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Wang X, Yang Y, Laforge G, Chen X, Norton L, Owen AM, He J, Cong F. Global Field Time-Frequency Representation-Based Discriminative Similarity Analysis of Passive Auditory ERPs for Diagnosis of Disorders of Consciousness. IEEE Trans Biomed Eng 2024; 71:1820-1830. [PMID: 38215326 DOI: 10.1109/tbme.2024.3353110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Behavioural diagnosis of patients with disorders of consciousness (DOC) is challenging and prone to inaccuracies. Consequently, there have been increased efforts to develop bedside assessment based on EEG and event-related potentials (ERPs) that are more sensitive to the neural factors supporting conscious awareness. However, individual detection of residual consciousness using these techniques is less established. Here, we hypothesize that the cross-state similarity (defined as the similarity between healthy and impaired conscious states) of passive brain responses to auditory stimuli can index the level of awareness in individual DOC patients. To this end, we introduce the global field time-frequency representation-based discriminative similarity analysis (GFTFR-DSA). This method quantifies the average cross-state similarity index between an individual patient and our constructed healthy templates using the GFTFR as an EEG feature. We demonstrate that the proposed GFTFR feature exhibits superior within-group consistency in 34 healthy controls over traditional EEG features such as temporal waveforms. Second, we observed the GFTFR-based similarity index was significantly higher in patients with a minimally conscious state (MCS, 40 patients) than those with unresponsive wakefulness syndrome (UWS, 54 patients), supporting our hypothesis. Finally, applying a linear support vector machine classifier for individual MCS/UWS classification, the model achieved a balanced accuracy and F1 score of 0.77. Overall, our findings indicate that combining discriminative and interpretable markers, along with automatic machine learning algorithms, is effective for the differential diagnosis in patients with DOC. Importantly, this approach can, in principle, be transferred into any ERP of interest to better inform DOC diagnoses.
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Nourski KV, Steinschneider M, Rhone AE, Dappen ER, Kawasaki H, Howard MA. Processing of auditory novelty in human cortex during a semantic categorization task. Hear Res 2024; 444:108972. [PMID: 38359485 PMCID: PMC10984345 DOI: 10.1016/j.heares.2024.108972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/17/2024]
Abstract
Auditory semantic novelty - a new meaningful sound in the context of a predictable acoustical environment - can probe neural circuits involved in language processing. Aberrant novelty detection is a feature of many neuropsychiatric disorders. This large-scale human intracranial electrophysiology study examined the spatial distribution of gamma and alpha power and auditory evoked potentials (AEP) associated with responses to unexpected words during performance of semantic categorization tasks. Participants were neurosurgical patients undergoing monitoring for medically intractable epilepsy. Each task included repeatedly presented monosyllabic words from different talkers ("common") and ten words presented only once ("novel"). Targets were words belonging to a specific semantic category. Novelty effects were defined as differences between neural responses to novel and common words. Novelty increased task difficulty and was associated with augmented gamma, suppressed alpha power, and AEP differences broadly distributed across the cortex. Gamma novelty effect had the highest prevalence in planum temporale, posterior superior temporal gyrus (STG) and pars triangularis of the inferior frontal gyrus; alpha in anterolateral Heschl's gyrus (HG), anterior STG and middle anterior cingulate cortex; AEP in posteromedial HG, lower bank of the superior temporal sulcus, and planum polare. Gamma novelty effect had a higher prevalence in dorsal than ventral auditory-related areas. Novelty effects were more pronounced in the left hemisphere. Better novel target detection was associated with reduced gamma novelty effect within auditory cortex and enhanced gamma effect within prefrontal and sensorimotor cortex. Alpha and AEP novelty effects were generally more prevalent in better performing participants. Multiple areas, including auditory cortex on the superior temporal plane, featured AEP novelty effect within the time frame of P3a and N400 scalp-recorded novelty-related potentials. This work provides a detailed account of auditory novelty in a paradigm that directly examined brain regions associated with semantic processing. Future studies may aid in the development of objective measures to assess the integrity of semantic novelty processing in clinical populations.
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Affiliation(s)
- Kirill V Nourski
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States; Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA 52242, United States.
| | - Mitchell Steinschneider
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States; Departments of Neurology, Neuroscience, and Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, United States
| | - Ariane E Rhone
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States
| | - Emily R Dappen
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States; Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA 52242, United States
| | - Hiroto Kawasaki
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States
| | - Matthew A Howard
- Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, United States; Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA 52242, United States; Pappajohn Biomedical Institute, The University of Iowa, Iowa City, IA 52242, United States
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Alnes SL, Bächlin LZM, Schindler K, Tzovara A. Neural complexity and the spectral slope characterise auditory processing in wakefulness and sleep. Eur J Neurosci 2024; 59:822-841. [PMID: 38100263 DOI: 10.1111/ejn.16203] [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: 03/10/2023] [Revised: 10/11/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023]
Abstract
Auditory processing and the complexity of neural activity can both indicate residual consciousness levels and differentiate states of arousal. However, how measures of neural signal complexity manifest in neural activity following environmental stimulation and, more generally, how the electrophysiological characteristics of auditory responses change in states of reduced consciousness remain under-explored. Here, we tested the hypothesis that measures of neural complexity and the spectral slope would discriminate stages of sleep and wakefulness not only in baseline electroencephalography (EEG) activity but also in EEG signals following auditory stimulation. High-density EEG was recorded in 21 participants to determine the spatial relationship between these measures and between EEG recorded pre- and post-auditory stimulation. Results showed that the complexity and the spectral slope in the 2-20 Hz range discriminated between sleep stages and had a high correlation in sleep. In wakefulness, complexity was strongly correlated to the 20-40 Hz spectral slope. Auditory stimulation resulted in reduced complexity in sleep compared to the pre-stimulation EEG activity and modulated the spectral slope in wakefulness. These findings confirm our hypothesis that electrophysiological markers of arousal are sensitive to sleep/wake states in EEG activity during baseline and following auditory stimulation. Our results have direct applications to studies using auditory stimulation to probe neural functions in states of reduced consciousness.
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Affiliation(s)
- Sigurd L Alnes
- Institute of Computer Science, University of Bern, Bern, Switzerland
- Zentrum für Experimentelle Neurologie, Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Lea Z M Bächlin
- Institute of Computer Science, University of Bern, Bern, Switzerland
| | - Kaspar Schindler
- Sleep-Wake-Epilepsy Center, NeuroTec, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Athina Tzovara
- Institute of Computer Science, University of Bern, Bern, Switzerland
- Zentrum für Experimentelle Neurologie, Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
- Sleep-Wake-Epilepsy Center, NeuroTec, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Chabert M, Dauleac C, Beaudoin-Gobert M, De-Quelen M, Ciancia S, Jacquesson T, Bertrand S, Vivier E, De-Marignan D, Jung J, Andre-Obadia N, Gobert F, Cotton F, Luauté J. Locked-in syndrome after central pontine myelinolysis, an outstanding outcome of two patients. Ann Clin Transl Neurol 2024; 11:826-836. [PMID: 38263791 DOI: 10.1002/acn3.51994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/30/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE Central pontine myelinolysis (CPM) is a rare demyelinating disease that affects the pons and which can cause extreme disabilities such as locked-in syndrome (LIS) in the initial phase. The aim of the study was to describe the evolution over a 12-month period of two patients with CPM causing an initial LIS. METHOD We retrospectively report the unexpected clinical outcome of these two patients in relation with the anatomical damages documented by brain MRI, associated with diffusion tensor imaging and reconstruction of corticospinal tracts in tractography. The following clinical parameters systematically assessed at 3, 6, 9, and 12 months: muscle testing on 12 key muscles (Medical Research Council), prehension metrics (box and block test and purdue pegboard), and independence for acts of daily living (functional independence measure). RESULTS Both patients showed a progressive recovery beginning between 2 and 3 months after the onset of symptoms, leading to almost complete autonomy at 12 months (FIM > 110), with motor strength greater than 4/5 in all joint segments (MRC > 50/60). On brain MRI with tractography, CST appeared partially preserved at pons level. INTERPRETATION The possibility of a near-complete functional recovery at 12 months is important to consider given the ethical issues at stake and the discussions about limiting care that may take place initially. It seems to be the consequence of reversible myelin damage combined with partially preserved neurons. Development of collateral pathways or resolution of conduction block may explain this recovery. MRI comprising DTI and tractography could play a key role in the prognosis of motor recovery.
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Affiliation(s)
- Maïlys Chabert
- Department of Physical Medicine and Rehabilitation, Hospices Civils de Lyon, Lyon, France
- University Lyon 1 Claude Bernard, Villeurbanne, France
| | - Corentin Dauleac
- University Lyon 1 Claude Bernard, Villeurbanne, France
- Department of Neurosurgery, Hospices Civils de Lyon, Lyon, France
- Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, Inserm U1044, INSA-Lyon, Lyon, France
| | - Maude Beaudoin-Gobert
- University Lyon 1 Claude Bernard, Villeurbanne, France
- Lyon Neurosciences Research Center, Trajectoires Team, CAP Team, Inserm UMR-S 1028, CNRS UMR 5292, Lyon, France
| | - Mélaine De-Quelen
- Department of Physical Medicine and Rehabilitation, Hospices Civils de Lyon, Lyon, France
| | - Sophie Ciancia
- Department of Physical Medicine and Rehabilitation, Hospices Civils de Lyon, Lyon, France
| | - Timothée Jacquesson
- Department of Neurosurgery, Hospices Civils de Lyon, Lyon, France
- Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, Inserm U1044, INSA-Lyon, Lyon, France
- Department of Anatomy, University of Lyon 1, Lyon, France
| | - Simon Bertrand
- Department of Physical Medicine and Rehabilitation, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Vivier
- Department of Intensive-Care, Hôpital Saint Luc Saint Joseph, Lyon, France
| | - Donatien De-Marignan
- Department of Anesthesia and Critical Care, Hospices Civils de Lyon, Lyon, France
| | - Julien Jung
- Department of Neurophysiology & Epilepsy, Hospices Civils de Lyon, Lyon, France
| | | | - Florent Gobert
- Lyon Neurosciences Research Center, Trajectoires Team, CAP Team, Inserm UMR-S 1028, CNRS UMR 5292, Lyon, France
- Department of Anesthesia and Critical Care, Hospices Civils de Lyon, Lyon, France
| | - François Cotton
- University Lyon 1 Claude Bernard, Villeurbanne, France
- Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, Inserm U1044, INSA-Lyon, Lyon, France
- Department of Radiology, Hospices Civils de Lyon, Lyon, France
| | - Jacques Luauté
- Department of Physical Medicine and Rehabilitation, Hospices Civils de Lyon, Lyon, France
- University Lyon 1 Claude Bernard, Villeurbanne, France
- Lyon Neurosciences Research Center, Trajectoires Team, CAP Team, Inserm UMR-S 1028, CNRS UMR 5292, Lyon, France
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Portell Penadés E, Alvarez V. A Comprehensive Review and Practical Guide of the Applications of Evoked Potentials in Neuroprognostication After Cardiac Arrest. Cureus 2024; 16:e57014. [PMID: 38681279 PMCID: PMC11046378 DOI: 10.7759/cureus.57014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2024] [Indexed: 05/01/2024] Open
Abstract
Cardiorespiratory arrest is a very common cause of morbidity and mortality nowadays, and many therapeutic strategies, such as induced coma or targeted temperature management, are used to reduce patient sequelae. However, these procedures can alter a patient's neurological status, making it difficult to obtain useful clinical information for the reliable estimation of neurological prognosis. Therefore, complementary investigations are conducted in the early stages after a cardiac arrest to clarify functional prognosis in comatose cardiac arrest survivors in the first few hours or days. Current practice relies on a multimodal approach, which shows its greatest potential in predicting poor functional prognosis, whereas the data and tools to identify patients with good functional prognosis remain relatively limited in comparison. Therefore, there is considerable interest in investigating alternative biological parameters and advanced imaging technique studies. Among these, somatosensory evoked potentials (SSEPs) remain one of the simplest and most reliable tools. In this article, we discuss the technical principles, advantages, limitations, and prognostic implications of SSEPs in detail. We will also review other types of evoked potentials that can provide useful information but are less commonly used in clinical practice (e.g., visual evoked potentials; short-, medium-, and long-latency auditory evoked potentials; and event-related evoked potentials, such as mismatch negativity or P300).
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Carroll EE, Der-Nigoghossian C, Alkhachroum A, Appavu B, Gilmore E, Kromm J, Rohaut B, Rosanova M, Sitt JD, Claassen J. Common Data Elements for Disorders of Consciousness: Recommendations from the Electrophysiology Working Group. Neurocrit Care 2023; 39:578-585. [PMID: 37606737 DOI: 10.1007/s12028-023-01795-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Electroencephalography (EEG) has long been recognized as an important tool in the investigation of disorders of consciousness (DoC). From inspection of the raw EEG to the implementation of quantitative EEG, and more recently in the use of perturbed EEG, it is paramount to providing accurate diagnostic and prognostic information in the care of patients with DoC. However, a nomenclature for variables that establishes a convention for naming, defining, and structuring data for clinical research variables currently is lacking. As such, the Neurocritical Care Society's Curing Coma Campaign convened nine working groups composed of experts in the field to construct common data elements (CDEs) to provide recommendations for DoC, with the main goal of facilitating data collection and standardization of reporting. This article summarizes the recommendations of the electrophysiology DoC working group. METHODS After assessing previously published pertinent CDEs, we developed new CDEs and categorized them into "disease core," "basic," "supplemental," and "exploratory." Key EEG design elements, defined as concepts that pertained to a methodological parameter relevant to the acquisition, processing, or analysis of data, were also included but were not classified as CDEs. RESULTS After identifying existing pertinent CDEs and developing novel CDEs for electrophysiology in DoC, variables were organized into a framework based on the two primary categories of resting state EEG and perturbed EEG. Using this categorical framework, two case report forms were generated by the working group. CONCLUSIONS Adherence to the recommendations outlined by the electrophysiology working group in the resting state EEG and perturbed EEG case report forms will facilitate data collection and sharing in DoC research on an international level. In turn, this will allow for more informed and reliable comparison of results across studies, facilitating further advancement in the realm of DoC research.
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Affiliation(s)
- Elizabeth E Carroll
- Department of Neurology, Columbia University Medical Center, 177 Fort Washington Avenue, MHB 8 Center, Room 300, New York, NY, 10032, USA
- NewYork-Presbyterian Hospital, New York, NY, USA
| | | | | | - Brian Appavu
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Emily Gilmore
- Divisions of Neurocritical Care and Emergency Neurology and Epilepsy, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
- Yale New Haven Hospital, New Haven, CT, USA
| | - Julie Kromm
- Departments of Critical Care Medicine and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Benjamin Rohaut
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, Centre national de la recherche scientifique, Assistance Publique-Hôpitaux de Paris, Neurosciences, Hôpital de La Pitié Salpêtrière, Paris, France
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Jacobo Diego Sitt
- Paris Brain Institute (ICM), Centre national de la recherche scientifique, Paris, France
| | - Jan Claassen
- Department of Neurology, Columbia University Medical Center, 177 Fort Washington Avenue, MHB 8 Center, Room 300, New York, NY, 10032, USA.
- NewYork-Presbyterian Hospital, New York, NY, USA.
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7
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Poublan-Couzardot A, Lecaignard F, Fucci E, Davidson RJ, Mattout J, Lutz A, Abdoun O. Time-resolved dynamic computational modeling of human EEG recordings reveals gradients of generative mechanisms for the MMN response. PLoS Comput Biol 2023; 19:e1010557. [PMID: 38091350 PMCID: PMC10752554 DOI: 10.1371/journal.pcbi.1010557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/27/2023] [Accepted: 11/20/2023] [Indexed: 12/28/2023] Open
Abstract
Despite attempts to unify the different theoretical accounts of the mismatch negativity (MMN), there is still an ongoing debate on the neurophysiological mechanisms underlying this complex brain response. On one hand, neuronal adaptation to recurrent stimuli is able to explain many of the observed properties of the MMN, such as its sensitivity to controlled experimental parameters. On the other hand, several modeling studies reported evidence in favor of Bayesian learning models for explaining the trial-to-trial dynamics of the human MMN. However, direct comparisons of these two main hypotheses are scarce, and previous modeling studies suffered from methodological limitations. Based on reports indicating spatial and temporal dissociation of physiological mechanisms within the timecourse of mismatch responses in animals, we hypothesized that different computational models would best fit different temporal phases of the human MMN. Using electroencephalographic data from two independent studies of a simple auditory oddball task (n = 82), we compared adaptation and Bayesian learning models' ability to explain the sequential dynamics of auditory deviance detection in a time-resolved fashion. We first ran simulations to evaluate the capacity of our design to dissociate the tested models and found that they were sufficiently distinguishable above a certain level of signal-to-noise ratio (SNR). In subjects with a sufficient SNR, our time-resolved approach revealed a temporal dissociation between the two model families, with high evidence for adaptation during the early MMN window (from 90 to 150-190 ms post-stimulus depending on the dataset) and for Bayesian learning later in time (170-180 ms or 200-220ms). In addition, Bayesian model averaging of fixed-parameter models within the adaptation family revealed a gradient of adaptation rates, resembling the anatomical gradient in the auditory cortical hierarchy reported in animal studies.
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Affiliation(s)
- Arnaud Poublan-Couzardot
- Cente de Recherche en Neurosciences de Lyon (CRNL), CNRS UMRS5292, INSERM U1028, Université Claude Bernard Lyon 1, Bron, France
| | - Françoise Lecaignard
- Cente de Recherche en Neurosciences de Lyon (CRNL), CNRS UMRS5292, INSERM U1028, Université Claude Bernard Lyon 1, Bron, France
| | - Enrico Fucci
- 2 Institute for Globally Distributed Open Research and Education (IGDORE), Sweden
| | - Richard J. Davidson
- Center for Healthy Minds, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Psychology, University of Wisconsin, Madison, Wisconsin, United States of America
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Psychiatry, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Jérémie Mattout
- Cente de Recherche en Neurosciences de Lyon (CRNL), CNRS UMRS5292, INSERM U1028, Université Claude Bernard Lyon 1, Bron, France
| | - Antoine Lutz
- Cente de Recherche en Neurosciences de Lyon (CRNL), CNRS UMRS5292, INSERM U1028, Université Claude Bernard Lyon 1, Bron, France
| | - Oussama Abdoun
- Cente de Recherche en Neurosciences de Lyon (CRNL), CNRS UMRS5292, INSERM U1028, Université Claude Bernard Lyon 1, Bron, France
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Vatrano M, Nemirovsky IE, Tonin P, Riganello F. Assessing Consciousness through Neurofeedback and Neuromodulation: Possibilities and Challenges. Life (Basel) 2023; 13:1675. [PMID: 37629532 PMCID: PMC10455583 DOI: 10.3390/life13081675] [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: 07/03/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023] Open
Abstract
Neurofeedback is a non-invasive therapeutic approach that has gained traction in recent years, showing promising results for various neurological and psychiatric conditions. It involves real-time monitoring of brain activity, allowing individuals to gain control over their own brainwaves and improve cognitive performance or alleviate symptoms. The use of electroencephalography (EEG), such as brain-computer interface (BCI), transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS), has been instrumental in developing neurofeedback techniques. However, the application of these tools in patients with disorders of consciousness (DoC) presents unique challenges. In this narrative review, we explore the use of neurofeedback in treating patients with DoC. More specifically, we discuss the advantages and challenges of using tools such as EEG neurofeedback, tDCS, TMS, and BCI for these conditions. Ultimately, we hope to provide the neuroscientific community with a comprehensive overview of neurofeedback and emphasize its potential therapeutic applications in severe cases of impaired consciousness levels.
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Affiliation(s)
- Martina Vatrano
- S. Anna Institute, Research in Advanced Neurorehabilitation, Via Siris, 11, 88900 Crotone, Italy;
| | - Idan Efim Nemirovsky
- Department of Physics and Astronomy, Brain and Mind Institute, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Paolo Tonin
- S. Anna Institute, Research in Advanced Neurorehabilitation, Via Siris, 11, 88900 Crotone, Italy;
| | - Francesco Riganello
- S. Anna Institute, Research in Advanced Neurorehabilitation, Via Siris, 11, 88900 Crotone, Italy;
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Laukkonen RE, Sacchet MD, Barendregt H, Devaney KJ, Chowdhury A, Slagter HA. Cessations of consciousness in meditation: Advancing a scientific understanding of nirodha samāpatti. PROGRESS IN BRAIN RESEARCH 2023; 280:61-87. [PMID: 37714573 DOI: 10.1016/bs.pbr.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Absence of consciousness can occur due to a concussion, anesthetization, intoxication, epileptic seizure, or other fainting/syncope episode caused by lack of blood flow to the brain. However, some meditation practitioners also report that it is possible to undergo a total absence of consciousness during meditation, lasting up to 7 days, and that these "cessations" can be consistently induced. One form of extended cessation (i.e., nirodha samāpatti) is thought to be different from sleep because practitioners are said to be completely impervious to external stimulation. That is, they cannot be 'woken up' from the cessation state as one might be from a dream. Cessations are also associated with the absence of any time experience or tiredness, and are said to involve a stiff rather than a relaxed body. Emergence from meditation-induced cessations is said to have profound effects on subsequent cognition and experience (e.g., resulting in a sudden sense of clarity, openness, and possibly insights). In this paper, we briefly outline the historical context for cessation events, present preliminary data from two labs, set a research agenda for their study, and provide an initial framework for understanding what meditation induced cessation may reveal about the mind and brain. We conclude by integrating these so-called nirodha and nirodha samāpatti experiences-as they are known in classical Buddhism-into current cognitive-neurocomputational and active inference frameworks of meditation.
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Affiliation(s)
- Ruben E Laukkonen
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia.
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Henk Barendregt
- Faculty of Science, Radboud University, Nijmegen, The Netherlands
| | - Kathryn J Devaney
- UC Berkeley Center for the Science of Psychedelics, Berkeley, CA, United States
| | - Avijit Chowdhury
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Heleen A Slagter
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, the Netherlands & Institute for Brain and Behavior, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Herrera-Diaz A, Boshra R, Tavakoli P, Lin CYA, Pajankar N, Bagheri E, Kolesar R, Fox-Robichaud A, Hamielec C, Reilly JP, Connolly JF. Tracking auditory mismatch negativity responses during full conscious state and coma. Front Neurol 2023; 14:1111691. [PMID: 36970526 PMCID: PMC10036371 DOI: 10.3389/fneur.2023.1111691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
The mismatch negativity (MMN) is considered the electrophysiological change-detection response of the brain, and therefore a valuable clinical tool for monitoring functional changes associated with return to consciousness after severe brain injury. Using an auditory multi-deviant oddball paradigm, we tracked auditory MMN responses in seventeen healthy controls over a 12-h period, and in three comatose patients assessed over 24 h at two time points. We investigated whether the MMN responses show fluctuations in detectability over time in full conscious awareness, or whether such fluctuations are rather a feature of coma. Three methods of analysis were utilized to determine whether the MMN and subsequent event-related potential (ERP) components could be identified: traditional visual analysis, permutation t-test, and Bayesian analysis. The results showed that the MMN responses elicited to the duration deviant-stimuli are elicited and reliably detected over the course of several hours in healthy controls, at both group and single-subject levels. Preliminary findings in three comatose patients provide further evidence that the MMN is often present in coma, varying within a single patient from easily detectable to undetectable at different times. This highlights the fact that regular and repeated assessments are extremely important when using MMN as a neurophysiological predictor of coma emergence.
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Affiliation(s)
- Adianes Herrera-Diaz
- Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, ON, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
- *Correspondence: Adianes Herrera-Diaz
| | - Rober Boshra
- Princenton Neuroscience Institute, Princeton University, Princeton, NJ, United States
| | - Paniz Tavakoli
- Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, ON, Canada
| | - Chia-Yu A. Lin
- Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, ON, Canada
| | - Netri Pajankar
- Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, ON, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Elham Bagheri
- Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, ON, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Richard Kolesar
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Alison Fox-Robichaud
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Critical Care Medicine, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Cindy Hamielec
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Critical Care Medicine, Hamilton Health Sciences, Hamilton, ON, Canada
| | - James P. Reilly
- Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, ON, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - John F. Connolly
- Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, ON, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
- VoxNeuro, Inc., Toronto, ON, Canada
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11
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Zhou L, Chen Y, Liu Z, You J, Chen S, Liu G, Yu Y, Wang J, Chen X. A predictive model for consciousness recovery of comatose patients after acute brain injury. Front Neurosci 2023; 17:1088666. [PMID: 36845443 PMCID: PMC9945265 DOI: 10.3389/fnins.2023.1088666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
Background Predicting the consciousness recovery for comatose patients with acute brain injury is an important issue. Although some efforts have been made in the study of prognostic assessment methods, it is still unclear which factors can be used to establish model to directly predict the probability of consciousness recovery. Objectives We aimed to establish a model using clinical and neuroelectrophysiological indicators to predict consciousness recovery of comatose patients after acute brain injury. Methods The clinical data of patients with acute brain injury admitted to the neurosurgical intensive care unit of Xiangya Hospital of Central South University from May 2019 to May 2022, who underwent electroencephalogram (EEG) and auditory mismatch negativity (MMN) examinations within 28 days after coma onset, were collected. The prognosis was assessed by Glasgow Outcome Scale (GOS) at 3 months after coma onset. The least absolute shrinkage and selection operator (LASSO) regression analysis was applied to select the most relevant predictors. We combined Glasgow coma scale (GCS), EEG, and absolute amplitude of MMN at Fz to develop a predictive model using binary logistic regression and then presented by a nomogram. The predictive efficiency of the model was evaluated with AUC and verified by calibration curve. The decision curve analysis (DCA) was used to evaluate the clinical utility of the prediction model. Results A total of 116 patients were enrolled for analysis, of which 60 had favorable prognosis (GOS ≥ 3). Five predictors, including GCS (OR = 13.400, P < 0.001), absolute amplitude of MMN at Fz site (FzMMNA, OR = 1.855, P = 0.038), EEG background activity (OR = 4.309, P = 0.023), EEG reactivity (OR = 4.154, P = 0.030), and sleep spindles (OR = 4.316, P = 0.031), were selected in the model by LASSO and binary logistic regression analysis. This model showed favorable predictive power, with an AUC of 0.939 (95% CI: 0.899-0.979), and calibration. The threshold probability of net benefit was between 5% and 92% in the DCA. Conclusion This predictive model for consciousness recovery in patients with acute brain injury is based on a nomogram incorporating GCS, EEG background activity, EEG reactivity, sleep spindles, and FzMMNA, which can be conveniently obtained during hospitalization. It provides a basis for care givers to make subsequent medical decisions.
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Affiliation(s)
- Liang Zhou
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Yuanyi Chen
- Central of Stomatology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ziyuan Liu
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Jia You
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Siming Chen
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Ganzhi Liu
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Yang Yu
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, Hunan, China
| | - Jian Wang
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China,*Correspondence: Jian Wang,
| | - Xin Chen
- Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China,Xin Chen,
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12
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Aellen FM, Alnes SL, Loosli F, Rossetti AO, Zubler F, De Lucia M, Tzovara A. Auditory stimulation and deep learning predict awakening from coma after cardiac arrest. Brain 2023; 146:778-788. [PMID: 36637902 PMCID: PMC9924902 DOI: 10.1093/brain/awac340] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/28/2022] [Accepted: 09/02/2022] [Indexed: 01/14/2023] Open
Abstract
Assessing the integrity of neural functions in coma after cardiac arrest remains an open challenge. Prognostication of coma outcome relies mainly on visual expert scoring of physiological signals, which is prone to subjectivity and leaves a considerable number of patients in a 'grey zone', with uncertain prognosis. Quantitative analysis of EEG responses to auditory stimuli can provide a window into neural functions in coma and information about patients' chances of awakening. However, responses to standardized auditory stimulation are far from being used in a clinical routine due to heterogeneous and cumbersome protocols. Here, we hypothesize that convolutional neural networks can assist in extracting interpretable patterns of EEG responses to auditory stimuli during the first day of coma that are predictive of patients' chances of awakening and survival at 3 months. We used convolutional neural networks (CNNs) to model single-trial EEG responses to auditory stimuli in the first day of coma, under standardized sedation and targeted temperature management, in a multicentre and multiprotocol patient cohort and predict outcome at 3 months. The use of CNNs resulted in a positive predictive power for predicting awakening of 0.83 ± 0.04 and 0.81 ± 0.06 and an area under the curve in predicting outcome of 0.69 ± 0.05 and 0.70 ± 0.05, for patients undergoing therapeutic hypothermia and normothermia, respectively. These results also persisted in a subset of patients that were in a clinical 'grey zone'. The network's confidence in predicting outcome was based on interpretable features: it strongly correlated to the neural synchrony and complexity of EEG responses and was modulated by independent clinical evaluations, such as the EEG reactivity, background burst-suppression or motor responses. Our results highlight the strong potential of interpretable deep learning algorithms in combination with auditory stimulation to improve prognostication of coma outcome.
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Affiliation(s)
- Florence M Aellen
- Correspondence to: Florence Aellen University of Bern; Institute for Computer Science Neubrückstrasse 10; CH-3012 Bern E-mail:
| | - Sigurd L Alnes
- Institute of Computer Science, University of Bern, Bern, Switzerland,Zentrum für Experimentelle Neurologie, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fabian Loosli
- Institute of Computer Science, University of Bern, Bern, Switzerland
| | - Andrea O Rossetti
- Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Frédéric Zubler
- Sleep-Wake-Epilepsy-Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marzia De Lucia
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Athina Tzovara
- Correspondence may also be addressed to: Athina Tzovara E-mail:
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13
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O'Reilly JA. Modelling mouse auditory response dynamics along a continuum of consciousness using a deep recurrent neural network. J Neural Eng 2022; 19. [DOI: 10.1088/1741-2552/ac9257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/15/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective Understanding neurophysiological changes that accompany transitions between anaesthetized and conscious states is a key objective of anesthesiology and consciousness science. This study aimed to characterize the dynamics of auditory-evoked potential morphology in mice along a continuum of consciousness. Approach Epidural field potentials were recorded from above the primary auditory cortices of two groups of laboratory mice: urethane-anaesthetized (A, n = 14) and conscious (C, n = 17). Both groups received auditory stimulation in the form of a repeated pure-tone stimulus, before and after receiving 10 mg/kg i.p. ketamine (AK and CK). Evoked responses were then ordered by ascending sample entropy into AK, A, CK, and C, considered to reflect physiological correlates of awareness. These data were used to train a recurrent neural network (RNN) with an input parameter encoding state. Model outputs were compared with grand-average event-related potential (ERP) waveforms. Subsequently, the state parameter was varied to simulate changes in the ERP that occur during transitions between states, and relationships with dominant peak amplitudes were quantified. Main results The RNN synthesized output waveforms that were in close agreement with grand-average ERPs for each group (r2 > 0.9, p < 0.0001). Varying the input state parameter generated model outputs reflecting changes in ERP morphology predicted to occur between states. Positive peak amplitudes within 25 to 50 ms, and negative peak amplitudes within 50 to 75 ms post-stimulus-onset, were found to display a sigmoidal characteristic during the transition from anaesthetized to conscious states. In contrast, negative peak amplitudes within 0 to 25 ms displayed greater linearity. Significance This study demonstrates a method for modelling changes in ERP morphology that accompany transitions between states of consciousness using a RNN. In future studies, this approach may be applied to human data to support the clinical use of ERPs to predict transition to consciousness.
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Wang J, Chen X, Zhou L, Liu ZY, Xia YG, You J, Lan S, Liu JF. Assessment of electroencephalography and event-related potentials in unresponsive patients with brain injury. Neurophysiol Clin 2022; 52:384-393. [PMID: 36008205 DOI: 10.1016/j.neucli.2022.07.007] [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: 02/11/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE To investigate the predictors of clinical outcomes in unresponsive patients with acquired brain injuries. METHODS Patients with coma or disorders of consciousness were enrolled from August 2019 to March 2021. A retrospective analysis of demographics, etiology, clinical score, diagnosis, electroencephalography (EEG), and event-related potential (ERP) data from 1 week to 2 months after coma onset was conducted. Findings were assessed for predicting favorable outcomes at 6 months post-coma, and functional outcomes were determined using the Glasgow Outcome Scale-Extended (GOS-E). RESULTS Of 68 patients, 22 patients had a good neurological outcome at 6 months, while 11 died. Univariate analysis showed that motor response (Motor-R; p < 0.001), EEG pattern (p = 0.015), sleep spindles (p = 0.018), EEG reactivity (EEG-R; p < 0.001), mismatch negativity (MMN) amplitude at electrode Fz (FzMMNA; p = 0.001), P3a latency (p = 0.044), and P3a amplitude at electrode Cz (CzP3aA; p < 0.001) were significantly correlated with patient prognosis. Multivariable logistic regression analysis showed that FzMMNA, CzP3aA, EEG-R, and Motor-R were significant independent predictors of a favorable outcome. The sensitivity and specificity of FzMMNA (dichotomized at 1.16 μV) were 86.4% and 58.5%, and of CzP3aA (cut-off value 2.76 μV) were 90.9% and 70.7%, respectively. ERP amplitude (ERP-A), a combination of FzMMNA and CzP3aA, improved prediction accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.884. A model incorporating Motor-R, EEG-R, and ERP-A yielded an outstanding predictive performance (AUC=0.921) for a favorable outcome. CONCLUSION ERP-A and the prognostic model resulted in the efficient prediction of a favorable outcome in unresponsive patients.
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Affiliation(s)
- Jian Wang
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008
| | - Xin Chen
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008
| | - Liang Zhou
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008
| | - Zi-Yuan Liu
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008
| | - Yu-Guo Xia
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008
| | - Jia You
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008
| | - Song Lan
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008
| | - Jin-Fang Liu
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, PR China, 410008.
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15
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Yelden K, James LM, Duport S, Kempny A, Farmer SF, Leff AP, Playford ED. A simple intervention for disorders of consciousness- is there a light at the end of the tunnel? Front Neurol 2022; 13:824880. [PMID: 35937075 PMCID: PMC9355643 DOI: 10.3389/fneur.2022.824880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
Sleep is a physiological state necessary for memory processing, learning and brain plasticity. Patients with disorders of consciousness (DOC) show none or minimal sign of awareness of themselves or their environment but appear to have sleep-wake cycles. The aim of our study was to assess baseline circadian rhythms and sleep in patients with DOC; to optimize circadian rhythm using an intervention combining blue light, melatonin and caffeine, and to identify the impact of this intervention on brain function using event related potentials. We evaluated baseline circadian rhythms and sleep in 17 patients with DOC with 24-h polysomnography (PSG) and 4-hourly saliva melatonin measurements for 48 h. Ten of the 17 patients (5 female, age 30–71) were then treated for 5 weeks with melatonin each night and blue light and caffeine treatment in the mornings. Behavioral assessment of arousal and awareness [Coma recovery scale-revised (CRS-R)], 24-h polysomnography and 4-hourly saliva melatonin measurements, oddball mismatch negativity (MMN) and subject's own name (SON) experiments were performed twice at baseline and following intervention. Baseline sleep was abnormal in all patients. Cosinor analysis of saliva melatonin results revealed that averaged baseline % rhythmicity was low (M: 31%, Range: 13–66.4%, SD: 18.4). However, increase in % Melatonin Rhythm following intervention was statistically significant (p = 0.012). 7 patients showed improvement of CRS-R scores with intervention and this was statistically significant (p = 0.034). All the patients who had improvement of clinical scores also had statistically significant improvement of neurophysiological responses on MMN and SON experiments at group level (p = 0.001). Our study shows that sleep and circadian rhythms are severely deranged in DOC but optimization is possible with melatonin, caffeine and blue light treatment. Clinical and physiological parameters improved with this simple and inexpensive intervention. Optimization of sleep and circadian rhythms should be integrated into rehabilitation programs for people with DOC.
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Affiliation(s)
- Kudret Yelden
- Neurological Rehabilitation, Royal Hospital for Neuro-Disability, London, United Kingdom
- Department of Neuroscience, King's College Hospital, London, United Kingdom
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- *Correspondence: Kudret Yelden
| | - Leon M. James
- Neurophysiology Department, Bupa Cromwell Hospital, London, United Kingdom
| | - Sophie Duport
- Research Department, Royal Hospital for Neuro-Disability, London, United Kingdom
| | - Agnieszka Kempny
- Research Department, Royal Hospital for Neuro-Disability, London, United Kingdom
| | - Simon F. Farmer
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- National Hospital for Neurology and Neurosurgery, University College London Hospital, London, United Kingdom
| | - Alex P. Leff
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- National Hospital for Neurology and Neurosurgery, University College London Hospital, London, United Kingdom
| | - E. Diane Playford
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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16
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Liu B, Zhang X, Li Y, Duan G, Hou J, Zhao J, Guo T, Wu D. tDCS-EEG for Predicting Outcome in Patients With Unresponsive Wakefulness Syndrome. Front Neurosci 2022; 16:771393. [PMID: 35812233 PMCID: PMC9263392 DOI: 10.3389/fnins.2022.771393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives We aimed to assess the role of transcranial direct current stimulation (tDCS) combined with electroencephalogram (EEG) for predicting prognosis in UWS cases. Methods This was a historical control study that enrolled 85 patients with UWS. The subjects were assigned to the control (without tDCS) and tDCS groups. Conventional treatments were implemented in both the control and tDCS groups, along with 40 multi-target tDCS sessions only in the tDCS group. Coma Recovery Scale-Revised (CRS-R) was applied at admission. The non-linear EEG index was evaluated after treatment. The modified Glasgow Outcome Scale (mGOS) was applied 12 months after disease onset. Results The mGOS improvement rate in the tDCS group (37.1%) was higher than the control value (22.0%). Linear regression analysis revealed that the local and remote cortical networks under unaffected pain stimulation conditions and the remote cortical network under affected pain stimulation conditions were the main relevant factors for mGOS improvement. Furthermore, the difference in prefrontal-parietal cortical network was used to examine the sensitivity of prognostic assessment in UWS patients. The results showed that prognostic sensitivity could be increased from 54.5% (control group) to 84.6% (tDCS group). Conclusions This study proposes a tDCS-EEG protocol for predicting the prognosis of UWS. With multi-target tDCS combined with EEG, the sensitivity of prognostic assessment in patients with UWS was improved. The recovery might be related to improved prefrontal-parietal cortical networks of the unaffected hemisphere.
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Affiliation(s)
- Baohu Liu
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Xu Zhang
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanyuan Li
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Guoping Duan
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Hou
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiayi Zhao
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Tongtong Guo
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Dongyu Wu
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Dongyu Wu
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O'Reilly JA, Angsuwatanakul T, Wehrman J. Decoding violated sensory expectations from the auditory cortex of anaesthetised mice: Hierarchical recurrent neural network depicts separate 'danger' and 'safety' units. Eur J Neurosci 2022; 56:4154-4175. [PMID: 35695993 PMCID: PMC9545291 DOI: 10.1111/ejn.15736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/27/2022]
Abstract
The ability to respond appropriately to sensory information received from the external environment is among the most fundamental capabilities of central nervous systems. In the auditory domain, processes underlying this behaviour are studied by measuring auditory‐evoked electrophysiology during sequences of sounds with predetermined regularities. Identifying neural correlates of ensuing auditory novelty responses is supported by research in experimental animals. In the present study, we reanalysed epidural field potential recordings from the auditory cortex of anaesthetised mice during frequency and intensity oddball stimulation. Multivariate pattern analysis (MVPA) and hierarchical recurrent neural network (RNN) modelling were adopted to explore these data with greater resolution than previously considered using conventional methods. Time‐wise and generalised temporal decoding MVPA approaches revealed previously underestimated asymmetry between responses to sound‐level transitions in the intensity oddball paradigm, in contrast with tone frequency changes. After training, the cross‐validated RNN model architecture with four hidden layers produced output waveforms in response to simulated auditory inputs that were strongly correlated with grand‐average auditory‐evoked potential waveforms (r2 > .9). Units in hidden layers were classified based on their temporal response properties and characterised using principal component analysis and sample entropy. These demonstrated spontaneous alpha rhythms, sound onset and offset responses and putative ‘safety’ and ‘danger’ units activated by relatively inconspicuous and salient changes in auditory inputs, respectively. The hypothesised existence of corresponding biological neural sources is naturally derived from this model. If proven, this could have significant implications for prevailing theories of auditory processing.
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Affiliation(s)
- Jamie A O'Reilly
- College of Biomedical Engineering, Rangsit University, Lak Hok, Thailand
| | | | - Jordan Wehrman
- Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
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Cai G, Zhuang Z, Jia K, Xu S, Wang X, Pei S, Sun M, Cui C, Guo S, Xu K, Gao Z, Kang Y. Effects of cross electro-nape-acupuncture (CENA) on recovery of consciousness and tracheotomy tube sealing in serious cerebral hemorrhage. Am J Transl Res 2022; 14:1868-1876. [PMID: 35422919 PMCID: PMC8991123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/12/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study was designed to explore the effects of cross electro-nape-acupuncture (CENA) treatment on the recovery of consciousness and tracheotomy tube sealing in patients with serious cerebral hemorrhage (SCH). METHODS A total of 60 patients with SCH admitted to the Intensive Care Unit of the South Hospital of the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from November 2020 to June 2021 were selected and randomized into two groups: the CENA group and a control group, given no acupuncture. Both groups were given the same basic treatment and patients in the CENA group were additionally given CENA treatment. Glasgow coma scale (GCS) scores, mismatch negative wave (MMN) and the cough reflex grading score (TCRGS) were recorded and compared after treatment for four weeks. The time to tracheostomy tube sealing was also recorded. RESULTS After treatment, the GCS scores and MMN latency values of the two groups were significantly improved, with significantly better GCS scores and MMN latency values in the CENA group than in the control group. After treatment, the two groups of TCRGS were reduced, with more significant decreases in the CENA group than in the control group. CONCLUSION With CENA, it took less time to achieve recovery of consciousness, improve cough reflex score and shortened the time to tracheal tube cutting and sealing in patients with SCH.
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Affiliation(s)
- Guofeng Cai
- Hanan Branch of Second Affiliated Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Zhe Zhuang
- Hanan Branch of Second Affiliated Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Kunping Jia
- Hanan Branch of Second Affiliated Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Shengnan Xu
- Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Xiuzhen Wang
- Hanan Branch of Second Affiliated Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Siying Pei
- Hanan Branch of Second Affiliated Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Manchao Sun
- Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Cheng Cui
- Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Sihui Guo
- Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Ke Xu
- Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Ziyin Gao
- Hospital of Heilongjiang University of Traditional Chinese MedicineHarbin, Heilongjiang, China
| | - Yun Kang
- Fiori Physical Examination Clinic of Tokyo Social Insurance AssociationTokyo, Japan
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Privitera AJ, Tang AC. Functional Significance of Individual Differences in P3 Network Spatial Configuration. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The amplitude and latency of the P3 component in the electroencephalogram (EEG) event-related potentials (ERPs) are among the most extensively used markers for individual differences in normal and abnormal brain functions. In contrast, individual variations in spatial topography of the temporally-defined P3 component are relatively under-explored. Development in EEG-based source imaging opened up the possibility that individual-specific spatial configuration of the neural network underlying the temporally-defined P3 component bear a novel source of information for marking an individual difference in behavioral and cognitive function. In testing this hypothesis, a hybrid method consisting of blind source separation (BSS), equivalent current dipole (ECD) modeling, and hits-vector-based analysis was applied to continuous un-epoched EEG data collected from 13 healthy human participants performing a visual color oddball task. By analyzing the spatial configuration of the network underlying the temporally-defined P3 component, hereafter referred to as the P3N, we discovered that the contribution of each constituent structure within the P3N is not uniform. Instead, frontal lobe structures have significantly more involvement than other constituent structures, as quantitatively characterized by cross-individual reliability and a within-individual contribution to the P3N. A factor analysis of the hits vector data revealed that although P3 latency and amplitude did not show significant correlations with measures of the behavioral outcomes, scores of two factors derived from the hits vectors selectively predict behavioral reaction time and response correctness. These results support the hypothesis that variations in P3 spatial configuration reflect not merely noise but individual-specific features with functional significance.
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Affiliation(s)
- Adam John Privitera
- College of Liberal Arts, Wenzhou-Kean University, Wenzhou, PR China
- Faculty of Education, The University of Hong Kong, Hong Kong, SAR, PR China
| | - Akaysha C. Tang
- Neural Dialogue Shenzhen Educational Technology, Shenzhen, PR China
- Neuroscience for Education Group, The University of Hong Kong, Hong Kong, SAR, PR China
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Ouyang G, Dien J, Lorenz R. Handling EEG artifacts and searching individually optimal experimental parameter in real time: a system development and demonstration. J Neural Eng 2022; 19. [PMID: 34902847 DOI: 10.1088/1741-2552/ac42b6] [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: 07/30/2021] [Accepted: 12/13/2021] [Indexed: 02/02/2023]
Abstract
Objective.Neuroadaptive paradigms that systematically assess event-related potential (ERP) features across many different experimental parameters have the potential to improve the generalizability of ERP findings and may help to accelerate ERP-based biomarker discovery by identifying the exact experimental conditions for which ERPs differ most for a certain clinical population. Obtaining robust and reliable ERPs online is a prerequisite for ERP-based neuroadaptive research. One of the key steps involved is to correctly isolate electroencephalography artifacts in real time because they contribute a large amount of variance that, if not removed, will greatly distort the ERP obtained. Another key factor of concern is the computational cost of the online artifact handling method. This work aims to develop and validate a cost-efficient system to support ERP-based neuroadaptive research.Approach.We developed a simple online artifact handling method, single trial PCA-based artifact removal (SPA), based on variance distribution dichotomies to distinguish between artifacts and neural activity. We then applied this method in an ERP-based neuroadaptive paradigm in which Bayesian optimization was used to search individually optimal inter-stimulus-interval (ISI) that generates ERP with the highest signal-to-noise ratio.Main results.SPA was compared to other offline and online algorithms. The results showed that SPA exhibited good performance in both computational efficiency and preservation of ERP pattern. Based on SPA, the Bayesian optimization procedure was able to quickly find individually optimal ISI.Significance.The current work presents a simple yet highly cost-efficient method that has been validated in its ability to extract ERP, preserve ERP effects, and better support ERP-based neuroadaptive paradigm.
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Affiliation(s)
- Guang Ouyang
- Faculty of Education, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Joseph Dien
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States of America
| | - Romy Lorenz
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom.,Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Psychology, Stanford University, Stanford, CA, United States of America
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21
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Malmierca MS. How the bat brain detects novel sounds (commentary on Wetekam et al., 2021). Eur J Neurosci 2022; 55:895-897. [PMID: 35075703 PMCID: PMC9304208 DOI: 10.1111/ejn.15606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Manuel S. Malmierca
- Cognitive and Auditory Neuroscience Laboratory (CANELAB), Institute of Neuroscience of Castilla y León (INCYL) University of Salamanca Salamanca Spain
- Institute for Biomedical Research of Salamanca University of Salamanca Salamanca Spain
- Department of Cell Biology and Pathology, School of Medicine University of Salamanca Salamanca Spain
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22
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Porcaro C, Nemirovsky IE, Riganello F, Mansour Z, Cerasa A, Tonin P, Stojanoski B, Soddu A. Diagnostic Developments in Differentiating Unresponsive Wakefulness Syndrome and the Minimally Conscious State. Front Neurol 2022; 12:778951. [PMID: 35095725 PMCID: PMC8793804 DOI: 10.3389/fneur.2021.778951] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022] Open
Abstract
When treating patients with a disorder of consciousness (DOC), it is essential to obtain an accurate diagnosis as soon as possible to generate individualized treatment programs. However, accurately diagnosing patients with DOCs is challenging and prone to errors when differentiating patients in a Vegetative State/Unresponsive Wakefulness Syndrome (VS/UWS) from those in a Minimally Conscious State (MCS). Upwards of ~40% of patients with a DOC can be misdiagnosed when specifically designed behavioral scales are not employed or improperly administered. To improve diagnostic accuracy for these patients, several important neuroimaging and electrophysiological technologies have been proposed. These include Positron Emission Tomography (PET), functional Magnetic Resonance Imaging (fMRI), Electroencephalography (EEG), and Transcranial Magnetic Stimulation (TMS). Here, we review the different ways in which these techniques can improve diagnostic differentiation between VS/UWS and MCS patients. We do so by referring to studies that were conducted within the last 10 years, which were extracted from the PubMed database. In total, 55 studies met our criteria (clinical diagnoses of VS/UWS from MCS as made by PET, fMRI, EEG and TMS- EEG tools) and were included in this review. By summarizing the promising results achieved in understanding and diagnosing these conditions, we aim to emphasize the need for more such tools to be incorporated in standard clinical practice, as well as the importance of data sharing to incentivize the community to meet these goals.
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Affiliation(s)
- Camillo Porcaro
- Department of Neuroscience and Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
- Institute of Cognitive Sciences and Technologies (ISTC)–National Research Council (CNR), Rome, Italy
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Camillo Porcaro ; orcid.org/0000-0003-4847-163X
| | - Idan Efim Nemirovsky
- Department of Physics and Astronomy, Brain and Mind Institute, University of Western Ontario, London, ON, Canada
| | - Francesco Riganello
- Sant'Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
| | - Zahra Mansour
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Antonio Cerasa
- Sant'Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
- Institute for Biomedical Research and Innovation (IRIB), National Research Council, Messina, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, Rende, Italy
| | - Paolo Tonin
- Sant'Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
| | - Bobby Stojanoski
- Faculty of Social Science and Humanities, University of Ontario Institute of Technology, Oshawa, ON, Canada
- Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, ON, Canada
| | - Andrea Soddu
- Department of Physics and Astronomy, Brain and Mind Institute, University of Western Ontario, London, ON, Canada
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23
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Pruvost-Robieux E, Marchi A, Martinelli I, Bouchereau E, Gavaret M. Evoked and Event-Related Potentials as Biomarkers of Consciousness State and Recovery. J Clin Neurophysiol 2022; 39:22-31. [PMID: 34474424 PMCID: PMC8715993 DOI: 10.1097/wnp.0000000000000762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
SUMMARY The definition of consciousness has been the subject of great interest for many scientists and philosophers. To better understand how evoked potentials may be identified as biomarkers of consciousness and recovery, the different theoretical models sustaining neural correlates of consciousness are reviewed. A multimodal approach can help to better predict clinical outcome in patients presenting with disorders of consciousness. Evoked potentials are inexpensive and easy-to-implement bedside examination techniques. Evoked potentials are an integral part of prognostic evaluation, particularly in cases of cognitive motor dissociation. Prognostic criteria are well established in postanoxic disorders of consciousness, especially postcardiac arrest but are less well determined in other etiologies. In the early examination, bilateral absence of N20 in disorder of consciousness patients is strongly associated with unfavorable outcome (i.e., death or unresponsive wakefulness syndrome) especially in postanoxic etiologies. This predictive value is lower in other etiologies and probably also in children. Both N20 and mismatch negativity are proven outcome predictors for acute coma. Many studies have shown that mismatch negativity and P3a are characterized by a high prognostic value for awakening, but some patients presenting unresponsive wakefulness syndrome also process a P3a. The presence of long-latency event-related potential components in response to stimuli is indicative of a better recovery. All neurophysiological data must be integrated within a multimodal approach combining repeated clinical evaluation, neuroimaging, functional imaging, biology, and neurophysiology combining passive and active paradigms.
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Affiliation(s)
- Estelle Pruvost-Robieux
- Neurophysiology Department, GHU Paris Psychiatry & Neurosciences, Sainte Anne, Paris, France
- Paris University, Paris, France
| | - Angela Marchi
- Neurophysiology Department, GHU Paris Psychiatry & Neurosciences, Sainte Anne, Paris, France
| | - Ilaria Martinelli
- Department of Neurosciences, St. Agostino-Estense Hospital, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy;
| | - Eléonore Bouchereau
- Department of Anesthesiology and intensive care, GHU Paris Psychiatry & Neurosciences, Sainte Anne, Paris, France; and
| | - Martine Gavaret
- Neurophysiology Department, GHU Paris Psychiatry & Neurosciences, Sainte Anne, Paris, France
- Paris University, Paris, France
- INSERM UMR 1266, Paris, France
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24
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Kazazian K, Norton L, Laforge G, Abdalmalak A, Gofton TE, Debicki D, Slessarev M, Hollywood S, Lawrence KS, Owen AM. Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol. Front Neurol 2021; 12:757219. [PMID: 34938260 PMCID: PMC8685572 DOI: 10.3389/fneur.2021.757219] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/10/2021] [Indexed: 12/12/2022] Open
Abstract
Multi-modal neuroimaging techniques have the potential to dramatically improve the diagnosis of the level consciousness and prognostication of neurological outcome for patients with severe brain injury in the intensive care unit (ICU). This protocol describes a study that will utilize functional Magnetic Resonance Imaging (fMRI), electroencephalography (EEG), and functional Near Infrared Spectroscopy (fNIRS) to measure and map the brain activity of acute critically ill patients. Our goal is to investigate whether these modalities can provide objective and quantifiable indicators of good neurological outcome and reliably detect conscious awareness. To this end, we will conduct a prospective longitudinal cohort study to validate the prognostic and diagnostic utility of neuroimaging techniques in the ICU. We will recruit 350 individuals from two ICUs over the course of 7 years. Participants will undergo fMRI, EEG, and fNIRS testing several times over the first 10 days of care to assess for residual cognitive function and evidence of covert awareness. Patients who regain behavioral awareness will be asked to complete web-based neurocognitive tests for 1 year, as well as return for follow up neuroimaging to determine which acute imaging features are most predictive of cognitive and functional recovery. Ultimately, multi-modal neuroimaging techniques may improve the clinical assessments of patients' level of consciousness, aid in the prediction of outcome, and facilitate efforts to find interventional methods that improve recovery and quality of life.
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Affiliation(s)
- Karnig Kazazian
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Brain and Mind Institute, Western University, London, ON, Canada
| | - Loretta Norton
- Department of Psychology, King's University College at Western University, London, ON, Canada
| | - Geoffrey Laforge
- Brain and Mind Institute, Western University, London, ON, Canada.,Department of Psychology, Western University, London, ON, Canada
| | - Androu Abdalmalak
- Brain and Mind Institute, Western University, London, ON, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Teneille E Gofton
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Derek Debicki
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Marat Slessarev
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Sarah Hollywood
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Keith St Lawrence
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Adrian M Owen
- Brain and Mind Institute, Western University, London, ON, Canada.,Department of Psychology, Western University, London, ON, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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25
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Implicit auditory perception of local and global irregularities in passive listening condition. Neuropsychologia 2021; 165:108129. [PMID: 34929262 DOI: 10.1016/j.neuropsychologia.2021.108129] [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: 07/17/2020] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
The auditory system detects differences in sounds at an implicit level, but data on this difference might not be sufficient to make explicit discrimination. The biomarkers of implicit auditory memory of ambiguous stimuli could shed light on unconscious auditory processing and implicit auditory learning. Mismatch negativity (MMN) and P3a, components of event-related potentials (ERPs) reflecting stimuli discrimination without direct attention, were previously detected in response to the local (short-term) irregularity in the auditory sequence even in an unconscious state. At the same time, P3b was elicited only in case of direct attention in response to the global (long-term) irregularity. In this study, we applied the local-global auditory paradigm to obtain possible electrophysiological signatures of implicit detection of hardly distinguishable auditory stimuli. ERPs were recorded from 20 healthy volunteers during active discrimination of deviant sounds in the old-ball sequence and passive listening of the same sounds in the sequence with local-global irregularity. The discrimination task consisted of two blocks with different deviant sounds targeted to respond. The sound discrimination accuracy was at an average of 40%, implying the difficulty of explicit sound recognition. Comparing ERPs to standard and deviant sounds, we found posterior negativity in ERP around 450-600 ms in response to targeted deviant sounds. MMN was significant only in response to non-target deviants. In the passive local-global paradigm, we observed an anterior positivity (284-412 ms), compatible with P3a, in response to a violation of local regularity. Violation of global regularity elicited an anterior negative response (228-586 ms), resembling the N400 component of ERPs. Importantly, the other indexes of auditory discrimination, such as MMN and P3b, were insignificant in ERPs to both regularity violations. The observed P3a and N400 components of ERPs may reflect prediction error signals in the implicit perception of sound patterns even if behavioral recognition was poor.
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26
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Pérez P, Madsen J, Banellis L, Türker B, Raimondo F, Perlbarg V, Valente M, Niérat MC, Puybasset L, Naccache L, Similowski T, Cruse D, Parra LC, Sitt JD. Conscious processing of narrative stimuli synchronizes heart rate between individuals. Cell Rep 2021; 36:109692. [PMID: 34525363 DOI: 10.1016/j.celrep.2021.109692] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 06/15/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022] Open
Abstract
Heart rate has natural fluctuations that are typically ascribed to autonomic function. Recent evidence suggests that conscious processing can affect the timing of the heartbeat. We hypothesized that heart rate is modulated by conscious processing and therefore dependent on attentional focus. To test this, we leverage the observation that neural processes synchronize between subjects by presenting an identical narrative stimulus. As predicted, we find significant inter-subject correlation of heart rate (ISC-HR) when subjects are presented with an auditory or audiovisual narrative. Consistent with our hypothesis, we find that ISC-HR is reduced when subjects are distracted from the narrative, and higher ISC-HR predicts better recall of the narrative. Finally, patients with disorders of consciousness have lower ISC-HR, as compared to healthy individuals. We conclude that heart rate fluctuations are partially driven by conscious processing, depend on attentional state, and may represent a simple metric to assess conscious state in unresponsive patients.
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Affiliation(s)
- Pauline Pérez
- Paris Brain Institute, ICM, 75013 Paris, France; Inserm U 1127, 75013 Paris, France; CNRS UMR 7225, 75013 Paris, France
| | - Jens Madsen
- Department of Biomedical Engineering, City College of New York, New York, NY, USA
| | - Leah Banellis
- School of Psychology, University of Birmingham, Birmingham B15 2TT, England; Centre for Human Brain Health, University of Birmingham, Birmingham B15 2TT, England
| | - Bașak Türker
- Paris Brain Institute, ICM, 75013 Paris, France; Inserm U 1127, 75013 Paris, France; CNRS UMR 7225, 75013 Paris, France
| | | | - Vincent Perlbarg
- Bioinformatics and Biostatistics Core Facility, iCONICS, IHU-A-ICM, Institut du Cerveau et de la Moelle épinière, Paris, France
| | | | - Marie-Cécile Niérat
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France
| | - Louis Puybasset
- Department of Anesthesia and Intensive Care, Pitié-Salpetrière Hospital, Paris, France; Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
| | - Lionel Naccache
- Paris Brain Institute, ICM, 75013 Paris, France; Inserm U 1127, 75013 Paris, France; CNRS UMR 7225, 75013 Paris, France; Department of Neurophysiology, Hôpital de la Pitié-Salpetrière, AP-HP, 75013 Paris, France; Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), 75013 Paris, France
| | - Damian Cruse
- School of Psychology, University of Birmingham, Birmingham B15 2TT, England; Centre for Human Brain Health, University of Birmingham, Birmingham B15 2TT, England
| | - Lucas C Parra
- Department of Biomedical Engineering, City College of New York, New York, NY, USA.
| | - Jacobo D Sitt
- Paris Brain Institute, ICM, 75013 Paris, France; Inserm U 1127, 75013 Paris, France; CNRS UMR 7225, 75013 Paris, France.
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27
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Tivadar RI, Knight RT, Tzovara A. Automatic Sensory Predictions: A Review of Predictive Mechanisms in the Brain and Their Link to Conscious Processing. Front Hum Neurosci 2021; 15:702520. [PMID: 34489663 PMCID: PMC8416526 DOI: 10.3389/fnhum.2021.702520] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/12/2021] [Indexed: 01/22/2023] Open
Abstract
The human brain has the astonishing capacity of integrating streams of sensory information from the environment and forming predictions about future events in an automatic way. Despite being initially developed for visual processing, the bulk of predictive coding research has subsequently focused on auditory processing, with the famous mismatch negativity signal as possibly the most studied signature of a surprise or prediction error (PE) signal. Auditory PEs are present during various consciousness states. Intriguingly, their presence and characteristics have been linked with residual levels of consciousness and return of awareness. In this review we first give an overview of the neural substrates of predictive processes in the auditory modality and their relation to consciousness. Then, we focus on different states of consciousness - wakefulness, sleep, anesthesia, coma, meditation, and hypnosis - and on what mysteries predictive processing has been able to disclose about brain functioning in such states. We review studies investigating how the neural signatures of auditory predictions are modulated by states of reduced or lacking consciousness. As a future outlook, we propose the combination of electrophysiological and computational techniques that will allow investigation of which facets of sensory predictive processes are maintained when consciousness fades away.
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Affiliation(s)
| | - Robert T. Knight
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Athina Tzovara
- Institute of Computer Science, University of Bern, Bern, Switzerland
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
- Sleep-Wake Epilepsy Center | NeuroTec, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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28
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The posterior auditory field is the chief generator of prediction error signals in the auditory cortex. Neuroimage 2021; 242:118446. [PMID: 34352393 DOI: 10.1016/j.neuroimage.2021.118446] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 01/13/2023] Open
Abstract
The auditory cortex (AC) encompasses distinct fields subserving partly different aspects of sound processing. One essential function of the AC is the detection of unpredicted sounds, as revealed by differential neural activity to predictable and unpredictable sounds. According to the predictive coding framework, this effect can be explained by repetition suppression and/or prediction error signaling. The present study investigates functional specialization of the rat AC fields in repetition suppression and prediction error by combining a tone frequency oddball paradigm (involving high-probable standard and low-probable deviant tones) with two different control sequences (many-standards and cascade). Tones in the control sequences were comparable to deviant events with respect to neural adaptation but were not violating a regularity. Therefore, a difference in the neural activity between deviant and control tones indicates a prediction error effect, whereas a difference between control and standard tones indicates a repetition suppression effect. Single-unit recordings revealed by far the largest prediction error effects for the posterior auditory field, while the primary auditory cortex, the anterior auditory field, the ventral auditory field, and the suprarhinal auditory field were dominated by repetition suppression effects. Statistically significant repetition suppression effects occurred in all AC fields, whereas prediction error effects were less robust in the primary auditory cortex and the anterior auditory field. Results indicate that the non-lemniscal, posterior auditory field is more engaged in context-dependent processing underlying deviance-detection than the other AC fields, which are more sensitive to stimulus-dependent effects underlying differential degrees of neural adaptation.
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29
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Liu Y, Huang H, Su Y, Wang M, Zhang Y, Chen W, Liu G, Jiang M. The Combination of N60 with Mismatch Negativity Improves the Prediction of Awakening from Coma. Neurocrit Care 2021; 36:727-737. [PMID: 34291392 DOI: 10.1007/s12028-021-01308-y] [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] [Received: 08/20/2020] [Accepted: 06/18/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Our objective was to evaluate the use of event-related potentials and the middle-latency somatosensory evoked potential (MLSEP) for the prediction of awakening in coma, determine the evaluation day that evoked potentials (EPs) best predict an awakening outcome, and determine whether the mismatch negativity (MMN) combined with the MLSEP, when recorded at 7 days after coma, improved the prediction of awakening from coma. METHODS Design prospective blinded cohort study. Setting neurointensive care unit of a university hospital. Patients 113 consecutive patients who were severely comatose, whose etiologies of coma included stroke (65 patients), hypoxic-ischemic encephalopathy (28 patients), intracranial infection (6 patients), and other (14 patients). Interventions none. Measurements we gathered Glasgow Coma Scale scores and recorded EPs for all patients who were comatose at 7, 14, and 30 days after coma onset, unless the patients returned to consciousness. The EPs examined included the MLSEP, the middle-latency auditory evoked potential, the N100, and the MMN. With telephone follow-up after 3 months, the patients were classified as awakening or nonawakening according to Glasgow Outcome Scale. RESULTS When predicting an awakening outcome, at least the unilateral presence of the N60 had the highest sensitivity (82.7%), whereas the presence of the MMN showed the highest specificity (82.0%). The area under the receiver operating characteristic curve for the EPs were high at 7 days after coma onset. At 7 days after coma onset, the combination of the N60 and MMN offered good predictive performance for awakening (area under the receiver operating characteristic curve = 0.852, 95% confidence interval 0.765-0.940), with increased sensitivity (70.0%) and improved specificity (91.7%). CONCLUSIONS The N60 and MMN were the strongest prognostic factors for an awakening outcome. Furthermore, at 7 days after coma onset, the combination of the N60 and MMN improved the prediction of an awakening outcome in patients who were comatose.
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Affiliation(s)
- Yifei Liu
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Huijin Huang
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yingying Su
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Miao Wang
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Zhang
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weibi Chen
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Gang Liu
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Mengdi Jiang
- Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, China
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30
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Bednaya E, Pavani F, Ricciardi E, Pietrini P, Bottari D. Oscillatory signatures of Repetition Suppression and Novelty Detection reveal altered induced visual responses in early deafness. Cortex 2021; 142:138-153. [PMID: 34265736 DOI: 10.1016/j.cortex.2021.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 04/01/2021] [Accepted: 05/17/2021] [Indexed: 12/26/2022]
Abstract
The ability to differentiate between repeated and novel events represents a fundamental property of the visual system. Neural responses are typically reduced upon stimulus repetition, a phenomenon called Repetition Suppression (RS). On the contrary, following a novel visual stimulus, the neural response is generally enhanced, a phenomenon referred to as Novelty Detection (ND). Here, we aimed to investigate the impact of early deafness on the oscillatory signatures of RS and ND brain responses. To this aim, electrophysiological data were acquired in early deaf and hearing control individuals during processing of repeated and novel visual events unattended by participants. By studying evoked and induced oscillatory brain activities, as well as inter-trial phase coherence, we linked response modulations to feedback and/or feedforward processes. Results revealed selective experience-dependent changes on both RS and ND mechanisms. Compared to hearing controls, early deaf individuals displayed: (i) greater attenuation of the response following stimulus repetition, selectively in the induced theta-band (4-7 Hz); (ii) reduced desynchronization following the onset of novel visual stimuli, in the induced alpha and beta bands (8-12 and 13-25 Hz); (iii) comparable modulation of evoked responses and inter-trial phase coherence. The selectivity of the effects in the induced responses parallels findings observed in the auditory cortex of deaf animal models following intracochlear electric stimulation. The present results support the idea that early deafness alters induced oscillatory activity and the functional tuning of basic visual processing.
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Affiliation(s)
- Evgenia Bednaya
- Molecular Mind Laboratory, IMT School for Advanced Studies Lucca, Italy
| | - Francesco Pavani
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Italy; Department of Psychology and Cognitive Science, University of Trento, Italy
| | | | - Pietro Pietrini
- Molecular Mind Laboratory, IMT School for Advanced Studies Lucca, Italy
| | - Davide Bottari
- Molecular Mind Laboratory, IMT School for Advanced Studies Lucca, Italy.
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31
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From many to (n)one: Meditation and the plasticity of the predictive mind. Neurosci Biobehav Rev 2021; 128:199-217. [PMID: 34139248 DOI: 10.1016/j.neubiorev.2021.06.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/21/2022]
Abstract
How profoundly can humans change their own minds? In this paper we offer a unifying account of deconstructive meditation under the predictive processing view. We start from simple axioms. First, the brain makes predictions based on past experience, both phylogenetic and ontogenetic. Second, deconstructive meditation brings one closer to the here and now by disengaging anticipatory processes. We propose that practicing meditation therefore gradually reduces counterfactual temporally deep cognition, until all conceptual processing falls away, unveiling a state of pure awareness. Our account also places three main styles of meditation (focused attention, open monitoring, and non-dual) on a single continuum, where each technique relinquishes increasingly engrained habits of prediction, including the predicted self. This deconstruction can also permit certain insights by making the above processes available to introspection. Our framework is consistent with the state of empirical and (neuro)phenomenological evidence and illuminates the top-down plasticity of the predictive mind. Experimental rigor, neurophenomenology, and no-report paradigms are needed to further understanding of how meditation affects predictive processing and the self.
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32
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Cappotto D, Auksztulewicz R, Kang H, Poeppel D, Melloni L, Schnupp J. Decoding the Content of Auditory Sensory Memory Across Species. Cereb Cortex 2021; 31:3226-3236. [PMID: 33625488 DOI: 10.1093/cercor/bhab002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/08/2020] [Accepted: 01/03/2021] [Indexed: 02/06/2023] Open
Abstract
In contrast to classical views of working memory (WM) maintenance, recent research investigating activity-silent neural states has demonstrated that persistent neural activity in sensory cortices is not necessary for active maintenance of information in WM. Previous studies in humans have measured putative memory representations indirectly, by decoding memory contents from neural activity evoked by a neutral impulse stimulus. However, it is unclear whether memory contents can also be decoded in different species and attentional conditions. Here, we employ a cross-species approach to test whether auditory memory contents can be decoded from electrophysiological signals recorded in different species. Awake human volunteers (N = 21) were exposed to auditory pure tone and noise burst stimuli during an auditory sensory memory task using electroencephalography. In a closely matching paradigm, anesthetized female rats (N = 5) were exposed to comparable stimuli while neural activity was recorded using electrocorticography from the auditory cortex. In both species, the acoustic frequency could be decoded from neural activity evoked by pure tones as well as neutral frozen noise burst stimuli. This finding demonstrates that memory contents can be decoded in different species and different states using homologous methods, suggesting that the mechanisms of sensory memory encoding are evolutionarily conserved across species.
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Affiliation(s)
- Drew Cappotto
- Department of Neuroscience, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Ryszard Auksztulewicz
- Department of Neuroscience, City University of Hong Kong, Kowloon Tong, Hong Kong.,Department of Neuroscience, Max Planck Institute for Empirical Aesthetics, 60322 Frankfurt am Main, Germany
| | - HiJee Kang
- Department of Neuroscience, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - David Poeppel
- Department of Neuroscience, Max Planck Institute for Empirical Aesthetics, 60322 Frankfurt am Main, Germany
| | - Lucia Melloni
- Department of Neuroscience, Max Planck Institute for Empirical Aesthetics, 60322 Frankfurt am Main, Germany
| | - Jan Schnupp
- Department of Neuroscience, City University of Hong Kong, Kowloon Tong, Hong Kong
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Zhou L, Wang J, Wu Y, Liu ZY, Yu Y, Liu JF, Chen X. Clinical significance of mismatch negativity in predicting the awakening of comatose patients after severe brain injury. J Neurophysiol 2021; 126:140-147. [PMID: 34038175 DOI: 10.1152/jn.00658.2020] [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: 11/22/2022] Open
Abstract
We assessed the clinical significance of mismatch negativity (MMN) in predicting the awakening of comatose patients with severe brain injury. The clinical data of patients with severe brain injury, admitted to the neurosurgical intensive care unit of Xiangya Hospital of Central South University from July 2018 to March 2020, who underwent auditory MMN examinations within 28 days after coma onset, were reviewed. Correlations between clinical factors and prognosis [Glasgow Outcome Scale (GCS) for 3 mo] were analyzed. Fifty-three patients were included; 37 (69.8%) had favorable outcomes. A univariate analysis revealed the Glasgow Coma Scale (GCS) and absolute MMN amplitudes at electrodes Fz and Cz were significantly correlated with prognosis. Only GCS scores and MMN amplitude at Fz were independent predictors in multivariate logistic regression analysis (area under the curve 0.744 vs. 0.753, respectively); both combined, improved accuracy to 84.6%. MMN amplitudes at Fz were dichotomized at a value of 1.08 μV with a sensitivity and specificity of 81.1% and 68.7%, respectively, for predicting comatose patients' awakening. In conclusion, MMN amplitude at Fz is a reliable prognostic indicator for comatose patients with severe brain injury; the prediction value improved when combined with GCS. Thus, an event-related potential component with a clear site and cutoff value may support prognostication in severe brain injury.NEW & NOTEWORTHY Mismatch negativity (MMN) can assess the prognosis of comatose patients after severe brain injury, especially for MMN amplitude. In addition, MMN analysis at electrode Fz best predicts recovery of consciousness in patients with severe brain injury. Importantly, a quantitative approach (cutoff value of 1.08 μV) may improve the use of MMN for prognostication.
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Affiliation(s)
- Liang Zhou
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha, Hunan Province, China
| | - Jian Wang
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha, Hunan Province, China
| | - Yun Wu
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha, Hunan Province, China
| | - Zi-Yuan Liu
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha, Hunan Province, China
| | - Yang Yu
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, Hunan Province, China
| | - Jin-Fang Liu
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha, Hunan Province, China
| | - Xin Chen
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha, Hunan Province, China
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Liu B, Zhang X, Wang L, Li Y, Hou J, Duan G, Guo T, Wu D. Outcome Prediction in Unresponsive Wakefulness Syndrome and Minimally Conscious State by Non-linear Dynamic Analysis of the EEG. Front Neurol 2021; 12:510424. [PMID: 33692735 PMCID: PMC7937604 DOI: 10.3389/fneur.2021.510424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives: This study aimed to investigate the role of non-linear dynamic analysis (NDA) of the electroencephalogram (EEG) in predicting patient outcome in unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS). Methods: This was a prospective longitudinal cohort study. A total of 98 and 64 UWS and MCS cases, respectively, were assessed. During admission, EEGs were acquired under eyes-closed and pain stimulation conditions. EEG nonlinear indices, including approximate entropy (ApEn) and cross-ApEn, were calculated. The modified Glasgow Outcome Scale (mGOS) was employed to assess functional prognosis 1 year following brain injury. Results: The mGOS scores were improved in 25 (26%) patients with UWS and 42 (66%) with MCS. Under the painful stimulation condition, both non-linear indices were lower in patients with UWS than in those with MCS. The frontal region, periphery of the primary sensory area (S1), and forebrain structure might be the key points modulating disorders of consciousness. The affected local cortical networks connected to S1 and unaffected distant cortical networks connecting S1 to the prefrontal area played important roles in mGOS score improvement. Conclusions: NDA provides an objective assessment of cortical excitability and interconnections of residual cortical functional islands. The impaired interconnection of the residual cortical functional island meant a poorer prognosis. The activation in the affected periphery of the S1 and the increase in the interconnection of affected local cortical areas around the S1 and unaffected S1 to the prefrontal and temporal areas meant a relatively favorable prognosis.
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Affiliation(s)
- Baohu Liu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xu Zhang
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lijia Wang
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Yuanyuan Li
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Hou
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guoping Duan
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tongtong Guo
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Dongyu Wu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Meiron O, Barron J, David J, Jaul E. Neural reactivity parameters of awareness predetermine one-year survival in patients with disorders of consciousness. Brain Inj 2021; 35:453-459. [PMID: 33599140 DOI: 10.1080/02699052.2021.1879398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: The current investigation evaluated the sensitivity of neural-reactivity markers of awareness versus standard clinical assessments in predicting 1-year survival in nonresponsive-awake patients with disorders of consciousness (DOC).Methods: Pre-attentive auditory mismatch-negativity (MMN) event-related potentials (ERP's), globally induced electroencephalography (EEG) spectral power following verbal command, and clinical parameters were assessed. The study included 10 patients with DOC with mixed etiology and 10 healthy controls (HC) at baseline. The clinical status of patients with DOC was reassessed after 1 year.Results: Unlike baseline clinical assessment scores, baseline MMN amplitudes of non-survivors and induced theta-power following verbal-command clearly distinguished the non-surviving patients versus surviving patients. Baseline MMN peak-amplitude latencies in survivors with DOC were significantly related to clinical outcome over a 1-year period.Conclusion: Current findings underscore the increased sensitivity of EEG-reactivity markers of awareness versus standard clinical scores in predicting 1-year clinical outcome and survival in patients with DOC. Further longitudinal research in larger DOC samples is needed to confirm the prognostic-reliability, and validity of neural reactivity parameters of awareness in patients with DOC. Current finding may have implications for clinical care and medical-legal decisions in unresponsive-awake patients, and could assist clinicians to predict their survival up to 1 year from admission.
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Affiliation(s)
- Oded Meiron
- Electrophysiology and Neurocognition Lab, Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel
| | - Jeremy Barron
- Electrophysiology and Neurocognition Lab, Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel.,Herzog Medical Center, Ventilator Care Department, Jerusalem, Israel.,Johns Hopkins University, Division of Geriatric Medicine, Baltimore, MD, USA
| | - Jonathan David
- Electrophysiology and Neurocognition Lab, Clinical Research Center for Brain Sciences, Herzog Medical Center, Jerusalem, Israel
| | - Efraim Jaul
- Johns Hopkins University, Division of Geriatric Medicine, Baltimore, MD, USA.,Herzog Medical Center, Geriatric Skilled Nursing Department, Jerusalem, Israel.,School of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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36
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Friston KJ, Sajid N, Quiroga-Martinez DR, Parr T, Price CJ, Holmes E. Active listening. Hear Res 2021; 399:107998. [PMID: 32732017 PMCID: PMC7812378 DOI: 10.1016/j.heares.2020.107998] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/27/2022]
Abstract
This paper introduces active listening, as a unified framework for synthesising and recognising speech. The notion of active listening inherits from active inference, which considers perception and action under one universal imperative: to maximise the evidence for our (generative) models of the world. First, we describe a generative model of spoken words that simulates (i) how discrete lexical, prosodic, and speaker attributes give rise to continuous acoustic signals; and conversely (ii) how continuous acoustic signals are recognised as words. The 'active' aspect involves (covertly) segmenting spoken sentences and borrows ideas from active vision. It casts speech segmentation as the selection of internal actions, corresponding to the placement of word boundaries. Practically, word boundaries are selected that maximise the evidence for an internal model of how individual words are generated. We establish face validity by simulating speech recognition and showing how the inferred content of a sentence depends on prior beliefs and background noise. Finally, we consider predictive validity by associating neuronal or physiological responses, such as the mismatch negativity and P300, with belief updating under active listening, which is greatest in the absence of accurate prior beliefs about what will be heard next.
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Affiliation(s)
- Karl J Friston
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK.
| | - Noor Sajid
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK.
| | | | - Thomas Parr
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK.
| | - Cathy J Price
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK.
| | - Emma Holmes
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK.
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37
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Campanella S, Arikan K, Babiloni C, Balconi M, Bertollo M, Betti V, Bianchi L, Brunovsky M, Buttinelli C, Comani S, Di Lorenzo G, Dumalin D, Escera C, Fallgatter A, Fisher D, Giordano GM, Guntekin B, Imperatori C, Ishii R, Kajosch H, Kiang M, López-Caneda E, Missonnier P, Mucci A, Olbrich S, Otte G, Perrottelli A, Pizzuti A, Pinal D, Salisbury D, Tang Y, Tisei P, Wang J, Winkler I, Yuan J, Pogarell O. Special Report on the Impact of the COVID-19 Pandemic on Clinical EEG and Research and Consensus Recommendations for the Safe Use of EEG. Clin EEG Neurosci 2021; 52:3-28. [PMID: 32975150 PMCID: PMC8121213 DOI: 10.1177/1550059420954054] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The global COVID-19 pandemic has affected the economy, daily life, and mental/physical health. The latter includes the use of electroencephalography (EEG) in clinical practice and research. We report a survey of the impact of COVID-19 on the use of clinical EEG in practice and research in several countries, and the recommendations of an international panel of experts for the safe application of EEG during and after this pandemic. METHODS Fifteen clinicians from 8 different countries and 25 researchers from 13 different countries reported the impact of COVID-19 on their EEG activities, the procedures implemented in response to the COVID-19 pandemic, and precautions planned or already implemented during the reopening of EEG activities. RESULTS Of the 15 clinical centers responding, 11 reported a total stoppage of all EEG activities, while 4 reduced the number of tests per day. In research settings, all 25 laboratories reported a complete stoppage of activity, with 7 laboratories reopening to some extent since initial closure. In both settings, recommended precautions for restarting or continuing EEG recording included strict hygienic rules, social distance, and assessment for infection symptoms among staff and patients/participants. CONCLUSIONS The COVID-19 pandemic interfered with the use of EEG recordings in clinical practice and even more in clinical research. We suggest updated best practices to allow safe EEG recordings in both research and clinical settings. The continued use of EEG is important in those with psychiatric diseases, particularly in times of social alarm such as the COVID-19 pandemic.
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Affiliation(s)
- Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Kemal Arikan
- Kemal Arıkan Psychiatry Clinic, Istanbul, Turkey
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Italy.,San Raffaele Cassino, Cassino (FR), Italy
| | - Michela Balconi
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Maurizio Bertollo
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Viviana Betti
- Department of Psychology, Sapienza University of Rome, Fondazione Santa Lucia, Rome, Italy
| | - Luigi Bianchi
- Dipartimento di Ingegneria Civile e Ingegneria Informatica (DICII), University of Rome Tor Vergata, Rome, Italy
| | - Martin Brunovsky
- National Institute of Mental Health, Klecany Czech Republic.,Third Medical Faculty, Charles University, Prague, Czech Republic
| | - Carla Buttinelli
- Department of Neurosciences, Public Health and Sense Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Silvia Comani
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Chair of Psychiatry, Department of Systems Medicine, School of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Daniel Dumalin
- AZ Sint-Jan Brugge-Oostende AV, Campus Henri Serruys, Lab of Neurophysiology, Department Neurology-Psychiatry, Ostend, Belgium
| | - Carles Escera
- Brainlab-Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Andreas Fallgatter
- Department of Psychiatry, University of Tübingen, Germany; LEAD Graduate School and Training Center, Tübingen, Germany.,German Center for Neurodegenerative Diseases DZNE, Tübingen, Germany
| | - Derek Fisher
- Department of Psychology, Mount Saint Vincent University, and Department of Psychiatry, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | | | - Bahar Guntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Ryouhei Ishii
- Department of Psychiatry Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hendrik Kajosch
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Michael Kiang
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Eduardo López-Caneda
- Psychological Neuroscience Laboratory, Center for Research in Psychology, School of Psychology, University of Minho, Braga, Portugal
| | - Pascal Missonnier
- Mental Health Network Fribourg (RFSM), Sector of Psychiatry and Psychotherapy for Adults, Marsens, Switzerland
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Sebastian Olbrich
- Psychotherapy and Psychosomatics, Department for Psychiatry, University Hospital Zurich, Zurich, Switzerland
| | | | - Andrea Perrottelli
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandra Pizzuti
- Department of Psychology, Sapienza University of Rome, Fondazione Santa Lucia, Rome, Italy
| | - Diego Pinal
- Psychological Neuroscience Laboratory, Center for Research in Psychology, School of Psychology, University of Minho, Braga, Portugal
| | - Dean Salisbury
- Clinical Neurophysiology Research Laboratory, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Paolo Tisei
- Department of Neurosciences, Public Health and Sense Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Istvan Winkler
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Jiajin Yuan
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Casado-Román L, Carbajal GV, Pérez-González D, Malmierca MS. Prediction error signaling explains neuronal mismatch responses in the medial prefrontal cortex. PLoS Biol 2020; 18:e3001019. [PMID: 33347436 PMCID: PMC7785337 DOI: 10.1371/journal.pbio.3001019] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 01/05/2021] [Accepted: 12/03/2020] [Indexed: 02/06/2023] Open
Abstract
The mismatch negativity (MMN) is a key biomarker of automatic deviance detection thought to emerge from 2 cortical sources. First, the auditory cortex (AC) encodes spectral regularities and reports frequency-specific deviances. Then, more abstract representations in the prefrontal cortex (PFC) allow to detect contextual changes of potential behavioral relevance. However, the precise location and time asynchronies between neuronal correlates underlying this frontotemporal network remain unclear and elusive. Our study presented auditory oddball paradigms along with "no-repetition" controls to record mismatch responses in neuronal spiking activity and local field potentials at the rat medial PFC. Whereas mismatch responses in the auditory system are mainly induced by stimulus-dependent effects, we found that auditory responsiveness in the PFC was driven by unpredictability, yielding context-dependent, comparatively delayed, more robust and longer-lasting mismatch responses mostly comprised of prediction error signaling activity. This characteristically different composition discarded that mismatch responses in the PFC could be simply inherited or amplified downstream from the auditory system. Conversely, it is more plausible for the PFC to exert top-down influences on the AC, since the PFC exhibited flexible and potent predictive processing, capable of suppressing redundant input more efficiently than the AC. Remarkably, the time course of the mismatch responses we observed in the spiking activity and local field potentials of the AC and the PFC combined coincided with the time course of the large-scale MMN-like signals reported in the rat brain, thereby linking the microscopic, mesoscopic, and macroscopic levels of automatic deviance detection.
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Affiliation(s)
- Lorena Casado-Román
- Cognitive and Auditory Neuroscience Laboratory (CANELAB), Institute of Neuroscience of Castilla y León (INCYL), Salamanca, Spain
- Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Guillermo V. Carbajal
- Cognitive and Auditory Neuroscience Laboratory (CANELAB), Institute of Neuroscience of Castilla y León (INCYL), Salamanca, Spain
- Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - David Pérez-González
- Cognitive and Auditory Neuroscience Laboratory (CANELAB), Institute of Neuroscience of Castilla y León (INCYL), Salamanca, Spain
- Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Manuel S. Malmierca
- Cognitive and Auditory Neuroscience Laboratory (CANELAB), Institute of Neuroscience of Castilla y León (INCYL), Salamanca, Spain
- Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Department of Biology and Pathology, Faculty of Medicine, University of Salamanca, Salamanca, Spain
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Subjective visibility report is facilitated by conscious predictions only. Conscious Cogn 2020; 87:103048. [PMID: 33262026 DOI: 10.1016/j.concog.2020.103048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/05/2020] [Accepted: 11/04/2020] [Indexed: 11/21/2022]
Abstract
Predictions in the visual domain have been shown to modulate conscious access. Yet, little is known about how predictions may do so and to what extent they need to be consciously implemented to be effective. To address this, we administered an attentional blink (AB) task in which target 1 (T1) identity predicted target 2 (T2) identity, while participants rated their perceptual awareness of validly versus invalidly predicted T2s (Experiment 1 & 2) or reported T2 identity (Experiment 3). Critically, we tested the effects of conscious and non-conscious predictions, after seen and unseen T1s, on T2 visibility. We found that valid predictions increased subjective visibility reports and discrimination of T2s, but only when predictions were generated by a consciously accessed T1, irrespective of the timing at which the effects were measured (short vs. longs lags). These results further our understanding of the intricate relationship between predictive processing and consciousness.
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40
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Duclos C, Norton L, Laforge G, Frantz A, Maschke C, Badawy M, Letourneau J, Slessarev M, Gofton T, Debicki D, Owen AM, Blain-Moraes S. Protocol for the Prognostication of Consciousness Recovery Following a Brain Injury. Front Hum Neurosci 2020; 14:582125. [PMID: 33281582 PMCID: PMC7690215 DOI: 10.3389/fnhum.2020.582125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/20/2020] [Indexed: 11/13/2022] Open
Abstract
Individuals who have suffered a severe brain injury typically require extensive hospitalization in intensive care units (ICUs), where critical treatment decisions are made to maximize their likelihood of recovering consciousness and cognitive function. These treatment decisions can be difficult when the neurological assessment of the patient is limited by unreliable behavioral responses. Reliable objective and quantifiable markers are lacking and there is both (1) a poor understanding of the mechanisms underlying the brain's ability to reconstitute consciousness and cognition after an injury and (2) the absence of a reliable and clinically feasible method of tracking cognitive recovery in ICU survivors. Our goal is to develop and validate a clinically relevant EEG paradigm that can inform the prognosis of unresponsive, brain-injured patients in the ICU. This protocol describes a study to develop a point-of-care system intended to accurately predict outcomes of unresponsive, brain-injured patients in the ICU. We will recruit 200 continuously-sedated brain-injured patients across five ICUs. Between 24 h and 7 days post-ICU admission, high-density EEG will be recorded from behaviorally unresponsive patients before, during and after a brief cessation of pharmacological sedation. Once patients have reached the waking stage, they will be asked to complete an abridged Cambridge Brain Sciences battery, a web-based series of neurocognitive tests. The test series will be repeated every day during acute admission (ICU, ward), or as often as possible given the constraints of ICU and ward care. Following discharge, patients will continue to complete the same test series on weekly, and then monthly basis, for up to 12 months following injury. Functional outcomes will also be assessed up to 12 months post-injury. We anticipate our findings will lead to an increased ability to identify patients, as soon as possible after their brain injury, who are most likely to survive, and to make accurate predictions about their long-term cognitive and functional outcome. In addition to providing critically needed support for clinical decision-making, this study has the potential to transform our understanding of key functional EEG networks associated with consciousness and cognition.
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Affiliation(s)
- Catherine Duclos
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Loretta Norton
- Department of Psychology, King’s University College at Western University, London, ON, Canada
- The Brain and Mind Institute, Western University, London, ON, Canada
| | - Geoffrey Laforge
- The Brain and Mind Institute, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Allison Frantz
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Charlotte Maschke
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Mohamed Badawy
- Department of Anesthesia, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Division of Neurocritical Care, McGill University Health Center, Montreal, QC, Canada
- Montreal Neurological Hospital, McGill University Health Center, Montreal, QC, Canada
| | - Justin Letourneau
- Department of Anesthesia, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Division of Neurocritical Care, McGill University Health Center, Montreal, QC, Canada
- Montreal Neurological Hospital, McGill University Health Center, Montreal, QC, Canada
| | - Marat Slessarev
- The Brain and Mind Institute, Western University, London, ON, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Teneille Gofton
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Derek Debicki
- The Brain and Mind Institute, Western University, London, ON, Canada
- Neurocritical Care Program, Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Adrian M. Owen
- The Brain and Mind Institute, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
- Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - Stefanie Blain-Moraes
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
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41
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Ruiter KI, Boshra R, DeMatteo C, Noseworthy M, Connolly JF. Neurophysiological markers of cognitive deficits and recovery in concussed adolescents. Brain Res 2020; 1746:146998. [PMID: 32574566 DOI: 10.1016/j.brainres.2020.146998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The present study sought to determine: 1) whether concussed adolescents exhibited deficits in neurocognitive functioning as reflected by neurophysiological alterations; 2) if neurophysiological alterations could be linked to supplementary data such as the number of previous concussions and days since injury; and 3) if deficits in psychological health and behavioural tests increased during diagnosis duration. METHODS Twenty-six concussed adolescents were compared to twenty-eight healthy controls with no prior concussions. Self-report inventories evaluated depressive and concussive symptomatology, while behavioral tests evaluated cognitive ability qualitatively. To assess neurophysiological markers of cognitive function, two separate auditory oddball tasks were employed: 1) an active oddball task measuring executive control and attention as reflected by the N2b and P300, respectively; and 2) a passive oddball task assessing the early, automatic pre-conscious awareness processes as reflected by the MMN. RESULTS Concussed adolescents displayed delayed N2b and attenuated P300 responses relative to controls; showed elevated levels of depressive and concussive symptomatology; scored average-to- low-average in behavioral tests; and exhibited N2b response latencies that correlated with number of days since injury. CONCLUSION These findings demonstrate that concussed adolescents exhibit clear deficiencies in neurocognitive function, and that N2b response latency may be a marker of concussion recovery.
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Affiliation(s)
- Kyle I Ruiter
- McMaster University - ARiEAL Research Centre, L.R. Wilson Hall, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4M2, Canada; McMaster University - Department of Linguistics and Languages, Canada.
| | - Rober Boshra
- McMaster University - ARiEAL Research Centre, L.R. Wilson Hall, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4M2, Canada; McMaster University - School of Biomedical Engineering, McMaster University, ETB-406, 1280 Main St., West, Hamilton, ON L8S 4K1, Canada; MaRS Centre - Vector Institute, Canada.
| | - Carol DeMatteo
- McMaster University - School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Institute of Applied Health Sciences, Room 403, 1400 Main St. W., Hamilton, ON L8S 1C7, Canada.
| | - Michael Noseworthy
- McMaster University - School of Biomedical Engineering, McMaster University, ETB-406, 1280 Main St., West, Hamilton, ON L8S 4K1, Canada.
| | - John F Connolly
- McMaster University - ARiEAL Research Centre, L.R. Wilson Hall, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4M2, Canada; McMaster University - Department of Linguistics and Languages, Canada; McMaster University - School of Biomedical Engineering, McMaster University, ETB-406, 1280 Main St., West, Hamilton, ON L8S 4K1, Canada; McMaster University - Department of Psychology, Neuroscience and Behaviour, Canada; MaRS Centre - Vector Institute, Canada.
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42
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Lecaignard F, Bertrand O, Caclin A, Mattout J. Empirical Bayes evaluation of fused EEG-MEG source reconstruction: Application to auditory mismatch evoked responses. Neuroimage 2020; 226:117468. [PMID: 33075561 DOI: 10.1016/j.neuroimage.2020.117468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 09/08/2020] [Accepted: 10/09/2020] [Indexed: 12/12/2022] Open
Abstract
We here turn the general and theoretical question of the complementarity of EEG and MEG for source reconstruction, into a practical empirical one. Precisely, we address the challenge of evaluating multimodal data fusion on real data. For this purpose, we build on the flexibility of Parametric Empirical Bayes, namely for EEG-MEG data fusion, group level inference and formal hypothesis testing. The proposed approach follows a two-step procedure by first using unimodal or multimodal inference to derive a cortical solution at the group level; and second by using this solution as a prior model for single subject level inference based on either unimodal or multimodal data. Interestingly, for inference based on the same data (EEG, MEG or both), one can then formally compare, as alternative hypotheses, the relative plausibility of the two unimodal and the multimodal group priors. Using auditory data, we show that this approach enables to draw important conclusions, namely on (i) the superiority of multimodal inference, (ii) the greater spatial sensitivity of MEG compared to EEG, (iii) the ability of EEG data alone to source reconstruct temporal lobe activity, (iv) the usefulness of EEG to improve MEG based source reconstruction. Importantly, we largely reproduce those findings over two different experimental conditions. We here focused on Mismatch Negativity (MMN) responses for which generators have been extensively investigated with little homogeneity in the reported results. Our multimodal inference at the group level revealed spatio-temporal activity within the supratemporal plane with a precision which, to our knowledge, has never been achieved before with non-invasive recordings.
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Affiliation(s)
- Françoise Lecaignard
- Lyon Neuroscience Research Center, CRNL; INSERM, U1028; CNRS, UMR5292; Brain Dynamics and Cognition Team, Lyon, F-69000, France; University Lyon 1, Lyon, F-69000, France.
| | - Olivier Bertrand
- Lyon Neuroscience Research Center, CRNL; INSERM, U1028; CNRS, UMR5292; Brain Dynamics and Cognition Team, Lyon, F-69000, France; University Lyon 1, Lyon, F-69000, France
| | - Anne Caclin
- Lyon Neuroscience Research Center, CRNL; INSERM, U1028; CNRS, UMR5292; Brain Dynamics and Cognition Team, Lyon, F-69000, France; University Lyon 1, Lyon, F-69000, France
| | - Jérémie Mattout
- Lyon Neuroscience Research Center, CRNL; INSERM, U1028; CNRS, UMR5292; Brain Dynamics and Cognition Team, Lyon, F-69000, France; University Lyon 1, Lyon, F-69000, France
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43
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Sajid N, Parr T, Hope TM, Price CJ, Friston KJ. Degeneracy and Redundancy in Active Inference. Cereb Cortex 2020; 30:5750-5766. [PMID: 32488244 PMCID: PMC7899066 DOI: 10.1093/cercor/bhaa148] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 12/16/2022] Open
Abstract
The notions of degeneracy and redundancy are important constructs in many areas, ranging from genomics through to network science. Degeneracy finds a powerful role in neuroscience, explaining key aspects of distributed processing and structure-function relationships in the brain. For example, degeneracy accounts for the superadditive effect of lesions on functional deficits in terms of a "many-to-one" structure-function mapping. In this paper, we offer a principled account of degeneracy and redundancy, when function is operationalized in terms of active inference, namely, a formulation of perception and action as belief updating under generative models of the world. In brief, "degeneracy" is quantified by the "entropy" of posterior beliefs about the causes of sensations, while "redundancy" is the "complexity" cost incurred by forming those beliefs. From this perspective, degeneracy and redundancy are complementary: Active inference tries to minimize redundancy while maintaining degeneracy. This formulation is substantiated using statistical and mathematical notions of degenerate mappings and statistical efficiency. We then illustrate changes in degeneracy and redundancy during the learning of a word repetition task. Finally, we characterize the effects of lesions-to intrinsic and extrinsic connections-using in silico disconnections. These numerical analyses highlight the fundamental difference between degeneracy and redundancy-and how they score distinct imperatives for perceptual inference and structure learning that are relevant to synthetic and biological intelligence.
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Affiliation(s)
- Noor Sajid
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK
| | - Thomas Parr
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK
| | - Thomas M Hope
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, WC1N 3AR, UK
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44
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Doradzińska Ł, Wójcik MJ, Paź M, Nowicka MM, Nowicka A, Bola M. Unconscious perception of one's own name modulates amplitude of the P3B ERP component. Neuropsychologia 2020; 147:107564. [DOI: 10.1016/j.neuropsychologia.2020.107564] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 12/30/2022]
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45
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Affiliation(s)
- Manuel S Malmierca
- Cognitive and Auditory Neuroscience Laboratory, Institute of Neuroscience of Castilla y León, Calle Pintor Fernando Gallego 1, 37007 Salamanca, Spain; Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; Department of Biology and Pathology, Faculty of Medicine, Campus Miguel de Unamuno, University of Salamanca, 37007 Salamanca, Spain.
| | - Ryszard Auksztulewicz
- Department of Neuroscience, City University of Hong Kong, Hong Kong S.A.R.; Neuroscience Department, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany.
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46
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Long-term limb immobilization modulates inhibition-related electrophysiological brain activity. Neuroimage 2020; 218:116911. [DOI: 10.1016/j.neuroimage.2020.116911] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/18/2022] Open
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47
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Comanducci A, Boly M, Claassen J, De Lucia M, Gibson RM, Juan E, Laureys S, Naccache L, Owen AM, Rosanova M, Rossetti AO, Schnakers C, Sitt JD, Schiff ND, Massimini M. Clinical and advanced neurophysiology in the prognostic and diagnostic evaluation of disorders of consciousness: review of an IFCN-endorsed expert group. Clin Neurophysiol 2020; 131:2736-2765. [PMID: 32917521 DOI: 10.1016/j.clinph.2020.07.015] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 07/06/2020] [Accepted: 07/26/2020] [Indexed: 12/13/2022]
Abstract
The analysis of spontaneous EEG activity and evoked potentialsis a cornerstone of the instrumental evaluation of patients with disorders of consciousness (DoC). Thepast few years have witnessed an unprecedented surge in EEG-related research applied to the prediction and detection of recovery of consciousness after severe brain injury,opening up the prospect that new concepts and tools may be available at the bedside. This paper provides a comprehensive, critical overview of bothconsolidated and investigational electrophysiological techniquesfor the prognostic and diagnostic assessment of DoC.We describe conventional clinical EEG approaches, then focus on evoked and event-related potentials, and finally we analyze the potential of novel research findings. In doing so, we (i) draw a distinction between acute, prolonged and chronic phases of DoC, (ii) attempt to relate both clinical and research findings to the underlying neuronal processes and (iii) discuss technical and conceptual caveats.The primary aim of this narrative review is to bridge the gap between standard and emerging electrophysiological measures for the detection and prediction of recovery of consciousness. The ultimate scope is to provide a reference and common ground for academic researchers active in the field of neurophysiology and clinicians engaged in intensive care unit and rehabilitation.
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Affiliation(s)
- A Comanducci
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - M Boly
- Department of Neurology and Department of Psychiatry, University of Wisconsin, Madison, USA; Wisconsin Institute for Sleep and Consciousness, Department of Psychiatry, University of Wisconsin-Madison, Madison, USA
| | - J Claassen
- Department of Neurology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - M De Lucia
- Laboratoire de Recherche en Neuroimagerie, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - R M Gibson
- The Brain and Mind Institute and the Department of Physiology and Pharmacology, Western Interdisciplinary Research Building, N6A 5B7 University of Western Ontario, London, Ontario, Canada
| | - E Juan
- Wisconsin Institute for Sleep and Consciousness, Department of Psychiatry, University of Wisconsin-Madison, Madison, USA; Amsterdam Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - S Laureys
- Coma Science Group, Centre du Cerveau, GIGA-Consciousness, University and University Hospital of Liège, 4000 Liège, Belgium; Fondazione Europea per la Ricerca Biomedica Onlus, Milan 20063, Italy
| | - L Naccache
- Inserm U 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Sorbonne Université, UPMC Université Paris 06, Faculté de Médecine Pitié-Salpêtrière, Paris, France
| | - A M Owen
- The Brain and Mind Institute and the Department of Physiology and Pharmacology, Western Interdisciplinary Research Building, N6A 5B7 University of Western Ontario, London, Ontario, Canada
| | - M Rosanova
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy; Fondazione Europea per la Ricerca Biomedica Onlus, Milan 20063, Italy
| | - A O Rossetti
- Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - C Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, USA
| | - J D Sitt
- Inserm U 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - N D Schiff
- Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA
| | - M Massimini
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy; Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
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Szalárdy O, Tóth B, Farkas D, Orosz G, Honbolygó F, Winkler I. Linguistic predictability influences auditory stimulus classification within two concurrent speech streams. Psychophysiology 2020; 57:e13547. [DOI: 10.1111/psyp.13547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Orsolya Szalárdy
- Faculty of Medicine Institute of Behavioural Sciences Semmelweis University Budapest Hungary
- Institute of Cognitive Neuroscience and Psychology Research Centre for Natural Sciences Hungarian Academy of Sciences Budapest Hungary
| | - Brigitta Tóth
- Institute of Cognitive Neuroscience and Psychology Research Centre for Natural Sciences Hungarian Academy of Sciences Budapest Hungary
| | - Dávid Farkas
- Analytics Development, Performance Management and Analytics, Business Development, Integrated Supply Chain Management, Nokia Business Services, Nokia Operations, Nokia Budapest Hungary
| | - Gábor Orosz
- Department of Psychology Stanford University Stanford CA USA
| | - Ferenc Honbolygó
- Brain Imaging Centre Research Centre for Natural Sciences Hungarian Academy of Sciences Budapest Hungary
- Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary
| | - István Winkler
- Institute of Cognitive Neuroscience and Psychology Research Centre for Natural Sciences Hungarian Academy of Sciences Budapest Hungary
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Meyer L, Schaadt G. Aberrant Prestimulus Oscillations in Developmental Dyslexia Support an Underlying Attention Shifting Deficit. Cereb Cortex Commun 2020; 1:tgaa006. [PMID: 34296087 PMCID: PMC8152944 DOI: 10.1093/texcom/tgaa006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 02/14/2020] [Accepted: 03/17/2020] [Indexed: 11/14/2022] Open
Abstract
Developmental dyslexia (DD) impairs reading and writing acquisition in 5–10% of children, compromising schooling, academic success, and everyday adult life. DD associates with reduced phonological skills, evident from a reduced auditory mismatch negativity (MMN) in the electroencephalogram (EEG). It was argued that such phonological deficits are secondary to an underlying deficit in the shifting of attention to upcoming speech sounds. Here, we tested whether the aberrant MMN in individuals with DD is a function of EEG correlates of prestimulus attention shifting; based on prior findings, we focused prestimulus analyses on alpha-band oscillations. We administered an audio–visual oddball paradigm to school children with and without DD. Children with DD showed EEG markers of deficient attention switching (i.e., increased prestimulus alpha-band intertrial phase coherence [ITPC]) to precede and predict their reduced MMN—aberrantly increased ITPC predicted an aberrantly reduced MMN. In interaction, ITPC and MMN predicted reading abilities, such that poor readers showed both high ITPC and a reduced MMN, the reverse being true in good readers. Prestimulus ITPC may be an overlooked biomarker of deficient attention shifting in DD. The findings support the proposal that an attention shifting deficit underlies phonological deficits in DD, entailing new opportunities for targeted intervention.
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Affiliation(s)
- Lars Meyer
- Research Group "Language Cycles", Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig 04103, Germany
| | - Gesa Schaadt
- Clinic of Cognitive Neurology, Medical Faculty, University Leipzig, Leipzig 04103, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig 04103, Germany
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50
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Wu M, Li F, Wu Y, Zhang T, Gao J, Xu P, Luo B. Impaired Frontoparietal Connectivity in Traumatic Individuals with Disorders of Consciousness: A Dynamic Brain Network Analysis. Aging Dis 2020; 11:301-314. [PMID: 32257543 PMCID: PMC7069467 DOI: 10.14336/ad.2019.0606] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/06/2019] [Indexed: 12/25/2022] Open
Abstract
Recent advances in neuroimaging have demonstrated that patients with disorders of consciousness (DOC) may retain residual consciousness through activation of a complex functional brain network. However, an understanding of the hierarchy of residual consciousness and dynamic network connectivity in DOC patients is lacking. This study aimed to investigate residual consciousness and the dynamics of neural processing in DOC patients. We included 42 patients with DOC, categorized by aetiology. Event-related potentials combined with time-varying electroencephalography networks were used to probe affective consciousness in DOC and examine the related network mechanisms. The results showed an obvious frontal P3a component among patients in minimally conscious state (MCS), while a prominent N1 was observed in unresponsive wakefulness syndrome (UWS). No late positive potential (LPP) was detected in these patients. Next, we divided the results by aetiology. Patients with nontraumatic injury presented an obvious frontal P3a response compared to those with traumatic injury. With respect to the dynamic network mechanism, patients with UWS, both with and without trauma, exhibited impaired frontoparietal network connectivity during the middle to late emotion processing period (P3a and LPP). Surprisingly, unconscious post-traumatic patients had an evident deficit in top-down connectivity. This, it appears that early automatic sensory identification is preserved in UWS and that exogenous attention was preserved even in MCS. However, high-level cognitive abilities were severely attenuated in unconscious patients. We also speculate that reduced frontoparietal connectivity may be useful as a biomarker to distinguish patients in an MCS from those with UWS given the same aetiology.
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Affiliation(s)
- Min Wu
- 1Department of Neurology & Brain Medical Centre, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fali Li
- 2The Clinical Hospital of Chengdu Brain Science Institute, Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuehao Wu
- 1Department of Neurology & Brain Medical Centre, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tieying Zhang
- 1Department of Neurology & Brain Medical Centre, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jian Gao
- 3Department of Rehabilitation, Hangzhou Hospital of Zhejiang Armed Police Corps, Hangzhou, China
| | - Peng Xu
- 2The Clinical Hospital of Chengdu Brain Science Institute, Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benyan Luo
- 1Department of Neurology & Brain Medical Centre, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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