The EEG activity of the thalamus and temporal lobe structures (hippocampus, entorhinal cortex and neocortex) was obtained using intracerebral recordings (stereoelectroencephalography, SEEG) performed in patients with TLE seizures undergoing pre-surgical evaluation. Synchrony was studied using a statistical measure of SEEG signal interdependencies (non-linear correlation). The results demonstrated an overall increase of synchrony between the thalamus and temporal lobe structures during seizures. Moreover, although there was great inter-individual variability, we found that values from seizure onset period were significantly higher than values from the background period (P = 0.001). Values at the end of seizure were significantly higher than values from the seizure onset (P < 0.0001). Several indices were also defined in order to correlate some clinical features to the degree of coupling between cortical structures and the thalamus. In patients with mesial TLE seizures, a correlation was found between the degree of thalamocortical synchrony and the presence of an early loss of consciousness but not with other clinical parameters. In addition, surgical prognosis seemed better in patients with low values of thalamocortical couplings at the seizure onset. This report demonstrates that the thalamus and remote cortical structures synchronize their activity during TLE seizures and suggest that the extension of the epileptogenic network to the thalamus is a potential important factor determining surgical prognosis.
The class IV semaphorin Sema4A provides a costimulatory signal to T cells. To investigate the possible developmental and regulatory roles of Sema4A in vivo, we generated Sema4A-deficient mice. Although Sema4A-deficient mice develop normally, DCs and T cells from knockout mice display poor allostimulatory activities and T helper cell (Th) differentiation, respectively. Interestingly, in addition to its expression on DCs, Sema4A is upregulated on Th1-differentiating cells, and it is necessary for in vitro Th1 differentiation and T-bet expression. Consequently, in vivo antigen-specific T cell priming and antibody responses against T cell-dependent antigens are impaired in the mutant mice. Additionally, Sema4A-deficient mice exhibit defective Th1 responses. Furthermore, reconstitution studies with antigen-pulsed DCs reveal that DC-derived Sema4A is important for T cell priming, while T cell-derived Sema4A is involved in developing Th1 responses. Collectively, these results indicate a nonredundant role of Sema4A not only in T cell priming, but also in the regulation of Th1/Th2 responses.
R áegis and co-workers investigated the cerebral cortical folding pattern and proposed a generic sulcal root model based on MR imaging data of 20 normal subjects (4 females and 16 males). They tried to resolve the cortical folding pattern of the individuals using a computer three-dimensional visualization tool of the MR images. They tried to define`pli de passage' in French, which means a small gyri buried inside the deep main sulci. They hypothesized that the`pli de passage' subdivide in subunits (sulcal roots) large sulcus. Their observations are still under investigation, however, their approach using precise computer graphics is brand new. This method may be useful to understand brain function and to open new doors for brain mapping. Further improvement will be required not only for the resolution of the three dimensional MR imaging but also for the software of the image processing for the universal use of this technique. AbstractThe great variability of cerebral cortical folding patterns raises major problems for the systematic study of functional-structural relationships. This paper describes a novel perspective for explaining this variability, a perspective that relies on gyri buried in the depth of the sulci. From this perspective we propose a generic model of folding, based on indivisible units, called sulcal roots, which correspond to the first folding locations during antenatal life. These units are organized according to a basic scheme allowing us to describe the cortical surface using a system of meridians and parallels. This scheme is thought to be stable across individuals at the fetal stage, and may be related to the protomap model. Variability at the adult stage is thought to result from the chaotic behavior of the folding process: inter-individual differences in cortical areas can lead to qualitatively different folding patterns. We have tested the capacity of this model to match actual cortical anatomy with a database of magnetic resonance images of 20 normal subjects, using new three-dimensional visualization tools giving access to shapes buried in the cortex.
Gamma knife radiosurgery may represent a therapeutic approach in patients with moderate initial or residual GH hypersecretion.
Dizziness after cochlear implant (CI) was studied in a series of 94 consecutive adult patients receiving a cochlear implant, 46 (49.0%) of whom experienced dizziness post-operatively. In 29 patients, post-operative dizziness occurred soon after surgery and subsided within one month. Dizziness of the continuous type, lasting more than 6 months, was a complaint in only two patients. In addition to these already known forms of dizziness, spells of vertigo occurring later than one month after cochlear implant were experienced by 15 patients (delayed-V). The spells of delayed-V occurred suddenly and persisted for several hours. Moreover, 85.7% of delayed-V patients complained of hearing and tinnitus abnormalities during these spells. The clinical features of delayed-V were similar to those in patients with Meniere's disease. The preoperative bithermal caloric test showed a significantly higher response for the delayed-V group than the other groups (ANOVA: P < 0.05) in terms of slow phase eye velocity of caloric nystagmus. These findings suggest that inner ear lesions due to cochlear implant surgery develop gradually. Similarities in clinical features between delayed-V and Ménière's disease indicate the presence of labyrinthine hydrops.
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