A cortical representation of the local visual environment

Medial temporal brain regions such as the hippocampal formation and parahippocampal cortex have been generally implicated in navigation and visual memory. However, the specific function of each of these regions is not yet clear. Here we present evidence that a particular area within human parahippocampal cortex is involved in a critical component of navigation: perceiving the local visual environment. This region, which we name the 'parahippocampal place area' (PPA), responds selectively and automatically in functional magnetic resonance imaging (fMRI) to passively viewed scenes, but only weakly to single objects and not at all to faces. The critical factor for this activation appears to be the presence in the stimulus of information about the layout of local space. The response in the PPA to scenes with spatial layout but no discrete objects (empty rooms) is as strong as the response to complex meaningful scenes containing multiple objects (the same rooms furnished) and over twice as strong as the response to arrays of multiple objects without three-dimensional spatial context (the furniture from these rooms on a blank background). This response is reduced if the surfaces in the scene are rearranged so that they no longer define a coherent space. We propose that the PPA represents places by encoding the geometry of the local environment.

Parahippocampal and retrosplenial contributions to human spatial navigation

Spatial navigation is a core cognitive ability in humans and animals. Neuroimaging studies have identified two functionally defined brain regions that activate during navigational tasks and also during passive viewing of navigationally relevant stimuli such as environmental scenes: the parahippocampal place area (PPA) and the retrosplenial complex (RSC). Recent findings indicate that the PPA and RSC have distinct and complementary roles in spatial navigation, with the PPA more concerned with representation of the local visual scene and RSC more concerned with situating the scene within the broader spatial environment. These findings are a first step towards understanding the separate components of the cortical network that mediates spatial navigation in humans.

The parahippocampal place area: recognition, navigation, or encoding?

The parahippocampal place area (PPA) has been demonstrated to respond more strongly in fMRI to scenes depicting places than to other kinds of visual stimuli. Here, we test several hypotheses about the function of the PPA. We find that PPA activity (1) is not affected by the subjects' familiarity with the place depicted, (2) does not increase when subjects experience a sense of motion through the scene, and (3) is greater when viewing novel versus repeated scenes but not novel versus repeated faces. Thus, we find no evidence that the PPA is involved in matching perceptual information to stored representations in memory, in planning routes, or in monitoring locomotion through the local or distal environment but some evidence that it is involved in encoding new perceptual information about the appearance and layout of scenes.

The cognitive map in humans: spatial navigation and beyond

The 'cognitive map' hypothesis proposes that brain builds a unified representation of the spatial environment to support memory and guide future action. Forty years of electrophysiological research in rodents suggest that cognitive maps are neurally instantiated by place, grid, border and head direction cells in the hippocampal formation and related structures. Here we review recent work that suggests a similar functional organization in the human brain and yields insights into how cognitive maps are used during spatial navigation. Specifically, these studies indicate that (i) the human hippocampus and entorhinal cortex support map-like spatial codes, (ii) posterior brain regions such as parahippocampal and retrosplenial cortices provide critical inputs that allow cognitive maps to be anchored to fixed environmental landmarks, and (iii) hippocampal and entorhinal spatial codes are used in conjunction with frontal lobe mechanisms to plan routes during navigation. We also discuss how these three basic elements of cognitive map based navigation-spatial coding, landmark anchoring and route planning-might be applied to nonspatial domains to provide the building blocks for many core elements of human thought.

Viewpoint-specific scene representations in human parahippocampal cortex

The "parahippocampal place area" (PPA) responds more strongly in functional magnetic resonance imaging (fMRI) to scenes than to faces, objects, or other visual stimuli. We used an event-related fMRI adaptation paradigm to test whether the PPA represents scenes in a viewpoint-specific or viewpoint-invariant manner. The PPA responded just as strongly to viewpoint changes that preserved intrinsic scene geometry as it did to complete scene changes, but less strongly to object changes within the scene. In contrast, lateral occipital cortex responded more strongly to object changes than to spatial changes. These results demonstrate that scene processing in the PPA is viewpoint specific and suggest that the PPA represents the relationship between the observer and the surfaces that define local space.

'Insight' in the pigeon: antecedents and determinants of an intelligent performance

In 1917 Wolfgang Köhler reported some rather extraordinary instances of problem solving by a number of chimpanzees, and his observations have been the subject of controversy ever since. The period of quiescence that sometimes preceded the solution, its sudden onset, and its smooth, continuous emergence were proffered as evidence that (1) contrary to suggestions of learning theorists of the day, problem solving was not necessarily a trial-and-error process, and (2) constructs such as 'insight' were necessary for an adequate account. Here, in an attempt to shed further light on these issues, we have replicated with pigeons a classic problem with that Köhler confronted his chimpanzees. Pigeons that had acquired relevant skills solved the problem in a remarkably chimpanzee-like (and, perforce, human-like) fashion. The possible contributions of different experiences were determined by varying the training histories of different birds. We offer a tentative moment-to-moment account of a successful performance.

Where am I now? Distinct roles for parahippocampal and retrosplenial cortices in place recognition

A key component of spatial navigation is the ability to use visual information to ascertain where one is located and how one is oriented in the world. We used functional magnetic resonance imaging to examine the neural correlates of this phenomenon in humans. Subjects were scanned while retrieving different kinds of topographical and nontopographical information in response to visual scenes. In the three critical conditions, they viewed images of a familiar college campus, and reported either the location of the place depicted in the image (location task), the compass direction that the camera was facing when the image was taken (orientation task), or whether the location was on campus or not (familiarity task). Our analyses focused on the retrosplenial cortex (RSC)/parietal-occipital sulcus region and the parahippocampal place area (PPA), which previous studies indicate play a critical role in place recognition. RSC activity depended on the type of information retrieved, with the strongest response in the location task. In contrast, PPA activity did not depend on the retrieval task. Additional analyses revealed a strong effect of familiarity in RSC but not in the PPA, with the former region responding much more strongly to images of the familiar campus than to images of an unfamiliar campus. These results suggest that the PPA and RSC play distinct but complementary roles in place recognition. In particular, the PPA may primarily support perception of the immediate scene, whereas RSC may support memory retrieval mechanisms that allow the scene to be localized within the broader spatial environment.

Perceptual deficits in amnesia: challenging the medial temporal lobe ‘mnemonic’ view

Recent animal studies suggest that the medial temporal lobe (MTL), which is thought to subserve memory exclusively, may support non-mnemonic perceptual processes, with the hippocampus and perirhinal cortex contributing to spatial and object perception, respectively. There is, however, no support for this view in humans, with human MTL lesions causing prominent memory deficits in the context of apparently normal perception. We assessed visual discrimination in amnesic cases to reveal that while selective hippocampal damaged patients could discriminate faces, objects, abstract art and colour, they were significantly poorer in discriminating spatial scenes. By contrast, patients with MTL damage, including perirhinal cortex, were significantly impaired in discriminating scenes, faces, and to a lesser extent objects, with relatively intact discrimination of art and colour. These novel observations imply that the human MTL subserves both perceptual and mnemonic functions, with the hippocampus and perirhinal cortex playing distinct roles in spatial and object discrimination, respectively.

Congenital failure of automatic control of ventilation, gastrointestinal motility and heart rate

A new congenital syndrome characterized by the simultaneous failure of control of ventilation (Ondine's curse) and intestinal motility (Hirschsprung's disease) is reported in three infants, all of whom died in the first few months of life; two were siblings. Detailed studies in one also revealed markedly decreased esophageal motility and abnormal control of heart rate. In one infant, minute ventilation was lower in quiet than in REM sleep and lower in both states of sleep than in wakefulness. Although the mean inspiratory flow was decreased in quiet sleep, the hypoventilation resulted primarily from a decrease in respiratory frequency. Intravenous doxapram increased ventilation but did not reverse respiratory failure. Aminophyllin, progesterone, physostigmine and chlorpromazine did not change ventilation significantly; imipramine resulted in a significant decrease. Both long and short-term variability of the heart rate were markedly decreased when compared with the normal infant. Although neuropathologic studies postmorten did not reveal an anatomic defect, we postulate that a developmental abnormality in serotonergic neurons is responsible for this new syndrome.

Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia

The objectives of this study were to determine appropriate acoustic and outcome measures for the evaluation of a method of laryngeal manual therapy (LMT) used in the treatment of patients with muscle tension dysphonia (MTD). The effects of this technique were also investigated. The study was based on the hypotheses that the vertical position of the larynx in the vocal tract would lower, that the quality of the voice would normalize, and that a reduction in any vocal tract discomfort (VTD) would occur after LMT. This was a small, prospective, repeated measures pilot study in which each member of the research team was "blinded" to all other stages of the study and during which all data were anonymized until the final stage of data analysis. Ten subjects presenting with MTD completed outcome measures and provided audiorecordings immediately before, immediately after, and 1 week after LMT. The Kay CSL 4150 was used for signal acquisition and for some acoustic measurements. Spectrographic evaluation was accomplished with Praat. A new perceptual, self-rating scale, the VTD scale, and a new proforma for use by the clinician for palpatory evaluation, were developed for the study. Relative average perturbation during connected speech was significantly reduced after LMT, indicating a reduction in abnormal vocal function. The severity and frequency of VTD was shown to have reduced after LMT. This pilot study showed positive evidence for LMT as a method of therapy in the treatment of hyperfunctional voice disorders. Its effects were shown to be measurable with both acoustical analysis and the VTD scale.

Comparison of methods for defining prevalent vertebral deformities: the Study of Osteoporotic Fractures

Women with vertebral deformities caused by osteoporosis have more back pain and disability and are at higher risk for subsequent vertebral deformities than women without deformities. Despite the importance of vertebral deformities, there has been a great deal of controversy about how to identify or define them. In order to compare methods for defining vertebral deformities, we studied spinal radiographs from women in the Study of Osteoporotic Fractures (SOF), a cohort study of 9704 non-black women over age 65 recruited from population-based listings in four clinical centers. Using radiographs obtained at the baseline exam, we compared five methods for defining vertebral deformities: one based on a semiquantitative reading by a radiologist and four using vertebral morphometry. The semiquantitative method was compared with the other methods in a random sample of 503 films, while the morphometric methods were compared with each other in a larger sample of 9575 films. We tested a system of "triage" in which only those films with evidence of deformity were assessed by morphometry. We compared the relationship between deformity, defined by each method, and a variety of clinical criteria including bone mineral density at the lumbar spine, height loss since age 25, back pain, and incidence of subsequent deformity. Semiquantitative reading and three of the four morphometry-based methods provided similar relationships to clinical criteria. The fourth morphometry method (based on ratios of each vertebral height to the corresponding height at T4) produced significantly weaker relationships for several of the clinical validation criteria. Triage of radiographs rarely resulted in missed deformities and did not reduce the performance of any of the methods. We conclude that use of any of the similar methods, with or without triage, provides a valid approach to defining vertebral deformities.

Symbolic Communication Between Two Pigeons, (Columba livia domestica)

Through the use of learned symbols, a pigeon accurately communicated information about hidden colors to another pigeon. Each verbal exchange was initiated with a spontaneous request for information. The two pigeons engaged in a sustained and natural conversation without human intervention.

"Self-awareness" in the pigeon

Each of three pigeons used a mirror to locate a spot on its body which it could not see directly. Although similar behavior in primates has been attributed to a self-concept or other cognitive process, the present example suggests an account in terms of environmental events.

Starting times of school: effects on daytime functioning of fifth-grade children in Israel

In the present study we investigated the effects of school starting time on daytime behavior and sleep. Eight-hundred and eleven 5th grade pupils (10-12 years old) from 28 classes in 18 schools throughout Israel were divided into "early risers" (N = 232) who started school at 07:10 (42%) at least 2 times a week, and "regular risers" (N = 340) who always started school at 08:00 (58%). The remaining 239 pupils started school between 7:20 and 07:55 (and also after 08:00), and were not included in the study. Self-administered questionnaires concerning sleep habits during school days, weekends, and holidays, daytime fatigue, sleepiness, and difficulties concentrating and paying attention in school were completed by all children. Mean sleep time of the "early risers" was significantly shorter than that of the "regular risers." Early risers complained significantly more about daytime fatigue and sleepiness, and about attention and concentration difficulties in school. Their complaints were independent of the reported hours of sleep. We conclude that early starting of school negatively affects total sleep time and, as a consequence, has a negative effect on daytime behavior. The implications of these findings to the ongoing controversy concerning sleep need in contemporary society are discussed.

Scene Perception in the Human Brain

Humans are remarkably adept at perceiving and understanding complex real-world scenes. Uncovering the neural basis of this ability is an important goal of vision science. Neuroimaging studies have identified three cortical regions that respond selectively to scenes: parahippocampal place area, retrosplenial complex/medial place area, and occipital place area. Here, we review what is known about the visual and functional properties of these brain areas. Scene-selective regions exhibit retinotopic properties and sensitivity to low-level visual features that are characteristic of scenes. They also mediate higher-level representations of layout, objects, and surface properties that allow individual scenes to be recognized and their spatial structure ascertained. Challenges for the future include developing computational models of information processing in scene regions, investigating how these regions support scene perception under ecologically realistic conditions, and understanding how they operate in the context of larger brain networks.

The economic cost of hip fractures in community-dwelling older adults: a prospective study

OBJECTIVES

To evaluate the incremental cost in the year after hip fracture.

DESIGN

Prospective cohort study.

SETTING

Baltimore, Maryland.

PARTICIPANTS

759 community dwelling older patients who sustained a hip fracture and participated in the Baltimore Hip Fracture Study.

MEASUREMENTS

Resource use for direct medical care, formal nonmedical care, and informal care in the 6 months before and the year after fracture was estimated from interviews with patients or proxy respondents. Costs in 1993 dollars were estimated by multiplying resources times national unit cost estimates.

RESULTS

The annualized costs in the year before the fracture ranged between $18,523 and $20,928. The costs in the year after the fracture equaled $37,250. The incremental costs in the year after the fracture, compared with the costs in the year before the fracture, ranged between $16,322 and $18,727. The largest cost differences were attributable to hospitalizations, nursing home stays, and rehabilitation services.

CONCLUSIONS

Because we compared the costs after a fracture with costs before, our estimates of the incremental cost of a hip fracture are lower than others in the literature. These results, obtained from interviews with patients enrolled in a cohort study, or their proxies, provide the best data available to date on the economic cost of hip fractures among community-dwelling older persons.

Long-term sleep disturbances in adolescents after minor head injury

It has been demonstrated that patients in the acute phase after minor head injury (MHI) complain of sleep disturbances. The purpose of the present study was to characterize the long-term effects of MHI on sleep in adolescents. Nineteen adolescents who had suffered MHI 3 years before the study and had complained of sleep disturbances completed a sleep questionnaire and were investigated in the sleep laboratory by whole-night polysomnographic recordings and were actigraphically monitored for 5 days at home. Questionnaire results revealed severe complaints regarding sleep behavior. Polysomnographic recordings revealed that in comparison with controls, MHI was associated with lower sleep efficiency (79.8 +/- [9.8]% vs 87.7 +/- [6.8]%; P < 0.005), with more wake time (10.6 +/- [9.0]% vs 3.4 +/- [4.4]%; P < 0.005), and with more awakenings lasting more than 3 minutes (2.1 +/- [1.5] vs 0.6 +/- [0.8]; P < 0.005). These findings were confirmed by actigraphic monitoring that revealed lower sleep efficiency (90 +/- [5]% vs 94 +/- [3]%; P < 0.05), more minutes of wake time (49 +/- [21] min vs 28 +/- [15] min; P < 0.05), and a trend toward more awakenings longer than 5 minutes (1.8 +/- [0.8] vs 1.2 +/- [0.8]; P = 0.063). Our data demonstrated that 3 years after MHI without any discernible clinical sequel, adolescents still complain of sleep disturbances that could be confirmed by both polysomnographic and actigraphic monitoring.

Differential parahippocampal and retrosplenial involvement in three types of visual scene recognition

Human observers can quickly and accurately interpret the meaning of complex visual scenes. The neural mechanisms underlying this ability are largely unexplored. We used functional magnetic resonance imaging to measure cortical activity while subjects identified briefly presented scenes as specific familiar locations ("Houston Hall"), general place categories ("kitchen"), or general situational categories ("party"). Scene-responsive voxels in the parahippocampal place area (PPA) and retrosplenial cortex (RSC) were highly sensitive to recognition level when identifying scenes, responding more strongly during location identification than during place category or situation identification. In contrast, the superior temporal sulcus, cingulate sulcus, and supermarginal gyrus displayed the opposite pattern, responding more strongly during place category and situation identification. Consideration of results from 4 experiments suggests that the PPA represents the visuospatial structure of individual scenes, whereas RSC supports processes that allow scenes to be localized within a larger extended environment. These results suggest that different scene identification tasks tap distinct cortical networks. In particular, we hypothesize that the PPA and RSC are critically involved in the identification of specific locations but play a less central role in other scene recognition tasks.

Learning Places from Views: Variation in Scene Processing as a Function of Experience and Navigational Ability

Humans and animals use information obtained from different viewpoints to form representations of the spatial structure of the world. We used functional magnetic resonance imaging (fMRI) adaptation to investigate the neural basis of this learning process and to show how the concomitant representations vary across individuals as a function of navigational ability. In particular, we examined the effect of repeating viewpoint and/ or place information over both short (within-trial) and long (across-scan) intervals on the neural response in scene processing regions. Short-term fMRI adaptation effects in the parahippocampal cortex were initially highly viewpoint-specific but became less so over time. Long-term fMRI repetition effects included a significant viewpoint-invariant component. When individual differences in navigational ability were considered, a significant correlation between the strength of these effects and self-reported navigational competence was observed. In particular, good navigators encoded representations that differed between new and old views and new and old places, whereas bad navigators did not. These results suggest that cortical scene representations evolve over time to become more viewpoint-invariant and that the quality of these representations directly impacts navigational ability.

Sleep patterns in autistic children

Sleep disturbances are regarded as a common clinical feature in autistic children. This concept is based primarily on informal observations or studies conducted with questionnaires. In this study we compared data obtained by questionnaires to that obtained with actigraphy. Among 22 autistic children, 12 were reported as having sleep problems and 8 patients completed 72 hours actigraphy. While the employment of questionnaires disclosed that autistic children had an earlier morning awakening time and multiple and early night arousals, actigraphic monitoring showed that with the exception of an earlier morning arousal time (p = .045), sleep patterns of autistic children were similar to that of normal children. Parental oversensitivity to sleep disturbances of the autistic children may explain this phenomenon.

Visual scene processing in familiar and unfamiliar environments

Humans and animals use information obtained from the local visual scene to orient themselves in the wider world. Although neural systems involved in scene perception have been identified, the extent to which processing in these systems is affected by previous experience is unclear. We addressed this issue by scanning subjects with functional magnetic resonance imaging (fMRI) while they viewed photographs of familiar and unfamiliar locations. Scene-selective regions in parahippocampal cortex (the parahippocampal place area, or PPA), retrosplenial cortex (RSC), and the transverse occipital sulcus (TOS) responded more strongly to images of familiar locations than to images of unfamiliar locations with the strongest effects (>50% increase) in RSC. Examination of fMRI repetition suppression (RS) effects indicated that images of familiar and unfamiliar locations were processed with the same degree of viewpoint specificity; however, increased viewpoint invariance was observed as individual scenes became more familiar over the course of a scan session. Surprisingly, these within-scan-session viewpoint-invariant RS effects were only observed when scenes were repeated across different trials but not when scenes were repeated within a trial, suggesting that within- and between-trial RS effects may index different aspects of visual scene processing. The sensitivity to environmental familiarity observed in the PPA, RSC, and TOS supports earlier claims that these regions mediate the extraction of navigationally relevant spatial information from visual scenes. As locations become familiar, the neural representations of these locations become enriched, but the viewpoint invariance of these representations does not change.

Hippocampal size predicts rapid learning of a cognitive map in humans

The idea that humans use flexible map-like representations of their environment to guide spatial navigation has a long and controversial history. One reason for this enduring controversy might be that individuals vary considerably in their ability to form and utilize cognitive maps. Here we investigate the behavioral and neuroanatomical signatures of these individual differences. Participants learned an unfamiliar campus environment over a period of three weeks. In their first visit, they learned the position of different buildings along two routes in separate areas of the campus. During the following weeks, they learned these routes for a second and third time, along with two paths that connected both areas of the campus. Behavioral assessments after each learning session indicated that subjects formed a coherent representation of the spatial structure of the entire campus after learning a single connecting path. Volumetric analyses of structural MRI data and voxel-based morphometry (VBM) indicated that the size of the right posterior hippocampus predicted the ability to use this spatial knowledge to make inferences about the relative positions of different buildings on the campus. An inverse relationship between gray matter volume and performance was observed in the caudate. These results suggest that (i) humans can rapidly acquire cognitive maps of large-scale environments and (ii) individual differences in hippocampal anatomy may provide the neuroanatomical substrate for individual differences in the ability to learn and flexibly use these cognitive maps. © 2013 Wiley Periodicals, Inc.