Characterization of antiseizure medications effects on the EEG neurodynamic by fractal dimension

Objectives

An important challenge in epilepsy is to define biomarkers of response to treatment. Many electroencephalography (EEG) methods and indices have been developed mainly using linear methods, e.g., spectral power and individual alpha frequency peak (IAF). However, brain activity is complex and non-linear, hence there is a need to explore EEG neurodynamics using nonlinear approaches. Here, we use the Fractal Dimension (FD), a measure of whole brain signal complexity, to measure the response to anti-seizure therapy in patients with Focal Epilepsy (FE) and compare it with linear methods.

Materials

Twenty-five drug-responder (DR) patients with focal epilepsy were studied before (t1, named DR-t1) and after (t2, named DR-t2) the introduction of the anti-seizure medications (ASMs). DR-t1 and DR-t2 EEG results were compared against 40 age-matched healthy controls (HC).

Methods

EEG data were investigated from two different angles: frequency domain-spectral properties in δ, θ, α, β, and γ bands and the IAF peak, and time-domain-FD as a signature of the nonlinear complexity of the EEG signals. Those features were compared among the three groups.

Results

The δ power differed between DR patients pre and post-ASM and HC (DR-t1 vs. HC, p < 0.01 and DR-t2 vs. HC, p < 0.01). The θ power differed between DR-t1 and DR-t2 (p = 0.015) and between DR-t1 and HC (p = 0.01). The α power, similar to the δ, differed between DR patients pre and post-ASM and HC (DR-t1 vs. HC, p < 0.01 and DR-t2 vs. HC, p < 0.01). The IAF value was lower for DR-t1 than DR-t2 (p = 0.048) and HC (p = 0.042). The FD value was lower in DR-t1 than in DR-t2 (p = 0.015) and HC (p = 0.011). Finally, Bayes Factor analysis showed that FD was 195 times more likely to separate DR-t1 from DR-t2 than IAF and 231 times than θ.

Discussion

FD measured in baseline EEG signals is a non-linear brain measure of complexity more sensitive than EEG power or IAF in detecting a response to ASMs. This likely reflects the non-oscillatory nature of neural activity, which FD better describes.

Conclusion

Our work suggests that FD is a promising measure to monitor the response to ASMs in FE.

Mindfulness meditation styles differently modulate source-level MEG microstate dynamics and complexity

Background

The investigation of mindfulness meditation practice, classically divided into focused attention meditation (FAM), and open monitoring meditation (OMM) styles, has seen a long tradition of theoretical, affective, neurophysiological and clinical studies. In particular, the high temporal resolution of magnetoencephalography (MEG) or electroencephalography (EEG) has been exploited to fill the gap between the personal experience of meditation practice and its neural correlates. Mounting evidence, in fact, shows that human brain activity is highly dynamic, transiting between different brain states (microstates). In this study, we aimed at exploring MEG microstates at source-level during FAM, OMM and in the resting state, as well as the complexity and criticality of dynamic transitions between microstates.

Methods

Ten right-handed Theravada Buddhist monks with a meditative expertise of minimum 2,265 h participated in the experiment. MEG data were acquired during a randomized block design task (6 min FAM, 6 min OMM, with each meditative block preceded and followed by 3 min resting state). Source reconstruction was performed using eLORETA on individual cortical space, and then parcellated according to the Human Connect Project atlas. Microstate analysis was then applied to parcel level signals in order to derive microstate topographies and indices. In addition, from microstate sequences, the Hurst exponent and the Lempel-Ziv complexity (LZC) were computed.

Results

Our results show that the coverage and occurrence of specific microstates are modulated either by being in a meditative state or by performing a specific meditation style. Hurst exponent values in both meditation conditions are reduced with respect to the value observed during rest, LZC shows significant differences between OMM, FAM, and REST, with a progressive increase from REST to FAM to OMM.

Discussion

Importantly, we report changes in brain criticality indices during meditation and between meditation styles, in line with a state-like effect of meditation on cognitive performance. In line with previous reports, we suggest that the change in cognitive state experienced in meditation is paralleled by a shift with respect to critical points in brain dynamics.

Brain Dynamics Complexity as a Signature of Cognitive Decline in Parkinson's Disease

BACKGROUND

Higuchi's fractal dimension (FD) captures brain dynamics complexity and may be a promising method to analyze resting-state functional magnetic resonance imaging (fMRI) data and detect the neuronal interaction complexity underlying Parkinson's disease (PD) cognitive decline.

OBJECTIVES

The aim was to compare FD with a more established index of spontaneous neural activity, the fractional amplitude of low-frequency fluctuations (fALFF), and identify through machine learning (ML) models which method could best distinguish across PD-cognitive states, ranging from normal cognition (PD-NC), mild cognitive impairment (PD-MCI) to dementia (PDD). Finally, the aim was to explore correlations between fALFF and FD with clinical and cognitive PD features.

METHODS

Among 118 PD patients age-, sex-, and education matched with 35 healthy controls, 52 were classified with PD-NC, 46 with PD-MCI, and 20 with PDD based on an extensive cognitive and clinical evaluation. fALFF and FD metrics were computed on rs-fMRI data and used to train ML models.

RESULTS

FD outperformed fALFF metrics in differentiating between PD-cognitive states, reaching an overall accuracy of 78% (vs. 62%). PD showed increased neuronal dynamics complexity within the sensorimotor network, central executive network (CEN), and default mode network (DMN), paralleled by a reduction in spontaneous neuronal activity within the CEN and DMN, whose increased complexity was strongly linked to the presence of dementia. Further, we found that some DMN critical hubs correlated with worse cognitive performance and disease severity.

CONCLUSIONS

Our study indicates that PD-cognitive decline is characterized by an altered spontaneous neuronal activity and increased temporal complexity, involving the CEN and DMN, possibly reflecting an increased segregation of these networks. Therefore, we propose FD as a prognostic biomarker of PD-cognitive decline. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Fractal Dimension as a discriminative feature for high accuracy classification in motor imagery EEG-based brain-computer interface

BACKGROUND AND OBJECTIVE

The brain-computer interface (BCI) technology acquires human brain electrical signals, which can be effectively and successfully used to control external devices, potentially supporting subjects suffering from motor impairments in the interaction with the environment. To this aim, BCI systems must correctly decode and interpret neurophysiological signals reflecting the intention of the subjects to move. Therefore, the accurate classification of single events in motor tasks represents a fundamental challenge in ensuring efficient communication and control between users and BCIs. Movement-associated changes in electroencephalographic (EEG) sensorimotor rhythms, such as event-related desynchronization (ERD), are well-known features of discriminating motor tasks. Fractal dimension (FD) can be used to evaluate the complexity and self-similarity in brain signals, potentially providing complementary information to frequency-based signal features.

METHODS

In the present work, we introduce FD as a novel feature for subject-independent event classification, and we test several machine learning (ML) models in behavioural tasks of motor imagery (MI) and motor execution (ME).

RESULTS

Our results show that FD improves the classification accuracy of ML compared to ERD. Furthermore, unilateral hand movements have higher classification accuracy than bilateral movements in both MI and ME tasks.

CONCLUSIONS

These results provide further insights into subject-independent event classification in BCI systems and demonstrate the potential of FD as a discriminative feature for EEG signals.

Fractal Time Series: Background, Estimation Methods, and Performances

Over the past 40 years, from its classical application in the characterization of geometrical objects, fractal analysis has been progressively applied to study time series in several different disciplines. In neuroscience, starting from identifying the fractal properties of neuronal and brain architecture, attention has shifted to evaluating brain signals in the time domain. Classical linear methods applied to analyzing neurophysiological signals can lead to classifying irregular components as noise, with a potential loss of information. Thus, characterizing fractal properties, namely, self-similarity, scale invariance, and fractal dimension (FD), can provide relevant information on these signals in physiological and pathological conditions. Several methods have been proposed to estimate the fractal properties of these neurophysiological signals. However, the effects of signal characteristics (e.g., its stationarity) and other signal parameters, such as sampling frequency, amplitude, and noise level, have partially been tested. In this chapter, we first outline the main properties of fractals in the domain of space (fractal geometry) and time (fractal time series). Then, after providing an overview of the available methods to estimate the FD, we test them on synthetic time series (STS) with different sampling frequencies, signal amplitudes, and noise levels. Finally, we describe and discuss the performances of each method and the effect of signal parameters on the accuracy of FD estimation.

EEG fractal dimensions predict high-level behavioral responses in minimally conscious patients

Objective.Brain-injured patients may enter a state of minimal or inconsistent awareness termed minimally conscious state (MCS). Such patient may (MCS+) or may not (MCS-) exhibit high-level behavioral responses, and the two groups retain two inherently different rehabilitative paths and expected outcomes. We hypothesized that brain complexity may be treated as a proxy of high-level cognition and thus could be used as a neural correlate of consciousness.Approach.In this prospective observational study, 68 MCS patients (MCS-: 30; women: 31) were included (median [IQR] age 69 [20]; time post-onset 83 [28]). At admission to intensive rehabilitation, 30 min resting-state closed-eyes recordings were performed together with consciousness diagnosis following international guidelines. The width of the multifractal singularity spectrum (MSS) was computed for each channel time series and entered nested cross-validated interpretable machine learning models targeting the differential diagnosis of MCS±.Main results.Frontal MSS widths (p< 0.05), as well as the ones deriving from the left centro-temporal network (C3:p= 0.018, T3:p= 0.017; T5:p= 0.003) were found to be significantly higher in the MCS+ cohort. The best performing solution was found to be the K-nearest neighbor model with an aggregated test accuracy of 75.5% (median [IQR] AuROC for 100 executions 0.88 [0.02]). Coherently, the electrodes with highest Shapley values were found to be Fz and Cz, with four out the first five ranked features belonging to the fronto-central network.Significance.MCS+ is a frequent condition associated with a notably better prognosis than the MCS-. High fractality in the left centro-temporal network results coherent with neurological networks involved in the language function, proper of MCS+ patients. Using EEG-based interpretable algorithm to complement differential diagnosis of consciousness may improve rehabilitation pathways and communications with caregivers.

Nonlinear and machine learning analyses on high-density EEG data of math experts and novices

Current trend in neurosciences is to use naturalistic stimuli, such as cinema, class-room biology or video gaming, aiming to understand the brain functions during ecologically valid conditions. Naturalistic stimuli recruit complex and overlapping cognitive, emotional and sensory brain processes. Brain oscillations form underlying mechanisms for such processes, and further, these processes can be modified by expertise. Human cortical functions are often analyzed with linear methods despite brain as a biological system is highly nonlinear. This study applies a relatively robust nonlinear method, Higuchi fractal dimension (HFD), to classify cortical functions of math experts and novices when they solve long and complex math demonstrations in an EEG laboratory. Brain imaging data, which is collected over a long time span during naturalistic stimuli, enables the application of data-driven analyses. Therefore, we also explore the neural signature of math expertise with machine learning algorithms. There is a need for novel methodologies in analyzing naturalistic data because formulation of theories of the brain functions in the real world based on reductionist and simplified study designs is both challenging and questionable. Data-driven intelligent approaches may be helpful in developing and testing new theories on complex brain functions. Our results clarify the different neural signature, analyzed by HFD, of math experts and novices during complex math and suggest machine learning as a promising data-driven approach to understand the brain processes in expertise and mathematical cognition.

Opioid-induced short-term consciousness improvement in patients with disorders of consciousness

Introduction

Effective treatment to facilitate recovery from prolonged disorders of consciousness is a complex topic for the medical community. In clinical practice, we have found that a subset of patients has a short-term improvement of consciousness after general anesthesia.

Methods

To determine the clinical factors responsible for the consciousness improvement, we enrolled 50 patients with disorders of consciousness who underwent surgery from October 2021 to June 2022. Their states of consciousness were evaluated before surgery, within 48 h after surgery, and 3 months after surgery. Clinical-related factors and intraoperative anesthetic drug doses were collected and compared between patients with and without consciousness improvement. Independent associations between selected factors and postoperative improvement were assessed using multivariate logistical regression analyses.

Results

Postoperative short-term consciousness improvement was found in 44% (22/50) of patients, with significantly increased scores of auditory and visual subscales. Patients with traumatic etiology, a preoperative diagnosis of minimally conscious state, and higher scores in the auditory, visual, and motor subscales were more likely to have postoperative improvement. This short-term increase in consciousness after surgery correlated with patients' abilities to communicate in the long term. Furthermore, the amount of opioid analgesic used was significantly different between the improved and non-improved groups. Finally, analgesic dose, etiology, and preoperative diagnosis were independently associated with postoperative consciousness improvement.

Discussion

In conclusion, postoperative consciousness improvement is related to the residual consciousness of the patient and can be used to evaluate prognosis. Administration of opioids may be responsible for this short-term improvement in consciousness, providing a potential therapeutic approach for disorders of consciousness.