Behavioral and neurophysiological studies suggest that skill learning can be mediated by discrete, experience-driven changes within specific neural representations subserving the performance of the trained task. We have shown that a few minutes of daily practice on a sequential finger opposition task induced large, incremental performance gains over a few weeks of training. These gains did not generalize to the contralateral hand nor to a matched sequence of identical component movements, suggesting that a lateralized representation of the learned sequence of movements evolved through practice. This interpretation was supported by functional MRI data showing that a more extensive representation of the trained sequence emerged in primary motor cortex after 3 weeks of training. The imaging data, however, also indicated important changes occurring in primary motor cortex during the initial scanning sessions, which we proposed may ref lect the setting up of a task-specific motor processing routine. Here we provide behavioral and functional MRI data on experience-dependent changes induced by a limited amount of repetitions within the first imaging session. We show that this limited training experience can be sufficient to trigger performance gains that require time to become evident. We propose that skilled motor performance is acquired in several stages: "fast" learning, an initial, withinsession improvement phase, followed by a period of consolidation of several hours duration, and then "slow" learning, consisting of delayed, incremental gains in performance emerging after continued practice. This time course may ref lect basic mechanisms of neuronal plasticity in the adult brain that subserve the acquisition and retention of many different skills.The performance of many tasks improves, throughout life, with repetition and practice. Even in adulthood simple tasks such as reaching to a target or rapidly and accurately tapping a short sequence of finger movements, which appear, when mastered, to be effortlessly performed, often require extensive training before skilled performance develops. What changes occur in the adult brain when a new skill is acquired through practice? When, and after how much practice, do these changes occur? Functional reorganization of adult mammalian sensory and motor cortical representations has been found to occur in many different animal models of brain plasticity in the last two decades, advancing the idea that throughout life the functional properties of central nervous system neurons, as well as the neural circuitry within different brain areas, are malleable and retain a functionally significant degree of plasticity (e.g., refs. 1-4). These representational changes have been shown to be induced not only in response to lesions of peripheral or central sensory input or motor output pathways but also, in normal individuals, as a result of practice and experience. The advent of new brain imaging techniques, especially functional MRI (fMRI) (5), which allows repeated mapping of cor...
The immune response might suppress thyroid cancer recurrence. Although the factors that control this are unknown, CD-40 and CD-40 ligand might be important. To test this, we stained 36 papillary (PTC) and four follicular (FTC) thyroid carcinomas for CD-40 (n = 37) and CD-40 ligand (n = 36) and graded staining from absent (grade 0) to intense (grade 3). Follicular cells of the majority of thyroid tumors expressed CD-40 (30/37, 81%) and CD-40 ligand (15/24, 69%). Cancers from young patients (< or =21 years of age) that expressed CD-40 contained more numerous lymphocytes/high-power field (36 +/- 11) than cancers that failed to express CD-40 (4 +/- 3, p = 0.01), but there was no correlation with clinical outcome. Among young patients, CD-40 ligand expression was more intense in multifocal (1.1 +/- 0.2 vs. 0.45 +/- 0.2, p = 0.037), aggressive (1.14 +/- 0.14 vs. 0.65 +/- 0.2, p = 0.05) and recurrent tumors (1.2 +/- 0.2 vs. 0.65 +/- 0.2, p = 0.05) and associated with reduced disease-free survival (p = 0.03). We conclude that the majority of thyroid cancers express CD-40 and CD-40 ligand. In patients< or =21 years of age, tumors with intense expression of CD-40 ligand are more often multifocal, aggressive, and recurrent.
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