Lamotrigine suppresses neurophysiological responses to somatosensory stimulation in the rodent

Mapping oxidative metabolism in the human brain with calibrated fMRI in health and disease

Conventional functional MRI (fMRI) with blood-oxygenation level dependent (BOLD) contrast is an important tool for mapping human brain activity non-invasively. Recent interest in quantitative fMRI has renewed the importance of oxidative neuroenergetics as reflected by cerebral metabolic rate of oxygen consumption (CMR_O2) to support brain function. Dynamic CMR_O2 mapping by calibrated fMRI require multi-modal measurements of BOLD signal along with cerebral blood flow (CBF) and/or volume (CBV). In human subjects this "calibration" is typically performed using a gas mixture containing small amounts of carbon dioxide and/or oxygen-enriched medical air, which are thought to produce changes in CBF (and CBV) and BOLD signal with minimal or no CMR_O2 changes. However non-human studies have demonstrated that the "calibration" can also be achieved without gases, revealing good agreement between CMR_O2 changes and underlying neuronal activity (e.g., multi-unit activity and local field potential). Given the simpler set-up of gas-free calibrated fMRI, there is evidence of recent clinical applications for this less intrusive direction. This up-to-date review emphasizes technological advances for such translational gas-free calibrated fMRI experiments, also covering historical progression of the calibrated fMRI field that is impacting neurological and neurodegenerative investigations of the human brain.

Metabolic underpinnings of activated and deactivated cortical areas in human brain

Neuroimaging with functional MRI (fMRI) identifies activated and deactivated brain regions in task-based paradigms. These patterns of (de)activation are altered in diseases, motivating research to understand their underlying biochemical/biophysical mechanisms. Essentially, it remains unknown how aerobic metabolism of glucose to lactate (aerobic glycolysis) and excitatory-inhibitory balance of glutamatergic and GABAergic neuronal activities vary in these areas. In healthy volunteers, we investigated metabolic distinctions of activating visual cortex (VC, a task-positive area) using a visual task and deactivating posterior cingulate cortex (PCC, a task-negative area) using a cognitive task. We used fMRI-guided J-edited functional MRS (fMRS) to measure lactate, glutamate plus glutamine (Glx) and γ-aminobutyric acid (GABA), as indicators of aerobic glycolysis and excitatory-inhibitory balance, respectively. Both lactate and Glx increased upon activating VC, but did not change upon deactivating PCC. Basal GABA was negatively correlated with BOLD responses in both brain areas, but during functional tasks GABA decreased in VC upon activation and GABA increased in PCC upon deactivation, suggesting BOLD responses in relation to baseline are impacted oppositely by task-induced inhibition. In summary, opposite relations between BOLD response and GABAergic inhibition, and increases in aerobic glycolysis and glutamatergic activity distinguish the BOLD response in (de)activated areas.

Changes in amygdala, cerebellum, and nucleus accumbens volumes in bipolar patients treated with lamotrigine

The neural mechanisms underlying the therapeutic effects of lamotrigine in bipolar depression are still unexplored. This preliminary study compares the effects of a 12-week treatment with lamotrigine on brain volumes in adults with bipolar disorder (BD).12 BD type II patients (age: 49.33 ± 9.95 years, 3 males, 9 females) and 12 age and gender-matched healthy controls (HC) (HC; age: 41 ± 8.60 years, 3 males, 9 females). BD patients were initially administered 25 mg/day of lamotrigine, which was progressively escalated to 200 mg/d. BD participants underwent brain imaging prior to and following lamotrigine treatment. A 50% reduction in depressive scores indicated "remission". Bayesian general linear models controlled for age, gender and intracranial volume were used to examine changes in relevant brain region following treatment. A posterior probability > 0.90 indicated evidence that there was an effect of diagnosis or remission on brain volumes. Probability distributions of interaction effects between remission and time indicated that BD responders displayed decreased amygdala, cerebellum and nucleus accumbens volumes following lamotrigine treatment. No serious adverse side effects were reported. The antidepressant effects of lamotrigine may be linked to volumetric changes in brain regions involved in mood and emotional regulation. These findings are preliminary and replication in a larger sample is warranted.

Advances in Imaging Brain Metabolism

Metabolism is central to neuroimaging because it can reveal pathways by which neuronal and glial cells use nutrients to fuel their growth and function. We focus on advanced magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) methods used in brain metabolic studies. ¹⁷O-MRS and ³¹P-MRS, respectively, provide rates of oxygen use and ATP synthesis inside mitochondria, whereas ¹⁹F-MRS enables measurement of cytosolic glucose metabolism. Calibrated functional MRI (fMRI), an advanced form of fMRI that uses contrast generated by deoxyhemoglobin, provides maps of oxygen use that track neuronal firing across brain regions. ¹³C-MRS is the only noninvasive method of measuring both glutamatergic neurotransmission and cell-specific energetics with signaling and nonsignaling purposes. Novel MRI contrasts, arising from endogenous diamagnetic agents and exogenous paramagnetic agents, permit pH imaging of glioma. Overall, these magnetic resonance methods for imaging brain metabolism demonstrate translational potential to better understand brain disorders and guide diagnosis and treatment.

Chronic antiepileptic drug use and functional network efficiency: A functional magnetic resonance imaging study

AIM

To increase our insight in the neuronal mechanisms underlying cognitive side-effects of antiepileptic drug (AED) treatment.

METHODS

The relation between functional magnetic resonance-acquired brain network measures, AED use, and cognitive function was investigated. Three groups of patients with epilepsy with a different risk profile for developing cognitive side effects were included: A “low risk” category (lamotrigine or levetiracetam, n = 16), an “intermediate risk” category (carbamazepine, oxcarbazepine, phenytoin, or valproate, n = 34) and a “high risk” category (topiramate, n = 5). Brain connectivity was assessed using resting state functional magnetic resonance imaging and graph theoretical network analysis. The Computerized Visual Searching Task was used to measure central information processing speed, a common cognitive side effect of AED treatment.

RESULTS

Central information processing speed was lower in patients taking AEDs from the intermediate and high risk categories, compared with patients from the low risk category. The effect of risk category on global efficiency was significant (P < 0.05, ANCOVA), with a significantly higher global efficiency for patient from the low category compared with the high risk category (P < 0.05, post-hoc test). Risk category had no significant effect on the clustering coefficient (ANCOVA, P > 0.2). Also no significant associations between information processing speed and global efficiency or the clustering coefficient (linear regression analysis, P > 0.15) were observed.

CONCLUSION

Only the four patients taking topiramate show aberrant network measures, suggesting that alterations in functional brain network organization may be only subtle and measureable in patients with more severe cognitive side effects.

Emotional Experience and Awareness of Self: Functional MRI Studies of Depersonalization Disorder

This paper presents functional MRI work on emotional processing in depersonalization disorder (DPD). This relatively neglected disorder is hallmarked by a disturbing change in the quality of first-person experience, almost invariably encompassing a diminished sense of self and an alteration in emotional experience such that the sufferer feels less emotionally reactive, with emotions experienced as decreased or “damped down,” so that emotional life seems to lack spontaneity and subjective validity. Here we explored responses to emotive visual stimuli to examine the functional neuroanatomy of emotional processing in DPD before and after pharmacological treatment. We also employed concurrent skin conductance measurement as an index of autonomic arousal. In common with previous studies we demonstrated that in DPD, there is attenuated psychophysiological response to emotional material, reflected in altered patterns of (i) regional brain response, (ii) autonomic responses. By scanning participants before and after treatment we were able to build on previous findings by examining the changes in functional MRI response in patients whose symptoms had improved at time 2. The attenuation of emotional experience was associated with reduced activity of the insula, whereas clinical improvement in DPD symptoms was associated with increased insula activity. The insula is known to be implicated in interoceptive awareness and the generation of feeling states. In addition an area of right ventrolateral prefrontal cortex emerged as particularly implicated in what may be “top-down” inhibition of emotional responses. The relevance of these findings to the wider study of emotion, self-related processes, and interoception is discussed.

Right mesial temporal lobe epilepsy impairs empathy-related brain responses to dynamic fearful faces

Unilateral mesial temporal lobe epilepsy (MTLE) has been associated with reduced amygdala responsiveness to fearful faces. However, the effect of unilateral MTLE on empathy-related brain responses in extra-amygdalar regions has not been investigated. Using functional magnetic resonance imaging, we measured empathy-related brain responses to dynamic fearful faces in 34 patients with unilateral MTLE (18 right sided), in an epilepsy (extra-MTLE; n = 16) and in a healthy control group (n = 30). The primary finding was that right MTLE (RMTLE) was associated with decreased activity predominantly in the right amygdala and also in bilateral periaqueductal gray (PAG) but normal activity in the right anterior insula. The results of the extra-MTLE group demonstrate that these reduced amygdala and PAG responses go beyond the attenuation caused by antiepileptic and antidepressant medication. These findings clearly indicate that RMTLE affects the function of mesial temporal and midbrain structures that mediate basic interoceptive input necessary for the emotional awareness of empathic experiences of fear. Together with the decreased empathic concern found in the RMTLE group, this study provides neurobehavioral evidence that patients with RMTLE are at increased risk for reduced empathy towards others' internal states and sheds new light on the nature of social-cognitive impairments frequently accompanying MTLE.

A systematic review of physiological methods in rodent pharmacological MRI studies

RATIONALE

Pharmacological magnetic resonance imaging (phMRI) provides an approach to study effects of drug challenges on brain processes. Elucidating mechanisms of drug action helps us to better understand the workings of neurotransmitter systems, map brain function or facilitate drug development. phMRI is increasingly used in preclinical research employing rodent models; however, data interpretation and integration are complicated by the use of different experimental approaches between laboratories. In particular, the effects of different anaesthetic regimes upon neuronal and haemodynamic processes and baseline physiology could be problematic.

OBJECTIVES

This paper investigates how differences in phMRI research methodologies are manifested and considers associated implications, placing particular emphasis on choice of anaesthetic regimes.

METHODS

A systematic review of rodent phMRI studies was conducted. Factors such as those describing anaesthetic regimes (e.g. agent, dosage) and parameters relating to physiological maintenance (e.g. ventilatory gases) and MRI method were recorded.

RESULTS

We identified 126 eligible studies and found that the volatile agents isoflurane (43.7 %) and halothane (33.3 %) were most commonly used for anaesthesia, but dosage and mixture of ventilatory gases varied substantially between laboratories. Relevant physiological parameters were usually recorded, although 32 % of studies did not provide cardiovascular measures.

CONCLUSIONS

Anaesthesia and animal preparation can influence phMRI data profoundly. The variation of anaesthetic type, dosage regime and ventilatory gases makes consolidation of research findings (e.g. within a specific neurotransmitter system) difficult. Standardisation of a small(er) number of preclinical phMRI research methodologies and/or increased consideration of approaches that do not require anaesthesia is necessary to address these challenges.

Insights from neuroenergetics into the interpretation of functional neuroimaging: an alternative empirical model for studying the brain's support of behavior

Functional neuroimaging measures quantitative changes in neurophysiological parameters coupled to neuronal activity during observable behavior. These results have usually been interpreted by assuming that mental causation of behavior arises from the simultaneous actions of distinct psychological mechanisms or modules. However, reproducible localization of these modules in the brain using functional magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging has been elusive other than for sensory systems. In this paper, we show that neuroenergetic studies using PET, calibrated functional magnetic resonance imaging (fMRI), (13)C magnetic resonance spectroscopy, and electrical recordings do not support the standard approach, which identifies the location of mental modules from changes in brain activity. Of importance in reaching this conclusion is that changes in neuronal activities underlying the fMRI signal are many times smaller than the high ubiquitous, baseline neuronal activity, or energy in resting, awake humans. Furthermore, the incremental signal depends on the baseline activity contradicting theoretical assumptions about linearity and insertion of mental modules. To avoid these problems, while making use of these valuable results, we propose that neuroimaging should be used to identify observable brain activities that are necessary for a person's observable behavior rather than being used to seek hypothesized mental processes.

Effect of tolperisone on the resting brain and on evoked responses, an phMRI BOLD study

Tolperisone is a voltage gated sodium channel blocker, centrally acting muscle relaxant drug, with a very advantageous side effect profile. Like other sodium channel blockers, it has weak affinity to the resting state and high affinity to the open/inactivated state of the channel. In this paper, its effect on BOLD responses in rat brain were elucidated both on the resting brain and paw stimulation evoked BOLD responses. Tolperisone did not exert any visible effect on resting brain, but strongly inhibited the paw stimulation evoked BOLD responses, showing somewhat higher efficacy in brain areas involved in pain sensation. This finding is in a good agreement with its sodium channel blocking profile. In the resting brain, most of the channels are in resting state. Electric train stimuli of the paw results in over activated neurons, where most sodium channels are in open or inactivated state. These data suggest that the very advantageous profile of tolperisone can be explained by its selective action on open or inactivated sodium channels of over-activated neurons in various brain regions rather than by a selective effect in the spinal cord as suggested previously.

Functional magnetic resonance imaging in rodents: an unique tool to study in vivo pharmacologic neuromodulation

When new compounds targeting the brain are developed, it is important to assess both the acute and chronic effects on brain functioning. This can be done non-invasively using a technique called functional magnetic resonance imaging (fMRI). This review discusses the possibilities of both stimulation-based and resting state fMRI to study pharmacological modulations of the rodent brain. Moreover, attention is given to the use of anesthetics which could importantly influence the outcome of both techniques.

Role of ongoing, intrinsic activity of neuronal populations for quantitative neuroimaging of functional magnetic resonance imaging-based networks

A primary objective in neuroscience is to determine how neuronal populations process information within networks. In humans and animal models, functional magnetic resonance imaging (fMRI) is gaining increasing popularity for network mapping. Although neuroimaging with fMRI-conducted with or without tasks-is actively discovering new brain networks, current fMRI data analysis schemes disregard the importance of the total neuronal activity in a region. In task fMRI experiments, the baseline is differenced away to disclose areas of small evoked changes in the blood oxygenation level-dependent (BOLD) signal. In resting-state fMRI experiments, the spotlight is on regions revealed by correlations of tiny fluctuations in the baseline (or spontaneous) BOLD signal. Interpretation of fMRI-based networks is obscured further, because the BOLD signal indirectly reflects neuronal activity, and difference/correlation maps are thresholded. Since the small changes of BOLD signal typically observed in cognitive fMRI experiments represent a minimal fraction of the total energy/activity in a given area, the relevance of fMRI-based networks is uncertain, because the majority of neuronal energy/activity is ignored. Thus, another alternative for quantitative neuroimaging of fMRI-based networks is a perspective in which the activity of a neuronal population is accounted for by the demanded oxidative energy (CMR(O2)). In this article, we argue that network mapping can be improved by including neuronal energy/activity of both the information about baseline and small differences/fluctuations of BOLD signal. Thus, total energy/activity information can be obtained through use of calibrated fMRI to quantify differences of ΔCMR(O2) and through resting-state positron emission tomography/magnetic resonance spectroscopy measurements for average CMR(O2).

Quantitative fMRI and oxidative neuroenergetics

The discovery of functional magnetic resonance imaging (fMRI) has greatly impacted neuroscience. The blood oxygenation level-dependent (BOLD) signal, using deoxyhemoglobin as an endogenous paramagnetic contrast agent, exposes regions of interest in task-based and resting-state paradigms. However the BOLD contrast is at best a partial measure of neuronal activity, because the functional maps obtained by differencing or correlations ignore the total neuronal activity in the baseline state. Here we describe how studies of brain energy metabolism at Yale, especially with (13)C magnetic resonance spectroscopy and related techniques, contributed to development of quantitative functional brain imaging with fMRI by providing a reliable measurement of baseline energy. This narrative takes us on a journey, from molecules to mind, with illuminating insights about neuronal-glial activities in relation to energy demand of synaptic activity. These results, along with key contributions from laboratories worldwide, comprise the energetic basis for quantitative interpretation of fMRI data.

Differential effect of isoflurane, medetomidine, and urethane on BOLD responses to acute levo-tetrahydropalmatine in the rat

Levo-tetrahydropalmatine (l-THP) has shown significant promise in preclinical and clinical studies to treat drug addiction. Pharmacological MRI methods can elucidate the regional cerebral effects of l-THP, but there are potential confounds from the use of general anesthesia. To investigate the possible anesthetic-drug interactions for the pharmacological MRI result of acute l-THP, we examined acute blood oxygen level-dependent responses of both 5 and 20 mg/kg l-THP in naïve rats during general anesthesia achieved with three agents: isoflurane, medetomidine, and urethane. We found that with acute l-THP administration, isoflurane revealed the smallest blood oxygen level-dependent activation areas. In addition, urethane had the most activation areas; however, they were all negative. Medetomidine showed mixed positive and negative activations. Region-specific interactions were found between the l-THP-induced blood oxygen level-dependent responses and the anesthetic agents.

Neural and BOLD responses across the brain

Functional Magnetic Resonance Imaging (fMRI) has quickly grown into one of the most important tools for studying brain function, especially in humans. Despite its prevalence, we still do not have a clear picture of what exactly the blood oxygenation level dependent (BOLD) signal represents or how it compares to the signals obtained with other methods (e.g., electrophysiology). We particularly refer to single neuron recordings and electroencephalography when we mention 'electrophysiological methods', given that these methods have been used for more than 50 years, and have formed the basis of much of our current understanding of brain function. Brain function involves the coordinated activity of many different areas and many different cell types that can participate in an enormous variety of processes (neural firing, inhibitory and excitatory synaptic activity, neuromodulation, oscillatory activity, etc.). Of these cells and processes, only a subset is sampled with electrophysiological techniques, and their contribution to the recorded signals is not exactly known. Functional imaging signals are driven by the metabolic needs of the active cells, and are most likely also biased toward certain cell types and certain neural processes, although we know even less about which processes actually drive the hemodynamic response. This article discusses the current status on the interpretation of the BOLD signal and how it relates to neural activity measured with electrophysiological techniques. WIREs Cogn Sci 2012, 3:75-86. doi: 10.1002/wcs.153 For further resources related to this article, please visit the WIREs website.

Convergence of human brain mapping tools: neuronavigated TMS parameters and fMRI activity in the hand motor area

Functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) are well-established tools for investigating the human motor system in-vivo. We here studied the relationship between movement-related fMRI signal changes in the primary motor cortex (M1) and electrophysiological properties of the hand motor area assessed with neuronavigated TMS in 17 healthy subjects. The voxel showing the highest task-related BOLD response in the left hand motor area during right hand movements was identified for each individual subject. This fMRI peak voxel in M1 served as spatial target for coil positioning during neuronavigated TMS. We performed correlation analyses between TMS parameters, BOLD signal estimates and effective connectivity parameters of M1 assessed with dynamic causal modeling (DCM). The results showed a negative correlation between the movement-related BOLD signal in left M1 and resting as well as active motor threshold (MT) obtained for left M1. The DCM analysis revealed that higher excitability of left M1 was associated with a stronger coupling between left supplementary motor area (SMA) and M1. Furthermore, BOLD activity in left M1 correlated with ipsilateral silent period (ISP), i.e. the stronger the task-related BOLD response in left M1, the higher interhemispheric inhibition effects targeting right M1. DCM analyses revealed a positive correlation between the coupling of left SMA with left M1 and the duration of ISP. The data show that TMS parameters assessed for the hand area of M1 do not only reflect the intrinsic properties at the stimulation site but also interactions with remote areas in the human motor system.

Clinical functional MRI of the language domain in children with epilepsy

Functional MRI (fMRI) for the assessment of language functions is increasingly used in the diagnostic workup of patients with epilepsy. Termed "clinical fMRI," such an approach is also feasible in children who may display specific patterns of language reorganization. This study was aimed at assessing language reorganization in pediatric epilepsy patients, using fMRI. We studied 26 pediatric epilepsy patients (median age, 13.05 years; range, 5.6-18.7 years) and 23 healthy control children (median age, 9.37 years; range, 6.2-15.4 years), using two child-friendly fMRI tasks and adapted data-processing streams. Overall, 81 functional series could be analyzed. Reorganization seemed to occur primarily in homotopic regions in the contralateral hemisphere, but lateralization in the frontal as well as in the temporal lobes was significantly different between patients and controls. The likelihood to find atypical language organization was significantly higher in patients. Additionally, we found significantly stronger activation in the healthy controls in a primarily passive task, suggesting a systematic confounding influence of antiepileptic medication. The presence of a focal cortical dysplasia was significantly associated with atypical language lateralization. We conclude that important confounds need to be considered and that the pattern of language reorganization may be distinct from the patterns seen in later-onset epilepsy.

Characterization of the hemodynamic modes associated with interictal epileptic activity using a deformable model-based analysis of combined EEG and functional MRI recordings

Simultaneous electroencephalography and functional magnetic resonance imaging (EEG/fMRI) have been proposed to contribute to the definition of the epileptic seizure onset zone. Following interictal epileptiform discharges, one usually assumes a canonical hemodynamic response function (HRF), which has been derived from fMRI studies in healthy subjects. However, recent findings suggest that the hemodynamic properties of the epileptic brain are likely to differ significantly from physiological responses. Here, we propose a simple and robust approach that provides HRFs, defined as a limited set of gamma functions, optimized so as to elicit strong activations after standard model-driven statistical analysis at the single subject level. The method is first validated on healthy subjects using experimental data acquired during motor, visual and memory encoding tasks. Second, interictal EEG/fMRI data measured in 10 patients suffering from epilepsy are analyzed. Results show dramatic changes of activation patterns, depending on whether physiological or pathological assumptions are made on the hemodynamics of the epileptic brain. Our study suggests that one cannot assume a priori that HRFs in epilepsy are similar to the canonical model. This may explain why a significant fraction of EEG/fMRI exams in epileptic patients are inconclusive after standard data processing. The heterogeneous perfusion in epileptic regions indicates that the properties of brain vasculature in epilepsy deserve careful attention.

Effects of lamotrigine on hippocampal activation in corticosteroid-treated patients

BACKGROUND

An extensive animal literature suggests that stress or excessive corticosteroid exposure is associated with changes in hippocampal function and memory. These findings are pertinent to psychiatric disorders with elevated cortisol, Cushing's disease and the millions of patients receiving prescription corticosteroids. In animals, agents that decrease glutamate release attenuate the effects of corticosteroids on the hippocampus. Minimal data are available on preventing or reversing the effects of corticosteroids on the human hippocampus. We previously reported improvement in memory in corticosteroid-treated patients given lamotrigine. In this report, we examined the impact of lamotrigine on task-related hippocampal activation in patients taking prescription corticosteroids.

METHODS

A total of 28 outpatients taking long-term oral prednisone for medical conditions, such as renal transplant rejection, were randomized to lamotrigine or placebo for 24 weeks. Hippocampal activation in response to a visual memory task was assessed with blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI).

RESULTS

Consistent with a reduction in glutamate release, the right posterior hippocampus showed a significant decrease in task-related activation in the lamotrigine group as compared to the placebo group.

LIMITATIONS

The modest sample size and an assessment period of only 24 weeks are study limitations.

CONCLUSIONS

Between-group differences in hippocampal activation were observed. The results suggest that an agent that modulates glutamate may modify the effects of long-term corticosteroid exposure on the human hippocampus.

Neurovascular and Neurometabolic Couplings in Dynamic Calibrated fMRI: Transient Oxidative Neuroenergetics for Block-Design and Event-Related Paradigms

Functional magnetic resonance imaging (fMRI) with blood-oxygenation level dependent (BOLD) contrast is an important tool for mapping brain activity. Interest in quantitative fMRI has renewed awareness in importance of oxidative neuroenergetics, as reflected by cerebral metabolic rate of oxygen consumption(CMRO2), for supporting brain function. Relationships between BOLD signal and the underlying neurophysiological parameters have been elucidated to allow determination of dynamic changes inCMRO2 by "calibrated fMRI," which require multi-modal measurements of BOLD signal along with cerebral blood flow (CBF) and volume (CBV). But how doCMRO2 changes, steady-state or transient, derived from calibrated fMRI compare with neural activity recordings of local field potential (LFP) and/or multi-unit activity (MUA)? Here we discuss recent findings primarily from animal studies which allow high magnetic fields studies for superior BOLD sensitivity as well as multi-modal CBV and CBF measurements in conjunction with LFP and MUA recordings from activated sites. A key observation is that while relationships between neural activity and sensory stimulus features range from linear to non-linear, associations between hyperemic components (BOLD, CBF, CBV) and neural activity (LFP, MUA) are almost always linear. More importantly, the results demonstrate good agreement between the changes inCMRO2 and independent measures of LFP or MUA. The tight neurovascular and neurometabolic couplings, observed from steady-state conditions to events separated by <200 ms, suggest rapid oxygen equilibration between blood and tissue pools and thus calibrated fMRI at high magnetic fields can provide high spatiotemporal mapping ofCMRO2 changes.

How and when the fMRI BOLD signal relates to underlying neural activity: the danger in dissociation

Functional magnetic resonance imaging (fMRI) has become the dominant means of measuring behavior-related neural activity in the human brain. Yet the relation between the blood oxygen-level dependent (BOLD) signal and underlying neural activity remains an open and actively researched question. A widely accepted model, established for sensory neo-cortex, suggests that the BOLD signal reflects peri-synaptic activity in the form of the local field potential rather than the spiking rate of individual neurons. Several recent experimental results, however, suggest situations in which BOLD, spiking, and the local field potential dissociate. Two different models are discussed, based on the literature reviewed to account for this dissociation, a circuitry-based and vascular-based explanation. Both models are found to account for existing data under some testing situations and in certain brain regions. Because both the vascular and local circuitry-based explanations challenge the BOLD-LFP coupling model, these models provide guidance in predicting when BOLD can be expected to reflect neural processing and when the underlying relation with BOLD may be more complex than a direct correspondence.

Enhanced activity during associative encoding in the affected hippocampus in right temporal lobe epilepsy patients

Mnestic deficits represent the core cognitive impairment of patients with temporal lobe epilepsy (TLE), irrespective of the existence of overt morphological lesions. Compared to controls, patients with symptomatic TLE show altered functional activation patterns in fMRI studies on memory processes. But, so far, such studies have rarely investigated patients with temporal lobe epilepsy of unknown cause. Therefore, in the current study, a small sample of 6 right TLE patients with normal structural MRIs was compared to controls with respect to brain activity during encoding of face-name associations using fMRI. Compared to controls, patients retrieved fewer face-name associations correctly, but showed significantly greater activation of the affected hippocampus for successfully encoded stimuli. Therefore, higher hippocampal activation seems necessary for successful encoding of associations in patients compared to controls. But, this process is not entirely successful since the patients cannot achieve the same performance as controls. In conclusion, the hyperactivation of the hippocampus might represent a compensational but inefficient process.

Principal cell spiking, postsynaptic excitation, and oxygen consumption in the rat cerebellar cortex

One contention within the field of neuroimaging concerns the character of the depicted activity: Does it represent neuronal action potential generation (i.e., spiking) or postsynaptic excitation? This question is related to the metabolic costs of different aspects of neurosignaling. The cerebellar cortex is well suited for addressing this problem because synaptic input to and spiking of the principal cell, the Purkinje cell (PC), are spatially segregated. Also, PCs are pacemakers, able to generate spikes endogenously. We examined the contributions to cerebellar cortical oxygen consumption (CMRO2) of postsynaptic excitation and PC spiking during evoked and ongoing neuronal activity in the rat. By inhibiting excitatory synaptic input using ionotropic glutamate receptor blockers, we found that the increase in CMRO2 evoked by parallel fiber (PF) stimulation depended entirely on postsynaptic excitation. In contrast, PC spiking was largely responsible for the increase in CMRO2 when ongoing neuronal activity was increased by gamma-aminobutyric acid type A receptor blockade. In this case, CMRO2 increased equally during PC spiking with excitatory synaptic activity as during PC pacemaker spiking without excitatory synaptic input. Subsequent inhibition of action potential propagation and neurotransmission by blocking voltage-gated Na+-channels eliminated the increases in CMRO2 due to PF stimulation and increased PC spiking, but left a large fraction of CMRO2, i.e., basal CMRO2, intact. In conclusion, whereas basal CMRO2 in anesthetized animals did not seem to be related to neurosignaling, increases in CMRO2 could be induced by all aspects of neurosignaling. Our findings imply that CMRO2 responses cannot a priori be assigned to specific neuronal activities.

Neurophysiology of functional imaging

The successes of PET and fMRI in non-invasively localizing sensory functions had encouraged efforts to transform the subjective concepts of cognitive psychology into objective physical measures. The assumption was that mental functions could be decomposed into non-overlapping, context-independent modules that are operated on by separable areas of a computer-like brain. The failures of cognitive modularity and of a very localized phrenology are generally, but not universally, accepted; but in their place, and usually not distinguished from the original revolutionary hopes of clarification, experimental results are being interpreted in terms of rather flexible definitions of both cognitive concepts and the degree of localization. In an alternative approach, we have connected fMRI, (13)C MRS, and electrophysiology measurements of brain energy to connect with observable properties of mental life (i.e., awareness). We illustrate this approach with a sensory stimulation experiment; the degree of localization found in BOLD signals was related to the global energy of the brain which, when manipulated by anesthetics, affected the degree of awareness. The influence of brain energy upon functional imaging maps is changing the interpretations of neuroimaging experiments, from psychological concepts generating computer-like responses to empirical responses dominated by the high brain energy and signaling at rest. In our view "baseline" is an operational term, an adjective that defines a property of a state of the system before it is perturbed by a stimulus. Given the dependence of observable psychological properties upon the "baseline" energy, we believe that it is unnecessarily limiting to define a particular state as the baseline.

Oxidative neuroenergetics in event-related paradigms

Energetic basis of neural activity provides a solid foundation for noninvasive neuroimaging with calibrated functional magnetic resonance imaging (fMRI). Calculating dynamic changes in cerebral oxidative energy utilization (CMR(O(2))) is limited by uncertainties about whether or not the conventional blood oxygenation level-dependent (BOLD) model can be applied transiently using multimodal measurements of blood flow (CBF) and volume (CBV) that affect the BOLD signal. A prerequisite for dynamic calibrated fMRI is testing the linearity of multimodal signals within a temporal regimen, as assessed by signal strength (i.e., both intensity and width). If each hyperemic component (BOLD, CBV, CBF) is demonstrated to be linear with neural activity under various experimental conditions, then the respective transfer functions generated by deconvolution with neural activity should be time invariant and thus could potentially be used for calculating CMR(O(2)) transients. Hyperemic components were investigated at 11.7 T in alpha-chloralose-anesthetized rats and combined with electrophysiological recordings of local field potential (LFP) and multiunit activity (MUA) from the cortex during forepaw stimulation, in which stimulus number and frequency were varied. Although relationships between neural activity and stimulus features ranged from linear to nonlinear, associations between hyperemic components and neural activity were linear. Specific to each hyperemic component, a universal transfer function (with LFP or MUA) yielded predictions in agreement with experimental measurements. The results identified a component of the BOLD signal that can be attributed to significant changes in CMR(O(2)), even for temporal events separated by <200 ms.

Tactile and non-tactile sensory paradigms for fMRI and neurophysiologic studies in rodents

Functional magnetic resonance imaging (fMRI) has become a popular functional imaging tool for human studies. Future diagnostic use of fMRI depends, however, on a suitable neurophysiologic interpretation of the blood oxygenation level dependent (BOLD) signal change. This particular goal is best achieved in animal models primarily due to the invasive nature of other methods used and/or pharmacological agents applied to probe different nuances of neuronal (and glial) activity coupled to the BOLD signal change. In the last decade, we have directed our efforts towards the development of stimulation protocols for a variety of modalities in rodents with fMRI. Cortical perception of the natural world relies on the formation of multi-dimensional representation of stimuli impinging on the different sensory systems, leading to the hypothesis that a sensory stimulus may have very different neurophysiologic outcome(s) when paired with a near simultaneous event in another modality. Before approaching this level of complexity, reliable measures must be obtained of the relatively small changes in the BOLD signal and other neurophysiologic markers (electrical activity, blood flow) induced by different peripheral stimuli. Here we describe different tactile (i.e., forepaw, whisker) and non-tactile (i.e., olfactory, visual) sensory paradigms applied to the anesthetized rat. The main focus is on development and validation of methods for reproducible stimulation of each sensory modality applied independently or in conjunction with one another, both inside and outside the magnet. We discuss similarities and/or differences across the sensory systems as well as advantages they may have for studying essential neuroscientific questions. We envisage that the different sensory paradigms described here may be applied directly to studies of multi-sensory interactions in anesthetized rats, en route to a rudimentary understanding of the awake functioning brain where various sensory cues presumably interrelate.

The effect of intravenous lidocaine on brain activation during non-noxious and acute noxious stimulation of the forepaw: a functional magnetic resonance imaging study in the rat

BACKGROUND

Lidocaine can alleviate acute as well as chronic neuropathic pain at very low plasma concentrations in humans and laboratory animals. The mechanism(s) underlying lidocaine's analgesic effect when administered systemically is poorly understood but clearly not related to interruption of peripheral nerve conduction. Other targets for lidocaine's analgesic action(s) have been suggested, including sodium channels and other receptor sites in the central rather than peripheral nervous system. To our knowledge, the effect of lidocaine on the brain's functional response to pain has never been investigated. Here, we therefore characterized the effect of systemic lidocaine on the brain's response to innocuous and acute noxious stimulation in the rat using functional magnetic resonance imaging (fMRI).

METHODS

Alpha-chloralose anesthetized rats underwent fMRI to quantify brain activation patterns in response to innocuous and noxious forepaw stimulation before and after IV administration of lidocaine.

RESULTS

Innocuous forepaw stimulation elicited brain activation only in the contralateral primary somatosensory (S1) cortex. Acute noxious forepaw stimulation induced activation in additional brain areas associated with pain perception, including the secondary somatosensory cortex (S2), thalamus, insula and limbic regions. Lidocaine administered at IV doses of either 1 mg/kg, 4 mg/kg or 10 mg/kg did not abolish or diminish brain activation in response to innocuous or noxious stimulation. In fact, IV doses of 4 mg/kg and 10 mg/kg lidocaine enhanced S1 and S2 responses to acute nociceptive stimulation, increasing the activated cortical volume by 50%-60%.

CONCLUSION

The analgesic action of systemic lidocaine in acute pain is not reflected in a straightforward interruption of pain-induced fMRI brain activation as has been observed with opioids. The enhancement of cortical fMRI responses to acute pain by lidocaine observed here has also been reported for cocaine. We recently showed that both lidocaine and cocaine increased intracellular calcium concentrations in cortex, suggesting that this pharmacological effect could account for the enhanced sensitivity to somatosensory stimulation. As our model only measured physiological acute pain, it will be important to also test the response of these same pathways to lidocaine in a model of neuropathic pain to further investigate lidocaine's analgesic mechanism of action.

Frequency-dependent activation pattern in the rat hippocampus, a simultaneous electrophysiological and fMRI study

Frequency-dependent hippocampal activation during electrical perforant pathway stimulation was analyzed simultaneously by electrophysiological recordings in dentate gyrus and functional magnetic resonance imaging (fMRI). Pulse trains at low-frequency stimulation (2.5 Hz) did not influence electrophysiological responses within stimulation trains in the dentate gyrus and triggered no detectable BOLD responses. Increased stimulation frequencies (5.0-20 Hz) generated a roughly linear enhancement of the BOLD response. The BOLD signal within the dentate gyrus correlated more closely with stimulus pattern than with generated action potentials of the granular cells. However, the BOLD signal was strongly influenced by additional local signal processing activated by repetitive stimulus trains. fMRI visualized a frequency-specific spatial activation pattern of the hippocampus; spatially restricted activation in the dentate gyrus during 5-Hz stimulation, activation of the entire hippocampus and subiculum at 10 Hz and activation of the contralateral hippocampus during 20-Hz stimulation.

A BOLD search for baseline

While we occasionally observe negative BOLD signals, its physiological basis has remained uncertain. This is in part due to the qualitative use of fMRI where the baseline is conveniently differenced away to reveal focal area(s) of interest. Recently, however, there has been a noticeable trend towards quantitative neuroimaging where changes in oxidative energetics (CMR(O2)) are quantified by calibrated fMRI. Pasley et al. [Pasley, B.N., Inglis, B.A., Freeman, R.D., 2007. Analysis of oxygen metabolism implies a neural origin for the negative BOLD response in human visual cortex. NeuroImage] used calibrated fMRI in conjunction with a novel stimulus paradigm to investigate the neural basis of the negative BOLD signal in awake humans. They hypothesized - based on prior results - that if the baseline was lowered then DeltaCMR(O2) would have to be larger. While their main findings point to an energetic basis for the negative BOLD signal, their results have far reaching implications for the present definition of baseline as well as for future research investigating the neural and/or energetic basis of baseline.

Blood-oxygen-level-dependent magnetic resonance signal and cerebral oxygenation responses to brain activation are enhanced by concurrent transient hypertension in rats

Neuronal activation results in increases in blood-oxygen-level-dependent (BOLD) signal increases in magnetic resonance images, increases in cerebral blood flow (CBF), and changes in tissue oxygenation. We hypothesized that transient hypertension concurrent with neuronal activation would interfere with the normal physiological responses to neuronal activation potentially leading to additive responses. Anesthetized rats were prepared for functional magnetic resonance imaging studies in which increases in BOLD signal were measured in response to: (1) electrical forepaw stimulation, (2) different graded levels of transient hypertension produced with norepinephrine, and both 1 and 2. In other experiments with a similar protocol, changes in CBF and cortical oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) were measured using Laser Doppler Flowmetry and near-infrared (IR) spectroscopy. BOLD signal within the sensory-motor cortex increased during forepaw stimulation. These matched increases in CBF and oxyHb and decreases in deoxyHb. During moderate or severe transient hypertension, there was a blood pressure-dependent increase in BOLD signal, CBF, and oxyHb; and a decrease in deoxyHb. When transient hypertension and forepaw stimulation were combined, the responses of oxyHb, deoxyHb, or BOLD signal were generally a summation of each response. In contrast, the CBF response to forepaw stimulation was relatively unaffected by transient hypertension. We conclude that during stimulation with concurrent hypertension, the normal changes in tissue oxygenation that accompany neuronal activation are enhanced by the increases produced by hypertension despite an excellent autoregulation of CBF. The latter could reflect highly transient decreases in oxygen consumption or likely a redistribution of flow through more nonexchange vessels.

Dynamics of changes in blood flow, volume, and oxygenation: implications for dynamic functional magnetic resonance imaging calibration

Changes in cerebral blood flow (CBF), volume (CBV), and oxygenation (blood-oxygenation level dependent (BOLD)) during functional activation are important for calculating changes in cerebral metabolic rate of oxygen consumption (CMRo2) from calibrated functional MRI (fMRI). An important part of this process is the CBF/CBV relationship, which is signified by a power-law parameter: gamma=ln (1+DeltaCBV/CBV)/ln (1+DeltaCBF/CBF). Because of difficulty in measuring CBF and CBV with MRI, the value of gamma is therefore assumed to be approximately 0.4 from a prior primate study under hypercapnia. For dynamic fMRI calibration, it is important to know if the value of gamma varies after stimulation onset. We measured transient relationships between DeltaCBF, DeltaCBV, and DeltaBOLD by multimodal MRI with temporal resolution of 500 ms (at 7.0 T) from the rat somatosensory cortex during forepaw stimulation, where the stimulus duration ranged from 4 to 32 secs. Changes in CBF and BOLD were measured before the administration of the contrast agent for CBV measurements in the same subjects. We observed that the relationship between DeltaCBF and DeltaCBV varied dynamically from stimulation onset for all stimulus durations. Typically after stimulation onset and at the peak or plateau of the DeltaCBF, the value of gamma ranged between 0.1 and 0.2. However, after stimulation offset, the value of gamma increased to 0.4 primarily because of rapid and slow decays in DeltaCBF and DeltaCBV, respectively. These results suggest caution in using dynamic measurements of DeltaCBF and DeltaBOLD required for calculating DeltaCMRo2 for functional stimulation, when either DeltaCBV has not been accurately measured or a fixed value of gamma during hypercapnia perturbation is used.

Emotional memory in depersonalization disorder: a functional MRI study

This study examines emotional memory effects in primary depersonalization disorder (DPD). A core complaint of DPD sufferers is the dulling of emotional responses, and previous work has shown that, in response to aversive stimuli, DPD patients do not show activation of brain regions involved in normal emotional processing. We hypothesized that DPD sufferers would not show the normal emotional enhancement of memory, and that they would not show activation of brain regions concerned with emotional processing during encoding and recognition of emotional verbal material. Using fMRI, 10 DPD patients were compared with an age-matched healthy control group while performing a test of emotional verbal memory, comprising one encoding and two recognition memory tasks. DPD patients showed significantly enhanced recognition for overtly emotive words, but did not show enhancement of memory for neutral words encoded in an emotive context. In addition, patients did not show activation of emotional processing areas during encoding, and exhibited no substantial difference in their neural responses to emotional and neutral material in the encoding and emotional word recognition tasks. This study provides further evidence that patients with DPD do not process emotionally salient material in the same way as healthy controls, in accordance with their subjective descriptions of reduced or absent emotional responses.

Differential effects of NMDA and AMPA glutamate receptors on functional magnetic resonance imaging signals and evoked neuronal activity during forepaw stimulation of the rat

Most of the currently used methods for functional brain imaging do not visualize neuronal activity directly but rather rely on the elicited hemodynamic and/or metabolic responses. Glutamate, the major excitatory neurotransmitter, plays an important role in the neurovascular/neurometabolic coupling, but the specific mechanisms are still poorly understood. To investigate the role of the two major ionotropic glutamate receptors [NMDA receptors (NMDA-Rs) and AMPA receptors (AMPA-Rs)] for the generation of functional magnetic resonance imaging (fMRI) signals, we used fMRI [measurements of blood oxygenation level-dependent (BOLD), perfusion-weighted imaging (PWI), and cerebral blood volume (CBV)] together with recordings of somatosensory evoked potentials (SEPs) during electrical forepaw stimulation in the alpha-chloralose anesthetized rat. Intravenous injection of the NMDA-R antagonist MK-801 [(+)-5-methyl-10,11-dihydro-5H-dibenzo [a,d] cyclohepten-5,10-imine maleate] (0.06 mg/kg plus 3.6 microg x kg(-1) x h(-1)) significantly decreased BOLD (-51 +/- 19%; n = 5) and PWI (-57 +/- 26%; n = 5) responses but reduced the SEPs only mildly (approximately -10%). Systemic application of the AMPA-R antagonist GYKI-53655 [1-(4-aminophenyl)-3-methylcarbamyl-4-methyl-7,8-methylenedioxy-3,4-dihydro-5H-2,3-benzodiazepine] significantly decreased both the hemodynamic response (BOLD, -49 +/- 13 and -65 +/- 15%; PWI, -22 +/- 48 and -68 +/- 4% for 5 and 7 mg/kg, i.v., respectively; CBV, -80 +/- 7% for 7 mg/kg; n = 4) and the SEPs (up to -60%). These data indicate that the interaction of glutamate with its postsynaptic and/or glial receptors is necessary for the generation of blood flow and BOLD responses and illustrate the differential role of NMDA-Rs and AMPA-Rs in the signaling chain leading from increased neuronal activity to the hemodynamic response in the somatosensory cortex.