margaret A.; Martin, Paula I.; Ho, Michael; Wang, Yunyan; Baker, Errol; Pascual-Leone, Alvaro

    2010-01-01

    The arcuate fasciculus (AF) is a white matter pathway traditionally considered to connect left Broca’s area with posterior language zones. We utilized diffusion tensor imaging (DTI) in eight healthy subjects (5M) to track pathways in the horizontal mid-portion of the AF (hAF) to subregions of Broca’s area - pars triangularis (PTr) and pars opercularis (POp); and to ventral premotor cortex (vPMC) in the right and left hemispheres (RH, LH). These pathways have previously been studied in the LH, but not in the RH. Only 1/8 subjects showed fiber tracts between PTr and hAF in the RH (also, only 1/8 in the LH). In contrast to PTr, 5/8 subjects showed fiber tracts between POp and hAF in the RH (8/8 in the LH). Fiber tracts for vPMC were similar to those of POp, where 7/8 subjects showed fiber tracts between vPMC and hAF in the RH (8/8 in the LH). Our designated hAF could have included some of the superior longitudinal fasciculus (SLF) III, because it is difficult to separate the two fiber bundles. The SLF III has been previously reported to connect supramarginal gyrus with POp and vPMC in the LH. Thus, although the present DTI study showed almost no pathways between PTr and hAF in the RH (and in the LH), robust pathways were observed between POp and/or vPMC with hAF in the RH (and in LH). These results replicate previous studies for the LH, but are new, for the RH. They could contribute to better understanding of recovery in aphasia. PMID:20438853

  19. Dissociated functional connectivity profiles for motor and attention deficits in acute right-hemisphere stroke.

    PubMed

    Baldassarre, Antonello; Ramsey, Lenny; Rengachary, Jennifer; Zinn, Kristi; Siegel, Joshua S; Metcalf, Nicholas V; Strube, Michael J; Snyder, Abraham Z; Corbetta, Maurizio; Shulman, Gordon L

    2016-07-01

    Strokes often cause multiple behavioural deficits that are correlated at the population level. Here, we show that motor and attention deficits are selectively associated with abnormal patterns of resting state functional connectivity in the dorsal attention and motor networks. We measured attention and motor deficits in 44 right hemisphere-damaged patients with a first-time stroke at 1-2 weeks post-onset. The motor battery included tests that evaluated deficits in both upper and lower extremities. The attention battery assessed both spatial and non-spatial attention deficits. Summary measures for motor and attention deficits were identified through principal component analyses on the raw behavioural scores. Functional connectivity in structurally normal cortex was estimated based on the temporal correlation of blood oxygenation level-dependent signals measured at rest with functional magnetic resonance imaging. Any correlation between motor and attention deficits and between functional connectivity in the dorsal attention network and motor networks that might spuriously affect the relationship between each deficit and functional connectivity was statistically removed. We report a double dissociation between abnormal functional connectivity patterns and attention and motor deficits, respectively. Attention deficits were significantly more correlated with abnormal interhemispheric functional connectivity within the dorsal attention network than motor networks, while motor deficits were significantly more correlated with abnormal interhemispheric functional connectivity patterns within the motor networks than dorsal attention network. These findings indicate that functional connectivity patterns in structurally normal cortex following a stroke link abnormal physiology in brain networks to the corresponding behavioural deficits. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please

  20. Music, Hemisphere Preference and Imagery.

    ERIC Educational Resources Information Center

    Stratton, Valerie N.; Zalanowski, Annette H.

    Two experiments were conducted to determine a possible relationship between the right hemisphere, music perception, and mental imagery. The first experiment compared two groups of college students, one of which showed a preference for left hemisphere thinking (n=22) and the other a preference for right hemisphere thinking (n=20), in order to test…

  1. Automatic segmentation of short association bundles using a new multi-subject atlas of the left hemisphere fronto-parietal brain connections.

    PubMed

    Guevara, M; Seguel, D; Roman, C; Duclap, D; Lebois, A; Le Bihan; Mangin, J-F; Poupon, C; Guevara, P

    2015-08-01

    Human brain connection map is far from being complete. In particular the study of the superficial white matter (SWM) is an unachieved task. Its description is essential for the understanding of human brain function and the study of the pathogenesis associated to it. In this work we developed a method for the automatic creation of a SWM bundle multi-subject atlas. The atlas generation method is based on a cortical parcellation for the extraction of fibers connecting two different gyri. Then, an intra-subject fiber clustering is applied, in order to divide each bundle into sub-bundles with similar shape. After that, a two-step inter-subject fiber clustering is used in order to find the correspondence between the sub-bundles across the subjects, fuse similar clusters and discard the outliers. The method was applied to 40 subjects of a high quality HARDI database, focused on the left hemisphere fronto-parietal and insula brain regions. We obtained an atlas composed of 44 bundles connecting 22 pair of ROIs. Then the atlas was used to automatically segment 39 new subjects from the database.

  2. Feasibility of the cognitive assessment scale for stroke patients (CASP) vs. MMSE and MoCA in aphasic left hemispheric stroke patients.

    PubMed

    Barnay, J-L; Wauquiez, G; Bonnin-Koang, H Y; Anquetil, C; Pérennou, D; Piscicelli, C; Lucas-Pineau, B; Muja, L; le Stunff, E; de Boissezon, X; Terracol, C; Rousseaux, M; Bejot, Y; Binquet, C; Antoine, D; Devilliers, H; Benaim, C

    2014-01-01

    Post-stroke aphasia makes it difficult to assess cognitive deficiencies. We thus developed the CASP, which can be administered without using language. Our objective was to compare the feasibility of the CASP, the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in aphasic stroke patients. All aphasic patients consecutively admitted to seven French rehabilitation units during a 4-month period after a recent first left hemispheric stroke were assessed with CASP, MMSE and MoCA. We determined the proportion of patients in whom it was impossible to administer at least one item from these 3 scales, and compared their administration times. Forty-four patients were included (age 64±15, 26 males). The CASP was impossible to administer in eight of them (18%), compared with 16 for the MMSE (36%, P=0.05) and 13 for the MoCA (30%, P=0.21, NS). It was possible to administer the CASP in all of the patients with expressive aphasia, whereas the MMSE and the MoCA could not be administered. Administration times were longer for the CASP (13±4min) than for the MMSE (8±3min, P<10(-6)) and the MoCA (11±5min, P=0.23, NS). The CASP is more feasible than the MMSE and the MoCA in aphasic stroke patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. [Incidence and management of acute left main coronary artery dissection as a complication of acute transluminal coronary angioplasty].

    PubMed

    Dittel, M; Prachar, H; Spiel, R; Mlczoch, J

    1996-09-01

    Out of 1730 consecutive patients undergoing percutaneous transluminal coronary angioplasty (PTCA) of left descending coronary artery (LAD) or circumflex artery (CX) five patients (0.3%) suffered an acute dissection of left main coronary artery. In three patients dissection developed because of manipulation of the guiding catheter. In one patient retrograde dissection of the left main stem occurred because of balloon angioplasty of ostial LAD stenosis and in a second patient because of balloon rupture in the setting of stent deployment in the proximal part of the LAD. Four patients were selected for emergency operation, but one patient died before reacting the operation theatre. Out of the three remaining patients one patient died postoperatively and another patient suffered a transmural myocardial infarction. In the fifth patient three AVE Micro stents were implanted; one just at the origin of the LAD, one at the origin of the CX and the third in the left main stem. This patient was not sent for operation and was discharged without symptoms.

  4. Relation of left ventricular free wall rupture and/or aneurysm with acute myocardial infarction in patients with aortic stenosis

    PubMed Central

    Sheikh, Irtiza N.

    2017-01-01

    This minireview describes 6 previously reported patients with left ventricular free wall rupture and/or aneurysm complicating acute myocardial infarction (AMI) in patients with aortic stenosis. The findings suggest that left ventricular rupture and/or aneurysm is more frequent in patients with AMI associated with aortic stenosis than in patients with AMI unassociated with aortic stenosis, presumably because of retained elevation of the left ventricular peak systolic pressure after the appearance of the AMI. PMID:28405066

  5. Expression of Bax Protein and Morphological Changes in the Myocardium in Experimental Acute Pressure Overload of the Left Ventricle.

    PubMed

    Blagonravov, M L; Korshunova, A Yu; Azova, M M; Bryk, A A; Frolov, V A

    2016-06-01

    The expression of Bax protein, marker of intracellular pathway of apoptosis initiation, in viable left ventricular cardiomyocytes and morphological changes in the myocardium in acute pressure overload of the left ventricle were studied in experiment on male rabbits. The content of Bax protein in the cardiomyocyte cytoplasm decreased, this indicating that the mitochondrial pathway was not involved in the realization of the apoptotic program. This decrease was associated with manifest destructive changes in the left ventricular myocardium.

  6. Association between high arterial stiffness and left ventricular filling pressures in patients with acute myocardial infarction.

    PubMed

    Milewska, Agata; Krauze, Tomasz; Piskorski, Jarosław; Minczykowski, Andrzej; Wykrętowicz, Andrzej; Guzik, Przemysław

    2015-01-01

    High arterial stiffness increases the left ventricular (LV) filling pressures in different cardiac disorders. The association between arterial stiffness and LV filling pressures has not been studied so far in patients with acute myocardial infarction (MI). The aim of the study was to assess the association between arterial stiffness and LV filling pressures in patients with acute MI. Arterial stiffness, measured using the digital volume pulse stiffness index (SIDVP), and LV filling pressures, quantified as the ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e'), were evaluated in 263 patients with acute MI (mean age, 63.8 ±11 years; 69 women). The association between high E/e' (>15) and very stiff arteries (SIDVP >18 m/s) was analyzed by logistic regression, with data presented as odds ratios (OR s) and 95% confidence intervals (CIs). A multivariate logistic regression analysis revealed an association between E/e' >15 and SIDVP >18 m/s (OR, 4.7; 95% CI, 1.8-12.3), independently of female sex (OR, 4.3; 95% CI, 1.4-10.2), LV ejection fraction <35% (OR, 3.1; 95% CI, 1.2-8.2), left atrial volume >34 ml/m2 (OR, 17.4; 95% CI, 5.8-52.0). There was no significant association between E/e' >15 and previous MI (OR, 2.2; 95% CI, 0.9-5.7). High arterial stiffness is an independent risk factor for LV diastolic dysfunction in patients with acute MI. A reduction in arterial stiffness may improve LV diastolic function in this patient group.

  7. Left main stent thrombosis complicated by eptifibatide-induced acute thrombocytopenia.

    PubMed

    Yang, Eric H; Perez, Edwin; Zhiroff, Katrine A; Burstein, Steven

    2011-01-01

    A 57-year-old man with a history of coronary artery disease and placement of an implantable cardioverter-defibrillator presented at our emergency room with an anterior ST-elevation myocardial infarction. Cardiac catheterization revealed an acutely occluded left main coronary artery, which was revascularized successfully with a bare-metal stent. Periprocedurally, the patient received aspirin, clopidogrel, unfractionated heparin, and eptifibatide. The patient was discharged a week later, but he returned to the emergency room the same day with recurrence of severe chest pain. Repeat cardiac catheterization revealed an acutely occluded stent, and the patient underwent repeat bare-metal stent placement and readministration of eptifibatide. On the next day, the patient's platelet count dropped acutely to less than 12,000/mm3. A test for heparin-induced thrombocytopenia antibody was negative. After discontinuation of eptifibatide, the patient's platelet count gradually returned to normal, and he was later discharged from the hospital with no complications. Eptifibatide-induced acute thrombocytopenia is a known but rare adverse effect. We review the handful of case reports in the medical literature, with emphasis on the prevalence, observed clinical course, and recently proposed physiologic mechanisms that probably are responsible for this phenomenon.

  8. Association between multilayer left ventricular rotational mechanics and the development of left ventricular remodeling after acute myocardial infarction.

    PubMed

    Abate, Elena; Hoogslag, Georgette E; Leong, Darryl P; Bertini, Matteo; Antoni, M Louisa; Nucifora, Gaetano; Joyce, Emer; Holman, Eduard R; Siebelink, Hans-Marc J; Schalij, Martin J; Bax, Jeroen J; Delgado, Victoria; Ajmone Marsan, Nina

    2014-03-01

    The identification of patients at risk for developing left ventricular (LV) remodeling after acute myocardial infarction (AMI) has crucial prognostic implications. The aims of this study were (1) to investigate the relationship between peak subepicardial and subendocardial twist and infarct transmurality, as assessed using contrast-enhanced magnetic resonance imaging, and (2) to evaluate the association between peak subepicardial and subendocardial twist and LV remodeling 6 months after AMI. A total of 213 patients with ST-segment elevation AMIs who underwent three-dimensional echocardiography for LV volumes and functional assessment and two-dimensional speckle-tracking analysis for the evaluation of LV twist (subendocardial vs subepicardial) were retrospectively included. A subgroup of 40 patients underwent magnetic resonance imaging within 2 months for infarct size quantification. Peak subepicardial twist was strongly related to infarct size (number of segments with transmural scar: r(2) = 0.526, P < .001; total scar score: r(2) = 0.515, P < .001) compared with peak subendocardial twist (number of segments with transmural scar: r(2) = 0.379, P < .001; total scar score: r(2) = 0.331, P < .001). In the overall population, 44 patients (21%) developed significant LV remodeling at 6-month follow-up (LV end-systolic volume increase ≥ 15%). These patients showed significantly more impaired peak subepicardial and subendocardial twist at baseline compared with patients without LV remodeling (4.5 ± 1.3° vs 9.4 ± 3.5°, P < .001; 7.0 ± 3.2° vs 12.9 ± 5.8°, P < .001, respectively). Importantly, peak subepicardial twist (odds ratio, 0.241; 95% confidence interval, 0.134-0.431; P < .001) and peak troponin T (odds ratio, 1.152; 95% confidence interval, 1.006-1.320; P = .041) were independently associated with the development of LV remodeling. Peak subepicardial twist strongly reflects infarct transmurality as assessed with magnetic resonance imaging and is

  9. Left ventricular performance in type-II diabetics with first acute myocardial infarction: A radionuclide assessment

    SciTech Connect

    Amin, E.M.; Karimeddini, M.K.; El-Haieg, M.O.; Dey, H.M.; Antar, M.A.

    1985-05-01

    To assess myocardial performance in diabetics following acute myocardial infarction (AMI), resting gated radionuclide studies with Tc-99m were performed within two weeks of the onset of symptoms in matched groups of 18 type-II diabetics with their first clinical AMI (D-AMI), 20 nondiabetics with their first AMI (ND-AMI), and 20 nondiabetic noncardiac controls. Eighty-three percent of D-AMI and 50% of ND-AMI had left ventricular ejection fractions below 2 SD of normal. Diabetics had a significantly lower resting LVEF than nondiabetics (p<0.05). All patients with LVEF < 35% were diabetics. LV mean ejection and filling rates were similar in diabetics and nondiabetics. While 72% of diabetics showed abnormal wall motion in 5 or more segments (out of 9), only 45% of the nondiabetics were this extensively affected. Seventy-two percent of the diabetics showed one or more of akinesis and 39% had one or more areas of dyskinesis, compared to 30% and 5% of the nondiabetics respectively. The authors conclude that the extent, as well as the severity of the left ventricular impairment is more evident in the diabetics than in the nondiabetics, following the first acute MI.

  10. Acute aortocaval fistula: role of low perfusion pressure and subendocardial remodeling on left ventricular function

    PubMed Central

    Mazzo, Flávia R R; de Carvalho Frimm, Clovis; Moretti, Ana Iochabel S; Guido, Maria C; Koike, Marcia K

    2013-01-01

    The experimental model of aortocaval fistula is a useful model of cardiac hypertrophy in response to volume overload. In the present study it has been used to investigate the pathologic subendocardial remodeling associated with the development of heart failure during the early phases (day 1, 3, and 7) following volume overload. Compared with sham treated rats, aortocaval fistula rats showed lower systemic blood pressure and higher left ventricular end-diastolic pressure This resulted in lower coronary driving pressure and left ventricular systolic and diastolic dysfunction. Signs of myocyte necrosis, leukocyte cell infiltration, fibroplasia and collagen deposition appeared sequentially in the subendocardium where remodeling was more prominent than in the non-subendocardium. Accordingly, increased levels of TNF-alpha, IL-1 beta, and IL-6, and enhanced MMP-2 activity were all found in the subendocardium of rats with coronary driving pressure ≤60 mmHg. The coronary driving pressure was inversely correlated with MMP-2 activity in subendocardium in all time-points studied, and blood flow in this region showed positive correlation with systolic and diastolic function at day 7. Thus the predominant subendocardial remodeling that occurs in response to low myocardial perfusion pressure during the acute phases of aortocaval fistula contributes to early left ventricular dysfunction. PMID:23593971

  11. The effect of acute mechanical left ventricular unloading on ovine tricuspid annular size and geometry.

    PubMed

    Malinowski, Marcin; Wilton, Penny; Khaghani, Asghar; Brown, Michael; Langholz, David; Hooker, Victoria; Eberhart, Lenora; Hooker, Robert L; Timek, Tomasz A

    2016-09-01

    tricuspid annulus had a complex 3D saddle-shaped geometry that was unaffected during experimental conditions. In healthy sheep hearts, left ventricular unloading increased septal-free wall RV diameter and reduced the length of the septal annulus, without altering the motion or geometry of the tricuspid annulus. Acute left ventricular unloading alone in healthy sheep was not sufficient to significantly perturb tricuspid annular dynamics and result in tricuspid insufficiency. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  12. Hemispheric contributions to pragmatics.

    PubMed

    Zaidel, E; Kasher, A; Soroker, N; Batori, G; Giora, R; Graves, D

    2000-01-01

    Twenty-seven patients with right-hemisphere damage (RBD) and thirty-one patients with left-hemisphere damage (LBD) received a new pragmatics battery in Hebrew consisting of two parts: (1) comprehension and production of basic speech acts (BSAs), including tests of assertions, questions, requests, and commands, and (2) comprehension of implicatures, including implicatures of quantity, quality, relevance, and manner. Each test had a verbal and a nonverbal version. Patients also received Hebrew versions of the Western Aphasia Battery and of the Right Hemisphere Communication Battery. Both LBD and RBD patients were impaired relative to controls but did not differ from each other in their overall scores on BSAs and on Implicatures when scores were corrected by aphasia and neglect indices. There was a systematic localization of BSAs in the left hemisphere (LH) but not in the right hemisphere (RH). There was poor localization of Implicatures in either hemisphere. In LBD patients, BSAs were associated with language functions measured with the WAB, suggesting the radical possibility that the classic localization of language functions in aphasia is influenced by the localization of the BSAs required by aphasia language tests. Both BSAs and implicatures show greater functional independence from other pragmatic, language and cognitive functions in the RBD than in the LBD patients. Thus, the LH is more likely to contain an unmodular domain-nonspecific set of central cognitive mechanisms for applying means-ends rationality principles to intentional activity.

  13. Acute Effect of Treatment of Mitral Stenosis on Left Atrium Function

    PubMed Central

    Rohani, Atooshe; Kargar, Shahram; Fazlinejad, Afsoon; Ghaderi, Fereshte; Vakili, Vida; Falsoleiman, Homa; Bagheri, Ramin Khamene

    2017-01-01

    Aim: Peak atrial longitudinal strain (PALS) is used to evaluate left atrium (LA) function in patients with mitral stenosis (MS), before and after percutaneous transmitral commissurotomy (PTMC) and mitral valve replacement (MVR). Methods: Patients with severe symptomatic MS, who were referred to our echocardiographic laboratory for a diagnostic examination before cardiac surgery or PTMC from October of 2014 to October of 2015, were included in the study. Result: The peak systolic global LA strain improved post-PTMC (P < 0.001) and post-MVR (P = 0.012). This difference was statistically highly significant. Conclusion: PALS is impaired in patients with severe symptomatic MS and improved acutely after treatment and may be a good indicator of LA function and may predict the right time for intervention on mitral valve. PMID:28074794

  14. Noninvasive assessment of right and left ventricular function in acute and chronic respiratory failure

    SciTech Connect

    Matthay, R.A.; Berger, H.J.

    1983-05-01

    This review evaluates noninvasive techniques for assessing cardiovascular performance in acute and chronic respiratory failure. Radiographic, radionuclide, and echocardiographic methods for determining ventricular volumes, right (RV) and left ventricular (LV) ejection fractions, and pulmonary artery pressure (PAP) are emphasized. These methods include plain chest radiography, radionuclide angiocardiography, thallium-201 myocardial imaging, and M mode and 2-dimensional echocardiography, which have recently been applied in patients to detect pulmonary artery hypertension (PAH), right ventricular enlargement, and occult ventricular performance abnormalities at rest or exercise. Moreover, radionuclide angiocardiography has proven useful in combination with hemodynamic measurements, for evaluating the short-and long-term cardiovascular effects of therapeutic agents, such as oxygen, digitalis, theophylline, beta-adrenergic agents, and vasodilators.

  15. Effects of recanalisation on global left ventricular function in acute myocardial infarction

    SciTech Connect

    van der Wall, E.E.; Res, J.; Verheugt, F.W.A.; Simoons, M.L.; Wijns, W.; Braat, S.; de Zwaan, C.; Remme, P.; Vermeer, F.

    1985-05-01

    302 patients (pts) with acute myocardial infarction (MI) were enrolled in a multicentre trial, comparing conventional treatment (C) with attempted recanalisation by intracoronary streptokinase (SK). Out of 153 pts allocated to SK 17 refused intervention. The infarct related vessel was patent in 26 pts, recanalisation was achieved in 87 out of 110 pts with an occluded vessel. Median interval between onset of symptoms and recanalization was 220 minutes. Data were analyzed according to the original treatment allocation. Left ventricular ejection fraction (LVEF) was measured by radionuclide angiography within 48 hours in 232 pts, at 2 weeks in 179 pts and after 3 months in 128 pts. Paired data both within 48 hours and at 2 weeks were available in 152 pts. Global LV function remains unchanged C between 48 hr and at 3 months. Recanalisation by earlier intracoronary SK improves global LV function at 2 weeks in inferior MI and both at 2 weeks and 3 months in anterior MI.

  16. Left ventricular responses to acute changes in late systolic pressure augmentation in older adults.

    PubMed

    Sweitzer, Nancy K; Hetzel, Scott J; Skalski, Joseph; Velez, Mauricio; Eggleston, Kevin; Mitchell, Gary F

    2013-07-01

    Changes in the cardiovascular system with age may predispose older persons to development of heart failure with preserved ejection fraction. Vascular stiffening, aortic pressure augmentation, and ventricular-vascular coupling have been implicated. We explored the potential for acute reductions in late systolic pressure augmentation to impact left ventricular relaxation in older persons without heart failure. Sixteen older persons free of known cardiovascular disease with the exception of hypertension had noninvasive tonometry and cardiac ultrasound to evaluate central augmentation index (AI) and diastolic function at baseline and after randomized, blinded administration of intravenous B-type natriuretic peptide (BNP) and hydralazine in a crossover design. AI was significantly reduced after BNP (11.4±8.9 to -0.2±14.7%; P = 0.02) and nonsignificantly reduced after hydralazine (14.7±8.4% to 11.5±8.8%; P = 0.39). With decreased AI during BNP, a trend toward worsened myocardial relaxation by tissue Doppler imaging occurred (E' velocity pre- and post-BNP: 10.0±2.5 and 8.8±2.0cm/s, respectively; P = 0.06). There was a significant fall in stroke volume with BNP (68.5±18.3 to 60.9±18.1ml; P = 0.02), suggesting that changes in preload overwhelmed effects of afterload reduction on ventricular performance. With hydralazine, neither relaxation nor stroke volume changed. Acute changes in late systolic aortic pressure augmentation do not necessarily lead to improved systolic or diastolic function in older people. Preload may be a more important determinant of cardiac performance than afterload in older people with compensated ventricular function. The potential for changes in preload to impair rather than enhance left ventricular systolic and diastolic function in older people warrants further study. This study is registered at clinicaltrials.gov as NCT00204984.

  17. Aberrant Left Inferior Bronchial Artery Originating from the Left Gastric Artery in a Patient with Acute Massive Hemoptysis

    SciTech Connect

    Jiang, Sen Sun, Xi-Wen Yu, Dong Jie, Bing

    2013-10-15

    Massive hemoptysis is a life-threatening condition, and the major source of bleeding in this condition is the bronchial circulation. Bronchial artery embolization is a safe and effective treatment for controlling hemoptysis. However, the sites of origin of the bronchial arteries (BAs) have numerous anatomical variations, which can result in a technical challenge to identify a bleeding artery. We present a rare case of a left inferior BA that originated from the left gastric artery in a patient with recurrent massive hemoptysis caused by bronchiectasis. The aberrant BA was embolized, and hemoptysis has been controlled for 8 months.

  18. Coronary flow reserve in the remote myocardium predicts left ventricular remodeling following acute myocardial infarction.

    PubMed

    Cheng, Rongchao; Wei, Guoqian; Yu, Longhao; Su, Zhendong; Wei, Li; Bai, Xiuping; Tian, Jiawei; Li, Xueqi

    2014-07-01

    Coronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI. We enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration. CFR was 1.55±0.11 in the infarcted zone and 2.05±0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty. Microvascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI.

  19. Correlation between QTc interval duration and left ventricular systolic dysfunction in patients with acute myocardial infarction.

    PubMed

    Stajer, D; Mozina, H; Noc, M; Rode, P

    1993-10-01

    QTc interval and left ventricular regional wall motion abnormality score (WMS) were assessed in 61 consecutive patients with 4-day-old acute myocardial infarction (AMI). There were 45 men and 16 women, aged 60.6 +/- 8.7 years; 24 had anterior wall AMI and 37 had inferior wall AMI. Twenty-nine patients received thrombolytic treatment, which was presumably successful in 19. The longest QTc interval from a standard 12-lead electrocardiogram, corrected by Bazett's formula, was considered for the study. The WMS was evaluated echocardiographically. The authors found a statistically significant correlation between WMS and QTc interval duration; the correlation was stronger in patients with anterior AMI (r = .9, P < .001) than in those with inferior AMI (r = .66, P < .001). The WMS and QTc values were significantly lower in patients with successful thrombolytic treatment compared to those with unsuccessful thrombolysis (P < .003 and P < .002, respectively). The authors could demonstrate no significant correlation between serum potassium concentration and the QTc interval. In patients with anterior AMI, QTc interval duration might represent an additional marker of left ventricular systolic dysfunction. It could also be used as an additional noninvasive criterion of coronary artery reperfusion in patients with AMI.

  20. Xenon protects left ventricular diastolic function during acute ischemia, less than ischemic preconditioning

    PubMed Central

    Baumert, Jan-H.; Roehl, Anna B.; Funcke, Sandra; Hein, Marc

    2016-01-01

    Anesthetics modify regional left ventricular (LV) dysfunction following ischemia/reperfusion but their effects on global function in this setting are less clear. Aim of this study was to test the hypothesis that xenon would limit global LV dysfunction as caused by acute anterior wall ischemia, comparable to ischemic preconditioning. In an open-chest model under thiopental anesthesia, 30 pigs underwent 60-minute left anterior descending coronary artery occlusion, followed by 120 minutes of reperfusion. A xenon group (constant inhalation from previous to ischemia through end of reperfusion) was compared to control and ischemic preconditioning. Load-independent measures of diastolic function (end-diastolic pressure-volume relation, time constant of relaxation) and systolic function (end-systolic pressure-volume relation, preload-recruitable stroke work) were determined. Heart rate, arterial pressure, cardiac output, and arterial elastance were recorded. Data were compared in 26 pigs. Ischemia impaired global diastolic but not systolic function in control, which recovered during reperfusion. Xenon limited and preconditioning abolished diastolic dysfunction during ischemia. Arterial pressure decreased during reperfusion while arterial elastance increased. Tachycardia and antero-septal wall edema during reperfusion were observed in all groups. In spite of ischemia of 40% of LV mass, global systolic function was preserved. Deterioration in global diastolic function was limited by xenon and prevented by preconditioning. PMID:27867480

  1. Enhanced preservation of acutely ischemic myocardium with transseptal left ventricular assist.

    PubMed

    Fonger, J D; Zhou, Y; Matsuura, H; Aldea, G S; Shemin, R J

    1994-03-01

    Mechanical support for acute regional ischemia without hemodynamic collapse may be achieved percutaneously with an intraaortic balloon pump (IABP) or with transseptal left ventricular assist (TLVA) while awaiting revascularization. The relative benefits of these two percutaneous transfemoral techniques for the treatment of ischemia were compared in a representative animal model. During 90 minutes of regional coronary occlusion, four groups of 8 pigs were treated with either no support (control), IABP, TLVA, or both IABP and TLVA. Cardioplegic arrest for 30 minutes to simulate coronary grafting was followed by 180 minutes of global reperfusion on bypass. In all groups regional wall motion and interstitial pH in the area at risk were significantly depressed with ischemia, but wall motion fully recovered after reperfusion. However, histochemical staining of the area of necrosis/area at risk was significantly reduced with IABP versus control (20.2% versus 34.1%; p < 0.05) and further significantly reduced with TLVA and IABP + TLVA (10.7% and 6.7% versus IABP alone; p < 0.05). We conclude that in supporting even a modest-sized myocardial region at risk (12% of the left ventricle) the area that went on to infarction was significantly reduced with the use of TLVA over IABP. Regional wall motion and myocardial pH measurements did not reflect this difference in the early reperfusion period. The benefit of TLVA over IABP during more extensive or prolonged ischemia may have real clinical significance.

  2. Fibrinolytic therapy in left side-prosthetic valve acute thrombosis. In depth systematic review.

    PubMed

    Reyes-Cerezo, Esteban; Jerjes-Sánchez, Carlos; Archondo-Arce, Tamara; García-Sosa, Anabel; Garza-Ruiz, Angel; Ramírez-Rivera, Alicia; Ibarra-Pérez, Carlos

    2008-01-01

    Limited data are available on the impact and safety of fibrinolytic therapy (FT) in left - side prosthetic valve acute thrombosis (PVAT). To improve our knowledge about the FT role in left -side PVAT. Bibliographic search and analysis. MEDLINE search from January 1970 to January 2007. Studies were classified according to the evidence level recommendations of the American College of Chest Physicians and included if they had objective diagnosis of left-side PAVT and FT efficacy assessment (hemodynamic, echocardiographic or fluoroscopic improvement). New York Heart Association class was used to establish functional state. Data on clinical characteristics, diagnosis strategy, anticoagulation status, fibrinolytic and heparin regimens, cardiovascular adverse events, outcome, and follow-up were also required. A systematic search produced a total of 900 references. Each abstract was analyzed according to the predetermined criteria. Thirty-two references with 904 patients constitute the subject of this analysis. Only one trial had evidence III and thirty-one evidence V. FT was more used in young female patients (64%) with prosthetic mitral valve thrombosis (77%), and clinical instability (82%). Transesophageal echocardiogram had a higher thrombus detection rate (100%). Although several fibrinolytic regimens were used in a first or second course, streptokinase was the most frequent agent (61%). Clinical improvement was observed in 86% of the patients, objective success in 78%, and failure in 14%. Rescue fibrinolysis was done in 17%. peripheral and cerebral embolism rate was 5% and 4%, respectively. Major bleeding 4% and intracranial hemorrhage 1%. The available evidence demonstrates that in PVAT fibrinolytic therapy improves the outcome in younger, more ill patients, especially females, independently of the fibrinolytic regimen used with a low complications rate.

  3. Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production.

    PubMed

    Hartwigsen, Gesa; Saur, Dorothee; Price, Cathy J; Ulmer, Stephan; Baumgaertner, Annette; Siebner, Hartwig R

    2013-10-08

    The role of the right hemisphere in aphasia recovery after left hemisphere damage remains unclear. Increased activation of the right hemisphere has been observed after left hemisphere damage. This may simply reflect a release from transcallosal inhibition that does not contribute to language functions. Alternatively, the right hemisphere may actively contribute to language functions by supporting disrupted processing in the left hemisphere via interhemispheric connections. To test this hypothesis, we applied off-line continuous theta burst stimulation (cTBS) over the left inferior frontal gyrus (IFG) in healthy volunteers, then used functional MRI to investigate acute changes in effective connectivity between the left and right hemispheres during repetition of auditory and visual words and pseudowords. In separate sessions, we applied cTBS over the left anterior IFG (aIFG) or posterior IFG (pIFG) to test the anatomic specificity of the effects of cTBS on speech processing. Compared with cTBS over the aIFG, cTBS over the pIFG suppressed activity in the left pIFG and increased activity in the right pIFG during pseudoword vs. word repetition in both modalities. This effect was associated with a stronger facilitatory drive from the right pIFG to the left pIFG during pseudoword repetition. Critically, response became faster as the influence of the right pIFG on left pIFG increased, indicating that homologous areas in the right hemisphere actively contribute to language function after a focal left hemisphere lesion. Our findings lend further support to the notion that increased activation of homologous right hemisphere areas supports aphasia recovery after left hemisphere damage.

  4. Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production

    PubMed Central

    Hartwigsen, Gesa; Saur, Dorothee; Price, Cathy J.; Ulmer, Stephan; Baumgaertner, Annette; Siebner, Hartwig R.

    2013-01-01

    The role of the right hemisphere in aphasia recovery after left hemisphere damage remains unclear. Increased activation of the right hemisphere has been observed after left hemisphere damage. This may simply reflect a release from transcallosal inhibition that does not contribute to language functions. Alternatively, the right hemisphere may actively contribute to language functions by supporting disrupted processing in the left hemisphere via interhemispheric connections. To test this hypothesis, we applied off-line continuous theta burst stimulation (cTBS) over the left inferior frontal gyrus (IFG) in healthy volunteers, then used functional MRI to investigate acute changes in effective connectivity between the left and right hemispheres during repetition of auditory and visual words and pseudowords. In separate sessions, we applied cTBS over the left anterior IFG (aIFG) or posterior IFG (pIFG) to test the anatomic specificity of the effects of cTBS on speech processing. Compared with cTBS over the aIFG, cTBS over the pIFG suppressed activity in the left pIFG and increased activity in the right pIFG during pseudoword vs. word repetition in both modalities. This effect was associated with a stronger facilitatory drive from the right pIFG to the left pIFG during pseudoword repetition. Critically, response became faster as the influence of the right pIFG on left pIFG increased, indicating that homologous areas in the right hemisphere actively contribute to language function after a focal left hemisphere lesion. Our findings lend further support to the notion that increased activation of homologous right hemisphere areas supports aphasia recovery after left hemisphere damage. PMID:24062469

  5. Functional magnetic resonance imaging study on dysphagia after unilateral hemispheric stroke: a preliminary study.

    PubMed

    Li, S; Luo, C; Yu, B; Yan, B; Gong, Q; He, C; He, L; Huang, X; Yao, D; Lui, S; Tang, H; Chen, Q; Zeng, Y; Zhou, D

    2009-12-01

    Swallowing dysfunction is common and disabling after acute stroke; however, the mechanism of dysphagia or recovery of swallowing from dysphagia remains uncertain. The purpose of this study was to explore cerebral activation of swallowing in dysphagia using functional MRI (fMRI) to compare the functional anatomy of swallowing in unilateral hemispheric stroke patients and healthy adults. In total, five left hemispheric stroke patients with dysphagia, five right hemispheric stroke patients with dysphagia and 10 healthy controls were examined with event related fMRI while laryngeal swallow related movements were recorded. Data were processed using the general linear model. A multifocal cerebral representation of swallowing was identified predominantly in the left hemisphere, in a bilateral and asymmetrical manner. Cerebral activation during swallowing tasks was localised to the precentral, postcentral and anterior cingulate gyri, insula and thalamus in all groups. Activation of volitional swallowing in dysphagic unilateral hemispheric stroke patients might require reorganisation of the dominant hemispheric motor cortex, or a compensatory shift in activation to unaffected areas of the hemisphere. The results indicate that unilateral stroke of either cerebral hemisphere can produce dysphagia. Effective recovery is associated with cerebral activation related to cortical swallowing representation in the compensating or recruited areas of the intact hemisphere. Functional MRI is a useful method for exploring the spatial localisation of changes in neuronal activity during tasks that may be related to recovery. Therefore, the subsequent information gleaned from changes in neural plasticity could be useful for assessing the prognosis of dysphagic stroke.

  6. General and acute care surgical procedures in patients with left ventricular assist devices.

    PubMed

    Arnaoutakis, George J; Bittle, Gregory J; Allen, Jeremiah G; Weiss, Eric S; Alejo, Jennifer; Baumgartner, William A; Shah, Ashish S; Wolfgang, Christopher L; Efron, David T; Conte, John V

    2014-04-01

    Left ventricular assist devices (LVADs) have become common as a bridge to heart transplant as well as destination therapy. Acute care surgical (ACS) problems in this population are prevalent but remain ill-defined. Therefore, we reviewed our experience with ACS interventions in LVAD patients. A total of 173 patients who received HeartMate(®) XVE or HeartMate(®) II (HMII) LVADs between December 2001 and March 2010 were studied. Patient demographics, presentation of ACS problem, operative intervention, co-morbidities, transplantation, complications, and survival were analyzed. A total of 47 (27 %) patients underwent 67 ACS procedures at a median of 38 days after device implant (interquartile range 15-110), with a peri-operative mortality rate of 5 % (N = 3). Demographics, device type, and acuity were comparable between the ACS and non-ACS groups. A total of 21 ACS procedures were performed emergently, eight were urgent, and 38 were elective. Of 29 urgent and emergent procedures, 28 were for abdominal pathology. In eight patients, the cause of the ACS problem was related to LVADs or anticoagulation. Cumulative survival estimates revealed no survival differences if patients underwent ACS procedures (p = 0.17). Among HMII patients, transplantation rates were unaffected by an ACS intervention (p = 0.2). ACS problems occur frequently in LVAD patients and are not associated with adverse outcomes in HMII patients. The acute care surgeon is an integral member of a comprehensive approach to effective LVAD management.

  7. Assessment of regional left ventricular myocardial function in rats after acute occlusion of left anterior descending artery by two-dimensional speckle tracking imaging.

    PubMed

    Fu, Qian; Xie, Mingxing; Wang, Jing; Wang, Xinfang; Lv, Qing; Lu, Xiaofang; Fang, Lingyun; Chang, Long

    2009-12-01

    This study evaluated the change in regional left ventricular myocardial function in rats following acute occlusion of the left anterior descending coronary artery (LAD) by using two-dimensional speckle tracking imaging (2D-STI). Sixty Wistar rats were randomly divided into two groups, a myocardial infarction (MI) group, in which 50 rats were subjected to LAD occlusion for 30-45 min, and a sham-operated (SHAM) group that contained 10 rats serving as control. Echocardiography was performed at baseline and 1, 4 and 8 week(s) after the operation. High frequency two-dimensional images of left ventricular short axis at papillary muscle level were recorded. Peak systolic radial strain (PRS) and circumferential strain (PCS) were measured in the mid-ventricle in short-axis view by using EchoPAC workstation. Left ventricular internal diameter at diastole (LVIDd) and systole (LVIDs), fractional shortening (FS), ejection fraction (EF) and left ventricular mass (LVM) were measured by anatomical M-model echocardiography. Infarct size was measured using triphenyl tetrazolium chloride (TTC) staining 1 week and 8 weeks after the operation. Fibrosis of left ventricular myocardium was displayed using Van Gieson staining 1 week after the infarction. In terms of the TTC staining results, the left ventricle fell into three categories: infarcted, peri-infarcted and remote myocardial regions. Compared with those at baseline and in the SHAM group, (1) PRS and PCS in the infarcted, peri-infarcted and remote myocardial regions were significantly decreased in the MI group within 1 week after the operation (P<0.05) and the low levels lasted 8 weeks; (2) Compared with those at baseline, LVIDd, LVIDs, FS, EF and LVM in the MI group showed no significant difference 1 week after the operation (P>0.05). However, LVIDd, LVIDs and LVM were increased significantly 4 and 8 weeks after the operation (P<0.05), and FS and EF were decreased substantially (P<0.05). Van Gieson staining showed that fibrosis

  8. [Use of isosorbide dinitrate (Risordan) injection in left ventricular failure following acute myocardial infarction (author's transl)].

    PubMed

    Szwarc, G; Lellouche, D; Usdin, J P

    1982-06-10

    Haemodynamic and echocardiographic studies of isosorbide dinitrate were conducted in 12 patients (8 men and 4 women) with left ventricular failure consecutive to recent myocardial infarction. The groups: group I received 5 mg/h and group II 10 mg/h Risordan intravenously. After one hour treatment, group I patients showed a significant fall in both PAP (from 32.3 +/- 5.3 to 26.7 +/- 6.9 mmHg; p less than 0.01) and PCP (from 21.8 +/- 4.7 to 17.3 +/- 7.7 mmHg; p less than 0.05). These haemodynamic changes were amplified after a second hour of treatment: PAP fell to 24 +/- 7.9 mmHg (p less than 0.01) and PCP to 14.2 +/- 4.4 mmHg (p less than 0.001). RAP decreased from 7.2 +/- 5.1 to 3.5 +/- 5 (p less than 0.05). There were no changes in heart rate, systemic arterial pressure, peripheral resistance, cardiac index, forward stroke work nor, on echocardiography, in ventricular diameters, shortening fraction and VCF. After one hour treatment, group II patients showed a fall in PAP (from 30.5 +/- 4.7 to 21.7 +/- 3.5 mmHg; p less than 0.01), PCP (from 21.7 +/- 4.8 to 14.8 +/- 4.9 mmHg: p less than 0.001) and RAP (from 10.3 +/- 2.9 to 7.2 +/- 2; p less than 0.01). The systolic diameter of the left ventricle was reduced from 66.3 +/- 10.6 to 64.3 +/- 11.3 (p less than 0.01). After 4 hours, improvement in PAP and PCP was maintained; the other values remained stable. The effectiveness of Risordan i.v. in left ventricular failure consecutive to acute myocardial infarction is due to reduction of filling pressures in the left ventricule. With the 10 mg/h dose, as opposed to the 5 mg/h dose, the systemic arterial pressure and the double and triple products tend to be reduced, which suggests greater effectiveness.

  9. Survival after Left Ventricular Free Wall Rupture in an Elderly Woman with Acute Myocardial Infarction Treated Only Medically

    PubMed Central

    Roa-Castro, Víctor Hugo; Molina-Bello, Ervin; Valenzuela-Suárez, Hector; Rotberg-Jagode, Tobías; Espinola-Zavaleta, Nilda

    2012-01-01

    Pseudoaneurysm of the left ventricle is rare and may occur as a result of transmural myocardial infarction. The course of rupture after acute myocardial infarction varies from a catastrophic event, with an acute tear leading to immediate death (acute rupture), or slow and incomplete tear leading to a late rupture (subacute rupture). Incomplete rupture may occur when the thrombus and haematoma together with the pericardium seal the rupture of the left ventricle and may develop into a pseudoaneurysm. Early diagnosis and treatment is essential in this condition. Two-dimensional color Doppler echocardiography is the first-choice method for most patients with suspected left ventricular pseudoaneurysm (LVP) and suggests left ventricular rupture in 85% to 90% of patients. We report the case of an 87-year-old woman presenting with symptoms and findings of myocardial infarction and left ventricular free wall rupture with a pseudoaneurysm formation diagnosed by echocardiography and confirmed on CT, MRI, and NM. She received only intense medical treatment, because she refused surgery with a favorable outcome. After 24-month followup, she is in NYHA functional class II. The survival of this patient is due to the contained pseudoaneurysm by dense pericardial adhesions, related to her previous coronary bypass surgery. PMID:22953155

  10. The relationship between acute phase serum amyloid A (SAA) protein concentrations and left ventricular systolic function in acute myocardial infarction patients treated with primary coronary angioplasty.

    PubMed

    Katayama, Toshiro; Nakashima, Hiroshi; Honda, Yukiharu; Suzuki, Shin; Yamamoto, Tadashi; Iwasaki, Yoshihiro; Yano, Katsusuke

    2007-01-01

    Our study was planned to investigate the relationship between plasma levels of serum amyloid A protein (SAA) concentrations and the subsequent left ventricular systolic function in patients with acute myocardial infarction (AMI) treated with primary coronary angioplasty. Reperfusion by primary percutaneous coronary intervention was successful in 486 consecutive AMI patients who were admitted within 12 hours of onset. Plasma SAA concentrations were evaluated 24 hours after onset. Left ventricular (LV) function was serially determined by left ventriculography performed in the acute (soon after recanalization) and chronic phases (6 months after onset). (I) There was no significant correlation between SAA concentration and acute phase left ventricular ejection fraction (LVEF) or regional wall motion (RWM). (II) The SAA concentration was significantly correlated with both highly sensitive C-reactive protein (hs-CRP) and the peak-CK value (hs-CRP: r = 0.69, P < 0.0001, peak-CK: r = 0.21, P = 0.0003). (III) SAA was significantly negatively correlated with both LVEF and RWM in the chronic phase (LVEF: r = -0.42, P = 0.001; RWM: r = -0.41, P = 0.007). (IV) The plasma level of SAA also showed a significant negative correlation with the differences in LVEF between the 2 stages (delta-LVEF) (r = -0.43, P = 0.02). In the setting of AMI, plasma SAA concentrations may be closely related to subsequent left-ventricular systolic dysfunction.

  11. Increased BOLD Signals Elicited by High Gamma Auditory Stimulation of the Left Auditory Cortex in Acute State Schizophrenia.

    PubMed

    Kuga, Hironori; Onitsuka, Toshiaki; Hirano, Yoji; Nakamura, Itta; Oribe, Naoya; Mizuhara, Hiroaki; Kanai, Ryota; Kanba, Shigenobu; Ueno, Takefumi

    2016-10-01

    Recent MRI studies have shown that schizophrenia is characterized by reductions in brain gray matter, which progress in the acute state of the disease. Cortical circuitry abnormalities in gamma oscillations, such as deficits in the auditory steady state response (ASSR) to gamma frequency (>30-Hz) stimulation, have also been reported in schizophrenia patients. In the current study, we investigated neural responses during click stimulation by BOLD signals. We acquired BOLD responses elicited by click trains of 20, 30, 40 and 80-Hz frequencies from 15 patients with acute episode schizophrenia (AESZ), 14 symptom-severity-matched patients with non-acute episode schizophrenia (NASZ), and 24 healthy controls (HC), assessed via a standard general linear-model-based analysis. The AESZ group showed significantly increased ASSR-BOLD signals to 80-Hz stimuli in the left auditory cortex compared with the HC and NASZ groups. In addition, enhanced 80-Hz ASSR-BOLD signals were associated with more severe auditory hallucination experiences in AESZ participants. The present results indicate that neural over activation occurs during 80-Hz auditory stimulation of the left auditory cortex in individuals with acute state schizophrenia. Given the possible association between abnormal gamma activity and increased glutamate levels, our data may reflect glutamate toxicity in the auditory cortex in the acute state of schizophrenia, which might lead to progressive changes in the left transverse temporal gyrus.

  12. Left atrial strain as evaluated by two-dimensional speckle tracking predicts left atrial appendage dysfunction in patients with acute ischemic stroke.

    PubMed

    Sasaki, Shintaro; Watanabe, Tetsu; Tamura, Harutoshi; Nishiyama, Satoshi; Wanezaki, Masahiro; Sato, Chika; Yamaura, Gensai; Ishino, Mitsunori; Arimoto, Takanori; Takahashi, Hiroki; Shishido, Tetsuro; Miyamoto, Takuya; Kubota, Isao

    2014-12-01

    Left atrial appendage (LAA) dysfunction predisposes patients with atrial fibrillation (AF) to cardioembolic stroke. Two-dimensional (2D) speckle tracking was reported to be useful for evaluating left atrial (LA) regional function, as well as left ventricular function. However, it remains unclear whether 2D speckle tracking is useful for evaluating LAA dysfunction. Therefore, we investigated whether decreased LA strain may predict LAA dysfunction and thrombus formation in patients with acute ischemic stroke. We performed transthoracic and transesophageal echocardiography in 120 patients (83 males, mean age 72 ± 11 years) within 7 days of onset of an acute ischemic stroke. Longitudinal LA strain was evaluated using 2D speckle tracking imaging at each LA segment, and peak systolic strain was calculated by averaging the results for each segment. Forty-eight patients had LAA dysfunction as defined by the presence of LAA thrombus and/or severe spontaneous echo contrast. LA peak systolic strain was significantly decreased in patients with LAA dysfunction compared to those without (32.3 ± 13.7% vs. 12.1 ± 7.2%, p < 0.0001). LA peak systolic strain was significantly correlated with LAA emptying flow velocity (r = 0.693, p < 0.0001). The optimum LA peak systolic strain cut-off value for predicting LAA dysfunction was 19%. Multivariate logistic regression analysis showed that LA peak systolic strain was an independent predictor of LAA dysfunction (odds ratio 0.059, 95% confidence interval 0.018-0.146; p < 0.0001). Decreased LA peak systolic strain was independently associated with LAA dysfunction in patients with acute ischemic stroke.

  13. Coronary Flow Reserve in the Remote Myocardium Predicts Left Ventricular Remodeling Following Acute Myocardial Infarction

    PubMed Central

    Cheng, Rongchao; Wei, Guoqian; Yu, Longhao; Su, Zhendong; Wei, Li; Bai, Xiuping; Tian, Jiawei

    2014-01-01

    Purpose Coronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI. Materials and Methods We enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration. Results CFR was 1.55±0.11 in the infarcted zone and 2.05±0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty. Conclusion Microvascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI. PMID:24954317

  14. [Effectiveness of anticoagulant oral treatment in patients with thrombus in left ventricle after acute myocardial infarction].

    PubMed

    Carrillo, A M; Valdespino, A; Solorio, S; Badui, E; Enciso, R; Lepe, L; Lara, A; Ocampo, S; Alonso, R; Romero, M A

    1997-01-01

    Left ventricular mural thrombi (LVMT) is a complication of acute myocardial infarction (AMI), that may produce peripheral embolism which could be fatal. In order to establish an adequate time of oral anticoagulant (OA) therapy, we undertook a prospective study that included 45 patients with AMI and left ventricular thrombi detected by echocardiographic study, in the first 5 to 10 days postinfarction, the study was repeated, in 3 and 6 months. Treatment with oral anticoagulant was initiated at the point of the detection of thrombi maintaining an INR of 1.5 to 2. Thirty nine patients (79%) were males and 6 (11%) were females, with an age of 29 to 85 years and a range of 62 +/- 11 years. Forty four patients (98%) presented anterior wall infarction and 1 (2%) posteroinferior infarction. In patients with anterior infarction, in 38 (85%) the thrombi was located at the apical wall (p < 0.05), 5 (11%) in the septal wall and other (2%) in anterior and apical walls. The patient with the posteroinferior infarction presented extension to the right ventricle, where the thrombus was located (2%). The contractility alterations related with thrombi were diskinesia, followed by hipokinesia and finally akinesia. The ejection fraction had not relationship with thrombi formation. LVMT dissolved in 32 patients (71%) at 3 months (p < 0.05), in 8 (18%) in 6 months and in 5 (11%) it was maintained for more than 6 months. None of the patients presented complications of OA. We conclude that the LVMT are more frequent in anterior infarctions, essentially in those that present diskinesia. The majority of LVMT are resolved in 6 months with OA therapy.

  15. Left Ventricular Responses to Acute Changes in Late Systolic Pressure Augmentation in Older Adults

    PubMed Central

    2013-01-01

    BACKGROUND Changes in the cardiovascular system with age may predispose older persons to development of heart failure with preserved ejection fraction. Vascular stiffening, aortic pressure augmentation, and ventricular–vascular coupling have been implicated. We explored the potential for acute reductions in late systolic pressure augmentation to impact left ventricular relaxation in older persons without heart failure. METHODS Sixteen older persons free of known cardiovascular disease with the exception of hypertension had noninvasive tonometry and cardiac ultrasound to evaluate central augmentation index (AI) and diastolic function at baseline and after randomized, blinded administration of intravenous B-type natriuretic peptide (BNP) and hydralazine in a crossover design. RESULTS AI was significantly reduced after BNP (11.4±8.9 to −0.2±14.7%; P = 0.02) and nonsignificantly reduced after hydralazine (14.7±8.4% to 11.5±8.8%; P = 0.39). With decreased AI during BNP, a trend toward worsened myocardial relaxation by tissue Doppler imaging occurred (E’ velocity pre- and post-BNP: 10.0±2.5 and 8.8±2.0cm/s, respectively; P = 0.06). There was a significant fall in stroke volume with BNP (68.5±18.3 to 60.9±18.1ml; P = 0.02), suggesting that changes in preload overwhelmed effects of afterload reduction on ventricular performance. With hydralazine, neither relaxation nor stroke volume changed. CONCLUSIONS Acute changes in late systolic aortic pressure augmentation do not necessarily lead to improved systolic or diastolic function in older people. Preload may be a more important determinant of cardiac performance than afterload in older people with compensated ventricular function. The potential for changes in preload to impair rather than enhance left ventricular systolic and diastolic function in older people warrants further study. CLINICAL TRIALS REGISTRATION This study is registered at clinicaltrials.gov as NCT00204984. PMID:23537892

  16. Left ventricular platelet deposition after acute myocardial infarction. An attempt at quantification using blood pool subtracted indium-111 platelet scintigraphy.

    PubMed Central

    Verheugt, F W; Lindenfeld, J; Kirch, D L; Steele, P P

    1984-01-01

    Since indium-111 platelet scintigraphy for the detection of left ventricular thrombosis often shows considerable non-specific blood pool activity a subtraction method using simultaneous technetium-99m blood pool scintigraphy was undertaken in 11 subjects with well documented remote myocardial infarction, who served as positive or negative controls, and in 18 consecutive patients with acute myocardial infarction. The results were compared with those of cross sectional echocardiography. Thirteen patients had transmural myocardial infarction and the calculated count per pixel in the left ventricle of the subtracted indium-111 platelet scintigram was (mean (SD)) 0.28(0.35), but five patients with subendocardial myocardial infarction had a mean count of 0.04(0.06). In seven patients with transmural myocardial infarction (two anterior and five inferior) left ventricular thrombosis was detected by indium-111 platelet scintigraphy but in only one of these by cross sectional echocardiography. None of the patients with subendocardial myocardial infarction had left ventricular thrombosis. Subtracted left ventricular counts correlated well with the visual results. It is concluded that left ventricular platelet sequestration after acute myocardial infarction may be quantified and precisely located and that quantitative longitudinal studies of the natural history and drug intervention are now possible. Images PMID:6437421

  17. Hypertrophic obstructive cardiomyopathy. Effects of acute and chronic verapamil treatment on left ventricular systolic and diastolic function.

    PubMed Central

    Anderson, D M; Raff, G L; Ports, T A; Brundage, B H; Parmley, W W; Chatterjee, K

    1984-01-01

    Changes in left ventricular systolic and diastolic function and outflow gradient were evaluated in patients with obstructive hypertrophic cardiomyopathy after intravenous acute treatment with verapamil (15 patients) and after six months of oral chronic treatment (11 patients). All patients had severe symptoms despite beta blockade, and the condition of all but two improved appreciably after chronic treatment with verapamil. Resting left ventricular outflow tract gradient decreased in six of 15 patients after intravenous verapamil, and in five of 11 patients after long term treatment, but there was no change in provocable gradients nor any correlation between changes in gradient and improvement in symptoms. Left ventricular ejection rate did not change after intravenous or oral treatment. End systolic pressure/end systolic volume index remained unchanged after oral verapamil treatment. Whereas left ventricular total stroke volume index and end diastolic volume index increased without any significant change in left ventricular end diastolic pressure, indicating improved left ventricular diastolic function. In some patients the left ventricular diastolic pressure-volume curve shifted downwards or to the right or both. These findings suggest that improvement in symptoms with verapamil in patients with obstructive hypertrophic cardiomyopathy is unlikely to be related to changes in left ventricular outflow gradient or in systolic function and may be related to improved diastolic function. PMID:6539120

  18. Acute right ventricular pressure overload compromises left ventricular function by altering septal strain and rotation.

    PubMed

    Chua, Jason; Zhou, Wei; Ho, Jonathan K; Patel, Nikhil A; Mackensen, G Burkhard; Mahajan, Aman

    2013-07-15

    While right ventricular (RV) dysfunction has long been known to affect the performance of left ventricle (LV), the mechanisms remain poorly defined. Recently, speckle-tracking echocardiography has demonstrated that preservation of strain and rotational dynamics is crucial to both LV systolic and diastolic function. We hypothesized that alteration in septal strain and rotational dynamics of the LV occurs during acute RV pressure overload (RVPO) and leads to decreased cardiac performance. Seven anesthetized pigs underwent median sternotomy and placement of intraventricular pressure-volume conductance catheters. Two-dimensional echocardiographic images and LV pressure-volume loops were acquired for offline analysis at baseline and after banding of the pulmonary artery to achieve RVPO (>50 mmHg) induced RV dysfunction. RVPO resulted in a significant decrease (P < 0.05) in LV end-systolic elastance (50%), systolic change in pressure over change in time (19%), end-diastolic volume (22%), and cardiac output (37%) that correlated with decrease in LV global circumferential strain (58%), LV apical rotation (28%), peak untwisting (reverse rotation) rate (27%), and prolonged time to peak rotation (17%), while basal rotation was not significantly altered. RVPO reduced septal radial and circumferential strain, while no other segment of the LV midpapillary wall was affected. RVPO decreased septal radial strain on LV side by 27% and induced a negative radial strain from 28 ± 5 to -16 ± 2% on the RV side of the septum. The septal circumferential strain on both LV and RV side decreased by 46 and 50%, respectively, following RVPO (P < 0.05). Our results suggest that acute RVPO impairs LV performance by primarily altering septal strain and apical rotation.

  19. Left Atrial Volume Index and Prediction of Events in Acute Coronary Syndrome: Solar Registry

    PubMed Central

    Secundo Junior, Jose Alves; Santos, Marcos Antonio Almeida; Faro, Gustavo Baptista de Almeida; Soares, Camile Bittencourt; Silva, Allyson Matos Porto; Secundo, Paulo Fernando Carvalho; Teixeira, Clarissa Karine Cardoso; Oliveira, Joselina Luzia Menezes; Barreto Filho, Jose Augusto Soares; Sousa, Antônio Carlos Sobral

    2014-01-01

    Background According to some international studies, patients with acute coronary syndrome (ACS) and increased left atrial volume index (LAVI) have worse long-term prognosis. However, national Brazilian studies confirming this prediction are still lacking. Objective To evaluate LAVI as a predictor of major cardiovascular events (MCE) in patients with ACS during a 365-day follow-up. Methods Prospective cohort of 171 patients diagnosed with ACS whose LAVI was calculated within 48 hours after hospital admission. According to LAVI, two groups were categorized: normal LAVI (≤ 32 mL/m2) and increased LAVI (> 32 mL/m2). Both groups were compared regarding clinical and echocardiographic characteristics, in- and out-of-hospital outcomes, and occurrence of ECM in up to 365 days. Results Increased LAVI was observed in 78 patients (45%), and was associated with older age, higher body mass index, hypertension, history of myocardial infarction and previous angioplasty, and lower creatinine clearance and ejection fraction. During hospitalization, acute pulmonary edema was more frequent in patients with increased LAVI (14.1% vs. 4.3%, p = 0.024). After discharge, the occurrence of combined outcome for MCE was higher (p = 0.001) in the group with increased LAVI (26%) as compared to the normal LAVI group (7%) [RR (95% CI) = 3.46 (1.54-7.73) vs. 0.80 (0.69-0.92)]. After Cox regression, increased LAVI increased the probability of MCE (HR = 3.08, 95% CI = 1.28-7.40, p = 0.012). Conclusion Increased LAVI is an important predictor of MCE in a one-year follow-up. PMID:25119895

  20. Association between Left Ventricular Dysfunction and Functional Outcomes at Three Months in Acute Ischemic Stroke.

    PubMed

    Kim, Wook-Joo; Nah, Hyun-Wook; Kim, Dae-Hyun; Cha, Jae-Kwan

    2016-09-01

    Left ventricular dysfunction (LVD) was associated with stroke occurrence and mortality. However, few studies have published the impact of LVD on functional stroke outcomes in the acute stroke period. We enrolled 1554 patients who were admitted to Dong-A University Hospital between January 2011 and November 2014. To determine the functional outcomes, the modified Rankin Scale (mRS) score at 3 months after stroke was used. The severity of LVD was defined depending on ejection fraction (EF): (1) severe (EF ≤ 40%); (2) mild (40% < EF < 55%); and (3) normal (EF ≥ 55%). EF was measured using transthoracic two-dimensional echocardiography. The distribution of mRS scores at 3 months after stroke was presented using LVD. Multivariable analysis was performed to predict poor functional outcomes. Of the 1554 patients, 1417 had normal LV function, 87 had mild LVD, and 50 had severe LVD. Patients with LVD were older and had a high incidence of diabetes mellitus, atrial fibrillation, coronary artery disease, and severe stroke symptoms. With respect to treatment, patients with LVD received more thrombolysis and more anticoagulation medication after stroke. Stroke-related disability at discharge and at 3 months was significantly associated with LVD. In the multivariable analyses, old age, diabetes mellitus, high initial National Institutes of Health Stroke Scale score, stroke mechanism, and LVD were independent predictors of poor functional outcomes at 3 months. LVD is associated with poor functional outcomes after acute ischemic stroke. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  1. Survival and Left Ventricular Function Changes in Fulminant Versus Nonfulminant Acute Myocarditis.

    PubMed

    Ammirati, Enrico; Cipriani, Manlio; Lilliu, Marzia; Sormani, Paola; Varrenti, Marisa; Raineri, Claudia; Petrella, Duccio; Garascia, Andrea; Pedrotti, Patrizia; Roghi, Alberto; Bonacina, Edgardo; Moreo, Antonella; Bottiroli, Maurizio; Gagliardone, Maria P; Mondino, Michele; Ghio, Stefano; Totaro, Rossana; Turazza, Fabio M; Russo, Claudio F; Oliva, Fabrizio; Camici, Paolo G; Frigerio, Maria

    2017-08-08

    Previous reports have suggested that despite their dramatic presentation, patients with fulminant myocarditis (FM) might have better outcome than those with acute nonfulminant myocarditis (NFM). In this retrospective study, we report outcome and changes in left ventricular ejection fraction (LVEF) in a large cohort of patients with FM compared with patients with NFM. The study population consists of 187 consecutive patients admitted between May 2001 and November 2016 with a diagnosis of acute myocarditis (onset of symptoms <1 month) of whom 55 required inotropes and/or mechanical circulatory support (FM) and the remaining 132 were hemodynamically stable (NFM). We also performed a subanalysis in 130 adult patients with acute viral myocarditis and viral prodrome within 2 weeks from the onset, which includes 34 with FM and 96 with NFM. Patients with giant-cell myocarditis, eosinophilic myocarditis, or cardiac sarcoidosis and those <15 years of age were excluded from the subanalysis. In the whole population (n=187), the rate of in-hospital death or heart transplantation was 25.5% versus 0% in FM versus NFM, respectively (P<0.0001). Long-term heart transplantation-free survival at 9 years was lower in FM than NFM (64.5% versus 100%, log-rank P<0.0001). Despite greater improvement in LVEF during hospitalization in FM versus NFM forms (median, 32% [interquartile range, 20%-40%] versus 3% [0%-10%], respectively; P<0.0001), the proportion of patients with LVEF <55% at last follow-up was higher in FM versus NFM (29% versus 9%; relative risk, 3.32; 95% confidence interval, 1.45-7.64, P=0.003). Similar results for survival and changes in LVEF in FM versus NFM were observed in the subgroup (n=130) with viral myocarditis. None of the patients with NFM and LVEF ≥55% at discharge had a significant decrease in LVEF at follow-up. Patients with FM have an increased mortality and need for heart transplantation compared with those with NFM. From a functional viewpoint, patients with

  2. Acute Haemodynamic and Echocardiographic Effects of Multiple Configurations of Left Ventricular Pacing Sites in Acute Myocardial Infarction: Experimental Study.

    PubMed

    Matthaios, I; Kaladaridou, A; Skaltsiotes, E; Agrios, J; Antoniou, A; Georgiopoulos, G; Papadopoulou, E; Pamboucas, C; Toumanidis, S

    2017-04-01

    Left ventricular (LV) pacing is unsuccessful in a significant number of patients, mainly due to sub-optimal LV pacing location. Nevertheless, data about the impact of different pacing sites on LV function in ischaemic myocardium are scarce. The purpose of this study was to investigate the effect of combinations of alternative LV pacing sites on LV mechanics after experimental acute anterior myocardial infarction (AMI), in order to define the optimal configuration. Atrioventricular epicardial pacing at alternative pacing sites was performed in 16 healthy pigs simultaneously, after experimental AMI. Standard right ventricular (RV) apical pacing was combined with: i) LV apex lateral wall; ii) LV basal posterior wall; iii) LV basal anterior wall, and; iv) LV basal anterior wall + LV basal posterior wall. Moreover the pacing configurations of, v) LV basal posterior wall + LV apex lateral wall; vi) LV basal posterior wall + LV basal anterior wall, and; vii) LV basal anterior wall + LV apex lateral wall were also investigated. Haemodynamic parameters, together with classic and novel echocardiographic indices were used, to evaluate the effect of each pacing combination. A speckle tracking technique using EchoPAC software was used. After AMI, the pacing combination of LV apex lateral wall and LV basal posterior wall had the most favourable effect on LV function, leading to similar haemodynamic and torsional effects with sinus rhythm (all variables p>0.05). In pig hearts after AMI, the combination of pacing LV apex lateral wall and LV basal posterior wall managed to maintain the LV function at a level comparable to the sinus rhythm. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  3. Volumetric Integral Phase-shift Spectroscopy for Noninvasive Detection of Hemispheric Bioimpedance Asymmetry in Acute Brain Pathology

    ClinicalTrials.gov

    2017-07-20

    Stroke; Stroke, Acute; Ischemic Stroke; Hemorrhage; Clot (Blood); Brain; Subarachnoid Hemorrhage; Cerebral Infarction; Cerebral Hemorrhage; Cerebral Stroke; Intracerebral Hemorrhage; Intracerebral Injury

  4. Acute Heart Failure and a Pseudo Cystic Image in the Left Ventricle

    PubMed Central

    RIMBAS, Roxana C.; VINEREANU, Dragos

    2014-01-01

    The association between acute heart failure (AHF) and cardiac tumor may change the short and long term management of both conditions. A 51-year-old man presented with signs of AHF. ECG showed sinus tachycardia and left ventricular (LV) hypertrophy. Chest x-Ray found dilated heart and pulmonary congestion. There were no significant changes in blood tests. Transthoracic echocardiography revealed chambers dilation, and LV ejection fraction (LVEF) of 17%. Unexpectedly, we found an apical 2/2 cm cystic image in the LV. This had a myocardium-like membrane, seen better in 3D echocardiography, suggestive for hydatic cyst. Cerebral, thoracic, and abdomino-pelvic CT scan showed no hydatic lesions. Anti-Echinococcus antibodies were negative. Initially the clinical challenge was the management of the tumor in a patient with AHF and dilated cardiomyopathy. He was treated for AHF and followed up for the cystic image. He exhibited significant improvement of the clinical status and LVEF (increased to 42 %), with important cardiac reverse remodeling. Surprisingly, the apical cystic image disappeared. However, we found a hypertrophic aberrant cordae from apex to mid-septum, in the same position as the previous image. Thus, we believe that this cordae, by important remodeling and torsion generated the cystic image. This case highlights the importance of serial 2D and 3D echo examinations in patients with severely remodeled LV, and also with tumoral images. PMID:25705277

  5. Brain Hemispheric Functions and the Native American.

    ERIC Educational Resources Information Center

    Ross, Allen Chuck

    1982-01-01

    Uses brain research conducted by Dr. Roger Sperry to show that traditional Native Americans are more dominant in right hemisphere thinking, setting them apart from a modern left hemisphere-oriented society (especially emphasized in schools). Describes some characteristics of Native American thinking that illustrate a right hemisphere orientation…

  6. Brain Hemispheric Functions and the Native American.

    ERIC Educational Resources Information Center

    Ross, Allen Chuck

    1982-01-01

    Uses brain research conducted by Dr. Roger Sperry to show that traditional Native Americans are more dominant in right hemisphere thinking, setting them apart from a modern left hemisphere-oriented society (especially emphasized in schools). Describes some characteristics of Native American thinking that illustrate a right hemisphere orientation…

  7. Emotional Television Scenes and Hemispheric Specialization.

    ERIC Educational Resources Information Center

    Reeves, Byron; And Others

    1989-01-01

    Examines hemispheric differences in cortical arousal as a function of positive and negative emotional television scenes. Finds that (1) the processing of emotional content is hemispherically asymmetric; and (2) negative material produced greater cortical arousal in the right hemisphere and positive material greater arousal in the left. (MS)

  8. Right Hemisphere Dominance in Visual Statistical Learning

    ERIC Educational Resources Information Center

    Roser, Matthew E.; Fiser, Jozsef; Aslin, Richard N.; Gazzaniga, Michael S.

    2011-01-01

    Several studies report a right hemisphere advantage for visuospatial integration and a left hemisphere advantage for inferring conceptual knowledge from patterns of covariation. The present study examined hemispheric asymmetry in the implicit learning of new visual feature combinations. A split-brain patient and normal control participants viewed…

  9. Right Hemisphere Dominance in Visual Statistical Learning

    ERIC Educational Resources Information Center

    Roser, Matthew E.; Fiser, Jozsef; Aslin, Richard N.; Gazzaniga, Michael S.

    2011-01-01

    Several studies report a right hemisphere advantage for visuospatial integration and a left hemisphere advantage for inferring conceptual knowledge from patterns of covariation. The present study examined hemispheric asymmetry in the implicit learning of new visual feature combinations. A split-brain patient and normal control participants viewed…

  10. Effect of acute sleep deprivation on left atrial mechanics assessed by three-dimensional echocardiography.

    PubMed

    Cincin, Altug; Sari, Ibrahim; Sunbul, Murat; Kepez, Alper; Oguz, Mustafa; Sert, Sena; Sahin, Anil; Ozben, Beste; Tigen, Kursat; Basaran, Yelda

    2016-03-01

    Although sleep deprivation (SD) affects cardiovascular system in many ways, physio-pathological changes in cardiac chamber volume and function have not been described well. The aim of the present study was to investigate the effect of SD on left atrial (LA) and ventricular function with three-dimensional (3D) echocardiography. Thirty-two healthy individuals (12 females, mean age 33.25 ± 8.18) were evaluated. Echocardiographic examination was performed once after a night of regular sleep and a night of sleep debt. Beside conventional parameters, 3D phasic volumes and function were measured using a commercially available 3D echocardiography system and offline analysis software. Mean sleep duration of the study group was 8.15 ± 2.19 h in the day of regular sleep and 2.56 ± 2.25 h in the day of sleep deprivation. There was a significant prolongation in deceleration time (180.83 ± 15.34 vs. 166.44 ± 26.12; p = 0.044) and increase in E/e' (6.95 ± 1.26 vs. 6.38 ± 0.85; p = 0.005). Among 3D measurements, the difference in left ventricular ejection fraction (EF), LA EF, LA reservoir function and LA active EF were not significant. Mean LA passive EF of the individuals was significantly lower after night shift (24.10 ± 7.66 vs. 31.49 ± 7.75; p = 0.006). Acute SD is associated with a reduction in LA passive emptying function in healthy adults. 3D-derived indices were sufficient to show subclinical diastolic dysfunction according to impairment in passive phase of LA ejection. Prospective large-scale studies are needed to enlighten this issue.

  11. The Mechanics of Left Ventricular Contraction in Acute Experimental Cardiac Failure*

    PubMed Central

    Ross, John; Covell, James W.; Sonnenblick, Edmund H.

    1967-01-01

    The effects of acute cardiac failure induced by pentobarbital or pronethalol on the basic mechanical properties of the intact left ventricle were examined in the dog, and the influence on auxotonic and isovolumic contractions of the increase in end-diastolic volume that usually accompanies cardiac failure was assessed. The right heart bypass preparation was employed, and isovolumic beats were induced by sudden balloon occlusion of the aortic root. The ventricular pressure-volume curve was determined directly, and the mechanical responses of the myocardial fibers and contractile elements were calculated. When end-diastolic pressure was held constant, failure reduced the extent of circumferential fiber shortening, and the tension-velocity relation calculated during isovolumic beats was always shifted, with reductions in both maximal velocity (average decrease 30%) and maximal developed tension (average 23%); in addition, during failure achievement of maximal contractile element velocity and maximal tension was delayed, whereas the total duration of contraction was always prolonged. Acetylstrophanthidin tended to reverse all of these changes. When end-diastolic volume was augmented during failure at a constant stroke volume, the extent of circumferential fiber shortening was reduced (3.82 cm to 2.02 cm), and during ejection the fiber and contractile element velocities were diminished at wall tensions comparable to control; maximal velocity and velocity at peak tension were also decreased. The tension-velocity relation during isovolumic beats was shifted by failure with consistent reductions in maximal shortening velocity, but changes in maximal tension were small. Maximal instantaneous power was always reduced by failure, and a striking alteration occurred in the relation between work expended in stretching the series elastic component and the external work; the former, “internal work,” increased by an average of 90%, the latter diminished by 11%, and the total

  12. Hemispheric Dominance of Native American Indian Students.

    ERIC Educational Resources Information Center

    Stellern, John; And Others

    1986-01-01

    Examines language and spatial lateralization of 49 elementary American Indian students using a cognitive-manual dual task model and psychoeducational assessment techniques. All students were found to be left-hemisphere dominant for language and some were lateralized to the left hemisphere for spatial function. Contradicts evidence of right-brain…

  13. Fantasy and the Brain's Right Hemisphere.

    ERIC Educational Resources Information Center

    Shuman, R. Baird

    While the left hemisphere of the brain is responsible for logical and verbal activity, the right brain is the center of much of human feeling and emotion. Its vision is holistic rather than segmented or compartmentalized. Although schools today are geared almost exclusively to training the brain's left hemisphere, fantasy literature can provide…

  14. IPOD Study: Management of Acute Left Colonic Diverticulitis in Italian Surgical Departments.

    PubMed

    Sartelli, Massimo; Binda, Gian Andrea; Brandara, Francesco; Borasi, Andrea; Feroci, Francesco; Vadalà, Salvatore; Labricciosa, Francesco M; Birindelli, Arianna; Luridiana, Gianluigi; Coccolini, Federico; Di Saverio, Salomone; Catena, Fausto; Ansaloni, Luca; Campanile, Fabio Cesare; Agresta, Ferdinando; Piazza, Diego

    2017-03-01

    In recent years, the emergency management of acute left colonic diverticulitis (ALCD) has evolved dramatically despite lack of strong evidence. As a consequence, management strategies are frequently guided by surgeon's personal preference, rather than by scientific evidence. The primary aim of IPOD study (Italian Prospective Observational Diverticulitis study) is to describe both the diagnostic and treatment profiles of patients with ALCD in the Italian surgical departments. IPOD study is a prospective observational study performed during a 6-month period (from April 1 2015 to September 1 2015) and including 89 Italian surgical departments. All consecutive patients with suspected clinical diagnosis of ALCD confirmed by imaging and seen by a surgeon were included in the study. The study was promoted by the Italian Society of Hospital Surgeons and the World Society of Emergency Surgery Italian chapter. Eleven hundred and twenty-five patients with a median age of 62 years [interquartile range (IQR), 51-74] were enrolled in the IPOD study. One thousand and fifty-four (93.7%) patients were hospitalized with a median duration of hospitalization of 7 days (IQR 5-10). Eight hundred and twenty-eight patients (73.6%) underwent medical treatment alone, 13 patients had percutaneous drainage (1.2%), and the other 284 (25.2%) patients underwent surgery as first treatment. Among 121 patients having diffuse peritonitis, 71 (58.7%) underwent Hartmann's resection. However, the Hartmann's resection was used even in patients with lower stages of ALCD (36/479; 7.5%) where other treatment options could be more adequate. The IPOD study demonstrates that in the Italian surgical departments treatment strategies for ALCD are often guided by the surgeon's personal preference.

  15. Females have greater left ventricular twist mechanics than males during acute reductions to preload.

    PubMed

    Williams, Alexandra M; Shave, Rob E; Stembridge, Mike; Eves, Neil D

    2016-07-01

    Compared to males, females have smaller left ventricular (LV) dimensions and volumes, higher ejection fractions (EF), and higher LV longitudinal and circumferential strain. LV twist mechanics determine ventricular function and are preload-dependent. Therefore, the sex differences in LV structure and myocardial function may result in different mechanics when preload is altered. This study investigated sex differences in LV mechanics during acute challenges to preload. With the use of conventional and speckle-tracking echocardiography, LV structure and function were assessed in 20 males (24 ± 6.2 yr) and 20 females (23 ± 3.1 yr) at baseline and during progressive levels of lower body negative pressure (LBNP). Fourteen participants (8 males, 6 females) were also assessed following a rapid infusion of saline. LV end-diastolic volume, end-systolic volume, stroke volume (SV), and EF were reduced in both groups during LBNP (P < 0.001). While males had greater absolute volumes (P < 0.001), there were no sex differences in allometrically scaled volumes at any stage. Sex differences were not detected at baseline in basal rotation, apical rotation, or twist. Apical rotation and twist increased in both groups (P < 0.001) with LBNP. At -60 mmHg, females had greater apical rotation (P = 0.009), twist (P = 0.008), and torsion (P = 0.002) and faster untwisting velocity (P = 0.02) than males. There were no differences in mechanics following saline infusion. Females have larger LV twist and a faster untwisting velocity than males during large reductions to preload, supporting that females have a greater reliance on LV twist mechanics to maintain SV during severe reductions to preload. Copyright © 2016 the American Physiological Society.

  16. Prognosis after acute coronary syndrome in relation with ventricular-arterial coupling and left ventricular strain.

    PubMed

    Milewska, Agata; Minczykowski, Andrzej; Krauze, Tomasz; Piskorski, Jarosław; Heathers, James; Szczepanik, Adam; Banaszak, Agnieszka; Guzik, Przemyslaw; Wykretowicz, Andrzej

    2016-10-01

    The value of modern non-invasive indices of the left ventricle (LV) and arterial system function, and their interaction for determining prognosis in contemporarily treated patients with acute coronary syndrome (ACS) is not well established. The study aimed to determine the association of ventricular-arterial (VA) coupling, LV global longitudinal peak systolic strain (GLPSS), global strain rate (GSR) and end-diastolic volume at end-diastolic pressure 30mmHg (V30) with long-term clinical outcomes in patients with ACS. Echocardiography was applied in 569 ACS patients followed up for >12months after hospitalization. Univariate Cox proportional hazard regression models adjusted to various clinical factors, including reduced LV ejection fraction <40%, were used to compare patients between the first and third tertiles of various indices of LV and arterial systems function and their interaction for the prediction of a combined end-point (defined as either stroke, myocardial infarction or death). Results are presented as hazard ratio (HR) with 95% confidence interval (CI). There were 57 clinical outcomes during a median follow-up of 625days. Increased VA coupling >1.68 (HR 2.4; 95% CI: 1.04-5.6); V30>107mL (HR 4.5; 95% CI: 1.9-10.6), GLPSS > -12.8% (HR 2.4; 95% CI: 1.02-5.7), GSR > -0.96 1/s (HR 3.8; 95% CI: 1.6-9.1) were robustly associated with increased hazard. With a sample of contemporarily treated ACS patients, abnormal values of non-invasive indices of LV function and their interaction with arterial system, predict adverse clinical outcomes, independently of LV ejection fraction. Copyright © 2016. Published by Elsevier Ireland Ltd.

  17. Left ventricular twist during dobutamine stress echocardiography after acute myocardial infarction: association with reverse remodeling.

    PubMed

    Joyce, Emer; Leong, Darryl P; Hoogslag, Georgette E; van Herck, Paul L; Debonnaire, Philippe; Abate, Elena; Holman, Eduard R; Schalij, Martin J; Bax, Jeroen J; Delgado, Victoria; Marsan, Nina Ajmone

    2014-02-01

    Left ventricular (LV) twist is emerging as a marker of global LV contractility after acute myocardial infarction (AMI). This study aimed to describe stress-induced changes in LV twist during dobutamine stress echocardiography (DSE) after AMI and investigate their association with LV reverse remodeling at 6 months follow-up. In 82 consecutive first AMI patients (61 ± 12 years, 85 % male) treated with primary percutaneous coronary intervention, DSE was performed at 3 months follow-up. Two-dimensional speckle-tracking-derived apical and basal rotation and LV twist were calculated at rest, low- and peak-dose stages. LV reverse remodeling was defined as ≥10 % decrease in LV end-systolic volume between baseline and 6 months follow-up. Patterns of LV twist response on DSE consisted of either a progressive increase throughout each stage (n = 18), an increase at either low- or peak-dose (n = 53) or no significant increase (n = 11). LV reverse remodeling occurred in 28 (34 %) patients, who showed significantly higher peak-dose LV twist (8.51° vs. 6.69°, p = 0.03) and more frequently progressive LV twist increase from rest to peak-dose (39 vs. 13 %, p < 0.01) compared to patients without reverse remodeling. Furthermore, increase in LV twist from rest to peak-dose was the only independent predictor of LV reverse remodeling at 6 months follow-up (OR 1.3, 95 % CI 1.1-1.5, p = 0.005). Both the pattern of progressive increase in LV twist and the stress-induced increment in LV twist on DSE are significantly associated with LV reverse remodeling at 6 month follow-up after AMI, suggesting its potential use as a novel marker of contractile reserve.

  18. Acute Left Arm Ischemia Associated with Floating Thrombus in the Proximal Descending Aorta: Combined Endovascular and Surgical Therapy

    SciTech Connect

    Fanelli, F.; Gazzetti, M.; Boatta, E.; Ruggiero, M.; Lucatelli, P.; Speziale, F.

    2011-02-15

    Free floating thrombus in the proximal descending aorta is an uncommon and dangerous condition that can be associated with acute peripheral embolization. The few cases described were solved with surgical and/or medical therapy. We report the case of a patient with acute left arm ischemia secondary to the presence of floating thrombus in the proximal descending aorta extending into the left subclavian artery, solved with combined endovascular and surgical therapy. Treatment was successfully performed with thrombembolectomy combined with temporary deployment, into the descending aorta, of a Wallstent in a 'basket-fashion' to avoid distal embolization secondary to thrombus fragmentation. At 1 year follow-up the patient remained symptom-free.

  19. Repaired left ventricular free wall rupture after acute myocardial infarction by percutaneous intrapericardial fibrin-glue injection therapy.

    PubMed

    Okonogi, Taichi; Otsuka, Yoritaka; Saito, Taro

    2013-09-01

    Left ventricular free wall rupture is a rare, but occasionally lethal, complication after acute myocardial infarction (AMI). This case report describes a patient who presented with cardiogenic shock due to oozing-type rupture secondary to AMI and successfully underwent percutaneous intrapericardial fibrin-glue injection therapy. Cardiac magnetic resonance imaging demonstrated the thin layer of fibrin that covered the ruptured infarct myocardium immediately after fibrin-glue injection and its disappearance without any complications at 6 months.

  20. Left ventricular rotation and right-left ventricular interaction in congenital heart disease: the acute effects of interventional closure of patent arterial ducts and atrial septal defects.

    PubMed

    Laser, Kai T; Haas, Nikolaus A; Fischer, Markus; Habash, Sheeraz; Degener, Franziska; Prinz, Christian; Körperich, Hermann; Sandica, Eugen; Kececioglu, Deniz

    2014-08-01

    Left ventricular rotation is physiologically affected by acute changes in preload. We investigated the acute effect of preload changes in chronically underloaded and overloaded left ventricles in children with shunt lesions. A total of 15 patients with atrial septal defects (Group A: 7.4 ± 4.7 years, 11 females) and 14 patients with patent arterial ducts (Group B: 2.7 ± 3.1 years, 10 females) were investigated using 2D speckle-tracking echocardiography before and after interventional catheterisation. The rotational parameters of the patient group were compared with those of 29 matched healthy children (Group C). Maximal torsion (A: 2.45 ± 0.9°/cm versus C: 1.8 ± 0.8°/cm, p < 0.05), apical peak systolic rotation (A: 12.6 ± 5.7° versus C: 8.7 ± 3.5°, p < 0.05), and the peak diastolic torsion rate (A: -147 ± 48°/second versus C: -110 ± 31°/second, p < 0.05) were elevated in Group A and dropped immediately to normal values after intervention (maximal torsion 1.5 ± 1.1°/cm, p < 0.05, apical peak systolic rotation 7.2 ± 4.1°, p < 0.05, and peak diastolic torsion rate -106 ± 35°/second, p < 0.05). Patients in Group B had decreased maximal torsion (B: 1.8 ± 1.1°/cm versus C: 3.8 ± 1.4°/cm, p < 0.05) and apical peak systolic rotation (B: 8.3 ± 6.1° versus C: 13.9 ± 4.3°, p < 0.05). Defect closure was followed by an increase in maximal torsion (B: 2.7 ± 1.4°/cm, p < 0.05) and the peak diastolic torsion rate (B: -133 ± 66°/second versus -176 ± 84°/second, p < 0.05). Patients with chronically underloaded left ventricles compensate with an enhanced apical peak systolic rotation, maximal torsion, and quicker diastolic untwisting to facilitate diastolic filling. In patients with left ventricular dilatation by volume overload, the peak systolic apical rotation and the maximal torsion are decreased. After normalisation of the preload, they immediately return to normal and diastolic untwisting rebounds. These mechanisms are important for

  1. Right Hemisphere Brain Damage

    MedlinePlus

    ... Language and Swallowing / Disorders and Diseases Right Hemisphere Brain Damage [ en Español ] What is right hemisphere brain ... right hemisphere brain damage ? What is right hemisphere brain damage? Right hemisphere brain damage (RHD) is damage ...

  2. Alteration of Interictal Brain Activity in Patients with Temporal Lobe Epilepsy in the Left Dominant Hemisphere: A Resting-State MEG Study

    PubMed Central

    Zhu, Haitao; Zhu, Jinlong; Zhao, Tiezhu; Wu, Yong; Liu, Hongyi; Wu, Ting; Yang, Lu; Zou, Yuanjie; Zhang, Rui; Zheng, Gang

    2014-01-01

    Resting MEG activities were compared between patients with left temporal lobe epilepsy (LTLE) and normal controls. Using SAMg2, the activities of MEG data were reconstructed and normalized. Significantly elevated SAMg2 signals were found in LTLE patients in the left temporal lobe and medial structures. Marked decreases of SAMg2 signals were found in the wide extratemporal lobe regions, such as the bilateral visual cortex. The study also demonstrated a positive correlation between the seizure frequency and brain activities of the abnormal regions after the multiple linear regression analysis. These results suggested that the aberrant brain activities not only were related to the epileptogenic zones, but also existed in other extratemporal regions in patients with LTLE. The activities of the aberrant regions could be further damaged with the increase of the seizure frequency. Our findings indicated that LTLE could be a multifocal disease, including complex epileptic networks and brain dysfunction networks. PMID:25136558

  3. Acute changes of left ventricular hemodynamics and function during percutaneous coronary intervention in patients with unprotected left main coronary artery disease.

    PubMed

    Park, Seong-Mi; Ahn, Chul-Min; Hong, Soon-Jun; Kim, Yong-Hyun; Park, Jae-Hyoung; Shim, Wan-Joo; Lim, Do-Sun

    2015-07-01

    Percutaneous coronary interventions (PCIs) are increasingly being used to treat unprotected left main coronary artery (ULMCA) lesions. However, research is sparse on the acute changes of left ventricular (LV) hemodynamics and function during PCI in patients with ULMCA stenosis. We aimed to assess the acute changes of LV function using speckle-tracking imaging during PCI in these patients. Fifteen consecutive patients who underwent elective PCI for ULMCA stenosis were enrolled. Echocardiographic studies and pressure measurement were performed at baseline, during PCI and after PCI. LMCA occlusion with a first balloon inflation induced a marked reduction in the peak positive derivative of LV pressure (dP/dt max), LV global longitudinal strain (GLS), and systolic and diastolic strain rates, and a marked increase in LV end-diastolic pressure (EDP) (all P < 0.01). During the second inflation, the degrees of LV hemodynamic and functional changes were similar to those of the first inflation, even with a higher inflation pressure. During the third inflation, the values of GLS and dP/dt max were higher than those of the second inflation (P = 0.03 and P = 0.05, respectively). After optimal PCI, dP/dt max, LVEDP, and strain parameters were improved to baseline values. LV hemodynamics and function were considerably impaired with the first ballooning during PCI for ULMCA stenosis. However, the degrees of LV hemodynamic and functional changes decreased with each successive balloon inflation, which can be explained by ischemic preconditioning. After all procedures were safely completed, LV systolic function was improved without LV diastolic stunning.

  4. Emergency Stenting of Unprotected Left Main Coronary Artery after Acute Catheter-Induced Occlusive Dissection

    PubMed Central

    Akgul, Ferit; Batyraliev, Talantbek; Besnili, Fikret; Karben, Zarema

    2006-01-01

    Left main coronary artery dissection occurs very rarely during selective coronary angiography, but it generally progresses to complete coronary occlusion. The traditional treatment of occlusive dissection of the unprotected left main coronary artery has been surgical. Percutaneous treatment has been sporadic and controversial. We report a case of iatrogenic occlusive dissection of the unprotected left main coronary artery during diagnostic coronary angiography, followed by successful stenting of the lesion. PMID:17215985

  5. Acute Fulminant Myocarditis Successfully Bridged to Recovery with Left Ventricular Assist Device and Complicated by Flail Mitral Valve

    PubMed Central

    Duyuler, Pınar Türker; Duyuler, Serkan; Şahan, Ekrem; Küçüker, Şeref Alp

    2016-01-01

    Acute fulminant myocarditis is a life-threatening inflammatory disease of the myocardium characterized by the rapid deterioration of the hemodynamic status of the affected individual. With prompt recognition and appropriate management, complete recovery of ventricular function is likely within a few weeks. We introduce a 28-year-old man with acute fulminant myocarditis, who experienced circulatory collapse following acute angina and dyspnea. The patient had high troponin levels with low ejection fraction and normal coronary arteries. He was successfully bridged to recovery with a left ventricular assist device but was complicated by flail mitral valve. Perioperative myocardial biopsy was also compatible with myocarditis. At 4 months’ follow-up, the patient was stable with functional capacity I according to the New York Heart Association’s classification. A possible mechanism for this very rare complication is the rupture of the chordal structure secondary to the fragility of an inflamed subvalvular apparatus stretched by a recovered ventricle. PMID:27403189

  6. Two-Dimensional Speckle Tracking Echocardiography Predict Left Ventricular Remodeling after Acute Myocardial Infarction in Patients with Preserved Ejection Fraction

    PubMed Central

    Hsiao, Ju-Feng; Chung, Chang-Min; Chu, Chi-Ming; Lin, Yu-Shen; Pan, Kuo-Li; Chang, Shih-Tai

    2016-01-01

    Objectives Left ventricular remodeling after acute myocardial infarction increases cardiovascular events and mortality. But few study was done in patients with preserved ejection fraction (EF > 40%). We investigate whether the strain and strain rate by 2D speckle tracking echocardiography could predict left ventricular remodeling after acute myocardial infarction in this cohort. Methods The 83 patients (average age 60.7 ± 12.3 y, 75 [90.4%] male) with new-onset acute myocardial infarction receiving echocardiography immediately, and 6 months after admission were grouped by the presence or absence of left ventricular remodeling. Strain and strain rate including longitudinal, circumferential, and radial direction were calculated. The average of strain and strain rate of which segmental longitudinal strains > – 15% were defined as the injury longitudinal strain (InjLS). Results Left ventricular remodeling occurred in 24 of 83 patients (28.9%). In univariate logistic regression analyses, gender, peak CK-MB, log BNP, use of statin before discharge, wall motion score index, and InjLS were significantly associated with left ventricular remodeling (p < 0.05). In multivariate analysis using the forward stepwise method, gender, CK-MB, and InjLS were independent predictors. The hazard ratio for InjLS was 1.48 (p = 0.04). Receiver operating characteristic curve (ROC) analyses showed the area under the curve (AUC) of InjLS was largest (AUC = 0.75, cut-off value = –11.7%, sensitivity = 81%, specificity = 71%, p < 0.01). In ST-segment elevation myocardial infarction subgroup, InjLS was the only predictor according to ROC analysis (AUC = 0.79, p < 0.01, cut-off value = –11.4%, sensitivity = 88%, specificity = 77%) and multivariate logistic regression analysis (hazard ratio = 1.88, 95% CI: 1.22–2.88, p < 0.01). Conclusions InjLS was an excellent predictor for left ventricular remodeling after acute myocardial infarction in patient with preserved ejection fraction. PMID

  7. Hemispheric Amphigory.

    ERIC Educational Resources Information Center

    Youngblood, Michael

    1981-01-01

    Reviewing some empirical studies on brain hemisphere functions, the author concludes that though the brain is lateralized for specific tasks, this fact has no necessary bearing on educational methodology. He asserts that we do not yet know enough to label and teach art as a "right brain" activity. (Author/SJL)

  8. Cardiac MRI documented left ventricular thrombus complicating acute Takotsubo syndrome: an uncommon dilemma.

    PubMed

    Singh, Veerpal; Mayer, Tom; Salanitri, John; Salinger, Michael H

    2007-10-01

    Transient left ventricular apical hypokinesis results in a typical ampullary shape and has been described as Takotsubo cardiomyopathy (TCM). We report a case of TCM with the rare complication of left ventricular thrombus formation. Cardiac magnetic resonance imaging aided the diagnosis by characterizing the non-enhancing mass and evaluating the surrounding myocardium for scarring.

  9. Music Appreciation and Hemisphere Orientation: Visual versus Verbal Involvement.

    ERIC Educational Resources Information Center

    Zalanowski, Annette H.

    1990-01-01

    Analyzes effect of brain hemisphere orientation on music appreciation. Reports results from 36 left-hemisphere and 36 right-hemisphere undergraduates who responded to a musical selection verbally or visually. Finds right-hemisphere students show greater appreciation, measured by attention, understanding, and enjoyment scores. Discusses…

  10. Music Appreciation and Hemisphere Orientation: Visual versus Verbal Involvement.

    ERIC Educational Resources Information Center

    Zalanowski, Annette H.

    1990-01-01

    Analyzes effect of brain hemisphere orientation on music appreciation. Reports results from 36 left-hemisphere and 36 right-hemisphere undergraduates who responded to a musical selection verbally or visually. Finds right-hemisphere students show greater appreciation, measured by attention, understanding, and enjoyment scores. Discusses…

  11. Hemispheric Specialization and Cognitive Development: Implications for Mathematics Education

    ERIC Educational Resources Information Center

    Wheatley, Grayson, H.; And Others

    1978-01-01

    Evidence is presented for the theory that the two brain hemispheres process stimuli differently: the left hemisphere is specialized for logico-analytic tasks and the right hemisphere for visuo-spatial tasks. They contend that cognitive ability is related to the development of hemispheric asymmetry and present implications for mathematics education…

  12. Fast left prefrontal rTMS acutely suppresses analgesic effects of perceived controllability on the emotional component of pain experience.

    PubMed

    Borckardt, Jeffrey J; Reeves, Scott T; Frohman, Heather; Madan, Alok; Jensen, Mark P; Patterson, David; Barth, Kelly; Smith, A Richard; Gracely, Richard; George, Mark S

    2011-01-01

    The prefrontal cortex may be a promising target for transcranial magnetic stimulation (TMS) in the management of pain. It is not clear how prefrontal TMS affects pain perception, but previous findings suggest that ventral lateral and medial prefrontal circuits may comprise an important part of a circuit of perceived controllability regarding pain, stress, and learned helplessness. Although the left dorsolateral prefrontal cortex is a common TMS target for treating clinical depression as well as modulating pain, little is known about whether TMS over this area may affect perceived controllability. The present study explored the immediate effects of fast TMS over the left dorsolateral prefrontal cortex on the analgesic effects of perceived pain controllability. Twenty-four healthy volunteers underwent a laboratory pain task designed to manipulate perception of pain controllability. Real TMS, compared with sham, suppressed the analgesic benefits of perceived control on the emotional dimension of pain, but not the sensory/discriminatory dimension. Findings suggest that, at least acutely, fast TMS over the left dorsolateral prefrontal cortex may interrupt the perceived-controllability effect on the emotional dimension of pain experience. Although it is not clear whether this cortical area is directly involved with modulating perceived controllability or whether downstream effects are responsible for the present findings, it appears possible that left dorsolateral prefrontal TMS may produce analgesic effects by acting through a cortical perceived-control circuit regulating limbic and brainstem areas of the pain circuit. Despite evidence that prefrontal TMS can have analgesic effects, fast left prefrontal TMS appears to acutely suppress analgesia associated with perceived-control. This effect may be limited to the emotional dimension of pain experience. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  13. Flexible Contrast Gain Control in the Right Hemisphere

    ERIC Educational Resources Information Center

    Okubo, Matia; Nicholls, Michael E. R.

    2005-01-01

    This study investigates whether the right hemisphere has more flexible contrast gain control settings for the identification of spatial frequency. Right-handed participants identified 1 and 9 cycles per degree sinusoidal gratings presented either to the left visual field-right hemisphere (LVF-RH) or the right visual field-left hemisphere (RVF-LH).…

  14. Cognitive Correlates of Hemispheric Performance on Dichotic Tasks.

    ERIC Educational Resources Information Center

    Johnson, Ronald C.; And Others

    1984-01-01

    Examined the relationship between performance on left and right hemisphere dominant measures of cognition and performance on dichotic memory tasks in 53 adults age 50 and older. Right hemisphere performance on dichotic and cognitive tasks showed a negative association with age while left hemisphere performance showed no decline. (JAC)

  15. Flexible Contrast Gain Control in the Right Hemisphere

    ERIC Educational Resources Information Center

    Okubo, Matia; Nicholls, Michael E. R.

    2005-01-01

    This study investigates whether the right hemisphere has more flexible contrast gain control settings for the identification of spatial frequency. Right-handed participants identified 1 and 9 cycles per degree sinusoidal gratings presented either to the left visual field-right hemisphere (LVF-RH) or the right visual field-left hemisphere (RVF-LH).…

  16. Silent left ventricular dysfunction during routine activity after thrombolytic therapy for acute myocardial infarction

    SciTech Connect

    Kayden, D.S.; Wackers, F.J.; Zaret, B.L. )

    1990-06-01

    To investigate prospectively the occurrence and significance of postinfarction transient left ventricular dysfunction, 33 ambulatory patients who underwent thrombolytic therapy after myocardial infarction were monitored continuously for 187 +/- 56 min during normal activity with a radionuclide left ventricular function detector at the time of hospital discharge. Twelve patients demonstrated 19 episodes of transient left ventricular dysfunction (greater than 0.05 decrease in ejection fraction, lasting greater than or equal to 1 min), with no change in heart rate. Only two episodes in one patient were associated with chest pain and electrocardiographic changes. The baseline ejection fraction was 0.52 +/- 0.12 in patients with transient left ventricular dysfunction and 0.51 +/- 0.13 in patients without dysfunction (p = NS). At follow-up study (19.2 +/- 5.4 months), cardiac events (unstable angina, myocardial infarction or death) occurred in 8 of 12 patients with but in only 3 of 21 patients without transient left ventricular dysfunction (p less than 0.01). During submaximal supine bicycle exercise, only two patients demonstrated a decrease in ejection fraction greater than or equal to 0.05 at peak exercise; neither had a subsequent cardiac event. These data suggest that transient episodes of silent left ventricular dysfunction at hospital discharge in patients treated with thrombolysis after myocardial infarction are common and associated with a poor outcome. Continuous left ventricular function monitoring during normal activity may provide prognostic information not available from submaximal exercise test results.

  17. Hemispheric lateralization in reasoning.

    PubMed

    Turner, Benjamin O; Marinsek, Nicole; Ryhal, Emily; Miller, Michael B

    2015-11-01

    A growing body of evidence suggests that reasoning in humans relies on a number of related processes whose neural loci are largely lateralized to one hemisphere or the other. A recent review of this evidence concluded that the patterns of lateralization observed are organized according to two complementary tendencies. The left hemisphere attempts to reduce uncertainty by drawing inferences or creating explanations, even at the cost of ignoring conflicting evidence or generating implausible explanations. Conversely, the right hemisphere aims to reduce conflict by rejecting or refining explanations that are no longer tenable in the face of new evidence. In healthy adults, the hemispheres work together to achieve a balance between certainty and consistency, and a wealth of neuropsychological research supports the notion that upsetting this balance results in various failures in reasoning, including delusions. However, support for this model from the neuroimaging literature is mixed. Here, we examine the evidence for this framework from multiple research domains, including an activation likelihood estimation analysis of functional magnetic resonance imaging studies of reasoning. Our results suggest a need to either revise this model as it applies to healthy adults or to develop better tools for assessing lateralization in these individuals.

  18. [Infarct size and left ventricular function in patients after thrombolytic therapy of acute myocardial infarct].

    PubMed

    Sochman, J; Málek, I; Ouhrabková, R; Englis, M; Fabián, J

    1989-06-01

    The authors give an account of factors which influence left ventricular function after thrombolytic treatment of an occluded coronary artery. They found that improvement of left ventricular function following a three-week interval after recanalization of the artery the occlusion of which led to myocardial infarction, depends on the size of the necrotic focus. Improvement of global left ventricular function and above all of the regional function of the infarction segment can be expected if the size of the focus is such that less than 40 gram-equivalent of total creatine kinase are liberated from it.

  19. Berberine attenuates adverse left ventricular remodeling and cardiac dysfunction after acute myocardial infarction in rats: role of autophagy.

    PubMed

    Zhang, Yao-Jun; Yang, Shao-Hua; Li, Ming-Hui; Iqbal, Javaid; Bourantas, Christos V; Mi, Qiong-Yu; Yu, Yi-Hui; Li, Jing-Jing; Zhao, Shu-Li; Tian, Nai-Liang; Chen, Shao-Liang

    2014-12-01

    The present study aimed to test the hypothesis that berberine, a plant-derived anti-oxidant, attenuates adverse left ventricular remodelling and improves cardiac function in a rat model of myocardial infarction (MI). Furthermore, the potential mechanisms that mediated the cardioprotective actions of berberine, in particular the effect on autophagy, were also investigated. Acute MI was induced by ligating the left anterior descending coronary artery of Sprague-Dawley rats. Cardiac function was assessed by transthoracic echocardiography. The protein activity/levels of autophagy related to signalling pathways (e.g. LC-3B, Beclin-1) were measured in myocardial tissue by immunohistochemical staining and western blot. Four weeks after MI, berberine significantly prevented cardiac dysfunction and adverse cardiac remodelling. MI rats treated with low dose berberine (10 mg/kg per day) showed higher left ventricular ejection fraction and fractional shortening than those treated with high-dose berberine (50 mg/kg per day). Both doses reduced interstitial fibrosis and post-MI adverse cardiac remodelling. The cardioprotective action of berberine was associated with increased LC-3B II and Beclin-1 expressions. Furthermore, cardioprotection with berberine was potentially related to p38 MAPK inhibition and phospho-Akt activation. The present in vivo study showed that berberine is effective in promoting autophagy, and subsequently attenuating left ventricular remodelling and cardiac dysfunction after MI. The potential underlying mechanism is augmentation of autophagy through inhibition of p38 MAPK and activation of phospho-Akt signalling pathways.

  20. [Acute stent thrombosis and reverse transient left ventricular dilatation after performing a single-photon emission computed tomography myocardial perfusion].

    PubMed

    Miranda, B; Pizzi, M N; Aguadé-Bruix, S; Domingo, E; Candell-Riera, J

    2015-01-01

    A 63-year-old male patient with a history of stent implantation in the left anterior descending three months before. Due to the presentation of vegetative symptoms, he was referred for gated-SPECT myocardial perfusion. During acquisition of the resting images he presented chest pain and ST segment elevation, so that urgent cardiac catheterization was performed, showing stent thrombosis. Rest perfusion imaging showed a defect in anterior and apical perfusion, more severe and extensive than in the stress images, with striking left ventricular dilatation and a fall in the ejection fraction related to the acute ischemia phenomenon. Intense exercise is associated with a transient activation of the coagulation system and hemodynamic changes that might induce thrombosis, especially in recently implanted coronary stents that probably still have not become completely endothelialized. Copyright © 2014 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  1. Acute sleep deprivation in healthy adults is associated with a reduction in left atrial early diastolic strain rate.

    PubMed

    Açar, Göksel; Akçakoyun, Mustafa; Sari, Ibrahim; Bulut, Mustafa; Alizade, Elnur; Özkan, Birol; Yazicioğlu, Mehmet Vefik; Alici, Gökhan; Avci, Anil; Kargin, Ramazan; Esen, Ali Metin

    2013-09-01

    Sleep deprivation (SD) is known to be associated with adverse cardiovascular events. Strain and strain rate measure the local deformation of the myocardium and have been used to evaluate atrial phasic function in various disease states. The aim of the study was to investigate whether strain rate imaging enables the identification of left atrial dysfunction in otherwise healthy young adults with acute SD which has not been studied previously. Adequate echocardiographic images of 27 healthy volunteers were obtained both after a night with regular sleep and after a night with SD. Tissue Doppler-derived strain and strain rate were measured from the apical four- and two-chamber views of the left atrium, and global values were calculated as the mean of all segments. Measurements included peak systolic strain, systolic strain rate (S-Sr), early diastolic (E-Sr) and late diastolic (A-Sr) strain rate. Phasic left atrial (LA) volumes and fractions were also calculated. There was no significant difference in the traditional parameters of atrial function and LA volumes. Subjects had similar S-Sr, A-Sr and global atrial strain values after the night of sleep debt when compared after regular sleep, whereas they had significantly reduced E-Sr values (mean (SD) 3.2 (0.7) s(-1) vs 3.7 (0.6) s(-1), p < 0.001). Moreover, global E-Sr showed a significant correlation with sleep time (r = 0.554, p < 0.001). Acute SD in healthy adults is associated with a reduction in LA early diastolic strain rate in the absence of geometric alterations or functional impairment of the left atrium, raising the possibility that chronic SD may more profoundly affect LA function and thereby promote the occurrence of atrial fibrillation.

  2. Hemisphericity and Journalism--How Do Journalists Think?

    ERIC Educational Resources Information Center

    Vannatta, Bonnie Ann

    1981-01-01

    Reports on a study finding that journalists preferred a right brain hemisphere or integrated style of information processing. Proposes the further application of right-left brain hemisphere research in the field of journalism. (RL)

  3. Endovascular Mechanical Thrombectomy of an Occluded Superior Division Branch of the Left MCA for Acute Cardioembolic Stroke

    SciTech Connect

    Schumacher, H. C. Meyers, P. M.; Yavagal, D. R.; Harel, N. Y.; Elkind, M. S. V.; Mohr, J. P.; Pile-Spellman, J.

    2003-06-15

    Cardiac embolism accounts for a large proportion of ischemic stroke. Revascularization using systemic or intra-arterial thrombolysis is associated with increasing risks of cerebral hemorrhageas time passes from stroke onset. We report successful mechanicalthrombectomy from a distal branch of the middle cerebral artery (MCA)using a novel technique. A 72-year old man suffered an acute ischemic stroke from an echocardiographically proven ventricular thrombus due toa recent myocardial infarction. Intra-arterial administration of 4 mgrt-PA initiated at 5.7 hours post-ictus failed to recanalize an occluded superior division branch of the left MCA. At 6 hours,symptomatic embolic occlusion persisted. Mechanical extraction of the clot using an Attracter-18 device (Target Therapeutics, Freemont, CA) resulted in immediate recanalization of the MCA branch. Attracter-18 for acute occlusion of MCA branches may be considered in selected patients who fail conventional thrombolysis or are nearing closure of the therapeutic window for use of thrombolytic agents.

  4. Endovascular mechanical thrombectomy of an occluded superior division branch of the left MCA for acute cardioembolic stroke.

    PubMed

    Schumacher, H C; Meyers, P M; Yavagal, D R; Harel, N Y; Elkind, M S V; Mohr, J P; Pile-Spellman, J

    2003-01-01

    Cardiac embolism accounts for a large proportion of ischemic stroke. Revascularization using systemic or intra-arterial thrombolysis is associated with increasing risks of cerebral hemorrhage as time passes from stroke onset. We report successful mechanical thrombectomy from a distal branch of the middle cerebral artery (MCA) using a novel technique. A 72-year old man suffered an acute ischemic stroke from an echocardiographically proven ventricular thrombus due to a recent myocardial infarction. Intraarterial administration of 4 mg rt-PA initiated at 5.7 hours post-ictus failed to recanalize an occluded superior division branch of the left MCA. At 6 hours, symptomatic embolic occlusion persisted. Mechanical extraction of the clot using an Attracter-18 device (Target Therapeutics, Freemont, CA) resulted in immediate recanalization of the MCA branch. Attracter-18 for acute occlusion of MCA branches may be considered in selected patients who fail conventional thrombolysis or are nearing closure of the therapeutic window for use of thrombolytic agents.

  5. Neglect severity after left and right brain damage.

    PubMed

    Suchan, Julia; Rorden, Chris; Karnath, Hans-Otto

    2012-05-01

    While unilateral spatial neglect after left brain damage is undoubtedly less common than spatial neglect after a right hemisphere lesion, it is also assumed to be less severe. Here we directly test this latter hypothesis using a continuous measure of neglect severity: the so-called Center of Cancellation (CoC). Rorden and Karnath (2010) recently validated this index for right brain damaged neglect patients. A first aim of the present study was to evaluate this new measure for spatial neglect after left brain damage. In a group of 48 left-sided stroke patients with and without neglect, a score greater than -0.086 on the Bells Test and greater than -0.024 on the Letter Cancellation Task turned out to indicate neglect behavior for acute left brain damaged patients. A second aim was to directly compare the severity of spatial neglect after left versus right brain injury by using the new CoC measure. While neglect is less frequent following left than right hemisphere injury, we found that when this symptom occurs it is of similar severity in acute left brain injury as in patients after acute right brain injury.

  6. Acute left-sided colonic diverticulitis: clinical expressions, therapeutic insights, and role of computed tomography

    PubMed Central

    Ambrosetti, Patrick

    2016-01-01

    The diagnostic approach of patients with suspected acute diverticulitis remains debated. On the one hand, a scoring system with the best predictive value in diagnosing acute diverticulitis has been developed in order to reduce the use of computed tomography (CT) scan, while, on the other hand, patients with a high probability of acute diverticulitis should benefit from CT scan from a clinical viewpoint, ensuring that they will receive the most appropriate treatment. The place and classification of CT scan for acute diverticulitis need to be reassessed. If the management of uncomplicated acute diverticulitis, abscess, and fecal peritonitis is now well codified, urgent surgical or medical treatment of hemodynamically stable patients presenting with intraperitoneal air or fluid without uncontrolled sepsis is still under discussion. Furthermore, the indications for laparoscopic lavage are not yet well established. It is known for years that episode(s) of acute uncomplicated diverticulitis may induce painful recurrent bowel symptoms, known as symptomatic uncomplicated diverticular disease and irritable bowel syndrome-like diverticular disease. These two clinical expressions of diverticular disease, that may darken quality of life, are treated medically aimed at symptom relief. The possible place of surgery should be discussed. Clinical and CT scan classifications should be separated entities. PMID:27574459

  7. Cerebrolysin adjuvant treatment in Broca's aphasics following first acute ischemic stroke of the left middle cerebral artery

    PubMed Central

    Muresanu, DF; Bajenaru, O; Popescu, BO; Deme, SM; Moessler, H; Meinzingen, SZ; Petrica, L; Serpe, M; Ursoniu, S

    2010-01-01

    Background: The aim of our study was to assess the efficacy of Cerebrolysin administration in Broca's aphasics with acute ischemic stroke. Methods: We registered 2,212 consecutive Broca's aphasics following an acute ischemic stroke admitted in four departments of neurology in Romania, between September 2005 and September 2009. Language was evaluated with the Romanian version of the Western Aphasia Battery (WAB). The following inclusion criteria were used for this study: age 20%75 years, admission in the hospital within 12 hours from the onset of the symptoms, diagnosis of first acute left middle cerebral artery (MCA) ischemic stroke, presence of large artery disease (LAD) stroke, a NIHSS score of 5%22 points, and a therapeutic time window within 72 h. Fifty two patients were treated with Cerebrolysin (Cerebrolysin group) as an adjunctive treatment. A placebo group, which received saline infusions (n=104 patients) were matched to the NIHSS and WAB scores, gender and age of the Cerebrolysin group at baseline. We assessed spontaneous speech (SS), comprehension (C), repetition (R), naming (N), and Aphasia Quotient (AQ) scores of the two groups in an open label design, over 90 days, the mRS scores and mortality. Results: The Cerebrolysin and the placebo groups had similar age (66+/%8 versus 65+/%8 years) and sex ratio (14/38 versus 30/74). The mean AQ scores and the mean subscores for 3 subtests of WAB (SS, R, N) were similar at baseline and improved in the Cerebrolysin group significantly (p<0.05) over placebo group at all study time points. The mRS score at 90 days was also lower in the Cerebrolysin group than in the placebo group. Cerebrolysin and placebo were both tolerated and safe, and no difference in the mortality rate was seen (3.8% in each group). Conclusion: Cerebrolysin is effective for the treatment of Broca's aphasics with a first acute ischemic stroke of the left MCA territory. PMID:20945821

  8. Primary percutaneous coronary intervention for acute myocardial infarction secondary to acute left main coronary occlusion in an institution without on-site cardiothoracic surgical support.

    PubMed

    Chia, Pow-Li; Khoo, Brian-Chung-Hoe; Ng, Chee-Keong; Lim, Jimmy-Tien-Wei

    2009-03-01

    There is no consensus on the optimal management of acute myocardial infarction due to acute left main coronary occlusion (LMCO). We evaluated the feasibility of primary percutaneous coronary intervention (PCI) for acute LMCO in an institution without on-site cardiothoracic surgical (CTS) support. We retrospectively identified 20 patients, median age 67 years (range 38 to 81). Sixteen patients presented with cardiogenic shock. All patients required intra-aortic balloon pump counterpulsation and inotropic support. Sixteen patients underwent stenting and four had balloon angioplasty only. Thrombolysis In Myocardial Infarction 3 flow was restored in 13 patients. Post-PCI, six patients were transferred to a tertiary institution for further care: three underwent extracorporeal membrane oxygenation (ECMO), one underwent both ECMO and coronary artery bypass grafting (CABG), one died before ECMO initiation and one stabilised without further intervention. Thirteen patients died in-hospital. There was one subsequent death out of the seven hospital survivors, with median follow-up 390 days (range 60 to 660 days). There was a trend towards survival with a shorter door-to-balloon time (p = 0.07). Primary PCI may be a feasible initial revascularisation strategy for acute LMCO in centres without on-site CTS support.

  9. Right hand predominant constructional apraxia due to right hemisphere infarction without corpus callosum lesions.

    PubMed

    Kobayashi, Zen; Watanabe, Mayumi; Karibe, Yuri; Nakazawa, Chika; Numasawa, Yoshiyuki; Tomimitsu, Hiroyuki; Shintani, Shuzo

    2014-01-01

    A 74-year-old right-handed woman without cognitive impairment suddenly developed nonfluent aphasia. Brain MRI showed acute infarction in the right frontal lobe and insula without involvement of the corpus callosum. A neurological examination demonstrated not only transcortical motor aphasia, but also ideomotor apraxia and right hand predominant constructional apraxia (CA). To date, right hand predominant CA has only been reported in patients with corpus callosum lesions. The right hand predominant CA observed in our patient may be associated with the failure to transfer information on the spatial structure from the right hemisphere to the motor cortex of the left hemisphere.

  10. Right hemisphere dominance in visual statistical learning.

    PubMed

    Roser, Matthew E; Fiser, József; Aslin, Richard N; Gazzaniga, Michael S

    2011-05-01

    Several studies report a right hemisphere advantage for visuospatial integration and a left hemisphere advantage for inferring conceptual knowledge from patterns of covariation. The present study examined hemispheric asymmetry in the implicit learning of new visual feature combinations. A split-brain patient and normal control participants viewed multishape scenes presented in either the right or the left visual fields. Unbeknownst to the participants, the scenes were composed from a random combination of fixed pairs of shapes. Subsequent testing found that control participants could discriminate fixed-pair shapes from randomly combined shapes when presented in either visual field. The split-brain patient performed at chance except when both the practice and the test displays were presented in the left visual field (right hemisphere). These results suggest that the statistical learning of new visual features is dominated by visuospatial processing in the right hemisphere and provide a prediction about how fMRI activation patterns might change during unsupervised statistical learning.

  11. The Marc Dax (1770-1837)/Paul Broca (1824-1880) controversy over priority in science: left hemisphere specificity for seat of articulate language and for lesions that cause aphemia.

    PubMed

    Buckingham, Hugh W

    2006-01-01

    One of the most fascinating and frustrating issues in the priority of discovery in science is over just who, for the first time, went on record in the public forum, either orally at a conference or through a published communication, proclaiming that the faculty of articulate human speech was located in the left, not the right, cortical hemisphere. The disputed paper was purportedly written in 1836 by Marc Dax, who died subsequently in 1837. He was a physician in southern France in the city of Montpellier--far from the medical center of Paris. Little note was made of the presumed paper until the early and mid-1860s, when the issue of language localization in the human brain took on increased activity, as the clinico-pathological method of explanation continued to flourish in the "Art of Physick." Marc Dax's son, Gustave, happened to be studying medicine in Paris in the 1860s, and, as most of the neuroscientific and anthropological researchers, came to know of Broca's published work, which in 1861, agreed with phrenological theory that this faculty was, indeed, in the anterior lobes, but further claimed, de novo, that the region in the anterior lobe was more precisely focused at the foot of the 3rd frontal convolution in that lobe, still assuming with phrenological theory and the "Law of Symmetry" that the faculty was bilaterally located. It was not until 1865 that Broca clearly, non-hesitatingly, and unambiguously claimed that the faculty was in the left hemisphere. As it turned out, Gustave, six weeks before Broca's paper appeared, had published the paper he said his father had written in 1836. In 1863, in fact, Gustave had submitted his (Gustave's) long monograph on aphemia, integrating what he claimed to be his father's 1836 pronouncement along with his own data. He sent this communication to the French Academy of Sciences and to the French Academy of Medicine; he heard nothing back from either academy. After waiting two years, he managed to publish his material

  12. Traumatic mitral valve avulsion from the annulus fibrosis producing acute left heart failure in a dog.

    PubMed

    Miller, Lisa M; Keirstead, Natalie D; Snyder, Patti S

    2004-09-01

    Traumatic detachment of the mitral valve from the annulus fibrosis occurred in a dog following blunt chest trauma. Euthanasia was elected approximately 7 months posttrauma due to refractory, chronic left heart failure. This is the first reported case of traumatic mitral valve rupture in a dog.

  13. The influence of acute unloading on left ventricular strain and strain rate by speckle tracking echocardiography in a porcine model.

    PubMed

    Dahle, Geir Olav; Stangeland, Lodve; Moen, Christian Arvei; Salminen, Pirjo-Riitta; Haaverstad, Rune; Matre, Knut; Grong, Ketil

    2016-05-15

    Noninvasive measurements of myocardial strain and strain rate by speckle tracking echocardiography correlate to cardiac contractile state but also to load, which may weaken their value as indices of inotropy. In a porcine model, we investigated the influence of acute dynamic preload reductions on left ventricular strain and strain rate and their relation to the pressure-conductance catheter-derived preload recruitable stroke work (PRSW) and peak positive first derivative of left ventricular pressure (LV-dP/dtmax). Speckle tracking strain and strain rate in the longitudinal, circumferential, and radial directions were measured during acute dynamic reductions of end-diastolic volume during three different myocardial inotropic states. Both strain and strain rate were sensitive to unloading of the left ventricle (P < 0.001), but the load dependency for strain rate was modest compared with strain. Changes in longitudinal and circumferential strain correlated more strongly to changes in end-diastolic volume (r = -0.86 and r = -0.72) than did radial strain (r = 0.35). Longitudinal, circumferential, and radial strain significantly correlated with LV-dP/dtmax (r = -0.53, r = -0.46, and r = 0.86), whereas only radial strain correlated with PRSW (r = 0.55). Strain rate in the longitudinal, circumferential and radial direction significantly correlated with both PRSW (r = -0.64, r = -0.58, and r = 0.74) and LV-dP/dtmax (r = -0.95, r = -0.70, and r = 0.85). In conclusion, the speckle tracking echocardiography-derived strain rate is more robust to dynamic ventricular unloading than strain. Longitudinal and circumferential strain could not predict load-independent contractility. Strain rates, and especially in the radial direction, are good predictors of preload-independent inotropic markers derived from conductance catheter.

  14. Non-alcoholic fatty liver disease is associated with early left ventricular dysfunction in childhood acute lymphoblastic leukaemia survivors.

    PubMed

    Delvecchio, Maurizio; Muggeo, Paola; Monteduro, Mariantonietta; Lassandro, Giuseppe; Novielli, Chiara; Valente, Federica; Salinaro, Emanuela; Zito, Annapaola; Ciccone, Marco Matteo; Miniello, Vito Leonardo; Santoro, Nicola; Giordano, Paola; Faienza, Maria Felicia

    2017-02-01

    Childhood acute lymphoblastic leukaemia (ALL) survivors have an increased risk of metabolic and cardiovascular disease. We aimed to assess the presence of non-alcoholic fatty liver disease (NAFLD) in childhood ALL and if it is associated with early cardiovascular dysfunction. In total, 53 childhood ALL survivors and 34 controls underwent auxological evaluation, biochemical assay, liver, heart and vascular ultrasound study. NAFLD was more frequent in ALL patients than in controls (39.6% vs 11.7%, P < 0.01). Patients with NAFLD were more obese and insulin resistant than patients without NAFLD. Flow-mediated dilatation and interventricular septum were lower in the ALL group than those in the control group (P < 0.001 for both). The patients with NAFLD showed lower left ventricular ejection fraction than those without NAFLD (P = 0.011). In ALL survivors, BMI-SDS and subcutaneous fat were the strongest predictors of NAFLD, whereas preperitoneal adipose tissue and C-reactive protein were the strongest predictors of left ventricular ejection fraction. Childhood ALL survivors had higher prevalence of NAFLD than healthy controls, which is associated with early left ventricular impairment. In the case of fatty liver, a comprehensive heart evaluation is mandatory. We strongly recommend to prevent visceral adiposity in ALL survivors, to search for metabolic syndrome or its components and to reinforce the need of intervention on diet and lifestyle during the follow-up of these patients. © 2017 European Society of Endocrinology.

  15. Predictive value of indium-111 antimyosin uptake for improvement of left ventricular wall motion after thrombolysis in acute myocardial infarction

    SciTech Connect

    van Vlies, B.; Baas, J.; Visser, C.A.; van Royen, E.; Delemarre, B.J.; Bot, H.; Dunning, A.J.

    1989-07-15

    In 21 patients treated with thrombolysis for acute myocardial infarction (AMI), the degree of myocardial uptake of indium-111 monoclonal antimyosin antibodies injected within 24 hours after onset of AMI was compared with the degree and extent of regional asynergy on admission and discharge, as assessed by 2-dimensional echocardiography. On the first day of AMI, 80 MBq of indium-111 antimyosin was injected and planar images were made 24 hours later. Indium-111 antimyosin uptake was evaluated for count density index (count density of infarct zone/left lung count density) in the left anterior oblique projection, in which the infarction zone was well displayed in all patients. Using 2-dimensional echocardiography, the left ventricle was divided into 13 segments and evaluated for regional asynergy, which was considered severe (akinesia or dyskinesia) or mild (hypokinesia). The extent of regional asynergy was measured by the number of asynergic segments. All 21 patients had severe regional asynergy on admission. Nine of 21 showed only mild regional asynergy on discharge and 12 of 21 had persistent severe regional asynergy in at least 1 segment. The count density index was significantly lower in patients with mild regional asynergy on discharge compared with patients with severe regional asynergy (1.63 +/- 0.27 vs 2.50 +/- 0.42, p less than 0.01).

  16. [Nursing tasks left undone in German acute care hospitals - results from the international study RN4Cast].

    PubMed

    Zander, Britta; Dobler, L; Bäumler, M; Busse, R

    2014-11-01

    Implicit rationing of nursing care - likewise as in medical care - has never been empirically measured in German hospitals. Thus, little is known about prevalence and patterns of nursing care left undone as well as its association with nurse work environment and staffing. We surveyed 1,511 registered nurses from 49 German acute hospitals participating in the multi-country cross-sectional study RN4CAST. Analyses were made by descriptive statistics as well as multilevel regression analysis to calculate predictors from the nurse work environment and staffing. On average 4.7 out of 13 nursing tasks were rationed. The range was between 82% for "comfort/talk with patients" and 15% for "treatments and procedures". The analysis revealed that hospital work environments and staffing ratios were significantly associated with the level of nursing care left undone. Further significant associations were found between poor leadership, inadequate organisation of nursing work as well as high emotional exhaustion and rationing. The phenomenon of nursing care left undone was prevalent in German hospitals. Those tasks which are most likely to have negative consequences for patients (e. g., pain management and medication on time) seem to receive higher priority than tasks whose potential effects are less immediate or direct (e. g., psychosocial care). With regard to the measured correlation with the nurse work environment, it is recommend to invest in a good environment before (or simultaneously) investing in nurse staffing. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Interaction of cerebral hemispheres and artistic thinking

    NASA Astrophysics Data System (ADS)

    Nikolaenko, Nikolay N.

    1998-07-01

    Study of drawings by patients with local lesions of the right or left hemisphere allows to understand how artistic thinking is supported by brain structures. The role of the right hemisphere is significant at the early stage of creative process. The right hemisphere is a generator of nonverbal visuo-spatial thinking. It operates with blurred nonverbal images and arrange them in a visual space. With the help of iconic signs the right hemisphere reflects the world and creates perceptive visual standards which are stored in the long-term right hemisphere memory. The image, which appeared in the `inner' space, should be transferred into a principally different language, i.e. a left hemispheric sign language. This language operates with a number of discrete units, logical succession and learned grammar rules. This process can be explained by activation (information) transfer from the right hemisphere to the left one. Thus, natural and spontaneous creative process, which is finished by a conscious effort, can be understood as an activation impulse transfer from the right hemisphere to the left one and back.

  18. Cognitive correlates of hemispheric performance on dichotic tasks.

    PubMed

    Johnson, R C; Green, P; Ahern, F M; Cole, R E

    Older (age 50+) adults were tested twice on three measures of dichotic memory and once on three measures of cognition. Internal consistencies of all three measures generally were adequate. However, test-retest reliabilities, by ear of presentation, were comparatively low for the three dichotic measures. A measure of vocabulary (a left hemisphere dominant cognitive ability) was related to performance on most dichotic tasks. Years of education (an index of left hemisphere mediated crystallized intelligence) was related to performance on left but not right hemisphere function on two of three dichotic tasks. Performance on tests of spatial ability was related to performance on left ear/right hemisphere but not right ear/left hemisphere function on two of three dichotic memory tasks. Individual differences in accuracy of recall and recognition of stimuli presented via dichotic tasks to the right ear/left hemisphere and the left ear/right hemisphere appear to have different cognitive correlates. Right hemisphere performance on dichotic tasks generally shows a significant negative association with age, as did performance on right hemisphere dominant cognitive tasks. On the other hand, most measures of left hemisphere performance showed no decline associated with age.

  19. Stroke Laterality Bias in the Management of Acute Ischemic Stroke.

    PubMed

    McCluskey, Gavin; Wade, Carrie; McKee, Jacqueline; McCarron, Peter; McVerry, Ferghal; McCarron, Mark O

    2016-11-01

    Little is known of the impact of stroke laterality on the management process and outcome of patients with acute ischemic stroke (AIS). Consecutive patients admitted to a general hospital over 1 year with supratentorial AIS were eligible for inclusion in the study. Baseline characteristics and risk factors, delays in hospital admission, imaging, intrahospital transfer to an acute stoke unit, stroke severity and classification, length of hospital admission, as well as 10-year mortality were measured and compared among right and left hemisphere AIS patients. There were 141 patients (77 men, 64 women; median age 73 [interquartile range 63-79] years), There were 71 patients with left hemisphere AIS and 70 with right hemisphere AIS. Delays to hospital admission from stroke onset to neuroimaging were similar among right and left hemisphere AIS patients. Delay in transfer to an acute stroke unit (ASU) following hospital admission was on average 14 hours more for right hemisphere compared to left hemisphere AIS patients (P = .01). Laterality was not associated with any difference in 10-year survival. Patients with mild and nondominant AIS merit particular attention to minimize their intrahospital transfer time to an ASU. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. Acute arterial embolism of left lower extremity caused by paradoxical embolism in Ebstein's anomaly

    PubMed Central

    LI, Jun-Sheng; Ma, Jie; Yan, Zi-Xing; Cheng, Dong-Ming; Chang, Liang; Zhang, Hai-Chun; Liu, Jiang-Yan

    2017-01-01

    Abstract Introduction: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients’ quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted. Case report: An 11-year-old girl falling off the bed suffered pain from left lower extremity. Echocardiographic evaluation revealed an EA, severe tricuspid regurgitation, and secundum atrial septal defect. Both left leg amputation and cardiac surgery were conducted after recovery. Under the condition of anesthesia cardiopulmonary bypass extracorporeal circulation, atrial septal defect repair and Cone reconstruction of the tricuspid valve were performed. Patient recovered well and left hospital smoothly. Discussion: EA is a rare and complex congenital cardiac malformation. There are about 80% to 90% of EA patients with combined atrial septal defect and patent foramen ovale. Sudden arterial occlusion is very rare especially in childhood. When thoracic roentgenoscopy, arterial blood gas analysis, coagulation test, and echocardiographic of lower extremity deep venous system are all normal, one should consider the possibility of a paradoxical embolism. If patients have the paradoxical embolism or worsening tricuspid regurgitation, the most suitable therapeutic regimen should be chosen according to patients’ condition. With surgical techniques and methods renewed continuously, cone reconstruction of the tricuspid valve has been confirmed in clinical trials, which can use its own tissues to form not only central bloodstream, but also the coaption between leaflet and leaflet. PMID:28151866

  1. Low-Intensity Pulsed Ultrasound Enhances Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Mouse Model of Acute Myocardial Infarction.

    PubMed

    Shindo, Tomohiko; Ito, Kenta; Ogata, Tsuyoshi; Hatanaka, Kazuaki; Kurosawa, Ryo; Eguchi, Kumiko; Kagaya, Yuta; Hanawa, Kenichiro; Aizawa, Kentaro; Shiroto, Takashi; Kasukabe, Sachie; Miyata, Satoshi; Taki, Hirofumi; Hasegawa, Hideyuki; Kanai, Hiroshi; Shimokawa, Hiroaki

    2016-06-01

    Left ventricular (LV) remodeling after acute myocardial infarction still remains an important issue in cardiovascular medicine. We have recently demonstrated that low-intensity pulsed ultrasound (LIPUS) therapy improves myocardial ischemia in a pig model of chronic myocardial ischemia through enhanced myocardial angiogenesis. In the present study, we aimed to demonstrate whether LIPUS also ameliorates LV remodeling after acute myocardial infarction and if so, to elucidate the underlying molecular mechanisms involved in the beneficial effects of LIPUS. We examined the effects of LIPUS on LV remodeling in a mouse model of acute myocardial infarction, where the heart was treated with either LIPUS or no-LIPUS 3 times in the first week (days 1, 3, and 5). The LIPUS improved mortality and ameliorated post-myocardial infarction LV remodeling in mice. The LIPUS upregulated the expression of vascular endothelial growth factor, endothelial nitric oxide synthase, phosphorylated ERK, and phosphorylated Akt in the infarcted area early after acute myocardial infarction, leading to enhanced angiogenesis. Microarray analysis in cultured human endothelial cells showed that a total of 1050 genes, including those of the vascular endothelial growth factor signaling and focal adhesion pathways, were significantly altered by the LIPUS. Knockdown with small interfering RNA of either β1-integrin or caveolin-1, both of which are known to play key roles in mechanotransduction, suppressed the LIPUS-induced upregulation of vascular endothelial growth factor. Finally, in caveolin-1-deficient mice, the beneficial effects of LIPUS on mortality and post-myocardial infarction LV remodeling were absent. These results indicate that the LIPUS therapy ameliorates post-myocardial infarction LV remodeling in mice in vivo, for which mechanotransduction and its downstream pathways may be involved. © 2016 American Heart Association, Inc.

  2. Impella™ Left Ventricular Assist Device for Acute Peripartum Cardiomyopathy After Cesarean Delivery.

    PubMed

    Padilla, Cesar; Hernandez Conte, Antonio; Ramzy, Danny; Sanchez, Michael; Zhao, Manxu; Park, Donald; Lubin, Lorraine

    2016-07-01

    Peripartum cardiomyopathy is a rare form of heart failure with significant perioperative implications. In this case report, we describe a 34-year-old gravida 5, parity 3, patient who was admitted for an elective cesarean delivery. During the delivery, the patient developed sudden cardiac arrest and was emergently intubated in the operating room. An emergent transesophageal echocardiogram revealed a left ventricular ejection fraction of 10% with global biventricular hypokinesis. Urgent multidisciplinary consultations led to the rapid implementation of the Impella™ 2.5 for ventricular support. The patient recovered ventricular function within 4 days and recovered to baseline function.

  3. Higher mortality in patients with right hemispheric intracerebral haemorrhage: INTERACT1 and 2.

    PubMed

    Sato, Shoichiro; Heeley, Emma; Arima, Hisatomi; Delcourt, Candice; Hirakawa, Yoichiro; Pamidimukkala, Vijaya; Li, Zhendong; Tao, Qingling; Xu, Yuehong; Hennerici, Michael G; Robinson, Thompson; Tzourio, Christophe; Lindley, Richard I; Chalmers, John; Anderson, Craig S; Anderson, C S; Huang, Y; Wang, J G; Arima, H; Neal, B; Peng, B; Heeley, E; Skulina, C; Parsons, M W; Kim, J S; Tao, Q L; Li, Y C; Jiang, J D; Tai, L W; Zhang, L J; Xu, E; Cheng, Y; Heritier, S; Morgenstern, L B; Chalmers, J

    2015-12-01

    Controversy exists over the prognostic significance of the affected hemisphere in stroke. We aimed to determine the relationship between laterality of acute intracerebral haemorrhage (ICH) and poor clinical outcomes. A subsidiary analysis of the INTERACT Pilot and INTERACT2 studies--randomised controlled trials of patients with spontaneous acute ICH with elevated systolic blood pressure (BP), randomly assigned to intensive (target systolic BP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Outcomes were the combined and separate end points of death and major disability (modified Rankin scale (mRS) scores of 3-6, 6 and 3-5, respectively) at 90 days. A total of 2708 patients had supratentorial/hemispheric ICH and information on mRS at 90 days. Patients with right hemispheric ICH (1327, 49%) had a higher risk of death at 90 days compared to those with left hemispheric ICH after adjustment for potential confounding variables (OR, 1.77 (95% CI 1.33 to 2.37)). There were no differences between patients with right and left hemispheric ICH regarding the combined end point of death or major disability or major disability in the multivariable-adjusted models (1.07 (0.89 to 1.29) and 0.85 (0.72 to 1.01), respectively). Right hemispheric lesion was associated with increased risk of death in patients with acute ICH. The laterality of the ICH does not appear to affect the level of disability in survivors. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00226096 and NCT00716079. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Primary anastomosis in the treatment of acute disease of the unprepared left colon.

    PubMed

    Trillo, C; Paris, M F; Brennan, J T

    1998-09-01

    Between June 1, 1990 and December 31, 1996, 58 consecutive patients with unprepared colons were urgently explored for nontraumatic disease with intent to proceed with primary left-sided colonic anastomosis. Unprotected anastomoses were not attempted in 15 patients. The causes of exclusion included preoperative and intraoperative shock in three patients, and three patients were on long-term high-dose steroids, four had gross fecal contamination of the peritoneal cavity, four had large pelvic abscesses, and one had ischemic colitis. All 43 patients undergoing anastomosis without protective colostomy had stapled anastomoses. Indications included complicated diverticular disease in 32 cases. There were nine cases of obstruction from colorectal carcinoma and one obstruction due to sigmoid volvulus. There was one case of perforation from pseudomembranous enterocolitis. The most common complications were: atelectasis in nine cases, wound infection in two cases, and prolonged ileus in two cases. Pelvic abscess occurred in one case. There was one wound dehiscence. There was one anastomotic dehiscence, and there was no mortality. Operative time averaged 85 minutes and hospital length of stay 9.7 days. Primary anastomosis of the unprepared left colon is safe in most urgent and emergent situations, thus avoiding the significant morbidity and cost of colostomy closure.

  5. Hemispheric differences in motor control.

    PubMed

    Goodale, M A

    1988-09-15

    Two lines of evidence are presented to suggest that the left hemisphere in human beings plays a special role in the organization of complex motor behaviour, an idea first put forward by Liepmann and extended more recently by Kimura. The results of one line of research suggest that the right-sided asymmetries observed in movements of the mouth during verbal and non-verbal tasks reflect the fact that mechanisms within the left hemisphere are particularly involved in selecting individual movements and facilitating the transition from one movement to another. The results of the second line of research extend this idea and suggest that the organization of eye and limb movements during visually guided reaching is also dependent on these left-hemisphere mechanisms. These findings, together with the work of a number of other workers, all point to the same conclusion: that speech is but one example of a great number of different motor patterns mediated in part by neural systems within the so-called 'dominant' hemisphere.

  6. Acute left colonic diverticulitis: can CT findings be used to predict recurrence?

    PubMed

    Poletti, Pierre-Alexandre; Platon, Alexandra; Rutschmann, Olivier; Kinkel, Karen; Nyikus, Vince; Ghiorghiu, Serban; Morel, Philippe; Terrier, François; Becker, Christoph D

    2004-05-01

    We explored CT and demographic predictors for unfavorable outcome of nonoperative treatment in patients with a first event of left colonic diverticulitis. We retrospectively analyzed the medical files and CT scans of 312 consecutive patients who were diagnosed as having diverticulitis on an admission CT report or who had a final diagnosis of left colonic diverticulitis. Patients who did not undergo nonoperative treatment or were lost to follow-up (n = 144) were excluded from the study. Admission CT scans of 168 consecutive patients with a diagnosis of left colonic diverticulitis who underwent nonoperative treatment and had an 18-month follow-up were reassessed by three radiologists unaware of the clinical findings. Nonoperative treatment was defined as an attempt to treat the patient with only antibiotics without scheduling them for elective (delayed) surgery. Unfavorable outcome was defined as a failure of nonoperative treatment 18 months after admission that required either surgery or rehospitalization for antibiotic treatment. The risk of unfavorable outcome was modeled using logistic regression as a function of sex, age, and CT criteria including the maximum number of diverticula per 10 cm of colon; the presence of intraabdominal abscess or extraintestinal gas bubbles (< 5 mm diameter) or gas pockets (>or=5 mm); the length and location of the abnormal colonic segment; the maximum thickness of the colonic wall; the presence of associated free intraperitoneal fluid; and the extent of fatty infiltration. Among these 168 patients, 115 (68%) had an uneventful outcome, but nonoperative treatment failed in 53 (32%). The presence of an abscess (n = 19) or extraintestinal gas pocket (n = 14) were the only CT findings significantly associated with failure of nonoperative treatment. Adjusted odds ratios (95% confidence interval) for failure were 6.18 (1.76-21.68) when an abscess was diagnosed and 4.26 (1.04-17.57) when pockets of free air were observed. Sex and age were

  7. Emergency preoperative stenting versus surgery for acute left-sided malignant colonic obstruction: a multicenter randomized controlled trial.

    PubMed

    Pirlet, Isabelle A; Slim, Karem; Kwiatkowski, Fabrice; Michot, Francis; Millat, Bertrand L

    2011-06-01

    Surgical management of left colonic cancer presenting as an acute obstruction remains controversial and still is associated with high mortality and morbidity rates. Recently, self-expandable metallic stents (SEMS) have been used as a bridge to surgery in an attempt to decompress the colon and then allow elective one-stage surgical resection without stoma placement. This study aimed to compare the outcomes of emergency surgery alone with emergency placement of colonic SEMS as a bridge to surgery in terms of efficiency and reduction of the stoma placement rate. A multicenter prospective, randomized, controlled trial was conducted according to the consolidated standards of reporting trials (CONSORT) Statement criteria. Patients eligible for the study were randomized to either emergency surgery or emergency SEMS as a bridge to surgery. The primary outcome was the need for a stoma (temporary or permanent) for any reason. The secondary end points were mortality, morbidity, and length of hospital stay. Nine centers participated in the trial. Among the 70 patients eligible for the study, 60 were randomized and included for the final analysis, 30 patients in each group. Seven patients were randomized but did not fulfill the entry requirements, whereas three further eligible patients were not randomized for various reasons. Concerning the primary outcome, 17 patients in the surgery group sustained a stoma placement versus 13 patients in the SEMS group (p=0.30). No statistically significant difference was noted concerning the secondary outcomes. A total of 16 attempts at SEMS placement (53.3%) were technical failures. Two colonic perforations directly related to the stent placement procedure occurred among the 30 randomized patients and 1 perforation occurred among the nonrandomized patients, leading to premature closure of inclusions in the study before the expected number of 80 patients was reached. This randomized trial failed to demonstrate that emergency preoperative

  8. Acute occlusion of the left iliac artery after long-distance-running.

    PubMed

    Schmidt, O; Thaler, K H; Lang, W

    2001-02-01

    We report a case of spontaneous iliac occlusion in a 44-year-old male patient after long-distance running. Atherogenic risk factors like hypertension, diabetes, hypercholesterolemia and smoking were missing. Spontaneous iliac occlusion is extremely rare and only a few cases have been documented. Angiography showed occlusion of the left iliac artery with collateral flow via the obturator artery to the common femoral artery. Thrombectomy was performed but reocclusion occurred. An iliacofemoral bypass, arterial lysis and bypass thrombectomy was necessary within a few months. At the last follow-up visit two years afterwards the patient was symptom-free. This case indicates that exercise-dependent blood flow disturbances in long-distance-runners could produce changes of the intima.

  9. Left Atrial Enlargement and Anticoagulation Status in Patients with Acute Ischemic Stroke and Atrial Fibrillation.

    PubMed

    Dakay, Katarina; Chang, Andrew D; Hemendinger, Morgan; Cutting, Shawna; McTaggart, Ryan A; Jayaraman, Mahesh V; Chu, Antony; Panda, Nikhil; Song, Christopher; Merkler, Alexander; Gialdini, Gino; Kummer, Benjamin; Lerario, Michael P; Kamel, Hooman; Elkind, Mitchell S V; Furie, Karen L; Yaghi, Shadi

    2017-09-13

    Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2.0 or non-vitamin K oral anticoagulant with uninterrupted use in the prior 2 weeks) versus nontherapeutic on anticoagulation. Univariable and multivariable models were used to estimate associations between therapeutic anticoagulation and clinical factors, including CHADS2 score and LAE (none/mild versus moderate/severe). We identified 225 patients during the study period; 52 (23.1%) were therapeutic on anticoagulation. Patients therapeutic on anticoagulation were more likely to have a larger left atrial diameter in millimeters (45.6 ± 9.2 versus 42.3 ± 8.6, P = .032) and a higher CHADS2 score (2.9 ± 1.1 versus 2.4 ± 1.1, P = .03). After adjusting for the CHADS2 score, patients who had a stroke despite therapeutic anticoagulation were more likely to have moderate to severe LAE (odds ratio, 2.05; 95% confidence interval, 1.01-4.16). LAE is associated with anticoagulation failure in AF patients admitted with an ischemic stroke. This provides indirect evidence that LAE may portend failure of anticoagulation therapy in patients with AF; further studies are needed to delineate the significance of this association and improve stroke prevention strategies. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. 3D Echo Pilot Study of Geometric Left Ventricular Changes after Acute Myocardial Infarction

    PubMed Central

    Vieira, Marcelo Luiz Campos; Oliveira, Wercules Antonio; Cordovil, Adriana; Rodrigues, Ana Clara Tude; Mônaco, Cláudia Gianini; Afonso, Tânia; Lira Filho, Edgar Bezerra; Perin, Marco; Fischer, Cláudio Henrique; Morhy, Samira Saady

    2013-01-01

    Background Left ventricular remodeling (LVR) after AMI characterizes a factor of poor prognosis. There is little information in the literature on the LVR analyzed with three-dimensional echocardiography (3D ECHO). Objective To analyze, with 3D ECHO, the geometric and volumetric modifications of the left ventricle (VE) six months after AMI in patients subjected to percutaneous primary treatment. Methods Prospective study with 3D ECHO of 21 subjects (16 men, 56 ± 12 years-old), affected by AMI with ST segment elevation. The morphological and functional analysis (LV) with 3D ECHO (volumes, LVEF, 3D sphericity index) was carried out up to seven days and six months after the AMI. The LVR was considered for increase > 15% of the end diastolic volume of the LV (LVEDV) six months after the AMI, compared to the LVEDV up to seven days from the event. Results Eight (38%) patients have presented LVR. Echocardiographic measurements (n = 21 patients): I- up to seven days after the AMI: 1- LVEDV: 92.3 ± 22.3 mL; 2- LVEF: 0.51 ± 0.01; 3- sphericity index: 0.38 ± 0.05; II- after six months: 1- LVEDV: 107.3 ± 26.8 mL; 2- LVEF: 0.59 ± 0.01; 3- sphericity index: 0.31 ± 0.05. Correlation coefficient (r) between the sphericity index up to seven days after the AMI and the LVEDV at six months (n = 8) after the AMI: r: 0.74, p = 0.0007; (r) between the sphericity index six months after the AMI and the LVEDV at six months after the AMI: r: 0.85, p < 0.0001. Conclusion In this series, LVR has been observed in 38% of the patients six months after the AMI. The three-dimensional sphericity index has been associated to the occurrence of LVR. PMID:23740401

  11. Hemispheric lateralization of semantic feature distinctiveness.

    PubMed

    Reilly, M; Machado, N; Blumstein, S E

    2015-08-01

    Recent models of semantic memory propose that the semantic representation of concepts is based, in part, on a network of features. In this view, a feature that is distinctive for an object (a zebra has stripes) is processed differently from a feature that is shared across many objects (a zebra has four legs). The goal of this paper is to determine whether there are hemispheric differences in such processing. In a feature verification task, participants responded 'yes' or 'no' following concepts which were presented to a single visual field (left or right) paired with a shared or distinctive feature. Both hemispheres showed faster reaction times to shared features than to distinctive features, although right hemisphere responses were significantly slower overall and particularly in the processing of distinctive features. These findings support models of semantic processing in which the dominant left hemisphere more efficiently performs highly discriminating 'fine' encoding, in contrast to the right hemisphere which performs less discriminating 'coarse' encoding.

  12. Patient-specific assessment of left ventricular thrombogenesis risk after acute myocardial infarction: a pilot clinical study

    NASA Astrophysics Data System (ADS)

    Rossini, L.; Khan, A.; Del Alamo, J. C.; Martinez-Legazpi, P.; Pérez Del Villar, C.; Benito, Y.; Yotti, R.; Barrio, A.; Delgado-Montero, A.; Gonzalez-Mansilla, A.; Fernandez-Avilés, F.; Bermejo, J.

    2016-11-01

    Left ventricular thrombosis (LVT) is a major complication of acute myocardial infarction (AMI). In these patients, the benefits of chronic anticoagulation therapy need to be balanced with its pro-hemorrhagic effects. Blood stasis in the cardiac chambers, a risk factor for LVT, is not addressed in current clinical practice. We recently developed a method to quantitatively assess the blood residence time (RT) inside the left ventricle (LV) based on 2D color-Doppler velocimetry (echo-CDV). Using time-resolved blood velocity fields acquired non-invasively, we integrate a modified advection equation to map intraventricular stasis regions. Here, we present how this tool can be used to estimate the risk of LVT in patients with AMI. 73 patients with a first anterior-AMI were studied by echo-CDV and RT analysis within 72h from admission and at a 5-month follow-up. Patients who eventually develop LVT showed early abnormalities of intraventricular RT: the apical region with RT>2s was significantly larger, had a higher RT and a longer wall contact length. Thus, quantitative analysis of intraventricular flow based on echocardiography may provide subclinical markers of LV thrombosis risk to guide clinical decision making.

  13. The hemodynamic effects of acute aortic regurgitation into a stiffened left ventricle resulting from chronic aortic stenosis.

    PubMed

    Okafor, Ikechukwu; Raghav, Vrishank; Midha, Prem; Kumar, Gautam; Yoganathan, Ajit

    2016-06-01

    Acute aortic regurgitation (AR) post-chronic aortic stenosis is a prevalent phenomenon occurring in patients who undergo transcatheter aortic valve replacement (TAVR) surgery. The objective of this work was to characterize the effects of left ventricular diastolic stiffness (LVDS) and AR severity on LV performance. Three LVDS models were inserted into a physiological left heart simulator. AR severity was parametrically varied through four levels (ranging from trace to moderate) and compared with a competent aortic valve. Hemodynamic metrics such as average diastolic pressures (DP) and reduction in transmitral flow were measured. AR index was calculated as a function of AR severity and LVDS, and the work required to make up for lost volume due to AR was estimated. In the presence of trace AR, higher LVDS had up to a threefold reduction in transmitral flow (13% compared with 3.5%) and a significant increase in DP (2-fold). The AR index ranged from ∼42 to 16 (no AR to moderate AR), with stiffer LVs having lower values. To compensate for lost volume due to AR, the low, medium, and high LVDS models were found to require 5.1, 5.5, and 6.6 times more work, respectively. This work shows that the LVDS has a significant effect on the LV performance in the presence of AR. Therefore, the LVDS of potential TAVR patients should be assessed to gain an initial indication of their ability to tolerate post-procedural AR.

  14. The efficacy and tolerability of azilsartan in mice with left ventricular pressure overload or acute myocardial infarction.

    PubMed

    Quinn Baumann, Patricia; Zaman, A K M Tarikuz; McElroy-Yaggy, Keara; Sobel, Burton E

    2013-05-01

    Angiotensin II receptor blockers (ARBs) are used for the treatment of patients with heart failure and hypertension. Yet their safety has been questioned by some who observed delayed cardiac healing and scar thinning after myocardial infarction (MI). To clarify potential efficacy and safety of ARBs, we administered Azilsartan medoxomil, a prodrug of an ARB (Takeda Pharmaceutical Company Limited), assessed cardiac fibrosis (hydroxyproline content), left ventricular (LV) wall thickness (premortem echocardiography and caliper measurement at necropsy), and LV mass and cardiac function with high-resolution ultrasound in mice with either surgically induced LV pressure overload (aortic banding) or acute MI. Drug-treated aortic-banded mice exhibited less LV wall thickness, hypertrophy, and dilation compared with that exhibited by controls. Survival in drug-treated MI mice was greater though not significantly. Drug-treated mice with acute MI exhibited less cardiomyocyte injury reflected by LV creatine kinase content and less LV hypertrophy and dilation. Thus, Azilsartan exerted favorable biological effects on the hearts of mice subjected to LV pressure overload or MI without compromising survival consistent with its potential utility and tolerability in patients with analogous conditions.

  15. Hyperbaric oxygen in skeletal muscle of rats submitted to total acute left hindlimb ischemia: A research report.

    PubMed

    da Silva, Luis Gustavo Campos; Dalio, Marcelo Bellini; Joviliano, Edwaldo Edner; Feres, Omar; Piccinato, Carlos Eli

    2015-01-01

    Determine the effect of hyperbaric oxygen treatment in skeletal muscle of rats submitted to total acute left hindlimb ischemia. An experimental study was designed using 48 Wistar rats divided into four groups (n = 12): Control; Ischemia (I)--total hindlimb ischemia for 270 minutes; Hyperbaric oxygen treatment during ischemia (HBO2)--total hindlimb ischemia for 270 minutes and hyperbaric oxygen during the first 90 minutes; Pre-treatment with hyperbaric oxygen (PHBO2)--90 minutes of hyperbaric oxygen treatment before total hindlimb ischemia for 270 minutes. Skeletal muscle injury was evaluated by measuring levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), total creatine phosphokinase (CPK); muscular malondialdehyde (MDA), muscular glycogen, and serum ischemia-modified albumin (IMA). AST was significantly higher in I, HBO2 and PHBO2 compared with control (P = .001). There was no difference in LDH. CPK was significantly higher in I, HBO2 and PHBO2, compared with control (p = .014). MDA was significantly higher in PHBO2, compared with other groups (p = .042). Glycogen was significantly decreased in I, HBO2 and PHBO2, compared with control (p < .001). Hyperbaric oxygen treatment in acute total hindlimb ischemia exerted no protective effect on muscle injury, regardless of time of application. When applied prior to installation of total ischemia, hyperbaric oxygen treatment aggravated muscle injury.

  16. Dyscalculia, Dysgraphia, and Left-Right Confusion from a Left Posterior Peri-Insular Infarct

    PubMed Central

    Bhattacharyya, S.; Cai, X.; Klein, J. P.

    2014-01-01

    The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation. PMID:24817791

  17. Dyscalculia, dysgraphia, and left-right confusion from a left posterior peri-insular infarct.

    PubMed

    Bhattacharyya, S; Cai, X; Klein, J P

    2014-01-01

    The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation.

  18. Acute myocardial infarction due to left main coronary artery disease in men and women: does ST-segment elevation matter?

    PubMed Central

    Gutkowski, Wojciech; Raczyński, Grzegorz; Janion-Sadowska, Agnieszka; Gierlotka, Marek; Poloński, Lech

    2015-01-01

    Introduction Gender-specific issues regarding ST-segment elevation (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) due to unprotected left main coronary artery (ULMCA) disease were not sufficiently studied. We assessed the value of STEMI/NSTEMI initial classification on the management of men and women with acute MI due to critical stenosis or occlusion of the ULMCA. Material and methods The study group consisted of 643 consecutive patients with acute MI with the ULMCA as the infarct-related artery. Data derive from an ongoing, nationwide, multicenter, prospective, observational registry. Results Isolated ULMCA disease was more frequent in women and multivessel disease was more frequent in men in the NSTEMI group. The incidence of cardiogenic shock or pulmonary edema and cardiac arrest was higher in the STEMI group. Totally occluded ULMCA was more frequent in the STEMI group. Although the majority of patients underwent percutaneous coronary intervention (PCI), it was less frequently used in NSTEMI women and NSTEMI men. Although in-hospital and long-term mortality rates were higher in the STEMI group, there were no gender-related differences within groups. The initial ST-segment elevation was an independent predictor of in-hospital (OR = 2.37, 95% CI: 1.14–4.91, p = 0.02) and 12-month (OR = 1.52, 95% CI: 1.01–2.27, p = 0.045) mortality. Conclusions There were no gender-related differences in the management within the STEMI or NSTEMI group. Although acute myocardial infarction due to ULMCA disease is associated with high mortality in both genders, STEMI was a negative prognostic factor of in-hospital and 12-month mortality. Despite poor baseline characteristics and clinical presentation in women, female gender itself did not influence mortality. PMID:26788080

  19. Intermittent cardiac overload results in adaptive hypertrophy and provides protection against left ventricular acute pressure overload insult.

    PubMed

    Moreira-Gonçalves, Daniel; Henriques-Coelho, Tiago; Fonseca, Hélder; Ferreira, Rita; Padrão, Ana Isabel; Santa, Cátia; Vieira, Sara; Silva, Ana Filipa; Amado, Francisco; Leite-Moreira, Adelino; Duarte, José Alberto

    2015-09-01

    The present study aimed to test whether a chronic intermittent workload could induce an adaptive cardiac phenotype Chronic intermittent workload induced features of adaptive hypertrophy This was paralleled by protection against acute pressure overload insult The heart may adapt favourably to balanced demands, regardless of the nature of the stimuli. The present study aimed to test whether submitting the healthy heart to intermittent and tolerable amounts of workload, independently of its nature, could result in an adaptive cardiac phenotype. Male Wistar rats were subjected to treadmill running (Ex) (n = 20), intermittent cardiac overload with dobutamine (ITO) (2 mg kg(-1) , s.c.; n = 20) or placebo administration (Cont) (n = 20) for 5 days week(-1) for 8 weeks. Animals were then killed for histological and biochemical analysis or subjected to left ventricular haemodynamic evaluation under baseline conditions, in response to isovolumetric contractions and to sustained LV acute pressure overload (35% increase in peak systolic pressure maintained for 2 h). Baseline cardiac function was enhanced only in Ex, whereas the response to isovolumetric heartbeats was improved in both ITO and Ex. By contrast to the Cont group, in which rats developed diastolic dysfunction with sustained acute pressure overload, ITO and Ex showed increased tolerance to this stress test. Both ITO and Ex developed cardiomyocyte hypertrophy without fibrosis, no overexpression of osteopontin-1 or β-myosin heavy chain, and increased expression of sarcoplasmic reticulum Ca(2+) protein. Regarding hypertrophic pathways, ITO and Ex showed activation of the protein kinase B/mammalian target of rapamycin pathway but not calcineurin. Mitochondrial complex IV and V activities were also increased in ITO and Ex. Chronic submission to controlled intermittent cardiac overload, independently of its nature, results in an adaptive cardiac phenotype. Features of the cardiac overload, such as the duration and

  20. Hemispheric Asymmetries in the Activation and Monitoring of Memory Errors

    ERIC Educational Resources Information Center

    Giammattei, Jeannette; Arndt, Jason

    2012-01-01

    Previous research on the lateralization of memory errors suggests that the right hemisphere's tendency to produce more memory errors than the left hemisphere reflects hemispheric differences in semantic activation. However, all prior research that has examined the lateralization of memory errors has used self-paced recognition judgments. Because…

  1. Hemisphericity Research: An Overview with Some Implications for Problem Solving.

    ERIC Educational Resources Information Center

    Myers, John T.

    1982-01-01

    Research on cerebral hemisphericity and lateral dominance is reviewed, and relationships between right and left hemispheric modes of information processing as well as problem solving techniques are discussed. Conclusions focus mainly on need for educators to know information processing differences of the two hemispheres to teach children problem…

  2. Hemispheric Specialization and Implications for Education of the Hearing Impaired.

    ERIC Educational Resources Information Center

    Levine, Shari

    The paper reviews research on cerebral hemispheric functioning and considers the implications for instruction of the deaf. The nature of right and left hemisphere function and communication is addressed, as are findings on cerebral asymmetry for aspects of language processing. Studies on hemispheric specialization of hearing impaired persons…

  3. The Influence of Context on Hemispheric Recruitment during Metaphor Processing

    ERIC Educational Resources Information Center

    Diaz, Michele T.; Hogstrom, Larson J.

    2011-01-01

    Although the left hemisphere's prominence in language is well established, less emphasis has been placed on possible roles for the right hemisphere. Behavioral, patient, and neuroimaging research suggests that the right hemisphere may be involved in processing figurative language. Additionally, research has demonstrated that context can modify…

  4. Teaching ESL from the Right Hemisphere of the Brain.

    ERIC Educational Resources Information Center

    Curt, Carmen Judith Nine

    Based on the idea that the brain consists of hemispheres which control different types of behavior, this paper argues that the Puerto Rican school system is deteriorating because its emphasis on left hemisphere (quantitative) activities does not synchronize with Puerto Rico's cultural orientation toward the right hemisphere (qualitative…

  5. Hemispheric Asymmetries in the Activation and Monitoring of Memory Errors

    ERIC Educational Resources Information Center

    Giammattei, Jeannette; Arndt, Jason

    2012-01-01

    Previous research on the lateralization of memory errors suggests that the right hemisphere's tendency to produce more memory errors than the left hemisphere reflects hemispheric differences in semantic activation. However, all prior research that has examined the lateralization of memory errors has used self-paced recognition judgments. Because…

  6. The Influence of Context on Hemispheric Recruitment during Metaphor Processing

    ERIC Educational Resources Information Center

    Diaz, Michele T.; Hogstrom, Larson J.

    2011-01-01

    Although the left hemisphere's prominence in language is well established, less emphasis has been placed on possible roles for the right hemisphere. Behavioral, patient, and neuroimaging research suggests that the right hemisphere may be involved in processing figurative language. Additionally, research has demonstrated that context can modify…

  7. Intravenous tissue plasminogen activator and size of infarct, left ventricular function, and survival in acute myocardial infarction.

    PubMed Central

    Van de Werf, F.; Arnold, A. E.

    1988-01-01

    STUDY OBJECTIVE--To assess effect of intravenous recombinant tissue type plasminogen activator on size of infarct, left ventricular function, and survival in acute myocardial infarction. DESIGN--Double blind, randomised, placebo controlled prospective trial of patients with acute myocardial infarction within five hours after onset of symptoms. SETTING--Twenty six referral centres participating in European cooperative study for recombinant tissue type plasminogen activator. PATIENTS--Treatment group of 355 patients with acute myocardial infarction allocated to receive intravenous recombinant plasminogen activator. Controls comprised 366 similar patients allocated to receive placebo. INTERVENTION--All patients were given aspirin 250 mg and bolus injection of 5000 IU heparin immediately before start of trial. Patients in treatment group were given 100 mg recombinant tissue plasminogen activator over three hours (10 mg intravenous bolus, 50 mg during one hour, and 40 mg during next two hours) by infusion. Controls were given placebo by same method. Full anticoagulation treatment and aspirin were given to both groups until angiography (10-22 days after admission). beta Blockers were given at discharge. END POINT--Left ventricular function at 10-22 days, enzymatic infarct size, clinical course, and survival to three month follow up. MEASUREMENTS AND MAIN RESULTS--Mortality was reduced by 51% (95% confidence interval -76 to 1) in treated patients at 14 days after start of treatment and by 36% (-63 to 13) at three months. For treatment within three hours after myocardial infarction mortality was reduced by 82% (-95 to -31) at 14 days and by 59% (-83 to -2) at three months. During 14 days in hospital incidence of cardiac complications was lower in treated patients than controls (cardiogenic shock, 2.5% v 6.0%; ventricular fibrillation, 3.4% v 6.3%; and pericarditis, 6.2% v 11.0% respectively), but that of angioplasty or artery bypass, or both was higher (15.8% v 9

  8. Complementary hemispheric specialization for word and accent detection.

    PubMed

    Berman, Steven M; Mandelkern, Mark A; Phan, Hao; Zaidel, Eran

    2003-06-01

    When we hear a familiar word pronounced in a foreign accent, which parts of the brain identify the word and which identify the accent? Here we present converging evidence from PET blood flow, event-related scalp potentials, and behavioral responses during dichotic listening, showing homologous and complementary hemispheric specialization for word and accent detection. Accuracy of detecting target words was greater when stimuli were presented to the right ear, indicating left hemisphere specialization, with no ear advantage for detecting target accents. Detection of words also produced increased blood flow in a left frontal area associated with motor and phonetic processing, and a left temporal area associated with semantic memory. Homologous areas of the right hemisphere, together with right prefrontal and precuneus regions, showed increased blood flow during detection of accents. Separate analyses for each detection task indicated that voxels whose activity maximally correlated with accuracy were in the left hemisphere for word detection, but in the right hemisphere for accent detection. Voxels whose activity maximally correlated with inaccuracy were in the opposite hemisphere for both tasks, strengthening the interpretation that between-task differences in brain activation are related to lateralized specializations for task performance. ERP waveforms and reaction times suggested that greater left hemisphere activation during word detection preceded greater right hemisphere activation during accent detection. The results are interpreted as supporting left hemisphere specialization for extraction of the linguistic, phonetic, and semantic information contained in speech, and right hemisphere specialization for pragmatics, the social context of linguistic communication.

  9. Integrated microRNA and mRNA responses to acute human left ventricular ischemia.

    PubMed

    Saddic, Louis A; Chang, Tzuu-Wang; Sigurdsson, Martin I; Heydarpour, Mahyar; Raby, Benjamin A; Shernan, Stanton K; Aranki, Sary F; Body, Simon C; Muehlschlegel, Jochen D

    2015-10-01

    MicroRNAs (miRNAs) play a significant role in ischemic heart disease. Animal models of left ventricular (LV) ischemia demonstrate a unique miRNA profile; however, these models have limitations in describing human disease. In this study, we performed next-generation miRNA and mRNA sequencing on LV tissue from nine patients undergoing cardiac surgery with cardiopulmonary bypass and cardioplegic arrest. Samples were obtained immediately after aortic cross clamping (baseline) and before aortic cross clamp removal (postischemic). Of 1,237 identified miRNAs, 21 were differentially expressed between baseline and postischemic LV samples including the upregulated miRNAs miR-339-5p and miR-483-3p and the downregulated miRNA miR-139-5p. Target prediction analysis of these miRNAs was integrated with mRNA expression from the same LV samples to identify anticorrelated miRNA-mRNA pairs. Gene enrichment studies of candidate mRNA targets demonstrated an association with cardiovascular disease, cell death, and metabolism. Therapeutics that intervene on these miRNAs and their downstream targets may lead to novel mechanisms of mitigating the damage caused by ischemic insults on the human heart.

  10. Catestatin-A Novel Predictor of Left Ventricular Remodeling After Acute Myocardial Infarction

    PubMed Central

    Zhu, Dan; Xie, Hong; Wang, Xinyu; Liang, Ying; Yu, Haiyi; Gao, Wei

    2017-01-01

    Catestatin was discovered as a potent inhibitor of catecholamine secretion and plays important roles in the cardiovascular system. Our previous study demonstrates a close relationship between catestatin levels and prognosis of ST-elevation myocardial infarction (STEMI). Using the same population, the goal of this study is to investigate the ability of catestatin to predict left ventricular (LV) remodeling in STEMI patients. 72 patients and 30 controls were included. Catestatin was sampled after admission to the emergency room (ER), at day3 (D3), and day7 (D7) after STEMI. Echocardiography was performed at D3 and after 65 months for evaluation of LVEDD, EF, IVS, LVPW, E, A, E’, E/A, and E/E’. The changes of these parameters from D3 to 65 months were used to reflect the changes of ventricular structure and function. We found that plasma catestatin levels at D3 were highly correlated with the changes of LVEDD, EF, E, A, E’, E/A, as well as E/E’. Patients with higher catestatin levels developed worse ventricular function during the follow-up period. Single-point catestatin was effective to predict LVEDD change. And concurrently increasing catestatin and NT-proBNP levels predicted the highest risk of LV remodeling. This study suggests an important prognostic information of catestatin on LV remodeling. PMID:28397784

  11. Discourse functions and hemispheric asymmetry.

    PubMed

    Osiejuk, E

    1993-01-01

    This paper presents a review of the main results of an application of discourse analysis in aphasics with the left hemisphere damages and in the right hemisphere damaged (RHD) patients. Research findings indicate that aphasics have marked deficits on the level of microstructure, especially cohesion of discourse, whereas the coherence and superstructure of their texts are relatively well preserved. RHD patients show difficulties at the microstructure of discourse but not so marked as that of aphasic subjects. The main impairments of RHD patients' discourse can be observed at the level of text coherence. The both populations have also preserved cognitive representation concerned with script knowledge. Discourse processing at macrostructural level of discourse is affected in aphasics as well as in RHD patients. These results suggest that both hemispheres are necessary for normal discourse processes.

  12. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging.

    PubMed

    Delewi, Ronak; Nijveldt, Robin; Hirsch, Alexander; Marcu, Constantin B; Robbers, Lourens; Hassell, Marriela E C J; de Bruin, Rianne H A; Vleugels, Jim; van der Laan, Anja M; Bouma, Berto J; Tio, René A; Tijssen, Jan G P; van Rossum, Albert C; Zijlstra, Felix; Piek, Jan J

    2012-12-01

    Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B=0.02, SE=0.02, p<0.001). Routine TTE had a sensitivity of 21-24% and a specificity of 95-98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ=0.91 and κ=0.96) compared to TTE (κ=0.74 and κ=0.53). LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Schiaparelli Hemisphere

    NASA Image and Video Library

    1996-06-03

    This mosaic is composed of about 100 red- and violet- filter Viking Orbiter images, digitally mosaiced in an orthographic projection at a scale of 1 km/pixel. The images were acquired in 1980 during mid northern summer on Mars (Ls = 89 degrees). The center of the image is near the impact crater Schiaparelli (latitude -3 degrees, longitude 343 degrees). The limits of this mosaic are approximately latitude -60 to 60 degrees and longitude 280 to 30 degrees. The color variations have been enhanced by a factor of two, and the large-scale brightness variations (mostly due to sun-angle variations) have been normalized by large-scale filtering. The large circular area with a bright yellow color (in this rendition) is known as Arabia. The boundary between the ancient, heavily-cratered southern highlands and the younger northern plains occurs far to the north (latitude 40 degrees) on this side of the planet, just north of Arabia. The dark streaks with bright margins emanating from craters in the Oxia Palus region (to the left of Arabia) are caused by erosion and/or deposition by the wind. The dark blue area on the far right, called Syrtis Major Planum, is a low-relief volcanic shield of probable basaltic composition. Bright white areas to the south, including the Hellas impact basin at the lower right, are covered by carbon dioxide frost. http://photojournal.jpl.nasa.gov/catalog/PIA00004

  14. [A case of rupture of the left ventricle free wall with papillary muscle dysfunction following acute myocardial infarction, operated on successfully].

    PubMed

    de Lima, R; Perdigão, C; Neves, L; Cravino, J; Dantas, M; Bordalo, A; Pais, F; Diogo, A N; Ferreira, R; Ribeiro, C

    1990-09-01

    The authors present a case of left ventricular free wall rupture post acute myocardial infarction, associated with mitral papillary posterior muscle necrosis, operated by infartectomy and mitral valvular protesis replacement. They refer the various complications occurred during the hospital staying, and discuss its medical and surgical approach. The patient was discharged alive and six months after the infarction keeps a moderate activity.

  15. Neptune's Southern Hemisphere

    NASA Technical Reports Server (NTRS)

    1989-01-01

    This photograph of Neptune's southern hemisphere was taken by the narrow-angle camera on NASA's Voyager 2 when the spacecraft was 4.2 million km (2.6 million miles) from the planet. The smallest features that can be seen are 38 km (24 miles) across. The almond-shaped structure at the left is a large cloud system that has been seen for several weeks. Internal details in the feature have become increasingly apparent as Voyager 2 has approached. Systems with similar shapes in Jupiter's atmosphere rotate about their centers, rolling in the local winds that increase toward the south. However, the wispy nature of the white central clouds in this Neptunian feature make confirmation of the system's rotation difficult. The Voyager Mission is conducted by JPL for NASA's Office of Space Science and Applications.

  16. Hypnosis and hemispheric asymmetry.

    PubMed

    Naish, Peter L N

    2010-03-01

    Participants of low and high hypnotic susceptibility were tested on a temporal order judgement task, both with and without hypnosis. Judgements were made of the order of presentation of light flashes appearing in first one hemi-field then the other. There were differences in the inter-stimulus intervals required accurately to report the order, depending upon which hemi-field led. This asymmetry was most marked in hypnotically susceptible participants and reversed when they were hypnotized. This implies not only that brain activity changes in hypnosis, but also that there is a difference in brain function between people of low and high hypnotic susceptibility. The latter exhibited a faster-acting left hemisphere in the waking state, but faster right when hypnotized.

  17. Apical rotation as an early indicator of left ventricular systolic dysfunction in acute anterior myocardial infarction: experimental study.

    PubMed

    Toumanidis, Savvas T; Kaladaridou, Anna; Bramos, Dimitrios; Skaltsiotes, Elias; Agrios, John N; Vasiladiotis, Nikolaos; Pamboucas, Constantinos; Kottis, George; Moulopoulos, Spyridon D

    2013-01-01

    The aim of this study was to determine whether left ventricular (LV) apical rotation assessed by speckle tracking echocardiography (STE) can predict global LV systolic dysfunction after acute anterior myocardial infarction (AMI). STE analysis was applied to LV short-axis images at the basal and apical levels in 21 open-chest pigs, before and after left anterior descending coronary artery ligation. LV radial and circumferential strain and strain rate, apical and basal rotation, and LV torsion were recorded. LV apical rotation (3.68 ± 1.73° pre-AMI vs. 2.19 ± 1.64° post-AMI, p<0.009), peak systolic rotation rate, and radial and circumferential strain as well as strain rate decreased significantly 30 min postAMI. The LV global torsion decreased significantly. Strain and rotational changes of the LV apex were primarily correlated with ejection fraction (EF), but those of the LV base were not. EF had a significant correlation with the global LV twist (r=0.31, p<0.05). On multivariate linear regression analysis, fractional shortening of the long-axis (FSL) (b=0.58, p<0.001), rotation of the LV apex (b=0.32, p<0.006) and LV dp/dtmax (b=0.26, p<0.02) were independently related with EF. On analysis, of the receiver operating characteristic curve, the area under the curve for apical rotation was 0.765, p<0.006; the best cutoff value of 2.92° had sensitivity 80% and specificity 71% in predicting EF<40%. Apical rotation assessed by STE is a potential noninvasive early indicator of global LV systolic dysfunction in AMI and has a satisfactory association with LVEF. Its assessment could be valuable in clinical and research cardiology.

  18. Left atrial volume index is an independent predictor of major adverse cardiovascular events in acute coronary syndrome.

    PubMed

    Gunasekaran, Ramsamy; Maskon, Oteh; Hassan, Hamat H Che; Safian, Nazarudin; Sakthiswary, Rajalingham

    2012-01-01

    Left atrial volume index (LAVI) is well proven to be a reliable method of determining left atrial size, which has prognostic implications in cardiovascular diseases. Studies demonstrate that increased LAVI is a predictor of mortality in myocardial infarction, but its association with other major adverse cardiovascular events (MACEs) among patients post acute coronary syndrome (ACS) has not been adequately evaluated. We calculated the baseline LAVI for all patients who were admitted with ACS between December 2010 and August 2011. The patients were stratified into 2 arms: normal LAVI and increased LAVI, with a cutoff value of 28 mL/m(2). All patients were prospectively followed up during 6 months for development of MACEs. Of the 75 patients who completed the study, 32 had increased LAVI, and 43 had normal LAVI. More than half (55%) of the patients were diagnosed with unstable angina. During the follow-up period of 6 months, 30 patients (93.8%) in the increased-LAVI arm and 23 patients (53.5%) in the normal-LAVI arm developed at least a single MACE. Patients with increased LAVI had significantly more MACEs (P = 0.021). The occurrence of MACE remained significantly higher in the increased-LAVI group even when atrial fibrillation was excluded (P = 0.016). After adjusting for confounding variables by multivariate analysis, LAVI was found to have a significant association with MACEs (P = 0.030, odds ratio = 1.229 (95% confidence interval, 1.020-1.481). LAVI is a useful tool for prognostication and an independent predictor of MACEs post ACS. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  19. A Small Molecule Inhibitor of Sarcomere Contractility Acutely Relieves Left Ventricular Outflow Tract Obstruction in Feline Hypertrophic Cardiomyopathy

    PubMed Central

    Stern, Joshua A.; Markova, Svetlana; Ueda, Yu; Kim, Jae B.; Pascoe, Peter J.; Evanchik, Marc J.; Green, Eric M.; Harris, Samantha P.

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is an inherited disease of the heart muscle characterized by otherwise unexplained thickening of the left ventricle. Left ventricular outflow tract (LVOT) obstruction is present in approximately two-thirds of patients and substantially increases the risk of disease complications. Invasive treatment with septal myectomy or alcohol septal ablation can improve symptoms and functional status, but currently available drugs for reducing obstruction have pleiotropic effects and variable therapeutic responses. New medical treatments with more targeted pharmacology are needed, but the lack of preclinical animal models for HCM with LVOT obstruction has limited their development. HCM is a common cause of heart failure in cats, and a subset exhibit systolic anterior motion of the mitral valve leading to LVOT obstruction. MYK-461 is a recently-described, mechanistically novel small molecule that acts at the sarcomere to specifically inhibit contractility that has been proposed as a treatment for HCM. Here, we use MYK-461 to test whether direct reduction in contractility is sufficient to relieve LVOT obstruction in feline HCM. We evaluated mixed-breed cats in a research colony derived from a Maine Coon/mixed-breed founder with naturally-occurring HCM. By echocardiography, we identified five cats that developed systolic anterior motion of the mitral valve and LVOT obstruction both at rest and under anesthesia when provoked with an adrenergic agonist. An IV MYK-461 infusion and echocardiography protocol was developed to serially assess contractility and LVOT gradient at multiple MYK-461 concentrations. Treatment with MYK-461 reduced contractility, eliminated systolic anterior motion of the mitral valve and relieved LVOT pressure gradients in an exposure-dependent manner. Our findings provide proof of principle that acute reduction in contractility with MYK-461 is sufficient to relieve LVOT obstruction. Further, these studies suggest that feline

  20. A Small Molecule Inhibitor of Sarcomere Contractility Acutely Relieves Left Ventricular Outflow Tract Obstruction in Feline Hypertrophic Cardiomyopathy.

    PubMed

    Stern, Joshua A; Markova, Svetlana; Ueda, Yu; Kim, Jae B; Pascoe, Peter J; Evanchik, Marc J; Green, Eric M; Harris, Samantha P

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is an inherited disease of the heart muscle characterized by otherwise unexplained thickening of the left ventricle. Left ventricular outflow tract (LVOT) obstruction is present in approximately two-thirds of patients and substantially increases the risk of disease complications. Invasive treatment with septal myectomy or alcohol septal ablation can improve symptoms and functional status, but currently available drugs for reducing obstruction have pleiotropic effects and variable therapeutic responses. New medical treatments with more targeted pharmacology are needed, but the lack of preclinical animal models for HCM with LVOT obstruction has limited their development. HCM is a common cause of heart failure in cats, and a subset exhibit systolic anterior motion of the mitral valve leading to LVOT obstruction. MYK-461 is a recently-described, mechanistically novel small molecule that acts at the sarcomere to specifically inhibit contractility that has been proposed as a treatment for HCM. Here, we use MYK-461 to test whether direct reduction in contractility is sufficient to relieve LVOT obstruction in feline HCM. We evaluated mixed-breed cats in a research colony derived from a Maine Coon/mixed-breed founder with naturally-occurring HCM. By echocardiography, we identified five cats that developed systolic anterior motion of the mitral valve and LVOT obstruction both at rest and under anesthesia when provoked with an adrenergic agonist. An IV MYK-461 infusion and echocardiography protocol was developed to serially assess contractility and LVOT gradient at multiple MYK-461 concentrations. Treatment with MYK-461 reduced contractility, eliminated systolic anterior motion of the mitral valve and relieved LVOT pressure gradients in an exposure-dependent manner. Our findings provide proof of principle that acute reduction in contractility with MYK-461 is sufficient to relieve LVOT obstruction. Further, these studies suggest that feline

  1. Impaired speech repetition and left parietal lobe damage.

    PubMed

    Fridriksson, Julius; Kjartansson, Olafur; Morgan, Paul S; Hjaltason, Haukur; Magnusdottir, Sigridur; Bonilha, Leonardo; Rorden, Christopher

    2010-08-18

    Patients with left hemisphere damage and concomitant aphasia usually have difficulty repeating others' speech. Although impaired speech repetition, the primary symptom of conduction aphasia, has been associated with involvement of the left arcuate fasciculus, its specific lesion correlate remains elusive. This research examined speech repetition among 45 stroke patients who underwent aphasia testing and MRI examination. Based on lesion-behavior mapping, the primary structural damage most closely associated with impaired speech repetition was found in the posterior portion of the left arcuate fasciculus. However, perfusion-weighted MRI revealed that tissue dysfunction, in the form of either frank damage or hypoperfusion, to the left inferior parietal lobe, rather than the underlying white matter, was associated with impaired speech repetition. This latter result suggests that integrity of the left inferior parietal lobe is important for speech repetition and, as importantly, highlights the importance of examining cerebral perfusion for the purpose of lesion-behavior mapping in acute stroke.

  2. Echocardiographic Predictors for Left Ventricular Remodeling after Acute ST Elevation Myocardial Infarction with Low Risk Group: Speckle Tracking Analysis

    PubMed Central

    Na, Hyun-Min; Lee, Joo Myung; Cha, Myung-Jin; Yoon, Yeonyee E.; Lee, Seung-Pyo; Kim, Hyung-Kwan; Kim, Yong-Jin; Sohn, Dae-Won

    2016-01-01

    Background We sought to assess echocardiographic predictors of left ventricular (LV) adverse remodeling after successfully reperfused acute ST elevation myocardial infarction (STEMI). LV remodeling is commonly found in STEMI patients and it may suggest adverse outcome in acute myocardial infarction. We sought to identify whether 2D strain and torsion be independent parameters for prediction of LV adverse remodeling. Methods We investigated 208 patients with low-risk STEMI patients who had follow up echocardiography at 6 or more months. After clinical assessments, all patients received revascularization according to current guideline. LV remodeling was defined as > 20% increase in end-diastolic volume (EDV) at follow up. Results During the follow-up (11.9 ± 5.3 months), 53 patients (25.5%) showed LV remodeling. In univariate analysis, EDV, end-systolic volume, deceleration time (DT), CK-MB, and global longitudinal strain (GLS) were associated with LV remodeling. In multivariate analysis, EDV [hazard ratio (HR): 0.922, 95% confidence interval (CI): 0.897–0.948, p< 0.001], GLS (HR: 0.842, 95% CI: 0.728–0.974, p = 0.020), DT (HR: 0.989, 95% CI: 0.980–0.998, p = 0.023) and CK-MB (HR: 1.003, 95% CI: 1.000–1.005, p = 0.033) independently predicted LV remodeling. However, global circumferential strain, net twist, and twist or untwist rate were not associated with remodeling. Conclusion Of various parameters of speckle strain, only GLS predicted adverse remodeling in STEMI patients. PMID:27358705

  3. The effects of anodal stimulation on electrocardiogram, left ventricular dyssynchrony, and acute haemodynamics in patients with biventricular pacemakers.

    PubMed

    Abu Sham'a, Raed; Kuperstein, Rafael; Barsheshet, Alon; Bar-Lev, David; Luria, David; Gurevitz, Osnat; Bachar, Sharona; Eldar, Michael; Feinberg, Micha; Glikson, Michael

    2011-07-01

    Anodal stimulation (ANS) is a recognized phenomenon among patients with cardiac resynchronization therapy (CRT); this is noted during left ventricular (LV) pacing by the LV tip to right ventricular (RV) ring configuration. Its incidence varies according to the implanted hardware. We aim at evaluating the incidence of ANS and its acute haemodynamic effects among CRT patients. We screened all our patients who previously had an implanted CRT-P/D devices for ANS. After excluding all non-eligible devices, the initial screening was done by evaluating the programmer electrocardiogram (ECG) during device interrogation while pacing LV only from LV tip to RV ring. Those with ANS underwent screening by 12-lead ECG during biventricular pacing with VV interval programmed to 0. Patients with electrocardiographic evidence of ANS underwent detailed echocardiography. We screened 224 patients, 187 patients were excluded due to various causes. Thirty-seven subjects were analysed for this study. Anodal stimulation was found in 29 patients (78.4%) by primary screening. Twelve patients (41.4%) showed electrocardiographic evidence of ANS by 12-lead ECG. The ANS threshold was significantly higher than true bipolar LV threshold (4.5±1.7 vs. 1.1±0.3 V, respectively, P=<0.0001). Ten patients, with ECG evidence of ANS, underwent detailed echocardiography during biventricular pacing with and without ANS. Overall, there were no significant differences in the haemodynamic, echocardiographic, or resynchronization effects with and without ANS, two patients showed significant reduction in LV function with ANS. Anodal stimulation is a common phenomenon among CRT patients. In many cases ANS is seen with LV pacing only, while these changes may not be seen by ECG during biventricular pacing. Echocardiography did not show any significant acute haemodynamic benefit during ANS, and some patients may even deteriorate.

  4. Protective effect of Xuebijing injection against acute lung injury induced by left ventricular ischemia/reperfusion in rabbits

    PubMed Central

    JI, MINGLI; WANG, YUXIA; WANG, LEI; CHEN, LIPING; LI, JING

    2016-01-01

    Xuebijing (XBJ) is a Chinese herbal preparation. Previous studies have demonstrated that XBJ injection is able to inhibit the uncontrolled release of endogenous inflammatory mediators, attenuate inflammation, and alleviate organ damage. However, there are no relevant reports on the protective effect of XBJ against left ventricular ischemia/reperfusion (I/R)-induced acute lung injury (ALI). Therefore, the aim of the present study was to evaluate the protective effect of XBJ on ALI induced by left ventricular I/R, and provide evidence for the clinical application of XBJ. In the present study, 120 healthy rabbits of mixed gender were randomly assigned to a normal control group, ischemia group, I/R group (I/RG) and XBJ-injection treatment group (TG). In addition, each group was further divided into three subgroups (n=10/subgroup), namely, 30 min pre-ischemia, 30 min post-ischemia and 30 min post-reperfusion subgroups. Blood samples (5 ml) were collected from the jugularis externa and carotis communis of the rabbits at the three time points, and a blood gas analyzer was used to measure the arterial partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2). Following sacrifice, the lungs of the rabbits were removed and a bronchoalveolar lavage (BAL) was immediately performed. An enzyme-linked immunosorbent assay was used to measure the expression levels of tumor necrosis factor-α (TNF-α) in the BAL fluid (BALF) and peripheral blood. In addition, the lower lobe of the right lung was removed in order to measure the protein expression levels of intercellular adhesion molecule-1 (ICAM-1) and TNF-α. The results demonstrated that in the rabbits of the TG PaO2 was increased, PaCO2 was decreased, the lung tissue congestion edema was attenuated, the expression levels of TNF-α in the peripheral blood and BALF were reduced and the protein expression levels of ICAM-1 and TNF-α in the lung tissue samples were decreased, as compared with those in the I/RG rabbits. These

  5. Predictors of Long-Term Survival in Acute Coronary Syndrome Patients With Left Ventricular Dysfunction After Percutaneous Coronary Intervention

    PubMed Central

    Lee, Doo Hwan; Rhee, Jung Ae; Choi, Jin Su; Lee, Ki Hong; Lee, Min Goo; Sim, Doo Sun; Park, Keun-Ho; Yoon, Nam Sik; Yoon, Hyun Ju; Kim, Kye Hun; Park, Hyung Wook; Hong, Young Joon; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

    2012-01-01

    Background and Objectives Predictive factors of mortality in acute coronary syndrome (ACS) patients with left ventricular dysfunction were analyzed during 5-year clinical follow-up after percutaneous coronary intervention (PCI). Subjects and Methods A total of 329 ACS consecutive patients (64.6±11.3 years, 227 males) who underwent PCI from January 2001 to March 2006 were followed for 5 years. All patients had lower than 40% of left ventricular ejection fraction (LVEF). Patients were divided into Group I (survived longer than 5-years: n=130, 101 males) and Group II (survived shorter than 5 years: n=199, 126 males). Results The cumulative survival rate was 88.0% at 1 month, 78.0% at 6 months, 75.0% at 1 year, 67.0% at 2 years, 62.0% at 3 years, 57.0% at 4 years and 40% at 5-years. Group II was older (61.6±11.2 years vs. 66.4±11.4 years, p<0.001), and showed higher prevalence of female gender (28.4% vs. 36.7%, p=0.006) and lower LVEF (35.3±5.2 vs. 33.6±5.6) than Group I. The independent predictors for mortality were LVEF <30% {odds ratio (OR)=1.793, 95% confidence interval (CI): 1.234-2.452, p=0.002}, serum creatinine >3.0 mg/dL (OR=2.455, 95% CI: 1.306-4.614, p=0.005), older than 65 years (OR=1.594, 95% CI: 1.152-2.206, p=0.005), and female gender (OR=1.524, 95% CI: 1.090-2.130, p=0.014). Conclusion Five-year survival rate was 40% in ACS patients with left ventricular dysfunction, and the predictors for mortality were low LVEF, high serum creatinine, old age, and female gender. PMID:23170097

  6. Structural Integrity of the Contralesional Hemisphere Predicts Cognitive Impairment in Ischemic Stroke at Three Months

    PubMed Central

    Dacosta-Aguayo, Rosalia; Graña, Manuel; Fernández-Andújar, Marina; López-Cancio, Elena; Cáceres, Cynthia; Bargalló, Núria; Barrios, Maite; Clemente, Immaculada; Monserrat, Pere Toran; Sas, Maite Alzamora; Dávalos, Antoni

    2014-01-01

    After stroke, white matter integrity can be affected both locally and distally to the primary lesion location. It has been shown that tract disruption in mirror’s regions of the contralateral hemisphere is associated with degree of functional impairment. Fourteen patients suffering right hemispheric focal stroke (S) and eighteen healthy controls (HC) underwent Diffusion Weighted Imaging (DWI) and neuropsychological assessment. The stroke patient group was divided into poor (SP; n = 8) and good (SG; n = 6) cognitive recovery groups according to their cognitive improvement from the acute phase (72 hours after stroke) to the subacute phase (3 months post-stroke). Whole-brain DWI data analysis was performed by computing Diffusion Tensor Imaging (DTI) followed by Tract Based Spatial Statistics (TBSS). Assessment of effects was obtained computing the correlation of the projections on TBSS skeleton of Fractional Anisotropy (FA) and Radial Diffusivity (RD) with cognitive test results. Significant decrease of FA was found only in right brain anatomical areas for the S group when compared to the HC group. Analyzed separately, stroke patients with poor cognitive recovery showed additional significant FA decrease in several left hemisphere regions; whereas SG patients showed significant decrease only in the left genu of corpus callosum when compared to the HC. For the SG group, whole brain analysis revealed significant correlation between the performance in the Semantic Fluency test and the FA in the right hemisphere as well as between the performance in the Grooved Pegboard Test (GPT) and theTrail Making Test-part A and the FA in the left hemisphere. For the SP group, correlation analysis revealed significant correlation between the performance in the GPT and the FA in the right hemisphere. PMID:24475078

  7. Structural integrity of the contralesional hemisphere predicts cognitive impairment in ischemic stroke at three months.

    PubMed

    Dacosta-Aguayo, Rosalia; Graña, Manuel; Fernández-Andújar, Marina; López-Cancio, Elena; Cáceres, Cynthia; Bargalló, Núria; Barrios, Maite; Clemente, Immaculada; Monserrat, Pere Toran; Sas, Maite Alzamora; Dávalos, Antoni; Auer, Tibor; Mataró, Maria

    2014-01-01

    After stroke, white matter integrity can be affected both locally and distally to the primary lesion location. It has been shown that tract disruption in mirror's regions of the contralateral hemisphere is associated with degree of functional impairment. Fourteen patients suffering right hemispheric focal stroke (S) and eighteen healthy controls (HC) underwent Diffusion Weighted Imaging (DWI) and neuropsychological assessment. The stroke patient group was divided into poor (SP; n = 8) and good (SG; n = 6) cognitive recovery groups according to their cognitive improvement from the acute phase (72 hours after stroke) to the subacute phase (3 months post-stroke). Whole-brain DWI data analysis was performed by computing Diffusion Tensor Imaging (DTI) followed by Tract Based Spatial Statistics (TBSS). Assessment of effects was obtained computing the correlation of the projections on TBSS skeleton of Fractional Anisotropy (FA) and Radial Diffusivity (RD) with cognitive test results. Significant decrease of FA was found only in right brain anatomical areas for the S group when compared to the HC group. Analyzed separately, stroke patients with poor cognitive recovery showed additional significant FA decrease in several left hemisphere regions; whereas SG patients showed significant decrease only in the left genu of corpus callosum when compared to the HC. For the SG group, whole brain analysis revealed significant correlation between the performance in the Semantic Fluency test and the FA in the right hemisphere as well as between the performance in the Grooved Pegboard Test (GPT) and the Trail Making Test-part A and the FA in the left hemisphere. For the SP group, correlation analysis revealed significant correlation between the performance in the GPT and the FA in the right hemisphere.

  8. Clinical aspects of left ventricular diastolic function assessed by Doppler echocardiography following acute myocardial infarction.

    PubMed

    Poulsen, S H

    2001-11-01

    abnormal myocardial relaxation which can be reversed to normal by restoring normal myocardial blood flow. The diastolic abnormality is present within seconds and a characteristic impaired relaxation filling pattern are identified by mitral and pulmonary venous flow analysis. Diastolic dysfunction has been recognized during the early as well during the post-MI phase with or without LV systolic dysfunction. In the acute phase both an abnormal relaxation pattern and restrictive LV filling pattern are present which has been related to in-hospital heart failure. The identification of a pseudonormal or restrictive LV filling pattern are associated with later readmission to hospital with heart failure and cardiac death. Abnormal relaxation filling is the most pronounced filling pattern after one year which might be related to the remodeling process including compensatory hypertrophy, scarring of the infarct zone leading to a non-uniform relaxation of the LV. Remodeling of the LV following a MI is subject to several factors which might involve diastolic function. This is supported by the presence of an impaired relaxation and restrictive filling pattern are associated with progressive LV dilatation following Ml. Furthermore, the LV remodeling process following the very early phase includes the scarring process with collagen deposition in the infarcted and non-infarcted myocardium. The extent and quality of the repair process involving collagen deposition are believed to influence the remodeling process. Increased collagen deposition in the subacute phase of Ml indicated by elevated values of the collagen marker PIIINP is found to be related to LV dilation, depressed systolic function and restrictive LV filling. Development of a restrictive filling in patients with increased collagen deposition might be due to increasing LV volume but also to increased myocardial stiffness. Regarding prognosis diastolic dysfunction seems to be an important marker of outcome as abnormal diastolic

  9. Relation between early mitral regurgitation and left ventricular thrombus formation after acute myocardial infarction: results of the GISSI-3 echo substudy

    PubMed Central

    Ascione, L; Antonini-Canterin, F; Macor, F; Cervesato, E; Chiarella, F; Giannuzzi, P; Temporelli, P L; Gentile, F; Lucci, D; Maggioni, A P; Tavazzi, L; Badano, L; Stoian, I; Piazza, R; Bosimini, E; Pavan, D; Nicolosi, G L

    2002-01-01

    Objective: To evaluate the prevalence and correlates of left ventricular thrombosis in patients with acute myocardial infarction, and whether the occurrence of early mitral regurgitation has a protective effect against the formation of left ventricular thrombus. Design and setting: Multicentre clinical trial carried out in 47 Italian coronary care units. Patients and methods: 757 patients from the GISSI-3 echo substudy population with their first acute myocardial infarct were studied by echocardiography at 24–48 hours from symptom onset (S1), at discharge (S2), at six weeks (S3), and at six months (S4). The diagnosis of left ventricular thrombosis was based on the detection of an echo dense mass with defined margins visible throughout the cardiac cycle in at least two orthogonal views. Results: In 64 patients (8%), left ventricular thrombosis was detected in one or more examinations. Compared with the remaining 693 patients, subjects with left ventricular thrombosis were older (mean (SD) age: 64.6 (13.0) v 59.8 (11.7) years, p < 0.005), and had larger infarcts (extent of wall motion asynergy: 40.9 (11.5)% v 24.9 (14)%, p < 0.001), greater depression of left ventricular ejection fraction at S1 (43.3 (6.9)% v 48.1 (6.8)%, p < 0.001), and greater left ventricular volumes at S1 (end diastolic volume: 87 (22) v 78 (18) ml/m2, p < 0.001; end systolic volume: 50 (17) v 41 (14) ml/m2, p < 0.001). The prevalence of moderate to severe mitral regurgitation on colour Doppler at S1 was greater in patients who had left ventricular thrombosis at any time (10.2% v 4.2%, p < 0.05). On stepwise multiple logistic regression analysis the only independent variables related to the presence of left ventricular thrombosis were the extent of wall motion asynergy and anterior site of infarction. Conclusions: Left ventricular thrombosis is not reduced, and may even be increased, by early moderate to severe mitral regurgitation after acute myocardial infarction. The only independent

  10. Effects of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) Trial.

    PubMed

    Iliceto, S; Scrutinio, D; Bruzzi, P; D'Ambrosio, G; Boni, L; Di Biase, M; Biasco, G; Hugenholtz, P G; Rizzon, P

    1995-08-01

    This study was performed to evaluate the effects of L-carnitine administration on long-term left ventricular dilation in patients with acute anterior myocardial infarction. Carnitine is a physiologic compound that performs an essential role in myocardial energy production at the mitochondrial level. Myocardial carnitine deprivation occurs during ischemia, acute myocardial infarction and cardiac failure. Experimental studies have suggested that exogenous carnitine administration during these events has a beneficial effect on function. The L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) trial was a randomized, double-blind, placebo-controlled, multicenter trial in which 472 patients with a first acute myocardial infarction and high quality two-dimensional echocardiograms received either placebo (239 patients) or L-carnitine (233 patients) within 24 h of onset of chest pain. Placebo or L-carnitine was given at a dose of 9 g/day intravenously for the first 5 days and then 6 g/day orally for the next 12 months. Left ventricular volumes and ejection fraction were evaluated on admission, at discharge from hospital and at 3, 6 and 12 months after acute myocardial infarction. A significant attenuation of left ventricular dilation in the first year after acute myocardial infarction was observed in patients treated with L-carnitine compared with those receiving placebo. The percent increase in both end-diastolic and end-systolic volumes from admission to 3-, 6- and 12-month evaluation was significantly reduced in the L-carnitine group. No significant differences were observed in left ventricular ejection fraction changes over time in the two groups. Although not designed to demonstrate differences in clinical end points, the combined incidence of death and congestive heart failure after discharge was 14 (6%) in the L-carnitine treatment group versus 23 (9.6%) in the placebo group (p = NS). Incidence of ischemic events during follow-up was similar in the

  11. Evolution of left ventricular ejection fraction after acute myocardial infarction: implications for implantable cardioverter-defibrillator eligibility.

    PubMed

    Sjöblom, Johanna; Muhrbeck, Josephine; Witt, Nils; Alam, Mahbubul; Frykman-Kull, Viveka

    2014-08-26

    Implantable cardioverter-defibrillator therapy improves survival in patients with reduced left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI). Although the risk of sudden cardiac death is highest in the first month after AMI, there is no survival benefit of early implantable cardioverter-defibrillator implantation, and the optimal time frame has yet to be established. Thus, the aim of this study was to investigate what proportion of post-AMI patients had improved LV function to such an extent that the indication for implantable cardioverter-defibrillator was no longer present. Patients admitted for AMI with reduced LVEF (≤40%) were eligible for inclusion. Repeat echocardiographic examinations were performed 5 days, 1 month, and 3 months after the AMI. We prospectively included 100 patients with LVEF of 31±5.8% after AMI. At the 1-month follow-up, 55% had an LVEF >35%. The main improvement in LVEF had occurred by 1 month. The mean difference in LVEF over the next 2 months was small, 1.9 percentage units. During the first 9 weeks, 10% of the patients suffered from life-threatening arrhythmias. Most patients have improved LVEF after AMI, and in the majority, the improvement can be confirmed after 1 month, implying that further delay of implantable cardioverter-defibrillator implantation may not be warranted. Life-threatening arrhythmias occurred in 10% of the patients, illustrating the high risk for sudden cardiac death in this population. © 2014 American Heart Association, Inc.

  12. Recovering two languages with the right hemisphere.

    PubMed

    Marini, Andrea; Galetto, Valentina; Tatu, Karina; Duca, Sergio; Geminiani, Giuliano; Sacco, Katiuscia; Zettin, Marina

    2016-08-01

    Converging evidence suggests that the right hemisphere (RH) plays an important role in language recovery from aphasia after a left hemisphere (LH) lesion. In this longitudinal study we describe the neurological, cognitive, and linguistic profile of A.C., a bilingual who, after a severe traumatic brain injury, developed a form of fluent aphasia that affected his two languages (i.e., Romanian and Italian). The trauma-induced parenchymal atrophy led to an exceptional ventricular dilation that, gradually, affected the whole left hemisphere. A.C. is now recovering both languages relying only on his right hemisphere. An fMRI experiment employing a bilingual covert verb generation task documented the involvement of the right middle temporal gyrus in processes of lexical selection and access. This case supports the hypothesis that the RH plays a role in language recovery from aphasia when the LH has suffered massive lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Biophysical Modeling to Determine the Optimization of Left Ventricular Pacing Site and AV/VV Delays in the Acute and Chronic Phase of Cardiac Resynchronization Therapy

    PubMed Central

    LEE, ANGELA W. C.; CROZIER, ANDREW; HYDE, EOIN R.; LAMATA, PABLO; TRUONG, MICHAEL; SOHAL, MANAV; JACKSON, THOMAS; BEHAR, JONATHAN M.; CLARIDGE, SIMON; SHETTY, ANOOP; SAMMUT, EVA; PLANK, GERNOT; RINALDI, CHRISTOPHER ALDO

    2017-01-01

    Device Optimization for Acute and Chronic CRT Background Cardiac anatomy and function adapt in response to chronic cardiac resynchronization therapy (CRT). The effects of these changes on the optimal left ventricle (LV) lead location and timing delay settings have yet to be fully explored. Objective To predict the effects of chronic CRT on the optimal LV lead location and device timing settings over time. Methods Biophysical computational cardiac models were generated for 3 patients, immediately post‐implant (ACUTE) and after at least 6 months of CRT (CHRONIC). Optimal LV pacing area and device settings were predicted by pacing the ACUTE and CHRONIC models across the LV epicardium (49 sites each) with a range of 9 pacing settings and simulating the acute hemodynamic response (AHR) of the heart. Results There were statistically significant differences between the distribution of the AHR in the ACUTE and CHRONIC models (P < 0.0005 in all cases). The site delivering the maximal AHR shifted location between the ACUTE and CHRONIC models but provided a negligible improvement (<2%). The majority of the acute optimal LV pacing regions (76–100%) and device settings (76–91%) remained optimal chronically. Conclusion Optimization of the LV pacing location and device settings were important at the time of implant, with a reduced benefit over time, where the majority of the acute optimal LV pacing region and device settings remained optimal with chronic CRT. PMID:27885749

  14. Hemispheric specialization in dogs for processing different acoustic stimuli.

    PubMed

    Siniscalchi, Marcello; Quaranta, Angelo; Rogers, Lesley J

    2008-01-01

    Considerable experimental evidence shows that functional cerebral asymmetries are widespread in animals. Activity of the right cerebral hemisphere has been associated with responses to novel stimuli and the expression of intense emotions, such as aggression, escape behaviour and fear. The left hemisphere uses learned patterns and responds to familiar stimuli. Although such lateralization has been studied mainly for visual responses, there is evidence in primates that auditory perception is lateralized and that vocal communication depends on differential processing by the hemispheres. The aim of the present work was to investigate whether dogs use different hemispheres to process different acoustic stimuli by presenting them with playbacks of a thunderstorm and their species-typical vocalizations. The results revealed that dogs usually process their species-typical vocalizations using the left hemisphere and the thunderstorm sounds using the right hemisphere. Nevertheless, conspecific vocalizations are not always processed by the left hemisphere, since the right hemisphere is used for processing vocalizations when they elicit intense emotion, including fear. These findings suggest that the specialisation of the left hemisphere for intraspecific communication is more ancient that previously thought, and so is specialisation of the right hemisphere for intense emotions.

  15. BET 1: IN PATIENTS WITH SUSPECTED ACUTE CORONARY SYNDROME, DOES WELLENS' SIGN ON THE ELECTROCARDIOGRAPH IDENTIFY CRITICAL LEFT ANTERIOR DESCENDING ARTERY STENOSIS?

    PubMed

    Morris, Niall; Howard, Laura

    2017-04-01

    Wellens' syndrome consists of a history suggestive of an acute coronary syndrome and biphasic or deeply inverted T waves in ECG leads V2-V3. A shortcut review was carried out to establish whether this ECG pattern identifies patients with a critical left anterior descending artery stenosis. Six relevant papers were found. The clinical bottom line is that biphasic T-wave inversion in lead V2-V3 should alert the clinician to a probable critical stenosis of the left anterior descending artery.

  16. Imaging network level language recovery after left PCA stroke

    PubMed Central

    Sebastian, Rajani; Long, Charltien; Purcell, Jeremy J.; Faria, Andreia V.; Lindquist, Martin; Jarso, Samson; Race, David; Davis, Cameron; Posner, Joseph; Wright, Amy; Hillis, Argye E.

    2016-01-01

    Purpose: The neural mechanisms that support aphasia recovery are not yet fully understood. Our goal was to evaluate longitudinal changes in naming recovery in participants with posterior cerebral artery (PCA) stroke using a case-by-case analysis. Methods: Using task based and resting state functional magnetic resonance imaging (fMRI) and detailed language testing, we longitudinally studied the recovery of the naming network in four participants with PCA stroke with naming deficits at the acute (0 week), sub acute (3–5 weeks), and chronic time point (5–7 months) post stroke. Behavioral and imaging analyses (task related and resting state functional connectivity) were carried out to elucidate longitudinal changes in naming recovery. Results: Behavioral and imaging analysis revealed that an improvement in naming accuracy from the acute to the chronic stage was reflected by increased connectivity within and between left and right hemisphere “language” regions. One participant who had persistent moderate naming deficit showed weak and decreasing connectivity longitudinally within and between left and right hemisphere language regions. Conclusions: These findings emphasize a network view of aphasia recovery, and show that the degree of inter- and intra- hemispheric balance between the language-specific regions is necessary for optimal recovery of naming, at least in participants with PCA stroke. PMID:27176918

  17. The calculating hemispheres: studies of a split-brain patient.

    PubMed

    Funnell, Margaret G; Colvin, Mary K; Gazzaniga, Michael S

    2007-06-11

    The purpose of the study was to investigate simple calculation in the two cerebral hemispheres of a split-brain patient. In a series of four experiments, the left hemisphere was superior to the right in simple calculation, confirming the previously reported left hemisphere specialization for calculation. In two different recognition paradigms, right hemisphere performance was at chance for all arithmetic operations, with the exception of subtraction in a two-alternative forced choice paradigm (performance was at chance when the lure differed from the correct answer by a magnitude of 1 but above chance when the magnitude difference was 4). In a recall paradigm, the right hemisphere performed above chance for both addition and subtraction, but performed at chance levels for multiplication and division. The error patterns in that experiment suggested that for subtraction and addition, the right hemisphere does have some capacity for approximating the solution even when it is unable to generate the exact solution. Furthermore, right hemisphere accuracy in addition and subtraction was higher for problems with small operands than with large operands. An additional experiment assessed approximate and exact addition in the two hemispheres for problems with small and large operands. The left hemisphere was equally accurate in both tasks but the right hemisphere was more accurate in approximate addition than in exact addition. In exact addition, right hemisphere accuracy was higher for problems with small operands than large, but the opposite pattern was found for approximate addition.

  18. Differential hemispheric modulation of preparatory attention.

    PubMed

    Fernández, Laura Gabriela; Siéroff, Eric

    2014-06-01

    Preparatory attention (PA) is the ability to allocate attention to a stimulus prior to its occurrence and is a crucial component of attentional control. We investigated the role of brain hemispheres in PA using an experimental test in which normal participants responded to a target that could appear in the right or the left visual fields, thus projecting to the left or the right hemispheres, while ignoring a central distractor that could appear in the preparatory phase preceding the target. This experimental test measures the ability of participants to modulate PA directed to a target location when the probability of a distractor occurrence varies across three blocks of trials (0%, 33%, 67%). The competition between distractors and target for PA should produce slower response times when the probability of distractors is high. Three experiments were conducted varying the temporal predictability of the target occurrence within a trial (high predictability in Experiments 1 and 3, and low predictability in Experiment 2), and the task used (location in Experiments 1 and 2, and detection in Experiment 3). We found that the modulation of PA by the expected probability of events was different in each visual field/hemisphere. Whereas the left hemisphere PA was influenced by the mere probability of events in each block of trials, the right hemisphere PA was mainly influenced by events with high temporal predictability. These results suggest that each hemisphere uses a different strategy to modulate PA when directed to a target location at the perceptual level of visual processing.

  19. Tympanic Membrane Temperature and Hemispheric Cognitive Style.

    PubMed

    Genovese, Jeremy E C; Sparks, Kenneth E; Little, Kathleen D

    2017-01-01

    The authors tested the hypothesis that there is a correlation between hemispheric cognitive style and ear temperature. A sample of 100 participants completed a measure of hemispheric cognitive style, the Hemispheric Consensus Prediction Profile. Ear temperatures were taken in 2 sessions, 2 times for each ear at each session. Average left ear temperature was subtracted from average right ear temperature as an index of dominant temperature. Only 56 of the participants showed a stable dominant ear temperature. For these 56 participants, there was a statistically significant positive correlation between scores on the Hemispheric Consensus Prediction Profile and tympanic member temperature (Spearman's  ρ =.29, 95% CI [.04,.51]). Individuals with a left hemispheric cognitive style tended to have a warmer left tympanic membrane temperature while those with a right hemispheric cognitive style tended to have a warmer right tympanic membrane temperature. Tympanic membrane temperatures are easily obtained using inexpensive and noninvasive technology. The relationship suggested by these findings may open new opportunities for the study of cerebral asymmetry.

  20. Left ventricular function by speckle-tracking echocardiography in patients with low-T3 syndrome and acute myocardial infarction.

    PubMed

    Jankauskienė, Edita; Orda, Paulius; Rumbinaitė, Eglė; Žaliaduonytė-Pekšienė, Diana; Steponavičiutė, Rasa; Krasauskienė, Aurelija; Vaškelytė, Jolanta Justina; Bunevičius, Robertas

    2015-01-01

    Low-T3 syndrome is common in patients with acute myocardial infarction (AMI). Recent experimental and clinical data have suggested a potential negative impact of low-T3 syndrome on myocardial function in patients with AMI. The aim of this study was to assess left ventricular (LV) myocardial function in patients with low-T3 syndrome and to investigate the association between hormonal profile and the severity of LV dysfunction using speckle-tracking echocardiography (STE). In 130 patients with first-onset ST-segment elevation acute myocardial infarction (STEMI), conventional 2D and speckle-tracking echocardiography within 48-72h after the hospitalization was performed, and blood samples for TSH, fT4, fT3, and anti-TPO levels were obtained to investigate thyroid hormone production within 24h and on the fourth day after the onset of STEMI symptoms. The patients were divided into two groups according to their serum level of fT3: group 1 with fT3 concentration below 3.2pmol/L (n=34) and group 2 with normal fT3 (>3.2pmol/L) level (n=96). LV ejection fraction (EF) tended to be lower in the low fT3 group. The systolic longitudinal strain did not differ between the groups, but the late diastolic longitudinal strain rate was lower in group 1 (P=0.011). The systolic basal LV rotation positively correlated with the level of fT3 (r=0.4; P<0.001), while a negative correlation was detected between myocardial rotational parameters - systolic apical rotation (r=-0.2; P<0.05), torsion (r=-0.3; P<0.001), and diastolic apical rotation rate (r=-0.3; P<0.01) - and fT3 levels. The late diastolic longitudinal LV strain rate and LV rotation evaluated by speckle-tracking echocardiography were impaired in patients with low-T3 syndrome after AMI. Copyright © 2015 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  1. Knowledge-Based Inferences across the Hemispheres: Domain Makes a Difference

    ERIC Educational Resources Information Center

    Shears, Connie; Hawkins, Amanda; Varner, Andria; Lewis, Lindsey; Heatley, Jennifer; Twachtmann, Lisa

    2008-01-01

    Language comprehension occurs when the left-hemisphere (LH) and the right-hemisphere (RH) share information derived from discourse [Beeman, M. J., Bowden, E. M., & Gernsbacher, M. A. (2000). Right and left hemisphere cooperation for drawing predictive and coherence inferences during normal story comprehension. "Brain and Language, 71", 310-336].…

  2. Knowledge-Based Inferences across the Hemispheres: Domain Makes a Difference

    ERIC Educational Resources Information Center

    Shears, Connie; Hawkins, Amanda; Varner, Andria; Lewis, Lindsey; Heatley, Jennifer; Twachtmann, Lisa

    2008-01-01

    Language comprehension occurs when the left-hemisphere (LH) and the right-hemisphere (RH) share information derived from discourse [Beeman, M. J., Bowden, E. M., & Gernsbacher, M. A. (2000). Right and left hemisphere cooperation for drawing predictive and coherence inferences during normal story comprehension. "Brain and Language, 71", 310-336].…

  3. Biophysical Modeling to Determine the Optimization of Left Ventricular Pacing Site and AV/VV Delays in the Acute and Chronic Phase of Cardiac Resynchronization Therapy.

    PubMed

    Lee, Angela W C; Crozier, Andrew; Hyde, Eoin R; Lamata, Pablo; Truong, Michael; Sohal, Manav; Jackson, Thomas; Behar, Jonathan M; Claridge, Simon; Shetty, Anoop; Sammut, Eva; Plank, Gernot; Rinaldi, Christopher Aldo; Niederer, Steven

    2017-02-01

    Cardiac anatomy and function adapt in response to chronic cardiac resynchronization therapy (CRT). The effects of these changes on the optimal left ventricle (LV) lead location and timing delay settings have yet to be fully explored. To predict the effects of chronic CRT on the optimal LV lead location and device timing settings over time. Biophysical computational cardiac models were generated for 3 patients, immediately post-implant (ACUTE) and after at least 6 months of CRT (CHRONIC). Optimal LV pacing area and device settings were predicted by pacing the ACUTE and CHRONIC models across the LV epicardium (49 sites each) with a range of 9 pacing settings and simulating the acute hemodynamic response (AHR) of the heart. There were statistically significant differences between the distribution of the AHR in the ACUTE and CHRONIC models (P < 0.0005 in all cases). The site delivering the maximal AHR shifted location between the ACUTE and CHRONIC models but provided a negligible improvement (<2%). The majority of the acute optimal LV pacing regions (76-100%) and device settings (76-91%) remained optimal chronically. Optimization of the LV pacing location and device settings were important at the time of implant, with a reduced benefit over time, where the majority of the acute optimal LV pacing region and device settings remained optimal with chronic CRT. © 2016 Wiley Periodicals, Inc.

  4. Different contribution of extent of myocardial injury to left ventricular systolic and diastolic function in early reperfused acute myocardial infarction

    PubMed Central

    2014-01-01

    Background We sought to investigate the influence of the extent of myocardial injury on left ventricular (LV) systolic and diastolic function in patients after reperfused acute myocardial infarction (AMI). Methods Thirty-eight reperfused AMI patients underwent cardiac magnetic resonance (CMR) imaging after percutaneous coronary revascularization. The extent of myocardial edema and scarring were assessed by T2 weighted imaging and late gadolinium enhancement (LGE) imaging, respectively. Within a day of CMR, echocardiography was done. Using 2D speckle tracking analysis, LV longitudinal, circumferential strain, and twist were measured. Results Extent of LGE were significantly correlated with LV systolic functional indices such as ejection fraction (r = -0.57, p < 0.001), regional wall motion score index (r = 0.52, p = 0.001), and global longitudinal strain (r = 0.56, p < 0.001). The diastolic functional indices significantly correlated with age (r = -0.64, p < 0.001), LV twist (r = -0.39, p = 0.02), average non-infarcted myocardial circumferential strain (r = -0.52, p = 0.001), and LV end-diastolic wall stress index (r = -0.47, p = 0.003 with e’) but not or weakly with extent of LGE. In multivariate analysis, age and non-infarcted myocardial circumferential strain independently correlated with diastolic functional indices rather than extent of injury. Conclusions In patients with timely reperfused AMI, not only extent of myocardial injury but also age and non-infarcted myocardial function were more significantly related to LV chamber diastolic function. PMID:24512272

  5. Usefulness of ambulatory radionuclide monitoring of left ventricular function early after acute myocardial infarction for predicting residual myocardial ischemia

    SciTech Connect

    Breisblatt, W.M.; Weiland, F.L.; McLain, J.R.; Tomlinson, G.C.; Burns, M.J.; Spaccavento, L.J.

    1988-11-15

    Ambulatory radionuclide monitoring of left ventricular function was performed with the nuclear Vest device in 35 patients early after acute myocardial infarction. Patients were evaluated during post-infarction treadmill, other activities that included mental stress and cold pressor challenge, and with stress thallium imaging and cardiac catheterization. Of the 35 patients evaluated, 14 had ischemic responses on treadmill testing and 21 had negative responses. By contrast, 20 had redistribution by thallium imaging suggesting ischemia. Vest studies demonstrated 56 responses suggestive of ischemia in 23 patients. Twenty-two occurred during exercise and 13 with mental stress. Seventy-five percent were silent and only 39% had associated electrocardiographic changes. Vest responses were compared in patients whose thallium scan was indicative of ischemia (thallium-positive) and those without ischemia (thallium-negative). Ejection fraction was higher in the thallium-positive group (0.52 +/- 0.11), as compared with thallium-negative patients (0.44 +/- 0.1). With exercise, ejection fraction decreased for the thallium-positive patients from 0.52 +/- 0.11 to 0.40 +/- 0.09 at peak exercise. For thallium-negative patients, ejection fraction changes were not significant. During mental stress, ejection fraction decreased from 0.51 +/- 0.11 to 0.45 +/- 0.12 for thallium-positive patients while thallium-negative patients were unchanged. Vest-measured decreases in ejection fraction of greater than or equal to 5 units during exercise were highly sensitive (90%), specific (73%) and predictive (82%) of a positive thallium scan. The same response for mental stress was specific (87%) and predictive (85%) of a positive scan result.

  6. Assessment of Smith Algorithms for the Diagnosis of Acute Myocardial Infarction in the Presence of Left Bundle Branch Block.

    PubMed

    Di Marco, Andrea; Anguera, Ignasi; Rodríguez, Marcos; Sionis, Alessandro; Bayes-Genis, Antoni; Rodríguez, Jany; Ariza-Solé, Albert; Sánchez-Salado, José Carlos; Díaz-Nuila, Mario; Masotti, Mónica; Villuendas, Roger; Dallaglio, Paolo; Gómez-Hospital, Joan Antoni; Cequier, Ángel

    2017-07-01

    Recently, a new electrocardiography algorithm has shown promising results for the the diagnosis of acute myocardial infarction in the presence of left bundle branch block (LBBB). We aimed to assess these new electrocardiography rules in a cohort of patients referred for primary percutaneous coronary intervention (pPCI). Retrospective observational cohort study that included all patients with suspected myocardial infarction and LBBB on the presenting electrocardiogram, referred for pPCI to 4 tertiary hospitals in Barcelona, Spain. A total of 145 patients were included. Fifty four (37%) had an ST-segment elevation myocardial infarction (STEMI) equivalent. Among patients with STEMI, 25 (46%) presented in Killip class III or IV, and in-hospital mortality was 15%. Smith I and II rules performed better than Sgarbossa algorithms and showed good specificity (90% and 97%, respectively) but their sensitivity was 67% and 54%, respectively. In a strategy guided by Smith I or Smith II rules, 18 (33%) or 25 (46%) patients with STEMI would have not received a pPCI, respectively. Moreover, the severity and prognosis of STEMI patients was similar regardless of the positivity of Smith rules. Cardiac biomarkers were positive in 54% of non-STEMI patients, limiting their usefulness for initial diagnostic screening. Diagnosis of STEMI in the presence of LBBB remains a challenge. Smith rules can be useful but are limited by suboptimal sensitivity. The search for new electrocardiography algorithms should be encouraged to avoid unnecessary aggressive treatments in the majority of patients, while providing timely reperfusion to a high-risk subgroup of patients. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Evaluation of T-Wave Morphology in Patients With Left Bundle Branch Block and Suspected Acute Coronary Syndrome.

    PubMed

    Meyers, H Pendell; Jaffa, Elias; Smith, Stephen W; Drake, Weiying; Limkakeng, Alexander T

    2016-09-01

    T-wave morphology in the setting of left bundle branch block (LBBB) has been proposed as an indicator of myocardial ischemia. We sought to identify T-wave morphology findings in patients with LBBB that predict non-ST-segment elevation myocardial infarction (NSTEMI). We hypothesized that two or more contiguous leads with concordant T waves would be predictive of NSTEMI. This was a retrospective cohort study performed by chart review in a tertiary care center emergency department. We identified a consecutive cohort who presented with LBBB and symptoms consistent with acute coronary syndrome. Exclusion criteria were diastolic blood pressure > 120 mm Hg, heart rate > 130 beats/min, positive pressure ventilation, potassium > 5.5 mEq/L, and cardiac arrest without prearrest electrocardiogram (ECG) available. We collected ECGs and classified T waves into five categories based on morphology, blinded to clinical outcome. Clinical outcome data were collected blinded to ECG findings. Those with ECG diagnostic of STEMI by modified Sgarbossa criteria were excluded from the primary analysis, which was sensitivity and specificity of two or more contiguous leads with concordant T waves for NSTEMI. There were 246 patients included. Mean age was 73 years; 160 (65%) were female, and 32 had myocardial infarction. Thirty percent had two or more contiguous precordial leads with partially or completely concordant T waves. For NSTEMI, the sensitivity and specificity of this finding were 19% (95% confidence interval [CI] 8-37) and 68% (95% CI 61-74). We found no clinically useful relationship between T-wave concordance and myocardial infarction in our patient population. Future investigation of LBBB T-wave morphology should focus on alternative populations and findings. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Awake right hemisphere brain surgery.

    PubMed

    Hulou, M Maher; Cote, David J; Olubiyi, Olutayo I; Smith, Timothy R; Chiocca, E Antonio; Johnson, Mark D

    2015-12-01

    We report the indications and outcomes of awake right hemispheric brain surgery, as well as a rare patient with crossed aphasia. Awake craniotomies are often performed to protect eloquent cortex. We reviewed the medical records for 35 of 96 patients, in detail, who had awake right hemisphere brain operations. Intraoperative cortical mapping of motor and/or language function was performed in 29 of the 35 patients. A preoperative speech impairment and left hand dominance were the main indicators for awake right-sided craniotomies in patients with right hemisphere lesions. Four patients with lesion proximity to eloquent areas underwent awake craniotomies without cortical mapping. In addition, one patient had a broncho-pulmonary fistula, and another had a recent major cardiac procedure that precluded awake surgery. An eloquent cortex representation was identified in 14 patients (48.3%). Postoperatively, seven of 17 patients (41.1%) who presented with weakness, experienced improvements in their motor functions, 11 of 16 (68.7%) with seizures became seizure-free, and seven of nine (77.7%) with moderate to severe headaches and one of two with a visual field deficit improved significantly. There were also improvements in speech and language functions in all patients who presented with speech difficulties. A right sided awake craniotomy is an excellent option for left handed patients, or those with right sided cortical lesions that result in preoperative speech impairments. When combined with intraoperative cortical mapping, both speech and motor function can be well preserved.

  9. Magnetic resonance imaging demonstration of anomalous origin of the right coronary artery from the left coronary sinus associated with acute myocardial infarction.

    PubMed

    Lee, Jongmee; Choe, Yeon Hyeon; Kim, Hyun-Joong; Park, Jeong Euy

    2003-01-01

    Coronary MR angiography can be useful for noninvasive diagnosis of potentially life-threatening coronary artery anomalies. However, there has been no report to date on MR demonstration of acute myocardial infarction associated with right coronary artery anomaly. A 55-year-old man was admitted with chest pain. Catheter coronary angiography revealed an anomalous origin with compression in the proximal segment of right coronary artery. Breath-hold MR angiography using spiral acquisition technique showed that the right coronary artery originated from the left coronary sinus with a separate os. The proximal segment of the artery was compressed by right ventricle outflow tract during the diastolic phase of cine MR imaging. Contrast-enhanced MR imaging 5 minutes after Gd-DTPA injection showed hyperenhancement suggestive of acute myocardial infarction in the posteroinferior wall of the left ventricle.

  10. Concept and verbal ability as related to the cerebral hemispheres.

    PubMed

    Cook, N D

    1977-10-01

    A new theory of human brain function is outlined in terms of the cooperative interaction of the cerebral hemispheres. The well-established verbal, symbolic functions of the left hemisphere and the wholistic, spatial functions of the right hemisphere are seen as separate and independent manifestations of the normally integrated verbal-analytic (or "error detector") and conceptual (or "goal state") functions of the left and right, respectively. The relationship between the hemispheres is described in terms of the "goal-directed" system of cybernetics and then compared with related ideas previously presented by Dimond, Penfield, and Piaget.

  11. Developmental trends in right hemispheric participation in reading.

    PubMed

    Waldie, K E; Mosley, J L

    2000-01-01

    Behavioral laterality tasks assessed the differential processing efficiencies of the cerebral hemispheres in younger and older reading-age children. Lateralized lexical decision task findings supported a "direct access" model of hemispheric processing for the younger children whereas the older children demonstrated a "callosal relay" pattern. A dual-task with oral and silent reading indicated that the right hand was significantly more disrupted than the left during unimanual finger tapping. The findings suggest that although the left hemisphere's involvement during reading is developmentally stable, the involvement of the right hemisphere appears to change dynamically as reading experience increases.

  12. Management of a subclavian artery thrombosis causing acute anterior wall infarction and concurrent left arm ischemia in a patient with prior coronary bypass.

    PubMed

    Akgüllü, Çağdaş; Eryılmaz, Ufuk; Zencir, Cemil; Güngör, Hasan

    2014-12-01

    We report a 57-year-old patient with acute anterior wall infarction with a history of a coronary baypass graft operation in 2007. He also had concurrent left arm cyanosis and severe pain. He had received diagnosis of pancreatic adenocarcinoma one month previously and had had his first chemotherapy in the previous week with gemcitabine and 5-fluorouracil. After the angiography, a giant thrombus was detected in the proximal left subclavian artery, deteriorating the flows of both left internal mammarian artery (LIMA) to left anterior descending (LAD) coronary artery graft, as well as the left brachial artery. The proximal subclavian artery was stented and good flow was achieved. Through the LIMA, the distal part of LAD, which was totally obstructed with probable distal thrombus embolization, was reached and a percutaneous balloon angioplasty performed. However, the no-reflow phenomenon was observed in distal LAD. A Fogarty traction of thrombus was performed successfully for the revascularization of the left arm. Approximately 30 minutes after the procedure, both angina and ST segment elevation in ECG were resolved under unfractioned heparin and nitroglycerin infusion. However, the patient died due to sepsis seven days after admission to hospital. In the literature, there are only a few previous reports on this rare clinical entity. The eitology, presentation, and the possible management strategies of this clinical entity is presented in this report.

  13. IgG4-related pleural disease diagnosed by a re-evaluation of chronic bilateral pleuritis in a patient who experienced occasional acute left bacterial pleuritis.

    PubMed

    Yamamoto, Hiroshi; Suzuki, Toshiro; Yasuo, Masanori; Kobayashi, Orie; Tsushima, Kenji; Ito, Michiko; Urushihata, Kazuhisa; Yamazaki, Yoshitaka; Hanaoka, Masayuki; Koizumi, Tomonobu; Uehara, Takeshi; Kawakami, Satoshi; Hamano, Hideaki; Kawa, Shigeyuki; Kubo, Keishi

    2011-01-01

    A 78-year-old man with cryptogenic chronic bilateral lymphoplasmacytic pleuritis, diagnosed based on left parietal pleural biopsy specimens obtained by pleuroscopy, developed acute left bacterial pleuritis. The left pleural effusion was neutrophil dominant, however, the right pleural effusion showed lymphoplasmacytic infiltration. Laboratory examinations revealed that his serum IgG4 concentration was increased, with a higher level of IgG4 in the right pleural effusion. Re-evaluation of the previous biopsy specimens using an immunostaining method revealed numerous IgG4-positive plasma cell infiltrations with IgG4-positive/IgG-positive plasma cells at 85.4%. Accordingly, the new diagnosis of this patient was considered to be chronic bilateral IgG4-related pleuritis.

  14. Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke.

    PubMed

    May, Nelson H; Pisegna, Jessica M; Marchina, Sarah; Langmore, Susan E; Kumar, Sandeep; Pearson, William G

    2017-05-01

    Computational analysis of swallowing mechanics (CASM) is a method that utilizes multivariate shape change analysis to uncover covariant elements of pharyngeal swallowing mechanics associated with impairment using videofluoroscopic swallowing studies. The goals of this preliminary study were to (1) characterize swallowing mechanics underlying stroke-related dysphagia, (2) decipher the impact of left and right hemispheric strokes on pharyngeal swallowing mechanics, and (3) determine pharyngeal swallowing mechanics associated with penetration-aspiration status. Videofluoroscopic swallowing studies of 18 dysphagic patients with hemispheric infarcts and age- and gender-matched controls were selected from well-controlled data sets. Patient data including laterality and penetration-aspiration status were collected. Coordinates mapping muscle group action during swallowing were collected from videos. Multivariate morphometric analyses of coordinates associated with stroke, affected hemisphere, and penetration-aspiration status were performed. Pharyngeal swallowing mechanics differed significantly in the following comparisons: stroke versus controls (D = 2.19, P < .0001), right hemispheric stroke versus controls (D = 3.64, P < .0001), left hemispheric stroke versus controls (D = 2.06, P < .0001), right hemispheric stroke versus left hemispheric stroke (D = 2.89, P < .0001), and penetration-aspiration versus within normal limits (D = 2.25, P < .0001). Differences in pharyngeal swallowing mechanics associated with each comparison were visualized using eigenvectors. Whereas current literature focuses on timing changes in stroke-related dysphagia, these data suggest that mechanical changes are also functionally important. Pharyngeal swallowing mechanics differed by the affected hemisphere and the penetration-aspiration status. CASM can be used to identify patient-specific swallowing impairment associated with stroke injury that could help

  15. Hypnosis in the right hemisphere.

    PubMed

    Kihlstrom, John F; Glisky, Martha L; McGovern, Susan; Rapcsak, Steven Z; Mennemeier, Mark S

    2013-02-01

    Speculations about the neural substrates of hypnosis have often focused on the right hemisphere (RH), implying that RH damage should impair hypnotic responsiveness more than left-hemisphere (LH) damage. The present study examined the performance of a patient who suffered a stroke destroying most of his LH, on slightly modified versions of two hypnotizability scales. This patient was at least modestly hypnotizable, as indicated in particular by the arm rigidity and age regression items, suggesting that hypnosis can be mediated by the RH alone - provided that the language capacities normally found in the LH remain available. A further study of 16 patients with unilateral strokes of the LH or RH found no substantial differences in hypnotizability between the two groups. Future neuropsychological studies of hypnosis might explore the dorsal/ventral or anterior/posterior dichotomies, with special emphasis on the role of prefrontal cortex. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Phonological decisions require both the left and right supramarginal gyri

    PubMed Central

    Hartwigsen, Gesa; Baumgaertner, Annette; Price, Cathy J.; Koehnke, Maria; Ulmer, Stephan; Siebner, Hartwig R.

    2010-01-01

    Recent functional imaging studies demonstrated that both the left and right supramarginal gyri (SMG) are activated when healthy right-handed subjects make phonological word decisions. However, lesion studies typically report difficulties with phonological processing after left rather than right hemisphere damage. Here, we used a unique dual-site transcranial magnetic stimulation (TMS) approach to test whether the SMG in the right hemisphere contributes to modality-independent (i.e., auditory and visual) phonological decisions. To test task-specificity, we compared the effect of real or sham TMS during phonological, semantic, and perceptual decisions. To test laterality and anatomical specificity, we compared the effect of TMS over the left, right, or bilateral SMG and angular gyri. The accuracy and reaction times of phonological decisions were selectively disrupted relative to semantic and perceptual decisions when real TMS was applied over the left, right, or bilateral SMG. These effects were not observed for TMS over the angular gyri. A follow-up experiment indicated that the threshold-intensity for inducing a disruptive effect on phonological decisions was identical for unilateral TMS over the right or left SMG. Taken together, these findings provide converging evidence that the right SMG contributes to accurate and efficient phonological decisions in the healthy brain, with no evidence that the left and right SMG can compensate for one another during TMS. Our findings motivate detailed studies of phonological processing in patients with acute or long-term damage of the right SMG. PMID:20807747

  17. Right hemisphere involvement in imprinting memory revealed by glutamate treatment.

    PubMed

    Johnston, A N; Rogers, L J

    1998-08-01

    The lateralized use of the forebrain hemispheres during recall of imprinting memory was investigated using unilateral intrahemispheric injections of glutamate. Administration of glutamate to the right hemisphere 1.3, or 6 h after exposure to the imprinting stimulus disrupted recall 8 h after the end of training, whereas the same treatment of the left hemisphere had no effect. Imprinted chicks treated with glutamate injected into the right hemisphere did not approach the imprinting stimulus in preference to an alternative, unfamiliar stimulus during a simultaneous choice test, whereas imprinted chicks treated with glutamate injected into the left hemisphere showed a preference for the imprinting stimulus. Thus, the left and right hemispheres are involved differentially in the recall of imprinting memory. Fear behavior or activity levels were not altered by glutamate treatment of either the right or left hemisphere, indicating that the effects of glutamate were specific to recall of imprinting memory. However, the amnestic effect of treatment of the right hemisphere with glutamate was transient: it was no longer evident by 48 h after the end of training. Also, glutamate had no effect when the chicks were treated 9 h after the end of training. These results suggest that regions in right hemisphere of the chick brain are involved in early (0-8 h after training) recall of imprinting memory.

  18. On Policy-Making: Lessons from the Left Hand.

    ERIC Educational Resources Information Center

    Manley-Casimir, Michael E.

    Interest has recently revived in the theory that the left and right hemispheres of the brain control distinguishable facets of cognitive behavior. Robert Samples has described the realm of the left hemisphere as that of rationality, logic, linear thinking, and separation of reality into its component parts. He sees the right hemisphere as the…

  19. Callisto's Southern Hemisphere

    NASA Technical Reports Server (NTRS)

    1997-01-01

    These views of Callisto's southern hemisphere were taken by the Near Infrared Mapping Spectrometer just after closest approach in orbit G8 on May 6, 1997. These false color images show surface compositional differences, red = more ice, blue = less ice.

    The upper left view contains Buri, a crater with a diameter of about 60 km. In the infrared spectrum, Buri and the rays that extend from the crater have high abundance of water ice compared to the surrounding region. The center view, a large (200 km or 120 mile diameter) unnamed impact crater with a distinct ring or circle around it reveals a complex mix of ice and non-ice materials. This is possibly due to impact excavation of the ice-rich subsurface which suggests that the darker material is just a thin surface covering caused by impact debris or a lag deposit from which the ice has evaporated away. The infrared data shows spectral signatures for both sulfur and carbon as two potential materials which could play a part in the complicated make-up of Callisto's surface.

    The Jet Propulsion Laboratory, Pasadena, CA manages the Galileo mission for NASA's Office of Space Science, Washington, DC. JPL is an operating division of California Institute of Technology (Caltech).

    This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page at URL http://galileo.jpl.nasa.gov.

  20. Europa's Leading Hemisphere

    NASA Technical Reports Server (NTRS)

    1997-01-01

    This image of Europa's leading hemisphere was obtained by the solid state imaging (CCD) system on board NASA's Galileo spacecraft during its seventh orbit of Jupiter. In the upper left part of the image is Tyre, a multi-ringed structure that may have formed as a result of an ancient impact. Also visible are numerous lineaments that extend for over 1000 kilometers. The limb, or edge, of Europa in this image can be used by scientists to constrain the radius and shape of the satellite. North is to the top of the picture and the sun illuminates the surface from the right. The image, centered at -40 latitude and 180 longitude, covers an area approximately 2000 by 1300 kilometers. The finest details that can be discerned in this picture are about 6.6 kilometers across. The images were taken on April 3, 1997 at 17 hours, 42 minutes, 19 seconds Universal Time when the spacecraft was at a range of 31,8628 kilometers.

    The Jet Propulsion Laboratory, Pasadena, CA manages the mission for NASA's Office of Space Science, Washington, DC.

    This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page at URL http://galileo.jpl.nasa.gov. Background information and educational context for the images can be found at URL http://www.jpl.nasa.gov/galileo/sepo

  1. Predicting Outcomes Over Time in Patients With Heart Failure, Left Ventricular Systolic Dysfunction, or Both Following Acute Myocardial Infarction.

    PubMed

    Lopes, Renato D; Pieper, Karen S; Stevens, Susanna R; Solomon, Scott D; McMurray, John J V; Pfeffer, Marc A; Leimberger, Jeffrey D; Velazquez, Eric J

    2016-06-27

    Most studies of risk assessment or stratification in patients with myocardial infarction (MI) have been static and fail to account for the evolving nature of clinical events and care processes. We sought to identify predictors of mortality, cardiovascular death or nonfatal MI, and cardiovascular death or nonfatal heart failure (HF) over time in patients with HF, left ventricular systolic dysfunction, or both post-MI. Using data from the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial, we developed models to estimate the association between patient characteristics and the likelihood of experiencing an event from the time of a follow-up visit until the next visit. The intervals are: hospital arrival to discharge or 14 days, whichever occurs first; hospital discharge to 30 days; 30 days to 6 months; and 6 months to 3 years. Models were also developed to predict the entire 3-year follow-up period using baseline information. Multivariable Cox proportional hazards modeling was used throughout with Wald chi-squares as the comparator of strength for each predictor. For the baseline model of overall mortality, the 3 strongest predictors were age (adjusted hazard ratio [HR], 1.35; 95% CI, 1.28-1.42; P<0.0001), baseline heart rate (adjusted HR, 1.17; 95% CI, 1.14-1.21; P<0.0001), and creatinine clearance (≤100 mL/min; adjusted HR, 0.86; 95% CI, 0.84-0.89; P<0.0001). According to the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices, the updated model had significant improvement over the model with baseline covariates only in all follow-up periods and with all outcomes. Patient information assessed closest to the time of the outcome was more valuable in predicting death when compared with information obtained at the time of the index hospitalization. Using updated patient information improves prognosis over using only the information available at the time of the index event. © 2016 The Authors. Published on behalf

  2. Significance of NT-pro-BNP in acute exacerbation of COPD patients without underlying left ventricular dysfunction.

    PubMed

    Adrish, Muhammad; Nannaka, Varalaxmi Bhavani; Cano, Edison J; Bajantri, Bharat; Diaz-Fuentes, Gilda

    2017-01-01

    B-type natriuretic peptide (BNP) and the N-terminal fragment of pro-BNP (NT-pro-BNP) are established biomarkers of heart failure. Increased levels of natriuretic peptide (NP) have been associated with poor outcomes in acute exacerbation of COPD (AECOPD); however, most studies did not address the conditions that can also increase NT-pro-BNP levels. We aimed to determine if NT-pro-BNP levels correlate with outcomes of AECOPD in patients without heart failure and other conditions that can affect NT-pro-BNP levels. We conducted a retrospective study in patients hospitalized for AECOPD with available NT-pro-BNP levels and normal left ventricular ejection fraction. We compared patients with normal and elevated NT-pro-BNP levels and analyzed the clinical and outcome data. A total of 167 of 1,420 (11.7%) patients met the study criteria. A total of 77% of male patients and 53% of female patients had elevated NT-pro-BNP levels (P=0.0031). NT-pro-BNP levels were not associated with COPD severity and comorbid illnesses. Log-transformed NT-pro-BNP levels were positively associated with echocardiographically estimated right ventricular systolic pressure (r=0.3658; 95% confidence interval [CI]: 0.2060-0.5067; P<0.0001). Patients with elevated NT-pro-BNP levels were more likely to require intensive care (63% vs 43%; P=0.0207) and had a longer hospital length of stay (P=0.0052). There were no differences in the need for noninvasive positive pressure ventilation (P=0.1245) or mechanical ventilation (P=0.9824) or in regard to in-hospital mortality (P=0.5273). Patients with AECOPD and elevated NT-pro-BNP levels had increased hospital length of stay and need for intensive care. Based on our study, serum NT-pro-BNP levels cannot be used as a biomarker for increased mortality or requirement for invasive or noninvasive ventilation in this group of patients.

  3. Acute aphasia in multiple sclerosis.

    PubMed

    Devere, T R; Trotter, J L; Cross, A H

    2000-08-01

    Acute aphasia is rare in multiple sclerosis. We describe 3 patients with multiple sclerosis who had acute exacerbations presenting as aphasias. One patient had a mixed transcortical aphasia, 1 had a transcortical motor aphasia, and 1 had a Broca aphasia. Magnetic resonance imaging scans of the brain with contrast enhancement revealed new white matter lesions in the left hemisphere in all 3 patients. Two of the 3 patients had a good response to treatment with methylprednisolone sodium succinate. Arch Neurol. 2000;57:1207-1209

  4. Trastuzumab (Herceptin)-associated cardiomyopathy presented as new onset of complete left bundle-branch block mimicking acute coronary syndrome: a case report and literature review.

    PubMed

    Tu, Chung-Ming; Chu, Kai-Ming; Yang, Shin-Ping; Cheng, Shu-Mung; Wang, Wen-Been

    2009-09-01

    Trastuzumab (Herceptin) is well documented in reducing suffering and mortality from breast cancer. The clinically most important side effect of Herceptin is cardiotoxicity, which is reported in 2.6% to 4.5% of patients receiving trastuzumab alone and in as many as 27% of patients when trastuzumab is combined with an anthracycline in metastatic disease. We reported the case of a 50-year-old woman who presented to our emergency department (ED) because of chest pain and shortness of breath. On physical examination, holosystolic murmur over apex could be heard. Pulmonary and abdominal examinations were unremarkable. Twelve-lead electrocardiography showed sinus tachycardia and new onset of complete left bundle-branch block. Emergent transthoracic echocardiography revealed generalized hypokinesia of left ventricle and akinesia over interventricular septum and apex. She subsequently underwent immediate coronary angiography that revealed normal coronary angiography, and left ventriculogram revealed generalized hypokinesia with severe left ventricle dysfunction with ejection fraction of 33%. During right heart catheterization and endomyocardial biopsy, cardiac tamponade developed and was successfully relieved by pericardial window. She was discharged event-free 3 weeks later with conservative treatment. Although new onset of complete left bundle-branch block in a patient with chest pain may be acute coronary syndrome, careful review of medicine history is mandatory to avoid unnecessary procedure and complications.

  5. Sirolimus-Versus Zotarolimus-Eluting Stents in Acute Coronary Syndromes With C Type Left Anterior Descending Artery Lesions: A Three-Year Clinical Follow-Up

    PubMed Central

    Gokay, Seher; Cicek, Davran; Muderrisoglu, Haldun

    2012-01-01

    Background Drug-eluting stents have improved the efficacy of percutaneous coronary intervention and made it the preferred therapy in the treatment of ischemic heart diseases including acute coronary syndromes. The objective of the study was to compare the clinical efficacy and safety of sirolimus-eluting stent with that of zotarolimus-eluting stent following percutaneous coronary intervention for acute coronary syndrome patients with C-type left anterior descending stenosis. Methods A total of 154 acute coronary syndrome patients with C-type lesions in the left anterior descending artery, requiring a stent > 28 mm in length, were randomized into two groups to receive either sirolimus- (n = 74) or zotarolimus-eluting stent (n = 80). The follow-up period after stent implantation was approximately 36 months. The primary endpoint was a major cardiac event (a composite of cardiac death, myocardial infarction, or ischemia-related target vessel revascularization), and the secondary endpoint included these individual end points plus stent thrombosis. Results After 3 years follow-up, the rate of the primary end point (major cardiac event: cardiac death, myocardial infarction, ischemia-related target vessel revascularization) was 16% in the sirolimus group (n = 12) versus 11.2% in the zotarolimus group (n = 9) (P = 0.2). Although there were four cases of stent thrombosis with sirolimus-eluting stent and one with zotarolimus-eluting stent (4.0% sirolimus vs. 1.25% zotarolimus; P = 0.2), neither non-Q myocardial infarction (4.0%sirolimus vs. 1.25% zotarolimus; P = 0.2) nor stent thrombosis, differed significantly. Conclusions Although zotarolimus-eluting stent implantation showed more favorable results with respect to stent thrombosis and major adverse cardiac event rates compared to sirolimus-eluting stent implantation, statistically, both stent groups have nearly similar clinical safety and efficacy in the treatment of acute coronary syndromes with C-type lesions in the left

  6. Stereotyping, self-affirmation, and the cerebral hemispheres.

    PubMed

    Shrira, Ilan; Martin, Leonard L

    2005-06-01

    The authors used the processing characteristics of the left and right cerebral hemispheres to gain some insight into the relation between self-affirmation and stereotyping. In Study 1, self-affirmation led to greater stereotyping (of a librarian) and to greater left hemisphere activation, which in turn mediated the self-affirmation/stereotyping relationship. Study 2 replicated these results but also found that self-affirmation decreased stereotyping for a stigmatized target. However, relative hemisphere activation did not mediate this self-affirmation/stereotyping relationship. These studies showed that self-affirmation can either increase or decrease stereotyping depending on the status of the target and that relative hemisphere activation may provide clues as to underlying processes of stereotyping. In both studies, relative hemisphere activation was assessed using a line bisection task. Discussion focuses on possible mechanisms of different kinds of stereotyping and on the ways in which a consideration of relative hemisphere activation could help researchers gain insights into those mechanisms.

  7. Hemispheric specialization in quantification processes.

    PubMed

    Pasini, M; Tessari, A

    2001-01-01

    Three experiments were carried out to study hemispheric specialization for subitizing (the rapid enumeration of small patterns) and counting (the serial quantification process based on some formal principles). The experiments consist of numerosity identification of dot patterns presented in one visual field, with a tachistoscopic technique, or eye movements monitored through glasses, and comparison between centrally presented dot patterns and lateralized tachistoscopically presented digits. Our experiments show left visual field advantage in the identification and comparison tasks in the subitizing range, whereas right visual field advantage has been found in the comparison task for the counting range.

  8. Hemispheric processing of memory is affected by sleep.

    PubMed

    Monaghan, Padraic; Shaw, John J; Ashworth-Lord, Anneliese; Newbury, Chloe R

    2017-04-01

    Sleep is known to affect learning and memory, but the extent to which it influences behavioural processing in the left and right hemispheres of the brain is as yet unknown. We tested two hypotheses about lateralised effects of sleep on recognition memory for words: whether sleep reactivated recent experiences of words promoting access to the long-term store in the left hemisphere (LH), and whether sleep enhanced spreading activation differentially in semantic networks in the hemispheres. In Experiment 1, participants viewed lists of semantically related words, then slept or stayed awake for 12h before being tested on seen, unseen but related, or unrelated words presented to the left or the right hemisphere. Sleep was found to promote word recognition in the LH, and to spread activation equally within semantic networks in both hemispheres. Experiment 2 ensured that the results were not due to time of day effects influencing cognitive performance.

  9. In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study

    PubMed Central

    Sterliński, Maciej; Sokal, Adam; Lenarczyk, Radosław; Van Heuverswyn, Frederic; Rinaldi, C. Aldo; Vanderheyden, Marc; Khalameizer, Vladimir; Francis, Darrel; Heynens, Joeri; Stegemann, Berthold; Cornelussen, Richard

    2016-01-01

    Introduction Recent efforts to increase CRT response by multiSPOT pacing (MSP) from multiple bipols on the same left ventricular lead are still inconclusive. Aim The Left Ventricular (LV) MultiSPOTpacing for CRT (iSPOT) study compared the acute hemodynamic response of MSP pacing by using 3 electrodes on a quadripolar lead compared with conventional biventricular pacing (BiV). Methods Patients with left bundle branch block (LBBB) underwent an acute hemodynamic study to determine the %change in LV+dP/dtmax from baseline atrial pacing compared to the following configurations: BiV pacing with the LV lead in a one of lateral veins, while pacing from the distal, mid, or proximal electrode and all 3 electrodes together (i.e. MSP). All measurements were repeated 4 times at 5 different atrioventricular delays. We also measured QRS-width and individual Q-LV durations. Results Protocol was completed in 24 patients, all with LBBB (QRS width 171±20 ms) and 58% ischemic aetiology. The percentage change in LV+dP/dtmax for MSP pacing was 31.0±3.3% (Mean±SE), which was not significantly superior to any BiV pacing configuration: 28.9±3.2% (LV-distal), 28.3±2.7% (LV-mid), and 29.5±3.0% (LV-prox), respectively. Correlation between LV+dP/dtmax and either QRS-width or Q-LV ratio was poor. Conclusions In patients with LBBB MultiSPOT LV pacing demonstrated comparable improvement in contractility to best conventional BiV pacing. Optimization of atrioventricular delay is important for the best performance for both BiV and MultiSPOT pacing configurations. Trial Registration ClinicalTrials.gov NTC01883141 PMID:27124724

  10. Embolization for Acute Small-Bowel Bleeding from the Collateral Artery of the Superior Mesenteric Left Deep Circumflex Iliac Artery Associated with Narrowing of the Bilateral Common External Iliac Arteries

    SciTech Connect

    Shimohira, Masashi Ogino, Hiroyuki; Sasaki, Shigeru; Nishikawa, Hiroko; Shibamoto, Yuta

    2009-03-15

    We present a case of acute small-bowel bleeding from the collateral artery of the superior mesenteric-left deep circumflex iliac artery that was successfully managed by transarterial coil embolization.

  11. [Hemispheric interaction during the processing of spatial information].

    PubMed

    Gabibov, I M

    1993-01-01

    As a result studying the features of single neurons of prestrial cortex (field 21) of a cat the interhemispheric differences are revealed. It is found that the sizes of receptive fields (RF) of the neurons of this region in the left hemisphere is 1.5 larger as in the right one. The RFs of the left hemisphere consist of zones (mainly 5-9) than the RFs of the right hemisphere which in turn consist of 1-4 zones. About 70% of neurons of the left hemisphere are invariant to a direction of the movement of stimulus, the similar number of the right hemisphere neurons are selective with respect to orientation of a stimulus. The study of the spatial-frequency characteristics of RTs of this region indicated that the left hemisphere neurons are tuned to more lower frequencies (0.05-0.89 cycle/grade) than neurons of the right hemisphere (0.11-3.5 cycle/grade). The study of an activity of the neurons of field 21 after commissurotomy has demonstrated that in this case the hemispheres are fully lost the possibility to receive information from contralateral semifield of the vision. The sizes of RFs are significantly less and become equal in the both hemispheres. The neurons of this region become selective to an orientation of stimulus both in the left and right hemispheres. On the basis of the results of clinical and psychophysical studies it is customary to assume that the two sides of the visual perception--concrete and abstract--to a certain extent are disintegrated between each other and are supplied chiefly by different hemispheres.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Onsite-effects of dual-hemisphere versus conventional single-hemisphere transcranial direct current stimulation: A functional MRI study.

    PubMed

    Kwon, Yong Hyun; Jang, Sung Ho

    2012-08-25

    We performed functional MRI examinations in six right-handed healthy subjects. During functional MRI scanning, transcranial direct current stimulation was delivered with the anode over the right primary sensorimotor cortex and the cathode over the left primary sensorimotor cortex using dual-hemispheric transcranial direct current stimulation. This was compared to a cathode over the left supraorbital area using conventional single-hemispheric transcranial direct current stimulation. Voxel counts and blood oxygenation level-dependent signal intensities in the right primary sensorimotor cortex regions were estimated and compared between the two transcranial direct current stimulation conditions. Our results showed that dual-hemispheric transcranial direct current stimulation induced greater cortical activities than single-hemispheric transcranial direct current stimulation. These findings suggest that dual-hemispheric transcranial direct current stimulation may provide more effective cortical stimulation than single-hemispheric transcranial direct current stimulation.

  13. Visual Hemispheric Specialization: A Computational Theory.

    DTIC Science & Technology

    1985-10-31

    language and arithmetic), will in general become stronger in the left hemisphere. This notion is supported by evidence from studies of stroke patients and...instructions) and right-side hemiplegia (making it difficult, or impossible, to use the right hand). In addition, drawing is a problematic dependent

  14. Probability Matching in the Right Hemisphere

    ERIC Educational Resources Information Center

    Miller, M.B.; Valsangkar-Smyth, M.

    2005-01-01

    Previously it has been shown that the left hemisphere, but not the right, of split-brain patients tends to match the frequency of previous occurrences in probability-guessing paradigms (Wolford, Miller, & Gazzaniga, 2000). This phenomenon has been attributed to an ''interpreter,'' a mechanism for making interpretations and forming hypotheses,…

  15. Europa Hemispherical Globes

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The images used for the base of this globe were chosen from coverage supplied by the Galileo solid-state imaging (SSI) camera and Voyager 1 and 2 spacecraft. The individual images were radiometrically calibrated and photometrically normalized using a Lunar-Lambert function with empirically derived values. A linear correction based on the statistics of all overlapping areas was then applied to minimize image brightness variations. The image data were selected on the basis of overall image quality, reasonable original input resolution (from 20 km/pixel for gap fill to as much as 200 m/pixel), and availability of moderate emission/incidence angles for topography. Although consistency was achieved where possible, different filters were included for global image coverage as necessary: clear/blue for Voyager 1 and 2, and clear, near-IR (757 nm), and green (559 nm) for Galileo SSI. Individual images were projected to a Sinusoidal Equal-Area projection at an image resolution of 500 m/pixel, and a final global mosaic was constructed in this same Sinusoidal projection.

    The global mosaic was then reprojected so that the entire surface of Europa is portrayed in a manner suitable for the production of a globe. A specialized program was used to create the 'flower petal' appearance of the images; the area of each petal from 0 to 75 degrees latitude is in the Transverse Mercator projection, and the area from 75 to 90 degrees latitude is in the Lambert Azimuthal Equal-Area projection. The projections for adjacent petals overlap by 2 degrees of longitude, so that some features are shown twice.

    Names shown on the globe are approved by the International Astronomical Union. The number, size, and placement of text were chosen for a 9-inch globe. A complete list of Europa nomenclature can be found at the Gazetteer of Planetary Nomenclature at http://planetarynames.wr.usgs.gov. The northern hemisphere is shown on the left, and the southern hemisphere is shown on the right.

  16. Callisto Hemispherical Globes

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The images used for the base of this globe were chosen from the best image quality and moderate resolution coverage supplied by Galileo SSI and Voyager 1 and 2 (Batson, 1987; Becker and others, 1998; Becker and others, 1999; Becker and others, 2001). The digital map was produced using Integrated Software for Imagers and Spectrometers (ISIS) (Eliason, 1997; Gaddis and others, 1997; Torson and Becker, 1997). The individual images were radiometrically calibrated and photometrically normalized using a Lunar-Lambert function with empirically derived values (McEwen, 1991; Kirk and others, 2000). A linear correction based on the statistics of all overlapping areas was then applied to minimize image brightness variations. The image data were selected on the basis of overall image quality, reasonable original input resolution (from 20 km/pixel for gap fill to as much as 150 m/pixel), and availability of moderate emission/incidence angles for topography. Although consistency was achieved where possible, different filters were included for global image coverage as necessary: clear for Voyager 1 and 2; clear and green (559 nm) for Galileo SSI. Individual images were projected to a Sinusoidal Equal-Area projection at an image resolution of 1.0 kilometer/pixel, and a final global mosaic was constructed in this same projection. The final mosaic was enhanced using commercial software. The global mosaic was then reprojected so that the entire surface of Callisto is portrayed in a manner suitable for the production of a globe. A specialized program was used to create the 'flower petal' appearance of the images; the area of each petal from 0 to 75 degrees latitude is in the Transverse Mercator projection, and the area from 75 to 90 degrees latitude is in the Lambert Azimuthal Equal-Area projection. The projections for adjacent petals overlap by 2 degrees of longitude, so that some features are shown twice. The northern hemisphere is shown on the left, and the southern hemisphere is

  17. Europa Hemispherical Globes

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The images used for the base of this globe were chosen from coverage supplied by the Galileo solid-state imaging (SSI) camera and Voyager 1 and 2 spacecraft. The individual images were radiometrically calibrated and photometrically normalized using a Lunar-Lambert function with empirically derived values. A linear correction based on the statistics of all overlapping areas was then applied to minimize image brightness variations. The image data were selected on the basis of overall image quality, reasonable original input resolution (from 20 km/pixel for gap fill to as much as 200 m/pixel), and availability of moderate emission/incidence angles for topography. Although consistency was achieved where possible, different filters were included for global image coverage as necessary: clear/blue for Voyager 1 and 2, and clear, near-IR (757 nm), and green (559 nm) for Galileo SSI. Individual images were projected to a Sinusoidal Equal-Area projection at an image resolution of 500 m/pixel, and a final global mosaic was constructed in this same Sinusoidal projection.

    The global mosaic was then reprojected so that the entire surface of Europa is portrayed in a manner suitable for the production of a globe. A specialized program was used to create the 'flower petal' appearance of the images; the area of each petal from 0 to 75 degrees latitude is in the Transverse Mercator projection, and the area from 75 to 90 degrees latitude is in the Lambert Azimuthal Equal-Area projection. The projections for adjacent petals overlap by 2 degrees of longitude, so that some features are shown twice.

    Names shown on the globe are approved by the International Astronomical Union. The number, size, and placement of text were chosen for a 9-inch globe. A complete list of Europa nomenclature can be found at the Gazetteer of Planetary Nomenclature at http://planetarynames.wr.usgs.gov. The northern hemisphere is shown on the left, and the southern hemisphere is shown on the right.

  18. Callisto Hemispherical Globes

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The images used for the base of this globe were chosen from the best image quality and moderate resolution coverage supplied by Galileo SSI and Voyager 1 and 2 (Batson, 1987; Becker and others, 1998; Becker and others, 1999; Becker and others, 2001). The digital map was produced using Integrated Software for Imagers and Spectrometers (ISIS) (Eliason, 1997; Gaddis and others, 1997; Torson and Becker, 1997). The individual images were radiometrically calibrated and photometrically normalized using a Lunar-Lambert function with empirically derived values (McEwen, 1991; Kirk and others, 2000). A linear correction based on the statistics of all overlapping areas was then applied to minimize image brightness variations. The image data were selected on the basis of overall image quality, reasonable original input resolution (from 20 km/pixel for gap fill to as much as 150 m/pixel), and availability of moderate emission/incidence angles for topography. Although consistency was achieved where possible, different filters were included for global image coverage as necessary: clear for Voyager 1 and 2; clear and green (559 nm) for Galileo SSI. Individual images were projected to a Sinusoidal Equal-Area projection at an image resolution of 1.0 kilometer/pixel, and a final global mosaic was constructed in this same projection. The final mosaic was enhanced using commercial software. The global mosaic was then reprojected so that the entire surface of Callisto is portrayed in a manner suitable for the production of a globe. A specialized program was used to create the 'flower petal' appearance of the images; the area of each petal from 0 to 75 degrees latitude is in the Transverse Mercator projection, and the area from 75 to 90 degrees latitude is in the Lambert Azimuthal Equal-Area projection. The projections for adjacent petals overlap by 2 degrees of longitude, so that some features are shown twice. The northern hemisphere is shown on the left, and the southern hemisphere is

  19. Assessment of the Utility of the Septal E/(E′ × S′) Ratio and Tissue Doppler Index in Predicting Left Ventricular Remodeling after Acute Myocardial Infarction

    PubMed Central

    Kenar Tiryakioglu, Selma; Yalin, Kıvanc; Coskun, Senol

    2016-01-01

    Background. The aim of this study is to show whether the septal E/(E′ × S′) ratio assessed by tissue Doppler echocardiography can predict left ventricular remodeling after first ST segment elevation myocardial infarction treated successfully with primary percutaneous intervention. Methods. Consecutive patients (n = 111) presenting with acute anterior myocardial infarction for the first time in their life were enrolled. All patients underwent successful primary percutaneous coronary intervention. Standard and tissue Doppler echocardiography were performed in the first 24-36 hours of admission. Echocardiographic examination was repeated after 6 months to reassess left ventricular volumes. Septal E/(E′ × S′) ratio was assessed by pulsed Doppler echocardiography. Results. Group 1 consisted of 33 patients with left ventricular (LV) remodeling, and Group 2 had 78 patients without LV remodeling. E/(E′ × S′) was significantly higher in Group 1 (4.1 ± 1.9 versus 1.65 ± 1.32, p = 0.001). The optimal cutoff value for E/(E′ × S′) ratio was 2.34 with 87.0% sensitivity and 82.1% specificity. Conclusion. Septal E/(E′ × S′) values measured after the acute anterior myocardial infarction can strongly predict LV remodeling in the 6-month follow-up. In the risk assessment, the septal E/(E′ × S′) can be evaluated together with the conventional echocardiographic techniques. PMID:27703973

  20. [Value of the replacement of intravenous trinitrin by oral trinitrin in the acute phase of myocardial infarction complicated by regressive left ventricular insufficiency].

    PubMed

    Gibelin, P; Ferrari, E; Tiger, F; Morand, P

    1991-09-01

    Left ventricular failure is a common complication of the acute phase of myocardial infarction. The most appropriate current treatment, when an increase in preload is the predominant or sole feature, involves nitroglycerin by infusion combined in varying degrees with diuretics. The aim of this study was to assess the value of maintenance treatment following intravenous nitroglycerin based upon a long acting nitrate derivative designed to achieve a hemodynamic result. Twenty patients with a mean age of 62 and with left ventricular failure during the acute phase of a myocardial infarction were studied. They were all treated with IV nitroglycerin using an automatic pump syringe. Pulmonary artery diastolic pressure, cardiac output, blood pressure and heart rate were measured hourly for six hours then every 6 hours. When PADP fell to below 18 mmHg, maintenance treatment with placebo or long acting nitroglycerin was given double-blind (10 patients were given long acting nitroglycerin and 10 patients the placebo). Pulmonary artery pressures, blood pressure and heart rate were measured every 2 hours for 8 hours, then at 12 and 24 hours. No significant difference was found in heart rate, blood pressure, cardiac output nor PADP (10 +/- 3.5 mmHg cf. 12 +/- 2.8 mmHg; NS) between the two groups. In total, maintenance treatment with long acting nitrate derivatives following IV nitroglycerin for hemodynamic purposes in patients with an acute myocardial infarction complicated by regressive cardiac failure would no appear to be necessary.

  1. ERP Evidence of Hemispheric Independence in Visual Word Recognition

    ERIC Educational Resources Information Center

    Nemrodov, Dan; Harpaz, Yuval; Javitt, Daniel C.; Lavidor, Michal

    2011-01-01

    This study examined the capability of the left hemisphere (LH) and the right hemisphere (RH) to perform a visual recognition task independently as formulated by the Direct Access Model (Fernandino, Iacoboni, & Zaidel, 2007). Healthy native Hebrew speakers were asked to categorize nouns and non-words (created from nouns by transposing two middle…

  2. Divergent hemispheric reasoning strategies: reducing uncertainty versus resolving inconsistency.

    PubMed

    Marinsek, Nicole; Turner, Benjamin O; Gazzaniga, Michael; Miller, Michael B

    2014-01-01

    Converging lines of evidence from diverse research domains suggest that the left and right hemispheres play distinct, yet complementary, roles in inferential reasoning. Here, we review research on split-brain patients, brain-damaged patients, delusional patients, and healthy individuals that suggests that the left hemisphere tends to create explanations, make inferences, and bridge gaps in information, while the right hemisphere tends to detect conflict, update beliefs, support mental set-shifts, and monitor and inhibit behavior. Based on this evidence, we propose that the left hemisphere specializes in creating hypotheses and representing causality, while the right hemisphere specializes in evaluating hypotheses, and rejecting those that are implausible or inconsistent with other evidence. In sum, we suggest that, in the domain of inferential reasoning, the left hemisphere strives to reduce uncertainty while the right hemisphere strives to resolve inconsistency. The hemispheres' divergent inferential reasoning strategies may contribute to flexible, complex reasoning in the healthy brain, and disruption in these systems may explain reasoning deficits in the unhealthy brain.

  3. Specialization of the Cerebral Hemispheres: Implications for Learning.

    ERIC Educational Resources Information Center

    Hiscock, Merrill; Kinsbourne, Marcel

    1987-01-01

    Among conclusions of this review of findings regarding contemporary neuropsychology and cerebral hemisphere specialization as related to learning disabilities are: (1) differential specialization occurs very early; (2) anomalous hemispheric specialization is not necessarily associated with cognitive deficit; and (3) left- and right-hemisphere…

  4. ERP Evidence of Hemispheric Independence in Visual Word Recognition

    ERIC Educational Resources Information Center

    Nemrodov, Dan; Harpaz, Yuval; Javitt, Daniel C.; Lavidor, Michal

    2011-01-01

    This study examined the capability of the left hemisphere (LH) and the right hemisphere (RH) to perform a visual recognition task independently as formulated by the Direct Access Model (Fernandino, Iacoboni, & Zaidel, 2007). Healthy native Hebrew speakers were asked to categorize nouns and non-words (created from nouns by transposing two middle…

  5. Left Atrial Size and Long-Term Risk of Recurrent Stroke After Acute Ischemic Stroke in Patients With Nonvalvular Atrial Fibrillation.

    PubMed

    Ogata, Toshiyasu; Matsuo, Ryu; Kiyuna, Fumi; Hata, Jun; Ago, Tetsuro; Tsuboi, Yoshio; Kitazono, Takanari; Kamouchi, Masahiro

    2017-08-15

    Among patients with ischemic stroke and atrial fibrillation, which ones are at high risk of recurrent stroke is unclear. This study aimed to determine whether left atrial size was associated with long-term risk of stroke recurrence in patients with nonvalvular atrial fibrillation. In this multicenter prospective cohort study, nonvalvular atrial fibrillation patients hospitalized for acute ischemic stroke were enrolled and followed up after discharge. Indexed-left atrial diameter was obtained by dividing left atrial diameter by body surface area. Cause-specific and subdistribution hazard ratios of recurrent stroke were estimated by Cox proportional hazards and Fine-Gray models, respectively. Risk prediction was evaluated by integrated discrimination improvement and net reclassification improvement. In total, 1611 patients (77.8±10.2 [mean±SD] years, 44.5% female) were included. During follow-up for 2.40±1.63 (mean±SD) years, 251 patients had recurrent stroke and 514 patients died. An increased indexed-left atrial diameter (per 1 cm/m(2)) was significantly associated with elevated risk of stroke recurrence (hazard ratio 1.60, 95% CI 1.30-1.98). The association was maintained when death was regarded as the competing risk and in 1464 patients who were treated with anticoagulants (hazard ratio 1.59, 95% CI 1.27-2.00). Risk prediction for recurrent stroke was significantly improved by adding indexed-left atrial diameter to the baseline model composed of the factors in the CHADS2 score or those in the CHA2DS2-VASc score. These findings suggest that left atrial enlargement is associated with an increased risk of recurrent stroke in nonvalvular atrial fibrillation patients with ischemic stroke. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  6. Acute kidney injury following first-stage palliation in hypoplastic left heart syndrome: hybrid versus Norwood palliation.

    PubMed

    Garcia, Richard U; Natarajan, Girija; Walters, Henry L; Delius, Ralph E; Aggarwal, Sanjeev

    2017-09-11

    The aim of this study was to evaluate the prevalence of acute kidney injury after first-stage surgical palliation in patients with a single ventricle and to explore associated risk factors and outcomes. Design and patients This single-centre retrospective study included neonates who underwent either Norwood or Hybrid procedure from 2008 to 2015 for a single ventricle. Postoperative acute kidney injury was defined using the paediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE), criteria within 72 hours of the procedure. Main results Our cohort (n=48) underwent surgical palliation at a mean (SD) age of 12 (11) days. Postoperative acute kidney injury was diagnosed in 14 (29%) patients. The prevalence of acute kidney injury in the Hybrid group was 16% and 53% in the Norwood group. Infants who developed acute kidney injury underwent surgery at younger ages [6 (5-10) versus 10 (8-16) days, p=0.016], and had a higher peak lactate level in the initial 24 hours [5.9 (4.2-9.1) versus 3.4 (2.4-6.7), p=0.007]. Norwood procedure was significantly associated with acute kidney injury [odds ratio 11.7 (95% confidence interval 1.3-101.9), p=0.03]. ICU stay [38 (21-84) versus 16 (6-45) days, p=0.038] and time to extubation [204 (120-606) versus 72 (26-234) hours, p=0.014] were longer in those with acute kidney injury. The two patients who developed early postoperative renal failure as per pRIFLE died before discharge from associated comorbidities. Acute kidney injury occurs in a third of the patients with single ventricle after surgical palliation but is mostly transient. Norwood, compared with Hybrid procedure, is a risk factor for postoperative acute kidney injury, which, in turn, is associated with longer ICU stay and time to extubation.

  7. [The clinico-neurophysiological study of the effect of cerebrolysin on brain function in the acute and early recovery periods of hemispheric ischemic stroke].

    PubMed

    Gusev, E I; Burd, G S; Gekht, A B; Skvortsova, V I; Bogomolova, M A; Selikhova, M V; Fidler, S M

    1994-01-01

    Thirty patients with acute ischemic stroke and at early terms of postapoplectic recovery received cerebrolysin in daily doses 10, 20 and 30 ml for 5 days or 10 ml, i. v. for 10 days, respectively. The patients were examined for neurological status and cerebral function. In acute stroke the highest effect occurred in the affection of moderate severity. In severe stroke the drug stimulated recovery of impaired functions which tended to restore more quickly than in control subjects. In early convalescents cerebrolysin improved motor functions. Details of the results of the combined neurophysiological examination in the course of the treatment are discussed.

  8. Auditory Word Comprehension Impairment in Acute Stroke: Relative Contribution of Phonemic versus Semantic Factors

    ERIC Educational Resources Information Center

    Rogalsky, Corianne; Pitz, Eleanor; Hillis, Argye E.; Hickok, Gregory

    2008-01-01

    Auditory word comprehension was assessed in a series of 289 acute left hemisphere stroke patients. Participants decided whether an auditorily presented word matched a picture. On different trials, words were presented with a matching picture, a semantic foil, or a phonemic foil. Participants had significantly more trouble with semantic foils…

  9. Independent prognostic value of left atrial function by two-dimensional speckle tracking imaging in patients with non -ST-segment-elevation acute myocardial infarction.

    PubMed

    Shao, Chunlai; Zhu, Jing; Chen, Jianchang; Xu, Weiting

    2015-11-04

    The objective of this study is to evaluate left atrial(LA) function and its prognostic value by two-dimensional speckle tracking echocardiography (STE) in patients with non-ST-segment-elevation acute myocardial infarction (NSTEAMI). Global longitudinal LA S/SR data obtained by 2D speckle imaging with automated software (Echo PAC, GE Medical). Clinical variables and angiographic, echocardiographic, and STE parameters were studied in 65 patients with NSTEAMI (51 males and 14 females; mean age of 60.7 ± 9.8 years) who underwent elective PCI. The final study population consisted of 51 individuals (43 males and 8 females; mean age of 62.9 ± 11.1 years) and a 12 ± 3 months follow-up was performed. A total of 22 combined cardiovascular events(20 patients) occurred. With the use of Univariable Cox regression, all parameters were evaluated in the prediction of cardiac events, ischemic events, and/or cardiac death. According to ROC analysis, baseline mean global left atrial SRs (