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Gogulski J, Cline CC, Ross JM, Truong J, Sarkar M, Parmigiani S, Keller CJ. Mapping cortical excitability in the human dorsolateral prefrontal cortex. Clin Neurophysiol 2024; 164:138-148. [PMID: 38865780 PMCID: PMC11246810 DOI: 10.1016/j.clinph.2024.05.008] [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: 11/04/2023] [Revised: 04/10/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) to the dorsolateral prefrontal cortex (dlPFC) is an effective treatment for depression, but the neural effects after TMS remains unclear. TMS paired with electroencephalography (TMS-EEG) can causally probe these neural effects. Nonetheless, variability in single pulse TMS-evoked potentials (TEPs) across dlPFC subregions, and potential artifact induced by muscle activation, necessitate detailed mapping for accurate treatment monitoring. OBJECTIVE To characterize early TEPs anatomically and temporally (20-50 ms) close to the TMS pulse (EL-TEPs), as well as associated muscle artifacts (<20 ms), across the dlPFC. We hypothesized that TMS location and angle influence EL-TEPs, and specifically that conditions with larger muscle artifact may exhibit lower observed EL-TEPs due to over-rejection during preprocessing. Additionally, we sought to determine an optimal group-level TMS target and angle, while investigating the potential benefits of a personalized approach. METHODS In 16 healthy participants, we applied single-pulse TMS to six targets within the dlPFC at two coil angles and measured EEG responses. RESULTS Stimulation location significantly influenced observed EL-TEPs, with posterior and medial targets yielding larger EL-TEPs. Regions with high EL-TEP amplitude had less muscle artifact, and vice versa. The best group-level target yielded 102% larger EL-TEP responses compared to other dlPFC targets. Optimal dlPFC target differed across subjects, suggesting that a personalized targeting approach might boost the EL-TEP by an additional 36%. SIGNIFICANCE EL-TEPs can be probed without significant muscle-related confounds in posterior-medial regions of the dlPFC. The identification of an optimal group-level target and the potential for further refinement through personalized targeting hold significant implications for optimizing depression treatment protocols.
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Affiliation(s)
- Juha Gogulski
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA; Department of Clinical Neurophysiology, HUS Diagnostic Center, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, FI-00029 HUS, Finland
| | - Christopher C Cline
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Jessica M Ross
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94394, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Jade Truong
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Manjima Sarkar
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Sara Parmigiani
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Corey J Keller
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, 94394, USA.
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Bardel B, Créange A, Bonardet N, Bapst B, Zedet M, Wahab A, Ayache SS, Lefaucheur JP. Motor function in multiple sclerosis assessed by navigated transcranial magnetic stimulation mapping. J Neurol 2024; 271:4513-4528. [PMID: 38709305 DOI: 10.1007/s00415-024-12398-x] [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: 02/09/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Impaired motor function is a major cause of disability in multiple sclerosis (MS), involving various neuroplasticity processes typically assessed by neuroimaging. This study aimed to determine whether navigated transcranial magnetic stimulation (nTMS) could also provide biomarkers of motor cortex plasticity in patients with MS (pwMS). METHODS nTMS motor mapping was performed for hand and leg muscles bilaterally. nTMS variables included the amplitude and latency of motor evoked potentials (MEPs), corticospinal excitability measures, and the size of cortical motor maps (CMMs). Clinical assessment included disability (Expanded Disability Status Scale, EDSS), strength (MRC scale, pinch and grip), and dexterity (9-hole Pegboard Test). RESULTS nTMS motor mapping was performed in 68 pwMS. PwMS with high disability (EDSS ≥ 3) had enlarged CMMs with less dense distribution of MEPs and various MEP parameter changes compared to pwMS with low disability (EDSS < 3). Patients with progressive MS had also various MEP parameter changes compared to pwMS with relapsing remitting form. MRC score correlated positively with MEP amplitude and negatively with MEP latency, pinch strength correlated negatively with CMM volume and dexterity with MEP latency. CONCLUSIONS This is the first study to perform 4-limb cortical motor mapping in pwMS using a dedicated nTMS procedure. By quantifying the cortical surface representation of a given muscle and the variability of MEP within this representation, nTMS can provide new biomarkers of motor function impairment in pwMS. Our study opens perspectives for the use of nTMS as an objective method for assessing pwMS disability in clinical practice.
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Affiliation(s)
- Benjamin Bardel
- Excitabilité Nerveuse Et Thérapeutique (ENT), Univ Paris Est Creteil, EA 4391, 8 Rue du Général Sarrail, Créteil, 94000, France.
- Service Des Explorations Fonctionnelles Non Invasives, Department of Clinical Neurophysiology, DMU FIxIT, AP-HP, Unité de Neurophysiologie Clinique, Hôpital Universitaire Henri Mondor, Henri Mondor University Hospital, 1 Rue Gustave Eiffel, 94000, Creteil, France.
- Centre de Ressources Et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, 1 Rue Gustave Eiffel, 94000, Creteil, France.
| | - Alain Créange
- Excitabilité Nerveuse Et Thérapeutique (ENT), Univ Paris Est Creteil, EA 4391, 8 Rue du Général Sarrail, Créteil, 94000, France
- Centre de Ressources Et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, 1 Rue Gustave Eiffel, 94000, Creteil, France
- Department of Neurology, AP-HP, Henri Mondor University Hospital, DMU Médecine, 1 Rue Gustave Eiffel, 94000, Creteil, France
| | - Nathalie Bonardet
- Excitabilité Nerveuse Et Thérapeutique (ENT), Univ Paris Est Creteil, EA 4391, 8 Rue du Général Sarrail, Créteil, 94000, France
| | - Blanche Bapst
- Excitabilité Nerveuse Et Thérapeutique (ENT), Univ Paris Est Creteil, EA 4391, 8 Rue du Général Sarrail, Créteil, 94000, France
- Centre de Ressources Et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, 1 Rue Gustave Eiffel, 94000, Creteil, France
- Department of Neuroradiology, AP-HP, Henri Mondor University Hospital, DMU FIxIT, 1 Rue Gustave Eiffel, 94000, Creteil, France
| | - Mickael Zedet
- Centre de Ressources Et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, 1 Rue Gustave Eiffel, 94000, Creteil, France
- Department of Neurology, AP-HP, Henri Mondor University Hospital, DMU Médecine, 1 Rue Gustave Eiffel, 94000, Creteil, France
| | - Abir Wahab
- Centre de Ressources Et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, 1 Rue Gustave Eiffel, 94000, Creteil, France
- Department of Neurology, AP-HP, Henri Mondor University Hospital, DMU Médecine, 1 Rue Gustave Eiffel, 94000, Creteil, France
| | - Samar S Ayache
- Excitabilité Nerveuse Et Thérapeutique (ENT), Univ Paris Est Creteil, EA 4391, 8 Rue du Général Sarrail, Créteil, 94000, France
- Service Des Explorations Fonctionnelles Non Invasives, Department of Clinical Neurophysiology, DMU FIxIT, AP-HP, Unité de Neurophysiologie Clinique, Hôpital Universitaire Henri Mondor, Henri Mondor University Hospital, 1 Rue Gustave Eiffel, 94000, Creteil, France
- Centre de Ressources Et de Compétences SEP Grand-Paris Est, Hôpital Universitaire Henri Mondor, 1 Rue Gustave Eiffel, 94000, Creteil, France
- Department of Neurology, AP-HP, Henri Mondor University Hospital, DMU Médecine, 1 Rue Gustave Eiffel, 94000, Creteil, France
| | - Jean-Pascal Lefaucheur
- Excitabilité Nerveuse Et Thérapeutique (ENT), Univ Paris Est Creteil, EA 4391, 8 Rue du Général Sarrail, Créteil, 94000, France
- Service Des Explorations Fonctionnelles Non Invasives, Department of Clinical Neurophysiology, DMU FIxIT, AP-HP, Unité de Neurophysiologie Clinique, Hôpital Universitaire Henri Mondor, Henri Mondor University Hospital, 1 Rue Gustave Eiffel, 94000, Creteil, France
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Bressler S, Neely R, Yost RM, Wang D. A randomized controlled trial of alpha phase-locked auditory stimulation to treat symptoms of sleep onset insomnia. Sci Rep 2024; 14:13039. [PMID: 38844793 PMCID: PMC11156862 DOI: 10.1038/s41598-024-63385-1] [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: 06/27/2023] [Accepted: 05/28/2024] [Indexed: 06/09/2024] Open
Abstract
Sleep onset insomnia is a pervasive problem that contributes significantly to the poor health outcomes associated with insufficient sleep. Auditory stimuli phase-locked to slow-wave sleep oscillations have been shown to augment deep sleep, but it is unknown whether a similar approach can be used to accelerate sleep onset. The present randomized controlled crossover trial enrolled adults with objectively verified sleep onset latencies (SOLs) greater than 30 min to test the effect of auditory stimuli delivered at specific phases of participants' alpha oscillations prior to sleep onset. During the intervention week, participants wore an electroencephalogram (EEG)-enabled headband that delivered acoustic pulses timed to arrive anti-phase with alpha for 30 min (Stimulation). During the Sham week, the headband silently recorded EEG. The primary outcome was SOL determined by blinded scoring of EEG records. For the 21 subjects included in the analyses, stimulation had a significant effect on SOL according to a linear mixed effects model (p = 0.0019), and weekly average SOL decreased by 10.5 ± 15.9 min (29.3 ± 44.4%). These data suggest that phase-locked acoustic stimulation can be a viable alternative to pharmaceuticals to accelerate sleep onset in individuals with prolonged sleep onset latencies. Trial Registration: This trial was first registered on clinicaltrials.gov on 24/02/2023 under the name Sounds Locked to ElectroEncephalogram Phase For the Acceleration of Sleep Onset Time (SLEEPFAST), and assigned registry number NCT05743114.
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Affiliation(s)
- Scott Bressler
- Elemind Technologies, Inc., Cambridge, MA, USA
- Science and Research, Elemind Technologies, Inc., Cambridge, MA, 02139, USA
| | - Ryan Neely
- Elemind Technologies, Inc., Cambridge, MA, USA.
- Science and Research, Elemind Technologies, Inc., Cambridge, MA, 02139, USA.
| | - Ryan M Yost
- Elemind Technologies, Inc., Cambridge, MA, USA
- Science and Research, Elemind Technologies, Inc., Cambridge, MA, 02139, USA
| | - David Wang
- Elemind Technologies, Inc., Cambridge, MA, USA
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Zrenner C, Ziemann U. Closed-Loop Brain Stimulation. Biol Psychiatry 2024; 95:545-552. [PMID: 37743002 PMCID: PMC10881194 DOI: 10.1016/j.biopsych.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
In the same way that beauty lies in the eye of the beholder, what a stimulus does to the brain is determined not simply by the nature of the stimulus but by the nature of the brain that is receiving the stimulus at that instant in time. Over the past decades, therapeutic brain stimulation has typically applied open-loop fixed protocols and has largely ignored this principle. Only recent neurotechnological advancements have enabled us to predict the nature of the brain (i.e., the electrophysiological brain state in the next instance in time) with sufficient temporal precision in the range of milliseconds using feedforward algorithms applied to electroencephalography time-series data. This allows stimulation exclusively whenever the targeted brain area is in a prespecified excitability or connectivity state. Preclinical studies have shown that repetitive stimulation during a particular brain state (e.g., high-excitability state), but not during other states, results in lasting modification (e.g., long-term potentiation) of the stimulated circuits. Here, we survey the evidence that this is also possible at the systems level of the human cortex using electroencephalography-informed transcranial magnetic stimulation. We critically discuss opportunities and difficulties in developing brain state-dependent stimulation for more effective long-term modification of pathological brain networks (e.g., in major depressive disorder) than is achievable with conventional fixed protocols. The same real-time electroencephalography-informed transcranial magnetic stimulation technology will allow closing of the loop by recording the effects of stimulation. This information may enable stimulation protocol adaptation that maximizes treatment response. This way, brain states control brain stimulation, thereby introducing a paradigm shift from open-loop to closed-loop stimulation.
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Affiliation(s)
- Christoph Zrenner
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute for Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany.
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
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Gogulski J, Cline CC, Ross JM, Truong J, Sarkar M, Parmigiani S, Keller CJ. Mapping cortical excitability in the human dorsolateral prefrontal cortex. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.20.524867. [PMID: 36711689 PMCID: PMC9882363 DOI: 10.1101/2023.01.20.524867] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective To characterize early TEPs anatomically and temporally (20-50 ms) close to the TMS pulse (EL-TEPs), as well as associated muscle artifacts (<20 ms), across the dlPFC. We hypothesized that TMS location and angle influence EL-TEPs, and that EL-TEP amplitude is inversely related to muscle artifact. Additionally, we sought to determine an optimal group-level TMS target and angle, while investigating the potential benefits of a personalized approach. Methods In 16 healthy participants, we applied single-pulse TMS to six targets within the dlPFC at two coil angles and measured EEG responses. Results Stimulation location significantly influenced EL-TEPs, with posterior and medial targets yielding larger EL-TEPs. Regions with high EL-TEP amplitude had less muscle artifact, and vice versa. The best group-level target yielded 102% larger EL-TEP responses compared to other dlPFC targets. Optimal dlPFC target differed across subjects, suggesting that a personalized targeting approach might boost the EL-TEP by an additional 36%. Significance Early local TMS-evoked potentials (EL-TEPs) can be probed without significant muscle-related confounds in posterior-medial regions of the dlPFC. The identification of an optimal group-level target and the potential for further refinement through personalized targeting hold significant implications for optimizing depression treatment protocols. Highlights Early local TMS-evoked potentials (EL-TEPs) varied significantly across the dlPFC as a function of TMS target.TMS targets with less muscle artifact had significantly larger EL-TEPs.Selection of a postero-medial target increased EL-TEPs by 102% compared to anterior targets.
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Xiong H, Di Y, Liu J, Han Y, Zheng Y. A three-dimensional adaptive rational interpolation algorithm for removing TMS-EEG pulse artifacts. Physiol Meas 2023; 44:115002. [PMID: 37852282 DOI: 10.1088/1361-6579/ad04b3] [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: 07/26/2023] [Accepted: 10/18/2023] [Indexed: 10/20/2023]
Abstract
Objective.Transcranial magnetic stimulation in combination with electroencephalography (TMS-EEG) has been widely used to study the reactivity and connectivity of brain regions. In order to efficiently and fast solve the pulse artifacts problem caused by TMS electromagnetic pulses, a three-dimensional adaptive rational quadratic Hermite interpolation algorithm is proposed.Approach.Firstly, a three-dimensional signal matrix is obtained by a signal recombination algorithm, where the removed window is automatically obtained by a derivative threshold. Secondly, the adaptive rational quartic Hermite interpolation algorithm is used to interpolate the removed window. Finally, the performance of the algorithm is verified using simulated and public database data.Main results.The simulation results show that the proposed algorithm improves the SNR by 23.88%-47.60%, reduces the RMSE by 46.52%-81.11%, reduces the average MAE by 47.83%-58.33%, and reduces the time consumption of the proposed algorithm by 45.90% compared with the piecewise cubic Hermite interpolation algorithm.Significance.Therefore, TMS-EEG pulse artifacts can be removed effectively and quickly with the proposed algorithm.
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Affiliation(s)
- Hui Xiong
- The School of Control Science and Engineering, Tiangong University, Tianjin 300387, People's Republic of China
- Key Laboratory of Intelligent Control of Electrical Equipment, Tiangong University, Tianjin 300387, People's Republic of China
| | - Yajun Di
- The School of Control Science and Engineering, Tiangong University, Tianjin 300387, People's Republic of China
- Key Laboratory of Intelligent Control of Electrical Equipment, Tiangong University, Tianjin 300387, People's Republic of China
| | - Jinzhen Liu
- The School of Control Science and Engineering, Tiangong University, Tianjin 300387, People's Republic of China
- Key Laboratory of Intelligent Control of Electrical Equipment, Tiangong University, Tianjin 300387, People's Republic of China
| | - Yuqing Han
- Neurosurgery, Tianjin Xiqing Hospital, Tianjin 300387, People's Republic of China
| | - Yu Zheng
- The School of Life Sciences, Tiangong University, Tianjin 300387, People's Republic of China
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Pillen S, Shulga A, Zrenner C, Ziemann U, Bergmann TO. Repetitive sensorimotor mu-alpha phase-targeted afferent stimulation produces no phase-dependent plasticity related changes in somatosensory evoked potentials or sensory thresholds. PLoS One 2023; 18:e0293546. [PMID: 37903116 PMCID: PMC10615264 DOI: 10.1371/journal.pone.0293546] [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: 05/24/2023] [Accepted: 10/13/2023] [Indexed: 11/01/2023] Open
Abstract
Phase-dependent plasticity has been proposed as a neurobiological mechanism by which oscillatory phase-amplitude cross-frequency coupling mediates memory process in the brain. Mimicking this mechanism, real-time EEG oscillatory phase-triggered transcranial magnetic stimulation (TMS) has successfully induced LTP-like changes in corticospinal excitability in the human motor cortex. Here we asked whether EEG phase-triggered afferent stimulation alone, if repetitively applied to the peaks, troughs, or random phases of the sensorimotor mu-alpha rhythm, would be sufficient to modulate the strength of thalamocortical synapses as assessed by changes in somatosensory evoked potential (SEP) N20 and P25 amplitudes and sensory thresholds (ST). Specifically, we applied 100 Hz triplets of peripheral electrical stimulation (PES) to the thumb, middle, and little finger of the right hand in pseudorandomized trials, with the afferent input from each finger repetitively and consistently arriving either during the cortical mu-alpha trough or peak or at random phases. No significant changes in SEP amplitudes or ST were observed across the phase-dependent PES intervention. We discuss potential limitations of the study and argue that suboptimal stimulation parameter choices rather than a general lack of phase-dependent plasticity in thalamocortical synapses are responsible for this null finding. Future studies should further explore the possibility of phase-dependent sensory stimulation.
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Affiliation(s)
- Steven Pillen
- Department of Neurology & Stroke, Eberhard Karls University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Anastasia Shulga
- Ward for Demanding Rehabilitation, Helsinki University Hospital, Department of Physical and Rehabilitation Medicine, Helsinki, Finland
- BioMag Laboratory, Helsinki University Hospital Medical Imaging Center, Helsinki, Finland
| | - Christoph Zrenner
- Department of Neurology & Stroke, Eberhard Karls University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute for Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Ulf Ziemann
- Department of Neurology & Stroke, Eberhard Karls University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Til Ole Bergmann
- Department of Neurology & Stroke, Eberhard Karls University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
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Cardone P, Bodart O, Kirsch M, Sanfilippo J, Virgillito A, Martial C, Simon J, Wannez S, Sanders RD, Laureys S, Massimini M, Vandewalle G, Bonhomme V, Gosseries O. Depth of sedation with dexmedetomidine increases transcranial magnetic stimulation-evoked potential amplitude non-linearly. Br J Anaesth 2023; 131:715-725. [PMID: 37596183 DOI: 10.1016/j.bja.2023.05.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Cortical excitability is higher in unconsciousness than in wakefulness, but it is unclear how this relates to anaesthesia. We investigated cortical excitability in response to dexmedetomidine, the effects of which are not fully known. METHODS We recorded transcranial magnetic stimulation (TMS) and EEG in frontal and parietal cortex of 20 healthy subjects undergoing dexmedetomidine sedation in four conditions (baseline, light sedation, deep sedation, recovery). We used the first component (0-30 ms) of the TMS-evoked potential (TEP) to measure cortical excitability (amplitude), slope, and positive and negative peak latencies (collectively, TEP indices). We used generalised linear mixed models to test the effect of condition, brain region, and responsiveness on TEP indices. RESULTS Compared with baseline, amplitude in the frontal cortex increased by 6.52 μV (P<0.001) in light sedation, 4.55 μV (P=0.003) in deep sedation, and 5.03 μV (P<0.001) in recovery. Amplitude did not change in the parietal cortex. Compared with baseline, slope increased in all conditions (P<0.02) in the frontal but not parietal cortex. The frontal cortex showed 5.73 μV higher amplitude (P<0.001), 0.63 μV ms-1 higher slope (P<0.001), and 2.2 ms shorter negative peak latency (P=0.001) than parietal areas. Interactions between dexmedetomidine and region had effects over amplitude (P=0.004) and slope (P=0.009), with both being higher in light sedation, deep sedation, and recovery compared with baseline. CONCLUSIONS Transcranial magnetic stimulation-evoked potential amplitude changes non-linearly as a function of depth of sedation by dexmedetomidine, with a region-specific paradoxical increase. Future research should investigate other anaesthetics to elucidate the link between cortical excitability and depth of sedation.
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Affiliation(s)
- Paolo Cardone
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium
| | - Olivier Bodart
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium; Department of Neurology, University of Liège, Liège, Belgium
| | - Murielle Kirsch
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, University of Liège, Liège, Belgium; Department of Anaesthesia and Intensive Care Medicine, University of Liège, Liège, Belgium
| | - Julien Sanfilippo
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, University of Liège, Liège, Belgium
| | | | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium
| | - Jessica Simon
- Psychology and Neuroscience of Cognition, University of Liège, Liège, Belgium
| | - Sarah Wannez
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Robert D Sanders
- Specialty of Anaesthetics, University of Sydney, Camperdown, Australia; Department of Anaesthetics & Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, CIUSS, University Laval, Québec City, QC, Canada
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy; IRCCS Fondazione Don Gnocchi, Milan, Italy
| | - Gilles Vandewalle
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Vincent Bonhomme
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, University of Liège, Liège, Belgium; Department of Anaesthesia and Intensive Care Medicine, University of Liège, Liège, Belgium; University Department of Anaesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liège, Belgium.
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium.
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Esfahani MJ, Farboud S, Ngo HVV, Schneider J, Weber FD, Talamini LM, Dresler M. Closed-loop auditory stimulation of sleep slow oscillations: Basic principles and best practices. Neurosci Biobehav Rev 2023; 153:105379. [PMID: 37660843 DOI: 10.1016/j.neubiorev.2023.105379] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/05/2023]
Abstract
Sleep is essential for our physical and mental well-being. During sleep, despite the paucity of overt behavior, our brain remains active and exhibits a wide range of coupled brain oscillations. In particular slow oscillations are characteristic for sleep, however whether they are directly involved in the functions of sleep, or are mere epiphenomena, is not yet fully understood. To disentangle the causality of these relationships, experiments utilizing techniques to detect and manipulate sleep oscillations in real-time are essential. In this review, we first overview the theoretical principles of closed-loop auditory stimulation (CLAS) as a method to study the role of slow oscillations in the functions of sleep. We then describe technical guidelines and best practices to perform CLAS and analyze results from such experiments. We further provide an overview of how CLAS has been used to investigate the causal role of slow oscillations in various sleep functions. We close by discussing important caveats, open questions, and potential topics for future research.
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Affiliation(s)
| | - Soha Farboud
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, the Netherlands
| | - Hong-Viet V Ngo
- Department of Psychology, University of Essex, United Kingdom; Department of Psychology, University of Lübeck, Germany; Center for Brain, Behaviour and Metabolism, University of Lübeck, Germany
| | - Jules Schneider
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Frederik D Weber
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, the Netherlands; Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Lucia M Talamini
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, the Netherlands.
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10
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Alavi SMM, Mahdi A, Vila-Rodriguez F, Goetz SM. Identifiability Analysis and Noninvasive Online Estimation of the First-Order Neural Activation Dynamics in the Brain With Closed-Loop Transcranial Magnetic Stimulation. IEEE Trans Biomed Eng 2023; 70:2564-2572. [PMID: 37656637 DOI: 10.1109/tbme.2023.3253674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
BACKGROUND Neurons demonstrate very distinct nonlinear activation dynamics, influenced by the neuron type, morphology, ion channel expression, and various other factors. The measurement of the activation dynamics can identify the neural target of stimulation and detect deviations, e.g., for diagnosis. This paper describes a tool for closed-loop sequential parameter estimation (SPE) of the activation dynamics through transcranial magnetic stimulation (TMS). The proposed SPE method operates in real time, selects ideal stimulus parameters, detects and processes the response, and concurrently estimates the input-output (IO) curve and the first-order approximation of the activated neural target. OBJECTIVE To develop a method for concurrent SPE of the first-order activation dynamics and IO curve with closed-loop TMS. METHOD First, identifiability of an integrated model of the first-order neural activation dynamics and IO curve is assessed, demonstrating that at least two IO curves need to be acquired with different pulse widths. Then, a two-stage SPE method is proposed. It estimates the IO curve by using Fisher information matrix (FIM) optimization in the first stage and subsequently estimates the membrane time constant as well as the coupling gain in the second stage. The procedure continues in a sequential manner until a stopping rule is satisfied. RESULTS The results of 73 simulation cases confirm the satisfactory estimation of the membrane time constant and coupling gain with average absolute relative errors (AREs) of 6.2% and 5.3%, respectively, with an average of 344 pulses (172 pulses for each IO curve or pulse width). The method estimates the IO curves' lower and upper plateaus, mid-point, and slope with average AREs of 0.2%, 0.7%, 0.9%, and 14.5%, respectively. The conventional time constant estimation method based on the strength-duration (S-D) curve leads to 33.3% ARE, which is 27.0% larger than 6.2% ARE obtained through the proposed real-time FIM-based SPE method in this paper. CONCLUSIONS SPE of the activation dynamics requires acquiring at least two IO curves with different pulse widths, which needs a controllable TMS (cTMS) device with adjustable pulse duration. SIGNIFICANCE The proposed SPE method enhances the cTMS functionality, which can contribute novel insights in research and clinical studies.
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11
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Kim B, Erickson BA, Fernandez-Nunez G, Rich R, Mentzelopoulos G, Vitale F, Medaglia JD. EEG Phase Can Be Predicted with Similar Accuracy across Cognitive States after Accounting for Power and Signal-to-Noise Ratio. eNeuro 2023; 10:ENEURO.0050-23.2023. [PMID: 37558464 PMCID: PMC10481640 DOI: 10.1523/eneuro.0050-23.2023] [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: 02/13/2023] [Revised: 05/25/2023] [Accepted: 06/15/2023] [Indexed: 08/11/2023] Open
Abstract
EEG phase is increasingly used in cognitive neuroscience, brain-computer interfaces, and closed-loop stimulation devices. However, it is unknown how accurate EEG phase prediction is across cognitive states. We determined the EEG phase prediction accuracy of parieto-occipital alpha waves across rest and task states in 484 participants over 11 public datasets. We were able to track EEG phase accurately across various cognitive conditions and datasets, especially during periods of high instantaneous alpha power and signal-to-noise ratio (SNR). Although resting states generally have higher accuracies than task states, absolute accuracy differences were small, with most of these differences attributable to EEG power and SNR. These results suggest that experiments and technologies using EEG phase should focus more on minimizing external noise and waiting for periods of high power rather than inducing a particular cognitive state.
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Affiliation(s)
- Brian Kim
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania 19104
| | - Brian A Erickson
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania 19104
| | | | - Ryan Rich
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania 19104
| | - Georgios Mentzelopoulos
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104
| | - Flavia Vitale
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104
- Departments of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania 19146
| | - John D Medaglia
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania 19104
- Departments of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Department of Neurology, Drexel University, Philadelphia, Pennsylvania 19104
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12
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Spampinato DA, Ibanez J, Rocchi L, Rothwell J. Motor potentials evoked by transcranial magnetic stimulation: interpreting a simple measure of a complex system. J Physiol 2023; 601:2827-2851. [PMID: 37254441 PMCID: PMC10952180 DOI: 10.1113/jp281885] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique that is increasingly used to study the human brain. One of the principal outcome measures is the motor-evoked potential (MEP) elicited in a muscle following TMS over the primary motor cortex (M1), where it is used to estimate changes in corticospinal excitability. However, multiple elements play a role in MEP generation, so even apparently simple measures such as peak-to-peak amplitude have a complex interpretation. Here, we summarize what is currently known regarding the neural pathways and circuits that contribute to the MEP and discuss the factors that should be considered when interpreting MEP amplitude measured at rest in the context of motor processing and patients with neurological conditions. In the last part of this work, we also discuss how emerging technological approaches can be combined with TMS to improve our understanding of neural substrates that can influence MEPs. Overall, this review aims to highlight the capabilities and limitations of TMS that are important to recognize when attempting to disentangle sources that contribute to the physiological state-related changes in corticomotor excitability.
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Affiliation(s)
- Danny Adrian Spampinato
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- Department of Human NeurosciencesSapienza University of RomeRomeItaly
- Department of Clinical and Behavioral NeurologyIRCCS Santa Lucia FoundationRomeItaly
| | - Jaime Ibanez
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- BSICoS group, I3A Institute and IIS AragónUniversity of ZaragozaZaragozaSpain
- Department of Bioengineering, Centre for NeurotechnologiesImperial College LondonLondonUK
| | - Lorenzo Rocchi
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
- Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
| | - John Rothwell
- Department of Clinical and Movement NeurosciencesUniversity College LondonLondonUK
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13
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Alavi SMM, Vila-Rodriguez F, Mahdi A, Goetz SM. Closed-loop optimal and automatic tuning of pulse amplitude and width in EMG-guided controllable transcranial magnetic stimulation. Biomed Eng Lett 2023; 13:119-127. [PMID: 37124104 PMCID: PMC10130260 DOI: 10.1007/s13534-022-00259-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/26/2022] [Accepted: 12/20/2022] [Indexed: 01/01/2023] Open
Abstract
This paper proposes an efficient algorithm for automatic and optimal tuning of pulse amplitude and width for sequential parameter estimation (SPE) of the neural membrane time constant and input-output (IO) curve parameters in closed-loop electromyography-guided (EMG-guided) controllable transcranial magnetic stimulation (cTMS). The proposed SPE is performed by administering a train of optimally tuned TMS pulses and updating the estimations until a stopping rule is satisfied or the maximum number of pulses is reached. The pulse amplitude is computed by the Fisher information maximization. The pulse width is chosen by maximizing a normalized depolarization factor, which is defined to separate the optimization and tuning of the pulse amplitude and width. The normalized depolarization factor maximization identifies the critical pulse width, which is an important parameter in the identifiability analysis, without any prior neurophysiological or anatomical knowledge of the neural membrane. The effectiveness of the proposed algorithm is evaluated through simulation. The results confirm satisfactory estimation of the membrane time constant and IO curve parameters for the simulation case. By defining the stopping rule based on the satisfaction of the convergence criterion with tolerance of 0.01 for 5 consecutive times for all parameters, the IO curve parameters are estimated with 52 TMS pulses, with absolute relative estimation errors (AREs) of less than 7%. The membrane time constant is estimated with 0.67% ARE, and the pulse width value tends to the critical pulse width with 0.16% ARE with 52 TMS pulses. The results confirm that the pulse width and amplitude can be tuned optimally and automatically to estimate the membrane time constant and IO curve parameters in real-time with closed-loop EMG-guided cTMS.
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Affiliation(s)
- S. M. Mahdi Alavi
- The Non-Invasive Neurostimulation Therapies (NINET) Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC Canada
| | - Fidel Vila-Rodriguez
- The Non-Invasive Neurostimulation Therapies (NINET) Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC Canada
| | - Adam Mahdi
- Surrey Institute for People-Centred AI, University of Surrey, Surrey, UK
- Oxford Internet Institute, University of Oxford, Oxford, UK
| | - Stefan M. Goetz
- Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC USA
- Department of Electrical and Computer Engineering, Duke University, Durham, NC USA
- Department of Neurosurgery, Duke University, Durham, NC USA
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14
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Covariation of the amplitude and latency of motor evoked potentials elicited by transcranial magnetic stimulation in a resting hand muscle. Exp Brain Res 2023; 241:927-936. [PMID: 36811686 PMCID: PMC9985579 DOI: 10.1007/s00221-023-06575-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique used to study human neurophysiology. A single TMS pulse delivered to the primary motor cortex can elicit a motor evoked potential (MEP) in a target muscle. MEP amplitude is a measure of corticospinal excitability and MEP latency is a measure of the time taken for intracortical processing, corticofugal conduction, spinal processing, and neuromuscular transmission. Although MEP amplitude is known to vary across trials with constant stimulus intensity, little is known about MEP latency variation. To investigate MEP amplitude and latency variation at the individual level, we scored single-pulse MEP amplitude and latency in a resting hand muscle from two datasets. MEP latency varied from trial to trial in individual participants with a median range of 3.9 ms. Shorter MEP latencies were associated with larger MEP amplitudes for most individuals (median r = - 0.47), showing that latency and amplitude are jointly determined by the excitability of the corticospinal system when TMS is delivered. TMS delivered during heightened excitability could discharge a greater number of cortico-cortical and corticospinal cells, increasing the amplitude and, by recurrent activation of corticospinal cells, the number of descending indirect waves. An increase in the amplitude and number of indirect waves would progressively recruit larger spinal motor neurons with large-diameter fast-conducting fibers, which would shorten MEP onset latency and increase MEP amplitude. In addition to MEP amplitude variability, understanding MEP latency variability is important given that these parameters are used to help characterize pathophysiology of movement disorders.
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15
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Baena D, Fang Z, Gibbings A, Smith D, Ray LB, Doyon J, Owen AM, Fogel SM. Functional differences in cerebral activation between slow wave-coupled and uncoupled sleep spindles. Front Neurosci 2023; 16:1090045. [PMID: 36741053 PMCID: PMC9889560 DOI: 10.3389/fnins.2022.1090045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Spindles are often temporally coupled to slow waves (SW). These SW-spindle complexes have been implicated in memory consolidation that involves transfer of information from the hippocampus to the neocortex. However, spindles and SW, which are characteristic of NREM sleep, can occur as part of this complex, or in isolation. It is not clear whether dissociable parts of the brain are recruited when coupled to SW vs. when spindles or SW occur in isolation. Here, we tested differences in cerebral activation time-locked to uncoupled spindles, uncoupled SW and coupled SW-spindle complexes using simultaneous EEG-fMRI. Consistent with the "active system model," we hypothesized that brain activations time-locked to coupled SW-spindles would preferentially occur in brain areas known to be critical for sleep-dependent memory consolidation. Our results show that coupled spindles and uncoupled spindles recruit distinct parts of the brain. Specifically, we found that hippocampal activation during sleep is not uniquely related to spindles. Rather, this process is primarily driven by SWs and SW-spindle coupling. In addition, we show that SW-spindle coupling is critical in the activation of the putamen. Importantly, SW-spindle coupling specifically recruited frontal areas in comparison to uncoupled spindles, which may be critical for the hippocampal-neocortical dialogue that preferentially occurs during sleep.
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Affiliation(s)
- Daniel Baena
- Sleep Unit, University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - Zhuo Fang
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Aaron Gibbings
- Sleep Unit, University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - Dylan Smith
- Sleep Unit, University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - Laura B. Ray
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Julien Doyon
- McConnell Brain Imaging Centre, McGill University, Montreal, QC, Canada
| | - Adrian M. Owen
- The Brain and Mind Institute, Western University, London, ON, Canada,Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - Stuart M. Fogel
- Sleep Unit, University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada,School of Psychology, University of Ottawa, Ottawa, ON, Canada,The Brain and Mind Institute, Western University, London, ON, Canada,Department of Physiology and Pharmacology, Western University, London, ON, Canada,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada,*Correspondence: Stuart M. Fogel,
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16
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Ozdemir RA, Kirkman S, Magnuson JR, Fried PJ, Pascual-Leone A, Shafi MM. Phase matters when there is power: Phasic modulation of corticospinal excitability occurs at high amplitude sensorimotor mu-oscillations. NEUROIMAGE. REPORTS 2022; 2:100132. [PMID: 36570046 PMCID: PMC9784422 DOI: 10.1016/j.ynirp.2022.100132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Prior studies have suggested that oscillatory activity in cortical networks can modulate stimulus-evoked responses through time-varying fluctuations in neural excitation-inhibition dynamics. Studies combining transcranial magnetic stimulation (TMS) with electromyography (EMG) and electroencephalography (EEG) can provide direct measurements to examine how instantaneous fluctuations in cortical oscillations contribute to variability in TMS-induced corticospinal responses. However, the results of these studies have been conflicting, as some reports showed consistent phase effects of sensorimotor mu-rhythms with increased excitability at the negative mu peaks, while others failed to replicate these findings or reported unspecific mu-phase effects across subjects. Given the lack of consistent results, we systematically examined the modulatory effects of instantaneous and pre-stimulus sensorimotor mu-rhythms on corticospinal responses with offline EEG-based motor evoked potential (MEP) classification analyses across five identical visits. Instantaneous sensorimotor mu-phase or pre-stimulus mu-power alone did not significantly modulate MEP responses. Instantaneous mu-power analyses showed weak effects with larger MEPs during high-power trials at the overall group level analyses, but this trend was not reproducible across visits. However, TMS delivered at the negative peak of high magnitude mu-oscillations generated the largest MEPs across all visits, with significant differences compared to other peak-phase combinations. High power effects on MEPs were only observed at the trough phase of ongoing mu oscillations originating from the stimulated region, indicating site and phase specificity, respectively. More importantly, such phase-dependent power effects on corticospinal excitability were reproducible across multiple visits. We provide further evidence that fluctuations in corticospinal excitability indexed by MEP amplitudes are partially driven by dynamic interactions between the magnitude and the phase of ongoing sensorimotor mu oscillations at the time of TMS, and suggest promising insights for (re)designing neuromodulatory TMS protocols targeted to specific cortical oscillatory states.
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Affiliation(s)
- Recep A. Ozdemir
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA,Corresponding author. Mouhsin Shafi Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Medical Center, Harvard Medical School, Boston, MA, USA. (R.A. Ozdemir)
| | - Sofia Kirkman
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Justine R. Magnuson
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Peter J. Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA,Hinda and Arthur Marcus Institute for Aging Research and Deanne and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Boston, MA, USA,Guttmann Brain Health Institute, Institut Guttmann de Neurorehabilitació, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Mouhsin M. Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Neurology, Harvard Medical School, Boston, MA, USA,Corresponding author. Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA. (M.M. Shafi)
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17
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Singh MF, Cole MW, Braver TS, Ching S. Control-theoretic integration of stimulation and electrophysiology for cognitive enhancement. FRONTIERS IN NEUROIMAGING 2022; 1:982288. [PMID: 37555140 PMCID: PMC10406304 DOI: 10.3389/fnimg.2022.982288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/28/2022] [Indexed: 08/10/2023]
Abstract
Transcranial electrical stimulation (tES) technology and neuroimaging are increasingly coupled in basic and applied science. This synergy has enabled individualized tES therapy and facilitated causal inferences in functional neuroimaging. However, traditional tES paradigms have been stymied by relatively small changes in neural activity and high inter-subject variability in cognitive effects. In this perspective, we propose a tES framework to treat these issues which is grounded in dynamical systems and control theory. The proposed paradigm involves a tight coupling of tES and neuroimaging in which M/EEG is used to parameterize generative brain models as well as control tES delivery in a hybrid closed-loop fashion. We also present a novel quantitative framework for cognitive enhancement driven by a new computational objective: shaping how the brain reacts to potential "inputs" (e.g., task contexts) rather than enforcing a fixed pattern of brain activity.
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Affiliation(s)
- Matthew F. Singh
- Electrical and Systems Engineering, Washington University in St. Louis, St. Louis, MO, United States
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, United States
- Psychological and Brain Science, Washington University in St. Louis, St. Louis, MO, United States
| | - Michael W. Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, United States
| | - Todd S. Braver
- Psychological and Brain Science, Washington University in St. Louis, St. Louis, MO, United States
| | - ShiNung Ching
- Electrical and Systems Engineering, Washington University in St. Louis, St. Louis, MO, United States
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18
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Shaping overnight consolidation via slow-oscillation closed-loop targeted memory reactivation. Proc Natl Acad Sci U S A 2022; 119:e2123428119. [PMID: 36279449 PMCID: PMC9636934 DOI: 10.1073/pnas.2123428119] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sleep represents a window of opportunity to modulate the mnemonic fate of recent experiences. Prior work has shown that delivering auditory reminder cues can slow down overnight forgetting, and so does experimental enhancement of natural sleep rhythms. Here, we combined both methods to selectively provide auditory cues during moments of high (UP states) or low (DOWN states) neuronal excitability. We found that UP-state cueing enhanced ongoing UP states and led to significantly lower forgetting rates than DOWN-state cueing. Moreover, electrophysiological markers of memory reprocessing were more pronounced after UP-state cueing. These results illustrate the impact of delivering exogenous stimuli at optimal phases of endogenous brain rhythms and will help improve experimental approaches to strengthening memories during sleep. Sleep constitutes a privileged state for new memories to reactivate and consolidate. Previous work has demonstrated that consolidation can be bolstered experimentally either via delivery of reminder cues (targeted memory reactivation [TMR]) or via noninvasive brain stimulation geared toward enhancing endogenous sleep rhythms. Here, we combined both approaches, controlling the timing of TMR cues with respect to ongoing slow-oscillation (SO) phases. Prior to sleep, participants learned associations between unique words and a set of repeating images (e.g., car) while hearing a prototypical image sound (e.g., engine starting). Memory performance on an immediate test vs. a test the next morning quantified overnight memory consolidation. Importantly, two image sounds were designated as TMR cues, with one cue delivered at SO UP states and the other delivered at SO DOWN states. A novel sound was used as a TMR control condition. Behavioral results revealed a significant reduction of overnight forgetting for words associated with UP-state TMR compared with words associated with DOWN-state TMR. Electrophysiological results showed that UP-state cueing led to enhancement of the ongoing UP state and was followed by greater spindle power than DOWN-state cueing. Moreover, UP-state (and not DOWN-state) cueing led to reinstatement of target image representations. Together, these results unveil the behavioral and mechanistic effects of delivering reminder cues at specific phases of endogenous sleep rhythms and mark an important step for the endeavor to experimentally modulate memories during sleep.
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19
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Antony JW, Ngo HV, Bergmann TO, Rasch B. Real‐time, closed‐loop, or open‐loop stimulation? Navigating a terminological jungle. J Sleep Res 2022; 31:e13755. [DOI: 10.1111/jsr.13755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022]
Affiliation(s)
- James W. Antony
- Department of Psychology and Child Development California Polytechnic State University San Luis Obispo California USA
| | - Hong‐Viet V. Ngo
- Department of Psychology University of Lübeck Lübeck Germany
- Center for Brain, Behavior and Metabolism University of Lübeck Lübeck Germany
| | - Til Ole Bergmann
- Neuroimaging Center Johannes Gutenberg University Medical Center Mainz Germany
- Leibniz Institute for Resilience Research Mainz Germany
| | - Björn Rasch
- Department of Psychology University of Fribourg Fribourg Switzerland
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20
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Ngo HVV, Antony JW, Rasch B. Real-time stimulation during sleep: prior findings, novel developments, and future perspectives. J Sleep Res 2022; 31:e13735. [PMID: 36180062 DOI: 10.1111/jsr.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Real-time brain stimulation is a powerful technique that continues to gain importance in the field of sleep and cognition. In this special issue, we collected 14 articles about real-time stimulation during sleep, including one review, 12 research articles and one letter covering both human and rodent research from various fields. We hope this special issue sparks greater interest and inspires fellow sleep researchers and clinicians to develop new ideas in the exciting topic of real-time stimulation.
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Affiliation(s)
- Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany.,Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - James W Antony
- Department of Psychology and Child Development, California Polytechnic State University, San Luis Obispo, California, USA
| | - Björn Rasch
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
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21
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Hassan U, Feld GB, Bergmann TO. Automated real-time EEG sleep spindle detection for brain-state-dependent brain stimulation. J Sleep Res 2022; 31:e13733. [PMID: 36130730 DOI: 10.1111/jsr.13733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022]
Abstract
Sleep spindles are a hallmark electroencephalographic feature of non-rapid eye movement sleep, and are believed to be instrumental for sleep-dependent memory reactivation and consolidation. However, direct proof of their causal relevance is hard to obtain, and our understanding of their immediate neurophysiological consequences is limited. To investigate their causal role, spindles need to be targeted in real-time with sensory or non-invasive brain-stimulation techniques. While fully automated offline detection algorithms are well established, spindle detection in real-time is highly challenging due to their spontaneous and transient nature. Here, we present the real-time spindle detector, a robust multi-channel electroencephalographic signal-processing algorithm that enables the automated triggering of stimulation during sleep spindles in a phase-specific manner. We validated the real-time spindle detection method by streaming pre-recorded sleep electroencephalographic datasets to a real-time computer system running a Simulink® Real-Time™ implementation of the algorithm. Sleep spindles were detected with high levels of Sensitivity (~83%), Precision (~78%) and a convincing F1-Score (~81%) in reference to state-of-the-art offline algorithms (which reached similar or lower levels when compared with each other), for both naps and full nights, and largely independent of sleep scoring information. Detected spindles were comparable in frequency, duration, amplitude and symmetry, and showed the typical time-frequency characteristics as well as a centroparietal topography. Spindles were detected close to their centre and reliably at the predefined target phase. The real-time spindle detection algorithm therefore empowers researchers to target spindles during human sleep, and apply the stimulation method and experimental paradigm of their choice.
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Affiliation(s)
- Umair Hassan
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany
| | - Gordon B Feld
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Til Ole Bergmann
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.,Leibniz Institute for Resilience Research, Mainz, Germany.,Department of Neurology & Stroke, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
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22
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Jia J. Exploration on neurobiological mechanisms of the central–peripheral–central closed-loop rehabilitation. Front Cell Neurosci 2022; 16:982881. [PMID: 36119128 PMCID: PMC9479450 DOI: 10.3389/fncel.2022.982881] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Central and peripheral interventions for brain injury rehabilitation have been widely employed. However, as patients’ requirements and expectations for stroke rehabilitation have gradually increased, the limitations of simple central intervention or peripheral intervention in the rehabilitation application of stroke patients’ function have gradually emerged. Studies have suggested that central intervention promotes the activation of functional brain regions and improves neural plasticity, whereas peripheral intervention enhances the positive feedback and input of sensory and motor control modes to the central nervous system, thereby promoting the remodeling of brain function. Based on the model of a central–peripheral–central (CPC) closed loop, the integration of center and peripheral interventions was effectively completed to form “closed-loop” information feedback, which could be applied to specific brain areas or function-related brain regions of patients. Notably, the closed loop can also be extended to central and peripheral immune systems as well as central and peripheral organs such as the brain–gut axis and lung–brain axis. In this review article, the model of CPC closed-loop rehabilitation and the potential neuroimmunological mechanisms of a closed-loop approach will be discussed. Further, we highlight critical questions about the neuroimmunological aspects of the closed-loop technique that merit future research attention.
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Affiliation(s)
- Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Regional Medical Center, Fujian, China
- The First Affiliated Hospital of Fujian Medical University, Fujian, China
- *Correspondence: Jie Jia,
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23
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Alavi SMM, Vila-Rodriguez F, Mahdi A, Goetz SM. A formalism for sequential estimation of neural membrane time constant and input--output curve towards selective and closed-loop transcranial magnetic stimulation. J Neural Eng 2022; 19. [PMID: 36055218 DOI: 10.1088/1741-2552/ac8ed5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/01/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To obtain a formalism for real-time concurrent sequential estimation of neural membrane time constant and input--output (IO) curve with transcranial magnetic stimulation (TMS). APPROACH First, the neural membrane response and depolarization factor, which leads to motor evoked potentials (MEPs) with TMS are analytically computed and discussed. Then, an integrated model is developed which combines the neural membrane time constant and input--output curve. Identifiability of the proposed integrated model is discussed. A condition is derived, which assures estimation of the proposed integrated model. Finally, sequential parameter estimation (SPE) of the neural membrane time constant and IO curve is described through closed-loop optimal sampling and open-loop uniform sampling TMS. Without loss of generality, this paper focuses on a specific case of commercialized TMS pulse shapes. The proposed formalism and SPE method are directly applicable to other pulse shapes. MAIN RESULTS The results confirm satisfactory estimation of the membrane time constant and IO curve parameters. By defining a stopping rule based on five times consecutive convergence of the estimation parameters with a tolerances of 0.01, the membrane time constant and IO curve parameters are estimated with 82 TMS pulses with absolute relative estimation errors (AREs) of less than 4% with the optimal sampling SPE method. At this point, the uniform sampling SPE method leads to AREs up to 16%. The uniform sampling method does not satisfy the stopping rule due to the large estimation variations. SIGNIFICANCE This paper provides a tool for real-time closed-loop SPE of the neural time constant and IO curve, which can contribute novel insights in TMS studies. SPE of the membrane time constant enables selective stimulation, which can be used for advanced brain research, precision medicine and personalized medicine.
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Affiliation(s)
- S M Mahdi Alavi
- Department of Psychiatry , The University of British Columbia, 2255 Wesbrook Mall, Vancouver, British Columbia, V6T 2A1, CANADA
| | - Fidel Vila-Rodriguez
- Department of Psychiatry , The University of British Columbia Faculty of Medicine, Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, British Columbia, V6T 2A1, CANADA
| | - Adam Mahdi
- University of Oxford, Oxford Internet Institute, 1 St Giles, Oxford, Oxfordshire, OX1 2JD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Stefan M Goetz
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 200 Trent Drive, Duke University Medical Center, Durham, North Carolina, 27710, UNITED STATES
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24
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Abstract
Over the past few decades, the importance of sleep has become increasingly recognized for many physiologic functions, including cognition. Many studies have reported the deleterious effect of sleep loss or sleep disruption on cognitive performance. Beyond ensuring adequate sleep quality and duration, discovering methods to enhance sleep to augment its restorative effects is important to improve learning in many populations, such as the military, students, age-related cognitive decline, and cognitive disorders.
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Affiliation(s)
- Roneil G Malkani
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 525, Chicago, IL 60611, USA; Jesse Brown Veterans Affairs Medical Center, Chicago, IL 60612, USA.
| | - Phyllis C Zee
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 520, Chicago, IL 60611, USA
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25
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Iwata GZ, Hu Y, Wickenbrock A, Sander T, Muthuraman M, Chirumamilla VC, Groppa S, Liu Q, Budker D. Biomagnetic signals recorded during transcranial magnetic stimulation (TMS)-evoked peripheral muscular activity. BIOMED ENG-BIOMED TE 2022; 67:333-344. [PMID: 35960879 DOI: 10.1515/bmt-2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Abstract
Transcranial magnetic stimulation (TMS) has widespread clinical applications from diagnosis to treatment. We combined TMS with non-contact magnetic detection of TMS-evoked muscle activity in peripheral limbs to explore a new diagnostic modality that enhances the utility of TMS as a clinical tool by leveraging technological advances in magnetometry. We recorded measurements in a regular hospital room using an array of optically pumped magnetometers (OPMs) inside a portable shield that encloses only the forearm and hand of the subject. We present magnetomyograms (MMG)s of TMS-evoked movement in a human hand, together with a simultaneous surface electromyograph (EMG) data. The biomagnetic signals recorded in the MMG provides detailed spatial and temporal information that is complementary to that of the electric signal channels. Moreover, we identify features in the magnetic recording beyond that of the EMG. This system demonstrates the value of biomagnetic signals in TMS-based clinical approaches and widens its availability and practical potential.
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Affiliation(s)
- Geoffrey Z Iwata
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany
| | - Yinan Hu
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany
| | - Arne Wickenbrock
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany
| | | | - Muthuraman Muthuraman
- Department of Neurology, Biomedical Statistics and Multimodal Signal Processing Unit, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Venkata Chaitanya Chirumamilla
- Department of Neurology, Biomedical Statistics and Multimodal Signal Processing Unit, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, Biomedical Statistics and Multimodal Signal Processing Unit, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Qishan Liu
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Dmitry Budker
- Johannes Gutenberg-Universität Mainz, Mainz, Germany.,Helmholtz-Institut Mainz, GSI Helmholtzzentrum für Schwerionenforschung Mainz, Germany.,Department of Physics, University of California, Berkeley, CA, USA
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26
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Veldema J, Gharabaghi A. Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke. J Neuroeng Rehabil 2022; 19:84. [PMID: 35922846 PMCID: PMC9351139 DOI: 10.1186/s12984-022-01062-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive brain stimulation/spinal cord stimulation on gait, balance and/or lower limb motor recovery in stroke patients. Methods The PubMed database was searched from its inception through to 31/03/2021 for randomized controlled trials investigating repetitive transcranial magnetic stimulation or transcranial/trans-spinal direct current/alternating current stimulation for improving gait, balance and/or lower limb motor function in stroke patients. Results Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation. Conclusions The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.
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Affiliation(s)
- Jitka Veldema
- Department of Sport Science, Bielefeld University, 33 501, Bielefeld, Germany. .,Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany.
| | - Alireza Gharabaghi
- Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany
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27
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Siebner HR, Funke K, Aberra AS, Antal A, Bestmann S, Chen R, Classen J, Davare M, Di Lazzaro V, Fox PT, Hallett M, Karabanov AN, Kesselheim J, Beck MM, Koch G, Liebetanz D, Meunier S, Miniussi C, Paulus W, Peterchev AV, Popa T, Ridding MC, Thielscher A, Ziemann U, Rothwell JC, Ugawa Y. Transcranial magnetic stimulation of the brain: What is stimulated? - A consensus and critical position paper. Clin Neurophysiol 2022; 140:59-97. [PMID: 35738037 PMCID: PMC9753778 DOI: 10.1016/j.clinph.2022.04.022] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 03/14/2022] [Accepted: 04/15/2022] [Indexed: 12/11/2022]
Abstract
Transcranial (electro)magnetic stimulation (TMS) is currently the method of choice to non-invasively induce neural activity in the human brain. A single transcranial stimulus induces a time-varying electric field in the brain that may evoke action potentials in cortical neurons. The spatial relationship between the locally induced electric field and the stimulated neurons determines axonal depolarization. The induced electric field is influenced by the conductive properties of the tissue compartments and is strongest in the superficial parts of the targeted cortical gyri and underlying white matter. TMS likely targets axons of both excitatory and inhibitory neurons. The propensity of individual axons to fire an action potential in response to TMS depends on their geometry, myelination and spatial relation to the imposed electric field and the physiological state of the neuron. The latter is determined by its transsynaptic dendritic and somatic inputs, intrinsic membrane potential and firing rate. Modeling work suggests that the primary target of TMS is axonal terminals in the crown top and lip regions of cortical gyri. The induced electric field may additionally excite bends of myelinated axons in the juxtacortical white matter below the gyral crown. Neuronal excitation spreads ortho- and antidromically along the stimulated axons and causes secondary excitation of connected neuronal populations within local intracortical microcircuits in the target area. Axonal and transsynaptic spread of excitation also occurs along cortico-cortical and cortico-subcortical connections, impacting on neuronal activity in the targeted network. Both local and remote neural excitation depend critically on the functional state of the stimulated target area and network. TMS also causes substantial direct co-stimulation of the peripheral nervous system. Peripheral co-excitation propagates centrally in auditory and somatosensory networks, but also produces brain responses in other networks subserving multisensory integration, orienting or arousal. The complexity of the response to TMS warrants cautious interpretation of its physiological and behavioural consequences, and a deeper understanding of the mechanistic underpinnings of TMS will be critical for advancing it as a scientific and therapeutic tool.
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Affiliation(s)
- Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Klaus Funke
- Department of Neurophysiology, Medical Faculty, Ruhr-University Bochum, Bochum, Germany
| | - Aman S Aberra
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Sven Bestmann
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Robert Chen
- Krembil Brain Institute, University Health Network and Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Marco Davare
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, via Álvaro del Portillo 21, 00128 Rome, Italy
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anke N Karabanov
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Nutrition and Exercise, University of Copenhagen, Copenhagen, Denmark
| | - Janine Kesselheim
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Mikkel M Beck
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Giacomo Koch
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Non-invasive Brain Stimulation Unit, Laboratorio di NeurologiaClinica e Comportamentale, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - David Liebetanz
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Sabine Meunier
- Sorbonne Université, Faculté de Médecine, INSERM U 1127, CNRS 4 UMR 7225, Institut du Cerveau, F-75013, Paris, France
| | - Carlo Miniussi
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Italy; Cognitive Neuroscience Section, IRCCS Centro San Giovanni di DioFatebenefratelli, Brescia, Italy
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Angel V Peterchev
- Department of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA; Department of Electrical & Computer Engineering, Duke University, Durham, NC, USA; Department of Neurosurgery, School of Medicine, Duke University, Durham, NC, USA
| | - Traian Popa
- Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland; Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de Réadaptation, Sion, Switzerland
| | - Michael C Ridding
- University of South Australia, IIMPACT in Health, Adelaide, Australia
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Ulf Ziemann
- Department of Neurology & Stroke, University Tübingen, Tübingen, Germany; Hertie Institute for Clinical Brain Research, University Tübingen, Tübingen, Germany
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Yoshikazu Ugawa
- Department of Neurology, Fukushima Medical University, Fukushima, Japan; Fukushima Global Medical Science Centre, Advanced Clinical Research Centre, Fukushima Medical University, Fukushima, Japan
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28
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Granö I, Mutanen TP, Tervo A, Nieminen JO, Souza VH, Fecchio M, Rosanova M, Lioumis P, Ilmoniemi RJ. Local brain-state dependency of effective connectivity: a pilot TMS-EEG study. OPEN RESEARCH EUROPE 2022; 2:45. [PMID: 36035767 PMCID: PMC7613446 DOI: 10.12688/openreseurope.14634.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 11/20/2022]
Abstract
Background: Spontaneous cortical oscillations have been shown to modulate cortical responses to transcranial magnetic stimulation (TMS). However, whether these oscillations influence cortical effective connectivity is largely unknown. We conducted a pilot study to set the basis for addressing how spontaneous oscillations affect cortical effective connectivity measured through TMS-evoked potentials (TEPs). Methods: We applied TMS to the left primary motor cortex and right pre-supplementary motor area of three subjects while recording EEG. We classified trials off-line into positive- and negative-phase classes according to the mu and beta rhythms. We calculated differences in the global mean-field amplitude (GMFA) and compared the cortical spreading of the TMS-evoked activity between the two classes. Results: Phase affected the GMFA in four out of 12 datasets (3 subjects × 2 stimulation sites × 2 frequency bands). Two of the observed significant intervals were before 50 ms, two between 50 and 100 ms, and one after 100 ms post-stimulus. Source estimates showed complex spatial differences between the classes in the cortical spreading of the TMS-evoked activity. Conclusions: TMS-evoked effective connectivity seems to depend on the phase of local cortical oscillations at the stimulated site. This work paves the way to design future closed-loop stimulation paradigms.
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Affiliation(s)
- Ida Granö
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas P. Mutanen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aino Tervo
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko O. Nieminen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Victor H. Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- School of Physiotherapy, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Matteo Fecchio
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Pantelis Lioumis
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Risto J. Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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29
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Rostami M, Zomorrodi R, Rostami R, Hosseinzadeh GA. Impact of methodological variability on EEG responses evoked by transcranial magnetic stimulation: a meta-analysis. Clin Neurophysiol 2022; 142:154-180. [DOI: 10.1016/j.clinph.2022.07.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
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30
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Bonnesen MT, Fuglsang SA, Siebner HR, Christiansen L. The recent history of afferent stimulation modulates corticospinal excitability. Neuroimage 2022; 258:119365. [PMID: 35690256 DOI: 10.1016/j.neuroimage.2022.119365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/01/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) is widely used to probe corticospinal excitability and fast sensorimotor integration in the primary motor hand area (M1-HAND). A conditioning electrical stimulus, applied to the contralateral hand, can suppress the motor evoked potential (MEP) elicited by TMS of M1-HAND when the afferent stimulus arrives in M1-HAND at the time of TMS. The magnitude of this short-latency afferent inhibition (SAI) is expressed as the ratio between the conditioned and unconditioned MEP amplitude. OBJECTIVE/HYPOTHESIS We hypothesized that corticospinal excitability and SAI are influenced by the recent history of peripheral electrical stimulation. METHODS In twenty healthy participants, we recorded MEPs from the right first dorsal interosseus muscle. MEPs were evoked by single-pulse TMS of the left M1-HAND alone (unconditioned TMS) or by TMS preceded by electrical stimulation of the right index finger ("homotopic" conditioning) or little finger ("heterotopic" conditioning). The three conditions were either pseudo-randomly intermixed or delivered in blocks in which a single condition was repeated five or ten times. MEP amplitudes and SAI magnitudes were compared using linear mixed-effect models and one-way ANOVAs. RESULTS All stimulation protocols consistently produced SAI, which was stronger after homotopic stimulation. Randomly intermingling the three stimulation conditions reduced the relative magnitude of homotopic and heterotopic SAI as opposed to blocked stimulation. The apparent attenuation of SAI was caused by a suppression of the unconditioned but not the conditioned MEP amplitude during the randomly intermixed pattern. CONCLUSION(S) The recent history of afferent stimulation modulates corticospinal excitability. This "history effect" impacts on the relative magnitude of SAI depending on how conditioned and unconditioned responses are intermixed and needs to be taken into consideration when probing afferent inhibition and corticospinal excitability.
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Affiliation(s)
- Marie Trolle Bonnesen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Søren Asp Fuglsang
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Christiansen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.
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31
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Goetz SM, Howell B, Wang B, Li Z, Sommer MA, Peterchev AV, Grill WM. Isolating two sources of variability of subcortical stimulation to quantify fluctuations of corticospinal tract excitability. Clin Neurophysiol 2022; 138:134-142. [PMID: 35397278 PMCID: PMC9271909 DOI: 10.1016/j.clinph.2022.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/17/2022] [Accepted: 02/01/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Investigate the variability previously found with cortical stimulation and handheld transcranial magnetic stimulation (TMS) coils, criticized for its high potential of coil position fluctuations, bypassing the cortex using deep brain electrical stimulation (DBS) of the corticospinal tract with fixed electrodes where both latent variations of the coil position of TMS are eliminated and cortical excitation fluctuations should be absent. METHODS Ten input-output curves were recorded from five anesthetized cats with implanted DBS electrodes targeting the corticospinal tract. Goodness of fit of regressions with a conventional single variability source as well as a dual variability source model was quantified using a Schwarz Bayesian Information approach to avoid overfitting. RESULTS Motor evoked potentials (MEPs) through DBS of the corticospinal tract revealed short-term fluctuations in excitability of the targeted neuron pathway reflecting endogenous input-side variability at similar magnitude as TMS despite bypassing cortical networks. CONCLUSION Input-side variability, i.e., variability resulting in changing MEP amplitudes as if the stimulation strength was modulated, also emerges in electrical stimulation at a similar degree and is not primarily a result of varying stimulation, such as minor coil movements in TMS. More importantly, this variability component is present, although the cortex is bypassed. Thus, it may be of spinal origin, which can include cortical input from spinal projections. Further, the nonlinearity of the compound variability entails complex heteroscedastic non-Gaussian distributions and typically does not allow simple linear averages in statistical analysis of MEPs. As the average is dominated by outliers, it risks bias. With appropriate regression, the net effects of excitatory and inhibitory inputs to the targeted neuron pathways become noninvasively observable and quantifiable. SIGNIFICANCE The neural responses evoked by artificial stimulation in the cerebral cortex are variable. For example, MEPs in response to repeated presentations of the same stimulus can vary from no response to saturation across trials. Several sources of such variability have been suggested, and most of them may be technical in nature, but localization is missing.
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Affiliation(s)
- Stefan M Goetz
- Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK; Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC 27710, USA; Department of Neurosurgery, Duke University, Durham, NC 27710, USA; Department of Electrical & Computer Engineering, Duke University, Durham, NC 27708, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC 27710, USA.
| | - Bryan Howell
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Boshuo Wang
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC 27710, USA
| | - Zhongxi Li
- Department of Electrical & Computer Engineering, Duke University, Durham, NC 27708, USA
| | - Marc A Sommer
- Duke Institute of Brain Sciences, Duke University, Durham, NC 27710, USA; Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; Department of Neurobiology, Duke University, Durham, NC 27710, USA
| | - Angel V Peterchev
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC 27710, USA; Department of Neurosurgery, Duke University, Durham, NC 27710, USA; Department of Electrical & Computer Engineering, Duke University, Durham, NC 27708, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC 27710, USA; Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Warren M Grill
- Department of Neurosurgery, Duke University, Durham, NC 27710, USA; Department of Electrical & Computer Engineering, Duke University, Durham, NC 27708, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC 27710, USA; Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA; Department of Neurobiology, Duke University, Durham, NC 27710, USA
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Hussain SJ, Quentin R. Decoding personalized motor cortical excitability states from human electroencephalography. Sci Rep 2022; 12:6323. [PMID: 35428785 PMCID: PMC9012777 DOI: 10.1038/s41598-022-10239-3] [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: 11/09/2021] [Accepted: 03/30/2022] [Indexed: 11/22/2022] Open
Abstract
Brain state-dependent transcranial magnetic stimulation (TMS) requires real-time identification of cortical excitability states. Current approaches deliver TMS during brain states that correlate with motor cortex (M1) excitability at the group level. Here, we hypothesized that machine learning classifiers could successfully discriminate between high and low M1 excitability states in individual participants using information obtained from low-density electroencephalography (EEG) signals. To test this, we analyzed a publicly available dataset that delivered 600 single TMS pulses to the right M1 during EEG and electromyography (EMG) recordings in 20 healthy adults. Multivariate pattern classification was used to discriminate between brain states during which TMS evoked small and large motor-evoked potentials (MEPs). Results show that personalized classifiers successfully discriminated between low and high M1 excitability states in 80% of tested participants. MEPs elicited during classifier-predicted high excitability states were significantly larger than those elicited during classifier-predicted low excitability states in 90% of tested participants. Personalized classifiers did not generalize across participants. Overall, results show that individual participants exhibit unique brain activity patterns which predict low and high M1 excitability states and that these patterns can be efficiently captured using low-density EEG signals. Our findings suggest that deploying individualized classifiers during brain state-dependent TMS may enable fully personalized neuromodulation in the future.
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Affiliation(s)
- Sara J Hussain
- Movement and Cognitive Rehabilitation Science Program, Department of Kinesiology and Health Education, University of Texas at Austin, 540 Bellmont Hall, 2109 San Jacinto Blvd, Austin, TX, 78712, USA.
| | - Romain Quentin
- MEL Group, EDUWELL Team, Lyon Neuroscience Research Center (CRNL), INSERM U1028, CRNS UMR5292, Université Claude Bernard Lyon 1, Lyon, France
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Removing artifacts from TMS-evoked EEG: A methods review and a unifying theoretical framework. J Neurosci Methods 2022; 376:109591. [PMID: 35421514 DOI: 10.1016/j.jneumeth.2022.109591] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/15/2022] [Accepted: 03/26/2022] [Indexed: 11/24/2022]
Abstract
Transcranial magnetic stimulation (TMS) combined with electroencephalography (EEG) is a technique for studying cortical excitability and connectivity in health and disease, allowing basic research and potential clinical applications. A major methodological issue, severely limiting the applicability of TMS-EEG, relates to the contamination of EEG signals by artifacts of biologic or non-biologic origin. To solve this problem, several methods, based on independent component analysis (ICA), principal component analysis (PCA), signal space projection (SSP), and other approaches, have been developed over the last decade. This article is divided into two parts. In the first part, we review the theoretical background of the currently available TMS-EEG artifact removal methods. In the second part, we formally introduce the mathematics underpinnings of the cleaning methods. We classify them into spatial and temporal filters based on their properties. Since the most frequently used TMS-EEG cleaning approach are spatial filter methods, we focus on them and introduce beamforming as a unified framework of the most popular spatial filtering techniques. This unifying approach enables the comparative assessment of these methods by highlighting their differences in terms of assumptions, challenges, and applicability for different types of artifacts and data. The different properties and challenges of the methods discussed are illustrated with both simulated and recorded data. This article targets non-mathematical and mathematical audiences. Accordingly, those readers interested in essential background information on these methods can focus on Section 2. Whereas theory-oriented readers may find Section 3 helpful for making informed decisions between existing methods and developing the methodology further.
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Wang JY, Heck KL, Born J, Ngo HVV, Diekelmann S. No difference between slow oscillation up- and down-state cueing for memory consolidation during sleep. J Sleep Res 2022; 31:e13562. [PMID: 35166422 DOI: 10.1111/jsr.13562] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/30/2022]
Abstract
The beneficial effects of sleep for memory consolidation are assumed to rely on the reactivation of memories in conjunction with the coordinated interplay of sleep rhythms like slow oscillations and spindles. Specifically, slow oscillations are assumed to provide the temporal frame for spindles to occur in the slow oscillations up-states, enabling a redistribution of reactivated information within hippocampal-neocortical networks for long-term storage. Memory reactivation can also be triggered externally by presenting learning-associated cues (like odours or sounds) during sleep, but it is presently unclear whether there is an optimal time-window for the presentation of such cues in relation to the phase of the slow oscillations. In the present within-subject comparison, participants (n = 16) learnt word-pairs visually presented with auditory cues of the first syllable. These syllables were subsequently used for real-time cueing either in the up- or down-state of endogenous slow oscillations. Contrary to our hypothesis, we found differences in memory performance neither between up- and down-state cueing, nor between word-pairs that were cued versus uncued. In the up-state cueing condition, higher amounts of rapid eye movement sleep were associated with better memory for cued contents, whereas higher amounts of slow-wave sleep were associated with better memory for uncued contents. Evoked response analyses revealed signs of cue processing in both conditions. Interestingly, both up- and down-state cueing evoked a similar spindle response with the induced slow oscillations up-state at ~1000 ms post-cue. We speculate that our cueing procedure triggered generalised reactivation processes that facilitated the consolidation of both cued and uncued memories irrespective of the slow oscillation phase.
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Affiliation(s)
- Jing-Yi Wang
- Institute of Medical Psychology and Behavioral Neurobiology, University Tübingen, Tübingen, Germany.,State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Faculty of Psychology at Beijing Normal University, Beijing, China
| | - Katharina L Heck
- Institute of Medical Psychology and Behavioral Neurobiology, University Tübingen, Tübingen, Germany
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, University Tübingen, Tübingen, Germany.,Centre for Integrative Neuroscience, University Tübingen, Tübingen, Germany
| | - Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Susanne Diekelmann
- Institute of Medical Psychology and Behavioral Neurobiology, University Tübingen, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Tervo AE, Nieminen JO, Lioumis P, Metsomaa J, Souza VH, Sinisalo H, Stenroos M, Sarvas J, Ilmoniemi RJ. Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback. Brain Stimul 2022; 15:523-531. [PMID: 35337598 PMCID: PMC8940636 DOI: 10.1016/j.brs.2022.01.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/17/2021] [Accepted: 01/28/2022] [Indexed: 12/16/2022] Open
Abstract
Background Transcranial magnetic stimulation (TMS) is widely used in brain research and treatment of various brain dysfunctions. However, the optimal way to target stimulation and administer TMS therapies, for example, where and in which electric field direction the stimuli should be given, is yet to be determined. Objective To develop an automated closed-loop system for adjusting TMS parameters (in this work, the stimulus orientation) online based on TMS-evoked brain activity measured with electroencephalography (EEG). Methods We developed an automated closed-loop TMS–EEG set-up. In this set-up, the stimulus parameters are electronically adjusted with multi-locus TMS. As a proof of concept, we developed an algorithm that automatically optimizes the stimulation orientation based on single-trial EEG responses. We applied the algorithm to determine the electric field orientation that maximizes the amplitude of the TMS–EEG responses. The validation of the algorithm was performed with six healthy volunteers, repeating the search twenty times for each subject. Results The validation demonstrated that the closed-loop control worked as desired despite the large variation in the single-trial EEG responses. We were often able to get close to the orientation that maximizes the EEG amplitude with only a few tens of pulses. Conclusion Optimizing stimulation with EEG feedback in a closed-loop manner is feasible and enables effective coupling to brain activity. Closed-loop set-up for guiding TMS with brain activity feedback. Automatic stimulus orientation optimization based on TMS-evoked EEG responses. Adjusting TMS parameters electronically allows fast and effortless procedures. TMS-evoked EEG responses depend on the stimulus orientation.
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Affiliation(s)
- Aino E Tervo
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; AMI Centre, Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland
| | - Jaakko O Nieminen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Pantelis Lioumis
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Metsomaa
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Neurology & Stroke and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Victor H Souza
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Heikki Sinisalo
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Matti Stenroos
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Jukka Sarvas
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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36
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OUP accepted manuscript. Cereb Cortex 2022; 32:4782-4796. [DOI: 10.1093/cercor/bhab516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 11/14/2022] Open
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Janssens SEW, Sack AT. Spontaneous Fluctuations in Oscillatory Brain State Cause Differences in Transcranial Magnetic Stimulation Effects Within and Between Individuals. Front Hum Neurosci 2021; 15:802244. [PMID: 34924982 PMCID: PMC8674306 DOI: 10.3389/fnhum.2021.802244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 01/01/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) can cause measurable effects on neural activity and behavioral performance in healthy volunteers. In addition, TMS is increasingly used in clinical practice for treating various neuropsychiatric disorders. Unfortunately, TMS-induced effects show large intra- and inter-subject variability, hindering its reliability, and efficacy. One possible source of this variability may be the spontaneous fluctuations of neuronal oscillations. We present recent studies using multimodal TMS including TMS-EMG (electromyography), TMS-tACS (transcranial alternating current stimulation), and concurrent TMS-EEG-fMRI (electroencephalography, functional magnetic resonance imaging), to evaluate how individual oscillatory brain state affects TMS signal propagation within targeted networks. We demonstrate how the spontaneous oscillatory state at the time of TMS influences both immediate and longer-lasting TMS effects. These findings indicate that at least part of the variability in TMS efficacy may be attributable to the current practice of ignoring (spontaneous) oscillatory fluctuations during TMS. Ignoring this state-dependent spread of activity may cause great individual variability which so far is poorly understood and has proven impossible to control. We therefore also compare two technical solutions to directly account for oscillatory state during TMS, namely, to use (a) tACS to externally control these oscillatory states and then apply TMS at the optimal (controlled) brain state, or (b) oscillatory state-triggered TMS (closed-loop TMS). The described multimodal TMS approaches are paramount for establishing more robust TMS effects, and to allow enhanced control over the individual outcome of TMS interventions aimed at modulating information flow in the brain to achieve desirable changes in cognition, mood, and behavior.
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Affiliation(s)
- Shanice E W Janssens
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Maastricht Brain Imaging Centre (MBIC), Maastricht, Netherlands
| | - Alexander T Sack
- Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Maastricht Brain Imaging Centre (MBIC), Maastricht, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain + Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands.,Centre for Integrative Neuroscience (CIN), Maastricht University, Maastricht, Netherlands
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38
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Pokorny L, Jarczok TA, Bender S. Topography and lateralization of long-latency trigeminal somatosensory evoked potentials. Clin Neurophysiol 2021; 135:37-50. [PMID: 35026539 DOI: 10.1016/j.clinph.2021.11.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/20/2021] [Accepted: 11/08/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Long-latency trigeminal somatosensory evoked potentials (SSEPs) have not been sufficiently studied regarding their topography and lateralization. SSEPs are hypothesized to contribute to the evoked potentials after transcranial magnetic stimulation (TMS). This study focused on trigeminal SSEPs with latencies > 100 ms, potentially overlapping with TMS-evoked N100. METHODS In 14 healthy subjects, the trigeminus was electrically stimulated on the left and right forehead, and time-course, topography, and lateralization of trigeminal SSEPs were examined in 64-channel electroencephalogram (EEG). SSEPs were then compared to TMS-evoked potentials when TMS was applied to the left and right dorsolateral prefrontal cortex. RESULTS Trigeminal stimulation produced a somatosensory N140 with topographic maximum over centroparietal electrodes with larger amplitudes contra- than ipsilaterally to the stimulation. Contralateral potentials after TMS were partly comparable in their topography but differed in latencies. CONCLUSIONS SSEPs generated by electrical stimulation of the trigeminus occurred over somatosensory areas with a contralateral lateralization. Therefore, contralateral potentials after TMS should be interpreted with caution, as they may include somatosensory components. SIGNIFICANCE The topography and lateralization of long-latency trigeminal SSEPs should be considered in future TMS-EEG designs.
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Affiliation(s)
- Lena Pokorny
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.
| | - Tomasz Antoni Jarczok
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Frankfurt, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, KJF Klinik Josefinum, Kapellenstrasse 30, 86154, Augsburg, Germany.
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.
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Facilitation of Motor Evoked Potentials in Response to a Modified 30 Hz Intermittent Theta-Burst Stimulation Protocol in Healthy Adults. Brain Sci 2021; 11:brainsci11121640. [PMID: 34942942 PMCID: PMC8699605 DOI: 10.3390/brainsci11121640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/06/2021] [Accepted: 12/11/2021] [Indexed: 12/24/2022] Open
Abstract
Theta-burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation (rTMS) developed to induce neuroplasticity. TBS usually consists of 50 Hz bursts at 5 Hz intervals. It can facilitate motor evoked potentials (MEPs) when applied intermittently, although this effect can vary between individuals. Here, we sought to determine whether a modified version of intermittent TBS (iTBS) consisting of 30 Hz bursts repeated at 6 Hz intervals would lead to lasting MEP facilitation. We also investigated whether recruitment of early and late indirect waves (I-waves) would predict individual responses to 30 Hz iTBS. Participants (n = 19) underwent single-pulse TMS to assess MEP amplitude at baseline and variations in MEP latency in response to anterior-posterior, posterior-anterior, and latero-medial stimulation. Then, 30 Hz iTBS was administered, and MEP amplitude was reassessed at 5-, 20- and 45-min. Post iTBS, most participants (13/19) exhibited MEP facilitation, with significant effects detected at 20- and 45-min. Contrary to previous evidence, recruitment of early I-waves predicted facilitation to 30 Hz iTBS. These observations suggest that 30 Hz/6 Hz iTBS is effective in inducing lasting facilitation in corticospinal excitability and may offer an alternative to the standard 50 Hz/5 Hz protocol.
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Bihemispheric sensorimotor oscillatory network states determine cortical responses to transcranial magnetic stimulation. Brain Stimul 2021; 15:167-178. [PMID: 34896304 DOI: 10.1016/j.brs.2021.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Brain responses to external stimuli vary with fluctuating states of neuronal activity. Previous work has demonstrated effects of phase and power of the ongoing local sensorimotor μ-alpha-oscillation on responses to transcranial magnetic stimulation (TMS) of motor cortex (M1). However, M1 is part of a distributed network, and the effects of oscillatory activity in this network on TMS-evoked EEG responses (TEPs) have not been explored. OBJECTIVES To determine the effects of oscillatory activity in the bihemispheric sensorimotor network on TEPs. METHODS 31 healthy subjects received single-pulse TMS of the left M1 hand area during EEG recording. Ongoing bihemispheric sensorimotor cortex oscillatory states were reconstructed from the EEG directly preceding TMS, and inferred by a data-driven method combining a multivariate autoregressive model and a Hidden Markov model. TEP amplitudes (P25, N45, P70, N100 and P180) were then compared between different bihemispheric sensorimotor cortex oscillatory states. RESULTS Four bihemispheric sensorimotor cortex oscillatory states were identified, with different interhemispheric expressions of theta and alpha oscillations. High alpha-power states in the stimulated sensorimotor cortex increased P25 amplitude. Alpha power in the alpha-alpha state (stimulated - non-stimulated hemisphere) correlated in both hemispheres with N45 amplitude. Theta power in the alpha-theta state correlated in the non-stimulated hemisphere with P70 amplitude. CONCLUSIONS Bihemispheric sensorimotor cortex oscillatory states contribute to TEPs, with a relevance shift from stimulated to non-stimulated M1 from P25 over N45 to P70. This significantly extends previous findings: not only ongoing local oscillations but distributed network oscillatory states determine cortical responsiveness to external stimuli.
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Using Brain Imaging to Improve Spatial Targeting of Transcranial Magnetic Stimulation for Depression. Biol Psychiatry 2021; 90:689-700. [PMID: 32800379 DOI: 10.1016/j.biopsych.2020.05.033] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 01/18/2023]
Abstract
Transcranial magnetic stimulation (TMS) is an effective treatment for depression but is limited in that the optimal therapeutic target remains unknown. Early TMS trials lacked a focal target and thus positioned the TMS coil over the prefrontal cortex using scalp measurements. Over time, it became clear that this method leads to variation in the stimulation site and that this could contribute to heterogeneity in antidepressant response. Newer methods allow for precise positioning of the TMS coil over a specific brain location, but leveraging these precise methods requires a more precise therapeutic target. We review how neuroimaging is being used to identify a more focal therapeutic target for depression. We highlight recent studies showing that more effective TMS targets in the frontal cortex are functionally connected to deep limbic regions such as the subgenual cingulate cortex. We review how connectivity might be used to identify an optimal TMS target for use in all patients and potentially even a personalized target for each individual patient. We address the clinical implications of this emerging field and highlight critical questions for future research.
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Onojima T, Kitajo K. A state-informed stimulation approach with real-time estimation of the instantaneous phase of neural oscillations by a Kalman filter. J Neural Eng 2021; 18. [PMID: 34644689 DOI: 10.1088/1741-2552/ac2f7b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/13/2021] [Indexed: 11/11/2022]
Abstract
Objective.We propose a novel method to estimate the instantaneous oscillatory phase to implement a real-time system for state-informed sensory stimulation in electroencephalography (EEG) experiments.Approach.The method uses Kalman filter-based prediction to estimate current and future EEG signals. We tested the performance of our method in a real-time situation.Main results.Our method showed higher accuracy in predicting the EEG phase than the conventional autoregressive (AR) model-based method.Significance.A Kalman filter allows us to easily estimate the instantaneous phase of EEG oscillations based on the automatically estimated AR model implemented in a real-time signal processing machine. The proposed method has a potential for versatile applications targeting the modulation of EEG phase dynamics and the plasticity of brain networks in relation to perceptual or cognitive functions.
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Affiliation(s)
- Takayuki Onojima
- CBS-TOYOTA Collaboration Center, RIKEN Center for Brain Science, Wako 351-0198, Japan
| | - Keiichi Kitajo
- CBS-TOYOTA Collaboration Center, RIKEN Center for Brain Science, Wako 351-0198, Japan.,Division of Neural Dynamics, Department of System Neuroscience, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Okazaki 444-8585, Japan.,Department of Physiological Sciences, School of Life Science, The Graduate University for Advanced Studies (SOKENDAI), Okazaki 444-8585, Japan
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Geffen A, Bland N, Sale MV. Effects of Slow Oscillatory Transcranial Alternating Current Stimulation on Motor Cortical Excitability Assessed by Transcranial Magnetic Stimulation. Front Hum Neurosci 2021; 15:726604. [PMID: 34588969 PMCID: PMC8473706 DOI: 10.3389/fnhum.2021.726604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Converging evidence suggests that transcranial alternating current stimulation (tACS) may entrain endogenous neural oscillations to match the frequency and phase of the exogenously applied current and this entrainment may outlast the stimulation (although only for a few oscillatory cycles following the cessation of stimulation). However, observing entrainment in the electroencephalograph (EEG) during stimulation is extremely difficult due to the presence of complex tACS artifacts. The present study assessed entrainment to slow oscillatory (SO) tACS by measuring motor cortical excitability across different oscillatory phases during (i.e., online) and outlasting (i.e., offline) stimulation. 30 healthy participants received 60 trials of intermittent SO tACS (0.75 Hz; 16 s on/off interleaved) at an intensity of 2 mA peak-to-peak. Motor cortical excitability was assessed using transcranial magnetic stimulation (TMS) of the hand region of the primary motor cortex (M1HAND) to induce motor evoked potentials (MEPs) in the contralateral thumb. MEPs were acquired at four time-points within each trial – early online, late online, early offline, and late offline – as well as at the start and end of the overall stimulation period (to probe longer-lasting aftereffects of tACS). A significant increase in MEP amplitude was observed from pre- to post-tACS (paired-sample t-test; t29 = 2.64, P = 0.013, d = 0.48) and from the first to the last tACS block (t29 = −2.93, P = 0.02, d = 0.54). However, no phase-dependent modulation of excitability was observed. Therefore, although SO tACS had a facilitatory effect on motor cortical excitability that outlasted stimulation, there was no evidence supporting entrainment of endogenous oscillations as the underlying mechanism.
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Affiliation(s)
- Asher Geffen
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Nicholas Bland
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.,Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Martin V Sale
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.,Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
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44
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Sifuentes-Ortega R, Lenc T, Nozaradan S, Peigneux P. Partially Preserved Processing of Musical Rhythms in REM but Not in NREM Sleep. Cereb Cortex 2021; 32:1508-1519. [PMID: 34491309 DOI: 10.1093/cercor/bhab303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The extent of high-level perceptual processing during sleep remains controversial. In wakefulness, perception of periodicities supports the emergence of high-order representations such as the pulse-like meter perceived while listening to music. Electroencephalography (EEG) frequency-tagged responses elicited at envelope frequencies of musical rhythms have been shown to provide a neural representation of rhythm processing. Specifically, responses at frequencies corresponding to the perceived meter are enhanced over responses at meter-unrelated frequencies. This selective enhancement must rely on higher-level perceptual processes, as it occurs even in irregular (i.e., syncopated) rhythms where meter frequencies are not prominent input features, thus ruling out acoustic confounds. We recorded EEG while presenting a regular (unsyncopated) and an irregular (syncopated) rhythm across sleep stages and wakefulness. Our results show that frequency-tagged responses at meter-related frequencies of the rhythms were selectively enhanced during wakefulness but attenuated across sleep states. Most importantly, this selective attenuation occurred even in response to the irregular rhythm, where meter-related frequencies were not prominent in the stimulus, thus suggesting that neural processes selectively enhancing meter-related frequencies during wakefulness are weakened during rapid eye movement (REM) and further suppressed in non-rapid eye movement (NREM) sleep. These results indicate preserved processing of low-level acoustic properties but limited higher-order processing of auditory rhythms during sleep.
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Affiliation(s)
- Rebeca Sifuentes-Ortega
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Center for Research in Cognition & Neurosciences, and UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Tomas Lenc
- Institute of Neuroscience (IONS), Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Sylvie Nozaradan
- Institute of Neuroscience (IONS), Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Philippe Peigneux
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Center for Research in Cognition & Neurosciences, and UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
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45
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Wunderlin M, Züst MA, Hertenstein E, Fehér KD, Schneider CL, Klöppel S, Nissen C. Modulating overnight memory consolidation by acoustic stimulation during slow-wave sleep: a systematic review and meta-analysis. Sleep 2021; 44:6066545. [PMID: 33406249 DOI: 10.1093/sleep/zsaa296] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/12/2020] [Indexed: 12/18/2022] Open
Abstract
STUDY OBJECTIVES The low-frequency high-amplitude oscillations of slow-wave sleep (SWS) are considered to promote the consolidation of episodic memory. Previous research suggests that sleep slow waves can be entrained and enhanced by presenting short acoustic stimuli to the up-states of endogenous waves. Several studies have investigated the effects of these increases in slow-wave activity on overnight memory consolidation, with inconsistent results. The aim of this meta-analysis was to evaluate the accumulated evidence connecting acoustic stimulation during sleep to episodic memory consolidation. METHODS A systematic literature search was conducted in October 2020 using PubMed, Web of Science, and PsycInfo. The main study inclusion criteria were the application of acoustic slow wave enhancement in healthy participants and an assessment of pre- and post-sleep episodic memory performance. Effect sizes were pooled using a random-effects model. RESULTS A total of 10 primary studies with 11 experiments and 177 participants were included. Results showed a combined effect size (Hedges' g) of 0.25 (p = 0.07). Subgroup models based on young adults (n = 8), phase-locked stimulation approaches (n = 8), and their combination (n = 6) showed combined effect sizes of 0.31 (p = 0.051), 0.36 (p = 0.047), and 0.44 (p = 0.01), respectively. There was no indication of publication bias or bias in individual studies. CONCLUSIONS Acoustic enhancement of SWS tends to increase the overnight consolidation of episodic memory but effects remain small and-with the exception of subgroup models-at trend levels. Currently, the evidence is not sufficient to recommend the use of commercially available devices.
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Affiliation(s)
- Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kristoffer D Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carlotta L Schneider
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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46
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Rurak BK, Rodrigues JP, Power BD, Drummond PD, Vallence AM. Test Re-test Reliability of Dual-site TMS Measures of SMA-M1 Connectivity Differs Across Inter-stimulus Intervals in Younger and Older Adults. Neuroscience 2021; 472:11-24. [PMID: 34333064 DOI: 10.1016/j.neuroscience.2021.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 12/24/2022]
Abstract
Dual-site transcranial magnetic stimulation (TMS) is a promising tool to measure supplementary motor area and primary motor cortex (SMA-M1) connectivity in younger and older adults, and could be used to understand the pathophysiology of movement disorders. However, test re-test reliability of dual-site TMS measures of SMA-M1 connectivity has not been established. We examined the reliability of SMA-M1 connectivity using dual-site TMS in two sessions in 30 younger and 30 older adults. For dual-site TMS, a conditioning pulse delivered to SMA (140% of active motor threshold) preceded a test pulse delivered to M1 (intensity that elicited MEPs of ~1 mV) by inter-stimulus intervals (ISI) of 6 ms, 7 ms, and 8 ms. Moderate intraclass correlation coefficients (ICC) were found for SMA-M1 connectivity at an ISI of 7 ms in younger (ICC: 0.69) and older adults (ICC: 0.68). Poor ICCs were found for SMA-M1 connectivity at ISIs of 6 ms and 8 ms in both age groups (ICC range: 0.01-0.40). We report evidence for stable measures of SMA-M1 connectivity at an ISI of 7 ms in both age groups. These findings are foundational for future research developing evidence-based interventions to strengthen SMA-M1 connectivity to improve bilateral motor control in older adults and populations with movement disorders.
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Affiliation(s)
- B K Rurak
- Discipline of Psychology, College of Science, Health, Engineering and Education, Murdoch University, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch 6150, Australia.
| | | | - B D Power
- Hollywood Private Hospital, Australia; School of Medicine Fremantle, University of Notre Dame, Australia
| | - P D Drummond
- Discipline of Psychology, College of Science, Health, Engineering and Education, Murdoch University, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch 6150, Australia
| | - A M Vallence
- Discipline of Psychology, College of Science, Health, Engineering and Education, Murdoch University, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch 6150, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch 6150, Australia
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47
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Gordon PC, Dörre S, Belardinelli P, Stenroos M, Zrenner B, Ziemann U, Zrenner C. Prefrontal Theta-Phase Synchronized Brain Stimulation With Real-Time EEG-Triggered TMS. Front Hum Neurosci 2021; 15:691821. [PMID: 34234662 PMCID: PMC8255809 DOI: 10.3389/fnhum.2021.691821] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background Theta-band neuronal oscillations in the prefrontal cortex are associated with several cognitive functions. Oscillatory phase is an important correlate of excitability and phase synchrony mediates information transfer between neuronal populations oscillating at that frequency. The ability to extract and exploit the prefrontal theta rhythm in real time in humans would facilitate insight into neurophysiological mechanisms of cognitive processes involving the prefrontal cortex, and development of brain-state-dependent stimulation for therapeutic applications. Objectives We investigate individual source-space beamforming-based estimation of the prefrontal theta oscillation as a method to target specific phases of the ongoing theta oscillations in the human dorsomedial prefrontal cortex (DMPFC) with real-time EEG-triggered transcranial magnetic stimulation (TMS). Different spatial filters for extracting the prefrontal theta oscillation from EEG signals are compared and additional signal quality criteria are assessed to take into account the dynamics of this cortical oscillation. Methods Twenty two healthy participants were recruited for anatomical MRI scans and EEG recordings with 18 composing the final analysis. We calculated individual spatial filters based on EEG beamforming in source space. The extracted EEG signal was then used to simulate real-time phase-detection and quantify the accuracy as compared to post-hoc phase estimates. Different spatial filters and triggering parameters were compared. Finally, we validated the feasibility of this approach by actual real-time triggering of TMS pulses at different phases of the prefrontal theta oscillation. Results Higher phase-detection accuracy was achieved using individualized source-based spatial filters, as compared to an average or standard Laplacian filter, and also by detecting and avoiding periods of low theta amplitude and periods containing a phase reset. Using optimized parameters, prefrontal theta-phase synchronized TMS of DMPFC was achieved with an accuracy of ±55°. Conclusion This study demonstrates the feasibility of triggering TMS pulses during different phases of the ongoing prefrontal theta oscillation in real time. This method is relevant for brain state-dependent stimulation in human studies of cognition. It will also enable new personalized therapeutic repetitive TMS protocols for more effective treatment of neuropsychiatric disorders.
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Affiliation(s)
- Pedro Caldana Gordon
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Sara Dörre
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Paolo Belardinelli
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,CIMeC, Center for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Matti Stenroos
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Brigitte Zrenner
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Christoph Zrenner
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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48
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Rapid computation of TMS-induced E-fields using a dipole-based magnetic stimulation profile approach. Neuroimage 2021; 237:118097. [PMID: 33940151 PMCID: PMC8353625 DOI: 10.1016/j.neuroimage.2021.118097] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/25/2021] [Accepted: 04/23/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND TMS neuronavigation with on-line display of the induced electric field (E-field) has the potential to improve quantitative targeting and dosing of stimulation, but present commercially available solutions are limited by simplified approximations. OBJECTIVE Developing a near real-time method for accurate approximation of TMS induced E-fields with subject-specific high-resolution surface-based head models that can be utilized for TMS navigation. METHODS Magnetic dipoles are placed on a closed surface enclosing an MRI-based head model of the subject to define a set of basis functions for the incident and total E-fields that define the subject's Magnetic Stimulation Profile (MSP). The near real-time speed is achieved by recognizing that the total E-field of the coil only depends on the incident E-field and the conductivity boundary geometry. The total E-field for any coil position can be obtained by matching the incident field of the stationary dipole basis set with the incident E-field of the moving coil and applying the same basis coefficients to the total E-field basis functions. RESULTS Comparison of the MSP-based approximation with an established TMS solver shows great agreement in the E-field amplitude (relative maximum error around 5%) and the spatial distribution patterns (correlation >98%). Computation of the E-field took ~100 ms on a cortical surface mesh with 120k facets. CONCLUSION The numerical accuracy and speed of the MSP approximation method make it well suited for a wide range of computational tasks including interactive planning, targeting, dosing, and visualization of the intracranial E-fields for near real-time guidance of coil positioning.
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49
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Fehér KD, Wunderlin M, Maier JG, Hertenstein E, Schneider CL, Mikutta C, Züst MA, Klöppel S, Nissen C. Shaping the slow waves of sleep: A systematic and integrative review of sleep slow wave modulation in humans using non-invasive brain stimulation. Sleep Med Rev 2021; 58:101438. [PMID: 33582581 DOI: 10.1016/j.smrv.2021.101438] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 10/14/2020] [Accepted: 11/10/2020] [Indexed: 01/19/2023]
Abstract
The experimental study of electroencephalographic slow wave sleep (SWS) stretches over more than half a century and has corroborated its importance for basic physiological processes, such as brain plasticity, metabolism and immune system functioning. Alterations of SWS in aging or pathological conditions suggest that modulating SWS might constitute a window for clinically relevant interventions. This work provides a systematic and integrative review of SWS modulation through non-invasive brain stimulation in humans. A literature search using PubMed, conducted in May 2020, identified 3220 studies, of which 82 fulfilled inclusion criteria. Three approaches have been adopted to modulate the macro- and microstructure of SWS, namely auditory, transcranial electrical and transcranial magnetic stimulation. Our current knowledge about the modulatory mechanisms, the space of stimulation parameters and the physiological and behavioral effects are reported and evaluated. The integration of findings suggests that sleep slow wave modulation bears the potential to promote our understanding of the functions of SWS and to develop new treatments for conditions of disrupted SWS.
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Affiliation(s)
- Kristoffer D Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jonathan G Maier
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Carlotta L Schneider
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland; Privatklinik Meiringen, Meiringen, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
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50
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Romanella SM, Roe D, Tatti E, Cappon D, Paciorek R, Testani E, Rossi A, Rossi S, Santarnecchi E. The Sleep Side of Aging and Alzheimer's Disease. Sleep Med 2021; 77:209-225. [PMID: 32912799 PMCID: PMC8364256 DOI: 10.1016/j.sleep.2020.05.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 01/23/2023]
Abstract
As we age, sleep patterns undergo significant modifications in micro and macrostructure, worsening cognition and quality of life. These are associated with remarkable brain changes, like deterioration in synaptic plasticity, gray and white matter, and significant modifications in hormone levels. Sleep alterations are also a core component of mild cognitive impairment (MCI) and Alzheimer's Disease (AD). AD night time is characterized by a gradual decrease in slow-wave activity and a substantial reduction of REM sleep. Sleep abnormalities can accelerate AD pathophysiology, promoting the accumulation of amyloid-β (Aβ) and phosphorylated tau. Thus, interventions that target sleep disturbances in elderly people and MCI patients have been suggested as a possible strategy to prevent or decelerate conversion to dementia. Although cognitive-behavioral therapy and pharmacological medications are still first-line treatments, despite being scarcely effective, new interventions have been proposed, such as sensory stimulation and Noninvasive Brain Stimulation (NiBS). The present review outlines the current state of the art of the relationship between sleep modifications in healthy aging and the neurobiological mechanisms underlying age-related changes. Furthermore, we provide a critical analysis showing how sleep abnormalities influence the prognosis of AD pathology by intensifying Aβ and tau protein accumulation. We discuss potential therapeutic strategies to target sleep disruptions and conclude that there is an urgent need for testing new therapeutic sleep interventions.
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Affiliation(s)
- S M Romanella
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy
| | - D Roe
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - E Tatti
- Department of Molecular, Cellular & Biomedical Sciences, CUNY, School of Medicine, New York, NY, USA
| | - D Cappon
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - R Paciorek
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - E Testani
- Sleep Medicine Center, Department of Neurology, Policlinico Santa Maria Le Scotte, Siena, Italy
| | - A Rossi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy; Human Physiology Section, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - S Rossi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy; Human Physiology Section, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - E Santarnecchi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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