There is increasing interest in the use of edited proton magnetic resonance spectroscopy for the detection of GABA in the human brain. At a recent meeting held at Cardiff University, a number of spectroscopy groups met to discuss the acquisition, analysis and interpretation of GABA-edited MR spectra. This paper aims to set out the issues discussed at this meeting, reporting areas of consensus around parameters and procedures in the field and highlighting those areas where differences remain. It is hoped that this paper can fulfill two needs, providing a summary of the current ‘state-of-the-art’ in the field of GABA-edited MRS at 3 T using MEGA-PRESS and a basic guide to help researchers new to the field to avoid some of the pitfalls inherent in the acquisition and processing of edited MRS for GABA.

Fundamental to the concept of idiopathic or primary headache, including migraine, tension-type headache and cluster headache, is the currently accepted view that these conditions are due to abnormal brain function with completely normal brain structure. Cluster headache is one such idiopathic headache with many similarities to migraine, including normal brain structure on magnetic resonance imaging and abnormal function in the hypothalamic grey matter by positron emission tomography. Given the consistency of the positron emission tomography findings with the clinical presentation, we sought to assess whether the brains of such patients were structurally normal. We used voxel-based morphometry, an objective and automated method of analyzing changes in brain structure, to study the structure of the brains of patients with cluster headache. We found a co-localization of structural changes and changes in local brain activity with positron emission tomography in the same area of the brain in the same patients. The results indicate that the current view of the neurobiology of cluster headache requires complete revision and that this periodic headache is associated with a hitherto unrecognized brain abnormality in the hypothalamic region. We believe that voxel-based morphometry has the potential to change in the most fundamental way our concept of primary headache disorders, requiring a radical reappraisal of the tenet of structural normality.

The results from a single functional magnetic resonance imaging session are typically reported as indicative of the subject's functional neuroanatomy. Underlying this interpretation is the implicit assumption that there are no responses specific to that particular session, i.e., that the potential variability of response between sessions is negligible. The present study sought to examine this assumption empirically. A total of 99 sessions, comprising 33 repeats of simple motor, visual, and cognitive paradigms, were collected over a period of 2 months on a single male subject. For each paradigm, the inclusion of session-by-condition interactions explained a significant amount of error variance (P < 0.05 corrected for multiple comparisons) over a model assuming a common activation magnitude across all sessions. However, many of those voxels displaying significant session-by-condition interactions were not seen in a multisession fixed-effects analysis of the same data set; i.e., they were not activated on average across all sessions. Most voxels that were both significantly variable and activated on average across all sessions did not survive a randomeffects analysis (modeling between-session variance). We interpret our results as demonstrating that correct inference about subject responses to activation tasks can be derived through the use of a statistical model which accounts for both within-and between-session variance, combined with an appropriately large session sample size. If researchers have access to only a single session from a single subject, erroneous conclusions are a possibility, in that responses specific to this single session may be claimed to be typical responses for this subject.

This study demonstrated activations of various subcortical structures, in particular the posterior hypothalamus and the dorsal rostral pons. If posterior hypothalamic and brainstem activation are considered as markers of trigeminal autonomic headaches and migrainous syndromes, respectively, then the activation pattern demonstrated in hemicrania continua mirrors the clinical phenotype, with its overlap with trigeminal autonomic headaches and migraine.

The neural mechanisms underlying variability in human sensory perception remain incompletely understood. In particular, few studies have attempted to investigate the relationship between in vivo measurements of neurochemistry and individuals’ behavioral performance. Our previous work found a relationship between GABA concentration in the visual cortex and orientation discrimination thresholds (Edden et al., 2009). In the present study, we used magnetic resonance spectroscopy of GABA and psychophysical testing of vibrotactile frequency thresholds to investigate whether individual differences in tactile frequency discrimination performance are correlated with GABA concentration in sensorimotor cortex. Behaviorally, individuals showed a wide range of discrimination thresholds ranging from 3 to 7.6 Hz around the 25 Hz standard. These frequency discrimination thresholds were significantly correlated with GABA concentration (r = −0.58; p < 0.05) in individuals’ sensorimotor cortex, but not with GABA concentration in an occipital control region (r = −0.04). These results demonstrate a link between GABA concentration and frequency discrimination in vivo, and support the hypothesis that GABAergic mechanisms have an important role to play in sensory discrimination.

The capacity for imagery, enabling us to visualise absent items and events, is a ubiquitous feature of our experience. This paper describes the case of a patient, MX, who abruptly lost the ability to generate visual images. He rated himself as experiencing almost no imagery on standard questionnaires, yet performed normally on standard tests of perception, visual imagery and visual memory. These unexpected findings were explored using functional MRI scanning (fMRI). Activation patterns while viewing famous faces were not significantly different between MX and controls, including expected activity in the fusiform gyrus. However, during attempted imagery, activation in MX's brain was significantly reduced in a network of posterior regions while activity in frontal regions was increased compared to controls. These findings are interpreted as suggesting that MX adopted a different cognitive strategy from controls when performing the imagery task. Evidence from experimental tasks thought to rely on mental imagery, such as the Brooks' matrices and mental rotation, support this interpretation. Taken together, these results indicate that successful performance in visual imagery and visual memory tasks can be dissociated from the phenomenal experience of visual imagery.

BACKGROUND The amygdala plays a central role in detecting and responding to fear related stimuli. A number of recent studies have reported decreased amygdala activation in schizophrenia to emotional stimuli (such as fearful faces) compared to matched neutral stimuli (such as neutral faces). Here we have investigated whether the apparent decrease in amygdala activation in schizophrenia could actually derive from increased amygdala activation to the neutral comparator stimuli.METHODS Nineteen patients with schizophrenia and 24 matched control participants viewed pictures of faces with either fearful or neutral facial expressions, and a baseline condition, during functional magnetic resonance imaging scanning.RESULTS Patients with schizophrenia showed a relative decrease in amygdala activation to fearful faces when compared to neutral faces. However this difference resulted from an increase in amygdala activation to the neutral faces in patients with schizophrenia, not from a decreased response to the fearful faces. 2. The relevance of the findings to symptoms that characterize the disorder would strengthen the paper (i.e., relate the findings to symptoms in individuals with schizophrenia in the context of theories in the literature on amygdala function). Otherwise, the findings seem overly data driven.Response: We have sought to relate the current data to two of the main theories of the pathogenesis of schizophrenia in the discussion (2, 3). The former of these theories (2) argues for inappropriate amygdala activation in schizophrenia, a view which is directly supported by our data. The second hypothesis (3) argues that individual with schizophrenia attribute increased affective salience to otherwise neutral events, providing the setting for the formation of symptoms such as delusional beliefs. We believe that the present finding of increased amygdala activation to neutral faces in schizophrenia provides a potential biological basis for such a liability to psychosis. We have attempted to re-word part of the discussion to make these links more explicit, although fuller coverage is precluded by the word limit. Fear of faces in schizophreniaHall et al looked at the response of the amygdala, a brain region mediating fear, to faces in control subjects and participants with schizophrenia. They found that control subjects show amygdala activation to fearful faces, but not neutral faces. However patients with schizophrenia activated the amygdala fear system to both neutral and fearful faces. These results suggest that people with schizophrenia may perceive neutral faces as fearful, potentially contributing to the development of psychotic symptoms. IN THIS ISSUE StatementHall J et al AbstractBackground The amygdala plays a central role in detecting and responding to fear

The cerebellum is thought to play a key role in the integration of sensory and motor events. Little is known, however, about how sensory and motor maps in the cerebellum superimpose. In the present study we investigated the relationship between these two maps for the representation of single fingers. Participants made isometric key presses with individual fingers or received vibratory tactile stimulation to the fingertips while undergoing high-resolution functional magnetic resonance imaging (fMRI). Using multivariate analysis, we have demonstrated that the ipsilateral lobule V and VIII show patterns of activity that encode, within the same region, both which finger pressed and which finger was stimulated. The individual finger-specific activation patches are smaller than 3 mm and only show a weak somatotopic organization. To study the superposition of sensory and motor maps, we correlated the finger-specific patterns across the two conditions. In the neocortex, sensory stimulation of one digit led to activation of the same patches as force production by the same digit; in the cerebellum, these activation patches were organized in an uncorrelated manner. This suggests that, in the cerebellum, a movement of a particular finger is paired with a range of possible sensory outcomes. In summary, our results indicate a small and fractured representation of single digits in the cerebellum and suggest a fundamental difference in how the cerebellum and the neocortex integrate sensory and motor events.