Early insulin therapy offers little clinical benefit in very-low-birth-weight infants. It reduces hyperglycemia but may increase hypoglycemia (Current Controlled Trials number, ISRCTN78428828.)

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Punctate lesions are predominantly seen in preterm infants, are usually linearly organised, and border the lateral ventricles. Isolated punctate lesions may imply a good prognosis, because most of these subjects have a normal neurodevelopmental outcome so far.

To obtain further evidence for the functional specialization and task-dependent processing in the human visual system, we used positron emission tomography to compare regional cerebral blood flow in two direction discrimination tasks and four control tasks. The stimulus configuration, which was identical in all tasks, included the motion of a random dot pattern, dimming of a fixation point, and a tone burst. The discrimination tasks comprised the identification of motion direction and successive direction discrimination. The control tasks were motion detection, dimming detection, tone detection, and passive viewing. There was little difference in the activation patterns evoked by the three detection tasks except for decreased activity in the parietal cortex during the detection of a tone. Thus attention to a nonvisual stimulus modulated different visual cortical regions nonuniformly. Comparison of successive discrimination with motion detection yielded significant activation in the right fusiform gyrus, right lingual gyrus, right frontal operculum, left inferior frontal gyrus, and right thalamus. The fusiform and opercular activation sites persisted even after subtracting direction identification from successive discrimination, indicating their involvement in temporal comparison. Functional magnetic resonance imaging (fMRI) experiments confirmed the weak nature of the activation of human MT/V5 by successive direction discrimination but also indicated the involvement of an inferior satellite of human MT/V5. The fMRI experiments moreover confirmed the involvement of human V3A, lingual, and parietal regions in successive discrimination. Our results provide further evidence for the functional specialization of the human visual system because the cortical regions involved in direction discrimination partially differ from those involved in orientation discrimination. They also support the principle of task-dependent visual processing and indicate that the right fusiform gyrus participates in temporal comparison, irrespective of the stimulus attribute.

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