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Cappotto D, Luo D, Lai HW, Peng F, Melloni L, Schnupp JWH, Auksztulewicz R. "What" and "when" predictions modulate auditory processing in a mutually congruent manner. Front Neurosci 2023; 17:1180066. [PMID: 37781257 PMCID: PMC10540699 DOI: 10.3389/fnins.2023.1180066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 08/04/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Extracting regularities from ongoing stimulus streams to form predictions is crucial for adaptive behavior. Such regularities exist in terms of the content of the stimuli and their timing, both of which are known to interactively modulate sensory processing. In real-world stimulus streams such as music, regularities can occur at multiple levels, both in terms of contents (e.g., predictions relating to individual notes vs. their more complex groups) and timing (e.g., pertaining to timing between intervals vs. the overall beat of a musical phrase). However, it is unknown whether the brain integrates predictions in a manner that is mutually congruent (e.g., if "beat" timing predictions selectively interact with "what" predictions falling on pulses which define the beat), and whether integrating predictions in different timing conditions relies on dissociable neural correlates. Methods To address these questions, our study manipulated "what" and "when" predictions at different levels - (local) interval-defining and (global) beat-defining - within the same stimulus stream, while neural activity was recorded using electroencephalogram (EEG) in participants (N = 20) performing a repetition detection task. Results Our results reveal that temporal predictions based on beat or interval timing modulated mismatch responses to violations of "what" predictions happening at the predicted time points, and that these modulations were shared between types of temporal predictions in terms of the spatiotemporal distribution of EEG signals. Effective connectivity analysis using dynamic causal modeling showed that the integration of "what" and "when" predictions selectively increased connectivity at relatively late cortical processing stages, between the superior temporal gyrus and the fronto-parietal network. Discussion Taken together, these results suggest that the brain integrates different predictions with a high degree of mutual congruence, but in a shared and distributed cortical network. This finding contrasts with recent studies indicating separable mechanisms for beat-based and memory-based predictive processing.
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Affiliation(s)
- Drew Cappotto
- Department of Neuroscience, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Ear Institute, University College London, London, United Kingdom
| | - Dan Luo
- Department of Neuroscience, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Hiu Wai Lai
- Department of Neuroscience, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Fei Peng
- Department of Neuroscience, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Lucia Melloni
- Department of Neuroscience, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | | | - Ryszard Auksztulewicz
- Department of Neuroscience, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Neuroscience, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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Beamforming Seizures from the Temporal Lobe Using Magnetoencephalography. Can J Neurol Sci 2023; 50:201-213. [PMID: 35022091 DOI: 10.1017/cjn.2022.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Surgical treatment of drug-resistant temporal lobe epilepsy (TLE) depends on proper identification of the seizure onset zone (SOZ) and differentiation of mesial, temporolimbic seizure onsets from temporal neocortical seizure onsets. Noninvasive source imaging using electroencephalography (EEG) and magnetoencephalography (MEG) can provide accurate information on interictal spike localization; however, EEG and MEG have low sensitivity for epileptiform activity restricted to deep temporolimbic structures. Moreover, in mesial temporal lobe epilepsy (MTLE), interictal spikes frequently arise in neocortical foci distant from the SOZ, rendering interictal spike localization potentially misleading for presurgical planning. METHODS In this study, we used two different beamformer techniques applied to the MEG signal of ictal events acquired during EEG-MEG recordings in six patients with TLE (three neocortical, three MTLE) in whom the ictal source localization results could be compared to ground truth SOZ localizations determined from intracranial EEG and/or clinical, neuroimaging, and postsurgical outcome evidence. RESULTS Beamformer analysis proved to be highly accurate in all cases and was able to identify focal SOZs in mesial, temporolimbic structures. In three patients, interictal spikes were absent, too complex for dipole modeling, or localized to anterolateral temporal neocortex distant to a mesial temporal SOZ, and thus unhelpful in presurgical investigation. CONCLUSIONS MEG beamformer source reconstruction is suitable for analysis of ictal events in TLE and can complement or supersede the traditional analysis of interictal spikes. The method outlined is applicable to any type of epileptiform event, expanding the information value of MEG and broadening its utility for presurgical recording in epilepsy.
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van den Berg B, Manoochehri M, Schouten AC, van der Helm FCT, Buitenweg JR. Nociceptive Intra-epidermal Electric Stimulation Evokes Steady-State Responses in the Secondary Somatosensory Cortex. Brain Topogr 2022; 35:169-181. [PMID: 35050427 PMCID: PMC8860817 DOI: 10.1007/s10548-022-00888-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
Recent studies have established the presence of nociceptive steady-state evoked potentials (SSEPs), generated in response to thermal or intra-epidermal electric stimuli. This study explores cortical sources and generation mechanisms of nociceptive SSEPs in response to intra-epidermal electric stimuli. Our method was to stimulate healthy volunteers (n = 22, all men) with 100 intra-epidermal pulse sequences. Each sequence had a duration of 8.5 s, and consisted of pulses with a pulse rate between 20 and 200 Hz, which was frequency modulated with a multisine waveform of 3, 7 and 13 Hz (n = 10, 1 excluded) or 3 and 7 Hz (n = 12, 1 excluded). As a result, evoked potentials in response to stimulation onset and contralateral SSEPs at 3 and 7 Hz were observed. The SSEPs at 3 and 7 Hz had an average time delay of 137 ms and 143 ms respectively. The evoked potential in response to stimulation onset had a contralateral minimum (N1) at 115 ms and a central maximum (P2) at 300 ms. Sources for the multisine SSEP at 3 and 7 Hz were found through beamforming near the primary and secondary somatosensory cortex. Sources for the N1 were found near the primary and secondary somatosensory cortex. Sources for the N2-P2 were found near the supplementary motor area. Harmonic and intermodulation frequencies in the SSEP power spectrum remained below a detectable level and no evidence for nonlinearity of nociceptive processing, i.e. processing of peripheral firing rate into cortical evoked potentials, was found.
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Affiliation(s)
- Boudewijn van den Berg
- Biomedical Signals and Systems, Technical Medical Centre, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
| | - Mana Manoochehri
- Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Alfred C Schouten
- Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Biomechanical Engineering, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Frans C T van der Helm
- Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Jan R Buitenweg
- Biomedical Signals and Systems, Technical Medical Centre, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands
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Duecker K, Gutteling TP, Herrmann CS, Jensen O. No Evidence for Entrainment: Endogenous Gamma Oscillations and Rhythmic Flicker Responses Coexist in Visual Cortex. J Neurosci 2021; 41:6684-6698. [PMID: 34230106 PMCID: PMC8336697 DOI: 10.1523/jneurosci.3134-20.2021] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/25/2021] [Accepted: 06/13/2021] [Indexed: 12/02/2022] Open
Abstract
Over the past decades, numerous studies have linked cortical gamma oscillations (∼30-100 Hz) to neurocomputational mechanisms. Their functional relevance, however, is still passionately debated. Here, we asked whether endogenous gamma oscillations in the human brain can be entrained by a rhythmic photic drive >50 Hz. Such a noninvasive modulation of endogenous brain rhythms would allow conclusions about their causal involvement in neurocognition. To this end, we systematically investigated oscillatory responses to a rapid sinusoidal flicker in the absence and presence of endogenous gamma oscillations using magnetoencephalography (MEG) in combination with a high-frequency projector. The photic drive produced a robust response over visual cortex to stimulation frequencies of up to 80 Hz. Strong, endogenous gamma oscillations were induced using moving grating stimuli as repeatedly done in previous research. When superimposing the flicker and the gratings, there was no evidence for phase or frequency entrainment of the endogenous gamma oscillations by the photic drive. Unexpectedly, we did not observe an amplification of the flicker response around participants' individual gamma frequencies (IGFs); rather, the magnitude of the response decreased monotonically with increasing frequency. Source reconstruction suggests that the flicker response and the gamma oscillations were produced by separate, coexistent generators in visual cortex. The presented findings challenge the notion that cortical gamma oscillations can be entrained by rhythmic visual stimulation. Instead, the mechanism generating endogenous gamma oscillations seems to be resilient to external perturbation.SIGNIFICANCE STATEMENT We aimed to investigate to what extent ongoing, high-frequency oscillations in the gamma-band (30-100 Hz) in the human brain can be entrained by a visual flicker. Gamma oscillations have long been suggested to coordinate neuronal firing and enable interregional communication. Our results demonstrate that rhythmic visual stimulation cannot hijack the dynamics of ongoing gamma oscillations; rather, the flicker response and the endogenous gamma oscillations coexist in different visual areas. Therefore, while a visual flicker evokes a strong neuronal response even at high frequencies in the gamma-band, it does not entrain endogenous gamma oscillations in visual cortex. This has important implications for interpreting studies investigating the causal and neuroprotective effects of rhythmic sensory stimulation in the gamma-band.
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Affiliation(s)
- Katharina Duecker
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2SA, United Kingdom
| | - Tjerk P Gutteling
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2SA, United Kingdom
| | - Christoph S Herrmann
- Department of Psychology, Faculty VI-Medicine and Health Sciences, Carl-von-Ossietzky University of Oldenburg, Oldenburg 26129, Germany
| | - Ole Jensen
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2SA, United Kingdom
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Luria G, Duran D, Visani E, Sommariva S, Rotondi F, Rossi Sebastiano D, Panzica F, Piana M, Sorrentino A. Bayesian multi-dipole modelling in the frequency domain. J Neurosci Methods 2019; 312:27-36. [PMID: 30452978 DOI: 10.1016/j.jneumeth.2018.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/18/2018] [Accepted: 11/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Magneto- and Electro-encephalography record the electromagnetic field generated by neural currents with high temporal frequency and good spatial resolution, and are therefore well suited for source localization in the time and in the frequency domain. In particular, localization of the generators of neural oscillations is very important in the study of cognitive processes in the healthy and in the pathological brain. NEW METHOD We introduce the use of a Bayesian multi-dipole localization method in the frequency domain. Given the Fourier Transform of the data at one or multiple frequencies and/or trials, the algorithm approximates numerically the posterior distribution with Monte Carlo techniques. RESULTS We use synthetic data to show that the proposed method behaves well under a wide range of experimental conditions, including low signal-to-noise ratios and correlated sources. We use dipole clusters to mimic the effect of extended sources. In addition, we test the algorithm on real MEG data to confirm its feasibility. COMPARISON WITH EXISTING METHOD(S) Throughout the whole study, DICS (Dynamic Imaging of Coherent Sources) is used systematically as a benchmark. The two methods provide similar general pictures; the posterior distributions of the Bayesian approach contain much richer information at the price of a higher computational cost. CONCLUSIONS The Bayesian method described in this paper represents a reliable approach for localization of multiple dipoles in the frequency domain.
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Affiliation(s)
| | - Dunja Duran
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Elisa Visani
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Sara Sommariva
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Fabio Rotondi
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Davide Rossi Sebastiano
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Ferruccio Panzica
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Michele Piana
- Department of Mathematics, University of Genoa, Genoa, Italy; CNR - SPIN, Genoa, Italy
| | - Alberto Sorrentino
- Department of Mathematics, University of Genoa, Genoa, Italy; CNR - SPIN, Genoa, Italy.
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Gohel B, Lim S, Kim MY, Kwon H, Kim K. Dynamic pattern decoding of source-reconstructed MEG or EEG data: Perspective of multivariate pattern analysis and signal leakage. Comput Biol Med 2018; 93:106-116. [DOI: 10.1016/j.compbiomed.2017.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 11/30/2022]
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Code-modulated visual evoked potentials using fast stimulus presentation and spatiotemporal beamformer decoding. Sci Rep 2017; 7:15037. [PMID: 29118386 PMCID: PMC5678079 DOI: 10.1038/s41598-017-15373-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 10/26/2017] [Indexed: 11/15/2022] Open
Abstract
When encoding visual targets using various lagged versions of a pseudorandom binary sequence of luminance changes, the EEG signal recorded over the viewer’s occipital pole exhibits so-called code-modulated visual evoked potentials (cVEPs), the phase lags of which can be tied to these targets. The cVEP paradigm has enjoyed interest in the brain-computer interfacing (BCI) community for the reported high information transfer rates (ITR, in bits/min). In this study, we introduce a novel decoding algorithm based on spatiotemporal beamforming, and show that this algorithm is able to accurately identify the gazed target. Especially for a small number of repetitions of the coding sequence, our beamforming approach significantly outperforms an optimised support vector machine (SVM)-based classifier, which is considered state-of-the-art in cVEP-based BCI. In addition to the traditional 60 Hz stimulus presentation rate for the coding sequence, we also explore the 120 Hz rate, and show that the latter enables faster communication, with a maximal median ITR of 172.87 bits/min. Finally, we also report on a transition effect in the EEG signal following the onset of the stimulus sequence, and recommend to exclude the first 150 ms of the trials from decoding when relying on a single presentation of the stimulus sequence.
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Moratti S, Méndez-Bértolo C, Del-Pozo F, Strange BA. Dynamic gamma frequency feedback coupling between higher and lower order visual cortices underlies perceptual completion in humans. Neuroimage 2013; 86:470-9. [PMID: 24185019 DOI: 10.1016/j.neuroimage.2013.10.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/29/2013] [Accepted: 10/18/2013] [Indexed: 11/29/2022] Open
Abstract
To perceive a coherent environment, incomplete or overlapping visual forms must be integrated into meaningful coherent percepts, a process referred to as "Gestalt" formation or perceptual completion. Increasing evidence suggests that this process engages oscillatory neuronal activity in a distributed neuronal assembly. A separate line of evidence suggests that Gestalt formation requires top-down feedback from higher order brain regions to early visual cortex. Here we combine magnetoencephalography (MEG) and effective connectivity analysis in the frequency domain to specifically address the effective coupling between sources of oscillatory brain activity during Gestalt formation. We demonstrate that perceptual completion of two-tone "Mooney" faces induces increased gamma frequency band power (55-71Hz) in human early visual, fusiform and parietal cortices. Within this distributed neuronal assembly fusiform and parietal gamma oscillators are coupled by forward and backward connectivity during Mooney face perception, indicating reciprocal influences of gamma activity between these higher order visual brain regions. Critically, gamma band oscillations in early visual cortex are modulated by top-down feedback connectivity from both fusiform and parietal cortices. Thus, we provide a mechanistic account of Gestalt perception in which gamma oscillations in feature sensitive and spatial attention-relevant brain regions reciprocally drive one another and convey global stimulus aspects to local processing units at low levels of the sensory hierarchy by top-down feedback. Our data therefore support the notion of inverse hierarchical processing within the visual system underlying awareness of coherent percepts.
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Affiliation(s)
- S Moratti
- Department of Basic Psychology I, Complutense University of Madrid (UCM), 28223 Pozuelo de Alarcón, Madrid, Spain; Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Technical University of Madrid (UPM), Campus Montegancedo, 28223 Pozuelo de Alarcón, Madrid, Spain.
| | - C Méndez-Bértolo
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Technical University of Madrid (UPM), Campus Montegancedo, 28223 Pozuelo de Alarcón, Madrid, Spain; CEI Campus Moncloa, UCM-UPM, Avenida Complutense s/n, 28040 Madrid, Spain
| | - F Del-Pozo
- Laboratory for Cognitive and Computational Neuroscience, Centre for Biomedical Technology, Technical University of Madrid (UPM), Campus Montegancedo, 28223 Pozuelo de Alarcón, Madrid, Spain
| | - B A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Technical University of Madrid (UPM), Campus Montegancedo, 28223 Pozuelo de Alarcón, Madrid, Spain
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Murzin V, Fuchs A, Scott Kelso JA. Detection of correlated sources in EEG using combination of beamforming and surface Laplacian methods. J Neurosci Methods 2013; 218:96-102. [PMID: 23769770 DOI: 10.1016/j.jneumeth.2013.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/28/2013] [Accepted: 05/06/2013] [Indexed: 11/19/2022]
Abstract
Beamforming offers a way to estimate the solution to the inverse problem in EEG and MEG but is also known to perform poorly in the presence of highly correlated sources, e.g. during binaural auditory stimulation, when both left and right primary auditory cortices are activated simultaneously. Surface Laplacian, or the second spatial derivative calculated from the electric potential, allows for deblurring of EEG potential recordings reducing the effects of low skull conductivity and is independent of the reference electrode location. We show that anatomically constrained beamforming in conjunction with the surface Laplacian allows for detection of both locations and dynamics of temporally correlated sources in EEG. Whole-head 122 channel binaural stimulus EEG data were simulated using a boundary element method (BEM) and realistic geometry forward model. We demonstrate that in contrast to conventional potential-based EEG beamforming, Laplacian beamforming allows to determine locations of correlated source dipoles without any a priori assumption about the number of sources. We also show (by providing simulations of auditory evoked potentials) that the dynamics at the detected source locations can be derived from subsets of electrodes. Deblurring auditory evoked potential maps subdivides EEG signals from each hemisphere and allows for the beamformer to be applied separately for left and right hemispheres.
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Affiliation(s)
- Vyacheslav Murzin
- Florida Atlantic University, Center for Complex Systems and Brain Sciences, Boca Raton, FL, USA.
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Rose DF, Fujiwara H, Holland-Bouley K, Greiner HM, Arthur T, Mangano FT. Focal Peak Activities in Spread of Interictal-Ictal Discharges in Epilepsy with Beamformer MEG: Evidence for an Epileptic Network? Front Neurol 2013; 4:56. [PMID: 23675367 PMCID: PMC3653127 DOI: 10.3389/fneur.2013.00056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/30/2013] [Indexed: 11/17/2022] Open
Abstract
Non-invasive studies to predict regions of seizure onset are important for planning intracranial grid locations for invasive cortical recordings prior to resective surgery for patients with medically intractable epilepsy. The neurosurgeon needs to know both the seizure onset zone (SOZ) and the region of immediate cortical spread to determine the epileptogenic zone to be resected. The immediate zone of spread may be immediately adjacent, on a nearby gyrus, in a different lobe, and sometimes even in the contralateral cerebral hemisphere. We reviewed consecutive simultaneous EEG/MEG recordings on 162 children with medically intractable epilepsy. We analyzed the MEG signals in the bandwidth 20-70 Hz with a beamformer algorithm, synthetic aperture magnetometry, at a 2.5 mm voxel spacing throughout the brain (virtual sensor locations, VSLs) with the kurtosis statistic (g 2) to determine presence of excess kurtosis (γ2) consistent with intermittent increased high frequency spikiness of the background. The MEG time series was reconstructed (virtual sensor signals) at each of these VSLs. The VS signals were further examined with a relative peak amplitude spike detection algorithm. The time of VS spike detection was compared to the simultaneous EEG and MEG sensor signals for presence of conventional epileptiform spike morphology in the latter signals. The time of VS spike detection was compared across VSLs to determine earliest and last VSL to show a VS spike. Seven subjects showed delay in activation across VS locations detectable on visual examination. We compared the VS locations that showed earliest and later VS spikes with the locations on intracranial grid locations by electrocorticography (ECoG) that showed spikes and both onset and spread of seizures. We compared completeness of resection of VS locations to postoperative outcome. The VS locations for spike onset and spread were similar to locations for ictal onset and spread by ECoG.
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Affiliation(s)
- Douglas F. Rose
- Division of Neurology, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterCincinnati, OH, USA
| | - Hisako Fujiwara
- Division of Neurology, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterCincinnati, OH, USA
| | - Katherine Holland-Bouley
- Division of Neurology, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterCincinnati, OH, USA
| | - Hansel M. Greiner
- Division of Neurology, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterCincinnati, OH, USA
| | - Todd Arthur
- Division of Neurology, Department of Pediatrics, Cincinnati Children’s Hospital Medical CenterCincinnati, OH, USA
| | - Francesco T. Mangano
- Division of Neurosurgery, Department of Neurosurgery, Cincinnati Children’s Hospital Medical CenterCincinnati, OH, USA
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