A specific role for the thalamus in mediating the interaction of attention and arousal in humans

High-frequency oscillations in somatosensory system

The recent revival of interest in high-frequency oscillation (HFO) is triggered by getting an opportunity to noninvasively monitor the timing of highly synchronized and rapidly repeating population spikes generated in the human somatosensory system. HFOs could be recorded from brainstem, cuneothalamic relay neurons, thalamus, thalamocortical radiation, thalamocortical terminals and cortex with deep brain or surface electrodes, or with magnetoencephalography. Here we briefly review the HFOs at each level of somatosensory pathways. HFOs recorded at brainstem might be produced by volume conduction from oscillations of the medial lemniscus. Thalamic HFOs at around 1000 Hz frequency would be generated within the somatosensory thalamus. Cortical HFOs would be generated by at least a few different mechanisms, thalamo-cortical projection terminals, interneurons and pyramidal cells of the primary sensory cortex. HFOs have been studied in several ways: their modulation by arousal changes, movements or drugs, their recovery function, effects of transcranial magnetic stimulation on them and also their changes in patients with various neurological diseases.

Effects of attention and arousal on early responses in striate cortex

Humans employ attention to facilitate perception of relevant stimuli. Visual attention can bias the selection of a location in the visual field, a whole visual object or any visual feature of an object. Attention draws on both current behavioral goals and/or the saliency of physical attributes of a stimulus, and it influences activity of different brain regions at different latencies. Attentional effect in the striate and extrastriate cortices has been the subject of intense research interest in many recent studies. The consensus emerging from them places the first attentional effects in extrastriate areas, which in turn modulate activity of V1 at later latencies. In this view attention influences activity in striate cortex some 150 ms after stimulus onset. Here we use magnetoencephalography to compare brain responses to foveally presented identical stimuli under the conditions of passive viewing, when the stimuli are irrelevant to the subject and under an active GO/NOGO task, when the stimuli are cues instructing the subject to make or inhibit movement of his/her left or right index finger. The earliest striate activity was identified 40-45 ms after stimulus onset, and it was identical in passive and active conditions. Later striate response starting at about 70 ms and reaching a peak at about 100 ms showed a strong attentional modulation. Even before the striate cortex, activity of the right inferior parietal lobule was modulated by attention, suggesting this region as a candidate for mediating attentional signals to the striate cortex.

Fatigue in the executive cortical network demonstrated in narcoleptics using functional magnetic resonance imaging—a preliminary study

BACKGROUND AND PURPOSE

To demonstrate dynamic changes in cerebral functional activation during a working memory task in a state of severe excessive daytime sleepiness.

PATIENTS AND METHODS

Omitting the usual morning dose of stimulants in three narcoleptics induced sleepiness. Functional magnetic resonance imaging (fMRI) was used to map cerebral activation during the performance of a 2-back verbal working memory task. Repeated 9.5 min scans were performed, until the subjects felt they could not continue. This was the functional imaging equivalent of the maintenance of wakefulness test.

RESULTS

Bilateral and widespread activation in known nodes of the executive network were seen during the first scan in all subjects, including the lateral prefrontal, posterior parietal and anterior cingulate cortex. There was a reduction in cerebral activation, especially but not exclusively in the prefrontal cortex, associated with slowing of performance from the first to the last tolerated scan. On stimulants, subjective alertness, activation and objective performance were readily maintained.

CONCLUSION

This preliminary study suggests that fatigue in the executive cortical network may be demonstrated by a progressive reduction in regional cerebral activation across scans, which may be prevented by stimulant use. Averaging multiple scan runs, a typical practice in fMRI, could blur important dynamic components of activation.

Sustained attention in traumatic brain injury (tbi) and healthy controls: enhanced sensitivity with dual-task load

Poor sustained attention or alertness is a common consequence of traumatic brain injury (TBI) and has a considerable impact on the recovery and adjustment of TBI patients. Here, we describe the development of a sensitive laboratory task in healthy subjects (Experiment 1) and its enhanced sensitivity to sustained attention errors in TBI patients (Experiment 2). The task involves withholding a key press to an infrequent no-go target embedded within a predictable sequence of numbers (primary goal) and detecting grey-coloured targets within the sequence (secondary goal). In Experiment 1, we report that neurologically healthy subjects are more likely to experience a lapse of attention and neglect the primary task goal, despite ceiling performance on the secondary task. Further, attentional lapses on the task correlated with everyday attentional failures and variability of response time. In Experiment 2, the task discriminates between TBI patients and controls with a large effect size. The dual-task yields more errors in both groups than a simple task involving only the primary goal that is commonly used to detect sustained attention deficits in neurologically impaired groups. TBI patients' errors also correlated with everyday cognitive failures and variability of response time. This was not the case in the simple version of the task. We conclude that the dual-task demand associated with this task enhances its sensitivity as a measure of sustained attention in TBI patients and neurologically healthy controls that relates to everyday slips of attention.

Functional connectivity of dissociative responses in posttraumatic stress disorder: a functional magnetic resonance imaging investigation

BACKGROUND

The purpose of this study was to assess interregional brain activity covariations during traumatic script-driven imagery in subjects with posttraumatic stress disorder (PTSD).

METHODS

Functional magnetic resonance imaging and functional connectivity analyses were used to assess interregional brain activity covariations during script-driven imagery in PTSD subjects with a dissociative response, PTSD subjects with a flashback response, and healthy control subjects.

RESULTS

Significant between-group differences in functional connectivity were found. Comparing dissociated PTSD patients and control subjects' connectivity maps in the left ventrolateral thalamus (VLT) [-14, -16, 4] revealed that control subjects had higher covariations between activations in VLT and in the left superior frontal gyrus (Brodmann's area [BA] 10), right parahippocampal gyrus (BA 30), and right superior occipital gyrus (BA 19, 39), whereas greater covariation with VLT in dissociated PTSD subjects occurred in the right insula (BA 13, 34), left parietal lobe (BA 7), right middle frontal gyrus (BA 8), superior temporal gyrus (BA 38, 34), and right cuneus (BA 19). Comparing dissociated PTSD and flashback PTSD connectivity maps in the right cingulate gyrus [3, 16, 30] revealed that dissociated PTSD subjects had higher covariations between activations in this region and the left inferior frontal gyrus (BA 47).

CONCLUSIONS

Greater activation of neural networks involved in representing bodily states was seen in dissociated PTSD subjects than in non-PTSD control subjects. These findings might illuminate the mechanisms underlying distorted body perceptions often observed clinically during dissociative episodes.

Dissociation of cortical regions modulated by both working memory load and sleep deprivation and by sleep deprivation alone

Working memory is an important mental capacity that is compromised following sleep deprivation (SD). To understand how working memory load interacts with state to influence brain activation in load-sensitive regions, and the extent to which SD-related changes are common across different loads, we used fMRI to study twelve healthy subjects following 24 h of SD using a verbal n-back task with three load levels. Performance decline was observed by way of reduced accuracy and slower response times following SD. The left prefrontal region and thalamus showed load dependent activity modulation that interacted with state. The right parietal and anterior medial frontal regions showed load dependent changes in activity as well as an effect of state. The anterior cingulate and occipital regions showed activation that displayed state effects that were independent of working memory load. These findings represent a step toward identifying how different brain regions exhibit varying vulnerability to the deleterious effects of SD on working memory.

The neurophysiological time pattern of illusionary visual perceptual transitions: a simultaneous EEG and fMRI study

Several divergent cortical mechanisms generating multistability in visual perception have been suggested. Here, we investigated the neurophysiologic time pattern of multistable perceptual changes by means of a simultaneous recording with electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). Volunteers responded to the subjective perception of a sudden change between stable patterns of illusionary motion (multistable transition) during a stroboscopic paradigm. We found a global deceleration of the EEG frequency prior to a transition and an occipital-accentuated acceleration after a transition, as obtained by low-resolution electromagnetic tomography analysis (LORETA) analysis. A decrease in BOLD response was found in the prefrontal cortex before, and an increase after the transitions was observed in the right anterior insula, the MT/V5 regions and the SMA. The thalamus and left superior temporal gyrus showed a pattern of decrease before and increase after transitions. No such temporal course was found in the control condition. The multimodal approach of data acquisition allows us to argue that the top-down control of illusionary visual perception depends on selective attention, and that a diminution of vigilance reduces selective attention. These are necessary conditions to allow for the occurrence of a perception discontinuity in absence of a physical change of the stimulus.

Functional imaging of working memory in obstructive sleep-disordered breathing

Functional magnetic resonance imaging was used to map cerebral activation in 16 patients with obstructive sleep-disordered breathing (OSDB) and 16 healthy subjects, during the performance of a 2-back verbal working memory task. Six patients with OSDB were reimaged after a minimum period of 8 wk of treatment with positive airway pressure. Working memory speed in OSDB was significantly slower than in healthy subjects, and a group average map showed absence of dorsolateral prefrontal activation, regardless of nocturnal hypoxia. After treatment, resolution of subjective sleepiness contrasted with no significant change in behavioral performance, persistent lack of prefrontal activation, and partial recovery of posterior parietal activation. These findings suggest that working memory may be impaired in OSDB and that this impairment is associated with disproportionate impairment of function in the dorsolateral prefrontal cortex. Nocturnal hypoxia may not be a necessary determinant of cognitive dysfunction, and sleep fragmentation may be sufficient. There may be dissociations between respiratory vs. cortical recovery and objective vs. subjective recovery. Hypofrontality may provide a plausible biological mechanism for a clinical overlap with disorders of mood and attention.

Brain activity underlying emotional valence and arousal: a response-related fMRI study

Emotional behavior is organized along two psychophysiologic dimensions: (1) valence, varying from negative to positive, and (2) arousal, varying from low to high. Behavioral responses along these dimensions are assumed to be mediated by different brain circuits. We recorded startle reflex modulation and skin conductance responses in healthy volunteers during functional magnetic resonance imaging (fMRI) while they viewed a set of emotional pictures and took verbal ratings of the emotional valence and arousal of each picture after scanning. Response-related multiple correlation analysis revealed differential brain activity in five brain regions. Startle reflex changes, associated with the valence of a stimulus, correlated with activity in the amygdala, while verbal reports of negative emotional valence varied with insular activity. Peripheral physiologic and verbal responses along the arousal dimension varied with thalamic and frontomedial activity. Peripheral physiologic responses along both dimensions correlated with activity in somatosensory association areas in the anterior parietal cortex. In the valence dimension, activity in the left anterior parietal cortex was associated with highly correlating peripheral physiologic and verbal responses, suggesting that verbal reports of emotional valence might depend partly on brain circuits representing peripheral physiologic changes. Our data provide direct evidence for a functional segregation of brain structures underlying peripheral physiologic responses and verbal ratings along the emotional dimensions of valence and arousal.

Neuropsychological performance and sleep disturbance following traumatic brain injury

OBJECTIVE

To examine the relation between sleep disturbance and neurocognitive ability among persons with traumatic brain injury (TBI).

DESIGN

Correlational research evaluating demographic and neuropsychological predictors of sleep disturbance using multiple regression analysis and analysis of variance.

PARTICIPANTS

Eighty-seven patients with mild to severe TBI admitted to a comprehensive outpatient neurorehabilitation program.

MAIN OUTCOME MEASURES

Sleep disturbance assessed using the Pittsburgh Sleep Quality Index.

RESULTS

Hierarchical regression analysis revealed that performance on selected measures of cognitive functioning significantly improved prediction of sleep disturbance, accounting for 14% of variance beyond that accounted for by injury severity and gender. The total model accounted for 31% of the variance in Pittsburgh Sleep Quality Index scores. Patients with mild TBI reported more sleep disturbance (P < .01) than did patients with severe TBI.

CONCLUSIONS

Sleep disturbance among patients with TBI may be associated with a particular constellation of neuropsychological abilities. These issues are discussed in relation to prior findings that indicate the involvement of additional neuropsychiatric factors associated with sleep disturbance in mild TBI.

Sleep deprivation, cognitive performance, and hormone therapy in postmenopausal women

OBJECTIVE

To study the effects of sleep deprivation on cognitive performance in postmenopausal women and to evaluate whether hormone therapy (HT) has a modifying effect on coping.

DESIGN

Twenty-six postmenopausal women, aged 58 to 72 years (mean 64 years), volunteered for the study (HT users, n = 16; nonusers, n = 10). They spent four consecutive nights in the sleep laboratory. The cognitive tests were performed three times: after the baseline night, after one night of sleep deprivation, and after the rebound night. The cognitive measures included visual episodic memory, visuomotor performance, verbal attention, and shared attention.

RESULTS

The practice effect typically occurring in cognitive tests was blunted during sleep deprivation, which indicated deterioration of performance. At rebound, performance improved in visual episodic memory (immediate recall P < 0.01; delayed recall P < 0.05), visuomotor performance (P < 0.001), verbal attention (P < 0.0001), and shared attention (P < 0.05). HT users performed better than nonusers in the visual episodic memory test (P < 0.05) and in one of three subtests of shared attention (cancellation P = 0.040). Otherwise hormone therapy did not influence the results.

CONCLUSIONS

In postmenopausal women, sleep deprivation impaired visual functions and attention. However, this effect was not prolonged because after one rebound night the performance was improved, compared with baseline. Hormone therapy did not modify the cognitive performance during sleep deprivation.

The Role of Temporal Parameters in a Thalamocortical Model of Analogy

How multiple specialized cortical areas in the brain interact with each other to give rise to an integrated behavior is a largely unanswered question. This paper proposes that such an integration can be understood under the framework of analogy and that part of the thalamus and the thalamic reticular nucleus (TRN) may be playing a key role in this respect. The proposed thalamocortical model of analogy heavily depends on a diverse set of temporal parameters including axonal delay and membrane time constant, each of which is critical for the proper functioning of the model. The model requires a specific set of conditions derived from the need of the model to process analogies. Computational results with a network of integrate and fire (IF) neurons suggest that these conditions are indeed necessary, and furthermore, data found in the experimental literature also support these conditions. The model suggests that there is a very good reason for each temporal parameter in the thalamocortical network having a particular value, and that to understand the integrated behavior of the brain, we need to study these parameters simultaneously, not separately.

Where arousal meets attention: a simultaneous fMRI and EEG recording study

In this fMRI study, we looked for the regions supporting interaction between cortical arousal and attention during three conditions: detection, observation, and rest. Arousal measurements were obtained from the EEG low-frequency (LF) power (5-9.5 Hz) recorded continuously together with fMRI. Whatever the condition, arousal was positively correlated with the fMRI signal of the right dorsal-lateral prefrontal and superior parietal cortices, closely overlapping regions involved in the maintenance of attention. Although the inferior temporal areas also presented a correlation with arousal during detection, path analysis suggests that this influence may be indirect, through the top-down influence of the previously mentioned network. However, those visual-processing areas could account for the correlation between arousal and performances. Lastly, the medial frontal cortex, frontal opercula, and thalamus were inversely correlated with arousal but only during detection and observation so that they could account for the control of arousal.

Behavioural and physiological impairments of sustained attention after traumatic brain injury

Sustaining attention under conditions of low external demand taxes our ability to stay on task and to avoid more appealing trains of thought or environmental distractions. By contrast, a stimulating, novel environment engages attention far more freely without the subjective feeling of having to override monotony. Our ability to maintain a goal-directed focus without support from the environment requires the endogenous control of behaviour. This control can be modulated by fronto-parietal circuits and this ability is compromised following traumatic brain injury (TBI) leading to increased lapses of attention. In this paper, we further explore a laboratory paradigm that we argue is particularly sensitive to sustained attention as opposed to other aspects of attentional control involving the selection and management of goals in working memory. The paradigm (fixed sequence Sustained Attention to Response Task--SARTfixed) involves withholding a key press to an infrequent no-go target embedded within a predictable sequence of numbers. We demonstrate that TBI patients in this study make disproportionately more errors than controls on this task. An analysis of response times (RTs) and EEG alpha power across the task demonstrates group differences preceding the critical no-go trial. Controls demonstrate a lengthening of RTs accompanied by desynchronization of power within the alpha band (approximately 10 Hz) preceding the no-go trial. Conversely, the TBI group showed a shortening of RTs during this period with no evidence of alpha desynchronization. These findings suggest that TBI patients may have dysfunctional alpha generators as a consequence of their injury that impairs endogenous control during the task.

Attentional effects of noradrenaline vary with arousal level: selective activation of thalamic pulvinar in humans

Subjects sedated by noradrenergic alpha2 agonists can switch rapidly from a state of extremely low to almost full consciousness following phasic increases in arousal or cognitive demand. Such flexibility is not displayed by traditional sedatives, such as the benzodiazepine diazepam. Experimentally, the phasic modulation of alpha2 effect by arousing or distracting stimuli can counteract the deleterious cognitive effects of alpha2 agonists. We used behavioural and fMRI indices of brain function to investigate the phasic modulatory effect that presentation of loud white noise would have on attentional dysfunction induced by administration of dexmedotomidine, an alpha2 agonist. Dexmedotomidine and midazolam were compared to placebo during performance of a target detection task, which was presented in the presence or absence of white noise. Compared to placebo, both dexmedotomidine and midazolam impaired task performance. This impairment was significantly attenuated by presentation of white noise in the dexmedotomidine condition only. This functional improvement corresponded to selective increase in activity of left medial pulvinar nucleus of the thalamus. This regional increase is suggested to index increases in phasic arousal, which counteract dexmedotomidine's detrimental attentional effects. Finally, despite sedating subjects to equivalent degrees, dexmedotomidine and midazolam had strikingly different regional effects on task-induced brain activity. Therefore, for the same level of sedation, the behavioural and anatomical attributes identifying the quality of sedation can vary.

An event-related fMRI study of the neurobehavioral impact of sleep deprivation on performance of a delayed-match-to-sample task

Eighteen subjects (ages 18-35) underwent event-related functional magnetic resonance imaging (efMRI) while performing a delayed-match-to-sample (DMS) task before and immediately after 48 h of sustained wakefulness. The DMS trial events were: a 3-s study period of either a one-, three-, or six-letter visual array; a 7-s retention interval; and a 3-s probe period, where a button press indicated whether the probe letter was in the study array. Ordinal Trend Canonical Variates Analysis (OrT CVA) was applied to the data from the probe period for trials with six-letter study lists prior to and immediately following sleep deprivation to find an activation pattern whose expression decreased with sleep deprivation in as many subjects as possible, while being present in both conditions. The first principal component of the OrT analysis identified a covariance pattern whose expression decreased as a function of sleep deprivation in 17 of 18 subjects (p<0.001). While overall expression of the pattern showed a systematic decrease with sleep deprivation, the brain regions that make up the pattern show covarying increases and decreases in activation. Regions that decreased their activation were noted in the parietal (BA 7 and 40), temporal (BA 37, 38 and 39) and occipital (BA 18 and 19) lobes; regions that increased their activation were noted in the cerebellum, basal ganglia, thalamus and the anterior cingulate gyrus (BA 32). The reduction in pattern expression with sleep deprivation for each subject was related to the change in performance on the DMS task. Subject decreases in pattern expression were correlated with reductions in recognition accuracy (p<0.05), increased intra-individual variability in reaction time (p<0.005) and increased lapsing (p<0.005).

Decreased cerebral activation during CPT performance: structural and functional deficits in schizophrenic patients

Voxel-based morphometry (VBM) allows the output of structural data in a Statistical Parametric Map of the brain in the same way that the SPM can do with functional data. Using functional magnetic resonance (fMR), we studied brain activation in 14 patients with schizophrenia and 14 matched normal controls. We found significant hypoactivation in patients in several regions, especially in the right hemisphere, in the dorsolateral frontal and temporal regions and in the inferior parietal. Subcortically, we found strong hypoactivity in the thalamus. The optimized VBM method revealed gray matter (GM) abnormalities in the bilateral supramarginal gyrus and cingulate cortex, and in the right inferior temporal regions. Three regions involved in attentional processes showed both structural and functional deficits: the thalamus, the anterior cingulate and the inferior parietal. The results suggest that these regions may be involved in the attentional deficit in schizophrenia.

Dopaminergic effects of caffeine in the human striatum and thalamus

Epidemiological studies have provided evidence that caffeine, an adenosine receptor antagonist, reduces the risk for Parkinson's disease. There are indications of specific interactions between striatal adenosine A(2A) and dopamine D(2) receptors, but the in vivo effects of caffeine on human dopamine system have not been investigated. In the present study, the dopaminergic effects of caffeine were examined with [(11)C]raclopride positron emission tomography (PET) in eight healthy habitual coffee drinkers after 24 h caffeine abstinence. Compared to oral placebo, 200 mg oral caffeine induced a 12% decrease in midline thalamic binding potential (p < 0.001). A trend-level increase in ventral striatal [(11)C]raclopride binding potential was seen with a correlation between caffeine-related arousal and putaminal dopamine D(2) receptor binding (r = -0.81, p = 0.03). The findings indicate that caffeine has effects on dopaminergic neurotransmission in the human brain, which may be differential in the striatum and the thalamus.

Receptive field structure of burst and tonic firing in feline lateral geniculate nucleus

There are two recognised modes of firing activity in thalamic cells, burst and tonic. A low-threshold (LT) burst (referred to from now on as 'burst') comprises a small number of high-frequency action potentials riding the peak of a LT Ca(2+) spike which is preceded by a silent hyperpolarised state > 50 ms. This is traditionally viewed as a sleep-like phenomenon, with a shift to tonic mode at wake-up. However, bursts have also been seen in the wake state and may be a significant feature for full activation of recipient cortical cells. Here we show that for visual stimulation of anaesthetised cats, burst firing is restricted to a reduced area within the receptive field centre of lateral geniculate nucleus cells. Consistently, the receptive field size of all the recorded neurons decreased in size proportionally to the percentage of spikes in bursts versus tonic spikes, an effect that is further demonstrated with pharmacological manipulation. The role of this shrinkage may be distinct from that also seen in sleep-like states and we suggest that this is a mechanism that trades spatial resolution for security of information transfer.

The neural basis of the complex mental task of meditation: neurotransmitter and neurochemical considerations

Meditation is a complex mental process involving changes in cognition, sensory perception, affect, hormones, and autonomic activity. Meditation has also become widely used in psychological and medical practices for stress management as well as a variety of physical and mental disorders. However, until now, there has been limited understanding of the overall biological mechanism of these practices in terms of the effects in both the brain and body. We have previously described a rudimentary neuropsychological model to explain the brain mechanisms underlying meditative experiences. This paper provides a substantial development by integrating neurotransmitter systems and the results of recent brain imaging advances into the model. The following is a review and synthesis of the current literature regarding the various neurophysiological mechanisms and neurochemical substrates that underlie the complex processes of meditation. It is hoped that this model will provide hypotheses for future biological and clinical studies of meditation.

Pulse width is associated with cognitive decline after thalamic stimulation for essential tremor

The present study sought to identify predictors of cognitive decline after thalamic deep brain stimulation (DBS) for essential tremor (ET). Twenty-seven patients (55%) with ET demonstrated mild cognitive decrements relative to pre-surgical baseline (ET-D), whereas 22 patients (45%) were classified as neuropsychologically stable (ET-S). The ET-D and ET-S groups were comparable in terms of baseline demographic, disease, and neuropsychological characteristics, as well as post-surgical motor outcomes. However, the ET-D group had significantly higher pulse width (PW) stimulator settings, and a greater proportion of ET-D than ET-S patients underwent left in comparison to right thalamic stimulation. A subsequent step-wise discriminant function analysis revealed that disease onset after age 37 years and higher PW settings (>or=120 micros) were the strongest predictors of post-surgical cognitive decline in this sample. Findings indicate that although relatively higher PW settings might afford optimal tremor control in some patients, the corresponding risk of mild, probably often subclinical, cognitive morbidity must be weighed accordingly.

Responses of thalamic neurons to input from the male genitalia

There have been relatively few electrophysiological studies, in any species, describing the supraspinal processing of inputs from the male genital tract. The thalamus was the focus of the present study. In 11 urethan-anesthetized male rats, subregions of the thalamus were surveyed for neuronal responses to the search stimulus, bilateral electrical stimulation of the dorsal nerve of the penis (DNP). A total of 133 DNP-responsive neurons were found and further tested for degree of somatovisceral convergence from other peripheral structures. Histological reconstruction of the recording sites revealed that the penile-responsive neurons were distributed among various thalamic subregions. These thalamic subregions included the medial-dorsal nuclei and ventral and lateral thalamic subregions (majority of neurons responsive to both tactile and pinch stimulation of the penis) as well as intralaminar, posterior and reticular subregions (majority responsive to pinch only). Taken together, the data demonstrate the existence of thalamic neurons with inputs from the male genitalia with widespread somatovisceral convergence. These neurons likely contribute to the neural circuitries underlying various aspects of penile sensation associated with reproductive and nociceptive events.

Subcortical structures involved in pain processing: evidence from single-trial fMRI

Pain is processed in multiple cortical and subcortical brain areas. Subcortical structures are substantially involved in different processes that are closely linked to pain processing, e.g. motor preparation, autonomic responses, affective components and learning. However, it is unclear to which extent nociceptive information is relayed to and processed in subcortical structures. We used single-trial functional magnetic resonance imaging (fMRI) to identify subcortical regions displaying hemodynamic responses to painful stimulation. Thulium-YAG (yttrium-aluminum-granate) laser evoked pain stimuli, which have no concomitant tactile component, were applied to either hand of healthy volunteers in a randomized order. This procedure allowed identification of areas displaying differential fMRI responses to right- and left-sided stimuli. Hippocampal complex, amygdala, red nucleus, brainstem and cerebellum were activated in response to painful stimuli. Structures related to the affective processing of pain showed bilateral activation, whereas structures involved in the generation of withdrawal behavior, namely red nucleus, putamen and cerebellum displayed differential (i.e. asymmetric) responses according to the side of stimulation. This suggests that spatial information about the nociceptive stimulus is made available in these structures for the guidance of defensive and withdrawal behavior.

Hypnosis modulates activity in brain structures involved in the regulation of consciousness

The notion of consciousness is at the core of an ongoing debate on the existence and nature of hypnotic states. Previously, we have described changes in brain activity associated with hypnosis (Rainville, Hofbauer, Paus, Duncan, Bushnell, & Price, 1999). Here, we replicate and extend those findings using positron emission tomography (PET) in 10 normal volunteers. Immediately after each of 8 PET scans performed before (4 scans) and after (4 scans) the induction of hypnosis, subjects rated their perceived level of "mental relaxation" and "mental absorption," two of the key dimensions describing the experience of being hypnotized. Regression analyses between regional cerebral blood flow (rCBF) and self-ratings confirm the hypothesized involvement of the anterior cingulate cortex (ACC), the thalamus, and the ponto-mesencephalic brainstem in the production of hypnotic states. Hypnotic relaxation further involved an increase in occipital rCBF that is consistent with our previous interpretation that hypnotic states are characterized by a decrease in cortical arousal and a reduction in cross-modality suppression (disinhibition). In contrast, increases in mental absorption during hypnosis were associated with rCBF increases in a distributed network of cortical and subcortical structures previously described as the brain's attentional system. These findings are discussed in support of a state theory of hypnosis in which the basic changes in phenomenal experience produced by hypnotic induction reflect, at least in part, the modulation of activity within brain areas critically involved in the regulation of consciousness.

Imaging how attention modulates pain in humans using functional MRI

Current clinical and experimental literature strongly supports the phenomenon of reduced pain perception whilst attention is distracted away from noxious stimuli. This study used functional MRI to elucidate the underlying neural systems and mechanisms involved. An analogue of the Stroop task, the counting Stroop, was used as a cognitive distraction task whilst subjects received intermittent painful thermal stimuli. Pain intensity scores were significantly reduced when subjects took part in the more cognitively demanding interference task of the counting Stroop than in the less demanding neutral task. When subjects were distracted during painful stimulation, brain areas associated with the affective division of the anterior cingulate cortex (ACC) and orbitofrontal regions showed increased activation. In contrast, many areas of the pain matrix (i.e. thalamus, insula, cognitive division of the ACC) displayed reduced activation, supporting the behavioural results of reduced pain perception.

Brain regions involved in prospective memory as determined by positron emission tomography

Prospective memory (PM) refers to the functions that enables a person to carry out an intended act after a delay. Despite the ubiquity of this behaviour, little is known about the supporting brain structures and the roles that they play. In this study, eight healthy participants performed four different PM tasks, each under three conditions: a baseline, and two conditions involving an intention. In the first of the intention conditions, subjects were asked to make a novel response to a certain class of stimuli whilst performing an attention-demanding task. However, the expected stimuli never actually occurred. In the second intention condition subjects were expecting to see these stimuli as before, and they did occur on approximately 20% of trials. Relative to the baseline condition, increases in regional cerebral blood flow (rCBF) as estimated by oxygen-15 positron emission tomography technique across all four tasks were seen in the frontal pole (Brodmann's area 10) bilaterally, right lateral prefrontal and inferior parietal regions plus the precuneus when subjects were expecting a PM stimulus regardless of whether it actually occurred. Further activation was seen in the thalamus when the PM stimuli occurred and was acted upon, with a corresponding rCBF decrease in right lateral prefrontal cortex. It is argued that the first set of region play a role in the maintenance of an intention, with the second set involved additionally in its realisation.

Thalamic volume predicts performance on tests of cognitive speed and decreases in healthy aging. A magnetic resonance imaging-based volumetric analysis

Recent studies have indicated a role for the thalamus in attention, arousal and the capacity to perform tasks of speeded information processing. The present study evaluated the role of the thalamus in age-related cognitive decline by investigating the correlations between thalamic volume, cognition and age. This was done in 57 healthy subjects ranging from 21 to 82 years of age. All subjects underwent neurocognitive testing with information processing tests and structural magnetic resonance imaging. A significant decrease in volume of the thalamus with increasing age was found, relatively stronger than and independent of the decrease of total brain volume. The decrease of thalamic volume was apparent before the onset of loss of volume of the total brain. Over the age-span studied, the thalamic decrease in volume correlated with the diminished performance on tests of cognitive speed. Additionally, in young and middle-aged, but not in old subjects, the size of the thalamus predicted performance on tasks that require cognitive speed.

The cognitive neuroscience of sustained attention: where top-down meets bottom-up

The psychological construct 'sustained attention' describes a fundamental component of attention characterized by the subject's readiness to detect rarely and unpredictably occurring signals over prolonged periods of time. Human imaging studies have demonstrated that activation of frontal and parietal cortical areas, mostly in the right hemisphere, are associated with sustained attention performance. Animal neuroscientific research has focused on cortical afferent systems, particularly on the cholinergic inputs originating in the basal forebrain, as crucial components of the neuronal network mediating sustained attentional performance. Sustained attention performance-associated activation of the basal forebrain corticopetal cholinergic system is conceptualized as a component of the 'top-down' processes initiated by activation of the 'anterior attention system' and designed to mediate knowledge-driven detection and selection of target stimuli. Activated cortical cholinergic inputs facilitate these processes, particularly under taxing attentional conditions, by enhancing cortical sensory and sensory-associational information processing, including the filtering of noise and distractors. Collectively, the findings from human and animal studies provide the basis for a relatively precise description of the neuronal circuits mediating sustained attention, and the dissociation between these circuits and those mediating the 'arousal' components of attention.

The noradrenergic alpha2 agonist clonidine modulates behavioural and neuroanatomical correlates of human attentional orienting and alerting

We examined whether the known noradrenergic attenuation of the alerting effect (the beneficial effect of a warning cue) results from an underlying effect of noradrenaline on temporal orienting (orienting toward a particular moment in time). Following a within-subjects, counterbalanced design, 10 healthy human volunteers received placebo, 200 microg clonidine or 1 mg guanfacine (alpha2 agonists) in three separate testing sessions. Subjects were scanned by fMRI while performing attentional orienting tasks containing spatially informative, temporally informative, non-informative or no cues. The alerting effect primarily activated left-lateralized prefrontal, premotor and parietal regions. Clonidine, but not guanfacine, impaired behavioural measures of the alerting effect while attenuating activity in the left temporo-parietal junction. Replicating previous results, the temporal orienting task activated left parietal and frontal cortex, while parietal cortex was activated bilaterally during spatial orienting. Of these networks, clonidine, but not guanfacine, attenuated left prefrontal cortex and insula activity during temporal orienting and attenuated right superior parietal cortex activity during spatial orienting,. To complement these neuroanatomical changes, clonidine produced selective behavioural effects on both temporal and spatial orienting. The anatomical dissociation between the effects of clonidine during temporal orienting versus alerting suggests that noradrenergic modulation of the alerting effect does not result only from an underlying effect on temporal orienting. Furthermore, we have demonstrated lateralized neuroanatomical substrates for the noradrenergic modulation of human attentional orienting in the spatial and temporal domains.

Sleep stage dependant changes of the high-frequency part of the somatosensory evoked potentials at the thalamus and cortex

OBJECTIVES

It is known that the high-frequency oscillations (above 400 Hz) of the somatosensory evoked potentials (SEPs) diminish during sleep while the N20 persists (Neurology 38 (1988) 64; Electroenceph clin Neurophysiol 70 (1988) 126; Electroenceph clin Neurophysiol 100 (1996) 189). We investigated possible differential effects of sleep on the 600 Hz SEPs at the thalamus and cortex.

METHODS

SEPs from 10 subjects were recorded using 64 channels following electric stimulation at the wrist during awake state and sleep stages II, IV and REM. Dipole source analysis was applied to separate brain-stem, thalamic and cortical activity in the low-frequency (20-450 Hz) and the high-frequency (450-750 Hz) part of the signal.

RESULTS

The low-frequency SEPs showed a non-significant increase of the latency of the N20 and a bifid change of the waveform in 3 subjects. The high-frequency SEPs showed a significant decrease of their amplitude at the level of the thalamus and cortex but not at the brain-stem. This decrease in amplitude at the thalamus and cortex were significantly correlated. There was no effect on the latency of the signal. In addition, at the cortex, differential effects on early and late parts of the 600 Hz oscillations were found by time-frequency analysis using a wavelet transformation.

CONCLUSIONS

Sleep dependent decrease of the high-frequency SEPs were first observed at the thalamus pointing to the known function of the reticular thalamic nucleus regulating arousal. The results presented here provide further evidence for a thalamic origin of the 600 Hz oscillations. In addition, on the basis of the differential effects on early (up to the N20 peak) and late (between 20 and 25 ms) parts of the signal, at least one intracortical generator of these oscillations is proposed. In general, the high-frequency SEPs (600 Hz oscillations) are supposed to reflect activity of a somatosensory arousal system.

Abnormalities in the thalamus and prefrontal cortex during episodic object recognition in schizophrenia

BACKGROUND

Many patients with schizophrenia demonstrate memory deficits. We studied patterns of brain activity during episodic recognition of new and previously seen three-dimensional objects.

METHODS

We used (15)O positron emission tomography to study regional cerebral blood flow in eight normal subjects and nine patients with schizophrenia during a visual object recognition task.

RESULTS

In comparison with control subjects, patients with schizophrenia showed less regional cerebral blood flow increases in the pulvinar region of the right thalamus and the right prefrontal cortex during the recognition of new objects and significantly greater left prefrontal cortex regional cerebral blood flow increases during the recognition of previously seen objects. Patients with schizophrenia exhibited alarm rates to new objects similar to those of control subjects, but significantly lower recognition rates for previously seen objects.

CONCLUSIONS

Schizophrenia is associated with attenuated right thalamic and right prefrontal activation during the recognition of novel visual stimuli and with increased left prefrontal cortical activation during impaired episodic recognition of previously seen visual stimuli. This study provides further evidence for abnormal thalamic and prefrontal cortex function in schizophrenia.

Functional imaging of brain responses to pain. A review and meta-analysis (2000)

Brain responses to pain, assessed through positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are reviewed. Functional activation of brain regions are thought to be reflected by increases in the regional cerebral blood flow (rCBF) in PET studies, and in the blood oxygen level dependent (BOLD) signal in fMRI. rCBF increases to noxious stimuli are almost constantly observed in second somatic (SII) and insular regions, and in the anterior cingulate cortex (ACC), and with slightly less consistency in the contralateral thalamus and the primary somatic area (SI). Activation of the lateral thalamus, SI, SII and insula are thought to be related to the sensory-discriminative aspects of pain processing. SI is activated in roughly half of the studies, and the probability of obtaining SI activation appears related to the total amount of body surface stimulated (spatial summation) and probably also by temporal summation and attention to the stimulus. In a number of studies, the thalamic response was bilateral, probably reflecting generalised arousal in reaction to pain. ACC does not seem to be involved in coding stimulus intensity or location but appears to participate in both the affective and attentional concomitants of pain sensation, as well as in response selection. ACC subdivisions activated by painful stimuli partially overlap those activated in orienting and target detection tasks, but are distinct from those activated in tests involving sustained attention (Stroop, etc.). In addition to ACC, increased blood flow in the posterior parietal and prefrontal cortices is thought to reflect attentional and memory networks activated by noxious stimulation. Less noted but frequent activation concerns motor-related areas such as the striatum, cerebellum and supplementary motor area, as well as regions involved in pain control such as the periaqueductal grey. In patients, chronic spontaneous pain is associated with decreased resting rCBF in contralateral thalamus, which may be reverted by analgesic procedures. Abnormal pain evoked by innocuous stimuli (allodynia) has been associated with amplification of the thalamic, insular and SII responses, concomitant to a paradoxical CBF decrease in ACC. It is argued that imaging studies of allodynia should be encouraged in order to understand central reorganisations leading to abnormal cortical pain processing. A number of brain areas activated by acute pain, particularly the thalamus and anterior cingulate, also show increases in rCBF during analgesic procedures. Taken together, these data suggest that hemodynamic responses to pain reflect simultaneously the sensory, cognitive and affective dimensions of pain, and that the same structure may both respond to pain and participate in pain control. The precise biochemical nature of these mechanisms remains to be investigated.

The role of arousal and "gating" systems in the neurology of impaired consciousness

A brief taxonomy of neurologic disorders resulting in global impairments of consciousness is presented. Particular emphasis is placed on focal injuries of subcortical structures that may produce disorders that are otherwise associated to large bilateral cortical injuries. A distinction between subcortical arousal and "gating" systems is developed. Both clinical and experimental studies are reviewed in the context of these disorders and their possible underlying mechanisms.

Effect of ethanol on BOLD response to acoustic stimulation: implications for neuropharmacological fMRI

The effects of ethanol on acoustically stimulated blood oxygenation level-dependent (BOLD) signal response in healthy humans was examined with echo planar functional magnetic resonance imaging (fMRI). An acquisition mode minimizing neuronal activation by scanner noise in combination with acoustic excitation by a pulsed 1000-Hz sine tone was used. Paradigms were repeated three times before and after the ingestion of 0.7 g of ethanol/kg(body weight). Linear correlation analyses (r>/=0.40) revealed bilateral BOLD responses in the auditory cortex. Significant voxels covered a cortical volume of approximately 3 ml that was reduced by approximately 40% after ethanol. The BOLD signal change initially reaching approximately 3% was reduced by 12-27%, depending on the definition of the region of interest for signal quantitation. Because ethanol produces vasodilation, the hemodynamic contribution to the BOLD signal change was estimated by modeling the relationship between regional cerebral blood flow (rCBF) and BOLD signal changes. Assuming a baseline flow increase by 10% after ethanol intake, the resulting 'Flow-BOLD-Dependence' (FBD) curve suggested that the ethanol-related BOLD signal reduction was approximately 7-12% greater than the reduction contributed purely by vasodilation. However, simultaneous determination of rCBF and regional cerebral blood volume would be required for an exact quantitation of the neuronally induced BOLD response. Although the FBD model needs empirical validation, its cautious implementation appears to be helpful if fMRI is used in combination with vasoactive drugs.

The control of low-level information flow in the visual system

Visual information processing needs to be error free and efficient. Our visual system tries to achieve the first goal by accommodating a wide variety of visual algorithms for the extraction of the relevant features in the scene, while at the same time the second goal is addressed by controlling the amount of visual information flow in the network employing selective attention. Attentional or pre-attentional mechanisms are found throughout many visual areas and these processes may start as early as in the visual thalamus (lateral geniculate nucleus, LGN). In this review we pay particular attention to experimental and theoretical findings which indicate that even low-level structures, such as LGN and V1, can play a major role in the flow-control of visual information.

Altered brain response to verbal learning following sleep deprivation

The effects of sleep deprivation on the neural substrates of cognition are poorly understood. Here we used functional magnetic resonance imaging to measure the effects of 35 hours of sleep deprivation on cerebral activation during verbal learning in normal young volunteers. On the basis of a previous hypothesis, we predicted that the prefrontal cortex (PFC) would be less responsive to cognitive demands following sleep deprivation. Contrary to our expectations, however, the PFC was more responsive after one night of sleep deprivation than after normal sleep. Increased subjective sleepiness in sleep-deprived subjects correlated significantly with activation of the PFC. The temporal lobe was activated after normal sleep but not after sleep deprivation; in contrast, the parietal lobes were not activated after normal sleep but were activated after sleep deprivation. Although sleep deprivation significantly impaired free recall compared with the rested state, better free recall in sleep-deprived subjects was associated with greater parietal lobe activation. These findings show that there are dynamic, compensatory changes in cerebral activation during verbal learning after sleep deprivation and implicate the PFC and parietal lobes in this compensation.

The cognitive-energetic model: an empirical approach to attention-deficit hyperactivity disorder

Attention Deficit/Hyperactivity Disorder (ADHD) is a childhood psychiatric disorder which when carefully defined, affects around 1% of the childhood population [Swanson JM, Sergeant JA, Taylor E, Sonuga-Barke EJS, Jensen PS, Canwell DP. Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet 1998;351:429-433]. The primary symptoms: distractibility, impulsivity and overactivity vary in degree and association in such children, which led DSM IV to propose three subgroups. Only one of these subgroups, the combined subtype: deficits in all three areas, meets the ICD-10 criteria. Since the other two subtypes are used extensively in North America (but not in Europe), widely different results between centres are to be expected and have been reported. Central to the ADHD syndrome is the idea of an attention deficit. In order to investigate attention, it is necessary to define what one means by this term and to operationalize it in such a manner that others can test and replicate findings. We have advocated the use of a cognitive-energetic model [Sanders, AF. Towards a model of stress and performance. Acta Psychologica 1983;53: 61-97]. The cognitive-energetic model of ADHD approaches the ADHD deficiency at three distinct levels. First, a lower set of cognitive processes: encoding, central processing and response organisation is postulated. Study of these processes has indicated that there are no deficits of processing at encoding or central processing but are present in motor organisation [Sergeant JA, van der Meere JJ. Convergence of approaches in localizing the hyperactivity deficit. In Lahey BB, Kazdin AE, editors. Advancements in clinical child psychology, vol. 13. New York: Plenum press, 1990. p. 207-45; Sergeant, JA, van der Meere JJ. Additive factor methodology applied to psychopathology with special reference to hyperactivity. Acta Psychologica 1990;74:277-295]. A second level of the cognitive-energetic model consists of the energetic pools: arousal, activation and effort. At this level, the primary deficits of ADHD are associated with the activation pool and (to some extent) effort. The third level of the model contains a management or executive function system. Barkley [Barkley RA, Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological Bulletin 1997;121:65-94] reviewed the literature and concluded that executive function deficiencies were primarily due to a failure of inhibition. Oosterlaan, Logan and Sergeant [Oosterlaan J, Logan GD, Sergeant JA. Response inhibition in ADHD, CD, comorbid ADHD + CD, anxious and normal children: a meta-analysis of studies with the stop task. Journal of Child Psychology and Psychiatry 1998;39:411-426] demonstrated that this explanation was not specific to ADHD but also applied to children with the associated disorders of oppositional defiant and conduct disorder. Other executive functions seem to be intact, while others, are deficient. It is argued here that the cognitive-energetic model is a useful guide for determining not only ADHD deficiencies and associated disorders but also linking human cognitive neuroscience studies with neurobiological models of ADHD using animals [Sadile AG. Multiple evidence of a segmental defect in the anterior forebrain of an animal model of hyperactivity and attention deficits. Neuroscience and Biobehavioral Reviews, in press; Sagvolden T, Sergeant JA. Attention-deficit hyperactivity disorder: from brain dysyfunctions to behaviour. Behavioural Brain Research 1998;94:1-10]. A plea for an integrated attack on this research problem is made and the suggestion that conceptual refinement between levels of analysis is essential for further fundamental work to succeed is offered here.

Two circadian rhythms in the human electroencephalogram during wakefulness

The influence of the circadian pacemaker and of the duration of time awake on the electroencephalogram (EEG) was investigated in 19 humans during approximately 40 h of sustained wakefulness. Two circadian rhythms in spectral power density were educed. The first rhythm was centered in the theta band (4.25-8.0 Hz) and exhibited a minimum approximately 1 h after the onset of melatonin secretion. The second rhythm was centered in the high-frequency alpha band (10.25-13.0 Hz) and exhibited a minimum close to the body temperature minimum. The latter rhythm showed a close temporal association with the rhythms in subjective alertness, plasma melatonin, and body temperature. In addition, increasing time awake was associated with an increase of power density in the 0.25- to 9.0-Hz and 13.25- to 20. 0-Hz ranges. It is concluded that the waking EEG undergoes changes that can be attributed to circadian and homeostatic (i.e., sleep-wake dependent) processes. The distinct circadian variations of EEG activity in the theta band and in the high-frequency alpha band may represent electrophysiological correlates of different aspects of the circadian rhythm in arousal.