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Most functional imaging studies of the auditory system have employed complex stimuli. We used positron emission tomography to map neural responses to 0.5 and 4.0 kHz sine-wave tones presented to the right ear at 30, 50, 70 and 90 dB HL and found activation in a complex neural network of elements traditionally associated with the auditory system as well as non-traditional sites such as the posterior cingulate cortex. Cingulate activity was maximal at low stimulus intensities, suggesting that it may function as a gain control center. In the right temporal lobe, the location of the maximal response varied with the intensity, but not with the frequency of the stimuli. In the left temporal lobe, there was evidence for tonotopic organization: a site lateral to the left primary auditory cortex was activated equally by both tones while a second site in primary auditory cortex was more responsive to the higher frequency. Infratentorial activations were contralateral to the stimulated ear and included the lateral cerebellum, the lateral pontine tegmentum, the midbrain and the medial geniculate. Contrary to predictions based on cochlear membrane mechanics, at each intensity, 4.0 kHz stimuli were more potent activators of the brain than the 0.5 kHz stimuli.

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Do the brains of men and women show similar patterns of functional organization for language, or are men more strongly lateralized? We used PET to measure cerebral blood flow (CBF) as men and women read real and nonce verbs, and produced past tense forms. While the overall patterns of reaction time, error, and brain activation were similar, there were also significant sex-related differences in CBF patterns. During the past tense generation tasks, men showed left-lateralized activation while women recruited bilateral perisylvian cortex, confirming differences in functional laterality. During all tasks, women showed higher activation in occipital and/or cerebellar regions, suggesting differences in basic reading strategies. We conclude that sex differences in functional cortical organization exist in the absence of significant behavioral differences.

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Previous functional neuroimaging studies of attention have emphasized the visual modality. We developed an auditory version of the continuous performance test (CPT) that included simple, focused and divided attention conditions. Positron emission tomographic (PET) scans were acquired during CPT performance in normal young adults and then submitted to statistical parametric mapping. Simple attention brought about a large region of activation involving the anterior cingulate gyrus and the right anterior/mesial frontal lobe. Focused and divided attention CPT conditions were compared but there were few significant differences. The findings are consistent with activation of an anterior attention network during auditory attention, without involvement of posterior attention structures which are more likely to vary in accordance with sensory modality.

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We used PET to map brain regions responding to changes in tinnitus loudness in four patients who could alter tinnitus loudness by performing voluntary oral facial movements (OFMs). Cerebral blood flow was measured in four patients and six controls at rest, during the OFM, and during stimulation with pure tones. OFM-induced loudness changes affected the auditory cortex contralateral to the ear in which tinnitus was perceived, whereas unilateral cochlear stimulation caused bilateral effects, suggesting a retrocochlear origin for their tinnitus. Patients, compared with controls, showed evidence for more widespread activation by the tones and aberrant links between the limbic and auditory systems. These abnormal patterns provide evidence for cortical plasticity that may account for tinnitus and associated symptoms. Although audiologic symptoms and examinations of these patients were typical, the unusual ability to modulate tinnitus loudness with an OFM suggests some caution may be warranted in generalizing these findings.

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To evaluate the possible role of attentional centers as modulators of neural networks that mediate visual tasks involving reading and grammatical manipulations of verbs, we measured cerebral blood flow (CBF) using positron emission tomography (PET), and reaction times as subjects read verbs, "nonce verbs" such as jelt or brep, and formed past tenses of regular, irregular and nonce verbs after viewing their stems. Statistical parametric maps (SPMs) showed significant activation of the pulvinar in the read verb irregular, and generate nonce past tense tasks, compared to rest. This was confirmed by a post hoc ANOVA of CBF values from a discrete locus in the pulvinar (p = .0000417). Functional links between the pulvinar and other brain regions were shown by high correlations of CBF in the pulvinar with CBF in brain regions known to have anatomical connections to the pulvinar, particularly those mediating vision. There was also a significant relationship between task-specific reaction times and rest minus task CBF differences in a multiple regression analysis that included CBF values from the pulvinar, superior colliculus plus reticular formation, and the anterior cingulate, known attentional centers (p = .021, r2 = 0.99). Regression analyses relating reaction time to the amount of brain activated (pixels in the SPMs) and the degree of activation of the pixels (mean Z score) yielded p values of .078 and .074, respectively. Our data provide direct experimental evidence to support the hypothesis that attentional centers are activated in proportion to the complexity of visually mediated language tasks and that the centers that mediate attention modulate the activity of task-specific neural networks.

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Many patients with compensated cirrhosis without overt hepatic encephalopathy have deficits in visual-spatial perception, a condition we call minimal hepatic encephalopathy. Five patients with alcohol-induced cirrhosis and nine control subjects underwent positron-emission tomographic imaging of the brain with 18F-fluorodeoxyglucose. Patients also underwent neuropsychological and clinical chemistry tests. The patients had mild arterial hyperammonemia (62 +/- 13 mumol/L, range = 11 to 35 mumol/L) and other abnormalities typical of patients with cirrhosis. The patients' mean percentile scores on the digit symbol and block design subtests, from the Wechsler Adult Intelligence Scale (revised), and Purdue pegboard test were 11 +/- 7, 24 +/- 7 and 7 +/- 8 (right hand). Tests of vocabulary, memory, and new learning were normal. The technique of statistical parametric mapping was used to identify regions where cerebral 18F-fluorodeoxyglucose uptake and metabolism were abnormal. We noted significant reductions in the cingulate gyrus, a center mediating attention, target analysis and response formulation and significant increases in visual associative regions subserving motion and color perception and object orientation. We suggest that minimal hepatic encephalopathy is due to a deficit in the detection and formulation of responses to visual stimuli, a function of the cingulate, which is a part of the anterior attentional system of the brain. Increases in 18F-fluorodeoxyglucose metabolism may be compensatory. These studies show that brain regions differ in their sensitivity to the agents that cause hepatic encephalopathy and that positron-emission tomography is useful in studying the pathophysiology of this disorder.

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The signal-to-noise ratio (SNR) in magnetic resonance imaging represents one of the system operating variables that must be determined both for evaluating the performance of different imaging protocols on a particular machine, and for monitoring machine performance as part of a routine quality control (QC) program. Utilizing a phantom and set of automated analysis programs currently under development, this study evaluated several ways of measuring image signal and noise and demonstrated the importance of utilizing measured voxel volumes as opposed to nominal volumes in the calculation of SNR. The NEMA proposed standard for SNR is compared with several other SNR measures and is recommended as the measure to be used in routine SNR reporting. The importance of utilizing other SNR measures in addition to the NEMA proposed standard for routine QC is discussed.

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As with other digital imaging systems in heavy medical use, it is desirable with magnetic resonance imaging (MRI) to obtain extensive, rigorous system performance measures from a small set of images of one or two relatively simple test objects. Digital analysis of the parallel square rod (PSR) test object introduces digital image system self-evaluation to MRI and extends automated image evaluation to include rigorous measures throughout the imaging volume rather than just average measures over the image. Precise comparisons with theory and between systems can be performed as well as quality control and corrections for nonuniformities. The PSR test object consists of an 18 X 18 X 36 cm rectangular acrylic container enclosing 60 parallel square acrylic rods running the entire length. The inter-rod space is filled with a liquid or gel that produces strong, tissuelike signals in MRI and high contrast relative to the rods for computed tomography (CT). For profiles of slice thickness and separation, the rods are tilted in the test object to intersect the image plane at a 45 degree angle when the test object sides are parallel and perpendicular to the image plane. The test object itself is rotated 6-12 degrees about its major axis so that the sides of the rods make a small angle to the rows and columns of pixels. This allows digital sampling at finer spacing than the pixels for determination of edge response functions.(ABSTRACT TRUNCATED AT 250 WORDS)

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