Disrupting the right pars opercularis with electrical stimulation frees the song: case report

2015 ◽  
Vol 123 (6) ◽  
pp. 1401-1404 ◽  
Author(s):  
Guillaume Herbet ◽  
Gilles Lafargue ◽  
Fabien Almairac ◽  
Sylvie Moritz-Gasser ◽  
François Bonnetblanc ◽  
...  
Keyword(s):  
Language Production ◽  
Inferior Frontal Gyrus ◽  
Awake Surgery ◽  
Low Grade ◽  
Speech Impairment ◽  
First Case ◽  
Pars Opercularis ◽  
The Right

The authors report the first case of a strikingly unusual speech impairment evoked by intraoperative electrostimulation in a 36-year-old right-handed patient, a well-trained singer, who underwent awake surgery for a right fronto-temporo-insular low-grade glioma. Functionally disrupting the pars opercularis of the right inferior frontal gyrus led the patient to automatically switch from a speaking to a singing mode of language production. Given the central role of the right pars opercularis in the inhibitory control network, the authors propose that this finding may be interpreted as possible evidence for a competitive and independent neurocognitive subnetwork devoted to the melodically intoned articulation of words (normal language-based vs singing-based) in subjects with high expertise. From a more clinical perspective, such data may have implications for awake neurosurgery, especially to preserve the quality of life for singers.

Involvement of the right inferior longitudinal fascicle in visual hemiagnosia: a brain stimulation mapping study

2013 ◽  
Vol 118 (1) ◽  
pp. 202-205 ◽  
Author(s):  
Alejandro Fernández Coello ◽  
Sophie Duvaux ◽  
Alessandro De Benedictis ◽  
Ryosuke Matsuda ◽  
Hugues Duffau
Keyword(s):  
Brain Stimulation ◽  
Brain Mapping ◽  
Visual Recognition ◽  
Awake Surgery ◽  
Low Grade ◽  
Mapping Study ◽  
Visual Agnosia ◽  
The Right ◽  
Tractography Data

Neural foundations underlying visual agnosia are poorly understood. The authors present the case of a patient who underwent awake surgery for a right basal temporooccipital low-grade glioma in which direct electrostimulation was used both at the cortical and subcortical level. Brain mapping over the inferior longitudinal fascicle generated contralateral visual hemiagnosia. These original findings are in agreement with recent tractography data that have confirmed the existence of an occipitotemporal pathway connecting occipital visual input to higher-level processing in temporal lobe structures. This is the first report of a true transient visual hemiagnosia elicited through electrostimulation, supporting the crucial role of inferior longitudinal fascicle in visual recognition.

scholarly journals Combining Electrostimulation With Fiber Tracking to Stratify the Inferior Fronto-Occipital Fasciculus

2021 ◽  
Vol 15 ◽  
Author(s):  
Alexandre Roux ◽  
Anne-Laure Lemaitre ◽  
Jeremy Deverdun ◽  
Sam Ng ◽  
Hugues Duffau ◽  
...  
Keyword(s):  
Awake Surgery ◽  
Low Grade ◽  
Network Organization ◽  
Hemispheric Differences ◽  
Interindividual Variations ◽  
Fiber Tracts ◽  
The Right ◽  
Subcortical Mapping ◽  
High Degree

The inferior fronto-occipital fasciculus (IFOF) is one of the longest association fiber tracts of the brain. According to the most recent anatomical studies, it may be formed by several layers, suggesting a role in multiple cognitive functions. However, to date, no attempt has been made to dissociate the functional contribution of the IFOF subpathways. In this study, real-time, cortico-subcortical mapping with direct electrostimulation was performed in 111 patients operated on in wide-awake surgery for a right low-grade glioma. Patients performed two behavioral tasks during stimulation, tapping, respectively, mentalizing and visual semantic cognition—two functions supposed to be partly mediated by the IFOF. Responsive white matter sites were first subjected to a clustering analysis to assess potential topological differences in network organization. Then they were used as seeds to generate streamline tractograms based on the HC1021 diffusion dataset (template-based approach). The tractograms obtained for each function were overlapped and contrasted to determine whether some fiber pathways were more frequently involved in one or the other function. The obtained results not only provided strong evidence for a role of the right IFOF in both functions, but also revealed that the tract is dissociable into two functional strata according to a ventral (semantic) and dorsal (mentalizing) compartmentalization. Besides, they showed a high degree of anatomo-functionnal variability across patients in the functional implication of the IFOF, possibly related to symmetrical/hemispheric differences in network organization. Collectively, these findings support the view that the right IFOF is a functionally multi-layered structure, with nevertheless interindividual variations.

The role of the right inferior frontal gyrus following reversal of consistent stimulus-stop mappings

2013 ◽  
Author(s):  
Maisy Best ◽  
Tobias Stevens ◽  
Fraser Milton ◽  
Christopher D. Chambers ◽  
Ian P. McLaren ◽  
...  
Keyword(s):  
Inferior Frontal Gyrus ◽  
The Right

scholarly journals A nudge in the right direction: the role of food choice architecture in changing populations' diets

2021 ◽  
pp. 1-12
Author(s):  
H. Ensaff
Keyword(s):  
Food Choice ◽  
Empirical Studies ◽  
Food Selection ◽  
Theoretical Background ◽  
Choice Architecture ◽  
Different Populations ◽  
The Right ◽  
Care Costs

Populations' diets typically fall short of recommendations. The implication of this on ill health and quality of life is well established, as are the subsequent health care costs. An area of growing interest within public health nutrition is food choice architecture; how a food choice is framed and its influence on subsequent food selection. In particular, there is an appeal to manipulating the choice architecture in order to nudge individuals' food choice. This review outlines the current understanding of food choice architecture, theoretical background to nudging and the evidence on the effectiveness of nudge strategies, as well as their design and implementation. Interventions emphasising the role of nudge strategies have investigated changes to the accessibility, availability and presentation of food and the use of prompts. Empirical studies have been conducted in laboratories, online and in real-world food settings, and with different populations. Evidence on the effectiveness of nudge strategies in shifting food choice is encouraging. Underpinning mechanisms, not yet fully explicated, are proposed to relate to salience, social norms and the principle of least effort. Emerging evidence points to areas for development including the effectiveness of choice architecture interventions with different and diverse populations, and the combined effect of multiple nudges. This, alongside further examination of theoretical mechanisms and guidance to engage and inspire across the breadth of food provision, is critical. In this way, the potential of choice architecture to effect meaningful change in populations' diets will be realised.

Foix-Chavany-Marie syndrome caused by a disconnection between the right pars opercularis of the inferior frontal gyrus and the supplementary motor area

2012 ◽  
Vol 117 (5) ◽  
pp. 844-850 ◽  
Author(s):  
Juan Martino ◽  
Enrique Marco de Lucas ◽  
Francisco Javier Ibáñez-Plágaro ◽  
José Manuel Valle-Folgueral ◽  
Alfonso Vázquez-Barquero
Keyword(s):  
Supplementary Motor Area ◽  
Diffusion Tensor ◽  
Anterior Part ◽  
Inferior Frontal Gyrus ◽  
Motor Area ◽  
Lower Limbs ◽  
Rare Type ◽  
Orofacial Movement ◽  
Pars Opercularis ◽  
The Right

Foix-Chavany-Marie syndrome (FCMS) is a rare type of suprabulbar palsy characterized by an automaticvoluntary dissociation of the orofacial musculature. Here, the authors report an original case of FCMS that occurred intraoperatively while resecting the pars opercularis of the inferior frontal gyrus. This 25-year-old right-handed man with an incidentally diagnosed right frontotemporoinsular tumor underwent surgery using an asleep-awake-asleep technique with direct cortical and subcortical electrical stimulation and a transopercular approach to the insula. While resecting the anterior part of the pars opercularis the patient suffered sudden anarthria and bilateral facial weakness. He was unable to speak or show his teeth on command, but he was able to voluntarily move his upper and lower limbs. This syndrome lasted for 8 days. Postoperative diffusion tensor imaging tractography revealed that connections of the pars opercularis of the right inferior frontal gyrus with the frontal aslant tract (FAT) and arcuate fasciculus (AF) were damaged. This case supplies evidence for localizing the structural substrate of FCMS. It was possible, for the first time in the literature, to accurately correlate the occurrence of FCMS to the resection of connections between the FAT and AF, and the right pars opercularis of the inferior frontal gyrus. The FAT has been recently described, but it may be an important connection to mediate supplementary motor area control of orofacial movement. The present case also contributes to our knowledge of complication avoidance in operculoinsular surgery. A transopercular approach to insuloopercular gliomas can generate FCMS, especially in cases of previous contralateral lesions. The prognosis is favorable, but the patient should be informed of this particular hazard, and the surgeon should anticipate the surgical strategy in case the syndrome occurs intraoperatively in an awake patient.

scholarly journals ROLE OF A PEDODONTIST IN CLEFT LIP AND CLEFT PALATE REHABILITATION - AN OVERVIEW

2021 ◽  
Vol 9 (07) ◽  
pp. 882-906
Author(s):  
Payel Basu ◽  
◽  
Rani Somani ◽  
Deepti Jawa ◽  
Shipra Jaidka ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Multidisciplinary Care ◽  
Vital Role ◽  
Pediatric Dentist ◽  
Orofacial Region ◽  
The Right ◽  
Potential Area

Cleft lip and palate is one of the most common congenital anomalies requiring multidisciplinary care. Such anomaly is associated with many problems such as impaired feeding, defective speech, hearing difficulties, malocclusion, dental abnormalities, gross facial deformity as well severe psychological problems. Cleft of the lip and palate is one of the complex conditions that occur at a functionally potential area in the orofacial region and also at such a crucial time that strategic interventions at the right age by the concerned specialists becomes the need of the hour. Pediatric dentist is an integral part of the cleft rehabilitative process right from the neonatal period upto the phase of permanent dentition. Being well versed with a childs growth and development, both physical and mental, a Pedodontist helps in restoring function and esthetics in a cleft child, in a most empathetic way. This article describes the enormous challenges faced by these innocent souls and the vital role played by a Pedodontist, to provide comprehensive cleft care, be it preventive, restorative, or interventional care, in order to achieve the best possible outcome and meaningfully improve their quality of life.

scholarly journals Peran E-Servqual Dalam Customer Engagement

2019 ◽  
Vol 15 (1) ◽  
pp. 36-42
Author(s):  
Nadia Sasmita Wijayanti
Keyword(s):  
Service Quality ◽  
Customer Service ◽  
Customer Loyalty ◽  
Customer Engagement ◽  
Online Service ◽  
Market Leader ◽  
The Right ◽  
Modern Era

Sejumlah brand sukses menempatkan diri di hati konsumen, namun banyak pula yang gagal. Keberhasilan brand memikat hati customer berarti sukses menjalin hubungan dengan customer. Perlu cara dan startegi yang tepat agar brand mampu memikat kosumen dan keluar sebagai market leader. Dalam menjalankan bisnis dan memberikan pelayanan konsumen perlu memperhatikan keinginan konsumen. Di era serba modern dan informasi tanpa batas, bermunculan marketplace dan perusahaan eksponensial, menyebabkan keinginan konsumen untuk dilayani serba cepat dan ringkas. Kualitas jasa layanan online yang maksimal akan menciptakan customer loyalty yang berujung pada customer engagement. Kata kunci: E-servqual, Kualitas layanan jasa online, customer loyalty, customer engagement.  Abstract: The Role of E-Servqual in Customer Engagement. A number of brands successfully place themselves in the hearts of consumers, but many also fail. The success of the brand captivates the customer means successful relationship with the customer. Need the right way and strategy so that the brand can attract consumers and come out as the market leader. In running a business and providing customer service, it is necessary to pay attention to consumer desires. In the modern era and unlimited information, emerging marketplaces and exponential companies, cause consumers to be served quickly and concisely. The maximum quality of online services will create customer loyalty which leads to customer engagement. Kata kunci: E-servqual, Online Service Quality, customer loyalty, customer engagement.

scholarly journals Current issues in Scandinavian acute psychiatric wards

2006 ◽  
Vol 15 (2) ◽  
pp. 99-103 ◽  
Author(s):  
Torleif Ruud ◽  
Nils Lindefors ◽  
Anne Lindhardt
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Policy Makers ◽  
Health Practitioners ◽  
Psychiatric Units ◽  
Acute Psychiatric Wards ◽  
Field Information ◽  
The Right

AbstractThe aim of the paper is to provide an overview of some of the most important issues faced by acute inpatient facilities in three Scandinavian countries, including reflections and critical remarks for discussion in this field. Information was drawn from scientific articles and official reports published in recent years, as well as the authors' own knowledge of acute facilities in their home countries. Acute inpatient facilities, including General Hospital Psychiatric Units (GHPUs), in all Scandinavian countries have several issues and problems in common, which include the organisation and capacity of acute services, the assessment of dangerousness and suicidality, the use of coercion and efforts to reduce coercion, the need to define and improve the quality of acute services, and the necessity to improve collaboration and continuity between acute services and other services. Although the emphasis some of these issues receive can vary across the three countries, Scandinavian mental health professionals (and policy makers) have begun to systematically share their experiences in developing a growing spirit of collaboration. Despite the role of welfare state and the deployment of substantial resources in Scandinavian countries, mental health practitioners are struggling to implement best practices in acute wards, to develop differentiated forms of acute services, and to reach the right balance and coordination between acute services and other services.

Legal Capacity

2011 ◽  
Author(s):  
Timothy Besley ◽  
Torsten Persson
Keyword(s):  
Total Factor Productivity ◽  
Legal Capacity ◽  
Factor Productivity ◽  
Empirical Observation ◽  
Role Of Government ◽  
Doing Business ◽  
The Right ◽  
Productive Role

This chapter focuses on the productive role of government in improving the environment for doing business. Improvements in the performance of government are measured as total factor productivity and differences in income across countries can be explained by differences in the quality of their economic institutions. This makes it essential to understand why some countries make the right investments in legal institutions and deploy such legal capacity effectively. A running theme of the chapter is the possibility of a complementarity between the extractive (taxation) and the productive (supporting markets) roles of government. This is at the heart of the empirical observation that market development and state development move hand in hand. But the key insight from this is that we have to understand the incentives of a government to make investments to improve the workings of the economy.

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