Connectivity differences between consciousness and unconsciousness in non-rapid eye movement sleep: a TMS-EEG study

Influence of Large-Scale Brain State Dynamics on the Evoked Response to Brain Stimulation

Understanding how spontaneous brain activity influences the response to neurostimulation is crucial for the development of neurotherapeutics and brain-computer interfaces. Localized brain activity is suggested to influence the response to neurostimulation, but whether fast-fluctuating (i.e., tens of milliseconds) large-scale brain dynamics also have any such influence is unknown. By stimulating the prefrontal cortex using combined transcranial magnetic stimulation (TMS) and electroencephalography, we examined how dynamic global brain state patterns, as defined by microstates, influence the magnitude of the evoked brain response. TMS applied during what resembled the canonical Microstate C was found to induce a greater evoked response for up to 80 ms compared with other microstates. This effect was found in a repeated experimental session, was absent during sham stimulation, and was replicated in an independent dataset. Ultimately, ongoing and fast-fluctuating global brain states, as probed by microstates, may be associated with intrinsic fluctuations in connectivity and excitation-inhibition balance and influence the neurostimulation outcome. We suggest that the fast-fluctuating global brain states be considered when developing any related paradigms.

Technological Modalities in the Assessment and Treatment of Disorders of Consciousness

Over the last 10 years, there have been rapid advances made in technologies that can be utilized in the diagnosis and treatment of patients with a disorder of consciousness (DoC). This article provides a comprehensive review of these modalities including the evidence supporting their potential use in DoC. This review specifically addresses diagnostic, non-invasive therapeutic, and invasive therapeutic technological modalities except for neuroimaging, which is discussed in another article. While technologic advances appear promising for both assessment and treatment of patients with a DoC, high-quality evidence supporting widespread clinical adoption remains limited.

Effects of Targeted Memory Reactivation on Cortical Networks

Sleep is a complex physiological process with an important role in memory consolidation characterised by a series of spatiotemporal changes in brain activity and connectivity. Here, we investigate how task-related responses differ between pre-sleep wake, sleep, and post-sleep wake. To this end, we trained participants on a serial reaction time task using both right and left hands using Targeted Memory Reactivation (TMR), in which auditory cues are associated with learned material and then re-presented in subsequent wake or sleep periods in order to elicit memory reactivation. The neural responses just after each cue showed increased theta band connectivity between frontal and other cortical regions, as well as between hemispheres, in slow wave sleep compared to pre- or post-sleep wake. This pattern was consistent across the cues associated with both right- and left-handed movements. We also searched for hand-specific connectivity and found that this could be identified in within-hemisphere connectivity after TMR cues during sleep and post-sleep sessions. The fact that we could identify which hand had been cued during sleep suggests that these connectivity measures could potentially be used to determine how successfully memory is reactivated by our manipulation. Collectively, these findings indicate that TMR modulates the brain cortical networks showing clear differences between wake and sleep connectivity patterns.

SeriesSleepNet: an EEG time series model with partial data augmentation for automatic sleep stage scoring

Introduction: We propose an automatic sleep stage scoring model, referred to as SeriesSleepNet, based on convolutional neural network (CNN) and bidirectional long short-term memory (bi-LSTM) with partial data augmentation. We used single-channel raw electroencephalography signals for automatic sleep stage scoring. Methods: Our framework was focused on time series information, so we applied partial data augmentation to learn the connected time information in small series. In specific, the CNN module learns the time information of one epoch (intra-epoch) whereas the bi-LSTM trains the sequential information between the adjacent epochs (inter-epoch). Note that the input of the bi-LSTM is the augmented CNN output. Moreover, the proposed loss function was used to fine-tune the model by providing additional weights. To validate the proposed framework, we conducted two experiments using the Sleep-EDF and SHHS datasets. Results and Discussion: The results achieved an overall accuracy of 0.87 and 0.84 and overall F1-score of 0.80 and 0.78 and kappa value of 0.81 and 0.78 for five-class classification, respectively. We showed that the SeriesSleepNet was superior to the baselines based on each component in the proposed framework. Our architecture also outperformed the state-of-the-art methods with overall F1-score, accuracy, and kappa value. Our framework could provide information on sleep disorders or quality of sleep to automatically classify sleep stages with high performance.

Intracortical and intercortical networks in patients after stroke: a concurrent TMS-EEG study

BACKGROUND

Concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) recording provides information on both intracortical reorganization and networking, and that information could yield new insights into post-stroke neuroplasticity. However, a comprehensive investigation using both concurrent TMS-EEG and motor-evoked potential-based outcomes has not been carried out in patients with chronic stroke. Therefore, this study sought to investigate the intracortical and network neurophysiological features of patients with chronic stroke, using concurrent TMS-EEG and motor-evoked potential-based outcomes.

METHODS

A battery of motor-evoked potential-based measures and concurrent TMS-EEG recording were performed in 23 patients with chronic stroke and 21 age-matched healthy controls.

RESULTS

The ipsilesional primary motor cortex (M1) of the patients with stroke showed significantly higher resting motor threshold (P = 0.002), reduced active motor-evoked potential amplitudes (P = 0.001) and a prolonged cortical silent period (P = 0.007), compared with their contralesional M1. The ipsilesional stimulation also produced a reduction in N100 amplitude of TMS-evoked potentials around the stimulated M1 (P = 0.007), which was significantly correlated with the ipsilesional resting motor threshold (P = 0.011) and motor-evoked potential amplitudes (P = 0.020). In addition, TMS-related oscillatory power was significantly reduced over the ipsilesional midline-prefrontal and parietal regions. Both intra/interhemispheric connectivity and network measures in the theta band were significantly reduced in the ipsilesional hemisphere compared with those in the contralesional hemisphere.

CONCLUSIONS

The ipsilesional M1 demonstrated impaired GABA-B receptor-mediated intracortical inhibition characterized by reduced duration, but reduced magnitude. The N100 of TMS-evoked potentials appears to be a useful biomarker of post-stroke recovery.

The Current of Consciousness: Neural Correlates and Clinical Aspects

PURPOSE OF REVIEW

In this review, we summarize the current understanding of consciousness including its neuroanatomic basis. We discuss major theories of consciousness, physical exam-based and electroencephalographic metrics used to stratify levels of consciousness, and tools used to shed light on the neural correlates of the conscious experience. Lastly, we review an expanded category of 'disorders of consciousness,' which includes disorders that impact either the level or experience of consciousness.

RECENT FINDINGS

Recent studies have revealed many of the requisite EEG, ERP, and fMRI signals to predict aspects of the conscious experience. Neurological disorders that disrupt the reticular activating system can affect the level of consciousness, whereas cortical disorders from seizures and migraines to strokes and dementia may disrupt phenomenal consciousness. The recently introduced memory theory of consciousness provides a new explanation of phenomenal consciousness that may explain better than prior theories both experimental studies and the neurologist's clinical experience. Although the complete neurobiological basis of consciousness remains a mystery, recent advances have improved our understanding of the physiology underlying level of consciousness and phenomenal consciousness.

Neurophysiological Response Based on Auditory Sense for Brain Modulation Using Monaural Beat

Brain modulation is a modification process of brain activity through external stimulations. However, which condition can induce the activation is still unclear. Therefore, we aimed to identify brain activation conditions using 40 Hz monaural beat (MB). Under this stimulation, auditory sense status which is determined by frequency and power range is the condition to consider. Hence, we designed five sessions to compare; no stimulation, audible (AB), inaudible in frequency, inaudible in power, and inaudible in frequency and power. Ten healthy participants underwent each stimulation session for ten minutes with electroencephalogram (EEG) recording. For analysis, we calculated the power spectral density (PSD) of EEG for each session and compared them in frequency, time, and five brain regions. As a result, we observed the prominent power peak at 40 Hz in only AB. The induced EEG amplitude increase started at one minute and increased until the end of the session. These results of AB had significant differences in frontal, central, temporal, parietal, and occipital regions compared to other stimulations. From the statistical analysis, the PSD of the right temporal region was significantly higher than the left. We figure out the role that the auditory sense is important to lead brain activation. These findings help to understand the neurophysiological principle and effects of auditory stimulation.

Natural Oscillatory Frequency Slowing in the Premotor Cortex of Early-Course Schizophrenia Patients: A TMS-EEG Study

Despite the heavy burden of schizophrenia, research on biomarkers associated with its early course is still ongoing. Single-pulse Transcranial Magnetic Stimulation coupled with electroencephalography (TMS-EEG) has revealed that the main oscillatory frequency (or "natural frequency") is reduced in several frontal brain areas, including the premotor cortex, of chronic patients with schizophrenia. However, no study has explored the natural frequency at the beginning of illness. Here, we used TMS-EEG to probe the intrinsic oscillatory properties of the left premotor cortex in early-course schizophrenia patients (<2 years from onset) and age/gender-matched healthy comparison subjects (HCs). State-of-the-art real-time monitoring of EEG responses to TMS and noise-masking procedures were employed to ensure data quality. We found that the natural frequency of the premotor cortex was significantly reduced in early-course schizophrenia compared to HCs. No correlation was found between the natural frequency and age, clinical symptom severity, or dose of antipsychotic medications at the time of TMS-EEG. This finding extends to early-course schizophrenia previous evidence in chronic patients and supports the hypothesis of a deficit in frontal cortical synchronization as a core mechanism underlying this disorder. Future work should further explore the putative role of frontal natural frequencies as early pathophysiological biomarkers for schizophrenia.

EEG Lempel-Ziv complexity varies with sleep stage, but does not seem to track dream experience

In a recent electroencephalography (EEG) sleep study inspired by complexity theories of consciousness, we found that multi-channel signal diversity progressively decreased from wakefulness to slow wave sleep, but failed to find any significant difference between dreaming and non-dreaming awakenings within the same sleep stage (NREM2). However, we did find that multi-channel Lempel-Ziv complexity (LZC) measured over the posterior cortex increased with more perceptual ratings of NREM2 dream experience along a thought-perceptual axis. In this follow-up study, we re-tested our previous findings, using a slightly different approach. Partial sleep-deprivation was followed by evening sleep experiments, with repeated awakenings and immediate dream reports. Participants reported whether they had been dreaming, and were asked to rate how diverse, vivid, perceptual, and thought-like the contents of their dreams were. High density (64 channel) EEG was recorded throughout the experiment, and mean single-channel LZC was calculated for each 30 s sleep epoch. LZC progressively decreased with depth of non-REM sleep. Surprisingly, estimated marginal mean LZC was slightly higher for NREM1 than for wakefulness, but the difference did not remain significant after adjusting for multiple comparisons. We found no significant difference in LZC between dream and non-dream awakenings, nor any significant relationship between LZC and subjective ratings of dream experience, within the same sleep stage (NREM2). The failure to reproduce our own previous finding of a positive correlation between posterior LZC and more perceptual dream experiences, or to find any other correlation between brain signal complexity and subjective experience within NREM2 sleep, raises the question of whether EEG LZC is really a reliable correlate of richness of experience as such, within the same sleep stage.

Consciousness as a Memory System

We suggest that there is confusion between why consciousness developed and what additional functions, through continued evolution, it has co-opted. Consider episodic memory. If we believe that episodic memory evolved solely to accurately represent past events, it seems like a terrible system-prone to forgetting and false memories. However, if we believe that episodic memory developed to flexibly and creatively combine and rearrange memories of prior events in order to plan for the future, then it is quite a good system. We argue that consciousness originally developed as part of the episodic memory system-quite likely the part needed to accomplish that flexible recombining of information. We posit further that consciousness was subsequently co-opted to produce other functions that are not directly relevant to memory per se, such as problem-solving, abstract thinking, and language. We suggest that this theory is compatible with many phenomena, such as the slow speed and the after-the-fact order of consciousness, that cannot be explained well by other theories. We believe that our theory may have profound implications for understanding intentional action and consciousness in general. Moreover, we suggest that episodic memory and its associated memory systems of sensory, working, and semantic memory as a whole ought to be considered together as the conscious memory system in that they, together, give rise to the phenomenon of consciousness. Lastly, we suggest that the cerebral cortex is the part of the brain that makes consciousness possible, and that every cortical region contributes to this conscious memory system.

Brain and brain-heart Granger causality during wakefulness and sleep

In this exploratory study we apply Granger Causality (GC) to investigate the brain-brain and brain-heart interactions during wakefulness and sleep. Our analysis includes electroencephalogram (EEG) and electrocardiogram (ECG) data during all-night polysomnographic recordings from volunteers with apnea, available from the Massachusetts General Hospital's Computational Clinical Neurophysiology Laboratory and the Clinical Data Animation Laboratory. The data is manually annotated by clinical staff at the MGH in 30 second contiguous intervals (wakefulness and sleep stages 1, 2, 3, and rapid eye movement (REM). We applied GC to 4-s non-overlapping segments of available EEG and ECG across all-night recordings of 50 randomly chosen patients. To identify differences in GC between the different sleep stages, the GC for each sleep stage was subtracted from the GC during wakefulness. Positive (negative) differences indicated that GC was greater (lower) during wakefulness compared to the specific sleep stage. The application of GC to study brain-brain and brain-heart bidirectional connections during wakefulness and sleep confirmed the importance of fronto-posterior connectivity during these two states, but has also revealed differences in ipsilateral and contralateral mechanisms of these connections. It has also confirmed the existence of bidirectional brain-heart connections that are more prominent in the direction from brain to heart. Our exploratory study has shown that GC can be successfully applied to sleep data analysis and captures the varying physiological mechanisms that are related to wakefulness and different sleep stages.

2020 International brain-computer interface competition: A review

The brain-computer interface (BCI) has been investigated as a form of communication tool between the brain and external devices. BCIs have been extended beyond communication and control over the years. The 2020 international BCI competition aimed to provide high-quality neuroscientific data for open access that could be used to evaluate the current degree of technical advances in BCI. Although there are a variety of remaining challenges for future BCI advances, we discuss some of more recent application directions: (i) few-shot EEG learning, (ii) micro-sleep detection (iii) imagined speech decoding, (iv) cross-session classification, and (v) EEG(+ear-EEG) detection in an ambulatory environment. Not only did scientists from the BCI field compete, but scholars with a broad variety of backgrounds and nationalities participated in the competition to address these challenges. Each dataset was prepared and separated into three data that were released to the competitors in the form of training and validation sets followed by a test set. Remarkable BCI advances were identified through the 2020 competition and indicated some trends of interest to BCI researchers.

Brain Activity Characteristics of Patients With Disorders of Consciousness in the EEG Resting State Paradigm: A Review

The assessment of the level of consciousness in disorders of consciousness (DoC) is still one of the most challenging problems in contemporary medicine. Nevertheless, based on the multitude of studies conducted over the last 20 years on resting states based on electroencephalography (EEG) in DoC, it is possible to outline the brain activity profiles related to both patients without preserved consciousness and minimally conscious ones. In the case of patients without preserved consciousness, the dominance of low, mostly delta, frequency, and the marginalization of the higher frequencies were observed, both in terms of the global power of brain activity and in functional connectivity patterns. In turn, the minimally conscious patients revealed the opposite brain activity pattern—the characteristics of higher frequency bands were preserved both in global power and in functional long-distance connections. In this short review, we summarize the state of the art of EEG-based research in the resting state paradigm, in the context of providing potential support to the traditional clinical assessment of the level of consciousness.

Quantifying arousal and awareness in altered states of consciousness using interpretable deep learning

Consciousness can be defined by two components: arousal (wakefulness) and awareness (subjective experience). However, neurophysiological consciousness metrics able to disentangle between these components have not been reported. Here, we propose an explainable consciousness indicator (ECI) using deep learning to disentangle the components of consciousness. We employ electroencephalographic (EEG) responses to transcranial magnetic stimulation under various conditions, including sleep (n = 6), general anesthesia (n = 16), and severe brain injury (n = 34). We also test our framework using resting-state EEG under general anesthesia (n = 15) and severe brain injury (n = 34). ECI simultaneously quantifies arousal and awareness under physiological, pharmacological, and pathological conditions. Particularly, ketamine-induced anesthesia and rapid eye movement sleep with low arousal and high awareness are clearly distinguished from other states. In addition, parietal regions appear most relevant for quantifying arousal and awareness. This indicator provides insights into the neural correlates of altered states of consciousness.

Motor Impairment in Stroke Patients is Associated with Network Properties During Consecutive Motor Imagery

OBJECTIVE

Our study aimed to predict the Fugl-Meyer assessment (FMA) upper limb using network properties during motor imagery using electroencephalography (EEG) signals.

METHODS

The subjects performed a finger tapping imagery task according to consecutive cues. We measured the weighted phase lag index (wPLI) as functional connectivity and directed transfer function (DTF) as causal connectivity in healthy controls and stroke patients. The network properties based on the wPLI and DTF were calculated. We predicted the FMA upper limb using partial least squares regression.

RESULTS

A higher DTF in the mu band was observed in stroke patients than in healthy controls. Notably, the difference in local properties at node F3 was negatively correlated with motor impairment in stroke patients. Finally, using significant network properties based on the wPLI and DTF, we predicted motor impairments using the FMA upper limb with a root-mean-square error of 1.68 (R² = 0.97). This outperformed the state-of-the-art predictors.

CONCLUSION

These findings demonstrate that network properties based on functional and causal connectivity were highly associated with motor function in stroke patients.

SIGNIFICANCE

Our network properties can help calculate the predictor of motor impairments in stroke rehabilitation and provide insight into the neural correlates related to motor function based on EEG after reorganization induced by stroke.

Functional Connectivity Analysis in Motor-Imagery Brain Computer Interfaces

Motor Imagery BCI systems have a high rate of users that are not capable of modulating their brain activity accurately enough to communicate with the system. Several studies have identified psychological, cognitive, and neurophysiological measures that might explain this MI-BCI inefficiency. Traditional research had focused on mu suppression in the sensorimotor area in order to classify imagery, but this does not reflect the true dynamics that underlie motor imagery. Functional connectivity reflects the interaction between brain regions during the MI task and resting-state network and is a promising tool in improving MI-BCI classification. In this study, 54 novice MI-BCI users were split into two groups based on their accuracy and their functional connectivity was compared in three network scales (Global, Large and Local scale) during the resting-state, left vs. right-hand motor imagery task, and the transition between the two phases. Our comparison of High and Low BCI performers showed that in the alpha band, functional connectivity in the right hemisphere was increased in High compared to Low aptitude MI-BCI users during motor imagery. These findings contribute to the existing literature that indeed connectivity might be a valuable feature in MI-BCI classification and in solving the MI-BCI inefficiency problem.

Consciousness and complexity: a consilience of evidence

Over the last years, a surge of empirical studies converged on complexity-related measures as reliable markers of consciousness across many different conditions, such as sleep, anesthesia, hallucinatory states, coma, and related disorders. Most of these measures were independently proposed by researchers endorsing disparate frameworks and employing different methods and techniques. Since this body of evidence has not been systematically reviewed and coherently organized so far, this positive trend has remained somewhat below the radar. The aim of this paper is to make this consilience of evidence in the science of consciousness explicit. We start with a systematic assessment of the growing literature on complexity-related measures and identify their common denominator, tracing it back to core theoretical principles and predictions put forward more than 20 years ago. In doing this, we highlight a consistent trajectory spanning two decades of consciousness research and provide a provisional taxonomy of the present literature. Finally, we consider all of the above as a positive ground to approach new questions and devise future experiments that may help consolidate and further develop a promising field where empirical research on consciousness appears to have, so far, naturally converged.

[Sleep and neurophysiological correlates of consciousness activation upon awakening]

The authors discuss modern ideas about the neurophysiological mechanisms of awakening from sleep and the results of own EEG studies of the spatio-temporal dynamics of the activity of the cerebral hemispheres using the own experimental model for studying consciousness in the sleep-wake paradigm. This model is based on continuous execution of a monotonous psychomotor test performed lying down with eyes closed and allows observing several short-term sleep episodes during a 1-hour experiment, followed by spontaneous awakening and restoration of the psychomotor test. A necessary condition for the restoration of activity during spontaneous awakening is the emergence of the EEG alpha rhythm, the parameters of which determine the effectiveness of the restoration of the psychomotor test and, accordingly, the achievement of a certain level of consciousness, and therefore can be considered as a neurophysiological correlate of consciousness activation upon awakening. The considered experimental model of consciousness can be useful for analyzing the neurophysiological mechanisms of consciousness activation in patients with chronic impairments of consciousness and for searching for effective methods for the rehabilitation of such patients.

EEG Signal Diversity Varies With Sleep Stage and Aspects of Dream Experience

Several theories link consciousness to complex cortical dynamics, as suggested by comparison of brain signal diversity between conscious states and states where consciousness is lost or reduced. In particular, Lempel-Ziv complexity, amplitude coalition entropy and synchrony coalition entropy distinguish wakefulness and REM sleep from deep sleep and anesthesia, and are elevated in psychedelic states, reported to increase the range and vividness of conscious contents. Some studies have even found correlations between complexity measures and facets of self-reported experience. As suggested by integrated information theory and the entropic brain hypothesis, measures of differentiation and signal diversity may therefore be measurable correlates of consciousness and phenomenological richness. Inspired by these ideas, we tested three hypotheses about EEG signal diversity related to sleep and dreaming. First, diversity should decrease with successively deeper stages of non-REM sleep. Second, signal diversity within the same sleep stage should be higher for periods of dreaming vs. non-dreaming. Third, specific aspects of dream contents should correlate with signal diversity in corresponding cortical regions. We employed a repeated awakening paradigm in sleep deprived healthy volunteers, with immediate dream report and rating of dream content along a thought-perceptual axis, from exclusively thought-like to exclusively perceptual. Generalized linear mixed models were used to assess how signal diversity varied with sleep stage, dreaming and thought-perceptual rating. Signal diversity decreased with sleep depth, but was not significantly different between dreaming and non-dreaming, even though there was a significant positive correlation between Lempel-Ziv complexity of EEG recorded over the posterior cortex and thought-perceptual ratings of dream contents.

Alcoholic EEG signal classification with Correlation Dimension based distance metrics approach and Modified Adaboost classification

The basic function of the brain is severely affected by alcoholism. For the easy depiction and assessment of the mental condition of a human brain, Electroencephalography (EEG) signals are highly useful as it can record and measure the electrical activities of the brain much to the satisfaction of doctors and researchers. Utilizing the standard conventional techniques is quite hectic to derive the useful information as these signals are highly non-linear and non-stationary in nature. While recording the EEG signals, the activities of the neurons are recorded from various scalp regions which has varied characteristics and has a very low magnitude. Therefore, human interpretation of such signals is very difficult and consumes a lot of time. Hence, with the advent of Computer Aided Diagnosis (CAD) Techniques, identifying the normal versus alcoholic EEG signals has been of great utility in the medical field. In this work, we perform the initial clustering of the alcoholic EEG signals by means of using Correlation Dimension (CD) for easy feature extraction and then the suitable features are selected in it by means of employing various distance metrics like correlation distance, city block distance, cosine distance and chebyshev distance. Proceeding in such a methodology aids and assures that a good discrimination could be achieved between normal and alcoholic EEG signals using non-linear features. Finally, classification is then carried out with the suitable classifiers chosen such as Adaboost.RT classifier, the proposed Modified Adaboost.RT classifier by means of introducing Ridge and Lasso based soft thresholding technique, Random Forest with bootstrap resampling technique, Artificial Neural Networks (ANN) such as Radial Basis Functions (RBF) and Multi-Layer Perceptron (MLP), Support Vector Machine (SVM) with Linear, Polynomial and RBF Kernel, Naïve Bayesian Classifier (NBC), K-means classifier, and K Nearest Neighbor (KNN) Classifier and the results are analyzed. Results report a comparatively high classification accuracy of about 98.99% when correlation distance metrics are utilized with CD and the proposed Modified Adaboost.RT classifier using Ridge based soft thresholding technique.

Granger Causality of the Electroencephalogram Reveals Abrupt Global Loss of Cortical Information Flow during Propofol-induced Loss of Responsiveness

It is a commonly held view that information flow between widely separated regions of the cerebral cortex is a necessary component in the generation of wakefulness (also termed “connected” consciousness). This study therefore hypothesized that loss of wakefulness caused by propofol anesthesia should be associated with loss of information flow, as estimated by the effective connectivity in the scalp electroencephalogram (EEG) signal.

In healthy adult volunteers, propofol anesthesia–induced loss of consciousness was associated with an abrupt, substantial, and global decrease in connectivity. These changes are comparably reversed at regain of consciousness. These observations suggest that information flow is an important indicator of wakefulness.

Supplemental Digital Content is available in the text.

Prediction of Memory Retrieval Performance Using Ear-EEG Signals

Many studies have explored brain signals during the performance of a memory task to predict later remembered items. However, prediction methods are still poorly used in real life and are not practical due to the use of electroencephalography (EEG) recorded from the scalp. Ear-EEG has been recently used to measure brain signals due to its flexibility when applying it to real world environments. In this study, we attempt to predict whether a shown stimulus is going to be remembered or forgotten using ear-EEG and compared its performance with scalp-EEG. Our results showed that there was no significant difference between ear-EEG and scalp-EEG. In addition, the higher prediction accuracy was obtained using a convolutional neural network (pre-stimulus: 74.06%, on-going stimulus: 69.53%) and it was compared to other baseline methods. These results showed that it is possible to predict performance of a memory task using ear-EEG signals and it could be used for predicting memory retrieval in a practical brain-computer interface.

End-to-End Automatic Sleep Stage Classification Using Spectral-Temporal Sleep Features

Sleep disorder is one of many neurological diseases that can affect greatly the quality of daily life. It is very burdensome to manually classify the sleep stages to detect sleep disorders. Therefore, the automatic sleep stage classification techniques are needed. However, the previous automatic sleep scoring methods using raw signals are still low classification performance. In this study, we proposed an end-to-end automatic sleep staging framework based on optimal spectral-temporal sleep features using a sleep-edf dataset. The input data were modified using a bandpass filter and then applied to a convolutional neural network model. For five sleep stage classification, the classification performance 85.6% and 91.1% using the raw input data and the proposed input, respectively. This result also shows the highest performance compared to conventional studies using the same dataset. The proposed framework has shown high performance by using optimal features associated with each sleep stage, which may help to find new features in the automatic sleep stage method.Clinical Relevance- The proposed framework would help to diagnose sleep disorders such as insomnia by improving sleep stage classification performance.

Decreased Evoked Slow-Activity After tDCS in Disorders of Consciousness

Due to life-saving medical advances, the diagnosis and treatment of disorders of consciousness (DOC) has become a more commonly occurring clinical issue. One recently developed intervention option has been non-invasive transcranial direct current stimulation. This dichotomy of patient responders may be better understood by investigating the mechanism behind the transcranial direct current stimulation (tDCS) intervention. The combination of transcranial magnetic stimulation and electroencephalography (TMS-EEG) has been an important diagnostic tool in DOC patients. We therefore examined the neural response using TMS-EEG both before and after tDCS in seven DOC patients (four diagnosed as in a minimally conscious state and three with unresponsive wakefulness syndrome). tDCS was applied over the dorsolateral prefrontal cortex, while TMS pulses were applied to the premotor cortex. None of the seven patients showed relevant behavioral change after tDCS. We did, however, find that the overall evoked slow activity was reduced following tDCS intervention. We also found a positive correlation between the strength of the slow activity and the amount of high-frequency suppression. However, there was no significant pre-post tDCS difference in high frequencies. In the resting-state EEG, we observed that both the incidence of slow waves and the positive slope of the wave were affected by tDCS. Taken together, these results suggest that the tDCS intervention can reduce the slow-wave activity component of bistability, but this may not directly affect high-frequency activity. We hypothesize that while reduced slow activity may be necessary for the recovery of neural function, especially consciousness, this alone is insufficient.

Predicting Motor Imagery Performance From Resting-State EEG Using Dynamic Causal Modeling

Motor imagery-based brain–computer interfaces (MI-BCIs) send commands to a computer using the brain activity registered when a subject imagines—but does not perform—a given movement. However, inconsistent MI-BCI performance occurs in variations of brain signals across subjects and experiments; this is considered to be a significant problem in practical BCI. Moreover, some subjects exhibit a phenomenon referred to as “BCI-inefficiency,” in which they are unable to generate brain signals for BCI control. These subjects have significant difficulties in using BCI. The primary goal of this study is to identify the connections of the resting-state network that affect MI performance and predict MI performance using these connections. We used a public database of MI, which includes the results of psychological questionnaires and pre-experimental resting-state taken over two sessions on different days. A dynamic causal model was used to calculate the coupling strengths between brain regions with directionality. Specifically, we investigated the motor network in resting-state, including the dorsolateral prefrontal cortex, which performs motor planning. As a result, we observed a significant difference in the connectivity strength from the supplementary motor area to the right dorsolateral prefrontal cortex between the low- and high-MI performance groups. This coupling, measured in the resting-state, is significantly stronger in the high-MI performance group than the low-MI performance group. The connection strength is positively correlated with MI-BCI performance (Session 1: r = 0.54; Session 2: r = 0.42). We also predicted MI performance using linear regression based on this connection (r-squared = 0.31). The proposed predictors, based on dynamic causal modeling, can develop new strategies for improving BCI performance. These findings can further our understanding of BCI-inefficiency and help BCI users to lower costs and save time.

Prediction of Event Related Potential Speller Performance Using Resting-State EEG

Event-related potential (ERP) speller can be utilized in device control and communication for locked-in or severely injured patients. However, problems such as inter-subject performance instability and ERP-illiteracy are still unresolved. Therefore, it is necessary to predict classification performance before performing an ERP speller in order to use it efficiently. In this study, we investigated the correlations with ERP speller performance using a resting-state before an ERP speller. In specific, we used spectral power and functional connectivity according to four brain regions and five frequency bands. As a result, the delta power in the frontal region and functional connectivity in the delta, alpha, gamma bands are significantly correlated with the ERP speller performance. Also, we predicted the ERP speller performance using EEG features in the resting-state. These findings may contribute to investigating the ERP-illiteracy and considering the appropriate alternatives for each user.

Brain functional connectivity during the first day of coma reflects long-term outcome

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Coma patients show different connectivity patterns depending on long-term outcome.

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Time-variance of functional connectivity is an early prognostic marker for coma patients.

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Connectivity patterns observed in chronic patients may develop early after coma onset.

Objective

In patients with disorders of consciousness (DOC), properties of functional brain networks at rest are informative of the degree of consciousness impairment and of long-term outcome. Here we investigate whether connectivity differences between patients with favorable and unfavorable outcome are already present within 24 h of coma onset.

Methods

We prospectively recorded 63-channel electroencephalography (EEG) at rest during the first day of coma after cardiac arrest. We analyzed 98 adults, of whom 57 survived beyond unresponsive wakefulness. Functional connectivity was estimated by computing the ‘debiased weighted phase lag index’ over epochs of five seconds duration. We evaluated the network’s topological features, including clustering coefficient, path length, modularity and participation coefficient and computed their variance over time. Finally, we estimated the predictive value of these topological features for patients’ outcomes by splitting the patient sample in training and test datasets.

Results

Group-level analysis revealed lower clustering coefficient, higher modularity and path length variance in patients with favorable compared to those with unfavorable outcomes (p < 0.01). Within all features, the path length variance in the network provided the best positive predictive value (PPV) for favorable outcome and specificity for unfavorable outcome in the test dataset (PPV: 0.83, p < 0.01; specificity: 0.86, p < 0.01) with above-chance negative predictive value and accuracy. Of note, the exclusion of patients with epileptiform activity (20 in total) eliminates all false positive predictions (n = 6) for path length variance.

Interpretation

Topological features of functional connectivity differ as a function of long-term outcome in patients on the first day of coma. These differences are not interpretable in terms of consciousness levels as all patients were in a deep unconscious state. The time variance of path length is informative of comatose patients’ outcome, as patients with favorable outcome exhibit a richer repertoire of path length than those with unfavorable outcomes.

Possible Effect of Binaural Beat Combined With Autonomous Sensory Meridian Response for Inducing Sleep

Sleep is important to maintain physical and cognitive functions in everyday life. However, the prevalence of sleep disorders is on the rise. One existing solution to this problem is to induce sleep using an auditory stimulus. When we listen to acoustic beats of two tones in each ear simultaneously, a binaural beat is generated which induces brain signals at a specific desired frequency. However, this auditory stimulus is uncomfortable for users to listen to induce sleep. To overcome this difficulty, we can exploit the feelings of calmness and relaxation that are induced by the perceptual phenomenon of autonomous sensory meridian response (ASMR). In this study, we proposed a novel auditory stimulus for inducing sleep. Specifically, we used a 6 Hz binaural beat corresponding to the center of the theta band (4-8 Hz), which is the frequency at which brain activity is entrained during non-rapid eye movement (NREM) in sleep stage 1. In addition, the "ASMR triggers" that cause ASMR were presented from natural sound as the sensory stimuli. In session 1, we combined two auditory stimuli (the 6 Hz binaural beat and ASMR triggers) at three-decibel ratios to find the optimal combination ratio. As a result, we determined that the combination of a 30:60 dB ratio of binaural beat to ASMR trigger is most effective for inducing theta power and psychological stability. In session 2, the effects of these combined stimuli (CS) were compared with an only binaural beat, only the ASMR trigger, or a sham condition. The combination stimulus retained the advantages of the binaural beat and resolved its shortcomings with the ASMR triggers, including psychological self-reports. Our findings indicate that the proposed auditory stimulus could induce the brain signals required for sleep, while simultaneously keeping the user in a psychologically comfortable state. This technology provides an important opportunity to develop a novel method for increasing the quality of sleep.