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Mathew J, Perez TM, Adhia DB, De Ridder D, Mani R. Is There a Difference in EEG Characteristics in Acute, Chronic, and Experimentally Induced Musculoskeletal Pain States? a Systematic Review. Clin EEG Neurosci 2024; 55:101-120. [PMID: 36377346 DOI: 10.1177/15500594221138292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Electroencephalographic (EEG) alterations have been demonstrated in acute, chronic, and experimentally induced musculoskeletal (MSK) pain conditions. However, there is no cumulative evidence on the associated EEG characteristics differentiating acute, chronic, and experimentally induced musculoskeletal pain states, especially compared to healthy controls. The present systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA) to review and summarize available evidence for cortical brain activity and connectivity alterations in acute, chronic, and experimentally induced MSK pain states. Five electronic databases were systematically searched from their inception to 2022. A total of 3471 articles were screened, and 26 full articles (five studies on chronic pain and 21 studies on experimentally induced pain) were included for the final synthesis. Using the Downs and Black risk of assessment tool, 92% of the studies were assessed as low to moderate quality. The review identified a 'very low' level of evidence for the changes in EEG and subjective outcome measures for both chronic and experimentally induced MSK pain based on the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. Overall, the findings of this review indicate a trend toward decreased alpha and beta EEG power in evoked chronic clinical pain conditions and increased theta and alpha power in resting-state EEG recorded from chronic MSK pain conditions. EEG characteristics are unclear under experimentally induced pain conditions.
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Affiliation(s)
- Jerin Mathew
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Tyson Michael Perez
- Department of Surgical Sciences, Section of Neurosurgery, Otago Medical School-Dunedin campus, University of Otago, Dunedin, New Zealand
| | - Divya Bharatkumar Adhia
- Department of Surgical Sciences, Section of Neurosurgery, Otago Medical School-Dunedin campus, University of Otago, Dunedin, New Zealand
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Otago Medical School-Dunedin campus, University of Otago, Dunedin, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand
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2
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Jaroszynski C, Amorim-Leite R, Deman P, Perrone-Bertolotti M, Chabert F, Job-Chapron AS, Minotti L, Hoffmann D, David O, Kahane P. Brain mapping of auditory hallucinations and illusions induced by direct intracortical electrical stimulation. Brain Stimul 2022; 15:1077-1087. [PMID: 35952963 DOI: 10.1016/j.brs.2022.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The exact architecture of the human auditory cortex remains a subject of debate, with discrepancies between functional and microstructural studies. In a hierarchical framework for sensory perception, simple sound perception is expected to take place in the primary auditory cortex, while the processing of complex, or more integrated perceptions is proposed to rely on associative and higher-order cortices. OBJECTIVES We hypothesize that auditory symptoms induced by direct electrical stimulation (DES) offer a window into the architecture of the brain networks involved in auditory hallucinations and illusions. The intracranial recordings of these evoked perceptions of varying levels of integration provide the evidence to discuss the theoretical model. METHODS We analyzed SEEG recordings from 50 epileptic patients presenting auditory symptoms induced by DES. First, using the Juelich cytoarchitectonic parcellation, we quantified which regions induced auditory symptoms when stimulated (ROI approach). Then, for each evoked auditory symptom type (illusion or hallucination), we mapped the cortical networks showing concurrent high-frequency activity modulation (HFA approach). RESULTS Although on average, illusions were found more laterally and hallucinations more posteromedially in the temporal lobe, both perceptions were elicited in all levels of the sensory hierarchy, with mixed responses found in the overlap. The spatial range was larger for illusions, both in the ROI and HFA approaches. The limbic system was specific to the hallucinations network, and the inferior parietal lobule was specific to the illusions network. DISCUSSION Our results confirm a network-based organization underlying conscious sound perception, for both simple and complex components. While symptom localization is interesting from an epilepsy semiology perspective, the hallucination-specific modulation of the limbic system is particularly relevant to tinnitus and schizophrenia.
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Affiliation(s)
- Chloé Jaroszynski
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France.
| | - Ricardo Amorim-Leite
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Pierre Deman
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Marcela Perrone-Bertolotti
- Univ. Grenoble Alpes, CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNC, 38000, Grenoble, France
| | - Florian Chabert
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Anne-Sophie Job-Chapron
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Lorella Minotti
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Dominique Hoffmann
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Olivier David
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France; Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
| | - Philippe Kahane
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France.
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3
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Paulk AC, Zelmann R, Crocker B, Widge AS, Dougherty DD, Eskandar EN, Weisholtz DS, Richardson RM, Cosgrove GR, Williams ZM, Cash SS. Local and distant cortical responses to single pulse intracranial stimulation in the human brain are differentially modulated by specific stimulation parameters. Brain Stimul 2022; 15:491-508. [PMID: 35247646 PMCID: PMC8985164 DOI: 10.1016/j.brs.2022.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Electrical neuromodulation via direct electrical stimulation (DES) is an increasingly common therapy for a wide variety of neuropsychiatric diseases. Unfortunately, therapeutic efficacy is inconsistent, likely due to our limited understanding of the relationship between the massive stimulation parameter space and brain tissue responses. OBJECTIVE To better understand how different parameters induce varied neural responses, we systematically examined single pulse-induced cortico-cortico evoked potentials (CCEP) as a function of stimulation amplitude, duration, brain region, and whether grey or white matter was stimulated. METHODS We measured voltage peak amplitudes and area under the curve (AUC) of intracranially recorded stimulation responses as a function of distance from the stimulation site, pulse width, current injected, location relative to grey and white matter, and brain region stimulated (N = 52, n = 719 stimulation sites). RESULTS Increasing stimulation pulse width increased responses near the stimulation location. Increasing stimulation amplitude (current) increased both evoked amplitudes and AUC nonlinearly. Locally (<15 mm), stimulation at the boundary between grey and white matter induced larger responses. In contrast, for distant sites (>15 mm), white matter stimulation consistently produced larger responses than stimulation in or near grey matter. The stimulation location-response curves followed different trends for cingulate, lateral frontal, and lateral temporal cortical stimulation. CONCLUSION These results demonstrate that a stronger local response may require stimulation in the grey-white boundary while stimulation in the white matter could be needed for network activation. Thus, stimulation parameters tailored for a specific anatomical-functional outcome may be key to advancing neuromodulatory therapy.
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Affiliation(s)
- Angelique C Paulk
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | - Rina Zelmann
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Britni Crocker
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Harvard-MIT Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Darin D Dougherty
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Emad N Eskandar
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Daniel S Weisholtz
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - R Mark Richardson
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - Ziv M Williams
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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McMullen DP, Thomas TM, Fifer MS, Candrea DN, Tenore FV, Nickl RW, Pohlmeyer EA, Coogan C, Osborn LE, Schiavi A, Wojtasiewicz T, Gordon CR, Cohen AB, Ramsey NF, Schellekens W, Bensmaia SJ, Cantarero GL, Celnik PA, Wester BA, Anderson WS, Crone NE. Novel intraoperative online functional mapping of somatosensory finger representations for targeted stimulating electrode placement: technical note. J Neurosurg 2021; 135:1493-1500. [PMID: 33770760 DOI: 10.3171/2020.9.jns202675] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/29/2020] [Indexed: 11/06/2022]
Abstract
Defining eloquent cortex intraoperatively, traditionally performed by neurosurgeons to preserve patient function, can now help target electrode implantation for restoring function. Brain-machine interfaces (BMIs) have the potential to restore upper-limb motor control to paralyzed patients but require accurate placement of recording and stimulating electrodes to enable functional control of a prosthetic limb. Beyond motor decoding from recording arrays, precise placement of stimulating electrodes in cortical areas associated with finger and fingertip sensations allows for the delivery of sensory feedback that could improve dexterous control of prosthetic hands. In this study, the authors demonstrated the use of a novel intraoperative online functional mapping (OFM) technique with high-density electrocorticography to localize finger representations in human primary somatosensory cortex. In conjunction with traditional pre- and intraoperative targeting approaches, this technique enabled accurate implantation of stimulating microelectrodes, which was confirmed by postimplantation intracortical stimulation of finger and fingertip sensations. This work demonstrates the utility of intraoperative OFM and will inform future studies of closed-loop BMIs in humans.
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Affiliation(s)
- David P McMullen
- 1National Institute of Mental Health, National Institutes of Health, Bethesda
| | | | - Matthew S Fifer
- 3Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland
| | | | - Francesco V Tenore
- 3Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland
| | | | - Eric A Pohlmeyer
- 3Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland
| | | | - Luke E Osborn
- 3Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland
| | | | | | - Chad R Gordon
- 8Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore
| | - Adam B Cohen
- 3Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland
- 5Neurology
| | - Nick F Ramsey
- 9UMC Utrecht Brain Center, Utrecht, The Netherlands; and
| | | | - Sliman J Bensmaia
- 10Department of Organismal Biology and Anatomy, University of Chicago, Illinois
| | | | | | - Brock A Wester
- 3Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland
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5
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Papasavvas CA, Schroeder GM, Diehl B, Baier G, Taylor PN, Wang Y. Band power modulation through intracranial EEG stimulation and its cross-session consistency. J Neural Eng 2020; 17:054001. [PMID: 33022661 PMCID: PMC7612301 DOI: 10.1088/1741-2552/abbecf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Direct electrical stimulation of the brain through intracranial electrodes is currently used to probe the epileptic brain as part of pre-surgical evaluation, and it is also being considered for therapeutic treatments through neuromodulation. In order to effectively modulate neural activity, a given neuromodulation design must elicit similar responses throughout the course of treatment. However, it is unknown whether intracranial electrical stimulation responses are consistent across sessions. The objective of this study was to investigate the within-subject, cross-session consistency of the electrophysiological effect of electrical stimulation delivered through intracranial electroencephalography (iEEG). APPROACH We analysed data from 79 epilepsy patients implanted with iEEG who underwent brain stimulation as part of a memory experiment. We quantified the effect of stimulation in terms of band power modulation and compared this effect from session to session. As a reference, we made the same measurements during baseline periods. MAIN RESULTS In most sessions, the effect of stimulation on band power could not be distinguished from baseline fluctuations of band power. Stimulation effect was consistent in a third of the session pairs, while the rest had a consistency measure not exceeding the baseline standards. Cross-session consistency was highly correlated with the degree of band power increase, and it also tended to be higher when the baseline conditions were more similar between sessions. SIGNIFICANCE These findings can inform our practices for designing neuromodulation with greater efficacy when using direct electrical brain stimulation as a therapeutic treatment.
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Affiliation(s)
- Christoforos A Papasavvas
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
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6
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Perrone-Bertolotti M, Alexandre S, Jobb AS, De Palma L, Baciu M, Mairesse MP, Hoffmann D, Minotti L, Kahane P, David O. Probabilistic mapping of language networks from high frequency activity induced by direct electrical stimulation. Hum Brain Mapp 2020; 41:4113-4126. [PMID: 32697353 PMCID: PMC7469846 DOI: 10.1002/hbm.25112] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 11/29/2022] Open
Abstract
Direct electrical stimulation (DES) at 50 Hz is used as a gold standard to map cognitive functions but little is known about its ability to map large‐scale networks and specific subnetwork. In the present study, we aim to propose a new methodological approach to evaluate the specific hypothesis suggesting that language errors/dysfunction induced by DES are the result of large‐scale network modification rather than of a single cortical region, which explains that similar language symptoms may be observed after stimulation of different cortical regions belonging to this network. We retrospectively examined 29 patients suffering from focal drug‐resistant epilepsy who benefitted from stereo‐electroencephalographic (SEEG) exploration and exhibited language symptoms during a naming task following 50 Hz DES. We assessed the large‐scale language network correlated with behavioral DES‐induced responses (naming errors) by quantifying DES‐induced changes in high frequency activity (HFA, 70–150 Hz) outside the stimulated cortical region. We developed a probabilistic approach to report the spatial pattern of HFA modulations during DES‐induced language errors. Similarly, we mapped the pattern of after‐discharges (3–35 Hz) occurring after DES. HFA modulations concurrent to language symptoms revealed a brain network similar to our current knowledge of language gathered from standard brain mapping. In addition, specific subnetworks could be identified within the global language network, related to different language processes, generally described in relation to the classical language regions. Spatial patterns of after‐discharges were similar to HFA induced during DES. Our results suggest that this new methodological DES‐HFA mapping is a relevant approach to map functional networks during SEEG explorations, which would allow to shift from “local” to “network” perspectives.
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Affiliation(s)
- Marcela Perrone-Bertolotti
- CNRC, Laboratoire de Psychologie et NeuroCognition, University of Grenoble Alpes, University of Savoie Mont Blanc, Grenoble, France.,Institut Universitaire de, Paris, France
| | - Sarah Alexandre
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France
| | - Anne-Sophie Jobb
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France.,University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
| | - Luca De Palma
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France
| | - Monica Baciu
- CNRC, Laboratoire de Psychologie et NeuroCognition, University of Grenoble Alpes, University of Savoie Mont Blanc, Grenoble, France.,Institut Universitaire de, Paris, France
| | | | | | - Lorella Minotti
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France.,University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
| | - Philippe Kahane
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France.,University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
| | - Olivier David
- University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
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7
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Khambhati AN, Kahn AE, Costantini J, Ezzyat Y, Solomon EA, Gross RE, Jobst BC, Sheth SA, Zaghloul KA, Worrell G, Seger S, Lega BC, Weiss S, Sperling MR, Gorniak R, Das SR, Stein JM, Rizzuto DS, Kahana MJ, Lucas TH, Davis KA, Tracy JI, Bassett DS. Functional control of electrophysiological network architecture using direct neurostimulation in humans. Netw Neurosci 2019; 3:848-877. [PMID: 31410383 PMCID: PMC6663306 DOI: 10.1162/netn_a_00089] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/14/2019] [Indexed: 01/30/2023] Open
Abstract
Chronically implantable neurostimulation devices are becoming a clinically viable option for treating patients with neurological disease and psychiatric disorders. Neurostimulation offers the ability to probe and manipulate distributed networks of interacting brain areas in dysfunctional circuits. Here, we use tools from network control theory to examine the dynamic reconfiguration of functionally interacting neuronal ensembles during targeted neurostimulation of cortical and subcortical brain structures. By integrating multimodal intracranial recordings and diffusion-weighted imaging from patients with drug-resistant epilepsy, we test hypothesized structural and functional rules that predict altered patterns of synchronized local field potentials. We demonstrate the ability to predictably reconfigure functional interactions depending on stimulation strength and location. Stimulation of areas with structurally weak connections largely modulates the functional hubness of downstream areas and concurrently propels the brain towards more difficult-to-reach dynamical states. By using focal perturbations to bridge large-scale structure, function, and markers of behavior, our findings suggest that stimulation may be tuned to influence different scales of network interactions driving cognition. Brain stimulation devices capable of perturbing the physiological state of neural systems are rapidly gaining popularity for their potential to treat neurological and psychiatric disease. A root problem is that underlying dysfunction spans a large-scale network of brain regions, requiring the ability to control the complex interactions between multiple brain areas. Here, we use tools from network control theory to examine the dynamic reconfiguration of functionally interacting neuronal ensembles during targeted neurostimulation of cortical and subcortical brain structures. We demonstrate the ability to predictably reconfigure patterns of interactions between functional brain areas by modulating the strength and location of stimulation. Our findings have high significance for designing stimulation protocols capable of modulating distributed neural circuits in the human brain.
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Affiliation(s)
- Ankit N Khambhati
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Ari E Kahn
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Julia Costantini
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Youssef Ezzyat
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ethan A Solomon
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert E Gross
- Department of Neurosurgery, Emory University Hospital, Atlanta, GA, USA
| | - Barbara C Jobst
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Kareem A Zaghloul
- Surgical Neurology Branch, National Institutes of Health, Bethesda, MD, USA
| | | | - Sarah Seger
- Department of Neurosurgery, University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Bradley C Lega
- Department of Neurosurgery, University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Shennan Weiss
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Michael R Sperling
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Richard Gorniak
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Sandhitsu R Das
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Joel M Stein
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel S Rizzuto
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael J Kahana
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Timothy H Lucas
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Kathryn A Davis
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph I Tracy
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
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