Lack of heart rate changes during an attention‐demanding task after right hemisphere lesions

Yokoyama, Kenichi; Jennings, Roger A.; Ackles, Patrick K.; Hood, Philip; Boller, François

doi:10.1212/wnl.37.4.624

Cited by 88 publications

(38 citation statements)

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“…Both prefrontal and hippocampal lesions abolish the normal P3a increase to the first few novel events. Hippocampal lesions disrupt the P3a and sympathetic skin response (Knight, 1996), and prefrontal lesions reduce the frontal P3a component (Knight, 1984) and the autonomic response to novel stimuli (Yokoyama et al, 1987). Thus, this lesion data and the fMRI results in normals provide converging data on the habituation properties of these regions to novel events.…”

Section: Discussionmentioning

confidence: 55%

Rapid Prefrontal-Hippocampal Habituation to Novel Events

Yamaguchi

Hale²,

D’Esposito³

et al. 2004

Journal of Neuroscience

196

159

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Unexpected novel events generate an orienting response that plays an important role in some forms of learning and memory. The orienting response involuntarily captures attention and rapidly habituates as events become familiarized. Although evidence from patients with focal lesions and scalp and intracranial event-related brain potential recordings supports the involvement of a distributed neural network involving association cortex and the limbic system in novelty detection, the key neural substrates and temporal dynamics have not been defined. While subjects performed a bi-field visual-selective attention task with random novel stimuli embedded in either attended or unattended visual fields, we measured rapid changes of regional blood oxygenation level-dependent (BOLD) signal to target and novel stimuli using single-trial analysis of event-related functional magnetic resonance imaging with a 4T scanner. Habituation was quantified by serial BOLD signal changes during the first 10 novel stimuli for each subject. Novel stimuli activated the bilateral superior/ middle frontal gyrus, temporal-parietal junction, superior parietal lobe, cingulate gyrus, hippocampus, and fusiform gyrus. The superior/middle frontal gyrus and hippocampus showed significant reduction of BOLD signal during the first few novel stimuli, whereas the signals in the fusiform and cingulate gyrus were constant. Prefrontal and hippocampal responses to attended and unattended novel stimuli were comparably habituated. These results, and previous data from lesion studies, support the view that prefrontal and hippocampal regions are involved in rapid automatic detection and habituation to unexpected environmental events and are key elements of the orienting response in humans.

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Section: Discussionmentioning

confidence: 55%

Rapid Prefrontal-Hippocampal Habituation to Novel Events

Yamaguchi

Hale²,

D’Esposito³

et al. 2004

Journal of Neuroscience

196

159

View full text Add to dashboard Cite

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“…12 These data suggest that there are differential cerebral effects on autonomic function that depend on the side of the cerebrum. [13][14][15] Results of human insular cortex stimulation suggest rightsided dominance in sympathetic cardiovascular effects and left-sided dominance in parasympathetic effects. 2 In addition, animal experimentation using a rat model with middle cerebral artery occlusion, which results in a consistent lesion of brain including the insular cortex, directly addresses the role of lateralization of brain hemisphere, the site of cerebral infarction, and the effect of age on the ECG perturbations that develop after stroke.…”

Section: Discussionmentioning

confidence: 99%

Right Sylvian Fissure Subarachnoid Hemorrhage Has Electrocardiographic Consequences

Hirashima

Takashima

Matsumura

et al. 2001

Stroke

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Background and Purpose-Abnormal ECG changes are frequently observed in patients with subarachnoid hemorrhage (SAH). Recently, evidence has been obtained that right insular cortex mediates sympathetic cardiovascular effects. We therefore assessed the laterality and location of SAH dominance in inducing cardiovascular changes as measured by ECG, blood pressure, and heart rate. Methods-After exclusion of 11 SAH patients who died within 1 month after onset, we studied 118 consecutive patients.Data were obtained from records of blood pressure and pulse on admission. Abnormal ECG changes were determined from ECGs on admission and almost 1 month later. From brain CT scans performed immediately after admission, the amount of SAH in each of the 8 cisterns and fissures was measured semiquantitatively. Results-Twenty-six patients had abnormal changes on admission ECG, while 92 patients did not. Systolic blood pressure, diastolic blood pressure, and the amounts of blood in the left ambient cistern, left suprasellar cistern, quadrigeminal cistern, right ambient cistern, right suprasellar cistern, right sylvian fissure, and the set of all cisterns were significantly greater in the group with ECG change than in the group without ECG change. Multivariate logistic regression analysis with stepwise method indicated that systolic blood pressure Ͼ160 mm Hg (Pϭ0.0006) and the amounts of SAH in the quadrigeminal cistern (Pϭ0.022) and right sylvian fissure (Pϭ0.0019) were independently associated with abnormal ECG change. Conclusions-Cardiac

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“…In addition, recent but limited data obtained in patients with cerebral lesions (24,27) suggested that different types of arrhythmias might be the result of right and left hemispheric lesions. These data could explain our observation of different alterations in the spectral parameters in patients with epilepsy with a right or left EEG focus.…”

Section: Discussionmentioning

confidence: 99%

Alteration of Cardiac Function in Patients with Temporal Lobe Epilepsy: Different Roles of EEG‐ECG Monitoring and Spectral Analysis of RR Variability

et al. 1997

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Summary: Purpose: Because several reports have described the relation between epilepsy and cardiac arrhythmias and suggest that changes in autonomic neural control of the heart could be involved in the pathogenesis of sudden unexplained death in patients with epilepsy, the aim of this study was to evaluate cardiac function in patients with temporal lobe epilepsy.Methods: Sixty-five patients with epilepsy were evaluated by simultaneous ambulatory 24-h EEG-ECG monitoring, and in 30 of these, power spectral analysis of relative-risk (RR) variability also was carried out, both in the supine position and in a passive tilt position at 60". The power spectrum of RR variability, the two major spectral components detectable at low frequency (LF) and at high frequency (HF), respectively, and the LF/HF ratio were calculated.Results: By EEG-ECG monitoring, we recorded six partial seizures, and in four cases, discharges were associated with sinus tachycardia. However, interictally the occurrence of ventricular and supraventricular arrhythmias was not different from that in normal subjects. The spectral analysis of RR variability, on the other hand, demonstrated in patients with epilepsy a significant decrease in the total RR variability and in both of its components (LF and HF) in the supine position, and of the LF/HF ratio in orthostatic position.Conclusions: These findings suggest that the spectral analysis of RR variability may detect disorders of autonomic cardiac control in patients with epilepsy, even in the absence of abnormal findings during ECG monitoring. This alteration, which is more severe in cases with right EEG focus, could play a role in the pathogenesis of cardiac arrhythmias. Key Words: Temporal lobe epilepsy-Sudden unexplained death in patients with epilepsy-ECG monitoring-Heart rate variabilityAutonomic disorders.Sudden unexplained death in patients with epilepsy (SUDEP) is a well-recognized phenomenon (l), although its pathogenesis is not yet completely understood. In a recent cohort study (2), the maximal overall incidence of SUDEP observed was 1.35 cases/l,OOO person-years, which was similar to values described in previous studies (3,4). In particular, the incidence of SUDEP is increased in males and is correlated with the number of antiepileptic drugs (AEDs) prescribed and with treatment. with psychotropic drugs. It is also associated with alcohol abuse and slightly with mental retardation.With regard to the pathogenesis of SUDEP, the hypothesis of an acute disturbance of the cardiac rhythm as a possible mechanism is supported by various clinical case reports of patients with temporal lobe epilepsy (5,6) Accepted September 13, 1996. Address correspondence and reprint requests to Dr. L. Mum at Department of Neurosciences, Institute of Neurology, Via Roma, 67, 56126 Pisa, Italy and by the finding that both simple and complex partial seizures (CPSs) are consistently associated with tachycardia (7,s) and rarely with bradycardia (9,lO). On the other hand, certain data obtained interictally provide only par...

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Lack of heart rate changes during an attention‐demanding task after right hemisphere lesions

Cited by 88 publications

References 0 publications

Rapid Prefrontal-Hippocampal Habituation to Novel Events

Rapid Prefrontal-Hippocampal Habituation to Novel Events

Right Sylvian Fissure Subarachnoid Hemorrhage Has Electrocardiographic Consequences

Alteration of Cardiac Function in Patients with Temporal Lobe Epilepsy: Different Roles of EEG‐ECG Monitoring and Spectral Analysis of RR Variability

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