Multi-modal biomarkers of low back pain: A machine learning approach

Chronic low back pain (LBP) is a very common health problem worldwide and a major cause of disability. Yet, the lack of quantifiable metrics on which to base clinical decisions leads to imprecise treatments, unnecessary surgery and reduced patient outcomes. Although, the focus of LBP has largely focused on the spine, the literature demonstrates a robust reorganization of the human brain in the setting of LBP. Brain neuroimaging holds promise for the discovery of biomarkers that will improve the treatment of chronic LBP. In this study, we report on morphological changes in cerebral cortical thickness (CT) and resting-state functional connectivity (rsFC) measures as potential brain biomarkers for LBP. Structural MRI scans, resting state functional MRI scans and self-reported clinical scores were collected from 24 LBP patients and 27 age-matched healthy controls (HC). The results suggest widespread differences in CT in LBP patients relative to HC. These differences in CT are correlated with self-reported clinical summary scores, the Physical Component Summary and Mental Component Summary scores. The primary visual, secondary visual and default mode networks showed significant age-corrected increases in connectivity with multiple networks in LBP patients. Cortical regions classified as hubs based on their eigenvector centrality (EC) showed differences in their topology within motor and visual processing regions. Finally, a support vector machine trained using CT to classify LBP subjects from HC achieved an average classification accuracy of 74.51%, AUC = 0.787 (95% CI: 0.66-0.91). The findings from this study suggest widespread changes in CT and rsFC in patients with LBP while a machine learning algorithm trained using CT can predict patient group. Taken together, these findings suggest that CT and rsFC may act as potential biomarkers for LBP to guide therapy

The Relative Contribution of High-Gamma Linguistic Processing Stages of Word Production, and Motor Imagery of Articulation in Class Separability of Covert Speech Tasks in EEG Data

Word production begins with high-Gamma automatic linguistic processing functions followed by speech motor planning and articulation. Phonetic properties are processed in both linguistic and motor stages of word production. Four phonetically dissimilar phonemic structures “BA”, “FO”, “LE”, and “RY” were chosen as covert speech tasks. Ten neurologically healthy volunteers with the age range of 21–33 participated in this experiment. Participants were asked to covertly speak a phonemic structure when they heard an auditory cue. EEG was recorded with 64 electrodes at 2048 samples/s. Initially, one-second trials were used, which contained linguistic and motor imagery activities. The four-class true positive rate was calculated. In the next stage, 312 ms trials were used to exclude covert articulation from analysis. By eliminating the covert articulation stage, the four-class grand average classification accuracy dropped from 96.4% to 94.5%. The most valuable features emerge after Auditory cue recognition (~100 ms post onset), and within the 70–128 Hz frequency range. The most significant identified brain regions were the Prefrontal Cortex (linked to stimulus driven executive control), Wernicke’s area (linked to Phonological code retrieval), the right IFG, and Broca’s area (linked to syllabification). Alpha and Beta band oscillations associated with motor imagery do not contain enough information to fully reflect the complexity of speech movements. Over 90% of the most class-dependent features were in the 30-128 Hz range, even during the covert articulation stage. As a result, compared to linguistic functions, the contribution of motor imagery of articulation in class separability of covert speech tasks from EEG data is negligible

A Blueprint for Real-Time Functional Mapping via Human Intracranial Recordings

International audienceBACKGROUND: The surgical treatment of patients with intractable epilepsy is preceded by a pre-surgical evaluation period during which intracranial EEG recordings are performed to identify the epileptogenic network and provide a functional map of eloquent cerebral areas that need to be spared to minimize the risk of post-operative deficits. A growing body of research based on such invasive recordings indicates that cortical oscillations at various frequencies, especially in the gamma range (40 to 150 Hz), can provide efficient markers of task-related neural network activity. PRINCIPAL FINDINGS: Here we introduce a novel real-time investigation framework for mapping human brain functions based on online visualization of the spectral power of the ongoing intracranial activity. The results obtained with the first two implanted epilepsy patients who used the proposed online system illustrate its feasibility and utility both for clinical applications, as a complementary tool to electrical stimulation for presurgical mapping purposes, and for basic research, as an exploratory tool used to detect correlations between behavior and oscillatory power modulations. Furthermore, our findings suggest a putative role for high gamma oscillations in higher-order auditory processing involved in speech and music perception. CONCLUSION/SIGNIFICANCE: The proposed real-time setup is a promising tool for presurgical mapping, the investigation of functional brain dynamics, and possibly for neurofeedback training and brain computer interfaces