Utilizing Excitatory and Inhibitory Activity Derived from Interictal Intracranial Electroencephalography as Potential Biomarkers for Epileptogenicity

Epileptogenic zones (EZs), where epileptic seizures cease after resection, are localized by assessing the seizure-onset zone using ictal electroencephalography (EEG). Owing to the difficulty in capturing unpredictable seizures, biomarkers capable of identifying EZs from interictal EEG are anticipated. Recent studies using intracranial EEG have identified several potential candidate biomarkers for epileptogenicity. High-frequency oscillation (HFO) was initially expected to be a robust biomarker of abnormal excitatory activity in the ictogenic region. However, HFO-guided resection failed to improve seizure prognosis. Meanwhile, the regularity of low-gamma oscillations (30-80 Hz) indicates inhibitory interneurons' hypersynchronization, which could be used to localize the EZ. Besides resting-state EEG assessments, evoked potentials elicited by single-pulse electrical stimulation, such as corticocortical evoked potentials (CCEP), became valuable tools for assessing epileptogenic regions. CCEP responses recorded in the cortex remote from the stimulation site indicate functional connectivity, revealing increased internal connectivity within the ictogenic region and elevated inhibitory input from the non-involved regions to the ictogenic region. Conversely, large responses close to the stimulation site reflect local excitability, manifesting as an increased N1 amplitude and overriding HFO. Further research is required to establish whether these novel electrophysiological methods, either individually or in combination, can function as robust biomarkers of epileptogenicity and hold promise for improving seizure prognosis.

Interictal Gamma Event Connectivity Differentiates the Seizure Network and Outcome in Patients after Temporal Lobe Epilepsy Surgery

Studies of interictal EEG functional connectivity in the epileptic brain seek to identify abnormal interactions between brain regions involved in generating seizures, which clinically often is defined by the seizure onset zone (SOZ). However, there is evidence for abnormal connectivity outside the SOZ (NSOZ), and removal of the SOZ does not always result in seizure control, suggesting, in some cases, that the extent of abnormal connectivity indicates a larger seizure network than the SOZ. To better understand the potential differences in interictal functional connectivity in relation to the seizure network and outcome, we computed event connectivity in the theta (4-8 Hz, ThEC), low-gamma (30-55 Hz, LGEC), and high-gamma (65-95 Hz, HGEC) bands from interictal depth EEG recorded in surgical patients with medication-resistant seizures suspected to begin in the temporal lobe. Analysis finds stronger LGEC and HGEC in SOZ than NSOZ of seizure-free (SF) patients (p = 1.10e-9, 0.0217), but no difference in not seizure-free (NSF) patients. There were stronger LGEC and HGEC between mesial and lateral temporal SOZ of SF than NSF patients (p = 0.00114, 0.00205), and stronger LGEC and ThEC in NSOZ of NSF than SF patients (p = 0.0089, 0.0111). These results show that event connectivity is sensitive to differences in the interactions between regions in SOZ and NSOZ and SF and NSF patients. Patients with differential strengths in event connectivity could represent a well-localized seizure network, whereas an absence of differences could indicate a larger seizure network than the one localized by the SOZ and higher likelihood for seizure recurrence.

Interictal localization of the epileptogenic zone: Utilizing the observed resonance behavior in the spectral band of surrounding inhibition

Introduction

The gold standard for identification of the epileptogenic zone (EZ) continues to be the visual inspection of electrographic changes around seizures' onset by experienced electroencephalography (EEG) readers. Development of an epileptogenic focus localization tool that can delineate the EZ from analysis of interictal (seizure-free) periods is still an open question of great significance for improved diagnosis (e.g., presurgical evaluation) and treatment of epilepsy (e.g., surgical outcome).

Methods

We developed an EZ interictal localization algorithm (EZILA) based on novel analysis of intracranial EEG (iEEG) using a univariate periodogram-type power measure, a straight-forward ranking approach, a robust dimensional reduction method and a clustering technique. Ten patients with temporal and extra temporal lobe epilepsies, and matching the inclusion criteria of having iEEG recordings at the epilepsy monitoring unit (EMU) and being Engel Class I ≥12 months post-surgery, were recruited in this study.

Results

In a nested k-fold cross validation statistical framework, EZILA assigned the highest score to iEEG channels within the EZ in all patients (10/10) during the first hour of the iEEG recordings and up to their first typical clinical seizure in the EMU (i.e., early interictal period). To further validate EZILA's performance, data from two new (Engel Class I) patients were analyzed in a double-blinded fashion; the EZILA successfully localized iEEG channels within the EZ from interictal iEEG in both patients.

Discussion

Out of the sampled brain regions, iEEG channels in the EZ were most frequently and maximally active in seizure-free (interictal) periods across patients in specific narrow gamma frequency band (∼60-80 Hz), which we have termed focal frequency band (FFB). These findings are consistent with the hypothesis that the EZ may interictally be regulated (controlled) by surrounding inhibitory neurons with resonance characteristics within this narrow gamma band.

Source-sink connectivity: a novel interictal EEG marker for seizure localization

Over 15 million epilepsy patients worldwide have drug-resistant epilepsy. Successful surgery is a standard of care treatment but can only be achieved through complete resection or disconnection of the epileptogenic zone, the brain region(s) where seizures originate. Surgical success rates vary between 20% and 80%, because no clinically validated biological markers of the epileptogenic zone exist. Localizing the epileptogenic zone is a costly and time-consuming process, which often requires days to weeks of intracranial EEG (iEEG) monitoring. Clinicians visually inspect iEEG data to identify abnormal activity on individual channels occurring immediately before seizures or spikes that occur interictally (i.e. between seizures). In the end, the clinical standard mainly relies on a small proportion of the iEEG data captured to assist in epileptogenic zone localization (minutes of seizure data versus days of recordings), missing opportunities to leverage these largely ignored interictal data to better diagnose and treat patients. IEEG offers a unique opportunity to observe epileptic cortical network dynamics but waiting for seizures increases patient risks associated with invasive monitoring. In this study, we aimed to leverage interictal iEEG data by developing a new network-based interictal iEEG marker of the epileptogenic zone. We hypothesized that when a patient is not clinically seizing, it is because the epileptogenic zone is inhibited by other regions. We developed an algorithm that identifies two groups of nodes from the interictal iEEG network: those that are continuously inhibiting a set of neighbouring nodes ('sources') and the inhibited nodes themselves ('sinks'). Specifically, patient-specific dynamical network models were estimated from minutes of iEEG and their connectivity properties revealed top sources and sinks in the network, with each node being quantified by source-sink metrics. We validated the algorithm in a retrospective analysis of 65 patients. The source-sink metrics identified epileptogenic regions with 73% accuracy and clinicians agreed with the algorithm in 93% of seizure-free patients. The algorithm was further validated by using the metrics of the annotated epileptogenic zone to predict surgical outcomes. The source-sink metrics predicted outcomes with an accuracy of 79% compared to an accuracy of 43% for clinicians' predictions (surgical success rate of this dataset). In failed outcomes, we identified brain regions with high metrics that were untreated. When compared with high frequency oscillations, the most commonly proposed interictal iEEG feature for epileptogenic zone localization, source-sink metrics outperformed in predictive power (by a factor of 1.2), suggesting they may be an interictal iEEG fingerprint of the epileptogenic zone.

Analysis of power spectrum and phase lag index changes following deep brain stimulation of the anterior nucleus of the thalamus in patients with drug-resistant epilepsy: A retrospective study

OBJECTIVES

The mechanisms underlying the anterior nucleus of the thalamus (ANT) deep brain stimulation (DBS) for the treatment of drug-resistant epilepsy (DRE) have not been fully explored. The present study aimed to measure the changes in whole-brain activity generated by ANT DBS using interictal electroencephalography (EEG).

MATERIALS AND METHODS

Interictal EEG signals were retrospectively collected in 20 DRE patients who underwent ANT DBS surgery. Patients were classified as responders or non-responders depending on their response to ANT DBS treatment. The power spectrum (PS) and Phase Lag Index (PLI) were determined and data analyzed using a paired sample t-test to evaluate activity differences between pre-and-post-treatment on different frequency categories. Student's t-test, Mann-Whitney test (non-parametric test) and Fisher exact test were used to compare groups in terms of clinical variables and EEG metrics. P values < 0.05 were considered statistically significant, and FDR-corrected values were used for multiple testing.

RESULTS

PS analysis revealed that whole-brain spectral power had a significant decrease in the beta (p = 0.005) and gamma (p = 0.037) bands following ANT DBS treatment in responders. The analysis of scalp topographic images of all patients showed that ANT DBS decreases PS in the beta band at the F3, F7 and Cz electrode sites. The findings indicated a decrease in PS in the gamma band at the Fp2, F3, Cz, T3, T5 and Oz electrode sites. After ANT DBS treatment, PLI analysis showed a significant decrease in PLI between Fp1 and T3 in the gamma band in responders.

CONCLUSION

The findings showed that ANT DBS induces a decrease in power in the left frontal lobe, left temporal lobe and midline areas in the beta and gamma bands. Lower whole-brain power in the beta and gamma bands can be used as biomarkers for a favorable therapeutic response to ANT DBS, and decreased synchronization between the left frontal pole and temporal lobe in the gamma band can also be used as a biomarker for effective clinical stimulation to guide postoperative programming.

Brain injuries can set up an epileptogenic neuronal network

Development of epilepsy or epileptogenesis promotes recurrent seizures. As of today, there are no effective prophylactic therapies to prevent the onset of epilepsy. Contributing to this deficiency of preventive therapy is the lack of clarity in fundamental neurobiological mechanisms underlying epileptogenesis and lack of reliable biomarkers to identify patients at risk for developing epilepsy. This limits the development of prophylactic therapies in epilepsy. Here, neural network dysfunctions reflected by oscillopathies and microepileptiform activities, including neuronal hyperexcitability and hypersynchrony, drawn from both clinical and experimental epilepsy models, have been reviewed. This review suggests that epileptogenesis reflects a progressive and dynamic dysfunction of specific neuronal networks which recruit further interconnected groups of neurons, with this resultant pathological network mediating seizure occurrence, recurrence, and progression. In the future, combining spatial and temporal resolution of neuronal non-invasive recordings from patients at risk of developing epilepsy, together with analytics and computational tools, may contribute to determining whether the brain is undergoing epileptogenesis in asymptomatic patients following brain injury.

Modeling genetic epileptic encephalopathies using brain organoids

Developmental and epileptic encephalopathies (DEE) are a group of disorders associated with intractable seizures, brain development, and functional abnormalities, and in some cases, premature death. Pathogenic human germline biallelic mutations in tumor suppressor WW domain-containing oxidoreductase (WWOX) are associated with a relatively mild autosomal recessive spinocerebellar ataxia-12 (SCAR12) and a more severe early infantile WWOX-related epileptic encephalopathy (WOREE). In this study, we generated an in vitro model for DEEs, using the devastating WOREE syndrome as a prototype, by establishing brain organoids from CRISPR-engineered human ES cells and from patient-derived iPSCs. Using these models, we discovered dramatic cellular and molecular CNS abnormalities, including neural population changes, cortical differentiation malfunctions, and Wnt pathway and DNA damage response impairment. Furthermore, we provide a proof of concept that ectopic WWOX expression could potentially rescue these phenotypes. Our findings underscore the utility of modeling childhood epileptic encephalopathies using brain organoids and their use as a unique platform to test possible therapeutic intervention strategies.

Acute effects of brain-responsive neurostimulation in drug-resistant partial onset epilepsy

OBJECTIVE

Understanding the acute effects of responsive stimulation (AERS) based on intracranial EEG (iEEG) recordings in ambulatory patients with drug-resistant partial epilepsy, and correlating these with changes in clinical seizure frequency, may help clinicians more efficiently optimize responsive stimulation settings.

METHODS

In patients implanted with the NeuroPace® RNS® System, acute changes in iEEG spectral power following active and sham stimulation periods were quantified and compared within individual iEEG channels. Additionally, acute stimulation-induced acute iEEG changes were compared within iEEG channels before and after patients experienced substantial reductions in clinical seizure frequency.

RESULTS

Responsive stimulation resulted in a 20.7% relative decrease in spectral power in the 2-4 second window following active stimulation, compared to sham stimulation. On several detection channels, the AERS features changed when clinical outcomes improved but were relatively stable otherwise. AERS change direction associated with clinical improvement was generally consistent within detection channels.

CONCLUSIONS

In this retrospective analysis, patients with drug-resistant partial epilepsy treated with direct brain-responsive neurostimulation showed an acute stimulation related reduction in iEEG spectral power that was associated with reductions in clinical seizure frequency.

SIGNIFICANCE

Identifying favorable stimulation related changes in iEEG activity could help physicians to more rapidly optimize stimulation settings for each patient.

EEG based interpretation of human brain activity during yoga and meditation using machine learning: A systematic review

OBJECTIVES

The present investigation is to study the impact of yoga and meditation on Brain waves concerning physical and mental health. There are mainly three stages (steps) in the brain wave classification:(i) preprocessing, ii) feature extraction, and iii) classification. This work provides a review of interpretation methods of Brain signals (Electroencephalogram (EEG)) EEG during yoga and meditation. Past research has revealed significant mental and physical advantages with yoga and meditation.

METHODS

The research topic reviewed focused on the machine learning strategies applied for the interpretation of brain waves. In addressing the research questions highlighted earlier in the general introduction, we conducted a systematic search of articles from targeted scientific and journal online databases that included PubMed, Web of Science, IEEE Xplore Digital Library (IEEE), and Arxiv databases based on their relevance to the research questions and domain topic. The survey topic is relatively nascent, and therefore, the scope of the search period was limited to the 20-year timeline that was deemed representative of the research topic under investigation. The literature search was based on the keywords "EEG", "yoga*" and "meditation*". The key phrases were concatenated using Boolean expressions and applied to search through the selected online databases yielding a total of 120 articles. The online databases were selected based on the relevancy of content with the research title, research questions, and the domain application. The literature review search, process, and classification were carefully conducted guided by two defined measures; 1.) Inclusion criteria; and 2.) Exclusion criteria. These measures define the criteria for searching and extracting relevant articles relating to the research title and domain of interest.

RESULTS

Our literature search and review indicate a broad spectrum of neural mechanics under a variety of meditation styles have been investigated. A detailed analysis of various mental states using Zen, CHAN, mindfulness, TM, Rajayoga, Kundalini, Yoga, and other meditation styles have been described by means of EEG bands. Classification of mental states using KNN, SVM, Random forest, Fuzzy logic, neural networks, Convolutional Neural Networks has been described. Superior research is still required to classify the EEG signatures corresponding to different mental states.

CONCLUSIONS

Yoga practice may be an effective adjunctive treatment for a clinical and aging population. Advanced research can examine the effects of specific branches of yoga on a designated clinical grouping. Yoga and meditation increased overall healthy brain activity.

Variation of functional brain connectivity in epileptic seizures: an EEG analysis with cross-frequency phase synchronization

Frequency coupling in nervous system is believed to be associated with normal and impaired brain functions. However, most of the existing experiments have been concentrated on the coupling strength within frequency bands, while the coupling strength between different bands is ignored. In this work, we apply phase synchronization index (PSI) to investigate the cross-frequency coupling (CFC) of Electroencephalogram (EEG) signals. The PSI matrixes for the multi-channel EEG signals are calculated from interictal to ictal period in each sliding time window. The results show that CFC changes obviously once seizure occurs between the different bands, and such alteration is earlier than the appearance of clinical symptoms in seizure. Considering the similar role of the within-frequency coupling (WFC), we further reconstruct multi-layered brain networks, including CFC networks and WFC networks. The graph metrics are applied to investigate the variation of network structure of the epileptic brain. Significant decreases/increases of the local/global efficiency are found in δ-β, δ-α, θ-α and δ-θ bands from the CFC network, while WFC network shows a significant decline in the local efficiency in θ and α bands. These findings suggest that CFC may provide a new perspective to observe the alteration of brain structure when seizure occurs, and the investigation of functional connectivity across the full frequency spectrum can give us a deeper understanding of epileptic brains.

Aberrant Connectivity During Pilocarpine-Induced Status Epilepticus

Status epilepticus (SE) is a common, life-threatening neurological disorder that may lead to permanent brain damage. In rodent models, SE is an acute phase of seizures that could be reproduced by injecting with pilocarpine and then induce chronic temporal lobe epilepsy (TLE) seizures. However, how SE disrupts brain activity, especially communications among brain regions, is still unclear. In this study, we aimed to identify the characteristic abnormalities of network connections among the frontal cortex, hippocampus and thalamus during the SE episodes in a pilocarpine model with functional and effective connectivity measurements. We showed that the coherence connectivity among these regions increased significantly during the SE episodes in almost all frequency bands (except the alpha band) and that the frequency band with enhanced connections was specific to different stages of SE episodes. Moreover, with the effective analysis, we revealed a closed neural circuit of bidirectional effective interactions between the frontal regions and the hippocampus and thalamus in both ictal and post-ictal stages, implying aberrant enhancement of communication across these brain regions during the SE episodes. Furthermore, an effective connection from the hippocampus to the thalamus was detected in the delta band during the pre-ictal stage, which shifted in an inverse direction during the ictal stage in the theta band and in the theta, alpha, beta and low-gamma bands during the post-ictal stage. This specificity of the effective connection between the hippocampus and thalamus illustrated that the hippocampal structure is critical for the initiation of SE discharges, while the thalamus is important for the propagation of SE discharges. Overall, our results demonstrated enhanced interaction among the frontal cortex, hippocampus and thalamus during the SE episodes and suggested the modes of information flow across these structures for the initiation and propagation of SE discharges. These findings may reveal an underlying mechanism of aberrant network communication during pilocarpine-induced SE discharges and deepen our knowledge of TLE seizures.

Effects of Diazepam and Ketamine on Pilocarpine-Induced Status Epilepticus in Mice

Status epilepticus (SE) is a life-threatening condition needing immediate care to prevent brain damage. SE with electrographic and behavioral features similar to those seen in humans is reproduced in rodents by i.p. pilocarpine injection, and can be terminated by diazepam and ketamine treatment but only behaviourally, not electrographically. Little is known on the behavioral and EEG effects induced by a delayed administration of ketamine (25 mg/kg) after diazepam (10 mg/kg) or vice versa. Therefore, we analysed behavior and EEG activity recorded from the mouse hippocampal CA3 region before, during SE and after anticonvulsant treatments. In the first group (n = 4), diazepam was administered one hour before ketamine whereas in the second group (n = 4) ketamine was administered one hour before diazepam. The EEG SE did not disappear after each of the two treatments but progressed within 4 h to a pattern of interictal discharges. However, diazepam administration before ketamine significantly shortened the time of behavioral recovery compared to when ketamine was administered before diazepam (p < 0.05). The two protocols were also associated to distinct EEG changes in gamma and high frequency oscillations. In conclusion, although diazepam and ketamine are not effective in stopping EEG SE, diazepam administration one hour before ketamine shortens behavioral recovery in pilocarpine-treated mice.

Dynamic Preictal Discharges in Patients With Mesial Temporal Lobe Epilepsy

PURPOSE

It has been challenging to detect early changes preceding seizure onset in patients with epilepsy. This study investigated the preictal discharges (PIDs) by intracranial electroencephalogram of 11 seizures from 7 patients with mesial temporal lobe epilepsy.

METHODS

The EEG segments consisting of 30 seconds before ictal onset and 5 seconds after ictal onset were selected for analysis. After PID detection, the amplitude and interval were measured. According to the timing of PID onset, the 30-second period preceding seizure onset was divided into two stages: before PID stage and PID stage. The autocorrelation coefficients during the two stages were calculated and compared.

RESULTS

Preictal discharge amplitude progressively increased, while PID interval gradually decreased toward seizure onset. The autocorrelation coefficients of PID channels were significantly higher during PID stage than before PID stage. There was an overlap between channels with PIDs and seizure onset channels (80.77%).

CONCLUSIONS

Preictal discharges emerge prior to ictal event, with a dynamic change and a spatial correlation with seizure onset zone. These findings deepen our understanding of seizure generation and help early prediction and localization of seizure onset zone.

Phase-amplitude coupling and epileptogenesis in an animal model of mesial temporal lobe epilepsy

Polyrhythmic coupling of oscillatory components in electrophysiological signals results from the interactions between neuronal sub-populations within and between cell assemblies. Since the mechanisms underlying epileptic disorders should affect such interactions, abnormal level of cross-frequency coupling is expected to provide a signal marker of epileptogenesis. We measured phase-amplitude coupling (PAC), a form of cross-frequency coupling between neural oscillations, in a rodent model of mesial temporal lobe epilepsy. Sprague-Dawley rats (n = 4, 250-300 g) were injected with pilocarpine (380 mg/kg, i.p) to induce a status epilepticus (SE) that was stopped after 1 h with diazepam (5 mg/kg, s.c.) and ketamine (50 mg/kg, s.c.). Control animals (n = 6) did not receive any injection or treatment. Three days after SE, all animals were implanted with bipolar electrodes in the hippocampal CA3 subfield, entorhinal cortex, dentate gyrus and subiculum. Continuous video/EEG recordings were performed 24/7 at a sampling rate of 2 kHz, over 15 consecutive days. Pilocarpine-treated animals showed interictal spikes (5.25 (±2.5) per minute) and seizures (n = 32) that appeared 7 (±0.8) days after SE. We found that CA3 was the seizure onset zone in most epileptic animals, with stronger ongoing PAC coupling between seizures than in controls (Kruskal-Wallis test: chi2 (1,36) = 46.3, Bonferroni corrected, p < 0.001). Strong PAC in CA3 occurred between the phase of slow-wave oscillations (<1 Hz) and the amplitude of faster rhythms (50-180 Hz), with the strongest bouts of high-frequency activity occurring preferentially on the ascending phase of the slow wave. We also identified that cross-frequency coupling in CA3 (rho = 0.44, p < 0.001) and subiculum (rho = 0.41, p < 0.001) was positively correlated with the daily number of seizures. Overall, our study demonstrates that cross-frequency coupling may represent a signal marker in epilepsy and suggests that this methodology could be transferred to clinical scalp MEG and EEG recordings.

Epileptic Seizure Prediction Using Diffusion Distance and Bayesian Linear Discriminate Analysis on Intracranial EEG

Epilepsy is a chronic neurological disorder characterized by sudden and apparently unpredictable seizures. A system capable of forecasting the occurrence of seizures is crucial and could open new therapeutic possibilities for human health. This paper addresses an algorithm for seizure prediction using a novel feature — diffusion distance (DD) in intracranial Electroencephalograph (iEEG) recordings. Wavelet decomposition is conducted on segmented electroencephalograph (EEG) epochs and subband signals at scales 3, 4 and 5 are utilized to extract the diffusion distance. The features of all channels composing a feature vector are then fed into a Bayesian Linear Discriminant Analysis (BLDA) classifier. Finally, postprocessing procedure is applied to reduce false prediction alarms. The prediction method is evaluated on the public intracranial EEG dataset, which consists of 577.67[Formula: see text]h of intracranial EEG recordings from 21 patients with 87 seizures. We achieved a sensitivity of 85.11% for a seizure occurrence period of 30[Formula: see text]min and a sensitivity of 93.62% for a seizure occurrence period of 50[Formula: see text]min, both with the seizure prediction horizon of 10[Formula: see text]s. Our false prediction rate was 0.08/h. The proposed method yields a high sensitivity as well as a low false prediction rate, which demonstrates its potential for real-time prediction of seizures.

Spatiotemporal changes in regularity of gamma oscillations contribute to focal ictogenesis

In focal ictogenesis, gamma oscillations (30–70 Hz) recorded by electroencephalography (EEG) are related to the epileptiform synchronization of interneurons that links the seizure onset zone (SOZ) to the surrounding epileptogenic zone. We hypothesized that the synchronization of interneurons could be detected as changes in the regularity of gamma oscillation rhythmicity. We used multiscale entropy (MSE) analysis, which can quantify the regularity of EEG rhythmicity, to investigate how the regularity of gamma oscillations changes over the course of a seizure event. We analyzed intracranial EEG data from 13 pediatric patients with focal cortical dysplasia. The MSE analysis revealed the following characteristic changes of MSE score (gamma oscillations): (1) during the interictal periods, the lowest MSE score (the most regular gamma oscillations) was always found in the SOZ; (2) during the preictal periods, the SOZ became more similar to the epileptogenic zone as the MSE score increased in the SOZ (gamma oscillations became less regular in the SOZ); and (3) during the ictal periods, a decreasing MSE score (highly regular gamma oscillations) propagated over the epileptogenic zone. These spatiotemporal changes in regularity of gamma oscillations constitute an important demonstration that focal ictogenesis is caused by dynamic changes in interneuron synchronization.

Hyper-coherence and increased energy of gamma oscillations in patient with first onset schizophrenia and cerebral white matter damage

Background: According to current knowledge, gamma frequency is closely related to the functioning of neural networks underlying the basic activity of the brain and mind. Disorders in mechanisms synchronizing brain activity observed in patients diagnosed with schizophrenia are at the roots of neurocognitive disorders and psychopathological symptoms of the disease. Synchronization mechanisms are also related to the structure and functional effectiveness of the white matter. So far, not many analysis has been conducted concerning changes in the image of high frequency in patients with comorbid schizophrenia and white matter damage. The aim of this research was to present specific features of gamma waves in subjects with different psychiatric diagnoses and condition of brain structure.

Methods: Quantitative analysis of an EEG record registered from a patient diagnosed with schizophrenia and comorbid white matter hyperintensities (SCH+WM), a patient with an identical diagnosis but without structural brain changes present in the MRI (SCH-WM) of a healthy control (HC). The range of gamma waves has been obtained by using analogue filters. In order to obtain precise analysis, gamma frequencies have been divided into three bands: 30-50Hz, 50-70Hz, 70-100Hz. Matching Pursuit algorithm has been used for signal analysis enabling assessing the changes in signal energy. Synchronization effectiveness of particular areas of the brain was measured with the aid of coherence value for selected pairs of electrodes.

Results: The electrophysiological signals recorded for the SCH+WM patient showed the highest signal energy level identified for all the analyzed bands compared to the results obtained for the same pairs of electrodes of the other subjects. Coherence results revealed hipercompensation for the SCH+WM patient and her level differed substantially compared to the results of the other subjects.

Conclusions: The coexistence of schizophrenia with white matter damage can significantly disturb parameters of neural activity with high frequencies. The paper discusses possible explanations for the obtained results.

Correlated EEG Signals Simulation Based on Artificial Neural Networks

In recent years, simulation of the human electroencephalogram (EEG) data found its important role in medical domain and neuropsychology. In this paper, a novel approach to simulation of two cross-correlated EEG signals is proposed. The proposed method is based on the principles of artificial neural networks (ANN). Contrary to the existing EEG data simulators, the ANN-based approach was leveraged solely on the experimentally acquired EEG data. More precisely, measured EEG data were utilized to optimize the simulator which consisted of two ANN models (each model responsible for generation of one EEG sequence). In order to acquire the EEG recordings, the measurement campaign was carried out on a healthy awake adult having no cognitive, physical or mental load. For the evaluation of the proposed approach, comprehensive quantitative and qualitative statistical analysis was performed considering probability distribution, correlation properties and spectral characteristics of generated EEG processes. The obtained results clearly indicated the satisfactory agreement with the measurement data.

EEG Derived Neuronal Dynamics during Meditation: Progress and Challenges

Meditation advances positivity but how these behavioral and psychological changes are brought can be explained by understanding neurophysiological effects of meditation. In this paper, a broad spectrum of neural mechanics under a variety of meditation styles has been reviewed. The overall aim of this study is to review existing scientific studies and future challenges on meditation effects based on changing EEG brainwave patterns. Albeit the existing researches evidenced the hold for efficacy of meditation in relieving anxiety and depression and producing psychological well-being, more rigorous studies are required with better design, considering client variables like personality characteristics to avoid negative effects, randomized controlled trials, and large sample sizes. A bigger number of clinical trials that concentrate on the use of meditation are required. Also, the controversial subject of epileptiform EEG changes and other adverse effects during meditation has been raised.

Usefulness of multiple frequency band source localizations in ictal MEG

OBJECTIVE

We evaluated the diagnostic value of multiple frequency band MEG source localization within a wide time window during the preictal period.

METHODS

Data for 13 epilepsy patients who showed an ictal event during MEG were analyzed. Several seconds of preictal data were localized in the theta, alpha, beta, and gamma bands by using wavelet transformation and the sLORETA algorithm. The same analysis was performed with narrow time and frequency band. Localization concordances to the surgically resected area were compared.

RESULTS

Source localization in the gamma band for a 10s window before ictal onset showed best concordance to the resection cavity. Eight of 13 patients showed sub-lobar concordance in the 10s gamma band localization, whereas 3 showed concordance in the narrow time and frequency analysis. Four of 7 patients with focal cortical dysplasia (FCD) achieved seizure-free outcome, and all 4 showed sub-lobar concordance.

CONCLUSIONS

A 10s time window gamma source localization method can be used to delineate the epileptogenic zone.

SIGNIFICANCE

The use of a long period during preictal gamma source localization has the potential to become a localizing biomarker of the epileptogenic zone in candidates for surgical intervention, especially in MRI-suspected FCD.

Genetic Programming and Frequent Itemset Mining to Identify Feature Selection Patterns of iEEG and fMRI Epilepsy Data

Pattern classification for intracranial electroencephalogram (iEEG) and functional magnetic resonance imaging (fMRI) signals has furthered epilepsy research toward understanding the origin of epileptic seizures and localizing dysfunctional brain tissue for treatment. Prior research has demonstrated that implicitly selecting features with a genetic programming (GP) algorithm more effectively determined the proper features to discern biomarker and non-biomarker interictal iEEG and fMRI activity than conventional feature selection approaches. However for each the iEEG and fMRI modalities, it is still uncertain whether the stochastic properties of indirect feature selection with a GP yield (a) consistent results within a patient data set and (b) features that are specific or universal across multiple patient data sets. We examined the reproducibility of implicitly selecting features to classify interictal activity using a GP algorithm by performing several selection trials and subsequent frequent itemset mining (FIM) for separate iEEG and fMRI epilepsy patient data. We observed within-subject consistency and across-subject variability with some small similarity for selected features, indicating a clear need for patient-specific features and possible need for patient-specific feature selection or/and classification. For the fMRI, using nearest-neighbor classification and 30 GP generations, we obtained over 60% median sensitivity and over 60% median selectivity. For the iEEG, using nearest-neighbor classification and 30 GP generations, we obtained over 65% median sensitivity and over 65% median selectivity except one patient.

p38 MAP kinase-mediated NMDA receptor-dependent suppression of hippocampal hypersynchronicity in a mouse model of Alzheimer's disease

Hypersynchronicity of neuronal brain circuits is a feature of Alzheimer's disease (AD). Mouse models of AD expressing mutated forms of the amyloid-β precursor protein (APP), a central protein involved in AD pathology, show cortical hypersynchronicity. We studied hippocampal circuitry in APP23 transgenic mice using telemetric electroencephalography (EEG), at the age of onset of memory deficits. APP23 mice display spontaneous hypersynchronicity in the hippocampus including epileptiform spike trains. Furthermore, spectral contributions of hippocampal theta and gamma oscillations are compromised in APP23 mice, compared to non-transgenic controls. Using cross-frequency coupling analysis, we show that hippocampal gamma amplitude modulation by theta phase is markedly impaired in APP23 mice. Hippocampal hypersynchronicity and waveforms are differentially modulated by injection of riluzole and the non-competitive N-methyl-D-aspartate (NMDA) receptor inhibitor MK801, suggesting specific involvement of voltage-gated sodium channels and NMDA receptors in hypersynchronicity thresholds in APP23 mice. Furthermore, APP23 mice show marked activation of p38 mitogen-activated protein (MAP) kinase in hippocampus, and injection of MK801 but not riluzole reduces activation of p38 in the hippocampus. A p38 inhibitor induces hypersynchronicity in APP23 mice to a similar extent as MK801, thus supporting suppression of hypersynchronicity involves NMDA receptors-mediated p38 activity. In summary, we characterize components of hippocampal hypersynchronicity, waveform patterns and cross-frequency coupling in the APP23 mouse model by pharmacological modulation, furthering the understanding of epileptiform brain activity in AD.

An interictal EEG spectral metric for temporal lobe epilepsy lateralization

OBJECTIVE

Visually-obvious abnormalities in the resting baseline EEG--slowing, spiking and high-frequency oscillations (HFOs)--are cardinal, though incompletely understood, features of the seizure onset zone in focal epilepsy. We hypothesized that evidence of cortical network dysfunction in temporal lobe epilepsy (TLE) would persist in the absence of visually-classifiable abnormalities in the baseline EEG recorded within the conventional passband, and that metrics of such dysfunction could serve as a lateralizing diagnostic in TLE.

METHODS

Epochs of resting EEG without significant abnormalities in light sleep over several days were compared between a group of 10 patients with proven TLE and 10 subjects without epilepsy. A novel laterality metric computed from the line length of normalized power spectra from the temporal channels was compared between the two groups.

RESULTS

Significant group differences in spectral line length laterality metric were found between the TLE and control group. At the individual level, seven of 10 TLE patients had highly significant laterality metrics, all concordant with the known laterality of their disease.

SIGNIFICANCE

Detailed spectral analysis offers novel insight into TLE network behavior, independent of the orthodox abnormalities of EEG slowing, spikes or HFOs. The results may be deployed in a practical diagnostic manner, offer insight into the EEG manifestations of disordered cellular network architecture in TLE, and maybe understood through simple analogy with the theory of linear time-invariant physical systems.

Early prediction of medication refractoriness in children with idiopathic epilepsy based on scalp EEG analysis

Refractory epilepsy often has deleterious effects on an individual's health and quality of life. Early identification of patients whose seizures are refractory to antiepileptic drugs is important in considering the use of alternative treatments. Although idiopathic epilepsy is regarded as having a significantly lower risk factor of developing refractory epilepsy, still a subset of patients with idiopathic epilepsy might be refractory to medical treatment. In this study, we developed an effective method to predict the refractoriness of idiopathic epilepsy. Sixteen EEG segments from 12 well-controlled patients and 14 EEG segments from 11 refractory patients were analyzed at the time of first EEG recordings before antiepileptic drug treatment. Ten crucial EEG feature descriptors were selected for classification. Three of 10 were related to decorrelation time, and four of 10 were related to relative power of delta/gamma. There were significantly higher values in these seven feature descriptors in the well-controlled group as compared to the refractory group. On the contrary, the remaining three feature descriptors related to spectral edge frequency, kurtosis, and energy of wavelet coefficients demonstrated significantly lower values in the well-controlled group as compared to the refractory group. The analyses yielded a weighted precision rate of 94.2%, and a 93.3% recall rate. Therefore, the developed method is a useful tool in identifying the possibility of developing refractory epilepsy in patients with idiopathic epilepsy.

High-Frequency Oscillations Recorded on the Scalp of Patients With Epilepsy Using Tripolar Concentric Ring Electrodes

Epilepsy is the second most prevalent neurological disorder ([Formula: see text]% prevalence) affecting [Formula: see text] million people worldwide with up to 75% from developing countries. The conventional electroencephalogram is plagued with artifacts from movements, muscles, and other sources. Tripolar concentric ring electrodes automatically attenuate muscle artifacts and provide improved signal quality. We performed basic experiments in healthy humans to show that tripolar concentric ring electrodes can indeed record the physiological alpha waves while eyes are closed. We then conducted concurrent recordings with conventional disc electrodes and tripolar concentric ring electrodes from patients with epilepsy. We found that we could detect high frequency oscillations, a marker for early seizure development and epileptogenic zone, on the scalp surface that appeared to become more narrow-band just prior to seizures. High frequency oscillations preceding seizures were present in an average of 35.5% of tripolar concentric ring electrode data channels for all the patients with epilepsy whose seizures were recorded and absent in the corresponding conventional disc electrode data. An average of 78.2% of channels that contained high frequency oscillations were within the seizure onset or irritative zones determined independently by three epileptologists based on conventional disc electrode data and videos.

Coupling between gamma-band power and cerebral blood volume during recurrent acute neocortical seizures

Characterization of neural and hemodynamic biomarkers of epileptic activity that can be measured using non-invasive techniques is fundamental to the accurate identification of the epileptogenic zone (EZ) in the clinical setting. Recently, oscillations at gamma-band frequencies and above (>30 Hz) have been suggested to provide valuable localizing information of the EZ and track cortical activation associated with epileptogenic processes. Although a tight coupling between gamma-band activity and hemodynamic-based signals has been consistently demonstrated in non-pathological conditions, very little is known about whether such a relationship is maintained in epilepsy and the laminar etiology of these signals. Confirmation of this relationship may elucidate the underpinnings of perfusion-based signals in epilepsy and the potential value of localizing the EZ using hemodynamic correlates of pathological rhythms. Here, we use concurrent multi-depth electrophysiology and 2-dimensional optical imaging spectroscopy to examine the coupling between multi-band neural activity and cerebral blood volume (CBV) during recurrent acute focal neocortical seizures in the urethane-anesthetized rat. We show a powerful correlation between gamma-band power (25-90 Hz) and CBV across cortical laminae, in particular layer 5, and a close association between gamma measures and multi-unit activity (MUA). Our findings provide insights into the laminar electrophysiological basis of perfusion-based imaging signals in the epileptic state and may have implications for further research using non-invasive multi-modal techniques to localize epileptogenic tissue.

A new parametric feature descriptor for the classification of epileptic and control EEG records in pediatric population

This study evaluates the sensitivity, specificity and accuracy in associating scalp EEG to either control or epileptic patients by means of artificial neural networks (ANNs) and support vector machines (SVMs). A confluence of frequency and temporal parameters are extracted from the EEG to serve as input features to well-configured ANN and SVM networks. Through these classification results, we thus can infer the occurrence of high-risk (epileptic) as well as low risk (control) patients for potential follow up procedures.

Application of intrinsic time-scale decomposition (ITD) to EEG signals for automated seizure prediction

Intrinsic time-scale decomposition (ITD) is a new nonlinear method of time-frequency representation which can decipher the minute changes in the nonlinear EEG signals. In this work, we have automatically classified normal, interictal and ictal EEG signals using the features derived from the ITD representation. The energy, fractal dimension and sample entropy features computed on ITD representation coupled with decision tree classifier has yielded an average classification accuracy of 95.67%, sensitivity and specificity of 99% and 99.5%, respectively using 10-fold cross validation scheme. With application of the nonlinear ITD representation, along with conceptual advancement and improvement of the accuracy, the developed system is clinically ready for mass screening in resource constrained and emerging economy scenarios.

EFFICIENT AUTOMATIC SELECTION AND COMBINATION OF EEG FEATURES IN LEAST SQUARES CLASSIFIERS FOR MOTOR IMAGERY BRAIN–COMPUTER INTERFACES

Discriminative features have to be properly extracted and selected from the electroencephalographic (EEG) signals of each specific subject in order to achieve an adaptive brain–computer interface (BCI) system. This work presents an efficient wrapper-based methodology for feature selection and least squares discrimination of high-dimensional EEG data with low computational complexity. Features are computed in different time segments using three widely used methods for motor imagery tasks and, then, they are concatenated or averaged in order to take into account the time course variability of the EEG signals. Once EEG features have been extracted, proposed framework comprises two stages. The first stage entails feature ranking and, in this work, two different procedures have been considered, the least angle regression (LARS) and the Wilcoxon rank sum test, to compare the performance of each one. The second stage selects the most relevant features using an efficient leave-one-out (LOO) estimation based on the Allen's PRESS statistic. Experimental comparisons with the state-of-the-art BCI methods shows that this approach gives better results than current state-of-the-art approaches in terms of recognition rates and computational requirements and, also with respect to the first ranking stage, it is confirmed that the LARS algorithm provides better results than the Wilcoxon rank sum test for these experiments.

Comparison of frequency bands using spectral entropy for epileptic seizure prediction

Introduction. Under the hypothesis that the uncontrolled neuronal synchronization propagates recruiting more and more neurons, the aim is to detect its onset as early as possible by signal analysis. This synchronization is not noticeable just by looking at the EEG, so mathematical tools are needed for its identification. Objective. The aim of this study is to compare the results of spectral entropies calculated in different frequency bands of the EEG signals to decide which band may be a better tool to predict an epileptic seizure. Materials and Methods. Invasive ictal records were used. We measured the Fourier spectrum entropy of the electroencephalographic signals 4 to 32 minutes before the attack in low, medium and high frequencies. Results. The high-frequency band shows a markedly rate of increase of the entropy, with positive slopes and low correlation coefficient. The entropy rate of growth in the low-frequency band is practically zero, with a correlation around 0.2 and mostly positive slopes. The mid-frequency band showed both positive and negative slopes with low correlation. Conclusions. The entropy in the high frequencies could be predictor, because it shows changes in the previous moments of the attack. Its main problem is the variability, which makes it difficult to set the threshold that ensures an adequate prediction.

AUTOMATED DIAGNOSIS OF EPILEPSY USING CWT, HOS AND TEXTURE PARAMETERS

Epilepsy is a chronic brain disorder which manifests as recurrent seizures. Electroencephalogram (EEG) signals are generally analyzed to study the characteristics of epileptic seizures. In this work, we propose a method for the automated classification of EEG signals into normal, interictal and ictal classes using Continuous Wavelet Transform (CWT), Higher Order Spectra (HOS) and textures. First the CWT plot was obtained for the EEG signals and then the HOS and texture features were extracted from these plots. Then the statistically significant features were fed to four classifiers namely Decision Tree (DT), K-Nearest Neighbor (KNN), Probabilistic Neural Network (PNN) and Support Vector Machine (SVM) to select the best classifier. We observed that the SVM classifier with Radial Basis Function (RBF) kernel function yielded the best results with an average accuracy of 96%, average sensitivity of 96.9% and average specificity of 97% for 23.6 s duration of EEG data. Our proposed technique can be used as an automatic seizure monitoring software. It can also assist the doctors to cross check the efficacy of their prescribed drugs.

DESIGN OF ASSISTIVE WHEELCHAIR SYSTEM DIRECTLY STEERED BY HUMAN THOUGHTS

Integration of brain–computer interface (BCI) technique and assistive device is one of chief and promising applications of BCI system. With BCI technique, people with disabilities do not have to communicate with external environment through traditional and natural pathways like peripheral nerves and muscles, and could achieve it only by their brain activities. In this paper, we designed an electroencephalogram (EEG)-based wheelchair which can be steered by users' own thoughts without any other involvements. We evaluated the feasibility of BCI-based wheelchair in terms of accuracies and real-world testing. The results demonstrate that our BCI wheelchair is of good performance not only in accuracy, but also in practical running testing in a real environment. This fact implies that people can steer wheelchair only by their thoughts, and may have a potential perspective in daily application for disabled people.

Feasibility of recording high frequency oscillations with tripolar concentric ring electrodes during pentylenetetrazole-induced seizures in rats

As epilepsy remains a refractory condition in about 30% of patients with complex partial seizures, electrical stimulation of the brain has recently shown potential for additive seizure control therapy. Previously, we applied noninvasive transcranial focal stimulation via novel tripolar concentric ring electrodes (TCREs) on the scalp of rats after inducing seizures with pentylenetetrazole (PTZ). We developed a close-loop system to detect seizures and automatically trigger the stimulation and evaluated its effect on the electrographic activity recorded by TCREs in rats. In our previous work the detectors of seizure onset were based on seizure-induced changes in signal power in the frequency range up to 100 Hz, while in this preliminary study we assess the feasibility of recording high frequency oscillations (HFOs) in the range up to 300 Hz noninvasively with scalp TCREs during PTZ-induced seizures. Grand average power spectral density estimate and generalized likelihood ratio tests were used to compare power of electrographic activity at different stages of seizure development in a group of rats (n= 8). The results suggest that TCREs have the ability to record HFOs from the scalp as well as that scalp-recorded HFOs can potentially be used as features for seizure onset detection.

PHASE SYNCHRONIZATION OF NEURONAL NOISE IN MOUSE HIPPOCAMPAL EPILEPTIFORM DYNAMICS

Organized brain activity is the result of dynamical, segregated neuronal signals that may be used to investigate synchronization effects using sophisticated neuroengineering techniques. Phase synchrony analysis, in particular, has emerged as a promising methodology to study transient and frequency-specific coupling effects across multi-site signals. In this study, we investigated phase synchronization in intracellular recordings of interictal and ictal epileptiform events recorded from pairs of cells in the whole (intact) mouse hippocampus. In particular, we focused our analysis on the background noise-like activity (NLA), previously reported to exhibit complex neurodynamical properties. Our results show evidence for increased linear and nonlinear phase coupling in NLA across three frequency bands [theta (4–10 Hz), beta (12–30 Hz) and gamma (30–80 Hz)] in the ictal compared to interictal state dynamics. We also present qualitative and statistical evidence for increased phase synchronization in the theta, beta and gamma frequency bands from paired recordings of ictal NLA. Overall, our results validate the use of background NLA in the neurodynamical study of epileptiform transitions and suggest that what is considered "neuronal noise" is amenable to synchronization effects in the spatiotemporal domain.

ANALYSIS OF ABSENCE SEIZURE GENERATION USING EEG SPATIAL-TEMPORAL REGULARITY MEASURES

Epileptic seizures are thought to be generated and to evolve through an underlying anomaly of synchronization in the activity of groups of neuronal populations. The related dynamic scenario of state transitions is revealed by detecting changes in the dynamical properties of Electroencephalography (EEG) signals. The recruitment procedure ending with the crisis can be explored through a spatial-temporal plot from which to extract suitable descriptors that are able to monitor and quantify the evolving synchronization level from the EEG tracings. In this paper, a spatial-temporal analysis of EEG recordings based on the concept of permutation entropy (PE) is proposed. The performance of PE are tested on a database of 24 patients affected by absence (generalized) seizures. The results achieved are compared to the dynamical behavior of the EEG of 40 healthy subjects. Being PE a feature which is dependent on two parameters, an extensive study of the sensitivity of the performance of PE with respect to the parameters' setting was carried out on scalp EEG. Once the optimal PE configuration was determined, its ability to detect the different brain states was evaluated. According to the results here presented, it seems that the widely accepted model of "jump" transition to absence seizure should be in some cases coupled (or substituted) by a gradual transition model characteristic of self-organizing networks. Indeed, it appears that the transition to the epileptic status is heralded before the preictal state, ever since the interictal stages. As a matter of fact, within the limits of the analyzed database, the frontal-temporal scalp areas appear constantly associated to PE levels higher compared to the remaining electrodes, whereas the parieto-occipital areas appear associated to lower PE values. The EEG of healthy subjects neither shows any similar dynamic behavior nor exhibits any recurrent portrait in PE topography.

APPLICATION OF EMPIRICAL MODE DECOMPOSITION (EMD) FOR AUTOMATED DETECTION OF EPILEPSY USING EEG SIGNALS

Epilepsy is a global disease with considerable incidence due to recurrent unprovoked seizures. These seizures can be noninvasively diagnosed using electroencephalogram (EEG), a measure of neuronal electrical activity in brain recorded along scalp. EEG is highly nonlinear, nonstationary and non-Gaussian in nature. Nonlinear adaptive models such as empirical mode decomposition (EMD) provide intuitive understanding of information present in these signals. In this study a novel methodology is proposed to automatically classify EEG of normal, inter-ictal and ictal subjects using EMD decomposition. EEG decomposition using EMD yields few intrinsic mode functions (IMF), which are amplitude and frequency modulated (AM and FM) waves. Hilbert transform of these IMF provides AM and FM frequencies. Features such as spectral peaks, spectral entropy and spectral energy in each IMF are extracted and fed to decision tree classifier for automated diagnosis. In this work, we have compared the performance of classification using two types of decision trees (i) classification and regression tree (CART) and (ii) C4.5. We have obtained the highest average accuracy of 95.33%, average sensitivity of 98%, and average specificity of 97% using C4.5 decision tree classifier. The developed methodology is ready for clinical validation on large databases and can be deployed for mass screening.

ARTIFICIAL NEURAL NETWORK BASED APPROACH TO EEG SIGNAL SIMULATION

In this paper a new approach to the electroencephalogram (EEG) signal simulation based on the artificial neural networks (ANN) is proposed. The aim was to simulate the spontaneous human EEG background activity based solely on the experimentally acquired EEG data. Therefore, an EEG measurement campaign was conducted on a healthy awake adult in order to obtain an adequate ANN training data set. As demonstration of the performance of the ANN based approach, comparisons were made against autoregressive moving average (ARMA) filtering based method. Comprehensive quantitative and qualitative statistical analysis showed clearly that the EEG process obtained by the proposed method was in satisfactory agreement with the one obtained by measurements.

Multiscale causal connectivity analysis by canonical correlation: theory and application to epileptic brain

Multivariate Granger causality is a well-established approach for inferring information flow in complex systems, and it is being increasingly applied to map brain connectivity. Traditional Granger causality is based on vector autoregressive (AR) or mixed autoregressive moving average (ARMA) model, which are potentially affected by errors in parameter estimation and may be contaminated by zero-lag correlation, notably when modeling neuroimaging data. To overcome this issue, we present here an extended canonical correlation approach to measure multivariate Granger causal interactions among time series. The procedure includes a reduced rank step for calculating canonical correlation analysis (CCA), and extends the definition of causality including instantaneous effects, thus avoiding the potential estimation problems of AR (or ARMA) models. We tested this approach on simulated data and confirmed its practical utility by exploring local network connectivity at different scales in the epileptic brain analyzing scalp and depth-EEG data during an interictal period.