1
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Luppi AI, Gellersen HM, Liu ZQ, Peattie ARD, Manktelow AE, Adapa R, Owen AM, Naci L, Menon DK, Dimitriadis SI, Stamatakis EA. Systematic evaluation of fMRI data-processing pipelines for consistent functional connectomics. Nat Commun 2024; 15:4745. [PMID: 38834553 PMCID: PMC11150439 DOI: 10.1038/s41467-024-48781-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/10/2024] [Indexed: 06/06/2024] Open
Abstract
Functional interactions between brain regions can be viewed as a network, enabling neuroscientists to investigate brain function through network science. Here, we systematically evaluate 768 data-processing pipelines for network reconstruction from resting-state functional MRI, evaluating the effect of brain parcellation, connectivity definition, and global signal regression. Our criteria seek pipelines that minimise motion confounds and spurious test-retest discrepancies of network topology, while being sensitive to both inter-subject differences and experimental effects of interest. We reveal vast and systematic variability across pipelines' suitability for functional connectomics. Inappropriate choice of data-processing pipeline can produce results that are not only misleading, but systematically so, with the majority of pipelines failing at least one criterion. However, a set of optimal pipelines consistently satisfy all criteria across different datasets, spanning minutes, weeks, and months. We provide a full breakdown of each pipeline's performance across criteria and datasets, to inform future best practices in functional connectomics.
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Affiliation(s)
- Andrea I Luppi
- Division of Anaesthesia, University of Cambridge, Cambridge, UK.
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
- St John's College, University of Cambridge, Cambridge, UK.
- Montreal Neurological Institute, McGill University, Montreal, Canada.
| | - Helena M Gellersen
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Zhen-Qi Liu
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Alexander R D Peattie
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Anne E Manktelow
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Ram Adapa
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Adrian M Owen
- Department of Psychology, Western Institute for Neuroscience (WIN), Western University, London, ON, Canada
- Department of Physiology and Pharmacology, Western Institute for Neuroscience (WIN), Western University, London, ON, Canada
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - David K Menon
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - Stavros I Dimitriadis
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Neuroinformatics Group, Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales, UK
- Neuroscience and Mental Health Research Institute, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales, UK
- Integrative Neuroimaging Lab, Thessaloniki, Greece
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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2
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Hassanzadeh E, Hornak A, Hassanzadeh M, Warfield SK, Pearl PL, Bolton J, Suarez R, Stone S, Stufflebeam S, Ailion AS. Comparison of fMRI language laterality with and without sedation in pediatric epilepsy. Neuroimage Clin 2023; 38:103448. [PMID: 37285796 PMCID: PMC10250119 DOI: 10.1016/j.nicl.2023.103448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/07/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
Functional MRI is an essential component of presurgical language mapping. In clinical settings, young children may be sedated for the MRI with the functional stimuli presented passively. Research has found that sedation changes language activation in healthy adults and children. However, there is limited research comparing sedated and unsedated functional MRI in pediatric epilepsy patients. We compared language activation patterns in children with epilepsy who received sedation for functional MRI to the ones who did not. We retrospectively identified the patients with focal epilepsy who underwent presurgical functional MRI including Auditory Descriptive Decision Task at Boston Children's Hospital from 2014 to 2022. Patients were divided into sedated and awake groups, based on their sedation status during functional MRI. Auditory Descriptive Decision Task stimuli were presented passively to the sedated group per clinical protocol. We extracted language activation maps contrasted against a control task (reverse speech) in the Frontal and Temporal language regions and calculated separate language laterality indexes for each region. We considered positive laterality indexes as left dominant, negative laterality indexes as right dominant, and absolute laterality indexes <0.2 as bilateral. We defined 2 language patterns: typical (i.e., primarily left-sided) and atypical. Typical pattern required at least one left dominant region (either frontal or temporal) and no right dominant region. We then compared the language patterns between the sedated and awake groups. Seventy patients met the inclusion criteria, 25 sedated, and 45 awake. Using the Auditory Descriptive Decision Task paradigm, when adjusted for age, handedness, gender, and laterality of lesion in a weighted logistic regression model, the odds of the atypical pattern were 13.2 times higher in the sedated group compared to the awake group (Confidence Interval: 2.55-68.41, p-value < 0.01). Sedation may alter language activation patterns in pediatric epilepsy patients. Language patterns on sedated functional MRI with passive tasks may not represent language networks during wakefulness, sedation may differentially suppress some networks, or require a different task or method of analysis to capture the awake language network. Given the critical surgical implication of these findings, additional studies are needed to better understand how sedation impacts the functional MRI blood oxygenation level-dependent signal. Consistent with current practice, sedated functional MRI should be interpreted with greater caution and requires additional validation as well as research on post-surgical language outcomes.
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Affiliation(s)
- Elmira Hassanzadeh
- Neuroradiology, Massachusetts General Hospital, Harvard Medical School, 02116, USA.
| | - Alena Hornak
- Neurology, Boston Children's Hospital, Harvard Medical School, 02116, USA
| | | | - Simon K Warfield
- Radiology, Boston Children's Hospital, Harvard Medical School, 02116, USA
| | - Phillip L Pearl
- Neurology, Boston Children's Hospital, Harvard Medical School, 02116, USA
| | - Jeffrey Bolton
- Neurology, Boston Children's Hospital, Harvard Medical School, 02116, USA
| | - Ralph Suarez
- Radiology, Boston Children's Hospital, Harvard Medical School, 02116, USA
| | - Scellig Stone
- Neurosurgery, Boston Children's Hospital, Harvard Medical School, 02116, USA
| | - Steve Stufflebeam
- Neuroradiology, Massachusetts General Hospital, Harvard Medical School, 02116, USA
| | - Alyssa S Ailion
- Neurology, Boston Children's Hospital, Harvard Medical School, 02116, USA
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3
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Lawn T, Martins D, O'Daly O, Williams S, Howard M, Dipasquale O. The effects of propofol anaesthesia on molecular-enriched networks during resting-state and naturalistic listening. Neuroimage 2023; 271:120018. [PMID: 36935083 PMCID: PMC10410200 DOI: 10.1016/j.neuroimage.2023.120018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
Placing a patient in a state of anaesthesia is crucial for modern surgical practice. However, the mechanisms by which anaesthetic drugs, such as propofol, impart their effects on consciousness remain poorly understood. Propofol potentiates GABAergic transmission, which purportedly has direct actions on cortex as well as indirect actions via ascending neuromodulatory systems. Functional imaging studies to date have been limited in their ability to unravel how these effects on neurotransmission impact the system-level dynamics of the brain. Here, we leveraged advances in multi-modal imaging, Receptor-Enriched Analysis of functional Connectivity by Targets (REACT), to investigate how different levels of propofol-induced sedation alter neurotransmission-related functional connectivity (FC), both at rest and when individuals are exposed to naturalistic auditory stimulation. Propofol increased GABA-A- and noradrenaline transporter-enriched FC within occipital and somatosensory regions respectively. Additionally, during auditory stimulation, the network related to the dopamine transporter showed reduced FC within bilateral regions of temporal and mid/posterior cingulate cortices, with the right temporal cluster showing an interaction between auditory stimulation and level of consciousness. In bringing together these micro- and macro-scale systems, we provide support for both direct GABAergic and indirect noradrenergic and dopaminergic-related network changes under propofol sedation. Further, we delineate a cognition-related reconfiguration of the dopaminergic network, highlighting the utility of REACT to explore the molecular substrates of consciousness and cognition.
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Affiliation(s)
- Timothy Lawn
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK.
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Steve Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Matthew Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's college London, London, UK
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4
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Luppi AI, Vohryzek J, Kringelbach ML, Mediano PAM, Craig MM, Adapa R, Carhart-Harris RL, Roseman L, Pappas I, Peattie ARD, Manktelow AE, Sahakian BJ, Finoia P, Williams GB, Allanson J, Pickard JD, Menon DK, Atasoy S, Stamatakis EA. Distributed harmonic patterns of structure-function dependence orchestrate human consciousness. Commun Biol 2023; 6:117. [PMID: 36709401 PMCID: PMC9884288 DOI: 10.1038/s42003-023-04474-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/11/2023] [Indexed: 01/29/2023] Open
Abstract
A central question in neuroscience is how consciousness arises from the dynamic interplay of brain structure and function. Here we decompose functional MRI signals from pathological and pharmacologically-induced perturbations of consciousness into distributed patterns of structure-function dependence across scales: the harmonic modes of the human structural connectome. We show that structure-function coupling is a generalisable indicator of consciousness that is under bi-directional neuromodulatory control. We find increased structure-function coupling across scales during loss of consciousness, whether due to anaesthesia or brain injury, capable of discriminating between behaviourally indistinguishable sub-categories of brain-injured patients, tracking the presence of covert consciousness. The opposite harmonic signature characterises the altered state induced by LSD or ketamine, reflecting psychedelic-induced decoupling of brain function from structure and correlating with physiological and subjective scores. Overall, connectome harmonic decomposition reveals how neuromodulation and the network architecture of the human connectome jointly shape consciousness and distributed functional activation across scales.
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Affiliation(s)
- Andrea I Luppi
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK.
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK.
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, CB2 1SB, UK.
| | - Jakub Vohryzek
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
- Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, 08005, Spain
| | - Morten L Kringelbach
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Pedro A M Mediano
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
- Department of Computing, Imperial College London, London, W12 0NN, UK
| | - Michael M Craig
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Ram Adapa
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Robin L Carhart-Harris
- Center for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, W12 0NN, UK
- Psychedelics Division - Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Leor Roseman
- Center for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, W12 0NN, UK
| | - Ioannis Pappas
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
- Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Alexander R D Peattie
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Anne E Manktelow
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Barbara J Sahakian
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Psychiatry, MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Paola Finoia
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Guy B Williams
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Judith Allanson
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Neurosciences, Cambridge University Hospitals NHS Foundation, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - John D Pickard
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, CB2 0QQ, UK
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - David K Menon
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Selen Atasoy
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
- Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
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5
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Norton L, Kazazian K, Gofton T, Debicki DB, Fernandez-Espejo D, Peelle JE, Al Thenayan E, Young GB, Owen AM. Functional Neuroimaging as an Assessment Tool in Critically Ill Patients. Ann Neurol 2023; 93:131-141. [PMID: 36222470 DOI: 10.1002/ana.26530] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Little is known about residual cognitive function in the earliest stages of serious brain injury. Functional neuroimaging has yielded valuable diagnostic and prognostic information in chronic disorders of consciousness, such as the vegetative state (also termed unresponsive wakefulness syndrome). The objective of the current study was to determine if functional neuroimaging could be efficacious in the assessment of cognitive function in acute disorders of consciousness, such as coma, where decisions about the withdrawal of life-sustaining therapies are often made. METHODS A hierarchical functional magnetic resonance imaging (fMRI) approach assessed sound perception, speech perception, language comprehension, and covert command following in 17 critically ill patients admitted to the intensive care unit (ICU). RESULTS Preserved auditory function was observed in 15 patients (88%), whereas 5 (29%) also had preserved higher-order language comprehension. Notably, one patient could willfully modulate his brain activity when instructed to do so, suggesting a level of covert conscious awareness that was entirely inconsistent with his clinical diagnosis at the time of the scan. Across patients, a positive relationship was also observed between fMRI responsivity and the level of functional recovery, such that patients with the greatest functional recovery had neural responses most similar to those observed in healthy control participants. INTERPRETATION These results suggest that fMRI may provide important diagnostic and prognostic information beyond standard clinical assessment in acutely unresponsive patients, which may aid discussions surrounding the continuation or removal of life-sustaining therapies during the early post-injury period. ANN NEUROL 2023;93:131-141.
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Affiliation(s)
- Loretta Norton
- Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Psychology, King's University College at Western University, London, Ontario, Canada
| | - Karnig Kazazian
- Brain and Mind Institute, Western University, London, Ontario, Canada
| | - Teneille Gofton
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Derek B Debicki
- Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Davinia Fernandez-Espejo
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.,Centre for Human Brain Health and School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Jonathan E Peelle
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, USA
| | - Eyad Al Thenayan
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - G Bryan Young
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Adrian M Owen
- Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Physiology and Pharmacology and Department of Psychology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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6
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Coppola P, Allanson J, Naci L, Adapa R, Finoia P, Williams GB, Pickard JD, Owen AM, Menon DK, Stamatakis EA. The complexity of the stream of consciousness. Commun Biol 2022; 5:1173. [PMID: 36329176 PMCID: PMC9633704 DOI: 10.1038/s42003-022-04109-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Typical consciousness can be defined as an individual-specific stream of experiences. Modern consciousness research on dynamic functional connectivity uses clustering techniques to create common bases on which to compare different individuals. We propose an alternative approach by combining modern theories of consciousness and insights arising from phenomenology and dynamical systems theory. This approach enables a representation of an individual's connectivity dynamics in an intrinsically-defined, individual-specific landscape. Given the wealth of evidence relating functional connectivity to experiential states, we assume this landscape is a proxy measure of an individual's stream of consciousness. By investigating the properties of this landscape in individuals in different states of consciousness, we show that consciousness is associated with short term transitions that are less predictable, quicker, but, on average, more constant. We also show that temporally-specific connectivity states are less easily describable by network patterns that are distant in time, suggesting a richer space of possible states. We show that the cortex, cerebellum and subcortex all display consciousness-relevant dynamics and discuss the implication of our results in forming a point of contact between dynamical systems interpretations and phenomenology.
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Affiliation(s)
- Peter Coppola
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Judith Allanson
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Department of Neurosciences, Cambridge University Hospitals NHS Foundation, Addenbrooke's Hospital, Cambridge, UK
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Lloyd Building, Trinity College Dublin, Dublin, Ireland
| | - Ram Adapa
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Paola Finoia
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Guy B Williams
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - John D Pickard
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Adrian M Owen
- The Brain and Mind Institute, Western Interdisciplinary Research Building, N6A 5B7 University of Western Ontario, London, ON, Canada
| | - David K Menon
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
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7
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Mainali S, Aiyagari V, Alexander S, Bodien Y, Boerwinkle V, Boly M, Brown E, Brown J, Claassen J, Edlow BL, Fink EL, Fins JJ, Foreman B, Frontera J, Geocadin RG, Giacino J, Gilmore EJ, Gosseries O, Hammond F, Helbok R, Claude Hemphill J, Hirsch K, Kim K, Laureys S, Lewis A, Ling G, Livesay SL, McCredie V, McNett M, Menon D, Molteni E, Olson D, O'Phelan K, Park S, Polizzotto L, Javier Provencio J, Puybasset L, Venkatasubba Rao CP, Robertson C, Rohaut B, Rubin M, Sharshar T, Shutter L, Sampaio Silva G, Smith W, Stevens RD, Thibaut A, Vespa P, Wagner AK, Ziai WC, Zink E, I Suarez J. Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness. Neurocrit Care 2022; 37:326-350. [PMID: 35534661 PMCID: PMC9283342 DOI: 10.1007/s12028-022-01505-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/29/2022] [Indexed: 12/21/2022]
Abstract
This proceedings article presents actionable research targets on the basis of the presentations and discussions at the 2nd Curing Coma National Institutes of Health (NIH) symposium held from May 3 to May 5, 2021. Here, we summarize the background, research priorities, panel discussions, and deliverables discussed during the symposium across six major domains related to disorders of consciousness. The six domains include (1) Biology of Coma, (2) Coma Database, (3) Neuroprognostication, (4) Care of Comatose Patients, (5) Early Clinical Trials, and (6) Long-term Recovery. Following the 1st Curing Coma NIH virtual symposium held on September 9 to September 10, 2020, six workgroups, each consisting of field experts in respective domains, were formed and tasked with identifying gaps and developing key priorities and deliverables to advance the mission of the Curing Coma Campaign. The highly interactive and inspiring presentations and panel discussions during the 3-day virtual NIH symposium identified several action items for the Curing Coma Campaign mission, which we summarize in this article.
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Affiliation(s)
- Shraddha Mainali
- Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | - Venkatesh Aiyagari
- Neurological Surgery and Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sheila Alexander
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yelena Bodien
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Varina Boerwinkle
- Division of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Melanie Boly
- Departments of Neurology and Psychiatry, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin, Madison, WI, USA
| | - Emery Brown
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jeremy Brown
- Office of Emergency Care Research, Division of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Jan Claassen
- Department of Neurology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Brian L Edlow
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Ericka L Fink
- Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Joseph J Fins
- Division of Medical Ethics, Weill Cornell Medical College, New York, NY, USA
- Yale Law School, New Haven, CT, USA
| | - Brandon Foreman
- Division of Neurocritical Care, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer Frontera
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Romergryko G Geocadin
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joseph Giacino
- Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Emily J Gilmore
- Comprehensive Epilepsy Center, Department of Neurology, Yale University, New Haven, CT, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Flora Hammond
- Indiana University Department of Physical Medicine and Rehabilitation, University of Indiana School of Medicine, Indianapolis, IN, USA
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Claude Hemphill
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Karen Hirsch
- Division of Neurocritical Care, Department of Neurology, Stanford University, Stanford, CA, USA
| | - Keri Kim
- College of Pharmacy, University of Illinois, Chicago, IL, USA
| | - Steven Laureys
- Coma Science Group, Cyclotron Research Center, University of Liege, Liege, Belgium
- Department of Neurology, Centre Hospitalier Universitaire Sart Tilman, University of Liege, Liege, Belgium
| | - Ariane Lewis
- Department of Neurology and Neurosurgery, New York University Langone Health, New York, NY, USA
| | - Geoffrey Ling
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah L Livesay
- Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA
| | - Victoria McCredie
- Interdepartmental Division of Critical Care, Department of Respirology, University of Toronto, Toronto, ON, Canada
| | - Molly McNett
- College of Nursing, Ohio State University, Columbus, OH, USA
| | - David Menon
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - Erika Molteni
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - DaiWai Olson
- Neuroscience Intensive Care Unit, O'Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kristine O'Phelan
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Soojin Park
- Department of Neurology and Neurocritical Care, Columbia University, New York, NY, USA
| | - Len Polizzotto
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Jose Javier Provencio
- Department of Neurology and Neuroscience, University of Virginia, Charlottesville, VA, USA
| | - Louis Puybasset
- Department of Neuroradiology, University of Paris VI, Pierre et Marie Curie, Pitié-Salpêtrière Hospital, Paris, France
| | - Chethan P Venkatasubba Rao
- Division of Vascular Neurology and Neurocritical Care, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Baylor College of Medicine, Houston, TX, USA
| | - Courtney Robertson
- Departments of Anesthesiology and Critical Care Medicine, and Pediatrics, Johns Hopkins Children's Center, The Johns Hopkins University School of Medcine, Baltimore, MD, USA
| | - Benjamin Rohaut
- Neuroscience Intensive Care Unit, Department of Neurology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Michael Rubin
- Neurological Surgery and Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tarek Sharshar
- Department of Intensive Care, Paris Descartes University, Paris, France
| | | | - Gisele Sampaio Silva
- Hospital Israelita Albert Einstein, Academic Research Organization and Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Wade Smith
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Robert D Stevens
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aurore Thibaut
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Paul Vespa
- Ronald Reagan UCLA Medical Center, UCLA Santa Monica Medical Center, Santa Monica, CA, USA
| | - Amy K Wagner
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wendy C Ziai
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Zink
- Department of Neuroscience Nursing, The Johns Hopkins Hospital, The Johns Hopkins University, Baltimore, MD, USA
| | - Jose I Suarez
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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8
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Coppola P, Spindler LRB, Luppi AI, Adapa R, Naci L, Allanson J, Finoia P, Williams GB, Pickard JD, Owen AM, Menon DK, Stamatakis EA. Network dynamics scale with levels of awareness. Neuroimage 2022; 254:119128. [PMID: 35331869 DOI: 10.1016/j.neuroimage.2022.119128] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/10/2022] [Accepted: 03/20/2022] [Indexed: 02/04/2023] Open
Abstract
Small world topologies are thought to provide a valuable insight into human brain organisation and consciousness. However, functional magnetic resonance imaging studies in consciousness have not yielded consistent results. Given the importance of dynamics for both consciousness and cognition, here we investigate how the diversity of small world dynamics (quantified by sample entropy; dSW-E1) scales with decreasing levels of awareness (i.e., sedation and disorders of consciousness). Paying particular attention to result reproducibility, we show that dSW-E is a consistent predictor of levels of awareness even when controlling for the underlying functional connectivity dynamics. We find that dSW-E of subcortical and cortical areas are predictive, with the former showing higher and more robust effect sizes across analyses. We find that the network dynamics of intermodular communication in the cerebellum also have unique predictive power for levels of awareness. Consequently, we propose that the dynamic reorganisation of the functional information architecture, in particular of the subcortex, is a characteristic that emerges with awareness and has explanatory power beyond that of the complexity of dynamic functional connectivity.
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Affiliation(s)
- Peter Coppola
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Lennart R B Spindler
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Andrea I Luppi
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Ram Adapa
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Division of Neurosurgery, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Judith Allanson
- Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Neurosciences, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation, Hills Rd., Cambridge, CB2 0QQ, UK
| | - Paola Finoia
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Division of Neurosurgery, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Guy B Williams
- Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus (Box 65), Cambridge CB2 0QQ, UK
| | - John D Pickard
- Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Division of Neurosurgery, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus (Box 65), Cambridge CB2 0QQ, UK
| | - Adrian M Owen
- The Brain and Mind Institute, Western Interdisciplinary Research Building, University of Western Ontario, London, ON N6A 5B7, Canada
| | - David K Menon
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus (Box 65), Cambridge CB2 0QQ, UK
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK.
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9
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Chen X, Zheng X, Cai J, Yang X, Lin Y, Wu M, Deng X, Peng YG. Effect of Anesthetics on Functional Connectivity of Developing Brain. Front Hum Neurosci 2022; 16:853816. [PMID: 35360283 PMCID: PMC8963106 DOI: 10.3389/fnhum.2022.853816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/21/2022] [Indexed: 11/27/2022] Open
Abstract
The potential anesthetic neurotoxicity on the neonate is an important focus of research investigation in the field of pediatric anesthesiology. It is essential to understand how these anesthetics may affect the development and growth of neonatal immature and vulnerable brains. Functional magnetic resonance imaging (fMRI) has suggested that using anesthetics result in reduced functional connectivity may consider as core sequence for the neurotoxicity and neurodegenerative changes in the developed brain. Anesthetics either directly impact the primary structures and functions of the brain or indirectly alter the hemodynamic parameters that contribute to cerebral blood flow (CBF) in neonatal patients. We hypothesis that anesthetic agents may either decrease the brain functional connectivity in neonatal patients or animals, which was observed by fMRI. This review will summarize the effect and mechanism of anesthesia on the rapid growth and development infant and neonate brain with fMRI through functional connectivity. It is possible to provide the new mechanism of neuronal injury induced by anesthetics and objective imaging evidence in animal developing brain.
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Affiliation(s)
- Xu Chen
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuemei Zheng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jianghui Cai
- Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao Yang
- Department of Obstetrics, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yonghong Lin
- Department of Gynecology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Mengjun Wu
- Department of Anesthesiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Mengjun Wu,
| | - Xiaofan Deng
- Center of Organ Transplantation, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, China
| | - Yong G. Peng
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, United States
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10
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Linke AC, Slušná D, Kohli JS, Álvarez-Linera Prado J, Müller RA, Hinzen W. Morphometry and functional connectivity of auditory cortex in school-age children with profound language disabilities: Five comparative case studies. Brain Cogn 2021; 155:105822. [PMID: 34837801 DOI: 10.1016/j.bandc.2021.105822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
Many neurodevelopmental conditions imply absent or severely reduced language capacities at school age. Evidence from functional magnetic resonance imaging is highly limited. We selected a series of five cases scanned with the same fMRI paradigm and the aim of relating individual language profiles onto underlying patterns of functional connectivity (FC) across auditory language cortex: three with neurogenetic syndromes (Coffin-Siris, Landau-Kleffner, and Fragile-X), one with idiopathic intellectual disability, one with autism spectrum disorder (ASD). Compared to both a group with typical development (TD) and a verbal ASD group (total N = 110), they all showed interhemispheric FC below two standard deviations of the TD mean. Children with higher language scores showed higher intrahemispheric FC between Heschl's gyrus and other auditory language regions, as well as an increase of FC during language stimulation compared to rest. An increase of FC in forward vs. reversed speech in the posterior and middle temporal gyri was seen across all cases. The Coffin-Siris case, the most severe, also had the most anomalous FC patterns and showed reduced myelin content, while the Landau-Kleffner case showed reduced cortical thickness. These results suggest potential for neural markers and mechanisms of severe language processing deficits under highly heterogeneous etiological conditions.
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Affiliation(s)
- Annika Carola Linke
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Dominika Slušná
- Department of Translation and Language Sciences, Campus Poblenou, Pompeu Fabra University, Barcelona 08018, Barcelona, Spain
| | - Jiwandeep Singh Kohli
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Ralph-Axel Müller
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Wolfram Hinzen
- Department of Translation and Language Sciences, Campus Poblenou, Pompeu Fabra University, Barcelona 08018, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats, ICREA, 08010 Barcelona, Spain
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11
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Coffey BJ, Threlkeld ZD, Foulkes AS, Bodien YG, Edlow BL. Reemergence of the language network during recovery from severe traumatic brain injury: A pilot functional MRI study. Brain Inj 2021; 35:1552-1562. [PMID: 34546806 DOI: 10.1080/02699052.2021.1972455] [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] [Indexed: 10/20/2022]
Abstract
PRIMARY OBJECTIVE We hypothesized that, in patients with acute severe traumatic brain injury (TBI) who recover basic language function, speech-evoked blood-oxygen-level-dependent (BOLD) functional MRI (fMRI) responses within the canonical language network increase over the first 6 months post-injury. RESEARCH DESIGN We conducted a prospective, longitudinal fMRI pilot study of adults with acute severe TBI admitted to the intensive care unit. We also enrolled age- and sex-matched healthy subjects. METHODS AND PROCEDURES We evaluated BOLD signal in bilateral superior temporal gyrus (STG) and inferior frontal gyrus (IFG) regions of interest acutely and approximately 6 months post-injury. Given evidence that regions outside the canonical language network contribute to language processing, we also performed exploratory whole-brain analyses. MAIN OUTCOMES AND RESULTS Of the 16 patients enrolled, eight returned for follow-up fMRI, all of whom recovered basic language function. We observed speech-evoked longitudinal BOLD increases in the left STG, but not in the right STG, right IFG, or left IFG. Whole-brain analysis revealed increases in the right supramarginal and middle temporal gyri but no differences between patients and healthy subjects (n = 16). CONCLUSION This pilot study suggests that, in patients with severe TBI who recover llanguage function, speech-evoked responses in bihemispheric language-processing cortex reemerge by 6 months post-injury.
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Affiliation(s)
- Brian J Coffey
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurology, University of Florida Health, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Zachary D Threlkeld
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurology, Stanford University School of Medicine, Stanford, California, USA
| | - Andrea S Foulkes
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yelena G Bodien
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
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12
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Ntemou E, Ohlerth AK, Ille S, Krieg SM, Bastiaanse R, Rofes A. Mapping Verb Retrieval With nTMS: The Role of Transitivity. Front Hum Neurosci 2021; 15:719461. [PMID: 34539364 PMCID: PMC8442843 DOI: 10.3389/fnhum.2021.719461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/31/2021] [Indexed: 11/25/2022] Open
Abstract
Navigated Transcranial Magnetic Stimulation (nTMS) is used to understand the cortical organization of language in preparation for the surgical removal of a brain tumor. Action naming with finite verbs can be employed for that purpose, providing additional information to object naming. However, little research has focused on the properties of the verbs that are used in action naming tasks, such as their status as transitive (taking an object; e.g., to read) or intransitive (not taking an object; e.g., to wink). Previous neuroimaging data show higher activation for transitive compared to intransitive verbs in posterior perisylvian regions bilaterally. In the present study, we employed nTMS and production of finite verbs to investigate the cortical underpinnings of transitivity. Twenty neurologically healthy native speakers of German participated in the study. They underwent language mapping in both hemispheres with nTMS. The action naming task with finite verbs consisted of transitive (e.g., The man reads the book) and intransitive verbs (e.g., The woman winks) and was controlled for relevant psycholinguistic variables. Errors were classified in four different error categories (i.e., non-linguistic errors, grammatical errors, lexico-semantic errors and, errors at the sound level) and were analyzed quantitatively. We found more nTMS-positive points in the left hemisphere, particularly in the left parietal lobe for the production of transitive compared to intransitive verbs. These positive points most commonly corresponded to lexico-semantic errors. Our findings are in line with previous aphasia and neuroimaging studies, suggesting that a more widespread network is used for the production of verbs with a larger number of arguments (i.e., transitives). The higher number of lexico-semantic errors with transitive compared to intransitive verbs in the left parietal lobe supports previous claims for the role of left posterior areas in the retrieval of argument structure information.
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Affiliation(s)
- Effrosyni Ntemou
- International Doctorate in Experimental Approaches to Language and Brain (IDEALAB, Universities of Groningen, Potsdam, Newcastle, Trento and Macquarie University), Sydney, NSW, Australia.,Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
| | - Ann-Katrin Ohlerth
- International Doctorate in Experimental Approaches to Language and Brain (IDEALAB, Universities of Groningen, Potsdam, Newcastle, Trento and Macquarie University), Sydney, NSW, Australia.,Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Roelien Bastiaanse
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia
| | - Adrià Rofes
- Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
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13
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Huang Z, Tarnal V, Vlisides PE, Janke EL, McKinney AM, Picton P, Mashour GA, Hudetz AG. Asymmetric neural dynamics characterize loss and recovery of consciousness. Neuroimage 2021; 236:118042. [PMID: 33848623 PMCID: PMC8310457 DOI: 10.1016/j.neuroimage.2021.118042] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/01/2021] [Accepted: 04/04/2021] [Indexed: 02/07/2023] Open
Abstract
Anesthetics are known to disrupt neural interactions in cortical and subcortical brain circuits. While the effect of anesthetic drugs on consciousness is reversible, the neural mechanism mediating induction and recovery may be different. Insight into these distinct mechanisms can be gained from a systematic comparison of neural dynamics during slow induction of and emergence from anesthesia. To this end, we used functional magnetic resonance imaging (fMRI) data obtained in healthy volunteers before, during, and after the administration of propofol at incrementally adjusted target concentrations. We analyzed functional connectivity of corticocortical and subcorticocortical networks and the temporal autocorrelation of fMRI signal as an index of neural processing timescales. We found that en route to unconsciousness, temporal autocorrelation across the entire brain gradually increased, whereas functional connectivity gradually decreased. In contrast, regaining consciousness was associated with an abrupt restoration of cortical but not subcortical temporal autocorrelation and an abrupt boost of subcorticocortical functional connectivity. Pharmacokinetic effects could not account for the difference in neural dynamics between induction and emergence. We conclude that the induction and recovery phases of anesthesia follow asymmetric neural dynamics. A rapid increase in the speed of cortical neural processing and subcorticocortical neural interactions may be a mechanism that reboots consciousness.
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Affiliation(s)
- Zirui Huang
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
| | - Vijay Tarnal
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Phillip E Vlisides
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Ellen L Janke
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Amy M McKinney
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Paul Picton
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - George A Mashour
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Anthony G Hudetz
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA.
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14
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Dopaminergic brainstem disconnection is common to pharmacological and pathological consciousness perturbation. Proc Natl Acad Sci U S A 2021; 118:2026289118. [PMID: 34301891 PMCID: PMC8325270 DOI: 10.1073/pnas.2026289118] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Understanding the neural bases of consciousness is of basic scientific and clinical importance. Human neuroimaging has established that a network of interconnected brain regions known as the default mode network disintegrates in anesthesia and after brain damage that causes disorders of consciousness. However, the neurochemical underpinnings of this network change remain largely unknown. Motivated by preclinical animal work and clinical observations, we found that across pharmacological (sedation) and pathological (disorders of consciousness) consciousness perturbation, the dopaminergic source nucleus, the ventral tegmental area, disconnects from the main nodes of the default mode network. As the severity of this dopaminergic disconnection was associated with default mode network disintegration, we propose that dopaminergic modulation may be a central mechanism for consciousness maintenance. Clinical research into consciousness has long focused on cortical macroscopic networks and their disruption in pathological or pharmacological consciousness perturbation. Despite demonstrating diagnostic utility in disorders of consciousness (DoC) and monitoring anesthetic depth, these cortico-centric approaches have been unable to characterize which neurochemical systems may underpin consciousness alterations. Instead, preclinical experiments have long implicated the dopaminergic ventral tegmental area (VTA) in the brainstem. Despite dopaminergic agonist efficacy in DoC patients equally pointing to dopamine, the VTA has not been studied in human perturbed consciousness. To bridge this translational gap between preclinical subcortical and clinical cortico-centric perspectives, we assessed functional connectivity changes of a histologically characterized VTA using functional MRI recordings of pharmacologically (propofol sedation) and pathologically perturbed consciousness (DoC patients). Both cohorts demonstrated VTA disconnection from the precuneus and posterior cingulate (PCu/PCC), a main default mode network node widely implicated in consciousness. Strikingly, the stronger VTA–PCu/PCC connectivity was, the more the PCu/PCC functional connectome resembled its awake configuration, suggesting a possible neuromodulatory relationship. VTA-PCu/PCC connectivity increased toward healthy control levels only in DoC patients who behaviorally improved at follow-up assessment. To test whether VTA–PCu/PCC connectivity can be affected by a dopaminergic agonist, we demonstrated in a separate set of traumatic brain injury patients without DoC that methylphenidate significantly increased this connectivity. Together, our results characterize an in vivo dopaminergic connectivity deficit common to reversible and chronic consciousness perturbation. This noninvasive assessment of the dopaminergic system bridges preclinical and clinical work, associating dopaminergic VTA function with macroscopic network alterations, thereby elucidating a critical aspect of brainstem–cortical interplay for consciousness.
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15
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Wang Y, Wan C, Zhang Y, Zhou Y, Wang H, Yan F, Song D, Du R, Wang Q, Huang L. Detecting Connected Consciousness During Propofol-Induced Anesthesia Using EEG Based Brain Decoding. Int J Neural Syst 2021; 31:2150021. [PMID: 33970056 DOI: 10.1142/s0129065721500210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Connected consciousness refers to the state when external stimuli can enter into the stream of our consciousness experience. Emerging evidence suggests that although patients may not respond behaviorally to external stimuli during anesthesia, they may be aware of their surroundings. In this work, we investigated whether EEG based brain decoding could be used for detecting connected consciousness in the absence of behavioral responses during propofol infusion. A total of 14 subjects participated in our experiment. Subjects were asked to discriminate two types of auditory stimuli with a finger press during an ultraslow propofol infusion. We trained an EEG based brain decoding model using data collected in the awakened state using the same auditory stimuli and tested the model on data collected during the propofol infusion. The model provided a correct classification rate (CCR) of [Formula: see text]% when subjects were able to respond to the stimuli during the propofol infusion. The CCR dropped to [Formula: see text]% when subjects ceased responding and further decreased to [Formula: see text]% when we increased the propofol concentration by another 0.2 [Formula: see text]g/ml. After terminating the propofol infusion, we observed that the CCR rebounded to [Formula: see text]% before the subjects regained consciousness. With the classification results, we provided evidence that loss of consciousness is a gradual process and may progress from full consciousness to connected consciousness and then to disconnected consciousness.
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Affiliation(s)
- Yubo Wang
- School of Life Science and Technology, Xidian University, Xi'an, P. R. China
| | - Chenghao Wan
- School of Life Science and Technology, Xidian University, Xi'an, P. R. China
| | - Yun Zhang
- School of Life Science and Technology, Xidian University, Xi'an, P. R. China
| | - Yu Zhou
- School of Life Science and Technology, Xidian University, Xi'an, P. R. China
| | - Haidong Wang
- School of Life Science and Technology, Xidian University, Xi'an, P. R. China
| | - Fei Yan
- Department of Anesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Dawei Song
- Department of Anesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Ruini Du
- Department of Anesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Qiang Wang
- Department of Anesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Liyu Huang
- School of Life Science and Technology, Xidian University, Xi'an, P. R. China
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16
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Brief Mindfulness Meditation Induces Gray Matter Changes in a Brain Hub. Neural Plast 2020; 2020:8830005. [PMID: 33299395 PMCID: PMC7704181 DOI: 10.1155/2020/8830005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/11/2020] [Accepted: 10/30/2020] [Indexed: 01/03/2023] Open
Abstract
Previous studies suggest that the practice of long-term (months to years) mindfulness meditation induces structural plasticity in gray matter. However, it remains unknown whether short-term (<30 days) mindfulness meditation in novices could induce similar structural changes. Our previous randomized controlled trials (RCTs) identified white matter changes surrounding the anterior cingulate cortex (ACC) and the posterior cingulate cortex (PCC) within 2 to 4 weeks, following 5-10 h of mindfulness training. Furthermore, these changes were correlated with emotional states in healthy adults. The PCC is a key hub in the functional anatomy implicated in meditation and other perspectival processes. In this longitudinal study using a randomized design, we therefore examined the effect of a 10 h of mindfulness training, the Integrative Body-Mind Training (IBMT) on gray matter volume of the PCC compared to an active control-relaxation training (RT). We found that brief IBMT increased ventral PCC volume and that baseline temperamental trait-an index of individual differences was associated with a reduction in training-induced gray matter increases. Our findings indicate that brief mindfulness meditation induces gray matter plasticity, suggesting that structural changes in ventral PCC-a key hub associated with self-awareness, emotion, cognition, and aging-may have important implications for protecting against mood-related disorders and aging-related cognitive declines.
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17
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Witon A, Shirazibehehsti A, Cooke J, Aviles A, Adapa R, Menon DK, Chennu S, Bekinschtein T, Lopez JD, Litvak V, Li L, Friston K, Bowman H. Sedation Modulates Frontotemporal Predictive Coding Circuits and the Double Surprise Acceleration Effect. Cereb Cortex 2020; 30:5204-5217. [PMID: 32427284 PMCID: PMC7472187 DOI: 10.1093/cercor/bhaa071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/22/2020] [Accepted: 02/20/2020] [Indexed: 12/14/2022] Open
Abstract
Two important theories in cognitive neuroscience are predictive coding (PC) and the global workspace (GW) theory. A key research task is to understand how these two theories relate to one another, and particularly, how the brain transitions from a predictive early state to the eventual engagement of a brain-scale state (the GW). To address this question, we present a source-localization of EEG responses evoked by the local-global task—an experimental paradigm that engages a predictive hierarchy, which encompasses the GW. The results of our source reconstruction suggest three phases of processing. The first phase involves the sensory (here auditory) regions of the superior temporal lobe and predicts sensory regularities over a short timeframe (as per the local effect). The third phase is brain-scale, involving inferior frontal, as well as inferior and superior parietal regions, consistent with a global neuronal workspace (GNW; as per the global effect). Crucially, our analysis suggests that there is an intermediate (second) phase, involving modulatory interactions between inferior frontal and superior temporal regions. Furthermore, sedation with propofol reduces modulatory interactions in the second phase. This selective effect is consistent with a PC explanation of sedation, with propofol acting on descending predictions of the precision of prediction errors; thereby constraining access to the GNW.
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Affiliation(s)
- Adrien Witon
- School of Computing, University of Kent, Kent CT2 7NF, UK.,Center for Neuroprosthetics, EPFL, Sion 1951, Switzerland
| | - Amirali Shirazibehehsti
- School of Computing, University of Kent, Kent CT2 7NF, UK.,East Kent Hospitals University NHS Foundation Trust, Kent & Canterbury Hospital, Canterbury CT1 3NG, UK
| | - Jennifer Cooke
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Alberto Aviles
- School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
| | - Ram Adapa
- Division of Anaesthesia, Box 97, Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0QQ, UK
| | - David K Menon
- Division of Anaesthesia, Box 97, Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Srivas Chennu
- School of Computing, University of Kent, Kent CT2 7NF, UK
| | | | - Jose David Lopez
- Electronic Engineering program, Universidad de Antioquia, Ciudad Universitaria, Medellín 1226, Colombia.,Wellcome Centre for Neuroimaging, University College London, London WC1N 3AR, UK
| | - Vladimir Litvak
- Wellcome Centre for Neuroimaging, University College London, London WC1N 3AR, UK
| | - Ling Li
- School of Computing, University of Kent, Kent CT2 7NF, UK
| | - Karl Friston
- Wellcome Centre for Neuroimaging, University College London, London WC1N 3AR, UK
| | - Howard Bowman
- School of Computing, University of Kent, Kent CT2 7NF, UK.,School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
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18
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Vatansever D, Schröter M, Adapa RM, Bullmore ET, Menon DK, Stamatakis EA. Reorganisation of Brain Hubs across Altered States of Consciousness. Sci Rep 2020; 10:3402. [PMID: 32099008 PMCID: PMC7042369 DOI: 10.1038/s41598-020-60258-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/31/2020] [Indexed: 12/12/2022] Open
Abstract
Patterns of functional interactions across distributed brain regions are suggested to provide a scaffold for the conscious processing of information, with marked topological alterations observed in loss of consciousness. However, establishing a firm link between macro-scale brain network organisation and conscious cognition requires direct investigations into neuropsychologically-relevant architectural modifications across systematic reductions in consciousness. Here we assessed both global and regional disturbances to brain graphs in a group of healthy participants across baseline resting state fMRI as well as two distinct levels of propofol-induced sedation. We found a persistent modular architecture, yet significant reorganisation of brain hubs that formed parts of a wider rich-club collective. Furthermore, the reduction in the strength of rich-club connectivity was significantly associated with the participants’ performance in a semantic judgment task, indicating the importance of this higher-order topological feature for conscious cognition. These results highlight a remarkable interplay between global and regional properties of brain functional interactions in supporting conscious cognition that is relevant to our understanding of clinical disorders of consciousness.
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Affiliation(s)
- D Vatansever
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, 200433, Shanghai, PR China. .,Division of Anaesthesia and Department of Clinical Neurosciences, School of Clinical Medicine, UK & Wolfson Brain Imaging Centre, University of Cambridge, CB2 0QQ, Cambridge, UK. .,Department of Psychiatry, School of Clinical Medicine, University of Cambridge, CB2 0QQ, Cambridge, UK.
| | - M Schröter
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, CB2 0QQ, Cambridge, UK.,Department of Biosystems Science and Engineering, Bio Engineering Laboratory, ETH Zurich, 4058, Basel, Switzerland
| | - R M Adapa
- Division of Anaesthesia and Department of Clinical Neurosciences, School of Clinical Medicine, UK & Wolfson Brain Imaging Centre, University of Cambridge, CB2 0QQ, Cambridge, UK
| | - E T Bullmore
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, CB2 0QQ, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge Road, Fulbourn, CB21 5HH, Cambridge, UK
| | - D K Menon
- Division of Anaesthesia and Department of Clinical Neurosciences, School of Clinical Medicine, UK & Wolfson Brain Imaging Centre, University of Cambridge, CB2 0QQ, Cambridge, UK
| | - E A Stamatakis
- Division of Anaesthesia and Department of Clinical Neurosciences, School of Clinical Medicine, UK & Wolfson Brain Imaging Centre, University of Cambridge, CB2 0QQ, Cambridge, UK
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19
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Varley TF, Craig M, Adapa R, Finoia P, Williams G, Allanson J, Pickard J, Menon DK, Stamatakis EA. Fractal dimension of cortical functional connectivity networks & severity of disorders of consciousness. PLoS One 2020; 15:e0223812. [PMID: 32053587 PMCID: PMC7017993 DOI: 10.1371/journal.pone.0223812] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/17/2019] [Indexed: 12/02/2022] Open
Abstract
Recent evidence suggests that the quantity and quality of conscious experience may be a function of the complexity of activity in the brain and that consciousness emerges in a critical zone between low and high-entropy states. We propose fractal shapes as a measure of proximity to this critical point, as fractal dimension encodes information about complexity beyond simple entropy or randomness, and fractal structures are known to emerge in systems nearing a critical point. To validate this, we tested several measures of fractal dimension on the brain activity from healthy volunteers and patients with disorders of consciousness of varying severity. We used a Compact Box Burning algorithm to compute the fractal dimension of cortical functional connectivity networks as well as computing the fractal dimension of the associated adjacency matrices using a 2D box-counting algorithm. To test whether brain activity is fractal in time as well as space, we used the Higuchi temporal fractal dimension on BOLD time-series. We found significant decreases in the fractal dimension between healthy volunteers (n = 15), patients in a minimally conscious state (n = 10), and patients in a vegetative state (n = 8), regardless of the mechanism of injury. We also found significant decreases in adjacency matrix fractal dimension and Higuchi temporal fractal dimension, which correlated with decreasing level of consciousness. These results suggest that cortical functional connectivity networks display fractal character and that this is associated with level of consciousness in a clinically relevant population, with higher fractal dimensions (i.e. more complex) networks being associated with higher levels of consciousness. This supports the hypothesis that level of consciousness and system complexity are positively associated, and is consistent with previous EEG, MEG, and fMRI studies.
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Affiliation(s)
- Thomas F. Varley
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, Indiana, United States of America
| | - Michael Craig
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
| | - Ram Adapa
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
| | - Paola Finoia
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
| | - Guy Williams
- Wolfson Brain Imaging Center, University of Cambridge, Cambridgeshire, England, United Kingdom
| | - Judith Allanson
- Department of Neurorehabilitation, Addenbrooke’s Hospital, Cambridgeshire, England, United Kingdom
| | - John Pickard
- Wolfson Brain Imaging Center, University of Cambridge, Cambridgeshire, England, United Kingdom
- Division of Neurosurgery, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
| | - David K. Menon
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
- Wolfson Brain Imaging Center, University of Cambridge, Cambridgeshire, England, United Kingdom
| | - Emmanuel A. Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom
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20
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Pappas I, Adapa RM, Menon DK, Stamatakis EA. Brain network disintegration during sedation is mediated by the complexity of sparsely connected regions. Neuroimage 2018; 186:221-233. [PMID: 30391346 DOI: 10.1016/j.neuroimage.2018.10.078] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/17/2018] [Accepted: 10/29/2018] [Indexed: 01/25/2023] Open
Abstract
The precise mechanism of anaesthetic action on a neural level remains unclear. Recent approaches suggest that anaesthetics attenuate the complexity of interactions (connectivity) however evidence remains insufficient. We used tools from network and information theory to show that, during propofol-induced sedation, a collection of brain regions displayed decreased complexity in their connectivity patterns, especially so if they were sparsely connected. Strikingly, we found that, despite their low connectivity strengths, these regions exhibited an inordinate role in network integration. Their location and connectivity complexity delineated a specific pattern of sparse interactions mainly involving default mode regions while their connectivity complexity during the awake state also correlated with reaction times during sedation signifying its importance as a reliable indicator of the effects of sedation on individuals. Contrary to established views suggesting sedation affects only richly connected brain regions, we propose that suppressed complexity of sparsely connected regions should be considered a critical feature of any candidate mechanistic description for loss of consciousness.
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Affiliation(s)
- I Pappas
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Box 93, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Box 165, A Block, Level 3, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
| | - R M Adapa
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Box 93, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
| | - D K Menon
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Box 93, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
| | - E A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Box 93, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Box 165, A Block, Level 3, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
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21
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Huang Z, Zhang J, Wu J, Liu X, Xu J, Zhang J, Qin P, Dai R, Yang Z, Mao Y, Hudetz AG, Northoff G. Disrupted neural variability during propofol-induced sedation and unconsciousness. Hum Brain Mapp 2018; 39:4533-4544. [PMID: 29974570 PMCID: PMC6223306 DOI: 10.1002/hbm.24304] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 06/04/2018] [Accepted: 06/24/2018] [Indexed: 12/16/2022] Open
Abstract
Variability quenching is a widespread neural phenomenon in which trial-to-trial variability (TTV) of neural activity is reduced by repeated presentations of a sensory stimulus. However, its neural mechanism and functional significance remain poorly understood. Recurrent network dynamics are suggested as a candidate mechanism of TTV, and they play a key role in consciousness. We thus asked whether the variability-quenching phenomenon is related to the level of consciousness. We hypothesized that TTV reduction would be compromised during reduced level of consciousness by propofol anesthetics. We recorded functional magnetic resonance imaging signals of resting-state and stimulus-induced activities in three conditions: wakefulness, sedation, and unconsciousness (i.e., deep anesthesia). We measured the average (trial-to-trial mean, TTM) and variability (TTV) of auditory stimulus-induced activity under the three conditions. We also examined another form of neural variability (temporal variability, TV), which quantifies the overall dynamic range of ongoing neural activity across time, during both the resting-state and the task. We found that (a) TTM deceased gradually from wakefulness through sedation to anesthesia, (b) stimulus-induced TTV reduction normally seen during wakefulness was abolished during both sedation and anesthesia, and (c) TV increased in the task state as compared to resting-state during both wakefulness and sedation, but not anesthesia. Together, our results reveal distinct effects of propofol on the two forms of neural variability (TTV and TV). They imply that the anesthetic disrupts recurrent network dynamics, thus prevents the stabilization of cortical activity states. These findings shed new light on the temporal dynamics of neuronal variability and its alteration during anesthetic-induced unconsciousness.
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Affiliation(s)
- Zirui Huang
- Department of Anesthesiology and Center for Consciousness ScienceUniversity of MichiganAnn ArborMichigan
| | - Jun Zhang
- Department of AnesthesiologyHuashan Hospital, Fudan UniversityShanghaiPeople's Republic of China
| | - Jinsong Wu
- Neurological Surgery DepartmentHuashan Hospital, Shanghai Medical College, Fudan UniversityShanghaiPeople's Republic of China
| | - Xiaoge Liu
- Department of AnesthesiologyHuashan Hospital, Fudan UniversityShanghaiPeople's Republic of China
| | - Jianghui Xu
- Department of AnesthesiologyHuashan Hospital, Fudan UniversityShanghaiPeople's Republic of China
| | - Jianfeng Zhang
- College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhouPeople's Republic of China
| | - Pengmin Qin
- School of PsychologySouth China Normal UniversityGuangzhouPeople's Republic of China
| | - Rui Dai
- State Key Laboratory of Brain and Cognitive ScienceInstitute of Biophysics, Chinese Academy of SciencesBeijingPeople's Republic of China
| | - Zhong Yang
- Department of RadiologyHuashan Hospital, Fudan UniversityShanghaiPeople's Republic of China
| | - Ying Mao
- Neurological Surgery DepartmentHuashan Hospital, Shanghai Medical College, Fudan UniversityShanghaiPeople's Republic of China
| | - Anthony G. Hudetz
- Department of Anesthesiology and Center for Consciousness ScienceUniversity of MichiganAnn ArborMichigan
| | - Georg Northoff
- Institute of Mental Health ResearchUniversity of OttawaOttawaOntarioCanada
- Center for Cognition and Brain DisordersHangzhou Normal UniversityHangzhouPeople's Republic of China
- Mental Health CentreZhejiang University School of MedicineHangzhouPeople's Republic of China
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22
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Meta-analysis of functional subdivisions within human posteromedial cortex. Brain Struct Funct 2018; 224:435-452. [DOI: 10.1007/s00429-018-1781-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/17/2018] [Indexed: 12/22/2022]
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23
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Functional diversity of brain networks supports consciousness and verbal intelligence. Sci Rep 2018; 8:13259. [PMID: 30185912 PMCID: PMC6125486 DOI: 10.1038/s41598-018-31525-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/15/2018] [Indexed: 11/08/2022] Open
Abstract
How are the myriad stimuli arriving at our senses transformed into conscious thought? To address this question, in a series of studies, we asked whether a common mechanism underlies loss of information processing in unconscious states across different conditions, which could shed light on the brain mechanisms of conscious cognition. With a novel approach, we brought together for the first time, data from the same paradigm-a highly engaging auditory-only narrative-in three independent domains: anesthesia-induced unconsciousness, unconsciousness after brain injury, and individual differences in intellectual abilities during conscious cognition. During external stimulation in the unconscious state, the functional differentiation between the auditory and fronto-parietal systems decreased significantly relatively to the conscious state. Conversely, we found that stronger functional differentiation between these systems in response to external stimulation predicted higher intellectual abilities during conscious cognition, in particular higher verbal acuity scores in independent cognitive testing battery. These convergent findings suggest that the responsivity of sensory and higher-order brain systems to external stimulation, especially through the diversification of their functional responses is an essential feature of conscious cognition and verbal intelligence.
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24
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Spoken words are processed during dexmedetomidine-induced unresponsiveness. Br J Anaesth 2018; 121:270-280. [PMID: 29935582 DOI: 10.1016/j.bja.2018.04.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/13/2018] [Accepted: 04/30/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Studying the effects of anaesthetic drugs on the processing of semantic stimuli could yield insights into how brain functions change in the transition from wakefulness to unresponsiveness. Here, we explored the N400 event-related potential during dexmedetomidine- and propofol-induced unresponsiveness. METHODS Forty-seven healthy subjects were randomised to receive either dexmedetomidine (n=23) or propofol (n=24) in this open-label parallel-group study. Loss of responsiveness was achieved by stepwise increments of pseudo-steady-state plasma concentrations, and presumed loss of consciousness was induced using 1.5 times the concentration required for loss of responsiveness. Pre-recorded spoken sentences ending either with an expected (congruous) or an unexpected (incongruous) word were presented during unresponsiveness. The resulting electroencephalogram data were analysed for the presence of the N400 component, and for the N400 effect defined as the difference between the N400 components elicited by congruous and incongruous stimuli, in the time window 300-600 ms post-stimulus. Recognition of the presented stimuli was tested after recovery of responsiveness. RESULTS The N400 effect was not observed during dexmedetomidine- or propofol-induced unresponsiveness. The N400 component, however, persisted during dexmedetomidine administration. The N400 component elicited by congruous stimuli during unresponsiveness in the dexmedetomidine group resembled the large component evoked by incongruous stimuli at the awake baseline. After recovery, no recognition of the stimuli heard during unresponsiveness occurred. CONCLUSIONS Dexmedetomidine and propofol disrupt the discrimination of congruous and incongruous spoken sentences, and recognition memory at loss of responsiveness. However, the processing of words is partially preserved during dexmedetomidine-induced unresponsiveness. CLINICAL TRIAL REGISTRATION NCT01889004.
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25
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Lichtner G, Auksztulewicz R, Kirilina E, Velten H, Mavrodis D, Scheel M, Blankenburg F, von Dincklage F. Effects of propofol anesthesia on the processing of noxious stimuli in the spinal cord and the brain. Neuroimage 2018; 172:642-653. [DOI: 10.1016/j.neuroimage.2018.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/03/2018] [Accepted: 02/02/2018] [Indexed: 12/20/2022] Open
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26
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Timescales of Intrinsic BOLD Signal Dynamics and Functional Connectivity in Pharmacologic and Neuropathologic States of Unconsciousness. J Neurosci 2018; 38:2304-2317. [PMID: 29386261 PMCID: PMC5830518 DOI: 10.1523/jneurosci.2545-17.2018] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/14/2017] [Accepted: 01/24/2018] [Indexed: 01/09/2023] Open
Abstract
Environmental events are processed on multiple timescales via hierarchical organization of temporal receptive windows (TRWs) in the brain. The dependence of neural timescales and TRWs on altered states of consciousness is unclear. States of reduced consciousness are marked by a shift toward slowing of neural dynamics (<1 Hz) in EEG/ECoG signals. We hypothesize that such prolongation of intrinsic timescales are also seen in blood-oxygen-level-dependent (BOLD) signals. To test this hypothesis, we measured the timescales of intrinsic BOLD signals using mean frequency (MF) and temporal autocorrelation (AC) in healthy volunteers (n = 23; male/female 14/9) during graded sedation with propofol. We further examined the relationship between the intrinsic timescales (local/voxel level) and its regional connectivity (across neighboring voxels; regional homogeneity, ReHo), global (whole-brain level) functional connectivity (GFC), and topographical similarity (Topo). Additional results were obtained from patients undergoing deep general anesthesia (n = 12; male/female: 5/7) and in patients with disorders of consciousness (DOC) (n = 21; male/female: 14/7). We found that MF, AC, and ReHo increased, whereas GFC and Topo decreased, during propofol sedation. The local alterations occur before changes of distant connectivity. Conversely, all of these parameters decreased in deep anesthesia and in patients with DOC. We conclude that propofol synchronizes local neuronal interactions and prolongs the timescales of intrinsic BOLD signals. These effects may impede communication among distant brain regions. Furthermore, the intrinsic timescales exhibit distinct dynamic signatures in sedation, deep anesthesia, and DOC. These results improve our understanding of the neural mechanisms of unconsciousness in pharmacologic and neuropathologic states. SIGNIFICANCE STATEMENT Information processing in the brain occurs through a hierarchy of temporal receptive windows (TRWs) in multiple timescales. Anesthetic drugs induce a reversible suppression of consciousness and thus offer a unique opportunity to investigate the state dependence of neural timescales. Here, we demonstrate for the first time that sedation with propofol is accompanied by the prolongation of the timescales of intrinsic BOLD signals presumably reflecting enlarged TRWs. We show that this is accomplished by an increase of local and regional signal synchronization, effects that may disrupt information exchange among distant brain regions. Furthermore, we show that the timescales of intrinsic BOLD signals exhibit distinct dynamic signatures in sedation, deep anesthesia, and disorders of consciousness.
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27
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Neuronal Connectivity, General Anesthesia, and the Elderly. CURRENT ANESTHESIOLOGY REPORTS 2017. [DOI: 10.1007/s40140-017-0241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Gaskell A, Hight D, Winders J, Tran G, Defresne A, Bonhomme V, Raz A, Sleigh J, Sanders R. Frontal alpha-delta EEG does not preclude volitional response during anaesthesia: prospective cohort study of the isolated forearm technique. Br J Anaesth 2017; 119:664-673. [DOI: 10.1093/bja/aex170] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/12/2022] Open
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29
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Wild CJ, Linke AC, Zubiaurre-Elorza L, Herzmann C, Duffy H, Han VK, Lee DSC, Cusack R. Adult-like processing of naturalistic sounds in auditory cortex by 3- and 9-month old infants. Neuroimage 2017. [PMID: 28648887 DOI: 10.1016/j.neuroimage.2017.06.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Functional neuroimaging has been used to show that the developing auditory cortex of very young human infants responds, in some way, to sound. However, impoverished stimuli and uncontrolled designs have made it difficult to attribute brain responses to specific auditory features, and thus made it difficult to assess the maturity of feature tuning in auditory cortex. To address this, we used functional magnetic resonance imaging (fMRI) to measure the brain activity evoked by naturalistic sounds (a series of sung lullabies) in two groups of infants (3 and 9 months) and adults. We developed a novel analysis method - inter-subject regression (ISR) - to quantify the similarity of cortical responses between infants and adults, and to decompose components of the response due to different auditory features. We found that the temporal pattern of activity in infant auditory cortex shared similarity with adults. Some of this shared response could be attributed to simple acoustic features, such as frequency, pitch, envelope, but other parts were not, suggesting that even more complex adult-like features are represented in auditory cortex in early infancy.
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Affiliation(s)
- Conor J Wild
- Brain and Mind Institute, Western University, London, Canada.
| | - Annika C Linke
- Brain and Mind Institute, Western University, London, Canada
| | | | | | - Hester Duffy
- Brain and Mind Institute, Western University, London, Canada
| | - Victor K Han
- Children's Health Research Institute, London, Canada
| | - David S C Lee
- Children's Health Research Institute, London, Canada
| | - Rhodri Cusack
- Brain and Mind Institute, Western University, London, Canada; Children's Health Research Institute, London, Canada; School of Psychology, Trinity College Dublin, Dublin, Ireland
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30
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Anesthesia, brain changes, and behavior: Insights from neural systems biology. Prog Neurobiol 2017; 153:121-160. [PMID: 28189740 DOI: 10.1016/j.pneurobio.2017.01.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/19/2017] [Accepted: 01/22/2017] [Indexed: 02/08/2023]
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31
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Uhrig L, Janssen D, Dehaene S, Jarraya B. Cerebral responses to local and global auditory novelty under general anesthesia. Neuroimage 2016; 141:326-340. [PMID: 27502046 PMCID: PMC5635967 DOI: 10.1016/j.neuroimage.2016.08.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 12/13/2022] Open
Abstract
Primate brains can detect a variety of unexpected deviations in auditory sequences. The local-global paradigm dissociates two hierarchical levels of auditory predictive coding by examining the brain responses to first-order (local) and second-order (global) sequence violations. Using the macaque model, we previously demonstrated that, in the awake state, local violations cause focal auditory responses while global violations activate a brain circuit comprising prefrontal, parietal and cingulate cortices. Here we used the same local-global auditory paradigm to clarify the encoding of the hierarchical auditory regularities in anesthetized monkeys and compared their brain responses to those obtained in the awake state as measured with fMRI. Both, propofol, a GABAA-agonist, and ketamine, an NMDA-antagonist, left intact or even enhanced the cortical response to auditory inputs. The local effect vanished during propofol anesthesia and shifted spatially during ketamine anesthesia compared with wakefulness. Under increasing levels of propofol, we observed a progressive disorganization of the global effect in prefrontal, parietal and cingulate cortices and its complete suppression under ketamine anesthesia. Anesthesia also suppressed thalamic activations to the global effect. These results suggest that anesthesia preserves initial auditory processing, but disturbs both short-term and long-term auditory predictive coding mechanisms. The disorganization of auditory novelty processing under anesthesia relates to a loss of thalamic responses to novelty and to a disruption of higher-order functional cortical networks in parietal, prefrontal and cingular cortices.
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Affiliation(s)
- Lynn Uhrig
- CEA DRF/I2BM, NeuroSpin Center, 91191 Gif-sur-Yvette, France; INSERM U992, Cognitive Neuroimaging Unit, 91191 Gif-sur-Yvette, France
| | - David Janssen
- CEA DRF/I2BM, NeuroSpin Center, 91191 Gif-sur-Yvette, France
| | - Stanislas Dehaene
- CEA DRF/I2BM, NeuroSpin Center, 91191 Gif-sur-Yvette, France; INSERM U992, Cognitive Neuroimaging Unit, 91191 Gif-sur-Yvette, France; Collège de France, 75231 Paris, France; Université Paris Sud, Université Paris-Saclay, 91405 Orsay, France
| | - Béchir Jarraya
- CEA DRF/I2BM, NeuroSpin Center, 91191 Gif-sur-Yvette, France; INSERM U992, Cognitive Neuroimaging Unit, 91191 Gif-sur-Yvette, France; Neuromodulation Unit, Department of Neurosurgery, Foch Hospital, 92150 Suresnes, France; University of Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, 78000 Versailles, France.
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Gibson RM, Owen AM, Cruse D. Brain-computer interfaces for patients with disorders of consciousness. PROGRESS IN BRAIN RESEARCH 2016; 228:241-91. [PMID: 27590972 DOI: 10.1016/bs.pbr.2016.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The disorders of consciousness refer to clinical conditions that follow a severe head injury. Patients diagnosed as in a vegetative state lack awareness, while patients diagnosed as in a minimally conscious state retain fluctuating awareness. However, it is a challenge to accurately diagnose these disorders with clinical assessments of behavior. To improve diagnostic accuracy, neuroimaging-based approaches have been developed to detect the presence or absence of awareness in patients who lack overt responsiveness. For the small subset of patients who retain awareness, brain-computer interfaces could serve as tools for communication and environmental control. Here we review the existing literature concerning the sensory and cognitive abilities of patients with disorders of consciousness with respect to existing brain-computer interface designs. We highlight the challenges of device development for this special population and address some of the most promising approaches for future investigations.
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Affiliation(s)
- R M Gibson
- The Brain and Mind Institute, University of Western Ontario, London, ON, Canada; University of Western Ontario, London, ON, Canada.
| | - A M Owen
- The Brain and Mind Institute, University of Western Ontario, London, ON, Canada; University of Western Ontario, London, ON, Canada
| | - D Cruse
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
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Pryor KO, Root JC, Mehta M, Stern E, Pan H, Veselis RA, Silbersweig DA. Effect of propofol on the medial temporal lobe emotional memory system: a functional magnetic resonance imaging study in human subjects. Br J Anaesth 2015; 115 Suppl 1:i104-i113. [PMID: 26174294 DOI: 10.1093/bja/aev038] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Subclinical doses of propofol produce anterograde amnesia, characterized by an early failure of memory consolidation. It is unknown how propofol affects the amygdala-dependent emotional memory system, which modulates consolidation in the hippocampus in response to emotional arousal and neurohumoral stress. We present an event-related functional magnetic resonance imaging study of the effects of propofol on the emotional memory system in human subjects. METHODS Thirty-five healthy subjects were randomized to receive propofol, at an estimated brain concentration of 0.90 μg ml(-1), or placebo. During drug infusion, emotionally arousing and neutral images were presented in a continuous recognition task, while blood-oxygen-level-dependent activation responses were acquired. After a drug-free interval of 2 h, subsequent memory for successfully encoded items was assessed. Imaging analysis was performed using statistical parametric mapping and behavioural analysis using signal detection models. RESULTS Propofol had no effect on the stereotypical amygdalar response to emotional arousal, but caused marked suppression of the hippocampal response. Propofol caused memory performance to become uncoupled from amygdalar activation, but it remained correlated with activation in the posterior hippocampus, which decreased in proportion to amnesia. CONCLUSIONS Propofol is relatively ineffective at suppressing amygdalar activation at sedative doses, but abolishes emotional modulation and causes amnesia via mechanisms that commonly involve hyporesponsiveness of the hippocampus. These findings raise the possibility that amygdala-dependent fear systems may remain intact even when a patient has diminished memory of events. This may be of clinical importance in the perioperative development of fear-based psychopathologies, such as post-traumatic stress disorder. CLINICAL TRIAL REGISTRATION NCT00504894.
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Affiliation(s)
- K O Pryor
- Department of Anesthesiology, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - J C Root
- Department of Anesthesiology, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - M Mehta
- Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - E Stern
- Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, 824 Boylston Street, Chestnut Hill, MA 02467, USA
| | - H Pan
- Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, 824 Boylston Street, Chestnut Hill, MA 02467, USA
| | - R A Veselis
- Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - D A Silbersweig
- Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, 824 Boylston Street, Chestnut Hill, MA 02467, USA
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Barttfeld P, Bekinschtein TA, Salles A, Stamatakis EA, Adapa R, Menon DK, Sigman M. Factoring the brain signatures of anesthesia concentration and level of arousal across individuals. Neuroimage Clin 2015; 9:385-91. [PMID: 26509121 PMCID: PMC4588413 DOI: 10.1016/j.nicl.2015.08.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 02/02/2023]
Abstract
Combining resting-state functional magnetic resonance imaging (fMRI) connectivity and behavioral analysis during sedation, we factored out general effects of the anesthetic drug propofol and a specific index of conscious report, participants' level of responsiveness. The factorial analysis shows that increasing concentration of propofol in blood specifically decreases the connectivity strength of fronto-parietal cortical loops. In contrast, loss of responsiveness is indexed by a functional disconnection between the thalamus and the frontal cortex, balanced by an increase in connectivity strength of the thalamus to the occipital and temporal regions of the cortex.
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Affiliation(s)
- Pablo Barttfeld
- Universidad Torcuato di Tella, Almirante Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina ; Cognitive Neuroimaging Unit, CEA DSV/I2BM, INSERM, Université Paris-Sud, Université Paris-Saclay, NeuroSpin center, 91191 Gif/Yvette, France
| | - Tristan A Bekinschtein
- Cognition and Brain Sciences Unit, Medical Research Council, Cambridge CB2 7EF, UK ; Department of Psychology, University of Cambridge, Cambridge, UK
| | - Alejo Salles
- Universidad Torcuato di Tella, Almirante Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina ; Instituto de Cálculo, FCEN, Universidad de Buenos Aires and CONICET, Argentina
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ram Adapa
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - David K Menon
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Mariano Sigman
- Universidad Torcuato di Tella, Almirante Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina
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Liang P, Zhang H, Xu Y, Jia W, Zang Y, Li K. Disruption of cortical integration during midazolam-induced light sedation. Hum Brain Mapp 2015; 36:4247-61. [PMID: 26314702 PMCID: PMC5049658 DOI: 10.1002/hbm.22914] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/08/2015] [Accepted: 07/14/2015] [Indexed: 11/05/2022] Open
Abstract
This work examines the effect of midazolam‐induced light sedation on intrinsic functional connectivity of human brain, using a randomized, double‐blind, placebo‐controlled, cross‐over, within‐subject design. Fourteen healthy young subjects were enrolled and midazolam (0.03 mg/kg of the participant's body mass, to a maximum of 2.5 mg) or saline were administrated with an interval of one week. Resting‐state fMRI was conducted before and after administration for each subject. We focus on two types of networks: sensory related lower‐level functional networks and higher‐order functions related ones. Independent component analysis (ICA) was used to identify these resting‐state functional networks. We hypothesize that the sensory (visual, auditory, and sensorimotor) related networks will be intact under midazolam‐induced light sedation while the higher‐order (default mode, executive control, salience networks, etc.) networks will be functionally disconnected. It was found that the functional integrity of the lower‐level networks was maintained, while that of the higher‐level networks was significantly disrupted by light sedation. The within‐network connectivity of the two types of networks was differently affected in terms of direction and extent. These findings provide direct evidence that higher‐order cognitive functions including memory, attention, executive function, and language were impaired prior to lower‐level sensory responses during sedation. Our result also lends support to the information integration model of consciousness. Hum Brain Mapp 36:4247–4261, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Peipeng Liang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Han Zhang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, 310015, China.,Department of Radiology and BRIC, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Yachao Xu
- Depart of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Wenbin Jia
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, 310015, China
| | - Yufeng Zang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, 311121, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, 310015, China
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
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Anesthesia and neuroimaging: investigating the neural correlates of unconsciousness. Trends Cogn Sci 2015; 19:100-7. [DOI: 10.1016/j.tics.2014.12.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 01/18/2023]
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Monti MM, Rosenberg M, Finoia P, Kamau E, Pickard JD, Owen AM. Thalamo-frontal connectivity mediates top-down cognitive functions in disorders of consciousness. Neurology 2015; 84:167-73. [PMID: 25480912 PMCID: PMC4336082 DOI: 10.1212/wnl.0000000000001123] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 08/06/2014] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE We employed functional MRI (fMRI) to assess whether (1) patients with disorders of consciousness (DOC) retain the ability to willfully engage in top-down processing and (2) what neurophysiologic factors distinguish patients who can demonstrate this ability from patients who cannot. METHODS Sixteen volunteers, 8 patients in vegetative state (VS), 16 minimally conscious patients (MCS), and 4 exit from MCS (eMCS) patients were enrolled in a prospective cross-sectional fMRI study. Participants performed a target detection task in which they counted the number of times a (changing) target word was presented amidst a set of distractors. RESULTS Three of 8 patients diagnosed as being in a VS exhibited significant activations in response to the task, thereby demonstrating a state of consciousness. Differential activations across tasks were also observed in 6 MCS patients and 1 eMCS patient. A psycho-physiologic interaction analysis revealed that the main factor distinguishing patients who responded to the task from those who did not was a greater connectivity between the anterior section of thalamus and prefrontal cortex. CONCLUSIONS In our sample of patients, the dissociation between overt behavior observable in clinical assessments and residual cognitive faculties is prevalent among DOC patients (37%). A substantial number of patients, including some diagnosed with VS, can demonstrate willful engagement in top-down cognition. While neuroimaging data are not the same as observable behavior, this suggests that the mental status of some VS patients exceeds what can be appreciated clinically. Furthermore, thalamo-frontal circuits might be crucial to sustaining top-down functions.
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Affiliation(s)
- Martin M Monti
- From the Department of Psychology (M.M.M., M.R.), University of California Los Angeles; the Department of Neurosurgery (M.M.M.), Brain Injury Research Center (BIRC), Geffen School of Medicine at UCLA, Los Angeles; the Cognition and Brain Sciences Unit (P.F.), Medical Research Council, Cambridge; the Division of Neurosurgery (P.F., E.K., J.D.P.), University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; and the Natural Science Building (A.M.O.), Brain & Mind Institute, The University of Western Ontario, London, Canada.
| | - Matthew Rosenberg
- From the Department of Psychology (M.M.M., M.R.), University of California Los Angeles; the Department of Neurosurgery (M.M.M.), Brain Injury Research Center (BIRC), Geffen School of Medicine at UCLA, Los Angeles; the Cognition and Brain Sciences Unit (P.F.), Medical Research Council, Cambridge; the Division of Neurosurgery (P.F., E.K., J.D.P.), University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; and the Natural Science Building (A.M.O.), Brain & Mind Institute, The University of Western Ontario, London, Canada
| | - Paola Finoia
- From the Department of Psychology (M.M.M., M.R.), University of California Los Angeles; the Department of Neurosurgery (M.M.M.), Brain Injury Research Center (BIRC), Geffen School of Medicine at UCLA, Los Angeles; the Cognition and Brain Sciences Unit (P.F.), Medical Research Council, Cambridge; the Division of Neurosurgery (P.F., E.K., J.D.P.), University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; and the Natural Science Building (A.M.O.), Brain & Mind Institute, The University of Western Ontario, London, Canada
| | - Evelyn Kamau
- From the Department of Psychology (M.M.M., M.R.), University of California Los Angeles; the Department of Neurosurgery (M.M.M.), Brain Injury Research Center (BIRC), Geffen School of Medicine at UCLA, Los Angeles; the Cognition and Brain Sciences Unit (P.F.), Medical Research Council, Cambridge; the Division of Neurosurgery (P.F., E.K., J.D.P.), University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; and the Natural Science Building (A.M.O.), Brain & Mind Institute, The University of Western Ontario, London, Canada
| | - John D Pickard
- From the Department of Psychology (M.M.M., M.R.), University of California Los Angeles; the Department of Neurosurgery (M.M.M.), Brain Injury Research Center (BIRC), Geffen School of Medicine at UCLA, Los Angeles; the Cognition and Brain Sciences Unit (P.F.), Medical Research Council, Cambridge; the Division of Neurosurgery (P.F., E.K., J.D.P.), University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; and the Natural Science Building (A.M.O.), Brain & Mind Institute, The University of Western Ontario, London, Canada
| | - Adrian M Owen
- From the Department of Psychology (M.M.M., M.R.), University of California Los Angeles; the Department of Neurosurgery (M.M.M.), Brain Injury Research Center (BIRC), Geffen School of Medicine at UCLA, Los Angeles; the Cognition and Brain Sciences Unit (P.F.), Medical Research Council, Cambridge; the Division of Neurosurgery (P.F., E.K., J.D.P.), University of Cambridge, Addenbrooke's Hospital, Cambridge, UK; and the Natural Science Building (A.M.O.), Brain & Mind Institute, The University of Western Ontario, London, Canada
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