• Emerging brain-based interventions for children and adolescents: overview and clinical perspective

      Hirshberg, Laurence M.; Chiu, Sufen; Frazier, Jean A. (2005-01-27)
      Electroencephalogram biofeedback (EBF), repetitive transcranial magnetic stimulation (rTMS), and vagal nerve stimulation (VNS) are emerging interventions that attempt to directly impact brain function through neurostimulation and neurofeedback mechanisms. This article provides a brief overview of each of these techniques, summarizes the relevant research findings, and examines the implications of this research for practice standards based on the guidelines for recommending evidence based treatments as developed by the American Academy of Child and Adolescent Psychiatry for attention deficit hyperactivity disorder (ADHD). EBF meets the "Clinical Guidelines" standard for ADHD, seizure disorders, anxiety, depression, and traumatic brain injury. VNS meets this same standard for treatment of refractory epilepsy and meets the lower "Options" standard for several other disorders. rTMS meets the standard for "Clinical Guidelines" for bipolar disorder, unipolar disorder, and schizophrenia. Several conditions are discussed regarding the use of evidence based thinking related to these emerging interventions and future directions.
    • Emerging interventions

      Hirshberg, Laurence M.; Chiu, Sufen; Frazier, Jean A. (2005-01-27)
    • Mapping the bilateral visual integration by EEG and fMRI

      Liu, Zhongming; Zhang, Nanyin; Chen, Wei; He, Bin (2009-07-15)
      In the human visual system, the internal representation of the left and right visual hemifields is split at the midline of the two cerebral hemispheres. The present study aims to address the questions of when and where the lateralized cortical visual representations are merged to form an intact percept by using a multimodal neuroimaging approach. Visual evoked potential (VEP) and functional magnetic resonance imaging (fMRI) data were acquired from a group of healthy subjects presented with unilateral versus bilateral visual stimuli. Cortical activities involved in processing bilateral visual information are expected to be equally responsive to ipsilateral and contralateral stimuli, and demonstrate spatial nonlinearity in the response to bilateral stimuli. Utilizing these features, we performed integrative as well as separate analyses for both VEP and fMRI data. The present results suggest that i) the majority of cortical activity that integrates visual information across hemifields takes place at extrastriate areas during late visual processing, and that ii) the lateral occipito-temporal (LOT) regions (likely the MT+ complex) and the medial occipital cortex (i.e. V1) may contribute to bilateral visual integration during early visual processing. Our findings are generally in agreement with the bottom-up visual hierarchy, with the exception of the evidence suggesting an early activation of the higher-tier LOT areas and the influence from ipsilateral visual inputs upon the V1 response.
    • Polysomnographic characteristics of young manic patients. Comparison with unipolar depressed patients and normal control subjects

      Hudson, James I.; Lipinski, Joseph F.; Keck, Paul E.; Aizley, Harlyn G.; Lukas, Scott E.; Rothschild, Anthony J.; Waternaux, Christine M.; Kupfer, David J. (1992-05-11)
      Although sleep disturbance is a prominent feature of mania, its polysomnographic (PSG) features have received little study. To investigate more systematically the PSG characteristics of sleep in mania, all-night PSG evaluations were performed for two to four consecutive nights in 19 young manic patients (age range, 18 to 36 years), 19 age-matched patients with major depression, and 19 age-matched normal control subjects. Manic and depressed patients displayed nearly identical profiles of PSG abnormalities compared with normal control subjects, including disturbed sleep continuity, increased percentage of stage 1 sleep, shortened rapid eye movement latency, and increased rapid eye movement density. These results are similar to those reported in previous studies of major depression, and they are consistent with the possibility that the sleep disturbance in mania and major depression is caused by the same mechanism.