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Díaz-Peregrino R, Kentar M, Trenado C, Sánchez-Porras R, Albiña-Palmarola P, Ramírez-Cuapio FL, San-Juan D, Unterberg A, Woitzik J, Santos E. The neurophysiological effect of mild hypothermia in gyrencephalic brains submitted to ischemic stroke and spreading depolarizations. Front Neurosci 2024; 18:1302767. [PMID: 38567280 PMCID: PMC10986791 DOI: 10.3389/fnins.2024.1302767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
Objective Characterize the neurophysiological effects of mild hypothermia on stroke and spreading depolarizations (SDs) in gyrencephalic brains. Methods Left middle cerebral arteries (MCAs) of six hypothermic and six normothermic pigs were permanently occluded (MCAo). Hypothermia began 1 h after MCAo and continued throughout the experiment. ECoG signals from both frontoparietal cortices were recorded. Five-minute ECoG epochs were collected 5 min before, at 5 min, 4, 8, 12, and 16 h after MCAo, and before, during, and after SDs. Power spectra were decomposed into fast (alpha, beta, and gamma) and slow (delta and theta) frequency bands. Results In the vascular insulted hemisphere under normothermia, electrodes near the ischemic core exhibited power decay across all frequency bands at 5 min and the 4th hour after MCAo. The same pattern was registered in the two furthest electrodes at the 12th and 16th hour. When mild hypothermia was applied in the vascular insulted hemispheres, the power decay was generalized and seen even in electrodes with uncompromised blood flow. During SD analysis, hypothermia maintained increased delta and beta power during the three phases of SDs in the furthest electrode from the ischemic core, followed by the second furthest and third electrode in the beta band during preSD and postSD segments. However, in hypothermic conditions, the third electrode showed lower delta, theta, and alpha power. Conclusion Mild hypothermia attenuates all frequency bands in the vascularly compromised hemisphere, irrespective of the cortical location. During SD formation, it preserves power spectra more significantly in electrodes further from the ischemic core.
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Affiliation(s)
- Roberto Díaz-Peregrino
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Modar Kentar
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Departement of Neurosurgery, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany
| | - Carlos Trenado
- Heinrich Heine University, Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Düsseldorf, Germany
- Institute for the Future of Education Europe, Tecnológico de Monterrey, Cantabria, Spain
| | - Renán Sánchez-Porras
- Department of Neurosurgery, Evangelisches Krankenhaus, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Pablo Albiña-Palmarola
- Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany
- Medizinische Fakultät, Universität Duisburg-Essen, Essen, Germany
- Department of Anatomy, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco L. Ramírez-Cuapio
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Daniel San-Juan
- Epilepsy Clinic, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Andreas Unterberg
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Johannes Woitzik
- Department of Neurosurgery, Evangelisches Krankenhaus, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Edgar Santos
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
- Department of Neurosurgery, Evangelisches Krankenhaus, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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San-Juan D, Ángeles EB, González-Aragón MDCF, Torres JEG, Lorenzana ÁL, Trenado C, Anschel DJ. Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico. J Clin Neurophysiol 2024; 41:221-229. [PMID: 38436389 DOI: 10.1097/wnp.0000000000000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE There is a lack of clinical and epidemiological knowledge about nonconvulsive status epilepticus (NCSE) in developing countries including Mexico, which has the highest prevalence of epilepsy in the Americas. Our aim was to describe the clinical findings, EEG features, and outcomes of NCSE in a tertiary center in Mexico. METHODS We conducted a retrospective case series study (2010-2020) including patients (≥15 years old) with NCSE according to the modified Salzburg NCSE criteria 2015 with at least 6 months of follow-up. We extracted the clinical data (age, sex, history of epilepsy, antiseizure medications, clinical manifestations, triggers, and etiology), EEG patterns of NCSE, and outcome. Descriptive statistics and multinomial logistic regression were used. RESULTS One hundred thirty-four patients were analyzed; 74 (54.8%) women, the total mean age was 39.5 (15-85) years, and 71% had a history of epilepsy. Altered state of consciousness was found in 82% (including 27.7% in coma). A generalized NCSE pattern was the most common (32.1%). The NCSE etiology was mainly idiopathic (56%), and previous uncontrolled epilepsy was the trigger in 48% of patients. The clinical outcome was remission with clinical improvement in 54.5%. Multinomial logistic regression showed that the patient's age (P = 0.04), absence of comorbidities (P = 0.04), history of perinatal hypoxia (P = 0.04), absence of clinical manifestations (P = 0.01), and coma (P = 0.03) were negatively correlated with the outcome and only the absence of generalized slowing in the EEG (P = 0.001) had a significant positive effect on the prognosis. CONCLUSIONS Age, history of perinatal hypoxia, coma, and focal ictal EEG pattern influence negatively the prognosis of NCSE.
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Affiliation(s)
- Daniel San-Juan
- Epilepsy Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico
| | - Erick B Ángeles
- Clinical Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico
| | | | - Jacob Eli G Torres
- Epilepsy Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico
| | - Ángel L Lorenzana
- Epilepsy Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico
| | - Carlos Trenado
- Düsseldorf and Systems Neuroscience and Neurotechnology Unit, Faculty of Medicine, Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Saarland University and HTW Saarland, Homburg, Germany; and
| | - David J Anschel
- St. Charles Epilepsy, New York University Comprehensive Epilepsy Center, St. Charles Hospital, Port Jefferson, New York, U.S.A
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Trenado C, Pedroarena-Leal N, Cif L, Ruge D. Electrophysiological variability as marker of dystonia worsening under deep brain stimulation successive withdrawal and renewal effects. Eur J Paediatr Neurol 2024; 48:109-112. [PMID: 38199204 DOI: 10.1016/j.ejpn.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 04/11/2023] [Accepted: 05/11/2023] [Indexed: 01/12/2024]
Abstract
DBS has been shown to be an effective intervention for neurological disorders. However, the intervention is complex and many aspects have not been understood. Various clinical situations have no solution and follow trial and error approaches. Dystonia is a movement disorder characterized by involuntary muscle contractions, which gives rise to abnormal movements and postures. Status dystonicus (SD) represents a life-threatening condition that requires urgent assessment and management. Electrophysiological markers for risk of symptom worsening and SD related patterns of evolution in patients treated with long-term deep brain stimulation (DBS), and specially under the effect of withdrawal and renewals of simulation are needed. To this end, we study the variability of neural synchronization as a mechanism for symptom generation under successive perturbations to a system, i.e. withdrawals and renewals of neuromodulation, through computational simulation of clinical profiles under different plasticity conditions. The simulation shows that the neuroplasticity makeup influences the variability of oscillation synchronization patterns in virtual "patients". The difference between the effect of different electrophysiological signatures is remarkable and under a certain condition (equal medium long term potentiation and long term depression) the situation resembles that of a stable equilibrium, putatively making the sudden worsening or change less likely. Stability of variability can only be observed in this condition and is clearly distinct from other scenarios. CONCLUSION: Our results demonstrate that the neuroplasticity makeup affects the variability of the oscillatory synchrony. This i) informs the shaping of the electrophysiological makeup and ii) might serve as a marker for clinical behavior.
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Affiliation(s)
- Carlos Trenado
- Laboratoire de Recherche en Neurosciences Cliniques, LRENC, Montpellier, France
| | | | - Laura Cif
- Département de Neurochirurgie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Diane Ruge
- Laboratoire de Recherche en Neurosciences Cliniques, LRENC, Montpellier, France.
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Trenado C, Trauberg P, Elben S, Dimenshteyn K, Folkerts AK, Witt K, Weiss D, Liepelt-Scarfone I, Kalbe E, Wojtecki L. Resting state EEG as biomarker of cognitive training and physical activity's joint effect in Parkinson's patients with mild cognitive impairment. Neurol Res Pract 2023; 5:46. [PMID: 37705108 PMCID: PMC10500911 DOI: 10.1186/s42466-023-00273-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/31/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Cognitive decline is a major factor for the deterioration of the quality of life in patients suffering from Parkinson's disease (PD). Recently, it was reported that cognitive training (CT) in PD patients with mild cognitive impairment (PD-MCI) led to an increase of physical activity (PA) accompanied by improved executive function (EF). Moreover, PA has been shown to alter positively brain function and cognitive abilities in PD. Both observations suggest an interaction between CT and PA. OBJECTIVES A previous multicenter (MC) study was slightly significant when considering independent effects of interventions (CT and PA) on EF. Here, we use MC constituent single center data that showed no effect of interventions on EF. Thus, this exploratory study considers pooling data from both interventions to gain insight into a recently reported interaction between CT and PA and provide a proof of principle for the usefulness of resting state EEG as a neurophysiological biomarker of joint intervention's effect on EF and attention in PD-MCI. METHODS Pre- and post-intervention resting state EEG and neuropsychological scores (EF and attention) were obtained from 19 PD-MCI patients (10 (CT) and 9 (PA)). We focused our EEG analysis on frontal cortical areas due to their relevance on cognitive function. RESULTS We found a significant joint effect of interventions on EF and a trend on attention, as well as trends for the negative correlation between attention and theta power (pre), the positive correlation between EF and alpha power (post) and a significant negative relationship between attention and theta power over time (post-pre). CONCLUSIONS Our results support the role of theta and alpha power at frontal areas as a biomarker for the therapeutic joint effect of interventions.
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Affiliation(s)
- Carlos Trenado
- Center for Movement Disorders and Neuromodulation, Departmemt of Neurology, University Clinic Duesseldorf, Duesseldorf, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
- Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Paula Trauberg
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Saskia Elben
- Center for Movement Disorders and Neuromodulation, Departmemt of Neurology, University Clinic Duesseldorf, Duesseldorf, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Karina Dimenshteyn
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Ann-Kristin Folkerts
- Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Karsten Witt
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller- Str. 3, 24105, Kiel, Germany
- Research Center Neurosensory Science, Carl von Ossietzky University Oldenburg, Heiligengeisthöfe 4, 26121, Oldenburg, Germany
| | - Daniel Weiss
- German Center of Neurodegenerative Diseases (DZNE) and Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Inga Liepelt-Scarfone
- German Center of Neurodegenerative Diseases (DZNE) and Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- IB Hochschule für Gesundheit und Soziales, Paulinenstr. 45, 70178, Stuttgart, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Lars Wojtecki
- Center for Movement Disorders and Neuromodulation, Departmemt of Neurology, University Clinic Duesseldorf, Duesseldorf, Germany.
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.
- Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Von-Broichhausen-Allee 1, 47906, Kempen, Germany.
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Trenado C, Mendez-Balbuena I, Damborská A, Hussain A, Mahmud M, Daliri MR. Editorial: The new frontier in brain network physiology: from temporal dynamics to the principles of integration in physiological brain networks. Front Comput Neurosci 2023; 17:1242834. [PMID: 37465647 PMCID: PMC10351975 DOI: 10.3389/fncom.2023.1242834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/20/2023] Open
Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | | | - Alena Damborská
- Central European Institute of Technology (CEITEC), Brain and Mind Research Program, Masaryk University, Brno, Czechia
- Department of Psychiatry, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czechia
| | - Amir Hussain
- School of Computing, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Mufti Mahmud
- Department of Computer Science, Nottingham Trent University, Nottingham, United Kingdom
| | - Mohammad Reza Daliri
- Neuroscience and Neuroengineering Research Laboratory, Biomedical Engineering Department, School of Electrical Engineering, Iran University of Science and Technology, Tehran, Iran
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Trenado C. Challenges and perspective of non-pharmacological cognitive enhancement. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Kentar M, Díaz-Peregrino R, Trenado C, Sánchez-Porras R, San-Juan D, Ramírez-Cuapio FL, Holzwarth N, Maier-Hein L, Woitzik J, Santos E. Spatial and temporal frequency band changes during infarct induction, infarct progression, and spreading depolarizations in the gyrencephalic brain. Front Neurosci 2022; 16:1025967. [PMID: 36570832 PMCID: PMC9769704 DOI: 10.3389/fnins.2022.1025967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/18/2022] [Indexed: 12/07/2022] Open
Abstract
Aim To describe the spatial and temporal electrocorticographic (ECoG) changes after middle cerebral artery occlusion (MCAo), including those caused by spreading depolarization (SD) in the pig brain. Methods The left middle cerebral arteries (MCAs) were clipped in six pigs. The clipping procedure lasted between 8 and 12 min, achieving a permanent occlusion (MCAo). Five-contact ECoG stripes were placed bilaterally over the frontoparietal cortices corresponding to the irrigation territory of the MCA and anterior cerebral artery (ACA). ECoG recordings were performed around 24 h: 1 h before and 23 h after the MCAo, and SDs were quantified. Five-minute ECoG signal segments were sampled before, 5 min, and 4, 8, and 12 h after cerebral artery occlusion and before, during, and after the negative direct current shift of the SDs. The power spectrum of the signals was decomposed into delta, theta, alpha, beta, and gamma bands. Descriptive statistics, Wilcoxon matched-pairs signed-rank tests, and Friedman tests were performed. Results Electrodes close to the MCAo showed instant decay in all frequency bands and SD onset during the first 5 h. Electrodes far from the MCAo exhibited immediate loss of fast frequencies and progressive decline of slow frequencies with an increased SD incidence between 6 and 14 h. After 8 h, the ACA electrode reported a secondary reduction of all frequency bands except gamma and high SD incidence within 12-17 h. During the SD, all electrodes showed a decline in all frequency bands. After SD passage, frequency band recovery was impaired only in MCA electrodes. Conclusion ECoG can identify infarct progression and secondary brain injury. Severe disturbances in all the frequency bands are generated in the cortices where the SDs are passing by.
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Affiliation(s)
- Modar Kentar
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Roberto Díaz-Peregrino
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Renán Sánchez-Porras
- Department of Neurosurgery, Evangelisches Krankenhaus, Carl-von-Ossietzky University, Oldenburg, Germany
| | - Daniel San-Juan
- Epilepsy Clinic, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - F. Leonardo Ramírez-Cuapio
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Niklas Holzwarth
- Division of Intelligent Medical Systems, German Cancer Research Center, Heidelberg, Germany
| | - Lena Maier-Hein
- Division of Intelligent Medical Systems, German Cancer Research Center, Heidelberg, Germany
| | - Johannes Woitzik
- Department of Neurosurgery, Evangelisches Krankenhaus, Carl-von-Ossietzky University, Oldenburg, Germany
| | - Edgar Santos
- Department of Neurosurgery, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany,Department of Neurosurgery, Evangelisches Krankenhaus, Carl-von-Ossietzky University, Oldenburg, Germany,*Correspondence: Edgar Santos,
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Cont C, Stute N, Galli A, Schulte C, Logmin K, Trenado C, Wojtecki L. Retrospective real-world pilot data on transcranial pulse stimulation in mild to severe Alzheimer's patients. Front Neurol 2022; 13:948204. [PMID: 36188380 PMCID: PMC9515314 DOI: 10.3389/fneur.2022.948204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Transcranial pulse stimulation (TPS) is a non-invasive neuromodulation therapy that uses short, repetitive shockwaves through a neuro-navigated device. Current research suggests that these pulses lead to a wide range of vascular, metabolic, and neurotrophic changes. This relatively new CE-marked treatment provided first promising results in a clinical pilot study for improving cognition in mild-to-moderate Alzheimer's. Data from other centers is lacking, so here we analyzed safety and pilot real-world short-term results of TPS from the first center in Germany. To gain information about effects in different stages, patients with not only mild but also moderate-to-severe Alzheimer's were analyzed. Methods A total of 11 patients were retrospectively examined for cognitive and emotional function before and after the first stimulation series. The effect was assessed using several neuropsychological tests [Alzheimer's Disease Assessment Scale (ADAS), including the ADAS cognitive score (ADAS Cog) and ADAS affective scores, Mini-Mental Status Examination (MMSE), and Montreal Cognitive Assessment (MoCA)] including in comparison between the groups of mild-to-severe patients. Moreover, subjective improvement of symptom severity, potential effects on depressive symptoms, and side effects were analyzed using Numeric Rating Scales (NRS). Results Side effects were rare (in 4% of sessions) with moderate subjective severity and only transient. Patients significantly improved in the ADAS and ADAS Cog, while there was no significant effect in MMSE and MoCA. Patients' self-reported symptom severity improved significantly. The depressive symptoms measured in an ADAS subscale also improved significantly. Statistical data analyses revealed no significant correlation of clinical improvement with baseline symptom severity. Conclusion TPS might be a safe and promising add-on therapy for Alzheimer's, even for moderate-to-severe patients. More research on long-term effects in patients as well as studies with sham control groups is needed. Moreover, translational research on the mechanisms of action and effects on cerebral network physiology will be needed to understand this new neuromodulation technique.
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Affiliation(s)
- Celine Cont
- Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Kempen, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nathalie Stute
- Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Kempen, Germany
| | - Anastasia Galli
- Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Kempen, Germany
| | - Christina Schulte
- Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Kempen, Germany
| | - Kazimierz Logmin
- Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Kempen, Germany
| | - Carlos Trenado
- Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Lars Wojtecki
- Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Kempen, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- *Correspondence: Lars Wojtecki
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Hassan S, Groiss S, Trenado C, Rageh T, Schnitzler A. TU-111. Effect of conditioning and test stimulus intensity on cortical excitability by using triad-conditioning Transcranial Magnetic Stimulation. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Alejandro David Cansino C, Alberto Gómez Ávila F, González-Aragón M, José Moreno Avellán Á, Trenado C, San-juan D. TH-219. Novel biomarkers in qEEG of patients with encephalitis due to antibodies against N-Methyl-D-Aspartate receptor: A case-control study. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.07.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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San-Juan Orta D, Bautista Ángeles E, del Carmen Fernández González-Aragon M, Eli García Torres J, Labra Lorenzana Á, Trenado C. WE-105. Non-convulsive status epilepticus: Electro-clinical features, and prognosis in a developing country, Mexico. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.07.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cont C, Trenado C, Rusch KM, Galli A, Stute N, Wojtecki L. TU-145. Short and long-term clinical and resting-state EEG results of Transcranial Pulse Stimulation in Alzheimer’s Disease. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lange EB, Omigie D, Trenado C, Müller V, Wald-Fuhrmann M, Merrill J. In touch: Cardiac and respiratory patterns synchronize during ensemble singing with physical contact. Front Hum Neurosci 2022; 16:928563. [PMID: 35992947 PMCID: PMC9390082 DOI: 10.3389/fnhum.2022.928563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Musical ensemble performances provide an ideal environment to gain knowledge about complex human interactions. Network structures of synchronization can reflect specific roles of individual performers on the one hand and a higher level of organization of all performers as a superordinate system on the other. This study builds on research on joint singing, using hyperscanning of respiration and heart rate variability (HRV) from eight professional singers. Singers performed polyphonic music, distributing their breathing within the same voice and singing without and with physical contact: that is touching each other's shoulder or waist. The idea of singing with touch was motivated by historical depictions of ensemble performances that showed singers touching each other. It raises the question of the potential benefit of touch for group performances. From a psycho-physiological point of view, physical contact should increase the synchronization of singing coordination. The results confirm previous findings on synchronization of respiration and HRV during choir singing and extend those findings to a non-homophonic musical repertoire while also revealing an increase in synchronization in respiration during physical contact. These effects were significant across different frequency ranges. The effect of physical contact was stronger when all singers were singing in comparison to the partial ensemble. Importantly, the synchronization could not be fully explained by the singing action (i.e., singing the same voice, or singing vs. listening) or by the standing position or touch. This finding suggests a higher level of organization of all singers, forming a superordinate system.
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Affiliation(s)
- Elke B. Lange
- Music Department, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- *Correspondence: Elke B. Lange
| | - Diana Omigie
- Music Department, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Carlos Trenado
- Music Department, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Viktor Müller
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Melanie Wald-Fuhrmann
- Music Department, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- Max Planck NYU Center for Music, Language, and Emotions, Frankfurt am Main, Germany
| | - Julia Merrill
- Music Department, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- Institute of Music, University of Kassel, Kassel, Germany
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14
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Ruge D, Pedroarena-Leal N, Trenado C. Leadership in Education, Medical Education and Health. Int J Environ Res Public Health 2022; 19:5730. [PMID: 35565125 PMCID: PMC9104542 DOI: 10.3390/ijerph19095730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 12/04/2022]
Abstract
We observe the impact of quality of leadership in our daily lives [...].
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Affiliation(s)
- Diane Ruge
- Laboratoire de Recherche en Neurosciences Cliniques (LRENC), 34725 Montpellier, France;
- Institute of Neurology, University College London (UCL), Queen Square, London WC1N 3BG, UK
| | - Nicole Pedroarena-Leal
- Laboratoire de Recherche en Neurosciences Cliniques (LRENC), 34725 Montpellier, France;
- Institute of Neurology, University College London (UCL), Queen Square, London WC1N 3BG, UK
| | - Carlos Trenado
- Laboratoire de Recherche en Neurosciences Cliniques (LRENC), 34725 Montpellier, France;
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, 40225 Duesseldorf, Germany
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15
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Wojtecki L, Cont C, Trenado C, Rusch K, Galli A, Stute N, Schnitzler A. P 42 Pilot clinical and EEG-biomarker results of transcranial pulse stimulation in Alzheimer's disease. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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16
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San-Juan D, Espinoza-López DA, Vázquez-Gregorio R, Trenado C, Aragón MFG, Pérez-Pérez D, Hernández-Ruiz A, Anschel DJ. A pilot randomized controlled clinical trial of Transcranial Alternating Current Stimulation in patients with multifocal pharmaco-resistant epilepsy. Epilepsy Behav 2022; 130:108676. [PMID: 35366528 DOI: 10.1016/j.yebeh.2022.108676] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 11/19/2022]
Abstract
Transcranial Alternating Current Stimulation (tACS) is a promising noninvasive electrical stimulation therapy for neuropsychiatric diseases. Invasive neuromodulation using alternating current has been efficacious for drug-resistant epilepsy, but it is associated with surgical and medical complications. We aimed to explore the safeness and effectivity on seizure frequency reduction of two tACS protocols against placebo in patients with multifocal refractory epilepsy. This was a randomized, double-blinded, placebo-controlled clinical trial with 3-arm parallel-group (placebo, 30 min/2 mA daily sessions for 3 days [tACS-30], and 60 min/2 mA weekday sessions [tACS-60]). The main outcome was considered a change in reducing seizure frequency at 2 months after the intervention. Secondary outcomes were the apparition of any adverse effects during follow-up. At the second month, we observed a nonsignificant reduction in the seizure frequency in the placebo (7.3 ± 40.4%, p > 0.05) and the tACS-60 (26 ± 37.7%, p > 0.05). While the tACS-30 group showed a nonsignificant increase in seizure frequency (63.6 ± 155.3%, p > 0.05). No changes were statistically different from the placebo group. Otherwise, participants experienced only minor adverse events - the most common being an initial local transient tingling sensation (21%). This pilot study of tACS raises no severe safety issues, but provides negligible evidence for efficacy using this brief treatment protocol. Therefore, more studies are warranted testing different parameters to further verify the safety and effectivity of tACS in multifocal epilepsy.
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Affiliation(s)
- Daniel San-Juan
- Epilepsy Clinic Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Tlalpan, Mexico City, Mexico.
| | - Dulce Anabel Espinoza-López
- Clinical Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Tlalpan, Mexico City, Mexico
| | - Rafael Vázquez-Gregorio
- Epilepsy Clinic Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Tlalpan, Mexico City, Mexico
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
| | | | - Daniel Pérez-Pérez
- Plan of Combined Studies in Medicine (PECEM), Faculty of Medicine, UNAM, Coyoacan, Mexico City, Mexico
| | - Axel Hernández-Ruiz
- Superior School of Medicine, National Polytechnic Institute, Miguel Hidalgo, Mexico City, Mexico
| | - David J Anschel
- St. Charles Epilepsy/New York University Comprehensive Epilepsy Center, St. Charles Hospital, Port Jefferson, NY, United States
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17
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Trenado C, Cif L, Pedroarena-Leal N, Ruge D. Electrophysiological Signature and the Prediction of Deep Brain Stimulation Withdrawal and Insertion Effects. Front Neurol 2021; 12:754701. [PMID: 34917015 PMCID: PMC8669963 DOI: 10.3389/fneur.2021.754701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/18/2021] [Indexed: 11/15/2022] Open
Abstract
Deep brain stimulation (DBS) serves as a treatment for neurological and psychiatric disorders, such as Parkinson's disease (PD), essential tremor, dystonia, Tourette Syndrome (GTS), Huntington's disease, and obsessive-compulsive disorder (OCD). There is broad experience with the short-term effects of DBS in individual diseases and their signs/symptoms. However, even in acute treatment and for the same disorder or a given disorder, a prediction of effect is not perfect. Even further, the factors that influence the long-term effect of DBS and its withdrawal are hardly characterized. In this work, we aim to shed light on an important topic, the question of “DBS dependency.” To address this, we make use of the Kuramoto model of phase synchronization (oscillation feature) endowed with neuroplasticity to study the effects of DBS under successive withdrawals and renewals of neuromodulation as well as influence of treatment duration in de novo DBS “patients.” The results of our simulation show that the characteristics of neuroplasticity have a profound effect on the stability and mutability of oscillation synchronization patterns across successive withdrawal and renewal of DBS in chronic “patients” and also in de novo DBS “patients” with varying duration of treatment (here referred to as the “number of iterations”). Importantly, the results demonstrate the strong effect of the individual neuroplasticity makeup on the behavior of synchrony of oscillatory activity that promotes certain disorder/disease states or symptoms. The effect of DBS-mediated neuromodulation and withdrawal is highly dependent on the makeup of the neuroplastic signature of a disorder or an individual.
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Affiliation(s)
- Carlos Trenado
- Laboratoire de Recherche en Neurosciences Cliniques, LRENC, Montpellier, France
| | - Laura Cif
- Département de Neurochirurgie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | - Diane Ruge
- Laboratoire de Recherche en Neurosciences Cliniques, LRENC, Montpellier, France
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18
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Wojtecki L, Trenado C, Cont C, Zimmermann KM, Stute N, Schnitzler A. The great reset: Transcranial pulse stimulation reduces global EEG-entropy in Alzheimer's Disease. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Flotho P, Bhamborae MJ, Grün T, Trenado C, Thinnes D, Limbach D, Strauss DJ. Multimodal data acquisition at SARS-CoV-2 drive through screening centers: Setup description and experiences in Saarland, Germany. J Biophotonics 2021; 14:e202000512. [PMID: 33987984 DOI: 10.1002/jbio.202000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/11/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
SARS-CoV-2 drive through screening centers (DTSC) have been implemented worldwide as a fast and secure way of mass screening. We use DTSCs as a platform for the acquisition of multimodal datasets that are needed for the development of remote screening methods. Our acquisition setup consists of an array of thermal, infrared and RGB cameras as well as microphones and we apply methods from computer vision and computer audition for the contactless estimation of physiological parameters. We have recorded a multimodal dataset of DTSC participants in Germany for the development of remote screening methods and symptom identification. Acquisition in the early stages of a pandemic and in regions with high infection rates can facilitate and speed up the identification of infection specific symptoms and large-scale data acquisition at DTSC is possible without disturbing the flow of operation.
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Affiliation(s)
- Philipp Flotho
- Systems Neuroscience and Neurotechnology Unit, Neurocenter, Faculty of Medicine, Saarland University and School of Engineering, htw saar, Saarbrücken, Germany
| | - Mayur J Bhamborae
- Systems Neuroscience and Neurotechnology Unit, Neurocenter, Faculty of Medicine, Saarland University and School of Engineering, htw saar, Saarbrücken, Germany
| | - Tobias Grün
- Systems Neuroscience and Neurotechnology Unit, Neurocenter, Faculty of Medicine, Saarland University and School of Engineering, htw saar, Saarbrücken, Germany
| | - Carlos Trenado
- Systems Neuroscience and Neurotechnology Unit, Neurocenter, Faculty of Medicine, Saarland University and School of Engineering, htw saar, Saarbrücken, Germany
| | - David Thinnes
- Systems Neuroscience and Neurotechnology Unit, Neurocenter, Faculty of Medicine, Saarland University and School of Engineering, htw saar, Saarbrücken, Germany
| | - Dominik Limbach
- Systems Neuroscience and Neurotechnology Unit, Neurocenter, Faculty of Medicine, Saarland University and School of Engineering, htw saar, Saarbrücken, Germany
| | - Daniel J Strauss
- Systems Neuroscience and Neurotechnology Unit, Neurocenter, Faculty of Medicine, Saarland University and School of Engineering, htw saar, Saarbrücken, Germany
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20
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Trauberg P, Trenado C, Elben S, Dimenshteyn K, Boschheidgen M, Rübenach J, Wojtecki L. P 41. Resting-state EEG as biomarker of cognitive training and movement training in Parkinson's Disease (PD) with mild cognitive impairment (MCI). Clin Neurophysiol 2021. [DOI: 10.1016/j.clinph.2021.02.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Elben S, Dimenshteyn K, Trenado C, Folkerts AK, Ophey A, Sulzer P, Becker S, Schmidt N, Tödt I, Witt K, Liepelt-Scarfone I, Yilmaz R, Kalbe E, Wojtecki L. Screen Fast, Screen Faster: A Pilot Study to Screen for Depressive Symptoms Using the Beck Depression Inventory Fast Screen in Parkinson's Disease With Mild Cognitive Impairment. Front Neurol 2021; 12:640137. [PMID: 33763020 PMCID: PMC7982682 DOI: 10.3389/fneur.2021.640137] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/11/2021] [Indexed: 01/14/2023] Open
Abstract
Objective: Depressive symptoms have a high prevalence in patients with Parkinson's disease (PD) and are associated with cognitive dysfunction. Especially in PD with mild cognitive impairment (MCI), a time-efficient and valid instrument for the assessment of depression primarily focusing on psychological symptoms and disregarding confounding somatic symptoms is needed. We performed an examination of the psychometric properties of the Beck Depression Inventory II (BDI-II) and the Beck Depression Inventory Fast Screen (BDI-FS). Methods: The sample consisted of 64 patients [22 females and 42 males, mean age: 67.27 years (SD = 7.32)]. Depressive symptoms were measured in a cohort of PD patients with MCI. For the BDI-II and BDI-FS the psychometric concepts of internal consistency, convergent validity and diagnostic agreement were assessed. Results: Patients gave higher ratings on test items addressing somatic symptoms than those addressing non-somatic ones. The correlation between the absolute total scores of the BDI-II and the BDI-FS was significant (r = 0.91, p < 0.001), which indicated convergent validity. The Cronbach's alpha values indicated adequate internal consistencies for both measures (BDI-II: 0.84; BDI-FS: 0.78). There was a higher than chance level agreement of diagnoses of the two questionnaires, measured by Cohen's kappa (0.58, p < 0.001). The agreements between previous diagnosis of depression and the diagnoses of the BDI-II/BDI-FS were also significantly higher than chance level (BDI-II: 0.34, p = 0.007, BDI-FS: 0.39, p = 0.002). Additional AUC analysis across different cutoffs showed that performance of BDI-FS was better than BDI-II, supporting the observation of an equivalent or better performance of BDI-FS than BDI-II. Importantly, AUC analysis confirmed that a cutoff = 4 for BDI-FS was suitable in the considered sample of patients with PD-MCI. Discussion: In a cohort of PD-MCI, the BDI-FS demonstrates adequate psychometric properties in comparison to the BDI-II and can be used as a screening measure for assessing depression in cognitively impaired PD patients, focusing solely on psychological symptoms. Still, further research is needed to validate this instrument.
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Affiliation(s)
- Saskia Elben
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Karina Dimenshteyn
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Systems Neuroscience and Neurotechnology Unit, Faculty of Medicine, Saarland University and HTW Saarland, Homburg, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anja Ophey
- Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Patricia Sulzer
- German Center of Neurodegenerative Diseases, Eberhard Karls University Tuebingen, Tübingen, Germany.,Clinical Neurodegeneration, Hertie-Institute for Clinical Brain Research, Eberhard Karls University Tuebingen, Tübingen, Germany
| | - Sara Becker
- German Center of Neurodegenerative Diseases, Eberhard Karls University Tuebingen, Tübingen, Germany.,Clinical Neurodegeneration, Hertie-Institute for Clinical Brain Research, Eberhard Karls University Tuebingen, Tübingen, Germany
| | - Nele Schmidt
- Department of Neurology, Christian-Albrechts University of Kiel, Kiel, Germany.,Department of Neurology and Research Center Neurosensory Science, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Inken Tödt
- Department of Neurology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Karsten Witt
- Department of Neurology, Christian-Albrechts University of Kiel, Kiel, Germany.,Department of Neurology and Research Center Neurosensory Science, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Inga Liepelt-Scarfone
- German Center of Neurodegenerative Diseases, Eberhard Karls University Tuebingen, Tübingen, Germany.,Clinical Neurodegeneration, Hertie-Institute for Clinical Brain Research, Eberhard Karls University Tuebingen, Tübingen, Germany.,Studienzentrum Stuttgart, IB Hochschule, Stuttgart, Germany
| | - Rezzak Yilmaz
- German Center of Neurodegenerative Diseases, Eberhard Karls University Tuebingen, Tübingen, Germany.,Clinical Neurodegeneration, Hertie-Institute for Clinical Brain Research, Eberhard Karls University Tuebingen, Tübingen, Germany.,Department of Neurology, University of Ankara Medical School, Ankara, Turkey
| | - Elke Kalbe
- Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lars Wojtecki
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Neurology and Neurorehabilitation, Hospital zum Heiligen Geist, Kempen, Germany
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22
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Trenado C, Pedroarena-Leal N, Ruge D. Considering the Role of Neurodidactics in Medical Education as Inspired by Learning Studies and Music Education. Med Sci Educ 2021; 31:267-272. [PMID: 34457881 PMCID: PMC8368535 DOI: 10.1007/s40670-020-01176-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 06/13/2023]
Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Nicole Pedroarena-Leal
- UCL-Institute of Neurology, University College London (UCL), Queen Square, London, WC1N 3BG UK
| | - Diane Ruge
- UCL-Institute of Neurology, University College London (UCL), Queen Square, London, WC1N 3BG UK
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23
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Bruno S, Nikolov P, Hartmann CJ, Trenado C, Slotty PJ, Vesper J, Schnitzler A, Groiss SJ. Directional Deep Brain Stimulation of the Thalamic Ventral Intermediate Area for Essential Tremor Increases Therapeutic Window. Neuromodulation 2020; 24:343-352. [PMID: 32666569 DOI: 10.1111/ner.13234] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/16/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Deep brain stimulation (DBS) of the posterior subthalamic area (PSA) and the ventral intermediate thalamic nucleus (VIM) is a well-established therapy for essential tremor (ET), but it is frequently associated with side effects like dysarthria or gait ataxia. Directional DBS (dDBS) may be a way to activate fiber tracts more selectively. Is dDBS for ET superior to omnidirectional DBS (oDBS) regarding therapeutic window and clinically as effective as oDBS? MATERIALS AND METHODS Ten patients with ET treated with PSA/VIM-DBS were recruited. Therapeutic window served as primary outcome parameter; clinical efficacy, volume of neuronal activation, and total electrical energy delivered (TEED) served as secondary outcome parameters. Therapeutic window was calculated for all three dDBS directions and for oDBS by determining therapeutic thresholds and side effect thresholds. Clinical efficacy was assessed by comparing the effect of best dDBS and oDBS on tremor and ataxia rating scales, and accelerometry. Volume of neural activation and TEED were also calculated for both paradigms. RESULTS For best dDBS, therapeutic window was wider and therapeutic threshold was lower compared to oDBS. While side effect threshold did not differ, volume of neural activation was larger for dDBS. In terms of clinical efficacy, dDBS was as effective as oDBS. CONCLUSIONS dDBS for ET widens therapeutic window due to reduction of therapeutic threshold. Larger volume of neural activation for dDBS at side effect threshold supports the notion of persistent directionality even at higher intensities. dDBS may compensate for slightly misplaced leads and should be considered first line for PSA/VIM-DBS.
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Affiliation(s)
- Sabine Bruno
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Petyo Nikolov
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian J Hartmann
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Philipp J Slotty
- Department of Functional Neurosurgery and Stereotaxy, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Jan Vesper
- Department of Functional Neurosurgery and Stereotaxy, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Stefan J Groiss
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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24
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Huidobro N, Gutierrez-Gomez A, Gutierrez J, Zea I, Mendez-Balbuena I, Flores A, Trenado C, Manjarrez E. Augmenting Global Coherence in EEG Signals with Binaural or Monaural Noises. Brain Topogr 2020; 33:461-476. [PMID: 32347473 DOI: 10.1007/s10548-020-00774-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
Internal stochastic resonance (internal SR) is a phenomenon of non-linear systems in which the addition of a non-zero level of noise produces an enhancement in the coherence between two or more signals. In a previous study, we found that the simultaneous administration of multisensory visual and auditory noise augments global coherence in electroencephalographic (EEG) signals via this phenomenon. Here, we examined whether such global coherence can also be augmented with at least one noisy acoustic source. We performed experiments on healthy subjects and applied the following binaural and monaural noise-stimulation protocols. First, we administered to the left ear Gaussian noise of fixed intensity, while we delivered to the right ear a second Gaussian noise of variable intensity levels (binaural protocol). Second, we applied the Gaussian noise of the same variable intensity levels but only to one ear (monaural protocol). We performed a permutation test analysis, finding that during both noise protocols there was a significant enhancement in the global coherence in EEG signals via the occurrence of internal SR within central pathways of the auditory system.
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Affiliation(s)
- N Huidobro
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, Col. San Manuel, Puebla, Mexico
| | | | - J Gutierrez
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, Col. San Manuel, Puebla, Mexico
| | - I Zea
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, Col. San Manuel, Puebla, Mexico
| | - I Mendez-Balbuena
- Facultad de Psicología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - A Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, Col. San Manuel, Puebla, Mexico
| | - C Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Systems Neuroscience and Neurotechnology Unit, Faculty of Medicine, Saarland University and HTW Saarland, Homburg/Saar, Germany
| | - E Manjarrez
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, Col. San Manuel, Puebla, Mexico.
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25
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Hassan SS, Trenado C, Rageh TA, Schnitzler A, Groiss SJ. Effect of conditioning and test stimulus intensity on cortical excitability using triad-conditioning transcranial magnetic stimulation. Exp Brain Res 2020; 238:1305-1309. [PMID: 32322929 PMCID: PMC7237525 DOI: 10.1007/s00221-020-05812-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/13/2020] [Indexed: 01/17/2023]
Abstract
Cortical facilitation assessed with triad conditioning transcranial magnetic stimulation has been termed triad-conditioned facilitation (TCF). TCF has been supposed to reflect increased intracortical facilitation (ICF) at short interstimulus intervals (ISI) around 10 ms and an intrinsic rhythm of the motor cortex at longer ISI around 25 ms. To gain further insight into the pathophysiological mechanism of TCF, we systematically studied the effect of suprathreshold conditioning stimulus (CS) and test stimulus (TS) intensity on TCF. Various CS intensities and TS intensities were used in a triad-conditioning paradigm that was applied to 11 healthy subjects. ISI between pulses were studied between 5 and 200 ms. TCF at 10 ms ISI enhanced with increasing CS intensity but decreased with increasing TS intensity. The duration of facilitation was longer with higher CS intensity. However, TCF at 25 ms ISI could not be elicited with none of the CS and TS intensities addressed here. Our results are consistent with the notion of TCF at short ISI reflecting ICF. The enhanced and prolonged facilitation with increase of CS without additional isolated facilitation at longer ISI suggest a prolongation of ICF.
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Affiliation(s)
- Shady Safwat Hassan
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Department of Neurology, Assiut University Hospital, Assiut, Egypt
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
| | - Tarek Ali Rageh
- Department of Neurology, Assiut University Hospital, Assiut, Egypt
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University, Moorenstr 5, 40225, Düsseldorf, Germany
| | - Stefan Jun Groiss
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
- Department of Neurology, Medical Faculty, Heinrich Heine University, Moorenstr 5, 40225, Düsseldorf, Germany.
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26
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Hassan S, Trenado C, Rageh T, Schnitzler A, Groiss S. P4 Effect of conditioning and test stimulus intensity on cortical excitability by using triad-conditioning Transcranial Magnetic Stimulation. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Trenado C, González-Ramírez A, Lizárraga-Cortés V, Pedroarena Leal N, Manjarrez E, Ruge D. The Potential of Trial-by-Trial Variabilities of Ongoing-EEG, Evoked Potentials, Event Related Potentials and fMRI as Diagnostic Markers for Neuropsychiatric Disorders. Front Neurosci 2019; 12:850. [PMID: 31379473 PMCID: PMC6657500 DOI: 10.3389/fnins.2018.00850] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/30/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carlos Trenado
- Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
| | - Anaí González-Ramírez
- Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany.,Integrative Neurophysiology and Neurophysics, Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Victoria Lizárraga-Cortés
- Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany.,Integrative Neurophysiology and Neurophysics, Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Nicole Pedroarena Leal
- Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
| | - Elias Manjarrez
- Integrative Neurophysiology and Neurophysics, Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Diane Ruge
- Translational Neuromodulation Unit, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
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Dresler M, Sandberg A, Bublitz C, Ohla K, Trenado C, Mroczko-Wąsowicz A, Kühn S, Repantis D. Hacking the Brain: Dimensions of Cognitive Enhancement. ACS Chem Neurosci 2019; 10:1137-1148. [PMID: 30550256 PMCID: PMC6429408 DOI: 10.1021/acschemneuro.8b00571] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/14/2018] [Indexed: 12/11/2022] Open
Abstract
In an increasingly complex information society, demands for cognitive functioning are growing steadily. In recent years, numerous strategies to augment brain function have been proposed. Evidence for their efficacy (or lack thereof) and side effects has prompted discussions about ethical, societal, and medical implications. In the public debate, cognitive enhancement is often seen as a monolithic phenomenon. On a closer look, however, cognitive enhancement turns out to be a multifaceted concept: There is not one cognitive enhancer that augments brain function per se, but a great variety of interventions that can be clustered into biochemical, physical, and behavioral enhancement strategies. These cognitive enhancers differ in their mode of action, the cognitive domain they target, the time scale they work on, their availability and side effects, and how they differentially affect different groups of subjects. Here we disentangle the dimensions of cognitive enhancement, review prominent examples of cognitive enhancers that differ across these dimensions, and thereby provide a framework for both theoretical discussions and empirical research.
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Affiliation(s)
- Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour , Radboud University Medical Centre , Nijmegen 6525 EN , The Netherlands
| | - Anders Sandberg
- Future of Humanity Institute , Oxford University , Oxford OX1 1PT , United Kingdom
| | | | - Kathrin Ohla
- Institute of Neuroscience and Medicine, Cognitive Neuroscience (INM3) , Forschungszentrum Jülich , Jülich 52428 , Germany
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology , Heinrich Heine University Düsseldorf , Düsseldorf 40225 , Germany
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors , TU Dortmund , Dortmund 44139 , Germany
| | | | - Simone Kühn
- Max Planck Institute for Human Development , Berlin 14195 , Germany
- Department of Psychiatry and Psychotherapy , University Clinic Hamburg Eppendorf , Hamburg 20246 , Germany
| | - Dimitris Repantis
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin 12203 , Germany
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Abstract
Multisensory integration is essential for maintenance of motor and cognitive abilities, thereby ensuring normal function and personal autonomy. Balance control is challenged during senescence or in motor disorders, leading to potential falls. Increased uncertainty in sensory signals is caused by a number of factors including noise, defined as a random and persistent disturbance that reduces the clarity of information. Counter-intuitively, noise can be beneficial in some conditions. Stochastic resonance is a mechanism whereby a particular level of noise actually enhances the response of non-linear systems to weak sensory signals. Here we review the effects of stochastic resonance on sensory modalities and systems directly involved in balance control. We highlight its potential for improving sensorimotor performance as well as cognitive and autonomic functions. These promising results demonstrate that stochastic resonance represents a flexible and non-invasive technique that can be applied to different modalities simultaneously. Finally we point out its benefits for a variety of scenarios including in ambulant elderly, skilled movements, sports and to patients with sensorimotor or autonomic dysfunctions.
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Affiliation(s)
- Olivier White
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France.,Acquired Brain Injury Rehabilitation, Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Jan Babič
- Laboratory for Neuromechanics and Biorobotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Carlos Trenado
- Leibniz Research Centre for Working Environment and Human Factors TU Dortmund (ifADO), Institute of Clinical Neuroscience and Medical Psychology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Leif Johannsen
- Acquired Brain Injury Rehabilitation, Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Nandu Goswami
- Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
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Abstract
Animals having a tendency to align their velocities to an average of those of their neighbors may flock as illustrated by the Vicsek model and its variants. If, in addition, they feel a systematic contrarian trend, the result may be a time periodic adjustment of the flock or period doubling in time. These exotic phases are predicted from kinetic theory and numerically found in a modified two-dimensional Vicsek model of self-propelled particles. Numerical simulations demonstrate striking effects of alignment noise on the polarization order parameter measuring particle flocking: maximum polarization length is achieved at an optimal nonzero noise level. When contrarian compulsions are more likely than conformist ones, nonuniform polarized phases appear as the noise surpasses threshold.
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Affiliation(s)
- L L Bonilla
- G. Millán Institute for Fluid Dynamics, Nanoscience and Industrial Mathematics, and Department of Materials Science and Engineering and Chemical Engineering, Universidad Carlos III de Madrid, 28911 Leganés, Spain
- Courant Institute for Mathematical Sciences, New York University, 251 Mercer St., New York, New York 10012, USA
| | - C Trenado
- G. Millán Institute for Fluid Dynamics, Nanoscience and Industrial Mathematics, and Department of Materials Science and Engineering and Chemical Engineering, Universidad Carlos III de Madrid, 28911 Leganés, Spain
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Trenado C, Boschheidgen M, Rübenach J, N'Diaye K, Schnitzler A, Mallet L, Wojtecki L. Assessment of Metacognition and Reversal Learning in Parkinson's Disease: Preliminary Results. Front Hum Neurosci 2018; 12:343. [PMID: 30254576 PMCID: PMC6141660 DOI: 10.3389/fnhum.2018.00343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/10/2018] [Indexed: 12/12/2022] Open
Abstract
Reversal learning (RL) has been widely used for assessment of behavioral adaptation, impulsivity, obsession, and compulsion in healthy controls as well as people suffering from psychiatric and neurological disorders such as Parkinson’s disease (PD). Nevertheless, studies addressing high cognitive functions such as metacognition in PD are scarce. Here, we address for the first time the effect of levodopa and PD on metacognition within the framework of a RL paradigm. In agreement with previous reports, PD patients exhibited reversal shifting impairment with respect to healthy controls (CTRL) regardless of medication condition (MED-ON and MED-OFF), which was supported by a well-known model of learning conditioning (Rescorla–Wagner). In spite that we found a significant association between accuracy and decision confidence level for MED-OFF and CTRL, analysis of metacognitive sensitivity assessed by type 2 signal detection theory (SDT) revealed only a significant underperformance for patients without medication (MED-OFF). This finding points toward a non-compromising positive effect of dopaminergic medication on metacognition for PD.
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Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Department of Psychology and Neurosciences, Translational Neuromodulation Unit, Leibniz Research Centre for Working Environment and Human Factors, TU Dortmund, Dortmund, Germany
| | - Matthias Boschheidgen
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Julia Rübenach
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Karim N'Diaye
- Institut du Cerveau et de la Moelle Épinière, Hôpital Pitié Salpêtrière, Paris, France
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Luc Mallet
- Institut du Cerveau et de la Moelle Épinière, Hôpital Pitié Salpêtrière, Paris, France
| | - Lars Wojtecki
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Mendez-Balbuena I, Arrieta P, Huidobro N, Flores A, Lemuz-Lopez R, Trenado C, Manjarrez E. Augmenting EEG-global-coherence with auditory and visual noise: Multisensory internal stochastic resonance. Medicine (Baltimore) 2018; 97:e12008. [PMID: 30170407 PMCID: PMC6393074 DOI: 10.1097/md.0000000000012008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The present investigation documents the electrophysiological occurrence of multisensory internal stochastic resonance (MISR) in the human electroencephalographic (EEG) coherence elicited by auditory and visual noise.We define MISR of EEG coherence as the phenomenon for which an intermediate level of input noise of a sensory modality enhances EEG coherence in response to another noisy sensory modality. Here, EEG coherence is computed by the global weighted coherence (GWC), modulated by quasi-Brownian noise. Specifically, we examined whether a particular level of auditory noise together with constant visual noise (experimental condition 1) and a specified level of visual noise together with constant auditory noise (experimental condition 2), improves EEG's GWC. We compared GWC between ongoing EEG basal activity (BA), zero noise (ZN), optimal noise (ON), and high noise (HN).The data disclosed an intermediate level of input noise that enhances the GWC for the majority of the subjects, thus demonstrating for the first time the occurrence of multisensory internal stochastic resonance (SR) in visuoauditory processing within the central nervous system.
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Affiliation(s)
| | | | | | | | - Rafael Lemuz-Lopez
- Faculty of Computational Sciences, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Carlos Trenado
- Department of Psychology and Neurosciences, Translational Neuromodulation Unit, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
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Moldovan AS, Hartmann CJ, Trenado C, Meumertzheim N, Slotty PJ, Vesper J, Schnitzler A, Groiss SJ. Less is more - Pulse width dependent therapeutic window in deep brain stimulation for essential tremor. Brain Stimul 2018; 11:1132-1139. [PMID: 29735344 DOI: 10.1016/j.brs.2018.04.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Shorter pulse widths than conventional pulse width settings may lead to reduction of side effects and therefore be a valuable therapeutic option for deep brain stimulation (DBS) in patients with essential tremor (ET). OBJECTIVE To compare the DBS effect of shorter pulse width at 40 μs (DBS-40 μs) to conventional pulse width at 60 μs (DBS-60 μs) on the therapeutic window in ET patients. METHODS For this prospective, randomized, double-blind, crossover study 9 ET patients with chronic DBS of the ventral intermediate nucleus (VIM)/posterior subthalamic area (PSA) were recruited. Therapeutic window was calculated by determining efficacy and side effect thresholds for DBS-40 μs and DBS-60 μs. Tremor Rating Scales and Kinesia tremor analyses were used to compare clinical efficacy between the considered settings and deactivated DBS (DBS-OFF). Volume of neural activation (VNA) was calculated for both efficacy and side effect thresholds at each pulse width. RESULTS DBS-40 μs showed a significantly larger therapeutic window than DBS-60 μs mainly due to higher side-effect thresholds. Both conditions significantly improved tremor compared to DBS-OFF, while efficacy was comparable between DBS-40 μs and DBS-60 μs. Moreover, VNA at efficacy threshold was smaller and less energy was required for tremor suppression with DBS-40 μs compared to DBS-60 μs. CONCLUSIONS VIM/PSA-DBS with short pulse width represents a promising programming option for DBS in ET as it reduces side effects while maintaining efficient tremor suppression. Furthermore, our data support the notion of pulse width dependent selective modulation of distinct fiber tracts leading to widening of the therapeutic window.
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Affiliation(s)
- Alexia-Sabine Moldovan
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Christian Johannes Hartmann
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Carlos Trenado
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Department of Psychology and Neurosciences, Translational Neuromodulation Unit, Leibniz Centre for Working Environment and Human Factors, TU Dortmund, Dortmund, Germany
| | - Nicola Meumertzheim
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Philipp Jörg Slotty
- Department of Functional and Stereotactic Neurosurgery, Center for Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Jan Vesper
- Department of Functional and Stereotactic Neurosurgery, Center for Neuromodulation, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Alfons Schnitzler
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Stefan Jun Groiss
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
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Padilla-Vazquez F, Zenteno MA, Balderrama J, Escobar-de la Garma VH, Juan DS, Trenado C. A proposed classification for assessing rupture risk in patients with intracranial arteriovenous malformations. Surg Neurol Int 2017; 8:303. [PMID: 29404190 PMCID: PMC5764916 DOI: 10.4103/sni.sni_273_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/19/2017] [Indexed: 11/12/2022] Open
Abstract
Background: Whether cerebral arteriovenous malformations (AVMs) should be treated remains an ongoing debate. Nevertheless, there is a need for predictive factors that assist in labelling lesions as low or high risk for future rupture. Our aim was to design a new classification that would consider hemodynamic and anatomic factors in the rapid assessment of rupture risk in patients with AVMs. Methods: This was a retrospective study that included 639 patients with ruptured and unruptured AVMs. We proposed a new classification score (1–4 points) for AVM rupture risk using three factors: feeding artery mean velocity (Vm), nidus size, and type of venous drainage. We employed descriptive statistics and logistic regression analysis. Results: A total of 639 patients with cerebral AVMs, 388 (60%) had unruptured AVMs and 251 (40%) had ruptured AVMs. Logistic regression analysis revealed a significant effect of Vm, nidus size, and venous drainage type in accounting for the variability of rupture odds (P = 0.0001, R2 = 0.437) for patients with AVMs. Based in the odds ratios, grades 1 and 2 of the proposed classification were corresponded to low risk of hemorrhage, while grades 3 and 4 were associated with hemorrhage: 1 point OR = (0.107 95% CI; 0.061–0.188), 2 point OR = (0.227 95% CI; 0.153–0.338), 3 point OR = (3.292 95% CI; 2.325–4.661), and 4 point OR = (23.304 95% CI; 11.077–49.027). Conclusion: This classification is useful and easy to use, and it may allow for the individualisation of each cerebral AVM and the assessment of rupture risk based on a model of categorisation.
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Affiliation(s)
- Felipe Padilla-Vazquez
- Department of Neuroendovascular Therapy, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico city, Mexico
| | - Marco A Zenteno
- Department of Neuroendovascular Therapy, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico city, Mexico
| | - Jorge Balderrama
- Department of Neuroendovascular Therapy, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico city, Mexico
| | - Victor Hugo Escobar-de la Garma
- Department of Neuroendovascular Therapy, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico city, Mexico
| | - Daniel San Juan
- Department of Clinical Research, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico city, Mexico
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, University Hospital Düsseldorf, Germany
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Alonso-Vanegas MA, Freire Carlier ID, San-Juan D, Martínez AR, Trenado C. Parahippocampectomy as a New Surgical Approach to Mesial Temporal Lobe Epilepsy Caused By Hippocampal Sclerosis: A Pilot Randomized Comparative Clinical Trial. World Neurosurg 2017; 110:e1063-e1071. [PMID: 29229342 DOI: 10.1016/j.wneu.2017.11.170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE The parahippocampal gyrus plays an important role in the epileptogenic pathways of mesial temporal lobe epilepsy caused by hippocampal sclerosis (mTLE-HS); its resection could prevent epileptic seizures with fewer complications. This study evaluates the initial efficacy and safety of anterior temporal lobectomy (ATL), selective amygdalohipppocampectomy (SAH), and parahippocampectomy (PHC) surgical approaches in mTLE-HS. METHODS A randomized comparative pilot clinical trial (2008-2011) was performed that included patients with mTLE-HS who underwent ATL, trans-T3 SAH, and trans-T3 PHC. Their sociodemographic characteristics, visual field profiles, verbal and visual memory profiles, and Engel scale outcome at baseline and at 1 and 5 years are described, using descriptive statistics along with parametric and nonparametric tests. RESULTS Forty-three patients with a mean age of 35.2 years (18-56 years), 65% female, were analyzed: 14 underwent PHC, 14 ATL, and 15 SAH. The following percentages refer to those patients who were seizure free (Engel class IA) at 1-year and 5-year follow-up, respectively: 42.9% PHC, 71.4% ATL, and 60% SAH (P = 0.304); 28.6% PHC, 50% ATL, and 53.3% SAH (P = 0.353). Postoperative visual field deficits were 0% PHC, 85.7% ATL, and 46.7% SAH (P = 0.001). Verbal and/or visual memory worsening were present in 21.3% PHC, 42.8% ATL, and 33.4% SAH (P = 0.488) and preoperative and postoperative visual memory scores were significantly different in the SAH group only (P = 0.046). CONCLUSIONS PHC, ALT, and SAH show a preliminary similar efficacy in short-term seizure-free rates in patients with mTLE-HS. However, PHC efficacy in the long-term decreases compared with the other surgical techniques. PHC does not produce postoperative visual field deficits.
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Affiliation(s)
| | - Iván D Freire Carlier
- Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Daniel San-Juan
- Department of Clinical Neurophysiology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
| | - Alma Rosa Martínez
- Department of Neuropsychology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, University Hospital Düsseldorf, Düsseldorf, Germany
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Trenado C, Elben S, Friggemann L, Groiss SJ, Vesper J, Schnitzler A, Wojtecki L. Intraoperative Localization of the Subthalamic Nucleus Using Long-Latency Somatosensory Evoked Potentials. Neuromodulation 2017; 21:582-587. [PMID: 29164724 DOI: 10.1111/ner.12727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/25/2017] [Accepted: 09/22/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Target localization for deep brain stimulation (DBS) is a challenging step that determines not only the correct placement of stimulation electrodes, but also influences the success of the DBS procedure as reflected in the desired clinical outcome of a patient. OBJECTIVE We report on the feasibility of DBS target localization in the subthalamic nucleus (STN) by long-latency somatosensory evoked potentials (LL-SSEPs) (>40 msec) in Parkinson's disease (PD) patients. METHODS Micro-macroelectrode recordings were performed intraoperatively on seven PD patients (eight STN hemispheres) who underwent DBS treatment. LL-SSEPs were elicited by ipsi- and contralateral median nerve stimulation to the wrist. RESULTS Four distinctive LL-SSEP components were elicited ("LL-complex" consisting of P80, N100, P140, and N200). The P80 appeared as the most visible and reliable intraoperative component. Localization of the "LL-complex" within the target was approved with typical microelectrode firing activity patterns, atlas visualization of recording electrodes, and postoperative CT-based visualization of final DBS electrodes. CONCLUSIONS LL-SSEPs represent a promising approach for DBS target localization in the STN, provided deeper understanding on their anesthesia effect is obtained. This approach is advantageous in that it does not require the patient's participation in an intraoperative setting.
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Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.,Department of Neurology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Saskia Elben
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.,Department of Neurology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Lena Friggemann
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Stefan Jun Groiss
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.,Department of Neurology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Jan Vesper
- Department of Functional and Stereotactic Neurosurgery, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.,Department of Neurology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Lars Wojtecki
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.,Department of Neurology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
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Hassan SS, Trenado C, Elben S, Schnitzler A, Groiss SJ. Alteration of cortical excitability and its modulation by Miglustat in Niemann-Pick disease type C. J Clin Neurosci 2017; 47:214-217. [PMID: 29074317 DOI: 10.1016/j.jocn.2017.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Abstract
Niemann-Pick type C (NP-C) is a rare, neurodegenerative, lysosomal storage disease. Cortical excitability using different transcranial magnetic stimulation (TMS) protocols together with clinical and neuropsychological testing was longitudinally assessed in a patient with NP-C. Cerebellar inhibition, a measure for the integrity of the cerebello-thalamo-cortical network, was impaired. Short-latency afferent inhibition, a measure for cholinergic transmission, and cognitive functions were also impaired and improved under Miglustat treatment. Short interval intracortical facilitation, a marker for glutamatergic neurotransmission, was absent initially but increased after treatment with Miglustat. Our results provide new insights into pathophysiological mechanisms of NP-C and the response to Miglustat treatment.
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Affiliation(s)
- Shady Safwat Hassan
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Neurology, Assiut University Hospital, Assiut, Egypt
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Saskia Elben
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Stefan Jun Groiss
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
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Ramírez MIG, Rodríguez-Arias LR, Santiago AO, Pizano AL, Zamora RL, Gregorio RV, Trenado C, Sánchez HMG, San-Juan D. Correlation Between Bispectral Index and Electrocorticographic Features During Epilepsy Surgery. Clin EEG Neurosci 2017; 48:272-279. [PMID: 27325591 DOI: 10.1177/1550059416654850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Surgical resection guided by intraoperative electrocorticography (iECoG) has been in clinical use for many decades. The use of the bispectral index (BIS) for monitoring depth of anesthesia during different types of surgery, including epilepsy surgery, is increasing nowadays. The BIS is an EEG-derived variable indicating cortical electrical activity. However, the correlation between the BIS score and the iECoG score, with the purpose of optimizing the quality and time of the iECoG recordings in epilepsy surgery is unknown. The goal of this study was to evaluate the correlation between BIS values and iECoG parameters during the epilepsy surgery under anesthesia with propofol and fentanyl. This is a prospective study that included patients with epilepsy who underwent epilepsy surgery guided by BIS and iECoG (September 2008 to October 2013). Clinical, physiological, and sociodemographic characteristics are shown. We correlated the iECoG parameters (presence of burst suppressions [BS], suppression time [seconds], background frequency [Hz], and type of iECoG score by Mathern et al) with BIS values. We included 28 patients, 15/28 (53.5%) female, general mean age of 30.5 years (range 13-56 years). Patients underwent epilepsy surgery: 22/28 (79%) temporal and 6/28 (21%) extratemporal. We found a nonlinear polynomial cubic relationship between the mentioned variables noting that a BIS range of 40 to 60 gave the following results: iECoG BS periods <5 seconds, background frequency 10 to 17 Hz, and iECoG score 2 characterized by lack of >20-Hz background frequencies. No BS were observed with a BIS > 60. In conclusion BIS values and iECoG parameters during the epilepsy surgery under anesthesia with propofol and fentanyl have a nonlinear correlation. BS patterns were not found with a BIS > 60. These findings show that BIS is a nonlinear multidimensional measure, which possesses high variability with the iECoG parameters. BS patterns are not found with BIS > 60.
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Affiliation(s)
| | | | - Areli O Santiago
- 1 Neuroanesthesiology Department. National Institute of Neurology, Mexico City, Mexico
| | | | | | - Rafael V Gregorio
- 3 Clinical Neurophysiology Department, National Institute of Neurology, Mexico City, Mexico
| | - Carlos Trenado
- 4 Institute of Clinical Neuroscience and Medical Psychology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Héctor Manuel G Sánchez
- 5 Faculty of Medicine of the Autonomous University of Baja California, Campus of Mexicali, Mexicali, Baja California, Mexico
| | - Daniel San-Juan
- 3 Clinical Neurophysiology Department, National Institute of Neurology, Mexico City, Mexico
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Groiss SJ, Mochizuki H, Hanajima R, Trenado C, Nakatani-Enomoto S, Otani K, Ugawa Y. Impairment of triad conditioned facilitation in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2017; 18:604-610. [PMID: 28485644 DOI: 10.1080/21678421.2017.1321676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The triad conditioned facilitation (TCF) technique has been shown to detect motor cortical intrinsic rhythms depending on the functioning of specific cortical layers by measuring motor evoked potential (MEP) enhancement after a triad of conditioning TMS pulses at a certain interval. However, the influence of cortical degeneration on TCF is still undetermined. We therefore studied TCF in patients with amyotrophic lateral sclerosis (ALS), a neurodegenerative disorder characterised by degeneration of the motor cortex. METHODS Thirteen patients with ALS and 11 age-matched disease control patients with cervical myelopathy (CM) or radiculopathy (CR) participated in the study. We studied short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and TCF using the paired-pulse and triad conditioned TMS paradigm. RESULTS TCF was significantly reduced in ALS patients compared to CM/CR patients, who had normal TCF. SICI and ICF did not differ between groups. CONCLUSION The absence of TCF with preserved SICI and ICF suggests changes in the intrinsic rhythm generation within the motor cortex due to cortical neurodegeneration in ALS patients. In contrast, TCF was normal in patents with CM/CR in whom the motor cortical intrinsic circuits are not involved. This technique may be valuable to differentiate patients with ALS from those with CM/CR.
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Affiliation(s)
- Stefan J Groiss
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan.,b Department of Neurology & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty , Heinrich-Heine-University , Düsseldorf , Germany
| | - Hitoshi Mochizuki
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan.,c Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine , University of Miyazaki , Miyazaki , Japan
| | - Ritsuko Hanajima
- d Department of Neurology , Kitasato University School of Medicine , Sagamihara , Japan
| | - Carlos Trenado
- b Department of Neurology & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty , Heinrich-Heine-University , Düsseldorf , Germany
| | - Setsu Nakatani-Enomoto
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan
| | - Koji Otani
- e Department of Orthopedic Surgery, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan , and
| | - Yoshikazu Ugawa
- a Department of Neurology, Faculty of Medicine , Fukushima Medical University , Fukushima , Japan.,f Neurology , Fukushima Global Medical Science Center, Advanced Clinical Research Center, Fukushima Medical University , Fukushima , Japan
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González-Camarena PI, San-Juan D, González-Olhovich I, Rodríguez-Arévalo D, Lozano-Elizondo D, Trenado C, Anschel DJ. Dynamic changes of the intraocular pressure and the pressure of cerebrospinal fluid in nonglaucomatous neurological patients. Acta Ophthalmol 2017; 95:e138-e143. [PMID: 27775228 DOI: 10.1111/aos.13236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/25/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the dynamic changes of the intraocular pressure (IOP) and intracranial pressure (ICP) with normal or pathological values (intracranial hypertension) in nonglaucomatous neurological patients during lumbar punction (LP). METHODS Case-control study, prospective measurement of tonometry in both groups referred for LP. Intraocular pressure, ICP and translaminar pressure difference (TPD) were compared pre- and post-LP. RESULTS Thirty-six patients (72 eyes) with mean age of 38.5 (16-64) years and BMI of 26.81 kg/m2 were analysed. The initial mean ICP was 12.81 (± 6.6) mmHg. The mean TPD before and after the LP was 1.48 mmHg and 0.65 mmHg, respectively. The mean IOP of both eyes decreased to 0.8 mmHg post-LP in patients with pathological ICP (p = 0.0193) and normal ICP (p = 0.006). CONCLUSIONS We found a statistically significant decrease of the IOP post-LP compared to the pre-LP in both groups, being higher in patients with pathological ICP. There were no significant differences of the IOP in patients with normal versus pathological ICP pre-LP/post-LP; neither was found a correlation between ICP and IOP.
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Affiliation(s)
| | - Daniel San-Juan
- Clinical Research Department; National Institute of Neurology and Neurosurgery; Mexico City Mexico
- ABC Medical Center at Santa Fe; Mexico City Mexico
| | - Irene González-Olhovich
- Neuro-Ophthalmology Department; National Institute of Neurology and Neurosurgery; Mexico City Mexico
| | | | - David Lozano-Elizondo
- Neuro-Ophthalmology Department; National Institute of Neurology and Neurosurgery; Mexico City Mexico
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology; University Hospital Düsseldorf; Düsseldorf Germany
| | - David J. Anschel
- Comprehensive Epilepsy Center of Long Island; St. Charles Hospital; Port Jefferson NY USA
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Alonso-Vanegas MA, San-Juan D, Buentello García RM, Castillo-Montoya C, Sentíes-Madrid H, Mascher EB, Bialik PS, Trenado C. Long-term surgical results of supplementary motor area epilepsy surgery. J Neurosurg 2017; 127:1153-1159. [PMID: 28156248 DOI: 10.3171/2016.8.jns16333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Supplementary motor area (SMA) epilepsy is a well-known clinical condition; however, long-term surgical outcome reports are scarce and correspond to small series or isolated case reports. The aim of this study is to present the surgical results of SMA epilepsy patients treated at 2 reference centers in Mexico City. METHODS For this retrospective descriptive study (1999-2014), 52 patients underwent lesionectomy and/or corticectomy of the SMA that was guided by electrocorticography (ECoG). The clinical, neurophysiological, neuroimaging, and pathological findings are described. The Engel scale was used to classify surgical outcome. Descriptive statistics, Student t-test, and Friedman, Kruskal-Wallis, and chi-square tests were used. RESULTS Of these 52 patients, the mean age at epilepsy onset was 26.3 years, and the mean preoperative seizure frequency was 14 seizures per month. Etiologies included low-grade tumors in 28 (53.8%) patients, cortical dysplasia in 17 (32.7%) patients, and cavernomas in 7 (13.5%) patients. At a mean follow-up of 5.7 years (range 1-10 years), 32 patients (61%) were classified as Engel Class I, 16 patients (31%) were classified as Engel Class II, and 4 (8%) patients were classified as Engel Class III. Overall seizure reduction was significant (p = 0.001). The absence of early postsurgical seizures and lesional etiology were associated with the outcome of Engel Class I (p = 0.05). Twenty-six (50%) patients had complications in the immediate postoperative period, all of which resolved completely with no residual neurological deficits. CONCLUSIONS Surgery for SMA epilepsy guided by ECoG using a multidisciplinary and multimodality approach is a safe, feasible procedure that shows good seizure control, moderate morbidity, and no mortality.
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Affiliation(s)
- Mario A Alonso-Vanegas
- Departments of 1 Neurosurgery and.,Clinical Neurophysiology, Centro Neurológico ABC, Centro Médico ABC Santa Fe, Mexico City
| | - Daniel San-Juan
- Clinical Neurophysiology, National Institute of Neurology and Neurosurgery, Mexico City.,Clinical Neurophysiology, Centro Neurológico ABC, Centro Médico ABC Santa Fe, Mexico City
| | | | | | - Horacio Sentíes-Madrid
- Department of Neurology, National Institute of Medical Science and Nutrition, Mexico City, Mexico ; and
| | | | - Paul Shkurovick Bialik
- Clinical Neurophysiology, Centro Neurológico ABC, Centro Médico ABC Santa Fe, Mexico City
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, University Hospital Düsseldorf, Germany
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42
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San-Juan D, Espinoza López DA, Vázquez Gregorio R, Trenado C, Fernández-González Aragón M, Morales-Quezada L, Hernandez Ruiz A, Hernandez-González F, Alcaraz-Guzmán A, Anschel DJ, Fregni F. Transcranial Direct Current Stimulation in Mesial Temporal Lobe Epilepsy and Hippocampal Sclerosis. Brain Stimul 2017; 10:28-35. [DOI: 10.1016/j.brs.2016.08.013] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 08/23/2016] [Accepted: 08/29/2016] [Indexed: 11/26/2022] Open
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Alonso-Vanegas MA, Buentello Garcia RM, Castillo-Montoya C, San-Juan D, Senties-Madrid H, Mascher EB, Bialik PS, Trenado C. 54. Long term surgical results in supplementary motor area epilepsy surgery. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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44
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Trenado C, Elben S, Petri D, Hirschmann J, Groiss SJ, Vesper J, Schnitzler A, Wojtecki L. Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans. J Vis Exp 2016. [PMID: 27286467 DOI: 10.3791/53466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging (fMRI) for extracting crucial information about the mechanism of the human brain, such methods remain insufficient to provide information about physiological processes reflecting cognitive and emotional functions at the subcortical level. In this respect, modern invasive clinical approaches in humans, such as deep brain stimulation (DBS), offer a tremendous possibility to record subcortical brain activity, namely local field potentials (LFPs) representing coherent activity of neural assemblies from localized basal ganglia or thalamic regions. Notwithstanding the fact that invasive approaches in humans are applied only after medical indication and thus recorded data correspond to altered brain circuits, valuable insight can be gained regarding the presence of intact brain functions in relation to brain oscillatory activity and the pathophysiology of disorders in response to experimental cognitive paradigms. In this direction, a growing number of DBS studies in patients with Parkinson's disease (PD) target not only motor functions but also higher level processes such as emotions, decision-making, attention, memory and sensory perception. Recent clinical trials also emphasize the role of DBS as an alternative treatment in neuropsychiatric disorders ranging from obsessive compulsive disorder (OCD) to chronic disorders of consciousness (DOC). Consequently, we focus on the use of combined invasive (LFP) and non-invasive (EEG) human brain recordings in assessing the role of cortical-subcortical structures in cognitive and emotional processing trough experimental paradigms (e.g. speech stimuli with emotional connotation or paradigms of cognitive control such as the Flanker task), for patients undergoing DBS treatment.
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Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University
| | - Saskia Elben
- Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - David Petri
- Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Jan Hirschmann
- Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Stefan J Groiss
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University; Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Jan Vesper
- Department of Neurosurgery, Functional Neurosurgery and Stereotaxy, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University; Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Lars Wojtecki
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University; Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf;
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Méndez-Balbuena I, Huidobro N, Silva M, Flores A, Trenado C, Quintanar L, Arias-Carrión O, Kristeva R, Manjarrez E. Effect of mechanical tactile noise on amplitude of visual evoked potentials: multisensory stochastic resonance. J Neurophysiol 2015; 114:2132-43. [PMID: 26156387 DOI: 10.1152/jn.00457.2015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 07/06/2015] [Indexed: 11/22/2022] Open
Abstract
The present investigation documents the electrophysiological occurrence of multisensory stochastic resonance in the human visual pathway elicited by tactile noise. We define multisensory stochastic resonance of brain evoked potentials as the phenomenon in which an intermediate level of input noise of one sensory modality enhances the brain evoked response of another sensory modality. Here we examined this phenomenon in visual evoked potentials (VEPs) modulated by the addition of tactile noise. Specifically, we examined whether a particular level of mechanical Gaussian noise applied to the index finger can improve the amplitude of the VEP. We compared the amplitude of the positive P100 VEP component between zero noise (ZN), optimal noise (ON), and high mechanical noise (HN). The data disclosed an inverted U-like graph for all the subjects, thus demonstrating the occurrence of a multisensory stochastic resonance in the P100 VEP.
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Affiliation(s)
| | - Nayeli Huidobro
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Mayte Silva
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Amira Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Carlos Trenado
- Institute of Clinical Neuroscience, Heinrich Heine University, Düsseldorf, Germany
| | - Luis Quintanar
- Facultad de Psicología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Oscar Arias-Carrión
- Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Dr. Manuel Gea González/IFC-UNAM, Mexico City, Mexico; and
| | - Rumyana Kristeva
- Department of Neurology, University of Freiburg, Freiburg, Germany
| | - Elias Manjarrez
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico;
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Trenado C. Commentary: EEG beta suppression and low gamma modulation are different elements of human upright walking. Front Hum Neurosci 2015; 9:380. [PMID: 26167148 PMCID: PMC4481860 DOI: 10.3389/fnhum.2015.00380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/15/2015] [Indexed: 12/30/2022] Open
Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience, Heinrich Heine University Düsseldorf Düsseldorf, Germany
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47
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Trenado C, Amtage F, Huethe F, Schulte-Mönting J, Mendez-Balbuena I, Baker SN, Baker M, Hepp-Reymond MC, Manjarrez E, Kristeva R. Suppression of enhanced physiological tremor via stochastic noise: initial observations. PLoS One 2014; 9:e112782. [PMID: 25397577 PMCID: PMC4232445 DOI: 10.1371/journal.pone.0112782] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 10/15/2014] [Indexed: 11/18/2022] Open
Abstract
Enhanced physiological tremor is a disabling condition that arises because of unstable interactions between central tremor generators and the biomechanics of the spinal stretch reflex. Previous work has shown that peripheral input may push the tremor-related spinal and cortical systems closer to anti-phase firing, potentially leading to a reduction in tremor through phase cancellation. The aim of the present study was to investigate whether peripherally applied mechanical stochastic noise can attenuate enhanced physiological tremor and improve motor performance. Eight subjects with enhanced physiological tremor performed a visuomotor task requiring the right index finger to compensate a static force generated by a manipulandum to which Gaussian noise (3–35 Hz) was applied. The finger position was displayed on-line on a monitor as a small white dot which the subjects had to maintain in the center of a larger green circle. Electromyogram (EMG) from the active hand muscles and finger position were recorded. Performance was measured by the mean absolute deviation of the white dot from the zero position. Tremor was identified by the acceleration in the frequency range 7–12 Hz. Two different conditions were compared: with and without superimposed noise at optimal amplitude (determined at the beginning of the experiment). The application of optimum noise reduced tremor (accelerometric amplitude and EMG activity) and improved the motor performance (reduced mean absolute deviation from zero). These data provide the first evidence of a significant reduction of enhanced physiological tremor in the human sensorimotor system due to application of external stochastic noise.
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Affiliation(s)
- Carlos Trenado
- Department of Neurology and Neurophysiology, University Freiburg, Freiburg, Germany
| | - Florian Amtage
- Department of Neurology and Neurophysiology, University Freiburg, Freiburg, Germany
| | - Frank Huethe
- Department of Neurology and Neurophysiology, University Freiburg, Freiburg, Germany
| | - Jürgen Schulte-Mönting
- Institute for Medical Biometry and Medical Informatics, University Freiburg, Freiburg, Germany
| | | | - Stuart N. Baker
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mark Baker
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Elias Manjarrez
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México
- * E-mail: (RK); (EM)
| | - Rumyana Kristeva
- Department of Neurology and Neurophysiology, University Freiburg, Freiburg, Germany
- * E-mail: (RK); (EM)
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Trenado C, Mendez-Balbuena I, Manjarrez E, Huethe F, Schulte-Moenting J, Feige B, Hepp-Reymond MC, Kristeva R. P861: The long-range corticomuscular synchronization as the neural correlate of the internal stochastic resonance phenomenon. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Trenado C, Mendez-Balbuena I, Manjarrez E, Huethe F, Schulte-Mönting J, Feige B, Hepp-Reymond MC, Kristeva R. Enhanced corticomuscular coherence by external stochastic noise. Front Hum Neurosci 2014; 8:325. [PMID: 24904365 PMCID: PMC4033016 DOI: 10.3389/fnhum.2014.00325] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 04/30/2014] [Indexed: 11/15/2022] Open
Abstract
Noise can have beneficial effects as shown by the stochastic resonance (SR) phenomenon which is characterized by performance improvement when an optimal noise is added. Modern attempts to improve human performance utilize this phenomenon. The purpose of the present study was to investigate whether performance improvement by addition of optimum noise (ON) is related to increased cortical motor spectral power (SP) and increased corticomuscular coherence. Eight subjects performed a visuomotor task requiring to compensate with the right index finger a static force (SF) generated by a manipulandum on which Gaussian noise was applied. The finger position was displayed on-line on a monitor as a small white dot which the subjects had to maintain in the center of a green bigger circle. Electroencephalogram from the contralateral motor area, electromyogram from active muscles and finger position were recorded. The performance was measured by the mean absolute deviation (MAD) of the white dot from the zero position. ON compared to the zero noise condition induced an improvement in motor accuracy together with an enhancement of cortical motor SP and corticomuscular coherence in beta-range. These data suggest that the improved sensorimotor performance via SR is consistent with an increase in the cortical motor SP and in the corticomuscular coherence.
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Affiliation(s)
- Carlos Trenado
- Department of Neurology, University of FreiburgFreiburg, Germany
| | - Ignacio Mendez-Balbuena
- Department of Neurology, University of FreiburgFreiburg, Germany
- Facultad de Psicologia, Benemérita Universidad Autonoma de PueblaPuebla, Mexico
| | - Elias Manjarrez
- Instituto de Fisiologia, Benemérita Universidad Autonoma de PueblaPuebla, Mexico
| | - Frank Huethe
- Department of Neurology, University of FreiburgFreiburg, Germany
| | - Jürgen Schulte-Mönting
- Institute for Medical Biometry and Medical Informatics, University of FreiburgFreiburg, Germany
| | - Bernd Feige
- Department of Psychiatry, University of FreiburgFreiburg, Germany
| | | | - Rumyana Kristeva
- Department of Neurology, University of FreiburgFreiburg, Germany
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Trenado C, Mikulić A, Manjarrez E, Mendez-Balbuena I, Schulte-Mönting J, Huethe F, Hepp-Reymond MC, Kristeva R. Broad-band Gaussian noise is most effective in improving motor performance and is most pleasant. Front Hum Neurosci 2014; 8:22. [PMID: 24550806 PMCID: PMC3910318 DOI: 10.3389/fnhum.2014.00022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/10/2014] [Indexed: 11/23/2022] Open
Abstract
Modern attempts to improve human performance focus on stochastic resonance (SR). SR is a phenomenon in non-linear systems characterized by a response increase of the system induced by a particular level of input noise. Recently, we reported that an optimum level of 0–15 Hz Gaussian noise applied to the human index finger improved static isometric force compensation. A possible explanation was a better sensorimotor integration caused by increase in sensitivity of peripheral receptors and/or of internal SR. The present study in 10 subjects compares SR effects in the performance of the same motor task and on pleasantness, by applying three Gaussian noises chosen on the sensitivity of the fingertip receptors (0–15 Hz mostly for Merkel receptors, 250–300 Hz for Pacini corpuscles and 0–300 Hz for all). We document that only the 0–300 Hz noise induced SR effect during the transitory phase of the task. In contrast, the motor performance was improved during the stationary phase for all three noise frequency bandwidths. This improvement was stronger for 0–300 Hz and 250–300 Hz than for 0–15 Hz noise. Further, we found higher degree of pleasantness for 0–300 Hz and 250–300 Hz noise bandwidths than for 0–15 Hz. Thus, we show that the most appropriate Gaussian noise that could be used in haptic gloves is the 0–300 Hz, as it improved motor performance during both stationary and transitory phases. In addition, this noise had the highest degree of pleasantness and thus reveals that the glabrous skin can also forward pleasant sensations.
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Affiliation(s)
- Carlos Trenado
- Department of Neurology and Neurophysiology, Albert-Ludwigs-University Freiburg, Germany
| | - Areh Mikulić
- Department of Neurology and Neurophysiology, Albert-Ludwigs-University Freiburg, Germany
| | - Elias Manjarrez
- Instituto de Fisiología, Benemérita Universidad Autonoma de Puebla Puebla, Mexico
| | | | - Jürgen Schulte-Mönting
- Institute for Medical Biometry and Medical Informatics, University of Freiburg Freiburg, Germany
| | - Frank Huethe
- Department of Neurology and Neurophysiology, Albert-Ludwigs-University Freiburg, Germany
| | | | - Rumyana Kristeva
- Department of Neurology and Neurophysiology, Albert-Ludwigs-University Freiburg, Germany
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