102 research outputs found

    Deep brain stimulation modulates synchrony within spatially and spectrally distinct resting state networks in Parkinson's disease

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    Oswal et al. characterise the effect of deep brain stimulation (DBS) on STN-cortical synchronisation in Parkinson-s disease. They propose that cortical driving of the STN in beta frequencies is subdivided anatomically and spectrally, corresponding to the hyperdirect and indirect pathways. DBS predominantly suppresses the former.Oswal et al. characterise the effect of deep brain stimulation (DBS) on STN-cortical synchronisation in Parkinson-s disease. They propose that cortical driving of the STN in beta frequencies is subdivided anatomically and spectrally, corresponding to the hyperdirect and indirect pathways. DBS predominantly suppresses the former.Chronic dopamine depletion in Parkinson's disease leads to progressive motor and cognitive impairment, which is associated with the emergence of characteristic patterns of synchronous oscillatory activity within cortico-basal-ganglia circuits. Deep brain stimulation of the subthalamic nucleus is an effective treatment for Parkinson's disease, but its influence on synchronous activity in cortico-basal-ganglia loops remains to be fully characterized. Here, we demonstrate that deep brain stimulation selectively suppresses certain spatially and spectrally segregated resting state subthalamic nucleus-cortical networks. To this end we used a validated and novel approach for performing simultaneous recordings of the subthalamic nucleus and cortex using magnetoencephalography (during concurrent subthalamic nucleus deep brain stimulation). Our results highlight that clinically effective subthalamic nucleus deep brain stimulation suppresses synchrony locally within the subthalamic nucleus in the low beta oscillatory range and furthermore that the degree of this suppression correlates with clinical motor improvement. Moreover, deep brain stimulation relatively selectively suppressed synchronization of activity between the subthalamic nucleus and mesial premotor regions, including the supplementary motor areas. These mesial premotor regions were predominantly coupled to the subthalamic nucleus in the high beta frequency range, but the degree of deep brain stimulation-associated suppression in their coupling to the subthalamic nucleus was not found to correlate with motor improvement. Beta band coupling between the subthalamic nucleus and lateral motor areas was not influenced by deep brain stimulation. Motor cortical coupling with subthalamic nucleus predominantly involved driving of the subthalamic nucleus, with those drives in the higher beta frequency band having much shorter net delays to subthalamic nucleus than those in the lower beta band. These observations raise the possibility that cortical connectivity with the subthalamic nucleus in the high and low beta bands may reflect coupling mediated predominantly by the hyperdirect and indirect pathways to subthalamic nucleus, respectively, and that subthalamic nucleus deep brain stimulation predominantly suppresses the former. Yet only the change in strength of local subthalamic nucleus oscillations correlates with the degree of improvement during deep brain stimulation, compatible with the current view that a strengthened hyperdirect pathway is a prerequisite for locally generated beta activity but that it is the severity of the latter that may determine or index motor impairment

    MEG Can Map Short and Long-Term Changes in Brain Activity following Deep Brain Stimulation for Chronic Pain

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    Deep brain stimulation (DBS) has been shown to be clinically effective for some forms of treatment-resistant chronic pain, but the precise mechanisms of action are not well understood. Here, we present an analysis of magnetoencephalography (MEG) data from a patient with whole-body chronic pain, in order to investigate changes in neural activity induced by DBS for pain relief over both short- and long-term. This patient is one of the few cases treated using DBS of the anterior cingulate cortex (ACC). We demonstrate that a novel method, null-beamforming, can be used to localise accurately brain activity despite the artefacts caused by the presence of DBS electrodes and stimulus pulses. The accuracy of our source localisation was verified by correlating the predicted DBS electrode positions with their actual positions. Using this beamforming method, we examined changes in whole-brain activity comparing pain relief achieved with deep brain stimulation (DBS ON) and compared with pain experienced with no stimulation (DBS OFF). We found significant changes in activity in pain-related regions including the pre-supplementary motor area, brainstem (periaqueductal gray) and dissociable parts of caudal and rostral ACC. In particular, when the patient reported experiencing pain, there was increased activity in different regions of ACC compared to when he experienced pain relief. We were also able to demonstrate long-term functional brain changes as a result of continuous DBS over one year, leading to specific changes in the activity in dissociable regions of caudal and rostral ACC. These results broaden our understanding of the underlying mechanisms of DBS in the human brain

    Balancing the Brain: Resting State Networks and Deep Brain Stimulation

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    Over the last three decades, large numbers of patients with otherwise treatment-resistant disorders have been helped by deep brain stimulation (DBS), yet a full scientific understanding of the underlying neural mechanisms is still missing. We have previously proposed that efficacious DBS works by restoring the balance of the brain's resting state networks. Here, we extend this proposal by reviewing how detailed investigations of the highly coherent functional and structural brain networks in health and disease (such as Parkinson's) have the potential not only to increase our understanding of fundamental brain function but of how best to modulate the balance. In particular, some of the newly identified hubs and connectors within and between resting state networks could become important new targets for DBS, including potentially in neuropsychiatric disorders. At the same time, it is of essence to consider the ethical implications of this perspective

    Methods for noninvasive localization of focal epileptic activity with magnetoencephalography

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    Magnetoencephalography (MEG) is a noninvasive brain signal acquisition technique that provides excellent temporal resolution and a whole-head coverage allowing the spatial mapping of sources. These characteristics make MEG an appropriate technique to localize the epileptogenic zone (EZ) in the preoperative evaluation of refractory epilepsy. Presurgical evaluation with MEG can guide the placement of intracranial EEG (iEEG), the current gold standard in the clinical practice, and even supply sufficient information for a surgical intervention without invasive recordings, reducing invasiveness, discomfort, and cost of the presurgical epilepsy diagnosis. However, MEG signals have low signal-to-noise ratio compared with iEEG and can sometimes be affected by noise that masks or distorts the brain activity. This may prevent the detection of interictal epileptiform discharges (IEDs) and high-frequency oscillations (HFOs), two important biomarkers used in the preoperative evaluation of epilepsy. In this thesis, the reduction of two kinds of interference is aimed to improve the signal-to-noise ratio of MEG signals: metallic artifacts mask the activity of IEDs; and the high-frequency noise, that masks HFO activity. Considering the large number of MEG channels and the long duration of the recordings, reducing noise and marking events manually is a time-consuming task. The algorithms presented in this thesis provide automatic solutions aimed at the reduction of interferences and the detection of HFOs. Firstly, a novel automatic BSS-based algorithm to reduce metallic interference is presented and validated using simulated and real MEG signals. Three methods are tested: AMUSE, a second-order BSS technique; and INFOMAX and FastICA, based on high-order statistics. The automatic detection algorithm exploits the known characteristics of metallic-related interferences. Results indicate that AMUSE performes better when recovering brain activity and allows an effective removal of artifactual components.Secondly, the influence of metallic artifact filtering using the developed algorithm is evaluated in the source localization of IEDs in patients with refractory focal epilepsy. A comparison between the resulting positions of equivalent current dipoles (ECDs) produced by IEDs is performed: without removing metallic interference, rejecting only channels with large metallic artifacts, and after BSS-based reduction. The results show that a significant reduction on dispersion is achieved using the BSS-based reduction procedure, yielding feasible locations of ECDs in contrast to the other approaches. Finally, an algorithm for the automatic detection of epileptic ripples in MEG using beamformer-based virtual sensors is developed. The automatic detection of ripples is performed using a two-stage approach. In the first step, beamforming is applied to the whole head to determine a region of interest. In the second step, the automatic detection of ripples is performed using the time-frequency characteristics of these oscillations. The performance of the algorithm is evaluated using simultaneous intracranial EEG recordings as gold standard.The novel approaches developed in this thesis allow an improved noninvasive detection and localization of interictal epileptic biomarkers, which can help in the delimitation of the epileptogenic zone and guide the placement of intracranial electrodes, or even to determine these areas without additional invasive recordings. As a consequence of this improved detection, and given that interictal biomarkers are much more frequent and easy to record than ictal episodes, the presurgical evaluation process can be more comfortable for the patient and in a more economic way.La magnetoencefalografía (MEG) es una técnica no invasiva de adquisición de señales cerebrales que proporciona una excelente resolución temporal y una cobertura total de la cabeza, permitiendo el mapeo espacial de las fuentes cerebrales. Estas características hacen del MEG una técnica apropiada para localizar la zona epileptogénica (EZ) en la evaluación preoperatoria de la epilepsia refractaria. La evaluación prequirúrgica con MEG puede orientar la colocación del EEG intracraneal (iEEG), el actual modelo de referencia en la práctica clínica, e incluso suministrar información suficiente para una intervención quirúrgica sin registros invasivos; reduciendo la invasividad, la incomodidad y el costo del diagnóstico de la epilepsia prequirúrgica. Sin embargo, las señales MEG tienen baja relación señal ruido en comparación con el iEEG pudiendo imposibilitar la detección de descargas epileptiformes interictales (IEDs) y oscilaciones de alta frecuencia (HFOs), dos importantes biomarcadores utilizados en la evaluación preoperatoria de la epilepsia.En esta tesis, la reducción de dos tipos de interferencia está dirigida a mejorar la relación señal-ruido de la señal MEG: los artefactos metálicos que enmascaran la actividad de las IEDs; y el ruido de alta frecuencia, que enmascara la actividad de las HFOs. Debido al gran número de canales MEG y la larga duración de los registros, tanto reducir el ruido como seleccionar los biomarcadores manualmente es una tarea que consume mucho tiempo. Los algoritmos presentados en esta tesis aportan soluciones automáticas dirigidas a la reducción de interferencias y la detección de HFOs. En primer lugar, se presenta y valida un nuevo algoritmo automático basado en BSS para reducir interferencias metálicas mediante señales simuladas y reales. Se prueban tres métodos: AMUSE, una técnica BSS de segundo orden; y INFOMAX y FastICA, basados en estadísticos de orden superior. El algoritmo de detección automático utiliza las características conocidas de la señal producida por la interferencia metálica. Los resultados indican que AMUSE recupera mejor la actividad cerebral y permite una eliminación efectiva de componentes artefactuales.Posteriormente, se evalúa la influencia del filtrado de artefactos metálicos en la localización de IEDs en pacientes con epilepsia focal refractaria. Se realiza una comparación entre las posiciones resultantes de dipolos de corriente equivalentes (ECDs) producidos por IEDs: sin eliminar interferencias metálicas, rechazando solamente canales con elevados artefactos metálicos y, por último, después de una reducción utilizando el algoritmo BSS desarrollado. Los resultados muestran que se logra una reducción significativa en la dispersión utilizando el procedimiento de reducción basado en BSS, lo que produce ubicaciones factibles de los dipolos en contraste con los otros enfoques.En segundo lugar, se desarrolla un algoritmo para la detección automática ripples epilépticos en MEG utilizando sensores virtuales basados en la técnica de beamformer. La detección de ripples se realiza mediante un enfoque en dos etapas. Primero, se determina el área de interés usando beamformer. Posteriormente, se realiza la detección automática de ripples utilizando las características en tiempo-frecuencia. El rendimiento del algoritmo se evalúa utilizando registros iEEG simultáneos.Los nuevos enfoques desarrollados en esta tesis permiten una detección no invasiva mejor de los biomarcadores interictales, que pueden ayudar a delimitar la zona epileptogénica y guiar la colocación de electrodos intracraneales, o incluso determinar estas áreas sin este tipo de registros. Como consecuencia de esta mejora en la detección, y dado que los biomarcadores interictales son mucho más frecuentes y fáciles de registrar que los episodios ictales, la evaluación prequirúrgica puede ser más cómoda y menos costosa para el paciente.Postprint (published version

    Localization of deep brain activity with scalp and subdural EEG

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    To what extent electrocorticography (ECoG) and electroencephalography (scalp EEG) differ in their capability to locate sources of deep brain activity is far from evident. Compared to EEG, the spatial resolution and signal- to-noise ratio of ECoG is superior but its spatial coverage is more restricted, as is arguably the volume of tissue activity effectively measured from. Moreover, scalp EEG studies are providing evidence of locating activity from deep sources such as the hippocampus using high-density setups during quiet wakefulness. To address this question, we recorded a multimodal dataset from 4 patients with refractory epilepsy during quiet wakefulness. This data comprises simultaneous scalp, subdural and depth EEG electrode recordings. The latter was located in the hippocampus or insula and provided us with our "ground truth" for source localization of deep activity. We ap- plied independent component analysis (ICA) for the purpose of separating the independent sources in theta, alpha and beta frequency band activity. In all patients subdural- and scalp EEG components were observed which had a significant zero-lag correlation with one or more contacts of the depth electrodes. Subsequent dipole modeling of the correlating components revealed dipole locations that were significantly closer to the depth electrodes compared to the dipole location of non-correlating components. These findings support the idea that components found in both recording modalities originate from neural activity in close proximity to the depth electrodes. Sources localized with subdural electrodes were similar to 70% closer to the depth electrode than sources localized with EEG with an absolute improvement of around similar to 2cm. In our opinion, this is not a considerable improvement in source localization accuracy given that, for clinical purposes, ECoG electrodes were implanted in close proximity to the depth electrodes. Furthermore, the ECoG grid attenuates the scalp EEG, due to the electrically isolating silastic sheets in which the ECoG electrodes are embedded. Our results on dipole modeling show that the deep source localization accuracy of scalp EEG is comparable to that of ECoG. Significance Statement Deep and subcortical regions play an important role in brain function. However, as joint recordings at multiple spatial scales to study brain function in humans are still scarce, it is still unresolved to what extent ECoG and EEG differ in their capability to locate sources of deep brain activity. To the best of our knowledge, this is the first study presenting a dataset of simultaneously recorded EEG, ECoG and depth electrodes in the hippocampus or insula, with a focus on non-epileptiform activity (quiet wakefulness). Furthermore, we are the first study to provide experimental findings on the comparison of source localization of deep cortical structures between invasive and non-invasive brain activity measured from the cortical surface

    Cortico-subthalamic Coherence in a Patient With Dystonia Induced by Chorea-Acanthocytosis: A Case Report

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    The subthalamic nucleus (STN) is a common target for deep brain stimulation (DBS) treatment in Parkinson’s disease (PD) but much less frequently targeted for other disorders. Here we report the results of simultaneous local field potential (LFP) recordings and magnetoencephalography (MEG) in a single patient who was implanted bilaterally in the STN for the treatment of dystonia induced by chorea-acanthocytosis. Consistent with the previous results in PD, the dystonia patient showed significant subthalamo-cortical coherence in the high beta band (28–35 Hz) on both sides localized to the mesial sensorimotor areas. In addition, on the right side, significant coherence was found in the theta-alpha band (4–12 Hz) that localized to the medial prefrontal cortex with the peak in the anterior cingulate gyrus. Comparison of STN power spectra with a previously reported PD cohort showed increased power in the theta and alpha bands and decreased power in the low beta band in dystonia which is consistent with most of the previous studies. The present report extends the range of disorders for which cortico-subthalamic oscillatory connectivity has been characterized. Our results strengthen the evidence that at least some of the subthalamo-cortical oscillatory coherent networks are a feature of the healthy brain, although we do not rule out that coherence magnitude could be affected by disease

    Functional Networks in Parkinson’s Disease

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    Parkinson’s Disease (PD) is a common neurodegenerative condition characterised pathologically by progressive dopaminergic cell loss in the substantia nigra pars compacta, dopamine depletion and resulting cortico- basal ganglia circuit dysfunction. There is a considerable variation in symptoms and treatment response between patients and therefore a need to individualise treatments, such as dopamine replacement therapy, and deep brain stimulation (DBS). We therefore require a better understanding of how different motor and non-motor symptoms emerge from the cortico-basal ganglia dysfunction characteristic of PD. In this thesis, I investigated the hypothesis that distinct symptoms in PD may be due to the dysfunction of distinct cortico-basal ganglia circuits. I characterised cortico-basal ganglia coupling by simultaneously recording cortical activity with magnetoencephalography (MEG) and basal ganglia activity from intracranial electrodes placed during DBS surgery for PD. Coupling was measured in terms of coherence – a frequency specific measure of coupling. I found that resting cortico-basal ganglia networks had distinct cortical topographies at different frequencies. Frontal regions coupled to both the subthalamic nucleus (STN) and the pedunculopontine nucleus region (PPNR) in the beta frequency band whilst temporal, parietal and cerebellar areas coupled in the alpha range. I hypothesised that activity in the frontal beta network may relate to executive function, and found that local synchronisation in two frontal cortical hubs was related to stopping an on-going movement – a crucial executive function. In a related experiment in PD patients, transient frontal – basal ganglia coupling was again apparent during motor inhibition, but how this is related to behavioural performance needs further investigation. These results are useful in highlighting how cortico-basal ganglia networks can be separated both spatially and spectrally and how the function and dysfunction of these networks can be interrogated in PD patients. Future work should determine how different stimulation parameters differentially affect these distinct circuits

    Detection and Magnetic Source Imaging of Fast Oscillations (40–160 Hz) Recorded with Magnetoencephalography in Focal Epilepsy Patients

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    We present a framework to detect fast oscillations (FOs) in magnetoencephalography (MEG) and to perform magnetic source imaging (MSI) to determine the location and extent of their generators in the cortex. FOs can be of physiologic origin associated to sensory processing and memory consolidation. In epilepsy, FOs are of pathologic origin and biomarkers of the epileptogenic zone. Seventeen patients with focal epilepsy previously confirmed with identified FOs in scalp electroencephalography (EEG) were evaluated. To handle data deriving from large number of sensors (275 axial gradiometers) we used an automatic detector with high sensitivity. False positives were discarded by two human experts. MSI of the FOs was performed with the wavelet based maximum entropy on the mean method. We found FOs in 11/17 patients, in only one patient the channel with highest FO rate was not concordant with the epileptogenic region and might correspond to physiologic oscillations. MEG FOs rates were very low: 0.02–4.55 per minute. Compared to scalp EEG, detection sensitivity was lower, but the specificity higher in MEG. MSI of FOs showed concordance or partial concordance with proven generators of seizures and epileptiform activity in 10/11 patients. We have validated the proposed framework for the non-invasive study of FOs with MEG. The excellent overall concordance with other clinical gold standard evaluation tools indicates that MEG FOs can provide relevant information to guide implantation for intracranial EEG pre-surgical evaluation and for surgical treatment, and demonstrates the important added value of choosing appropriate FOs detection and source localization methods.Facultad de IngenieríaInstituto de Investigaciones en Electrónica, Control y Procesamiento de Señale

    Cortico-subthalamic Coherence in a Patient With Dystonia Induced by Chorea-Acanthocytosis: A Case Report

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    The subthalamic nucleus (STN) is a common target for deep brain stimulation (DBS) treatment in Parkinson’s disease (PD) but much less frequently targeted for other disorders. Here we report the results of simultaneous local field potential (LFP) recordings and magnetoencephalography (MEG) in a single patient who was implanted bilaterally in the STN for the treatment of dystonia induced by chorea-acanthocytosis. Consistent with the previous results in PD, the dystonia patient showed significant subthalamo-cortical coherence in the high beta band (28–35 Hz) on both sides localized to the mesial sensorimotor areas. In addition, on the right side, significant coherence was found in the theta-alpha band (4–12 Hz) that localized to the medial prefrontal cortex with the peak in the anterior cingulate gyrus. Comparison of STN power spectra with a previously reported PD cohort showed increased power in the theta and alpha bands and decreased power in the low beta band in dystonia which is consistent with most of the previous studies. The present report extends the range of disorders for which cortico-subthalamic oscillatory connectivity has been characterized. Our results strengthen the evidence that at least some of the subthalamo-cortical oscillatory coherent networks are a feature of the healthy brain, although we do not rule out that coherence magnitude could be affected by disease

    The impact of MEG source reconstruction method on source-space connectivity estimation: A comparison between minimum-norm solution and beamforming.

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    Despite numerous important contributions, the investigation of brain connectivity with magnetoencephalography (MEG) still faces multiple challenges. One critical aspect of source-level connectivity, largely overlooked in the literature, is the putative effect of the choice of the inverse method on the subsequent cortico-cortical coupling analysis. We set out to investigate the impact of three inverse methods on source coherence detection using simulated MEG data. To this end, thousands of randomly located pairs of sources were created. Several parameters were manipulated, including inter- and intra-source correlation strength, source size and spatial configuration. The simulated pairs of sources were then used to generate sensor-level MEG measurements at varying signal-to-noise ratios (SNR). Next, the source level power and coherence maps were calculated using three methods (a) L2-Minimum-Norm Estimate (MNE), (b) Linearly Constrained Minimum Variance (LCMV) beamforming, and (c) Dynamic Imaging of Coherent Sources (DICS) beamforming. The performances of the methods were evaluated using Receiver Operating Characteristic (ROC) curves. The results indicate that beamformers perform better than MNE for coherence reconstructions if the interacting cortical sources consist of point-like sources. On the other hand, MNE provides better connectivity estimation than beamformers, if the interacting sources are simulated as extended cortical patches, where each patch consists of dipoles with identical time series (high intra-patch coherence). However, the performance of the beamformers for interacting patches improves substantially if each patch of active cortex is simulated with only partly coherent time series (partial intra-patch coherence). These results demonstrate that the choice of the inverse method impacts the results of MEG source-space coherence analysis, and that the optimal choice of the inverse solution depends on the spatial and synchronization profile of the interacting cortical sources. The insights revealed here can guide method selection and help improve data interpretation regarding MEG connectivity estimation
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