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Shigihara Y, Hoshi H, Fukasawa K, Ichikawa S, Kobayashi M, Sakamoto Y, Negishi K, Haraguchi R, Konno S. Resting-State Magnetoencephalography Reveals Neurobiological Bridges Between Pain and Cognitive Impairment. Pain Ther 2020; 10:349-361. [PMID: 33095348 PMCID: PMC8119570 DOI: 10.1007/s40122-020-00213-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/15/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction Pain has been identified as a risk factor for cognitive dysfunction, which in turn affects pain perception. Although pain, cognitive dysfunction, and their interaction are clinically important, the neural mechanism connecting the two phenomena remains unclear. Methods The resting-state brain activity of 38 participants was measured using magnetoencephalography before and after the patients underwent selective nerve root block (SNRB) for the treatment of their pain. We then assessed the extent to which these data correlated with the subjective levels of pain experienced by the patients across SNRB based on the visual analogue scale and the cognitive status of the patients measured after SNRB using the Japanese versions of the Mini-Mental State Examination (MMSE-J). Results Slow oscillations (delta) in the right precentral gyrus, right middle temporal gyrus, and left superior frontal gyrus were negatively correlated with the subjective level of pain, and fast oscillations (gamma) in the right insular cortex and right middle temporal gyrus before SNRB were negatively correlated with the MMSE-J score afterwards. These correlations disappeared after SNRB. Conclusion The presently observed changes in neural activity, as indicated by oscillation changes, might represent the transient bridge between pain and cognitive dysfunction in patients with severe pain. Our findings underscore the importance of treating pain before a transient diminishment of cognitive function becomes persistent.
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Affiliation(s)
- Yoshihito Shigihara
- Precision Medicine Centre, Hokuto Hospital, Obihiro, Japan. .,Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan.
| | - Hideyuki Hoshi
- Precision Medicine Centre, Hokuto Hospital, Obihiro, Japan
| | | | - Sayuri Ichikawa
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, Japan
| | - Momoko Kobayashi
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan
| | - Yuki Sakamoto
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan
| | | | - Rika Haraguchi
- Clinical Laboratory, Kumagaya General Hospital, Kumagaya, Japan
| | - Shin Konno
- Department of Orthopaedics, Kumagaya General Hospital, Kumagaya, Japan
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Shigihara Y, Hoshi H, Shinada K, Okada T, Kamada H. Non-pharmacological treatment changes brain activity in patients with dementia. Sci Rep 2020; 10:6744. [PMID: 32317774 PMCID: PMC7174400 DOI: 10.1038/s41598-020-63881-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 04/07/2020] [Indexed: 12/05/2022] Open
Abstract
Non-pharmacological treatment (NPT) improves cognitive functions and behavioural disturbances in patients with dementia, but the underlying neural mechanisms are unclear. In this observational study, 21 patients with dementia received NPTs for several months. Patients were scanned using magnetoencephalography twice during the NPT period to evaluate NPT effects on resting-state brain activity. Additionally, cognitive functions and behavioural disturbances were measured using the Mini-Mental State Examination (MMSE-J) and a short version of the Dementia Behaviour Disturbance Scale (DBD-13) at the beginning and the end of the NPT period. In contrast to the average DBD-13 score, the average MMSE-J score improved after the NPT period. Magnetoencephalography data revealed a reduced alpha activity in the right temporal lobe and fusiform gyrus, as well as an increased low-gamma activity in the right angular gyrus. DBD-13 score changes were correlated with beta activity in the sensorimotor area. These findings corroborate previous studies confirming NPT effects on brain activity in healthy participants and people at risk of dementia. Our results provide additional evidence that brains of patients with dementia have the capacity for plasticity, which may be responsible for the observed NPT effects. In dementia, NPT might lead to improvements in the quality of life.
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Affiliation(s)
- Yoshihito Shigihara
- Precision Medicine Centre, Hokuto Hospital, Obihiro City, Japan.
- Department of Neurosurgery, Hokuto Hospital, Obihiro City, Japan.
| | - Hideyuki Hoshi
- Precision Medicine Centre, Hokuto Hospital, Obihiro City, Japan
| | - Keita Shinada
- Geriatric Health Services Facility Kakehashi, Hokuto Hospital Group, Obihiro City, Japan
| | - Toyoji Okada
- Department of Clinical Laboratory, Hokuto Hospital, Obihiro City, Japan
| | - Hajime Kamada
- Department of Neurosurgery, Hokuto Hospital, Obihiro City, Japan
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de Haan W, van Straaten ECW, Gouw AA, Stam CJ. Altering neuronal excitability to preserve network connectivity in a computational model of Alzheimer's disease. PLoS Comput Biol 2017; 13:e1005707. [PMID: 28938009 PMCID: PMC5627940 DOI: 10.1371/journal.pcbi.1005707] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/04/2017] [Accepted: 07/17/2017] [Indexed: 01/03/2023] Open
Abstract
Neuronal hyperactivity and hyperexcitability of the cerebral cortex and hippocampal region is an increasingly observed phenomenon in preclinical Alzheimer's disease (AD). In later stages, oscillatory slowing and loss of functional connectivity are ubiquitous. Recent evidence suggests that neuronal dynamics have a prominent role in AD pathophysiology, making it a potentially interesting therapeutic target. However, although neuronal activity can be manipulated by various (non-)pharmacological means, intervening in a highly integrated system that depends on complex dynamics can produce counterintuitive and adverse effects. Computational dynamic network modeling may serve as a virtual test ground for developing effective interventions. To explore this approach, a previously introduced large-scale neural mass network with human brain topology was used to simulate the temporal evolution of AD-like, activity-dependent network degeneration. In addition, six defense strategies that either enhanced or diminished neuronal excitability were tested against the degeneration process, targeting excitatory and inhibitory neurons combined or separately. Outcome measures described oscillatory, connectivity and topological features of the damaged networks. Over time, the various interventions produced diverse large-scale network effects. Contrary to our hypothesis, the most successful strategy was a selective stimulation of all excitatory neurons in the network; it substantially prolonged the preservation of network integrity. The results of this study imply that functional network damage due to pathological neuronal activity can be opposed by targeted adjustment of neuronal excitability levels. The present approach may help to explore therapeutic effects aimed at preserving or restoring neuronal network integrity and contribute to better-informed intervention choices in future clinical trials in AD.
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Affiliation(s)
- Willem de Haan
- Department of Clinical Neurophysiology and MEG, VUmc, Amsterdam, The Netherlands
- Alzheimer Center and Department of Neurology, VUmc, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | | | - Alida A. Gouw
- Department of Clinical Neurophysiology and MEG, VUmc, Amsterdam, The Netherlands
- Alzheimer Center and Department of Neurology, VUmc, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Cornelis J. Stam
- Department of Clinical Neurophysiology and MEG, VUmc, Amsterdam, The Netherlands
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Engels MMA, van der Flier WM, Stam CJ, Hillebrand A, Scheltens P, van Straaten ECW. Alzheimer's disease: The state of the art in resting-state magnetoencephalography. Clin Neurophysiol 2017. [PMID: 28622527 DOI: 10.1016/j.clinph.2017.05.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease (AD) is accompanied by functional brain changes that can be detected in imaging studies, including electromagnetic activity recorded with magnetoencephalography (MEG). Here, we systematically review the studies that have examined resting-state MEG changes in AD and identify areas that lack scientific or clinical progress. Three levels of MEG analysis will be covered: (i) single-channel signal analysis, (ii) pairwise analyses over time series, which includes the study of interdependencies between two time series and (iii) global network analyses. We discuss the findings in the light of other functional modalities, such as electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). Overall, single-channel MEG results show consistent changes in AD that are in line with EEG studies, but the full potential of the high spatial resolution of MEG and advanced functional connectivity and network analysis has yet to be fully exploited. Adding these features to the current knowledge will potentially aid in uncovering organizational patterns of brain function in AD and thereby aid the understanding of neuronal mechanisms leading to cognitive deficits.
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Affiliation(s)
- M M A Engels
- Alzheimer Centrum and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - W M van der Flier
- Alzheimer Centrum and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - C J Stam
- Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, Amsterdam, The Netherlands
| | - A Hillebrand
- Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Ph Scheltens
- Alzheimer Centrum and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - E C W van Straaten
- Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, Amsterdam, The Netherlands
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Engels MMA, Hillebrand A, van der Flier WM, Stam CJ, Scheltens P, van Straaten ECW. Slowing of Hippocampal Activity Correlates with Cognitive Decline in Early Onset Alzheimer's Disease. An MEG Study with Virtual Electrodes. Front Hum Neurosci 2016; 10:238. [PMID: 27242496 PMCID: PMC4873509 DOI: 10.3389/fnhum.2016.00238] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/05/2016] [Indexed: 11/13/2022] Open
Abstract
Pathology in Alzheimer's disease (AD) starts in the entorhinal cortex and hippocampus. Because of their deep location, activity from these areas is difficult to record with conventional electro- or magnetoencephalography (EEG/MEG). The purpose of this study was to explore hippocampal activity in AD patients and healthy controls using "virtual MEG electrodes". We used resting-state MEG recordings from 27 early onset AD patients [age 60.6 ± 5.4, 12 females, mini-mental state examination (MMSE) range: 19-28] and 26 cognitively healthy age- and gender-matched controls (age 61.8 ± 5.5, 14 females). Activity was reconstructed using beamformer-based virtual electrodes for 78 cortical regions and 6 hippocampal regions. Group differences in peak frequency and relative power in six frequency bands were identified using permutation testing. For the patients, spearman correlations between the MMSE scores and peak frequency or relative power were calculated. Moreover, receiver operator characteristic curves were plotted to estimate the diagnostic accuracy. We found a lower hippocampal peak frequency in AD compared to controls, which, in the patients, correlated positively with MMSE [r(25) = 0.61; p < 0.01] whereas hippocampal relative theta power correlated negatively with MMSE [r(25) = -0.54; p < 0.01]. Cortical peak frequency was also lower in AD in association areas. Furthermore, cortical peak frequency correlated positively with MMSE [r(25) = 0.43; p < 0.05]. In line with this finding, relative theta power was higher in AD across the cortex, and relative alpha and beta power was lower in more circumscribed areas. The average cortical relative theta power was the best discriminator between AD and controls (sensitivity 82%; specificity 81%). Using beamformer-based virtual electrodes, we were able to detect hippocampal activity in AD. In AD, this hippocampal activity is slowed, and correlates better with cognition than the (slowed) activity in cortical areas. On the other hand, the average cortical relative power in the theta band was shown to be the best diagnostic discriminator. We postulate that this novel approach using virtual electrodes can be used in future research to quantify functional interactions between the hippocampi and cortical areas.
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Affiliation(s)
- Marjolein M A Engels
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Netherlands
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical CenterAmsterdam, Netherlands; Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical CenterAmsterdam, Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Netherlands
| | - Elisabeth C W van Straaten
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Neuroscience Campus Amsterdam, VU University Medical CenterAmsterdam, Netherlands; Nutricia Advanced Medical Nutrition, Nutricia ResearchUtrecht, Netherlands
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D'Amelio M, Rossini PM. Brain excitability and connectivity of neuronal assemblies in Alzheimer's disease: from animal models to human findings. Prog Neurobiol 2012; 99:42-60. [PMID: 22789698 DOI: 10.1016/j.pneurobio.2012.07.001] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Revised: 06/08/2012] [Accepted: 07/02/2012] [Indexed: 10/28/2022]
Abstract
The human brain contains about 100 billion neurons forming an intricate network of innumerable connections, which continuously adapt and rewire themselves following inputs from external and internal environments as well as the physiological synaptic, dendritic and axonal sculpture during brain maturation and throughout the life span. Growing evidence supports the idea that Alzheimer's disease (AD) targets selected and functionally connected neuronal networks and, specifically, their synaptic terminals, affecting brain connectivity well before producing neuronal loss and compartmental atrophy. The understanding of the molecular mechanisms underlying the dismantling of neuronal circuits and the implementation of 'clinically oriented' methods to map-out the dynamic interactions amongst neuronal assemblies will enhance early/pre-symptomatic diagnosis and monitoring of disease progression. More important, this will open the avenues to innovative treatments, bridging the gap between molecular mechanisms and the variety of symptoms forming disease phenotype. In the present review a set of evidence supports the idea that altered brain connectivity, exhausted neural plasticity and aberrant neuronal activity are facets of the same coin linked to age-related neurodegenerative dementia of Alzheimer type. Investigating their respective roles in AD pathophysiology will help in translating findings from basic research to clinical applications.
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Affiliation(s)
- Marcello D'Amelio
- IRCCS S. Lucia Foundation, Via del Fosso di Fiorano 65, 00143 Rome, Italy.
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Abstract
PURPOSE OF REVIEW Magnetoencephalography (MEG) has been available for over 30 years, but the past 10 years have seen serious investigation of its use as a clinical tool. It is therefore an opportune time to review how MEG is able to contribute to neuropsychiatric research and practice. RECENT FINDINGS We limit this review to the areas of dementia, schizophrenia, depression and autism. MEG can achieve correct classification of individuals with mild cognitive impairment versus Alzheimer's disease, may identify a marker of early disease in schizophrenia, can distinguish bipolar from major depressive disorder, and has been used to study cognitive and other deficits in autism. It provides a valuable tool to study cognitive dysfunction. SUMMARY The most important aspect of MEG is the ability to record neural activity with millisecond precision, allowing coherence analysis of neural data to examine how brain areas are synchronized. Such synchrony is thought to underlie cognitive processes. As cognitive dysfunction is a common marker of neuropsychiatric disorders, MEG is emerging as an important investigatory tool in neuropsychiatry. It may also be useful clinically for early or differential diagnosis of some neuropsychiatric disorders, or for the prediction of drug effects, but more research is necessary before this becomes a clinical reality.
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Paul R. Do you see what I see? J Clin Exp Neuropsychol 2008. [DOI: 10.1080/13803390701785757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Robert Paul
- a University of Missouri – St. Louis , St. Louis, MO, USA
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Magnetic Source Imaging of Cortical Dysfunction in Amyotrophic Lateral Sclerosis. Am J Phys Med Rehabil 2008; 87:427-37. [DOI: 10.1097/phm.0b013e318174e7f1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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