The effect of aging on the wave form of the somatosensory cortical evoked potential

Alternative cue and response modalities maintain the Simon effect but impact task performance

Inhibitory control, the ability to inhibit impulsive responses and irrelevant stimuli, enables high level functioning and activities of daily living. The Simon task probes inhibition using interfering stimuli, i.e., cues spatially presented on the opposite side of the indicated response; incongruent response times (RT) are slower than congruent RTs. Operational applicability of the Simon task beyond finger/hand manipulations and visual/auditory cues is unclear, but important to consider as new technologies provide tactile cues and require motor responses from the lower extremity (e.g., exoskeletons). In this study, twenty participants completed the Simon task under four conditions, each combination of two cue (visual/tactile) and response (upper/lower-extremity) modalities. RT were significantly longer for incongruent than congruent cues across cue-response pairs. However, alternative cue-response pairs yielded slower RT and decreased accuracy for tactile cues and lower-extremity responses. Results support operational usage of the Simon task to probe inhibition using tactile cues and lower-extremity responses relevant for new technologies like exoskeletons and immersive environments.

Motor Skill Learning-Induced Functional Plasticity in the Primary Somatosensory Cortex: A Comparison Between Young and Older Adults

While in young adults (YAs) the underlying neural mechanisms of motor learning are well-studied, studies on the involvement of the somatosensory system during motor skill learning in older adults (OAs) remain sparse. Therefore, the aim of the present study was to investigate motor learning-induced neuroplasticity in the primary somatosensory cortex (S1) in YAs and OAs. Somatosensory evoked potentials (SEPs) were used to quantify somatosensory activation prior and immediately after motor skill learning in 20 right-handed healthy YAs (age range: 19–35 years) and OAs (age range: 57–76 years). Participants underwent a single session of a 30-min co-contraction task of the abductor pollicis brevis (APB) and deltoid muscle. To assess the effect of motor learning, muscle onset asynchrony (MOA) between the onsets of the contractions of both muscles was measured using electromyography monitoring. In both groups, MOA shortened significantly during motor learning, with YAs showing bigger reductions. No changes were found in SEP amplitudes after motor learning in both groups. However, a correlation analysis revealed an association between baseline SEP amplitudes of the N20/P25 and N30 SEP component and the motor learning slope in YAs such that higher amplitudes are related to higher learning. Hence, the present findings suggest that SEP amplitudes might serve as a predictor of individual motor learning success, at least in YAs. Additionally, our results suggest that OAs are still capable of learning complex motor tasks, showing the importance of motor training in higher age to remain an active part of our society as a prevention for care dependency.

Does isolated somatosensory impairment affect the balance and ambulation of patients with supratentorial stroke after the acute phase?

Balance and ambulation are the result of a multicomponent control process through the interaction of the sensory and motor information. Despite the clinical relevance of the somatosensory system, its role has not drawn much attention from clinical researchers in that motor impairment is considered a major cause of dysfunction. There is little research on how somatosensory impairment alone affects functional disability after stroke. The purpose of this study was to investigate the effects of isolated somatosensory deficit on the balance and ambulation ability in patients with stroke. P38 latency of the SSEP was used to evaluate the integrity of the dorsal column-medial lemniscus pathway and the SSEP reference value was derived from the formula considering individual height and age. According to the SSEP latency, subjects were classified into 'normal', 'abnormal', and 'no response' group. A total of 110 supratentorial stroke patients with at least grade 4 of the Medical Research Council scale of lower extremity on the affected side were enrolled. Berg balance scale (BBS) and functional ambulatory categories (FAC) showed significant differences among the groups (P < 0.05). In post-hoc analysis, the BBS and FAC was significantly different between the 'normal' and 'abnormal SSEP' group (P = 0.013 for BBS, P = 0.004 for FAC) and the 'normal' and 'no response SSEP' group (P = 0.015 for BBS, P = 0.006 for FAC). We found that isolated somatosensory impairment has a negative effect on the balance and ambulation ability in patients with supratentorial stroke after the acute phase.

Early Somatosensory Processing Over Time in Individuals at Risk to Develop Psychosis

Objective: Somatosensory evoked potentials (SEPs) enable the investigation of thalamocortical and early cortical processing. Previous studies reported alterations of SEPs in patients with schizophrenia as well as in individuals in the prodromal stage. Moreover, cannabis use as an environmental risk factor for the development of schizophrenia has been demonstrated to influence SEP parameters in individuals at risk to develop psychosis. The aim of this study was to explore the course of SEP changes and the impact of concomitant cannabis use in individuals at risk to develop psychosis who sought medical help. Methods: Median nerve SEPs including high-frequency oscillations (HFOs) superimposed on the primary cortical response (N20) were investigated using multichannel EEG in individuals (n = 54 at baseline) remaining at risk to develop psychosis at follow-up after 1 year (high-risk: n = 19; ultra-high-risk: n = 27) vs. subjects with conversion to psychosis (n = 8) and a healthy control group (n = 35). Longitudinal and cross-sectional analyses of SEP components as estimated by dipole source analysis were performed. Results: The longitudinal development of the N20 strength depended on cannabis use. In cannabis non-users, a greater decrease of N20 strengths over time was associated with more negative symptoms at baseline. At baseline, converters did not differ from subjects remaining at risk. At follow-up, converters showed increased low- and high-frequency activity than at-risk subjects and did not differ from controls. Conclusion: The results of this study lead to the suggestion that the deficits in early somatosensory processing in individuals at risk to develop psychosis may not represent a marker for a genetic risk for psychosis but rather reflect state-dependent factors such as negative symptoms. On the other hand, the transition to psychosis seems to represent an interstage between reduced sensory registration from the at-risk state and gating deficits in the chronic state.

The neural dynamics of somatosensory processing and adaptation across childhood: a high-density electrical mapping study

Young children are often hyperreactive to somatosensory inputs hardly noticed by adults, as exemplified by irritation to seams or labels in clothing. The neurodevelopmental mechanisms underlying changes in sensory reactivity are not well understood. Based on the idea that neurodevelopmental changes in somatosensory processing and/or changes in sensory adaptation might underlie developmental differences in somatosensory reactivity, high-density electroencephalography was used to examine how the nervous system responds and adapts to repeated vibrotactile stimulation over childhood. Participants aged 6-18 yr old were presented with 50-ms vibrotactile stimuli to the right wrist over the median nerve at 5 blocked interstimulus intervals (ranging from ∼7 to ∼1 stimulus per second). Somatosensory evoked potentials (SEPs) revealed three major phases of activation within the first 200 ms, with scalp topographies suggestive of neural generators in contralateral somatosensory cortex. Although overall SEPs were highly similar for younger, middle, and older age groups (6.1-9.8, 10.0-12.9, and 13.0-17.8 yr old), there were significant age-related amplitude differences in initial and later phases of the SEP. In contrast, robust adaptation effects for fast vs. slow presentation rates were observed that did not differ as a function of age. A greater amplitude response in the later portion of the SEP was observed for the youngest group and may be related to developmental changes in responsivity to somatosensory stimuli. These data suggest the protracted development of the somatosensory system over childhood, whereas adaptation, as assayed in this study, is largely in place by ∼7 yr of age.

Increased cortical hyperexcitability and exaggerated myoclonus with aging in benign adult familial myoclonus epilepsy

The clinical implications of enlarged early cortical components of somatosensory evoked potentials in benign adult familial myoclonus epilepsy remain unknown. Somatosensory evoked potentials following electrical stimulation of the median nerve at the wrist were studied in 16 patients with a clinical diagnosis of benign adult familial myoclonus epilepsy (7 men and 9 women; mean age, 51 ± 18 years) and 19 age-matched apparently healthy control subjects (11 men and 8 women; mean age, 49 ± 18 years). Giant somatosensory evoked potentials were observed in 13 of the 16 patients. P25 and N35 amplitudes in the patient group were 11.4 ± 6.1 and 19.2 ± 11.5 μV, respectively, and both were significantly larger compared with those in control subjects (P = 0.008 for P25 and P < 0.0001 for N35). There was a significant positive relationship between age at somatosensory evoked potential examination and N20, P25, and N35 amplitudes, both in the patient and in the control groups (P < 0.05). The linear regression gradient of the N35 amplitude with respect to age was significantly larger in the patient group than in the control group (P = 0.04). Furthermore, regression analysis showed a significant positive relationship between the myoclonus rating scale and age at time of somatosensory evoked potential examination (R = 0.645, P = 0.007). Somatosensory evoked potential amplitude increased with age in patients with benign adult familial myoclonus epilepsy to a greater extent than in the control subjects, which suggests a progressive increase in cortical excitability based on progressive pathophysiology in benign adult familial myoclonus epilepsy.

Transient myoclonic state with asterixis: primary motor cortex hyperexcitability is correlated with myoclonus

OBJECTIVE

To clarify the clinical features and mechanism of the transience of myoclonus in patients with a transient myoclonic state with asterixis (TMA).

METHODS

We investigated the clinical and eletrophysiological profiles of 6 patients with TMA (age: 84±3 years). During an asymptomatic period, somatosensory evoked potentials (SEPs) were recorded in all 6 patients and motor evoked potentials (MEPs) were examined in 1 patient. SEPs were recorded and jerk-locked back averaging (JLA) was performed in 2 patients while symptomatic. SEPs were also recorded from 8 aged control subjects (age: 68±5 years).

RESULTS

All TMA patients had mild chronic systemic diseases. During an asymptomatic period, SEP amplitudes were not significantly enlarged in comparison with control subjects, and MEPs were normal. Examination of 2 patients during symptomatic period indicated no enlargement of SEP amplitudes and JLA disclosed a positive spike preceding myoclonic jerks. In one of these patients, the amplitude of the positive spike decreased once myoclonus improved.

CONCLUSION

TMA occurred in aged patients with mild chronic systemic diseases. JLA findings and the absence of giant SEPs further support that TMA is a cortical non-reflex myoclonus. In addition, transient hyperexcitability at the primary motor cortex disclosed by JLA correlated well with its transient symptoms.

Transformations in oscillatory activity and evoked responses in primary somatosensory cortex in middle age: a combined computational neural modeling and MEG study

Oscillatory brain rhythms and evoked responses are widely believed to impact cognition, but relatively little is known about how these measures are affected by healthy aging. The present study used MEG to examine age-related changes in spontaneous oscillations and tactile evoked responses in primary somatosensory cortex (SI) in healthy young (YA) and middle-aged (MA) adults. To make specific predictions about neurophysiological changes that mediate age-related MEG changes, we applied a biophysically realistic model of SI that accurately reproduces SI MEG mu rhythms, containing alpha (7-14 Hz) and beta (15-30 Hz) components, and evoked responses. Analyses of MEG data revealed a significant increase in prestimulus mu power in SI, driven predominately by greater mu-beta dominance, and a larger and delayed M70 peak in the SI evoked response in MA. Previous analysis with our computational model showed that the SI mu rhythm could be reproduced with a stochastic sequence of rhythmic approximately 10 Hz feedforward (FF) input to the granular layers of SI (representative of lemniscal thalamic input) followed nearly simultaneously by approximately 10 Hz feedback (FB) input to the supragranular layers (representative of input from high order cortical or non-specific thalamic sources) (Jones et al., 2009). In the present study, the model further predicted that the rhythmic FF and FB inputs become stronger with age. Further, the FB input is predicted to arrive more synchronously to SI on each cycle of the 10 Hz input in MA. The simulated neurophysiological changes are sufficient to account for the age-related differences in both prestimulus mu rhythms and evoked responses. Thus, the model predicts that a single set of neurophysiological changes intimately links these age-related changes in neural dynamics.

Pre-movement gating of somatosensory-evoked potentials by self-initiated movements: the effects of ageing and its implication

OBJECTIVE

To study whether the gating effect of the self-initiated movements on the cortical somatosensory-evoked potentials (SEPs) is affected by ageing.

METHODS

The SEPs elicited by stimulating the right median nerve were recorded in 14 young and 16 older healthy subjects, while self-initiated movements of the right fingers were performed at 5-10 s intervals. The amplitudes of the major components of the SEPs at F3 and C3' (2 cm posterior to C3) during the pre-movement period were analysed as the resting condition subserving the baseline.

RESULTS

The amplitudes at rest were significantly greater in the elderly than in the younger subjects. The amplitudes of P27, N35 and P45 at C3' as well as N30 at F3 decreased significantly during the pre-movement period. However, the ratio of amplitudes in the pre-movement period to the resting period in the elderly was not significantly different from that in the younger subjects, except for the interaction of N30.

CONCLUSIONS

The effect of age on the gating of N30 at F3 may indicate an altered preparatory processing of self-initiated movement in the elderly. The gating effect of older subjects at C3' is almost comparable to that of young ones, which appears to be a compensatory mechanism to maintain the precise movements.

SIGNIFICANCE

Ageing affects the SEPs differently at rest and pre-movement gating.

[Unverricht-Lundborg disease manifesting tremulous myoclonus with rare convulsive seizures: a case report]

We report a 23-year-old woman who slowly developed progressive tremulous myoclonus and rare convulsive seizures beginning at the age of 9 and 11 years, respectively. She also showed a mild degree of ataxia and cognitive dysfunction. Convulsive seizures were well suppressed by valproic acid since the age of 17 years, but tremulous myoclonus gradually progressed and became rather intractable in spite of treatment by clonazepam and piracetam. Her cognitive dysfunction was mild (total IQ score in Wechsler Adult Intelligence Scale Revised being 85 points). In addition, she had a fear of walking which disabled her in the daily life although she could actually walk without assistance. The brain MRI showed a mild cerebellar atrophy, and FDG-PET showed a mild hypometabolism in the cerebellar hemispheres. Somatosensory evoked potentials (SEPs) showed enlarged P25 and N33 amplitudes (giant SEPs). A Cystatin B gene analysis exhibited a homozygous expansion of the dodecamer repeat, and thus we made a diagnosis of Unverricht-Lundborg disease (ULD). We also did gene analysis and SEP study to her parents after written informed consents were obtained. They had heterozygous expansion of the dodecamer repeat. The mother also showed enlarged P25 and N33 amplitudes, whereas the father showed normal amplitudes. It is known that degree of clinical symptoms varies among patients with ULD diagnosed by gene analysis. Gene analysis was helpful for a diagnosis of ULD in this patient because the ataxia and cognitive dysfunction were much milder than those commonly seen in patients with ULD.

Low signal intensity and increased anisotropy on magnetic resonance imaging in the white matter lesion after head trauma: Unrecognized findings of diffuse axonal injury

We report on a four-year-old girl with head trauma caused by a motor vehicle accident. She presented with delirium, oculomotor palsy and ptosis in her left eye, left hemiparesis, and pyramidal signs in all extremities. Computed tomography on the day of admission showed diffuse cerebral edema with right-sided predominance. Magnetic resonance images on day 3 of admission showed lesions of diffuse axonal injury and contusion in the corpus callosum and right occipital and bilateral temporal lobes. There was a low-intensity lesion in the white matter of the right hemisphere on T2-weighted images, fluid-attenuated inversion recovery, T2()-weighted images, apparent diffusion coefficient maps and diffusion-weighted images. This low-intensity lesion disappeared by day 7, and a transient brain atrophy in the right hemisphere appeared on day 28. The low signal intensity in the cerebral white matter was apparently different from that associated with contusion and typical diffuse axonal injury, and might represent a late-onset accumulation of non-heme iron and free radicals in the white matter after head trauma.

Differences in waveforms of cerebral evoked potentials among healthy subjects, schizophrenics, manic-depres-sives and epileptics

The differences in the waveform of Cerebral EP (Evoked Potential)s; SEP, VEP and AEP, among healthy subjects, schizophrenics, manic-depressives and epileptics were investigated. In 585 subjects of both sexes comprising these diagnostic groups, 6 channels of EPs, each 2 channels for each sensory modality, were recorded simultaneously/parallelly from each subject, without assigning a mental task. Then, waveforms of the g-m (group mean) EPs of each diagnostic group were superimposed for inspection. Peak latencies and inter-peak amplitudes of individual EPs were statistically tested among (ANCOVA) and between (Scheffe's multiple comparison test) these diagnostic groups for each channel (modality), and for each sex. The waveforms of g-m EPs of each diagnostic group differed from each other. The differences of latencies and inter-peak amplitudes among these diagnostic groups attained to the significant level (P<0.05), with more significant differences between healthy subjects and each of these pathological diagnostic groups than between each of these pathological diagnostic groups, for each sex. Thus the differences in the waveform of EPs among these diagnostic groups were confirmed even taking the effect of medication on EPs into consideration. These results might suggest the existence of a waveform for individual EPs specific to each of these diagnostic groups, for each sex.

Hand cortical representation at rest and during activation: Gender and age effects in the two hemispheres

OBJECTIVE

To characterize the age- and gender- dependence of sensory hand cortical representation in the two hemispheres in healthy population.

METHODS

In 57 adults, the cerebral activity from rolandic areas as detected by magnetoencephalography was considered both in a resting state (spectral power properties) and in response to the electrical stimulation of the contralateral median nerve (M20 and M30 cortical sources).

RESULTS

We found a dependence of rest and evoked activity on age (alpha rhythm slowing, high frequency power increase, M20 latency increase, M20 strength increase, no change in M30) and on gender (higher alpha frequency, higher beta power, higher spectral entropy, lower M20 amplitude in women). These changes were quite symmetrical in the two hemispheres, making the interhemispheric differences non-dependent on age and gender. Moreover, lower total power and faster alpha rhythm appeared in the dominant hemisphere.

CONCLUSIONS

Age and gender have a significant effect on spontaneous and evoked activity at the primary sensorimotor cortex.

SIGNIFICANCE

The results consolidate the reference base in healthy population, to study pathological conditions. Inter-hemispheric asymmetries are confirmed as a sensitive indicator for the early identification of possible neuronal rearrangements due to unilateral brain injuries.

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 aging and sex on middle-latency somatosensory evoked potentials: normative data

OBJECTIVES

To investigate the exact relationship of middle-latency somatosensory evoked potential (SEP) components (in particular the third negative component N60) to age and sex in a normal population. Middle-latency SEPs are believed to show a considerable inter-individual variability and there is little published information on normative data of these components.

METHODS

Eighty-three healthy subjects aged 13-80 years were investigated using a standard SEP procedure.

RESULTS

Both latency and amplitude of N60 increased substantially with age. Least square polynomial regression analysis showed that a quadratic curve best described its relationship (r2=0.67 for the latency, r2=0.18 for the amplitude). Data did not differ significantly with reference to sex or side of stimulation.

CONCLUSIONS

The use of polynomial regression analysis for the determination of the normal range of N60 latencies and amplitudes has to be highly recommended. It might improve the accuracy with which abnormal results are detected in studies investigating the value of middle-latency SEPs in various diseases.

Somatosensory evoked fields in comatose survivors after severe traumatic brain injury

OBJECTIVE

To evaluate the cortical function quantitatively in patients in the chronic phase of severe traumatic brain injury.

METHODS

Thirteen patients with severe traumatic brain injury due to traffic accident followed by persistent consciousness disturbance and disability were studied. Somatosensory evoked magnetic fields (SEFs) for unilateral median nerve stimulation were measured using a whole-head magnetoencephalography system. The latency and electrical current dipole (ECD) moment for the N20m, P30m, N45m and P60m components were calculated and compared with those of 14 age-matched healthy adults.

RESULTS

The peak latency of N20m was longer (P<0.05) and those of P30m and N45m were shorter (P<0.01) in the patients than in normal adults. The ECD moment of N20m and P30m was smaller and that of N45m and P60m was larger in the patients than in normal adults (P<0.01).

CONCLUSIONS

These results can be explained by the hypothesis that diffuse brain injury induces decreased and delayed input of the somatosensory afferent and compensational amplification of the response in the primary somatosensory cortex. Middle-latency SEFs may be applicable as a cortical functional measure for patients with severe traumatic brain injury.

High-frequency oscillations of somatosensory evoked potentials and fields

A short review of previous studies is presented on somatic, evoked high-frequency oscillations. Also described briefly is recent data on the detection of high-frequency oscillations to posterior tibial nerve stimulation, and also on both tangential (area 3b) and radial (area 1) dipoles to median nerve stimulation. The findings show that high-frequency oscillations are not specific to median nerve stimulation but represent ubiquitous activity in the primary somatosensory cortex. Modulation of high-frequency oscillations versus electric and magnetic N20, N20 (m), primary response by a wake-sleep cycle, by attention or interference, by aging, and in central nervous system diseases such as Parkinson's disease and myoclonus epilepsy are also presented. Finally, a gamma-aminobutyric acid inhibitory interneuron hypothesis is presented for high-frequency oscillations based primarily on the findings regarding reciprocal modulation of the high-frequency oscillations and the underlying magnetic N20 (N20m) by a wake-sleep cycle and by attention or interference.

The later part of high-frequency oscillations in human somatosensory evoked potentials is enhanced in aged subjects

High-frequency oscillations (HFOs) in the range of 300-900 Hz have been shown to occur simultaneously with the primary response (N20) of the human somatosensory cortex following median nerve stimulation. We studied the effects of aging on somatosensory evoked HFOs. Somatosensory evoked potentials (SEPs) were recorded with a filter set at 10-2000 Hz following right median nerve stimulation in 15 normal young subjects and 15 normal aged subjects. The HFOs were obtained by digitally filtering the wide-band SEPs (10-2000 Hz) using a band-pass of 300-900 Hz. In the aged subjects, the number of negative peaks, amplitudes, duration and area of the HFOs between N20 peak and HFO endpoint were significantly larger than those of young subjects. However, those between N20 onset and N20 peak did not differ between the groups. These results suggest that the later part of HFOs is associated with aging.

Human somatosensory cortical activation strengths: comparison between males and females and age-related changes

The amplitudes of many scalp-recorded evoked potential (EP) deflections are higher in females than in males, and in elderly than in young subjects. Since EPs critically depend on the electric conductivity of the cranium, it is not known whether these differences reflect age- and gender-dependent changes in the intensity of neuronal activation, or changes in the volume conductor. Evoked magnetic fields are not significantly affected by the conductivities of the cranial tissues and therefore reflect more directly the neuronal activation than EPs. We report here on the effects of age and gender on somatosensory evoked fields (SEFs) from the primary somatosensory cortex (SI) in 43 healthy subjects (21 males) aged from 20 to 73 years (males 51+/-18 years, females 51+/-14 years). The intensity of neuronal activation was estimated with equivalent current dipoles (ECDs) found at the peaks of the N20m, P35m and P60m deflections from the left SI after right median nerve stimulation. The peak latencies of N20m and P35m (but not of P60m) were shorter in females than in males. The N20m latency was positively correlated with age in males, but otherwise the latencies did not correlate with age. The ECD amplitudes did not differ between males and females for any of the deflections. The N20m ECD strength showed a significant positive correlation (r=0.39, p<0.01) with age while P35m and P60m ECD strengths did not. The results thus did not disclose gender differences in the activation strengths of the somatosensory cortex, implying that such differences in evoked potentials may possibly be due to gender differences in the volume conductor. On the other hand, the results suggest a slight age-related increase in cortical excitability.

Dermatomal and mixed nerve somatosensory evoked potentials in the diagnosis of neurogenic thoracic outlet syndrome

To evaluate the diagnostic utility of dermatomal and mixed nerve somatosensory evoked potentials (SEPs) in patients with thoracic outlet syndrome (TOS) and to compare their value with routine electrodiagnostic methods, we studied a group of 44 patients with neurogenic TOS and 30 healthy controls. In addition to bilateral median and ulnar SEPs, evoked potentials were recorded after stimulation of C6 and C8 dermatomes from the first and fifth digits, respectively. The patients were classified into 3 groups according to the nature of their clinical condition. The abnormality rate for both ulnar and C8 dermatomal SEPs was 100% in a small group of patients with severe neurological signs like atrophy. In groups of patients with lesser degrees of neurogenic damage, abnormality rates for ulnar and C8 dermatomal SEPs on affected limb(s) were 67 and 50%, respectively. Same abnormality rates were 25 and 18% in patients with only subjective symptoms. In patients with objective neurological signs, the major increase in sensitivity was with electromyography (EMG). Abnormalities of routine nerve conduction studies and F-wave latency were observed in patients with severe neurogenic damage. We concluded that the most useful tests in the diagnosis of neurogenic TOS are needle EMG and ulnar SEPs.

Median nerve somatosensory evoked potentials during isoflurane anaesthesia

PURPOSE

The effect of isoflurane on the subcortical P14 component of the median nerve somatosensory evoked potential (SEP) is poorly known. We studied whether the P14 wave from the upper brainstem, recorded with a nasopharyngeal electrode, was attenuated at the isoflurane-induced EEG burst-suppression level. We also compared the effect of isoflurane on the P14, cervical N13 and cortical N20, N35 and N6, components.

METHODS

Seventeen elective patients were anaesthetized with isoflurane. Somatosensory evoked potentials were recorded prior to anaesthesia, at 0.5 MAC and 1 MAC end-tidal isoflurane as well as at the level when EEG was in burst-suppression (mean 1.9 vol% end-tidal isoflurane).

RESULTS

Isoflurane had varying effects on the subcortical components of median SEP. The amplitude of nasopharyngeal P14 was stable, but the mean latency increased from 14.4 +/- 1.2 msec at 0.5 MAC to 15.2 +/- 1.1 msec at burst-suppression level (P < 0.05). In contrast, the N13 neck response amplitude was attenuated from 3.3 +/- 0.6 microV to 2.6 +/- 0.5 microV (P < 0.005) without latency changes. The latency of the cortical N20 wave was increased from 19.7 +/- 1.1 msec at awake to 24.4 +/- 1.6 msec at burst-suppression level (P < 0.0001) and amplitude was reduced from 3.3 +/- 1.1 microV to 1.3 +/- 0.6 microV (P < 0.0001). The later cortical components were attenuated even during 0.5 MAC isoflurane and were not recordable during EEG burst-suppression.

CONCLUSION

We conclude that P14 can reliably be recorded with nasopharyngeal electrodes during isoflurane anaesthesia, even during EEG burst-suppression, when the N20 wave is attenuated. In contrast, the middle-latency SEP components are sensitive to isoflurane anaesthesia.

Enhanced amplitude reduction of somatosensory evoked potentials by voluntary movement in the elderly

We studied the effects of aging on modification of the median nerve somatosensory evoked potentials (SEPs) by voluntary movement in 17 aged (66.5 +/- 8.9 years, mean +/- SD) and 12 young normal humans (27.5 +/- 5.0 years). The amplitudes of cortical SEP components were generally larger in the aged group than in the young group. Following isometric contraction of the thenar muscle, the aged group showed significant attenuation of the prerolandic P22-N28-P45 and the postrolandic P24-N30-P45, while the young group only demonstrated significant reduction of the prerolandic P22-N28 amplitude. In the prerolandic N28-P45 and the postrolandic P24-N30 and N30-P45, amplitudes reduced by voluntary movement (gated amplitude) significantly correlated with amplitudes at rest (resting amplitude) and with the age of subjects. The effects of stimulus intensity and frequency on gating supported the correlative changes between gated and resting amplitudes. These results suggest that the magnitude of gating depends on SEP amplitudes at rest, and that augmented gating in the aged group is a result of enlarged SEPs. Since the cervical and Erb's potentials were not changed by movement, and passive movement did not significantly affect the SEPs, a centrifugal mechanism is probably responsible for gating in this study.

Pain perception and brain evoked potentials in patients with angina despite normal coronary angiograms

OBJECTIVE

To evaluate the role of nociception in patients with angina despite normal coronary angiograms and to investigate whether any abnormality is confined to visceral or somatosensory perception.

METHODS

Perception, pain threshold, and brain evoked potentials to nociceptive electrical stimuli of the oesophageal mucosa and the sternal skin were investigated in 10 patients who had angina but normal coronary angiograms, no other signs of cardiac disease, and normal upper endoscopy. Controls were 10 healthy volunteers. The peaks of the evoked potential signal were designated N for negative deflections and P for positive. Numbers were given to the peaks in order of appearance after the stimulus. The peak to peak amplitudes (P1/N1, N1/P2) were measured in microV.

RESULTS

(1) Angina pectoris was provoked in seven patients following continuous oesophageal stimulation. (2) Distant projection of pain occurred after continuous electrical stimulation of the oesophagus in four patients and in no controls. (3) Patients had higher oesophageal pain thresholds (median 16.3 mA v 7.3 mA, P = 0.02) to repeated stimuli than controls, whereas the values did not differ with respect to the skin. There were no intergroup differences in thresholds to single stimuli. (4) Patients had substantially reduced brain evoked potential amplitudes after both single oesophageal (P1/N1, median values: 7.2 microV, controls: 29.0 microV; N1/P2: 16.5 microV, controls: 66.0 microV; P < 0.001 for both) and skin (N1/P2: 13.5 microV; controls: 76.0 microV; P < 0.001) stimuli despite the similar pain thresholds.

CONCLUSION

Central nervous system responses to visceral and somatosensory nociceptive input are altered in patients who have angina despite normal coronary angiograms.

Age-and height-dependent changes of amplitude and latency of somatosensory evoked potentials in children and young adults with Down's syndrome

Middle-latency somatosensory evoked potentials (MLSEPs) were recorded from 19 scalp electrodes in 34 patients with Down's syndrome (DS) aged 7.4 to 35.7 years and in 16 normal control subjects aged 6.4 to 34.4 years. DS patients showed an increase in amplitude of P22, P45, and N60. P100 latency was significantly shortened. After normalization for height of subjects, N20 and N60 latencies were significantly longer in the patient group than in control subjects. On the other hand, it was possible to observe in both groups a significant trend for MLSEP amplitudes to decrease with age during the age period considered in this work. This study further confirms that the pattern of increase in amplitude of MLSEP components observed in DS is a finding peculiar of this syndrome and is not correlated with early aging processes.

Scalp topographic mapping of middle-latency somatosensory evoked potentials in normal aging and dementia

Middle-latency somatosensory evoked potentials (MLSEPs) were recorded in four groups of subjects: 13 normal young controls (mean age, 17.9 years). 11 normal elderly (mean age, 66.9 years), 11 patients with dementia of Alzheimer's type (DAT: mean age, 70.5), and four with vascular dementia (mean age, 79.3). MLSEPs in normal elderly showed an increase in the latency of P22, N30, P45, N60, and P100, and in the amplitude of N60. DAT patients also presented such changes; however, the increase in the amplitude of N60 was much more evident than that found in normal aging and was accompanied by a significant increase in amplitude of P45. Patients with vascular dementia tended to show longer latencies and larger amplitudes than the other groups. The increase in amplitude of P45 and N60 in MLSEPs seems to be characteristically associated with normal aging and the development of dementia. It is suggested that the mechanism of such functional changes might be correlated with the structural and neurochemical changes accompanying neuronal loss in these conditions.

Bit-mapped somatosensory evoked potentials in Down's syndrome individuals

Middle-latency somatosensory evoked potentials (MLSEPs) were recorded from 19 scalp electrodes in 19 patients with Down's syndrome (DS), in 13 age-matched normal controls and in 11 aged normal individuals. DS patients showed an increase in amplitude of P22, N30, P45, and N60. P100 latency was significantly shortened. After this potential, DS subjects showed the occurrence of a high voltage negative potential at around 100-110 msec followed by another high-voltage positive deflection; both these components showed a frontal-central distribution and were not observed in the two control groups. MLSEPs of DS subjects show peculiar alterations which could be supported by particular neurometabolic and/or neuropathologic changes.

Influence of age on cerebral potentials evoked by oesophageal balloon distension in humans

The recording of viscerosensory cerebral evoked potentials is a new field in the research on gastrointestinal perception. The aim of our study was to assess the relationships between age and peak amplitudes and latencies of cerebral potentials evoked by balloon distension of the human oesophagus. In 16 healthy volunteers (aged 21-59 years), cerebral evoked potentials were recorded from a midline scalp electrode, using a series of 50 rapid balloon inflations with 13 ml of air. Peak to peak amplitudes (N1-P1, P1-N2) and peak latencies (N1, P1, N2) were assessed. Inverse correlations were found between age and N1-P1 amplitude (P < 0.05), and between age and P1-N2 amplitudes (P < 0.05). N1 and P1 latencies were significantly longer in elderly patients (N1: P < 0.05; P1: P < 0.05). Amplitudes and peak latencies of cerebral potentials evoked by balloon distension of the oesophagus are age-dependent. In cerebral evoked potential studies, patients and healthy controls should be age-matched.

Electric stimulation of the esophageal mucosa. Perception and brain-evoked potentials

BACKGROUND

Brain potentials have been used to assess somatosensory, visual, and auditory function, whereas few attempts have been made to evoke brain potentials from viscera.

METHODS

The present study evaluated perception and brain potentials evoked by electric stimulation at four different intensities in the esophagus of healthy volunteers. Results were compared with somatosensory evoked potential variables.

RESULTS

In 6 of 10 subjects the two highest esophageal stimulus intensities caused a deep pain perception. A positive correlation between average esophageal stimulus intensity and age was demonstrated. The amplitude of brain potentials increased significantly as a function of both esophageal and cutaneous stimulus intensity. The latency of esophageally evoked potentials decreased with stimulus intensity and was substantially longer than cutaneously evoked potentials despite a comparable conduction distance.

CONCLUSIONS

The present methods provide possibilities to assess sensory mechanisms and perception related to the human esophagus.

Scalp topography of somatosensory evoked potentials following median and posterior tibial nerve stimulation in Down's syndrome

The scalp topography of somatosensory evoked potentials (SEPs) following stimulation of the median and posterior tibial nerve of 39 patients with Down's syndrome was compared with that of age-matched normal controls using significance probability mapping (SPM). The maximal area of each potential in Down's syndrome was similar to that in normal controls, but the scalp distribution was wider. The amplitudes of all components, except the N45 and P59 potentials of the posterior tibial nerve SEPs, were greater in Down's syndrome, and the t values calculated by SPM were significantly greater. However, the difference of SEP maps between Down's patients and aged controls (over 65 years) was much smaller than that between Down's patients and age-matched controls. Therefore, we conclude that the generator sources and generating mechanisms of SEPs in Down's syndrome are not different from those of normal control, however SEP potentials in Down's syndrome are remarkably enhanced, resulting in a wider distribution, probably due to accelerated aging in Down's patients.

Amplitude abnormalities in the scalp far-field N18 of SSEPs to median nerve stimulation in patients with midbrain-pontine lesion

Various amplitude ratios were measured in 20 normal controls and 36 patients with midbrain-pontine, thalamic or putaminal lesions in order to evaluate the amplitude abnormalities in scalp far-field N18 following median nerve stimulation. A study of normal controls showed that the distributions of P9/N18, P14/N18 and N18/P14 + N18 resembled a gaussian distribution and could be used as criteria for determining the decrease in N18 amplitude in each patient. There was a decrease in N18 amplitude, or the absence of N18, in patients with midbrain-pontine lesions, but not in those with thalamic or putaminal lesions. Nine amplitude ratios (P11/P9, P14/P9, N18/P9, P9/P11, P9/P14, P9/N18, N18/P14, P14/N18 and N18/P14 + N18) were compared statistically for normal controls and 3 groups of patients based on non-parametric, Wilcoxon's non-pairs and signed-rank tests. A decrease in N18 amplitude in midbrain-pontine lesion was shown by significant changes in N18/P9, P9/N18, N18/P14, P14/N18 and N18/P14 + N18, no amplitude decreases in P11 and P14 being found from the amplitude ratios of P11/P9, P9/P11, P14/P9 and P9/P14. No significant changes were seen in any of the 9 amplitude ratios when the normal controls and patients with thalamic and putaminal lesions were compared. The amplitude ratios of N18 can be used to detect a decrease in N18 amplitude in patients with midbrain-pontine lesions. The data obtained support the hypothesis that N18 originates in the midbrain-pontine region and that neither the thalamus nor thalamocortical radiation make major contributions to the formation of the N18 peak.

Differential age effects for components of the adult auditory middle latency response

The middle latency components of the auditory evoked response were obtained from a young (20-24 years of age) and an older (51 to 71 years of age) group of normal-hearing, healthy female subjects. Recording procedures and stimulus repetition rates were chosen to promote the resolution of both Pa and Pb. The absolute and peak-to-peak amplitudes of Pa and Pb were significantly larger for the older subjects at all stimulus rates. An amplitude reduction of Pb with increasing stimulus rate was much more pronounced for the young than for the older subjects. This, combined with a shorter latency for Pb in the older subjects, may have contributed to partial and/or complete fusion of Pa and Pb observed in 10 of the 17 older subjects. An apparent positive shift in the response baseline for older subjects also may have contributed to the age-related amplitude effects.

Middle-latency somatosensory evoked potentials following median and posterior tibial nerve stimulation in Down's syndrome

Middle-latency somatosensory evoked potentials (SEPs) following median and posterior tibial nerve stimulation were studied in 40 patients with Down's syndrome and in age- and gender-matched healthy controls as well as in middle-aged and aged healthy subjects. In median nerve SEPs, latencies of the initial cortical potentials, N18 and P18, showed no significant difference, but the following potentials N22, P25, N32, P41 and P46 were relatively or significantly shorter in latency in Down's patients than in the controls. Amplitudes of all components in Down's patients were significantly larger than those of age- and gender-matched controls as well as of those of middle-aged healthy subjects, but there was only a small difference in their amplitudes from aged healthy subjects. Results of posterior tibial nerve SEPs were generally consistent with those of median nerve SEPs. Therefore, 'short latency with large amplitude' is the main characteristic of middle-latency SEPs in Down's syndrome, possibly related to accelerated physiological aging of the central nervous system.

Effects of age on the adult auditory middle latency response

The middle latency components of the auditory evoked response were obtained from a group of normal-hearing, healthy female subjects from 22 to 68 years of age. Recordings were made at several intensity levels to assess the level-dependence of any age-related effects. Cross-sectional analyses revealed that the amplitude of component Pa grows linearly with age, becoming significantly larger in older (50-68 years of age) compared to younger (22-37 years) subjects. The amplitude-intensity function is steeper in the older subjects by a factor of two. Correlational analyses suggested that at higher intensity levels age accounts for about 20% of the variance in the amplitude of Pa. A positive shift in response baseline was observed in the older subjects, and could contribute to the age-related increase in the absolute amplitude of Pa. However, a similar increase in the peak-to-peak and area measures of Pa suggests that some of the increase in the magnitude of Pa is independent of baseline shift. A confounding of age and hearing sensitivity in this study makes it difficult to interpret the age-related effects as strictly central in nature.

Cerebral responses evoked by electrical stimulation of the esophagus in normal subjects

Cerebral responses to electrical stimulation of the esophagus were investigated in 11 healthy male volunteers, 20-40 yr old. The stimulus was applied via a probe equipped with bipolar ring electrodes. It was positioned in the middle and distal esophagus at 20 and 37 cm from the incisors, respectively, and sucked to the mucosa. Electrical stimuli (0.1-ms duration, different stimulus voltages) were applied at frequencies of 0.1-1.0 Hz or in randomized order. Cerebral responses to electrical stimulation were recorded after 20-40 stimulations and averaged on a time base of 1000 ms. Evoked potentials consisted of successive peaks and troughs in the averaged electroencephalogram with good reproducibility within and between subjects. Amplitudes of evoked potentials showed a significant reduction with electrical stimulation at 37 cm compared with 20 cm, and with stimulation frequencies of 0.5 and 1.0 Hz compared with 0.2 and 0.1 Hz. Evoked potentials from 37 cm showed longer latencies compared with those from 20 cm. Irregular stimulation and stimulation during mental distraction did not alter these responses. It is concluded that reproducible evoked potentials can be recorded from the scalp after electrical stimulation of the esophagus and that these are transferred centrally via vagal afferents. The technique may become a useful tool in the study of visceral nervous connections to the brain in health and disease.

Brain potentials in a memory-scanning task. II. Effects of aging on potentials to the probes

Brain potentials accompanying the classification of probe items as being members of a previously presented list were recorded from subjects ranging in age from 18 to 86 years old. A group of older subjects (average age = 66 years) was compared to a younger group (average age = 29 years). The items tested were verbal (digits) and non-verbal (musical notes). Digits were presented in the auditory and visual modalities, and notes were presented acoustically. Reaction times (RTs) and performance accuracy were computed. Potentials are described in terms of scalp distribution, latency and amplitude as a function of the type of stimulus (verbal/non-verbal, auditory/visual) and age group (younger/older). Evoked potentials to target notes in an auditory target-detection ('odd-ball') task were also recorded for comparison with the memory tasks. Potentials evoked by probes consisted of a sequence of sensory components in the first 250 msec followed by a cognitive component that was positive in polarity and sustained in duration (approximately 700 msec labeled P3), consisting of an earlier frontal component, P3a (mean latency: younger = 385 msec, older = 406 msec), and a large (15 microV) and later parietal constituent, P3b (mean latency: younger = 574 msec, older = 630 msec). The frontal derivation of the younger subjects showed a sustained negative bias of the wave forms in the latency range of 200-500 msec (P2 to P3) compared to the older subjects. Reaction times were longer in older subjects than in younger subjects for all stimulus types and set sizes. For the potentials evoked by the probes the younger group had consistently larger late parietal components (P3b) than the older group, whereas the late frontal potentials (P3a) were larger for the older than younger subjects. Except for visual stimuli, the latencies of the parietal sustained potentials were not influenced by subject age in contrast to the uniform changes in RT for all stimulus types. Significant amplitude and latency effects on the parietal sustained potentials accompanied the different stimulus types and memorized-set sizes which were similar for the two age groups. These results suggest that the effects of aging on short-term memory are primarily on response selection, as evidenced by RT slowing with aging, and not on memory-scanning processes as evidenced by the similarity of the latency measures of the accompanying brain potentials between the two age groups.

The effect of aging on somatosensory evoked potentials following stimulation of the posterior tibial nerve in man

Spinal- and scalp-recorded somatosensory evoked potentials following stimulation of the posterior tibial nerve were obtained in 20 normal young subjects, and 45 aged subjects who were classified into group A (61-74 years) and group B (75-88 years). The results may be summarized as follows: (1) Spinal potentials, N19 at the twelfth thoracic vertebra and N28 at the second cervical vertebra, were significantly prolonged in latency in aged subjects. The interpeak latency, N19-N28, which represents the conduction time through the spinal cord, was also prolonged in aged subjects. (2) The interpeak latencies, P28-N31 and P28-P35, which represent the conduction time from the medial lemniscus to the thalamus and to the sensory cortex, respectively, were prolonged in aged subjects, particularly in group B. (3) The interpeak latencies of cortical potentials following P35, which represent the intracortical transit times, did not show any significant difference between young and aged subjects. (4) Amplitudes of the spinal, and short- and middle-latency cortical potentials were smaller in the aged subjects than those of young subjects, particularly the far-field N31 potential at Cz' electrode. In contrast, the long-latency cortical potentials were larger in aged subjects, although not significantly so.

Somatosensory evoked potentials from posterior tibial nerve and lumbo-sacral dermatomes

Techniques for recording the somatosensory evoked potential following stimulation of the skin of L5 and S1 dermatomes are described and validated. Normal data and their range are given for 54 subjects (108 legs). The latency of the peak of the first positive wave (P40) can be predicted from the subject's height from the regression formulae: P40 latency in msec = height in metres X 23.7 + 8.6 for the L5 dermatome. P40 latency in msec = height in metres X 24.5 + 8.7 for the S1 dermatome. P40 latency in msec = height in metres X 15.0 + 14.6 for the posterior tibial nerve. The standard deviations are 2.90 for L5; 2.95 for S1 and 1.60 for the posterior tibial nerve. Age and sex of the subjects had no significant effect. The data will have value when dermatomal somatosensory evoked potentials are used to investigate radiculopathies.

Single unit activity in frontal cortex and caudate nucleus of young and old rats

Spontaneous neuronal activity was recorded extracellularly from isolated single units in frontal neocortex and caudate nucleus of young and aged F344 rats anesthetized with urethane. Average firing rates, mean interspike intervals (ISI) +/- standard deviations, and ISI frequency histograms were computed and analyzed by microprocessor. For frontal cortex cells (N = 226), there was a nonsignificant trend toward slower average discharge rates in the old group. However, a significantly longer mean ISI and proportionally more very slow firing cells (less than 1 Hz) were observed in old rats. A laminar analysis of frontal cortex unit activity in young animals showed average discharge rates to be distributed somewhat evenly throughout the cortical mantle with the exception of the zone 1200-1400 mu beneath brain surface. This depth corresponds approximately to layer V where a 50% increase in mean firing rate in young animals was observed. In aged animals, this increased cell firing in layer V was absent, while mean discharge rates in other laminae remained essentially the same in the young and old rat groups. Caudate nucleus cells (n = 70) showed a significant shift towards fewer fast discharging cells in old rats, with the average firing rate diminished by one-third. Although more brain regions need to be examined in a similar fashion, the consistency of the present results with those previously reported for the brainstem and cerebellum suggests that slower firing rates and longer ISIs are likely to be wide-spread throughout the brains of aged rats.

Somatosensory evoked potentials in healthy volunteers and in patients with dementia

In 56 healthy volunteers short, middle and long latency somatosensory evoked potentials were recorded bilaterally. The median nerve was electrically stimulated at the wrist. The impact of arm length and age on the peak latencies of the identified SEP components was investigated. Arm length relates to shoulder and neck SEP and to the N20, the primary cortical response. Age relates to all components of the SEP. A pilot study was performed in a small number of patients with senile dementia. A significant delay of the middle and long latency potentials compared to healthy volunteers was shown.

Sleep-wakefulness patterns in the aged cat

This investigation compared the 24 h sleep-wake characteristics of young adult (2-4 years) and old (10-11 years) cats in order to determine whether there were significant age- and/or gender-related differences. Aged animals had more brief (6-14 sec) awakenings, less REM sleep, and more NREM sleep than young adults. There were no significant age- or gender-related differences with respect to either the daily numbers or the mean durations of sleep and waking episodes. Compared with the young adults, aged males had substantially less DSWS and fewer numbers of short-duration (less than or equal to 2.5 min) LSWS bouts. Both males and females showed age-related differences with respect to the sequencing of state-patterns. The expression of these patterns in relation to time of day was comparable for young and old animals. Overall, these findings compare favorably with those commonly reported in the elderly human.

Subcortical and cortical somatosensory potentials evoked by posterior tibial nerve stimulation: normative values

Cortical somatosensory evoked potentials to posterior tibial nerve stimulation were obtained in 29 normal controls varying in age and body height. In obtaining these potentials we varied recording derivations and frequency settings. Our recordings demonstrated the following points: N20 (dorsal cord potential) and the early cortical components (P2, N2) were the only potentials that were consistently recorded. All other subcortical components (N18, N24, P27, N30) were of relatively low amplitude and not infrequently absent even in normals. All absolute latencies other than N2 were correlated with body height. However, interpeak latency differences were independent of body height. Below the age of 20, subcortical but not cortical peak latencies correlated with age, but this appeared to be due to changes in body height in this age group. Absolute amplitudes and amplitude ratios (left/right and uni/bilateral) showed marked interindividual variability and have very limited value in defining abnormality. The use of restricted filter windows facilitated the selective recording of postsynaptic potentials (30-250 Hz) and action potentials (150-1500 Hz).

Multivariate analysis of somatosensory evoked potential parameters in normal adults

Cervical and cortical somatosensory evoked potentials (SEP) to median nerve stimulation were recorded in 65 normal subjects. Absolute peak latencies and amplitudes of cervical components N9, P10, N11, N13, P17, and cortical components P16, N20, P25, and N35 were measured. By means of partial correlations the interdependency of SEP-features could be verified in addition to the well-known dependence on arm length and age. In certain respects our results replicate other studies finding significant correlations between age and latency of early SEP-components as well as inverse relations between age and cervical amplitudes. Further analysis disclosed high inter-correlations between the latencies and between the amplitudes of the cervical and cortical components also revealing a certain exceptional position of the positive wave P17. In contrast to an inverse relation of amplitude and latency of the cervical components there were positive correlations between the respective features in the cortical evoked response. The findings are discussed with regard to the current knowledge about the origins of the SEP-components.

Evoked potential latency change with age suggests differential aging of primary somatosensory cortex

The latencies of the first two cortical peaks in the somatosensory evoked potential were examined in subjects of various ages. Recent work on specialization of primary sensory cortex in primates implicates the cortical site of origin of the second cortical peak, P25, in the selective sensory losses of old age. The latency of the P25 peak changed significantly with age. The latency of the preceeding N20 peak, also of cortical origin but originating from a different site, showed no significant age-related change. Sex differences were present in both N20 and P25 latencies but were independent of the age effect in the latter. Our results provide electrophysiological evidence for differential aging of anatomically separate areas of somatosensory cortex.

[Neurophysiologic aspects of psychoorganic deficiency problems of depressive disorders of the involutional age]

From a multidimensional viewpoint 40 depressive patients of involutional age (mean age 55 years) were evaluated in terms of an operationally defined deficiency syndrome, i.e. vital reduction per organic brain coloration to establish a neurobiologic matrix of correlation between the level of clinical psychopathology and neurophysiology. A subtle diagnosis by means of evoked potentials (SEP and VEP) measuring the neuronal infrastructure allows for a global evaluation of sensory-specific "cortical-subcortical functional integrity", otherwise missed in terms of the conventional EEG. In both vitally reduced patients and in probands who were diagnosed as having an organic brain syndrome because of clinical psychopathologic phenomenology, impaired bioelectric signal processing, increased neuropsychological deficits, risk factors and enlargement of the third ventricle were measured together with a chronic course of the nosologically classified disease. Compared with depressive patients who may have any deficiency factor, and healthy elderly probands (mean age 86 years), a deficiency syndrome is suggested as being defined as a polysystemic aging process which is dynamically induced by endogenous and exogenous factors, thus, being time dependent. Although there are correlative results between the disciplines, an abnormal (neuronal) functional diagram should only be used in a pathoplastic sense as an indicative and associative reaction of the CNS to premature aging processes at various levels.

Central somatosensory conduction time from 10 to 79 years

Somatosensory evoked potentials were recorded simultaneously from the neck and scalp following stimulation of the median nerve at the wrist in 83 normal subjects aged 10-79 years. The central somatosensory conduction time was measured by subtracting the peak latency of the major response from the upper cervical area (N14) from that of the primary cortical response (N20). The central conduction time remained constant between 10 and 49 years but increased abruptly by approximately 0.3 msec between the fifth and sixth decades. Following this increase there was no further change in the central conduction time. Changes with age in the amplitude of N14 and N20 differed both from the changes in latency and from each other. The amplitude of N14 was stable between 10 and 39 years but then declined progressively. The amplitude of N20 deceased between 10 and 39 years and then increased until the end of the seventh decade.