We have developed a classifier capable of locating and identifying speech sounds using activity from rat auditory cortex with an accuracy equivalent to behavioral performance and without the need to specify the onset time of the speech sounds. This classifier can identify speech sounds from a large speech set within 40 ms of stimulus presentation. To compare the temporal limits of the classifier to behavior, we developed a novel task that requires rats to identify individual consonant sounds from a stream of distracter consonants. The classifier successfully predicted the ability of rats to accurately identify speech sounds for syllable presentation rates up to 10 syllables per second (up to 17.9 ± 1.5 bits/s), which is comparable to human performance. Our results demonstrate that the spatiotemporal patterns generated in primary auditory cortex can be used to quickly and accurately identify consonant sounds from a continuous speech stream without prior knowledge of the stimulus onset times. Improved understanding of the neural mechanisms that support robust speech processing in difficult listening conditions could improve the identification and treatment of a variety of speech-processing disorders.

One in 15 school age children have dyslexia, which is characterized by phoneme-processing problems and difficulty learning to read. Dyslexia is associated with mutations in the gene KIAA0319. It is not known whether reduced expression of KIAA0319 can degrade the brain's ability to process phonemes. In the current study, we used RNA interference (RNAi) to reduce expression of Kiaa0319 (the rat homolog of the human gene KIAA0319) and evaluate the effect in a rat model of phoneme discrimination. Speech discrimination thresholds in normal rats are nearly identical to human thresholds. We recorded multiunit neural responses to isolated speech sounds in primary auditory cortex (A1) of rats that received in utero RNAi of Kiaa0319. Reduced expression of Kiaa0319 increased the trial-by-trial variability of speech responses and reduced the neural discrimination ability of speech sounds. Intracellular recordings from affected neurons revealed that reduced expression of Kiaa0319 increased neural excitability and input resistance. These results provide the first evidence that decreased expression of the dyslexia-associated gene Kiaa0319 can alter cortical responses and impair phoneme processing in auditory cortex.

Upper limb impairment is a common debilitating consequence of ischemic stroke. Physical rehabilitation after stroke enhances neuroplasticity and improves limb function, but does not typically restore normal movement. We have recently developed a novel method that uses vagus nerve stimulation (VNS) paired with forelimb movements to drive specific, long-lasting map plasticity in rat primary motor cortex. Here we report that VNS paired with rehabilitative training can enhance recovery of forelimb force generation following infarction of primary motor cortex in rats. Quantitative measures of forelimb function returned to pre-lesion levels when VNS was delivered during rehab training. Intensive rehab training without VNS failed to restore function back to pre-lesion levels. Animals that received VNS during rehab improved twice as much as rats that received the same rehabilitation without VNS. VNS delivered during physical rehabilitation represents a novel method that may provide long-lasting benefits towards stroke recovery.

INTRODUCTION Transcranial Doppler (TCD) is a physiological ultrasound test with established safety and efficacy. Although imaging devices may be used to depict intracranial flow superimposed on structural visualization, the end-result provided by imaging duplex or nonimaging TCD is sampling physiological flow variables through the spectral waveform assessment. SUMMARY OF RESULTS Clinical indications considered by this multidisciplinary panel of experts as established are: sickle cell disease, cerebral ischemia, detection of right-to-left shunts (RLS), subarachnoid hemorrhage, brain death, and periprocedural or surgical monitoring. The following TCD-procedures are performed in routine in- and outpatient clinical practice: complete or partial TCD-examination to detect normal, stenosed, or occluded intracranial vessels, collaterals to locate an arterial obstruction and refine carotid-duplex or noninvasive angiographic findings; vasomotor reactivity testing to identify high-risk patients for first-ever or recurrent stroke; emboli detection to detect, localize, and quantify cerebral embolization in real time; RLS-detection in patients with suspected paradoxical embolism or those considered for shunt closure; monitoring of thrombolysis to facilitate recanalization and detect reocclusion; monitoring of endovascular stenting, carotid endarterectomy, and cardiac surgery to detect perioperative embolism, thrombosis, hypo- and hyperperfusion. CONCLUSION By defining the scope of practice, these standards will assist referring and reporting physicians and third parties involved in the process of requesting, evaluating, and acting upon TCD results.

Rats were trained in a 2-alternative odor choice task to discriminate between a 10-component odor mixture and the same mixture with one component removed and replaced with 1 of 3 concentrations of a different monomolecular odor (contaminant). All stimuli were presented within a training session, thus the rat essentially had to learn to discriminate the 10-component mixture from "not" the 10-component mixture. Rats performed most poorly discriminating the complete mixture from the mixture with one component removed and no contaminant added. As the concentration of the contaminant increased from 10 ppm to a concentration equal to the other components (100 ppm), discrimination improved linearly. In analyses of individual differences, rats that spent more time in the sampling port (sampling and making a decision) were more accurate than rats that spent less time. Together, these results emphasize the balance between perceptual stability and perceptual discrimination expressed by the olfactory system dealing with dynamic mixtures and the robust effects of contamination on those processes. In addition, they provide further support that modification of sampling/decision time is a strategy used by rats to deal with difficult discriminations of complex odors.

Journal of NeuroimagingVolume 19, Issue 3 p. 298-299 Current Issues in Neuroimaging Michael A. Sloan MD, MS, FAAN, Michael A. Sloan MD, MS, FAANSearch for more papers by this author Michael A. Sloan MD, MS, FAAN, Michael A. Sloan MD, MS, FAANSearch for more papers by this author First published: 22 June 2009 https://doi.org/10.1111/j.1552-6569.2007.00190.xCitations: 1 Correspondence: Address correspondence to Michael A. Sloan; Carolinas Medical Center – Division of Neurology, 1010 Edgehill Road North Charlotte North Carolina 28207. United States. E-mail: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Inglehart JK. The new era of medical imaging: progress and pitfalls. New Engl J Med 2006; 354: 2822– 2828. 2 Schriger DL, Kalafut M, Starkman S, Kreuger M, Saver JL. Cranial computed tomography interpretation in acute stroke. Physician accuracy in determining eligibility for thrombolytic therapy. JAMA 1998; 279: 1293– 1297. 3 McCarron MO, Sands C, McCarron P. Quality assurance of neuroradiology in a district general hospital. Q J Med 2006; 99: 171– 175. 4 Hillman BJ, Olson GT, Colbert RW, Bernhardt LB. Responses to a payment policy denying professional charges for diagnostic imaging by nonradiologist physicians. JAMA 1995; 274: 885– 887. Citing Literature Volume19, Issue3July 2009Pages 298-299 ReferencesRelatedInformation

point was all-cause death, MI, recurrent ischemia that required urgent revascularization, or thrombotic bailout at 96 hours. The key secondary efficacy end point was all-cause death or MI within 30 days. Safety end points included major hemorrhage and transfu-sions through 120 hours after randomization. The study was powered to detect 22.5% and 15% relative reductions in the primary and key secondary end points, respectively. the early administration of eptifibatide upstream before cardiac catheterization has not been identified. Early GP IIb/IIIa therapy in patient groups continues to appear reasonable if they are judged clinically to be at high risk of thrombotic events relative to bleeding risk. not been studied prospectively. For post-PCI patients receiving a DES, a daily MD should be given for at least 12 and up to 15 months unless the risk of bleeding outweighs the anticipated net benefit afforded b y a thienopyridine. Do not use prasugrel in patients with active pathological bleeding or a history of TIA or stroke. In patients (cid:1) 75 years of age, prasugrel is generally not recommended because of the increased risk of fatal and intracranial bleeding and uncertain benefit, except in high-risk situations (patients with diabetes or a history of prior MI) for which its effect appears to be greater and its use may be considered. Do not start prasugrel in patients likely to undergo urgent CABG. When possible, discontinue prasugrel at least 7 days before any surgery. Additional risk factors for bleeding include body weight (cid:4) 60 kg, propensity to bleed, concomitant use of medications that increase the risk of bleeding (eg, warfarin, heparin, fibrinolytic therapy, or chronic use of nonsteroidal antiinflammatory drugs). Angio angiography; coronary artery catheterization evidence; percutaneous coronary intervention; ST-elevation myocardial infarction. anticoagulant, oral antiplatelet agents, intravenous of symptoms; risk of STEMI; risks associated with fibrinolytic therapy; time required for transport to a skilled PCI

Acute low back pain with or without radiculopathy is one of the most common health problems in the United States, with high annual costs of evaluation and treatment, not including lost productivity. Multiple reports show that uncomplicated acute low back pain or radiculopathy is a benign, self-limited condition that does not warrant any imaging studies. Guidelines for recognition of patients with more complicated status can be used to identify those who require further evaluation for suspicion of more serious problems and contribute to appropriate imaging utilization.

Transcranial Doppler ultrasonography (TCD) is the only noninvasive real-time neuroimaging modality for the evaluation of characteristics of blood flow in basal intracerebral vessels that adds physiologic information to structural imaging. TCD has been rapidly evolving from a simple noninvasive diagnostic tool to an imaging modality with a broad spectrum of clinical applications. In acute stroke, TCD can provide rapid information about vascular stenosis and occlusion, the hemodynamic status of the cerebral circulation, and real-time monitoring of recanalization. Extended applications such as vasomotor reactivity testing, emboli monitoring, and right-to-left shunt detection help clinicians ascertain stroke mechanisms at the bedside, plan and monitor treatment, and determine prognosis. In the neurointensive care unit, TCD is useful for detecting increased intracranial pressure and confirming cerebral circulatory arrest. TCD is of established value for screening children with sickle cell disease and detecting and monitoring vasospasm after spontaneous subarachnoid hemorrhage.

*Chair of 2004 Writing Committee; †Recused from voting on Section 8: Anticoagulants as Ancillary Therapy and Section 10: Anticoagulants; ‡Recused from voting on Section 5: Facilitated PCI; §Canadian Cardiovascular Society Representative; American Academy of Family Physicians Representative; ¶American College of Physicians Representative; **Recused from voting on Section 7: PCI After Fibrinolysis or for Patients Not Undergoing Primary Reperfusion; ††Performance Measures Liaison; ublished by Elsevier Inc. doi:10.1016/j.jacc.2007.10.001

Indications for the clinical use of transcranial Doppler (TCD) continue to expand while scanning protocols and quality of reporting vary between institutions. Based on literature analysis and extensive personal experience, an international expert panel started the development of guidelines for TCD performance, interpretation, and competence. The first part describes complete diagnostic spectral TCD examination for patients with cerebrovascular diseases. Cranial temporal bone windows are used for the detection of the middle cerebral arteries (MCA), anterior cerebral arteries (ACA), posterior cerebral arteries (PCA), C1 segment of the internal carotid arteries (ICA), and collateralization of flow via the anterior (AComA) and posterior (PComA) communicating arteries; orbital windows-for the ophthalmic artery (OA) and ICA siphon; the foraminal window-for the terminal vertebral (VA) and basilar (BA) arteries. Although there is a significant individual variability of the circle of Willis with and without disease, the complete diagnostic TCD examination should include bilateral assessment of the M2 (arbitrarily located at 30-40 mm depth), M1 (40-65 mm) MCA [with M1 MCA mid-point at 50 mm (range 45-55 mm), average length 16 mm (range 5-24 mm), A1 ACA (60-75 mm), C1 ICA (60-70 mm), P1-P2 PCA (average depth 63 mm (range 55-75 mm), AComA (70-80 mm), PComA (58-65 mm), OA (40-50 mm), ICA siphons (55-65 mm), terminal VA (40-75 mm), proximal (75-80), mid (80-90 mm), and distal (90-110 mm) BA]. The distal ICA on the neck (40-60 mm) can be located via submandibular windows to calculate the VMCA/VICA index, or the Lindegaard ratio for vasospasm grading after subarachnoid hemorrhage. Performance goals of diagnostic TCD are to detect and optimize arterial segment-specific spectral waveforms, determine flow direction, measure cerebral blood flow velocities and flow pulsatility in the above-mentioned arteries. These practice standards will assist laboratory accreditation processes by providing a standard scanning protocol with transducer positioning and orientation, depth selection and vessel identification for ultrasound devices equipped with spectral Doppler and power motion Doppler.