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Maschke C, O'Byrne J, Colombo MA, Boly M, Gosseries O, Laureys S, Rosanova M, Jerbi K, Blain-Moraes S. Critical dynamics in spontaneous EEG predict anesthetic-induced loss of consciousness and perturbational complexity. Commun Biol 2024; 7:946. [PMID: 39103539 DOI: 10.1038/s42003-024-06613-8] [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: 02/13/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024] Open
Abstract
Consciousness has been proposed to be supported by electrophysiological patterns poised at criticality, a dynamical regime which exhibits adaptive computational properties, maximally complex patterns and divergent sensitivity to perturbation. Here, we investigate dynamical properties of the resting-state electroencephalogram (EEG) of healthy subjects undergoing general anesthesia with propofol, xenon or ketamine. Importantly, all participants were unresponsive under anesthesia, while consciousness was retained only during ketamine anesthesia (in the form of vivid dreams), enabling an experimental dissociation between unresponsiveness and unconsciousness. For each condition, we measure (i) avalanche criticality, (ii) chaoticity, and (iii) criticality-related metrics, revealing that states of unconsciousness are characterized by a distancing from both avalanche criticality and the edge of chaos. We then ask whether these same dynamical properties are predictive of the perturbational complexity index (PCI), a TMS-based measure that has shown remarkably high sensitivity in detecting consciousness independently of behavior. We successfully predict individual subjects' PCI values with considerably high accuracy from resting-state EEG dynamical properties alone. Our results establish a firm link between perturbational complexity and criticality, and provide further evidence that criticality is a necessary condition for the emergence of consciousness.
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Affiliation(s)
- Charlotte Maschke
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Montreal, QC, Canada
| | - Jordan O'Byrne
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Montreal, QC, Canada
- MILA (Québec Artificial Intelligence Institute), Montréal, QC, Canada
| | | | - Melanie Boly
- Department of Neurology and Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du cerveau, CHU of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- CERVO Brain Research Centre, Laval University, Laval, QC, Canada
- Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Karim Jerbi
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Montreal, QC, Canada
- MILA (Québec Artificial Intelligence Institute), Montréal, QC, Canada
- Centre UNIQUE (Union Neurosciences & Intelligence Artificielle), Montréal, QC, Canada
| | - Stefanie Blain-Moraes
- Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada.
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
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2
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Kazazian K, Edlow BL, Owen AM. Detecting awareness after acute brain injury. Lancet Neurol 2024; 23:836-844. [PMID: 39030043 DOI: 10.1016/s1474-4422(24)00209-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/28/2024] [Accepted: 05/07/2024] [Indexed: 07/21/2024]
Abstract
Advances over the past two decades in functional neuroimaging have provided new diagnostic and prognostic tools for patients with severe brain injury. Some of the most pertinent developments in this area involve the assessment of residual brain function in patients in the intensive care unit during the acute phase of severe injury, when they are at their most vulnerable and prognosis is uncertain. Advanced neuroimaging techniques, such as functional MRI and EEG, have now been used to identify preserved cognitive processing, including covert conscious awareness, and to relate them to outcome in patients who are behaviourally unresponsive. Yet, technical and logistical challenges to clinical integration of these advanced neuroimaging techniques remain, such as the need for specialised expertise to acquire, analyse, and interpret data and to determine the appropriate timing for such assessments. Once these barriers are overcome, advanced functional neuroimaging technologies could improve diagnosis and prognosis for millions of patients worldwide.
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Affiliation(s)
- Karnig Kazazian
- Western Institute of Neuroscience, Western University, London, ON, Canada.
| | - Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Adrian M Owen
- Western Institute of Neuroscience, Western University, London, ON, Canada; Department of Physiology and Pharmacology and Department of Psychology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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3
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Parr AC, Sydnor VJ, Calabro FJ, Luna B. Adolescent-to-adult gains in cognitive flexibility are adaptively supported by reward sensitivity, exploration, and neural variability. Curr Opin Behav Sci 2024; 58:101399. [PMID: 38826569 PMCID: PMC11138371 DOI: 10.1016/j.cobeha.2024.101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Cognitive flexibility exhibits dynamic changes throughout development, with different forms of flexibility showing dissociable developmental trajectories. In this review, we propose that an adolescent-specific mode of flexibility in the face of changing environmental contingencies supports the emergence of adolescent-to-adult gains in cognitive shifting efficiency. We first describe how cognitive shifting abilities monotonically improve from childhood to adulthood, accompanied by increases in brain state flexibility, neural variability, and excitatory/inhibitory balance. We next summarize evidence supporting the existence of a dopamine-driven, adolescent peak in flexible behavior that results in reward seeking, undirected exploration, and environmental sampling. We propose a neurodevelopmental framework that relates these adolescent behaviors to the refinement of neural phenotypes relevant to mature cognitive flexibility, and thus highlight the importance of the adolescent period in fostering healthy neurocognitive trajectories.
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Affiliation(s)
- Ashley C. Parr
- Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, 14213, USA
| | - Valerie J. Sydnor
- Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, 14213, USA
| | - Finnegan J. Calabro
- Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, 14213, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, 14213, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh PA, 14213, USA
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4
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De Koninck BP, Brazeau D, Deshaies AA, Briand MM, Maschke C, Williams V, Arbour C, Williamson D, Duclos C, Bernard F, Blain-Moraes S, De Beaumont L. Modulation of brain activity in brain-injured patients with a disorder of consciousness in intensive care with repeated 10-Hz transcranial alternating current stimulation (tACS): a randomised controlled trial protocol. BMJ Open 2024; 14:e078281. [PMID: 38991682 PMCID: PMC11243138 DOI: 10.1136/bmjopen-2023-078281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Therapeutic interventions for disorders of consciousness lack consistency; evidence supports non-invasive brain stimulation, but few studies assess neuromodulation in acute-to-subacute brain-injured patients. This study aims to validate the feasibility and assess the effect of a multi-session transcranial alternating current stimulation (tACS) intervention in subacute brain-injured patients on recovery of consciousness, related brain oscillations and brain network dynamics. METHODS AND ANALYSES The study is comprised of two phases: a validation phase (n=12) and a randomised controlled trial (n=138). Both phases will be conducted in medically stable brain-injured adult patients (traumatic brain injury and hypoxic-ischaemic encephalopathy), with a Glasgow Coma Scale score ≤12 after continuous sedation withdrawal. Recruitment will occur at the intensive care unit of a Level 1 Trauma Centre in Montreal, Quebec, Canada. The intervention includes a 20 min 10 Hz tACS at 1 mA intensity or a sham session over parieto-occipital cortical sites, repeated over five consecutive days. The current's frequency targets alpha brain oscillations (8-13 Hz), known to be associated with consciousness. Resting-state electroencephalogram (EEG) will be recorded four times daily for five consecutive days: pre and post-intervention, at 60 and 120 min post-tACS. Two additional recordings will be included: 24 hours and 1-week post-protocol. Multimodal measures (blood samples, pupillometry, behavioural consciousness assessments (Coma Recovery Scale-revised), actigraphy measures) will be acquired from baseline up to 1 week after the stimulation. EEG signal analysis will focus on the alpha bandwidth (8-13 Hz) using spectral and functional network analyses. Phone assessments at 3, 6 and 12 months post-tACS, will measure long-term functional recovery, quality of life and caregivers' burden. ETHICS AND DISSEMINATION Ethical approval for this study has been granted by the Research Ethics Board of the CIUSSS du Nord-de-l'Île-de-Montréal (Project ID 2021-2279). The findings of this two-phase study will be submitted for publication in a peer-reviewed academic journal and submitted for presentation at conferences. The trial's results will be published on a public trial registry database (ClinicalTrials.gov). TRIAL REGISTRATION NUMBER NCT05833568.
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Affiliation(s)
- Béatrice P De Koninck
- Psychology, University of Montreal, Montreal, Quebec, Canada
- Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
| | - Daphnee Brazeau
- Psychology, University of Montreal, Montreal, Quebec, Canada
- Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
| | | | - Marie-Michele Briand
- CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Quebec, Canada
- IRDPQ, Montreal, Quebec, Canada
| | - Charlotte Maschke
- McGill University, Montreal, Quebec, Canada
- Montreal General Hospital, Montreal, Quebec, Canada
| | - Virginie Williams
- Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
| | - Caroline Arbour
- Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
- University of Montreal, Montreal, Quebec, Canada
| | | | - Catherine Duclos
- Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
- Anesthesiology and Pain Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Francis Bernard
- Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
- Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Stefanie Blain-Moraes
- Montreal General Hospital, Montreal, Quebec, Canada
- Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Louis De Beaumont
- Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
- Surgery, University of Montreal, Montreal, Quebec, Canada
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Troyas C, Sleigh J. Electroencephalographic signatures of consciousness: uncovering the fake news. Br J Anaesth 2024; 132:218-219. [PMID: 38104006 DOI: 10.1016/j.bja.2023.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/19/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023] Open
Abstract
Amongst electroencephalographic markers of anaesthetic-induced unresponsiveness, those that estimate loss of frontoparietal functional connectivity detect loss of sensory perceptual connection with the outside world, rather than full phenomenological unconsciousness. This transition to unconsciousness is manifest as further incremental changes in indices of electroencephalographic complexity.
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Affiliation(s)
- Carla Troyas
- Department of Anesthesiology and Intensive Care Medicine, Technical University of Munich, School of Medicine, Munich, Germany
| | - Jamie Sleigh
- Department of Anaesthesia and Pain Medicine, Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
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6
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Maschke C, O'Byrne J, Colombo MA, Boly M, Gosseries O, Laureys S, Rosanova M, Jerbi K, Blain-Moraes S. Criticality of resting-state EEG predicts perturbational complexity and level of consciousness during anesthesia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.26.564247. [PMID: 37994368 PMCID: PMC10664178 DOI: 10.1101/2023.10.26.564247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Consciousness has been proposed to be supported by electrophysiological patterns poised at criticality, a dynamical regime which exhibits adaptive computational properties, maximally complex patterns and divergent sensitivity to perturbation. Here, we investigated dynamical properties of the resting-state electroencephalogram of healthy subjects undergoing general anesthesia with propofol, xenon or ketamine. We then studied the relation of these dynamic properties with the perturbational complexity index (PCI), which has shown remarkably high sensitivity in detecting consciousness independent of behavior. All participants were unresponsive under anesthesia, while consciousness was retained only during ketamine anesthesia (in the form of vivid dreams)., enabling an experimental dissociation between unresponsiveness and unconsciousness. We estimated (i) avalanche criticality, (ii) chaoticity, and (iii) criticality-related measures, and found that states of unconsciousness were characterized by a distancing from both the edge of activity propagation and the edge of chaos. We were then able to predict individual subjects' PCI (i.e., PCImax) with a mean absolute error below 7%. Our results establish a firm link between the PCI and criticality and provide further evidence for the role of criticality in the emergence of consciousness.
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Affiliation(s)
- Charlotte Maschke
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Québec, Canada
| | - Jordan O'Byrne
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Québec, Canada
- MILA (Québec Artificial Intelligence Institute), Montréal, Québec, Canada
| | | | - Melanie Boly
- Department of Neurology and Department of Psychiatry, University of Wisconsin, Madison, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du cerveau, CHU of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- CERVO Brain Research Centre, Laval University, Canada
- Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Karim Jerbi
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Québec, Canada
- MILA (Québec Artificial Intelligence Institute), Montréal, Québec, Canada
- Centre UNIQUE (Union Neurosciences & Intelligence Artificielle), Montréal, Québec, Canada
| | - Stefanie Blain-Moraes
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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7
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Baracchini G, Zhou Y, da Silva Castanheira J, Hansen JY, Rieck J, Turner GR, Grady CL, Misic B, Nomi J, Uddin LQ, Spreng RN. The biological role of local and global fMRI BOLD signal variability in human brain organization. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.22.563476. [PMID: 37961684 PMCID: PMC10634715 DOI: 10.1101/2023.10.22.563476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Variability drives the organization and behavior of complex systems, including the human brain. Understanding the variability of brain signals is thus necessary to broaden our window into brain function and behavior. Few empirical investigations of macroscale brain signal variability have yet been undertaken, given the difficulty in separating biological sources of variance from artefactual noise. Here, we characterize the temporal variability of the most predominant macroscale brain signal, the fMRI BOLD signal, and systematically investigate its statistical, topographical and neurobiological properties. We contrast fMRI acquisition protocols, and integrate across histology, microstructure, transcriptomics, neurotransmitter receptor and metabolic data, fMRI static connectivity, and empirical and simulated magnetoencephalography data. We show that BOLD signal variability represents a spatially heterogeneous, central property of multi-scale multi-modal brain organization, distinct from noise. Our work establishes the biological relevance of BOLD signal variability and provides a lens on brain stochasticity across spatial and temporal scales.
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Affiliation(s)
- Giulia Baracchini
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Yigu Zhou
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Jason da Silva Castanheira
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Justine Y. Hansen
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | | | - Gary R. Turner
- Department of Psychology, York University, Toronto, ON, Canada
| | - Cheryl L. Grady
- Rotman Research Institute at Baycrest, and Department of Psychiatry and Psychology, University of Toronto, Toronto, ON, Canada
| | - Bratislav Misic
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Jason Nomi
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - Lucina Q. Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - R. Nathan Spreng
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
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8
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Salvalaggio S, Turolla A, Andò M, Barresi R, Burgio F, Busan P, Cortese AM, D’Imperio D, Danesin L, Ferrazzi G, Maistrello L, Mascotto E, Parrotta I, Pezzetta R, Rigon E, Vedovato A, Zago S, Zorzi M, Arcara G, Mantini D, Filippini N. Prediction of rehabilitation induced motor recovery after stroke using a multi-dimensional and multi-modal approach. Front Aging Neurosci 2023; 15:1205063. [PMID: 37469951 PMCID: PMC10352609 DOI: 10.3389/fnagi.2023.1205063] [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: 04/13/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Background Stroke is a debilitating disease affecting millions of people worldwide. Despite the survival rate has significantly increased over the years, many stroke survivors are left with severe impairments impacting their quality of life. Rehabilitation programs have proved to be successful in improving the recovery process. However, a reliable model of sensorimotor recovery and a clear identification of predictive markers of rehabilitation-induced recovery are still needed. This article introduces the cross-modality protocols designed to investigate the rehabilitation treatment's effect in a group of stroke survivors. Methods/design A total of 75 stroke patients, admitted at the IRCCS San Camillo rehabilitation Hospital in Venice (Italy), will be included in this study. Here, we describe the rehabilitation programs, clinical, neuropsychological, and physiological/imaging [including electroencephalography (EEG), transcranial magnetic stimulation (TMS), and magnetic resonance imaging (MRI) techniques] protocols set up for this study. Blood collection for the characterization of predictive biological biomarkers will also be taken. Measures derived from data acquired will be used as candidate predictors of motor recovery. Discussion/summary The integration of cutting-edge physiological and imaging techniques, with clinical and cognitive assessment, dose of rehabilitation and biological variables will provide a unique opportunity to define a predictive model of recovery in stroke patients. Taken together, the data acquired in this project will help to define a model of rehabilitation induced sensorimotor recovery, with the final aim of developing personalized treatments promoting the greatest chance of recovery of the compromised functions.
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Affiliation(s)
- Silvia Salvalaggio
- IRCCS San Camillo Hospital, Venice, Italy
- Padova Neuroscience Center, Università degli Studi di Padova, Padua, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum – Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | | | | | | | - Anna Maria Cortese
- Department of Rehabilitation Medicine, AULSS 3 Serenissima, Venice, Italy
| | | | | | | | | | - Eleonora Mascotto
- Department of Physical Medicine and Rehabilitation, Venice Hospital, Venice, Italy
| | | | | | | | - Anna Vedovato
- General Hospital San Camillo of Treviso, Treviso, Italy
| | - Sara Zago
- IRCCS San Camillo Hospital, Venice, Italy
| | - Marco Zorzi
- IRCCS San Camillo Hospital, Venice, Italy
- Padova Neuroscience Center, Università degli Studi di Padova, Padua, Italy
- Department of General Psychology, University of Padova, Padua, Italy
| | | | - Dante Mantini
- IRCCS San Camillo Hospital, Venice, Italy
- Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium
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