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Yang L, Xu C, Qin Y, Chen K, Xie Y, Zhou X, Liu T, Tan S, Liu J, Yao D. Exploring resting-state EEG oscillations in patients with Neuromyelitis Optica Spectrum Disorder. Brain Res Bull 2024; 208:110900. [PMID: 38364986 DOI: 10.1016/j.brainresbull.2024.110900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/24/2024] [Accepted: 02/11/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND AND OBJECTIVE Quantitative resting-state electroencephalography (rs-EEG) is a convenient method for characterizing the functional impairments and adaptations of the brain that has been shown to be valuable for assessing many neurological and psychiatric disorders, especially in monitoring disease status and assisting neuromodulation treatment. However, it has not yet been explored in patients with neuromyelitis optica spectrum disorder (NMOSD). This study aimed to investigate the rs-EEG features of NMOSD patients and explore the rs-EEG features related to disease characteristics and complications (such as anxiety, depression, and fatigue). METHODS A total of 32 NMOSD patients and 20 healthy controls (HCs) were recruited; their demographic and disease information were collected, and their anxiety, depression, and fatigue symptoms were evaluated. The rs-EEG power spectra of all the participants were obtained. After excluding the participants with low-quality rs-EEG data during processing, statistical analysis was conducted based on the clinical information and rs-EEG data of 29 patients and 19 HCs. The rs-EEG power (the mean spectral energy (MSE) of absolute power and relative power in all frequency bands, as well as the specific power for all electrode sites) of NMOSD patients and HCs was compared. Furthermore, correlation analyses were performed between rs-EEG power and other variables for NMOSD patients (including the disease characteristics and complications). RESULTS The distribution of the rs-EEG power spectra in NMOSD patients was similar to that in HCs. The dominant alpha-peaks shifted significantly towards a lower frequency for patients when compared to HCs. The delta and theta power was significantly increased in the NMOSD group compared to that in the HC group. The alpha oscillation power was found to be significantly negatively associated with the degree of anxiety (reflected by the anxiety subscore of hospital anxiety and depression scale (HADS)) and the degree of depression (reflected by the depression subscore of HADS). The gamma oscillation power was revealed to be significantly positively correlated with the fatigue severity scale (FSS) score, while further analysis indicated that the electrode sites of almost the whole brain region showing correlations with fatigue. Regarding the disease variables, no statistically significant rs-EEG features were related to the main disease features in NMOSD patients. CONCLUSION The results of this study suggest that the rs-EEG power spectra of NMOSD patients show increased slow oscillations and are potential biomarkers of widespread white matter microstructural damage in NMOSD. Moreover, this study revealed the rs-EEG features associated with anxiety, depression, and fatigue in NMOSD patients, which might help in the evaluation of these complications and the development of neuromodulation treatment. Quantitative rs-EEG analysis may play an important role in the management of NMOSD patients, and future studies are warranted to more comprehensively understand its application value.
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Affiliation(s)
- Lili Yang
- Department of Neurology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Congyu Xu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Yun Qin
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Kai Chen
- Department of Neurology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Xie
- Department of Neurology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaobo Zhou
- Department of Psychosomatic, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Tiejun Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Song Tan
- Department of Neurology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; Sichuan Provincial Key Laboratory for Human Disease Gene Study, Chengdu, China.
| | - Jie Liu
- Department of Neurology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.
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Pascarella A, Bruni V, Armonaite K, Porcaro C, Conti L, Cecconi F, Paulon L, Vitulano D, Tecchio F. Functional balance at rest of hemispheric homologs assessed via normalized compression distance. Front Neurosci 2024; 17:1261701. [PMID: 38333603 PMCID: PMC10851083 DOI: 10.3389/fnins.2023.1261701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/13/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction The formation and functioning of neural networks hinge critically on the balance between structurally homologous areas in the hemispheres. This balance, reflecting their physiological relationship, is fundamental for learning processes. In our study, we explore this functional homology in the resting state, employing a complexity measure that accounts for the temporal patterns in neurodynamics. Methods We used Normalized Compression Distance (NCD) to assess the similarity over time, neurodynamics, of the somatosensory areas associated with hand perception (S1). This assessment was conducted using magnetoencephalography (MEG) in conjunction with Functional Source Separation (FSS). Our primary hypothesis posited that neurodynamic similarity would be more pronounced within individual subjects than across different individuals. Additionally, we investigated whether this similarity is influenced by hemisphere or age at a population level. Results Our findings validate the hypothesis, indicating that NCD is a robust tool for capturing balanced functional homology between hemispheric regions. Notably, we observed a higher degree of neurodynamic similarity in the population within the left hemisphere compared to the right. Also, we found that intra-subject functional homology displayed greater variability in older individuals than in younger ones. Discussion Our approach could be instrumental in investigating chronic neurological conditions marked by imbalances in brain activity, such as depression, addiction, fatigue, and epilepsy. It holds potential for aiding in the development of new therapeutic strategies tailored to these complex conditions, though further research is needed to fully realize this potential.
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Affiliation(s)
- Annalisa Pascarella
- Istituto per le Applicazioni del Calcolo ‘Mauro Picone’, National Research Council of Italy, Rome, Italy
| | - Vittoria Bruni
- Istituto per le Applicazioni del Calcolo ‘Mauro Picone’, National Research Council of Italy, Rome, Italy
- Department of Basic and Applied Science for Engineering (SBAI), University of Rome ‘Sapienza’, Rome, Italy
| | | | - Camillo Porcaro
- Department of Neuroscience and Padova Neuroscience Center, University of Padua, Padua, Italy
- Laboratory of Electrophysiology for Translational neuroScience and Laboratory for Agent Based Social Simulation, Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
- Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Livio Conti
- Faculty of Engineering, Uninettuno University, Rome, Italy
| | - Federico Cecconi
- Laboratory of Electrophysiology for Translational neuroScience and Laboratory for Agent Based Social Simulation, Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
| | - Luca Paulon
- Laboratory of Electrophysiology for Translational neuroScience and Laboratory for Agent Based Social Simulation, Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
- Luca Paulon, Independent Researcher, Rome, Italy
| | - Domenico Vitulano
- Department of Basic and Applied Science for Engineering (SBAI), University of Rome ‘Sapienza’, Rome, Italy
| | - Franca Tecchio
- Laboratory of Electrophysiology for Translational neuroScience and Laboratory for Agent Based Social Simulation, Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
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Bertoli M, Tataranni A, Porziani S, Pasqualetti P, Gianni E, Grifoni J, L’Abbate T, Armonaite K, Conti L, Cancelli A, Cottone C, Marinozzi F, Bini F, Cecconi F, Tecchio F. Effects on Corticospinal Tract Homology of Faremus Personalized Neuromodulation Relieving Fatigue in Multiple Sclerosis: A Proof-of-Concept Study. Brain Sci 2023; 13:brainsci13040574. [PMID: 37190539 DOI: 10.3390/brainsci13040574] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Objectives: Fatigue in multiple sclerosis (MS) is a frequent and invalidating symptom, which can be relieved by non-invasive neuromodulation, which presents only negligible side effects. A 5-day transcranial direct-current stimulation, 15 min per day, anodically targeting the somatosensory representation of the whole body against a larger occipital cathode was efficacious against MS fatigue (fatigue relief in multiple sclerosis, Faremus treatment). The present proof-of-concept study tested the working hypothesis that Faremus S1 neuromodulation modifies the homology of the dominant and non-dominant corticospinal (CST) circuit recruitment. Methods: CST homology was assessed via the Fréchet distance between the morphologies of motor potentials (MEPs) evoked by transcranial magnetic stimulation in the homologous left- and right-hand muscles of 10 fatigued MS patients before and after Faremus. Results: In the absence of any change in MEP features either as differences between the two body sides or as an effect of the treatment, Faremus changed in physiological direction the CST’s homology. Faremus effects on homology were more evident than recruitment changes within the dominant and non-dominant sides. Conclusions: The Faremus-related CST changes extend the relevance of the balance between hemispheric homologs to the homology between body sides. With this work, we contribute to the development of new network-sensitive measures that can provide new insights into the mechanisms of neuronal functional patterning underlying relevant symptoms.
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On the Homology of the Dominant and Non-Dominant Corticospinal Tracts: A Novel Neurophysiological Assessment. Brain Sci 2023; 13:brainsci13020278. [PMID: 36831821 PMCID: PMC9954672 DOI: 10.3390/brainsci13020278] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVES The homology of hemispheric cortical areas plays a crucial role in brain functionality. Here, we extend this concept to the homology of the dominant and non-dominant hemi-bodies, investigating the relationship of the two corticospinal tracts (CSTs). The evoked responses provide an estimate of the number of in-phase recruitments via their amplitude as a suitable indicator of the neuronal projections' integrity. An innovative concept derived from experience in the somatosensory system is that their morphology reflects the recruitment pattern of the whole circuit. METHODS CST homology was assessed via the Fréchet distance between the morphologies of motor-evoked potentials (MEPs) using a transcranial magnetic stimulation (TMS) in the homologous left- and right-hand first dorsal interosseous muscles of 40 healthy volunteers (HVs). We tested the working hypothesis that the inter-side Fréchet distance was higher than the two intra-side distances. RESULTS In addition to a clear confirmation of the working hypothesis (p < 0.0001 for both hemi-bodies) verified in all single subjects, we observed that the intra-side Fréchet distance was higher for the dominant than the non-dominant one. Interhemispheric morphology similarity increased with right-handedness prevalence (p = 0.004). CONCLUSIONS The newly introduced measure of circuit recruitment patterning represents a potential benchmark for the evaluation of inter-lateral mechanisms expressing the relationship between homologous hemilateral structures subtending learning and suggests that variability in recruitment patterning physiologically increases in circuits expressing greater functionality.
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5
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Mohebbirad M, Motaharinezhad F, Shahsavary M, Joveini G. Effects of Sensory Interventions on Fatigue in People With Multiple Sclerosis: A Systematic Review. Int J MS Care 2022; 24:29-34. [PMID: 35261569 PMCID: PMC8883809 DOI: 10.7224/1537-2073.2020-123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
BACKGROUND Fatigue is 1 of the most common and annoying symptoms in patients with multiple sclerosis (MS). The purpose of this study was to investigate the effect of sensory interventions on fatigue in people with MS based on a systematic review of sensory evidence. METHODS The Google Scholar, PubMed, Scopus, and Cochrane Library databases were searched from January 1990 to July 2020. Studies with nonpharmacologic sensory interventions as a main or secondary intervention according to the assessment of fatigue as the primary or secondary therapy outcome in patients with MS were included. RESULTS Nine articles were reviewed by examining the inclusion and exclusion criteria. Four types of interventions were related to exercises, including sensory integration exercises, vestibular rehabilitation, Frenkel exercises, and exercises with or without vibration; and 2 types were performed using robots and 1 type using vibration only. Vestibular rehabilitation therapies, exercise-based sensory integration interventions, and the use of vibration have shown significant effects in relieving fatigue in patients with MS. CONCLUSIONS The evidence in this study is insufficient to show a dramatic effect of sensory integration therapy in various forms. However, despite the studies, sensory integration therapy can be considered a potential treatment for fatigue in patients with MS. Further studies with stronger methods are needed to make this treatment a reality.
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Affiliation(s)
- Mohammad Mohebbirad
- From the Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran (MM, MS)
| | - Fatemeh Motaharinezhad
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran (FM)
| | - Mohammad Shahsavary
- From the Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran (MM, MS)
| | - Ghodsiyeh Joveini
- Department of Occupational Therapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran (GJ)
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Khan H, Sami MB, Litvak V. The utility of Magnetoencephalography in multiple sclerosis - A systematic review. NEUROIMAGE-CLINICAL 2021; 32:102814. [PMID: 34537682 PMCID: PMC8455859 DOI: 10.1016/j.nicl.2021.102814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 01/29/2023]
Abstract
We conducted a Systematic Review of studies, looking at 30 studies from 13 centres. MS patients had reduced power in some induced responses (motor beta, visual gamma). Increased latency and reduced connectivity were seen for somatosensory evoked fields. There was an association between upper alpha connectivity and cognitive function. MEG shows promise, although work is too preliminary to recommend current clinical use.
Introduction Magnetoencephalography (MEG), allows for a high degree temporal and spatial accuracy in recording cortical oscillatory activity and evoked fields. To date, no review has been undertaken to synthesise all MEG studies in Multiple Sclerosis (MS). We undertook a Systematic Review of the utility of MEG in MS. Methods We identified MEG studies carried out in MS using EMBASE, Medline, Cochrane, TRIP and Psychinfo databases. We included original research articles with a cohort of minimum of five multiple sclerosis patients and quantifying of at least one MEG parameter. We used a modified version of the JBI (mJBI) for case-control studies to assess for risk of bias. Results We identified 30 studies from 13 centres involving at least 433 MS patients and 347 controls. We found evidence that MEG shows perturbed activity (most commonly reduced power modulations), reduced connectivity and association with altered clinical function in Multiple Sclerosis. Specific replicated findings were decreased motor induced responses in the beta band, diminished increase of gamma power after visual stimulation, increased latency and reduced connectivity for somatosensory evoked fields. There was an association between upper alpha connectivity and cognitive measures in people with MS. Overall studies were of moderate quality (mean mJBI score 6.7). Discussion We find evidence for the utility of MEG in Multiple Sclerosis. Event-related designs are of particular value and show replicability between centres. At this stage, it is not clear whether these changes are specific to Multiple Sclerosis or are also observable in other diseases. Further studies should look to explore cognitive control in more depth using in-task designs and undertake longitudinal studies to determine whether these changes have prognostic value.
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Affiliation(s)
- H Khan
- UCL Queen's Square Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; Queen's Medical Centre Nottingham, Clifton Boulevard, Derby Rd, Nottingham NG7 2UH, United Kingdom.
| | - M B Sami
- Institute of Mental Health, Jubilee Campus, University of Nottingham Innovation Park, Triumph Road, Nottingham NG7 2TU, United Kingdom
| | - V Litvak
- UCL Queen's Square Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
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Padalino M, Scardino C, Zito G, Cancelli A, Cottone C, Bertoli M, Gianni E, L'Abbate T, Trombetta E, Porcaro C, Bini F, Marinozzi F, Filippi MM, Tecchio F. Effects on Motor Control of Personalized Neuromodulation Against Multiple Sclerosis Fatigue. Brain Topogr 2021; 34:363-372. [PMID: 33656622 DOI: 10.1007/s10548-021-00820-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 01/06/2021] [Indexed: 10/22/2022]
Abstract
Fatigue is a hidden symptom of Multiple Sclerosis (MS) disease that nevertheless impacts severely on patients' everyday life. Evidence indicates the involvement of the sensorimotor network and its inter-nodes communication at the basis of this symptom. Two randomized controlled trials (RCTs) showed that the personalized neuromodulation called Fatigue Relief in Multiple Sclerosis (FaReMuS) efficaciously fights multiple sclerosis (MS) fatigue. By this Proof of Concept study, we tested whether FaReMuS reverts the alteration of the brain-muscular synchronization previously observed occurring with fatigue. The cortico muscular coherence (CMC) was studied in 11 patients before and after FaReMuS, a 5-day tDCS (1.5 mA, 15 min per day) anodal over the whole body's somatosensory representation (S1) via a personalized MRI-based electrode (35 cm2) against the occipital cathode (70 cm2). Before FaReMuS, the CMC was observed at a mean frequency of 31.5 ± 1.6 Hz (gamma-band) and positively correlated with the level of fatigue (p = .027). After FaReMuS, fatigue reduced in average of 28% ± 33% the baseline level, and the CMC frequency reduced to 26.6 ± 1.5 Hz (p = .022), thus forthcoming the physiological beta-band as observed in healthy people. The personalized S1 neuromodulation treatment, ameliorating the central-peripheral communication that subtends simple everyday movements, supports the appropriateness of neuromodulations aiming at increasing the parietal excitability in fighting MS fatigue. The relationship between central-peripheral features and fatigue profile strengthens a central more than peripheral origin of the symptom.
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Affiliation(s)
| | - Carla Scardino
- LET'S-ISTC-CNR, via Palestro 32, 00185, Rome, Italy.,Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, Italy
| | - Giancarlo Zito
- Complex Operative Unit of Neurology, Emergency Department, San Camillo de Lellis Hospital, Viale Kennedy, Rieti, 02100, RI, Italy.,Diagnostic and Clinical Assessment Unit, Istituto di Ortofonologia, Via Salaria, 30, Rome, 00198, RM, Italy
| | | | | | - Massimo Bertoli
- LET'S-ISTC-CNR, via Palestro 32, 00185, Rome, Italy.,Department of Imaging and Neuroscience and Clinical Sciences, University 'G. D'Annunzio' of Chieti-Pescara, Chieti, Italy
| | - Eugenia Gianni
- LET'S-ISTC-CNR, via Palestro 32, 00185, Rome, Italy.,Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | | | | | - Camillo Porcaro
- LET'S-ISTC-CNR, via Palestro 32, 00185, Rome, Italy.,Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, UK.,Department of Information Engineering, Università Politecnica Delle Marche, Ancona, Italy.,S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
| | - Fabiano Bini
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, Italy
| | - Franco Marinozzi
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, Italy
| | - Maria Maddalena Filippi
- Complex Operative Unit of Neurology, Emergency Department, San Camillo de Lellis Hospital, Viale Kennedy, Rieti, 02100, RI, Italy
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Abstract
The last decade has seen the emergence of new theoretical frameworks to explain pathological fatigue, a much neglected, yet highly significant symptom across a wide range of diseases. While the new models of fatigue provide new hypotheses to test, they also raise a number of questions. The primary purpose of this essay is to examine the predictions of three recently proposed models of fatigue, the overlap and differences between them, and the evidence from diseases that may lend support to the models of fatigue. I also present expansions for the sensory attenuation model of fatigue. Further questions examined here are the following: What are the neural substrates of fatigue? How can sensory attenuation, which underpins agency also explain fatigue? Are fatigue and agency related?
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Affiliation(s)
- Annapoorna Kuppuswamy
- Department of Clinical and Movement Neuroscience, Institute of Neurology, University College London, London, UK
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9
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Zhang J, Safar K, Emami Z, Ibrahim GM, Scratch SE, da Costa L, Dunkley BT. Local and large-scale beta oscillatory dysfunction in males with mild traumatic brain injury. J Neurophysiol 2020; 124:1948-1958. [PMID: 33052746 DOI: 10.1152/jn.00333.2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Mild traumatic brain injury (mTBI) is impossible to detect with standard neuroradiological assessment such as structural magnetic resonance imaging (MRI). Injury does, however, disrupt the dynamic repertoire of neural activity indexed by neural oscillations. In particular, beta oscillations are reliable predictors of cognitive, perceptual, and motor system functioning, as well as correlating highly with underlying myelin architecture and brain connectivity-all factors particularly susceptible to dysregulation after mTBI. We measured local and large-scale neural circuit function by magnetoencephalography (MEG) with a data-driven model fit approach using the fitting oscillations and one-over f algorithm in a group of young adult men with mTBI and a matched healthy control group. We quantified band-limited regional power and functional connectivity between brain regions. We found reduced regional power and deficits in functional connectivity across brain areas, which pointed to the well-characterized thalamocortical dysconnectivity associated with mTBI. Furthermore, our results suggested that beta functional connectivity data reached the best mTBI classification performance compared with regional power and symptom severity [measured with Sport Concussion Assessment Tool 2 (SCAT2)]. The present study reveals the relevance of beta oscillations as a window into neurophysiological dysfunction in mTBI and also highlights the reliability of neural synchrony biomarkers in disorder classification.NEW & NOTEWORTHY Mild traumatic brain injury (mTBI) disrupts the dynamic repertoire of neural oscillations, but so far beta activity has not been studied. In mTBI, we found reductions in frontal beta and large-scale beta networks, indicative of thalamocortical dysconnectivity and disrupted information flow through cortico-basal ganglia-thalamic circuits. Relatively, connectivity more accurately classifies individual mTBI cases compared with regional power. We show the relevance of beta oscillations in mTBI and the reliability of these markers in classification.
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Affiliation(s)
- Jing Zhang
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.,Neurosciences & Mental Health, SickKids Research Institute, Toronto Ontario, Canada
| | - Kristina Safar
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.,Neurosciences & Mental Health, SickKids Research Institute, Toronto Ontario, Canada
| | - Zahra Emami
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.,Neurosciences & Mental Health, SickKids Research Institute, Toronto Ontario, Canada
| | - George M Ibrahim
- Neurosciences & Mental Health, SickKids Research Institute, Toronto Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute for Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,Department of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shannon E Scratch
- Bloorview Research Institute, Toronto, Ontario, Canada.,Holland Bloorview Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Leodante da Costa
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Benjamin T Dunkley
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.,Neurosciences & Mental Health, SickKids Research Institute, Toronto Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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10
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Bertoli M, Tecchio F. Fatigue in multiple sclerosis: Does the functional or structural damage prevail? Mult Scler 2020; 26:1809-1815. [DOI: 10.1177/1352458520912175] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Fatigue in multiple sclerosis (MS) is a highly invalidating symptom, lacking efficacious drugs. This topical review aims at assessing the signs in the literature of functional versus structural damage prevalence at the origin of MS fatigue by focusing on papers that assessed the two counterparts in the same patients, paying attention that the fatigue levels do not correlate with clinical severity. We summarize and discuss evidence of increased levels of fatigue occurring together with the alterations of functional connectivity at multiple levels, in the absence of any relationship with lesion load and local atrophy of the involved structures. Specifically, neuronal communication mainly altered in the corticomuscular synchronizations, between hemispheric homologs and in the resting-state networks involved in emotion (cingulate cortex) and effort-reward balance (striatum and inferior parietal lobule). Finally, given the functional prevalence in neuronal network alterations at the origin of fatigue in MS, we highlight the relevance of developing treatments aiming at compensating the neuronal electric communication dysfunctions.
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Affiliation(s)
- Massimo Bertoli
- LET’S – ISTC – CNR, Catholic University of the Sacred Heart, Rome, Italy
| | - Franca Tecchio
- LET’S – ISTC – CNR, Catholic University of the Sacred Heart, Rome, Italy
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11
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Tecchio F, Cecconi F, Colamartino E, Padalino M, Valci L, Reinert M. The Morphology of Somatosensory Evoked Potentials During Middle Cerebral Artery Aneurysm Clipping (MoSAC): A Pilot Study. Clin EEG Neurosci 2020; 51:130-136. [PMID: 31514539 DOI: 10.1177/1550059419874942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Somatosensory evoked potential (SEP) monitoring is a standard tool during clipping of aneurysms of the middle cerebral artery (MCA), and the parameter used to detect a state of cortical ischemia is amplitude. We think that the sensitivity of SEP can however be improved by using other parameters. Our study moves in this direction via SEP morphology. In this pilot preliminary study, involving a small sample without postoperative neurological deficit, we aimed at investigating the value of SEP morphology (in the 15- to 35-ms time frame), in comparison with SEP amplitude (N20 peak-to-peak), as a measure of sensitivity to blood flow reduction. The changes in the SEP morphology of 16 patients undergoing clipping of an unruptured MCA aneurysm was studied. We applied the Morph-Fréchet index for each recorded SEP (at 30-second intervals), quantifying the pattern shape change with regard to the average SEP recorded after dura opening (baseline). We also compared 3 measurements of the SEP morphology, without and with GARCH-derived filter. Filtered Morph-Fréchet never exceeded the individual's "normality" range in baseline but did so in 81% of the risk phase on average across the 16 subjects, which is more than that for amplitude (36%, P = .002). This pilot study indicates that a measurement derived from the networking nature of the brain was sensitive to blood flow reduction. The SEP morphology approach promises to improve SEP monitoring sensitivity during clipping of unruptured MCA aneurysms. New and Noteworthy. The higher sensitivity to blood flow reduction of SEP morphology than amplitude promises to improve the effectiveness of intraoperative monitoring during MCA aneurysm clipping procedures.
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Affiliation(s)
- Franca Tecchio
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) and Laboratory of Agent Based Social Simulation (LABSS), ISTC, CNR, Rome, Italy
| | - Federico Cecconi
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) and Laboratory of Agent Based Social Simulation (LABSS), ISTC, CNR, Rome, Italy
| | - Elisabetta Colamartino
- Depatment of Neurosurgery, Regional Hospital of Lugano, Neurocentro della Svizzera Italiana (NSI), Lugano, Swiss
| | - Matteo Padalino
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) and Laboratory of Agent Based Social Simulation (LABSS), ISTC, CNR, Rome, Italy
| | - Luca Valci
- Depatment of Neurosurgery, Regional Hospital of Lugano, Neurocentro della Svizzera Italiana (NSI), Lugano, Swiss
| | - Michael Reinert
- Depatment of Neurosurgery, Regional Hospital of Lugano, Neurocentro della Svizzera Italiana (NSI), Lugano, Swiss
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Cortical neurodynamics changes mediate the efficacy of a personalized neuromodulation against multiple sclerosis fatigue. Sci Rep 2019; 9:18213. [PMID: 31796805 PMCID: PMC6890667 DOI: 10.1038/s41598-019-54595-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/04/2019] [Indexed: 12/11/2022] Open
Abstract
The people with multiple sclerosis (MS) often report that fatigue restricts their life. Nowadays, pharmacological treatments are poorly effective accompanied by relevant side effects. A 5-day transcranial direct current stimulation (tDCS) targeting the somatosensory representation of the whole body (S1) delivered through an electrode personalized based on the brain MRI was efficacious against MS fatigue (FaReMuS treatment). This proof of principle study tested whether possible changes of the functional organization of the primary sensorimotor network induced by FaReMuS partly explained the effected fatigue amelioration. We measured the brain activity at rest through electroencephalography equipped with a Functional Source Separation algorithm and we assessed the neurodynamics state of the primary somatosensory (S1) and motor (M1) cortices via the Fractal Dimension and their functional connectivity via the Mutual Information. The dynamics of the neuronal electric activity, more distorted in S1 than M1 before treatment, as well as the network connectivity, altered maximally between left and right M1 homologs, reverted to normal after FaReMuS. The intervention-related changes explained 48% of variance of fatigue reduction in the regression model. A personalized neuromodulation tuned in on specific anatomo-functional features of the impaired regions can be effective against fatigue.
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Zhang J, Qian S, Jiang Q, Gong G, Liu K, Li B, Yin Y, Sun G. Thalamocortical neural responses during hyperthermia: a resting-state functional MRI study. Int J Hyperthermia 2017; 34:891-899. [PMID: 28927330 DOI: 10.1080/02656736.2017.1382014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The neural responses during hyperthermia, once thought of as simple physiological processes (e.g. thermal sensation and regulation), have now been recognised involving more cognitive processes, which would be of high importance to the management of those occupations during heavy heat exposure. Previous studies have demonstrated altered activity in localised subcortical clusters for thermal sensation and regulation, as well as cortical-cortical activity for behavioural tasks during hyperthermia. However, the involvement of cortical-subcortical activity during hyperthermia has not been investigated. In this study, we performed exploratory analyses comparing thalamocortical functional connectivity during whole body hyperthermic condition for an hour at 50 °C and normothermic condition at 25 °C. We found weakened functional connectivity of cortical fronto-polar/anterior cingulate cortex and prefrontal areas with the corresponding thalamic nuclei during hyperthermic versus normothermic comparisons. On the contrary, the motor/premotor, somatosensory and temporal cortical subdivisions showed increased connectivity with thalamic nuclei during hyperthermia. Thalamocortical connectivity changes in the prefrontal were identified to be correlated with the behavioural reaction time during psychomotor vigilance test after controlling for physiological variables. These distinct thalamocortical pathway alterations might reflect physiologically thermal sensation and regulation, as well as psychologically neural behaviour changes underlying cortical-subcortical activity during hyperthermia.
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Affiliation(s)
- Jing Zhang
- a Institute of Biomedical Sciences , School of Physics and Electronics, Shandong Normal University , Jinan , Shandong , People's Republic of China.,b Department of Radiation Oncology , Shandong Cancer Hospital and Institute , Jinan , Shandong , People's Republic of China.,c Shandong Province Key Laboratory of Medical Physics and Image Processing Technology , Jinan , Shandong , People's Republic of China
| | - Shaowen Qian
- d Department of Medical Imaging , Jinan Military General Hospital , Jinan , Shandong , People's Republic of China
| | - Qingjun Jiang
- d Department of Medical Imaging , Jinan Military General Hospital , Jinan , Shandong , People's Republic of China
| | - Guanzhong Gong
- b Department of Radiation Oncology , Shandong Cancer Hospital and Institute , Jinan , Shandong , People's Republic of China
| | - Kai Liu
- d Department of Medical Imaging , Jinan Military General Hospital , Jinan , Shandong , People's Republic of China
| | - Bo Li
- d Department of Medical Imaging , Jinan Military General Hospital , Jinan , Shandong , People's Republic of China
| | - Yong Yin
- b Department of Radiation Oncology , Shandong Cancer Hospital and Institute , Jinan , Shandong , People's Republic of China
| | - Gang Sun
- d Department of Medical Imaging , Jinan Military General Hospital , Jinan , Shandong , People's Republic of China
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Darvishi S, Ridding MC, Hordacre B, Abbott D, Baumert M. Investigating the impact of feedback update interval on the efficacy of restorative brain-computer interfaces. ROYAL SOCIETY OPEN SCIENCE 2017; 4:170660. [PMID: 28879007 PMCID: PMC5579123 DOI: 10.1098/rsos.170660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 07/31/2017] [Indexed: 06/07/2023]
Abstract
Restorative brain-computer interfaces (BCIs) have been proposed to enhance stroke rehabilitation. Restorative BCIs are able to close the sensorimotor loop by rewarding motor imagery (MI) with sensory feedback. Despite the promising results from early studies, reaching clinically significant outcomes in a timely fashion is yet to be achieved. This lack of efficacy may be due to suboptimal feedback provision. To the best of our knowledge, the optimal feedback update interval (FUI) during MI remains unexplored. There is evidence that sensory feedback disinhibits the motor cortex. Thus, in this study, we explore how shorter than usual FUIs affect behavioural and neurophysiological measures following BCI training for stroke patients using a single-case proof-of-principle study design. The action research arm test was used as the primary behavioural measure and showed a clinically significant increase (36%) over the course of training. The neurophysiological measures including motor evoked potentials and maximum voluntary contraction showed distinctive changes in early and late phases of BCI training. Thus, this preliminary study may pave the way for running larger studies to further investigate the effect of FUI magnitude on the efficacy of restorative BCIs. It may also elucidate the role of early and late phases of motor learning along the course of BCI training.
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Affiliation(s)
- Sam Darvishi
- School of Electrical and Electronic Engineering, The University of Adelaide, Australia
| | | | - Brenton Hordacre
- The Robinson Research Institute, The University of Adelaide, Australia
- School of Health Sciences, University of South Australia, Australia
| | - Derek Abbott
- School of Electrical and Electronic Engineering, The University of Adelaide, Australia
| | - Mathias Baumert
- School of Electrical and Electronic Engineering, The University of Adelaide, Australia
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Cancelli A, Cottone C, Giordani A, Migliore S, Lupoi D, Porcaro C, Mirabella M, Rossini PM, Filippi MM, Tecchio F. Personalized, bilateral whole-body somatosensory cortex stimulation to relieve fatigue in multiple sclerosis. Mult Scler 2017; 24:1366-1374. [PMID: 28756744 DOI: 10.1177/1352458517720528] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The patients suffering from multiple sclerosis (MS) often consider fatigue the most debilitating symptom they experience, but conventional medicine currently offers poorly efficacious therapies. OBJECTIVE We executed a replication study of an innovative approach for relieving MS fatigue. METHODS According to the sample size estimate, we recruited 10 fatigued MS patients who received 5-day transcranial direct current stimulation (tDCS) in a randomized, double-blind, Sham-controlled, crossover study, with modified Fatigue Impact Scale (mFIS) score reduction at the end of the treatment as primary outcome. A personalized anodal electrode, shaped on the magnetic resonance imaging (MRI)-derived individual cortical folding, targeted the bilateral whole-body primary somatosensory cortex (S1) with an occipital cathode. RESULTS The amelioration of fatigue symptoms after Real stimulation (40% of baseline) was significantly larger than after Sham stimulation (14%, p = 0.012). Anodal whole body S1 induced a significant fatigue reduction in mildly disabled MS patients when the fatigue-related symptoms severely hampered their quality of life. CONCLUSION This second result in an independent group of patients supports the idea that neuromodulation interventions that properly select a personalized target might be a suitable non-pharmacological treatment for MS fatigue.
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Affiliation(s)
- Andrea Cancelli
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) - ISTC - CNR, Rome, Italy
| | - Carlo Cottone
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) - ISTC - CNR, Rome, Italy
| | - Alessandro Giordani
- Department of Geriatrics, Neurosciences & Orthopedics, Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy/Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, AFaR Division, Rome, Italy
| | - Simone Migliore
- Clinical Psychology Service, University Campus Bio-Medico, Rome, Italy/LIRH Foundation, Rome, Italy
| | - Domenico Lupoi
- Neuroscience and Imaging, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Camillo Porcaro
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) - ISTC - CNR, Rome, Italy
| | - Massimiliano Mirabella
- Department of Geriatrics, Neurosciences & Orthopedics, Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy
| | - Paolo Maria Rossini
- Department of Geriatrics, Neurosciences & Orthopedics, Institute of Neurology, Catholic University of the Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy
| | | | - Franca Tecchio
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) - ISTC - CNR, Rome, Italy
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Vecchio F, Miraglia F, Porcaro C, Cottone C, Cancelli A, Rossini PM, Tecchio F. Electroencephalography-Derived Sensory and Motor Network Topology in Multiple Sclerosis Fatigue. Neurorehabil Neural Repair 2016; 31:56-64. [DOI: 10.1177/1545968316656055] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
People with multiple sclerosis (MS) frequently complain of excessive fatigue, which is the most disabling symptom for half of them. While the few drugs used to treat MS fatigue are of limited utility, we recently observed the efficacy of a personalized neuromodulation treatment. Here, we aim at strengthening knowledge of the brain network changes that occur when MS fatigue increases, using graph theory. We collected electroencephalographic (EEG; 23 or 64 channels) data in resting state with eyes open in 27 relapsing-remitting (RR) patients with mild MS (EDSS ≤2), suffering a wide range of fatigue as scored by the modified Fatigue Impact Scale (mFIS) (2-69, within a total range 0-84). To estimate graph theory small-world index (SW), we calculated the lagged linear coherence between EEG cortical eLORETA sources, in the standard frequency bands delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), beta2 (20-30 Hz), and gamma (30-45 Hz). We calculated the SW of these undirected and weighted networks separately in the four left and right frontal (motor) and parieto-occipito-temporal (sensory) brain networks. A correlative analysis demonstrated increased fatigue symptoms along with the SW specifically in the Sensory network of the left dominant hemisphere in the beta1 band (Pearson’s r = 0.404, P = .020). Our study indicates a specific involvement of the dominant-hemisphere sensory network in MS fatigue. It suggests that compensatory neuromodulation interventions could enhance efficacy in relieving this debilitating symptom by targeting this area.
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Affiliation(s)
| | | | - Camillo Porcaro
- LET’S-ISTC-CNR, Fatebenefratelli Hospital–Isola Tiberina, Rome, Italy
- Movement Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
- Università Politecnica delle Marche, Ancona, Italy
| | - Carlo Cottone
- LET’S-ISTC-CNR, Fatebenefratelli Hospital–Isola Tiberina, Rome, Italy
| | - Andrea Cancelli
- LET’S-ISTC-CNR, Fatebenefratelli Hospital–Isola Tiberina, Rome, Italy
- Catholic University, Rome, Italy
| | | | - Franca Tecchio
- LET’S-ISTC-CNR, Fatebenefratelli Hospital–Isola Tiberina, Rome, Italy
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Ghaffarian N, Mesgari M, Cerina M, Göbel K, Budde T, Speckmann EJ, Meuth SG, Gorji A. Thalamocortical-auditory network alterations following cuprizone-induced demyelination. J Neuroinflammation 2016; 13:160. [PMID: 27334140 PMCID: PMC4918138 DOI: 10.1186/s12974-016-0629-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 06/15/2016] [Indexed: 12/14/2022] Open
Abstract
Background Demyelination and remyelination are common pathological processes in many neurological disorders, including multiple sclerosis (MS). Clinical evidence suggests extensive involvement of the thalamocortical (TC) system in patients suffering from MS. Methods Using murine brain slices of the primary auditory cortex, we investigated the functional consequences of cuprizone-induced de- and remyelination on neuronal activity and auditory TC synaptic transmission in vitro. Results Our results revealed an impact of myelin loss and restoration on intrinsic cellular firing patterns, synaptic transmission, and neuronal plasticity in layer 3 and 4 neurons of the auditory TC network. While there was a complex hyper- and depolarizing shift of the resting membrane potential, spontaneous and induced action potential firing was reduced during demyelination and early remyelination. In addition, excitatory postsynaptic potential amplitudes were decreased and induction of LTP was reduced during demyelination. Conclusions These data indicate that demyelination-induced impairment of neurons and network activity within the TC system may underlie clinical symptoms observed in demyelinating diseases, corroborating human findings that disease progression is significantly correlated with microstructural tissue damage of the TC system. Further investigation into focal inflammation-induced demyelination models ex vivo and in vivo are needed to understand the functional implication of local and remote lesion formation on TC network activity in MS.
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Affiliation(s)
- Nikoo Ghaffarian
- Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, University of Münster, Robert-Koch-Straße 27a, 48149, Münster, Germany
| | - Masoud Mesgari
- Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, University of Münster, Robert-Koch-Straße 27a, 48149, Münster, Germany
| | - Manuela Cerina
- Department of Neurology, Westfälische Wilhelms-Universität, University of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
| | - Kerstin Göbel
- Department of Neurology, Westfälische Wilhelms-Universität, University of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
| | - Thomas Budde
- Institute of Physiology I, Westfälische Wilhelms-Universität, Münster, Germany
| | - Erwin-Josef Speckmann
- Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, University of Münster, Robert-Koch-Straße 27a, 48149, Münster, Germany
| | - Sven G Meuth
- Department of Neurology, Westfälische Wilhelms-Universität, University of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
| | - Ali Gorji
- Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, University of Münster, Robert-Koch-Straße 27a, 48149, Münster, Germany. .,Department of Neurology, Westfälische Wilhelms-Universität, University of Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany. .,Department of Neurosurgery, Westfälische Wilhelms-Universität Münster, Münster, Germany. .,Shefa Neuroscience Research Center, Khatam-Alanbia Hospital, Tehran, Iran.
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18
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Tecchio F, Cancelli A, Cottone C, Ferrucci R, Vergari M, Zito G, Pasqualetti P, Filippi MM, Ghazaryan A, Lupoi D, Smits FM, Giordani A, Migliore S, Porcaro C, Salustri C, Rossini PM, Priori A. Brain Plasticity Effects of Neuromodulation Against Multiple Sclerosis Fatigue. Front Neurol 2015; 6:141. [PMID: 26191036 PMCID: PMC4490242 DOI: 10.3389/fneur.2015.00141] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/11/2015] [Indexed: 11/25/2022] Open
Abstract
Rationale We recently reported on the efficacy of a personalized transcranial direct current stimulation (tDCS) treatment in reducing multiple sclerosis (MS) fatigue. The result supports the notion that interventions targeted at modifying abnormal excitability within the sensorimotor network could represent valid non-pharmacological treatments. Objective The present work aimed at assessing whether the mentioned intervention also induces changes in the excitability of sensorimotor cortical areas. Method Two separate groups of fatigued MS patients were given a 5-day tDCS treatments targeting, respectively, the whole body somatosensory areas (S1wb) and the hand sensorimotor areas (SM1hand). The study had a double blind, sham-controlled, randomized, cross-over (Real vs. Sham) design. Before and after each treatment, we measured fatigue levels (by the modified fatigue impact scale, mFIS), motor evoked potentials (MEPs) in response to transcranial magnetic stimulation and somatosensory evoked potentials (SEPs) in response to median nerve stimulation. We took MEPs and SEPs as measures of the excitability of the primary motor area (M1) and the primary somatosensory area (S1), respectively. Results The Real S1wb treatment produced a 27% reduction of the mFIS baseline level, while the SM1hand treatment showed no difference between Real and Sham stimulations. M1 excitability increased on average 6% of the baseline in the S1wb group and 40% in the SM1hand group. Observed SEP changes were not significant and we found no association between M1 excitability changes and mFIS decrease. Conclusion The tDCS treatment was more effective against MS fatigue when the electrode was focused on the bilateral whole body somatosensory area. Changes in S1 and M1 excitability did not correlate with symptoms amelioration. Significance The neuromodulation treatment that proved effective against MS fatigue induced only minor variations of the motor cortex excitability, not enough to explain the beneficial effects of the intervention.
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Affiliation(s)
- Franca Tecchio
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), Department of Neuroscience, ISTC, CNR, Fatebenefratelli Hospital - Isola Tiberina , Rome , Italy ; Unit of Neuroimaging, IRCCS San Raffaele Pisana , Rome , Italy
| | - Andrea Cancelli
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), Department of Neuroscience, ISTC, CNR, Fatebenefratelli Hospital - Isola Tiberina , Rome , Italy ; Clinical Neurology, Catholic University, Policlinico A. Gemelli , Rome , Italy
| | - Carlo Cottone
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), Department of Neuroscience, ISTC, CNR, Fatebenefratelli Hospital - Isola Tiberina , Rome , Italy
| | - Roberta Ferrucci
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano , Milan , Italy
| | - Maurizio Vergari
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano , Milan , Italy
| | - Giancarlo Zito
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), Department of Neuroscience, ISTC, CNR, Fatebenefratelli Hospital - Isola Tiberina , Rome , Italy ; AFaR Division, Fatebenefratelli Foundation for Health Research and Education , Rome , Italy
| | - Patrizio Pasqualetti
- Unit of Neuroimaging, IRCCS San Raffaele Pisana , Rome , Italy ; AFaR Division, Fatebenefratelli Foundation for Health Research and Education , Rome , Italy
| | | | - Anna Ghazaryan
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), Department of Neuroscience, ISTC, CNR, Fatebenefratelli Hospital - Isola Tiberina , Rome , Italy ; AFaR Division, Fatebenefratelli Foundation for Health Research and Education , Rome , Italy
| | - Domenico Lupoi
- AFaR Division, Fatebenefratelli Foundation for Health Research and Education , Rome , Italy
| | | | - Alessandro Giordani
- Clinical Neurology, Catholic University, Policlinico A. Gemelli , Rome , Italy ; AFaR Division, Fatebenefratelli Foundation for Health Research and Education , Rome , Italy
| | - Simone Migliore
- University of Campus Biomedico, Psychology Service , Rome , Italy
| | - Camillo Porcaro
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), Department of Neuroscience, ISTC, CNR, Fatebenefratelli Hospital - Isola Tiberina , Rome , Italy ; Institute of Neuroscience, Medical School, Newcastle University , Newcastle upon Tyne , UK
| | - Carlo Salustri
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), Department of Neuroscience, ISTC, CNR, Fatebenefratelli Hospital - Isola Tiberina , Rome , Italy
| | - Paolo M Rossini
- Unit of Neuroimaging, IRCCS San Raffaele Pisana , Rome , Italy ; Clinical Neurology, Catholic University, Policlinico A. Gemelli , Rome , Italy
| | - Alberto Priori
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano , Milan , Italy
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Yao S, Song J, Gao L, Yan Y, Huang C, Ding H, Huang H, He Y, Sun R, Xu G. Thalamocortical Sensorimotor Circuit Damage Associated with Disorders of Consciousness for Diffuse Axonal Injury Patients. J Neurol Sci 2015; 356:168-74. [PMID: 26165776 DOI: 10.1016/j.jns.2015.06.044] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 06/16/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
The relationship of structural and functional brain damage and disorders of consciousness (DOC) for diffuse axonal injury (DAI) is still not fully explored. We employed diffusion tensor imaging (DTI) and resting-state fMRI (RS-fMRI) to examine the changes of resting activations and white matter (WM) integrity for DAI with DOC. WM damages were observed in the body and genu of the corpus callosum, right external capsule (EC) and superior corona radiate (SCR), left superior cerebellar peduncle (SCP) and posterior thalamic radiation (PTR). The RS-fMRI revealed augmented amplitude of low-frequency fluctuation (ALFF) in the anterior cingulate cortex, hippocampus, insula, amygdala and putamen, and reduced ALFF in the precuneus, thalamus, pre-central and post-central gyri. Correlation analysis identified positive associations between the Glasgow Coma Scale (GCS) and activation of the precuneus and between GCS and DTI measurements in the left PTR and SCP, but a negative correlation was found between GCS and activation of the thalamus. Cross modality association analyses indicated that activations of the amygdala and postcentral gyrus were correlated with DTI measurements of the right EC and left PTR respectively. These results implicate that the WM damages in thalamocortical sensorimotor circuit and aberrant brain activity responding to self-awareness and sensation are critical factors to DOC, which expand the current understanding of the neural mechanisms underlying DAI.
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Affiliation(s)
- Shun Yao
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Jian Song
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Lichen Gao
- Department of Radiology, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Yan Yan
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Cheng Huang
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Huichao Ding
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - He Huang
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Yuanzhi He
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Ronghui Sun
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China
| | - Guozheng Xu
- Department of Neurosurgery, Wuhan General Hospital of Guangzhou Command, Wuhan 430070, China.
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20
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Tecchio F, Cancelli A, Cottone C, Zito G, Pasqualetti P, Ghazaryan A, Rossini PM, Filippi MM. Multiple sclerosis fatigue relief by bilateral somatosensory cortex neuromodulation. J Neurol 2014; 261:1552-8. [PMID: 24854634 DOI: 10.1007/s00415-014-7377-9] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 12/21/2022]
Abstract
Multiple sclerosis-related fatigue is highly common and often refractory to medical therapy. Ten fatigued multiple sclerosis patients received two blocks of 5-day anodal bilateral primary somatosensory areas transcranial direct current stimulation in a randomized, double-blind sham-controlled, cross-over study. The real neuromodulation by a personalized electrode, shaped on the MR-derived primary somatosensory cortical strip, reduced fatigue in all patients, by 26 % in average (p = 0.002), which did not change after sham (p = 0.901). Anodal tDCS over bilateral somatosensory areas was able to relief fatigue in mildly disabled MS patients, when the fatigue-related symptoms severely hamper their quality of life. These small-scale study results support the concept that interventions modifying the sensorimotor network activity balances could be a suitable non-pharmacological treatment for multiple sclerosis fatigue.
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Affiliation(s)
- Franca Tecchio
- Laboratory of Electrophysiology for Translational neuroScience (LET'S)-ISTC-CNR, Department of Clinical Neuroscience, Fatebenefratelli Hospital, Isola Tiberina, 00186, Rome, Italy,
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21
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Zito G, Luders E, Tomasevic L, Lupoi D, Toga AW, Thompson PM, Rossini PM, Filippi MM, Tecchio F. Inter-hemispheric functional connectivity changes with corpus callosum morphology in multiple sclerosis. Neuroscience 2014; 266:47-55. [PMID: 24486438 DOI: 10.1016/j.neuroscience.2014.01.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 01/15/2014] [Accepted: 01/19/2014] [Indexed: 12/27/2022]
Abstract
Multiple sclerosis (MS) affects myelin sheaths within the central nervous system, concurring to cause brain atrophy and neurodegeneration as well as gradual functional disconnections. To explore early signs of altered connectivity in MS from a structural and functional perspective, the morphology of corpus callosum (CC) was correlated with a dynamic inter-hemispheric connectivity index. Twenty mildly disabled patients affected by a relapsing-remitting (RR) form of MS (EDSS⩽3.5) and 15 healthy subjects underwent structural MRI to measure CC thickness over 100 sections and electroencephalography to assess a spectral coherence index between primary regions devoted to hand control, at rest and during an isometric handgrip. In patients, an overall CC atrophy was associated with increased lesion load. A less efficacious inter-hemispheric coherence (IHCoh) during movement was associated with CC atrophy in sections interconnecting homologous primary motor areas (anterior mid-body). In healthy controls, less efficacious IHCoh at rest was associated with a thinner CC splenium. Our data suggest that in mildly disabled RR-MS patients a covert impairment may be detected in the correlation between the structural (CC thickness) and functional (IHCoh) measures of homologous networks, whereas these two counterparts do not yet differ individually from controls.
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Affiliation(s)
- G Zito
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), ISTC, Consiglio Nazionale delle Ricerche, 'S. Giovanni Calibita' Fatebenefratelli Hospital, Rome I-00186, Italy; Department of Clinical Neuroscience, AFaR, 'San Giovanni Calibita' Fatebenefratelli Hospital, Rome I-00186, Italy.
| | - E Luders
- Laboratory of Neuro Imaging, Department of Neurology, University of California, Los Angeles, School of Medicine, Los Angeles, CA 90095-7334, USA
| | - L Tomasevic
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), ISTC, Consiglio Nazionale delle Ricerche, 'S. Giovanni Calibita' Fatebenefratelli Hospital, Rome I-00186, Italy; Department of Clinical Neuroscience, AFaR, 'San Giovanni Calibita' Fatebenefratelli Hospital, Rome I-00186, Italy
| | - D Lupoi
- Department of Clinical Neuroscience, AFaR, 'San Giovanni Calibita' Fatebenefratelli Hospital, Rome I-00186, Italy
| | - A W Toga
- Laboratory of Neuro Imaging, Department of Neurology, University of California, Los Angeles, School of Medicine, Los Angeles, CA 90095-7334, USA
| | - P M Thompson
- Laboratory of Neuro Imaging, Department of Neurology, University of California, Los Angeles, School of Medicine, Los Angeles, CA 90095-7334, USA
| | - P M Rossini
- Department of Imaging, IRCCS San Raffale Pisana, Rome I-00163, Italy; Institute of Neurology, Università Cattolica del Sacro Cuore, Rome I-00168, Italy
| | - M M Filippi
- Department of Clinical Neuroscience, AFaR, 'San Giovanni Calibita' Fatebenefratelli Hospital, Rome I-00186, Italy
| | - F Tecchio
- Laboratory of Electrophysiology for Translational neuroScience (LET'S), ISTC, Consiglio Nazionale delle Ricerche, 'S. Giovanni Calibita' Fatebenefratelli Hospital, Rome I-00186, Italy; Department of Imaging, IRCCS San Raffale Pisana, Rome I-00163, Italy
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22
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Kuhn KW, Cambron J. Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report. J Chiropr Med 2014; 12:274-80. [PMID: 24396330 DOI: 10.1016/j.jcm.2013.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 06/23/2013] [Accepted: 06/26/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE The purpose of this report is to describe chiropractic management, using a brain-based model of care, of a teen who had migraine headaches and several social and learning difficulties. CLINICAL FEATURES A 15-year-old adolescent boy with a chronic history of migraines and more than 10 years of learning and behavioral difficulties, including attention-deficit/hyperactivity disorder, obsessive compulsive disorder, and Tourette syndrome, presented for chiropractic care. INTERVENTION AND OUTCOME The patient received spinal manipulation and was given home physical coordination activities that were contralateral to the side of the involved basal ganglia and ipsilateral to the involved cerebellum, along with interactive metronome training. Quantitative changes were noted in neurological soft signs, tests of variables of attention Conners' Parent Rating Scale, the California Achievement Test, grade point, and reduction of medications. The patient reported qualitative improvements in tics, attention, reading, vision, health, relationships with his peers and his family, and self-esteem. CONCLUSION The patient with migraine headaches and learning difficulties responded well to the course of chiropractic care. This study suggests that there may be value in a brain-based model of care in the chiropractic management of conditions that are beyond musculoskeletal in nature.
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Affiliation(s)
| | - Jerrilyn Cambron
- Professor, Research, Basic and Clinical Science, National University of Health Sciences, Lombard, IL
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23
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Schoonheim MM, Geurts J, Wiebenga OT, De Munck JC, Polman CH, Stam CJ, Barkhof F, Wink AM. Changes in functional network centrality underlie cognitive dysfunction and physical disability in multiple sclerosis. Mult Scler 2013; 20:1058-65. [PMID: 24347184 DOI: 10.1177/1352458513516892] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 11/21/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cognitive dysfunction in multiple sclerosis (MS) has a large impact on the quality of life and is poorly understood. OBJECTIVE The aim of this study was to investigate functional network integrity in MS, and relate this to cognitive dysfunction and physical disability. METHODS Resting state fMRI scans were included of 128 MS patients and 50 controls. Eigenvector centrality mapping (ECM) was applied, a graph analysis technique that ranks the importance of brain regions based on their connectivity patterns. Significant ECM changes were related to physical disability and cognitive dysfunction. RESULTS In MS patients, ECM values were increased in bilateral thalamus and posterior cingulate (PCC) areas, and decreased in sensorimotor and ventral stream areas. Sensorimotor ECM decreases were related to higher EDSS (rho = -0.24, p = 0.007), while ventral stream decreases were related to poorer average cognition (rho = 0.23, p = 0.009). The thalamus displayed increased connectivity to sensorimotor and ventral stream areas. CONCLUSION In MS, areas in the ventral stream and sensorimotor cortex appear to become less central in the entire functional network of the brain, which is associated with clinico-cognitive dysfunction. The thalamus, however, displays increased connectivity with these areas. These findings may aid in further elucidating the function of functional reorganization processes in MS.
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Affiliation(s)
- M M Schoonheim
- Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands Department of Anatomy and Neurosciences, VU University Medical Center, The Netherlands
| | - Jjg Geurts
- Department of Anatomy and Neurosciences, VU University Medical Center, The Netherlands
| | - O T Wiebenga
- Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands
| | - J C De Munck
- Department of Physics and Medical Technology, VU University Medical Center, The Netherlands
| | - C H Polman
- Department of Neurology, VU University Medical Center, The Netherlands
| | - C J Stam
- Department of Clinical Neurophysiology, VU University Medical Center, The Netherlands
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands
| | - A M Wink
- Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands
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24
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Janssen AL, Boster A, Patterson BA, Abduljalil A, Prakash RS. Resting-state functional connectivity in multiple sclerosis: an examination of group differences and individual differences. Neuropsychologia 2013; 51:2918-29. [PMID: 23973635 DOI: 10.1016/j.neuropsychologia.2013.08.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 01/12/2023]
Abstract
Multiple sclerosis (MS) is a neurodegenerative, inflammatory disease of the central nervous system, resulting in physical and cognitive disturbances. The goal of the current study was to examine the association between network integrity and composite measures of cognition and disease severity in individuals with relapsing-remitting MS (RRMS), relative to healthy controls. All participants underwent a neuropsychological and neuroimaging session, where resting-state data was collected. Independent component analysis and dual regression were employed to examine network integrity in individuals with MS, relative to healthy controls. The MS sample exhibited less connectivity in the motor and visual networks, relative to healthy controls, after controlling for group differences in gray matter volume. However, no alterations were observed in the frontoparietal, executive control, or default-mode networks, despite previous evidence of altered neuronal patterns during tasks of exogenous processing. Whole-brain, voxel-wise regression analyses with disease severity and processing speed composites were also performed to elucidate the brain-behavior relationship with neuronal network integrity. Individuals with higher levels of disease severity demonstrated reduced intra-network connectivity of the motor network, and the executive control network, while higher disease burden was associated with greater inter-network connectivity between the medial visual network and areas involved in visuomotor learning. Our findings underscore the importance of examining resting-state oscillations in this population, both as a biomarker of disease progression and a potential target for therapeutic intervention.
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Affiliation(s)
- Alisha L Janssen
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH 43210, United States
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25
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Tewarie P, Schoonheim MM, Stam CJ, van der Meer ML, van Dijk BW, Barkhof F, Polman CH, Hillebrand A. Cognitive and clinical dysfunction, altered MEG resting-state networks and thalamic atrophy in multiple sclerosis. PLoS One 2013; 8:e69318. [PMID: 23935983 PMCID: PMC3729968 DOI: 10.1371/journal.pone.0069318] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 06/10/2013] [Indexed: 11/19/2022] Open
Abstract
The relation between pathological findings and clinical and cognitive decline in Multiple Sclerosis remains unclear. Here, we tested the hypothesis that altered functional connectivity could provide a missing link between structural findings, such as thalamic atrophy and white matter lesion load, and clinical and cognitive dysfunction. Resting-state magnetoencephalography recordings from 21 MS patients and 17 gender- and age matched controls were projected onto atlas-based regions-of-interest using beamforming. Average functional connectivity was computed for each ROI and literature-based resting-state networks using the phase-lag index. Structural measures of whole brain and thalamic atrophy and lesion load were estimated from MRI scans. Global analyses showed lower functional connectivity in the alpha2 band and higher functional connectivity in the beta band in patients with Multiple Sclerosis. Additionally, alpha2 band functional connectivity was lower for the patients in two resting-state networks, namely the default mode network and the visual network. Higher beta band functional connectivity was found in the default mode network and in the temporo-parietal network. Lower alpha2 band functional connectivity in the visual network was related to lower thalamic volumes. Beta band functional connectivity correlated positively with disability scores, most prominently in the default mode network, and correlated negatively with cognitive performance in this network. These findings illustrate the relationship between thalamic atrophy, altered functional connectivity and clinical and cognitive dysfunction in MS, which could serve as a bridge to understand how neurodegeneration is associated with altered functional connectivity and subsequently clinical and cognitive decline.
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Affiliation(s)
- Prejaas Tewarie
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
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26
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Tecchio F, Cancelli A, Cottone C, Tomasevic L, Devigus B, Zito G, Ercolani M, Carducci F. Regional personalized electrodes to select transcranial current stimulation target. Front Hum Neurosci 2013; 7:131. [PMID: 23626529 PMCID: PMC3631708 DOI: 10.3389/fnhum.2013.00131] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/25/2013] [Indexed: 11/18/2022] Open
Abstract
Rationale: Personalizing transcranial stimulations promises to enhance beneficial effects for individual patients. Objective: To stimulate specific cortical regions by developing a procedure to bend and position custom shaped electrodes; to probe the effects on cortical excitability produced when the properly customized electrode is targeting different cortical areas. Method: An ad hoc neuronavigation procedure was developed to accurately shape and place the personalized electrodes on the basis of individual brain magnetic resonance images (MRI) on bilateral primary motor (M1) and somatosensory (S1) cortices. The transcranial alternating current stimulation (tACS) protocol published by Feurra et al. (2011b) was used to test the effects on cortical excitability of the personalized electrode when targeting S1 or M1. Results: Neuronal excitability as evaluated by tACS was different when targeting M1 or S1, with the General Estimating Equation model indicating a clear tCS Effect (p < 0.001), and post hoc comparisons showing solely M1 20 Hz tACS to reduce M1 excitability with respect to baseline and other tACS conditions. Conclusions: The present work indicates that specific cortical regions can be targeted by tCS properly shaping and positioning the stimulating electrode. Significance: Through multimodal brain investigations continuous efforts in understanding the neuronal changes related to specific neurological or psychiatric diseases become more relevant as our ability to build the compensating interventions improves. An important step forward on this path is the ability to target the specific cortical area of interest, as shown in the present pilot work.
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Affiliation(s)
- Franca Tecchio
- Laboratory of Electrophysiology for Translational neuroScience (LET'S) - ISTC - CNR, Department of Neuroscience, Fatebenefratelli Hospital Rome, Italy ; Department of Neuroimaging, IRCCS San Raffaele Pisana Rome, Italy
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27
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Gallagher A, Tanaka N, Suzuki N, Liu H, Thiele EA, Stufflebeam SM. Diffuse cerebral language representation in tuberous sclerosis complex. Epilepsy Res 2013; 104:125-33. [PMID: 23092910 PMCID: PMC3574215 DOI: 10.1016/j.eplepsyres.2012.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 09/26/2012] [Accepted: 09/30/2012] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Tuberous sclerosis complex (TSC) is a multisystem genetic disorder affecting multiple organs, including the brain, and very often associated with epileptic activity. Language acquisition and development seems to be altered in a significant proportion of patients with TSC. In the present study, we used magnetoencephalography (MEG) to investigate spatiotemporal cerebral language processing in subjects with TSC and epilepsy during a reading semantic decision task, compared to healthy control participants. METHODS Fifteen patients with TSC and 31 healthy subjects performed a lexico-semantic decision task during MEG recording. Minimum-norm estimates (MNE) were computed allowing identification of cerebral generators of language evoked fields (EF) in each subject. RESULTS Source analysis of the language EF demonstrated early bilateral medial occipital activation (125ms) followed by a fusiform gyrus activation around 135ms. At 270ms post stimuli presentation, a strong cerebral activation was recorded in the left basal temporal language area. Finally, cerebral activations were measured in Wernicke's area followed by Broca's area. The healthy control group showed larger and earlier language activations in Broca and Wernicke's areas compared to TSC patients. Moreover, cerebral activation from Broca's area was greater than activation from Wernicke's area in both groups, but this difference between anterior and posterior regions was smaller in the TSC group. Finally, the activation latency difference between Broca and Wernicke's areas was greater in healthy controls than in TSC patients, which shows that activations in these areas are more serial in control subjects compared to TSC patients in whom activations occur more simultaneously. CONCLUSIONS This is the first study to investigate cerebral language pattern in patients with TSC. Compared to healthy controls, atypical neuromagnetic language responses may reflect cerebral reorganization in these patients in response to early epileptogenic activity or presence at birth of multiple brain lesions.
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Affiliation(s)
- Anne Gallagher
- Athinoula A. Martinos Center for Biomedical Imaging, 149 Thirteenth Street, Charlestown, MA 02129, USA.
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28
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Tur C, Ciccarelli O. An overview of the association between gray matter damage and cognitive impairment in multiple sclerosis. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY In multiple sclerosis (MS), cognitive impairment can be present in up to 70% of patients. Although pathological processes underlying cognitive impairment are complex, there is growing evidence that gray matter (GM) damage plays a crucial role in determining cognitive dysfunction. All forms of GM damage, namely GM volume loss, damage in the normal-appearing GM and cortical lesions have been found to be related to cognitive decline in patients with MS. GM can also be involved in cognitive impairment in the context of cortical reorganization, which is probably an adaptive phenomenon, the failure of which has been reported to be associated with cognitive impairment. In this review, the evidence for the involvement of GM damage in cognitive impairment in MS and the future directions of research are discussed.
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Affiliation(s)
- Carmen Tur
- Multiple Sclerosis Centre of Catalonia (CEM-Cat), Vall d’Hebron University Hospital, Barcelona, Spain
| | - Olga Ciccarelli
- Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology, Queen Square, London, UK
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29
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Tomasevic L, Zito G, Pasqualetti P, Filippi M, Landi D, Ghazaryan A, Lupoi D, Porcaro C, Bagnato F, Rossini P, Tecchio F. Cortico-muscular coherence as an index of fatigue in multiple sclerosis. Mult Scler 2012; 19:334-43. [PMID: 22760098 DOI: 10.1177/1352458512452921] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Highly common in multiple sclerosis (MS), fatigue severely impacts patients' daily lives. Previous findings of altered connectivity patterns led to the hypothesis that the distortion of functional connections within the brain-muscle circuit plays a crucial pathogenic role. OBJECTIVE The objective of this paper is to identify markers sensitive to fatigue in multiple sclerosis. METHODS Structural (magnetic resonance imaging with assessment of thalamic volume and cortical thickness of the primary sensorimotor areas) and functional (cortico-muscular coherence (CMC) from simultaneous electroencephalo- and surface electromyographic recordings during a weak handgrip task) measures were used on 20 mildly disabled MS patients (relapsing-remitting course, Expanded Disability Status Scale score ≤ 2) who were recruited in two fatigue-dependent groups according to the Modified Fatigue Index Scale (MFIS) score. RESULTS The two groups were similar in terms of demographic, clinical and imaging features, as well as task execution accuracy and weariness. In the absence of any fatigue-dependent brain and muscular oscillatory activity alterations, CMC worked at higher frequencies as fatigue increased, explaining 67% of MFIS variance (p=.002). CONCLUSION Brain-muscle functional connectivity emerged as a sensitive marker of phenomena related to the origin of MS fatigue, impacting central-peripheral communication well before the appearance of any impairment in the communicating nodes.
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Affiliation(s)
- L Tomasevic
- LET'S-ISTC-CNR, Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Italy
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30
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Heremans E, D’hooge AM, De Bondt S, Helsen W, Feys P. The relation between cognitive and motor dysfunction and motor imagery ability in patients with multiple sclerosis. Mult Scler 2012; 18:1303-9. [DOI: 10.1177/1352458512437812] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Motor imagery (MI) was recently shown to be a promising tool in neurorehabilitation. The ability to perform MI, however, may be impaired in some patients with neurological dysfunction. Objective: The objective was to assess the relation between cognitive and motor dysfunction and MI ability in patients with multiple sclerosis (MS). Methods: Thirty patients with MS underwent cognitive and motor screening, and also performed a composite test battery to assess their MI ability. This test battery consisted of a questionnaire, a hand rotation task and a test based on mental chronometry. Patients’ MI ability was compared with the MI ability of age-matched healthy controls. Moreover, their MI scores were compared between body sides and were correlated with their scores on tests of motor and cognitive functioning. Results: The average accuracy and temporal organization of MI significantly differed between MS patients and controls. Patients’ MI accuracy significantly correlated with impairments in cognitive functioning, but was independent of motor functioning. MI duration, on the other hand, was independent of cognitive performance, but differed between the patients’ most and least affected side. Conclusion: These findings are of use when considering the application of MI practice in MS patients’ rehabilitation.
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Affiliation(s)
- Elke Heremans
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium
- Department of Biomedical Kinesiology, Katholieke Universiteit Leuven, Belgium
| | | | | | - Werner Helsen
- Department of Biomedical Kinesiology, Katholieke Universiteit Leuven, Belgium
| | - Peter Feys
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium
- Department of Biomedical Kinesiology, Katholieke Universiteit Leuven, Belgium
- REVAL Rehabilitation & Healthcare Research Center, PHL-University College, and BIOMED, Universiteit Hasselt, Belgium
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31
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Schoonheim MM, Geurts JJG, Landi D, Douw L, van der Meer ML, Vrenken H, Polman CH, Barkhof F, Stam CJ. Functional connectivity changes in multiple sclerosis patients: a graph analytical study of MEG resting state data. Hum Brain Mapp 2011; 34:52-61. [PMID: 21954106 DOI: 10.1002/hbm.21424] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 06/27/2011] [Accepted: 07/01/2011] [Indexed: 11/06/2022] Open
Abstract
Multiple sclerosis (MS) is characterized by extensive damage in the central nervous system. Within this field, there is a strong need for more advanced, functional imaging measures, as abnormalities measured with structural imaging insufficiently explain clinicocognitive decline in MS. In this study we investigated functional connectivity changes in MS using resting-state magnetoencephalography (MEG). Data from 34 MS patients and 28 age and gender-matched controls was assessed using synchronization likelihood (SL) as a measure of functional interaction strength between brain regions, and graph analysis to characterize topological patterns of connectivity changes. Cognition was assessed using extensive neuropsychological evaluation. Structural measures included brain and lesion volumes, using MRI. Results show SL increases in MS patients in theta, lower alpha and beta bands, with decreases in the upper alpha band. Graph analysis revealed a more regular topology in the lower alpha band in patients, indicated by an increased path length (λ) and clustering coefficient (γ). Attention and working memory domains were impaired, with decreased brain volumes. A stepwise linear regression model using clinical, MRI and MEG parameters as predictors revealed that only increases in lower alpha band γ predicted impaired cognition. Cognitive impairments and related altered connectivity patterns were found to be especially predominant in male patients. These results show specific functional changes in MS as measured with MEG. Only changes in network topology were related to poorer cognitive outcome. This indicates the value of graph analysis beyond traditional structural and functional measures, with possible implications for diagnostic and/or prognostic purposes in MS.
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Affiliation(s)
- Menno M Schoonheim
- Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
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32
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Multiple sclerosis as a neurodegenerative disease: pathology, mechanisms and therapeutic implications. Curr Opin Neurol 2011; 24:224-9. [PMID: 21455066 DOI: 10.1097/wco.0b013e328346056f] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW Multiple sclerosis (MS) treatments targeting the inflammatory nature of the disease have become increasingly effective in recent years. However, our efforts at targeting the progressive disease phase have so far been largely unsuccessful. This has led to the hypothesis that disease mechanisms independent of an adaptive immune response contribute to disease progression and closely resemble neurodegeneration. RECENT FINDINGS Nonfocal, diffuse changes in the MS brain, especially axonal loss and mitochondrial dysfunction, prove better correlates of disability than total lesion load and have been associated with disease progression. Molecular changes in nondemyelinated MS tissue also suggest that alterations in the MS brain are widespread and consist of pro-inflammatory as well as anti-inflammatory responses. However, local lymphocytic inflammation and microglial activation are salient features of the chronic disease, and T-cell-mediated inflammation contributes to tissue damage. In addition, neuroaxonal cytoskeletal alterations have been associated with disease progression. SUMMARY Our knowledge of the molecular mechanisms leading to neuroaxonal damage and demise in MS is steadily increasing. Experimental therapies targeting neuroaxonal ionic imbalances and energy metabolism in part show promising results. A better understanding of the molecular mechanisms underlying chronic progression will substantially aid the development of new treatment strategies.
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