Exploring the Electrophysiological Correlates of the Default-Mode Network with Intracerebral EEG

While functional imaging studies allow for a precise spatial characterization of resting state networks, their neural correlates and thereby their fine-scale temporal dynamics remain elusive. A full understanding of the mechanisms at play requires input from electrophysiological studies. Here, we discuss human and non-human primate electrophysiological data that explore the neural correlates of the default-mode network. Beyond the promising findings obtained with non-invasive approaches, emerging evidence suggests that invasive recordings in humans will be crucial in order to elucidate the neural correlates of the brain's default-mode function. In particular, we contend that stereotactic-electroencephalography, which consists of implanting multiple depth electrodes for pre-surgical evaluation in drug-resistant epilepsy, is particularly suited for this endeavor. We support this view by providing rare data from depth recordings in human posterior cingulate cortex and medial prefrontal cortex that show transient neural deactivation during task-engagement

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Un réseau temporo-frontal soutenant des états cognitifs indépendant des stimulus ou induite par les stimulus

The brain displays moment-to-moment activity fluctuations that reflect various levels of engagement with the outside world. Processing external stimuli is not only associated with increased brain metabolism but also with prominent deactivation in specific structures, collectively known as the default-mode network (DMN). The role of the DMN remains enigmatic partly because its electrophysiological correlates and temporal dynamics are still poorly understood. Using unprecedented wide-spread depth recordings in epileptic patients, undergoing intracranial EEG during pre-surgical evaluation, we reveal that DMN neural populations display task-related suppressions of gamma (60-140 Hz) power and, critically, we show how millisecond temporal profile and amplitude of gamma deactivation tightly correlate with task demands and subject performance. The results show also that during an attentional task, sustained activations in the gamma band power are presented across large cortical networks, while transient activations are mostly specific to occipital and temporal regions. Our findings reveal a pivotal role for broadband gamma modulations in the interplay between activation and deactivation networks mediating efficient goal-directed behaviorLe cerveau présente des fluctuations de son activité qui reflètent différents niveaux d’engagement avec le monde extérieur. Le traitement des stimuli externes n’est pas seulement associé avec une augmentation du métabolisme cérébrale, mais également avec une désactivation importante dans un ensemble des structures spécifiques connus sous le nom de ‘Default-Mode Network’ (DMN, réseau par défaut). Le rôle du DMN reste énigmatique en partie parce que ses corrélats électrophysiologiques et sa dynamique temporelle sont encore mal compris. En utilisant des enregistrements éléctrophysiologiques intracrânien chez le patient épileptique, nous démontrons que la population neuronale de ce réseau montre des suppressions de l’activité gamma (60-140 Hz). Plus important, nous montrons de quelle manière le profil temporale (en millisecondes) et l’amplitude de cette désactivation sont étroitement corrélés avec la difficulté de la tâche et la performance individuelle. Les résultats mettent également en évidence que pendant une tâche attentionnelle, une activation soutenue dans le temps de la bande gamma est présente dans un large réseau, alors que des activations transitoires sont spécifiques aux régions temporale et occipitale. Nos résultats révèlent ainsi un rôle essentiel des mécanismes d’activation et de désactivation des oscillations large bande gamma dans l’exécution d’un comportement orienté vers un but

Brain state-dependent recruitment of high-frequency oscillations in the human hippocampus

International audienceRipples are high-frequency bouts of coordinated hippocampal activity believed to be crucial for information transfer and memory formation. We used intracortical macroelectrodes to record neural activity in the human hippocampus of awake subjects undergoing surgical treatment for refractory epilepsy and distinguished two populations of ripple episodes based on their frequency spectrum. The phase-coupling of one population, slow ripples (90e110 Hz), to cortical delta oscillations was differentially modulated by cognitive task; whereas the second population, fast ripples (130e170 Hz), was not seemingly correlated to local neural activity. Furthermore, as cognitive tasks changed, the ongoing coordination of neural activity associated to slow ripples progressively augmented along the parahippocampal axis. Thus, during resting states, slow ripples were coordinated in restricted hippocampal territories; whereas during active states, such as attentionallydemanding tasks, high frequency activity emerged across the hippocampus and parahippocampal cortex, that was synchronized with slow ripples, consistent with ripples supporting information transfer and coupling anatomically distant regions. Hence, our results provide further evidence of neural diversity in hippocampal high-frequency oscillations and their association to cognitive processing in humans

Human Anterior Insula Encodes Performance Feedback and Relays Prediction Error to the Medial Prefrontal Cortex

International audienc

Perceptual fusion of musical notes by native Amazonians suggests universal representations of musical intervals

© 2020, The Author(s). Music perception is plausibly constrained by universal perceptual mechanisms adapted to natural sounds. Such constraints could arise from our dependence on harmonic frequency spectra for segregating concurrent sounds, but evidence has been circumstantial. We measured the extent to which concurrent musical notes are misperceived as a single sound, testing Westerners as well as native Amazonians with limited exposure to Western music. Both groups were more likely to mistake note combinations related by simple integer ratios as single sounds (‘fusion’). Thus, even with little exposure to Western harmony, acoustic constraints on sound segregation appear to induce perceptual structure on note combinations. However, fusion did not predict aesthetic judgments of intervals in Westerners, or in Amazonians, who were indifferent to consonance/dissonance. The results suggest universal perceptual mechanisms that could help explain cross-cultural regularities in musical systems, but indicate that these mechanisms interact with culture-specific influences to produce musical phenomena such as consonance

How silent is silent reading? Intracerebral evidence for top-down activation of temporal voice areas during reading.

International audienceAs you might experience it while reading this sentence, silent reading often involves an imagery speech component: we can hear our own "inner voice" pronouncing words mentally. Recent functional magnetic resonance imaging studies have associated that component with increased metabolic activity in the auditory cortex, including voice-selective areas. It remains to be determined, however, whether this activation arises automatically from early bottom-up visual inputs or whether it depends on late top-down control processes modulated by task demands. To answer this question, we collaborated with four epileptic human patients recorded with intracranial electrodes in the auditory cortex for therapeutic purposes, and measured high-frequency (50-150 Hz) "gamma" activity as a proxy of population level spiking activity. Temporal voice-selective areas (TVAs) were identified with an auditory localizer task and monitored as participants viewed words flashed on screen. We compared neural responses depending on whether words were attended or ignored and found a significant increase of neural activity in response to words, strongly enhanced by attention. In one of the patients, we could record that response at 800 ms in TVAs, but also at 700 ms in the primary auditory cortex and at 300 ms in the ventral occipital temporal cortex. Furthermore, single-trial analysis revealed a considerable jitter between activation peaks in visual and auditory cortices. Altogether, our results demonstrate that the multimodal mental experience of reading is in fact a heterogeneous complex of asynchronous neural responses, and that auditory and visual modalities often process distinct temporal frames of our environment at the same time