Identification of EEG Dynamics During Freezing of Gait and Voluntary Stopping in Patients With Parkinson's Disease

Long-Range Temporal Correlations in Electroencephalography for Parkinson's Disease Progression

BACKGROUND

Patients with Parkinson's disease (PD) present progressive deterioration in both motor and non-motor manifestations. However, the absence of clinical biomarkers for disease progression hinders clinicians from tailoring treatment strategies effectively.

OBJECTIVES

To identify electroencephalography (EEG) biomarker that can track disease progression in PD.

METHODS

A total of 116 patients with PD were initially enrolled, whereas 63 completed 2-year follow-up evaluation. Fifty-eight age- and sex-matched healthy individuals were recruited as the control group. All participants underwent EEG and clinical assessments. Long-range temporal correlations (LRTC) of EEG data were analyzed using the detrended fluctuation analysis.

RESULTS

Patients with PD exhibited higher LRTC in left parietal θ oscillations (P = 0.0175) and lower LRTC in centro-parietal γ oscillations (P = 0.0258) compared to controls. LRTC in parietal γ oscillations inversely correlated with changes in Unified Parkinson's Disease Rating Scale (UPDRS) part III scores over 2 years (Spearman ρ = -0.34, P = 0.0082). Increased LRTC in left parietal θ oscillations were associated with rapid motor progression (P = 0.0107), defined as an annual increase in UPDRS part III score ≥3. In cognitive assessments, LRTC in parieto-occipital α oscillations exhibited a positive correlation with changes in Mini-Mental State Examination and Montreal Cognitive Assessment scores over 2 years (Spearman ρ = 0.27-0.38, P = 0.0037-0.0452).

CONCLUSIONS

LRTC patterns in EEG potentially predict rapid progression of both motor and non-motor manifestations in PD patients, enhancing clinical assessment and understanding of the disease. © 2024 International Parkinson and Movement Disorder Society.

Quantifying instability in neurological disorders EEG based on phase space DTM function

Classifying individuals with neurological disorders and healthy subjects using EEG is a crucial area of research. The current feature extraction approach focuses on the frequency domain features in each of the EEG frequency bands and functional brain networks. In recent years, researchers have discovered and extensively studied stability differences in the electroencephalograms (EEG) of patients with neurological disorders. Based on this, this paper proposes a feature descriptor to characterize EEG instability. The proposed method starts by forming a signal point cloud through Phase Space Reconstruction (PSR). Subsequently, a pseudo-metric space is constructed, and pseudo-distances are calculated based on the consistent measure of the point cloud. Finally, Distance to Measure (DTM) Function are generated to replace the distance function in the original metric space. We calculated the relative distances in the point cloud by measuring signal similarity and, based on this, summarized the point cloud structures formed by EEG with different stabilities after PSR. This process demonstrated that Multivariate Kernel Density Estimation (MKDE) based on a Gaussian kernel can effectively separate the mappings of different stable components within the signal in the phase space. The two average DTM values are then proposed as feature descriptors for EEG instability.In the validation phase, the proposed feature descriptor is tested on three typical neurological disorders: epilepsy, Alzheimer's disease, and Parkinson's disease, using the Bonn dataset, CHB-MIT, the Florida State University dataset, and the Iowa State University dataset. DTM values are used as feature inputs for four different machine learning classifiers, and The results show that the best classification accuracy of the proposed method reaches 98.00 %, 96.25 %, 96.71 % and 95.34 % respectively, outperforming commonly used nonlinear descriptors. Finally, the proposed method is tested and analyzed using noisy signals, demonstrating its robustness compared to other methods.

Sub-Scalp Implantable Telemetric EEG (SITE) for the Management of Neurological and Behavioral Disorders beyond Epilepsy

Sub-scalp Implantable Telemetric EEG (SITE) devices are under development for the treatment of epilepsy. However, beyond epilepsy, continuous EEG analysis could revolutionize the management of patients suffering from all types of brain disorders. This article reviews decades of foundational EEG research, collected from short-term routine EEG studies of common neurological and behavioral disorders, that may guide future SITE management and research. Established quantitative EEG methods, like spectral EEG power density calculation combined with state-of-the-art machine learning techniques applied to SITE data, can identify new EEG biomarkers of neurological disease. From distinguishing syncopal events from seizures to predicting the risk of dementia, SITE-derived EEG biomarkers can provide clinicians with real-time information about diagnosis, treatment response, and disease progression.

Use of common spatial patterns for early detection of Parkinson's disease

One of the most common diseases that affects human brain is Parkinson's disease. Detection of Parkinson's disease (PD) poses a serious challenge. Robust methods for feature extraction allowing separation between the electroencephalograms (EEG) of healthy subjects and PD patients are required. We used the EEG records of healthy subjects and PD patients which were subject to auditory tasks. We used the common spatial patterns (CSP) and Laplacian mask as methods to allow robust selection and extraction of features. We used the derived CSP whitening matrix to determine those channels that are the most promising in the terms of differentiating between EEGs of healthy controls and of PD patients. Using the selection of features calculated using the CSP we managed to obtain the classification accuracy of 85% when classifying EEG records belonging to groups of controls or PD patients. Using the features calculated using the Laplacian operator we obtained the classification accuracy of 90%. Diagnosing the PD in early stages using EEG is possible. The CSP proved to be a promising technique to detect informative channels and to separate between the groups. Use of the combination of features calculated using the Laplacian offers good separability between the two groups.

Assessing Neurokinematic and Neuromuscular Connectivity During Walking Using Mobile Brain-Body Imaging

Gait is a common but rather complex activity that supports mobility in daily life. It requires indeed sophisticated coordination of lower and upper limbs, controlled by the nervous system. The relationship between limb kinematics and muscular activity with neural activity, referred to as neurokinematic and neuromuscular connectivity (NKC/NMC) respectively, still needs to be elucidated. Recently developed analysis techniques for mobile high-density electroencephalography (hdEEG) recordings have enabled investigations of gait-related neural modulations at the brain level. To shed light on gait-related neurokinematic and neuromuscular connectivity patterns in the brain, we performed a mobile brain/body imaging (MoBI) study in young healthy participants. In each participant, we collected hdEEG signals and limb velocity/electromyography signals during treadmill walking. We reconstructed neural signals in the alpha (8–13 Hz), beta (13–30 Hz), and gamma (30–50 Hz) frequency bands, and assessed the co-modulations of their power envelopes with myogenic/velocity envelopes. Our results showed that the myogenic signals have larger discriminative power in evaluating gait-related brain-body connectivity with respect to kinematic signals. A detailed analysis of neuromuscular connectivity patterns in the brain revealed robust responses in the alpha and beta bands over the lower limb representation in the primary sensorimotor cortex. There responses were largely contralateral with respect to the body sensor used for the analysis. By using a voxel-wise analysis of variance on the NMC images, we revealed clear modulations across body sensors; the variability across frequency bands was relatively lower, and below significance. Overall, our study demonstrates that a MoBI platform based on hdEEG can be used for the investigation of gait-related brain-body connectivity. Future studies might involve more complex walking conditions to gain a better understanding of fundamental neural processes associated with gait control, or might be conducted in individuals with neuromotor disorders to identify neural markers of abnormal gait.

Evaluating the Different Stages of Parkinson's Disease Using Electroencephalography With Holo-Hilbert Spectral Analysis

Electroencephalography (EEG) can reveal the abnormalities of dopaminergic subcortico-cortical circuits in patients with Parkinson's disease (PD). However, conventional time-frequency analysis of EEG signals cannot fully reveal the non-linear processes of neural activities and interactions. A novel Holo-Hilbert Spectral Analysis (HHSA) was applied to reveal non-linear features of resting state EEG in 99 PD patients and 59 healthy controls (HCs). PD patients demonstrated a reduction of β bands in frontal and central regions, and reduction of γ bands in central, parietal, and temporal regions. Compared with early-stage PD patients, late-stage PD patients demonstrated reduction of β bands in the posterior central region, and increased θ and δ2 bands in the left parietal region. θ and β bands in all brain regions were positively correlated with Hamilton depression rating scale scores. Machine learning algorithms using three prioritized HHSA features demonstrated "Bag" with the best accuracy of 0.90, followed by "LogitBoost" with an accuracy of 0.89. Our findings strengthen the application of HHSA to reveal high-dimensional frequency features in EEG signals of PD patients. The EEG characteristics extracted by HHSA are important markers for the identification of depression severity and diagnosis of PD.

Synchronized Intracranial Electrical Activity and Gait Recording in Parkinson’s Disease Patients With Freezing of Gait

Background

This study aimed to describe a synchronized intracranial electroencephalogram (EEG) recording and motion capture system, which was designed to explore the neural dynamics during walking of Parkinson’s disease (PD) patients with freezing of gait (FOG). Preliminary analysis was performed to test the reliability of this system.

Methods

A total of 8 patients were enrolled in the study. All patients underwent bilateral STN-DBS surgery and were implanted with a right subdural electrode covering premotor and motor area. Synchronized electrophysiological and gait data were collected using the Nihon Kohden EEG amplifier and Codamotion system when subjects performed the Timed Up and Go (TUG) test. To verify the reliability of the acquisition system and data quality, we calculated and compared the FOG index between freezing and non-freezing periods during walking. For electrophysiological data, we first manually reviewed the scaled (five levels) quality during waking. Spectra comprising broadband electrocorticography (ECoG) and local field potential (LFP) were also compared between the FOG and non-FOG states. Lastly, connectivity analysis using coherence between cortical and STN electrodes were conducted. In addition, we also use machine learning approaches to classified FOG and non-FOG.

Results

A total of 8 patients completed 41 walking tests, 30 of which had frozen episodes, and 21 of the 30 raw data were level 1 or 2 in quality (70%). The mean ± SD walking time for the TUG test was 85.94 ± 47.68 s (range: 38 to 190.14 s); the mean ± SD freezing duration was 12.25 ± 7.35 s (range: 1.71 to 27.50 s). The FOG index significantly increased during the manually labeled FOG period (P < 0.05). The beta power of STN LFP in the FOG period was significantly higher than that in the non-FOG period (P < 0.05), while the band power of ECoG did not exhibit a significant difference between walking states. The coherence between the ECoG and STN LFP was significantly greater in high beta and gamma bands during the FOG period compared with the shuffled surrogates (P < 0.05). Lastly, STN-LFP band power features showed above-chance performance (p < 0.01, permutation test) in identifying FOG epochs.

Conclusion

In this study, we established and verified the synchronized ECoG/LFP and gait recording system in PD patients with FOG. Further neural substrates underlying FOG could be explored using the current system.