Rapid and efficient localization of depth electrodes and cortical labeling using free and open source medical software in epilepsy surgery candidates

Depth intracranial electrodes (IEs) placement is one of the most used procedures to identify the epileptogenic zone (EZ) in surgical treatment of drug resistant epilepsy patients, about 20?30% of this population. IEs localization is therefore a critical issue defining the EZ and its relation with eloquent functional areas. That information is then used to target the resective surgery and has great potential to affect outcome. We designed a methodological procedure intended to avoid the need for highly specialized medical resources and reduce time to identify the anatomical location of IEs, during the first instances of intracranial EEG recordings. This workflow is based on established open source software; 3D Slicer and Freesurfer that uses MRI and Post-implant CT fusion for the localization of IEs and its relation with automatic labeled surrounding cortex. To test this hypothesis we assessed the time elapsed between the surgical implantation process and the final anatomical localization of IEs by means of our proposed method compared against traditional visual analysis of raw post-implant imaging in two groups of patients. All IEs were identified in the first 24 H (6?24 H) of implantation using our method in 4 patients of the first group. For the control group; all IEs were identified by experts with an overall time range of 36 h to 3 days using traditional visual analysis. It included (7 patients), 3 patients implanted with IEs and the same 4 patients from the first group. Time to localization was restrained in this group by the specialized personnel and the image quality available. To validate our method; we trained two inexperienced operators to assess the position of IEs contacts on four patients (5 IEs) using the proposed method. We quantified the discrepancies between operators and we also assessed the efficiency of our method to define the EZ comparing the findings against the results of traditional analysis.Fil: Princich, Juan Pablo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos; ArgentinaFil: Wassermann, Demian. Harvard Medical School; Estados Unidos de América;Fil: Latini, Facundo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos; ArgentinaFil: Oddo, Silvia Andrea. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos; ArgentinaFil: Blenkmann, Alejandro Omar. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurcs. ; ArgentinaFil: Seifer, Gustavo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos; ArgentinaFil: Kochen, Sara Silvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurcs. ; Argentin

Doctor of Philosophy

dissertationRecording the neural activity of human subjects is indispensable for fundamental neuroscience research and clinical applications. Human studies range from examining the neural activity of large regions of the cortex using electroencephalography (EEG) or electrocorticography (ECoG) to single neurons or small populations of neurons using microelectrode arrays. In this dissertation, microscale recordings in the human cortex were analyzed during administration of propofol anesthesia and articulate movements such as speech, finger flexion, and arm reach. Recordings were performed on epilepsy patients who required long-term electrocorticographic monitoring and were implanted with penetrating or surface microelectrode arrays. We used penetrating microelectrode arrays to investigate the effects of propofol anesthesia on action potentials (APs) and local field potentials (LFPs). Increased propofol concentration correlated with decreased high-frequency power in LFP spectra and decreased AP firing rates, as well as the generation of large amplitude spike-like LFP activity; however, the temporal relationship between APs and LFPs remained relatively consistent at all levels of propofol anesthesia. The propofol-induced suppression of neocortical network activity allowed LFPs to be dominated by low-frequency spike-like activity, and correlated with sedation and unconsciousness. As the low-frequency spike-like activity increased, and the AP-LFP relationship became more predictable, firing rate encoding capacity was impaired. This suggests a mechanism for decreased information processing in the neocortex that accounts for propofol-induced unconsciousness. We also demonstrated that speech, finger, and arm movements can be decoded from LFPs recorded with dense grids of microelectrodes placed on the surface of human cerebral cortex for brain computer interface (BCI) applications using LFPs recorded over face-motor area, vocalized articulations of ten different words and silence were classified on a trial-by-trial basis with 82.4% accuracy. Using LFPs recorded over the hand area of motor cortex, three individual finger movements and rest were classified on a trial-by-trial basis with 62% accuracy. LFPs recorded over the arm area of motor cortex were used to continuously decode the arm trajectory with a maximum correlation coefficient of 0.82 in the x-direction and 0.76 in the y-direction. These findings demonstrate that LFPs recorded by micro-ECoG grids from the surface of the cerebral cortex contain sufficient information to provide rapid and intuitive control a BCI communication or motor prosthesis

AJILE Movement Prediction: Multimodal Deep Learning for Natural Human Neural Recordings and Video

Developing useful interfaces between brains and machines is a grand challenge of neuroengineering. An effective interface has the capacity to not only interpret neural signals, but predict the intentions of the human to perform an action in the near future; prediction is made even more challenging outside well-controlled laboratory experiments. This paper describes our approach to detect and to predict natural human arm movements in the future, a key challenge in brain computer interfacing that has never before been attempted. We introduce the novel Annotated Joints in Long-term ECoG (AJILE) dataset; AJILE includes automatically annotated poses of 7 upper body joints for four human subjects over 670 total hours (more than 72 million frames), along with the corresponding simultaneously acquired intracranial neural recordings. The size and scope of AJILE greatly exceeds all previous datasets with movements and electrocorticography (ECoG), making it possible to take a deep learning approach to movement prediction. We propose a multimodal model that combines deep convolutional neural networks (CNN) with long short-term memory (LSTM) blocks, leveraging both ECoG and video modalities. We demonstrate that our models are able to detect movements and predict future movements up to 800 msec before movement initiation. Further, our multimodal movement prediction models exhibit resilience to simulated ablation of input neural signals. We believe a multimodal approach to natural neural decoding that takes context into account is critical in advancing bioelectronic technologies and human neuroscience

Automated Extraction of Subdural Grid Electrodes from Post-Implant MRI Scans for Epilepsy Surgery

The objective of the current research was to develop an automated algorithm with no or little user assistance for extraction of Subdural Grid Electrodes (SGE) from post-implant MRI scans for epilepsy surgery. The algorithm utilizes the knowledge about the artifacts created by Subdural Electrodes (SE) in MRI scans. Also the algorithm does not only extract individual electrodes, but it also extracts them as a SGE structures. Information about the number and type of implanted electrodes is recorded during the surgery [1]. This information is used to reduce the search space and produce better results. Currently, the extraction of SGE from post-implant MRI scans is performed manually by a technologist [1, 2, 3]. It is a time-consuming process, requiring on average a few hours, depending on the number of implanted SE. In addition, the process does not conserve the geometry of the structures, since electrodes are identified individually. Usually SGE extraction is complicated by nearby artifacts, making manual extraction a non-trivial task that requires a good visualization of 3D space and orientation of SGE in it. Currently, most of the technologists use 2D slice viewers for extraction of SGE from 3D MRI scans. There is no commercial software to perform the automated extraction task. The only algorithm suggested in the literature is [4]. The goal of the proposed algorithm is to improve the performance of the algorithm in [4]. As a goal, the proposed algorithm performs extraction of SGE not only for individual electrodes, but by applying geometric constraints on SGE.M.S.Committee Chair: Dr. Oskar Skrinjar; Committee Member: Dr. Anthony Yezzi; Committee Member: Dr. John Oshinsk

A speech envelope landmark for syllable encoding in human superior temporal gyrus.

The most salient acoustic features in speech are the modulations in its intensity, captured by the amplitude envelope. Perceptually, the envelope is necessary for speech comprehension. Yet, the neural computations that represent the envelope and their linguistic implications are heavily debated. We used high-density intracranial recordings, while participants listened to speech, to determine how the envelope is represented in human speech cortical areas on the superior temporal gyrus (STG). We found that a well-defined zone in middle STG detects acoustic onset edges (local maxima in the envelope rate of change). Acoustic analyses demonstrated that timing of acoustic onset edges cues syllabic nucleus onsets, while their slope cues syllabic stress. Synthesized amplitude-modulated tone stimuli showed that steeper slopes elicited greater responses, confirming cortical encoding of amplitude change, not absolute amplitude. Overall, STG encoding of the timing and magnitude of acoustic onset edges underlies the perception of speech temporal structure