Faculty Bibliography

The study investigated the diagnostic utility of a routine electroencephalogram (EEG) to help identify seizure as the underlying etiology of the index event in patients referred with a diagnosis of migraine and not otherwise specified (NOS) headache disorders. A total of 50 patients yielded 50 routine EEGs (headache NOS, n = 32; migraine n = 18). Overall, there were 37 (74%) normal EEGs and 13 (26%) abnormal. Routine EEGs are mostly normal in young patients (18-40 years of age) who are referred to our laboratory with a diagnosis of headache NOS or migraine.

Understanding how the human brain translates sensory impressions into conscious percepts is a key challenge of neuroscience research. Work in this area has overwhelmingly centered on the conscious experience of vision at the exclusion of the other senses--in particular, smell. We hypothesized that the orbitofrontal cortex (OFC) is a central substrate for olfactory conscious experience because of its privileged physiological role in odor processing. Combining functional magnetic resonance imaging, peripheral autonomic recordings, and olfactory psychophysics, we studied a case of complete anosmia (smell loss) in a patient with circumscribed traumatic brain injury to the right OFC. Despite a complete absence of conscious olfaction, the patient exhibited robust "blind smell," as indexed by reliable odor-evoked neural activity in the left OFC and normal autonomic responses to odor hedonics during presentation of stimuli to the left nostril. These data highlight the right OFC's critical role in subserving human olfactory consciousness.