2003年诺贝尔医学奖给科学界的多重启示(上)

2003年诺贝尔医学奖授予了两位美英物理学家,劳特布尔和曼斯菲尔德,表彰他们在磁共振成像方面的发现.这些发现导致现代磁共振技术的开发,这一技术标志着医学诊断学和科学研究中的一项突破.该项发现建筑在核磁和核磁共振现象被发现的基础之上.核磁现象的发现及其应用导致了1943、1944和1952年诺贝尔物理学奖的获得.核磁共振现象的发现及其应用导致了1991年和2002年诺贝尔化学奖的获得.这意味着,2003年诺贝尔医学奖是该系列发现中第六个诺贝尔科学奖.     

语篇理解中背景信息的激活: 情景限制的共振过程

该研究采用双人物线索语篇材料,对语篇理解中背景信息激活过程的共振模型与剧景模型进行检验。实验一发现,如果主角和配角一直同时在故事情景中成为主线索,则目标句中主角的行为可以激活那些经过屏蔽的、与这一行为相关的配角特征。在实验二中,配角只是在特征描述段落中出现,而后通过适当的描述使其在故事情景中消失,使主角成为故事的主线索,结果发现,此时目标句中主角的行为并不会激活经过屏蔽的配角的特征描述。这些结果表明,背景信息的激活虽然具有共振的特点,但共振并不是无范围限制的,而是一种情景限制下的共振。     

Co-localisation of abnormal brain structure and function in specific language impairment

We assessed the relationship between brain structure and function in 10 individuals with specific language impairment (SLI), compared to six unaffected siblings, and 16 unrelated control participants with typical language. Voxel-based morphometry indicated that grey matter in the SLI group, relative to controls, was increased in the left inferior frontal cortex and decreased in the right caudate nucleus and superior temporal cortex bilaterally. The unaffected siblings also showed reduced grey matter in the caudate nucleus relative to controls. In an auditory covert naming task, the SLI group showed reduced activation in the left inferior frontal cortex, right putamen, and in the superior temporal cortex bilaterally. Despite spatially coincident structural and functional abnormalities in frontal and temporal areas, the relationships between structure and function in these regions were different. These findings suggest multiple structural and functional abnormalities in SLI that are differently associated with receptive and expressive language processing.     

Brain activity in adults who stutter: similarities across speaking tasks and correlations with stuttering frequency and speaking rate

Many differences in brain activity have been reported between persons who stutter (PWS) and typically fluent controls during oral reading tasks. An earlier meta-analysis of imaging studies identified stutter-related regions, but recent studies report less agreement with those regions. A PET study on adult dextral PWS (n = 18) and matched fluent controls (CONT, n = 12) is reported that used both oral reading and monologue tasks. After correcting for speech rate differences between the groups the task-activation differences were surprisingly small. For both analyses only some regions previously considered stutter-related were more activated in the PWS group than in the CONT group, and these were also activated during eyes-closed rest (ECR). In the PWS group, stuttering frequency was correlated with cortico-striatal-thalamic circuit activity in both speaking tasks. The neuroimaging findings for the PWS group, relative to the CONT group, appear consistent with neuroanatomic abnormalities being increasingly reported among PWS.     

Cognitive impairment and whole brain diffusion in patients with neuromyelitis optica after acute relapse

The objective of this study investigated cognitive impairments and their correlations with fractional anisotropy (FA) and mean diffusivity (MD) in patients with neuromyelitis optica (NMO) without visible lesions on conventional brain MRI during acute relapse. Twenty one patients with NMO and 21 normal control subjects received several cognitive tests to assess cognitive function. Head diffusion tensor imaging (DTI) of all patients with NMO were collected with a 3-T MR system. Correlations of cognitive test scores and whole brain FA and MD were examined by voxel-based analysis. Region-of-interest analysis was applied to the significantly correlated regions which the most frequently appeared. We found that NMO patients without visible brain lesions had significantly impaired learning and memory, decreased information processing speed, and damaged attention compared with normal control subjects. These impaired cognitive domains were significantly correlated with FA and MD in local regions of corpus callosum, anterior cingulate and medial frontal cortex. In corpus callosum of NMO patients, mean FA was significantly lower and mean MD higher than normal control subjects. Our findings suggest that cognitive impairments in learning and memory, information processing speed and attention occur in NMO patients without visible brain lesions during acute relapse. The impairments in immediate and short-term memory in NMO patients may be due to information encoding deficits in the process of information acquisition. The corpus callosum of such patients may have local microscopic damages that play a role in cognitive impairments during acute relapse.     

The role of the human extrastriate visual cortex in mirror symmetry discrimination: a TMS-adaptation study

The human visual system is able to efficiently extract symmetry information from the visual environment. Prior neuroimaging evidence has revealed symmetry-preferring neuronal representations in the dorsolateral extrastriate visual cortex; the objective of the present study was to investigate the necessity of these representations in symmetry discrimination. This was accomplished by the use of state-dependent transcranial magnetic stimulation, which combines the fine resolution of adaptation paradigms with the assessment of causality. Subjects were presented with adapters and targets consisting of dot configurations that could be symmetric along either the vertical or horizontal axis (or they could be non-symmetric), and they were asked to perform a symmetry discrimination task on the targets while fixating the center of the screen. TMS was applied during the delay between the adapter and the test stimulus over one of four different sites: Left or Right V1/V2, or left or right dorsolateral extrastriate cortex (DLO). TMS over both Left and Right DLO reduced the adaptation effect in detecting vertical and horizontal symmetry, although the Left DLO effect on horizontal symmetry and the Right DLO effect on both vertical and horizontal symmetry were present only when considering subjects who showed a behavioral adaptation effect in the baseline No-TMS condition. Application of TMS over the Left or Right V1/V2 did not modulate the adaptation effect. Overall, these data suggest that both the Left and Right DLO contain neuronal representations tuned to mirror symmetry which play a causal role in symmetry discrimination.     

Dorsolateral prefrontal cortex mediates working memory processes in motor skill learning

Neuroimaging studies have shown that the dorsolateral prefrontal cortex (DLPFC) is recruited during motor skill learning, which suggests the involvement of the DLPFC in working memory (WM) processes, such as selection and integration of motor representations temporarily stored in WM. However, direct evidence linking activation of the DLPFC to WM storage and manipulation during motor skill learning in real-time is rare. In this study, we conducted two experiments to investigate the causal role of DLPFC activity in WM storage and manipulation during motor skill learning under low and high WM-demand conditions. Participants received continuous theta burst stimulation (cTBS) and sham stimulation (crossover design) over the left DLPFC (experiment 1) or right DLPFC (experiment 2). Before and after stimulation, participants in both experiments performed a sequential finger-tapping (SFT) task containing repeated sequence (low-WM demand) and non-repeated sequence (high-WM demand) conditions which are used to study WM processes. The number of correct sequences (NoCS) and reproduction error rate were analyzed. Learning gains in NoCS improved significantly with the practice for both sequence types in the presence of either stimulation type. Compared to sham stimulation, cTBS over the left DLPFC resulted in significantly reduced learning gains in NoCS for non-repeated sequences. These results suggest that the left DLPFC contributes to WM manipulation during motor skill learning.     

Theory and teen dating violence victimization: Considering adolescent development

Teen dating violence is an important public health problem, with implications for the future health and well-being of adolescents. However, most work on teen dating violence has developed separately from literature on normative adolescent romantic relationships and development; understanding teen dating violence within the framework of adolescent psychosocial development may provide new areas for research. Thus, the present paper summarizes five theories of adolescent development that are relevant to the study of teen dating violence victimization, as well as empirical literature that demonstrates support for key theoretical tenets in research examining adolescent romantic relationships. We also present questions for future dating violence study that arise from these key theoretical tenets and past empirical research. Researchers interested in dating violence victimization can use the presented theories to guide new directions in research inquiry, so that findings are situated within the broader field of adolescent development.     

医学影像学见习应用PACS教学法与传统读片教学法的对比研究

将中南大学湘雅医学院2010级临床医学五年制197名学生随机分成两组,在医学影像学见习教学过程中分别应用影像存储及传输系统（PACS）教学法（98人）及传统读片教学法（99人）,学期结束时对两组学生考试成绩进行分析,并对PACS组学生进行问卷调查及结果分析.统计数据显示,PACS组学生读片测验及卷面考试中,病例分析题成绩显著高于传统读片组,问卷调查显示PACS组学生大多数认可该教学方法.因此,应用PACS教学有助于提高学生的临床分析能力及主动学习的能力,是学生欢迎的教学方式.但对医学影像学基本知识的传授,应用PACS法较传统读片法并无明显优势.