Pain-related somatosensory evoked potentials in syringomyelia
Brain : a journal of neurology, 1991
Pain-related somatosensory evoked potentials following CO2 laser stimulation (pain SEPs) and conv... more Pain-related somatosensory evoked potentials following CO2 laser stimulation (pain SEPs) and conventional electrically-stimulated SEPs (electric SEPs) were examined in 8 patients with syringomyelia who showed various forms of dissociated sensory loss. Unlike clinical examination using a pin or needle, pain SEP is considered to be an objective and quantitative test to investigate functions of peripheral and central sensory pathways responsible for pain-temperature sensation (A delta fibres and the spinothalamic tract). Pain SEPs were abnormal in all patients. The results were generally compatible with the degree of a clinical impairment of pain-temperature sensation. Subclinical abnormality was detected in 3 patients. Electric median nerve SEPs using the scalp reference (Fz) were normal in 6 out of 8 patients. However, anterior and posterior cervical responses using a noncephalic reference were absent or small in 7 patients. Electric SEPs following tibial nerve stimulation were norma...
We report a case of chronic recurrent polymyosi{;is associated with increasing antibody titers of... more We report a case of chronic recurrent polymyosi{;is associated with increasing antibody titers of coxsackievirus A9 in serum during clinical exacerbations. Muscle biopsy specimens showed pathologic changes consistent with chronic myositis, including perivascular mononuclear cell infiltration and hyalinization of muscle fibers with cytoplasmic vacuolations. The specific fluorescence was observed in the muscle fibers stained with antiserum for coxsackievirus A9. These findings indicate that this viral subtype as the etiologic agent in this case and virus plays a pathogenic role in somecases of chronic polymyositis.
Wereport a case of myasthenia gravis (MG)which became worse shortly after the administration of m... more Wereport a case of myasthenia gravis (MG)which became worse shortly after the administration of methimazole (MMI) for hyperthyroidism. The activation of immune responses was found during the worsening of MG. The findings suggests the possibility that the worsening of MGmight be induced by MMI, presumably by its immunomodulatory property.
Fifty-five consecutive cases of myoclonus owing to various etiologies were studied by conventiona... more Fifty-five consecutive cases of myoclonus owing to various etiologies were studied by conventional EEG-EMG polygraphic recordings and/or jerk-locked or back averaging. The technique of back-averaging was shown to be useful not only for detecting EEG correlates of myoclonus that are not recognizable on the routine polygraph but also for investigating the temporal and topographic relationship between the EEG activities and myoclonus. Thirteen of 17 cases of PME and related disorders, in whom back-averaging and SEP were studied, were shown to have both a myoclonus-related cortical spike over the contralateral central area, preceding the myoclonus of an upper extremity by 6 to 22 msec, and a giant SEP accompanied by an enhanced C reflex. In these cases of "cortical reflex myoclonus," the myoclonus-related spike was similar to the P25-N33 components of the giant SEP in its wave form, scalp topography, temporal relationship to myoclonus or to C reflex, succeeding cortical excita...
[A case of upper brainstem infarction developing symptomatic narcolepsy after the administration of anti-convulsant drugs]
Rinshō shinkeigaku = Clinical neurology, 1991
A 52-year-old woman, who had ischemic infarction in the ventral upper brainstem due to subarachno... more A 52-year-old woman, who had ischemic infarction in the ventral upper brainstem due to subarachnoid hemorrhage in October 1986, had recurrent sleep and cataplexy attacks from May 1987. She was receiving valproate and phenytoin daily since 1986. The diagnosis of narcolepsy was made based on the clinical symptoms and EEG findings showing REM sleep during a sleep attack. Both sleep and cataplexy attack increased in parallel with an increase of the dose of anti-convulsant drugs and disappeared immediately after the discontinuation of the treatment. The findings that suggest that the administration of anti-convulsant drug as well as the brainstem vascular lesion was deeply involved in the development of narcolepsy in this case.
[A case of adult-onset spike-wave stupor associated with hypoparathyroidism and hyperostosis frontalis interna (HFI)]
Rinshō shinkeigaku = Clinical neurology, 1990
A 34-year-old women without history of seizures was admitted to our hospital because of the dimin... more A 34-year-old women without history of seizures was admitted to our hospital because of the diminished responsiveness and the repeated blinking for two days. Her past history showed neither surgery nor inflammation of the thyroid gland. General physical examination was normal. On neurological examination, the patient was blinking frequently and staring without any responsiveness. However, she occasionally became able to respond correctly to verbal orders, such as "open your eyes", "open your mouth", "stand up" and so on, which occurred abruptly just like the switch-on. She was otherwise normal neurologically. The laboratory data showed hypocalcemia, hyperphosphatemia, decreased level of parathyroid hormone and normal renal function, indicating the presence of idiopathic hypoparathyroidism. EEG showed the continuous generalized 2-4 Hz spike and wave complexes with the maximum intensity on frontal lobes. Skull roentgenograms and MRI CT of the head disclos...
Recording of Event-Related Potentials (P300) from Human Cortex
Journal of Clinical Neurophysiology, 1992
Auditory event-related potentials were recorded simultaneously from chronically implanted subdura... more Auditory event-related potentials were recorded simultaneously from chronically implanted subdural electrodes and from scalp electrodes in three patients who were being evaluated for surgical treatment of epilepsy. These three cases showed clearly defined scalp-P300 and scalp-N300. A cortex-P300 was recorded from the midtemporal area, and a cortex-N300 was recorded from the inferior frontal area with some reflection at the basal temporal region. There were no potentials from an interhemispheric region. We could not observe any component from the cortex studied corresponding to scalp-recorded N200. Therefore, while the activity generated from the mesial temporal lobe may only make minor contributions to scalp-P300, that generated from the midtemporal area might make a major contribution to the scalp-P300. Additionally, generators of N200, P300, and N300 are different from each other. These findings, together with previous reports regarding the generator source of P300, also suggest that P300 is a complex arising from multifactorial generator sources, including the midtemporal and inferior frontal area.
Event-related brain potentials as indicators of visual recognition and detection of criminals by their use
Forensic Science International, 1991
An event-related potential (ERP) was recorded, using photographs as stimuli, in 12 subjects for a... more An event-related potential (ERP) was recorded, using photographs as stimuli, in 12 subjects for attended, 9 subjects for non-attended conditions and 14 subjects for a simulated criminal investigation. An ERP was detected only when a subject recognized a familiar image (target) mixed with other, unfamiliar images (non-target), regardless of whether he was asked to attend to or neglect the target image. ERPs in the subject who watched each picture but tried to ignore the relevant picture (non-attended) were more activated at the parietal region than at the central region, in contrast with ERPs in the subjects who paid attention to each picture without trying to ignore the relevant picture (attended). In the simulated criminal investigation, only a simulated thief, but not a simulated innocent subject elicited ERP only after the picture of a criminal site or thing was intermingled with pictures bearing no relationship to the crime. These findings indicate that the ERP using photographs as stimuli is useful as an objective indicator of crime-relevance.
A patient with intractable epilepsy secondary to a brain tumor was evaluated with a chronically i... more A patient with intractable epilepsy secondary to a brain tumor was evaluated with a chronically implanted array of 64 stainless-steel subdural electrodes covering the perirolandic area. Cortical potentials associated with voluntary, selfpaced middle-finger extension were recorded simultaneously from subdural and scalp electrodes using a computerassisted method for averaging movement-related potential (MRP) in relation to electromyographic (EMG) onset. A high-amplitude negative potential, Bereitschaftspotentialhegative slope (BPNS'), preceding the onset of the EMG activity by more than 1 sec was recorded in an extremely localized fashion exclusively from electrodes placed in the precentral hand motor area as well as in the more medial part of the somatosensory hand area. These results suggest that the hand motor and sensory areas have an essential participation in the generation of MRPs and, therefore, also in the preparation of voluntary finger movements.
Identification of a negative bitemporal component (N300) of the event-related potentials demonstrated by noncephalic recordings
Neurology, 1988
We studied the scalp distribution of auditory event-related potentials (P300), using simultaneous... more We studied the scalp distribution of auditory event-related potentials (P300), using simultaneously a cephalic (linked ears) and a noncephalic (balanced sternovertebra) reference. The recordings with noncephalic reference showed that infrequent, attended auditory stimuli evoke a negative bitemporal component (N300) as well as a positive vertex component (P300).
A new P300 testing protocol for evaluating memory function is proposed. Four stimuli (S1, S2, S3 ... more A new P300 testing protocol for evaluating memory function is proposed. Four stimuli (S1, S2, S3 and S4) are presented to the subject at 1.5 sec intervals and the subject is instructed to judge whether S4 was the same (80%) or not (20%) as S1, as well as whether S3 was the same (80%) or not (20%) as S2. The S2-S3 comparison acts as an attention shifting mechanism, and by inserting this comparison between S1 and S4, the subject must memorized S1 at the memory site in the brain until S4 is presented. This protocol was performed using both auditory and visual stimulations with 24 college students (age range: 19-28 years old) and a patient (23 years old) with bilateral medial temporal lobe lesions caused by limbic encephalitis. The P300 brain potentials after S3 and S4 were compared. The Wechsler memory scale-revised (WMS-R) test was also assessed in all subjects. The latency of P300 after S4 had a significantly (p < 0.01) longer than that after S3. The latency of P300 after S4 in th...
Pain-related somatosensory evoked potentials in syringomyelia
Brain : a journal of neurology, 1991
Pain-related somatosensory evoked potentials following CO2 laser stimulation (pain SEPs) and conv... more Pain-related somatosensory evoked potentials following CO2 laser stimulation (pain SEPs) and conventional electrically-stimulated SEPs (electric SEPs) were examined in 8 patients with syringomyelia who showed various forms of dissociated sensory loss. Unlike clinical examination using a pin or needle, pain SEP is considered to be an objective and quantitative test to investigate functions of peripheral and central sensory pathways responsible for pain-temperature sensation (A delta fibres and the spinothalamic tract). Pain SEPs were abnormal in all patients. The results were generally compatible with the degree of a clinical impairment of pain-temperature sensation. Subclinical abnormality was detected in 3 patients. Electric median nerve SEPs using the scalp reference (Fz) were normal in 6 out of 8 patients. However, anterior and posterior cervical responses using a noncephalic reference were absent or small in 7 patients. Electric SEPs following tibial nerve stimulation were norma...
We report a case of chronic recurrent polymyosi{;is associated with increasing antibody titers of... more We report a case of chronic recurrent polymyosi{;is associated with increasing antibody titers of coxsackievirus A9 in serum during clinical exacerbations. Muscle biopsy specimens showed pathologic changes consistent with chronic myositis, including perivascular mononuclear cell infiltration and hyalinization of muscle fibers with cytoplasmic vacuolations. The specific fluorescence was observed in the muscle fibers stained with antiserum for coxsackievirus A9. These findings indicate that this viral subtype as the etiologic agent in this case and virus plays a pathogenic role in somecases of chronic polymyositis.
Wereport a case of myasthenia gravis (MG)which became worse shortly after the administration of m... more Wereport a case of myasthenia gravis (MG)which became worse shortly after the administration of methimazole (MMI) for hyperthyroidism. The activation of immune responses was found during the worsening of MG. The findings suggests the possibility that the worsening of MGmight be induced by MMI, presumably by its immunomodulatory property.
Fifty-five consecutive cases of myoclonus owing to various etiologies were studied by conventiona... more Fifty-five consecutive cases of myoclonus owing to various etiologies were studied by conventional EEG-EMG polygraphic recordings and/or jerk-locked or back averaging. The technique of back-averaging was shown to be useful not only for detecting EEG correlates of myoclonus that are not recognizable on the routine polygraph but also for investigating the temporal and topographic relationship between the EEG activities and myoclonus. Thirteen of 17 cases of PME and related disorders, in whom back-averaging and SEP were studied, were shown to have both a myoclonus-related cortical spike over the contralateral central area, preceding the myoclonus of an upper extremity by 6 to 22 msec, and a giant SEP accompanied by an enhanced C reflex. In these cases of "cortical reflex myoclonus," the myoclonus-related spike was similar to the P25-N33 components of the giant SEP in its wave form, scalp topography, temporal relationship to myoclonus or to C reflex, succeeding cortical excita...
[A case of upper brainstem infarction developing symptomatic narcolepsy after the administration of anti-convulsant drugs]
Rinshō shinkeigaku = Clinical neurology, 1991
A 52-year-old woman, who had ischemic infarction in the ventral upper brainstem due to subarachno... more A 52-year-old woman, who had ischemic infarction in the ventral upper brainstem due to subarachnoid hemorrhage in October 1986, had recurrent sleep and cataplexy attacks from May 1987. She was receiving valproate and phenytoin daily since 1986. The diagnosis of narcolepsy was made based on the clinical symptoms and EEG findings showing REM sleep during a sleep attack. Both sleep and cataplexy attack increased in parallel with an increase of the dose of anti-convulsant drugs and disappeared immediately after the discontinuation of the treatment. The findings that suggest that the administration of anti-convulsant drug as well as the brainstem vascular lesion was deeply involved in the development of narcolepsy in this case.
[A case of adult-onset spike-wave stupor associated with hypoparathyroidism and hyperostosis frontalis interna (HFI)]
Rinshō shinkeigaku = Clinical neurology, 1990
A 34-year-old women without history of seizures was admitted to our hospital because of the dimin... more A 34-year-old women without history of seizures was admitted to our hospital because of the diminished responsiveness and the repeated blinking for two days. Her past history showed neither surgery nor inflammation of the thyroid gland. General physical examination was normal. On neurological examination, the patient was blinking frequently and staring without any responsiveness. However, she occasionally became able to respond correctly to verbal orders, such as "open your eyes", "open your mouth", "stand up" and so on, which occurred abruptly just like the switch-on. She was otherwise normal neurologically. The laboratory data showed hypocalcemia, hyperphosphatemia, decreased level of parathyroid hormone and normal renal function, indicating the presence of idiopathic hypoparathyroidism. EEG showed the continuous generalized 2-4 Hz spike and wave complexes with the maximum intensity on frontal lobes. Skull roentgenograms and MRI CT of the head disclos...
Recording of Event-Related Potentials (P300) from Human Cortex
Journal of Clinical Neurophysiology, 1992
Auditory event-related potentials were recorded simultaneously from chronically implanted subdura... more Auditory event-related potentials were recorded simultaneously from chronically implanted subdural electrodes and from scalp electrodes in three patients who were being evaluated for surgical treatment of epilepsy. These three cases showed clearly defined scalp-P300 and scalp-N300. A cortex-P300 was recorded from the midtemporal area, and a cortex-N300 was recorded from the inferior frontal area with some reflection at the basal temporal region. There were no potentials from an interhemispheric region. We could not observe any component from the cortex studied corresponding to scalp-recorded N200. Therefore, while the activity generated from the mesial temporal lobe may only make minor contributions to scalp-P300, that generated from the midtemporal area might make a major contribution to the scalp-P300. Additionally, generators of N200, P300, and N300 are different from each other. These findings, together with previous reports regarding the generator source of P300, also suggest that P300 is a complex arising from multifactorial generator sources, including the midtemporal and inferior frontal area.
Event-related brain potentials as indicators of visual recognition and detection of criminals by their use
Forensic Science International, 1991
An event-related potential (ERP) was recorded, using photographs as stimuli, in 12 subjects for a... more An event-related potential (ERP) was recorded, using photographs as stimuli, in 12 subjects for attended, 9 subjects for non-attended conditions and 14 subjects for a simulated criminal investigation. An ERP was detected only when a subject recognized a familiar image (target) mixed with other, unfamiliar images (non-target), regardless of whether he was asked to attend to or neglect the target image. ERPs in the subject who watched each picture but tried to ignore the relevant picture (non-attended) were more activated at the parietal region than at the central region, in contrast with ERPs in the subjects who paid attention to each picture without trying to ignore the relevant picture (attended). In the simulated criminal investigation, only a simulated thief, but not a simulated innocent subject elicited ERP only after the picture of a criminal site or thing was intermingled with pictures bearing no relationship to the crime. These findings indicate that the ERP using photographs as stimuli is useful as an objective indicator of crime-relevance.
A patient with intractable epilepsy secondary to a brain tumor was evaluated with a chronically i... more A patient with intractable epilepsy secondary to a brain tumor was evaluated with a chronically implanted array of 64 stainless-steel subdural electrodes covering the perirolandic area. Cortical potentials associated with voluntary, selfpaced middle-finger extension were recorded simultaneously from subdural and scalp electrodes using a computerassisted method for averaging movement-related potential (MRP) in relation to electromyographic (EMG) onset. A high-amplitude negative potential, Bereitschaftspotentialhegative slope (BPNS'), preceding the onset of the EMG activity by more than 1 sec was recorded in an extremely localized fashion exclusively from electrodes placed in the precentral hand motor area as well as in the more medial part of the somatosensory hand area. These results suggest that the hand motor and sensory areas have an essential participation in the generation of MRPs and, therefore, also in the preparation of voluntary finger movements.
Identification of a negative bitemporal component (N300) of the event-related potentials demonstrated by noncephalic recordings
Neurology, 1988
We studied the scalp distribution of auditory event-related potentials (P300), using simultaneous... more We studied the scalp distribution of auditory event-related potentials (P300), using simultaneously a cephalic (linked ears) and a noncephalic (balanced sternovertebra) reference. The recordings with noncephalic reference showed that infrequent, attended auditory stimuli evoke a negative bitemporal component (N300) as well as a positive vertex component (P300).
A new P300 testing protocol for evaluating memory function is proposed. Four stimuli (S1, S2, S3 ... more A new P300 testing protocol for evaluating memory function is proposed. Four stimuli (S1, S2, S3 and S4) are presented to the subject at 1.5 sec intervals and the subject is instructed to judge whether S4 was the same (80%) or not (20%) as S1, as well as whether S3 was the same (80%) or not (20%) as S2. The S2-S3 comparison acts as an attention shifting mechanism, and by inserting this comparison between S1 and S4, the subject must memorized S1 at the memory site in the brain until S4 is presented. This protocol was performed using both auditory and visual stimulations with 24 college students (age range: 19-28 years old) and a patient (23 years old) with bilateral medial temporal lobe lesions caused by limbic encephalitis. The P300 brain potentials after S3 and S4 were compared. The Wechsler memory scale-revised (WMS-R) test was also assessed in all subjects. The latency of P300 after S4 had a significantly (p < 0.01) longer than that after S3. The latency of P300 after S4 in th...
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