Neurophysiology

Fatigue is a multidimensional concept covering both physiological and psychological aspects. Chronic fatigue is a typical symptom of diseases such as cancer, multiple sclerosis (MS), Parkinson's disease (PD) and cerebrovascular disorders but is also presented by people in whom no defined somatic disease has been established. If certain criteria are met, chronic fatigue syndrome can be diagnosed. The 4-item Abbreviated Fatigue Questionnaire allows the extent of the experienced fatigue to be assessed with a high degree of reliability and validity. Physiological fatigue has been well defined and originates in both the peripheral and central nervous system. The condition can be assessed by combining force and surface-EMG measurements (including frequency analyses and muscle-fibre conduction estimations), twitch interpolation, magnetic stimulation of the motor cortex and analysis of changes in the readiness potential. Fatigue is a well-known phenomenon in both central and peripheral neurological disorders. Examples of the former conditions are multiple sclerosis, Parkinson's disease and stroke. Although it seems to be a universal symptom of many brain disorders, the unique characteristics of the concomitant fatigue also point to a specific relationship with several of these syndromes. As regards neuromuscular disorders, fatigue has been reported in patients with post-polio syndrome, myasthenia gravis, Guillain-Barré syndrome, facioscapulohumeral dystrophy, myotonic dystrophy and hereditary motor and sensory neuropathy type-I. More than 60% of all neuromuscular patients suffer from severe fatigue, a prevalence resembling that of patients with MS. Except for several rare myopathies with specific metabolic derangements leading to exercise-induced muscle fatigue, most studies have not identified a prominent peripheral cause for the fatigue in this population. In contrast, the central activation of the diseased neuromuscular system is generally found to be suboptimal. The reliability of the psychological and clinical neurophysiological assessment techniques available today allows a multidisciplinary approach to fatigue in neurological patients, which may contribute to the elucidation of the pathophysiological mechanisms of chronic fatigue, with the ultimate goal to develop tailored treatments for fatigue in neurological patients. The present report discusses the different manifestations of fatigue and the available tools to assess peripheral and central fatigue.

A computer-based data acquisition system has been developed to analyze the long term performance of polymer insulators using a fog chamber. The leakage currents flowing through the insulators under test are sensed, conditioned, digitized, processed, displayed, and finally stored for firther analysis.' Based on the requirements of the application, a comparative study of different data acquisition packages was conducted to select the appropriate software. Virtual instrumentation software, DASYLab, was determined to be the most suitable option for this application. An icon-based program has been developed to classib the leakage current pulse counts using bins, and to compute cumulative charge, and maximum and minimum current pulse values. It also provides real-time display and Fourier analysis of the acquired data. The data is reduced and stored in files on a hard disk for post-acquisition analysis.

An automatic Uni-or Multi-modal Inteligent Seizure Acquisition (UISA/MISA) system is highly applicable for onset detection of epileptic seizures based on motion data. The modalities used are surface electromyography (sEMG), acceleration (ACC) and angular velocity (ANG). The new proposed automatic algorithm on motion data is extracting features as "log-sum" measures of discrete wavelet components. Classification into the two groups "seizure" versus "nonseizure" is made based on the support vector machine (SVM) algorithm. The algorithm performs with a sensitivity of 91-100%, a median latency of 1 second and a specificity of 100% on multi-modal data from five healthy subjects simulating seizures. The uni-modal algorithm based on sEMG data from the subjects and patients performs satisfactorily in some cases. As expected, our results clearly show superiority of the multimodal approach, as compared with the uni-modal one.

We readily use the form of human figures to determine if they are moving. Human figures that have arms and legs outstretched (articulated) appear to be moving more than figures where the arms and legs are near the body (standing). We tested whether neurons in the macaque monkey superior temporal sulcus (STS), a region known to be involved in processing social stimuli, were sensitive to the degree of articulation of a static human figure. Additionally, we tested sensitivity to the same stimuli within forward and backward walking sequences. We found that 57% of cells that responded to the static image of a human figure was also sensitive to the degree of articulation of the figure. Some cells displayed selective responses for articulated postures, while others (in equal numbers) displayed selective responses for standing postures. Cells selective for static images of articulated figures were more likely to respond to movies of walking forwards than walking backwards. Cells selective for static images of standing figures were more likely to respond to movies of walking backwards than forwards. An association between form sensitivity and walking sensitivity could be consistent with an interpretation that cell responses to articulated figures act as an implied motion signal.

In general, information about the environment (for instance a target) is not instantaneously available for the nervous system. A minimal delay for visual information to affect the movement of the hand is about 110 ms. However, if the movement of a target is predictable, humans can pursue it with zero delay. To make this prediction, information about the speed of the target is necessary. Our results show that this information is used with a delay of about 200 ms. We discuss that oculomotor efference is a likely source of information for this prediction.

The effect of sensory input on hormones is essential to any explanation of mammalian behavior, including aspects of physical attraction. The chemical signals we send have direct and developmental effects on hormone levels in other people. Since we don t know either if, or how, visual cues might have direct and developmental effects on hormone levels in other people, the biological basis for the development of visually perceived human physical attraction is currently somewhat questionable. In contrast, the biological basis for the development of physical attraction based on chemical signals is well detailed.

We measured regional cerebral blood flow (rCBF) using positron emission tomography (PET) to determine which brain regions are involved in the assessment of facial emotion. We asked right-handed normal subjects to assess the signalers’ emotional state based on facial gestures and to assess the facial attractiveness, as well as to discriminate the background color of the facial stimuli, and compared the activity produced by each condition. The right inferior frontal cortex showed significant activation during the assessment of facial emotion in comparison with the other two tests. The activated area was located within a triangular area of the inferior frontal cortex in the right cerebral hemisphere. These results, together with those of previous imaging and clinical studies, suggest that the right inferior frontal cortex processes emotional communicative signals that could be visual or auditory and that there is a hemispheric asymmetry in the inferior frontal cortex in relation to the...

Background: Awareness and pain during palliative sedation is typically assessed by observational scales, but the use of such scales has been put into question. Case presentation: A woman in her mid-80s was admitted to a palliative care unit, presenting with chronic lymphatic leukemia, depression, and a cerebrovascular accident, with right-sided hemiplegia and aphasia. The patient was unable to eat and was suffering from nausea and vomiting. Before admission, the patient had expressed her desire to discontinue treatment on several occasions. Case management: The decision was made to initiate palliative sedation. The patient consented to take part in a study to assess level of comfort and pain using two monitoring devices (NeuroSense monitor and Analgesia Nociception Index monitor). Case outcome: The patient died 90 h after initiation of palliative sedation. Titration of the medication was challenging and sedation was not deep enough during the first 2 days. Thirteen assessments made with the Ramsay Sedation Scale showed that the patient was considered to be in a deep sleep, while in fact the NeuroSense monitor indicated otherwise. Conclusion: This case demonstrates the feasibility and potential advantages of using monitoring devices to objectify assessments of pain and discomfort in palliatively sedated patients.

The aging population in developed countries has shifted considerable research attention to diseases related to age. Because age is one of the highest risk factors for neurodegenerative diseases, the need for automated brain image analysis has significantly increased. Magnetic resonance imaging (MRI) is a commonly used modality to image brain. MRI provides high tissue contrast; hence, the existing brain image analysis methods have often preferred the intensity information to others, such as texture. Recently, an easy-to- compute texture descriptor, local binary pattern (LBP), has shown promise in various applications outside the medical field. In this paper, after extensive experiments, we show that rotation-invariant LBP is invariant to some common MRI artifacts that makes it possible to use it in various high-level brain MR image analysis applications.

Staff, Nathan P., Hae-Yoon Jung, Tara Thiagarajan, Michael Yao, and Nelson Spruston. Resting and active properties of pyramidal neurons in subiculum and CA1 of rat hippocampus. J Neurophysiol 84: 2398Neurophysiol 84: -2408Neurophysiol 84: , 2000. Action potentials are the end product of synaptic integration, a process influenced by resting and active neuronal membrane properties. Diversity in these properties contributes to specialized mechanisms of synaptic integration and action potential firing, which are likely to be of functional significance within neural circuits. In the hippocampus, the majority of subicular pyramidal neurons fire high-frequency bursts of action potentials, whereas CA1 pyramidal neurons exhibit regular spiking behavior when subjected to direct somatic current injection. Using patch-clamp recordings from morphologically identified neurons in hippocampal slices, we analyzed and compared the resting and active membrane properties of pyramidal neurons in the subiculum and CA1 regions of the hippocampus. In response to direct somatic current injection, three subicular firing types were identified (regular spiking, weak bursting, and strong bursting), while all CA1 neurons were regular spiking. Within subiculum strong bursting neurons were found preferentially further away from the CA1 subregion. Input resistance (R N ), membrane time constant ( m ), and depolarizing "sag" in response to hyperpolarizing current pulses were similar in all subicular neurons, while R N and m were significantly larger in CA1 neurons. The first spike of all subicular neurons exhibited similar action potential properties; CA1 action potentials exhibited faster rising rates, greater amplitudes, and wider half-widths than subicular action potentials. Therefore both the resting and active properties of CA1 pyramidal neurons are distinct from those of subicular neurons, which form a related class of neurons, differing in their propensity to burst. We also found that both regular spiking subicular and CA1 neurons could be transformed into a burst firing mode by application of a low concentration of 4-aminopyridine, suggesting that in both hippocampal subfields, firing properties are regulated by a slowly inactivating, D-type potassium current. The ability of all subicular pyramidal neurons to burst strengthens the notion that they form a single neuronal class, sharing a burst generating mechanism that is stronger in some cells than others.

amyotrophic lateral sclerosis motor neurons superoxide dismutase 1 a b s t r a c t Amyotrophic lateral sclerosis (ALS) is a rare and lethal neurodegenerative disease for which there is no effective medical treatment. Although riluzole, an N-methyl-D-aspartate receptor antagonist, has been shown to be reasonably safe for patients with ALS, the drug has been demonstrated to prolong median survival by only 2e5 months. There is mounting evidence that stem cell-based gene therapy is a promising treatment modality for patients with ALS. In this review, we focus on the types, sources, and doses of stem cells that have been shown to be effective for ALS patients, the differences in cytokines or chemokines secreted from these various stem cells, and the immune-modulation activity of stem cells as treatment for ALS.

A theoretical investigation of different electroneurogram recording techniques using electrode cuffs is presented. A new screened tripole arrangement is proposed with a higher inherent signal to interference ratio than the true tripole, which also allows the nulling of the residual electromyogram signal. The reduction in interference is small because the electrode impedance is large compared to the source resistance.

Historically, taste research has often been guided by the concept that there are only four (or possibly five) basic taste qualities (sweet, sour, salty, and bitter, and possibly "umami"). All other tastes have been presumed to be combinations of these basic tastes. This psychophysical concept has been extended to electrophysiological data. That is, the neural code for each basic taste is hypothesized to be coded by a dedicated channel of neurons (the "Labeled-Line" theory); i.e., one group of neurons signals "salty" and another separate group signals "sweet." Numerous psychophysical and electrophysiological findings, however, cannot be accomodated by this quadripartite theory, which limits taste to four basic qualities and four basic neuron types. Rather, the data described in this article suggest that the range of taste is more extensive than four or five basic tastes, and that this breadth of taste quality results initially from the activati...

The uncertain conductivity value of skull and brain tissue influences the accuracy of the electroencephalogram (EEG) inverse problem solution. Indeed, when the assumed conductivity in the numerical procedure is different from the actual conductivity then a source localization error is introduced. When using traditional least-squares minimization methods, the number of electrodes in the EEG cap does not influence the spatial resolution. A recently developed reduced conductivity dependence (RCD) methodology, based on the selection of electrodes, is able to increase the spatial resolution of the EEG inverse problem. This paper presents the implications of the RCD method when using a large number of electrodes in the EEG cap on the spatial resolution of the EEG inverse solutions. We show by means of numerical experiments that in contrast to traditional methods, the RCD method enables to increase the spatial resolution. The computations show that the EEG hardware should be modified with as large as possible electrodes.

Amidst controversy about methodology and safety, intraoperative neurophysiology has entered a new era of increasingly routine transcranial and direct electrical brain stimulation for motor evoked potential (MEP) monitoring. Based on literature review and illustrative clinical experience, this tutorial aims to present a balanced overview for experienced practitioners, surgeons and anesthesiologists as well as those new to the field. It details the physiologic basis, indications and methodology of current MEP monitoring techniques, evaluates their safety, explores interpretive controversies and outlines some applications and results, including aortic aneurysm, intramedullary spinal cord tumor, spinal deformity, posterior fossa tumor, intracranial aneurysm and peri-rolandic brain surgeries. The many advances in motor system assessment achieved in the last two decades undoubtedly improve monitoring efficacy without unduly compromising safety. Future studies and experience will likely clarify existing controversies and bring further advances.

Abstract² Optogenetic technology based on light activation of genetically targeted single component opsins such as Channelrhodopsin-2 (ChR2) has been changing the way neuroscience research is conducted. This technology is becoming increasingly important for neural engineering as well. The efficiency of neural stimulation with ChR2 drops at high frequencies, often before the natural limit of the neuron is reached. This study aims to investigate the underlying mechanisms that limit the efficiency of the stimulation at high frequencies. The study analyzes the dynamics of the spikes induced by ChR2 in comparison to control stimulations using patch clamp current injection. It shows that the stimulation dynamics is limited by two mechanisms: 1) a frequency independent reduction in the conductance-to-irradiance yield due to the ChR2 light adaptation process and 2) a frequency dependent reduction in the conductance-to-current yield due to a decrease in membrane re-polarization level between spikes that weakens the ionic driving force. The effect of the first mechanism can be minimized by using ChR2 mutants with lower irradiance threshold. In contrast the effect of the second mechanism is fundamentally limited by the rate the native ion channels re-polarize the membrane potential.

In this paper we draw a distinction between tele-operation and tele-presence. We argue that the disappearance of mediation, as well as the cognitive and physical integration between human subject and robotic alias are fundamental for the realization of telepresence systems. In the experimental parts of this paper, we propose a novel and more suitable approach for developing and designing natural interfaces, based on new knowledge about human's motion detection provided by neurosciences. We validate the hypothesis that anticipatory movements of the head take place also in case of driving robotic artefacts in locomotion tasks. We suggest that the anticipatory movements of the head could be used as a natural interface in order to detect the human's steering intention in advance and with no additional cognitive burden for the person. In the final part, we argue that in order to realize telepresence systems, it is necessary to take into account also the psychological and sociological effects caused by technological mediation. As a matter of fact, moral disengagement and abstraction may determine a loss of presence.

This paper presents an integrated stimulator that can be embedded in implantable electrode books for interfacing with nerve roots at the cauda equina. The Active Book overcomes the limitation of conventional nerve root stimulators which can only support a small number of stimulating electrodes due to cable count restriction through the dura. Instead, a distributed stimulation system with many tripole electrodes can be configured using several Active Books which are addressed sequentially.

Most contemporary text books of neurology and of psychology pay little attention to the function of the cerebellum beyond noting it to be an organ of motor control. A historical overview of research on cerebellar function is presented, from pre-Sherrinton suggestions of sensory and motor function, through the post-Sherrinton and dominant 20 th . Century view of "motor" function, to the 21 st . century perspective of "sensorimotor" function. The intrinsic capability of the cerebellum is briefly considered in terms of: its size/complexity/capacity; its information representation/processing characteristics (with "a particular computational function"); its sensory information processing capability; and, its role in sensorimotor regulatory control. It is suggested that the cerebellum can process sensorimotor stimulus information in a statistical (connectionist type) manner and respond to in on the basis of its own learning based sensorimotor representations, albeit at a "level" that does not necessarily involve cerebral "awareness".

A novel structure for chronically implantable cortical electrodes using new Benzocyclobutene (BCB) biopolymer was devised, which provides both flexibility for micro-motion compliance between brain tissues and skull and stiffness for better surgical handling. BCB is very attractive polymer for stable long-term implant function, because it has flexibility, biocompatibility, low moisture uptake (<0.2 wt%), and low dielectric constant (~2.6). For easy operation during surgical insertion, a 5~10µm thick silicon backbone layer is attached to the desired region of the electrode to increase the stiffness. It is then followed by 1 mm of flexible part of the electrode without silicon backbone layer designed to absorb stress from any micro-motion between the brain tissue and the electrode. The fabricated implants have tri-shanks with 5 recording sites (20 x 20µm) and 2 vias (40 x 40µm) on each shank. BCB electrodes with 5µm and 10µm thick backbone silicon penetrated pia of rat brain without buckling.

We measured the forces produced at the cat's hindpaw by microstimulation of the lumbar spinal cord and the movements resulting from those forces. We also measured the forces and movements produced by co-and sequential activation of two intraspinal sites. Isometric force responses were measured at nine limb configurations with the paw attached to a force transducer. The active forces elicited at different limb configurations were summarized as patterns representing the sagittal plane component of the forces produced at the paw throughout the workspace. The force patterns divided into the same distinct types found with the femur fixed. The responses during simultaneous activation of two spinal sites always resembled the response for activation of one of the two sites, i.e., winner-take-all, and we did not observe vectorial summation of the forces produced by activation of each site individually as reported in chronic spinal animals. The movements produced by activation of each of the sites were consistent with the force orientations, and different movements could be created by varying the sequence of activation of individual sites. Our results highlight the absence of a vectorial summation phenomenon during intraspinal microstimulation in decerebrate animals, and the preservation during movement of the orientation of isometric forces.

Odorant specificity to l-alpha-amino acids was determined for 245 olfactory bulb (OB) neurons recorded from 121 channel catfish. The initial tests included 4 amino acids representing acidic [monosodium glutamate (Glu)], basic [arginine (Arg)], and neutral [possessing short: alanine (Ala) and long: methionine (Met) side chains] amino acids that were previously indicated to bind to independent olfactory receptor sites. Ninety-one (37%) units (Group I) tested at 1, 10, and 100 microM showed high selectivity and were excited by only one of the 4 amino acids. Odorant specificity for the vast majority of Group I units did not change over the 3 s of response time analyzed. A total of 154 OB units (63%) (Group II) were excited by a second amino acid, but only at &gt;/=10x odorant concentration. An additional 69 Group I units were tested with related amino acids and derivatives from 10(-9) to 10(-5) M to determine their excitatory odorant thresholds and selectivities. Two groups of units ori...

A new portable brain imaging device based on continuous-wave functional near-infrared spectrometry (fNIRS) is presented. The source-detector part is composed of a multi-wavelength LED and a silicon photodetector that are directly placed on the scalp of the subject. The dimensions of the proposed device are small, as it has to be mounted on the head of an adult person. Acquired data are transmitted in real-time to a laptop for post processing using Matlab. Timemultiplexed light is used to achieve a higher SNR while keeping the device safe for long-term wearing. Preliminary evaluation on adults gave the expected accuracy and compare well with fNIRS characteristics found in literature, that are collected from bulky equipment. With a noise figure of -47dB and a sampling rate of 23Hz, the presented device is appropriate to isolate hemodynamic variations, which are strongly related to local cerebral activity.

The study of human behaviour ultimately requires the documentation of human movement. In some instances movements can be recorded through a simple button press on a computer input device. In other situations responses can be captured through questionnaire surveys. Nevertheless, there is a need within many neuroscience settings to capture how complex movements unfold over time (human kinematics). Current methods of measuring human kinematics range from accurate but multifarious laboratory configurations to ...

The American Society of Neurophysiologic Monitoring (ASNM) and American Society of Neuroimaging (ASN) Guidelines Committees formed a joint task force and developed guidelines to assist in the use of transcranial Doppler (TCD) monitoring in the surgical and intensive care settings. Specifically, these guidelines: (1) delineate the objectives of TCD monitoring; (2) characterize the responsibilities and behaviors of the sonographer during monitoring; (3) describe methodological and ethical issues uniquely relevant to monitoring. The ASNM and ASN strongly support the positions that (1) acquisition and interpretation of intraoperative TCD ultrasonograms be performed by qualified individuals, (2) service providers define their diagnostic criteria and develop on-going self-validation programs of these performance criteria in their practices. We agree with the guidelines of other professional societies regarding the technical and professional qualifications of individuals responsible for TCD signal acquisition and interpretation (Class III evidence, Type C recommendation). On the basis of current clinical literature and scientific evidence, TCD monitoring is an established monitoring modality for the: (1) assessment of cerebral vasomotor reactivity and autoregulation; (2) documentation of the circle of Willis functional status; (3) identification of cerebral hypo-and hyperperfusion, recanalization and re-occlusion; and (4) detection of cerebral emboli (Class II and III evidence, Type B recommendation). Adequate transcranial insonation of intracranial vessels generally requires ultrasonic probes with crystals operating at 2 MHz or less. Monitoring services should establish local probe performance standards and regularly document that each probe in current use meets these criteria. The crowded surgical/critical

Collection and analysis of limb kinematic data are essential components of the study of biological motion, including research into biomechanics, kinesiology, neurophysiology and brain-machine interfaces (BMIs). In particular, BMI research requires advanced, real-time systems capable of sampling limb kinematics with minimal contact to the subject's body. To answer this demand, we have developed an automated video tracking system for real-time tracking of multiple body parts in freely behaving primates. The system employs high-contrast markers painted on the animal's joints to continuously track the threedimensional positions of their limbs during activity. Two-dimensional coordinates captured by each video camera are combined and converted to three-dimensional coordinates using a quadratic fitting algorithm. Real-time operation of the system is accomplished using direct memory access (DMA). The system tracks the markers at a rate of 52 frames per second (fps) in real-time and up to 100 fps if video recordings are captured to be later analyzed off-line. The system has been tested in several BMI primate experiments, in which limb position was sampled simultaneously with chronic recordings of the extracellular activity of hundreds of cortical cells. During these recordings, multiple computational models were employed to extract a series of kinematic parameters from neuronal ensemble activity in real-time. The system operated reliably under these experimental conditions and was able to compensate for marker occlusions that occurred during natural movements. We propose that this system could also be extended to applications that include other classes of biological motion.

In our every day life, our brain is constantly processing information and paying attention, reacting accordingly, to all sorts of sensory inputs (auditory, visual, etc.). In some cases, there is a need to accurately measure a person's level of attention to monitor a sportsman performance, to detect Attention Deficit Hyperactivity Disorder (ADHD) in children, to evaluate the effectiveness of neuro-feedback treatment, etc.

Lack of a clear analytical metric for identifying artifact free, clean electroencephalographic (EEG) signals inhibits robust comparison of different artifact removal methods and lowers confidence in the results of EEG analysis. An algorithm is presented for identifying clean EEG epochs by thresholding statistical properties of the EEG. Thresholds are trained on EEG datasets from both healthy subjects and stroke / spinal cord injury patient populations via differential evolution (DE).

AND CONCLUSIONS 1. Slices of sensorimotor and anterior cingulate cortex from guinea pigs were maintained in vitro and bathed in a normal physiological medium. Electrophysiological properties of neurons were assessed with intracellular recording techniques. Some neurons were identified morphologically by intracellular injection of the fluorescent dye Lucifer yellow CH.

Functional architecture of the striate cortex is known mostly at the tissue level -how neurons of different function distribute across its depth and surface on a scale of millimetres. But explanations for its design -why it is just so -need to be addressed at the synaptic level, a much finer scale where the basic description is still lacking. Functional architecture of the retina is known from the scale of millimetres down to nanometres, so we have sought explanations for various aspects of its design. Here we review several aspects of the retina's functional architecture and find that all seem governed by a single principle: represent the most information for the least cost in space and energy. Specifically: (i) why are OFF ganglion cells more numerous than ON cells? Because natural scenes contain more negative than positive contrasts, and the retina matches its neural resources to represent them equally well; (ii) why do ganglion cells of a given type overlap their dendrites to achieve 3-fold coverage? Because this maximizes total information represented by the array -balancing signal-to-noise improvement against increased redundancy; (iii) why do ganglion cells form multiple arrays? Because this allows most information to be sent at lower rates, decreasing the space and energy costs for sending a given amount of information. This broad principle, operating at higher levels, probably contributes to the brain's immense computational efficiency.

Objective: To establish sound empirical evidence that clinical empathy (abbreviated as CE) is a core element in the clinician-patient relationship with profound therapeutic potential, a substantial theoretical-based understanding of CE in medical care and medical education is still required. The two aims of the present paper are, therefore, (1) to give a multidisciplinary overview of the ''nature'' and ''specific effectiveness'' of CE, and (2) to use this base as a means of deriving relevant questions for a theory-based research agenda. Method: We made an effort to identify current and past literature about conceptual and empirical work focusing on empathy and CE, which derives from a multiplicity of disciplines. We review the material in a structured fashion. Results: We describe the ''nature'' of empathy by briefly summarizing concepts and models from sociology, psychology, social psychology, education, (social-)epidemiology, and neurosciences. To explain the ''specific effectiveness'' of CE for patients, we develop the ''Effect model of empathic communication in the clinical encounter'', which demonstrates how an empathically communicating clinician can achieve improved patient outcomes. Both parts of theoretical findings are synthesized in a theory-based research agenda with the following key hypotheses: (1) CE is a determinant of quality in medical care, (2) clinicians biographical experiences influence their empathic behavior, and (3) CE is affected by situational factors. Conclusion: The main conclusions of our review are twofold. First of all, CE seems to be a fundamental determinant of quality in medical care, because it enables the clinician to fulfill key medical tasks more accurately, thereby achieving enhanced patient health outcomes. Second, the integration of biographical experiences and situational factors as determinants of CE in medical care and medical education appears to be crucial to develop and promote CE and ultimately ensuring high-quality patient care. Practice implications: Due to the complexity and multidimensionality of CE, evidence-based investigations of the derived hypotheses require both well-designed qualitative and quantitative studies as well as an interdisciplinary research approach. ß

In the last decade, the physiology of cerebellar neurons and synapses has been extended to a considerable extent. We have found that the mossy fiber-granule cell relay can generate a complex form of long-term potentiation (mf-GrC LTP) following high-frequency mf discharge. Induction. Mf-GrC LTP depends on NMDA and mGlu receptor activation, intracellular Ca(2+) increase, PKC activation, and NO production. The preventative action of intracellular agents (BAPTA, PKC-inhibitors) and of membrane hyperpolarization, and the correlated increase in intracellular Ca(2+) observed using fluorescent dyes, indicate that induction occurs postsynaptically. Expression. Expression includes three components: (a) an increase of synaptic currents, (b) an increase of intrinsic excitability in GrC, and (c) an increase of intrinsic excitability in mf terminals. Based on quantal analysis, the EPSC increase is mostly explained by enhanced neurotransmitter release. NO is a candidate retrograde neurotransmitte...

The cocktail party problem is a multi-faceted challenge which encompasses various aspects of auditory perception. Its processes underlie the brain&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to detect, identify and classify sound objects; to robustly represent and maintain speech intelligibility amidst severe distortions; and to guide actions and behaviors in line with complex goals and shifting acoustic soundscapes. Here, we present a perspective that considers the powerful Bayesian inference as a unifying framework to integrate the role of sensory cues as well as stimulus-driven priors and top-down schemas including attention.

It is with pleasure that I inform you that they have given me an electric spark, perceptible in its passage through a small gap or separation made in a tin lamina pasted on a glass. These fishes were in the air; since this experience has not succeeded in water; their electricity is very much stronger than that of the Torpedo, and there are some considerable differences in their electrical effects.' John Walsh's research on electric fish, carried out between 1772 and 1775, proved fundamental for demonstrating that electricity might be involved in animal physiology, and, moreover, in favouring a period of great progress in both the physiology and physics of electrical phenomena. However, Walsh is hardly known to modern neuroscientists and is largely neglected by science historians also. One of the reasons for this neglect is that he never published his 'crucial experiment' , that is the production of a spark from a discharge of the electric eel.

Existing brain-machine interfacing techniques allow either high precision recordings from one or a few single neurons, or low spatial resolution recordings with a sparse sampling within the networks. Through our approach an efficient simultaneous bidirectional communication to the brain is realized using capacitively coupled recording and stimulation sites arranged in a large 2D multi-transistor array (MTA) with 1000 elements, integrated to a planar chip at high resolution (10mum pitch and below). The aim of the present work is to evaluate the reliability of a simple-generation silicon micro-device in recording neuronal signals from rat brain. Simultaneous recording of signals using this chip from the somatosensory cortex (S1) of living rat, are compared to standard in vivo recordings with a glass micropipette. We show that the two types of signals are identical, indicating the possibility to record signals at the same time from different sites and to perform a real-time electrical imaging of the brain cortex in vivo.

Objectives: Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance.

Early-stage romantic love can induce euphoria, is a cross-cultural phenomenon, and is possibly a developed form of a mammalian drive to pursue preferred mates. It has an important influence on social behaviors that have reproductive and genetic consequences. To determine which reward and motivation systems may be involved, we used functional magnetic resonance imaging and studied 10 women and 7 men who were intensely &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;in love&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; from 1 to 17 mo. Participants alternately viewed a photograph of their beloved and a photograph of a familiar individual, interspersed with a distraction-attention task. Group activation specific to the beloved under the two control conditions occurred in dopamine-rich areas associated with mammalian reward and motivation, namely the right ventral tegmental area and the right postero-dorsal body and medial caudate nucleus. Activation in the left ventral tegmental area was correlated with facial attractiveness scores. Activation in the right anteromedial caudate was correlated with questionnaire scores that quantified intensity of romantic passion. In the left insula-putamen-globus pallidus, activation correlated with trait affect intensity. The results suggest that romantic love uses subcortical reward and motivation systems to focus on a specific individual, that limbic cortical regions process individual emotion factors, and that there is localization heterogeneity for reward functions in the human brain.