Combined use of transcranial magnetic stimulation and metal electrode implants: a theoretical assessment of safety considerations

This paper provides a theoretical assessment of the safety considerations encountered in the simultaneous use of transcranial magnetic stimulation (TMS) and neurological interventions involving implanted metallic electrodes, such as electrocorticography. Metal implants are subject to magnetic forces due to fast alternating magnetic fields produced by the TMS coil. The question of whether the mechanical movement of the implants leads to irreversible damage of brain tissue is addressed by an electromagnetic simulation which quantifies the magnitude of imposed magnetic forces. The assessment is followed by a careful mechanical analysis determining the maximum tolerable force which does not cause irreversible tissue damage. Results of this investigation provide useful information on the range of TMS stimulator output powers which can be safely used in patients having metallic implants. It is shown that conventional TMS applications can be considered safe when applied on patients with typical electrode implants as the induced stress in the brain tissue remains well below the limit of tissue damage.

Corticospinal output and loss of force during motor fatigue

The objective of this study was to analyze central motor output changes in relation to contraction force during motor fatigue. The triple stimulation technique (TST, Magistris et al. in Brain 121(Pt 3):437-450, 1998) was used to quantify a central conduction index (CCI = amplitude ratio of central conduction response and peripheral nerve response, obtained simultaneously by the TST). The CCI removes effects of peripheral fatigue from the quantification. It allows a quantification of the percentage of the entire target muscle motor unit pool driven to discharge by a transcranial magnetic stimulus. Subjects (n = 23) performed repetitive maximal voluntary contractions (MVC) of abductor digiti minimi (duration 1 s, frequency 0.5 Hz) during 2 min. TST recordings were obtained every 15 s, using stimulation intensities sufficient to stimulate all cortical motor neurons (MNs) leading to the target muscle, and during voluntary contractions of 20% of the MVC to facilitate the responses. TST was also repetitively recorded during recovery. This basic exercise protocol was modified in a number of experiments to further characterize influences on CCI of motor fatigue (4 min exercise at 50% MVC; delayed fatigue recovery during local hemostasis, "stimulated exercise" by 20 Hz trains of 1 s duration at 0.5 Hz during 2 min). In addition, the cortical silent period was measured during the basic exercise protocol. Force fatigued to approximately 40% of MVC in all experiments and in all subjects. In all subjects, CCI decreased during exercise, but this decrease varied markedly between subjects. On average, CCI reductions preceded force reductions during exercise, and CCI recovery preceded force recovery. Exercising at 50% for 4 min reduced muscle force more markedly than CCI. Hemostasis induced by a cuff delayed muscle force recovery, but not CCI recovery. Stimulated exercise reduced force markedly, but CCI decreased only marginally. Summarized, force reduction and reduction of the CCI related poorly quantitatively and in time, and voluntary drive was particularly critical to reduce the CCI. The fatigue induced reduction of CCI may result from a central inhibitory phenomenon. Voluntary muscle activation is critical for the CCI reduction, suggesting a primarily supraspinal mechanism.

Virtopsy: forensic traumatology of the subcutaneous fatty tissue; multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) as diagnostic tools

Traumatic lesions of the subcutaneous fatty tissue provide important clues for forensic reconstruction. The interpretation of these patterns requires a precise description and recording of the position and extent of each lesion. During conventional autopsy, this evaluation is performed by dissecting the skin and subcutaneous tissues in successive layers. In this way, depending on the force and type of impact (right angle or tangent), several morphologically distinct stages of fatty tissue damage can be differentiated: perilobular hemorrhage (I), contusion (II), or disintegration (III) of the fat lobuli, and disintegration with development of a subcutaneous cavity (IV). In examples of virtopsy cases showing blunt trauma to the skin and fatty tissue, we analyzed whether these lesions can also be recorded and classified using multislice computed tomography (MSCT) and magnetic resonance imaging (MRI). MSCT has proven to be a valuable screening method to detect the lesions, but MRI is necessary in order to properly differentiate and classify the grade of damage. These noninvasive radiological diagnostic tools can be further developed to play an important role in forensic examinations, in particular when it comes to evaluating living trauma victims.

Fatal steamer accident; blunt force injuries and drowning in post-mortem MSCT and MRI.

Steamer accidents, through contact with the bucket wheel, are very seldom today. No publication of such a kind of fatal accident could be found in literature. We present the case of a fatal steamer accident, in which the findings of a blunt traumatization of a person by the ship was completely documented by post-mortem combined multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) examinations. A rupture of the aorta was detected using both radiological methods without use of radiopaque material. Radiological examination revealed a comminuted fracture of the thorax vertebrae at the same level as the aortic rupture. Injuries of the soft tissues of the back, caused by the bucket wheel of the steamer, were also diagnosed. In addition to the signs of blunt force trauma the findings of drowning such as an over inflation of the lungs, fluid in the stomach and duodenum were revealed. Furthermore, algological analysis detected diatoms in the lung tissue and blood from the left heart. Therefore, the cause of death was considered being a combination of fatal hemorrhage, caused by the aortic rupture, and drowning. We conclude that virtual autopsy using combined post-mortem MSCT and MRI is a useful tool for documentation, visualisation and analysis of the findings of blunt force trauma and drowning with a large potential in forensic medicine.

Casimir effect with quantized charged spinor matter in background magnetic field

We study the influence of a background uniform magnetic field and boundary conditions on the vacuum of a quantized charged spinor matter field confined between two parallel neutral plates; the magnetic field is directed orthogonally to the plates. The admissible set of boundary conditions at the plates is determined by the requirement that the Dirac Hamiltonian operator be self-adjoint. It is shown that, in the case of a sufficiently strong magnetic field and a sufficiently large separation of the plates, the generalized Casimir force is repulsive, being independent of the choice of a boundary condition, as well as of the distance between the plates. The detection of this effect seems to be feasible in the foreseeable future.

(Table T1) Magnetic properties of MORB from ODP Leg 187 sites

The core samples of mid-ocean-ridge basalts (including Indian and Pacific type) recovered from the Southeast Indian Ridge (SEIR) area near the Australian Antarctic Discordance during Ocean Drilling Program Leg 187 were studied using rock magnetism, mineralogy, and petrography methods. On the basis of thermomagnetic analyses and low-temperature magnetometry, the dominant magnetic carrier in most of the basalt samples (pillow basalts) is characterized as titanomaghemite, which presumably formed by low-temperature oxidation of primary titanomagnetite. Some samples from unaltered massive basalts contain nearly unoxidized titanomagnetite as the main magnetic mineral. A metadiabase sample showing greenschist facies metamorphism contains magnetic minerals dominated by magnetite. The pillow basalts contain titanomaghemite ranging from stable single-domain to pseudosingle-domain (PSD) grains, and the majority are characterized by a single stable component of remanence. The massive basalts show hysteresis features of larger PSD grains and contain a very low coercivity remanence. The values of natural remanent magnetization (NRM) of the samples in this SEIR area are on the same order as those of other oceanic ridge basalts. They show a general decreasing trend of NRM with increasing crust age. However, the values of NRM show no correlation either with the tectonic zonations (Zone A vs. Zone B) or with the mantle provinces (Pacific vs. Indian types).

Magnetic hysteresis parameters of ODP Site 178-1096 (Table T1)

During Ocean Drilling Program (ODP) Leg 178, we drilled three sites on sediment drifts deposited on the continental rise on the western margin of the Antarctic Peninsula. These hemipelagic drifts were targeted for their potential to preserve a continuous record of the behavior of the West Antarctic Ice Sheet over the last 10 m.y. It has been proposed that drift development is linked to advances and retreats of the Antarctic continental ice sheet (Pudsey and Camerlenghi, 1998, doi:10.1017/S0954102098000376, and references therein; Barker, Camerlenghi, Acton, et al., 1999, doi:10.2973/odp.proc.ir.178.1999). However, the sediment is characterized by a very low carbonate content, with foraminifers restricted to very narrow intervals. This lack of carbonate precludes the construction of a delta18O or CaCO3 stratigraphy, depriving these sites of an important chronologic tool and global ice volume proxy.

Magnetic remanence acquisition in DSDP Leg 73 Holes

The major magnetic mineral in the turbidites and slumped sediments recovered at Leg 73 drill sites was near to magnetite in composition and in the form of small multidomain particles. There was no variation in magnetic mineralogy with the lithology. The variations in the intensities and directions of the natural remanent magnetization could be explained in terms of postdepositional grain rotations within the wet sediment. In the sands realignment was partial, whereas in some of the slumps the entire remanent magnetization was reset. Fine-particle magnetite was also the main magnetic constituent of the red clays. A significant proportion of a higher-coercivity mineral was also present. The magnetic characteristics of the red clays are explained as a combination of concentration and grain rotation effects. The implications to the assessment of the reliability of paleomagnetic data are discussed. Note: Conversion factors are as follows: 1 Am**2/kg = 1 emu/g, and 80 A/m about 1 Oe.

Magnetic properties and geochemistry in DSDP Holes 69-504B an d 69-505B

More than 60 basalt samples from two Deep Sea Drilling Project holes on the Costa Rica Rift were studied for magnetic properties and were found to have no properties significantly different from other DSDP basalts. Opaque mineralogical and thermomagnetic properties of these samples, however, to some extent show differences from normal submarine basalts; a new type of thermomagnetic curve and wide range of chemical compositions were recognized. Oxidized samples possibly containing incipient ilmenite exsolution lamellae were reduced and re-equilibrated during heating. The Curie temperatures of the re-equilibrated titanomagnetites are interpreted to be those of the original crystallized phase before oxidation.

Geochemical data and magnetic measurements of IODP Expedition 308, Hole U1319A from the Gulf of Mexico

A 160 m mostly turbiditic late Pleistocene sediment sequence (IODP Expedition 308, Hole U1319A) from the Brazos-Trinity intraslope basin system off Texas was investigated with paleo- and rock magnetic methods. Numerous layers depleted in iron oxides and enriched by the ferrimagnetic iron-sulfide mineral greigite (Fe3S4) were detected by diagnostic magnetic properties. From the distribution of these layers, their stratigraphic context and the present geochemical zonation, we develop two conceptual reaction models of greigite formation in non-steady depositional environments. The "sulfidization model" predicts single or twin greigite layers by incomplete transformation of iron monosulfides with polysulfides around the sulfate methane transition (SMT). The "oxidation model" explains greigite formation by partial oxidation of iron monosulfides near the iron redox boundary during periods of downward shifting oxidation fronts. The stratigraphic record provides evidence that both these greigite formation processes act here at typical depths of about 12-14 mbsf and 3-4 mbsf. Numerous "fossil" greigite layers most likely preserved by rapid upward shifts of the redox zonation denote past SMT and sea floor positions characterized by stagnant hemipelagic sedimentation conditions. Six diagenetic stages from a pristine magnetite-dominated to a fully greigite-dominated magnetic mineralogy were differentiated by combination of various hysteresis and remanence parameters.

Magnetic observation of ODP Site 152-919 in the Irminger Basin, North Atlantic

Component natural remanent magnetizations derived from u-channel and 1-qcm discrete samples from ODP Site 919 (Irminger Basin) indicate the existence of four intervals of negative inclinations in the upper Brunhes Chronozone. According to the age model based on planktic oxygen isotope data, these "excursional" intervals occur in sediments deposited during the following time intervals: 32-34 ka, 39-41 ka, 180-188 ka and 205-225 ka. These time intervals correspond to polarity excursions detected elsewhere, known as Mono Lake, Laschamp, Iceland Basin and Pringle Falls. The isotope-based age model is supported by the normalized remanence (paleointensity) record that can be correlated to other calibrated paleointensity records for the 0-500 ka interval, such as that from ODP Site 983. For the intervals associated with the Mono Lake and Laschamp excursions, virtual geomagnetic poles (VGPs) reach equatorial latitudes and mid-southerly latitudes, respectively. For intervals associated with the Iceland Basin and Pringle Falls excursions, repeated excursions of VGPs to high southerly latitudes indicate rapid directional swings rather than a single short-lived polarity reversal. The directional instability associated with polarity excursions is not often recorded, probably due to smoothing of the sedimentary record by the process of detrital remanence (DRM) acquisition.

Bulk rock magnetic measurements and thermomagnetic analyses of sediment core GeoB4901-8 from the southeastern flank of the Niger deep-sea fan

Diagenesis has extensively affected the magnetic mineral inventory of organic-rich late Quaternary sediments in the Niger deep-sea fan. Changes in concentration, grain size, and coercivity document modifications of the primary magnetic mineral assemblages at two horizons. The first front, the modern iron redox boundary, is characterized by a drastic decline in magnetic mineral content, coarsening of the grain size spectrum, and reduction in coercivity. Beneath a second front, the transition from the suboxic to the sulfidic anoxic domain, a further but less pronounced decrease in concentration and bulk grain size occurs. Finer grains and higher coercive magnetic constituents substantially increase in the anoxic environment. Low- and high-temperature experiments were performed on bulk sediments and on extracts which have also been examined by X-ray diffraction. Thermomagnetic analyses proved ferrimagnetic titanomagnetites of terrigenous provenance as the principal primary magnetic mineral components. Their broad range of titanium contents reflects the volcanogenic traits of the Niger River drainage areas. Diagenetic alteration is not only a grain size selective process but also critically depends on titanomagnetite composition. Low-titanium compounds are less resistant to diagenetic dissolution. Intermediate titanium content titanomagnetite thus persists as the predominant magnetic mineral fraction in the sulfidic anoxic sediments. At the Fe redox boundary, precipitation of authigenic, possibly bacterial, magnetite is documented. The presence of hydrogen sulfide in the pore water suggests a formation of secondary magnetic iron sulfides in the anoxic domain. Grain size-specific data argue for a gradual development of a superparamagnetic and single-domain iron sulfide phase in this milieu, most likely greigite.