|
 |
 |
 |
University of Pennsylvania Researchers Find that the Unexpected Is a Key to Human Learning
March 16, 2009
PHILADELPHIA - The human brain's sensitivity to unexpected outcomes plays a fundamental role in the ability to adapt and learn new behaviors, according to a new study by a team of psychologists and neuroscientists from the University of Pennsylvania. Using a computer-based card game and microelectrodes to observe neuronal activity of the brain, the Penn study, published this week in the journal Science, suggests that neurons in the human substantia nigra, or SN, play a central role in reward-based learning, modulating learning based on the discrepancy between the expected and the realized outcome. "This is the first study to directly record neural activity underlying this learning process in humans, confirming the hypothesized role of the basal ganglia, which includes the SN, in models of reinforcement including learning, addiction and other disorders involving reward-seeking behavior," said lead author Kareem Zaghloul, postdoctoral fellow in neurosurgery at Penn's School off Medicine. "By responding to unexpected financial rewards, these cells encode information that seems to help participants maximize reward in the probabilistic learning task." Learning, previously studied in animal models, seems to occur when dopaminergic neurons, which drive a larger basal ganglia circuit, are activated in response to unexpected rewards and depressed after the unexpected omission of reward. Put simply, a lucky win seems to be retained better than a probable loss. Similar to an economic theory, where efficient markets respond to unexpected events and expected events have no effect, we found that the dopaminergic system of the human brain seems to be wired in a similar rational manner -- tuned to learn whenever anything unexpected happens but not when things are predictable," said Michael J. Kahana, senior author and professor of psychology at Penn's School of Arts and Sciences. Zaghloul worked with Kahana and Gordon Baltuch, associate professor of neurosurgery, in a unique collaboration among departments of psychology, neurosurgery and bioengineering. They used microelectrode recordings obtained during deep brain stimulation surgery of Parkinson's patients to study neuronal activity in the SN, the midbrain structure that plays an important role in movement, as well as reward and addiction. Patients with Parkinson's disease show impaired learning from both positive and negative feedback in cognitive tasks due to the degenerative nature of their disease and the decreased number of dopaminergic neurons. The recordings were analyzed to determine whether responses were affected by reward expectation. Participants were asked to choose between red and blue decks of cards presented on a computer screen, one of which carried a higher probability of yielding a financial reward than the other. If the draw of a card yielded a reward, a stack of gold coins was displayed along with an audible ring of a cash register and a counter showing accumulated virtual earnings. If the draw did not yield a reward or if no choice was made, the screen turned blank and participants heard a buzz. "This new way to measure dopaminergic neuron activity has helped us gain a greater understanding of fundamental cognitive activity," said Baltuch, director of the Penn Medicine Center for Functional and Restorative Neurosurgery. The work is supported by grants from the National Institutes of Health, the Conte Center and the Dana Foundation. University of Pennsylvania

|
Handbook of Neurosurgery
by Mark S. Greenberg (Author)
A 'must-have'...[a] low-cost, highly portable, and extremely useful reference volume, which will undoubtedly enjoy continued longevity into the foreseeable future. --Journal of NeurosurgeryA vital resource...For rapid access to the diagnosis and management of all neurosurgical things, there is no substitute.--The Journal of TRAUMA Injury, Infection, and Critical CareFor two decades, Handbook of Neurosurgery -- now in a fully updated seventh edition -- has been an invaluable companion for every neurosurgery resident and nurse, as well as neurologists and others involved in the care of patients with brain and spine disorders. Dr. Greenberg's classic text covers the breadth of neurosurgery and its allied specialties and provides the latest information on anatomy and physiology, differential...
|

|
When the Air Hits Your Brain: Tales from Neurosurgery
by Frank Vertosick Jr. (Author)
"Dramatic, moving, and utterly fascinating." —New York Times Book ReviewWith poignant insight and humor, When the Air Hits Your Brain chronicles one man’s evolution from naïve and ambitious young intern to world-class neurosurgeon. In electrifying detail, Frank Vertosick Jr. describes some of the greatest challenges of his career, including a six-week-old infant with a tumor in her brain, a young man struck down in his prime by paraplegia, and a minister with a .22-caliber bullet lodged in his skull. Told through ...
|

|
Neurosurgery Rounds: Questions and Answers
by Mark Shaya (Author), Remi Nader (Author), Hamad Farhat (Author), Jonathan Stuart Citow (Author), Abdulrahman J Sabbagh (Author)
At a very reasonable price, this book will be very valuable to any student or resident preparing for neurosurgical rounds and board examinations. - AANS Young Neurosurgeons NewsletterNeurosurgery Rounds: Questions and Answers is the first guide dedicated to preparing residents and medical students for the challenging questions - known as pimping in the vernacular - they will frequently encounter on neurosurgery rotation.Nine succinct chapters fully cover the basic and clinical neurosciences in a convenient Q&A format that is ideal for self-study. Short answers and explanations appear directly below the questions to enable easy reading on the go.FeaturesOver 1,600 questions and answers quiz readers on a wide range of neurosurgical topics 30 cases - also in an accessible Q&A format - ...
|

|
Principles of Neurological Surgery: Expert Consult - Online and Print, 3e (PRINCIPLES OF NEUROSURGERY)
by Richard G. Ellenbogen MD FACS (Author), Saleem I. Abdulrauf MD FACS (Author), Laligam N Sekhar MD FACS (Author)
Principles of Neurosurgery, by Drs. Richard G. Ellenbogen and Saleem I. Abdulrauf, provides a broad overview of neurosurgery ideal for anyone considering or training in this specialty. From general principles to specific techniques, it equips you with the perspectives and skills you need to succeed. Comprehensive without being encyclopedic, this new edition familiarizes you with the latest advances in the field-neuroimaging, the medical and surgical treatment of epilepsy, minimally invasive techniques, and new techniques in position and incisions-and shows you how to perform key procedures via an online library of surgical videos at www.expertconsult.com. No other source does such an effective job of preparing you for this challenging field!Get comprehensive coverage of neurosurgery,...
|

|
Take It from an Intern: Medical Advice from a Brain Surgeon
Suffering from the worst headache of your life, you check into your community emergency room. Your neck hurts and you can’t seem to shake off the persistent feeling of nausea. You are rushed to the radiology department to get an urgent brain scan. Moments later, you are diagnosed with a brain bleed and the emergency physician wants to transfer you to a well known teaching hospital for definitive treatment. But what is a teaching hospital and who will care for you when you arrive? A cadre of medical teams will see you and some will operate on you. Some of these young eager doctors are learning the art of surgery and medical care for the first time. You might even have a surgical trainee operate on your brain. What would you ask if you knew that it was his first time...
|

|
Core Techniques in Operative Neurosurgery: Expert Consult - Online and Print, 1e
by Rahul Jandial MD PhD (Author), Paul McCormick MD MPH FACS (Author), Peter McL Black MD PhD (Author)
Core Techniques in Operative Neurosurgery provides step-by-step guidance to help you effectively manage the full range of cranial and spinal neurosurgical disorders. Drs. Rahul Jandial, Paul McCormick, and Peter Black offer their expertise and experience in consistent chapters that cover the indications and contraindications, pitfalls, tips and tricks, and more for each procedure. With access to the full text and procedural videos online at www.expertconsult.com, you'll have everything you need to minimize risk and get the best results.Master each technique by watching step-by-step videos online at www.expertconsult.com, and access the book's complete text and illustrations. Find information easily with consistent chapters that include indications and contraindications, common pitfalls,...
|

|
Neurology and Neurosurgery Illustrated, 5e
by Kenneth W. Lindsay PhD FRCS (Author), Ian Bone FRCP FACP (Author), Geraint Fuller MD FRCP (Author)
New edition of a highly successful illustrated guide to neurology and neurosurgery for medical students and junior doctors.Updated and revised in all areas where there have been developments in understanding of neurological disease and in neurological and neurosurgical management. This revision has also incorporated current guidelines, particularly recommendations from National Institute for Health and Clinical Excellence (NICE).
|

|
Fundamentals of Operative Techniques in Neurosurgery
by E. Sander Connolly (Author), Guy M. McKhann II (Author), Judy Huang (Author), Tanvir F. Choudhri (Author), Ricardo J Komotar (Author), J Mocco (Author)
Praise for the previous edition:The editors...know the needs of residents at a 'grass-root level'...An easily accessible source of information for residents in training.--Journal of NeurosurgeryThe only portable handbook on operative techniques in neurosurgery, this step-by-step guide offers unparalleled coverage of every major operative procedure seen in daily practice. Concise chapters hold key clinical information on indications, preoperative planning, intraoperative technique, postoperative care, and complications, with insights and advice from renowned experts representing every main specialty in the field.Features:Detailed coverage of all common neurosurgery procedures Over 40 new chapters featuring the latest information on intradural nerve sheath tumors, ulnar nerve submuscular...
|

|
Neurosurgery Case Review: Questions and Answers
by Remi Nader (Editor), Abdulrahman J Sabbagh (Editor)
An ideal resource for board exam preparation, this review distills the essentials of neurosurgery in a user-friendly question and answer format. Divided into three main sections, this text presents a comprehensive collection of cases covering intracranial pathology, spinal and peripheral nerve pathology, and neurology. Each chapter opens by detailing the clinical presentation of a problem frequently encountered in everyday practice followed by a list of questions and answers designed to test the reader's knowledge of diagnostic techniques, imaging, surgical indications, treatment options, potential complications, and outcomes.Highlights:Contributions from internationally recognized authorities in the main subspecialties of neurosurgery, including neurosurgical oncology, skull base...
|

|
Essential Neurosurgery
by Andrew H. Kaye (Author)
Essential Neurosurgery provides a comprehensive introduction to neurosurgery for junior surgical trainees and medical students. The book concentrates on the principles of neurosurgical diagnosis and management of the more common central nervous system problems, including an understanding of neurology and the pathological basis of neurological disease. There is also coverage of neurosurgical techniques and postoperative patient management. This new edition brings the text fully up to date and includes many of the biological and technological advances made in the field of neurosurgery that have improved surgical possibilities and patient outcomes. Review quotations from the previous edition
‘flowing and well highlighted text keeps the reader interested in the...
|
|