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Ueda R, Sakakura K, Mitsuhashi T, Sonoda M, Firestone E, Kuroda N, Kitazawa Y, Uda H, Luat AF, Johnson EL, Ofen N, Asano E. Cortical and white matter substrates supporting visuospatial working memory. Clin Neurophysiol 2024; 162:9-27. [PMID: 38552414 PMCID: PMC11102300 DOI: 10.1016/j.clinph.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/24/2024] [Accepted: 03/11/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE In tasks involving new visuospatial information, we rely on working memory, supported by a distributed brain network. We investigated the dynamic interplay between brain regions, including cortical and white matter structures, to understand how neural interactions change with different memory loads and trials, and their subsequent impact on working memory performance. METHODS Patients undertook a task of immediate spatial recall during intracranial EEG monitoring. We charted the dynamics of cortical high-gamma activity and associated functional connectivity modulations in white matter tracts. RESULTS Elevated memory loads were linked to enhanced functional connectivity via occipital longitudinal tracts, yet decreased through arcuate, uncinate, and superior-longitudinal fasciculi. As task familiarity grew, there was increased high-gamma activity in the posterior inferior-frontal gyrus (pIFG) and diminished functional connectivity across a network encompassing frontal, parietal, and temporal lobes. Early pIFG high-gamma activity was predictive of successful recall. Including this metric in a logistic regression model yielded an accuracy of 0.76. CONCLUSIONS Optimizing visuospatial working memory through practice is tied to early pIFG activation and decreased dependence on irrelevant neural pathways. SIGNIFICANCE This study expands our knowledge of human adaptation for visuospatial working memory, showing the spatiotemporal dynamics of cortical network modulations through white matter tracts.
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Affiliation(s)
- Riyo Ueda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; National Center Hospital, National Center of Neurology and Psychiatry, Tokyo 1878551, Japan.
| | - Kazuki Sakakura
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois 60612, USA; Department of Neurosurgery, University of Tsukuba, Tsukuba 3058575, Japan.
| | - Takumi Mitsuhashi
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Neurosurgery, Juntendo University, School of Medicine, Tokyo 1138421, Japan.
| | - Masaki Sonoda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Neurosurgery, Yokohama City University, Yokohama 2360004, Japan.
| | - Ethan Firestone
- Department of Physiology, Wayne State University, Detroit, Michigan 48202, USA.
| | - Naoto Kuroda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai 9808575, Japan.
| | - Yu Kitazawa
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Neurology and Stroke Medicine, Yokohama City University, Yokohama 2360004, Japan.
| | - Hiroshi Uda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka 5458585, Japan.
| | - Aimee F Luat
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Pediatrics, Central Michigan University, Mt. Pleasant, Michigan 48858, USA.
| | - Elizabeth L Johnson
- Departments of Medical Social Sciences, Pediatrics, and Psychology, Northwestern University, Chicago, Illinois 60611, USA.
| | - Noa Ofen
- Life-Span Cognitive Neuroscience Program, Institute of Gerontology and Merrill Palmer Skillman Institute, Wayne State University, Detroit, Michigan 48202, USA; Department of Psychology, Wayne State University, Detroit, Michigan 48202, USA.
| | - Eishi Asano
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, Michigan 48201, USA; Translational Neuroscience Program, Wayne State University, Detroit, Michigan 48201, USA.
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Hines K, Wu C. Epilepsy Networks and Their Surgical Relevance. Brain Sci 2023; 14:31. [PMID: 38248246 PMCID: PMC10813558 DOI: 10.3390/brainsci14010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
Surgical epilepsy is a rapidly evolved field. As the understanding and concepts of epilepsy shift towards a network disorder, surgical outcomes may shed light on numerous components of these systems. This review documents the evolution of the understanding of epilepsy networks and examines the data generated by resective, ablative, neuromodulation, and invasive monitoring surgeries in epilepsy patients. As these network tools are better integrated into epilepsy practice, they may eventually inform surgical decisions and improve clinical outcomes.
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Affiliation(s)
- Kevin Hines
- Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
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Gerstl JVE, Kiseleva A, Imbach L, Sarnthein J, Fedele T. High frequency oscillations in relation to interictal spikes in predicting postsurgical seizure freedom. Sci Rep 2023; 13:21313. [PMID: 38042925 PMCID: PMC10693609 DOI: 10.1038/s41598-023-48764-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/30/2023] [Indexed: 12/04/2023] Open
Abstract
We evaluate whether interictal spikes, epileptiform HFOs and their co-occurrence (Spike + HFO) were included in the resection area with respect to seizure outcome. We also characterise the relationship between high frequency oscillations (HFOs) and propagating spikes. We analysed intracranial EEG of 20 patients that underwent resective epilepsy surgery. The co-occurrence of ripples and fast ripples was considered an HFO event; the co-occurrence of an interictal spike and HFO was considered a Spike + HFO event. HFO distribution and spike onset were compared in cases of spike propagation. Accuracy in predicting seizure outcome was 85% for HFO, 60% for Spikes, and 79% for Spike + HFO. Sensitivity was 57% for HFO, 71% for Spikes and 67% for Spikes + HFO. Specificity was 100% for HFO, 54% for Spikes and 85% for Spikes + HFO. In 2/2 patients with spike propagation, the spike onset included the HFO area. Combining interictal spikes with HFO had comparable accuracy to HFO. In patients with propagating spikes, HFO rate was maximal at the onset of spike propagation.
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Affiliation(s)
- Jakob V E Gerstl
- University College London Medical School, London, UK
- Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - Alina Kiseleva
- Institute for Cognitive Neuroscience, HSE University, Myasnitskaya Ulitsa, 20, Moscow, Russian Federation, 101000
| | - Lukas Imbach
- Swiss Epilepsy Center, Klinik Lengg, Zurich, Switzerland
| | - Johannes Sarnthein
- Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - Tommaso Fedele
- Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland.
- Institute for Cognitive Neuroscience, HSE University, Myasnitskaya Ulitsa, 20, Moscow, Russian Federation, 101000.
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Withers CP, Diamond JM, Yang B, Snyder K, Abdollahi S, Sarlls J, Chapeton JI, Theodore WH, Zaghloul KA, Inati SK. Identifying sources of human interictal discharges with travelling wave and white matter propagation. Brain 2023; 146:5168-5181. [PMID: 37527460 PMCID: PMC11046055 DOI: 10.1093/brain/awad259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/30/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023] Open
Abstract
Interictal epileptiform discharges have been shown to propagate from focal epileptogenic sources as travelling waves or through more rapid white matter conduction. We hypothesize that both modes of propagation are necessary to explain interictal discharge timing delays. We propose a method that, for the first time, incorporates both propagation modes to identify unique potential sources of interictal activity. We retrospectively analysed 38 focal epilepsy patients who underwent intracranial EEG recordings and diffusion-weighted imaging for epilepsy surgery evaluation. Interictal discharges were detected and localized to the most likely source based on relative delays in time of arrival across electrodes, incorporating travelling waves and white matter propagation. We assessed the influence of white matter propagation on distance of spread, timing and clinical interpretation of interictal activity. To evaluate accuracy, we compared our source localization results to earliest spiking regions to predict seizure outcomes. White matter propagation helps to explain the timing delays observed in interictal discharge sequences, underlying rapid and distant propagation. Sources identified based on differences in time of receipt of interictal discharges are often distinct from the leading electrode location. Receipt of activity propagating rapidly via white matter can occur earlier than more local activity propagating via slower cortical travelling waves. In our cohort, our source localization approach was more accurate in predicting seizure outcomes than the leading electrode location. Inclusion of white matter in addition to travelling wave propagation in our model of discharge spread did not improve overall accuracy but allowed for identification of unique and at times distant potential sources of activity, particularly in patients with persistent postoperative seizures. Since distant white matter propagation can occur more rapidly than local travelling wave propagation, combined modes of propagation within an interictal discharge sequence can decouple the commonly assumed relationship between spike timing and distance from the source. Our findings thus highlight the clinical importance of recognizing the presence of dual modes of propagation during interictal discharges, as this may be a cause of clinical mislocalization.
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Affiliation(s)
- C Price Withers
- Neurophysiology of Epilepsy Unit, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Joshua M Diamond
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Braden Yang
- Neurophysiology of Epilepsy Unit, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kathryn Snyder
- Neurophysiology of Epilepsy Unit, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Shervin Abdollahi
- Neurophysiology of Epilepsy Unit, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Joelle Sarlls
- NIH MRI Research Facility, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Julio I Chapeton
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - William H Theodore
- Clinical Epilepsy Section, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kareem A Zaghloul
- Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sara K Inati
- Neurophysiology of Epilepsy Unit, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
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De Benedictis A, de Palma L, Rossi-Espagnet MC, Marras CE. Connectome-based approaches in pediatric epilepsy surgery: "State-of-the art" and future perspectives. Epilepsy Behav 2023; 149:109523. [PMID: 37944286 DOI: 10.1016/j.yebeh.2023.109523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
Modern epilepsy science has overcome the traditional interpretation of a strict region-specific origin of epilepsy, highlighting the involvement of wider patterns of altered neuronal circuits. In selected cases, surgery may constitute a valuable option to achieve both seizure freedom and neurocognitive improvement. Although epilepsy is now considered as a brain network disease, the most relevant literature concerning the "connectome-based" epilepsy surgery mainly refers to adults, with a limited number of studies dedicated to the pediatric population. In this review, the Authors summarized the main current available knowledge on the relevance of WM surgical anatomy in epilepsy surgery, the post-surgical modifications of brain structural connectivity and the related clinical impact of such modifications within the pediatric context. In the last part, possible implications and future perspectives of this approach have been discussed, especially concerning the optimization of surgical strategies and the predictive value of the epilepsy network analysis for planning tailored approaches, with the final aim of improving case selection, presurgical planning, intraoperative management, and postoperative results.
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Affiliation(s)
| | - Luca de Palma
- Epilepsy and Movement Disorders Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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Firestone E, Sonoda M, Kuroda N, Sakakura K, Jeong JW, Lee MH, Wada K, Takayama Y, Iijima K, Iwasaki M, Miyazaki T, Asano E. Sevoflurane-induced high-frequency oscillations, effective connectivity and intraoperative classification of epileptic brain areas. Clin Neurophysiol 2023; 150:17-30. [PMID: 36989866 PMCID: PMC10192072 DOI: 10.1016/j.clinph.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To determine how sevoflurane anesthesia modulates intraoperative epilepsy biomarkers on electrocorticography, including high-frequency oscillation (HFO) effective connectivity (EC), and to investigate their relation to epileptogenicity and anatomical white matter. METHODS We studied eight pediatric drug-resistant focal epilepsy patients who achieved seizure control after invasive monitoring and resective surgery. We visualized spatial distributions of the electrocorticography biomarkers at an oxygen baseline, three time-points while sevoflurane was increasing, and at a plateau of 2 minimum alveolar concentration (MAC) sevoflurane. HFO EC was combined with diffusion-weighted imaging, in dynamic tractography. RESULTS Intraoperative HFO EC diffusely increased as a function of sevoflurane concentration, although most in epileptogenic sites (defined as those included in the resection); their ability to classify epileptogenicity was optimized at sevoflurane 2 MAC. HFO EC could be visualized on major white matter tracts, as a function of sevoflurane level. CONCLUSIONS The results strengthened the hypothesis that sevoflurane-activated HFO biomarkers may help intraoperatively localize the epileptogenic zone. SIGNIFICANCE Our results help characterize how HFOs at non-epileptogenic and epileptogenic networks respond to sevoflurane. It may be warranted to establish a normative HFO atlas incorporating the modifying effects of sevoflurane and major white matter pathways, as critical reference in epilepsy presurgical evaluation.
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Affiliation(s)
- Ethan Firestone
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center,Wayne State University, Detroit, MI 48201, USA; Department of Physiology, Wayne State University, Detroit, MI 48201, USA
| | - Masaki Sonoda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center,Wayne State University, Detroit, MI 48201, USA; Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama 2360004, Japan
| | - Naoto Kuroda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center,Wayne State University, Detroit, MI 48201, USA; Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai 9808575, Japan
| | - Kazuki Sakakura
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center,Wayne State University, Detroit, MI 48201, USA; Department of Neurosurgery, University of Tsukuba, Tsukuba 3058575, Japan
| | - Jeong-Won Jeong
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center,Wayne State University, Detroit, MI 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
| | - Min-Hee Lee
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center,Wayne State University, Detroit, MI 48201, USA
| | - Keiko Wada
- Department of Anesthesiology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo 1878551, Japan; Department of Anesthesiology and Critical Care, Yokohama City University Graduate School of Medicine, Yokohama 2360004, Japan
| | - Yutaro Takayama
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama 2360004, Japan; Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo 1878551, Japan
| | - Keiya Iijima
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo 1878551, Japan
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo 1878551, Japan
| | - Tomoyuki Miyazaki
- Department of Anesthesiology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo 1878551, Japan; Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama 2360004, Japan
| | - Eishi Asano
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center,Wayne State University, Detroit, MI 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
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Kitazawa Y, Sonoda M, Sakakura K, Mitsuhashi T, Firestone E, Ueda R, Kambara T, Iwaki H, Luat AF, Marupudi NI, Sood S, Asano E. Intra- and inter-hemispheric network dynamics supporting object recognition and speech production. Neuroimage 2023; 270:119954. [PMID: 36828156 PMCID: PMC10112006 DOI: 10.1016/j.neuroimage.2023.119954] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
We built normative brain atlases that animate millisecond-scale intra- and inter-hemispheric white matter-level connectivity dynamics supporting object recognition and speech production. We quantified electrocorticographic modulations during three naming tasks using event-related high-gamma activity from 1,114 nonepileptogenic intracranial electrodes (i.e., non-lesional areas unaffected by epileptiform discharges). Using this electrocorticography data, we visualized functional connectivity modulations defined as significant naming-related high-gamma modulations occurring simultaneously at two sites connected by direct white matter streamlines on diffusion-weighted imaging tractography. Immediately after stimulus onset, intra- and inter-hemispheric functional connectivity enhancements were confined mainly across modality-specific perceptual regions. During response preparation, left intra-hemispheric connectivity enhancements propagated in a posterior-to-anterior direction, involving the left precentral and prefrontal areas. After overt response onset, inter- and intra-hemispheric connectivity enhancements mainly encompassed precentral, postcentral, and superior-temporal (STG) gyri. We found task-specific connectivity enhancements during response preparation as follows. Picture naming enhanced activity along the left arcuate fasciculus between the inferior-temporal and precentral/posterior inferior-frontal (pIFG) gyri. Nonspeech environmental sound naming augmented functional connectivity via the left inferior longitudinal and fronto-occipital fasciculi between the medial-occipital and STG/pIFG. Auditory descriptive naming task enhanced usage of the left frontal U-fibers, involving the middle-frontal gyrus. Taken together, the commonly observed network enhancements include inter-hemispheric connectivity optimizing perceptual processing exerted in each hemisphere, left intra-hemispheric connectivity supporting semantic and lexical processing, and inter-hemispheric connectivity for symmetric oral movements during overt speech. Our atlases improve the currently available models of object recognition and speech production by adding neural dynamics via direct intra- and inter-hemispheric white matter tracts.
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Affiliation(s)
- Yu Kitazawa
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurology and Stroke Medicine, Yokohama City University, Yokohama, 2360004, Japan
| | - Masaki Sonoda
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurosurgery, Yokohama City University, Yokohama, 2360004, Japan
| | - Kazuki Sakakura
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurosurgery, University of Tsukuba, Tsukuba, 3058575, Japan
| | - Takumi Mitsuhashi
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurosurgery, Juntendo University, Tokyo, 1138421, Japan
| | - Ethan Firestone
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Physiology, Wayne State University, Detroit, 48201, USA
| | - Riyo Ueda
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA
| | - Toshimune Kambara
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Psychology, Hiroshima University, Hiroshima, 7398524, Japan
| | - Hirotaka Iwaki
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Psychiatry, Hachinohe City Hospital, Hachinohe, 0318555, Japan
| | - Aimee F Luat
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Pediatrics, Central Michigan University, Mount Pleasant, 48858, USA
| | - Neena I Marupudi
- Department of Neurosurgery, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA
| | - Sandeep Sood
- Department of Neurosurgery, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA
| | - Eishi Asano
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA.
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Weiner VS, Zhou DW, Kahali P, Stephen EP, Peterfreund RA, Aglio LS, Szabo MD, Eskandar EN, Salazar-Gomez AF, Sampson AL, Cash SS, Brown EN, Purdon PL. Propofol disrupts alpha dynamics in functionally distinct thalamocortical networks during loss of consciousness. Proc Natl Acad Sci U S A 2023; 120:e2207831120. [PMID: 36897972 PMCID: PMC10089159 DOI: 10.1073/pnas.2207831120] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 01/14/2023] [Indexed: 03/12/2023] Open
Abstract
During propofol-induced general anesthesia, alpha rhythms measured using electroencephalography undergo a striking shift from posterior to anterior, termed anteriorization, where the ubiquitous waking alpha is lost and a frontal alpha emerges. The functional significance of alpha anteriorization and the precise brain regions contributing to the phenomenon are a mystery. While posterior alpha is thought to be generated by thalamocortical circuits connecting nuclei of the sensory thalamus with their cortical partners, the thalamic origins of the propofol-induced alpha remain poorly understood. Here, we used human intracranial recordings to identify regions in sensory cortices where propofol attenuates a coherent alpha network, distinct from those in the frontal cortex where it amplifies coherent alpha and beta activities. We then performed diffusion tractography between these identified regions and individual thalamic nuclei to show that the opposing dynamics of anteriorization occur within two distinct thalamocortical networks. We found that propofol disrupted a posterior alpha network structurally connected with nuclei in the sensory and sensory associational regions of the thalamus. At the same time, propofol induced a coherent alpha oscillation within prefrontal cortical areas that were connected with thalamic nuclei involved in cognition, such as the mediodorsal nucleus. The cortical and thalamic anatomy involved, as well as their known functional roles, suggests multiple means by which propofol dismantles sensory and cognitive processes to achieve loss of consciousness.
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Affiliation(s)
- Veronica S. Weiner
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
| | - David W. Zhou
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Center for Neurotechnology and Recovery, Department of Neurology, Massachusetts General Hospital, Boston, MA02114
| | - Pegah Kahali
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Emily P. Stephen
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
| | - Robert A. Peterfreund
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
| | - Linda S. Aglio
- Harvard Medical School, Boston, MA02115
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA02115
| | - Michele D. Szabo
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Emad N. Eskandar
- Harvard Medical School, Boston, MA02115
- Department of Neurological Surgery, Massachusetts General Hospital, Boston, MA02114
| | - Andrés F. Salazar-Gomez
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Aaron L. Sampson
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
| | - Sydney S. Cash
- Center for Neurotechnology and Recovery, Department of Neurology, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
| | - Emery N. Brown
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA02139
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
- Division of Health Sciences and Technology, Harvard Medical School/Massachusetts Institute of Technology, Cambridge, MA02139
- Institute of Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA02139
| | - Patrick L. Purdon
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA02114
- Harvard Medical School, Boston, MA02115
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9
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Azeem A, von Ellenrieder N, Royer J, Frauscher B, Bernhardt B, Gotman J. Integration of white matter architecture to stereo-EEG better describes epileptic spike propagation. Clin Neurophysiol 2023; 146:135-146. [PMID: 36379837 DOI: 10.1016/j.clinph.2022.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/12/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Stereo-electroencephalography (SEEG)-derived epilepsy networks are used to better understand a patient's epilepsy; however, a unimodal approach provides an incomplete picture. We combine tractography and SEEG to determine the relationship between spike propagation and the white matter architecture and to improve our understanding of spike propagation mechanisms. METHODS Probablistic tractography from diffusion imaging (dMRI) of matched subjects from the Human Connectome Project (HCP) was combined with patient-specific SEEG-derived spike propagation networks. Two regions-of-interest (ROIs) with a significant spike propagation relationship constituted a Propagation Pair. RESULTS In 56 of 59 patients, Propagation Pairs were more often tract-connected as compared to all ROI pairs (p < 0.01; d = -1.91). The degree of spike propagation between tract-connected ROIs was greater (39 ± 21%) compared to tract-unconnected ROIs (31 ± 18%; p < 0.0001). Within the same network, ROIs receiving propagation earlier were more often tract-connected to the source (59.7%) as compared to late receivers (25.4%; p < 0.0001). CONCLUSIONS Brain regions involved in spike propagation are more likely to be connected by white matter tracts. Between nodes, presence of tracts suggests a direct course of propagation, whereas the absence of tracts suggests an indirect course of propagation. SIGNIFICANCE We demonstrate a logical and consistent relationship between spike propagation and the white matter architecture.
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Affiliation(s)
- Abdullah Azeem
- Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Nicolás von Ellenrieder
- Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Jessica Royer
- Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Birgit Frauscher
- Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; Department of Neurology & Neurosurgery, Montreal Neurological Hospital, Montréal, QC, Canada
| | - Boris Bernhardt
- Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Jean Gotman
- Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC, Canada
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10
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Schlafly ED, Marshall FA, Merricks EM, Eden UT, Cash SS, Schevon CA, Kramer MA. Multiple Sources of Fast Traveling Waves during Human Seizures: Resolving a Controversy. J Neurosci 2022; 42:6966-6982. [PMID: 35906069 PMCID: PMC9464018 DOI: 10.1523/jneurosci.0338-22.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/26/2022] [Accepted: 06/18/2022] [Indexed: 11/21/2022] Open
Abstract
During human seizures, organized waves of voltage activity rapidly sweep across the cortex. Two contradictory theories describe the source of these fast traveling waves: either a slowly advancing narrow region of multiunit activity (an ictal wavefront) or a fixed cortical location. Limited observations and different analyses prevent resolution of these incompatible theories. Here we address this disagreement by combining the methods and microelectrode array recordings (N = 11 patients, 2 females, N = 31 seizures) from previous human studies to analyze the traveling wave source. We find, inconsistent with both existing theories, a transient relationship between the ictal wavefront and traveling waves, and multiple stable directions of traveling waves in many seizures. Using a computational model that combines elements of both existing theories, we show that interactions between an ictal wavefront and fixed source reproduce the traveling wave dynamics observed in vivo We conclude that combining both existing theories can generate the diversity of ictal traveling waves.SIGNIFICANCE STATEMENT The source of voltage discharges that propagate across cortex during human seizures remains unknown. Two candidate theories exist, each proposing a different discharge source. Support for each theory consists of observations from a small number of human subject recordings, analyzed with separately developed methods. How the different, limited data and different analysis methods impact the evidence for each theory is unclear. To resolve these differences, we combine the unique, human microelectrode array recordings collected separately for each theory and analyze these combined data with a unified approach. We show that neither existing theory adequately describes the data. We then propose a new theory that unifies existing proposals and successfully reproduces the voltage discharge dynamics observed in vivo.
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Affiliation(s)
- Emily D Schlafly
- Graduate Program in Neuroscience, Boston University, Boston, Massachusetts 02215
| | - François A Marshall
- Department of Mathematics and Statistics & Center for Systems Neuroscience, Boston University, Boston, Massachusetts 02215
| | - Edward M Merricks
- Department of Neurology, Columbia University, New York, New York 10032
| | - Uri T Eden
- Department of Mathematics and Statistics & Center for Systems Neuroscience, Boston University, Boston, Massachusetts 02215
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts 02114
| | | | - Mark A Kramer
- Department of Mathematics and Statistics & Center for Systems Neuroscience, Boston University, Boston, Massachusetts 02215
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11
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O'Hara NB, Lee MH, Juhász C, Asano E, Jeong JW. Diffusion tractography predicts propagated high-frequency activity during epileptic spasms. Epilepsia 2022; 63:1787-1798. [PMID: 35388455 DOI: 10.1111/epi.17251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/28/2022] [Accepted: 04/05/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Determine the structural networks that constrain propagation of ictal oscillations during epileptic spasm events, and compare observed propagation patterns across patients with successful or unsuccessful surgical outcomes. METHODS Subdural electrode recordings of 18 young patients (age 1-11 years) were analyzed during epileptic spasm events to determine ictal networks and quantify the amplitude and onset time of ictal oscillations across the cortical surface. Corresponding structural networks were generated with diffusion MRI tractography by seeding the cortical region associated with the earliest average oscillation onset time, and white matter pathways connecting active electrode regions within the ictal network were isolated. Properties of this structural network were used to predict oscillation onset times and amplitudes, and this relationship was compared across patients who did and did not achieve seizure freedom following resective surgery. RESULTS Onset propagation patterns were relatively consistent across each patients' spasm events. An electrode's average ictal oscillation onset latency was most significantly associated with the length of direct corticocortical tracts connecting to the area with the earliest average oscillation onset (p < .001, model R2 = 0.54). Moreover, patients demonstrating a faster propagation of ictal oscillation signals within the corticocortical network were more likely to have seizure recurrence following resective surgery (p = .039). Ictal oscillation amplitude was also associated with connecting tractography length and weighted fractional anisotropy (FA) measures along these pathways (p = .002/.030, model R2 = 0.31/0.25). Characteristics of analogous corticothalamic pathways did not show significant associations with ictal oscillation onset latency or amplitude. SIGNIFICANCE Spatiotemporal propagation patterns of high-frequency activity in epileptic spasms align with length and FA measures from onset-originating corticocortical pathways. Considering data in this individualized framework may help inform surgical decision making and expectations of surgical outcomes.
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Affiliation(s)
- Nolan B O'Hara
- Wayne State University (WSU) Translational Neuroscience Program.,Children's Hospital of Michigan Translational Imaging Laboratory
| | - Min-Hee Lee
- Children's Hospital of Michigan Translational Imaging Laboratory
| | - Csaba Juhász
- Wayne State University (WSU) Translational Neuroscience Program.,Children's Hospital of Michigan Translational Imaging Laboratory.,WSU Department of Pediatrics.,WSU Department of Neurology
| | - Eishi Asano
- Wayne State University (WSU) Translational Neuroscience Program.,Children's Hospital of Michigan Translational Imaging Laboratory.,WSU Department of Pediatrics.,WSU Department of Neurology
| | - Jeong-Won Jeong
- Wayne State University (WSU) Translational Neuroscience Program.,Children's Hospital of Michigan Translational Imaging Laboratory.,WSU Department of Pediatrics.,WSU Department of Neurology
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12
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Mitsuhashi T, Sonoda M, Firestone E, Sakakura K, Jeong JW, Luat AF, Sood S, Asano E. Temporally and functionally distinct large-scale brain network dynamics supporting task switching. Neuroimage 2022; 254:119126. [PMID: 35331870 PMCID: PMC9173207 DOI: 10.1016/j.neuroimage.2022.119126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/25/2022] [Accepted: 03/20/2022] [Indexed: 11/04/2022] Open
Abstract
Objective: Our daily activities require frequent switches among competing responses at the millisecond time scale. We determined the spatiotemporal characteristics and functional significance of rapid, large-scale brain network dynamics during task switching. Methods: This cross-sectional study investigated patients with drug-resistant focal epilepsy who played a Lumosity cognitive flexibility training game during intracranial electroencephalography (iEEG) recording. According to a given task rule, unpredictably switching across trials, participants had to swipe the screen in the direction the stimulus was pointing or moving. Using this data, we described the spatiotemporal characteristics of iEEG high-gamma augmentation occurring more intensely during switch than repeat trials, unattributable to the effect of task rule (pointing or moving), within-stimulus congruence (the direction of stimulus pointing and moving was same or different in a given trial), or accuracy of an immediately preceding response. Diffusion-weighted imaging (DWI) tractography determined whether distant cortical regions showing enhanced activation during task switch trials were directly connected by white matter tracts. Trial-by-trial iEEG analysis deduced whether the intensity of task switch-related high-gamma augmentation was altered through practice and whether high-gamma amplitude predicted the accuracy of an upcoming response among switch trials. Results: The average number of completed trials during five-minute gameplay was 221.4 per patient (range: 171–285). Task switch trials increased the response times, whereas later trials reduced them. Analysis of iEEG signals sampled from 860 brain sites effectively elucidated the distinct spatiotemporal characteristics of task switch, task rule, and post-error-specific high-gamma modulations. Post-cue, task switch-related high-gamma augmentation was initiated in the right calcarine cortex after 260 ms, right precuneus after 330 ms, right entorhinal after 420 ms, and bilateral anterior middle-frontal gyri after 450 ms. DWI tractography successfully showed the presence of direct white matter tracts connecting the right visual areas to the precuneus and anterior middle-frontal regions but not between the right precuneus and anterior middle-frontal regions. Task-related high-gamma amplitudes in later trials were reduced in the calcarine, entorhinal and anterior middle-frontal regions, but increased in the precuneus. Functionally, enhanced post-cue precuneus high-gamma augmentation improved the accuracy of subsequent responses among switch trials. Conclusions: Our multimodal analysis uncovered two temporally and functionally distinct network dynamics supporting task switching. High-gamma augmentation in the visual-precuneus pathway may reflect the neural process facilitating an attentional shift to a given updated task rule. High-gamma activity in the visual-dorsolateral prefrontal pathway, rapidly reduced through practice, may reflect the cost of executing appropriate stimulus-response translation.
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Affiliation(s)
- Takumi Mitsuhashi
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurosurgery, Juntendo University, Tokyo, 1138421, Japan
| | - Masaki Sonoda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurosurgery, Yokohama City University, Yokohama, 2360004, Japan
| | - Ethan Firestone
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Physiology, Wayne State University, Detroit, MI 48201, USA
| | - Kazuki Sakakura
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurosurgery, University of Tsukuba, Tsukuba, 3058575, Japan
| | - Jeong-Won Jeong
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA
| | - Aimee F Luat
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Pediatrics, Central Michigan University, Mount Pleasant, MI, 48858, USA
| | - Sandeep Sood
- Department of Neurosurgery, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA
| | - Eishi Asano
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA.
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13
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Miyazaki T, Takayama Y, Iwasaki M, Hatano M, Nakajima W, Ikegaya N, Yamamoto T, Tsuchimoto S, Kato H, Takahashi T. OUP accepted manuscript. Brain Commun 2022; 4:fcac023. [PMID: 35415605 PMCID: PMC8994107 DOI: 10.1093/braincomms/fcac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/11/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Presurgical identification of the epileptogenic zone is a critical determinant of seizure control following surgical resection in epilepsy. Excitatory glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor is a major component of neurotransmission. Although elevated α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor levels are observed in surgically resected brain areas of patients with epilepsy, it remains unclear whether increased α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor-mediated currents initiate epileptic discharges. We have recently developed the first PET tracer for α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor, [11C]K-2, to visualize and quantify the density of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors in living human brains. Here, we detected elevated [11C]K-2 uptake in the epileptogenic temporal lobe of patients with mesial temporal lobe epilepsy. Brain areas with high [11C]K-2 uptake are closely colocalized with the location of equivalent current dipoles estimated by magnetoencephalography or with seizure onset zones detected by intracranial electroencephalogram. These results suggest that epileptic discharges initiate from brain areas with increased α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors, providing a biological basis for epileptic discharges and an additional non-invasive option to identify the epileptogenic zone in patients with mesial temporal lobe epilepsy.
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Affiliation(s)
- Tomoyuki Miyazaki
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Yutaro Takayama
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira 187-8551, Japan
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira 187-8551, Japan
| | - Mai Hatano
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Waki Nakajima
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Shohei Tsuchimoto
- Division of System Neuroscience, National Institute for Physiological Sciences, Okazaki 444-8585, Japan
| | - Hiroki Kato
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita 565-0871, Japan
| | - Takuya Takahashi
- Department of Physiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
- Correspondence to: Takuya Takahashi Department of Physiology, Yokohama City University Graduate School of Medicine Fukuura 3-9, Kanazawa-ku, Yokohama, 236-0004, Japan E-mail:
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