Dynamics of magnetic cortico-cortical responses evoked by single-pulse electrical stimulation

OBJECTIVE

Intracranial single-pulse electrical stimulation (SPES) can elicit cortico-cortical evoked potentials. Their investigation with intracranial EEG is biased by the limited number and selected location of electrodes, which could be circumvented by simultaneous non-invasive whole-scalp recording. This study aimed at investigating the ability of magnetoencephalography (MEG) to characterize cortico-cortical evoked fields (CCEFs) and effective connectivity between the epileptogenic zone (EZ) and non-epileptogenic zone (i.e., non-involved [NIZ]).

METHODS

A total of 301 SPES trains (at 0.9 Hz during 120 s) were performed in 10 patients with refractory focal epilepsy. MEG signals were denoised, epoched, averaged, and decomposed using independent component analysis. Significant response deflections and significant source generators were detected. Peak latency/amplitude were compared between each different cortical/subcortical structure of the NIZ containing more than five SPES, and then between the EZ and corresponding brain structures in the NIZ.

RESULTS

MEG detected and localized polymorphic/polyphasic CCEFs, including one to eight significant consecutive deflections. The latency and amplitude of CCEFs within the NIZ differed significantly depending on the stimulated brain structure. Compared with the corresponding NIZ, SPES within the extratemporal EZ demonstrated delayed CCEF latency, whereas SPES within the temporal EZ showed decreased CCEF amplitude. SPES within the EZ elicited a significantly higher rate of CCEFs within the stimulated lobe compared with those within the NIZ.

SIGNIFICANCE

This study reveals polymorphic CCEFs with complex spatiotemporal dynamics both within the NIZ and EZ. It highlights significant differences in effective connectivity of the epileptogenic network. These cortico-cortical evoked responses could thus contribute to increasing the yield of intracranial recordings.

Variability of cortico-cortical evoked potentials in the epileptogenic zone is related to seizure occurrence

INTRODUCTION

Cortico-cortical evoked potentials (CCEPs) were described as reproducible during trains of single-pulse electrical stimulations (SPES). Still, few studies described a variability of CCEPs that was higher within the epileptogenic zone (EZ). This study aimed at characterizing the relationship of CCEP variability with the occurrence of interictal/ictal epileptiform discharges at the temporal vicinity of the stimulation, but not during the stimulation, by effective connectivity modifications.

METHODS

We retrospectively included 20 patients who underwent SPES during their stereo-electroencephalography (SEEG). We analyzed the variability of CCEPs by using the post-stimulation time course of intertrial standard deviation (amplitude) and the timing of peak amplitude signal of CCEP epochs (latency). Values were corrected for the Euclidian distance between stimulating/recording electrodes. Receiver operating characteristics curves were used to assess the relationship with the EZ. The link between CCEP variability and interictal discharges occurrence, seizure frequency prior to the SEEG recording, and number of seizures during SEEG recording was assessed with Spearman's correlations.

RESULTS

A relationship was demonstrated between the EZ and both the distance-corrected latency variation (area under the curve (AUC): 0.73-0.74) and the distance-corrected amplitude variation (AUC: 0.71-0.72) and both were related with the occurrence of seizures.

CONCLUSION

Seizures before/during SEEG impact the dynamics of effective connectivity within the epileptogenic network by reducing the variability of CCEP latency/amplitude when the seizure frequency increases. It suggests a strengthening of the epileptogenic network with the occurrence of many seizures. These findings stress the importance of early epilepsy surgery at a time when the network organization has not yet been complete.

Do Interictal Epileptiform Discharges and Brain Responses to Electrical Stimulation Come From the Same Location? An Advanced Source Localization Solution

Identification of seizure sources in the brain is of paramount importance, particularly for drug-resistant epilepsy patients who may require surgical operation. Interictal epileptiform discharges (IEDs), which may or may not be frequent, are known to originate from seizure networks. Delayed responses (DRs) to brain electrical stimulation have been recently discovered. If DRs and IEDs come from the same location and the DRs can be accurately localized, there will be a significant step in identification of the seizure sources. The solution to this important question has been investigated in this paper. For this, we have exploited the morphology of these spike-type events, as well as the variability in their temporal locations, to develop new constraints for an adaptive Bayesian beamformer that outperforms the conventional and recently proposed beamformers even for identifying correlated sources. This beamformer is applied to an array (a.k.a mat) of cortical EEG electrodes. The developed approach has been tested on 300 data segments from five epileptic patients included in this study, which clinically represent a large population of candidates for surgical treatment. As the significant outcome of applying this beamformer, it is very likely (if not certain) that for an epileptic subject, the IEDs and DRs originate from the same location in the brain. This paves the way for a quick identification of the source(s) of seizure in the brain.

Delayed effective connectivity characterizes the epileptogenic zone during stereo-EEG

OBJECTIVE

Single-pulse electrical stimulations (SPES) can elicit normal and abnormal responses that might characterize the epileptogenic zone, including spikes, high-frequency oscillations and cortico-cortical evoked potentials (CCEPs). In this study, we investigate their association with the epileptogenic zone during stereoelectroencephalography (SEEG) in 28 patients with refractory focal epilepsy.

METHODS

Characteristics of CCEPs (distance-corrected or -uncorrected latency, amplitude and the connectivity index) and the occurrence of spikes and ripples were assessed. Responses within the epileptogenic zone and within the non-involved zone were compared using receiver operating characteristics curves and analysis of variance (ANOVA) either in all patients, patients with well-delineated epileptogenic zone, and patients older than 15 years old.

RESULTS

We found an increase in distance-corrected CCEPs latency after stimulation within the epileptogenic zone (area under the curve = 0.71, 0.72, 0.70, ANOVA significant after false discovery rate correction).

CONCLUSIONS

The increased distance-corrected CCEPs latency suggests that neuronal propagation velocity is altered within the epileptogenic network. This association might reflect effective connectivity changes at cortico-cortical or cortico-subcortico-cortical levels. Other responses were not associated with the epileptogenic zone, including the CCEPs amplitude, the connectivity index, the occurrences of induced ripples and spikes. The discrepancy with previous descriptions may be explained by different spatial brain sampling between subdural and depth electrodes.

SIGNIFICANCE

Increased distance-corrected CCEPs latency, indicating delayed effective connectivity, characterizes the epileptogenic zone. This marker could be used to help tailor surgical resection limits after SEEG.

Design of Closed-Loop Control Schemes Based on the GA-PID and GA-RBF-PID Algorithms for Brain Dynamic Modulation

Neurostimulation can be used to modulate brain dynamics of patients with neuropsychiatric disorders to make abnormal neural oscillations restore to normal. The control schemes proposed on the bases of neural computational models can predict the mechanism of neural oscillations induced by neurostimulation, and then make clinical decisions that are suitable for the patient's condition to ensure better treatment outcomes. The present work proposes two closed-loop control schemes based on the improved incremental proportional integral derivative (PID) algorithms to modulate brain dynamics simulated by Wendling-type coupled neural mass models. The introduction of the genetic algorithm (GA) in traditional incremental PID algorithm aims to overcome the disadvantage that the selection of control parameters depends on the designer's experience, so as to ensure control accuracy. The introduction of the radial basis function (RBF) neural network aims to improve the dynamic performance and stability of the control scheme by adaptively adjusting control parameters. The simulation results show the high accuracy of the closed-loop control schemes based on GA-PID and GA-RBF-PID algorithms for modulation of brain dynamics, and also confirm the superiority of the scheme based on the GA-RBF-PID algorithm in terms of the dynamic performance and stability. This research of making hypotheses and predictions according to model data is expected to improve and perfect the equipment of early intervention and rehabilitation treatment for neuropsychiatric disorders in the biomedical engineering field.

Localization of Epileptic Brain Responses to Single-Pulse Electrical Stimulation by Developing an Adaptive Iterative Linearly Constrained Minimum Variance Beamformer

Delayed responses (DRs) to single pulse electrical stimulation (SPES) in patients with severe refractory epilepsy, from their intracranial recordings, can help to identify regions associated with epileptogenicity. Automatic DR localization is a large step in speeding up the identification of epileptogenic focus. Here, for the first time, an adaptive iterative linearly constrained minimum variance beamformer (AI-LCMV) is developed and employed to localize the DR sources from intracranial electroencephalogram (EEG) recorded using subdural electrodes. The prime objective here is to accurately localize the regions for the corresponding DRs using an adaptive localization method that exploits the morphology of DRs as the desired sources. The traditional closed-form linearly constrained minimum variance (CF-LCMV) solution is meant for tracking the sources with dominating power. Here, by incorporating the morphology of DRs, as a constraint, to an iterative linearly constrained minimum variance (LCMV) solution, the array of subdural electrodes is used to localize the low-power DRs, some not even visible in any of the electrode signals. The results from the cases included in this study also indicate more distinctive locations compared to those achievable by conventional beamformers. Most importantly, the proposed AI-LCMV is able to localize the DRs invisible over other electrodes.

Separating Inhibitory and Excitatory Responses of Epileptic Brain to Single-Pulse Electrical Stimulation

To enable an accurate recognition of neuronal excitability in an epileptic brain for modeling or localization of epileptic zone, here the brain response to single-pulse electrical stimulation (SPES) has been decomposed into its constituent components using adaptive singular spectrum analysis (SSA). Given the response at neuronal level, these components are expected to be the inhibitory and excitatory components. The prime objective is to thoroughly investigate the nature of delayed responses (elicited between 100[Formula: see text]ms-1 s after SPES) for localization of the epileptic zone. SSA is a powerful subspace signal analysis method for separation of single channel signals into their constituent uncorrelated components. The consistency in the results for both early and delayed brain responses verifies the usability of the approach.

Simultaneous stereo-EEG and high-density scalp EEG recordings to study the effects of intracerebral stimulation parameters

BACKGROUND

Cortico-cortical evoked potentials (CCEPs) recorded by stereo-electroencephalography (SEEG) are a valuable tool to investigate brain reactivity and effective connectivity. However, invasive recordings are spatially sparse since they depend on clinical needs. This sparsity hampers systematic comparisons across-subjects, the detection of the whole-brain effects of intracortical stimulation, as well as their relationships to the EEG responses evoked by non-invasive stimuli.

OBJECTIVE

To demonstrate that CCEPs recorded by high-density electroencephalography (hd-EEG) provide additional information with respect SEEG alone and to provide an open, curated dataset to allow for further exploration of their potential.

METHODS

The dataset encompasses SEEG and hd-EEG recordings simultaneously acquired during Single Pulse Electrical Stimulation (SPES) in drug-resistant epileptic patients (N = 36) in whom stimulations were delivered with different physical, geometrical, and topological parameters. Differences in CCEPs were assessed by amplitude, latency, and spectral measures.

RESULTS

While invasively and non-invasively recorded CCEPs were generally correlated, differences in pulse duration, angle and stimulated cortical area were better captured by hd-EEG. Further, intracranial stimulation evoked site-specific hd-EEG responses that reproduced the spectral features of EEG responses to transcranial magnetic stimulation (TMS). Notably, SPES, albeit unperceived by subjects, elicited scalp responses that were up to one order of magnitude larger than the responses typically evoked by sensory stimulation in awake humans.

CONCLUSIONS

CCEPs can be simultaneously recorded with SEEG and hd-EEG and the latter provides a reliable descriptor of the effects of SPES as well as a common reference to compare the whole-brain effects of intracortical stimulation to those of non-invasive transcranial or sensory stimulations in humans.

A Review of Methods of Diagnosis and Complexity Analysis of Alzheimer's Disease Using EEG Signals

This study will concentrate on recent research on EEG signals for Alzheimer's diagnosis, identifying and comparing key steps of EEG-based Alzheimer's disease (AD) detection, such as EEG signal acquisition, preprocessing function extraction, and classification methods. Furthermore, highlighting general approaches, variations, and agreement in the use of EEG identified shortcomings and guidelines for multiple experimental stages ranging from demographic characteristics to outcomes monitoring for future research. Two main targets have been defined based on the article's purpose: (1) discriminative (or detection), i.e., look for differences in EEG-based features across groups, such as MCI, moderate Alzheimer's disease, extreme Alzheimer's disease, other forms of dementia, and stable normal elderly controls; and (2) progression determination, i.e., look for correlations between EEG-based features and clinical markers linked to MCI-to-AD conversion and Alzheimer's disease intensity progression. Limitations mentioned in the reviewed papers were also gathered and explored in this study, with the goal of gaining a better understanding of the problems that need to be addressed in order to advance the use of EEG in Alzheimer's disease science.

Distinct Patterns of Functional Connectivity During the Comprehension of Natural, Narrative Speech

Recent continuous task studies, such as narrative speech comprehension, show that fluctuations in brain functional connectivity (FC) are altered and enhanced compared to the resting state. Here, we characterized the fluctuations in FC during comprehension of speech and time-reversed speech conditions. The correlations of Hilbert envelope of source-level EEG data were used to quantify FC between spatially separate brain regions. A symmetric multivariate leakage correction was applied to address the signal leakage issue before calculating FC. The dynamic FC was estimated based on a sliding time window. Then, principal component analysis (PCA) was performed on individually concatenated and temporally concatenated FC matrices to identify FC patterns. We observed that the mode of FC induced by speech comprehension can be characterized with a single principal component. The condition-specific FC demonstrated decreased correlations between frontal and parietal brain regions and increased correlations between frontal and temporal brain regions. The fluctuations of the condition-specific FC characterized by a shorter time demonstrated that dynamic FC also exhibited condition specificity over time. The FC is dynamically reorganized and FC dynamic pattern varies along a single mode of variation during speech comprehension. The proposed analysis framework seems valuable for studying the reorganization of brain networks during continuous task experiments.

Multiplex and Multilayer Network EEG Analyses: A Novel Strategy in the Differential Diagnosis of Patients with Chronic Disorders of Consciousness

The deterioration of specific topological network measures that quantify different features of whole-brain functional network organization can be considered a marker for awareness impairment. Such topological measures reflect the functional interactions of multiple brain structures, which support the integration of different sensorimotor information subtending awareness. However, conventional, single-layer, graph theoretical analysis (GTA)-based approaches cannot always reliably differentiate patients with Disorders of Consciousness (DoC). Using multiplex and multilayer network analyses of frequency-specific and area-specific networks, we investigated functional connectivity during resting-state EEG in 17 patients with Unresponsive Wakefulness Syndrome (UWS) and 15 with Minimally Conscious State (MCS). Multiplex and multilayer network metrics indicated the deterioration and heterogeneity of functional networks and, particularly, the frontal-parietal (FP), as the discriminant between patients with MCS and UWS. These data were not appreciable when considering each individual frequency-specific network. The distinctive properties of multiplex/multilayer network metrics and individual frequency-specific network metrics further suggest the value of integrating the networks as opposed to analyzing frequency-specific network metrics one at a time. The hub vulnerability of these regions was positively correlated with the behavioral responsiveness, thus strengthening the clinically-based differential diagnosis. Therefore, it may be beneficial to adopt both multiplex and multilayer network analyses when expanding the conventional GTA-based analyses in the differential diagnosis of patients with DoC. Multiplex analysis differentiated patients at a group level, whereas the multilayer analysis offered complementary information to differentiate patients with DoC individually. Although further studies are necessary to confirm our preliminary findings, these results contribute to the issue of DoC differential diagnosis and may help in guiding patient-tailored management.

Epileptogenic network of focal epilepsies mapped with cortico-cortical evoked potentials

OBJECTIVE

The goal of this study was to investigate the spatial extent and functional organization of the epileptogenic network through cortico-cortical evoked potentials (CCEPs) in patients being evaluated with intracranial stereoelectroencephalography.

METHODS

We retrospectively included 25 patients. We divided the recorded sites into three regions: epileptogenic zone (EZ); propagation zone (PZ); and noninvolved zone (NIZ). The root mean square of the amplitudes was calculated to reconstruct effective connectivity network. We also analyzed the N1/N2 amplitudes to explore the responsiveness influenced by epileptogenicity. Prognostic analysis was performed by comparing intra-region and inter-region connectivity between seizure-free and non-seizure-free groups.

RESULTS

Our results confirmed that stimulation of the EZ caused the strongest responses on other sites within and outside the EZ. Moreover, we found a hierarchical connectivity pattern showing the highest connectivity strength within EZ, and decreasing connectivity gradient from EZ, PZ to NIZ. Prognostic analysis indicated a stronger intra-EZ connection in the seizure-free group.

CONCLUSION

The EZ showed highest excitability and dominantly influenced other regions. Quantitative CCEPs can be useful in mapping epileptic networks and predicting surgical outcome.

SIGNIFICANCE

The generated computational connectivity model may enhance our understanding of epileptogenic networks and provide useful information for surgical planning and prognosis prediction.

Dynamic Reorganization of the Cortical Functional Brain Network in Affective Processing and Cognitive Reappraisal

Emotion and affect play crucial roles in human life that can be disrupted by diseases. Functional brain networks need to dynamically reorganize within short time periods in order to efficiently process and respond to affective stimuli. Documenting these large-scale spatiotemporal dynamics on the same timescale they arise, however, presents a large technical challenge. In this study, the dynamic reorganization of the cortical functional brain network during an affective processing and emotion regulation task is documented using an advanced multi-model electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) technique. Sliding time window correlation and [Formula: see text]-means clustering are employed to explore the functional brain connectivity (FC) dynamics during the unaltered perception of neutral (moderate valence, low arousal) and negative (low valence, high arousal) stimuli and cognitive reappraisal of negative stimuli. Betweenness centralities are computed to identify central hubs within each complex network. Results from 20 healthy subjects indicate that the cortical mechanism for cognitive reappraisal follows a ‘top-down’ pattern that occurs across four brain network states that arise at different time instants (0–170[Formula: see text]ms, 170–370[Formula: see text]ms, 380–620[Formula: see text]ms, and 620–1000[Formula: see text]ms). Specifically, the dorsolateral prefrontal cortex (DLPFC) is identified as a central hub to promote the connectivity structures of various affective states and consequent regulatory efforts. This finding advances our current understanding of the cortical response networks of reappraisal-based emotion regulation by documenting the recruitment process of four functional brain sub-networks, each seemingly associated with different cognitive processes, and reveals the dynamic reorganization of functional brain networks during emotion regulation.

EEG Connectivity Analysis Using Denoising Autoencoders for the Detection of Dyslexia

The Temporal Sampling Framework (TSF) theorizes that the characteristic phonological difficulties of dyslexia are caused by an atypical oscillatory sampling at one or more temporal rates. The LEEDUCA study conducted a series of Electroencephalography (EEG) experiments on children listening to amplitude modulated (AM) noise with slow-rythmic prosodic (0.5-1[Formula: see text]Hz), syllabic (4-8[Formula: see text]Hz) or the phoneme (12-40[Formula: see text]Hz) rates, aimed at detecting differences in perception of oscillatory sampling that could be associated with dyslexia. The purpose of this work is to check whether these differences exist and how they are related to children's performance in different language and cognitive tasks commonly used to detect dyslexia. To this purpose, temporal and spectral inter-channel EEG connectivity was estimated, and a denoising autoencoder (DAE) was trained to learn a low-dimensional representation of the connectivity matrices. This representation was studied via correlation and classification analysis, which revealed ability in detecting dyslexic subjects with an accuracy higher than 0.8, and balanced accuracy around 0.7. Some features of the DAE representation were significantly correlated ([Formula: see text]) with children's performance in language and cognitive tasks of the phonological hypothesis category such as phonological awareness and rapid symbolic naming, as well as reading efficiency and reading comprehension. Finally, a deeper analysis of the adjacency matrix revealed a reduced bilateral connection between electrodes of the temporal lobe (roughly the primary auditory cortex) in DD subjects, as well as an increased connectivity of the F7 electrode, placed roughly on Broca's area. These results pave the way for a complementary assessment of dyslexia using more objective methodologies such as EEG.

Controllability of Networks of Multiple Coupled Neural Populations: An Analytical Method for Neuromodulation's Feasibility

Neuromodulation plays a vital role in the prevention and treatment of neurological and psychiatric disorders. Neuromodulation's feasibility is a long-standing issue because it provides the necessity for neuromodulation to realize the desired purpose. A controllability analysis of neural dynamics is necessary to ensure neuromodulation's feasibility. Here, we present such a theoretical method by using the concept of controllability from the control theory that neuromodulation's feasibility can be studied smoothly. Firstly, networks of multiple coupled neural populations with different topologies are established to mathematically model complicated neural dynamics. Secondly, an analytical method composed of a linearization method, the Kalman controllable rank condition and a controllability index is applied to analyze the controllability of the established network models. Finally, the relationship between network dynamics or topological characteristic parameters and controllability is studied by using the analytical method. The proposed method provides a new idea for the study of neuromodulation's feasibility, and the results are expected to guide us to better modulate neurodynamics by optimizing network dynamics and network topology.

Reorganization of Large-Scale Functional Networks During Low-Frequency Electrical Stimulation of the Cortical Surface

We investigated the functional network reorganization caused by low-frequency electrical stimulation (LFES) of human brain cortical surface. Intracranial EEG data from subdural grid positions were analyzed in 16 pre-surgery epileptic patients. LFES was performed by injecting current pulses (10[Formula: see text]mA, 0.2[Formula: see text]ms pulse width, 0.5[Formula: see text]Hz, 25 trials) into all adjacent electrode contacts. Dynamic functional connectivity analysis was carried out on two frequency bands (low: 1–4[Formula: see text]Hz; high: 10–40[Formula: see text]Hz) to investigate the early, high frequency and late, low frequency responses elicited by the stimulation. The centralization increased in early compared to late responses, suggesting a more prominent role of direct neural links between primarily activated areas and distant brain regions. Injecting the current into the seizure onset zone (SOZ) evoked a more integrated functional topology during the early (N1) period of the response, whereas during the late (N2) period — regardless of the stimulation site — the connectedness of the SOZ was elevated compared to the non-SOZ tissue. The abnormal behavior of the epileptic sub-network during both part of the responses supports the idea of the pathogenic role of impaired inhibition and excitation mechanisms in epilepsy.

Pathological responses to single-pulse electrical stimuli in epilepsy: The role of feedforward inhibition

Delineation of epileptogenic cortex in focal epilepsy patients may profit from single‐pulse electrical stimulation during intracranial EEG recordings. Single‐pulse electrical stimulation evokes early and delayed responses. Early responses represent connectivity. Delayed responses are a biomarker for epileptogenic cortex, but up till now, the precise mechanism generating delayed responses remains elusive. We used a data‐driven modelling approach to study early and delayed responses. We hypothesized that delayed responses represent indirect responses triggered by early response activity and investigated this for 11 patients. Using two coupled neural masses, we modelled early and delayed responses by combining simulations and bifurcation analysis. An important feature of the model is the inclusion of feedforward inhibitory connections. The waveform of early responses can be explained by feedforward inhibition. Delayed responses can be viewed as second‐order responses in the early response network which appear when input to a neural mass falls below a threshold forcing it temporarily to a spiking state. The combination of the threshold with noisy background input explains the typical stochastic appearance of delayed responses. The intrinsic excitability of a neural mass and the strength of its input influence the probability at which delayed responses to occur. Our work gives a theoretical basis for the use of delayed responses as a biomarker for the epileptogenic zone, confirming earlier clinical observations. The combination of early responses revealing effective connectivity, and delayed responses showing intrinsic excitability, makes single‐pulse electrical stimulation an interesting tool to obtain data for computational models of epilepsy surgery.

Multiplex Limited Penetrable Horizontal Visibility Graph from EEG Signals for Driver Fatigue Detection

Driver fatigue is an important contributor to road accidents, and driver fatigue detection has attracted a great deal of attention on account of its significant importance. Numerous methods have been proposed to fulfill this challenging task, though, the characterization of the fatigue mechanism still, to a large extent, remains to be investigated. To address this problem, we, in this work, develop a novel Multiplex Limited Penetrable Horizontal Visibility Graph (Multiplex LPHVG) method, which allows in not only detecting fatigue driving but also probing into the brain fatigue behavior. Importantly, we use the method to construct brain networks from EEG signals recorded from different subjects performing simulated driving tasks under alert and fatigue driving states. We then employ clustering coefficient, global efficiency and characteristic path length to characterize the topological structure of the networks generated from different brain states. In addition, we combine average edge overlap with the network measures to distinguish alert and mental fatigue states. The high-accurate classification results clearly demonstrate and validate the efficacy of our multiplex LPHVG method for the fatigue detection from EEG signals. Furthermore, our findings show a significant increase of the clustering coefficient as the brain evolves from alert state to mental fatigue state, which yields novel insights into the brain behavior associated with fatigue driving.