Postmovement beta synchronization in patients with Parkinson's disease

Event-related desynchronization and synchronization in multiple sclerosis

BACKGROUND

Motor preparation and execution can be impaired in patients with multiple sclerosis (pwMS). These neural processes can be assessed using electroencephalography (EEG). During a self-paced movement, EEG signal amplitude decreases before movement (event-related desynchronization, ERD) and increases after movement (event-related synchronization, ERS).

OBJECTIVE

To reappraise ERD/ERS changes in pwMS compared to healthy controls (HC).

METHODS

This single-center study included 13 pwMS and 10 sex/age-matched HC. 60-channel EEG was recorded during two self-paced movements of the right hand: a simple index finger extension task and a more complex finger tapping task. Clinical variables included MS type, sex, age, disease duration, disability, grip strength, fatigue and attentional performance. EEG variables included ERD and ERS onset latency, duration, and amplitude determined using two methods of signal analyses (based on visual or automated determination) in the alpha and beta frequency bands in five cortical regions: right and left frontocentral and centroparietal regions and a midline region. Neuroimaging variables included the volumes of four deep brain structures (thalamus, putamen, pallidum and caudate nucleus) and the relative lesion load.

RESULTS

ERD/ERS changes in pwMS compared to HC were observed only in the beta band. In pwMS, beta-ERD had a delayed onset in the midline and right parietocentral regions and a shortened duration or increased amplitude in the parietocentral region; beta-ERS had a shorter duration, delayed onset, or reduced amplitude in the left parieto/frontocentral region. In addition, pwMS with a more delayed beta-ERD in the midline region had less impaired executive functions but increased caudate nuclei volume, while pwMS with a more delayed beta-ERS in the parietocentral region contralateral to the movement had less fatigue but increased thalami volume.

CONCLUSION

This study confirms an alteration of movement preparation and execution in pwMS, mainly characterized by a delayed cortical activation (ERD) and a delayed and reduced post-movement inhibition (ERS) in the beta band. Compensatory mechanisms could be involved in these changes, associating more preserved clinical performance and overactivation of deep brain structures.

Movement-related beta ERD and ERS abnormalities in neuropsychiatric disorders

Movement-related oscillations in the beta range (from 13 to 30 Hz) have been observed over sensorimotor areas with power decrease (i.e., event-related desynchronization, ERD) during motor planning and execution followed by an increase (i.e., event-related synchronization, ERS) after the movement's end. These phenomena occur during active, passive, imaged, and observed movements. Several electrophysiology studies have used beta ERD and ERS as functional indices of sensorimotor integrity, primarily in diseases affecting the motor system. Recent literature also highlights other characteristics of beta ERD and ERS, implying their role in processes not strictly related to motor function. Here we review studies about movement-related ERD and ERS in diseases characterized by motor dysfunction, including Parkinson's disease, dystonia, stroke, amyotrophic lateral sclerosis, cerebral palsy, and multiple sclerosis. We also review changes of beta ERD and ERS reported in physiological aging, Alzheimer's disease, and schizophrenia, three conditions without overt motor symptoms. The review of these works shows that ERD and ERS abnormalities are present across the spectrum of the examined pathologies as well as development and aging. They further suggest that cognition and movement are tightly related processes that may share common mechanisms regulated by beta modulation. Future studies with a multimodal approach are warranted to understand not only the specific topographical dynamics of movement-related beta modulation but also the general meaning of beta frequency changes occurring in relation to movement and cognitive processes at large. Such an approach will provide the foundation to devise and implement novel therapeutic approaches to neuropsychiatric disorders.

EEG and MEG primers for tracking DBS network effects

Deep brain stimulation (DBS) is an effective treatment method for a range of neurological and psychiatric disorders. It involves implantation of stimulating electrodes in a precisely guided fashion into subcortical structures and, at a later stage, chronic stimulation of these structures with an implantable pulse generator. While the DBS surgery makes it possible to both record brain activity and stimulate parts of the brain that are difficult to reach with non-invasive techniques, electroencephalography (EEG) and magnetoencephalography (MEG) provide complementary information from other brain areas, which can be used to characterize brain networks targeted through DBS. This requires, however, the careful consideration of different types of artifacts in the data acquisition and the subsequent analyses. Here, we review both the technical issues associated with EEG/MEG recordings in DBS patients and the experimental findings to date. One major line of research is simultaneous recording of local field potentials (LFPs) from DBS targets and EEG/MEG. These studies revealed a set of cortico-subcortical coherent networks functioning at distinguishable physiological frequencies. Specific network responses were linked to clinical state, task or stimulation parameters. Another experimental approach is mapping of DBS-targeted networks in chronically implanted patients by recording EEG/MEG responses during stimulation. One can track responses evoked by single stimulation pulses or bursts as well as brain state shifts caused by DBS. These studies have the potential to provide biomarkers for network responses that can be adapted to guide stereotactic implantation or optimization of stimulation parameters. This is especially important for diseases where the clinical effect of DBS is delayed or develops slowly over time. The same biomarkers could also potentially be utilized for the online control of DBS network effects in the new generation of closed-loop stimulators that are currently entering clinical use. Through future studies, the use of network biomarkers may facilitate the integration of circuit physiology into clinical decision making.

Neurophysiological Biomarkers of Parkinson's Disease

BACKGROUND

There is a need for reliable and robust Parkinson's disease biomarkers that reflect severity and are sensitive to disease modifying investigational therapeutics.

OBJECTIVE

To demonstrate the utility of EEG as a reliable, quantitative biomarker with potential as a pharmacodynamic endpoint for use in clinical assessments of neuroprotective therapeutics for Parkison's disease.

METHODS

A multi modal study was performed including aquisition of resting state EEG data and dopamine transporter PET imaging from Parkinson's disease patients off medication and compared against age-matched controls.

RESULTS

Qualitative and test/retest analysis of the EEG data demonstrated the reliability of the methods. Source localization using low resolution brain electromagnetic tomography identified significant differences in Parkinson's patients versus control subjects in the anterior cingulate and temporal lobe, areas with established association to Parkinson's disease pathology. Changes in cortico-cortical and cortico-thalamic coupling were observed as excessive EEG beta coherence in Parkinson's disease patients, and correlated with UPDRS scores and dopamine transporter activity, supporting the potential for cortical EEG coherence to serve as a reliable measure of disease severity. Using machine learning approaches, an EEG discriminant function analysis classifier was identified that parallels the loss of dopamine synapses as measured by dopamine transporter PET.

CONCLUSION

Our results support the utility of EEG in characterizing alterations in neurophysiological oscillatory activity associated with Parkinson's disease and highlight potential as a reliable method for monitoring disease progression and as a pharmacodynamic endpoint for Parkinson's disease modification therapy.

Levodopa Modulates Functional Connectivity in the Upper Beta Band Between Subthalamic Nucleus and Muscle Activity in Tonic and Phasic Motor Activity Patterns in Parkinson's Disease

Introduction: Striatal dopamine depletion disrupts basal ganglia function and causes Parkinson's disease (PD). The pathophysiology of the dopamine-dependent relationship between basal ganglia signaling and motor control, however, is not fully understood. We obtained simultaneous recordings of local field potentials (LFPs) from the subthalamic nucleus (STN) and electromyograms (EMGs) in patients with PD to investigate the impact of dopaminergic state and movement on long-range beta functional connectivity between basal ganglia and lower motor neurons. Methods: Eight PD patients were investigated 3 months after implantation of a deep brain stimulation (DBS)-system capable of recording LFPs via chronically-implanted leads (Medtronic, ACTIVA PC+S^®). We analyzed STN spectral power and its coherence with EMG in the context of two different movement paradigms (tonic wrist extension vs. alternating wrist extension and flexion) and the effect of levodopa (L-Dopa) intake using an unbiased data-driven approach to determine regions of interest (ROI). Results: Two ROIs capturing prominent coherence within a grand average coherogram were identified. A trend of a dopamine effect was observed for the first ROI (50-150 ms after movement start) with higher STN-EMG coherence in medicated patients. Concerning the second ROI (300-500 ms after movement start), an interaction effect of L-Dopa medication and movement task was observed with higher coherence in the isometric contraction task compared to alternating movements in the medication ON state, a pattern which was reversed in L-Dopa OFF. Discussion: L-Dopa medication may normalize functional connectivity between remote structures of the motor system with increased upper beta coherence reflecting a physiological restriction of the amount of information conveyed between remote structures. This may be necessary to maintain simple movements like isometric contraction. Our study adds dynamic properties to the complex interplay between STN spectral beta power and the nucleus' functional connectivity to remote structures of the motor system as a function of movement and dopaminergic state. This may help to identify markers of neuronal activity relevant for more individualized programming of DBS therapy.

Attenuated NoGo-related beta desynchronisation and synchronisation in Parkinson's disease revealed by magnetoencephalographic recording

Parkinson’s disease (PD) is a neurodegenerative disorder characterised by motor abnormalities. Many non-demented patients with PD have cognitive impairment especially in executive functions. Using magnetoencephalographic (MEG) recording combined with event-related desynchronisation/synchronisation (ERD/ERS) analysis, we investigated cortical executive functions during a Go/NoGo task in PD patients and matched healthy subjects. PD patients had a longer reaction time in the Go condition and had a higher error ratio in both Go and NoGo conditions. The MEG analysis showed that the PD patients had a significant reduction in beta ERD during the NoGo condition and in beta ERS during both Go and NoGo conditions compared with the healthy subjects (all p < 0.05). Moreover, in the Go condition, the onsets of beta ERD and ERS were delayed in PD patients. Notably, NoGo ERS was negatively correlated with the Unified Parkinson’s Disease Rating Scale (UPDRS) score in PD patients. The present study demonstrated abnormalities in motor programming, response inhibition, and frontal inhibitory modulation in PD. Further extensive investigations are necessary to confirm the longitudinal treatment responses in PD.

Attenuated beta rebound to proprioceptive afferent feedback in Parkinson's disease

Motor symptoms are defining traits in the diagnosis of Parkinson’s disease (PD). A crucial component in motor function is the integration of afferent proprioceptive sensory feedback. Previous studies have indicated abnormal movement-related cortical oscillatory activity in PD, but the role of the proprioceptive afference on abnormal oscillatory activity in PD has not been elucidated. We examine the cortical oscillations in the mu/beta-band (8–30 Hz) in the processing of proprioceptive stimulation in PD patients, ON/OFF levodopa medication, as compared to that of healthy controls (HC). We used a proprioceptive stimulator that generated precisely controlled passive movements of the index finger and measured the induced cortical oscillatory responses following the proprioceptive stimulation using magnetoencephalography. Both PD patients and HC showed a typical beta-band desynchronization during the passive movement. However, the subsequent beta rebound after the passive movement that was almost absent in PD patients compared to HC. Furthermore, we found no difference in the degree of beta rebound attenuation between patients ON and OFF levodopa medication. The results demonstrate a disease-related deterioration in cortical processing of proprioceptive afference in PD.

Neurophysiological markers of network dysfunction in neurodegenerative diseases

There is strong clinical, imaging and pathological evidence that neurodegeneration is associated with altered brain connectivity. While functional imaging (fMRI) can detect resting and activated states of metabolic activity, its use is limited by poor temporal resolution, cost and confounding vascular parameters. By contrast, electrophysiological (e.g. EEG/MEG) recordings provide direct measures of neural activity with excellent temporal resolution, and source localization methodologies can address problems of spatial resolution, permitting measurement of functional activity of brain networks with a spatial resolution similar to that of fMRI. This opens an exciting therapeutic approach focussed on pharmacological and physiological modulation of brain network activity. This review describes current neurophysiological approaches towards evaluating cortical network dysfunction in common neurodegenerative disorders. It explores how modern neurophysiologic tools can provide markers for diagnosis, prognosis, subcategorization and clinical trial outcome measures, and how modulation of brain networks can contribute to new therapeutic approaches.

Study of Repetitive Movements Induced Oscillatory Activities in Healthy Subjects and Chronic Stroke Patients

Repetitive movements at a constant rate require the integration of internal time counting and motor neural networks. Previous studies have proved that humans can follow short durations automatically (automatic timing) but require more cognitive efforts to track or estimate long durations. In this study, we studied sensorimotor oscillatory activities in healthy subjects and chronic stroke patients when subjects were performing repetitive finger movements. We found the movement-modulated changes in alpha and beta oscillatory activities were decreased with the increase of movement rates in finger lifting of healthy subjects and the non-paretic hands in stroke patients, whereas no difference was found in the paretic-hand movements at different movement rates in stroke patients. The significant difference in oscillatory activities between movements of non-paretic hands and paretic hands could imply the requirement of higher cognitive efforts to perform fast repetitive movements in paretic hands. The sensorimotor oscillatory response in fast repetitive movements could be a possible indicator to probe the recovery of motor function in stroke patients.

Post-Movement Beta Activity in Sensorimotor Cortex Indexes Confidence in the Estimations from Internal Models

Beta oscillations are a dominant feature of the sensorimotor system. A transient and prominent increase in beta oscillations is consistently observed across the sensorimotor cortical-basal ganglia network after cessation of voluntary movement: the post-movement beta synchronization (PMBS). Current theories about the function of the PMBS have been focused on either the closure of motor response or the processing of sensory afferance. Computational models of sensorimotor control have emphasized the importance of the integration between feedforward estimation and sensory feedback, and therefore the putative motor and sensory functions of beta oscillations may reciprocally interact with each other and in fact be indissociable. Here we show that the amplitude of sensorimotor PMBS is modulated by the history of visual feedback of task-relevant errors, and negatively correlated with the trial-to-trial exploratory adjustment in a sensorimotor adaptation task in young healthy human subjects. The PMBS also negatively correlated with the uncertainty associated with the feedforward estimation, which was recursively updated in light of new sensory feedback, as identified by a Bayesian learning model. These results reconcile the two opposing motor and sensory views of the function of PMBS, and suggest a unifying theory in which PMBS indexes the confidence in internal feedforward estimation in Bayesian sensorimotor integration. Its amplitude simultaneously reflects cortical sensory processing and signals the need for maintenance or adaptation of the motor output, and if necessary, exploration to identify an altered sensorimotor transformation.

SIGNIFICANCE STATEMENT

For optimal sensorimotor control, sensory feedback and feedforward estimation of a movement's sensory consequences should be weighted by the inverse of their corresponding uncertainties, which require recursive updating in a dynamic environment. We show that post-movement beta activity (13-30 Hz) over sensorimotor cortex in young healthy subjects indexes the evaluation of uncertainty in feedforward estimation. Our work contributes to the understanding of the function of beta oscillations in sensorimotor control, and provides further insight into how aberrant beta activity can contribute to the pathophysiology of movement disorders.

A mathematical model of dysfunction of the thalamo-cortical loop in schizophrenia

BACKGROUND

Recent experimental results suggest that impairment of auditory information processing in the thalamo-cortical loop is crucially related to schizophrenia. Large differences between schizophrenia patients and healthy controls were found in the cortical EEG signals.

METHODS

We derive a phenomenological mathematical model, based on coupled phase oscillators with continuously distributed frequencies to describe the neural activity of the thalamo-cortical loop. We examine the influence of the bidirectional coupling strengths between the thalamic and the cortical area with regard to the phase-locking effects observed in the experiments. We extend this approach to a model consisting of a thalamic area coupled to two cortical areas, each comprising a set of nonidentical phase oscillators. In the investigations of our model, we applied the Ott-Antonsen theory and the Pikovsky-Rosenblum reduction methods to the original system.

RESULTS

The results derived from our mathematical model satisfactorily reproduce the experimental data obtained by EEG measurements. Furthermore, they show that modifying the coupling strength from the thalamic region to a cortical region affects the duration of phase synchronization, while a change in the feedback to the thalamus affects the strength of synchronization in the cortex. In addition, our model provides an explanation in terms of nonlinear dynamics as to why brain waves desynchronize after a given phase reset.

CONCLUSION

Our model can explain functional differences seen between EEG records of healthy subjects and schizophrenia patients on a system theoretic basis. Because of this and its predictive character, the model may be considered to pave the way towards an early and reliable clinical detection of schizophrenia that is dependent on the interconnections between the thalamic and cortical regions. In particular, the model parameter that describes the strength of this connection can be used for a diagnostic classification of schizophrenia patients.

A shift from prospective to reactive modulation of beta-band oscillations in Parkinson's disease

Increased beta (13-30 Hz) oscillatory synchrony in basal ganglia-cortical circuits is a physiological characteristic of Parkinson's disease (PD). While the function of the beta rhythm is unknown, there is evidence that its modulation serves a predictive role, in preparation of future actions. We investigate the relation between predictive beta modulation and entrainment of brain oscillations in a task inviting behavioral entrainment by a regular task structure. MEG was recorded during a serial choice response task, in a group of 12 PD patients and 12 control subjects. In one condition, the reaction stimuli allowed for temporal preparation only (random condition), while in a second condition (predictable condition) the reaction stimuli allowed both temporal and effector preparation. Reaction times were identical between groups, and both groups benefited equally from the known effector side in the predictable condition. Analysis of oscillatory activity, by contrast, revealed marked differences between groups. In patients, the proportion of preparatory beta power desynchronization preceding the reaction stimuli was significantly smaller than in controls, while the proportion of beta desynchronization following the events was larger. In addition to this shift from prospective to reactive modulation of beta-band oscillations, patients showed a trend to reduced motor cortical pre-stimulus delta phase synchronization, and later gamma power synchronization than controls. Delta phase synchronization was, furthermore, significantly correlated with predictive beta desynchronization, supporting the relevance of hierarchical coupling between oscillations of different frequencies for the analysis of oscillatory changes in PD. Together, these features of task-related oscillatory activity indicate that entrainment fails to engender the same predictive mode of motor activation in PD patients as in healthy controls.

The effects of augmented visual feedback during balance training in Parkinson's disease: study design of a randomized clinical trial

BACKGROUND

Patients with Parkinson's disease often suffer from reduced mobility due to impaired postural control. Balance exercises form an integral part of rehabilitative therapy but the effectiveness of existing interventions is limited. Recent technological advances allow for providing enhanced visual feedback in the context of computer games, which provide an attractive alternative to conventional therapy. The objective of this randomized clinical trial is to investigate whether a training program capitalizing on virtual-reality-based visual feedback is more effective than an equally-dosed conventional training in improving standing balance performance in patients with Parkinson's disease.

METHODS/DESIGN

Patients with idiopathic Parkinson's disease will participate in a five-week balance training program comprising ten treatment sessions of 60 minutes each. Participants will be randomly allocated to (1) an experimental group that will receive balance training using augmented visual feedback, or (2) a control group that will receive balance training in accordance with current physical therapy guidelines for Parkinson's disease patients. Training sessions consist of task-specific exercises that are organized as a series of workstations. Assessments will take place before training, at six weeks, and at twelve weeks follow-up. The functional reach test will serve as the primary outcome measure supplemented by comprehensive assessments of functional balance, posturography, and electroencephalography.

DISCUSSION

We hypothesize that balance training based on visual feedback will show greater improvements on standing balance performance than conventional balance training. In addition, we expect that learning new control strategies will be visible in the co-registered posturographic recordings but also through changes in functional connectivity.

Event-related desynchronization and synchronization quantification in motor-related EEG by Kolmogorov entropy

OBJECTIVE

Various approaches have been applied for the quantification of event-related desynchronization/synchronization (ERD/ERS) in EEG/MEG data analysis, but most of them are based on band power analysis. In this paper, we sought a novel method using a nonlinear measurement to quantify the ERD/ERS time course of motor-related EEG.

APPROACH

We applied Kolmogorov entropy to quantify the ERD/ERS time course of motor-related EEG in relation to hand movement imagination and execution for the first time. To further test the validity of the Kolmogorov entropy measure, we tested it on five human subjects for feature extraction to classify the left and right hand motor tasks.

MAIN RESULTS

The results show that the relative increase and decrease of Kolmogorov entropy indicates the ERD and ERS respectively. An average classification accuracy of 87.3% was obtained for five subjects.

SIGNIFICANCE

The results prove that Kolmogorov entropy can effectively quantify the dynamic process of event-related EEG, and it also provides a novel method of classifying motor imagery tasks from scalp EEG by Kolmogorov entropy measurement with promising classification accuracy.

Inter-trial analysis of post-movement Beta activities in EEG signals using multivariate empirical mode decomposition

Event-related desynchronization/synchronization (ERD/ERS) is a technique to quantify subject's nonphase-locked neural activities underlying specific frequency bands, reactive to external/internal stimulus. However, conventional ERD/ERS studies usually utilize fixed frequency band determined from one or few channels to filter whole-head EEG/MEG data, which may inevitably include task-unrelated signals and result in underestimation of reactive oscillatory activities in multichannel studies. In this study, we adopted multivariate empirical mode decomposition (MEMD) to extract beta-related oscillatory activities in performing self-paced right and left index-finger lifting tasks. The MEMD extracts common modes from all channels in same-index intrinsic mode functions (IMFs) which allows the temporal-frequency features among different channels can be compared in each subband. The beta-band oscillatory activities were further bandpass filtered within trial-specific beta bands determined from sensorimotor-related channels (C3 and C4), and then rectified using amplitude modulation method to detect trial-by-trial beta rebound (BR) values in ERS time courses. The validity of the MEMD approach in BR values extraction has been demonstrated in multichannel EEG study which showed larger BR values than conventional ERS technique. The MEMD-based method enables the trial-by-trial extraction of sensorimotor oscillatory activities which might allow the exploration of subtle brain dynamics in future studies.

Motor-cortical oscillations in early stages of Parkinson's disease

Pathophysiological changes in basal ganglia-thalamo-cortical circuits are well established in idiopathic Parkinson's disease (PD). However, it remains open whether such alterations already occur at early stages representing a characteristic neurophysiological marker of PD. Therefore, the present study aims at elucidating changes of synchronised oscillatory activity in early PD patients. In this study, we performed whole-head magnetoencephalography (MEG) in a resting condition and during steady state contraction of the more severely affected forearm in 10 drug–naive, de novo patients, in 10 early-stage patients with chronic medication and in 10 age-matched control subjects. While cortico-muscular coherence (CMC) did not differ between groups, patients showed increased sensori-motor cortical power at beta frequency (13–30 Hz) during rest as well as during isometric contraction compared to controls. In healthy control subjects the power of the contralateral hemisphere was significantly suppressed during isometric contraction. By contrast, both hemispheres were activated equally strongly in de novo patients. In medicated patients, the pattern was found to be reversed. Contralateral beta power was significantly correlated with motor impairment during isometric contraction but not during rest. The present results suggest that the reduced ability of the primary motor cortex to disengage from increased beta band oscillations during the execution of movements is an early marker of PD.

Disturbed post-movement beta synchronization in Wilson's disease with neurological manifestation

We analyzed the changes of post-movement beta synchronization (PMBS) of the electroencephalogram (EEG) in Wilson's disease with neurological manifestation. Our aim was to determine if PMBS in Wilson's disease is altered in a different way than in Parkinson's disease or in essential tremor. Our purpose was to find out whether the analysis of PMBS could help the diagnosis in ambiguous cases. Ten patients with neurological manifestation of Wilson's disease and ten controls performed self-paced movements with the dominant hand during EEG acquisition. Five electrodes above the sensorimotor cortex were selected for evaluation (C3, C1, Cz, C2, C4) as contralateral (C); contralateral medial (CM); medial (M); ipsilateral medial (IM); ipsilateral (I) relative to the dominant hand. Power and latency of PMBS were calculated by time resolved power spectral analysis with multitaper method. PMBS power in the C electrode position was significantly lower in patients than in controls, its contralateral preponderance disappeared in the patient group. In every location, latency of PMBS was significantly longer in the Wilson group compared to controls. More altered PMBS could be measured in patients with both basal ganglia and cerebellar involvements. Since decreased power of PMBS was observed in Parkinson's disease and increased latency in essential tremor, the combined change of PMBS can indicate pathology of different neural circuits and may help the diagnosis in challenging cases.

Stability-dependent behavioural and electro-cortical reorganizations during intentional switching between bimanual tapping modes

This study investigated behavioural and electro-cortical reorganizations accompanying intentional switching between two distinct bimanual coordination tapping modes (In-phase and Anti-phase) that differ in stability when produced at the same movement rate. We expected that switching to a less stable tapping mode (In-to-Anti switching) would lead to larger behavioural perturbations and require supplementary neural resources than switching to a more stable tapping mode (Anti-to-In switching). Behavioural results confirmed that the In-to-Anti switching lasted longer than the Anti-to-In switching. A general increase in attention-related neural activity was found at the moment of switching for both conditions. Additionally, two condition-dependent EEG reorganizations were observed. First, a specific increase in cortico-cortical coherence appeared exclusively during the In-to-Anti switching. This result may reflect a strengthening in inter-regional communication in order to engage in the subsequent, less stable, tapping mode. Second, a decrease in motor-related neural activity (increased beta spectral power) was found for the Anti-to-In switching only. The latter effect may reflect the interruption of the previous, less stable, tapping mode. Given that previous results on spontaneous Anti-to-In switching revealing an inverse pattern of EEG reorganization (decreased beta spectral power), present findings give new insight on the stability-dependent neural correlates of intentional motor switching.

Extraction of single-trial cortical beta oscillatory activities in EEG signals using empirical mode decomposition

Background

Brain oscillatory activities are stochastic and non-linearly dynamic, due to their non-phase-locked nature and inter-trial variability. Non-phase-locked rhythmic signals can vary from trial-to-trial dependent upon variations in a subject's performance and state, which may be linked to fluctuations in expectation, attention, arousal, and task strategy. Therefore, a method that permits the extraction of the oscillatory signal on a single-trial basis is important for the study of subtle brain dynamics, which can be used as probes to study neurophysiology in normal brain and pathophysiology in the diseased.

Methods

This paper presents an empirical mode decomposition (EMD)-based spatiotemporal approach to extract neural oscillatory activities from multi-channel electroencephalograph (EEG) data. The efficacy of this approach manifests in extracting single-trial post-movement beta activities when performing a right index-finger lifting task. In each single trial, an EEG epoch recorded at the channel of interest (CI) was first separated into a number of intrinsic mode functions (IMFs). Sensorimotor-related oscillatory activities were reconstructed from sensorimotor-related IMFs chosen by a spatial map matching process. Post-movement beta activities were acquired by band-pass filtering the sensorimotor-related oscillatory activities within a trial-specific beta band. Signal envelopes of post-movement beta activities were detected using amplitude modulation (AM) method to obtain post-movement beta event-related synchronization (PM-bERS). The maximum amplitude in the PM-bERS within the post-movement period was subtracted by the mean amplitude of the reference period to find the single-trial beta rebound (BR).

Results

The results showed single-trial BRs computed by the current method were significantly higher than those obtained from conventional average method (P < 0.01; matched-pair Wilcoxon test). The proposed method provides high signal-to-noise ratio (SNR) through an EMD-based decomposition and reconstruction process, which enables event-related oscillatory activities to be examined on a single-trial basis.

Conclusions

The EMD-based method is effective for artefact removal and extracting reliable neural features of non-phase-locked oscillatory activities in multi-channel EEG data. The high extraction rate of the proposed method enables the trial-by-trial variability of oscillatory activities can be examined, which provide a possibility for future profound study of subtle brain dynamics.

Event-related desynchronization of motor cortical oscillations in patients with multiple system atrophy

Multiple system atrophy (MSA) is a progressive neurodegenerative disease characterized by parkinsonism (MSA-P), cerebellar and autonomic deficits. In Parkinson's disease (PD), an impaired modulation of motor cortical mu and beta range oscillations may be related to the pathophysiology of bradykinesia. Event-related desynchronization (ERD) of these oscillations occur for 1-2 s preceding a voluntary movement in normal subjects and patients with PD treated with levodopa while only lasting around 0.5 s in untreated patients. Motor cortical rhythms were recorded from subdural strip electrodes in three patients with MSA-P while taking their regular dopaminergic medications. Following a ready cue, patients performed an externally cued wrist extension movement to a go cue. In addition, recordings were obtained during imagined wrist extension movements to the same cues and during self-paced wrist extensions. ERD and event-related synchronization were examined in subject-specific frequency bands. All patients showed movement-related ERD in subject-specific frequency bands below ~40 Hz in both externally cued and self-paced conditions. Preparatory ERD latency preceding self-cued movement was 900 ms in one patient and at or after movement onset in the other two patients. In the externally cued task, a short lasting (<1.3 s) ready cue-related ERD that was not sustained to movement onset was observed in two patients. Imagined movements resulted in go cue-related ERD with a smaller magnitude in the same two patients. These results indicate that the modulation of motor cortical oscillations in patients with MSA that are treated with levodopa is similar to that occurring in untreated patients with PD. The findings suggest that cortical activation in patients with MSA is diminished, may be related to pathophysiological changes occurring in the basal ganglia and correlates with the poor clinical response that these patients typically obtain with dopaminergic therapy.

Single-trial analysis of cortical oscillatory activities during voluntary movements using empirical mode decomposition (EMD)-based spatiotemporal approach

This study presents a method based on empirical mode decomposition (EMD) and a spatial template-based matching approach to extract sensorimotor oscillatory activities from multi-channel magnetoencephalographic (MEG) measurements during right index finger lifting. The longitudinal gradiometer of the sensor unit which presents most prominent SEF was selected on which each single-trial recording was decomposed into a set of intrinsic mode functions (IMFs). The correlation between each IMF of the selected channel and raw data on other channels were created and represented as a spatial map. The sensorimotor-related IMFs with corresponding correlational spatial map exhibiting large values on primary sensorimotor area (SMI) were selected via spatial-template matching process. Trial-specific alpha and beta bands were determined in sensorimotor-related oscillatory activities using a two-spectrum comparison between the spectra obtained from baseline period (-4 to -3 s) and movement-onset period (-0.5 to 0.5 s). Sensorimotor-related oscillatory activities were filtered within the trial-specific frequency bands to resolve task-related oscillatory activities. Results demonstrated that the optimal phase and amplitude information were preserved not only for alpha suppression (event-related desynchronization) and beta rebound (event-related synchronization) but also for profound analysis of subtle dynamics across trials. The retention of high SNR in the extracted oscillatory activities allow various methods of source estimation that can be applied to study the intricate brain dynamics of motor control mechanisms. The present study enables the possibility of investigating cortical pathophysiology of movement disorder on a trial-by-trial basis which also permits an effective alternative for participants or patients who can not endure lengthy procedures or are incapable of sustaining long experiments.

Deficient "sensory" beta synchronization in Parkinson's disease

OBJECTIVE

Beta rhythm movement-related synchronization (beta synchronization) reflects motor cortex deactivation and sensory afference processing. In Parkinson's disease (PD), decreased beta synchronization after active movement reflects abnormal motor cortex idling and may be involved in the pathophysiology of akinesia. The objectives of the present study were to (i) compare event-related synchronization after active and passive movement and electrical nerve stimulation in PD patients and healthy, age-matched volunteers and (ii) evaluate the effect of levodopa.

METHODS

Using a 128-electrode EEG system, we studied beta synchronization after active and passive index finger movement and electrical median nerve stimulation in 13 patients and 12 control subjects. Patients were recorded before and after 150% of their usual morning dose of levodopa.

RESULTS

The peak beta synchronization magnitude in the contralateral primary sensorimotor (PSM) cortex was significantly lower in PD patients after active movement, passive movement and electrical median nerve stimulation, compared with controls. Levodopa partially reversed the drop in beta synchronization after active movement but not after passive movement or electrical median nerve stimulation.

DISCUSSION

If one considers that beta synchronization reflects sensory processing, our results suggest that integration of somaesthetic afferences in the PSM cortex is abnormal in PD during active and passive movement execution and after simple electrical median nerve stimulation.

SIGNIFICANCE

Better understanding of the mechanisms involved in the deficient beta synchronization observed here could prompt the development of new therapeutic approaches aimed at strengthening defective processes. The lack of full beta synchronization restoration by levodopa might be related to the involvement of non-dopaminergic pathways.

Slow Brain Potential and Oscillatory EEG Manifestations of Impaired Temporal Preparation in Parkinson's Disease

Performance in behavioral tasks is influenced by temporal expectations shaped by the temporal structure of the task. Such implicit temporal preparation is reflected in slow brain potentials and electroencephalographic oscillations and is attributed to interval timing mechanisms that probably depend on intact basal ganglia function. We investigated implicit timing in Parkinson's disease using a choice reaction task with two temporally regular stimulus presentation regimes, both including occasional deviant interstimulus intervals. Control subjects, but not patients, demonstrated temporal preparation in the form of an adjustment in time course of slow brain potentials to the duration of the interstimulus interval. However, in both groups, timing perturbations were accompanied by a slow brain potential amplitude drop at the time of expected stimulus occurrence, demonstrating intact representation of time in patients. In patients, oscillatory activity in beta and alpha bands showed attenuated preparatory desynchronization and reduced postmovement event-related synchronization, reflecting abnormal engagement and disengagement of sensorimotor and parietal areas. The results demonstrate profoundly deficient temporal preparation with preserved encoding of temporal information, a dissociation that may be explained by impaired dopamine-dependent motor learning. The results are discussed in the context of recent work on oscillatory activity in the basal ganglia.

Enhanced reactivity and delayed recovery of sensorimotor cortex in the novelty seeking personality

BACKGROUND

The novelty seeking (NS) personality trait is hypothesized to be associated with high cortical reactivity, poor inhibitory control and/or varied dopaminergic neurotransmission in the basal ganglia. After somatosensory stimulation, electrical oscillations in alpha and beta bands generated in the sensorimotor cortex show a short duration decrease (event-related desynchronization) and a subsequent increase (event-related synchronization) that is thought to reflect cortical activation and the inhibitory/recovery process, respectively. These oscillatory changes are also believed to be affected by the status of the basal ganglia and by dopaminergic functions. In the present study, we investigated the association between the NS personality trait and somatosensory oscillatory changes after median nerve stimulation assessed by magnetoencephalography.

METHODS

From 48 healthy subjects, we selected 14 high scorers and 14 age- and sex-matched low scorers on the NS dimension of the Temperament and Character Inventory. Magnetic fields were recorded while subjects received electrical stimulation of either the right or left median nerve with equal probability and with a randomized interstimulus interval. Frequency analysis was performed on the alpha and beta bands.

RESULTS

Compared with the low NS group, the high NS group showed larger magnitude of beta event-related desynchronization and larger latencies of the alpha and beta event-related synchronization.

CONCLUSION

These results suggest that individuals with high degrees of the NS trait have greater reactivity and delayed recovery of the sensorimotor cortex in response to simple somatosensory stimulation. This may be significant for the understanding of their exploratory and impulsive behavior.

A self-paced brain interface system that uses movement related potentials and changes in the power of brain rhythms

Movement execution results in the simultaneous generation of movement-related potentials (MRP) as well as changes in the power of Mu and Beta rhythms. This paper proposes a new self-paced multi-channel BI that combines features extracted from MRPs and from changes in the power of Mu and Beta rhythms. We developed a new algorithm to classify the high-dimensional feature space. It uses a two-stage multiple-classifier system (MCS). First, an MCS classifies each neurological phenomenon separately using the information extracted from specific EEG channels (EEG channels are selected by a genetic algorithm). In the second stage, another MCS combines the outputs of MCSs developed in the first stage. Analysis of the data of four able-bodied subjects shows the superior performance of the proposed algorithm compared with a scheme where the features were all combined in a single feature vector and then classified.

Symmetry of post-movement beta-ERS and motor recovery from stroke: a low-resolution EEG pilot study

The inter-hemispheric symmetry of electroencephalographic (EEG) post-movement beta-event-related synchronization (PMBS) after movements on a drawing board was studied in eight acute stroke subjects with mild hemiparesis and eight normal subjects. A follow-up testing was conducted 3 months after the initial recordings with a twofold purpose: (1) to validate the reproducibility of the experimental protocol in normal subjects; and (2) to study changes of inter-hemispheric PMBS-symmetry as a response to recovery of motor function. PMBS values were calculated and their topographic distributions illustrated at various time instances following movement offset. Significant PMBS patterns were present in all normal subjects, with only minor differences within consecutive recordings. The side of hemiparesis in acute stroke subjects could be distinguished (P = 0.04) on the basis of the signed symmetry index, a quantitative measure of lateralization. The follow-up testing on three recovered stroke subjects revealed a trend of changes in the lateralization towards the contralateral side of movement, an indication that the cortical organization of movement following recovery turned out as reported for normal subjects. Further clinical investigations need to be carried out to evaluate the relationship between recovery and PMBS symmetry on a large number of subjects, using the method presented here.

Predominance of the contralateral movement-related activity in the subthalamo-cortical loop

OBJECTIVE

Abnormal low- and high-frequency oscillatory activities have been linked to abnormal movement control in Parkinson's disease. We aimed to study how low- and high-frequency oscillatory activities are modulated by movement in the contralateral and ipsilateral subcorticocortical loops.

METHODS

We studied mu, beta and gamma rhythm event-related desynchronisation (ERD) and synchronisation (ERS) recorded from electrode contacts in the subthalamic nucleus (STN) areas and over the primary sensorimotor (PSM) cortex.

RESULTS

Mu and beta ERD/ERS patterns were very similar when comparing PSM cortex and STN areas and very different when comparing contralateral and ipsilateral structures. Beta rhythm ERS was more predominant over contralateral structures than over ipsilateral ones. Gamma rhythm ERS was only recorded from the contralateral STN area (particularly following administration of L-Dopa). For all patients, the best bipolar derivations - as defined by the earliest mu and beta ERD and the strongest beta and gamma ERS - always included the STN electrode contacts that produced the best clinical results.

CONCLUSIONS

Movement-related activity is involved in the movement preparation in the contralateral subthalamo-cortical loop and in the movement execution in the bilateral subthalamo-cortical loops.

SIGNIFICANCE

Contralateral beta rhythm ERD seemed to be related to bradykinesia of the limb performing the movement.

Effects of cognitive demands on postmovement motor cortical deactivation

Postmovement beta-rebounds induced by different intermovement intervals were investigated using magnetoencephalography in 14 healthy participants to test the hypothesis that postmovement motor cortical deactivation over the primary motor cortex depends on movement-related cognitive demands. Shorter latency and lower amplitude in postmovement beta-rebounds over the contralateral primary motor cortex were noted in the short-movement interval movement (repetitive finger lifting). Greater latency span of postmovement beta-rebounds jittering using single-trial analysis in the long-movement interval movement (discrete finger lifting) was observed. The study elucidates that the temporal interval between two adjacent movements reflecting different degrees of cognitive demands can affect postmovement motor cortical deactivation in terms of postmovement beta-rebounds latency and amplitude, and latency span of postmovement beta-rebounds jittering. Postmovement motor cortical deactivation can reflect cognitive demands in addition to motor and somatosensory processing.

Effect of deep brain stimulation and l-Dopa on electrocortical rhythms related to movement in Parkinson's disease

In the early stages of Parkinson's disease (PD), impaired motor preparation has been related to a decrease in the latency of mu rhythm event-related desynchronisation (ERD) compared with control subjects, suggesting hypo activation of the contralateral, primary sensorimotor (PSM) cortex. Following movement, a decrease in amplitude of beta rhythm ERS was observed over the same region and thought to be related to impairment in cortical deactivation. By monitoring ERD/ERS, we aimed (i) to extend to advanced PD the observations made in less-advanced parkinsonism and (ii) to test the effect of acute L-Dopa, internal pallidal or subthalamic stimulation on these abnormalities. For the clinical evaluation the motor score of UPDRS decreased by about 60% under subthalamic stimulation and following acute L-Dopa administration and by 40% under internal pallidal stimulation. The following concurrent ERD/ERS changes under subthalamic stimulation and L-Dopa were observed: a marked increase in mu ERD latency during movement preparation over contralateral central region; an increase in mu ERD during movement execution over bilateral central regions; a decrease in mu ERD latency over bilateral frontocentral region and an increase in beta ERS over contralateral central region after movement. On the contrary, mu ERD latency was not improved under internal pallidal stimulation. Changes of mu and beta rhythm parameters seemed to be inversely correlated with bradykinesia. Mu rhythm ERD latency and the beta ERS amplitude further decreased in advanced PD compared with early stages, suggesting greater impairment of cortical activation/deactivation as the disease progresses and a partial restoration in relation to clinical improvement under treatments. Consequently, it appears that L-Dopa and deep brain stimulation partially restored the normal patterns of cortical oscillatory activity in PD, possibly by decreasing the low frequency hyper synchronisation at rest. This mechanism could be involved at the basal ganglia level in the sensorimotor integration implicated in the movement control.

Movement-related event-related desynchronization in neuropsychiatric disorders

The analysis of event-related desynchronization (ERD) and event-related synchronization (ERS) provides information on the dynamics of cortical activation during cognitive and motor tasks and has been applied in a variety of neurological and psychiatric disorders. In this chapter, we focus on studies concerning movement-related activity, which showed changes in amount, topography, or time course in relation to not only involvement of the motor system--such as Parkinson's disease (PD), dystonia, and stroke affecting the sensorimotor (SM) pathways--but also physiological aging, degenerative dementia, obsessive-compulsive disorder (OCD), and fatigue associated with multiple sclerosis (MS). In these disorders, the extent of abnormality in the pattern of ERD/ERS is related to the severity of the underlying pathology. Moreover in MS, a correlation with the severity of brain tissue has been found. While there is consistency in changes related to ipokinetic disorders, mainly consisting of delayed appearance of ERD to movement preparation, changes occurring in other brain disorders need to be replicated or raise doubts on the specificity of changes across different diseases. Further studies are needed in order to validate the usefulness of this methodology in the assessment of the single patient for diagnosis and monitoring of the natural course of the disease and of treatment efficacy.

[Pathophysiological mechanisms implicated by high-frequency stimulation in Parkinson's disease: the restoration of high and low frequency oscillatory systems]

INTRODUCTION

Increased neuronal activity in the internal pallidum (GPi) and the subthalamic nucleus (STN) has been clearly demonstrated in Parkinsonian models, and the two structures have thus been selected as therapeutic targets for functional neurosurgery. High-frequency electrical stimulation of the GPi or the STN improves the parkinsonian symptoms but also dyskinesias directly by GPi stimulation or indirectly by reduction of L-Dopa associated with STN stimulation. According to Alexander's model of the organisation of the basal ganglia, electrical stimulation of GPi or STN should have led to uncontrolled hyperkinesia. This apparent paradox could be explained on one hand by the involvement of different anatomo-functional areas within these structures and on the other by spatial and temporal changes in neuronal discharge patterns in the basal ganglia which in turn produce variations in synchronisation.

RESULTS

Event-related (de)synchronisation (ERD) has enabled us to study variations in subcortico-cortical oscillatory activity: it has been shown that high-frequency electrical stimulation of the GPi/STN increases desynchronisation of low frequency rhythms (mu and beta,<30 Hz) during movement preparation and execution and augments post-movement synchronisation. Stimulation also decreases the abnormal frontocentral spreading of desynchronisation during movement preparation.

CONCLUSIONS

In accordance with previous coherence analyses, electrical stimulation of STN is likely to restore the activity of high-frequency and low-frequency systems, as evidenced by a decrease in the hypersynchronisation of low-frequency rhythms at rest and restoral of a high-frequency rhythm during movement. Stimulation may improve spatial selectivity by activating the selected programs in conjunction with the primary sensorimotor cortex, whilst inhibiting competitive programs represented by abnormal spreading outside the primary sensorimotor cortex.

Levodopa-induced modulation of subthalamic beta oscillations during self-paced movements in patients with Parkinson's disease

Excessive synchronization of neural activity in the beta frequency band ( approximately 20 Hz) within basal ganglia circuits might contribute to the paucity and slowness of movement in Parkinson's disease (PD). Treatment with dopaminergic drugs reduces the background level of beta frequency band synchronization in the subthalamic nucleus (STN), but has not been shown to increase the proportion of beta activity that is suppressed before voluntary movement in PD. We assessed changes in the event-related desynchronization (ERD) in the beta frequency band of local field potential signals from the region of the STN in 14 patients with PD as they performed self-paced movements of a joystick before and after levodopa administration. The dopamine precursor, levodopa, increased the duration and magnitude of the premovement beta ERD, but did not alter postmovement synchronization in the beta band. Both the latency and magnitude of the beta ERD inversely correlated with the degree of motor impairment. These findings suggest that the beta ERD recorded in the STN area reflects motor-preparative processes that are at least partly dependent on dopaminergic activity within the basal ganglia.

Cortico-cortical coupling in Parkinson's disease and its modulation by therapy

The role of changes in inter-regional cortical synchronization in the pathophysiology of Parkinson's disease and the mechanism of action of dopaminergic therapy and high frequency subthalamic nucleus (STN) stimulation is unclear. We hypothesized that synchronization between distributed cortical areas would correlate with parkinsonism and that changes in synchronization with treatment would correlate with improvements in parkinsonism. To this end, we recorded scalp EEG in parkinsonian patients off treatment (16 patients, 31 sides) and then separately during high frequency stimulation (HFS) of the STN (16 patients, 31 sides) and following drug treatment (12 patients, 24 sides). All recordings were made at rest to avoid the confounding effects of differences in task performance. The motor Unified Parkinson's Disease Rating Scale (UPDRS) score was determined in each state. We found that EEG-EEG coherence over approximately 10-35 Hz correlated with the severity of parkinsonism, and reductions in cortical coupling over this frequency range with both l-dopa and STN stimulation correlated with clinical improvement. These results suggest that both dopaminergic therapy and STN stimulation may support the restoration of normal cortico-cortical interactions in the frequency domain. This mechanistic similarity may underscore the strong clinical correlation between the therapeutic effects of these treatment modalities.

ICA-based spatiotemporal approach for single-trial analysis of postmovement MEG beta synchronization⋆

The extraction of event-related oscillatory neuromagnetic activities from single-trial measurement is challenging due to the non-phase-locked nature and variability from trial to trial. The present study presents a method based on independent component analysis (ICA) and the use of a template-based correlation approach to extract Rolandic beta rhythm from magnetoencephalographic (MEG) measurements of right finger lifting. A single trial recording was decomposed into a set of coupled temporal independent components and corresponding spatial maps using ICA and the reactive beta frequency band for each trial identified using a two-spectrum comparison between the postmovement interval and a reference period. Task-related components survived dual criteria of high correlation with both the temporal and the spatial templates with an acceptance rate of about 80%. Phase and amplitude information for noise-free MEG beta activities were preserved not only for optimal calculation of beta rebound (event-related synchronization) but also for profound penetration into subtle dynamics across trials. Given the high signal-to-noise ratio (SNR) of this method, various methods of source estimation were used on reconstructed single-trial data and the source loci coherently anchored in the vicinity of the primary motor area. This method promises the possibility of a window into the intricate brain dynamics of motor control mechanisms and the cortical pathophysiology of movement disorder on a trial-by-trial basis.

Motor preparation is more impaired in Parkinson's disease when sensorimotor integration is involved

OBJECTIVE

This study aimed to investigate changes in spatio-temporal, event-related (de)synchronization (ERD/ERS) patterns recorded with respect to the more akinetic versus the less akinetic side during performance of a visuo-guided targeting movement when compared to an index finger extension.

METHODS

Twelve de novo parkinsonian patients were recorded. ERD/ERS in mu and beta frequency bands was computed from 21 source derivations.

RESULTS

When the index finger extension was performed with the less akinetic limb, mu ERD focused over contralateral central region appeared 2 s before movement. With the targeting movement, additional pre-movement mu ERD was observed over the parietal region, as well as earlier ipsilateral mu ERD. When the same movements were performed with the more akinetic limb, we observed delayed mu ERD over contralateral regions, earlier ipsilateral mu ERD and a lack of contralateral parietal mu ERD before the targeting movement. Following index finger extension for the less akinetic limb, a focused contralateral central beta ERS was recorded, increasing and spreading after the targeting movement. In contrast, for the more akinetic limb, beta ERS was dramatically attenuated and remained unchanged after the targeting movement.

CONCLUSIONS

These results confirm the fact that motor programming is delayed, and provide some insight into what may well be impaired sensorimotor integration in Parkinson's disease.

Effect of L-Dopa on the pattern of movement-related (de)synchronisation in advanced Parkinson’s disease

In the early stages of Parkinson's disease (PD), impaired motor preparation has been related to a delay of mu rhythm movement-related desynchronisation, suggesting hypoactivation of the contralateral, primary sensorimotor (PSM) cortex. Following movement, a decrease in the amplitude of beta rhythm movement-related synchronisation was observed over the same region. This decrease--not seen in control subjects--was thus thought to be related to an impairment in cortical deactivation. By monitoring movement-related (de)synchronisation, we aimed (i) to extend to advanced PD the observations made in less-advanced situations and (ii) to test the effect of acute L-Dopa on these abnormalities. The United Parkinson's Disease Rating Scale (UPDRS) III score decreased by about 60% following acute L-Dopa administration, and we observed the following concurrent changes: a marked increase in mu desynchronisation pre-movement latency (thus reduced delay) during movement preparation over contralateral, central regions; an increase in mu desynchronisation during movement execution over bilateral central regions; a decrease in mu desynchronisation latency over bilateral frontocentral regions, and a significant increase in beta synchronisation over contralateral, central regions after movement. Changes of mu and beta rhythm parameters seemed to be inversely correlated with bradykinesia. Mu rhythm desynchronisation latency and beta synchronisation amplitude further decreased in advanced PD compared to earlier stages of the disease, suggesting greater impairment of cortical activation/deactivation as the disease progresses. L-Dopa partially restored the abnormal mu and beta rhythm cortical (de)synchronisation patterns over the PSM cortex.

Subthalamic stimulation influences postmovement cortical somatosensory processing in Parkinson's disease

In Parkinson's disease, poor motor performance (resulting primarily from abnormal cortical activation during movement preparation and execution) may also be due to impaired sensorimotor integration and defective cortical activity termination of the ongoing movement, thus delaying preparation of the following one. Reduced movement-related synchronization of the beta rhythm in Parkinson's disease compared to controls has been put forward as evidence for impaired postmovement cortical deactivation. We assessed the effects of subthalamic deep brain stimulation and l-dopa on beta rhythm synchronization over the premotor and primary sensorimotor cortex. Ten advanced patients performed self-paced wrist flexion in four conditions according to the presence or not of stimulation and l-dopa. Compared to without treatment, the motor score improved by approximately 60%; the beta synchronization was present over the contralateral frontocentral region and increased significantly over the contralateral central region under stimulation and under l-dopa, with a maximal effect when both treatments were associated. Our advanced patients displayed very focused and attenuated beta rhythm synchronization which, under stimulation, increased over the contralateral premotor and primary sensorimotor cortex. Stimulation and l-dopa both partly restored postmovement cortical deactivation in advanced Parkinson's disease, although the respective mechanisms probably differ. They may improve bradykinesia and cortical deactivation by reestablishing movement-related somatosensory processing at the end of the movement through the basal ganglia into the cortex.

Impairment of post-movement beta synchronisation in parkinson's disease is related to laterality of tremor

OBJECTIVE

Post-movement beta synchronisation (PMBS) is a physiological indicator of the activity of movement related neural networks. To investigate the pathophysiology of this phenomenon, we examined its characteristics in patients with unilateral tremor-dominant Parkinson's disease (PD).

METHODS

Movement duration and PMBS was measured after self-paced movement of the thumb at movement-reactive beta frequencies, over the supplementary motor area in 10 PD patients and 8 control subjects.

RESULTS

Movement duration in PD patients was longer than in controls. In left hand tremor patients, movement of the left hand was significantly longer compared to the right hand. When PD patients moved their non-affected hand, similarly to the controls, PMBS was higher contralateral to the movement. After movement of the tremulous hand, the contralateral PMBS decreased significantly and the contralateral preponderance disappeared. In the same hemisphere, PMBS was higher after contralateral to the non-affected hand movement, than after ipsilateral to the tremulous hand after movement.

CONCLUSIONS

PMBS in PD is affected by the activity of tremor related neural networks, suggesting that both cortical and subcortical sources are responsible for its generation. Examination of PMBS in various neurological diseases might provide further data on its physiological significance.

Fatigue in Multiple Sclerosis Is Associated with Abnormal Cortical Activation to Voluntary Movement—EEG Evidence

Converging evidence is consistent with the view that fatigue in Multiple Sclerosis is independent from pyramidal tract involvement, suggesting a possible involvement of frontal areas. During voluntary movement, changes of the EEG rhythms can be observed over sensorimotor areas. Event-related desynchronization (ERD) of the 10 and 20 Hz frequency bands occurs during motor planning and execution and is followed after movement termination by event-related synchronization (ERS), expressing cortical idling or inhibition. We evaluated the pattern of cortical activation to voluntary movement in MS patients complaining of fatigue assessed using the Fatigue Severity Scale. Fifteen MS patients complaining of fatigue, 18 MS patients without fatigue, and 14 normal controls were studied. The two patients groups were similar for age, sex, disease duration, and were not disabled (score <1.5 at the Expanded Disability Status Scale). Twenty-nine channel EEG was recorded during about 60 self-paced extensions of the right thumb. The onset latency and amount of the contralateral sensorimotor (C3 electrode) 10 and 18--22 Hz ERD were similar in the three groups. ERD was more widespread anteriorly in the fatigue group compared with normal controls (P < 0.01 over Fz electrode). Postmovement contralateral sensorimotor 18--22 Hz ERS was significantly lower in fatigue MS patients compared with normal subjects (P < 0.005) and with nonfatigue MS patients (P = 0.02). These findings are consistent with a central origin of fatigue in MS and indicate cortical dysfunction even during a simple motor task, resulting in hyperactivity during movement execution and failure of the inhibitory mechanisms intervening after movement termination.

Impairment of motor cortex activation and deactivation in Parkinson's disease

OBJECTIVES

To examine the time course of corticospinal excitability before and after voluntary movement in Parkinson's disease (PD).

METHODS

We studied 9 mild PD patients at least 12 h off medications and 11 healthy volunteers in a simple reaction time (RT) paradigm. Suprathreshold transcranial magnetic stimulation was delivered to the left motor cortex at intervals covering the periods before and after movement.

RESULTS

PD patients (284+/-90 ms) and normal subjects (282+/-56 ms) had similar median RT. The time courses of both the premovement increase and the postmovement decrease in corticospinal excitability were significantly different between PD patients and normal subjects. The increase in motor-evoked potential (MEP) amplitudes began earlier for PD patients (200 ms before electromyographic (EMG) onset) than for normal subjects (150 ms before EMG onset), but the rate of increase was slower in PD patients than controls. After EMG offset, MEP amplitudes were increased for about 150 ms in normal subjects, but in PD patients this period was prolonged to about 350 ms.

CONCLUSIONS

Impairment of motor cortex activation and deactivation is an early feature of PD and may be a physiological correlate of bradykinesia. The normal RT in our patients may be related to the earlier occurrence of the premovement increase in corticospinal excitability compensating for the slower rate of rise.

Long-lasting effect evoked by tonic muscle pain on parietal EEG activity in humans

OBJECTIVE

To explore EEG changes evoked by tonic experimental muscle pain compared to a non-painful vibratory stimulus.

METHODS

Thirty-one EEG channels were recorded before, during and after painful and non-painful stimulation. Pain was induced in the left brachioradialis muscle by injection of hypertonic (5%) saline. The vibratory stimulus was applied to the skin area overlying the brachioradialis muscle. The power of the major frequency components of the EEG activity (FFT, fast Fourier transform) was quantified and t-maps between the different experimental conditions were evaluated in frequency domain.

RESULTS

The main effect of muscle pain, compared to non-painful stimulation, was a significant and long-lasting increase of delta (1-3 Hz) power and an alpha-1 (9-11 Hz) power increase over the contralateral parietal locus. This finding could suggest a decreased excitability of the primary somatosensory cortex during muscle pain. The main effect of vibration, compared to its unstimulated baseline, consisted in an increase of beta-1 (14-20 Hz) power in the right frontal region.

CONCLUSIONS

Our data demonstrate significant and specific topographic EEG changes during tonic muscle pain. Since these modifications differ from those produced by an unstimulated baseline and during non-painful tonic stimulation, they might reflect mechanisms involved in the processing of nociceptive and adverse tonic stimuli.

Brief and sustained movements: differences in event-related (de)synchronization (ERD/ERS) patterns

OBJECTIVE

(1) To determine if there are changes in event-related desynchronization/event-related synchronization (ERD/ERS) patterns when the movement is sustained? (2) To determine, from a technical point of view for ERD calculation, if it is possible to take the reference period during muscular activation?

METHODS

Eight healthy subjects performed two series of brief and sustained self-paced extensions with their dominant wrist. The end of the sustained movement was externally triggered by the examinator. ERD/ERS was calculated in mu and beta bands from 13 source derivations covering motor areas, computed from 29 scalp electrodes. Movement onset and offset were determined by electromyographic activity (EMG) of wrist extensors.

RESULTS

When the movement was sustained, power in the mu and beta bands returned to baseline values within 4-5 s. Movement duration had little effect, if at all, on both pre and post-movement periods. Compared to brief movement, after the onset of the prolonged movement, mu ERD just returned to baseline, without synchronization. In contrast, beta ERS was still present though earlier and much lower.

CONCLUSIONS

The reference period for ERD calculation may be taken during muscular activation if its duration is long enough. Beta synchronization may occur despite a non-deactivated motor cortex, suggesting a contribution from afferent somesthetic inputs.

Event-related EEG/MEG synchronization and desynchronization: basic principles

An internally or externally paced event results not only in the generation of an event-related potential (ERP) but also in a change in the ongoing EEG/MEG in form of an event-related desynchronization (ERD) or event-related synchronization (ERS). The ERP on the one side and the ERD/ERS on the other side are different responses of neuronal structures in the brain. While the former is phase-locked, the latter is not phase-locked to the event. The most important difference between both phenomena is that the ERD/ERS is highly frequency band-specific, whereby either the same or different locations on the scalp can display ERD and ERS simultaneously. Quantification of ERD/ERS in time and space is demonstrated on data from a number of movement experiments.