Simultaneous trimodal PET-MR-EEG imaging: Do EEG caps generate artefacts in PET images?

Simultaneous electroencephalography-functional magnetic resonance imaging for assessment of human brain function

Electroencephalography (EEG) and functional Magnetic Resonance Imaging (MRI) have long been used as tools to examine brain activity. Since both methods are very sensitive to changes of synaptic activity, simultaneous recording of EEG and fMRI can provide both high temporal and spatial resolution. Therefore, the two modalities are now integrated into a hybrid tool, EEG-fMRI, which encapsulates the useful properties of the two. Among other benefits, EEG-fMRI can contribute to a better understanding of brain connectivity and networks. This review lays its focus on the methodologies applied in performing EEG-fMRI studies, namely techniques used for the recording of EEG inside the scanner, artifact removal, and statistical analysis of the fMRI signal. We will investigate simultaneous resting-state and task-based EEG-fMRI studies and discuss their clinical and technological perspectives. Moreover, it is established that the brain regions affected by a task-based neural activity might not be limited to the regions in which they have been initiated. Advanced methods can help reveal the regions responsible for or affected by a developed neural network. Therefore, we have also looked into studies related to characterization of structure and dynamics of brain networks. The reviewed literature suggests that EEG-fMRI can provide valuable complementary information about brain neural networks and functions.

Simultaneous EEG-fMRI: What Have We Learned and What Does the Future Hold?

Simultaneous EEG-fMRI has developed into a mature measurement technique in the past 25 years. During this time considerable technical and analytical advances have been made, enabling valuable scientific contributions to a range of research fields. This review will begin with an introduction to the measurement principles involved in EEG and fMRI and the advantages of combining these methods. The challenges faced when combining the two techniques will then be considered. An overview of the leading application fields where EEG-fMRI has made a significant contribution to the scientific literature and emerging applications in EEG-fMRI research trends is then presented.

Multi-scale neural decoding and analysis

Objective.

Complex spatiotemporal neural activity encodes rich information related to behavior and cognition. Conventional research has focused on neural activity acquired using one of many different measurement modalities, each of which provides useful but incomplete assessment of the neural code. Multi-modal techniques can overcome tradeoffs in the spatial and temporal resolution of a single modality to reveal deeper and more comprehensive understanding of system-level neural mechanisms. Uncovering multi-scale dynamics is essential for a mechanistic understanding of brain function and for harnessing neuroscientific insights to develop more effective clinical treatment.

Approach.

We discuss conventional methodologies used for characterizing neural activity at different scales and review contemporary examples of how these approaches have been combined. Then we present our case for integrating activity across multiple scales to benefit from the combined strengths of each approach and elucidate a more holistic understanding of neural processes.

Main results.

We examine various combinations of neural activity at different scales and analytical techniques that can be used to integrate or illuminate information across scales, as well the technologies that enable such exciting studies. We conclude with challenges facing future multi-scale studies, and a discussion of the power and potential of these approaches.

Significance.

This roadmap will lead the readers toward a broad range of multi-scale neural decoding techniques and their benefits over single-modality analyses. This Review article highlights the importance of multi-scale analyses for systematically interrogating complex spatiotemporal mechanisms underlying cognition and behavior.

Excitatory-inhibitory balance within EEG microstates and resting-state fMRI networks: assessed via simultaneous trimodal PET-MR-EEG imaging

The symbiosis of neuronal activities and glucose energy metabolism is reflected in the generation of functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) signals. However, their association with the balance between neuronal excitation and inhibition (E/I-B), which is closely related to the activities of glutamate and γ-aminobutyric acid (GABA) and the receptor availability (RA) of GABAA and mGluR5, remains unexplored. This research investigates these associations during the resting state (RS) condition using simultaneously recorded PET/MR/EEG (trimodal) data. The trimodal data were acquired from three studies using different radio-tracers such as, [11C]ABP688 (ABP) (N = 9), [11C]Flumazenil (FMZ) (N = 10) and 2-[18F]fluoro-2-deoxy-D-glucose (FDG) (N = 10) targeted to study the mGluR5, GABAA receptors and glucose metabolism respectively. Glucose metabolism and neuroreceptor binding availability (non-displaceable binding potential (BPND)) of GABAA and mGluR5 were found to be significantly higher and closely linked within core resting-state networks (RSNs). The neuronal generators of EEG microstates and the fMRI measures were most tightly associated with the BPND of GABAA relative to mGluR5 BPND and the glucose metabolism, emphasising a predominance of inhibitory processes within in the core RSNs at rest. Changes in the neuroreceptors leading to an altered coupling with glucose metabolism may render the RSNs vulnerable to psychiatric conditions. The paradigm employed here will likely help identify the precise neurobiological mechanisms behind these alterations in fMRI functional connectivity and EEG oscillations, potentially benefitting individualised healthcare treatment measures.

Simultaneous EEG-fMRI for Functional Neurological Assessment

The increasing incidence of neurodegenerative and psychiatric diseases requires increasingly sophisticated tools for their diagnosis and monitoring. Clinical assessment takes advantage of objective parameters extracted by electroencephalogram and magnetic resonance imaging (MRI) among others, to support clinical management of neurological diseases. The complementarity of these two tools can be now emphasized by the possibility of integrating the two technologies in a hybrid solution, allowing simultaneous acquisition of the two signals by the novel EEG-fMRI technology. This review will focus on simultaneous EEG-fMRI technology and related early studies, dealing about issues related to the acquisition and processing of simultaneous signals, and including critical discussion about clinical and technological perspectives.

Development of Dedicated Brain PET Imaging Devices: Recent Advances and Future Perspectives

Whole-body PET scanners are not optimized for imaging small structures in the human brain. Several PET devices specifically designed for this task have been proposed either for stand-alone operation or as MR-compatible inserts. The main distinctive features of some of the most recent concepts and their performance characteristics, with a focus on spatial resolution and sensitivity, are reviewed. The trade-offs between the various performance characteristics, desired capabilities, and cost that need to be considered when designing a dedicated brain scanner are presented. Finally, the aspirational goals for future-generation scanners, some of the factors that have contributed to the current status, and how recent advances may affect future developments in dedicated brain PET instrumentation are briefly discussed.

Alternative headphones for patient noise protection and communication in PET-MR studies of the brain

Introduction

Due to the high noise emission generated by the gradients in magnetic resonance imaging (MRI), an efficient method of noise protection is mandatory. In addition to providing hearing protection, appropriate headphone systems also serve to facilitate communication between the operator and the patient. However, in combined PET-MR devices, use of common pneumatic headphones, as delivered by the manufacturer, is problematic due to the potential generation of attenuation artefacts in the PET measurement. Furthermore, modern multichannel head coils rarely provide space for conventional headphones. This work presents an alternative system, which aims to address these limitations while still being appropriate for both patient noise protection and communication in PET-MR.

Material and methods

As an alternative to the standard headphones supplied with the PET-MR (3T MR-BrainPET, Siemens), the possibility of using earphones built out of commercially available earplugs has been investigated. The air channel (E-A-RLink) of the earplug is connected to the tubes of the original headphones. The attenuation characteristics of the conventional headphones and of the modified earphones were measured using a dedicated PET system with a ⁶⁸Ge transmission source. For this purpose, the headphones, and then the earphones, were attached to a non-radioactive head phantom. To investigate the influence of the different phones on PET emission images, measurements of the head phantom, filled with ¹⁸F solution, were performed in the PET-MR. A measurement of the head phantom without headphones or earphones was used as a reference.

Results

The linear attenuation coefficient of the headphones was 0.11 cm^-1 and that of the head phantom 0.10 cm^-1. The earphones were not identifiable in the transmission image. The emission image showed an activity underestimation of 10% near the headphones, compared to the reference image, whereas the earphones did not affect the image. Communication with the patient via the earphones was successful, and the noise protection—as confirmed by investigated subjects—was satisfying.

Conclusion

The presented earphones, which can be connected to the existing patient communication system, are a preferable alternative to the conventional headphones, as, in contrast to the use of headphones, qualitative and quantitative errors in the PET images can be avoided. Patient acceptance of the earphones was high, despite the increase in preparation time before the PET-MR study.

Comparison of EEG microstates with resting state fMRI and FDG-PET measures in the default mode network via simultaneously recorded trimodal (PET/MR/EEG) data

Simultaneous trimodal positron emission tomography/magnetic resonance imaging/electroencephalography (PET/MRI/EEG) resting state (rs) brain data were acquired from 10 healthy male volunteers. The rs-functional MRI (fMRI) metrics, such as regional homogeneity (ReHo), degree centrality (DC) and fractional amplitude of low-frequency fluctuations (fALFFs), as well as 2-[18F]fluoro-2-desoxy-d-glucose (FDG)-PET standardised uptake value (SUV), were calculated and the measures were extracted from the default mode network (DMN) regions of the brain. Similarly, four microstates for each subject, showing the diverse functional states of the whole brain via topographical variations due to global field power (GFP), were estimated from artefact-corrected EEG signals. In this exploratory analysis, the GFP of microstates was nonparametrically compared to rs-fMRI metrics and FDG-PET SUV measured in the DMN of the brain. The rs-fMRI metrics (ReHO, fALFF) and FDG-PET SUV did not show any significant correlations with any of the microstates. The DC metric showed a significant positive correlation with microstate C (r_s  = 0.73, p = .01). FDG-PET SUVs indicate a trend for a negative correlation with microstates A, B and C. The positive correlation of microstate C with DC metrics suggests a functional relationship between cortical hubs in the frontal and occipital lobes. The results of this study suggest further exploration of this method in a larger sample and in patients with neuropsychiatric disorders. The aim of this exploratory pilot study is to lay the foundation for the development of such multimodal measures to be applied as biomarkers for diagnosis, disease staging, treatment response and monitoring of neuropsychiatric disorders.

Hybrid PET/MRI Methodology

The hybrid PET/MR scanner represents the first implementation of the effective integration of two modalities allowing truly synchronous/simultaneous acquisition of their imaging signals. This integration, resulting from the innovation and development of specific hardware components has paved the way for new approaches in the study of neurodegenerative diseases. This chapter will describe the hardware development that has led to the availability of different clinical solutions for PET/MR imaging as well as the still-open technological challenges and opportunities related to the processing and exploitation of the simultaneous acquisition in neurological studies.

TRIMAGE: A dedicated trimodality (PET/MR/EEG) imaging tool for schizophrenia

Simultaneous PET/MR/EEG (Positron Emission Tomography - Magnetic Resonance - Electroencephalography), a new tool for the investigation of neuronal networks in the human brain, is presented here within the framework of the European Union Project TRIMAGE. The trimodal, cost-effective PET/MR/EEG imaging tool makes use of cutting edge technology both in PET and in MR fields. A novel type of magnet (1.5T, non-cryogenic) has been built together with a PET scanner that makes use of the most advanced photodetectors (i.e., SiPM matrices), scintillators matrices (LYSO) and digital electronics. The combined PET/MR/EEG system is dedicated to brain imaging and has an inner diameter of 260 mm and an axial Field-of-View of 160 mm. It enables the acquisition and assessment of molecular metabolic information with high spatial and temporal resolution in a given brain simultaneously. The dopaminergic system and the glutamatergic system in schizophrenic patients are investigated via PET, the same physiological/pathophysiological conditions with regard to functional connectivity, via fMRI, and its electrophysiological signature via EEG. In addition to basic neuroscience questions addressing neurovascular-metabolic coupling, this new methodology lays the foundation for individual physiological and pathological fingerprints for a wide research field addressing healthy aging, gender effects, plasticity and different psychiatric and neurological diseases. The preliminary performances of two components of the imaging tool (PET and MR) are discussed. Initial results of the search of possible candidates for suitable schizophrenia biomarkers are also presented as obtained with PET/MR systems available to the collaboration.