Work-worlds colliding: Self-reflexivity, power and emotion in organizational ethnography

While organizational ethnographers have embraced the concept of self-reflexivity, problems remain. In this article we argue that the prevalent assumption that self-reflexivity is the sole responsibility of the individual researcher limits its scope for understanding organizations. To address this, we propose an innovative method of collective reflection that is inspired by ideas from cultural and feminist anthropology. The value of this method is illustrated through an analysis of two ethnographic case studies, involving a ‘pair interview’ method. This collective approach surfaced self-reflexive accounts, in which aspects of the research encounter that still tend to be downplayed within organizational ethnographies, including emotion, intersubjectivity and the operation of power dynamics, were allowed to emerge. The approach also facilitated a second contribution through the conceptualization of organizational ethnography as a unique endeavour that represents a collision between one ‘world of work’: the university, with a second: the researched organization. We find that this ‘collision’ exacerbates the emotionality of ethnographic research, highlighting the refusal of ‘researched’ organizations to be domesticated by the specific norms of academia. Our article concludes by drawing out implications for the practice of self-reflexivity within organizational ethnography

TH‐D‐210A‐07: Multi‐Modal Image Guidance in Neurosurgery: An Approach for Direct Targeting in Deep Brain Stimulation (DBS)

Purpose: To develop and evaluate an integrated multi‐modal image guidance methodology for DBS. Method and Materials: An image guidance methodology was developed to integrate multiple imaging methods as well as atlas and intraoperatively acquired electrophysiology data. Imaging techniques were developed using a 3T MRI to provide unique contrast of specific structures in the brain. A new sequence, the Fast Grey matter Acquisition T1 Inversion Recovery (FGATIR), was developed to produce images that specifically nullified the white matter signal. In addition, diffusion tensor imaging (DTI) tractography was acquired to provide differentiation of target subregions through structural connectivity. These imaging techniques as well as standard (T1, T2 FLAIR, and CT) imaging protocols were integrated on a single platform. This integration was accomplished by the development of a graphical user interface (GUI) to allow for viewing and targeting based off these images along with a deformed atlas and intraoperatively acquired electrophysiology maps. Results: The developed image guidance system allowed for targeting based off all data types mentioned previously. The new imaging techniques developed were compared against intraoperatively acquired microelectrode data. The two novel imaging techniques, FGATIR and DTI tractography, provided elucidation of structure not seen by standard imaging methods and showed good correspondence with microelectrode maps. Contrast measurements for the FGATIR versus T1 and T2 FLAIR showed a higher contrast to noise ratio (CNR) for FGATIR scans. For example, the CNR for ventral lateral thalamus versus the remainder of thalamus was 2.19, 2.81, and 7.27 for T1, T2 FLAIR, and FGATIR, respectively. Conclusion: Our methodology for image guidance in DBS surgery has the potential to allow for direct visualization and targeting of regions that can not be visualized by standard techniques. The integration of all these methods within a single framework demonstrates the potential for multi‐modal image guidance in neurosurgery

TH‐C‐M100J‐10: Development of Image Guidance Methods for Deep Brain Stimulation

Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic functional procedure of deep brain stimulation (DBS) in regions that are poorly defined with anatomic imaging using a deformable atlas and functional imaging. Method and Materials: An image guidance system was developed to enhance targeting for stereotactic DBS surgeries. An atlas of the structures in the basal ganglia was created from the Schaltenbrand‐Bailey series of histologically stained sagittal and axial sections. By defining a surface that connects each plane, a voxelized binary atlas was created and smoothed to reduce inconsistencies. A set of programs were created using Matlab to allow for user driven linear atlas deformation to match the atlas with patient specific anatomy and landmarks. An additional set of programs were created to record intraoperative microelectrode recording (MER) maps and to visualize these maps through sagittal and coronal cuts in the patient deformed atlas. To add additional functional information, a high resolution functional MRI (fMRI) protocol was developed that allows for localization of motor, sensory, language, and emotional regions in the basal ganglia. Software to visualize the deformed atlas, MRI and fMRI all together was created to allow for target definition and planning based off multiple sources of information simultaneously. Results: The developed atlas‐based image guidance system has been used as a clinical tool for several months and now allows physicians the ability to deform an anatomic atlas to patient specific anatomy and also obtain and view electrode tracks through the atlas in oblique angles. fMRI data on initial subjects has shown good qualitative agreement with expected physiological locations and MER maps in patients. Conclusion: This work allows for improved targeting in DBS based off the simultaneous usage of a 3D deformed atlas, microelectrode recording maps, and fMRI data

Artistic creativity and DBS: A case report

Background: Deep brain stimulation (DBS) is a treatment for patients with Parkinson's disease (PD) who are not adequately controlled with medications. An artist reported changes in her artistic creativity and art appreciation when treated with left DBS. We sought to study her artistic productions and her appreciation of art while both "on" and "off" left DBS. Methods: A 69-year-old right-handed woman with an approximate 20-year history of PD was referred to us for management of a left subthalamic region nucleus (STN) DES placed at another institution 4years prior. In Experiment I we had her rate several dimensions (Evocative Impact, Aesthetics, Novelty, Technique, Closure and Representation) of another artist's paintings. In Experiment 2, we tested her with the Abbreviated Torrance Test (of creativity) for Adults (ATTA). During testing the patient remained on her dopaminergic medication, but was tested on and off left DBS. Results: On the judgment task while "on" left DBS, versus "off" DBS, there were significant reductions in her appreciation of artistic Closure and Technique. When "off" DBS her ATTA creativity index was above average, but when switched "on" her creativity index was below average. Conclusions: These results suggest the possibility that left ventral STN/SNR DBS reduces creativity as well as appreciation of art. The reason for these alterations is not known, but might be related to enhanced activation of the left hemisphere and reciprocal deactivation of the right hemisphere which mediates both visuospatial skills and global attention, both of which are important in artistic creativity and appreciation. (C) 2008 Elsevier B.V. All rights reserved

Effects of aerobic fitness on aging-related changes of interhemispheric inhibition and motor performance.

Physical fitness has been long associated with maintenance and improvement of motor performance as we age. In particular, measures of psychomotor speed and motor dexterity tend to be higher in physically fit aging adults as compared to their sedentary counterparts. Using functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS), we explored the patterns of neural activity that may, in part, account for differences between individuals of varying physical fitness levels. In this study, we enrolled both sedentary and physically fit middle age (40-60) and younger (18-30) adults and measured upper extremity motor performance during behavioral testing. In a follow-up session, we employed TMS and fMRI to assess levels of interhemispheric communication during unimanual tasks. Results show that increased physical fitness is associated with better upper extremity motor performance on distal dexterity assessments and increased levels of interhemispheric inhibition in middle age adults. Further, the functional correlates of changes of ipsilateral activity appears to be restricted to the aging process as younger adults of varying fitness levels do not differ in hemispheric patterns of activity or motor performance. We conclude that sedentary aging confers a loss of interhemispheric inhibition that is deleterious to some aspects of motor function, as early as midlife, but these changes can be mediated by chronic engagement in aerobic exercise

Broca's area and its striatal and thalamic connections: a diffusion-MRI tractography study.

In the recent decades structural connectivity between Broca's area and the basal ganglia has been postulated in the literature, though no direct evidence of this connectivity has yet been presented. The current study investigates this connectivity using a novel diffusion-weighted imaging (DWI) fiber tracking method in humans in vivo. Our findings suggest direct connections between sub-regions of Broca's area and the anterior one-third of the putamen, as well as the ventral anterior nucleus of the thalamus. Thus, we are the first to provide a detailed account of inferred circuitry involving basal ganglia, thalamus, and Broca's area, which would be a prerequisite to substantiate their support of language processing

Effects of aerobic fitness on aging-related changes of interhemispheric inhibition and motor performance.

Physical fitness has been long associated with maintenance and improvement of motor performance as we age. In particular, measures of psychomotor speed and motor dexterity tend to be higher in physically fit aging adults as compared to their sedentary counterparts. Using functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS), we explored the patterns of neural activity that may, in part, account for differences between individuals of varying physical fitness levels. In this study, we enrolled both sedentary and physically fit middle age (40-60) and younger (18-30) adults and measured upper extremity motor performance during behavioral testing. In a follow-up session, we employed TMS and fMRI to assess levels of interhemispheric communication during unimanual tasks. Results show that increased physical fitness is associated with better upper extremity motor performance on distal dexterity assessments and increased levels of interhemispheric inhibition in middle age adults. Further, the functional correlates of changes of ipsilateral activity appears to be restricted to the aging process as younger adults of varying fitness levels do not differ in hemispheric patterns of activity or motor performance. We conclude that sedentary aging confers a loss of interhemispheric inhibition that is deleterious to some aspects of motor function, as early as midlife, but these changes can be mediated by chronic engagement in aerobic exercise