Localization of cortico-peripheral coherence with electroencephalography.

Background The analysis of coherent networks from continuous recordings of neural activity with functional MRI or magnetoencephalography has provided important new insights into brain physiology and pathology. Here we assess whether valid localizations of coherent cortical networks can also be obtained from high-resolution electroencephalography (EEG) recordings. Methods EEG was recorded from healthy subjects and from patients with ischemic brain lesions during a tonic hand muscle contraction task and during continuous visual stimulation with an alternating checkerboard. These tasks induce oscillations in the primary hand motor area or in the primary visual cortex, respectively, which are coherent with extracerebral signals (hand muscle electromyogram or visual stimulation frequency). Cortical oscillations were reconstructed with different inverse solutions and the coherence between oscillations at each cortical voxel and the extracerebral signals was calculated. Moreover, simulations of coherent point sources were performed. Results Cortico-muscular coherence was correctly localized to the primary hand motor area and the steady-state visual evoked potentials to the primary visual cortex in all subjects and patients. Sophisticated head models tended to yield better localization accuracy than a single sphere model. A Minimum Variance Beamformer (MVBF) provided more accurate and focal localizations of simulated point sources than an L2 Minimum Norm (MN) inverse solution. In the real datasets, the MN maps had less localization error but were less focal than MVBF maps. Conclusions EEG can localize coherent cortical networks with sufficient accuracy

Human Processing of Behaviorally Relevant and Irrelevant Absence of Expected Rewards: A High-Resolution ERP Study

Acute lesions of the posterior medial orbitofrontal cortex (OFC) in humans may induce a state of reality confusion marked by confabulation, disorientation, and currently inappropriate actions. This clinical state is strongly associated with an inability to abandon previously valid anticipations, that is, extinction capacity. In healthy subjects, the filtering of memories according to their relation with ongoing reality is associated with activity in posterior medial OFC (area 13) and electrophysiologically expressed at 220–300 ms. These observations indicate that the human OFC also functions as a generic reality monitoring system. For this function, it is presumably more important for the OFC to evaluate the current behavioral appropriateness of anticipations rather than their hedonic value. In the present study, we put this hypothesis to the test. Participants performed a reversal learning task with intermittent absence of reward delivery. High-density evoked potential analysis showed that the omission of expected reward induced a specific electrocortical response in trials signaling the necessity to abandon the hitherto reward predicting choice, but not when omission of reward had no such connotation. This processing difference occurred at 200–300 ms. Source estimation using inverse solution analysis indicated that it emanated from the posterior medial OFC. We suggest that the human brain uses this signal from the OFC to keep thought and behavior in phase with reality

American Academy of Optometry Microbial Keratitis Think Tank

SIGNIFICANCE Think Tank 2019 affirmed that the rate of infection associated with contact lenses has not changed in several decades. Also, there is a trend toward more serious infections associated with Acanthamoeba and fungi. The growing use of contact lenses in children demands our attention with surveillance and case-control studies. PURPOSE The American Academy of Optometry (AAO) gathered researchers and key opinion leaders from around the world to discuss contact lens-associated microbial keratitis at the 2019 AAO Annual Meeting. METHODS Experts presented within four sessions. Session 1 covered the epidemiology of microbial keratitis, pathogenesis of Pseudomonas aeruginosa, and the role of lens care systems and storage cases in corneal disease. Session 2 covered nonbacterial forms of keratitis in contact lens wearers. Session 3 covered future needs, challenges, and research questions in relation to microbial keratitis in youth and myopia control, microbiome, antimicrobial surfaces, and genetic susceptibility. Session 4 covered compliance and communication imperatives. RESULTS The absolute rate of microbial keratitis has remained very consistent for three decades despite new technologies, and extended wear significantly increases the risk. Improved oxygen delivery afforded by silicone hydrogel lenses has not impacted the rates, and although the introduction of daily disposable lenses has minimized the risk of severe disease, there is no consistent evidence that they have altered the overall rate of microbial keratitis. Overnight orthokeratology lenses may increase the risk of microbial keratitis, especially secondary to Acanthamoeba, in children. Compliance remains a concern and a significant risk factor for disease. New insights into host microbiome and genetic susceptibility may uncover new theories. More studies such as case-control designs suited for rare diseases and registries are needed. CONCLUSIONS The first annual AAO Think Tank acknowledged that the risk of microbial keratitis has not decreased over decades, despite innovation. Important questions and research directions remain

The breast feeding mother and xenon anaesthesia: four case reports. Breast feeding and xenon anaesthesia

<p>Abstract</p> <p>Background</p> <p>Four nursing mothers consented to anaesthesia for urgent surgery only on condition that their ability to breast feed would not be impaired.</p> <p>Methods</p> <p>Following induction of general anaesthesia with propofol and remifentanil, 65-69% xenon supplemented with remifentanil was used as an inhalational anaesthetic for maintenance.</p> <p>Results</p> <p>After finishing surgery the women could be extubated between 2:52 and 7:22 minutes. The women were fully alert just minutes after extubation and spent about 45 minutes in the recovery room before discharge to a regular ward. They resumed regular breast feeding some time later. The propofol concentration in the blood was measured after 0, 30, 90, and 300 minutes and in the milk after 90 and 300 minutes. Just 90 minutes after extubation, the concentration of propofol in the milk was limited (> 3 mg/l) so that pharmacological effects on the babies were excluded after oral intake. Also, no traces of xenon gas were found in the maternal milk at any time. After propofol induction and maintenance of anaesthesia with xenon in combination with a water-soluble short-acting drug like remifentanil, the concentration of propofol in maternal milk is low (> 3 mg/l 90 min after anesthesia) and harmless after oral intake.</p> <p>Conclusions</p> <p>These results, as well as the rapid elimination and absence of metabolism of xenon, are of great interest to nursing mothers. General anaesthesia with propofol for induction only, combined with remifentanil and xenon for maintenance, has not yet been described in breast feeding mothers.</p

Rapid discrimination of visual and multisensory memories revealed by electrical neuroimaging.

Though commonly held that multisensory experiences enrich our memories and that memories influence ongoing sensory processes, their neural mechanisms remain unresolved. Here, electrical neuroimaging shows that auditory-visual multisensory experiences alter subsequent processing of unisensory visual stimuli during the same block of trials at early stages poststimulus onset and within visual object recognition areas. We show this with a stepwise analysis of scalp-recorded event-related potentials (ERPs) that statistically tested (1) ERP morphology and amplitude, (2) global electric field power, (3) topographic stability of and changes in the electric field configuration, and (4) intracranial distributed linear source estimations. Subjects performed a continuous recognition task, discriminating repeated vs. initial image presentations. Corresponding, but task-irrelevant, sounds accompanied half of the initial presentations during a given block of trials. On repeated presentations within a block of trials, only images appeared, yielding two situations-the image's prior presentation was only visual or with a sound. Image repetitions that had been accompanied by sounds yielded improved memory performance accuracy (old or new discrimination) and were differentiated as early as approximately 60-136 ms from images that had not been accompanied by sounds through generator changes in areas of the right lateral-occipital complex (LOC). It thus appears that unisensory percepts trigger multisensory representations associated with them. The collective data support the hypothesis that perceptual or memory traces for multisensory auditory-visual events involve a distinct cortical network that is rapidly activated by subsequent repetition of just the unisensory visual component