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Khaksari K, Chen WL, Chanvanichtrakool M, Taylor A, Kotla R, Gropman AL. Applications of near-infrared spectroscopy in epilepsy, with a focus on mitochondrial disorders. Neurotherapeutics 2024; 21:e00323. [PMID: 38244258 PMCID: PMC10903079 DOI: 10.1016/j.neurot.2024.e00323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
Mitochondrial diseases are inherited disorders that impede the mitochondria's ability to produce sufficient energy for the cells. They can affect different parts of the body, notably the brain. Neurological symptoms and epilepsy are prevalent in patients with mitochondrial disorders. The epileptogenicity of mitochondrial disorder is a complex process involving the intricate interplay between abnormal energy metabolism and neuronal activity. Several modalities have been used to detect seizures in different disorders including mitochondrial disorders. EEG serve as the gold standard for diagnosis and localization, commonly complemented by additional imaging modalities to enhance source localization. In the current work, we propose the use of functional near-infrared spectroscopy (fNIRS) to identify the occurrence of epilepsy and seizure in patients with mitochondrial disorders. fNIRS proves an advantageous imaging technique due to its portability and insensitivity to motion especially for imaging infants and children. It has added a valuable factor to our understanding of energy metabolism and neuronal activity. Its real-time monitoring with high spatial resolution supplements traditional diagnostic tools such as EEG and provides a comprehensive understanding of seizure and epileptogenesis. The utility of fNIRS extends to its ability to detect changes in Cytochrome c oxidase (CcO) which is a crucial enzyme in cellular respiration. This facet enhances our insight into the metabolic dimension of epilepsy related to mitochondrial dysfunction. By providing valuable insights into both energy metabolism and neuronal activity, fNIRS emerges as a promising imaging technique for unveiling the complexities of mitochondrial disorders and their neurological manifestations.
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Affiliation(s)
- Kosar Khaksari
- Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA; Department of Neurology, George Washington University, Washington, DC, USA.
| | - Wei-Liang Chen
- Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA; Department of Neurology, George Washington University, Washington, DC, USA
| | - Mongkol Chanvanichtrakool
- Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA
| | - Alexa Taylor
- Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA
| | - Rohan Kotla
- Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA; Thomas Jefferson High School for Science and Technology, Alexandria, VA, USA
| | - Andrea L Gropman
- Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA; Department of Neurology, George Washington University, Washington, DC, USA
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Gallagher A, Wallois F, Obrig H. Functional near-infrared spectroscopy in pediatric clinical research: Different pathophysiologies and promising clinical applications. NEUROPHOTONICS 2023; 10:023517. [PMID: 36873247 PMCID: PMC9982436 DOI: 10.1117/1.nph.10.2.023517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Over its 30 years of existence, functional near-infrared spectroscopy (fNIRS) has matured into a highly versatile tool to study brain function in infants and young children. Its advantages, amongst others, include its ease of application and portability, the option to combine it with electrophysiology, and its relatively good tolerance to movement. As shown by the impressive body of fNIRS literature in the field of cognitive developmental neuroscience, the method's strengths become even more relevant for (very) young individuals who suffer from neurological, behavioral, and/or cognitive impairment. Although a number of studies have been conducted with a clinical perspective, fNIRS cannot yet be considered as a truly clinical tool. The first step has been taken in this direction by studies exploring options in populations with well-defined clinical profiles. To foster further progress, here, we review several of these clinical approaches to identify the challenges and perspectives of fNIRS in the field of developmental disorders. We first outline the contributions of fNIRS in selected areas of pediatric clinical research: epilepsy, communicative and language disorders, and attention-deficit/hyperactivity disorder. We provide a scoping review as a framework to allow the highlighting of specific and general challenges of using fNIRS in pediatric research. We also discuss potential solutions and perspectives on the broader use of fNIRS in the clinical setting. This may be of use to future research, targeting clinical applications of fNIRS in children and adolescents.
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Affiliation(s)
- Anne Gallagher
- CHU Sainte-Justine University Hospital, Université de Montréal, LIONLab, Cerebrum, Department of Psychology, Montréal, Quebec, Canada
| | - Fabrice Wallois
- Université de Picardie Jules Verne, Inserm U1105, GRAMFC, Amiens, France
| | - Hellmuth Obrig
- University Hospital and Faculty of Medicine Leipzig/Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology, Clinic for Cognitive Neurology, Leipzig, Germany
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3
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Optical Monitoring in Neonatal Seizures. Cells 2022; 11:cells11162602. [PMID: 36010678 PMCID: PMC9407001 DOI: 10.3390/cells11162602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/30/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Neonatal seizures remain a significant cause of morbidity and mortality worldwide. The past decade has resulted in substantial progress in seizure detection and understanding the impact seizures have on the developing brain. Optical monitoring such as cerebral near-infrared spectroscopy (NIRS) and broadband NIRS can provide non-invasive continuous real-time monitoring of the changes in brain metabolism and haemodynamics. AIM To perform a systematic review of optical biomarkers to identify changes in cerebral haemodynamics and metabolism during the pre-ictal, ictal, and post-ictal phases of neonatal seizures. METHOD A systematic search was performed in eight databases. The search combined the three broad categories: (neonates) AND (NIRS) AND (seizures) using the stepwise approach following PRISMA guidance. RESULTS Fifteen papers described the haemodynamic and/or metabolic changes observed with NIRS during neonatal seizures. No randomised controlled trials were identified during the search. Studies reported various changes occurring in the pre-ictal, ictal, and post-ictal phases of seizures. CONCLUSION Clear changes in cerebral haemodynamics and metabolism were noted during the pre-ictal, ictal, and post-ictal phases of seizures in neonates. Further studies are necessary to determine whether NIRS-based methods can be used at the cot-side to provide clear pathophysiological data in real-time during neonatal seizures.
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Ayaz H, Baker WB, Blaney G, Boas DA, Bortfeld H, Brady K, Brake J, Brigadoi S, Buckley EM, Carp SA, Cooper RJ, Cowdrick KR, Culver JP, Dan I, Dehghani H, Devor A, Durduran T, Eggebrecht AT, Emberson LL, Fang Q, Fantini S, Franceschini MA, Fischer JB, Gervain J, Hirsch J, Hong KS, Horstmeyer R, Kainerstorfer JM, Ko TS, Licht DJ, Liebert A, Luke R, Lynch JM, Mesquida J, Mesquita RC, Naseer N, Novi SL, Orihuela-Espina F, O’Sullivan TD, Peterka DS, Pifferi A, Pollonini L, Sassaroli A, Sato JR, Scholkmann F, Spinelli L, Srinivasan VJ, St. Lawrence K, Tachtsidis I, Tong Y, Torricelli A, Urner T, Wabnitz H, Wolf M, Wolf U, Xu S, Yang C, Yodh AG, Yücel MA, Zhou W. Optical imaging and spectroscopy for the study of the human brain: status report. NEUROPHOTONICS 2022; 9:S24001. [PMID: 36052058 PMCID: PMC9424749 DOI: 10.1117/1.nph.9.s2.s24001] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions.
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Affiliation(s)
- Hasan Ayaz
- Drexel University, School of Biomedical Engineering, Science, and Health Systems, Philadelphia, Pennsylvania, United States
- Drexel University, College of Arts and Sciences, Department of Psychological and Brain Sciences, Philadelphia, Pennsylvania, United States
| | - Wesley B. Baker
- Children’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania, United States
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Giles Blaney
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - David A. Boas
- Boston University Neurophotonics Center, Boston, Massachusetts, United States
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Heather Bortfeld
- University of California, Merced, Departments of Psychological Sciences and Cognitive and Information Sciences, Merced, California, United States
| | - Kenneth Brady
- Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Department of Anesthesiology, Chicago, Illinois, United States
| | - Joshua Brake
- Harvey Mudd College, Department of Engineering, Claremont, California, United States
| | - Sabrina Brigadoi
- University of Padua, Department of Developmental and Social Psychology, Padua, Italy
| | - Erin M. Buckley
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
| | - Stefan A. Carp
- Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Robert J. Cooper
- University College London, Department of Medical Physics and Bioengineering, DOT-HUB, London, United Kingdom
| | - Kyle R. Cowdrick
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Joseph P. Culver
- Washington University School of Medicine, Department of Radiology, St. Louis, Missouri, United States
| | - Ippeita Dan
- Chuo University, Faculty of Science and Engineering, Tokyo, Japan
| | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Birmingham, United Kingdom
| | - Anna Devor
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Turgut Durduran
- ICFO – The Institute of Photonic Sciences, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
- Institució Catalana de Recerca I Estudis Avançats (ICREA), Barcelona, Spain
| | - Adam T. Eggebrecht
- Washington University in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, Missouri, United States
| | - Lauren L. Emberson
- University of British Columbia, Department of Psychology, Vancouver, British Columbia, Canada
| | - Qianqian Fang
- Northeastern University, Department of Bioengineering, Boston, Massachusetts, United States
| | - Sergio Fantini
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Maria Angela Franceschini
- Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Jonas B. Fischer
- ICFO – The Institute of Photonic Sciences, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
| | - Judit Gervain
- University of Padua, Department of Developmental and Social Psychology, Padua, Italy
- Université Paris Cité, CNRS, Integrative Neuroscience and Cognition Center, Paris, France
| | - Joy Hirsch
- Yale School of Medicine, Department of Psychiatry, Neuroscience, and Comparative Medicine, New Haven, Connecticut, United States
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Keum-Shik Hong
- Pusan National University, School of Mechanical Engineering, Busan, Republic of Korea
- Qingdao University, School of Automation, Institute for Future, Qingdao, China
| | - Roarke Horstmeyer
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
- Duke University, Department of Electrical and Computer Engineering, Durham, North Carolina, United States
- Duke University, Department of Physics, Durham, North Carolina, United States
| | - Jana M. Kainerstorfer
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
- Carnegie Mellon University, Neuroscience Institute, Pittsburgh, Pennsylvania, United States
| | - Tiffany S. Ko
- Children’s Hospital of Philadelphia, Division of Cardiothoracic Anesthesiology, Philadelphia, Pennsylvania, United States
| | - Daniel J. Licht
- Children’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania, United States
| | - Adam Liebert
- Polish Academy of Sciences, Nalecz Institute of Biocybernetics and Biomedical Engineering, Warsaw, Poland
| | - Robert Luke
- Macquarie University, Department of Linguistics, Sydney, New South Wales, Australia
- Macquarie University Hearing, Australia Hearing Hub, Sydney, New South Wales, Australia
| | - Jennifer M. Lynch
- Children’s Hospital of Philadelphia, Division of Cardiothoracic Anesthesiology, Philadelphia, Pennsylvania, United States
| | - Jaume Mesquida
- Parc Taulí Hospital Universitari, Critical Care Department, Sabadell, Spain
| | - Rickson C. Mesquita
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Noman Naseer
- Air University, Department of Mechatronics and Biomedical Engineering, Islamabad, Pakistan
| | - Sergio L. Novi
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Western University, Department of Physiology and Pharmacology, London, Ontario, Canada
| | | | - Thomas D. O’Sullivan
- University of Notre Dame, Department of Electrical Engineering, Notre Dame, Indiana, United States
| | - Darcy S. Peterka
- Columbia University, Zuckerman Mind Brain Behaviour Institute, New York, United States
| | | | - Luca Pollonini
- University of Houston, Department of Engineering Technology, Houston, Texas, United States
| | - Angelo Sassaroli
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - João Ricardo Sato
- Federal University of ABC, Center of Mathematics, Computing and Cognition, São Bernardo do Campo, São Paulo, Brazil
| | - Felix Scholkmann
- University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland
- University of Zurich, University Hospital Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Zürich, Switzerland
| | - Lorenzo Spinelli
- National Research Council (CNR), IFN – Institute for Photonics and Nanotechnologies, Milan, Italy
| | - Vivek J. Srinivasan
- University of California Davis, Department of Biomedical Engineering, Davis, California, United States
- NYU Langone Health, Department of Ophthalmology, New York, New York, United States
- NYU Langone Health, Department of Radiology, New York, New York, United States
| | - Keith St. Lawrence
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Ilias Tachtsidis
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Yunjie Tong
- Purdue University, Weldon School of Biomedical Engineering, West Lafayette, Indiana, United States
| | - Alessandro Torricelli
- Politecnico di Milano, Dipartimento di Fisica, Milan, Italy
- National Research Council (CNR), IFN – Institute for Photonics and Nanotechnologies, Milan, Italy
| | - Tara Urner
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Heidrun Wabnitz
- Physikalisch-Technische Bundesanstalt (PTB), Berlin, Germany
| | - Martin Wolf
- University of Zurich, University Hospital Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Zürich, Switzerland
| | - Ursula Wolf
- University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland
| | - Shiqi Xu
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | - Changhuei Yang
- California Institute of Technology, Department of Electrical Engineering, Pasadena, California, United States
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - Meryem A. Yücel
- Boston University Neurophotonics Center, Boston, Massachusetts, United States
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Wenjun Zhou
- University of California Davis, Department of Biomedical Engineering, Davis, California, United States
- China Jiliang University, College of Optical and Electronic Technology, Hangzhou, Zhejiang, China
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Yücel MA, Lühmann AV, Scholkmann F, Gervain J, Dan I, Ayaz H, Boas D, Cooper RJ, Culver J, Elwell CE, Eggebrecht A, Franceschini MA, Grova C, Homae F, Lesage F, Obrig H, Tachtsidis I, Tak S, Tong Y, Torricelli A, Wabnitz H, Wolf M. Best practices for fNIRS publications. NEUROPHOTONICS 2021; 8:012101. [PMID: 33442557 PMCID: PMC7793571 DOI: 10.1117/1.nph.8.1.012101] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 05/09/2023]
Abstract
The application of functional near-infrared spectroscopy (fNIRS) in the neurosciences has been expanding over the last 40 years. Today, it is addressing a wide range of applications within different populations and utilizes a great variety of experimental paradigms. With the rapid growth and the diversification of research methods, some inconsistencies are appearing in the way in which methods are presented, which can make the interpretation and replication of studies unnecessarily challenging. The Society for Functional Near-Infrared Spectroscopy has thus been motivated to organize a representative (but not exhaustive) group of leaders in the field to build a consensus on the best practices for describing the methods utilized in fNIRS studies. Our paper has been designed to provide guidelines to help enhance the reliability, repeatability, and traceability of reported fNIRS studies and encourage best practices throughout the community. A checklist is provided to guide authors in the preparation of their manuscripts and to assist reviewers when evaluating fNIRS papers.
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Affiliation(s)
- Meryem A. Yücel
- Boston University, Neurophotonics Center, Biomedical Engineering, Boston, Massachusetts, United States
- Massachusetts General Hospital, Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
- Address all correspondence to Meryem A. Yücel,
| | - Alexander v. Lühmann
- Boston University, Neurophotonics Center, Biomedical Engineering, Boston, Massachusetts, United States
- Massachusetts General Hospital, Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Felix Scholkmann
- University Hospital Zurich, University of Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Neonatology Research, Zurich, Switzerland
- University of Bern, Institute for Complementary and Integrative Medicine, Bern, Switzerland
| | - Judit Gervain
- Université de Paris, CNRS, Integrative Neuroscience and Cognition Center, Paris, France
- Università di Padova, Department of Social and Developmental Psychology, Padua, Italy
| | - Ippeita Dan
- Chuo University, Faculty of Science and Engineering, Applied Cognitive Neuroscience Laboratory, Tokyo, Japan
| | - Hasan Ayaz
- Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, Pennsylvania, United States
- Drexel University, College of Arts and Sciences, Department of Psychology, Philadelphia, Pennsylvania, United States
- Drexel University, Drexel Solutions Institute, Philadelphia, Pennsylvania, United States
- University of Pennsylvania, Department of Family and Community Health, Philadelphia, Pennsylvania, United States
- Children’s Hospital of Philadelphia, Center for Injury Research and Prevention, Philadelphia, Pennsylvania, United States
| | - David Boas
- Boston University, Neurophotonics Center, Biomedical Engineering, Boston, Massachusetts, United States
| | - Robert J. Cooper
- University College London, DOT-HUB, Department of Medical Physics and Biomedical Engineering, Biomedical Optics Research Laboratory, London, United Kingdom
| | - Joseph Culver
- Washington University School of Medicine, Department of Radiology, St. Louis, Missouri, United States
| | - Clare E. Elwell
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Adam Eggebrecht
- Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, Missouri, United States
| | - Maria A. Franceschini
- Massachusetts General Hospital, Harvard Medical School, MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown, Massachusetts, United States
| | - Christophe Grova
- Concordia University, Department of Physics and PERFORM Centre, Multimodal Functional Imaging Lab, Montreal, Québec, Canada
- McGill University, Biomedical Engineering Department, Multimodal Functional Imaging Lab, Montreal, Québec, Canada
| | - Fumitaka Homae
- Tokyo Metropolitan University, Department of Language Sciences, Tokyo, Japan
| | - Frédéric Lesage
- Polytechnique Montréal, Department Electrical Engineering, Montreal, Canada
| | - Hellmuth Obrig
- University Hospital Leipzig, Max-Planck-Institute for Human Cognitive and Brain Sciences and Clinic for Cognitive Neurology, Leipzig, Germany
| | - Ilias Tachtsidis
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Sungho Tak
- Korea Basic Science Institute, Research Center for Bioconvergence Analysis, Ochang, Cheongju, Republic of Korea
| | - Yunjie Tong
- Weldon School of Biomedical Engineering Purdue University, West Lafayette, Indiana, United States
| | - Alessandro Torricelli
- Politecnico di Milano, Dipartimento di Fisica, Milan, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Fotonica e Nanotecnologie, Milan, Italy
| | | | - Martin Wolf
- University Hospital Zurich, University of Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Neonatology Research, Zurich, Switzerland
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Rahman MA, Siddik AB, Ghosh TK, Khanam F, Ahmad M. A Narrative Review on Clinical Applications of fNIRS. J Digit Imaging 2020; 33:1167-1184. [PMID: 32989620 PMCID: PMC7573058 DOI: 10.1007/s10278-020-00387-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 08/06/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
Functional near-infrared spectroscopy (fNIRS) is a relatively new imaging modality in the functional neuroimaging research arena. The fNIRS modality non-invasively investigates the change of blood oxygenation level in the human brain utilizing the transillumination technique. In the last two decades, the interest in this modality is gradually evolving for its real-time monitoring, relatively low-cost, radiation-less environment, portability, patient-friendliness, etc. Including brain-computer interface and functional neuroimaging research, this technique has some important application of clinical perspectives such as Alzheimer's disease, schizophrenia, dyslexia, Parkinson's disease, childhood disorders, post-neurosurgery dysfunction, attention, functional connectivity, and many more can be diagnosed as well as in some form of assistive modality in clinical approaches. Regarding the issue, this review article presents the current scopes of fNIRS in medical assistance, clinical decision making, and future perspectives. This article also covers a short history of fNIRS, fundamental theories, and significant outcomes reported by a number of scholarly articles. Since this review article is hopefully the first one that comprehensively explores the potential scopes of the fNIRS in a clinical perspective, we hope it will be helpful for the researchers, physicians, practitioners, current students of the functional neuroimaging field, and the related personnel for their further studies and applications.
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Affiliation(s)
- Md. Asadur Rahman
- Department of Biomedical Engineering, Military Institute of Science and Technology (MIST), Dhaka, 1216 Bangladesh
| | - Abu Bakar Siddik
- Department of Biomedical Engineering, Khulna University of Engineering & Technology (KUET), Khulna, 9203 Bangladesh
| | - Tarun Kanti Ghosh
- Department of Biomedical Engineering, Khulna University of Engineering & Technology (KUET), Khulna, 9203 Bangladesh
| | - Farzana Khanam
- Department of Biomedical Engineering, Jashore University of Science and Technology (JUST), Jashore, 7408 Bangladesh
| | - Mohiuddin Ahmad
- Department of Electrical and Electronic Engineering, Khulna University of Engineering & Technology (KUET), Khulna, 9203 Bangladesh
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Hemispheric Cerebral Oximetry Monitoring During Pediatric Seizure Activity in a Pediatric Emergency Department. Pediatr Emerg Care 2020; 36:e513-e526. [PMID: 29140931 PMCID: PMC7469875 DOI: 10.1097/pec.0000000000001354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sustained neuronal activity during seizures causes cellular perturbations, alterations in cerebral physiology, and potentially neurological injury, a neurological emergency. With variable clinical manifestations of seizures, frequent failure of seizure recognition by providers in pediatric and developmentally challenged patients can increase seizure complications. Neuroresuscitation should include rapid cerebral physiology assessment for increased seizure recognition and optimal neurological outcomes. In neurological emergencies, cerebral oximetry has demonstrated its utility in altered cerebral physiology and a standard combat neurological assessment tool. During adult seizures, cerebral oximetry (regional cerebral oxygen saturation [rcSO2]) has been shown as a useful neurological assessment tool, but research is lacking in pediatric emergency department (PED) seizure patients. OBJECTIVE The aim of this study was to identify trends in rcSO2 readings for patients presenting to the PED with seizure activity and in the postseizure state in order to evaluate usefulness of rcSO2 as a neurological assessment tool in pediatric seizure patients. METHODS This was a PED observational case series comparing hemispheric rcSO2 readings in first-time clinically evident generalized and focal seizure patients to first-time postseizure patients with no PED seizures. RESULTS Generalized or focal seizure (n = 185) hemispheric rcSO2 revealed significant differences compared with nonseizure and controls' rcSO2 readings (n = 115) (P < 0.0001). Generalized and focal seizure rcSO2's were either less than 60% or greater than 80% compared with nonseizure rcSO2 (P < 0.0001). Ipsilateral focal seizure rcSO2 correlated to seizure side (P < 0.0001) and was less than the contralateral rcSO2 (P < 0.0001), with interhemispheric rcSO2 discordance greater than 16 (P < 0.0001). Seizure to preseizure rcSO2 discordance was as follows: generalized 15.2, focal: left 19.8, right 20.3 (P < 0.0001). CONCLUSIONS Hemispheric during-seizure rcSO2 readings significantly correlated with generalized and focal seizures and reflected altered cerebral physiology. Ipsilateral focal seizure rcSO2 readings correlated to the focal side with wide interhemispheric rcSO2 discordance. All postseizure rcSO2 readings returned to preseizure readings, showing altered cerebral physiology resolution. Overall, in generalized or focal seizure, rcSO2 readings were less than 60% or greater than 80%, and in focal seizure, interhemispheric rcSO2 discordance was greater than 10. During seizures, hemispheric rcSO2 readings demonstrated its potential pediatric seizure utility. Utilizing rcSO2 readings related to seizure activity could expedite pediatric and developmentally challenged patients' seizure recognition, cerebral assessment, and interventions especially in pharmacoresistant seizures.
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Chen WL, Wagner J, Heugel N, Sugar J, Lee YW, Conant L, Malloy M, Heffernan J, Quirk B, Zinos A, Beardsley SA, Prost R, Whelan HT. Functional Near-Infrared Spectroscopy and Its Clinical Application in the Field of Neuroscience: Advances and Future Directions. Front Neurosci 2020; 14:724. [PMID: 32742257 PMCID: PMC7364176 DOI: 10.3389/fnins.2020.00724] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/17/2020] [Indexed: 01/20/2023] Open
Abstract
Similar to functional magnetic resonance imaging (fMRI), functional near-infrared spectroscopy (fNIRS) detects the changes of hemoglobin species inside the brain, but via differences in optical absorption. Within the near-infrared spectrum, light can penetrate biological tissues and be absorbed by chromophores, such as oxyhemoglobin and deoxyhemoglobin. What makes fNIRS more advantageous is its portability and potential for long-term monitoring. This paper reviews the basic mechanisms of fNIRS and its current clinical applications, the limitations toward more widespread clinical usage of fNIRS, and current efforts to improve the temporal and spatial resolution of fNIRS toward robust clinical usage within subjects. Oligochannel fNIRS is adequate for estimating global cerebral function and it has become an important tool in the critical care setting for evaluating cerebral oxygenation and autoregulation in patients with stroke and traumatic brain injury. When it comes to a more sophisticated utilization, spatial and temporal resolution becomes critical. Multichannel NIRS has improved the spatial resolution of fNIRS for brain mapping in certain task modalities, such as language mapping. However, averaging and group analysis are currently required, limiting its clinical use for monitoring and real-time event detection in individual subjects. Advances in signal processing have moved fNIRS toward individual clinical use for detecting certain types of seizures, assessing autonomic function and cortical spreading depression. However, its lack of accuracy and precision has been the major obstacle toward more sophisticated clinical use of fNIRS. The use of high-density whole head optode arrays, precise sensor locations relative to the head, anatomical co-registration, short-distance channels, and multi-dimensional signal processing can be combined to improve the sensitivity of fNIRS and increase its use as a wide-spread clinical tool for the robust assessment of brain function.
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Affiliation(s)
- Wei-Liang Chen
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States.,School of Medicine, University of Washington, Seattle, WA, United States
| | - Julie Wagner
- Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Nicholas Heugel
- Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jeffrey Sugar
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Yu-Wen Lee
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States
| | - Lisa Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Marsha Malloy
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States
| | - Joseph Heffernan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Brendan Quirk
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Anthony Zinos
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Scott A Beardsley
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Biochemical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Robert Prost
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Harry T Whelan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, WI, United States
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Pacella M, Ghosh S, Middlebrook E, Bennett J, Bliznyuk N, Huene M, Copenhaver N, Sura L, Weiss MD. Combined vEEG and Cerebral Oximetry Results to Determine the Severity of Hypoxic–Ischemic Encephalopathy. JOURNAL OF PEDIATRIC NEUROLOGY 2020. [DOI: 10.1055/s-0039-1687883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AbstractThe objectives of the study were to evaluate the prognostic utility of bedside monitoring tools for hypoxic–ischemic encephalopathy (HIE) outcome and develop a prognostic predictive model. This retrospective study reviewed neonatal HIE treated with hypothermia between 2013 and 2016. Continuous video electroencephalography (vEEG) recordings scored for background electrocerebral activity, seizure, and sleep–wake cycles, and rSO2 data were stratified by magnetic resonance imaging (MRI) severity. The vEEG and rSO2 were combined in a predictive model. The analysis included 38 patients. The rSO2 was significantly higher in the severe group. vEEG showed early and persistent maximal suppression in the severe group. The predictive correlation of the rSO2 improves when combined with the vEEG.
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Affiliation(s)
- Marisa Pacella
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States
| | - Suman Ghosh
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States
| | - Erik Middlebrook
- Department of Radiology, University of Florida, Gainesville, Florida, United States
| | - Jeffrey Bennett
- Department of Radiology, University of Florida, Gainesville, Florida, United States
| | - Nikolay Bliznyuk
- Department of Agricultural and Biological Engineering, University of Florida, Gainesville, Florida, United States
| | - Melissa Huene
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States
| | - Nicole Copenhaver
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States
| | - Livia Sura
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States
| | - Michael D. Weiss
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States
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Spectral entropy indicates electrophysiological and hemodynamic changes in drug-resistant epilepsy - A multimodal MREG study. NEUROIMAGE-CLINICAL 2019; 22:101763. [PMID: 30927607 PMCID: PMC6444290 DOI: 10.1016/j.nicl.2019.101763] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 02/01/2019] [Accepted: 03/10/2019] [Indexed: 12/20/2022]
Abstract
Objective Epilepsy causes measurable irregularity over a range of brain signal frequencies, as well as autonomic nervous system functions that modulate heart and respiratory rate variability. Imaging dynamic neuronal signals utilizing simultaneously acquired ultra-fast 10 Hz magnetic resonance encephalography (MREG), direct current electroencephalography (DC-EEG), and near-infrared spectroscopy (NIRS) can provide a more comprehensive picture of human brain function. Spectral entropy (SE) is a nonlinear method to summarize signal power irregularity over measured frequencies. SE was used as a joint measure to study whether spectral signal irregularity over a range of brain signal frequencies based on synchronous multimodal brain signals could provide new insights in the neural underpinnings of epileptiform activity. Methods Ten patients with focal drug-resistant epilepsy (DRE) and ten healthy controls (HC) were scanned with 10 Hz MREG sequence in combination with EEG, NIRS (measuring oxygenated, deoxygenated, and total hemoglobin: HbO, Hb, and HbT, respectively), and cardiorespiratory signals. After pre-processing, voxelwise SEMREG was estimated from MREG data. Different neurophysiological and physiological subfrequency band signals were further estimated from MREG, DC-EEG, and NIRS: fullband (0–5 Hz, FB), near FB (0.08–5 Hz, NFB), brain pulsations in very-low (0.009–0.08 Hz, VLFP), respiratory (0.12–0.4 Hz, RFP), and cardiac (0.7–1.6 Hz, CFP) frequency bands. Global dynamic fluctuations in MREG and NIRS were analyzed in windows of 2 min with 50% overlap. Results Right thalamus, cingulate gyrus, inferior frontal gyrus, and frontal pole showed significantly higher SEMREG in DRE patients compared to HC. In DRE patients, SE of cortical Hb was significantly reduced in FB (p = .045), NFB (p = .017), and CFP (p = .038), while both HbO and HbT were significantly reduced in RFP (p = .038, p = .045, respectively). Dynamic SE of HbT was reduced in DRE patients in RFP during minutes 2 to 6. Fitting to the frontal MREG and NIRS results, DRE patients showed a significant increase in SEEEG in FB in fronto-central and parieto-occipital regions, in VLFP in parieto-central region, accompanied with a significant decrease in RFP in frontal pole and parietal and occipital (O2, Oz) regions. Conclusion This is the first study to show altered spectral entropy from synchronous MREG, EEG, and NIRS in DRE patients. Higher SEMREG in DRE patients in anterior cingulate gyrus together with SEEEG and SENIRS results in 0.12–0.4 Hz can be linked to altered parasympathetic function and respiratory pulsations in the brain. Higher SEMREG in thalamus in DRE patients is connected to disturbances in anatomical and functional connections in epilepsy. Findings suggest that spectral irregularity of both electrophysiological and hemodynamic signals are altered in specific way depending on the physiological frequency range. Simultaneous imaging methods indicate spectral irregularity in neurovascular and electrophysiological brain pulsations in DRE. Altered spectral entropy in EEG, NIRS and BOLD indicate dysfunctional brain pulsations in respiratory frequency in epilepsy. Spectral irregularity (0-5 Hz) of BOLD in right thalamus supports previous structural and functional findings in epilepsy.
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Epileptic Seizure Prediction Using CSP and LDA for Scalp EEG Signals. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2017; 2017:1240323. [PMID: 29225615 PMCID: PMC5684608 DOI: 10.1155/2017/1240323] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/15/2017] [Accepted: 10/04/2017] [Indexed: 11/17/2022]
Abstract
This paper presents a patient-specific epileptic seizure predication method relying on the common spatial pattern- (CSP-) based feature extraction of scalp electroencephalogram (sEEG) signals. Multichannel EEG signals are traced and segmented into overlapping segments for both preictal and interictal intervals. The features extracted using CSP are used for training a linear discriminant analysis classifier, which is then employed in the testing phase. A leave-one-out cross-validation strategy is adopted in the experiments. The experimental results for seizure prediction obtained from the records of 24 patients from the CHB-MIT database reveal that the proposed predictor can achieve an average sensitivity of 0.89, an average false prediction rate of 0.39, and an average prediction time of 68.71 minutes using a 120-minute prediction horizon.
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12
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Seizure self-prediction: Myth or missed opportunity? Seizure 2017; 51:180-185. [PMID: 28892758 DOI: 10.1016/j.seizure.2017.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/22/2017] [Accepted: 08/25/2017] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Many patients report being able to predict their own seizures, and yet most seizures appear to strike out of the blue. This inherent contradiction makes the topic of seizure self-prediction controversial as well as difficult to study. Here we review the evidence for whether this ability exists, how many patients are capable of self-prediction and the nature of this capability, and whether this could provide a target for intervention. METHODS Systematic searches of bibliographic databases including MEDLINE, EMBASE and PsycINFO through OVID were performed to identify relevant papers which were then screened by the study authors for inclusion in the study. 18 papers were selected for inclusion as the focus of this review. RESULTS On the basis of two studies, between 17% and 41% of patients demonstrate a significantly greater than chance ability to predict an upcoming seizure in the following 12-h time window. This risk is correlated with self-reported anxiety, stress, sleep deprivation, mood and certain prodromal symptoms. However, there is no evidence for any subjective experience which directly heralds an imminent seizure. Thus, while patients may be aware of seizure risk, and have some ability to predict seizure occurrence over a wide time window, they are unable to subjectively recognise seizure onset in advance. CONCLUSION Utilising subjectively acquired knowledge of seizure risk may provide a widely implementable tool for targeted intervention. The risk fluctuates over a time course appropriate for pharmacotherapy which may improve seizure control and the side-effect profile of anti-epileptic medication.
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Borsody MK, Garcia A, Bielawski DM, Yamada C, Sacristan E. Magnetic facial nerve stimulation in animal models of active seizure. Epilepsy Res 2017; 131:28-36. [PMID: 28236736 DOI: 10.1016/j.eplepsyres.2017.02.002] [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: 01/10/2016] [Revised: 01/04/2017] [Accepted: 02/07/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE As part of our efforts to develop a non-invasive facial nerve stimulator as an emergency treatment for ischemic stroke, we considered possible safety consequences if the technology was misapplied to stroke mimics, e.g., seizure. We hypothesized that magnetic facial nerve stimulation would worsen epileptiform activity in two animal models of active seizures. The rat intraperitoneal kainate model and pig intracortical penicillin model were employed. Magnetic facial nerve stimulation was delivered unilaterally at a variety of stimulation parameters, and the effect on ictal epileptiform activity measured by electroencephalography was determined according to an established categorical scale. PRINCIPAL RESULTS In 6 rats and 3 pigs evaluated with 83 stimulation trials, only a single stimulation trial was associated with worsening epileptiform activity according to a standard categorization scheme. Surprisingly, a reduction in the severity of the epileptiform activity was observed in 20 of 50 stimulation trials using patterned stimulation (3 pulses at 30Hz repeated at 0.5-10Hz) versus 2 of 33 stimulation trials using simple monotonic patterns (P<0.005, chi-squared test). The reduction of epileptiform activity after stimulation lasted a few minutes and was reproducible. Major Conclusions Epileptiform activity measured by electroencephalography was not reliably worsened by repetitive facial nerve stimulation with pulsed magnetic energy, even when significant brain exposure to the magnetic field occurred as in the rat model. To the contrary, a temporary reduction in epileptiform activity was often, but not invariably, observed with certain stimulation parameters.
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Affiliation(s)
- Mark K Borsody
- NeuroSpring, 35756 Foothills, Sterling Heights, MI 48312, United States; Nervive, Inc., 526 S. Main St., Suite 801-A, Akron, OH 44311, United States.
| | - Andrea Garcia
- National Center for the Investigation of Imaging and Medical Instrumentation, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Dawn M Bielawski
- NeuroSpring, 35756 Foothills, Sterling Heights, MI 48312, United States
| | - Chisa Yamada
- NeuroSpring, 35756 Foothills, Sterling Heights, MI 48312, United States
| | - Emilio Sacristan
- Nervive, Inc., 526 S. Main St., Suite 801-A, Akron, OH 44311, United States; National Center for the Investigation of Imaging and Medical Instrumentation, Universidad Autónoma Metropolitana, Mexico City, Mexico
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14
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Lal C, Leahy MJ. An Updated Review of Methods and Advancements in Microvascular Blood Flow Imaging. Microcirculation 2016; 23:345-63. [DOI: 10.1111/micc.12284] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 04/17/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Cerine Lal
- Department of Applied Physics; Tissue Optics and Microcirculation Imaging; National University of Ireland; Galway Ireland
| | - Martin J Leahy
- Department of Applied Physics; Tissue Optics and Microcirculation Imaging; National University of Ireland; Galway Ireland
- Royal College of Surgeons in Ireland; Dublin Ireland
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Peng K, Pouliot P, Lesage F, Nguyen DK. Multichannel continuous electroencephalography-functional near-infrared spectroscopy recording of focal seizures and interictal epileptiform discharges in human epilepsy: a review. NEUROPHOTONICS 2016; 3:031402. [PMID: 26958576 PMCID: PMC4750425 DOI: 10.1117/1.nph.3.3.031402] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/08/2015] [Indexed: 05/11/2023]
Abstract
Functional near-infrared spectroscopy (fNIRS) has emerged as a promising neuroimaging technique as it allows noninvasive and long-term monitoring of cortical hemodynamics. Recent work by our group and others has revealed the potential of fNIRS, combined with electroencephalography (EEG), in the context of human epilepsy. Hemodynamic brain responses attributed to epileptic events, such as seizures and interictal epileptiform discharges (IEDs), are routinely observed with a good degree of statistical significance and in concordance with clinical presentation. Recording done with over 100 channels allows sufficiently large coverage of the epileptic focus and other areas. Three types of seizures have been documented: frontal lobe seizures, temporal lobe seizures, and posterior seizures. Increased oxygenation was observed in the epileptic focus in most cases, while rapid but similar hemodynamic variations were identified in the contralateral homologous region. While investigating IEDs, it was shown that their hemodynamic effect is observable with fNIRS, that their response is associated with significant (inhibitive) nonlinearities, and that the sensitivity and specificity of fNIRS to localize the epileptic focus can be estimated in a sample of 40 patients. This paper first reviews recent EEG-fNIRS developments in epilepsy research and then describes applications to the study of focal seizures and IEDs.
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Affiliation(s)
- Ke Peng
- École Polytechnique de Montréal, Département de génie électrique and Institut de génie biomédical, C.P. 6079, Succursale Centre-ville, Montréal, Quebec H3C3A7, Canada
| | - Philippe Pouliot
- École Polytechnique de Montréal, Département de génie électrique and Institut de génie biomédical, C.P. 6079, Succursale Centre-ville, Montréal, Quebec H3C3A7, Canada
- Institut de Cardiologie de Montréal, Centre de recherche, 5000 rue Bélanger est, Montréal, Quebec H1T1C8, Canada
| | - Frédéric Lesage
- École Polytechnique de Montréal, Département de génie électrique and Institut de génie biomédical, C.P. 6079, Succursale Centre-ville, Montréal, Quebec H3C3A7, Canada
- Institut de Cardiologie de Montréal, Centre de recherche, 5000 rue Bélanger est, Montréal, Quebec H1T1C8, Canada
| | - Dang Khoa Nguyen
- Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, Service de neurologie, 1560 rue Sherbrooke est, Montréal, Quebec H2L4M1, Canada
- Address all correspondence to: Dang Khoa Nguyen, E-mail:
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Brinkmann BH, Wagenaar J, Abbot D, Adkins P, Bosshard SC, Chen M, Tieng QM, He J, Muñoz-Almaraz FJ, Botella-Rocamora P, Pardo J, Zamora-Martinez F, Hills M, Wu W, Korshunova I, Cukierski W, Vite C, Patterson EE, Litt B, Worrell GA. Crowdsourcing reproducible seizure forecasting in human and canine epilepsy. Brain 2016; 139:1713-22. [PMID: 27034258 PMCID: PMC5022671 DOI: 10.1093/brain/aww045] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/28/2016] [Indexed: 11/13/2022] Open
Abstract
See Mormann and Andrzejak (doi:10.1093/brain/aww091) for a scientific commentary on this article. Seizures are thought to arise from an identifiable pre-ictal state. Brinkmann et al. report the results of an online, open-access seizure forecasting competition using intracranial EEG recordings from canines with naturally occurring epilepsy and human patients undergoing presurgical monitoring. The winning algorithms forecast seizures at rates significantly greater than chance. See Mormann and Andrzejak (doi:10.1093/brain/aww091) for a scientific commentary on this article. Accurate forecasting of epileptic seizures has the potential to transform clinical epilepsy care. However, progress toward reliable seizure forecasting has been hampered by lack of open access to long duration recordings with an adequate number of seizures for investigators to rigorously compare algorithms and results. A seizure forecasting competition was conducted on kaggle.com using open access chronic ambulatory intracranial electroencephalography from five canines with naturally occurring epilepsy and two humans undergoing prolonged wide bandwidth intracranial electroencephalographic monitoring. Data were provided to participants as 10-min interictal and preictal clips, with approximately half of the 60 GB data bundle labelled (interictal/preictal) for algorithm training and half unlabelled for evaluation. The contestants developed custom algorithms and uploaded their classifications (interictal/preictal) for the unknown testing data, and a randomly selected 40% of data segments were scored and results broadcasted on a public leader board. The contest ran from August to November 2014, and 654 participants submitted 17 856 classifications of the unlabelled test data. The top performing entry scored 0.84 area under the classification curve. Following the contest, additional held-out unlabelled data clips were provided to the top 10 participants and they submitted classifications for the new unseen data. The resulting area under the classification curves were well above chance forecasting, but did show a mean 6.54 ± 2.45% (min, max: 0.30, 20.2) decline in performance. The kaggle.com model using open access data and algorithms generated reproducible research that advanced seizure forecasting. The overall performance from multiple contestants on unseen data was better than a random predictor, and demonstrates the feasibility of seizure forecasting in canine and human epilepsy.
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Affiliation(s)
- Benjamin H Brinkmann
- Mayo Systems Electrophysiology Laboratory, Departments of Neurology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Joost Wagenaar
- University of Pennsylvania, Penn Center for Neuroengineering and Therapeutics, Philadelphia, PA, USA
| | | | | | - Simone C Bosshard
- University of Queensland, Centre for Advanced Imaging, Queensland, Australia
| | - Min Chen
- University of Queensland, Centre for Advanced Imaging, Queensland, Australia
| | - Quang M Tieng
- University of Queensland, Centre for Advanced Imaging, Queensland, Australia
| | | | | | | | - Juan Pardo
- CEU Cardenal Herrera University, Valencia, Spain
| | | | | | | | | | | | - Charles Vite
- University of Pennsylvania, School of Veterinary Medicine Philadelphia, PA, USA
| | | | - Brian Litt
- University of Pennsylvania, Penn Center for Neuroengineering and Therapeutics, Philadelphia, PA, USA
| | - Gregory A Worrell
- Mayo Systems Electrophysiology Laboratory, Departments of Neurology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
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Pellegrino G, Machado A, von Ellenrieder N, Watanabe S, Hall JA, Lina JM, Kobayashi E, Grova C. Hemodynamic Response to Interictal Epileptiform Discharges Addressed by Personalized EEG-fNIRS Recordings. Front Neurosci 2016; 10:102. [PMID: 27047325 PMCID: PMC4801878 DOI: 10.3389/fnins.2016.00102] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/29/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: We aimed at studying the hemodynamic response (HR) to Interictal Epileptic Discharges (IEDs) using patient-specific and prolonged simultaneous ElectroEncephaloGraphy (EEG) and functional Near InfraRed Spectroscopy (fNIRS) recordings. Methods: The epileptic generator was localized using Magnetoencephalography source imaging. fNIRS montage was tailored for each patient, using an algorithm to optimize the sensitivity to the epileptic generator. Optodes were glued using collodion to achieve prolonged acquisition with high quality signal. fNIRS data analysis was handled with no a priori constraint on HR time course, averaging fNIRS signals to similar IEDs. Cluster-permutation analysis was performed on 3D reconstructed fNIRS data to identify significant spatio-temporal HR clusters. Standard (GLM with fixed HRF) and cluster-permutation EEG-fMRI analyses were performed for comparison purposes. Results: fNIRS detected HR to IEDs for 8/9 patients. It mainly consisted oxy-hemoglobin increases (seven patients), followed by oxy-hemoglobin decreases (six patients). HR was lateralized in six patients and lasted from 8.5 to 30 s. Standard EEG-fMRI analysis detected an HR in 4/9 patients (4/9 without enough IEDs, 1/9 unreliable result). The cluster-permutation EEG-fMRI analysis restricted to the region investigated by fNIRS showed additional strong and non-canonical BOLD responses starting earlier than the IEDs and lasting up to 30 s. Conclusions: (i) EEG-fNIRS is suitable to detect the HR to IEDs and can outperform EEG-fMRI because of prolonged recordings and greater chance to detect IEDs; (ii) cluster-permutation analysis unveils additional HR features underestimated when imposing a canonical HR function (iii) the HR is often bilateral and lasts up to 30 s.
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Affiliation(s)
- Giovanni Pellegrino
- Multimodal Functional Imaging Laboratory, Biomedical Engineering Department, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Alexis Machado
- Multimodal Functional Imaging Laboratory, Biomedical Engineering Department, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Nicolas von Ellenrieder
- Multimodal Functional Imaging Laboratory, Biomedical Engineering Department, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Satsuki Watanabe
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital Montreal, QC, Canada
| | - Jeffery A Hall
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital Montreal, QC, Canada
| | - Jean-Marc Lina
- Departement de Génie Electrique, Ecole de Technologie SupérieureMontreal, QC, Canada; Center of Advanced Research in Sleep Medicine, Hospital Du Sacre-CœurMontreal, QC, Canada; Centre de Recherches Mathematiques, University of MontréalMontreal, QC, Canada
| | - Eliane Kobayashi
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital Montreal, QC, Canada
| | - Christophe Grova
- Multimodal Functional Imaging Laboratory, Biomedical Engineering Department, Montreal Neurological Institute, McGill UniversityMontreal, QC, Canada; Department of Neurology and Neurosurgery, Montreal Neurological Institute and HospitalMontreal, QC, Canada; Centre de Recherches Mathematiques, University of MontréalMontreal, QC, Canada; Physics Department and Perform Center, Concordia UniversityMontreal, QC, Canada
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Monrad P, Sannagowdara K, Bozarth X, Bhosrekar S, Hecox K, Nwosu M, Schwabe M, Meyer M, Szabo A, Prigge J, Lemke R, Horn B, Whelan HT. Haemodynamic response associated with both ictal and interictal epileptiform activity using simultaneous video electroencephalography/near infrared spectroscopy in a within-subject study. JOURNAL OF NEAR INFRARED SPECTROSCOPY 2015; 23:209-218. [PMID: 26538840 PMCID: PMC4629858 DOI: 10.1255/jnirs.1170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This paper reports the findings from a pilot study of four patients with medically refractory epilepsy undergoing pre-surgical evaluation with ages ranging from 5 to 17 years. Video electroencephalography recordings and data from a near infrared spectroscopy cerebral/somatic oximeter were gathered and related to electrographic seizure onset and offset as determined by a paediatric epileptologist. All four patients showed haemodynamic changes associated with epileptiform activities. The increased blood flow clearly coincided with epileptiform activity and continued to increase as the epileptiform activity built up. Regional cerebral oxygen saturation increased in the epileptogenic focus, perhaps due to loss of cerebrovascular autoregulation. These findings reinforce that near infrared spectroscopy can potentially be used in a wide spectrum of patients with epilepsy regardless of the underlying brain pathology.
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Affiliation(s)
- Priya Monrad
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Kumar Sannagowdara
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Xiuhua Bozarth
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Sugandha Bhosrekar
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Kurt Hecox
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Michelle Nwosu
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Michael Schwabe
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Michael Meyer
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Medical College of Wisconsin, WI, USA
| | - Aniko Szabo
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Jenna Prigge
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Russ Lemke
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
| | - Briana Horn
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Medical College of Wisconsin, WI, USA
| | - Harry T. Whelan
- Department of Neurology, Division of Child Neurology, Medical College of Wisconsin, WI, USA
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Forecasting Seizures Using Intracranial EEG Measures and SVM in Naturally Occurring Canine Epilepsy. PLoS One 2015; 10:e0133900. [PMID: 26241907 PMCID: PMC4524640 DOI: 10.1371/journal.pone.0133900] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 07/02/2015] [Indexed: 12/02/2022] Open
Abstract
Management of drug resistant focal epilepsy would be greatly assisted by a reliable warning system capable of alerting patients prior to seizures to allow the patient to adjust activities or medication. Such a system requires successful identification of a preictal, or seizure-prone state. Identification of preictal states in continuous long- duration intracranial electroencephalographic (iEEG) recordings of dogs with naturally occurring epilepsy was investigated using a support vector machine (SVM) algorithm. The dogs studied were implanted with a 16-channel ambulatory iEEG recording device with average channel reference for a mean (st. dev.) of 380.4 (+87.5) days producing 220.2 (+104.1) days of intracranial EEG recorded at 400 Hz for analysis. The iEEG records had 51.6 (+52.8) seizures identified, of which 35.8 (+30.4) seizures were preceded by more than 4 hours of seizure-free data. Recorded iEEG data were stratified into 11 contiguous, non-overlapping frequency bands and binned into one-minute synchrony features for analysis. Performance of the SVM classifier was assessed using a 5-fold cross validation approach, where preictal training data were taken from 90 minute windows with a 5 minute pre-seizure offset. Analysis of the optimal preictal training time was performed by repeating the cross validation over a range of preictal windows and comparing results. We show that the optimization of feature selection varies for each subject, i.e. algorithms are subject specific, but achieve prediction performance significantly better than a time-matched Poisson random predictor (p<0.05) in 5/5 dogs analyzed.
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Acute Changes in the Cerebral Oximetry During Intraoperative Seizures: An NIRS-based Observation. J Neurosurg Anesthesiol 2014; 27:269-70. [PMID: 25318841 DOI: 10.1097/ana.0000000000000134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Epilepsy is the second most common neurological disorder, affecting 0.6-0.8% of the world's population. In this neurological disorder, abnormal activity of the brain causes seizures, the nature of which tend to be sudden. Antiepileptic Drugs (AEDs) are used as long-term therapeutic solutions that control the condition. Of those treated with AEDs, 35% become resistant to medication. The unpredictable nature of seizures poses risks for the individual with epilepsy. It is clearly desirable to find more effective ways of preventing seizures for such patients. The automatic detection of oncoming seizures, before their actual onset, can facilitate timely intervention and hence minimize these risks. In addition, advance prediction of seizures can enrich our understanding of the epileptic brain. In this study, drawing on the body of work behind automatic seizure detection and prediction from digitised Invasive Electroencephalography (EEG) data, a prediction algorithm, ASPPR (Advance Seizure Prediction via Pre-ictal Relabeling), is described. ASPPR facilitates the learning of predictive models targeted at recognizing patterns in EEG activity that are in a specific time window in advance of a seizure. It then exploits advanced machine learning coupled with the design and selection of appropriate features from EEG signals. Results, from evaluating ASPPR independently on 21 different patients, suggest that seizures for many patients can be predicted up to 20 minutes in advance of their onset. Compared to benchmark performance represented by a mean S1-Score (harmonic mean of Sensitivity and Specificity) of 90.6% for predicting seizure onset between 0 and 5 minutes in advance, ASPPR achieves mean S1-Scores of: 96.30% for prediction between 1 and 6 minutes in advance, 96.13% for prediction between 8 and 13 minutes in advance, 94.5% for prediction between 14 and 19 minutes in advance, and 94.2% for prediction between 20 and 25 minutes in advance.
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Affiliation(s)
- Negin Moghim
- Heriot-Watt University, Edinburgh, United Kingdom
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Ingram J, Zhang C, Cressman JR, Hazra A, Wei Y, Koo YE, Žiburkus J, Kopelman R, Xu J, Schiff SJ. Oxygen and seizure dynamics: I. Experiments. J Neurophysiol 2014; 112:205-12. [PMID: 24598521 DOI: 10.1152/jn.00540.2013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We utilized a novel ratiometric nanoquantum dot fluorescence resonance energy transfer (NQD-FRET) optical sensor to quantitatively measure oxygen dynamics from single cell microdomains during hypoxic episodes as well as during 4-aminopyridine (4-AP)-induced spontaneous seizure-like events in rat hippocampal slices. Coupling oxygen sensing with electrical recordings, we found the greatest reduction in the O2 concentration ([O2]) in the densely packed cell body stratum (st.) pyramidale layer of the CA1 and differential layer-specific O2 dynamics between the st. pyramidale and st. oriens layers. These hypoxic decrements occurred up to several seconds before seizure onset could be electrically measured extracellularly. Without 4-AP, we quantified a narrow range of [O2], similar to the endogenous hypoxia found before epileptiform activity, which permits a quiescent network to enter into a seizure-like state. We demonstrated layer-specific patterns of O2 utilization accompanying layer-specific neuronal interplay in seizure. None of the oxygen overshoot artifacts seen with polarographic measurement techniques were observed. We therefore conclude that endogenously generated hypoxia may be more than just a consequence of increased cellular excitability but an influential and critical factor for orchestrating network dynamics associated with epileptiform activity.
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Affiliation(s)
- Justin Ingram
- Center for Neural Engineering, The Pennsylvania State University, University Park, Pennsylvania; Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, Pennsylvania
| | - Chunfeng Zhang
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, Pennsylvania; Nanjing National Laboratory of Microstructures, Nanjing University, Nanjing, China
| | - John R Cressman
- Department of Physics, Astronomy, and Computational Sciences, George Mason University, Fairfax, Virginia
| | - Anupam Hazra
- Department of Biology and Biochemistry, University of Houston, Houston, Texas
| | - Yina Wei
- Center for Neural Engineering, The Pennsylvania State University, University Park, Pennsylvania; Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, Pennsylvania
| | - Yong-Eun Koo
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan; and
| | - Jokūbas Žiburkus
- Department of Biology and Biochemistry, University of Houston, Houston, Texas
| | - Raoul Kopelman
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan; and
| | - Jian Xu
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, Pennsylvania
| | - Steven J Schiff
- Center for Neural Engineering, The Pennsylvania State University, University Park, Pennsylvania; Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, Pennsylvania; Departments of Neurosurgery and Physics, The Pennsylvania State University, University Park, Pennsylvania
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Frontal hemodynamic changes precede EEG onset of temporal lobe seizures. Clin Neurophysiol 2014; 125:442-8. [DOI: 10.1016/j.clinph.2013.09.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/27/2013] [Accepted: 09/05/2013] [Indexed: 11/22/2022]
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Chaudhary U, Hall M, Gonzalez J, Elbaum L, Bloyer M, Godavarty A. Motor response investigation in individuals with cerebral palsy using near infrared spectroscopy: pilot study. APPLIED OPTICS 2014; 53:503-10. [PMID: 24514139 DOI: 10.1364/ao.53.000503] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 12/20/2013] [Indexed: 05/20/2023]
Abstract
Cerebral palsy (CP) describes a group of motor impairment syndromes secondary to genetic that may be due to acquired disorders of the developing brain. In this study, near infrared spectroscopy (NIRS) is used to investigate the prefrontal cortical activation and lateralization in response to the planning and execution of motor skills in controls and individuals with CP. The prefrontal cortex, which plays a dominant role in the planning and execution of motor skill stimulus, is noninvasively imaged using a continuous wave-based NIRS system. During the study, 7 controls (4 right-handed and 3 left-handed) and 2 individuals with CP (1 right-handed and 1 left-handed) over 18 years of age performed 30 s of a ball throwing task followed by 30 s rest in a 5-block paradigm. The optical signal acquired from the NIRS system was processed to elucidate the activation and lateralization in the prefrontal region of controls and individuals with CP. The preliminary result indicated a difference in activation between the task and rest conditions in all the participant types. Bilateral dominance was observed in the prefrontal cortex of controls in response to planning and execution of motor skill tasks, while an ipsilateral dominance was observed in individuals with CP. In conjunction, similar contralateral dominance was observed during rest periods, both in controls and individuals with CP.
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Howbert JJ, Patterson EE, Stead SM, Brinkmann B, Vasoli V, Crepeau D, Vite CH, Sturges B, Ruedebusch V, Mavoori J, Leyde K, Sheffield WD, Litt B, Worrell GA. Forecasting seizures in dogs with naturally occurring epilepsy. PLoS One 2014; 9:e81920. [PMID: 24416133 PMCID: PMC3885383 DOI: 10.1371/journal.pone.0081920] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 10/18/2013] [Indexed: 11/19/2022] Open
Abstract
Seizure forecasting has the potential to create new therapeutic strategies for epilepsy, such as providing patient warnings and delivering preemptive therapy. Progress on seizure forecasting, however, has been hindered by lack of sufficient data to rigorously evaluate the hypothesis that seizures are preceded by physiological changes, and are not simply random events. We investigated seizure forecasting in three dogs with naturally occurring focal epilepsy implanted with a device recording continuous intracranial EEG (iEEG). The iEEG spectral power in six frequency bands: delta (0.1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–30 Hz), low-gamma (30–70 Hz), and high-gamma (70–180 Hz), were used as features. Logistic regression classifiers were trained to discriminate labeled pre-ictal and inter-ictal data segments using combinations of the band spectral power features. Performance was assessed on separate test data sets via 10-fold cross-validation. A total of 125 spontaneous seizures were detected in continuous iEEG recordings spanning 6.5 to 15 months from 3 dogs. When considering all seizures, the seizure forecasting algorithm performed significantly better than a Poisson-model chance predictor constrained to have the same time in warning for all 3 dogs over a range of total warning times. Seizure clusters were observed in all 3 dogs, and when the effect of seizure clusters was decreased by considering the subset of seizures separated by at least 4 hours, the forecasting performance remained better than chance for a subset of algorithm parameters. These results demonstrate that seizures in canine epilepsy are not randomly occurring events, and highlight the feasibility of long-term seizure forecasting using iEEG monitoring.
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Affiliation(s)
| | - Edward E. Patterson
- Veterinary Medical Center, University of Minnesota, St. Paul, Minnesota, United States of America
| | - S. Matt Stead
- Mayo Systems Electrophysiology Laboratory, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Ben Brinkmann
- Mayo Systems Electrophysiology Laboratory, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Vincent Vasoli
- Mayo Systems Electrophysiology Laboratory, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Daniel Crepeau
- Mayo Systems Electrophysiology Laboratory, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Charles H. Vite
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Beverly Sturges
- Veterinary School, University of California Davis, Davis, California, United States of America
| | | | - Jaideep Mavoori
- NeuroVista Corp., Seattle, Washington, United States of America
| | - Kent Leyde
- NeuroVista Corp., Seattle, Washington, United States of America
| | | | - Brian Litt
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Gregory A. Worrell
- Mayo Systems Electrophysiology Laboratory, Mayo Clinic, Rochester, Minnesota, United States of America
- * E-mail:
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Modern Techniques of Epileptic Focus Localization. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2014; 114:245-78. [DOI: 10.1016/b978-0-12-418693-4.00010-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Haginoya K, Uematsu M, Munakata M, Kakisaka Y, Kikuchi A, Nakayama T, Hino-Fukuyo N, Tsuburaya R, Kitamura T, Sato-Shirai I, Abe Y, Matsumoto Y, Wakusawa K, Kobayashi T, Ishitobi M, Togashi N, Iwasaki M, Nakasato N, Iinuma K. The usefulness of subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome. Brain Dev 2013; 35:887-93. [PMID: 24047572 DOI: 10.1016/j.braindev.2013.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 08/02/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
Abstract
The recent findings on subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome were summarized and its availability for presurgical evaluation was discussed. The subtraction ictal SPECT study in patients with West syndrome demonstrated the cortical epileptic region and subcortical involvement, which may consist of epilepsy networks related to the spasms. Moreover, subtraction ictal SPECT may have predictive power for short-term seizure outcome. Patients with a symmetric hyperperfusion pattern are predicted to have a better seizure outcome, whereas patients with asymmetric hyperperfusion pattern may develop poor seizure control. Importantly, asymmetric MRI findings had no predictive power for seizure outcome. Multichannel near-infrared spectroscopic topography applied to the patients with West syndrome detected an increase in regional cerebral blood volume in multiple areas which were activated either simultaneously or sequentially during spasms. Topographic changes in cerebral blood volume were closely correlated with spasm phenotype, suggesting that the cortex is involved in the generation of spasms. In conclusion, subtraction ictal SPECT may be considered as a useful tool for presurgical evaluation of patients with West syndrome and investigation of the pathophysiology of spasms. The ictal near-infrared spectroscopic topography should be more investigated to see if this is useful tool for presurgical evaluation.
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Affiliation(s)
- Kazuhiro Haginoya
- Department of Pediatrics, Tohoku University School of Medicine, Sendai 980-8574, Japan; Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Sendai 982-0241, Japan.
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Prediction of seizure likelihood with a long-term, implanted seizure advisory system in patients with drug-resistant epilepsy: a first-in-man study. Lancet Neurol 2013; 12:563-71. [PMID: 23642342 DOI: 10.1016/s1474-4422(13)70075-9] [Citation(s) in RCA: 482] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Seizure prediction would be clinically useful in patients with epilepsy and could improve safety, increase independence, and allow acute treatment. We did a multicentre clinical feasibility study to assess the safety and efficacy of a long-term implanted seizure advisory system designed to predict seizure likelihood and quantify seizures in adults with drug-resistant focal seizures. METHODS We enrolled patients at three centres in Melbourne, Australia, between March 24, 2010, and June 21, 2011. Eligible patients had between two and 12 disabling partial-onset seizures per month, a lateralised epileptogenic zone, and no history of psychogenic seizures. After devices were surgically implanted, patients entered a data collection phase, during which an algorithm for identification of periods of high, moderate, and low seizure likelihood was established. If the algorithm met performance criteria (ie, sensitivity of high-likelihood warnings greater than 65% and performance better than expected through chance prediction of randomly occurring events), patients then entered an advisory phase and received information about seizure likelihood. The primary endpoint was the number of device-related adverse events at 4 months after implantation. Our secondary endpoints were algorithm performance at the end of the data collection phase, clinical effectiveness (measures of anxiety, depression, seizure severity, and quality of life) 4 months after initiation of the advisory phase, and longer-term adverse events. This trial is registered with ClinicalTrials.gov, number NCT01043406. FINDINGS We implanted 15 patients with the advisory system. 11 device-related adverse events were noted within four months of implantation, two of which were serious (device migration, seroma); an additional two serious adverse events occurred during the first year after implantation (device-related infection, device site reaction), but were resolved without further complication. The device met enabling criteria in 11 patients upon completion of the data collection phase, with high likelihood performance estimate sensitivities ranging from 65% to 100%. Three patients' algorithms did not meet performance criteria and one patient required device removal because of an adverse event before sufficient training data were acquired. We detected no significant changes in clinical effectiveness measures between baseline and 4 months after implantation. INTERPRETATION This study showed that intracranial electroencephalographic monitoring is feasible in ambulatory patients with drug-resistant epilepsy. If these findings are replicated in larger, longer studies, accurate definition of preictal electrical activity might improve understanding of seizure generation and eventually lead to new management strategies. FUNDING NeuroVista.
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Obrig H. NIRS in clinical neurology - a 'promising' tool? Neuroimage 2013; 85 Pt 1:535-46. [PMID: 23558099 DOI: 10.1016/j.neuroimage.2013.03.045] [Citation(s) in RCA: 151] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 03/14/2013] [Accepted: 03/21/2013] [Indexed: 12/13/2022] Open
Abstract
Near-infrared spectroscopy (NIRS) has become a relevant research tool in neuroscience. In special populations such as infants and for special tasks such as walking, NIRS has asserted itself as a low resolution functional imaging technique which profits from its ease of application, portability and the option to co-register other neurophysiological and behavioral data in a 'near natural' environment. For clinical use in neurology this translates into the option to provide a bed-side oximeter for the brain, broadly available at comparatively low costs. However, while some potential for routine brain monitoring during cardiac and vascular surgery and in neonatology has been established, NIRS is largely unknown to clinical neurologists. The article discusses some of the reasons for this lack of use in clinical neurology. Research using NIRS in three major neurologic diseases (cerebrovascular disease, epilepsy and headache) is reviewed. Additionally the potential to exploit the established position of NIRS as a functional imaging tool with regard to clinical questions such as preoperative functional assessment and neurorehabilitation is discussed.
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Affiliation(s)
- Hellmuth Obrig
- Clinic for Cognitive Neurology, University Clinic Leipzig, Leipzig, Germany; Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Dept. Neurology, Charité, University Medicine Berlin, Berlin, Germany.
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Nguyen DK, Tremblay J, Pouliot P, Vannasing P, Florea O, Carmant L, Lepore F, Sawan M, Lesage F, Lassonde M. Noninvasive continuous functional near-infrared spectroscopy combined with electroencephalography recording of frontal lobe seizures. Epilepsia 2012; 54:331-40. [DOI: 10.1111/epi.12011] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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31
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Nguyen DK, Tremblay J, Pouliot P, Vannasing P, Florea O, Carmant L, Lepore F, Sawan M, Lesage F, Lassonde M. Non-invasive continuous EEG-fNIRS recording of temporal lobe seizures. Epilepsy Res 2012; 99:112-26. [DOI: 10.1016/j.eplepsyres.2011.10.035] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 10/20/2011] [Accepted: 10/30/2011] [Indexed: 10/15/2022]
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Schwartz TH, Hong SB, Bagshaw AP, Chauvel P, Bénar CG. Preictal changes in cerebral haemodynamics: review of findings and insights from intracerebral EEG. Epilepsy Res 2011; 97:252-66. [PMID: 21855297 DOI: 10.1016/j.eplepsyres.2011.07.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 06/29/2011] [Accepted: 07/27/2011] [Indexed: 12/29/2022]
Abstract
The possibility of recording changes in brain signals occurring before epileptic seizures is of considerable interest, both as markers for seizure anticipation and as a window into the mechanisms of seizure generation. Several studies have reported preictal changes on electrophysiological traces. More recently, observations have been made of changes occurring on haemodynamic signals before interictal events or before seizures, often without concurrent changes observed on electrophysiology. We present here a critical review of these findings, in optical imaging, SPECT and fMRI, followed by a discussion based on data from intracerebral EEG.
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Affiliation(s)
- Theodore H Schwartz
- Department of Neurosurgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, USA
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Abstract
Near-infrared spectroscopy is a noninvasive means of determining real-time changes in regional oxygen saturation of cerebral and somatic tissues. Hypoxic neurologic injuries not only involve devastating effects on patients and their families but also increase health care costs to the society. At present, monitors of cerebral function such as electroencephalograms, transcranial Doppler, jugular bulb mixed venous oximetry, and brain tissue oxygenation monitoring involve an invasive procedure, are operator-dependent, and/or lack the sensitivity required to identify patients at risk for cerebral hypoxia. Although 20th century advances in the understanding and management of resuscitation of critically ill and injured children have focused on global parameters (ie, pulse oximetry, capnography, base deficit, lactate, etc), a growing body of evidence now points to regional disturbances in microcirculation that will lead us in a new direction of adjunctive tissue monitoring and response to resuscitation. In the coming years, near-infrared spectroscopy will be accepted as a way for clinicians to more quickly and noninvasively identify patients with altered levels of cerebral and/or somatic tissue oxygenation and, in conjunction with global physiologic parameters, guide efficient and effective resuscitation to improve outcomes for critically ill and injured pediatric patients.
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Machado A, Lina J, Tremblay J, Lassonde M, Nguyen D, Lesage F, Grova C. Detection of hemodynamic responses to epileptic activity using simultaneous Electro-EncephaloGraphy (EEG)/Near Infra Red Spectroscopy (NIRS) acquisitions. Neuroimage 2011; 56:114-25. [DOI: 10.1016/j.neuroimage.2010.12.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 10/30/2010] [Accepted: 12/07/2010] [Indexed: 11/28/2022] Open
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Chaudhary U, Hall M, DeCerce J, Rey G, Godavarty A. Frontal activation and connectivity using near-infrared spectroscopy: verbal fluency language study. Brain Res Bull 2011; 84:197-205. [PMID: 21255633 DOI: 10.1016/j.brainresbull.2011.01.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 11/15/2010] [Accepted: 01/05/2011] [Indexed: 11/30/2022]
Abstract
Near infrared spectroscopy (NIRS) is an optical technique with high temporal resolution and reasonably good spatial resolution, which allows non invasive measurement of the blood oxygenation of tissue. The current work is focused in assessing and correlating brain activation, connectivity and cortical lateralization of the frontal cortex in response to language-based stimuli, using NIRS. Experimental studies were performed on 15 normal right-handed adults, wherein the participants were presented with a verbal fluency task. The hemodynamic responses in the pre- and anterior frontal cortex were assessed in response to a Word generation task in comparison to the baseline random Jaw movement and Rest conditions. The functional connectivity analysis was performed using zero-order correlations and the cortical lateralization was evaluated as well. An increase in oxy- and a decrease in deoxy-hemoglobin were observed during verbal fluency task in the frontal cortex. Unlike in the pre-frontal cortex, the hemodynamic response in the anterior frontal during verbal fluency task was not significantly different from that during random Jaw movement. Bilateral activation and symmetrical connectivity were observed in the pre-frontal cortex, independent of the stimuli presented. A left cortical dominance and asymmetry connectivity was observed in the anterior frontal during the verbal fluency task. The work is focused to target the pediatric epileptic populations in the future, where understanding the brain functionality (activation, connectivity, and dominance) in response to language is essential as a part of the pre-surgical evaluation in a clinical environment.
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Affiliation(s)
- Ujwal Chaudhary
- Optical Imaging Laboratory, Department of Biomedical Engineering, Florida International University, Miami, FL 33174, United States
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36
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EEG-NIRS in epilepsy in children and neonates. Neurophysiol Clin 2010; 40:281-92. [DOI: 10.1016/j.neucli.2010.08.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 08/29/2010] [Accepted: 08/29/2010] [Indexed: 11/15/2022] Open
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37
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Schwartz TH. Neurovascular coupling and epilepsy: hemodynamic markers for localizing and predicting seizure onset. Epilepsy Curr 2010; 7:91-4. [PMID: 17694162 PMCID: PMC1941907 DOI: 10.1111/j.1535-7511.2007.00183.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Hemodynamic surrogates of epileptic activity are being used to map epileptic foci with PET, SPECT, and fMRI. However, there are few studies of neurovascular coupling in epilepsy. Recent data indicate that cerebral blood flow, although focally increased at the onset of a seizure, may be temporarily inadequate to meet the metabolic demands of both interictal and ictal epileptic events. Transient focal tissue hypoxia and hyperperfusion may be excellent markers for the epileptic focus and may even precede the onset of the ictal event.
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Affiliation(s)
- Theodore H Schwartz
- Department of Neurological Surgery, Weill Medical College of Cornell University, New York, NY, USA.
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Haemodynamic changes during seizure-like activity in a neonate: A simultaneous AC EEG-SPIR and high-resolution DC EEG recording. Neurophysiol Clin 2009; 39:217-27. [DOI: 10.1016/j.neucli.2009.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Revised: 07/09/2009] [Accepted: 08/10/2009] [Indexed: 11/23/2022] Open
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Huppert TJ, Diamond SG, Franceschini MA, Boas DA. HomER: a review of time-series analysis methods for near-infrared spectroscopy of the brain. APPLIED OPTICS 2009; 48:D280-98. [PMID: 19340120 PMCID: PMC2761652 DOI: 10.1364/ao.48.00d280] [Citation(s) in RCA: 904] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Near-infrared spectroscopy (NIRS) is a noninvasive neuroimaging tool for studying evoked hemodynamic changes within the brain. By this technique, changes in the optical absorption of light are recorded over time and are used to estimate the functionally evoked changes in cerebral oxyhemoglobin and deoxyhemoglobin concentrations that result from local cerebral vascular and oxygen metabolic effects during brain activity. Over the past three decades this technology has continued to grow, and today NIRS studies have found many niche applications in the fields of psychology, physiology, and cerebral pathology. The growing popularity of this technique is in part associated with a lower cost and increased portability of NIRS equipment when compared with other imaging modalities, such as functional magnetic resonance imaging and positron emission tomography. With this increasing number of applications, new techniques for the processing, analysis, and interpretation of NIRS data are continually being developed. We review some of the time-series and functional analysis techniques that are currently used in NIRS studies, we describe the practical implementation of various signal processing techniques for removing physiological, instrumental, and motion-artifact noise from optical data, and we discuss the unique aspects of NIRS analysis in comparison with other brain imaging modalities. These methods are described within the context of the MATLAB-based graphical user interface program, HomER, which we have developed and distributed to facilitate the processing of optical functional brain data.
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Affiliation(s)
- Theodore J Huppert
- Departments of Radiology and Bioengineering, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
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Abstract
This paper gives an account of the global evolution of (neuro-)chemistry in epileptology with an emphasis on the role of the International League Against Epilepsy (ILAE), which declared in its constitution a mission "to make the epilepsy-problem the object of special study and to make practical use of the results of such study." As Epilepsia is the scientific journal of the ILAE, the review emphasizes papers published in the journal.
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Affiliation(s)
- Clementina Van Rijn
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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41
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Roche-Labarbe N, Zaaimi B, Berquin P, Nehlig A, Grebe R, Wallois F. NIRS-measured oxy- and deoxyhemoglobin changes associated with EEG spike-and-wave discharges in children. Epilepsia 2008; 49:1871-80. [DOI: 10.1111/j.1528-1167.2008.01711.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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42
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Non-invasive pre-surgical investigation of a 10 year-old epileptic boy using simultaneous EEG–NIRS. Seizure 2008; 17:576-82. [DOI: 10.1016/j.seizure.2008.01.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 01/23/2008] [Indexed: 11/22/2022] Open
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43
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Vanzetta I, Grinvald A. Coupling between neuronal activity and microcirculation: implications for functional brain imaging. HFSP JOURNAL 2008; 2:79-98. [PMID: 19404475 PMCID: PMC2645573 DOI: 10.2976/1.2889618] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Accepted: 02/11/2008] [Indexed: 01/12/2023]
Abstract
In the neocortex, neurons with similar response properties are often clustered together in column-like structures, giving rise to what has become known as functional architecture-the mapping of various stimulus feature dimensions onto the cortical sheet. At least partially, we owe this finding to the availability of several functional brain imaging techniques, both post-mortem and in-vivo, which have become available over the last two generations, revolutionizing neuroscience by yielding information about the spatial organization of active neurons in the brain. Here, we focus on how our understanding of such functional architecture is linked to the development of those functional imaging methodologies, especially to those that image neuronal activity indirectly, through metabolic or haemodynamic signals, rather than directly through measurement of electrical activity. Some of those approaches allow exploring functional architecture at higher spatial resolution than others. In particular, optical imaging of intrinsic signals reaches the striking detail of approximately 50 mum, and, together with other methodologies, it has allowed characterizing the metabolic and haemodynamic responses induced by sensory-evoked neuronal activity. Here, we review those findings about the spatio-temporal characteristics of neurovascular coupling and discuss their implications for functional brain imaging, including position emission tomography, and non-invasive neuroimaging techniques, such as funtional magnetic resonance imaging, applicable also to the human brain.
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Affiliation(s)
- Ivo Vanzetta
- Department of Neurobiology, The Weizmann Institute of Science, 76100 Rehovot, Israel
- Institut de Neurosciences Cognitives de la Méditerranée, CNRS UMR 6193, Aix-Marseille Université, 13402 Marseille Cedex 20, France
| | - Amiram Grinvald
- Department of Neurobiology, The Weizmann Institute of Science, 76100 Rehovot, Israel
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Zhao M, Suh M, Ma H, Perry C, Geneslaw A, Schwartz TH. Focal Increases in Perfusion and Decreases in Hemoglobin Oxygenation Precede Seizure Onset in Spontaneous Human Epilepsy. Epilepsia 2007; 48:2059-67. [PMID: 17666071 DOI: 10.1111/j.1528-1167.2007.01229.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Optical recording of intrinsic signals provides the highest combined spatial and temporal resolution with broad spatial sampling for measuring cerebral blood volume (CBV) and hemoglobin oxygenation in cerebral cortex. Few opportunities arise to apply this laboratory method to record spontaneous seizures in unanesthetized human brain during neurosurgery. We report such a rare opportunity in a man with recurrent focal epilepsy arising from a cavernous malformation. METHODS We recorded intrinsic optical signals (IOS) from human cortex intraoperatively during spontaneous seizures arising from brain surrounding a small cavernous malformation in an awake patient using only local anesthesia with simultaneous electrocorticography. The IOS was recorded at two wavelengths, one an isosbestic point for hemoglobin to measure CBV (570 nm) and the other at a wavelength more sensitive to deoxygenated hemoglobin (Hbr) (610 nm). A modified Beer-Lambert calculation was used on two separate but similar seizures to approximate changes in Hbr, CBV as well as oxygenated hemoglobin (HbO(2)). RESULTS Electrographically recorded seizures (n = 3) elicited a focal increase in both Hbr and CBV that lasted for the duration of the seizure, indicating that perfusion was inadequate to meet metabolic demand. Remarkably, these hemodynamic changes preceded the onset of the seizures by approximately 20 s and occurred focally over the known location of the lesion and the seizure onsets. DISCUSSION These findings demonstrate that the hemoglobin becomes deoxygenated in spite of large increase in CBV during spontaneous human focal seizures and that optically recorded hemodynamic events can be used both to predict and localize human focal epilepsy. Such data may someday be useful to assist in the presurgical evaluation of patients considered for epilepsy surgery and to predict the timing and location of seizure onsets.
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Affiliation(s)
- Mingrui Zhao
- Department of Neurosurgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, 525 East 68th Street, New York, NY 10021, U.S.A
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45
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Irani F, Platek SM, Bunce S, Ruocco AC, Chute D. Functional Near Infrared Spectroscopy (fNIRS): An Emerging Neuroimaging Technology with Important Applications for the Study of Brain Disorders. Clin Neuropsychol 2007; 21:9-37. [PMID: 17366276 DOI: 10.1080/13854040600910018] [Citation(s) in RCA: 230] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Functional near-infrared spectroscopy (fNIRS) is an emerging functional neuroimaging technology offering a relatively non-invasive, safe, portable, and low-cost method of indirect and direct monitoring of brain activity. Most exciting is its potential to allow more ecologically valid investigations that can translate laboratory work into more realistic everyday settings and clinical environments. Our aim is to acquaint clinicians and researchers with the unique and beneficial characteristics of fNIRS by reviewing its relative merits and limitations vis-à-vis other brain-imaging technologies such as functional magnetic resonance imaging (fMRI). We review cross-validation work between fMRI and fNIRS, and discuss possible reservations about its deployment in clinical research and practice. Finally, because there is no comprehensive review of applications of fNIRS to brain disorders, we also review findings from the few studies utilizing fNIRS to investigate neurocognitive processes associated with neurological (Alzheimer's disease, Parkinson's disease, epilepsy, traumatic brain injury) and psychiatric disorders (schizophrenia, mood disorders, anxiety disorders).
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Affiliation(s)
- Farzin Irani
- Department of Psychology, Drexel University, Philadelphia, PA 19104, USA.
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Arca Diaz G, Cesaron E, Alfonso I, Dunoyer C, Yaylali I. Near infrared spectroscopy in the management of status epilepticus in a young infant. Eur J Paediatr Neurol 2006; 10:19-21. [PMID: 16529960 DOI: 10.1016/j.ejpn.2005.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2005] [Revised: 10/26/2005] [Accepted: 11/03/2005] [Indexed: 11/17/2022]
Abstract
We report the medication management of electroencephalographic status epilepticus with subtle clinical manifestations in a young infant while simultaneously recording electroencephalographic activity and cerebral regional oxygen saturation (rSO(2)) index using near infrared spectroscopy (NIRS). We found that antiepileptic drugs equally influence the frequency of rSO(2) index fluctuations and electroencephalographic seizures. The purpose of this report is to illustrate the use of NIRS in the medication management of an infant with status epilepticus and subtle or no clinical manifestations; and to suggest that if future studies confirm our finding, NIRS may be reliably used to gauge the effects of antiepileptic medications in similar patients.
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Affiliation(s)
- Gemma Arca Diaz
- Division of Neonatal Neurology, Department of Neurology, Miami Children's Hospital, 3200 SW 60th Street, Miami, FL 33155, USA
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47
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Diamond SG, Huppert TJ, Kolehmainen V, Franceschini MA, Kaipio JP, Arridge SR, Boas DA. Dynamic physiological modeling for functional diffuse optical tomography. Neuroimage 2005; 30:88-101. [PMID: 16242967 PMCID: PMC2670202 DOI: 10.1016/j.neuroimage.2005.09.016] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Accepted: 09/14/2005] [Indexed: 11/20/2022] Open
Abstract
Diffuse optical tomography (DOT) is a noninvasive imaging technology that is sensitive to local concentration changes in oxy- and deoxyhemoglobin. When applied to functional neuroimaging, DOT measures hemodynamics in the scalp and brain that reflect competing metabolic demands and cardiovascular dynamics. The diffuse nature of near-infrared photon migration in tissue and the multitude of physiological systems that affect hemodynamics motivate the use of anatomical and physiological models to improve estimates of the functional hemodynamic response. In this paper, we present a linear state-space model for DOT analysis that models the physiological fluctuations present in the data with either static or dynamic estimation. We demonstrate the approach by using auxiliary measurements of blood pressure variability and heart rate variability as inputs to model the background physiology in DOT data. We evaluate the improvements accorded by modeling this physiology on ten human subjects with simulated functional hemodynamic responses added to the baseline physiology. Adding physiological modeling with a static estimator significantly improved estimates of the simulated functional response, and further significant improvements were achieved with a dynamic Kalman filter estimator (paired t tests, n=10, P<0.05). These results suggest that physiological modeling can improve DOT analysis. The further improvement with the Kalman filter encourages continued research into dynamic linear modeling of the physiology present in DOT. Cardiovascular dynamics also affect the blood-oxygen-dependent (BOLD) signal in functional magnetic resonance imaging (fMRI). This state-space approach to DOT analysis could be extended to BOLD fMRI analysis, multimodal studies and real-time analysis.
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Affiliation(s)
- Solomon Gilbert Diamond
- Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA.
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48
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Hoshino T, Sakatani K, Katayama Y, Fujiwara N, Murata Y, Kobayashi K, Fukaya C, Yamamoto T. Application of multichannel near-infrared spectroscopic topography to physiological monitoring of the cortex during cortical mapping: technical case report. ACTA ACUST UNITED AC 2005; 64:272-5. [PMID: 16099265 DOI: 10.1016/j.surneu.2004.12.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2004] [Accepted: 12/29/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cortical stimulation via a subdural grid electrode (SGE) is one of the most reliable methods for identifying eloquent areas before surgery. However, the physiological conditions of the cortex during stimulation cannot be monitored electrophysiologically because of electrical artifacts. In the present case, we tested whether or not multichannel near-infrared spectroscopy (NIRS) topography, a noninvasive optical imaging technique, is applicable for monitoring the physiological conditions of the stimulated cortex. CASE DESCRIPTION The patient (a 27-year-old right-handed man) suffered from glioma in the left frontal lobe. For preoperative cortical mapping, SGEs were implanted over the left motor cortex before tumor resection. Employing NIRS topography, we undertook 2 dimensional imaging of the changes in oxyhemoglobin (Oxy-Hb) and deoxyhemoglobin (Deoxy-Hb) concentration during electrical stimulation. Five-hertz stimulation with 5 mA at the left-hand area produced a localized increase in Oxy-Hb and a decrease in Deoxy-Hb, associated with slight twitching of the right hand. In contrast, 50-Hz stimulation produced significant increases in both Oxy-Hb and Deoxy-Hb at the stimulation site, and the area with such cerebral blood oxygenation (CBO) changes propagated beyond the hand area associated with prominent muscle contractions of the right upper extremity, suggesting that 50-Hz stimulation caused epileptic discharge. CONCLUSION Near-infrared spectroscopy topography may represent a useful tool for imaging the degree and extent of the physiological effects of electrical stimulation on the cortex, and permits safe and accurate cortical mapping.
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Affiliation(s)
- Tatsuya Hoshino
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan
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Gonzalez H, Hunter CJ, Bennet L, Power GG, Gunn AJ. Cerebral oxygenation during postasphyxial seizures in near-term fetal sheep. J Cereb Blood Flow Metab 2005; 25:911-8. [PMID: 15729287 DOI: 10.1038/sj.jcbfm.9600087] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
After exposure to asphyxia, infants may develop both prolonged, clinically evident seizures and shorter, clinically silent seizures; however, their effect on cerebral tissue oxygenation is unclear. We therefore examined the hypothesis that the increase in oxygen delivery during postasphyxial seizures might be insufficient to meet the needs of increased metabolism, thus causing a fall in tissue oxygenation, in unanesthetized near-term fetal sheep in utero (gestational age 125+/-1 days). Fetuses were administered an infusion of the specific adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropylxanthine, followed by 10 mins of asphyxia induced by complete umbilical cord occlusion. The fetuses then recovered for 3 days. Sixty-one episodes of electrophysiologically defined seizures were identified in five fetuses. Tissue PO(2) (tPO(2)) did not change significantly during short seizures (<3.5 mins), 5.2+/-0.2 versus baseline 5.6+/-0.1 mm Hg (NS), but fell to 2.2+/-0.2 mm Hg during seizures lasting more than 3.5 mins (P<0.001). During prolonged seizures, cortical blood flow did not begin to increase until tPO(2) had begun to fall, and then rose more slowly than the increase in metabolism, with a widening of the brain to blood temperature gradient. In conclusion, in the immature brain, during prolonged, but not short seizures, there is a transient mismatch between cerebral blood flow and metabolism leading to significant cerebral deoxygenation.
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Affiliation(s)
- Hernan Gonzalez
- Facultad de Medicina, Pontificia Universidad Catolica, Chile
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50
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Cua CL, Hoffman TM, Taeed R, Weinstein S, Gomez D, Olshove VF, Craenen JM. Cerebral saturations trend with mixed venous saturations in patients undergoing extracorporeal life support. Perfusion 2005; 19:171-6. [PMID: 15298425 DOI: 10.1191/0267659104pf738oa] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cerebral saturation (SCO2) monitors are noninvasive tools that continuously measure saturations in the cerebral cortex, a predominately venous bed. The purpose of this study was to see if a trend existed between measurements of SCO2 and mixed venous saturation values (SVO2) for patients on extracorporeal life support (ECLS). Six patients required ECLS for cardiac failure after congenital cardiac surgery, and one patient required ECLS for pulmonary failure. Patients were divided into two groups, those without systemic/pulmonary venous mixing (n = 3, Group I) and those with mixing due to an intraatrial shunt or left ventricular vent (n = 4, Group II). The age of patients was 0.4 +/- 0.5 years (mean +/- SD), weight was 5.2 +/- 2.3 kg, and time on ECLS was 8.3 +/- 4.8 days. No significant abnormalities were seen on head imaging. A total of 786 paired data points were collected. Mean values were different; however, there was a significant trend between SCO2 and SVO2 for the entire sample (R2 = 0.66, p < 0.001). Cerebral saturation trends follow mixed venous trends and, therefore, may be helpful in combination with other physical and laboratory findings in the care of the critically ill child.
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Affiliation(s)
- Clifford L Cua
- Division of Cardiology, Department of Pediatrics, Columbus Children's Hospital, The Ohio State University College of Medicine, Columbus, OH 43205-2696, USA
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