Detection of Motor Cerebral Activity After Median Nerve Stimulation During General Anesthesia (STIM-MOTANA): Protocol for a Prospective Interventional Study

International audienceBackground Accidental awareness during general anesthesia (AAGA) is defined as an unexpected awareness of the patient during general anesthesia. This phenomenon occurs in 1%-2% of high-risk practice patients and can cause physical suffering and psychological after-effects, called posttraumatic stress disorder. In fact, no monitoring techniques are satisfactory enough to effectively prevent AAGA; therefore, new alternatives are needed. Because the first reflex for a patient during an AAGA is to move, but cannot do so because of the neuromuscular blockers, we believe that it is possible to design a brain-computer interface (BCI) based on the detection of movement intention to warn the anesthetist. To do this, we propose to describe and detect the changes in terms of motor cortex oscillations during general anesthesia with propofol, while a median nerve stimulation is performed. We believe that our results could enable the design of a BCI based on median nerve stimulation, which could prevent AAGA. Objective To our knowledge, no published studies have investigated the detection of electroencephalographic (EEG) patterns in relation to peripheral nerve stimulation over the sensorimotor cortex during general anesthesia. The main objective of this study is to describe the changes in terms of event-related desynchronization and event-related synchronization modulations, in the EEG signal over the motor cortex during general anesthesia with propofol while a median nerve stimulation is performed. Methods STIM-MOTANA is an interventional and prospective study conducted with patients scheduled for surgery under general anesthesia, involving EEG measurements and median nerve stimulation at two different times: (1) when the patient is awake before surgery (2) and under general anesthesia. A total of 30 patients will receive surgery under complete intravenous anesthesia with a target-controlled infusion pump of propofol. Results The changes in event-related desynchronization and event-related synchronization during median nerve stimulation according to the various propofol concentrations for 30 patients will be analyzed. In addition, we will apply 4 different offline machine learning algorithms to detect the median nerve stimulation at the cerebral level. Recruitment began in December 2022. Data collection is expected to conclude in June 2024. Conclusions STIM-MOTANA will be the first protocol to investigate median nerve stimulation cerebral motor effect during general anesthesia for the detection of intraoperative awareness. Based on strong practical and theoretical scientific reasoning from our previous studies, our innovative median nerve stimulation–based BCI would provide a way to detect intraoperative awareness during general anesthesia. Trial Registration Clinicaltrials.gov NCT05272202; https://clinicaltrials.gov/ct2/show/NCT05272202 International Registered Report Identifier (IRRID) PRR1-10.2196/4387

The oscillatory nature of the motor and perceptive kinematics invariants: Comment on "Motor invariants in action execution and perception" by Francesco Torricelli et al.

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[Mirror neurons, neural substrate of action understanding?]

In 1992, the Laboratory of Human Physiology at the University of Parma (Italy) publish a study describing “mirror” neurons in the macaque that activate both when the monkey performs an action and when it observes an experimenter performing the same action. The research team behind this discovery postulates that the mirror neurons system is the neural basis of our ability to understand the actions of others, through the motor mapping of the observed action on the observer's motor repertory (direct-matching hypothesis). Nevertheless, this conception met serious criticism. These critics attempt to relativize their function by placing them within a network of neurocognitive and sensory interdependencies. In short, the essential characteristic of these neurons is to combine the processing of sensory information, especially visual, with that of motor information. Their elementary function would be to provide a motor simulation of the observed action, based on visual information from it. They can contribute, with other non-mirror areas, to the identification/prediction of the action goal and to the interpretation of the intention of the actor performing it. Studying the connectivity and high frequency synchronizations of the different brain areas involved in action observation would likely provide important information about the dynamic contribution of mirror neurons to “action understanding”. The aim of this review is to provide an up-to-date analysis of the scientific evidence related to mirror neurons and their elementary functions, as well as to shed light on the contribution of these neurons to our ability to interpret and understand others’ actions.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Nucleus incertus provides eye velocity and position signals to the vestibulo-ocular cerebellum: a new perspective of the brainstem-cerebellum-hippocampus network.

The network formed by the brainstem, cerebellum, and hippocampus occupies a central position to achieve navigation. Multiple physiological functions are implicated in this complex behavior. Among these, control of the eye-head and body movements is crucial. The gaze-holding system realized by the brainstem oculomotor neural integrator (ONI) situated in the nucleus prepositus hypoglossi and fine-tuned by the contribution of different regions of the cerebellum assumes the stability of the image on the fovea. This function helps in the recognition of environmental targets and defining appropriate navigational pathways further elaborated by the entorhinal cortex and hippocampus. In this context, an enigmatic brainstem area situated in front of the ONI, the nucleus incertus (NIC), is implicated in the dynamics of brainstem-hippocampus theta oscillation and contains a group of neurons projecting to the cerebellum. These neurons are characterized by burst tonic behavior similar to the burst tonic neurons in the ONI that convey eye velocity-position signals to the cerebellar flocculus. Faced with these forgotten cerebellar projections of the NIC, the present perspective discusses the possibility that, in addition to the already described pathways linking the cerebellum and the hippocampus via the medial septum, these NIC signals related to the vestibulo-ocular reflex and gaze holding could participate in the hippocampal control of navigation.info:eu-repo/semantics/publishe

Sleep-push movement performance in elite field hockey champions with and without training specialization.

To investigate kinematic and muscle activity differences during the sleep-push movement in elite field hockey players. We hypothesized that players with specialized sleep-push movement training (specialists) would possess a lower center of mass (CoM) and enhanced reproducibility of muscle activations during the movement, compared to players without explicit movement training (non-specialists).info:eu-repo/semantics/publishe

The impact of dyspnea on postural control in healthy subjects

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Modification of EEG brain activity induced by respiratorymuscle regulationduring phonation

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Electrophysiological alterations of the Purkinje cells and deep cerebellar neurons in a mouse model of Alzheimer disease (electrophysiology on cerebellum of AD mice)

Alzheimer's disease is histopathologically well defined by the presence of amyloid deposits and tau-related neurofibrillary tangles in crucial regions of the brain. Interest is growing in revealing and determining possible pathological markers also in the cerebellum as its involvement in cognitive functions is now well supported. Despite the central position of the Purkinje cell in the cerebellum, its electrophysiological behaviour in mouse models of Alzheimer's disease is scarce in the literature. Our first aim was here to focus on the electrophysiological behaviour of the cerebellum in awake mouse model of Alzheimer's disease (APPswe/PSEN1dE9) and the related performance on the water-maze test classically used in behavioural studies. We found prevalent signs of electrophysiological alterations in both Purkinje cells and deep cerebellar nuclei neurons which might explain the behavioural deficits reported during the water-maze test. The alterations of neurons firing were accompanied by a dual (~16 and ~228 Hz) local field potential's oscillation in the Purkinje cell layer of Alzheimer's disease mice which was concomitant to an important increase of both the simple and the complex spikes. In addition, β-amyloid deposits were present in the molecular layer of the cerebellum. These results highlight the importance of the output firing modification of the AD cerebellum that may indirectly impact the activity of its subcortical and cortical targets.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Les neurosciences spatiales :l’électroencéphalographie dans la navigation virtuelle.

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Generator localization of emotional facial expressions processing in the child Developmental

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