Evaluating the Safety of Simultaneous Intracranial Electroencephalography and Functional Magnetic Resonance Imaging Acquisition Using a 3 Tesla Magnetic Resonance Imaging Scanner

Background: The unsurpassed sensitivity of intracranial electroencephalography (icEEG) and the growing interest in understanding human brain networks and ongoing activities in health and disease have make the simultaneous icEEG and functional magnetic resonance imaging acquisition (icEEG-fMRI) an attractive investigation tool. However, safety remains a crucial consideration, particularly due to the impact of the specific characteristics of icEEG and MRI technologies that were safe when used separately but may risk health when combined. Using a clinical 3-T scanner with body transmit and head-receive coils, we assessed the safety and feasibility of our icEEG-fMRI protocol. Methods: Using platinum and platinum-iridium grid and depth electrodes implanted in a custom-made acrylic-gel phantom, we assessed safety by focusing on three factors. First, we measured radio frequency (RF)-induced heating of the electrodes during fast spin echo (FSE, as a control) and the three sequences in our icEEG-fMRI protocol. Heating was evaluated with electrodes placed orthogonal or parallel to the static magnetic field. Using the configuration with the greatest heating observed, we then measured the total heating induced in our protocol, which is a continuous 70-min icEEG-fMRI session comprising localizer, echo-planar imaging (EPI), and magnetization-prepared rapid gradient-echo sequences. Second, we measured the gradient switching-induced voltage using configurations mimicking electrode implantation in the frontal and temporal lobes. Third, we assessed the gradient switching-induced electrode movement by direct visual detection and image analyses. Results: On average, RF-induced local heating on the icEEG electrode contacts tested were greater in the orthogonal than parallel configuration, with a maximum increase of 0.2°C during EPI and 1.9°C during FSE. The total local heating was below the 1°C safety limit across all contacts tested during the 70-min icEEG-fMRI session. The induced voltage was within the 100-mV safety limit regardless of the configuration. No gradient switching-induced electrode displacement was observed. Conclusion: We provide evidence that the additional health risks associated with heating, neuronal stimulation, or device movement are low when acquiring fMRI at 3 T in the presence of clinical icEEG electrodes under the conditions reported in this study. High specific absorption ratio sequences such as FSE should be avoided to prevent potential inadvertent tissue heating

〈Original〉The effect of laughter measured by scoring facial expressions: observation study

[Abstract] Background: Laughter is a universal expression of emotion for humans, and it has been linked with health and well-being. The purpose of this study is to clarify the physical and psychological effect of laughter by scoring procedure of facial expression. Method: During a period of a month, a total of three interventions to induce laughter were conducted for 22 adults. During the interventions, data on facial expression and vital signs were collected for future analysis, and psychological examinations were conducted. Measures related to quality of life, including scores on the Medical Outcomes Study 36-Item Short-Form Health Survey version 2, did not show signs of improvement between the measures before or after interventions for mean participants. Results: Those participants who laughed more heartily, showed significant reductions in their scores for Tension-Anxiety, and Pain. The male group, as a whole, had significantly lower scores for happiness according to the data for facial expression. Conclusion: This study suggests that laughter may not bring positive changes to total quality of life. However, it does appear that the effects of laughter may be more easily demonstrated for participants who are not habituated to its effects, which would depend on the specific intervention used and the context in which the laughter takes place

Emerging Options for Emergency Contraception

Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference

〈Original〉 The relationship between the construct of alexithymia and the steps of emotion expression

[Abstract] Background: Alexithymia is a central concept in psychosomatic disorders, but its treatment has not been established. Therefore, in order to clarify the details of the pathogenesis of alexithymia for further treatment, the present study aimed to evaluate the association between alexithymia pathophysiology, classified by the presence or absence of alexithymia as assessed by the 20-item version of The Toronto Alexithymia Scale (TAS-20), and emotional expressive process functioning as assessed by Japanese version of the Difficulties in Emotion Regulation Scale (J-DERS).Methods: From February 2018 to June 2019, first-time patients aged 16 years or older referred to our department were eligible for inclusion, and patients with mental illness, patients who declined to provide information, and those who consented but failed to complete the form were excluded.The comparison between the median J-DERS total and subscale scores of the TAS-20 high-scoring group (defined as ≥52 points) and the TAS-20 low-scoring group (defined as ≤51 points) was set as the primary outcome. J-DERS total score and subscales were used as dependent variables, and multiple linear regression analysis was used to analyze the association with the subscales of the TAS-20.Results: Of the 188 total subjects, 106 (56%) were included in the analysis. On the median total J-DERS score, the TAS-20 high scoring group was significantly higher than the low scoring group. Similarly, a significant difference was seen with each J-DERS subscale. Of the three TAS-20 subscales, only difficulty in identifying feelings correlated with the J-DERS total score and subscales.Conclusions: Although alexithymia has been considered to be a disruption in one of steps of the emotional expression process, the results of our study revealed that alexithymia affects the several emotional expression process. Future research may help treat alexithymia by providing psychotherapy that is commensurate with each step of the emotional expression process

Differential prefrontal response to infant facial emotions in mothers compared with non-mothers.

A considerable body of research has focused on neural responses evoked by emotional facial expressions, but little is known about mother-specific brain responses to infant facial emotions. We used near-infrared spectroscopy to investigate prefrontal activity during discriminating facial expressions of happy, angry, sad, fearful, surprised and neutral of unfamiliar infants and unfamiliar adults by 14 mothers and 14 age-matched females who have never been pregnant (non-mothers). Our results revealed that discriminating infant facial emotions increased the relative oxyHb concentration in mothers\u27 right prefrontal cortex but not in their left prefrontal cortex, compared with each side of the prefrontal cortices of non-mothers. However, there was no difference between mothers and non-mothers in right or left prefrontal cortex activation while viewing adult facial expressions. These results suggest that the right prefrontal cortex is involved in human maternal behavior concerning infant facial emotion discrimination