Inducing and detecting neuroplasticity: insights from TMS-EEG and RS-EEG

Damage to the brain, such as stroke, can lead to severe cognitive and motor disabilities in the affected individuals. Neuroplasticity refers to the intrinsic capacities of the brain to reorganize cortical networks at different spatial and temporal scales, potentially resulting in spontaneous recovery of function after such damage. A better understanding about the measurement and the support of those neuroplastic processes is an important prerequisite to improve therapeutic interventions and ultimately the outcome of the recovery process. This thesis comprises the results of two studies that investigated the ability to induce neuroplasticity using repetitive transcranial magnetic stimulation (TMS) and the ability to measure neuroplasticity using a combination of TMS and electroencephalography (EEG) or resting state (RS)-EEG measurements in cohorts of young and healthy individuals. The first study utilized continuous theta burst stimulation (cTBS) to induce neuroplasticity targeting the primary motor cortex. After-effects on cortical and corticospinal excitability were quantified in terms of TMS-evoked potentials (TEP) and motor-evoked potentials. The study demonstrated that cTBS-induced neuroplasticity leads to significant local and remote changes in cortical excitability that were measurable with TMS-EEG. The modulation of the N45 peak of the TEP suggests that the neuroplastic effects of cTBS are mediated by changes in gamma-aminobutyric acid (GABA)A-mediated cortical inhibition. The second study investigated the suitability of RS-EEG for individualized longitudinal tracking of neuroplastic processes. In this scenario, it is important to distinguish whether observed changes in activity between measurements are attributable to incidental variations in cognitive state or truly related to processes of neuroplastic reorganization. A classification algorithm was adopted to extract individual-specific signatures from EEG oscillations at rest. These signatures were very robust across multiple days and detectable across different cognitive states, indicating a close relationship to the underlying neurophysiology. Using these individual activity pattern, it was possible to distinguish inter-day variations in cognitive state from simulated changes in the neurophysiological organization of the brain with very high accuracy. The current thesis therefore provides important support for the usability of TMS-EEG and RS-EEG as methodological approaches to measure neuroplasticity within healthy and young individuals. Furthermore, cTBS may be used as a strategy to interact with abnormally elevated or reduced levels of GABAA-mediated cortical inhibition. Further studies are required to validate the significance of the current findings and to test whether they can be translated into clinical practice, especially into the realms of stroke recovery

Distinct neural correlates of social and object reward seeking motivation

open access articleThe “Choose‐a‐Movie‐CAM” is an established task to quantify the motivation for seeking social rewards. It allows participants to directly assess both the stimulus value and the effort required to obtain it. In the present study, we aimed to identify the neural mechanisms of such cost‐benefit decision‐making. To this end, functional Magnetic Resonance Imaging data were collected from 24 typical adults while they completed the CAM task. We partly replicated the results from our previous behavioural studies showing that typical adults prefer social over object stimuli and low effort over higher effort stimuli but found no interaction between the two. Results from neuroimaging data suggest that there are distinct neural correlates for social and object preferences. The precuneus and medial orbitofrontal cortex, two key areas involved in social processing are engaged when participants make a social choice. Areas of the ventral and dorsal stream pathways associated with object recognition are engaged when making an object choice. These activations can be seen during the decision phase even before the rewards have been consumed, indicating a transfer the hedonic properties of social stimuli to its cues. We also found that the left insula and bilateral clusters in the inferior occipital gyrus and the inferior parietal lobule were recruited for increasing effort investment. We discuss limitations and implications of this study which reveals the distinct neural correlates for social and object rewards, using a robust behavioural measure of social motivation

Differences in Characteristics of Error-Related Potentials Between Individuals With Spinal Cord Injury and Age- and Sex-Matched Able-Bodied Controls

Background: Non-invasive brain-computer interfaces (BCI) represent an emerging technology for enabling persons with impaired or lost grasping and reaching functions due to high spinal cord injury (SCI) to control assistive devices. A major drawback of BCIs is a high rate of false classifications. The robustness and performance of BCIs might be improved using cerebral electrophysiological correlates of error recognition (error-related potentials, ErrPs). As ErrPs have never been systematically examined in subjects with SCI, this study compares the characteristics of ErrPs in individuals with SCI with those of able-bodied control subjects.Methods: ErrPs at FCz and Cz were analyzed in 11 subjects with SCI (9 male, median age 28 y) and in 11 sex- and age-matched controls. Moving a shoulder joystick according to a visual cue, subjects received feedback about the match/mismatch of the performed movement. ErrPs occurring after “error”-feedback were evaluated by comparing means of voltage values within three consecutive time windows after feedback (wP1, wN1, wP2 containing peak voltages P1, N1, P2) using repeated-measurement analysis of variance.Results: In the control group, mean voltage values for the “error” and “correct” feedback condition differed significantly around N1 (FCz: 254 ms, Cz: 252 ms) and P2 (FCz: 347 ms, Cz: 345 ms), but not around P1 (FCz: 181 ms, Cz: 179 ms). ErrPs of the control and the SCI group showed similar morphology, however mean amplitudes of ErrPs were significantly smaller in individuals with SCI compared to controls for wN1 (FCz: control = −1.55 μV, SCI = −0.27 μV, p = 0.02; Cz: control = −1.03 μV, SCI = 0.11 μV, p = 0.04) and wP2 (FCz: control = 2.79 μV, SCI = 1.29 μV, p = 0.011; Cz: control = 2.12 μV, SCI = 0.81 μV, p = 0.003). Mean voltage values in wP1, wN1, and wP2 did not correlate significantly with either chronicity after or level of injury.Conclusion: The morphology of ErrPs in subjects with and without SCI is comparable, however, with reduced mean amplitude in wN1 and wP2 in the SCI group. Further studies should evaluate whether ErrP-classification can be used for online correction of false BCI-commands in individuals with SCI

Robustness of individualized inferences from longitudinal resting state EEG dynamics

Tracking how individual human brains change over extended timescales is crucial to clinical scenarios ranging from stroke recovery to healthy aging. The use of resting state (RS) activity for tracking is a promising possibility. However, it is unresolved how a person's RS activity over time can be decoded to distinguish neurophysiological changes from confounding cognitive variability. Here, we develop a method to screen RS activity changes for these confounding effects by formulating it as a problem of change classification. We demonstrate a novel solution to change classification by linking individual-specific change to inter-individual differences. Individual RS-electroencephalography (EEG) was acquired over 5 consecutive days including task states devised to simulate the effects of inter-day cognitive variation. As inter-individual differences are shaped by neurophysiological differences, the inter-individual differences in RS activity on 1 day were analysed (using machine learning) to identify distinctive configurations in each individual's RS activity. Using this configuration as a decision rule, an individual could be re-identified from 2-s samples of the instantaneous oscillatory power spectrum acquired on a different day both from RS and confounded RS with a limited loss in accuracy. Importantly, the low loss in accuracy in cross-day versus same-day classification was achieved with classifiers that combined information from multiple frequency bands at channels across the scalp (with a concentration at characteristic fronto-central and occipital zones). Taken together, these findings support the technical feasibility of screening RS activity for confounding effects and the suitability of longitudinal RS for robust individualized inferences about neurophysiological change in health and disease

Sensory Feedback Interferes with Mu Rhythm Based Detection of Motor Commands from Electroencephalographic Signals

Background: Electroencephalogram (EEG)-based brain-computer interfaces (BCI) represent a promising component of restorative motor therapies in individuals with partial paralysis. However, in those patients, sensory functions such as proprioception are at least partly preserved. The aim of this study was to investigate whether afferent feedback interferes with the BCI-based detection of efferent motor commands during execution of movements.Methods: Brain activity of 13 able-bodied subjects (age: 29.1 ± 4.8 years; 11 males) was compared between a motor task (MT) consisting of an isometric, isotonic grip and a somatosensory electrical stimulation (SS) of the fingertips. Modulation of the mu rhythm (8–13 Hz) was investigated to identify changes specifically related to the generation of efferent commands. A linear discriminant analysis (LDA) was used to investigate the activation pattern on a single-trial basis. Classifiers were trained with MT vs. REST (periods without MT/SS) and tested with SS and vice versa to quantify the impact of afferent feedback on the classification results.Results: Few differences in the spatial pattern between MT and SS were found in the modulation of the mu rhythm. All were characterized by event-related desynchronization (ERD) peaks at electrodes C3, C4, and CP3. Execution of the MT was associated with a significantly stronger ERD in the majority of sensorimotor electrodes [C3 (p < 0.01); CP3 (p < 0.05); C4 (p < 0.01)]. Classification accuracy of MT vs. REST was significantly higher than SS vs. REST (77% and 63%; p < 10-8). Classifiers trained on MT vs. REST were able to classify SS trials significantly above chance even though no motor commands were present during SS. Classifiers trained on SS performed better in classifying MT instead of SS.Conclusion: Our results challenge the notion that the modulation of the mu rhythm is a robust phenomenon for detecting efferent commands when afferent feedback is present. Instead, they indicate that the mu ERD caused by the processing of afferent feedback generates ERD patterns in the sensorimotor cortex that are masking the ERD patterns caused by the generation of efferent commands. Thus, processing of afferent feedback represents a considerable source of false positives when the mu rhythm is used for the detection of efferent commands

Microsleep disturbances are associated with noradrenergic dysfunction in Parkinson’s disease

Study ObjectivesParkinson’s disease (PD) commonly involves degeneration of sleep-wake regulating brainstem nuclei; likewise, sleep-wake disturbances are highly prevalent in PD patients. As polysomnography macroparameters typically show only minor changes in PD, we investigated sleep microstructure, particularly cyclic alternating pattern (CAP), and its relation to alterations of the noradrenergic system in these patients.MethodsWe analyzed 27 PD patients and 13 healthy control (HC) subjects who underwent overnight polysomnography and 11C-MeNER positron emission tomography for evaluation of noradrenaline transporter density. Sleep macroparameters, as well as CAP metrics, were evaluated according to the consensus statement from 2001. Statistical analysis comprised group comparisons and correlation analysis of CAP metrics with clinical characteristics of PD patients as well as noradrenaline transporter density.ResultsPD patients and HC subjects were comparable in demographic characteristics (age, sex, body mass index) and polysomnography macroparameters. CAP rate as well as A index differed significantly between groups, with PD patients having a lower CAP rate (46.7 ± 6.6% versus 38.0 ± 11.6%, p = 0.015) and lower A index (49.0 ± 8.7/hour versus 40.1 ± 15.4/hour, p = 0.042). In PD patients, both CAP metrics correlated significantly with diminished noradrenaline transporter density in arousal prompting brainstem nuclei (locus coeruleus, raphe nuclei) as well as arousal propagating brain structures like thalamus and bitemporal cortex.ConclusionsSleep microstructure is more severely altered than sleep macrostructure in PD patients and is associated with widespread dysfunction of the noradrenergic arousal system

Disruption of Sleep Microarchitecture Is a Sensitive and Early Marker of Parkinson’s Disease

AbstractBackground:Although sleep disturbances are highly prevalent in patients with Parkinson’s disease, sleep macroarchitecture metrics show only minor changes.Objective:To assess alterations of the cyclic alternating pattern (CAP) as a critical feature of sleep microarchitecture in patients with prodromal, recent, and established Parkinson’s disease.Methods:We evaluated overnight polysomnography for classic sleep macroarchitecture and CAP metrics in 68 patients at various disease stages and compared results to 22 age- and sex-matched controls.Results:Already at the prodromal stage, patients showed a significantly reduced CAP rate as a central characteristic of sleep microarchitecture. Temporal characteristics of CAP showed a gradual change over disease stages and correlated with motor performance. In contrast, the sleep macroarchitecture metrics did not differ between groups.Conclusion:Data suggest that alterations of sleep microarchitecture are an early and more sensitive characteristic of Parkinson’s disease than changes in sleep macroarchitecture