Cerebral correlates of muscle tone fluctuations in restless legs syndrome: A pilot study with combined functional magnetic resonance imaging and anterior tibial muscle electromyography

BACKGROUND: The pathology of restless legs syndrome (RLS) is still not understood. To investigate the pathomechanism of the disorder further we recorded a surface electromyogram (EMG) of the anterior tibial muscle during functional magnetic resonance imaging (fMRI) in patients with idiopathic RLS. METHODS: Seven subjects with moderate to severe RLS were investigated in the present pilot study. Patients were lying supine in the scanner for over 50min and were instructed not to move voluntarily. Sensory leg discomfort (SLD) was evaluated on a 10-point Likert scale. For brain image analysis, an algorithm for the calculation of tonic EMG values was developed. RESULTS: We found a negative correlation of tonic EMG and SLD (p <0.01). This finding provides evidence for the clinical experience that RLS-related subjective leg discomfort increases during muscle relaxation at rest. In the fMRI analysis, the tonic EMG was associated with activation in motor and somatosensory pathways and also in some regions that are not primarily related to motor or somatosensory functions. CONCLUSIONS: By using a newly developed algorithm for the investigation of muscle tone-related changes in cerebral activity, we identified structures that are potentially involved in RLS pathology. Our method, with some modification, may also be suitable for the investigation of phasic muscle activity that occurs during periodic leg movements.

EEG signs of vigilance fluctuations preceding perceptual flips in multistable illusionary motion

This EEG study was performed to clarify the time course of brain electrical events and possible vigilance changes associated with perceptual flips during multistable perception. 13 healthy subjects (28.5 3.8 years) were recorded with a 21-channel digital EEG during a stroboscopic alternative motion paradigm implying illusionary motion with ambiguous direction. Perceptual flips were preceded by a significant decrease of EEG frequencies, and followed by a significant frequency increase with a trend to overshoot. EEG slowing is a reliable sign of vigilance decrease and can be related to thalamic deactivation. This is consistent with a recent fMRI study, which showed thalamic deactivation associated with perceptual flips. The study added important chronological information about this phenomenon and allows the conclusion that reduced vigilance facilitates perceptual discontinuities during multistable perception.

Online correlation of spontaneous arterial and intracranial pressure fluctuations in patients with diffuse severe head injury

Determination of relevant clinical monitoring parameters for helping guide the intensive care therapy in patients with severe head injury, is one of the most demanding issues in neurotrauma research. New insights into cerebral autoregulation and metabolism have revealed that a rigid cerebral perfusion pressure (CPP) regimen might not be suitable for all severe head injured patients. We thus developed an online analysis technique to monitor the correlation (AI rho) between the spontaneous fluctuations of the mean arterial blood pressure (MABP) and the intracranial pressure (ICP). In addition, brain tissue oxygen (PtiO2) and metabolic microdialysate measures including glucose and lactate were registered. We found that in patients with good outcome, the AI rho values were significantly lower as compared with patients with poor outcome. Accordingly, microdialysate glucose and lactate were significantly higher in the good outcome group. We conclude that online determination of AI rho offers a valuable additional and technically easily performable tool for guidance of therapy in patients with severe head injury.

EXPERIMENTAL INVESTIGATION OF CERTAIN INTERNAL CONDENSING AND BOILING FLOWS: THEIR SENSITIVITY TO PRESSURE FLUCTUATIONS AND HEAT TRANSFER ENHANCEMENTS

Space-based (satellite, scientific probe, space station, etc.) and millimeter – to – microscale (such as are used in high power electronics cooling, weapons cooling in aircraft, etc.) condensers and boilers are shear/pressure driven. They are of increasing interest to system engineers for thermal management because flow boilers and flow condensers offer both high fluid flow-rate-specific heat transfer capacity and very low thermal resistance between the fluid and the heat exchange surface, so large amounts of heat may be removed using reasonably-sized devices without the need for excessive temperature differences. However, flow stability issues and degradation of performance of shear/pressure driven condensers and boilers due to non-desirable flow morphology over large portions of their lengths have mostly prevented their use in these applications. This research is part of an ongoing investigation seeking to close the gap between science and engineering by analyzing two key innovations which could help address these problems. First, it is recommended that the condenser and boiler be operated in an innovative flow configuration which provides a non-participating core vapor stream to stabilize the annular flow regime throughout the device length, accomplished in an energy-efficient manner by means of ducted vapor re-circulation. This is demonstrated experimentally. Second, suitable pulsations applied to the vapor entering the condenser or boiler (from the re-circulating vapor stream) greatly reduce the thermal resistance of the already effective annular flow regime. For experiments reported here, application of pulsations increased time-averaged heat-flux up to 900 % at a location within the flow condenser and up to 200 % at a location within the flow boiler, measured at the heat-exchange surface. Traditional fully condensing flows, reported here for comparison purposes, show similar heat-flux enhancements due to imposed pulsations over a range of frequencies. Shear/pressure driven condensing and boiling flow experiments are carried out in horizontal mm-scale channels with heat exchange through the bottom surface. The sides and top of the flow channel are insulated. The fluid is FC-72 from 3M Corporation.

Long-range correlations in rectal temperature fluctuations of healthy infants during maturation

BACKGROUND: Control of breathing, heart rate, and body temperature are interdependent in infants, where instabilities in thermoregulation can contribute to apneas or even life-threatening events. Identifying abnormalities in thermoregulation is particularly important in the first 6 months of life, where autonomic regulation undergoes critical development. Fluctuations in body temperature have been shown to be sensitive to maturational stage as well as system failure in critically ill patients. We thus aimed to investigate the existence of fractal-like long-range correlations, indicative of temperature control, in night time rectal temperature (T(rec)) patterns in maturing infants. METHODOLOGY/PRINCIPAL FINDINGS: We measured T(rec) fluctuations in infants every 4 weeks from 4 to 20 weeks of age and before and after immunization. Long-range correlations in the temperature series were quantified by the correlation exponent, alpha using detrended fluctuation analysis. The effects of maturation, room temperature, and immunization on the strength of correlation were investigated. We found that T(rec) fluctuations exhibit fractal long-range correlations with a mean (SD) alpha of 1.51 (0.11), indicating that T(rec) is regulated in a highly correlated and hence deterministic manner. A significant increase in alpha with age from 1.42 (0.07) at 4 weeks to 1.58 (0.04) at 20 weeks reflects a change in long-range correlation behavior with maturation towards a smoother and more deterministic temperature regulation, potentially due to the decrease in surface area to body weight ratio in the maturing infant. alpha was not associated with mean room temperature or influenced by immunization CONCLUSIONS: This study shows that the quantification of long-range correlations using alpha derived from detrended fluctuation analysis is an observer-independent tool which can distinguish developmental stages of night time T(rec) pattern in young infants, reflective of maturation of the autonomic system. Detrended fluctuation analysis may prove useful for characterizing thermoregulation in premature and other infants at risk for life-threatening events.