Neuroimaging of Epilepsy: EEG-fMRI in the Presurgical Evaluation of Focal Epilepsy

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Using gamification to incentivize sustainable urban mobility.

Sustainable urban mobility is an important dimension in a Smart City, and one of the key issues for city sustainability. However, innovative and often costly mobility policies and solutions introduced by cities are liable to fail, if not combined with initiatives aimed at increasing the awareness of citizens, and promoting their behavioural change. This paper explores the potential of gamification mechanisms to incentivize voluntary behavioural changes towards sustainable mobility solutions. We present a service-based gamification framework, developed within the STREETLIFE EU Project, which can be used to develop games on top of existing services and systems within a Smart City, and discuss the empirical findings of an experiment conducted in the city of Rovereto on the effectiveness of gamification to promote sustainable urban mobility

Front Temporal Dementia and Imputability: The Role of Forensic Neurosciences in the Ability to Understand and Want

Keynote speech for the annual Colloquium of the University of Bologna Law Review, February 22nd, 2021, Alma Mater Studiorum - University of Bologna (Bologna, Italy)  

EEG-fMRI in modalit\ue0 continua su pazienti affetti da epilessia parziale e focolaio irritativo a onde lente all'EGG

Introduzione. Le epilessie di interesse chirurgico necessitano di essere studiate con tecniche che permettano di distinguere il focolaio epilettogeno da quello irritativo, poich\ue9 solo il primo \ue8 di interesse chirurgico nelle forme farmaco-resistenti. Una di queste nuove tecniche di studio \ue8 la coregistrazione EEG-fMRI, fino ad oggi applicata a pazienti con un focolaio irritativo con attivit\ue0 a punta. Solo pochi studi (Laufs 2006, Avesani 2008, Manganotti 2008) hanno preso in considerazione il focolaio a onde lente. Scopo. Lo studio intende verificare se, in pazienti con epilessia parziale e con EEG di routine indicativo di focolaio intercritico a onde lente senza punte, la coregistrazione EEG-fMRI riesce a localizzare il corrispondente focolaio epilettogeno, fornendo cos\uec utili informazioni sulla sorgente della manifestazione critica. Materiali e metodi. Sedici pazienti con epilessia parziale e con EEG standard indicativo di focolaio irritativo a onde lente ad alta frequenza (almeno due eventi irritativi per minuto) sono stati sottoposti a EEG-fMRI. I dati EEG sono stati continuamente registrati per 24 minuti (4 sessioni concatenate) da 32 elettrodi, mentre le scansioni di fMRI venivano simultaneamente acquisite con uno scanner di RMN da 1.5 T. I dati EEG sono stati esaminati off-line, dopo le sessioni di registrazione e dopo la rimozione dell\u2019artefatto da campo magnetico sul tracciato EEG. Abbiamo posto in confronto i cambiamenti di segnale indotti dalle variazioni dell\u2019emoglobina ridotta (paramagnetica) al passaggio dei due stati di attivazione e di riposo (ovvero confrontando la differenza di emoglobina voxel per voxel tra i volumi con EEG privo di focalit\ue0 e EEG irritativo). Risultati. In 15 pazienti su 16, alla presenza di una chiara focalit\ue0 all\u2019EEG, la co-registrazione EEG-fMRI ha dimostrato una significativa attivazione nella corrispondente area cerebrale. Nei pazienti affetti da epilessia lesionale, l\u2019area epilettogenica (gi\ue0 nota) corrispondeva ai siti di attivazione emodinamica. Conclusioni. Anche nei pazienti affetti da epilessia parziale con focalit\ue0 a onde lente all\u2019EEG, la co-registrazione EEG-fMRI pu\uf2 visualizzare una correlata attivazione emodinamica, concorrendo cos\uec a fornire utili informazioni nello studio pre-chirurgico del paziente affetto da epilessia farmacoresistente.Introduction. Epilepsy of surgical interest needs to be studied with techniques distinguishing epileptogenic vs irritative areas, because only the first has a surgical interest. One of these new techniques is EEGfMRI, so now applied to patients with a spiked irritative focus. Only few studies (Laufs 2006, Avesani 2008, Manganotti 2008) considered a slow wave irritative focus. Purpose: To verify whether in patients with partial epilepsy and routine electroencephalogram (EEG) showing focal interictal slow-wave discharges without spikes combined EEG-functional magnetic resonance imaging (fMRI) would localize the corresponding epileptogenic focus, thus providing reliable information on the epileptic source. Methods: 16 patients with partial epileptic seizures whose routine scalp EEG recordings on presentation showed frequent focal interictal slow-wave activity (almost 2 IEDs/min) underwent EEG-fMRI. EEG data were continuously recorded for 24 min (four concatenated sessions) from 32 scalp electrodes, while fMRI scans were simultaneously acquired with a 1.5-Tesla magnetic resonance imaging (MRI) scanner. After recording sessions and MRI artefact removal, EEG data were analyzed offline. We compared blood oxygen level-dependent (BOLD) signal changes on fMRI with EEG recordings obtained at rest and during activation (with and without focal interictal slow-wave discharges). Results: In 15/16 patients, when the EEG tracing showed the onset of focal slow-wave discharges on a few lateralized electrodes, BOLD-fMRI activation in the corresponding brain area significantly increased. We detected significant concordance between focal EEG interictal slow-wave discharges and focal BOLD activation on fMRI. In patients with lesional epilepsy, the epileptogenic area corresponded to the sites of increased focal BOLD signal. Conclusions: Even in patients with partial epilepsy whose standard EEGs show focal interictal slow-wave discharges without spikes, EEG-fMRI can visualize related focal BOLD activation thus providing useful information for pre-surgical planning

Corticospinal excitability in human subjects during nonrapid eye movement sleep:single and paired-pulse transcranial magnetic stimulation study

The mechanisms responsible for changes in brain function during normal sleep are poorly understood. In this study, we aimed to investigate the effects of sleep on human corticospinal excitability by estimating resting motor threshold (RMT), and latency and amplitude of motor-evoked potentials (MEPs) after delivering transcranial magnetic stimulation (TMS) in ten healthy subjects. We also aimed to study short-interval intracortical inhibition (SICI) during sleep with paired-pulse TMS (pp-TMS). Ten healthy volunteers were studied. They were monitored immediately before, during and after a 3-h sleep (from 1 p.m. to 4 p.m., immediately after the mid-day meal). EEG was continuously recorded during sleep and the various sleep stages were identified off line. Every 10 min, subjects received ten single stimuli (to estimate RMT, MEP latency and amplitude) and six paired stimuli (to estimate SICI). MEP amplitude decreased and latency and RMT increased during the various sleep stages and returned to baseline values on awakening. Post hoc comparisons showed a significant difference in pp-TMS MEP amplitudes between the sleep and all the other conditions. The changes in TMS evoked variables during the different sleep stages indicate that during nonrapid eye movement sleep, cortical pyramidal neuron excitability (as measured by RMT, MEP latency and amplitude) progressively diminishes and the efficiency of the intracortical GABA-ergic network (as assessed by three pp-TMS) increases. On awakening, these sleep-induced changes in corticospinal excitability return rapidly to values observed during wakefulness

Effects of intravenous antidepressant drugs on the excitability of human motor cortex: a study with paired magnetic stimulation on depressed patients

The effect of various drugs was investigated by using transcranial magnetic stimulation (TMS) both in healthy subjects and patients, and the results indicated an influence of antidepressant drugs (ADs) on motor excitability

Using gamification to incentivize sustainable urban mobility

Sustainable urban mobility is an important dimension in a Smart City, and one of the key issues for city sustainability. However, innovative and often costly mobility policies and solutions introduced by cities are liable to fail, if not combined with initiatives aimed at increasing the awareness of citizens, and promoting their behavioural change. This paper explores the potential of gamification mechanisms to incentivize voluntary behavioural changes towards sustainable mobility solutions. We present a service-based gamification framework, developed within the STREETLIFE EU Project, which can be used to develop games on top of existing services and systems within a Smart City, and discuss the empirical findings of an experiment conducted in the city of Rovereto on the effectiveness of gamification to promote sustainable urban mobility

f-MRI in epilepsy with spike and wave activity evoked by eye closure: Different bold activation in a patient with idiopathic partial epilepsy with occipital spikes and a control group

SUMMARY \u2013 We performed functional magnetic resonance imaging (fMRI) in a 30-year-old man with idiopathic partial epilepsy with occipital spikes whose scalp EEG activity was characterized by persistent epileptiform discharges on eye closure, ceasing upon eye opening. We compared BOLD activation in the patient and in a control group of three normal volunteers. f-MRI showed that occipital cortex and frontal areas were activated in relation to eye movement in normal subjects during eye opening but not during eye closing. While persistent interictal spike and wave activity was present over the posterior and anterior scalp in the patient upon eye closing, f-MRI showed bilateral activation of the parietal and temporal regions. This fMRI study documents the activation of posterior and temporal areas related to continuous intercritical spikes evoked by eye closure, which are diffuse over the scalp. This activation was absent in the control group during eye closure

EEG-fMRI as an useful tool to detect epileptic foci associated with secondary bilateral synchrony

INTRODUCTION: Tailoring the epileptic cortex is the key issue in the pre-surgical work-up of patients with pharmacoresistant focal epilepsy. Not always, however, the conventional MRI and the scalp EEG are able to provide the information needed to address this issue since the imaging may be normal (criptogenetic epilepsy) and the EEG, even ictal, poorly localizing. PATIENT AND METHODS: We present a case of focal criptogenetic epilepsy with speech arrest seizures and bilateral synchronous spike and wave scalp EEG pattern (secondary bilateral synchrony). The patient underwent an EEG-fMRI continuous co-registration. RESULTS: The EEG-fMRI showed a clear cut activation of a BOLD signal during the epileptic discharge over the left Supplementary Motor Area (SMA) and, on lesser degree, over the homolateral motor strip. DISCUSSION: Knowledge and expertise about this technique has greatly increased over the last few years making it an useful tool for localizing purposes specially in patients with ambiguous scalp EEG and normal MRI just like the one we presented