1
|
Kalva P, Kanja K, Metzger BA, Fan X, Cui B, Pascuzzi B, Magnotti J, Mocchi M, Mathura R, Bijanki KR. Psychometric Properties of a Novel Affective Bias Task and its Application in Clinical and Non-Clinical Populations. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00192-7. [PMID: 39032695 DOI: 10.1016/j.bpsc.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/25/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
To mitigate limitations in self-reported mood assessments, we introduce a novel affective bias task (ABT). The task quantifies instantaneous emotional state by leveraging the phenomenon of affective bias, in which people interpret external emotional stimuli in a manner consistent with their current emotional state. This study establishes task stability in measuring and tracking depressive symptoms in clinical and non-clinical populations. Initial assessment in a large non-clinical sample established normative ratings. Depressive symptoms were tracked relative to task performance in a non-clinical sample, as well as in a clinical cohort undergoing surgical evaluation for severe epilepsy. In both cohorts, a stronger negative affective bias was associated with higher Beck Depression Inventory (BDI-II) scores. The ABT exhibits high stability and interrater reliability, as well as construct validity in predicting depression levels in both cohorts, suggesting the task as a reliable proxy for mood and a diagnostic tool for detecting depressive symptoms.
Collapse
Affiliation(s)
- Prathik Kalva
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030
| | - Kourtney Kanja
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030
| | - Brian A Metzger
- Department of Psychology, Swarthmore College, Swarthmore, Pennsylvania, USA 19081
| | - Xiaoxu Fan
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030
| | - Brian Cui
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030
| | - Bailey Pascuzzi
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030
| | - John Magnotti
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA, 19104
| | - Madaline Mocchi
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030
| | - Raissa Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030
| | - Kelly R Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA 77030; Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA 77030.
| |
Collapse
|
2
|
Xiao J, Adkinson JA, Allawala AB, Banks G, Bartoli E, Fan X, Mocchi M, Pascuzzi B, Pulapaka S, Franch MC, Mathew SJ, Mathura RK, Myers J, Pirtle V, Provenza NR, Shofty B, Watrous AJ, Pitkow X, Goodman WK, Pouratian N, Sheth S, Bijanki KR, Hayden BY. Insula uses overlapping codes for emotion in self and others. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.04.596966. [PMID: 38895233 PMCID: PMC11185604 DOI: 10.1101/2024.06.04.596966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
In daily life, we must recognize others' emotions so we can respond appropriately. This ability may rely, at least in part, on neural responses similar to those associated with our own emotions. We hypothesized that the insula, a cortical region near the junction of the temporal, parietal, and frontal lobes, may play a key role in this process. We recorded local field potential (LFP) activity in human neurosurgical patients performing two tasks, one focused on identifying their own emotional response and one on identifying facial emotional responses in others. We found matching patterns of gamma- and high-gamma band activity for the two tasks in the insula. Three other regions (MTL, ACC, and OFC) clearly encoded both self- and other-emotions, but used orthogonal activity patterns to do so. These results support the hypothesis that the insula plays a particularly important role in mediating between experienced vs. observed emotions.
Collapse
Affiliation(s)
- Jiayang Xiao
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Joshua A. Adkinson
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | | | - Garrett Banks
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Eleonora Bartoli
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Xiaoxu Fan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Madaline Mocchi
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Bailey Pascuzzi
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Suhruthaa Pulapaka
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Melissa C. Franch
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Sanjay J. Mathew
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, 77030
| | - Raissa K. Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - John Myers
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Victoria Pirtle
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Nicole R Provenza
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Ben Shofty
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Andrew J. Watrous
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Xaq Pitkow
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Wayne K. Goodman
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, 77030
| | - Nader Pouratian
- Department of Neurosurgery, University of Texas Southwestern, Dallas, TX, 75390
| | - Sameer Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Kelly R. Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| | - Benjamin Y. Hayden
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030
| |
Collapse
|
3
|
de Zwart B, Ruis C. An update on tests used for intraoperative monitoring of cognition during awake craniotomy. Acta Neurochir (Wien) 2024; 166:204. [PMID: 38713405 PMCID: PMC11076349 DOI: 10.1007/s00701-024-06062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Mapping higher-order cognitive functions during awake brain surgery is important for cognitive preservation which is related to postoperative quality of life. A systematic review from 2018 about neuropsychological tests used during awake craniotomy made clear that until 2017 language was most often monitored and that the other cognitive domains were underexposed (Ruis, J Clin Exp Neuropsychol 40(10):1081-1104, 218). The field of awake craniotomy and cognitive monitoring is however developing rapidly. The aim of the current review is therefore, to investigate whether there is a change in the field towards incorporation of new tests and more complete mapping of (higher-order) cognitive functions. METHODS We replicated the systematic search of the study from 2018 in PubMed and Embase from February 2017 to November 2023, yielding 5130 potentially relevant articles. We used the artificial machine learning tool ASReview for screening and included 272 papers that gave a detailed description of the neuropsychological tests used during awake craniotomy. RESULTS Comparable to the previous study of 2018, the majority of studies (90.4%) reported tests for assessing language functions (Ruis, J Clin Exp Neuropsychol 40(10):1081-1104, 218). Nevertheless, an increasing number of studies now also describe tests for monitoring visuospatial functions, social cognition, and executive functions. CONCLUSIONS Language remains the most extensively tested cognitive domain. However, a broader range of tests are now implemented during awake craniotomy and there are (new developed) tests which received more attention. The rapid development in the field is reflected in the included studies in this review. Nevertheless, for some cognitive domains (e.g., executive functions and memory), there is still a need for developing tests that can be used during awake surgery.
Collapse
Affiliation(s)
- Beleke de Zwart
- Experimental Psychology, Helmholtz Institution, Utrecht University, Utrecht, The Netherlands.
| | - Carla Ruis
- Experimental Psychology, Helmholtz Institution, Utrecht University, Utrecht, The Netherlands
- Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
4
|
Wang JB, Hassan U, Bruss JE, Oya H, Uitermarkt BD, Trapp NT, Gander PE, Howard MA, Keller CJ, Boes AD. Effects of transcranial magnetic stimulation on the human brain recorded with intracranial electrocorticography. Mol Psychiatry 2024; 29:1228-1240. [PMID: 38317012 DOI: 10.1038/s41380-024-02405-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024]
Abstract
Transcranial magnetic stimulation (TMS) is increasingly used as a noninvasive technique for neuromodulation in research and clinical applications, yet its mechanisms are not well understood. Here, we present the neurophysiological effects of TMS using intracranial electrocorticography (iEEG) in neurosurgical patients. We first evaluated safety in a gel-based phantom. We then performed TMS-iEEG in 22 neurosurgical participants with no adverse events. We next evaluated intracranial responses to single pulses of TMS to the dorsolateral prefrontal cortex (dlPFC) (N = 10, 1414 electrodes). We demonstrate that TMS is capable of inducing evoked potentials both locally within the dlPFC and in downstream regions functionally connected to the dlPFC, including the anterior cingulate and insular cortex. These downstream effects were not observed when stimulating other distant brain regions. Intracranial dlPFC electrical stimulation had similar timing and downstream effects as TMS. These findings support the safety and promise of TMS-iEEG in humans to examine local and network-level effects of TMS with higher spatiotemporal resolution than currently available methods.
Collapse
Affiliation(s)
- Jeffrey B Wang
- Biophysics Graduate Program, Stanford University Medical Center, Stanford, CA, 94305, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA
| | - Umair Hassan
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94305, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Joel E Bruss
- Department of Neurology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
- Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Hiroyuki Oya
- Department of Neurosurgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Brandt D Uitermarkt
- Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Nicholas T Trapp
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, 52242, USA
| | - Phillip E Gander
- Department of Neurosurgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
- Department of Radiology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Matthew A Howard
- Department of Neurosurgery, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Corey J Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, 94305, USA
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94305, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Aaron D Boes
- Department of Neurology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
- Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, 52242, USA.
| |
Collapse
|
5
|
Caruana F. Positive emotions elicited by cortical and subcortical electrical stimulation: A commentary on Villard et al. (2023). Cortex 2024; 174:234-237. [PMID: 37659914 DOI: 10.1016/j.cortex.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 09/04/2023]
Affiliation(s)
- Fausto Caruana
- Institute of Neuroscience, National Research Council of Italy (CNR), Via Volturno 39/E, 43125 Parma, Italy.
| |
Collapse
|
6
|
Metzger BA, Kalva P, Mocchi MM, Cui B, Adkinson JA, Wang Z, Mathura R, Kanja K, Gavvala J, Krishnan V, Lin L, Maheshwari A, Shofty B, Magnotti JF, Willie JT, Sheth SA, Bijanki KR. Intracranial stimulation and EEG feature analysis reveal affective salience network specialization. Brain 2023; 146:4366-4377. [PMID: 37293814 PMCID: PMC10545499 DOI: 10.1093/brain/awad200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 06/10/2023] Open
Abstract
Emotion is represented in limbic and prefrontal brain areas, herein termed the affective salience network (ASN). Within the ASN, there are substantial unknowns about how valence and emotional intensity are processed-specifically, which nodes are associated with affective bias (a phenomenon in which participants interpret emotions in a manner consistent with their own mood). A recently developed feature detection approach ('specparam') was used to select dominant spectral features from human intracranial electrophysiological data, revealing affective specialization within specific nodes of the ASN. Spectral analysis of dominant features at the channel level suggests that dorsal anterior cingulate (dACC), anterior insula and ventral-medial prefrontal cortex (vmPFC) are sensitive to valence and intensity, while the amygdala is primarily sensitive to intensity. Akaike information criterion model comparisons corroborated the spectral analysis findings, suggesting all four nodes are more sensitive to intensity compared to valence. The data also revealed that activity in dACC and vmPFC were predictive of the extent of affective bias in the ratings of facial expressions-a proxy measure of instantaneous mood. To examine causality of the dACC in affective experience, 130 Hz continuous stimulation was applied to dACC while patients viewed and rated emotional faces. Faces were rated significantly happier during stimulation, even after accounting for differences in baseline ratings. Together the data suggest a causal role for dACC during the processing of external affective stimuli.
Collapse
Affiliation(s)
- Brian A Metzger
- Department of Psychology, Swarthmore College, Swarthmore, PA 19081, USA
| | - Prathik Kalva
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Madaline M Mocchi
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Brian Cui
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Joshua A Adkinson
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zhengjia Wang
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Raissa Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kourtney Kanja
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jay Gavvala
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Vaishnav Krishnan
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lu Lin
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Atul Maheshwari
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ben Shofty
- Department of Neurosurgery, University of Utah Health, Salt Lake City, UT 84132, USA
| | - John F Magnotti
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jon T Willie
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kelly R Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA
| |
Collapse
|
7
|
Pelliccia V, Del Vecchio M, Avanzini P, Revay M, Sartori I, Caruana F. 70 Years of Human Cingulate Cortex Stimulation. Functions and Dysfunctions Through the Lens of Electrical Stimulation. J Clin Neurophysiol 2023; 40:491-500. [PMID: 36007014 DOI: 10.1097/wnp.0000000000000961] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY In this review, we retrace the results of 70 years of human cingulate cortex (CC) intracerebral electrical stimulation and discuss its contribution to our understanding of the anatomofunctional and clinical aspects of this wide cortical region. The review is divided into three main sections. In the first section, we report the results obtained by the stimulation of the anterior, middle, and posterior CC, in 30 studies conducted on approximately 1,000 patients from the 1950s to the present day. These studies show that specific manifestations can be reliably associated with specific cingulate subfields, with autonomic, interoceptive, and emotional manifestations clustered in the anterior cingulate, goal-oriented motor behaviors elicited from the anterior midcingulate and a variety of sensory symptoms characterizing the posterior cingulate regions. In the second section, we compare the effect of CC intracerebral electrical stimulation with signs and manifestations characterizing cingulate epilepsy, showing that the stimulation mapping of CC subfields provides precious information for understanding cingulate epileptic manifestations. The last section tackles the issue of the discrepancy emerging when comparing the results of clinical (electrical stimulation, epilepsy) studies-revealing the quintessential affective and motor nature of the CC-with that reported by neuroimaging studies-which focus on high-level cognitive functions. Particular attention will be paid to the hypothesis that CC hosts a "Pain Matrix" specifically involved in pain perception, which we will discuss in the light of the fact that the stimulation of CC (as well as cingulate epileptic seizures) does not induce nociceptive effects.
Collapse
Affiliation(s)
- Veronica Pelliccia
- "Claudio Munari" Epilepsy Surgery Center, ASST GOM Niguarda, Milano, Italy; and
| | - Maria Del Vecchio
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| | - Pietro Avanzini
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| | - Martina Revay
- "Claudio Munari" Epilepsy Surgery Center, ASST GOM Niguarda, Milano, Italy; and
| | - Ivana Sartori
- "Claudio Munari" Epilepsy Surgery Center, ASST GOM Niguarda, Milano, Italy; and
| | - Fausto Caruana
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| |
Collapse
|
8
|
Kragel PA, Treadway MT, Admon R, Pizzagalli DA, Hahn EC. A mesocorticolimbic signature of pleasure in the human brain. Nat Hum Behav 2023; 7:1332-1343. [PMID: 37386105 DOI: 10.1038/s41562-023-01639-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 05/22/2023] [Indexed: 07/01/2023]
Abstract
Pleasure is a fundamental driver of human behaviour, yet its neural basis remains largely unknown. Rodent studies highlight opioidergic neural circuits connecting the nucleus accumbens, ventral pallidum, insula and orbitofrontal cortex as critical for the initiation and regulation of pleasure, and human neuroimaging studies exhibit some translational parity. However, whether activation in these regions conveys a generalizable representation of pleasure regulated by opioidergic mechanisms remains unclear. Here we use pattern recognition techniques to develop a human functional magnetic resonance imaging signature of mesocorticolimbic activity unique to states of pleasure. In independent validation tests, this signature is sensitive to pleasant tastes and affect evoked by humour. The signature is spatially co-extensive with mu-opioid receptor gene expression, and its response is attenuated by the opioid antagonist naloxone. These findings provide evidence for a basis of pleasure in humans that is distributed across brain systems.
Collapse
Affiliation(s)
- Philip A Kragel
- Department of Psychology, Emory University, Atlanta, GA, USA.
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
| | - Michael T Treadway
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Roee Admon
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Evan C Hahn
- Department of Psychology, Emory University, Atlanta, GA, USA
| |
Collapse
|
9
|
Caston RM, Smith EH, Davis TS, Singh H, Rahimpour S, Rolston JD. Psychophysical pain encoding in the cingulate cortex predicts responsiveness of electrical stimulation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.18.23287266. [PMID: 36993429 PMCID: PMC10055607 DOI: 10.1101/2023.03.18.23287266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Background The anterior cingulate cortex (ACC) plays an important role in the cognitive and emotional processing of pain. Prior studies have used deep brain stimulation (DBS) to treat chronic pain, but results have been inconsistent. This may be due to network adaptation over time and variable causes of chronic pain. Identifying patient-specific pain network features may be necessary to determine patient candidacy for DBS. Hypothesis Cingulate stimulation would increase patients' hot pain thresholds if non-stimulation 70-150 Hz activity encoded psychophysical pain responses. Methods In this study, four patients who underwent intracranial monitoring for epilepsy monitoring participated in a pain task. They placed their hand on a device capable of eliciting thermal pain for five seconds and rated their pain. We used these results to determine the individual's thermal pain threshold with and without electrical stimulation. Two different types of generalized linear mixed-effects models (GLME) were employed to assess the neural representations underlying binary and graded pain psychophysics. Results The pain threshold for each patient was determined from the psychometric probability density function. Two patients had a higher pain threshold with stimulation than without, while the other two patients had no difference. We also evaluated the relationship between neural activity and pain responses. We found that patients who responded to stimulation had specific time windows where high-frequency activity was associated with increased pain ratings. Conclusion Stimulation of cingulate regions with increased pain-related neural activity was more effective at modulating pain perception than stimulating non-responsive areas. Personalized evaluation of neural activity biomarkers could help identify the best target for stimulation and predict its effectiveness in future studies evaluating DBS.
Collapse
Affiliation(s)
- Rose M Caston
- University of Utah Department of Biomedical Engineering
- University of Utah Department of Neurosurgery
| | - Elliot H Smith
- University of Utah Department of Neurosurgery
- University of Utah Interdepartmental Program in Neuroscience
| | | | - Hargunbir Singh
- Department of Neurosurgery, Brigham & Women's Hospital, Harvard Medical School
| | - Shervin Rahimpour
- University of Utah Department of Biomedical Engineering
- University of Utah Department of Neurosurgery
| | - John D Rolston
- University of Utah Department of Biomedical Engineering
- Department of Neurosurgery, Brigham & Women's Hospital, Harvard Medical School
| |
Collapse
|
10
|
Soulier H, Mauguière F, Catenoix H, Montavont A, Isnard J, Hermier M, Guenot M, Rheims S, Mazzola L. Visceral and emotional responses to direct electrical stimulations of the cortex. Ann Clin Transl Neurol 2022; 10:5-17. [PMID: 36424874 PMCID: PMC9852394 DOI: 10.1002/acn3.51694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/26/2022] [Accepted: 10/24/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Visceral sensations are bodily symptoms which are component manifestations of emotions frequently reported during epileptic seizures. Nowadays, the underlying mechanism and location of brain areas involved in the processing of these sensations remain unclear. Our objectives were to characterize the type and frequency of visceral and emotional responses evoked by electrical stimulations, to produce a mapping of brain structures involved in their processing, and to assess the link between visceral sensations and emotional feelings. METHODS We reviewed 12,088 bipolar stimulations performed in 203 patients during the presurgical evaluation of drug refractory epilepsy. Responses to stimulation were divided into viscero-sensitive, viscero-vegetative, and emotional sensations. Univariate analysis and conditional logistic regression were used to assess the association between visceral and emotional sensations and localization of the stimulated contacts. RESULTS In total, 543 stimulations evoked visceral and emotional sensations. Stimulations of operculo-insulolimbic structures (amygdala, anterior and posterior insula, anterior and mid-cingulate cortex, hippocampus, parahippocampus, temporal pole, frontal and parietal operculum) were significantly more associated with visceral and emotional sensations than all other cortical regions. Preferential implication of certain brain structures, depending on the type of visceral responses was evidenced: temporo-mesial structures, insula, and frontoparietal operculum for viscero-sensitive sensations; amygdala, insula, anterior and mid-cingulate cortex, and temporal pole for viscero-vegetative sensations; temporo-mesial structures, anterior cingulate cortex, and frontal operculum for emotional sensations. INTERPRETATION Our data can help to guide SEEG explorations when visceral or emotional symptoms are part of the ictal semiology. They also bring some insights into the mechanisms of visceroception and the functional significance of the co-localization of visceral and emotional representations in the human brain.
Collapse
Affiliation(s)
- Hugo Soulier
- Department of NeurologyUniversity HospitalSt EtienneFrance
| | - François Mauguière
- Lyon Neurosciences Research Center (CRNL)INSERM U1028, CNRS UMR5292 and Lyon 1 UniversityLyonFrance,Department of Functional Neurology and EpileptogyHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
| | - Hélène Catenoix
- Lyon Neurosciences Research Center (CRNL)INSERM U1028, CNRS UMR5292 and Lyon 1 UniversityLyonFrance,Department of Functional Neurology and EpileptogyHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
| | - Alexandra Montavont
- Lyon Neurosciences Research Center (CRNL)INSERM U1028, CNRS UMR5292 and Lyon 1 UniversityLyonFrance,Department of Functional Neurology and EpileptogyHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
| | - Jean Isnard
- Lyon Neurosciences Research Center (CRNL)INSERM U1028, CNRS UMR5292 and Lyon 1 UniversityLyonFrance,Department of Functional Neurology and EpileptogyHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
| | - Marc Hermier
- Department of Neuroradiology, East Group Hospital, Hospices Civils de LyonLyonFrance
| | - Marc Guenot
- Lyon Neurosciences Research Center (CRNL)INSERM U1028, CNRS UMR5292 and Lyon 1 UniversityLyonFrance,Department of Functional NeurosurgeryHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
| | - Sylvain Rheims
- Lyon Neurosciences Research Center (CRNL)INSERM U1028, CNRS UMR5292 and Lyon 1 UniversityLyonFrance,Department of Functional Neurology and EpileptogyHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
| | - Laure Mazzola
- Department of NeurologyUniversity HospitalSt EtienneFrance,Lyon Neurosciences Research Center (CRNL)INSERM U1028, CNRS UMR5292 and Lyon 1 UniversityLyonFrance
| |
Collapse
|
11
|
Specific tractography differences in autism compared to developmental coordination disorder. Sci Rep 2022; 12:19246. [PMID: 36376319 PMCID: PMC9663575 DOI: 10.1038/s41598-022-21538-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
About 85% of children with autism spectrum disorder (ASD) experience comorbid motor impairments, making it unclear whether white matter abnormalities previously found in ASD are related to social communication deficits, the hallmark of ASD, or instead related to comorbid motor impairment. Here we aim to understand specific white matter signatures of ASD beyond those related to comorbid motor impairment by comparing youth (aged 8-18) with ASD (n = 22), developmental coordination disorder (DCD; n = 16), and typically developing youth (TD; n = 22). Diffusion weighted imaging was collected and quantitative anisotropy, radial diffusivity, mean diffusivity, and axial diffusivity were compared between the three groups and correlated with social and motor measures. Compared to DCD and TD groups, diffusivity differences were found in the ASD group in the mid-cingulum longitudinal and u-fibers, the corpus callosum forceps minor/anterior commissure, and the left middle cerebellar peduncle. Compared to the TD group, the ASD group had diffusivity differences in the right inferior frontal occipital/extreme capsule and genu of the corpus callosum. These diffusion differences correlated with emotional deficits and/or autism severity. By contrast, children with DCD showed unique abnormality in the left cortico-spinal and cortico-pontine tracts.Trial Registration All data are available on the National Institute of Mental Health Data Archive: https://nda.nih.gov/edit_collection.html?id=2254 .
Collapse
|
12
|
Palagi E, Caruana F, de Waal FBM. The naturalistic approach to laughter in humans and other animals: towards a unified theory. Philos Trans R Soc Lond B Biol Sci 2022; 377:20210175. [PMID: 36126670 PMCID: PMC9489289 DOI: 10.1098/rstb.2021.0175] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/15/2022] [Indexed: 12/18/2022] Open
Abstract
This opinion piece aims to tackle the biological, psychological, neural and cultural underpinnings of laughter from a naturalistic and evolutionary perspective. A naturalistic account of laughter requires the revaluation of two dogmas of a longstanding philosophical tradition, that is, the quintessential link between laughter and humour, and the uniquely human nature of this behaviour. In the spirit of Provine's and Panksepp's seminal studies, who firstly argued against the anti-naturalistic dogmas, here we review compelling evidence that (i) laughter is first and foremost a social behaviour aimed at regulating social relationships, easing social tensions and establishing social bonds, and that (ii) homologue and homoplasic behaviours of laughter exist in primates and rodents, who also share with humans the same underpinning neural circuitry. We make a case for the hypothesis that the contagiousness of laughter and its pervasive social infectiousness in everyday social interactions is mediated by a specific mirror mechanism. Finally, we argue that a naturalistic account of laughter should not be intended as an outright rejection of classic theories; rather, in the last part of the piece we argue that our perspective is potentially able to integrate previous viewpoints-including classic philosophical theories-ultimately providing a unified evolutionary explanation of laughter. This article is part of the theme issue 'Cracking the laugh code: laughter through the lens of biology, psychology and neuroscience'.
Collapse
Affiliation(s)
- Elisabetta Palagi
- Unit of Ethology, Department of Biology, University of Pisa, via A. Volta 6, Pisa 56126, Italy
| | - Fausto Caruana
- Institute of Neuroscience, National Research Council of Italy (CNR), Via Volturno 39/E, Parma 43125, Italy
| | | |
Collapse
|
13
|
Zauli FM, Del Vecchio M, Russo S, Mariani V, Pelliccia V, d'Orio P, Sartori I, Avanzini P, Caruana F. The web of laughter: frontal and limbic projections of the anterior cingulate cortex revealed by cortico-cortical evoked potential from sites eliciting laughter. Philos Trans R Soc Lond B Biol Sci 2022; 377:20210180. [PMID: 36126672 PMCID: PMC9489285 DOI: 10.1098/rstb.2021.0180] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/02/2022] [Indexed: 12/20/2022] Open
Abstract
According to an evolutionist approach, laughter is a multifaceted behaviour affecting social, emotional, motor and speech functions. Albeit previous studies have suggested that high-frequency electrical stimulation (HF-ES) of the pregenual anterior cingulate cortex (pACC) may induce bursts of laughter-suggesting a crucial contribution of this region to the cortical control of this behaviour-the complex nature of laughter implies that outward connections from the pACC may reach and affect a complex network of frontal and limbic regions. Here, we studied the effective connectivity of the pACC by analysing the cortico-cortical evoked potentials elicited by single-pulse electrical stimulation of pACC sites whose HF-ES elicited laughter in 12 patients. Once these regions were identified, we studied their clinical response to HF-ES, to reveal the specific functional target of pACC representation of laughter. Results reveal that the neural representation of laughter in the pACC interacts with several frontal and limbic regions, including cingulate, orbitofrontal, medial prefrontal and anterior insular regions-involved in interoception, emotion, social reward and motor behaviour. These results offer neuroscientific support to the evolutionist approach to laughter, providing a possible mechanistic explanation of the interplay between this behaviour and emotion regulation, speech production and social interactions. This article is part of the theme issue 'Cracking the laugh code: laughter through the lens of biology, psychology and neuroscience'.
Collapse
Affiliation(s)
- F M Zauli
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
- Department of Philosophy 'Piero Martinetti', University of Milan, Milan, Italy
- 'Claudio Munari' Epilepsy Surgery Center, ASST GOM Niguarda, Milan, Italy
| | - M Del Vecchio
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| | - S Russo
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy
- Department of Philosophy 'Piero Martinetti', University of Milan, Milan, Italy
- Allen Institute, Seattle, WA
| | - V Mariani
- Neurology and Stroke Unit Division, Circolo Hospital ASST Settelaghi University of Insubria, Varese, Italy
| | - V Pelliccia
- 'Claudio Munari' Epilepsy Surgery Center, ASST GOM Niguarda, Milan, Italy
| | - P d'Orio
- 'Claudio Munari' Epilepsy Surgery Center, ASST GOM Niguarda, Milan, Italy
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma
| | - I Sartori
- 'Claudio Munari' Epilepsy Surgery Center, ASST GOM Niguarda, Milan, Italy
| | - P Avanzini
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| | - F Caruana
- Institute of Neuroscience, National Research Council of Italy (CNR), Parma, Italy
| |
Collapse
|
14
|
Tucker DM, Luu P, Johnson M. Neurophysiological Mechanisms of Implicit and Explicit Memory in the Process of Consciousness. J Neurophysiol 2022; 128:872-891. [PMID: 36044682 PMCID: PMC9576178 DOI: 10.1152/jn.00328.2022] [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] [Indexed: 11/22/2022] Open
Abstract
Neurophysiological mechanisms are increasingly understood to constitute the foundations of human conscious experience. These include the capacity for ongoing memory, achieved through a hierarchy of reentrant cross-laminar connections across limbic, heteromodal, unimodal, and primary cortices. The neurophysiological mechanisms of consciousness also include the capacity for volitional direction of attention to the ongoing cognitive process, through a reentrant fronto-thalamo-cortical network regulation of the inhibitory thalamic reticular nucleus. More elusive is the way that discrete objects of subjective experience, such as the color of deep blue or the sound of middle C, could be generated by neural mechanisms. Explaining such ineffable qualities of subjective experience is what Chalmers has called “the hard problem of consciousness,” which has divided modern neuroscientists and philosophers alike. We propose that insight into the appearance of the hard problem can be gained through integrating classical phenomenological studies of experience with recent progress in the differential neurophysiology of consolidating explicit versus implicit memory. Although the achievement of consciousness, once it is reflected upon, becomes explicit, the underlying process of generating consciousness, through neurophysiological mechanisms, is largely implicit. Studying the neurophysiological mechanisms of adaptive implicit memory, including brain stem, limbic, and thalamic regulation of neocortical representations, may lead to a more extended phenomenological understanding of both the neurophysiological process and the subjective experience of consciousness. NEW & NOTEWORTHY The process of consciousness, generating the qualia that may appear to be irreducible qualities of experience, can be understood to arise from neurophysiological mechanisms of memory. Implicit memory, organized by the lemnothalamic brain stem projections and dorsal limbic consolidation in REM sleep, supports the unconscious field and the quasi-conscious fringe of current awareness. Explicit memory, organized by the collothalamic midbrain projections and ventral limbic consolidation of NREM sleep, supports the focal objects of consciousness.
Collapse
Affiliation(s)
- Don M Tucker
- Department of Psychology, University of Oregon, Eugene, OR, United States.,Brain Electrophysiology Laboratory Company, Riverfront Research Park, Eugene OR, United States
| | - Phan Luu
- Department of Psychology, University of Oregon, Eugene, OR, United States.,Brain Electrophysiology Laboratory Company, Riverfront Research Park, Eugene OR, United States
| | - Mark Johnson
- Department of Philosophy, University of Oregon, Eugene, OR, United States
| |
Collapse
|
15
|
Herrman H, Osnes K, Egge A, Konglund A, Ramm‐Pettersen J, Dietrichs E, Taubøll E. ANT-DBS in epilepsy shows no effect on selected neuropsychiatric tests. Acta Neurol Scand 2022; 146:258-264. [PMID: 35649713 PMCID: PMC9545573 DOI: 10.1111/ane.13658] [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: 03/07/2022] [Revised: 05/07/2022] [Accepted: 05/20/2022] [Indexed: 11/29/2022]
Abstract
Objectives Deep brain stimulation of the anterior thalamic nucleus (ANT‐DBS) is an established option in treatment‐resistant epilepsy and obtained FDA approval in 2018. Increased psychiatric comorbidity is well known in epilepsy. The main objective of this study was to investigate possible neuropsychiatric treatment‐related changes in patients receiving ANT‐DBS. Materials and Methods Bilateral ANT electrodes were implanted in 18 adult patients with refractory epilepsy in a randomized, double‐blinded study. Immediately after implantation, patients were randomized to stimulation ON (n = 8) or OFF (n = 10) for the first 6 months (blinded phase). During the next six months (open phase), both groups received active stimulation. Neuropsychiatric assessment was conducted before implantation (T1), at the end of the blinded period (T2), and 1 year after implantation (T3). Results Comparing preoperative status (T1) and 12 months (T3), postoperative outcome in all patients did not show significant differences between the two groups for any of the applied tests. Groupwise comparisons across the two first time points (the blinded period, representing the randomized controlled trial) showed no significant differences between the two groups in any of the neuropsychiatric parameters studied. Comparing test results after 6 months of stimulation in both groups (sum of ON group T1 to T2 and OFF group T2 to T3) did not show significant changes for any of the psychiatric assessments. Conclusions Our results indicate that ANT‐DBS has limited effect concerning psychiatric issues. Subjective side effects were, however, reported in individual patients.
Collapse
Affiliation(s)
- Helle Herrman
- Department of Neurology Oslo University Hospital‐Rikshospitalet Oslo Norway
- National Center for Epilepsy Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
| | - Kåre Osnes
- Division of Mental Health and Substance Abuse Diakonhjemmet Hospital Oslo Norway
| | - Arild Egge
- Department of Neurosurgery Oslo University Hospital‐Rikshospitalet Oslo Norway
| | - Ane Konglund
- Department of Neurosurgery Oslo University Hospital‐Rikshospitalet Oslo Norway
| | - Jon Ramm‐Pettersen
- Department of Neurosurgery Oslo University Hospital‐Rikshospitalet Oslo Norway
| | - Espen Dietrichs
- Department of Neurology Oslo University Hospital‐Rikshospitalet Oslo Norway
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
| | - Erik Taubøll
- Department of Neurology Oslo University Hospital‐Rikshospitalet Oslo Norway
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
| |
Collapse
|
16
|
Anand A, Gavvala JR, Mathura R, Najera RA, Gadot R, Shofty B, Sheth SA. Elimination of anxiety after laser interstitial thermal ablation of the dominant cingulate gyrus for epilepsy. Surg Neurol Int 2022; 13:178. [PMID: 35509526 PMCID: PMC9062951 DOI: 10.25259/sni_241_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Anxiety is a common symptom of mental health disorders. Surgical treatment of anxiety-related disorders is limited by our understanding of the neural circuitry responsible for emotional regulation. Limbic regions communicate with other cortical and subcortical regions to generate emotional responses and behaviors toward anxiogenic stimuli. Epilepsy involving corticolimbic regions may disrupt normal neural circuitry and present with mood disorders. Anxiety presenting in patients with mesial temporal lobe epilepsy is common; however, anxiety in patients with cingulate epilepsy is not well described. Neurosurgical cases with rare clinical presentations may provide insight into the basic functionality of the human mind and ultimately lead to improvements in surgical treatments. Case Description: We present the case of a 24-year-old male with a 20-year history of nonlesional and cingulate epilepsy with an aura of anxiety and baseline anxiety. Noninvasive work-up was discordant. Intracranial evaluation using stereoelectroencephalography established the epileptogenic zone in the left anterior and mid-cingulate gyrus. Stimulation of the cingulate reproduced a sense of anxiety typical of the habitual auras. We performed laser interstitial thermal therapy of the left anterior and mid-cingulate gyrus. At 8 months following ablation, the patient reported a substantial reduction in seizure frequency and complete elimination of his baseline anxiety and anxious auras. Conclusion: This case highlights the role of the cingulate cortex (CC) in regulating anxiety. Ablation of the epileptic focus resolved both epilepsy-related anxiety and baseline features.a Future studies assessing the role of the CC in anxiety disorders may enable improvements in surgical treatments for anxiety disorders.
Collapse
Affiliation(s)
- Adrish Anand
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States,
| | - Jay R. Gavvala
- Department of Neurology, Baylor College of Medicine, Houston, Texas, United States
| | - Raissa Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States,
| | - Ricardo A. Najera
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States,
| | - Ron Gadot
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States,
| | - Ben Shofty
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States,
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States,
| |
Collapse
|
17
|
Abstract
Purpose of Review Postcraniotomy headache (PCH) is a highly underappreciated and very common adverse event following craniotomy. Recent Findings Analgetic medication with opioids often interferes with neurologic evaluation in the acute phase of recovery and should be kept to a minimal, in general, in the treatment of chronic pain as well. We provide an update on the latest evidence for the management of acute and chronic PCH. Summary Especially in the neurosurgical setting, enhanced recovery after surgery protocols need to include a special focus on pain control. Patients at risk of developing chronic pain must be identified and treated as early as possible.
Collapse
|
18
|
Revisiting Hemispheric Asymmetry in Mood Regulation: Implications for rTMS for Major Depressive Disorder. Brain Sci 2022; 12:brainsci12010112. [PMID: 35053856 PMCID: PMC8774216 DOI: 10.3390/brainsci12010112] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Hemispheric differences in emotional processing have been observed for over half a century, leading to multiple theories classifying differing roles for the right and left hemisphere in emotional processing. Conventional acceptance of these theories has had lasting clinical implications for the treatment of mood disorders. The theory that the left hemisphere is broadly associated with positively valenced emotions, while the right hemisphere is broadly associated with negatively valenced emotions, drove the initial application of repetitive transcranial magnetic stimulation (rTMS) for the treatment of major depressive disorder (MDD). Subsequent rTMS research has led to improved response rates while adhering to the same initial paradigm of administering excitatory rTMS to the left prefrontal cortex (PFC) and inhibitory rTMS to the right PFC. However, accumulating evidence points to greater similarities in emotional regulation between the hemispheres than previously theorized, with potential implications for how rTMS for MDD may be delivered and optimized in the near future. This review will catalog the range of measurement modalities that have been used to explore and describe hemispheric differences, and highlight evidence that updates and advances knowledge of TMS targeting and parameter selection. Future directions for research are proposed that may advance precision medicine and improve efficacy of TMS for MDD.
Collapse
|
19
|
Provenza NR, Sheth SA, Dastin-van Rijn EM, Mathura RK, Ding Y, Vogt GS, Avendano-Ortega M, Ramakrishnan N, Peled N, Gelin LFF, Xing D, Jeni LA, Ertugrul IO, Barrios-Anderson A, Matteson E, Wiese AD, Xu J, Viswanathan A, Harrison MT, Bijanki KR, Storch EA, Cohn JF, Goodman WK, Borton DA. Long-term ecological assessment of intracranial electrophysiology synchronized to behavioral markers in obsessive-compulsive disorder. Nat Med 2021; 27:2154-2164. [PMID: 34887577 PMCID: PMC8800455 DOI: 10.1038/s41591-021-01550-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/22/2021] [Indexed: 01/02/2023]
Abstract
Detection of neural signatures related to pathological behavioral states could enable adaptive deep brain stimulation (DBS), a potential strategy for improving efficacy of DBS for neurological and psychiatric disorders. This approach requires identifying neural biomarkers of relevant behavioral states, a task best performed in ecologically valid environments. Here, in human participants with obsessive-compulsive disorder (OCD) implanted with recording-capable DBS devices, we synchronized chronic ventral striatum local field potentials with relevant, disease-specific behaviors. We captured over 1,000 h of local field potentials in the clinic and at home during unstructured activity, as well as during DBS and exposure therapy. The wide range of symptom severity over which the data were captured allowed us to identify candidate neural biomarkers of OCD symptom intensity. This work demonstrates the feasibility and utility of capturing chronic intracranial electrophysiology during daily symptom fluctuations to enable neural biomarker identification, a prerequisite for future development of adaptive DBS for OCD and other psychiatric disorders.
Collapse
Affiliation(s)
- Nicole R Provenza
- Brown University School of Engineering, Providence, RI, USA
- Charles Stark Draper Laboratory, Cambridge, MA, USA
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | | | - Raissa K Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Yaohan Ding
- Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gregory S Vogt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Michelle Avendano-Ortega
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Nithya Ramakrishnan
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Noam Peled
- MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | | | - David Xing
- Brown University School of Engineering, Providence, RI, USA
| | - Laszlo A Jeni
- Robotics Institute, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Itir Onal Ertugrul
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, the Netherlands
| | | | - Evan Matteson
- Brown University School of Engineering, Providence, RI, USA
| | - Andrew D Wiese
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Junqian Xu
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Ashwin Viswanathan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | | | - Kelly R Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey F Cohn
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David A Borton
- Brown University School of Engineering, Providence, RI, USA.
- Carney Institute for Brain Science, Brown University, Providence, RI, USA.
- Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Department of Veterans Affairs, Providence, RI, USA.
| |
Collapse
|
20
|
Caruana F. Two simulation systems in the human frontal cortex? Disentangling between motor simulation and emotional mirroring using laughter. Cortex 2021; 148:215-217. [PMID: 34696898 DOI: 10.1016/j.cortex.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Fausto Caruana
- Institute of Neuroscience, National Research Council of Italy (CNR), Via Volturno 39/E, 43125 Parma, Italy.
| |
Collapse
|
21
|
Elias GJB, Germann J, Boutet A, Pancholi A, Beyn ME, Bhatia K, Neudorfer C, Loh A, Rizvi SJ, Bhat V, Giacobbe P, Woodside DB, Kennedy SH, Lozano AM. Structuro-functional surrogates of response to subcallosal cingulate deep brain stimulation for depression. Brain 2021; 145:362-377. [PMID: 34324658 DOI: 10.1093/brain/awab284] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/01/2021] [Accepted: 07/07/2021] [Indexed: 11/14/2022] Open
Abstract
Subcallosal cingulate deep brain stimulation (SCC-DBS) produces long-term clinical improvement in approximately half of patients with severe treatment-resistant depression (TRD). We hypothesized that both structural and functional brain attributes may be important in determining responsiveness to this therapy. In a TRD SCC-DBS cohort, we retrospectively examined baseline and longitudinal differences in MRI-derived brain volume (n = 65) and 18F-fluorodeoxyglucose-PET glucose metabolism (n = 21) between responders and non-responders. Support-vector machines (SVMs) were subsequently trained to classify patients' response status based on extracted baseline imaging features. A machine learning model incorporating pre-operative frontopolar, precentral/frontal opercular, and orbitofrontal local volume values classified binary response status (12 months) with 83% accuracy (leave-one-out cross-validation (LOOCV): 80% accuracy) and explained 32% of the variance in continuous clinical improvement. It was also predictive in an out-of-sample SCC-DBS cohort (n = 21) with differing primary indications (bipolar disorder/anorexia nervosa) (76% accuracy). Adding pre-operative glucose metabolism information from rostral anterior cingulate cortex and temporal pole improved model performance, enabling it to predict response status in the TRD cohort with 86% accuracy (LOOCV: 81% accuracy) and explain 67% of clinical variance. Response-related patterns of metabolic and structural post-DBS change were also observed, especially in anterior cingulate cortex and neighbouring white matter. Areas where responders differed from non-responders - both at baseline and longitudinally - largely overlapped with depression-implicated white matter tracts, namely uncinate fasciculus, cingulum bundle, and forceps minor/rostrum of corpus callosum. The extent of patient-specific engagement of these same tracts (according to electrode location and stimulation parameters) also served as a predictor of TRD response status (72% accuracy; LOOCV: 70% accuracy) and augmented performance of the volume-based (88% accuracy; LOOCV: 82% accuracy) and combined volume/metabolism-based SVMs (100% accuracy; LOOCV: 94% accuracy). Taken together, these results indicate that responders and non-responders to SCC-DBS exhibit differences in brain volume and metabolism, both pre- and post-surgery. Baseline imaging features moreover predict response to treatment (particularly when combined with information about local tract engagement) and could inform future patient selection and other clinical decisions.
Collapse
Affiliation(s)
- Gavin J B Elias
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada.,Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada
| | - Jürgen Germann
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada.,Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada
| | - Alexandre Boutet
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada.,Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada.,Joint Department of Medical Imaging, University of Toronto, Toronto, M5T 1W7, Canada
| | - Aditya Pancholi
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Michelle E Beyn
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Kartik Bhatia
- Joint Department of Medical Imaging, University of Toronto, Toronto, M5T 1W7, Canada
| | - Clemens Neudorfer
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Aaron Loh
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada.,Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada
| | - Sakina J Rizvi
- ASR Suicide and Depression Studies Unit, St. Michael's Hospital, University of Toronto, M5B 1M8, Canada.,Department of Psychiatry, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Venkat Bhat
- ASR Suicide and Depression Studies Unit, St. Michael's Hospital, University of Toronto, M5B 1M8, Canada.,Department of Psychiatry, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Peter Giacobbe
- Department of Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, M4N 3M5, Canada
| | - D Blake Woodside
- ASR Suicide and Depression Studies Unit, St. Michael's Hospital, University of Toronto, M5B 1M8, Canada
| | - Sidney H Kennedy
- Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada.,ASR Suicide and Depression Studies Unit, St. Michael's Hospital, University of Toronto, M5B 1M8, Canada.,Department of Psychiatry, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, M5T 2S8, Canada.,Krembil Research Institute, University of Toronto, Toronto, M5T 0S8, Canada
| |
Collapse
|
22
|
Bijanki KR, Metzger BA, Steger CM. Leveraging Intracranial Neural Data to Accelerate Progress Toward Novel Therapies for Psychiatric Symptoms and Disorders. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:506-507. [PMID: 33965166 DOI: 10.1016/j.bpsc.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Kelly R Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
| | - Brian A Metzger
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Camille M Steger
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, Massachusetts
| |
Collapse
|
23
|
Schmitgen A, Saal J, Sankaran N, Desai M, Joseph I, Starr P, Chang EF, Shirvalkar P. Musical Hallucinations in Chronic Pain: The Anterior Cingulate Cortex Regulates Internally Generated Percepts. Front Neurol 2021; 12:669172. [PMID: 34017308 PMCID: PMC8129573 DOI: 10.3389/fneur.2021.669172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/06/2021] [Indexed: 12/20/2022] Open
Abstract
The anterior cingulate cortex (ACC) has been extensively implicated in the functional brain network underlying chronic pain. Electrical stimulation of the ACC has been proposed as a therapy for refractory chronic pain, although, mechanisms of therapeutic action are still unclear. As stimulation of the ACC has been reported to produce many different behavioral and perceptual responses, this region likely plays a varied role in sensory and emotional integration as well as modulating internally generated perceptual states. In this case series, we report the emergence of subjective musical hallucinations (MH) after electrical stimulation of the ACC in two patients with refractory chronic pain. In an N-of-1 analysis from one patient, we identified neural activity (local field potentials) that distinguish MH from both the non-MH condition and during a task involving music listening. Music hallucinations were associated with reduced alpha band activity and increased gamma band activity in the ACC. Listening to similar music was associated with different changes in ACC alpha and gamma power, extending prior results that internally generated perceptual phenomena are supported by circuits in the ACC. We discuss these findings in the context of phantom perceptual phenomena and posit a framework whereby chronic pain may be interpreted as a persistent internally generated percept.
Collapse
Affiliation(s)
- Ashlyn Schmitgen
- Division of Pain Medicine, Department of Anesthesiology and Perioperative Care, University of California, San Francisco, San Francisco, CA, United States
- UCSF Weill Institute for Neurosciences, San Francisco, CA, United States
| | - Jeremy Saal
- UCSF Weill Institute for Neurosciences, San Francisco, CA, United States
| | - Narayan Sankaran
- UCSF Weill Institute for Neurosciences, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Maansi Desai
- Department of Speech, Language, and Hearing Science, University of Texas at Austin, Austin, TX, United States
| | - Isabella Joseph
- Division of Pain Medicine, Department of Anesthesiology and Perioperative Care, University of California, San Francisco, San Francisco, CA, United States
- UCSF Weill Institute for Neurosciences, San Francisco, CA, United States
| | - Philip Starr
- UCSF Weill Institute for Neurosciences, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- Department of Physiology, University of California, San Francisco, San Francisco, CA, United States
| | - Edward F. Chang
- UCSF Weill Institute for Neurosciences, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- Department of Physiology, University of California, San Francisco, San Francisco, CA, United States
| | - Prasad Shirvalkar
- Division of Pain Medicine, Department of Anesthesiology and Perioperative Care, University of California, San Francisco, San Francisco, CA, United States
- UCSF Weill Institute for Neurosciences, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
24
|
Bormann NL, Trapp NT, Narayanan NS, Boes AD. Developing Precision Invasive Neuromodulation for Psychiatry. J Neuropsychiatry Clin Neurosci 2021; 33:201-209. [PMID: 33985346 PMCID: PMC8576850 DOI: 10.1176/appi.neuropsych.20100268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Psychiatric conditions are common and often disabling. Although great strides have been made in alleviating symptoms with pharmacotherapy and psychotherapeutic approaches, many patients continue to have severe disease burden despite the best therapies available. One of the pervasive challenges to improving treatment is that present diagnostic and therapeutic strategies lag behind our modern conceptualization of the pathophysiology of these disorders. Psychiatric symptoms manifest through activity in specific neural circuits; thus, therapies capable of modulating these circuits are attractive. The investigators reviewed recent advances that facilitate treating medically refractory psychiatric disorders with intracranial neuromodulation in a way that intervenes more directly with the underlying pathophysiology. Specifically, they reviewed the prospects for using intracranial multielectrode arrays to record brain activity with high spatiotemporal resolution and identify circuit-level electrophysiological correlates of symptoms. A causal relationship of circuit electrophysiology to symptoms could then be established by modulating the circuits to disrupt the symptoms. Personalized therapeutic neuromodulation strategies can then proceed in a rational manner with stimulation protocols informed by the underlying circuit-based pathophysiology of the most bothersome symptoms. This strategy would enhance current methods in neurotherapeutics by identifying individualized anatomical targets with symptom-specific precision, circumventing many of the limitations inherent in modern psychiatric nosology and treatment.
Collapse
Affiliation(s)
- Nicholas L. Bormann
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City
| | - Nicholas T. Trapp
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif
| | | | - Aaron D. Boes
- Departments of Neurology, Psychiatry, and Pediatrics, University of Iowa Carver College of Medicine
| |
Collapse
|
25
|
Sweet JA, Beylergil SB, Thyagaraj S, Herring EZ, Drapekin JE, Gao K, Calabrese JR, Miller JP, McIntyre CC. Clinical Evaluation of Cingulum Bundle Connectivity for Neurosurgical Hypothesis Development. Neurosurgery 2020; 86:724-735. [PMID: 31264700 DOI: 10.1093/neuros/nyz225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 03/18/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The cingulum bundle (CB) has long been a target for psychiatric neurosurgical procedures, but with limited understanding of the brain networks being impacted. Recent advances in human tractography could provide a foundation to better understand the effects of neurosurgical interventions on the CB; however, the reliability of tractography remains in question. OBJECTIVE To evaluate the ability of different tractography techniques, derived from typical, human diffusion-weighted imaging (DWI) data, to characterize CB connectivity described in animal models. This will help validate the clinical applicability of tractography, and generate insight on current and future neurosurgical targets for psychiatric disorders. METHODS Connectivity of the CB in 15 healthy human subjects was evaluated using DWI-based tractography, and compared to tract-tracing findings from nonhuman primates. Brain regions of interest were defined to coincide with the animal model. Tractography was performed using 3 techniques (FSL probabilistic, Camino probabilistic, and Camino deterministic). Differences in connectivity were assessed, and the CB segment with the greatest connectivity was determined. RESULTS Each tractography technique successfully reproduced the animal tracing model with a mean accuracy of 72% (68-75%, P < .05). Additionally, one region of the CB, the rostral dorsal segment, had significantly greater connectivity to associated brain structures than all other CB segments (P < .05). CONCLUSION Noninvasive, in vivo human analysis of the CB, using clinically available DWI for tractography, consistently reproduced the results of an animal tract-tracing model. This suggests that tractography of the CB can be used for clinical applications, which may aid in neurosurgical targeting for psychiatric disorders.
Collapse
Affiliation(s)
- Jennifer A Sweet
- University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | | | | | | | | | - Keming Gao
- University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | - Joseph R Calabrese
- University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | - Jonathan P Miller
- University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | | |
Collapse
|
26
|
Shirvalkar P, Sellers KK, Schmitgen A, Prosky J, Joseph I, Starr PA, Chang EF. A Deep Brain Stimulation Trial Period for Treating Chronic Pain. J Clin Med 2020; 9:jcm9103155. [PMID: 33003443 PMCID: PMC7600449 DOI: 10.3390/jcm9103155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022] Open
Abstract
Early studies of deep brain stimulation (DBS) for various neurological disorders involved a temporary trial period where implanted electrodes were externalized, in which the electrical contacts exiting the patient's brain are connected to external stimulation equipment, so that stimulation efficacy could be determined before permanent implant. As the optimal brain target sites for various diseases (i.e., Parkinson's disease, essential tremor) became better established, such trial periods have fallen out of favor. However, deep brain stimulation trial periods are experiencing a modern resurgence for at least two reasons: (1) studies of newer indications such as depression or chronic pain aim to identify new targets and (2) a growing interest in adaptive DBS tools necessitates neurophysiological recordings, which are often done in the peri-surgical period. In this review, we consider the possible approaches, benefits, and risks of such inpatient trial periods with a specific focus on developing new DBS therapies for chronic pain.
Collapse
Affiliation(s)
- Prasad Shirvalkar
- Department of Anesthesiology (Pain Management), University of California San Francisco, San Francisco, CA 94143, USA;
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (K.K.S.); (A.S.); (I.J.); (P.A.S.); (E.F.C.)
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
- Correspondence:
| | - Kristin K. Sellers
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (K.K.S.); (A.S.); (I.J.); (P.A.S.); (E.F.C.)
| | - Ashlyn Schmitgen
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (K.K.S.); (A.S.); (I.J.); (P.A.S.); (E.F.C.)
| | - Jordan Prosky
- Department of Anesthesiology (Pain Management), University of California San Francisco, San Francisco, CA 94143, USA;
| | - Isabella Joseph
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (K.K.S.); (A.S.); (I.J.); (P.A.S.); (E.F.C.)
| | - Philip A. Starr
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (K.K.S.); (A.S.); (I.J.); (P.A.S.); (E.F.C.)
| | - Edward F. Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (K.K.S.); (A.S.); (I.J.); (P.A.S.); (E.F.C.)
| |
Collapse
|
27
|
Gerbella M, Pinardi C, Di Cesare G, Rizzolatti G, Caruana F. Two Neural Networks for Laughter: A Tractography Study. Cereb Cortex 2020; 31:899-916. [DOI: 10.1093/cercor/bhaa264] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/14/2020] [Accepted: 08/14/2020] [Indexed: 02/07/2023] Open
Abstract
Abstract
Laughter is a complex motor behavior occurring in both emotional and nonemotional contexts. Here, we investigated whether the different functions of laughter are mediated by distinct networks and, if this is the case, which are the white matter tracts sustaining them. We performed a multifiber tractography investigation placing seeds in regions involved in laughter production, as identified by previous intracerebral electrical stimulation studies in humans: the pregenual anterior cingulate (pACC), ventral temporal pole (TPv), frontal operculum (FO), presupplementary motor cortex, and ventral striatum/nucleus accumbens (VS/NAcc). The primary motor cortex (M1) and two subcortical territories were also studied to trace the descending projections. Results provided evidence for the existence of two relatively distinct networks. A first network, including pACC, TPv, and VS/NAcc, is interconnected through the anterior cingulate bundle, the accumbofrontal tract, and the uncinate fasciculus, reaching the brainstem throughout the mamillo-tegmental tract. This network is likely involved in the production of emotional laughter. A second network, anchored to FO and M1, projects to the brainstem motor nuclei through the internal capsule. It is most likely the neural basis of nonemotional and conversational laughter. The two networks interact throughout the pre-SMA that is connected to both pACC and FO.
Collapse
Affiliation(s)
- M Gerbella
- Department of Medicine and Surgery, University of Parma, Parma 43125, Italy
| | - C Pinardi
- Neuroradiology Department, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Milan 20133, Italy
| | - G Di Cesare
- Cognitive Architecture for Collaborative Technologies Unit, Italian Institute of Technology, Genova 16163, Italy
| | - G Rizzolatti
- Department of Medicine and Surgery, University of Parma, Parma 43125, Italy
- Institute of Neuroscience, Italian National Research Council (CNR), Parma 43125, Italy
| | - F Caruana
- Institute of Neuroscience, Italian National Research Council (CNR), Parma 43125, Italy
| |
Collapse
|
28
|
Smith EE, Schüller T, Huys D, Baldermann JC, Andrade P, Allen JJ, Visser-Vandewalle V, Ullsperger M, Gruendler TOJ, Kuhn J. A brief demonstration of frontostriatal connectivity in OCD patients with intracranial electrodes. Neuroimage 2020; 220:117138. [PMID: 32634597 DOI: 10.1016/j.neuroimage.2020.117138] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 06/19/2020] [Accepted: 07/02/2020] [Indexed: 01/05/2023] Open
Abstract
Closed-loop neuromodulation is presumed to be the logical evolution for improving the effectiveness of deep brain stimulation (DBS) treatment protocols (Widge et al., 2018). Identifying symptom-relevant biomarkers that provide meaningful feedback to stimulator devices is an important initial step in this direction. This report demonstrates a technique for assaying neural circuitry hypothesized to contribute to OCD and DBS treatment outcomes. We computed phase-lag connectivity between LFPs and EEGs in thirteen treatment-refractory OCD patients. Simultaneous recordings from scalp EEG and externalized DBS electrodes in the ventral capsule/ventral striatum (VC/VS) were collected at rest during the perioperative treatment stage. Connectivity strength between midfrontal EEG sensors and VC/VS electrodes correlated with baseline OCD symptoms and 12-month posttreatment OCD symptoms. Results are qualified by a relatively small sample size, and limitations regarding the conclusiveness of VS and mPFC as neural generators given some concerns about volume conduction. Nonetheless, findings are consistent with treatment-relevant tractography findings and theories that link frontostriatal hyperconnectivity to the etiopathogenesis of OCD. Findings support the continued investigation of connectivity-based assays for aiding in determination of optimal stimulation location, and are an initial step towards the identification of biomarkers that can guide closed-loop neuromodulation systems.
Collapse
Affiliation(s)
- Ezra E Smith
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychology, University of Arizona, Tucson, AZ, USA.
| | - Thomas Schüller
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Daniel Huys
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Juan Carlos Baldermann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Pablo Andrade
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany
| | - John Jb Allen
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Veerle Visser-Vandewalle
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany
| | - Markus Ullsperger
- Otto von Guericke University, Institute of Psychology, Magdeburg, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Theo O J Gruendler
- Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Jens Kuhn
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany; Department of Psychiatry, Psychotherapy, and Psychosomatics, Johanniter Hospital Oberhausen, Oberhausen, Germany
| |
Collapse
|
29
|
Caruana F, Avanzini P, Pelliccia V, Mariani V, Zauli F, Sartori I, Del Vecchio M, Lo Russo G, Rizzolatti G. Mirroring other's laughter. Cingulate, opercular and temporal contributions to laughter expression and observation. Cortex 2020; 128:35-48. [DOI: 10.1016/j.cortex.2020.02.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/29/2020] [Accepted: 02/25/2020] [Indexed: 01/19/2023]
|
30
|
Oane I, Barborica A, Chetan F, Donos C, Maliia MD, Arbune AA, Daneasa A, Pistol C, Nica AE, Bajenaru OA, Mindruta I. Cingulate cortex function and multi-modal connectivity mapped using intracranial stimulation. Neuroimage 2020; 220:117059. [PMID: 32562780 DOI: 10.1016/j.neuroimage.2020.117059] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/19/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022] Open
Abstract
The cingulate cortex is part of the limbic system. Its function and connectivity are organized in a rostro-caudal and ventral-dorsal manner which was addressed by various other studies using rather coarse cortical parcellations. In this study, we aim at describing its function and connectivity using invasive recordings from patients explored for focal drug-resistant epilepsy. We included patients that underwent stereo-electroencephalographic recordings using intracranial electrodes in the University Emergency Hospital Bucharest between 2012 and 2019. We reviewed all high frequency stimulations (50 Hz) performed for functional mapping of the cingulate cortex. We used two methods to characterize brain connectivity. Effective connectivity was inferred based on the analysis of cortico-cortical potentials (CCEPs) evoked by single pulse electrical stimulation (SPES) (15 s inter-pulse interval). Functional connectivity was estimated using the non-linear regression method applied to 60 s spontaneous electrical brain signal intervals. The effective (stimulation-evoked) and functional (non-evoked) connectivity analyses highlight brain networks in a different way. While non-evoked connectivity evidences areas having related activity, often in close proximity to each other, evoked connectivity highlights spatially extended networks. To highlight in a comprehensive way the cingulate cortex's network, we have performed a bi-modal connectivity analysis that combines the resting-state broadband h2 non-linear correlation with cortico-cortical evoked potentials. We co-registered the patient's anatomy with the fsaverage FreeSurfer template to perform the automatic labeling based on HCP-MMP parcellation. At a group level, connectivity was estimated by averaging responses over stimulated/recorded or recorded sites in each pair of parcels. Finally, for multiple regions that evoked a clinical response during high frequency stimulation, we combined the connectivity of individual pairs using maximum intensity projection. Connectivity was assessed by applying SPES on 2094 contact pairs and recording CCEPs on 3580 contacts out of 8582 contacts of 660 electrodes implanted in 47 patients. Clinical responses elicited by high frequency stimulations in 107 sites (pairs of contacts) located in the cingulate cortex were divided in 10 groups: affective, motor behavior, motor elementary, versive, speech, vestibular, autonomic, somatosensory, visual and changes in body perception. Anterior cingulate cortex was shown to be connected to the mesial temporal, orbitofrontal and prefrontal cortex. In the middle cingulate cortex, we located affective, motor behavior in the anterior region, and elementary motor and somatosensory in the posterior part. This region is connected to the prefrontal, premotor and primary motor network. Finally, the posterior cingulate was shown to be connected with the visual areas, mesial and lateral parietal and temporal cortex.
Collapse
Affiliation(s)
- Irina Oane
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania.
| | - Andrei Barborica
- Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Filip Chetan
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania.
| | - Cristian Donos
- Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Mihai Dragos Maliia
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Anca Adriana Arbune
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania.
| | - Andrei Daneasa
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania.
| | - Constantin Pistol
- Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Adriana Elena Nica
- Intensive Care Unit Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania.
| | - Ovidiu Alexandru Bajenaru
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania; Brain Research Group, Romanian Academy, 125 Calea Victoriei Street, Bucharest, Romania.
| | - Ioana Mindruta
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania; Brain Research Group, Romanian Academy, 125 Calea Victoriei Street, Bucharest, Romania.
| |
Collapse
|
31
|
Drane DL, Pedersen NP. Finding the Sweet Spot: Fine-Tuning DBS Parameters to Cure Seizures While Avoiding Psychiatric Complications. Epilepsy Curr 2019; 19:174-176. [PMID: 31068005 PMCID: PMC6610392 DOI: 10.1177/1535759719845326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Reversible Psychiatric Adverse Effects Related to Deep Brain Stimulation of the Anterior Thalamus in Patients With Refractory Epilepsy Järvenpää S, Peltola J, Rainesalo S, et al. Epilepsy Behav. 2018;88:373-379. doi:10.1016/j.yebeh.2018.09.006 Objective: Anterior nucleus of thalamus (ANT) deep brain stimulation (DBS) is becoming a more common treatment for drug-resistant epilepsy. Epilepsy and depression display a bidirectional association. Anterior nucleus of thalamus has connections to anterior cingulate cortex and orbitomedial prefrontal cortex, hence, a possible role in emotional and executive functions, and thus, ANT DBS might exert psychiatric adverse effects. Our aim was to evaluate previous and current psychiatric symptoms in patients with epilepsy undergoing ANT DBS surgery and assess the predictability of psychiatric adverse effects. Programming-related psychiatric adverse effects are also reported. Method: Twenty-two patients with ANT DBS for retractable epilepsy were examined, and a psychiatric evaluation of depressive and other psychiatric symptoms was performed with Montgomery-Åsberg Depression Rating Scale, Beck Depression Inventory, and Symptom Checklist prior to surgery, concentrating on former and current psychiatric symptoms and medications. The follow-up visit was 1 year after surgery. Results: At the group level, no changes in mood were observed during ANT DBS treatment. Two patients with former histories of depression experienced sudden depressive symptoms related to DBS programming settings; these were quickly alleviated after changing the stimulation parameters. In addition, 2 patients with no previous histories of psychosis gradually developed clear paranoid and anxiety symptoms that also relieved slowly after changing the programming settings. Conclusion: The majority of our ANT DBS patients did not experience psychiatric adverse effects. Certain DBS parameters might predispose to sudden depressive or slowly manifesting paranoid symptoms that are reversible via programming changes.
Collapse
|
32
|
Abstract
A variety of neurological procedures, including deep brain stimulation and craniotomies that require tissue removal near elegant cortices, require patients to remain awake and responsive in order to monitor function. Such procedures can produce anxiety and are poorly tolerated in some subjects. In this issue of the JCI, Bijanki and colleagues demonstrate that electrical stimulation of the left dorsal anterior cingulum bundle promoted a positive (mirthful) effect and reduced anxiety, without sedation, in three patients with epilepsy undergoing intracranial electrode monitoring. The results of this study highlight the need for further evaluation of anterior cingulum stimulation to reduce anxiety during awake surgery and as a possible approach for treating anxiety disorders.
Collapse
|
33
|
Einecke D. [Not Available]. MMW Fortschr Med 2019; 161:30. [PMID: 30778972 DOI: 10.1007/s15006-019-0178-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|