Spatio-temporal patterns of brain magnetic activity during a memory task in Alzheimer's disease

Compensatory Mechanisms in Early Alzheimer's Disease and Clinical Setting: The Need for Novel Neuropsychological Strategies

Despite advances in the detection of biomarkers and in the design of drugs that can slow the progression of Alzheimer's disease (AD), the underlying primary mechanisms have not been elucidated. The diagnosis of AD has notably improved with the development of neuroimaging techniques and cerebrospinal fluid biomarkers which have provided new information not available in the past. Although the diagnosis has advanced, there is a consensus among experts that, when making the diagnosis in a specific patient, many years have probably passed since the onset of the underlying processes, and it is very likely that the biomarkers in use and their cutoffs do not reflect the true critical points for establishing the precise stage of the ongoing disease. In this context, frequent disparities between current biomarkers and cognitive and functional performance in clinical practice constitute a major drawback in translational neurology. To our knowledge, the In-Out-test is the only neuropsychological test developed with the idea that compensatory brain mechanisms exist in the early stages of AD, and whose positive effects on conventional tests performance can be reduced in assessing episodic memory in the context of a dual-task, through which the executive auxiliary networks are 'distracted', thus uncover the real memory deficit. Furthermore, as additional traits, age and formal education have no impact on the performance of the In-Out-test.

In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer's Disease

BACKGROUND

Assessment of hippocampal amnesia is helpful to distinguish between normal cognition and mild cognitive impairment (MCI), but not for identifying converters to dementia. Here biomarkers are useful but novel neuropsychological approaches are needed in their absence. The In-out-test assesses episodic memory using a new paradigm hypothesized to avoid reliance on executive function, which may compensate for damaged memory networks.

OBJECTIVE

To assess the validity of the In-out-test in identifying prodromal Alzheimer's disease (PAD) in a clinical setting, by comparing this to the Free and Cued Selective Reminding Test (FCSRT) and cerebrospinal fluid biomarkers.

METHODS

A cross-sectional study of 32 cognitively healthy, 32 MCI, and 30 progressive dementia subjects. All participants were given both the In-out-test and the FCSRT; 40 of them also received a lumbar puncture.

RESULTS

Internal consistency was demonstrated using Cronbach Alpha (r = 0.81) and Inter-rater reliability with Kappa (k = 0.94). Intraclass correlation (ICC) for test-retest reliability: r = 0.57 (p = 0.57). ICC between the In-out-test and FCSRT r = 0.87 (p = 0.001). ICC between the In-out-test and Aβ42 and P-tau/Aβ42 for controls: 0.73 and 0.75, respectively; P-tau for MCI: 0.77 and total sample: 0.70; Aβ42 for dementia: 0.71. All ICC measures between FCSRT and biomarkers were ≤0.264. AD diagnosis: In-out-test k = 0.71; FCSRT k = 0.49. PAD diagnosis (N = 35): In-out-test k = 0.69; FCSRT k = 0.44.

CONCLUSIONS

The In-out-test detected prodromal AD with a higher degree of accuracy than a conventional hippocampal-based memory test. These results suggest that this new paradigm could be of value in clinical settings, predicting which patients with MCI will go on to develop AD.

From phenotype to genotype in complex brain networks

Generative models are a popular instrument for illuminating the relationships between the hidden variables driving the growth of a complex network and its final topological characteristics, a process known as the "genotype to phenotype problem". However, the definition of a complete methodology encompassing all stages of the analysis, and in particular the validation of the final model, is still an open problem. We here discuss a framework that allows to quantitatively optimise and validate each step of the model creation process. It is based on the execution of a classification task, and on estimating the additional precision provided by the modelled genotype. This encompasses the three main steps of the model creation, namely the selection of topological features, the optimisation of the parameters of the generative model, and the validation of the obtained results. We provide a minimum requirement for a generative model to be useful, prescribing the function mapping genotype to phenotype to be non-monotonic; and we further show how a previously published model does not fulfil such condition, casting doubts on its fitness for the study of neurological disorders. The generality of such framework guarantees its applicability beyond neuroscience, like the emergence of social or technological networks.

Early dysfunction of functional connectivity in healthy elderly with subjective memory complaints

It is still an open question whether subjective memory complaints (SMC) can actually be considered to be clinically relevant predictors for the development of an objective memory impairment and even dementia. There is growing evidence that suggests that SMC are associated with an increased risk of dementia and with the presence of biological correlates of early Alzheimer's disease. In this paper, in order to shed some light on this issue, we try to discern whether subjects with SMC showed a different profile of functional connectivity compared with subjects with mild cognitive impairment (MCI) and healthy elderly subjects. In the present study, we compare the degree of synchronization of brain signals recorded with magnetoencephalography between three groups of subjects (56 in total): 19 with MCI, 12 with SMC and 25 healthy controls during a memory task. Synchronization likelihood, an index based on the theory of nonlinear dynamical systems, was used to measure functional connectivity. Briefly, results show that subjects with SMC have a very similar pattern of connectivity to control group, but on average, they present a lower synchronization value. These results could indicate that SMC are representing an initial stage with a hypo-synchronization (in comparison with the control group) where the brain system is still not compensating for the failing memory networks, but behaving as controls when compared with the MCI subjects.

Brain activity patterns in stable and progressive mild cognitive impairment during working memory as evidenced by magnetoencephalography

It has been reported that mild cognitive impairment (MCI) patients, when compared with controls, show increased activity in different brain regions within the ventral pathway during memory tasks. A key question is whether this profile of increased activity could be useful to predict which patients will develop dementia. Herein, we present profiles of brain magnetic activity during a memory task recorded with magnetoencephalography from MCI patients (N = 10), Alzheimer's disease (AD) patients (N = 10), and healthy volunteers (N = 17). After 2½ years of follow-up, five of the MCI patients developed AD. Patients who progressed to AD (PMCI) showed higher activity than those who remained stable (SMCI), AD patients and controls. This increased activity in PMCI patients involves regions within the ventral and dorsal pathways. In contrast, SMCI patients showed higher activation than controls only along the ventral pathway. This increase in both the ventral and dorsal pathways in PMCI patients may reflect a compensatory mechanism for the loss in efficiency in memory networks, which would be absent in AD patients as they showed lower activity levels than the rest of the groups.

Reorganization of functional networks in mild cognitive impairment

Whether the balance between integration and segregation of information in the brain is damaged in Mild Cognitive Impairment (MCI) subjects is still a matter of debate. Here we characterize the functional network architecture of MCI subjects by means of complex networks analysis. Magnetoencephalograms (MEG) time series obtained during a memory task were evaluated by synchronization likelihood (SL), to quantify the statistical dependence between MEG signals and to obtain the functional networks. Graphs from MCI subjects show an enhancement of the strength of connections, together with an increase in the outreach parameter, suggesting that memory processing in MCI subjects is associated with higher energy expenditure and a tendency toward random structure, which breaks the balance between integration and segregation. All features are reproduced by an evolutionary network model that simulates the degenerative process of a healthy functional network to that associated with MCI. Due to the high rate of conversion from MCI to Alzheimer Disease (AD), these results show that the analysis of functional networks could be an appropriate tool for the early detection of both MCI and AD.

Increased biomagnetic activity in healthy elderly with subjective memory complaints

OBJECTIVE

Subjective memory complaints (SMCs) are frequently reported by elderly people with or without objective cognitive impairment (OMI) as assessed by neuropsychological tests. We investigate whether SMCs are associated with altered brain biomagnetic patterns even in the absence of OMI.

METHODS

We report spatio-temporal patterns of brain magnetic activity recorded with magnetoencephalography during a memory task in 51 elderly participants divided into the following groups: patients with mild cognitive impairment (MCI) with SMC and OMI, individuals with SMC but not OMI, and healthy controls without neither SMC nor OMI. Exclusion criteria for all three groups included a diagnosis of depression or any other psychiatric condition.

RESULTS

No statistically significant differences were found between MCI patients and participants with SMC. However, the SMC showed higher activation, between 200 and 900 ms after stimulus onset, than the control group in posterior ventral regions and in the dorsal pathway. MCI patients showed higher activation than the control group in the posterior part of the ventral pathway.

CONCLUSIONS

These findings suggest that similar physiological mechanisms may underlie SMC and MCI, which could be two stages in a cognitive continuum.

SIGNIFICANCE

MEG provide different neurophysiological profiles between SMC and control subjects.

Use of magnetoencephalography (MEG) to study functional brain networks in neurodegenerative disorders

The pathophysiological mechanisms underlying clinical symptoms in neurodegenerative disorders such as Parkinson's disease (PD) and Alzheimer's disease (AD) are incompletely understood. Magnetoencephalography (MEG) is a relatively new functional neuroimaging technique, which allows the simultaneous recording of the brain's magnetic activity from large arrays of sensors covering the whole head. MEG studies in PD and AD have identified characteristic patterns of abnormal oscillatory activity in different frequency bands. Furthermore, MEG studies aimed at the characterization of distributed functional networks have demonstrated distinct patterns of abnormal connectivity in demented and non-demented PD, as well as in AD. In PD abnormal oscillatory activity and disturbed connectivity may respond differently to dopaminergic treatment. Further studies in this field could benefit from new technological developments such as ultra low field MRI and from the application of a well-defined theoretical framework such as graph theory to the study of disturbed brain networks.

Event-related synchronization of alpha activity in early Alzheimer's disease and mild cognitive impairment: an MEG study combining beamformer and group comparison

In patients with Alzheimer's disease (AD), it is sometimes challenging to identify typical findings in electroencephalography (EEG) or magnetoencephalography (MEG) such as a slowing of the posterior dominant activity or an increase in slow activity. In this MEG study, we evaluated the event-related synchronization (ERS) of alpha activity after eye closing in patients with early AD and mild cognitive impairment (MCI) who presented no slow MEG pattern. Thirteen patients with probable AD and thirteen patients with MCI, who met NINCDS-ADRDA and Petersen's diagnostic criteria, respectively, were enrolled. We also selected fourteen age-matched normal control subjects. MEG activity was acquired during eye-open and eye-closed states. The ERS after eye closing within 8-15Hz frequency band was calculated and its cortical source was superimposed on the individual's MRI by using the beamformer implemented in Brain Electrical Source Analysis (BESA). The Source image was converted into a standardized image, and group comparisons across patients with AD, MCI and controls were performed using BrainVoyager QX. The averaged ERS was observed dominantly in posterior regions in all three groups. Significant difference in ERS was observed only for the comparison between AD patients and controls, with AD patients showing increased ERS in frontal regions. Frontal shift of posterior alpha activity was observed clearly in AD patients using the combination of beamformer and group comparison.

The use of neuroimaging to study behavior in patients with epilepsy

Structural and functional neuroimaging continues to play an increasing role in the presurgical evaluation of patients with epilepsy. In addition to its value in localizing the epileptogenic zone and eloquent cortex, neuroimaging is contributing to our understanding of mood comorbidity in epilepsy. Although the vast majority of research has focused on patients with temporal lobe epilepsy (TLE), neuroimaging studies of patients with extratemporal epilepsy and primary generalized epilepsy are increasing in number. In this review, structural and functional imaging modalities that have received considerable research attention in recent years are reviewed, and their strengths and limitations for understanding behavior in epilepsy are assessed. In addition, advances in multimodal imaging are discussed along with their potential application to the presurgical evaluation of patients with seizure disorders.

Exercise, APOE, and working memory: MEG and behavioral evidence for benefit of exercise in epsilon4 carriers

Performance on the Sternberg working memory task, and MEG cortical response on a variation of the Sternberg task were examined in middle-aged carriers and non-carriers of the APOE epsilon4 allele. Physical activity was also assessed to examine whether exercise level modifies the relationship between APOE genotype and neurocognitive function. Regression revealed that high physical activity was associated with faster RT in the six- and eight-letter conditions of the Sternberg in epsilon4 carriers, but not in the non-carriers after controlling for age, gender, and education (N=54). Furthermore, the MEG analysis revealed that sedentary epsilon4 carriers exhibited lower right temporal lobe activation on matching probe trials relative to high-active epsilon4 carriers, while physical activity did not distinguish non-carriers (N=23). The M170 peak was identified as a potential marker for pre-clinical decline as epsilon4 carriers exhibited longer M170 latency, and highly physically active participants exhibited greater M170 amplitude to matching probe trials.

Magnetoencephalographic evaluation of resting-state functional connectivity in Alzheimer's disease

Statistical interdependencies between magnetoencephalographic signals recorded over different brain regions may reflect the functional connectivity of the resting-state networks. We investigated topographic characteristics of disturbed resting-state networks in Alzheimer's disease patients in different frequency bands. Whole-head 151-channel MEG was recorded in 18 Alzheimer patients (mean age 72.1 years, SD 5.6; 11 males) and 18 healthy controls (mean age 69.1 years, SD 6.8; 7 males) during a no-task eyes-closed resting state. Pair-wise interdependencies of MEG signals were computed in six frequency bands (delta, theta, alpha1, alpha2, beta and gamma) with the synchronization likelihood (a nonlinear measure) and coherence and grouped into long distance (intra- and interhemispheric) and short distance interactions. In the alpha1 and beta band, Alzheimer patients showed a loss of long distance intrahemispheric interactions, with a focus on left fronto-temporal/parietal connections. Functional connectivity was increased in Alzheimer patients locally in the theta band (centro-parietal regions) and the beta and gamma band (occipito-parietal regions). In the Alzheimer group, positive correlations were found between alpha1, alpha2 and beta band synchronization likelihood and MMSE score. Resting-state functional connectivity in Alzheimer's disease is characterized by specific changes of long and short distance interactions in the theta, alpha1, beta and gamma bands. These changes may reflect loss of anatomical connections and/or reduced central cholinergic activity and could underlie part of the cognitive impairment.

Functional neuroimaging studies of cognitive recovery after acquired brain damage in adults

The first two decades of cognitive neuroimaging research have provided a constant increase of the knowledge about the neural organization of cognitive processes. Many cognitive functions (e.g.working memory) can now be associated with particular neural structures, and ongoing research promises to clarify this picture further, providing a new mapping between cognitive and neural function. The main goal of this paper is to outline conceptual issues that are particularly important in the context of imaging changes in neural function through recovery process. This review focuses primarily on studies made in stroke and traumatic brain injury patients, but most of the issues raised here are also relevant to studies using other acquired brain damages. Finally, we summarize a set of methodological issues related to functional neuroimaging that are relevant for the study of neural plasticity and recovery after rehabilitation.

Medial temporal lobe neuromagnetic hypoactivation and risk for developing cognitive decline in elderly population: A 2-year follow-up study

Cognition declines as a function of age. However, some elders could develop more severe status such as mild cognitive impairment (MCI). The aim of this study was the early detection of neurophysiological patterns of brain activity that may predict the possibility of certain subjects to develop MCI. Brain magnetic activity was recorded from 15 healthy subjects during a memory task by means of magnetoencephalography. None of the participants could be considered as MCI at the time of the first clinical evaluation. After 2-year follow-up, five subjects developed MCI and 10 maintained their cognitive status across time. The subjects who developed cognitive decline showed a lower number of activity sources in the left medial temporal lobe between 400 and 800 ms after stimulus onset, as compared to the non-cognitive decline group. These findings may help with the early identification of elderly subjects at high risk of cognitive decline, allowing the possibility of neuropsychological or pharmaceutical treatment that delay or prevent the progression of the cognitive impairment.

Evidence of biochemical and biomagnetic interactions in Alzheimer's disease: an MEG and MR spectroscopy study

BACKGROUND

Several neuroimaging studies have shown reliable differences between Alzheimer's disease (AD) patients and age-matched controls. However, few studies have demonstrated the interactions between neuroimaging methods for the diagnoses of AD.

OBJECTIVE

In this study, we try to elucidate the complementary nature of magnetoencephalography (MEG) and magnetic resonance spectroscopy (MRS) examinations in the assessmentof AD.

METHODS

Ten patients fulfilling the NINCDS-ADRDA criteria of probable AD, and 10 elderly individuals with no history of neurological or psychiatric illness serving as age-matched controls participated in the study. All patients and controls received an MRS, MEG and neuropsychological assessment. MEG data were obtained in the context of a working memory task, previously utilized in a similar sample of patients.

RESULTS

The AD group showed a reduced number of activity sources over left temporoparietal areas during the late portion of the evoked magnetic field (between 400-800 ms), as well as a bilateral temporoparietal increase in creatine and myoinositol concentrations, and in the myoinositol/N-acetyl-aspartate ratio. The combination of the variables 'number of dipoles during the late portion of the evoked magnetic field' and 'myoinositol/N-acetyl-aspartate ratio' accounted for 65% of the variance of the Mini Mental State Examination scores.

CONCLUSIONS

These results highlight the importance of assessing the complex brain pathology underlying AD by utilizing multiple brain examination modalities in a coordinate approach.

Dynamic brain activation patterns for face recognition: a magnetoencephalography study

The present study used magnetoencephalography (MEG) to investigate the spatiotemporal profile of neurophysiological activity associated with recognition of recently encountered human faces in seventeen healthy right-handed adults. Activity sources modeled as instantaneous equivalent current dipoles were found in ventral occipito-temporal regions during the early stages of stimulus processing and in lateral temporal cortices during later stages. Hemispheric asymmetries in regional activity were restricted to ventral occipitotemporal areas. The magnitude of magnetic flux originating in these regions was greater in the right hemisphere during the first 350 ms post-stimulus onset. In addition, the duration of neurophysiological activity was greater in the right hemisphere after 600 ms post-stimulus onset. The results indicate right hemisphere predominance in the degree of engagement of neurophysiological processes involved in both the pre- and post-recognition phases of face processing.

Is medial temporal lobe activation specific for encoding long-term memories?

Several neuroimaging studies have consistently demonstrated the critical involvement of prefrontal cortices and medial temporal lobes during long-term encoding. While the contribution of prefrontal lobes to working memory is well established, the role of the MTL structures remains controversial. To address this issue, we registered the neuromagnetic brain patterns of eight adult volunteers while they performed two working memory tasks (verbal and spatial) using magnetoencephalography (MEG). MEG recordings can provide real-time measures of brain activity, thus allowing detailed tracking of the time-course of brain activation during the encoding phase. We detected sustained and material-specific activity on the MTLs during the encoding phase of a working memory task, based on verbal and spatial information. Two peaks of activation were noted in the left MTL during word encoding in two non-consecutive time periods (500-600 ms and 700-800 ms after stimulus onset). Right MTL laterality was found for encoding locations when we collapsed activity sources in a wider time period (400-800 ms). In addition, we provided the spatiotemporal profiles of what seems to be two different brain circuits specific for each type of material. Finally, following an emerging conceptualization of working memory, we hypothesized that encoding processes mediated by the MTL to long-term memory would also apply to working memory.

Time-modulated enhancing of the fronto-parietal circuits in the very-old elders

Several studies have shown that memory circuits can be reorganised as a function of age. Brain magnetic activity evoked by a memory task was recorded in 19 healthy elderly subjects divided into two groups, a young-elder group (mean age of 62) and senior-elder group (mean age of 76). The young-elder group showed greater activity over the left medial temporal lobe in the late latency windows (between 400 and 800 ms) than the senior-elder group. The senior-elder group showed an initial increased activity (between 150 and 400 ms) over the complex of motor areas, followed by an increased activity in the left temporo-parietal cortex at the late latency window. These results revealed a reorganization of brain networks supporting memory in the eldest subjects. Furthermore, these circuits are reorganised in a time-dependent manner, meaning the rehearsal articulatory process active in the early time window followed by a phonological storage and recognition process in the late latency window.

Spatiotemporal brain dynamics during preparatory set shifting: MEG evidence

Humans can flexibly alter a plan of action to adjust their behavior adaptively in changing environments. Functional neuroimaging has shown distinct patterns of activation across a frontoparietal network responsible for switching and updating such plans of action or 'task sets.' However, little is known about the temporal order of activations within prefrontal or across with posterior regions subserving set-shifting operations. Here, whole-head magnetoencephalography (MEG) was used to explore the spatiotemporal brain dynamics in a modified version of the Wisconsin card-sorting test (WCST). Our task was designed to examine preparation of set-shifting rather than set-acquisition operations time locked to context-informative cues. Three cortical regions showed a larger number of MEG activity sources in response to shift and relative to nonshift cues: (a) inferior frontal gyrus (IFG; BA 45, 47/12), (b) anterior cingulate cortex (ACC; BA 24, 32), and (c) supramarginal gyrus (SMG; BA 40). Importantly, the timing of MEG activation differed across these regions. The earliest shift-related MEG activations were detected at the IFG (100-300 ms postcue onset), followed by two further peaks at the ACC (200-300 and 400-500 ms) and the SMG (300-400 and 500-600 ms). Several other prefrontal and posterior cortical areas were similarly activated by both shift and nonshift preparatory cues. The resulting temporal pattern of interactions within prefrontal and across with posterior association cortices is coherent with current models of task switching and provides novel information about the temporal course of brain activations responsible for the executive control of attention.

Activation of the prefrontal cortex in the human visual aesthetic perception

Visual aesthetic perception ("aesthetics") or the capacity to visually perceive a particular attribute added to other features of objects, such as form, color, and movement, was fixed during human evolutionary lineage as a trait not shared with any great ape. Although prefrontal brain expansion is mentioned as responsible for the appearance of such human trait, no current knowledge exists on the role of prefrontal areas in the aesthetic perception. The visual brain consists of "several parallel multistage processing systems, each specialized in a given task such as, color or motion" [Bartels, A. & Zeki, S. (1999) Proc. R. Soc. London Ser. B 265, 2327-2332]. Here we report the results of an experiment carried out with magnetoencephalography which shows that the prefrontal area is selectively activated in humans during the perception of objects qualified as "beautiful" by the participants. Therefore, aesthetics can be hypothetically considered as an attribute perceived by means of a particular brain processing system, in which the prefrontal cortex seems to play a key role.

Modulation of brain magnetic activity by different verbal learning strategies

In this study we examined spatiotemporal profiles of brain activity in the context of tasks designed to engage different verbal learning strategies (serial order, phonological, and semantic). The profile of activation associated with the serial-order strategy, which resulted in poor recall performance, featured early activation of the inferior frontal, sensorimotor, and insular region in the left hemisphere, between 200 and 400 ms after stimulus onset. Subsequently, activation was more prominent in dorsolateral prefrontal cortices bilaterally. In contrast, activation profiles associated with the phonological strategy featured predominantly activation of the superior temporal gyrus in the left hemisphere between 500 and 600 ms. Predominant activation of the left middle temporal gyrus, between 500 and 700 ms, was the key feature of the activation profile observed when the semantic elaboration strategy was utilized. These results suggest that different brain circuits are engaged to support learning of new verbal information as a function of the level and type of initial processing applied to the stimuli.

Do cognitive patterns of brain magnetic activity correlate with hippocampal atrophy in Alzheimer's disease?

BACKGROUND

Many reports support the clinical validity of volumetric MRI measurements in Alzheimer's disease.

OBJECTIVE

To integrate functional brain imaging data derived from magnetoencephalography (MEG) and volumetric data in patients with Alzheimer's disease and in age matched controls.

METHODS

MEG data were obtained in the context of a probe-letter memory task. Volumetric measurements were obtained for lateral and mesial temporal lobe regions.

RESULTS

As expected, Alzheimer's disease patients showed greater hippocampal atrophy than controls bilaterally. MEG derived indices of the degree of activation in left parietal and temporal lobe areas, occurring after 400 ms from stimulus onset, correlated significantly with the relative volume of lateral and mesial temporal regions. In addition, the size of the right hippocampus accounted for a significant portion of the variance in cognitive scores independently of brain activity measures.

CONCLUSIONS

These data support the view that there is a relation between hippocampal atrophy and the degree of neurophysiological activity in the left temporal lobe.

Advanced brain imaging procedures and human memory disorder

The impact of advanced brain imaging procedures in the field of human memory disorder is reviewed, with particular emphasis on current and potential applications that may impact upon the diagnosis and management of memory-disordered patients. While both advanced structural, resting physiological and functional physiological brain imaging procedures have been applied to conditions where memory disorder is a major feature, the specific implications of research findings for diagnosis and treatment in routine clinical practice remain tentative and promising, but not yet substantive enough to inform clinical decisions to a significant degree. In terms of diagnostic applications, several promising areas include dementia, epilepsy, and transient amnesic states. In the case of applications in treatment settings, advanced brain imaging procedures may help to monitor neural correlates of spontaneous recovery or progression of memory function, and may also help in the planning and monitoring of therapeutic intervention.

Spanish language mapping using MEG: a validation study

The purpose of the present study was to compare magnetoencephalography (MEG) data with the results of the intracarotid amytal procedure (IAP). Twenty-one native Spanish-speaking patients with intractable epilepsy underwent MEG language mapping. A subset of 8 patients also underwent an IAP. With the exception of 2 patients who showed right hemisphere dominance, all other patients showed left hemisphere dominance for language on the MEG recording. The IAP findings were consistent with MEG results in 7 patients. The eighth patient who, according to the MEG data, had probable right hemisphere dominance for language did not show clear hemispheric specialization for language on the IAP and suffered a transient global aphasia following a right temporal lobotomy. These results suggests that MEG-based language mapping can play an important role in presurgical clinical evaluation.

The hippocampus and memory of verbal and pictorial material

Recognition of words and kaleidoscope pictures showed a double dissociation of left and right hippocampal activity using magnetic source imaging (MSI). MSI has advantages over alternative imaging techniques that measure hemodynamic changes for identifying regional changes in brain activity in real time and on an individual subject basis without the need for image subtraction. In this study, lists of words or kaleidoscope pictures were presented for memorization followed by tests of list items and foils during which brain activity was recorded. There was greater activation in the left than the right hippocampus with abstract nouns (e.g., relief) and greater activation in the right than the left hippocampus with kaleidoscope pictures. This dissociation was evident on a case by case basis. This study demonstrates the specialization of the two medial temporal lobe (MTL) regions, including the hippocampi, for mnemonic processing of verbal and pictorial items that are difficult to encode verbally.