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Moser N, Popovic MR, Kalsi-Ryan S. Effectiveness of personalized rehabilitation in adults suffering from persistent concussion symptoms as compared to usual care: a randomized control trial protocol. BMC Neurol 2024; 24:239. [PMID: 38987676 PMCID: PMC11234705 DOI: 10.1186/s12883-024-03700-5] [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: 02/21/2024] [Accepted: 05/31/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Symptoms reported by patients who sustain a concussion are non-specific. As such, clinicians are better able to manage patients when a standardized clinical exam is performed to sub-type the driver(s) of symptoms. Aerobic exercise and multimodal rehabilitation have consistently shown to be a possibly effective means to manage this population; however, the optimal training prescription is unclear. Thus, there is a need to further examine the effectiveness of personalized rehabilitative treatments. Our primary aim is to evaluate the response to personalized therapy on recovery, as measured by The Rivermead Post-concussion Symptoms Questionnaire (RPQ) when compared to an active control. METHODS We will conduct a multi-center 12-week case-crossover randomized controlled trial. 50 participants will be recruited from out-patient University Health Network clinics and community-based clinical practices around the greater Toronto area. Participants will be randomized at baseline to Group A: a personalized care program followed by an active control or Group B: an active control followed by a personalized care program. Participants will be included should they be 21 years of age and older and have symptoms that have persisted beyond 4 weeks but less than 1 year. Participants will undergo 6-weeks of care in their respective streams. After 6-weeks, participants will undergo a re-examination. They will then crossover and undertake the alternative treatment for 6 weeks. At the end of 12 weeks, participants will undertake the endpoint examinations. The primary outcome will be the Rivermead Postconcussion Questionnaire (RPQ). The secondary outcomes will be changes in standardized clinical examination, Neck Disability Index (NDI), Patient Health Questionnaire (PHQ-9) and an electroencephalography (EEG) via NeuroCatch™. The statistical analysis to be performed is composed of an adjusted model using an analysis of variance, specifically using an unpaired t-test to test for associations between variables and outcomes. DISCUSSION Given the recommendations from reviews on the topic of rehabilitation for adults with persistent concussion symptoms, we are undertaking a controlled trial. The documented high costs for patients seeking care for persistent symptoms necessitate the need to evaluate the effectiveness of a personalized rehabilitative program compared to the current standard of care. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT06069700.
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Affiliation(s)
- Nicholas Moser
- KITE Research Institute-University Health Network, Toronto, ON, Canada.
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Nicholas, Canada.
| | - Milos R Popovic
- KITE Research Institute-University Health Network, Toronto, ON, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Nicholas, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Sukhvinder Kalsi-Ryan
- KITE Research Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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2
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Jones KB, Frizzell T, Fickling S, Pawlowski G, Brodie SM, Lakhani B, Venter J, D’Arcy RCN. Brain vital sign monitoring of sleep deprivation detects situational cognitive impairment. Front Hum Neurosci 2024; 18:1358551. [PMID: 38628971 PMCID: PMC11018923 DOI: 10.3389/fnhum.2024.1358551] [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: 12/19/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Objective, rapid evaluation of cognitive function is critical for identifying situational impairment due to sleep deprivation. The present study used brain vital sign monitoring to evaluate acute changes in cognitive function for healthy adults. Thirty (30) participants were scanned using portable electroencephalography before and after either a night of regular sleep or a night of total sleep deprivation. Brain vital signs were extracted from three established event-related potential components: (1) the N100 (Auditory sensation); (2) the P300 (Basic attention); and (3) the N400 (Cognitive processing) for all time points. As predicted, the P300 amplitude was significantly reduced in the sleep deprivation group. The findings indicate that it is possible to detect situational cognitive impairment due to sleep deprivation using objective, rapid brain vital sign monitoring.
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Affiliation(s)
| | - Tory Frizzell
- BrainNET, Health and Technology District, Surrey, BC, Canada
| | - Shaun Fickling
- BrainNET, Health and Technology District, Surrey, BC, Canada
| | - Gabriela Pawlowski
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
- BrainNET, Health and Technology District, Surrey, BC, Canada
| | - Sonia M. Brodie
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | - Bimal Lakhani
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | - Jan Venter
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
- Healthcode Ltd, Vancouver, BC, Canada
| | - Ryan C. N. D’Arcy
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
- BrainNET, Health and Technology District, Surrey, BC, Canada
- Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada
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3
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Kirby ED, Jones CB, Fickling SD, Pawlowski G, Brodie SM, Boyd LA, Venter J, Moser N, Kalsi-Ryan S, Medvedev G, D’Arcy RCN. Real world evidence of improved attention and cognition during physical therapy paired with neuromodulation: a brain vital signs study. Front Hum Neurosci 2023; 17:1209480. [PMID: 37362950 PMCID: PMC10289164 DOI: 10.3389/fnhum.2023.1209480] [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: 04/20/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Background Non-invasive neuromodulation using translingual neurostimulation (TLNS) has been shown to advance rehabilitation outcomes, particularly when paired with physical therapy (PT). Together with motor gains, patient-reported observations of incidental improvements in cognitive function have been noted. Both studies in healthy individuals and case reports in clinical populations have linked TLNS to improvements in attention-related cognitive processes. We investigated if the use of combined TLNS/PT would translate to changes in objective neurophysiological cognitive measures in a real-world clinical sample of patients from two separate rehabilitation clinics. Methods Brain vital signs were derived from event-related potentials (ERPs), specifically auditory sensation (N100), basic attention (P300), and cognitive processing (N400). Additional analyses explored the attention-related N200 response given prior evidence of attention effects from TLNS/PT. The real-world patient sample included a diverse clinical group spanning from mild-to-moderate traumatic brain injury (TBI), stroke, Multiple Sclerosis (MS), Parkinson's Disease (PD), and other neurological conditions. Patient data were also acquired from a standard clinical measure of cognition for comparison. Results Results showed significant N100 variation between baseline and endpoint following TLNS/PT treatment, with further examination showing condition-specific significant improvements in attention processing (i.e., N100 and N200). Additionally, CogBAT composite scores increased significantly from baseline to endpoint. Discussion The current study highlighted real-world neuromodulation improvements in neurophysiological correlates of attention. Overall, the real-world findings support the concept of neuromodulation-related improvements extending beyond physical therapy to include potential attention benefits for cognitive rehabilitation.
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Affiliation(s)
- Eric D. Kirby
- BrainNet, Faculty of Applied Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Christina B. Jones
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
- Brain Behaviour Laboratory, Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Shaun D. Fickling
- BrainNet, Faculty of Applied Sciences, Simon Fraser University, Vancouver, BC, Canada
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | | | - Sonia M. Brodie
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | - Lara A. Boyd
- Brain Behaviour Laboratory, Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Jan Venter
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
- Healthcode, Vancouver, BC, Canada
| | - Nicholas Moser
- KITE Research Institute-UHN, Toronto, ON, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Sukhvinder Kalsi-Ryan
- KITE Research Institute-UHN, Toronto, ON, Canada
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - George Medvedev
- Royal Columbian Hospital, Fraser Health, Vancouver, BC, Canada
| | - Ryan C. N. D’Arcy
- BrainNet, Faculty of Applied Sciences, Simon Fraser University, Vancouver, BC, Canada
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
- DM Centre for Brain Health, Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
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4
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Wang R, Liu Y, Shi J, Peng B, Fei W, Bi L. Sound Target Detection Under Noisy Environment Using Brain-Computer Interface. IEEE Trans Neural Syst Rehabil Eng 2023; 31:229-237. [PMID: 36331633 DOI: 10.1109/tnsre.2022.3219595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As an important means of environmental reconnaissance and regional security protection, sound target detection (STD) has been widely studied in the field of machine learning for a long time. Considering the shortcomings of the robustness and generalization performance of existing methods based on machine learning, we proposed a target detection method by an auditory brain-computer interface (BCI). We designed the experimental paradigm according to the actual application scenarios of STD, recorded the changes in Electroencephalogram (EEG) signals during the process of detecting target sound, and further extracted the features used to decode EEG signals through the analysis of neural representations, including Event-Related Potential (ERP) and Event-Related Spectral Perturbation (ERSP). Experimental results showed that the proposed method achieved good detection performance under noisy environment. As the first study of BCI applied to STD, this study shows the feasibility of this scheme in BCI and can serve as the foundation for future related applications.
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5
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Kim N, Watson W, Caliendo E, Nowak S, Schiff ND, Shah SA, Hill NJ. Objective Neurophysiologic Markers of Cognition After Pediatric Brain Injury. Neurol Clin Pract 2022; 12:352-364. [PMID: 36380885 PMCID: PMC9647802 DOI: 10.1212/cpj.0000000000200066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 06/22/2022] [Indexed: 01/27/2023]
Abstract
Background and Objectives Following brain injury, clinical assessments of residual and emerging cognitive function are difficult and fraught with errors. In adults, recent American Academy of Neurology (AAN) practice guidelines recommend objective neuroimaging and neurophysiologic measures to support diagnosis. Equivalent measures are lacking in pediatrics-an especially great challenge due to the combined heterogeneity of both brain injury and pediatric development. Therefore, we aim to establish quantitative, clinically practicable measures of cognitive function following pediatric brain injury. Methods Participants with and without brain injury were aged 8-18 years, clinically classified according to cognitive recovery state: N = 8 in disorders of consciousness (DoC), N = 7 in confusional state, N = 19 cognitively impaired, and N = 13 typically developing uninjured controls. We prospectively measured electroencephalographic markers of sensory processing and attention in an auditory oddball paradigm, and of covert movement attempts in a command-following paradigm. Results In 3 participants with DoC, EEG markers of active attempted command following revealed cognitive function that clinical assessment had failed to detect. These same 3 individuals could also be distinguished from the rest of their group by 2 event-related potentials that correlate with sensory processing and orienting attention in the oddball paradigm. Considered across the whole participant group, magnitudes of these 2 ERP markers significantly increased as cognitive recovery progressed (ANOVA: each p < 0.001); viewed jointly, the 2 ERP markers cleanly delineated the 4 cognitive states. Discussion Despite heterogeneity of brain injuries and brain development, our objective EEG markers reflected cognitive recovery independent of motor function. Two of these markers required no active participation. Together, they allowed us to identify 3 individuals who meet the criteria for cognitive-motor dissociation. To diagnose, prognose, and track cognitive recovery accurately, such markers should be used in pediatrics.
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Affiliation(s)
- Nayoung Kim
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - William Watson
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Eric Caliendo
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Sophie Nowak
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Nicholas D Schiff
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - Sudhin A Shah
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
| | - N Jeremy Hill
- Department of Radiology (NK, EC, SAS), Weill Cornell Medicine, New York, New York; Blythedale Children's Hospital (WW, SN), Valhalla, New York; Department of Neurology and BMRI (NDS), Weill Cornell Medicine, New York, New York; and National Center for Adaptive Neurotechnologies (NJH), Stratton VA Medical Center, Albany, New York
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6
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Monitoring the Impact of Spaceflight on the Human Brain. LIFE (BASEL, SWITZERLAND) 2022; 12:life12071060. [PMID: 35888147 PMCID: PMC9323314 DOI: 10.3390/life12071060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022]
Abstract
Extended exposure to radiation, microgravity, and isolation during space exploration has significant physiological, structural, and psychosocial effects on astronauts, and particularly their central nervous system. To date, the use of brain monitoring techniques adopted on Earth in pre/post-spaceflight experimental protocols has proven to be valuable for investigating the effects of space travel on the brain. However, future (longer) deep space travel would require some brain function monitoring equipment to be also available for evaluating and monitoring brain health during spaceflight. Here, we describe the impact of spaceflight on the brain, the basic principles behind six brain function analysis technologies, their current use associated with spaceflight, and their potential for utilization during deep space exploration. We suggest that, while the use of magnetic resonance imaging (MRI), positron emission tomography (PET), and computerized tomography (CT) is limited to analog and pre/post-spaceflight studies on Earth, electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and ultrasound are good candidates to be adapted for utilization in the context of deep space exploration.
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7
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Fickling SD, Poel DN, Dorman JC, D’Arcy RCN, Munce TA. Subconcussive changes in youth football players: objective evidence using brain vital signs and instrumented accelerometers. Brain Commun 2021; 4:fcab286. [PMID: 35291689 PMCID: PMC8914875 DOI: 10.1093/braincomms/fcab286] [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: 06/04/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 11/25/2022] Open
Abstract
Brain vital signs, measured by EEG, were used for portable, objective,
neurophysiological evaluation of cognitive function in youth tackle football
players. Specifically, we investigated whether previously reported pre- and
post-season subconcussive changes detected in youth ice hockey players were
comparably detected in football. The two objectives were to: (i) replicate
previously published results showing subconcussive cognitive deficits; and (ii)
the relationship between brain vital sign changes and head-impact exposure.
Using a longitudinal design, 15 male football players (age
12.89 ± 0.35 years) were tested pre- and
post-season, with none having a concussion diagnosis during the season. Peak
latencies and amplitudes were quantified for Auditory sensation (N100), Basic
attention (P300) and Cognitive processing (N400). Regression analyses tested the
relationships between these brain vital signs and exposure to head impacts
through both number of impacts sustained, and total sessions (practices and
games) participated. The results demonstrated significant pre/post differences
in N400 latencies, with ∼70 ms delay
(P < 0.01), replicating prior findings.
Regression analysis also showed significant linear relationships between brain
vital signs changes and head impact exposure based on accelerometer data and
games/practices played (highest
R = 0.863, P
< 0.001 for overall sessions). Number of head impacts in youth
football (age 12–14 years) findings corresponded most closely
with prior Junior-A ice hockey (age 16–21 years) findings,
suggesting comparable contact levels at younger ages in football. The predictive
relationship of brain vital signs provided a notable complement to instrumented
accelerometers, with a direct physiological measure of potential individual
exposure to subconcussive impacts.
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Affiliation(s)
- Shaun D Fickling
- Faculty of Sciences and Applied Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- BrainNET, Health and Technology District, Surrey, BC V3V 0C6, Canada
- Center for Neurology Studies, HealthTech Connex, Surrey, BC V3V 0C6, Canada
| | - Daniel N Poel
- Sanford Sports Science Institute, Sanford Health, Sioux Falls, SD 57107, USA
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD 57104, USA
| | - Jason C Dorman
- Sanford Sports Science Institute, Sanford Health, Sioux Falls, SD 57107, USA
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD 57104, USA
| | - Ryan C N D’Arcy
- Faculty of Sciences and Applied Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- BrainNET, Health and Technology District, Surrey, BC V3V 0C6, Canada
- Center for Neurology Studies, HealthTech Connex, Surrey, BC V3V 0C6, Canada
| | - Thayne A Munce
- Sanford Sports Science Institute, Sanford Health, Sioux Falls, SD 57107, USA
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD 57104, USA
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8
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Rios-Arismendy S, Ochoa-Gómez JF, Serna-Rojas C. Revisión de electroencefalografía portable y su aplicabilidad en neurociencias. REVISTA POLITÉCNICA 2021. [DOI: 10.33571/rpolitec.v17n34a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
La electroencefalografía (EEG) es una técnica que permite registrar la actividad eléctrica del cerebro y ha sido estudiada durante los últimos cien años en diferentes ámbitos de la neurociencia. En los últimos años se ha investigado y desarrollado equipos de medición que sean portables y que permitan una buena calidad de la señal, por lo cual se realizó una revisión bibliográfica de las compañías fabricantes de algunos dispositivos de electroencefalografía portable disponibles en el mercado, se exponen sus características principales, algunos trabajos encontrados que fueron realizados con los dispositivos, comparaciones entre los mismos y una discusión acerca de las ventajas y desventajas de sus características. Finalmente se concluye que a la hora de comprar un dispositivo para electroencefalografía portable es necesario tener en cuenta el uso que se le va a dar y el costo-beneficio que tiene el equipo de acuerdo con sus características.
Encephalography is a technique that allows the recording of electrical activity of the brain and has been studied during the last hundred years in different areas of neuroscience. For several years, measuring equipment that are portable and that allow a good signal quality to have been researched and developed, so a literature review of the manufacturing companies of some of portable electroencephalography devices available on the market was carried out: Its main features are exposed, as well as some of the work found that were made with those, comparisons between them and a discussion about the advantages and disadvantages of their features. It is concluded that, when a portable encephalography device is bought, it’s necessary to take into consideration the use that it will be having and the cost-benefit that the device has according to its features.
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9
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Event Related Potential Signal Capture Can Be Enhanced through Dynamic SNR-Weighted Channel Pooling. SENSORS 2021; 21:s21217258. [PMID: 34770564 PMCID: PMC8588067 DOI: 10.3390/s21217258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
Background: Electroencephalography (EEG)-derived event-related potentials (ERPs) provide information about a variety of brain functions, but often suffer from low inherent signal-to-noise ratio (SNR). To overcome the low SNR, techniques that pool data from multiple sensors have been applied. However, such pooling implicitly assumes that the SNR among sensors is equal, which is not necessarily valid. This study presents a novel approach for signal pooling that accounts for differential SNR among sensors. Methods: The new technique involves pooling together signals from multiple EEG channels weighted by their respective SNRs relative to the overall SNR of all channels. We compared ERP responses derived using this new technique with those derived using both individual channels as well as traditional averaged-based channel pooling. The outcomes were evaluated in both simulated data and real data from healthy adult volunteers (n = 37). Responses corresponding to a range of ERP components indexing auditory sensation (N100), attention (P300) and language processing (N400) were evaluated. Results: Simulation results demonstrate that, compared to traditional pooling technique, the new SNR-weighted channel pooling technique improved ERP response effect size in cases of unequal noise among channels (p’s < 0.001). Similarly, results from real-world experimental data showed that the new technique resulted in significantly greater ERP effect sizes compared to either traditional pooling or individual channel approach for all three ERP components (p’s < 0.001). Furthermore, the new channel pooling approach also resulted in larger ERP signal amplitudes as well as greater differences among experimental conditions (p’s < 0.001). Conclusion: These results suggest that the new technique improves the capture of ERP responses relative to traditional techniques. As such, SNR-weighted channel pooling can further enable widespread applications of ERP techniques, especially those that require rapid assessments in noisy out-of-laboratory environments.
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10
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D'Arcy RCN, Sandhu JK, Marshall S, Besemann M. Mitigating Long-Term COVID-19 Consequences on Brain Health. Front Neurol 2021; 12:630986. [PMID: 34646224 PMCID: PMC8502890 DOI: 10.3389/fneur.2021.630986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 08/31/2021] [Indexed: 12/13/2022] Open
Abstract
COVID-19 is increasingly being linked to brain health impacts. The emerging situation is consistent with evidence of immunological injury to the brain, which has been described as a resulting "brain fog." The situation need not be medicalized but rather clinically managed in terms of improving resilience for an over-stressed nervous system. Pre-existing comparisons include managing post-concussion syndromes and/or brain fog. The objective evaluation of changes in cognitive functioning will be an important clinical starting point, which is being accelerated through pandemic digital health innovations. Pre-morbid brain health can significantly optimize risk factors and existing clinical frameworks provide useful guidance in managing over-stressed COVID-19 nervous systems.
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Affiliation(s)
- Ryan C N D'Arcy
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada.,Faculty of Applied Sciences, Simon Fraser University, Vancouver, BC, Canada.,DM Centre for Brain Health (Radiology), University of British Columbia, Vancouver, BC, Canada
| | - Jagdeep K Sandhu
- Human Health Therapeutics Research Centre, National Research Council Canada, Ottawa, ON, Canada.,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Shawn Marshall
- Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON, Canada
| | - Markus Besemann
- Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON, Canada.,Rehabilitation Medicine, Canadian Forces Health Services, Ottawa, ON, Canada
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11
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Carrick FR, Pagnacco G, Azzolino SF, Hunfalvay M, Oggero E, Frizzell T, Smith CJ, Pawlowski G, Campbell NKJ, Fickling SD, Lakhani B, D'Arcy RCN. Brain Vital Signs in Elite Ice Hockey: Towards Characterizing Objective and Specific Neurophysiological Reference Values for Concussion Management. Front Neurosci 2021; 15:670563. [PMID: 34434084 PMCID: PMC8382572 DOI: 10.3389/fnins.2021.670563] [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: 02/21/2021] [Accepted: 07/09/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Prior concussion studies have shown that objective neurophysiological measures are sensitive to detecting concussive and subconcussive impairments in youth ice-hockey. These studies monitored brain vital signs at rink-side using a within-subjects design to demonstrate significant changes from pre-season baseline scans. However, practical clinical implementation must overcome inherent challenges related to any dependence on a baseline. This requires establishing the start of normative reference data sets. Methods: The current study collected specific reference data for N = 58 elite, youth, male ice-hockey players and compared these with a general reference dataset from N = 135 of males and females across the lifespan. The elite hockey players were recruited to a select training camp through CAA Hockey, a management agency for players drafted to leagues such as the National Hockey League (NHL). The statistical analysis included a test-retest comparison to establish reliability, and a multivariate analysis of covariance to evaluate differences in brain vital signs between groups with age as a covariate. Findings: Test-retest assessments for brain vital signs evoked potentials showed moderate-to-good reliability (Cronbach’s Alpha > 0.7, Intraclass correlation coefficient > 0.5) in five out of six measures. The multivariate analysis of covariance showed no overall effect for group (p = 0.105), and a significant effect of age as a covariate was observed (p < 0.001). Adjusting for the effect of age, a significant difference was observed in the measure of N100 latency (p = 0.022) between elite hockey players and the heterogeneous control group. Interpretation: The findings support the concept that normative physiological data can be used in brain vital signs evaluation in athletes, and should additionally be stratified for age, skill level, and experience. These can be combined with general norms and/or individual baseline assessments where appropriate and/or possible. The current results allow for brain vital sign evaluation independent of baseline assessment, therefore enabling objective neurophysiological evaluation of concussion management and cognitive performance optimization in ice-hockey.
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Affiliation(s)
- Frederick R Carrick
- University of Central Florida College of Medicine, Orlando, FL, United States.,MGH Institute of Health Professions, Boston, MA, United States.,Centre for Mental Health Research, University of Cambridge, Cambridge, United Kingdom.,Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom
| | - Guido Pagnacco
- Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom.,Department of Electrical and Computer Engineering, University of Wyoming, Laramie, WY, United States
| | - Sergio F Azzolino
- Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom
| | - Melissa Hunfalvay
- Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom
| | - Elena Oggero
- Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom.,Department of Electrical and Computer Engineering, University of Wyoming, Laramie, WY, United States
| | - Tory Frizzell
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | | | - Gabriela Pawlowski
- BrainNET, Health and Technology District, Vancouver, BC, Canada.,Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | - Natasha K J Campbell
- BrainNET, Health and Technology District, Vancouver, BC, Canada.,Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | - Shaun D Fickling
- BrainNET, Health and Technology District, Vancouver, BC, Canada.,Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | - Bimal Lakhani
- Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada
| | - Ryan C N D'Arcy
- BrainNET, Health and Technology District, Vancouver, BC, Canada.,Centre for Neurology Studies, HealthTech Connex, Vancouver, BC, Canada.,DM Centre for Brain Health, Department of Radiology, University of British Columbia, Vancouver, BC, Canada
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12
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Smith AM, Alford PA, Aubry M, Benson B, Black A, Brooks A, Burke C, D'Arcy R, Dodick D, Eaves M, Eickhoff C, Erredge K, Farrell K, Finnoff J, Fraser DD, Giza C, Greenwald RM, Hoshizaki B, Huston J, Jorgensen J, Joyner M, Krause D, LaVoi N, Leaf M, Leddy J, Margarucci K, Margulies S, Mihalik J, Munce T, Oeur A, Prideaux C, Roberts WO, Shen F, Soma D, Tabrum M, Stuart MB, Wethe J, Whitehead J, Wiese-Bjornstal D, Stuart MJ. Proceedings From the Ice Hockey Summit III: Action on Concussion. Clin J Sport Med 2021; 31:e150-e160. [PMID: 31842055 DOI: 10.1097/jsm.0000000000000745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/28/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these 5 objectives: (1) describe sport related concussion (SRC) epidemiology; (2) classify prevention strategies; (3) define objective, diagnostic tests; (4) identify treatment; and (5) integrate science and clinical care into prioritized action plans and policy. METHODS Our action plan evolved from 40 scientific presentations. The 155 attendees (physicians, athletic trainers, physical therapists, nurses, neuropsychologists, scientists, engineers, coaches, and officials) voted to prioritize these action items in the final Summit session. RESULTS To (1) establish a national and international hockey database for SRCs at all levels; (2) eliminate body checking in Bantam youth hockey games; (3) expand a behavior modification program (Fair Play) to all youth hockey levels; (4) enforce game ejection penalties for fighting in Junior A and professional hockey leagues; (5) establish objective tests to diagnose concussion at point of care; and (6) mandate baseline testing to improve concussion diagnosis for all age groups. CONCLUSIONS Expedient implementation of the Summit III prioritized action items is necessary to reduce the risk, severity, and consequences of concussion in the sport of ice hockey.
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Affiliation(s)
| | - Patrick A Alford
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Mark Aubry
- Ottawa Sports Medicine Center, Ottawa, ON, Canada
| | - Brian Benson
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Amanda Black
- Sport Injury Prevention Research Center, University of Calgary, Calgary, AB, Canada
| | - Alison Brooks
- Department of Orthopedic Surgery, University of Wisconsin, Madison, Wisconsin
| | - Charles Burke
- Brook & Bradley Orthopedics, University of Pittsburgh at St. Margaret, Pittsburgh, Pennsylvania
| | - Ryan D'Arcy
- School of Engineering Science, Advances Neuroimaging, Siman Fraser University, Burnaby, BC, Canada
| | - David Dodick
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona
| | - Michael Eaves
- Men's Ice Hockey, St. Olaf College, Northfield, Minnesota
| | - Chad Eickhoff
- Sports Medicine Center, Mayo Clinic, Rochester, Minnesota
| | | | | | - Jonathan Finnoff
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - Douglas D Fraser
- Department of Pediatrics, Physiology/Pharmacology/Clinical Neuroscience, University of Western Ontario, London, ON, Canada
| | - Christopher Giza
- Department of Neurosurgery, Brain Research Institute, University of California Los Angeles Health, Los Angeles, California
| | - Richard M Greenwald
- Department of Biomechanics, Thayer School of Engineering at Dartmouth, Hanover, New Hampshire
| | | | - John Huston
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | - Michael Joyner
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - David Krause
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - Nicole LaVoi
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
| | - Matthew Leaf
- Officiating Program, USA Hockey, Colorado Springs, Colorado
| | - John Leddy
- Department of Orthopedics, University at Buffalo, Jacobs School of Medicine and Biomedical Science, Buffalo, New York
| | | | - Susan Margulies
- Department of Biomedical Engineering, Georgia School of Technology, Atlanta, Georgia
| | - Jason Mihalik
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Thayne Munce
- Sports Medicine Center, Sanford Medical Center, Sioux Falls, South Dakota
| | - Anna Oeur
- Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Cara Prideaux
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - William O Roberts
- Department of Family Medicine and Community Health University of Minnesota, Minneapolis, Minnesota
| | - Francis Shen
- University of Minnesota Law School, University of Minnesota, Minneapolis, Minnesota
| | - David Soma
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mark Tabrum
- Coaching Education, USA Hockey, Colorado Springs, Colorado
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13
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Fickling SD, Smith AM, Stuart MJ, Dodick DW, Farrell K, Pender SC, D'Arcy RCN. Subconcussive brain vital signs changes predict head-impact exposure in ice hockey players. Brain Commun 2021; 3:fcab019. [PMID: 33855296 PMCID: PMC8023684 DOI: 10.1093/braincomms/fcab019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/04/2020] [Accepted: 03/08/2021] [Indexed: 01/09/2023] Open
Abstract
The brain vital signs framework is a portable, objective, neurophysiological evaluation of brain function at point-of-care. We investigated brain vital signs at pre- and post-season for age 14 or under (Bantam) and age 16-20 (Junior-A) male ice hockey players to (i) further investigate previously published brain vital sign results showing subconcussive cognitive deficits and (ii) validate these findings through comparison with head-impact data obtained from instrumented accelerometers. With a longitudinal study design, 23 male ice hockey players in Bantam (n = 13; age 13.63 ± 0.62) and Tier II Junior-A (n = 10; age 18.62 ± 0.86) divisions were assessed at pre- and post-season. None were diagnosed with a concussion during the season. Cognitive evoked potential measures of Auditory sensation (N100), Basic attention (P300) and Cognitive processing (N400) were analysed as changes in peak amplitudes and latencies (six standard scores total). A regression analysis examined the relationship between brain vital signs and the number of head impacts received during the study season. Significant pre/post differences in brain vital signs were detected for both groups. Bantam and Junior-A players also differed in number of head impacts (Bantam: 32.92 ± 17.68; Junior-A: 195.00 ± 61.08; P < 0.001). Importantly, the regression model demonstrated a significant linear relationship between changes in brain vital signs and total head impacts received (R = 0.799, P = 0.007), with clear differences between the Bantam and Junior-A groups. In the absence of a clinically diagnosed concussion, the brain vital sign changes appear to have demonstrated the compounding effects of repetitive subconcussive impacts. The findings underscored the importance of an objective physiological measure of brain function along the spectrum of concussive impacts.
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Affiliation(s)
- Shaun D Fickling
- Faculty of Science and Applied Sciences, Simon Fraser University, Metro Vancouver, BC V5A1S6, Canada.,Center for Neurology Studies, HealthTech Connex, Metro Vancouver, BC V3V0C6, Canada.,BrainNET, Health and Technology District, Surrey, BC V3V0C6, Canada
| | - Aynsley M Smith
- Department of Physical Medicine and Rehabilitation, Sports Medicine Center, Mayo Clinic, Rochester, MN 55905, USA.,Department of Orthopedic Surgery, Sports Medicine Center, Mayo Clinic, Rochester, MN 55905, USA
| | - Michael J Stuart
- Department of Orthopedic Surgery, Sports Medicine Center, Mayo Clinic, Rochester, MN 55905, USA
| | - David W Dodick
- Department of Neurology, Mayo Clinic, Phoenix, AZ 85259, USA
| | - Kyle Farrell
- Creighton University School of Medicine, Omaha, Nebraska 68178, USA
| | - Sara C Pender
- School of Medicine, University College Dublin, Dublin D04 V1W8, Ireland
| | - Ryan C N D'Arcy
- Faculty of Science and Applied Sciences, Simon Fraser University, Metro Vancouver, BC V5A1S6, Canada.,Center for Neurology Studies, HealthTech Connex, Metro Vancouver, BC V3V0C6, Canada.,BrainNET, Health and Technology District, Surrey, BC V3V0C6, Canada.,DM Centre for Brain Health, Radiology, University of British Columbia, Metro Vancouver, BC V6T1Z4, Canada
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14
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Tran KH, McDonald AP, D'Arcy RCN, Song X. Contextual Processing and the Impacts of Aging and Neurodegeneration: A Scoping Review. Clin Interv Aging 2021; 16:345-361. [PMID: 33658771 PMCID: PMC7917362 DOI: 10.2147/cia.s287619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/26/2020] [Indexed: 11/23/2022] Open
Abstract
Contextual processing (or context processing; CP) is an integral component of cognition. CP allows people to manage their thoughts and actions by adjusting to surroundings. CP involves the formation of an internal representation of context in relation to the environment, maintenance of this information over a period of time, and the updating of mental representations to reflect changes in the environment. Each of these functions can be affected by aging and associated conditions. Here, we introduced contextual processing research and summarized the literature studying the impact of normal aging and neurodegeneration-related cognitive decline on CP. Through searching the PubMed, PsycINFO, and Google Scholar databases, 23 studies were retrieved that focused on the impact of aging, mild cogniitve impairment (MCI), Alzheimer's disease (AD), and Parkinson's disease (PD) on CP. Results indicated that CP is particularly vulnerable to aging and neurodegeneration. Older adults had a delayed onset and reduced amplitude of electrophysiological response to information detection, comparison, and execution. MCI patients demonstrated clear signs of impaired CP compared to normal aging. The only study on AD suggested a decreased proactive control in AD participants in maintaining contextual information, but seemingly intact reactive control. Studies on PD restricted to non-demented older participants, who showed limited ability to use contextual information in cognitive and motor processes, exhibiting impaired reactive control but more or less intact proactive control. These data suggest that the decline in CP with age is further impacted by accelerated aging and neurodegeneration, providing insights for improving intervention strategies. This review highlights the need for increased attention to research this important but understudied field.
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Affiliation(s)
- Kim H Tran
- Clinical Research Centre, Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Andrew P McDonald
- Clinical Research Centre, Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ryan C N D'Arcy
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Xiaowei Song
- Clinical Research Centre, Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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15
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Krigolson OE, Hammerstrom MR, Abimbola W, Trska R, Wright BW, Hecker KG, Binsted G. Using Muse: Rapid Mobile Assessment of Brain Performance. Front Neurosci 2021; 15:634147. [PMID: 33584194 PMCID: PMC7876403 DOI: 10.3389/fnins.2021.634147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/11/2021] [Indexed: 11/13/2022] Open
Abstract
The advent of mobile electroencephalography (mEEG) has created a means for large scale collection of neural data thus affording a deeper insight into cognitive phenomena such as cognitive fatigue. Cognitive fatigue - a neural state that is associated with an increased incidence of errorful performance - is responsible for accidents on a daily basis which at times can cost human lives. To gain better insight into the neural signature of cognitive fatigue in the present study we used mEEG to examine the relationship between perceived cognitive fatigue and human-event related brain potentials (ERPs) and electroencephalographic (EEG) oscillations in a sample of 1,000 people. As a secondary goal, we wanted to further demonstrate the capability of mEEG to accurately measure ERP and EEG data. To accomplish these goals, participants performed a standard visual oddball task on an Apple iPad while EEG data were recorded from a Muse EEG headband. Counter to traditional EEG studies, experimental setup and data collection was completed in less than seven minutes on average. An analysis of our EEG data revealed robust N200 and P300 ERP components and neural oscillations in the delta, theta, alpha, and beta bands. In line with previous findings we observed correlations between ERP components and EEG power and perceived cognitive fatigue. Further, we demonstrate here that a linear combination of ERP and EEG features is a significantly better predictor of perceived cognitive fatigue than any ERP or EEG feature on its own. In sum, our results provide validation of mEEG as a viable tool for research and provide further insight into the impact of cognitive fatigue on the human brain.
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Affiliation(s)
- Olave E Krigolson
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | | | - Wande Abimbola
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Robert Trska
- Centre for Biomedical Research, University of Victoria, Victoria, BC, Canada
| | - Bruce W Wright
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Kent G Hecker
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Gordon Binsted
- Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada
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16
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Smith CJ, Livingstone A, Fickling SD, Tannouri P, Campbell NKJ, Lakhani B, Danilov Y, Sackier JM, D'Arcy RCN. Brain Vital Signs Detect Information Processing Differences When Neuromodulation Is Used During Cognitive Skills Training. Front Hum Neurosci 2020; 14:358. [PMID: 33117138 PMCID: PMC7521129 DOI: 10.3389/fnhum.2020.00358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Neuromodulation through translingual neurostimulation (TLNS) has been shown to initiate long-lasting processes of neuronal reorganization with a variety of outcomes (i.e., neuroplasticity). Non-invasive TLNS is increasingly accessible through the Portable Neuromodulation Stimulator (PoNS®), a medical device that delivers electrical stimulation to the tongue to activate the trigeminal (V) and facial (VII) cranial nerves. Anecdotal reports from previous clinical studies have suggested incidental improvements in cognitive function. To objectively explore this observation, we examined TLNS-related effects on the semantic N400 brain vital sign cognitive response during cognitive skills training in healthy individuals. Methods: Thirty-seven healthy volunteers were randomized to receive simultaneous TLNS (treatment) or no TLNS (control) while undergoing cognitive skills training. Cognitive training was conducted for two 20-min sessions (morning and afternoon/evening) over 3 consecutive days. Brain vital signs were evaluated at baseline, Day 1, and Day 3. Analyses focused on cognitive processing as measured by N400 changes in amplitude and latency. Results: Over the 3-day course of cognitive training, the N400 amplitude decreased significantly in the control group due to habituation (p = 0.028). In contrast, there was no significant change in the TLNS treatment group. Conclusion: TLNS led to a sustained N400 response during cognitive skills training, as measured by the brain's vital signs framework. The study findings suggest differential learning effects due to neuromodulation, consistent with increased attention and cognitive vigilance.
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Affiliation(s)
- Christopher J Smith
- Centre for Neurology Studies, HealthTech Connex, Metro-Vancouver, BC, Canada
| | - Ashley Livingstone
- Centre for Neurology Studies, HealthTech Connex, Metro-Vancouver, BC, Canada
| | - Shaun D Fickling
- Centre for Neurology Studies, HealthTech Connex, Metro-Vancouver, BC, Canada
| | - Pamela Tannouri
- Centre for Neurology Studies, HealthTech Connex, Metro-Vancouver, BC, Canada
| | | | - Bimal Lakhani
- Centre for Neurology Studies, HealthTech Connex, Metro-Vancouver, BC, Canada
| | - Yuri Danilov
- Pavlov Institute of Physiology, Russian Academy of Science, Saint Petersburg, Russia
| | - Jonathan M Sackier
- Helius Medical Technologies, Newtown, PA, United States.,Nuffield Department of Surgical Sciences, Oxford University, Oxford, United Kingdom
| | - Ryan C N D'Arcy
- Centre for Neurology Studies, HealthTech Connex, Metro-Vancouver, BC, Canada
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17
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Semantic Processing in Healthy Aging and Alzheimer's Disease: A Systematic Review of the N400 Differences. Brain Sci 2020; 10:brainsci10110770. [PMID: 33114051 PMCID: PMC7690742 DOI: 10.3390/brainsci10110770] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 01/18/2023] Open
Abstract
Semantic deficits are common in individuals with Alzheimer’s disease (AD). These deficits notably impact the ability to understand words. In healthy aging, semantic knowledge increases but semantic processing (i.e., the ability to use this knowledge) may be impaired. This systematic review aimed to investigate semantic processing in healthy aging and AD through behavioral responses and the N400 brain event-related potential. The results of the quantitative and qualitative analyses suggested an overall decrease in accuracy and increase in response times in healthy elderly as compared to young adults, as well as in individuals with AD as compared to age-matched controls. The influence of semantic association, as measured by N400 effect amplitudes, appears smaller in healthy aging and even more so in AD patients. Thus, semantic processing differences may occur in both healthy and pathological aging. The establishment of norms of healthy aging for these outcomes that vary between normal and pathological aging could eventually help early detection of AD.
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18
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Fickling SD, Greene T, Greene D, Frehlick Z, Campbell N, Etheridge T, Smith CJ, Bollinger F, Danilov Y, Rizzotti R, Livingstone AC, Lakhani B, D’Arcy RCN. Brain Vital Signs Detect Cognitive Improvements During Combined Physical Therapy and Neuromodulation in Rehabilitation From Severe Traumatic Brain Injury: A Case Report. Front Hum Neurosci 2020; 14:347. [PMID: 33132868 PMCID: PMC7513585 DOI: 10.3389/fnhum.2020.00347] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/04/2020] [Indexed: 12/19/2022] Open
Abstract
Using a longitudinal case study design, we have tracked the recovery of motor function following severe traumatic brain injury (TBI) through a multimodal neuroimaging approach. In 2006, Canadian Soldier Captain (retired) Trevor Greene (TG) was attacked with an axe to the head while on tour in Afghanistan. TG continues intensive daily rehabilitation, which recently included the integration of physical therapy (PT) with neuromodulation using translingual neurostimulation (TLNS) to facilitate neuroplasticity. Recent findings with PT + TLNS demonstrated that recovery of motor function occurred beyond conventional time limits, currently extending past 14-years post-injury. To investigate whether PT + TLNS similarly resulted in associated cognitive function improvements, we examined event-related potentials (ERPs) with the brain vital signs framework. In parallel with motor function improvements, brain vital signs detected significant increases in basic attention (as measured by P300 response amplitude) and cognitive processing (as measured by contextual N400 response amplitude). These objective cognitive improvements corresponded with TG's self-reported improvements, including a noteworthy and consistent reduction in ongoing symptoms of post-traumatic stress disorder (PTSD). The findings provide valuable insight into the potential importance of non-invasive neuromodulation in cognitive rehabilitation, in addition to initial indications for physical rehabilitation.
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Affiliation(s)
- Shaun D. Fickling
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
- Applied Sciences and Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Trevor Greene
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Debbie Greene
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Zack Frehlick
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Natasha Campbell
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Tori Etheridge
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Christopher J. Smith
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Fabio Bollinger
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Yuri Danilov
- Department of Kinesiology, University of Wisconsin-Madison, Madison, AL, United States
- Pavlov Institute of Physiology, Russian Academy of Sciences, Saint Petersburg, Russia
| | - Rowena Rizzotti
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
- Centre of Excellence in Mental and Physical Rehabilitation, Legion Veteran’s Village, Surrey, BC, Canada
| | - Ashley C. Livingstone
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Bimal Lakhani
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
| | - Ryan C. N. D’Arcy
- Centre for Neurology Studies, HealthTech Connex Inc., Vancouver, BC, Canada
- BrainNET, Health and Technology District, Vancouver, BC, Canada
- Applied Sciences and Sciences, Simon Fraser University, Vancouver, BC, Canada
- Centre for Brain Health (Radiology), University of British Columbia, Vancouver, BC, Canada
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19
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Differential neural processing of spontaneous blinking under visual and auditory sensory environments: An EEG investigation of blink-related oscillations. Neuroimage 2020; 218:116879. [PMID: 32422401 DOI: 10.1016/j.neuroimage.2020.116879] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/13/2020] [Accepted: 04/23/2020] [Indexed: 11/22/2022] Open
Abstract
Blink-related oscillations (BROs) are a recently discovered neurophysiological response associated with spontaneous blinking, distinct from the well-known oculomotor and visual suppression effects. BROs strongly activate the bilateral precuneus along with other cortical regions involved in visuospatial processing and associative episodic memory, and are believed to represent environmental monitoring processes that occur following blink-induced visual interruptions. Although these responses have been reported across multiple imaging modalities under both resting and cognitive loading conditions, it is yet unknown whether these responses also exist under external sensory stimulation conditions. To address this, we investigated BRO responses in healthy adults using 64-channel electroencephalography (EEG), while participants underwent passive external auditory and visual stimulation. Our results showed that BRO responses are present under both auditory and visual stimulation conditions (p < 0.05), with similar temporal and spectral features compared to rest. However, visual stimulation did result in decreased BRO amplitude compared to auditory and resting conditions (p < 0.05), suggesting decreased neuronal resources for processing blink-related information in the visual but not auditory environment. There were also additional pre-blink spectral changes in the visual condition compared to rest (p < 0.05), which suggest that passive visual stimulation induces neural preparatory processes occurring in anticipation of the upcoming blink event. Together, these findings provide new and compelling evidence that blink-related neural processes are modulated not only by the internal cognitive loading due to simultaneous task demands, but also by competing external sensory requirements. This highlights the link between blinking and cognition, and further demonstrates the importance of BROs as a new window into brain function.
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20
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Fickling SD, Bollinger FH, Gurm S, Pawlowski G, Liu CC, Hajra SG, Song X, D'Arcy RCN. Distant Sensor Prediction of Event-Related Potentials. IEEE Trans Biomed Eng 2020; 67:2916-2924. [PMID: 32070941 DOI: 10.1109/tbme.2020.2973617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The ability to measure event-related potentials (ERPs) as practical, portable brain vital signs is limited by the physical locations of electrodes. Standard electrode locations embedded within the hair result in challenges to obtaining quality signals in a rapid manner. Moreover, these sites require electrode gel, which can be inconvenient. As electrical activity in the brain is spatially volume distributed, it should be possible to predict ERPs from distant sensor locations at easily accessible mastoid and forehead scalp regions. METHODS An artificial neural network was trained on ERP signals recorded from below hairline electrode locations (Tp9, Tp10, Af7, Af8 referenced to Fp1, Fp2) to predict signals recorded at the ideal Cz location. RESULTS The model resulted in mean improvements in intraclass correlation coefficient relative to control for all stimulus types (Standard Tones: +9.74%, Deviant Tones: +3.23%, Congruent Words: +15.25%, Incongruent Words: +25.43%) and decreases in RMS Error (Standard Tones: -26.72%, Deviant Tones: -17.80%, Congruent Words: -28.78%, Incongruent Words: -29.61%) compared to the individual distant channels. Measured vs predicted ERP amplitudes were highly and significantly correlated with control for the N100 (R = 0.5, padj < 0.05), P300 (R = 0.75, padj < 0.01), and N400 (R = 0.75, padj < 0.01) ERPs. CONCLUSION ERP waveforms at distant channels can be combined using a neural network autoencoder to model the control channel features with better precision than those at individual distant channels. This is the first demonstration of feasibility of predicting evoked potentials and brain vital signs using signals recorded from more distant, practical locations. SIGNIFICANCE This solves a key engineering challenge for applications that require portability, comfort, and speed of measurement as design priorities for measurement of event-related potentials across a range of individuals, settings, and circumstances.
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21
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Fickling SD, Smith AM, Pawlowski G, Ghosh Hajra S, Liu CC, Farrell K, Jorgensen J, Song X, Stuart MJ, D'Arcy RCN. Brain vital signs detect concussion-related neurophysiological impairments in ice hockey. Brain 2019; 142:255-262. [PMID: 30649205 PMCID: PMC6351777 DOI: 10.1093/brain/awy317] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/29/2018] [Indexed: 01/25/2023] Open
Abstract
There is a growing demand for objective evaluations of concussion. We developed a portable evoked potential framework to extract ‘brain vital signs’ using electroencephalography. Brain vital signs were derived from well established evoked responses representing auditory sensation (N100), basic attention (P300), and cognitive processing (N400) amplitudes and latencies, converted to normative metrics (six total). The study evaluated whether concussion-related neurophysiological impairments were detected over the duration of ice hockey seasons using brain vital signs. Forty-seven Tier III, Junior A, male ice hockey players were monitored over two seasons. Twelve sustained concussions after baseline testing then completed post-injury and return-to-play assessments. Twenty-three were not diagnosed with a concussion during the season and completed both baseline and post-season testing. Scores were evaluated using a repeated-measures analysis of variance with post hoc two-tailed paired t-tests. Concussion resulted in significantly increased amplitude and delayed latency scores for all six brain vital signs (P < 0.0001). Importantly, significant changes at return-to-play were also detected in basic attention (P300) amplitude, indicating persistent subclinical impairment. In the non-concussed group, there was also a significant change between baseline and post-season (P = 0.0047), with specific decreases in cognitive processing (N400) speed (P = 0.011) and overall total score (P = 0.002).
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Affiliation(s)
- Shaun D Fickling
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada
| | - Aynsley M Smith
- Department of Orthopedic Surgery and Physical Medicine and Rehabilitation, Sports Medicine Center, Mayo Clinic, Rochester, MN, USA
| | - Gabriela Pawlowski
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada
| | - Sujoy Ghosh Hajra
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada
| | - Careesa C Liu
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada
| | - Kyle Farrell
- Department of Orthopedic Surgery and Physical Medicine and Rehabilitation, Sports Medicine Center, Mayo Clinic, Rochester, MN, USA
| | - Janelle Jorgensen
- Department of Orthopedic Surgery and Physical Medicine and Rehabilitation, Sports Medicine Center, Mayo Clinic, Rochester, MN, USA
| | - Xiaowei Song
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada
| | - Michael J Stuart
- Department of Orthopedic Surgery, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, MN, USA
| | - Ryan C N D'Arcy
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada.,HealthTech Connex Inc, Surrey, BC, Canada
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22
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Rosburg T, Mager R. P300 amplitudes after concussions are usually decreased not increased. Brain 2019; 142:e32. [PMID: 31203370 DOI: 10.1093/brain/awz145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Timm Rosburg
- University Psychiatric Clinics Basel, Forensic Department, Basel, Switzerland
| | - Ralph Mager
- University Psychiatric Clinics Basel, Forensic Department, Basel, Switzerland
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23
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Fickling SD, Smith AM, Ghosh Hajra S, Liu CC, Song X, Stuart MJ, D'Arcy RCN. Reply: P300 amplitudes after concussions are usually decreased not increased. Brain 2019; 142:e33. [PMID: 31203375 DOI: 10.1093/brain/awz147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shaun D Fickling
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada
| | - Aynsley M Smith
- Department of Physical Medicine and Rehabilitation, Sports Medicine Center, Mayo Clinic, Rochester, MN, USA.,Department of Orthopedic Surgery, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, MN, USA
| | - Sujoy Ghosh Hajra
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada
| | - Careesa C Liu
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada
| | - Xiaowei Song
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada
| | - Michael J Stuart
- Department of Orthopedic Surgery, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, MN, USA
| | - Ryan C N D'Arcy
- Faculty of Applied Sciences, Simon Fraser University, Metro Vancouver, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Metro Vancouver, BC, Canada.,HealthTech Connex Inc, Surrey, BC, Canada
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24
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Liu CC, Ghosh Hajra S, Fickling SD, Pawlowski G, Song X, D'Arcy RCN. Novel Signal Processing Technique for Capture and Isolation of Blink-Related Oscillations Using a Low-Density Electrode Array for Bedside Evaluation of Consciousness. IEEE Trans Biomed Eng 2019; 67:453-463. [PMID: 31059425 DOI: 10.1109/tbme.2019.2915185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Blink-related oscillations derived from electroencephalography (EEG) have recently emerged as an important measure of awareness. Combined with portable EEG hardware with low-density electrode arrays, this neural marker may crucially augment the existing bedside assessments of consciousness in unresponsive patients. Nonetheless, the close relationship between signal characteristics of the neural response of interest and blink-induced oculomotor artifacts poses particular challenges when measuring blink-related oscillations using a point-of-care platform. This study presents a novel denoising approach based on time-frequency (TF) filtering that exploits the differential temporal and spectral features to isolate the neural response from ocular artifact in a low-density array. METHODS We investigated the effectiveness of the TF filtering technique using 64-channel EEG data collected in healthy adults, with focal analysis of the Pz and POz channels. RESULTS TF filtering showed comparable performance in denoising the signal relative to the established gold-standard independent component analysis approach, with strong similarities in morphological characteristics as measured by intraclass correlations (p < 0.001), extent of artifact rejection based on the ocular contamination index (p < 0.006), as well as time- and frequency-domain signal capture (p < 0.05). Results are robust at the individual and group levels, and are crucially validated using raw data from only four electrodes comprising Pz, POz, Fp2, and T7. CONCLUSION These results demonstrate for the first time that TF filtering enables the successful capture and isolation of the blink-related oscillations response using a four-electrode array. SIGNIFICANCE This significantly advances the translation of the blink-related oscillations marker to a point-of-care platform for eventual bedside applications.
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25
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Atlan LS, Lan IS, Smith C, Margulies SS. Changes in event-related potential functional networks predict traumatic brain injury in piglets. Clin Biomech (Bristol, Avon) 2019; 64:14-21. [PMID: 29933967 PMCID: PMC6274597 DOI: 10.1016/j.clinbiomech.2018.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/19/2018] [Accepted: 05/21/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Traumatic brain injury is a leading cause of cognitive and behavioral deficits in children in the US each year. None of the current diagnostic tools, such as quantitative cognitive and balance tests, have been validated to identify mild traumatic brain injury in infants, adults and animals. In this preliminary study, we report a novel, quantitative tool that has the potential to quickly and reliably diagnose traumatic brain injury and which can track the state of the brain during recovery across multiple ages and species. METHODS Using 32 scalp electrodes, we recorded involuntary auditory event-related potentials from 22 awake four-week-old piglets one day before and one, four, and seven days after two different injury types (diffuse and focal) or sham. From these recordings, we generated event-related potential functional networks and assessed whether the patterns of the observed changes in these networks could distinguish brain-injured piglets from non-injured. FINDINGS Piglet brains exhibited significant changes after injury, as evaluated by five network metrics. The injury prediction algorithm developed from our analysis of the changes in the event-related potentials functional networks ultimately produced a tool with 82% predictive accuracy. INTERPRETATION This novel approach is the first application of auditory event-related potential functional networks to the prediction of traumatic brain injury. The resulting tool is a robust, objective and predictive method that offers promise for detecting mild traumatic brain injury, in particular because collecting event-related potentials data is noninvasive and inexpensive.
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Affiliation(s)
- Lorre S. Atlan
- Department of Bioengineering, University of Pennsylvania, 210 S. 33 St., 240 Skirkanich Hall, Philadelphia, PA 19104-6321, U.S.A
| | - Ingrid S. Lan
- Department of Bioengineering, University of Pennsylvania, 210 S. 33 St., 240 Skirkanich Hall, Philadelphia, PA 19104-6321, U.S.A
| | - Colin Smith
- Academic Department of Neuropathology, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Susan S. Margulies
- Department of Bioengineering, University of Pennsylvania, 210 S. 33 St., 240 Skirkanich Hall, Philadelphia, PA 19104-6321, U.S.A
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26
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Magnuson JR, Peatfield NA, Fickling SD, Nunes AS, Christie G, Vakorin V, D’Arcy RCN, Ribary U, Iarocci G, Moreno S, Doesburg SM. Electrophysiology of Inhibitory Control in the Context of Emotion Processing in Children With Autism Spectrum Disorder. Front Hum Neurosci 2019; 13:78. [PMID: 30914937 PMCID: PMC6422887 DOI: 10.3389/fnhum.2019.00078] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/14/2019] [Indexed: 11/13/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is an increasingly common developmental disorder that affects 1 in 59 children. Despite this high prevalence of ASD, knowledge regarding the biological basis of its associated cognitive difficulties remains scant. In this study, we aimed to identify altered neurophysiological responses underlying inhibitory control and emotion processing difficulties in ASD, together with their associations with age and various domains of cognitive and social function. This was accomplished by assessing electroencephalographic recordings during an emotional go/nogo task alongside parent rating scales of behavior. Event related potential (ERP) N200 component amplitudes were reduced in children with ASD compared to typically developing (TD) children. No group differences were found, however, for task performance, P300 amplitude or latency, or N170 amplitude or latency, suggesting that individuals with ASD may only present conflict monitoring abnormalities, as reflected by the reduced N200 component, compared to TD individuals. Consistent with previous findings, increased age correlated with improved task performance scores and reduced N200 amplitude in the TD group, indicating that as these children develop, their neural systems become more efficient. These associations were not identified in the ASD group. Results also showed significant associations between increased N200 amplitudes and improved executive control abilities and decreased autism traits in TD children only. The newly discovered findings of decreased brain activation in children with ASD, alongside differences in correlations with age compared to TD children, provide a potential neurophysiological indicator of atypical development of inhibitory control mechanisms in these individuals.
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Affiliation(s)
- Justine R. Magnuson
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
| | | | - Shaun D. Fickling
- School of Engineering Science, Simon Fraser University, Surrey, BC, Canada
- NeuroTech Laboratory, Surrey Memorial Hospital, Surrey, BC, Canada
| | - Adonay S. Nunes
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
| | - Greg Christie
- Digital Health Hub, Simon Fraser University, Surrey, BC, Canada
- AGE-WELL National Innovation Hub: Digital Health Circle, Surrey, BC, Canada
| | - Vasily Vakorin
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
| | - Ryan C. N. D’Arcy
- School of Engineering Science, Simon Fraser University, Surrey, BC, Canada
- NeuroTech Laboratory, Surrey Memorial Hospital, Surrey, BC, Canada
- Surrey Memorial Hospital, Health Sciences and Innovation, Surrey, BC, Canada
| | - Urs Ribary
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- Department Pediatrics and Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Grace Iarocci
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Sylvain Moreno
- Digital Health Hub, Simon Fraser University, Surrey, BC, Canada
- AGE-WELL National Innovation Hub: Digital Health Circle, Surrey, BC, Canada
- Department of School of Interactive Art and Technology, Simon Fraser University, Surrey, BC, Canada
| | - Sam M. Doesburg
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Behavioural and Cognitive Neuroscience Institute, Simon Fraser University, Burnaby, BC, Canada
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27
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Smith AM, Alford PA, Aubry M, Benson B, Black A, Brooks A, Burke C, D’Arcy R, Dodick D, Eaves M, Eickhoff C, Erredge K, Farrell K, Finnoff J, Fraser DD, Giza C, Greenwald RM, Hanzel M, Hoshizaki B, Huston J, Jorgenson J, Joyner M, Krause D, LaVoi N, Leaf M, Leddy J, Leopold J, Margarucci K, Margulies S, Mihalik J, Munce T, Oeur A, Podein S, Prideaux C, Roberts WO, Shen F, Soma D, Tabrum M, Stuart MB, Wethe J, Whitehead JR, Wiese-Bjornstal D, Stuart MJ. Proceedings from the Ice Hockey Summit III: Action on Concussion. EXERCISE MEDICINE 2019. [DOI: 10.26644/em.2019.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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28
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Pawlowski GM, Ghosh-Hajra S, Fickling SD, Liu CC, Song X, Robinovitch S, Doesburg SM, D'Arcy RCN. Brain Vital Signs: Expanding From the Auditory to Visual Modality. Front Neurosci 2019; 12:968. [PMID: 30713487 PMCID: PMC6346702 DOI: 10.3389/fnins.2018.00968] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 12/04/2018] [Indexed: 01/25/2023] Open
Abstract
The critical need for rapid objective, physiological evaluation of brain function at point-of-care has led to the emergence of brain vital signs-a framework encompassing a portable electroencephalography (EEG) and an automated, quick test protocol. This framework enables access to well-established event-related potential (ERP) markers, which are specific to sensory, attention, and cognitive functions in both healthy and patient populations. However, all our applications to-date have used auditory stimulation, which have highlighted application challenges in persons with hearing impairments (e.g., aging, seniors, dementia). Consequently, it has become important to translate brain vital signs into a visual sensory modality. Therefore, the objectives of this study were to: 1) demonstrate the feasibility of visual brain vital signs; and 2) compare and normalize results from visual and auditory brain vital signs. Data were collected from 34 healthy adults (33 ± 13 years) using a 64-channel EEG system. Visual and auditory sequences were kept as comparable as possible to elicit the N100, P300, and N400 responses. Visual brain vital signs were elicited successfully for all three responses across the group (N100: F = 29.8380, p < 0.001; P300: F = 138.8442, p < 0.0001; N400: F = 6.8476, p = 0.01). Initial auditory-visual comparisons across the three components showed attention processing (P300) was found to be the most transferrable across modalities, with no group-level differences and correlated peak amplitudes (rho = 0.7, p = 0.0001) across individuals. Auditory P300 latencies were shorter than visual (p < 0.0001) but normalization and correlation (r = 0.5, p = 0.0033) implied a potential systematic difference across modalities. Reduced auditory N400 amplitudes compared to visual (p = 0.0061) paired with normalization and correlation across individuals (r = 0.6, p = 0.0012), also revealed potential systematic modality differences between reading and listening language comprehension. This study provides an initial understanding of the relationship between the visual and auditory sequences, while importantly establishing a visual sequence within the brain vital signs framework. With both auditory and visual stimulation capabilities available, it is possible to broaden applications across the lifespan.
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Affiliation(s)
- Gabriela M Pawlowski
- NeuroTech Laboratory, Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada.,Biomedical Physiology and Kinesiology, Faculty of Science, Simon Fraser University, Burnaby, BC, Canada
| | - Sujoy Ghosh-Hajra
- NeuroTech Laboratory, Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
| | - Shaun D Fickling
- NeuroTech Laboratory, Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
| | - Careesa C Liu
- NeuroTech Laboratory, Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
| | - Xiaowei Song
- NeuroTech Laboratory, Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
| | - Stephen Robinovitch
- Biomedical Physiology and Kinesiology, Faculty of Science, Simon Fraser University, Burnaby, BC, Canada
| | - Sam M Doesburg
- Biomedical Physiology and Kinesiology, Faculty of Science, Simon Fraser University, Burnaby, BC, Canada
| | - Ryan C N D'Arcy
- NeuroTech Laboratory, Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada.,Biomedical Physiology and Kinesiology, Faculty of Science, Simon Fraser University, Burnaby, BC, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health, Surrey, BC, Canada
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29
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Smith AM, Farrell KJ, Roberts WO, Moris MR, Stuart MJ. Eliminating Fighting and Head Hits from Hockey: Opportunities and Barriers. Curr Sports Med Rep 2019; 18:35-40. [PMID: 30624333 DOI: 10.1249/jsr.0000000000000556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Removing fighting from ice hockey is an essential concussion prevention strategy that will improve the safety of the game at all levels.
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Affiliation(s)
- Aynsley M Smith
- Department of Orthopedic Surgery and Physical Medicine and Rehabilitation, Sports Medicine, Mayo Clinic, Rochester, MN
| | | | - William O Roberts
- Department of Family Medicine and Community Health University of Minnesota, Minneapolis, MN
| | | | - Michael J Stuart
- Department of Orthopedic Surgery, Sports Medicine, Mayo Clinic, Rochester, MN
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30
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Smith AM, Alford PA, Aubry M, Benson B, Black A, Brooks A, Burke C, D'Arcy R, Dodick D, Eaves M, Eickhoff C, Erredge K, Farrell K, Finnoff J, Fraser DD, Giza C, Greenwald RM, Hoshizaki B, Huston J, Jorgensen J, Joyner M, Krause D, LaVoi N, Leaf M, Leddy J, Margarucci K, Margulies S, Mihalik J, Munce T, Oeur A, Prideaux C, Roberts WO, Shen F, Soma D, Tabrum M, Stuart MB, Wethe J, Whitehead JR, Wiese-Bjornstal D, Stuart MJ. Proceedings from the Ice Hockey Summit III: Action on Concussion. Curr Sports Med Rep 2019; 18:23-34. [PMID: 30624332 DOI: 10.1249/jsr.0000000000000557] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these five objectives: 1) describe sport-related concussion (SRC) epidemiology, 2) classify prevention strategies, 3) define objective, diagnostic tests, 4) identify treatment, and 5) integrate science and clinical care into prioritized action plans and policy. Our action plan evolved from 40 scientific presentations. The 155 attendees (physicians, athletic trainers, physical therapists, nurses, neuropsychologists, scientists, engineers, coaches, and officials) voted to prioritize these action items in the final Summit session. 1) Establish a national and international hockey data base for SRC at all levels, 2) eliminate body checking in Bantam youth hockey games, 3) expand a behavior modification program (Fair Play) to all youth hockey levels, 4) enforce game ejection penalties for fighting in Junior A and professional hockey leagues, 5) establish objective tests to diagnose concussion at point of care (POC), and 6) mandate baseline testing to improve concussion diagnosis for all age groups. Expedient implementation of the Summit III prioritized action items is necessary to reduce the risk, severity, and consequences of concussion in the sport of ice hockey.
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Affiliation(s)
- Aynsley M Smith
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - Patrick A Alford
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN
| | - Mark Aubry
- Sports Medicine, Ottawa Sports Medicine Center, Ottawa, ON, Canada
| | - Brian Benson
- Faculty of Kinesiology, Department of Clinical Neurosciences, Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Amanda Black
- Sport Injury Prevention Research Centre and the Integrated Concussion Research Program at the University of Calgary, Calgary, AB, Canada
| | - Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, Madison, WI
| | - Charles Burke
- Department of Orthopedics, Burke & Bradley Orthopedics, UPMC St. Margaret, Pittsburgh, PA
| | - Ryan D'Arcy
- School of Computing Science, School of Engineering Science, Simon Frasier University, Surrey, BC, Canada
| | - David Dodick
- Department of Neurology, Mayo Clinic, Rochester, MN
| | | | - Chad Eickhoff
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - Kristen Erredge
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - Kyle Farrell
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - Jonathon Finnoff
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - Douglas D Fraser
- Department of Pediatrics, Department of Physiology/Pharmacology and Clinical Neurosciences, University of Western Ontario, London, ON, Canada
| | - Christopher Giza
- Department of Pediatrics, University of California-Los Angeles, Los Angeles, CA
| | - Richard M Greenwald
- Simbex, Lebanon, NH.,Thayer School of Engineering, Dartmouth College, Hanover, NH
| | - Blaine Hoshizaki
- Neurotrauma Impact Science Laboratory, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - John Huston
- Department of Radiology, Mayo Clinic, Rochester, MN
| | - Janelle Jorgensen
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - Michael Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - David Krause
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - Nicole LaVoi
- School of Kinesiology, University of Minnesota, Minneapolis, MN
| | | | - John Leddy
- Department of Orthopedics, Jacobs School of Medicine and Biomedical Science, University of Buffalo, Buffalo, NY
| | | | - Susan Margulies
- Wallace Coulter Department of Biomedical Engineering, Emory University, Atlanta, GA.,Georgia Institute of Technology, Atlanta, GA
| | - Jason Mihalik
- Department of Exercise and Sports Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Thayne Munce
- Sanford Sports Science Institution, Sanford Medical South Dakota, Sioux Falls, SD
| | - Anna Oeur
- Wallace Coulter Department of Biomedical Engineering, Emory University, Atlanta, GA
| | - Cara Prideaux
- Sports Medicine, Department of Physical Medicine Rehabilitation, Mayo Clinic, Rochester, MN
| | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Francis Shen
- University of Minnesota Law School, Minneapolis, MN
| | - David Soma
- Department of Pediatric and Adolescent Medicine, Sports Medicine, Mayo Clinic, Rochester, MN
| | | | - Michael B Stuart
- Department of Orthopedic Surgery, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Jennifer Wethe
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | | | - Michael J Stuart
- Department of Orthopedic Surgery, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
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31
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Hajra SG, Liu CC, Song X, Fickling SD, Cheung TPL, D'Arcy RCN. Accessing knowledge of the 'here and now': a new technique for capturing electromagnetic markers of orientation processing. J Neural Eng 2018; 16:016008. [PMID: 30507557 DOI: 10.1088/1741-2552/aae91e] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The ability to orient with respect to the current context (e.g. current time or location) is crucial for daily functioning, and is used to measure overall cognitive health across many frontline clinical assessments. However, these tests are often hampered by their reliance on verbal probes (e.g. 'What city are we in?') in evaluating orientation. Objective, physiology-based measures of orientation processing are needed, but no such measures are currently in existence. We report the initial development of potential brainwave-based markers of orientation processing as characterized using electroencephlography (EEG) and magnetoencephalography (MEG). APPROACH An auditory stimulus sequence embedded with words corresponding to orientation-relevant (i.e. related to the 'here and now') and orientation-irrelevant (i.e. unrelated to the current context) conditions was used to elicit orientation processing responses. EEG/MEG data, in concert with clinical assessments, were collected from 29 healthy adults. Analysis at sensor and source levels identified and characterized neural signals related to orientation processing. MAIN RESULTS Orientation-irrelevant stimuli elicited increased negative amplitude in EEG-derived event-related potential (ERP) waveforms during the 390-570 ms window (p < 0.05), with cortical activations across the left frontal, temporal, and parietal regions. These effects are consistent with the well-known N400 response to semantic incongruence. In contrast, ERP responses to orientation-relevant stimuli exhibited increased positive amplitude during the same interval (p < 0.05), with activations across the bilateral temporal and parietal regions. Importantly, these differential responses were robust at the individual level, with machine-learning classification showing high accuracy (89%), sensitivity (0.88) and specificity (0.90). SIGNIFICANCE This is the first demonstration of a neurotechnology platform that elicits, captures, and evaluates electrophysiological markers of orientation processing. We demonstrate neural responses to orientation stimuli that are validated across EEG and MEG modalities and robust at the individual level. The extraction of physiology-based markers through this technique may enable improved objective brain functional evaluation in clinical applications.
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Affiliation(s)
- Sujoy Ghosh Hajra
- Faculty of Applied Science, Simon Fraser University, Surrey, British Columbia, Canada
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32
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Fleck-Prediger CM, Ghosh Hajra S, Liu CC, Gray DS, Weaver DF, Gopinath S, Dick BD, D'Arcy RCN. Point-of-care brain injury evaluation of conscious awareness: wide scale deployment of portable HCS EEG evaluation. Neurosci Conscious 2018; 2018:niy011. [PMID: 30488005 PMCID: PMC6251986 DOI: 10.1093/nc/niy011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 09/16/2018] [Accepted: 09/22/2018] [Indexed: 11/14/2022] Open
Abstract
Survivors of severe brain injury may remain in a decreased state of conscious awareness for an extended period of time. Clinical scales are used to describe levels of consciousness but rely on behavioural responses, precipitating misdiagnosis. We have previously utilized event-related potentials (ERPs) to circumvent reliance on behavioural responses. However, practical implementation barriers limit the clinical utility of ERP assessment at point-of-care (POC). To address this challenge, we developed the Halifax Consciousness Scanner (HCS)-a rapid, semi-automated electroencephalography system. The current study evaluated: (i) HCS feasibility in sub-acute, POC settings nationwide; (ii) ERP P300 responses in patients with acquired brain injury versus healthy controls; and (iii) correlations within and between clinical measures and P300 latencies. We assessed 28 patients with severe, chronic impairments from brain injuries and contrasted the results with healthy control data (n = 100). Correlational analyses examined relationships between P300 latencies and the commonly used clinical scales. P300 latencies were significantly delayed in patients compared to healthy controls (P < 0.05). Clinical assessment scores were significantly inter-correlated and correlated significantly with P300 latencies (P < 0.05). In sub-acute and chronic care settings, the HCS provided a physiological measure of neurocognitive processing at POC for patients with severe acquired brain injury, including those with disorders of consciousness.
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Affiliation(s)
- Carolyn M Fleck-Prediger
- Neuroscience and Mental Health Institute, University of Alberta, Canada.,Halvar Jonson Centre for Brain Injury, Canada
| | - Sujoy Ghosh Hajra
- Faculty of Applied Sciences (Engineering Science and Computing Science), Simon Fraser University, Canada.,NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
| | - Careesa C Liu
- Faculty of Applied Sciences (Engineering Science and Computing Science), Simon Fraser University, Canada.,NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
| | - D Shaun Gray
- Neuroscience and Mental Health Institute, University of Alberta, Canada.,Halvar Jonson Centre for Brain Injury, Canada.,Division of Physical Medicine and Rehabilitation, University of Alberta, Canada
| | - Donald F Weaver
- Krembil Research Institute, UHN, University of Toronto, Canada
| | - Shishir Gopinath
- NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
| | - Bruce D Dick
- Neuroscience and Mental Health Institute, University of Alberta, Canada.,Departments of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, University of Alberta, Canada
| | - Ryan C N D'Arcy
- Faculty of Applied Sciences (Engineering Science and Computing Science), Simon Fraser University, Canada.,NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
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Liu CC, Hajra SG, Song X, Doesburg SM, Cheung TPL, D'Arcy RCN. Cognitive loading via mental arithmetic modulates effects of blink-related oscillations on precuneus and ventral attention network regions. Hum Brain Mapp 2018; 40:377-393. [PMID: 30240494 DOI: 10.1002/hbm.24378] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/02/2018] [Accepted: 08/22/2018] [Indexed: 12/12/2022] Open
Abstract
Blink-related oscillations (BROs) have been linked with environmental monitoring processes associated with blinking, with cortical activations in the bilateral precuneus. Although BROs have been described under resting and passive fixation conditions, little is known about their characteristics under cognitive loading. To address this, we investigated BRO effects during both mental arithmetic (MA) and passive fixation (PF) tasks using magnetoencephalography (n =20), while maintaining the same sensory environment in both tasks. Our results confirmed the presence of BRO effects in both MA and PF tasks, with similar characteristics including blink-related increase in global field power and blink-related activation of the bilateral precuneus. In addition, cognitive loading due to MA also modulated BRO effects by decreasing BRO-induced cortical activations in key brain regions including the bilateral anterior precuneus. Interestingly, blinking during MA-but not PF-activated regions of the ventral attention network (i.e., right supramarginal gyrus and inferior frontal gyrus), suggesting possible recruitment of these areas for blink processing under cognitive loading conditions. Time-frequency analysis revealed a consistent pattern of BRO-related effects in the precuneus in both tasks, but with task-related functional segregation within the anterior and posterior subregions. Based on these findings, we postulate a potential neurocognitive mechanism for blink processing in the precuneus. This study is the first investigation of BRO effects under cognitive loading, and our results provide compelling new evidence for the important cognitive implications of blink-related processing in the human brain.
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Affiliation(s)
- Careesa C Liu
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sujoy Ghosh Hajra
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Xiaowei Song
- Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health Authority, British Columbia, Canada
| | - Sam M Doesburg
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Teresa P L Cheung
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health Authority, British Columbia, Canada
| | - Ryan C N D'Arcy
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada.,Health Sciences and Innovation, Surrey Memorial Hospital, Fraser Health Authority, British Columbia, Canada
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Ghosh Hajra S, Liu CC, Song X, Fickling SD, Cheung TPL, D'Arcy RCN. Multimodal characterization of the semantic N400 response within a rapid evaluation brain vital sign framework. J Transl Med 2018; 16:151. [PMID: 29866112 PMCID: PMC5987605 DOI: 10.1186/s12967-018-1527-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 05/26/2018] [Indexed: 01/17/2023] Open
Abstract
Background For nearly four decades, the N400 has been an important brainwave marker of semantic processing. It can be recorded non-invasively from the scalp using electrical and/or magnetic sensors, but largely within the restricted domain of research laboratories specialized to run specific N400 experiments. However, there is increasing evidence of significant clinical utility for the N400 in neurological evaluation, particularly at the individual level. To enable clinical applications, we recently reported a rapid evaluation framework known as “brain vital signs” that successfully incorporated the N400 response as one of the core components for cognitive function evaluation. The current study characterized the rapidly evoked N400 response to demonstrate that it shares consistent features with traditional N400 responses acquired in research laboratory settings—thereby enabling its translation into brain vital signs applications. Methods Data were collected from 17 healthy individuals using magnetoencephalography (MEG) and electroencephalography (EEG), with analysis of sensor-level effects as well as evaluation of brain sources. Individual-level N400 responses were classified using machine learning to determine the percentage of participants in whom the response was successfully detected. Results The N400 response was observed in both M/EEG modalities showing significant differences to incongruent versus congruent condition in the expected time range (p < 0.05). Also as expected, N400-related brain activity was observed in the temporal and inferior frontal cortical regions, with typical left-hemispheric asymmetry. Classification robustly confirmed the N400 effect at the individual level with high accuracy (89%), sensitivity (0.88) and specificity (0.90). Conclusion The brain vital sign N400 characteristics were highly consistent with features of the previously reported N400 responses acquired using traditional laboratory-based experiments. These results provide important evidence supporting clinical translation of the rapidly acquired N400 response as a potential tool for assessments of higher cognitive functions.
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Affiliation(s)
- Sujoy Ghosh Hajra
- Faculty of Applied Science, Simon Fraser University, Burnaby, BC, Canada.,Surrey NeuroTech Lab, Surrey Memorial Hospital, 13750 96 Avenue, Surrey, BC, V3V 1Z2, Canada
| | - Careesa C Liu
- Faculty of Applied Science, Simon Fraser University, Burnaby, BC, Canada.,Surrey NeuroTech Lab, Surrey Memorial Hospital, 13750 96 Avenue, Surrey, BC, V3V 1Z2, Canada
| | - Xiaowei Song
- Faculty of Applied Science, Simon Fraser University, Burnaby, BC, Canada.,Health Science and Innovation, Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada.,ImageTech Lab, Surrey Memorial Hospital, 13750 96 Av, Surrey, BC, V3V 1Z2, Canada
| | - Shaun D Fickling
- Faculty of Applied Science, Simon Fraser University, Burnaby, BC, Canada.,Surrey NeuroTech Lab, Surrey Memorial Hospital, 13750 96 Avenue, Surrey, BC, V3V 1Z2, Canada
| | - Teresa P L Cheung
- Faculty of Applied Science, Simon Fraser University, Burnaby, BC, Canada.,Health Science and Innovation, Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada.,ImageTech Lab, Surrey Memorial Hospital, 13750 96 Av, Surrey, BC, V3V 1Z2, Canada
| | - Ryan C N D'Arcy
- Faculty of Applied Science, Simon Fraser University, Burnaby, BC, Canada. .,Health Science and Innovation, Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada. .,HealthTech Connex Inc, Surrey, BC, Canada. .,Surrey NeuroTech Lab, Surrey Memorial Hospital, 13750 96 Avenue, Surrey, BC, V3V 1Z2, Canada. .,ImageTech Lab, Surrey Memorial Hospital, 13750 96 Av, Surrey, BC, V3V 1Z2, Canada.
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Early visual ERPs show stable body-sensitive patterns over a 4-week test period. PLoS One 2018; 13:e0192583. [PMID: 29438399 PMCID: PMC5810991 DOI: 10.1371/journal.pone.0192583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/26/2018] [Indexed: 11/19/2022] Open
Abstract
Event-related potential (ERP) studies feature among the most cited papers in the field of body representation, with recent research highlighting the potential of ERPs as neuropsychiatric biomarkers. Despite this, investigation into how reliable early visual ERPs and body-sensitive effects are over time has been overlooked. This study therefore aimed to assess the stability of early body-sensitive effects and visual P1, N1 and VPP responses. Participants were asked to identify pictures of their own bodies, other bodies and houses during an EEG test session that was completed at the same time, once a week, for four consecutive weeks. Results showed that amplitude and latency of early visual components and their associated body-sensitive effects were stable over the 4-week period. Furthermore, correlational analyses revealed that VPP component amplitude might be more reliable than VPP latency and specific electrode sites might be more robust indicators of body-sensitive cortical activity than others. These findings suggest that visual P1, N1 and VPP responses, alongside body-sensitive N1/VPP effects, are robust indications of neuronal activity. We conclude that these components are eligible to be considered as electrophysiological biomarkers relevant to body representation.
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