1
|
Russo S, Claar L, Marks L, Krishnan G, Furregoni G, Zauli FM, Hassan G, Solbiati M, d’Orio P, Mikulan E, Sarasso S, Rosanova M, Sartori I, Bazhenov M, Pigorini A, Massimini M, Koch C, Rembado I. Thalamic feedback shapes brain responses evoked by cortical stimulation in mice and humans. bioRxiv 2024:2024.01.31.578243. [PMID: 38352535 PMCID: PMC10862802 DOI: 10.1101/2024.01.31.578243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Cortical stimulation with single pulses is a common technique in clinical practice and research. However, we still do not understand the extent to which it engages subcortical circuits which contribute to the associated evoked potentials (EPs). Here we find that cortical stimulation generates remarkably similar EPs in humans and mice, with a late component similarly modulated by the subject's behavioral state. We optogenetically dissect the underlying circuit in mice, demonstrating that the late component of these EPs is caused by a thalamic hyperpolarization and rebound. The magnitude of this late component correlates with the bursting frequency and synchronicity of thalamic neurons, modulated by the subject's behavioral state. A simulation of the thalamo-cortical circuit highlights that both intrinsic thalamic currents as well as cortical and thalamic GABAergic neurons contribute to this response profile. We conclude that the cortical stimulation engages cortico-thalamo-cortical circuits highly preserved across different species and stimulation modalities.
Collapse
Affiliation(s)
- Simone Russo
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
- Department of Philosophy ‘Piero Martinetti’, University of Milan, Milan, Italy
- Brain and Consciousness, Allen Institute, Seattle, United States
- Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Leslie Claar
- Brain and Consciousness, Allen Institute, Seattle, United States
| | - Lydia Marks
- Brain and Consciousness, Allen Institute, Seattle, United States
| | - Giri Krishnan
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Giulia Furregoni
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
| | - Flavia Maria Zauli
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
- Department of Philosophy ‘Piero Martinetti’, University of Milan, Milan, Italy
- ASST Grande Ospedale Metropolitano Niguarda, “C. Munari” Epilepsy Surgery Centre, Department of Neuroscience, Italy
| | - Gabriel Hassan
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
- Department of Philosophy ‘Piero Martinetti’, University of Milan, Milan, Italy
| | - Michela Solbiati
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
- ASST Grande Ospedale Metropolitano Niguarda, “C. Munari” Epilepsy Surgery Centre, Department of Neuroscience, Italy
| | - Piergiorgio d’Orio
- ASST Grande Ospedale Metropolitano Niguarda, “C. Munari” Epilepsy Surgery Centre, Department of Neuroscience, Italy
- University of Parma, Parma 43121, Italy
| | - Ezequiel Mikulan
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
| | - Ivana Sartori
- ASST Grande Ospedale Metropolitano Niguarda, “C. Munari” Epilepsy Surgery Centre, Department of Neuroscience, Italy
| | - Maxim Bazhenov
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
- Neurosciences Graduate Program, University of California San Diego, La Jolla, CA, 92093, USA
| | - Andrea Pigorini
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy
- UOC Maxillo-facial Surgery and dentistry, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan 20157, Italy
- Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan 20122, Italy
- Azrieli Program in Brain, Mind and Consciousness, Canadian Institute for Advanced Research (CIFAR), Toronto, Ontario M5G 1M1, Canada
| | - Christof Koch
- Brain and Consciousness, Allen Institute, Seattle, United States
| | - Irene Rembado
- Brain and Consciousness, Allen Institute, Seattle, United States
| |
Collapse
|
2
|
Castelnovo A, Casetta C, Cavallotti S, Marcatili M, Del Fabro L, Canevini MP, Sarasso S, D'Agostino A. Proof-of-concept evidence for high-density EEG investigation of sleep slow wave traveling in First-Episode Psychosis. Sci Rep 2024; 14:6826. [PMID: 38514761 PMCID: PMC10958040 DOI: 10.1038/s41598-024-57476-2] [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] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
Schizophrenia is thought to reflect aberrant connectivity within cortico-cortical and reentrant thalamo-cortical loops, which physiologically integrate and coordinate the function of multiple cortical and subcortical structures. Despite extensive research, reliable biomarkers of such "dys-connectivity" remain to be identified at the onset of psychosis, and before exposure to antipsychotic drugs. Because slow waves travel across the brain during sleep, they represent an ideal paradigm to study pathological conditions affecting brain connectivity. Here, we provide proof-of-concept evidence for a novel approach to investigate slow wave traveling properties in First-Episode Psychosis (FEP) with high-density electroencephalography (EEG). Whole-night sleep recordings of 5 drug-naïve FEP and 5 age- and gender-matched healthy control subjects were obtained with a 256-channel EEG system. One patient was re-recorded after 6 months and 3 years of continuous clozapine treatment. Slow wave detection and traveling properties were obtained with an open-source toolbox. Slow wave density and slow wave traveled distance (measured as the line of longest displacement) were significantly lower in patients (p < 0.05). In the patient who was tested longitudinally during effective clozapine treatment, slow wave density normalized, while traveling distance only partially recovered. These preliminary findings suggest that slow wave traveling could be employed in larger samples to detect cortical "dys-connectivity" at psychosis onset.
Collapse
Affiliation(s)
- Anna Castelnovo
- Sleep Medicine Unit, Neurocenter of Italian Switzerland, Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland.
- Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland.
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Cecilia Casetta
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simone Cavallotti
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
| | - Matteo Marcatili
- Psychiatric Department, ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Lorenzo Del Fabro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Maria Paola Canevini
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Via G.B. Grassi 74, 20157, Milan, Italy.
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| |
Collapse
|
3
|
Lanzone J, Zulueta A, Boscarino M, Gallotta M, Argentieri MR, Viganò A, Sarasso S, Colombo MA, D’Ambrosio S, Lunetta C, Parati E. Spectral exponent assessment and neurofilament light chain: a comprehensive approach to describe recovery patterns in stroke. Front Neurol 2024; 15:1329044. [PMID: 38562428 PMCID: PMC10982436 DOI: 10.3389/fneur.2024.1329044] [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: 10/27/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Understanding the residual recovery potential in stroke patients is crucial for tailoring effective neurorehabilitation programs. We propose using EEG and plasmatic Neurofilament light chain (NfL) levels as a model to depict longitudinal patterns of stroke recovery. Methods We enrolled 13 patients (4 female, mean age 74.7 ± 8.8) who underwent stroke in the previous month and were hospitalized for 2-months rehabilitation. Patients underwent blood withdrawal, clinical evaluation and high-definition EEG at T1 (first week of rehabilitation) and at T2 (53 ± 10 days after). We assessed the levels of NfL and we analyzed the EEG signal extracting Spectral Exponent (SE) values. We compared our variables between the two timepoint and between cortical and non-cortical strokes. Results We found a significant difference in the symmetry of SE values between cortical and non-cortical stroke at both T1 (p = 0.005) and T2 (p = 0.01). SE in the affected hemisphere showed significantly steeper values at T1 when compared with T2 (p = 0.001). EEG measures were consistently related to clinical scores, while NfL at T1 was related to the volume of ischemic lesions (r = 0.75; p = 0.003). Additionally, the combined use of NfL and SE indicated varying trends in longitudinal clinical recovery. Conclusion We present proof of concept of a promising approach for the characterization of different recovery patterns in stroke patients.
Collapse
Affiliation(s)
- Jacopo Lanzone
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy
| | - Aida Zulueta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy
| | - Marilisa Boscarino
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy
| | - Matteo Gallotta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy
| | - Maria Rosaria Argentieri
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy
| | | | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Michele A. Colombo
- Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Sasha D’Ambrosio
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy
- Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
- Department of Clinical and Experimental Epilepsy, University College London, London, United Kingdom
| | - Christian Lunetta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy
| | - Eugenio Parati
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department of the Milano Institute, Milan, Italy
| |
Collapse
|
4
|
Casarotto S, Hassan G, Rosanova M, Sarasso S, Derchi CC, Trimarchi PD, Viganò A, Russo S, Fecchio M, Devalle G, Navarro J, Massimini M, Comanducci A. Dissociations between spontaneous electroencephalographic features and the perturbational complexity index in the minimally conscious state. Eur J Neurosci 2024; 59:934-947. [PMID: 38440949 DOI: 10.1111/ejn.16299] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/21/2023] [Accepted: 02/13/2024] [Indexed: 03/06/2024]
Abstract
The analysis of spontaneous electroencephalogram (EEG) is a cornerstone in the assessment of patients with disorders of consciousness (DoC). Although preserved EEG patterns are highly suggestive of consciousness even in unresponsive patients, moderately or severely abnormal patterns are difficult to interpret. Indeed, growing evidence shows that consciousness can be present despite either large delta or reduced alpha activity in spontaneous EEG. Quantifying the complexity of EEG responses to direct cortical perturbations (perturbational complexity index [PCI]) may complement the observational approach and provide a reliable assessment of consciousness even when spontaneous EEG features are inconclusive. To seek empirical evidence of this hypothesis, we compared PCI with EEG spectral measures in the same population of minimally conscious state (MCS) patients (n = 40) hospitalized in rehabilitation facilities. We found a remarkable variability in spontaneous EEG features across MCS patients as compared with healthy controls: in particular, a pattern of predominant delta and highly reduced alpha power-more often observed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients-was found in a non-negligible number of MCS patients. Conversely, PCI values invariably fell above an externally validated empirical cutoff for consciousness in all MCS patients, consistent with the presence of clearly discernible, albeit fleeting, behavioural signs of awareness. These results confirm that, in some MCS patients, spontaneous EEG rhythms may be inconclusive about the actual capacity for consciousness and suggest that a perturbational approach can effectively compensate for this pitfall with practical implications for the individual patient's stratification and tailored rehabilitation.
Collapse
Affiliation(s)
- Silvia Casarotto
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Gabriel Hassan
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | | | | | | | - Simone Russo
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Matteo Fecchio
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Guya Devalle
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Jorge Navarro
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Angela Comanducci
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
- Università Campus Bio-Medico di Roma, Rome, Italy
| |
Collapse
|
5
|
Rutiku R, Fiscone C, Massimini M, Sarasso S. Assessing mismatch negativity (MMN) and P3b within-individual sensitivity - A comparison between the local-global paradigm and two specialized oddball sequences. Eur J Neurosci 2024; 59:842-859. [PMID: 38439197 DOI: 10.1111/ejn.16302] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024]
Abstract
Mismatch negativity (MMN) and P3b are well known for their clinical utility. There exists no gold standard, however, for acquiring them as EEG markers of consciousness in clinical settings. This may explain why the within-individual sensitivity of MMN/P3b paradigms is often quite poor and why seemingly identical EEG markers can behave differently across Disorders of consciousness (DoC) studies. Here, we compare two traditional paradigms for MMN or P3b assessment with the recently more popular local-global paradigm that promises to assess MMN and P3b orthogonally within one oddball sequence. All three paradigms were administered to healthy participants (N = 15) with concurrent EEG. A clear MMN and local effect were found for 15/15 participants. The P3b and global effect were found for 14/15 and 13/15 participants, respectively. There were no systematic differences between the global effect and P3b. Indeed, P3b amplitude was highly correlated across paradigms. The local effect differed clearly from the MMN, however. It occurred earlier than MMN and was followed by a much more prominent P3a. The peak latencies and amplitudes were also not correlated across paradigms. Caution should therefore be exercised when comparing the local effect and MMN across studies. We conclude that the within-individual MMN sensitivity is adequate for both the local-global and a dedicated MMN paradigm. The within-individual sensitivity of P3b was lower than expected for both the local-global and a dedicated P3b paradigm, which may explain the often-low sensitivity of P3b paradigms in patients with DoC.
Collapse
Affiliation(s)
- Renate Rutiku
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- C-lab, Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Chiara Fiscone
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| |
Collapse
|
6
|
D'Ambrosio S, Certo F, Bernardelli L, Pini L, Corbetta M, Pantoni L, Massimini M, Sarasso S. Detecting cortical reactivity alterations induced by structural disconnection in subcortical stroke. Clin Neurophysiol 2023; 156:1-3. [PMID: 37826930 DOI: 10.1016/j.clinph.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Sasha D'Ambrosio
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Francesco Certo
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Letizia Bernardelli
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Lorenzo Pini
- Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
| | - Maurizio Corbetta
- Padova Neuroscience Center (PNC), University of Padova, Padova, Italy; Department of Neuroscience, University of Padova, Padova, Italy; Venetian Institute of Molecular Medicine (VIMM), Fondazione Biomedica, Padova, Italy
| | - Leonardo Pantoni
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy; Neuroscience Research Center. Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Marcello Massimini
- Neuroscience Research Center. Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy; Azrieli Program in Brain, Mind and Consciousness, Canadian Institute for Advanced Research (CIFAR), Toronto, Canada
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
| |
Collapse
|
7
|
Favaro J, Colombo MA, Mikulan E, Sartori S, Nosadini M, Pelizza MF, Rosanova M, Sarasso S, Massimini M, Toldo I. The maturation of aperiodic EEG activity across development reveals a progressive differentiation of wakefulness from sleep. Neuroimage 2023:120264. [PMID: 37399931 DOI: 10.1016/j.neuroimage.2023.120264] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/04/2023] [Accepted: 07/01/2023] [Indexed: 07/05/2023] Open
Abstract
During development, the brain undergoes radical structural and functional changes following a posterior-to-anterior gradient, associated with profound changes of cortical electrical activity during both wakefulness and sleep. However, a systematic assessment of the developmental effects on aperiodic EEG activity maturation across vigilance states is lacking, particularly regarding its topographical aspects. Here, in a population of 160 healthy infants, children and teenagers (from 2 to 17 years, 10 subjects for each year), we investigated the development of aperiodic EEG activity in wakefulness and sleep. Specifically, we parameterized the shape of the aperiodic background of the EEG Power Spectral Density (PSD) by means of the spectral exponent and offset; the exponent reflects the rate of exponential decay of power over increasing frequencies and the offset reflects an estimate of the y-intercept of the PSD. We found that sleep and development caused the EEG-PSD to rotate over opposite directions: during wakefulness the PSD showed a flatter decay and reduced offset over development, while during sleep it showed a steeper decay and a higher offset as sleep becomes deeper. During deep sleep (N2, N3) only the spectral offset decreased over age, indexing a broad-band voltage reduction. As a result, the difference between values in deep sleep and those in both light sleep (N1) and wakefulness increased with age, suggesting a progressive differentiation of wakefulness from sleep EEG activity, most prominent over the frontal regions, the latest to complete maturation. Notably, the broad-band spectral exponent values during deep sleep stages were entirely separated from wakefulness values, consistently across developmental ages and in line with previous findings in adults. Concerning topographical development, the location showing the steepest PSD decay and largest offset shifted from posterior to anterior regions with age. This shift, particularly evident during deep sleep, paralleled the migration of sleep slow wave activity and was consistent with neuroanatomical and cognitive development. Overall, aperiodic EEG activity distinguishes wakefulness from sleep regardless of age; while, during development, it reveals a postero-anterior topographical maturation and a progressive differentiation of wakefulness from sleep. Our study could help to interpret changes due to pathological conditions and may elucidate the neurophysiological processes underlying the development of wakefulness and sleep.
Collapse
Affiliation(s)
- Jacopo Favaro
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children Health, University of Padua, 35128, Padua, Italy.
| | - Michele A Colombo
- Department of Clinical and Biomedical Sciences "L. Sacco", University of Milan, 20157, Milan, Italy.
| | - Ezequiel Mikulan
- Department of Clinical and Biomedical Sciences "L. Sacco", University of Milan, 20157, Milan, Italy
| | - Stefano Sartori
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children Health, University of Padua, 35128, Padua, Italy; Neuroimmunology Group, Pediatric Research Institute "Città della Speranza", 35127, Padua, Italy; Department of Neuroscience, University of Padua, 35121, Padua, Italy
| | - Margherita Nosadini
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children Health, University of Padua, 35128, Padua, Italy; Neuroimmunology Group, Pediatric Research Institute "Città della Speranza", 35127, Padua, Italy
| | - Maria Federica Pelizza
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children Health, University of Padua, 35128, Padua, Italy
| | - Mario Rosanova
- Department of Clinical and Biomedical Sciences "L. Sacco", University of Milan, 20157, Milan, Italy
| | - Simone Sarasso
- Department of Clinical and Biomedical Sciences "L. Sacco", University of Milan, 20157, Milan, Italy
| | - Marcello Massimini
- Department of Clinical and Biomedical Sciences "L. Sacco", University of Milan, 20157, Milan, Italy; IRCCS, Fondazione Don Carlo Gnocchi Onlus, 20148, Milan, Italy.
| | - Irene Toldo
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children Health, University of Padua, 35128, Padua, Italy
| |
Collapse
|
8
|
Pascarella A, Mikulan E, Sciacchitano F, Sarasso S, Rubino A, Sartori I, Cardinale F, Zauli F, Avanzini P, Nobili L, Pigorini A, Sorrentino A. An in-vivo validation of ESI methods with focal sources. Neuroimage 2023:120219. [PMID: 37307867 DOI: 10.1016/j.neuroimage.2023.120219] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/05/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
Electrophysiological source imaging (ESI) aims at reconstructing the precise origin of brain activity from measurements of the electric field on the scalp. Across laboratories/research centers/hospitals, ESI is performed with different methods, partly due to the ill-posedness of the underlying mathematical problem. However, it is difficult to find systematic comparisons involving a wide variety of methods. Further, existing comparisons rarely take into account the variability of the results with respect to the input parameters. Finally, comparisons are typically performed using either synthetic data, or in-vivo data where the ground-truth is only roughly known. We use an in-vivo high-density EEG dataset recorded during intracranial single pulse electrical stimulation, in which the true sources are substantially dipolar and their locations are precisely known. We compare ten different ESI methods, using their implementation in the MNE-Python package: MNE, dSPM, LORETA, sLORETA, eLORETA, LCMV beamformers, irMxNE, Gamma Map, SESAME and dipole fitting. We perform comparisons under multiple choices of input parameters, to assess the accuracy of the best reconstruction, as well as the impact of such parameters on the localization performance. Best reconstructions often fall within 1 cm from the true source, with most accurate methods hitting an average localization error of 1.2 cm and outperforming least accurate ones erring by 2.5 cm. As expected, dipolar and sparsity-promoting methods tend to outperform distributed methods. For several distributed methods, the best regularization parameter turned out to be the one in principle associated with low SNR, despite the high SNR of the available dataset. Depth weighting played no role for two out of the six methods implementing it. Sensitivity to input parameters varied widely between methods. While one would expect high variability being associated with low localization error at the best solution, this is not always the case, with some methods producing highly variable results and high localization error, and other methods producing stable results with low localization error. In particular, recent dipolar and sparsity-promoting methods provide significantly better results than older distributed methods. As we repeated the tests with "conventional" (32 channels) and dense (64, 128, 256 channels) EEG recordings, we observed little impact of the number of channels on localization accuracy; however, for distributed methods denser montages provide smaller spatial dispersion. Overall findings confirm that EEG is a reliable technique for localization of point sources and therefore reinforce the importance that ESI may have in the clinical context, especially when applied to identify the surgical target in potential candidates for epilepsy surgery.
Collapse
Affiliation(s)
| | - Ezequiel Mikulan
- Department of Biomedical and Clinical Sciences "L. Sacco",Università degli Studi di Milano, Milan, Italy
| | | | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco",Università degli Studi di Milano, Milan, Italy
| | - Annalisa Rubino
- Department of Neurosciences, Center for Epilepsy Surgery "C. Munari", Hospital Niguarda, Milan, Italy
| | - Ivana Sartori
- Department of Neurosciences, Center for Epilepsy Surgery "C. Munari", Hospital Niguarda, Milan, Italy
| | - Francesco Cardinale
- Department of Neurosciences, Center for Epilepsy Surgery "C. Munari", Hospital Niguarda, Milan, Italy
| | - Flavia Zauli
- Department of Biomedical and Clinical Sciences "L. Sacco",Università degli Studi di Milano, Milan, Italy
| | | | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS "G. Gaslini" Institute, Genoa, Italy; DINOGMI, Università degli Studi di Genova, Genoa, Italy
| | - Andrea Pigorini
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Alberto Sorrentino
- Department of Mathematics, Università degli Studi di Genova, Genoa, Italy.
| |
Collapse
|
9
|
Ort A, Smallridge JW, Sarasso S, Casarotto S, von Rotz R, Casanova A, Seifritz E, Preller KH, Tononi G, Vollenweider FX. TMS-EEG and resting-state EEG applied to altered states of consciousness: oscillations, complexity, and phenomenology. iScience 2023; 26:106589. [PMID: 37138774 PMCID: PMC10149373 DOI: 10.1016/j.isci.2023.106589] [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: 09/20/2022] [Revised: 12/22/2022] [Accepted: 04/03/2023] [Indexed: 05/05/2023] Open
Abstract
Exploring the neurobiology of the profound changes in consciousness induced by classical psychedelic drugs may require novel neuroimaging methods. Serotonergic psychedelic drugs such as psilocybin produce states of increased sensory-emotional awareness and arousal, accompanied by increased spontaneous electroencephalographic (EEG) signal diversity. By directly stimulating cortical tissue, the altered dynamics and propagation of the evoked EEG activity can reveal drug-induced changes in the overall brain state. We combine Transcranial Magnetic Stimulation (TMS) and EEG to reveal that psilocybin produces a state of increased chaotic brain activity which is not a result of altered complexity in the underlying causal interactions between brain regions. We also map the regional effects of psilocybin on TMS-evoked activity and identify changes in frontal brain structures that may be associated with the phenomenology of psychedelic experiences.
Collapse
Affiliation(s)
- Andres Ort
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Corresponding author
| | - John W. Smallridge
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Corresponding author
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi Milano, Milan, Italy
| | - Robin von Rotz
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andrea Casanova
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katrin H. Preller
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Franz X. Vollenweider
- Neurophenomenology of Consciousness Lab, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
10
|
Colombo MA, Comanducci A, Casarotto S, Derchi CC, Annen J, Viganò A, Mazza A, Trimarchi PD, Boly M, Fecchio M, Bodart O, Navarro J, Laureys S, Gosseries O, Massimini M, Sarasso S, Rosanova M. Beyond alpha power: EEG spatial and spectral gradients robustly stratify disorders of consciousness. Cereb Cortex 2023:7091601. [PMID: 36977648 DOI: 10.1093/cercor/bhad031] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 03/30/2023] Open
Abstract
Neurophysiological markers can overcome the limitations of behavioural assessments of Disorders of Consciousness (DoC). EEG alpha power emerged as a promising marker for DoC, although long-standing literature reported alpha power being sustained during anesthetic-induced unconsciousness, and reduced during dreaming and hallucinations. We hypothesized that EEG power suppression caused by severe anoxia could explain this conflict. Accordingly, we split DoC patients (n = 87) in postanoxic and non-postanoxic cohorts. Alpha power was suppressed only in severe postanoxia but failed to discriminate un/consciousness in other aetiologies. Furthermore, it did not generalize to an independent reference dataset (n = 65) of neurotypical, neurological, and anesthesia conditions. We then investigated EEG spatio-spectral gradients, reflecting anteriorization and slowing, as alternative markers. In non-postanoxic DoC, these features, combined in a bivariate model, reliably stratified patients and indexed consciousness, even in unresponsive patients identified as conscious by an independent neural marker (the Perturbational Complexity Index). Crucially, this model optimally generalized to the reference dataset. Overall, alpha power does not index consciousness; rather, its suppression entails diffuse cortical damage, in postanoxic patients. As an alternative, EEG spatio-spectral gradients, reflecting distinct pathophysiological mechanisms, jointly provide a robust, parsimonious, and generalizable marker of consciousness, whose clinical application may guide rehabilitation efforts.
Collapse
Affiliation(s)
| | - Angela Comanducci
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
- Department of Engineering, Università Campus Bio-Medico di Roma, Rome 00128, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | | | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | | | - Alice Mazza
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | | | - Melanie Boly
- Department of Neurology and Department of Psychiatry, University of Wisconsin, Madison, WI 53705-2281, USA
| | - Matteo Fecchio
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Olivier Bodart
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | - Jorge Navarro
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
| |
Collapse
|
11
|
Pigorini A, Mikulan E, Russo S, Sarasso S, Parmigiani S, Massimini M. Loss of differentiation and complexity in the sleeping human brain: a multi-scale analysis. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.048] [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
|
12
|
Rosanova M, Casarotto S, Derchi C, Hassan G, Russo S, Sarasso S, Viganò A, Massimini M, Comanducci A. The perturbational complexity index detects capacity for consciousness earlier than the recovery of behavioral responsiveness in subacute brain-injured patients. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.731] [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
|
13
|
Fecchio M, Simone R, Sarasso S, Puglisi GE, Palù DD, Pigorini A, Astolfi A, Massimini M, Rosanova M. TMS adaptable auditory control - a universal tool to deal with TMS-evoked auditory potential. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.261] [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
|
14
|
Furregoni G, Russo S, Pigorini A, Mikulan E, Sarasso S, Rubino A, Zauli F, Parmigiani S, Piergiorgio d'Orio, Cattani A, Francione S, Tassi L, Bassetti C, Lo Russo G, Avanzini P, Nobili L, Sartori I, Massimini M. Focal brain lesions induce spontaneous and evoked sleep-like intracerebral activity in awake humans. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.525] [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
|
15
|
Pigorini A, Mikulan E, Russo S, Zauli F, Sarasso S, Comolatti R, Parmigiani S, Rubino A, Furregoni G, Casarotto S, Sartori I, Massimini M. Loss of differentiation and complexity in the sleeping human brain: a multi-scale analysis. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.412] [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
|
16
|
Russo S, D'Ambrosio S, De Giampaulis P, Mora G, Massimini M, Sarasso S, Lanzone J. Probing cortical structural integrity after focal hemorrhagic stroke: a TMS-EEG case. Clin Neurophysiol 2022; 140:159-160. [DOI: 10.1016/j.clinph.2022.06.006] [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] [Received: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022]
|
17
|
Parmigiani S, Mikulan EP, Russo S, Sarasso S, Zauli FM, Rubino A, Cattani A, Fecchio M, Giampiccolo D, Lanzone J, D'Orio P, Del Vecchio M, Avanzini P, Nobili L, Sartori I, Massimini M, Pigorini A. Simultaneous stereo-EEG and high-density scalp EEG recordings to study the effects of intracerebral stimulation parameters. Brain Stimul 2022; 15:664-675. [PMID: 35421585 DOI: 10.1016/j.brs.2022.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cortico-cortical evoked potentials (CCEPs) recorded by stereo-electroencephalography (SEEG) are a valuable tool to investigate brain reactivity and effective connectivity. However, invasive recordings are spatially sparse since they depend on clinical needs. This sparsity hampers systematic comparisons across-subjects, the detection of the whole-brain effects of intracortical stimulation, as well as their relationships to the EEG responses evoked by non-invasive stimuli. OBJECTIVE To demonstrate that CCEPs recorded by high-density electroencephalography (hd-EEG) provide additional information with respect SEEG alone and to provide an open, curated dataset to allow for further exploration of their potential. METHODS The dataset encompasses SEEG and hd-EEG recordings simultaneously acquired during Single Pulse Electrical Stimulation (SPES) in drug-resistant epileptic patients (N = 36) in whom stimulations were delivered with different physical, geometrical, and topological parameters. Differences in CCEPs were assessed by amplitude, latency, and spectral measures. RESULTS While invasively and non-invasively recorded CCEPs were generally correlated, differences in pulse duration, angle and stimulated cortical area were better captured by hd-EEG. Further, intracranial stimulation evoked site-specific hd-EEG responses that reproduced the spectral features of EEG responses to transcranial magnetic stimulation (TMS). Notably, SPES, albeit unperceived by subjects, elicited scalp responses that were up to one order of magnitude larger than the responses typically evoked by sensory stimulation in awake humans. CONCLUSIONS CCEPs can be simultaneously recorded with SEEG and hd-EEG and the latter provides a reliable descriptor of the effects of SPES as well as a common reference to compare the whole-brain effects of intracortical stimulation to those of non-invasive transcranial or sensory stimulations in humans.
Collapse
Affiliation(s)
- S Parmigiani
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy
| | - E P Mikulan
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy
| | - S Russo
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Department of Philosophy "Piero Martinetti", Università degli Studi di Milano, Milan, Italy
| | - S Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy
| | - F M Zauli
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Department of Philosophy "Piero Martinetti", Università degli Studi di Milano, Milan, Italy
| | - A Rubino
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - A Cattani
- Department of Mathematics & Statistics, Boston University, Boston, MA, USA
| | - M Fecchio
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - D Giampiccolo
- Department of Neurosurgery, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Institute of Neurosciences, Cleveland Clinic London, London, UK
| | - J Lanzone
- Department of Systems Medicine, Neuroscience, University of Rome Tor Vergata, Rome, Italy; Istituti Clinici Scientifici Maugeri, IRCCS, Neurorehabilitation Department of Milano Institute, Milan, Italy
| | - P D'Orio
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan, Italy; Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Parma, Italy
| | - M Del Vecchio
- Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Parma, Italy
| | - P Avanzini
- Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Parma, Italy
| | - L Nobili
- Child Neuropsychiatry, IRCCS Istituto G. Gaslini, Genova, Italy
| | - I Sartori
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - M Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy; Azrieli Program in Brain, Mind and Consciousness, Canadian Institute for Advanced Research, Toronto, Canada
| | - A Pigorini
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Department of Biomedical, V, Università degli Studi di Milano, Milan, Italy.
| |
Collapse
|
18
|
Russo S, Sarasso S, Puglisi G, Dal Palù D, Pigorini A, Casarotto S, D’Ambrosio S, Astolfi A, Massimini M, Rosanova M, Fecchio M. TAAC - TMS Adaptable Auditory Control: a universal tool to mask TMS click. J Neurosci Methods 2022; 370:109491. [DOI: 10.1016/j.jneumeth.2022.109491] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
|
19
|
Russo S, Sarasso S, Puglisi GE, Palù DD, Pigorini A, Solbiati M, Astolfi A, Massimini M, Rosanova M, Fecchio M. TMS Adaptable Auditory Control: a universal tool to mask TMS click. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.166] [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: 10/19/2022] Open
|
20
|
Rosanova M, Sarasso S. Sleep-like cortical bistability after focal and multifocal brain lesions. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.518] [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] Open
|
21
|
Mikulan E, Theoharis A, Russo S, Zauli FM, Sartori I, Parmigiani S, Sarasso S, Del Vecchio M, Avanzini P, Pigorini A. Scalp EEG prediction of intracranial high-frequency responses to median nerve stimulation: insights from simultaneous recordings. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
22
|
D'Ambrosio S, Russo S, Mora G, Sarasso S, De Giampaulis P. Probing cortical functional integrity after focal haemorrhagic stroke: a TMS-EEG case. Brain Stimul 2021. [DOI: 10.1016/j.brs.2021.10.068] [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] Open
|
23
|
Sarasso S, Casali AG, Casarotto S, Rosanova M, Sinigaglia C, Massimini M. Consciousness and complexity: a consilience of evidence. Neurosci Conscious 2021; 2021:niab023. [PMID: 38496724 PMCID: PMC10941977 DOI: 10.1093/nc/niab023] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/19/2021] [Accepted: 07/29/2021] [Indexed: 03/19/2024] Open
Abstract
Over the last years, a surge of empirical studies converged on complexity-related measures as reliable markers of consciousness across many different conditions, such as sleep, anesthesia, hallucinatory states, coma, and related disorders. Most of these measures were independently proposed by researchers endorsing disparate frameworks and employing different methods and techniques. Since this body of evidence has not been systematically reviewed and coherently organized so far, this positive trend has remained somewhat below the radar. The aim of this paper is to make this consilience of evidence in the science of consciousness explicit. We start with a systematic assessment of the growing literature on complexity-related measures and identify their common denominator, tracing it back to core theoretical principles and predictions put forward more than 20 years ago. In doing this, we highlight a consistent trajectory spanning two decades of consciousness research and provide a provisional taxonomy of the present literature. Finally, we consider all of the above as a positive ground to approach new questions and devise future experiments that may help consolidate and further develop a promising field where empirical research on consciousness appears to have, so far, naturally converged.
Collapse
Affiliation(s)
- Simone Sarasso
- Department of Biomedical and Clinical Sciences ‘L. Sacco’, University of Milan, Milan 20157, Italy
| | - Adenauer Girardi Casali
- Instituto de Ciência e Tecnologia, Universidade Federal de São Paulo, Sao Jose dos Campos, 12247-014, Brazil
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences ‘L. Sacco’, University of Milan, Milan 20157, Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan 20148, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences ‘L. Sacco’, University of Milan, Milan 20157, Italy
| | | | - Marcello Massimini
- Department of Biomedical and Clinical Sciences ‘L. Sacco’, University of Milan, Milan 20157, Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan 20148, Italy
| |
Collapse
|
24
|
Gorgoni M, Sarasso S, Moroni F, Sartori I, Ferrara M, Nobili L, De Gennaro L. The distinctive sleep pattern of the human calcarine cortex: a stereo-electroencephalographic study. Sleep 2021; 44:6131365. [PMID: 33556162 DOI: 10.1093/sleep/zsab026] [Citation(s) in RCA: 3] [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] [Received: 08/01/2020] [Revised: 01/27/2021] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVES The aim of this study was to describe the spontaneous electroencephalographic (EEG) features of sleep in the human calcarine cortex, comparing them with the well-established pattern of the parietal cortex. METHODS We analyzed presurgical intracerebral EEG activity in calcarine and parietal cortices during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in seven patients with drug-resistant focal epilepsy. The time course of the EEG spectral power and NREM vs REM differences was assessed. Sleep spindles were automatically detected. To assess homeostatic dynamics, we considered the first vs second half of the night ratio in the delta frequency range (0.5-4 Hz) and the rise rate of delta activity during the first sleep cycle. RESULTS While the parietal area showed the classically described NREM and REM sleep hallmarks, the calcarine cortex exhibited a distinctive pattern characterized by: (1) the absence of sleep spindles; (2) a large similarity between EEG power spectra of NREM and REM; and (3) reduced signs of homeostatic dynamics, with a decreased delta ratio between the first and the second half of the night, a reduced rise rate of delta activity during the first NREM sleep cycle, and lack of correlation between these measures. CONCLUSIONS Besides describing for the first time the peculiar sleep EEG pattern in the human calcarine cortex, our findings provide evidence that different cortical areas may exhibit specific sleep EEG pattern, supporting the view of sleep as a local process and promoting the idea that the functional role of sleep EEG features should be considered at a regional level.
Collapse
Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | - Fabio Moroni
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Ivana Sartori
- C. Munari Center of Epilepsy Surgery, Niguarda Hospital, Milan, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (L'Aquila), Italy
| | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS, Giannina Gaslini Institute, Genoa, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Luigi De Gennaro
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
25
|
Donati FL, Fecchio M, Maestri D, Cornali M, Derchi CC, Casetta C, Zalaffi M, Sinigaglia C, Sarasso S, D'Agostino A. Reduced readiness potential and post-movement beta synchronization reflect self-disorders in early course schizophrenia. Sci Rep 2021; 11:15044. [PMID: 34294767 PMCID: PMC8298598 DOI: 10.1038/s41598-021-94356-5] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 07/06/2021] [Indexed: 02/05/2023] Open
Abstract
Disturbances of conscious awareness, or self-disorders, are a defining feature of schizophrenia. These include symptoms such as delusions of control, i.e. the belief that one's actions are controlled by an external agent. Models of self-disorders point at altered neural mechanisms of source monitoring, i.e. the ability of the brain to discriminate self-generated stimuli from those driven by the environment. However, evidence supporting this putative relationship is currently lacking. We performed electroencephalography (EEG) during self-paced, brisk right fist closures in ten (M = 9; F = 1) patients with Early-Course Schizophrenia (ECSCZ) and age and gender-matched healthy volunteers. We measured the Readiness Potential (RP), i.e. an EEG feature preceding self-generated movements, and movement-related EEG spectral changes. Self-disorders in ECSCZ were assessed with the Examination of Anomalous Self-Experience (EASE). Patients showed a markedly reduced RP and altered post-movement Event-Related Synchronization (ERS) in the beta frequency band (14-24 Hz) compared to healthy controls. Importantly, smaller RP and weaker ERS were associated with higher EASE scores in ECSCZ. Our data suggest that disturbances of neural correlates preceding and following self-initiated movements may reflect the severity of self-disorders in patients suffering from ECSCZ. These findings point towards deficits in basic mechanisms of sensorimotor integration as a substrate for self-disorders.
Collapse
Affiliation(s)
- Francesco Luciano Donati
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Matteo Fecchio
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Padiglione 'LITA', Piano 5, Via Gian Battista Grassi, 74, 20157, Milan, MI, Italy
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Davide Maestri
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy
| | - Mattia Cornali
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy
| | | | - Cecilia Casetta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Maristella Zalaffi
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Padiglione 'LITA', Piano 5, Via Gian Battista Grassi, 74, 20157, Milan, MI, Italy
| | | | - Simone Sarasso
- Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Padiglione 'LITA', Piano 5, Via Gian Battista Grassi, 74, 20157, Milan, MI, Italy.
| | - Armando D'Agostino
- Department of Health Sciences, University of Milan, Ospedale San Paolo, Blocco A, Piano 9. Via Antonio di Rudinì, 8, 20142, Milan, MI, Italy
| |
Collapse
|
26
|
Claassen J, Akbari Y, Alexander S, Bader MK, Bell K, Bleck TP, Boly M, Brown J, Chou SHY, Diringer MN, Edlow BL, Foreman B, Giacino JT, Gosseries O, Green T, Greer DM, Hanley DF, Hartings JA, Helbok R, Hemphill JC, Hinson HE, Hirsch K, Human T, James ML, Ko N, Kondziella D, Livesay S, Madden LK, Mainali S, Mayer SA, McCredie V, McNett MM, Meyfroidt G, Monti MM, Muehlschlegel S, Murthy S, Nyquist P, Olson DM, Provencio JJ, Rosenthal E, Sampaio Silva G, Sarasso S, Schiff ND, Sharshar T, Shutter L, Stevens RD, Vespa P, Videtta W, Wagner A, Ziai W, Whyte J, Zink E, Suarez JI. Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness. Neurocrit Care 2021; 35:4-23. [PMID: 34236619 PMCID: PMC8264966 DOI: 10.1007/s12028-021-01260-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/15/2021] [Indexed: 01/04/2023]
Abstract
Coma and disorders of consciousness (DoC) are highly prevalent and constitute a burden for patients, families, and society worldwide. As part of the Curing Coma Campaign, the Neurocritical Care Society partnered with the National Institutes of Health to organize a symposium bringing together experts from all over the world to develop research targets for DoC. The conference was structured along six domains: (1) defining endotype/phenotypes, (2) biomarkers, (3) proof-of-concept clinical trials, (4) neuroprognostication, (5) long-term recovery, and (6) large datasets. This proceedings paper presents actionable research targets based on the presentations and discussions that occurred at the conference. We summarize the background, main research gaps, overall goals, the panel discussion of the approach, limitations and challenges, and deliverables that were identified.
Collapse
Affiliation(s)
- Jan Claassen
- Department of Neurology, Columbia University and New York-Presbyterian Hospital, 177 Fort Washington Avenue, MHB 8 Center, Room 300, New York City, NY, 10032, USA.
| | - Yama Akbari
- Departments of Neurology, Neurological Surgery, and Anatomy & Neurobiology and Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA, USA
| | - Sheila Alexander
- Acute and Tertiary Care, School of Nursing and Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kathleen Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas P Bleck
- Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Melanie Boly
- Department of Neurology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jeremy Brown
- Office of Emergency Care Research, Division of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Sherry H-Y Chou
- Departments of Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael N Diringer
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Brian L Edlow
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, MA, USA
| | - Brandon Foreman
- Departments of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Olivia Gosseries
- GIGA Consciousness After Coma Science Group, University of Liege, Liege, Belgium
| | - Theresa Green
- School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - David M Greer
- Department of Neurology, School of Medicine, Boston University, Boston, MA, USA
| | - Daniel F Hanley
- Division of Brain Injury Outcomes, Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jed A Hartings
- Department of Neurosurgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Raimund Helbok
- Neurocritical Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Claude Hemphill
- Department of Neurology, Weill Institute for Neurosciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - H E Hinson
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Karen Hirsch
- Department of Neurology, Stanford University, Palo Alto, CA, USA
| | - Theresa Human
- Department of Pharmacy, Barnes Jewish Hospital, St. Louis, MO, USA
| | - Michael L James
- Departments of Anesthesiology and Neurology, Duke University, Durham, NC, USA
| | - Nerissa Ko
- Department of Neurology, Weill Institute for Neurosciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Kondziella
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sarah Livesay
- College of Nursing, Rush University, Chicago, IL, USA
| | - Lori K Madden
- Center for Nursing Science, University of California, Davis, Sacramento, CA, USA
| | - Shraddha Mainali
- Department of Neurology, The Ohio State University, Columbus, OH, USA
| | - Stephan A Mayer
- Department of Neurology, New York Medical College, Valhalla, NY, USA
| | - Victoria McCredie
- Interdepartmental Division of Critical Care, Department of Respirology, University of Toronto, Toronto, ON, Canada
| | - Molly M McNett
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Geert Meyfroidt
- Department of Intensive Care Medicine, University Hospitals Leuven and University of Leuven, Leuven, Belgium
| | - Martin M Monti
- Departments of Neurosurgery and Psychology, Brain Injury Research Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Susanne Muehlschlegel
- Departments of Neurology, Anesthesiology/Critical Care, and Surgery, Medical School, University of Massachusetts, Worcester, MA, USA
| | - Santosh Murthy
- Department of Neurology, Weill Cornell Medical College, New York City, NY, USA
| | - Paul Nyquist
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - DaiWai M Olson
- Departments of Neurology and Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J Javier Provencio
- Departments of Neurology and Neuroscience, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Eric Rosenthal
- Department of Neurology, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Gisele Sampaio Silva
- Department of Neurology, Albert Einstein Israelite Hospital and Universidade Federal de São Paulo, São Paulo, Brazil
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Nicholas D Schiff
- Department of Neurology and Brain Mind Research Institute, Weill Cornell Medicine, Cornell University, New York City, NY, USA
| | - Tarek Sharshar
- Department of Intensive Care, Paris Descartes University, Paris, France
| | - Lori Shutter
- Departments of Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert D Stevens
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Paul Vespa
- Departments of Neurosurgery and Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Walter Videtta
- National Hospital Alejandro Posadas, Buenos Aires, Argentina
| | - Amy Wagner
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wendy Ziai
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - John Whyte
- Moss Rehabilitation Research Institute, Elkins Park, PA, USA
| | - Elizabeth Zink
- Division of Neurosciences Critical Care, Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jose I Suarez
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
27
|
Russo S, Pigorini A, Mikulan E, Sarasso S, Rubino A, Zauli FM, Parmigiani S, d'Orio P, Cattani A, Francione S, Tassi L, Bassetti CLA, Lo Russo G, Nobili L, Sartori I, Massimini M. Focal lesions induce large-scale percolation of sleep-like intracerebral activity in awake humans. Neuroimage 2021; 234:117964. [PMID: 33771696 DOI: 10.1016/j.neuroimage.2021.117964] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022] Open
Abstract
Focal cortical lesions are known to result in large-scale functional alterations involving distant areas; however, little is known about the electrophysiological mechanisms underlying these network effects. Here, we addressed this issue by analysing the short and long distance intracranial effects of controlled structural lesions in humans. The changes in Stereo-Electroencephalographic (SEEG) activity after Radiofrequency-Thermocoagulation (RFTC) recorded in 21 epileptic subjects were assessed with respect to baseline resting wakefulness and sleep activity. In addition, Cortico-Cortical Evoked Potentials (CCEPs) recorded before the lesion were employed to interpret these changes with respect to individual long-range connectivity patterns. We found that small structural ablations lead to the generation and large-scale propagation of sleep-like slow waves within the awake brain. These slow waves match those recorded in the same subjects during sleep, are prevalent in perilesional areas, but can percolate up to distances of 60 mm through specific long-range connections, as predicted by CCEPs. Given the known impact of slow waves on information processing and cortical plasticity, demonstrating their intrusion and percolation within the awake brain add key elements to our understanding of network dysfunction after cortical injuries.
Collapse
Affiliation(s)
- S Russo
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - A Pigorini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - E Mikulan
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - S Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - A Rubino
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - F M Zauli
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - S Parmigiani
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - P d'Orio
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy; Institute of Neuroscience, CNR, via Volturno 39E, 43125 Parma, Italy
| | - A Cattani
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy; Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - S Francione
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - L Tassi
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - C L A Bassetti
- Department of Neurology, Inselspital, University of Bern, Switzerland
| | - G Lo Russo
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - L Nobili
- Child Neuropsychiatry, IRCCS Istituto G. Gaslini, Genova 16147, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - I Sartori
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - M Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy; IRCCS, Fondazione Don Carlo Gnocchi, Milan 20148, Italy; Azrieli Program in Brain, Mind and Consciousness, Canadian Institute for Advanced Research, Toronto, Canada.
| |
Collapse
|
28
|
Sarasso S, D'Ambrosio S, Fecchio M, Casarotto S, Viganò A, Landi C, Mattavelli G, Gosseries O, Quarenghi M, Laureys S, Devalle G, Rosanova M, Massimini M. Local sleep-like cortical reactivity in the awake brain after focal injury. Brain 2021; 143:3672-3684. [PMID: 33188680 PMCID: PMC7805800 DOI: 10.1093/brain/awaa338] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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: 04/02/2020] [Revised: 07/08/2020] [Accepted: 08/10/2020] [Indexed: 12/23/2022] Open
Abstract
The functional consequences of focal brain injury are thought to be contingent on neuronal alterations extending beyond the area of structural damage. This phenomenon, also known as diaschisis, has clinical and metabolic correlates but lacks a clear electrophysiological counterpart, except for the long-standing evidence of a relative EEG slowing over the injured hemisphere. Here, we aim at testing whether this EEG slowing is linked to the pathological intrusion of sleep-like cortical dynamics within an awake brain. We used a combination of transcranial magnetic stimulation and electroencephalography (TMS/EEG) to study cortical reactivity in a cohort of 30 conscious awake patients with chronic focal and multifocal brain injuries of ischaemic, haemorrhagic and traumatic aetiology. We found that different patterns of cortical reactivity typically associated with different brain states (coma, sleep, wakefulness) can coexist within the same brain. Specifically, we detected the occurrence of prominent sleep-like TMS-evoked slow waves and off-periods—reflecting transient suppressions of neuronal activity—in the area surrounding focal cortical injuries. These perilesional sleep-like responses were associated with a local disruption of signal complexity whereas complex responses typical of the awake brain were present when stimulating the contralesional hemisphere. These results shed light on the electrophysiological properties of the tissue surrounding focal brain injuries in humans. Perilesional sleep-like off-periods can disrupt network activity but are potentially reversible, thus representing a principled read-out for the neurophysiological assessment of stroke patients, as well as an interesting target for rehabilitation.
Collapse
Affiliation(s)
- Simone Sarasso
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Sasha D'Ambrosio
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy.,Chalfont Centre for Epilepsy, Chalfont St. Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Matteo Fecchio
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Silvia Casarotto
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Alessandro Viganò
- Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Cristina Landi
- Fondazione Europea per la Ricerca Biomedica Onlus, Milan, Italy
| | | | - Olivia Gosseries
- Coma Science Group, University and University Hospital of Liege, GIGA-Consciousness, 4000 Liege, Belgium
| | - Matteo Quarenghi
- Unità Operativa Radiologia, Azienda Ospedaliera Vizzolo P -Risonanza Magnetica- ASST Melegnano e Martesana, Vizzolo Predabissi, Italy
| | - Steven Laureys
- Coma Science Group, University and University Hospital of Liege, GIGA-Consciousness, 4000 Liege, Belgium
| | - Guya Devalle
- Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Mario Rosanova
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy.,Fondazione Europea per la Ricerca Biomedica Onlus, Milan, Italy
| | - Marcello Massimini
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy.,Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy
| |
Collapse
|
29
|
Font-Clos F, Spelta B, D'Agostino A, Donati F, Sarasso S, Canevini MP, Zapperi S, La Porta CAM. Information Optimized Multilayer Network Representation of High Density Electroencephalogram Recordings. Front Netw Physiol 2021; 1:746118. [PMID: 36925574 PMCID: PMC10013144 DOI: 10.3389/fnetp.2021.746118] [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] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022]
Abstract
High-density electroencephalography (hd-EEG) provides an accessible indirect method to record spatio-temporal brain activity with potential for disease diagnosis and monitoring. Due to their highly multidimensional nature, extracting useful information from hd-EEG recordings is a complex task. Network representations have been shown to provide an intuitive picture of the spatial connectivity underlying an electroencephalogram recording, although some information is lost in the projection. Here, we propose a method to construct multilayer network representations of hd-EEG recordings that maximize their information content and test it on sleep data recorded in individuals with mental health issues. We perform a series of statistical measurements on the multilayer networks obtained from patients and control subjects and detect significant differences between the groups in clustering coefficient, betwenness centrality, average shortest path length and parieto occipital edge presence. In particular, patients with a mood disorder display a increased edge presence in the parieto-occipital region with respect to healthy control subjects, indicating a highly correlated electrical activity in that region of the brain. We also show that multilayer networks at constant edge density perform better, since most network properties are correlated with the edge density itself which can act as a confounding factor. Our results show that it is possible to stratify patients through statistical measurements on a multilayer network representation of hd-EEG recordings. The analysis reveals that individuals with mental health issues display strongly correlated signals in the parieto-occipital region. Our methodology could be useful as a visualization and analysis tool for hd-EEG recordings in a variety of pathological conditions.
Collapse
Affiliation(s)
- Francesc Font-Clos
- Center for Complexity and Biosystems, Department of Physics, University of Milan, Milano, Italy
| | - Benedetta Spelta
- Center for Complexity and Biosystems, Department of Physics, University of Milan, Milano, Italy
| | - Armando D'Agostino
- Department of Health Sciences, University of Milan, Milano, Italy.,Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milano, Italy
| | - Francesco Donati
- Department of Health Sciences, University of Milan, Milano, Italy.,Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milano, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', Milano, Italy
| | - Maria Paola Canevini
- Department of Health Sciences, University of Milan, Milano, Italy.,Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milano, Italy
| | - Stefano Zapperi
- Center for Complexity and Biosystems, Department of Physics, University of Milan, Milano, Italy.,CNR-Consiglio Nazionale delle Ricerche, Istituto di Chimica della Materia Condensata e di Tecnologie per l'Energia, Milano, Italy
| | - Caterina A M La Porta
- Center for Complexity and Biosystems, Department of Environmental Science and Policy, University of Milan, Milano, Italy.,CNR-Consiglio Nazionale delle Ricerche, Istituto di Biofisica, Milano, Italy
| |
Collapse
|
30
|
Sarasso S, Zubler F, Pigorini A, Sartori I, Castana L, Nobili L. Thalamic and neocortical differences in the relationship between the time course of delta and sigma power during NREM sleep in humans. J Sleep Res 2020; 30:e13166. [PMID: 32830381 DOI: 10.1111/jsr.13166] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/14/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022]
Abstract
Sleep spindles and slow waves are the hallmarks of non-rapid eye movement (NREM) sleep and are produced by the dynamic interplay between thalamic and cortical regions. Several studies in both human and animal models have focused their attention on the relationship between electroencephalographic (EEG) spindles and slow waves during NREM, using the power in the sigma and delta bands as a surrogate for the production of spindles and slow waves. A typical report is an overall inverse relationship between the time course of sigma and delta power as measured by a single correlation coefficient both within and across NREM episodes. Here we analysed stereotactically implanted intracerebral electrode (Stereo-EEG [SEEG]) recordings during NREM simultaneously acquired from thalamic and from several neocortical sites in six neurosurgical patients. We investigated the relationship between the time course of delta and sigma power and found that, although at the cortical level it shows the expected inverse relationship, these two frequency bands follow a parallel time course at the thalamic level. Both these observations were consistent across patients and across different cortical as well as thalamic regions. These different temporal dynamics at the neocortical and thalamic level are discussed, considering classical as well as more recent interpretations of the neurophysiological determinants of sleep spindles and slow waves. These findings may also help understanding the regulatory mechanisms of these fundamental sleep EEG graphoelements across different brain compartments.
Collapse
Affiliation(s)
- Simone Sarasso
- Dipartimento di Scienze Biomediche e Cliniche ''L. Sacco'', Università degli Studi di Milano, Milan, Italy
| | - Frederic Zubler
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrea Pigorini
- Dipartimento di Scienze Biomediche e Cliniche ''L. Sacco'', Università degli Studi di Milano, Milan, Italy
| | - Ivana Sartori
- Claudio Munari" Centre for Epilepsy Surgery, Niguarda Hospital, Milan, Italy
| | - Laura Castana
- Claudio Munari" Centre for Epilepsy Surgery, Niguarda Hospital, Milan, Italy
| | - Lino Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,Child Neuropsychiatry Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
| |
Collapse
|
31
|
Castelnovo A, Zago M, Casetta C, Zangani C, Donati F, Canevini M, Riedner BA, Tononi G, Ferrarelli F, Sarasso S, D'Agostino A. Slow wave oscillations in Schizophrenia First-Degree Relatives: A confirmatory analysis and feasibility study on slow wave traveling. Schizophr Res 2020; 221:37-43. [PMID: 32220503 DOI: 10.1016/j.schres.2020.03.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Received: 10/06/2019] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
Abstract
Abnormal sleep oscillations have recently been proposed as endophenotypes of schizophrenia. However, optimization of methodological approaches is still necessary to standardize analyses of their microstructural characteristics. Additionally, some relevant features of these oscillations remain unexplored in pathological conditions. Among others, slow wave traveling is a promising proxy for diurnal processes of brain connectivity and excitability. The study of slow oscillations propagation appears particularly relevant when schizophrenia is conceptualized as a dys-connectivity syndrome. Given the rising knowledge on the neurobiological mechanisms underlying slow wave traveling, this measure might offer substantial advantages over other approaches in investigating brain connectivity. Herein we: 1) confirm the stability of our previous findings on slow waves and sleep spindles in FDRs using different automated algorithms, and 2) report the dynamics of slow wave traveling in FDRs of Schizophrenia patients. A 256-channel, high-density EEG system was employed to record a whole night of sleep of 16 FDRs and 16 age- and gender-matched control subjects. A recently developed, open source toolbox was used for slow wave visualization and detection. Slow waves were confirmed to be significantly smaller in FDRs compared to the control group. Additionally, several traveling parameters were analyzed. Traveled distances were found to be significantly reduced in FDRs, whereas origins showed a different topographical pattern of distribution from control subjects. In contrast, local speed did not differ between groups. Overall, these results suggest that slow wave traveling might be a viable method to study pathological conditions interfering with brain connectivity.
Collapse
Affiliation(s)
- Anna Castelnovo
- Department of Health Sciences, Università degli Studi di Milano, Italy; Sleep Center, Neurocenter of Southern Switzerland, Regional Civic Hospital of Lugano, Switzerland; University of Southern Switzerland, Lugano, Switzerland.
| | - Matteo Zago
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy
| | - Cecilia Casetta
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, United Kingdom of Great Britain and Northern Ireland
| | - Caroline Zangani
- Department of Health Sciences, Università degli Studi di Milano, Italy
| | - Francesco Donati
- Department of Health Sciences, Università degli Studi di Milano, Italy
| | | | - Brady A Riedner
- Department of Psychiatry, University of Wisconsin, Madison, United States
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, United States
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, United States
| | - Simone Sarasso
- "L. Sacco" Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | | |
Collapse
|
32
|
Donati F, Carrara C, Casetta C, del Giudice R, Zalaffi M, Cornali M, Maestri D, Sarasso S, D’Agostino A. M6. REDUCED READINESS POTENTIAL AS A NEUROPHYSIOLOGICAL CORRELATE OF SELF-DISTURBANCES IN EARLY–COURSE PSYCHOSIS: PRELIMINARY FINDINGS FROM A HIGH–DENSITY EEG STUDY. Schizophr Bull 2020. [PMCID: PMC7234199 DOI: 10.1093/schbul/sbaa030.318] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Self-disturbances reflect a core dimension of Schizophrenia that can be identified before disease onset and might underlie the development of typical psychotic symptoms. The Sense of Agency (SoA) can be conceptualized as the pre-reflective sensation of being the one who is causing or generating an action or thought. Passivity phenomena, such as the reported feeling and belief that one’s thoughts or actions are generated and/or controlled by an external agent, are exquisite examples of SoA disturbances observed in Schizophrenia. Despite intensive research, the neurobiological pathogenetic mechanisms underlying such disturbances remain unclear. Among several putative neurophysiological brain abnormalities, a reduction of the Bereitschaftspotential, also called pre-motor or Readiness Potential (RP), was described in chronic, medicated patients with Schizophrenia. Given its anticipation of voluntary movement by 1 – 2 seconds over the motor cortex and supplementary motor area contralateral to the effector, RP has previously been proposed to be a neural signature of volition to initiate movement. Interestingly, higher RPs among healthy subjects have been recently associated with stronger intentional binding, suggesting increased SoA in subjects exhibiting stronger premovement activity. The objective of our work was to study RP abnormalities in patients with a psychotic illness of recent onset and to relate them to self disturbances, in order to clarify the relationship between known neurophysiological and psychopathological abnormalities. Methods We employed high-density electroencephalography (64-channel BrainAmp, Brain Products GmbH, Gilching, Germany) to record scalp potentials during a self-paced movement task in a group of seven early–course psychosis patients (mean age = 24,5, range 20–33) and an equal group of age– and gender– matched (mean age =25,3, range 19 – 36) healthy control subjects. Patients were recruited during an acute stage of their disorder requiring hospitalization and were treated with low–dose atypical antipsychotics. Exclusion criteria included major medical or neurological illness affecting the CNS and any intellectual developmental disorder. Several parameters related to the elicited RP were recorded, including maximum amplitude and slope. The Examination of Anomalous Self Experience (EASE) scale was chosen to assess Self disturbances in the patient group by an experienced clinician who was blind to the neurophysiological outcome. Results RP was found to be reduced in patients, compared to healthy control subjects, in both its amplitude and slope (p < 0,005) despite comparable EMG activity. EASE scores of items ‘EASE-10’ (a comprehensive item that reflect most prototypically the disorders of self-experience) and ‘EASE-2’ (“Self-Awareness”) appeared to increase monotonically with the decrease of RP slope (p < 0,05). Discussion Our preliminary data show that disturbances of RP are present since the early course of psychotic disorders. They also suggest that such abnormalities may reflect the severity of self-disturbances in these patients. If confirmed in a larger, medication-naïve samples, our findings might clarify the underlying neural mechanisms of such abnormalities and provide a solid basis for further investigation of RP disturbances as an early biological marker for Schizophrenia spectrum disorders.
Collapse
Affiliation(s)
| | | | - Cecilia Casetta
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London
| | | | | | | | | | | | | |
Collapse
|
33
|
Mikulan E, Russo S, Parmigiani S, Sarasso S, Zauli FM, Rubino A, Avanzini P, Cattani A, Sorrentino A, Gibbs S, Cardinale F, Sartori I, Nobili L, Massimini M, Pigorini A. Simultaneous human intracerebral stimulation and HD-EEG, ground-truth for source localization methods. Sci Data 2020; 7:127. [PMID: 32345974 PMCID: PMC7189230 DOI: 10.1038/s41597-020-0467-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 08/19/2019] [Accepted: 03/31/2020] [Indexed: 11/08/2022] Open
Abstract
Precisely localizing the sources of brain activity as recorded by EEG is a fundamental procedure and a major challenge for both research and clinical practice. Even though many methods and algorithms have been proposed, their relative advantages and limitations are still not well established. Moreover, these methods involve tuning multiple parameters, for which no principled way of selection exists yet. These uncertainties are emphasized due to the lack of ground-truth for their validation and testing. Here we present the Localize-MI dataset, which constitutes the first open dataset that comprises EEG recorded electrical activity originating from precisely known locations inside the brain of living humans. High-density EEG was recorded as single-pulse biphasic currents were delivered at intensities ranging from 0.1 to 5 mA through stereotactically implanted electrodes in diverse brain regions during pre-surgical evaluation of patients with drug-resistant epilepsy. The uses of this dataset range from the estimation of in vivo tissue conductivity to the development, validation and testing of forward and inverse solution methods.
Collapse
Affiliation(s)
- Ezequiel Mikulan
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Simone Russo
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Sara Parmigiani
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Flavia Maria Zauli
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Annalisa Rubino
- Centre of Epilepsy Surgery "C. Munari", Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - Pietro Avanzini
- Institute of Neuroscience, National Research Council of Italy, Parma, Italy
| | - Anna Cattani
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | | | - Steve Gibbs
- Centre of Epilepsy Surgery "C. Munari", Department of Neuroscience, Niguarda Hospital, Milan, Italy
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Department of Neurosciences, University of Montreal, Montreal, Quebec, Canada
| | - Francesco Cardinale
- Centre of Epilepsy Surgery "C. Munari", Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - Ivana Sartori
- Centre of Epilepsy Surgery "C. Munari", Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS 'G. Gaslini' Institute, Genoa, Italy
- DINOGMI, University of Genoa, Genoa, Italy
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
- IRCCS Fondazione Don Gnocchi, Milan, Italy
| | - Andrea Pigorini
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy.
| |
Collapse
|
34
|
D'Ambrosio S, Castelnovo A, Guglielmi O, Nobili L, Sarasso S, Garbarino S. Sleepiness as a Local Phenomenon. Front Neurosci 2019; 13:1086. [PMID: 31680822 PMCID: PMC6813205 DOI: 10.3389/fnins.2019.01086] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 03/20/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022] Open
Abstract
Sleep occupies a third of our life and is a primary need for all animal species studied so far. Nonetheless, chronic sleep restriction is a growing source of morbidity and mortality in both developed and developing countries. Sleep loss is associated with the subjective feeling of sleepiness and with decreased performance, as well as with detrimental effects on general health, cognition, and emotions. The ideas that small brain areas can be asleep while the rest of the brain is awake and that local sleep may account for at least some of the cognitive and behavioral manifestations of sleepiness are making their way into the scientific community. We herein clarify the different ways sleep can intrude into wakefulness, summarize recent scientific advances in the field, and offer some hypotheses that help framing sleepiness as a local phenomenon.
Collapse
Affiliation(s)
- Sasha D'Ambrosio
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università Degli Studi di Milano, Milan, Italy
| | - Anna Castelnovo
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland
| | - Ottavia Guglielmi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy
| | - Lino Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genoa, Italy
| | - Simone Sarasso
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università Degli Studi di Milano, Milan, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy
| |
Collapse
|
35
|
Sarasso S, Casarotto S, Fecchio M, Derchi C, Mazza A, D’Ambrosio S, Viganò A, Casali AG, Comolatti R, Comanducci A, Rosanova M, Massimini M, Parmigiani S. P52-S State-dependent changes in cortical reactivity: comparison between direct cortical and peripheral stimulation. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.588] [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: 11/24/2022]
|
36
|
Mensen A, Pigorini A, Facchin L, Schöne C, D'Ambrosio S, Jendoubi J, Jaramillo V, Chiffi K, Eberhard-Moscicka AK, Sarasso S, Adamantidis A, Müri RM, Huber R, Massimini M, Bassetti C. Corrigendum to: "Sleep as a model to understand neuroplasticity and recovery after stroke: Observational, perturbational and interventional approaches" [Journal of Neuroscience Methods Volume 313, 1 February 2019, Pages 37-43]. J Neurosci Methods 2019; 321:79. [PMID: 31053231 DOI: 10.1016/j.jneumeth.2019.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
37
|
Comolatti R, Pigorini A, Casarotto S, Fecchio M, Faria G, Sarasso S, Rosanova M, Gosseries O, Boly M, Bodart O, Ledoux D, Brichant JF, Nobili L, Laureys S, Tononi G, Massimini M, Casali AG. A fast and general method to empirically estimate the complexity of brain responses to transcranial and intracranial stimulations. Brain Stimul 2019; 12:1280-1289. [PMID: 31133480 DOI: 10.1016/j.brs.2019.05.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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: 12/24/2018] [Revised: 05/11/2019] [Accepted: 05/13/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The Perturbational Complexity Index (PCI) was recently introduced to assess the capacity of thalamocortical circuits to engage in complex patterns of causal interactions. While showing high accuracy in detecting consciousness in brain-injured patients, PCI depends on elaborate experimental setups and offline processing, and has restricted applicability to other types of brain signals beyond transcranial magnetic stimulation and high-density EEG (TMS/hd-EEG) recordings. OBJECTIVE We aim to address these limitations by introducing PCIST, a fast method for estimating perturbational complexity of any given brain response signal. METHODS PCIST is based on dimensionality reduction and state transitions (ST) quantification of evoked potentials. The index was validated on a large dataset of TMS/hd-EEG recordings obtained from 108 healthy subjects and 108 brain-injured patients, and tested on sparse intracranial recordings (SEEG) of 9 patients undergoing intracranial single-pulse electrical stimulation (SPES) during wakefulness and sleep. RESULTS When calculated on TMS/hd-EEG potentials, PCIST performed with the same accuracy as the original PCI, while improving on the previous method by being computed in less than a second and requiring a simpler set-up. In SPES/SEEG signals, the index was able to quantify a systematic reduction of intracranial complexity during sleep, confirming the occurrence of state-dependent changes in the effective connectivity of thalamocortical circuits, as originally assessed through TMS/hd-EEG. CONCLUSIONS PCIST represents a fundamental advancement towards the implementation of a reliable and fast clinical tool for the bedside assessment of consciousness as well as a general measure to explore the neuronal mechanisms of loss/recovery of brain complexity across scales and models.
Collapse
Affiliation(s)
- Renzo Comolatti
- Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, 12231-280, Brazil
| | - Andrea Pigorini
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, 20157, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, 20157, Italy
| | - Matteo Fecchio
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, 20157, Italy
| | - Guilherme Faria
- Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, 12231-280, Brazil
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, 20157, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, 20157, Italy
| | - Olivia Gosseries
- GIGA-Consciousness, GIGA Research, University of Liège, Liège, 4000, Belgium; Coma Science Group, University Hospital of Liège, Liège, 4000, Belgium
| | - Mélanie Boly
- Department of Psychiatry, University of Wisconsin, Madison, 53719, USA
| | - Olivier Bodart
- GIGA-Consciousness, GIGA Research, University of Liège, Liège, 4000, Belgium; Coma Science Group, University Hospital of Liège, Liège, 4000, Belgium
| | - Didier Ledoux
- GIGA-Consciousness, GIGA Research, University of Liège, Liège, 4000, Belgium
| | - Jean-François Brichant
- Department of Anesthesia and Intensive Care Medicine, University Hospital of Liège, Liège, 4000, Belgium
| | - Lino Nobili
- Center of Epilepsy Surgery "C. Munari", Department of Neuroscience, Niguarda Hospital, Milan, 20162, Italy; Child Neuropsychiatry, IRCCS G. Gaslini, DINOGMI, University of Genoa, Genova, 16147, Italy
| | - Steven Laureys
- GIGA-Consciousness, GIGA Research, University of Liège, Liège, 4000, Belgium; Coma Science Group, University Hospital of Liège, Liège, 4000, Belgium
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, 53719, USA
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, 20157, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, 20148, Italy
| | - Adenauer G Casali
- Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, 12231-280, Brazil.
| |
Collapse
|
38
|
Colombo MA, Napolitani M, Boly M, Gosseries O, Casarotto S, Rosanova M, Brichant JF, Boveroux P, Rex S, Laureys S, Massimini M, Chieregato A, Sarasso S. The spectral exponent of the resting EEG indexes the presence of consciousness during unresponsiveness induced by propofol, xenon, and ketamine. Neuroimage 2019; 189:631-644. [DOI: 10.1016/j.neuroimage.2019.01.024] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/20/2018] [Accepted: 01/09/2019] [Indexed: 11/17/2022] Open
|
39
|
Mensen A, Pigorini A, Facchin L, Schöne C, D'Ambrosio S, Jendoubi J, Jaramillo V, Chiffi K, Eberhard-Moscicka AK, Sarasso S, Adamantidis A, Müri RM, Huber R, Massimini M, Bassetti C. Sleep as a model to understand neuroplasticity and recovery after stroke: Observational, perturbational and interventional approaches. J Neurosci Methods 2018; 313:37-43. [PMID: 30571989 DOI: 10.1016/j.jneumeth.2018.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 09/11/2018] [Revised: 11/19/2018] [Accepted: 12/16/2018] [Indexed: 01/28/2023]
Abstract
Our own experiences with disturbances to sleep demonstrate its crucial role in the recovery of cognitive functions. This importance is likely enhanced in the recovery from stroke; both in terms of its physiology and cognitive abilities. Decades of experimental research have highlighted which aspects and mechanisms of sleep are likely to underlie these forms of recovery. Conversely, damage to certain areas of the brain, as well as the indirect effects of stroke, may disrupt sleep. However, only limited research has been conducted which seeks to directly explore this bidirectional link between both the macro and micro-architecture of sleep and stroke. Here we describe a series of semi-independent approaches that aim to establish this link through observational, perturbational, and interventional experiments. Our primary aim is to describe the methodology for future clinical and translational research needed to delineate competing accounts of the current data. At the observational level we suggest the use of high-density EEG recording, combined analysis of macro and micro-architecture of sleep, detailed analysis of the stroke lesion, and sensitive measures of functional recovery. The perturbational approach attempts to find the causal links between sleep and stroke. We promote the use of transcranial magnetic stimulation combined with EEG to examine the cortical dynamics of the peri-infarct stroke area. Translational research should take this a step further using optogenetic techniques targeting more specific cell populations. The interventional approach focuses on how the same clinical and translational perturbational techniques can be adapted to influence long-term recovery of function.
Collapse
|
40
|
Amato N, Manconi M, Möller JC, Sarasso S, Stanzione P, Staedler C, Kaelin-Lang A, Galati S. Levodopa-induced dyskinesia in Parkinson disease: Sleep matters. Ann Neurol 2018; 84:905-917. [DOI: 10.1002/ana.25360] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Ninfa Amato
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland; Lugano Switzerland
| | - Mauro Manconi
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland; Lugano Switzerland
| | - Jens C. Möller
- Parkinson Center; Zihlschlacht-Sitterdorf Switzerland
- Department of Neurology; Philipp University of Marburg; Marburg Germany
| | - Simone Sarasso
- L. Sacco Department of Biomedical and Clinical Sciences; University of Milan; Milan Italy
| | - Paolo Stanzione
- Department of Medical Systems; University of Rome Tor Vergata; Rome Italy
| | - Claudio Staedler
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland; Lugano Switzerland
| | - Alain Kaelin-Lang
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland; Lugano Switzerland
- University of Italian Switzerland; Lugano Switzerland
| | - Salvatore Galati
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland; Lugano Switzerland
- University of Italian Switzerland; Lugano Switzerland
| |
Collapse
|
41
|
Rosanova M, Fecchio M, Casarotto S, Sarasso S, Casali AG, Pigorini A, Comanducci A, Seregni F, Devalle G, Citerio G, Bodart O, Boly M, Gosseries O, Laureys S, Massimini M. Sleep-like cortical OFF-periods disrupt causality and complexity in the brain of unresponsive wakefulness syndrome patients. Nat Commun 2018; 9:4427. [PMID: 30356042 PMCID: PMC6200777 DOI: 10.1038/s41467-018-06871-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [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: 03/16/2018] [Accepted: 10/01/2018] [Indexed: 12/21/2022] Open
Abstract
Unresponsive wakefulness syndrome (UWS) patients may retain intact portions of the thalamocortical system that are spontaneously active and reactive to sensory stimuli but fail to engage in complex causal interactions, resulting in loss of consciousness. Here, we show that loss of brain complexity after severe injuries is due to a pathological tendency of cortical circuits to fall into silence (OFF-period) upon receiving an input, a behavior typically observed during sleep. Spectral and phase domain analysis of EEG responses to transcranial magnetic stimulation reveals the occurrence of OFF-periods in the cortex of UWS patients (N = 16); these events never occur in healthy awake individuals (N = 20) but are similar to those detected in healthy sleeping subjects (N = 8). Crucially, OFF-periods impair local causal interactions, and prevent the build-up of global complexity in UWS. Our findings link potentially reversible local events to global brain dynamics that are relevant for pathological loss and recovery of consciousness. Many brain-injured patients retain large cortical islands that are intact, active and reactive but blocked in a state of low complexity, leading to unconsciousness. Here, the authors show that this loss of complexity is due to the pathological engagement of sleep-like neuronal mechanisms.
Collapse
Affiliation(s)
- M Rosanova
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, 20157, Italy.,Fondazione Europea per la Ricerca Biomedica Onlus, Milan, 20063, Italy.,Neurointensive Care Unit, ASTT Grande Ospedale Metropolitano Niguarda, Milan, 20162, Italy
| | - M Fecchio
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, 20157, Italy
| | - S Casarotto
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, 20157, Italy.,IRCCS Fondazione Don Gnocchi, Milan, 20149, Italy
| | - S Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, 20157, Italy
| | - A G Casali
- Instituto de Ciência e Tecnologia, Universidade Federal de São Paulo, Sao Jose dos Campos, 12231-280, Brazil
| | - A Pigorini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, 20157, Italy
| | - A Comanducci
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, 20157, Italy
| | - F Seregni
- Department of Paediatrics, Cambridge University Hospital NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - G Devalle
- IRCCS Fondazione Don Gnocchi, Milan, 20149, Italy
| | - G Citerio
- Scuola di Medicina e Chirurgia, University of Milan Bicocca, Milan, 20126, Italy
| | - O Bodart
- GIGA-consciousness, Coma Science Group, University and University Hospital of Liège, Liège, 4000, Belgium
| | - M Boly
- Department of Neurology, University of Wisconsin, Madison, WI, 53705, USA.,Department of Psychiatry, University of Wisconsin, Madison, WI, 53719, USA
| | - O Gosseries
- GIGA-consciousness, Coma Science Group, University and University Hospital of Liège, Liège, 4000, Belgium
| | - S Laureys
- GIGA-consciousness, Coma Science Group, University and University Hospital of Liège, Liège, 4000, Belgium
| | - M Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, 20157, Italy. .,IRCCS Fondazione Don Gnocchi, Milan, 20149, Italy.
| |
Collapse
|
42
|
Gaggioni G, Ly JQ, Chellappa SL, Coppieters ‘t Wallant D, Rosanova M, Sarasso S, Luxen A, Salmon E, Middleton B, Massimini M, Schmidt C, Casali A, Phillips C, Vandewalle G. Human fronto-parietal response scattering subserves vigilance at night. Neuroimage 2018; 175:354-364. [DOI: 10.1016/j.neuroimage.2018.03.055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/20/2018] [Accepted: 03/23/2018] [Indexed: 01/17/2023] Open
|
43
|
D'Agostino A, Castelnovo A, Cavallotti S, Casetta C, Marcatili M, Gambini O, Canevini M, Tononi G, Riedner B, Ferrarelli F, Sarasso S. Sleep endophenotypes of schizophrenia: slow waves and sleep spindles in unaffected first-degree relatives. NPJ Schizophr 2018; 4:2. [PMID: 29426848 PMCID: PMC5807540 DOI: 10.1038/s41537-018-0045-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 12/18/2017] [Accepted: 01/16/2018] [Indexed: 11/09/2022]
Abstract
Sleep spindles and slow waves are the main brain oscillations occurring in non-REM sleep. Several lines of evidence suggest that spindles are initiated within the thalamus, whereas slow waves are generated and modulated in the cortex. A decrease in sleep spindle activity has been described in Schizophrenia (SCZ), including chronic, early course, and early onset patients. In contrast, slow waves have been inconsistently found to be reduced in SCZ, possibly due to confounds like duration of illness and antipsychotic medication exposure. Nontheless, the implication of sleep spindles and slow waves in the neurobiology of SCZ and related disorders, including their heritability, remains largely unknown. Unaffected first-degree relatives (FDRs) share a similar genetic background and several neurophysiological and cognitive deficits with SCZ patients, and allow testing whether some of these measures are candidate endophenotypes. In this study, we performed sleep high-density EEG recordings to characterise the spatiotemporal features of sleep spindles and slow waves in FDRs of SCZ probands and healthy subjects (HS) with no family history of SCZ. We found a significant reduction of integrated spindle activity (ISAs) in FDRs relative to HS, whereas spindle density and spindle duration were not different between groups. FDRs also had decreased slow wave amplitude and slopes. Altogether, our results suggest that ISAs deficits might represent a candidate endophenotype for SCZ. Furthermore, given the slow wave deficits observed in FDRs, we propose that disrupted cortical synchronisation increases the risk for SCZ, but thalamic dysfunction is necessary for the disorder to fully develop.
Collapse
Affiliation(s)
- Armando D'Agostino
- Department of Health Sciences, University of Milan, Milan, Italy. .,Department of Mental Health, San Paolo Hospital, Milan, Italy.
| | - Anna Castelnovo
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Cecilia Casetta
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Matteo Marcatili
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Orsola Gambini
- Department of Health Sciences, University of Milan, Milan, Italy.,Department of Mental Health, San Paolo Hospital, Milan, Italy
| | - Mariapaola Canevini
- Department of Health Sciences, University of Milan, Milan, Italy.,Department of Mental Health, San Paolo Hospital, Milan, Italy
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, USA
| | - Brady Riedner
- Department of Psychiatry, University of Wisconsin, Madison, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Simone Sarasso
- 'L. Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
| |
Collapse
|
44
|
Pincherle A, Pace M, Sarasso S, Facchin L, Dreier JP, Bassetti CL. Sleep, Preconditioning and Stroke. Stroke 2017; 48:3400-3407. [DOI: 10.1161/strokeaha.117.018796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/07/2017] [Accepted: 08/23/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Alessandro Pincherle
- From the Department of Clinical Neurosciences, Acute Neurorehabilitation Unit, University Hospital CHUV, Lausanne, Switzerland (A.P.); ZEN Department of Neurology, Bern University Hospital, Switzerland (M.P., L.F., C.L.B.); Department of Genetics and Epigenetics of Behavior, Istituto Italiano di Tecnologia, Genoa, Italy (M.P.); L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy (S.S.); and Department of Neurology (J.P.D.) and Department of Experimental Neurology (J.P
| | - Marta Pace
- From the Department of Clinical Neurosciences, Acute Neurorehabilitation Unit, University Hospital CHUV, Lausanne, Switzerland (A.P.); ZEN Department of Neurology, Bern University Hospital, Switzerland (M.P., L.F., C.L.B.); Department of Genetics and Epigenetics of Behavior, Istituto Italiano di Tecnologia, Genoa, Italy (M.P.); L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy (S.S.); and Department of Neurology (J.P.D.) and Department of Experimental Neurology (J.P
| | - Simone Sarasso
- From the Department of Clinical Neurosciences, Acute Neurorehabilitation Unit, University Hospital CHUV, Lausanne, Switzerland (A.P.); ZEN Department of Neurology, Bern University Hospital, Switzerland (M.P., L.F., C.L.B.); Department of Genetics and Epigenetics of Behavior, Istituto Italiano di Tecnologia, Genoa, Italy (M.P.); L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy (S.S.); and Department of Neurology (J.P.D.) and Department of Experimental Neurology (J.P
| | - Laura Facchin
- From the Department of Clinical Neurosciences, Acute Neurorehabilitation Unit, University Hospital CHUV, Lausanne, Switzerland (A.P.); ZEN Department of Neurology, Bern University Hospital, Switzerland (M.P., L.F., C.L.B.); Department of Genetics and Epigenetics of Behavior, Istituto Italiano di Tecnologia, Genoa, Italy (M.P.); L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy (S.S.); and Department of Neurology (J.P.D.) and Department of Experimental Neurology (J.P
| | - Jens P. Dreier
- From the Department of Clinical Neurosciences, Acute Neurorehabilitation Unit, University Hospital CHUV, Lausanne, Switzerland (A.P.); ZEN Department of Neurology, Bern University Hospital, Switzerland (M.P., L.F., C.L.B.); Department of Genetics and Epigenetics of Behavior, Istituto Italiano di Tecnologia, Genoa, Italy (M.P.); L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy (S.S.); and Department of Neurology (J.P.D.) and Department of Experimental Neurology (J.P
| | - Claudio L. Bassetti
- From the Department of Clinical Neurosciences, Acute Neurorehabilitation Unit, University Hospital CHUV, Lausanne, Switzerland (A.P.); ZEN Department of Neurology, Bern University Hospital, Switzerland (M.P., L.F., C.L.B.); Department of Genetics and Epigenetics of Behavior, Istituto Italiano di Tecnologia, Genoa, Italy (M.P.); L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy (S.S.); and Department of Neurology (J.P.D.) and Department of Experimental Neurology (J.P
| |
Collapse
|
45
|
Fecchio M, Pigorini A, Comanducci A, Sarasso S, Casarotto S, Premoli I, Derchi CC, Mazza A, Russo S, Resta F, Ferrarelli F, Mariotti M, Ziemann U, Massimini M, Rosanova M. The spectral features of EEG responses to transcranial magnetic stimulation of the primary motor cortex depend on the amplitude of the motor evoked potentials. PLoS One 2017; 12:e0184910. [PMID: 28910407 PMCID: PMC5599017 DOI: 10.1371/journal.pone.0184910] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/01/2017] [Indexed: 01/05/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) can excite both cortico-cortical and cortico-spinal axons resulting in TMS-evoked potentials (TEPs) and motor-evoked potentials (MEPs), respectively. Despite this remarkable difference with other cortical areas, the influence of motor output and its amplitude on TEPs is largely unknown. Here we studied TEPs resulting from M1 stimulation and assessed whether their waveform and spectral features depend on the MEP amplitude. To this aim, we performed two separate experiments. In experiment 1, single-pulse TMS was applied at the same supra-threshold intensity on primary motor, prefrontal, premotor and parietal cortices and the corresponding TEPs were compared by means of local mean field power and time-frequency spectral analysis. In experiment 2 we stimulated M1 at resting motor threshold in order to elicit MEPs characterized by a wide range of amplitudes. TEPs computed from high-MEP and low-MEP trials were then compared using the same methods applied in experiment 1. In line with previous studies, TMS of M1 produced larger TEPs compared to other cortical stimulations. Notably, we found that only TEPs produced by M1 stimulation were accompanied by a late event-related desynchronization (ERD-peaking at ~300 ms after TMS), whose magnitude was strongly dependent on the amplitude of MEPs. Overall, these results suggest that M1 produces peculiar responses to TMS possibly reflecting specific anatomo-functional properties, such as the re-entry of proprioceptive feedback associated with target muscle activation.
Collapse
Affiliation(s)
- Matteo Fecchio
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Andrea Pigorini
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Angela Comanducci
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Isabella Premoli
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Tübingen, Germany
| | - Chiara-Camilla Derchi
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Alice Mazza
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Simone Russo
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Federico Resta
- Division of Radiology, Hospital Luigi Sacco, Milan, Italy
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, United States of America
| | - Maurizio Mariotti
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Ulf Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, University Tübingen, Tübingen, Germany
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
- IRCCS Fondazione Don Gnocchi Onlus, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
- Fondazione Europea per la Ricerca Biomedica Onlus, Milan, Italy
- * E-mail:
| |
Collapse
|
46
|
Demertzi A, Sitt JD, Sarasso S, Pinxten W. Measuring states of pathological (un)consciousness: research dimensions, clinical applications, and ethics. Neurosci Conscious 2017; 2017:nix010. [PMID: 30042843 PMCID: PMC6007135 DOI: 10.1093/nc/nix010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 12/30/2016] [Revised: 02/02/2017] [Accepted: 04/18/2017] [Indexed: 12/26/2022] Open
Abstract
Consciousness is a multidimensional construct with no widely accepted definition. Especially in pathological conditions, it is less clear what exactly is meant by (un)consciousness, how it can be reliably observed or measured. Here, we aim at (i) bringing together state of the art approaches to classification of single patients suffering from disorders of consciousness by means of motor-independent assessment of consciousness states with electrophysiology and functional neuroimaging, (ii) showing how each proposed metric translates into clinical practice and (iii) raising a discussion on the ethical aspects of consciousness measurements. We realize that when dealing with patients some issues commonly pertain to each methodology discussed here, such as the overall clinical condition, clinical heterogeneity, and diagnostic uncertainty. When predicting patients' diagnosis, though, each method adopts a different approach to determine (a) a "gold standard" of the benchmark population upon which the metric is computed and (b) the generalization and replicability in the attempt to avoid overfitting. From an applied ethics perspective, the focus is, hence, on knowing what one is measuring and on the validity of measurements. We conclude that, when searching for consciousness in pathological conditions, confident diagnosis can be based on the use of probabilistic predictions as well as on accumulative evidence stemming from multiple non-overlapping assessments with different modalities. A framework which will regulate the application order of these techniques (balancing their availability, sensitivity, and specificity, based on underlying clinical assumptions about a patient's conscious state), is expected to ameliorate clinical management and further inform on the critical patterns of (un)consciousness.
Collapse
Affiliation(s)
- Athena Demertzi
- Brain and Spine Institute- Institut du Cerveau et de la Moelle épinière (ICM), Hôpital Pitié-Salpêtrière, 47, bd de l'Hôpital - 75013 Paris, France
- Coma Science Group, GIGA Research, CHU Sart Tilman B34-Quartier Hôpital, Avenue de l'Hôpital, 11 4000 Liège, Belgium
| | - Jacobo Diego Sitt
- Brain and Spine Institute- Institut du Cerveau et de la Moelle épinière (ICM), Hôpital Pitié-Salpêtrière, 47, bd de l'Hôpital - 75013 Paris, France
- INSERM, U 1127, F-75013, Paris, France
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Via G.B. Grassi, 74. 20157, Milano, Italy
| | - Wim Pinxten
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
| |
Collapse
|
47
|
Schartner MM, Pigorini A, Gibbs SA, Arnulfo G, Sarasso S, Barnett L, Nobili L, Massimini M, Seth AK, Barrett AB. Global and local complexity of intracranial EEG decreases during NREM sleep. Neurosci Conscious 2017; 2017:niw022. [PMID: 30042832 PMCID: PMC6007155 DOI: 10.1093/nc/niw022] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [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: 07/04/2016] [Revised: 09/20/2016] [Accepted: 11/19/2016] [Indexed: 11/13/2022] Open
Abstract
Key to understanding the neuronal basis of consciousness is the characterization of the neural signatures of changes in level of consciousness during sleep. Here we analysed three measures of dynamical complexity on spontaneous depth electrode recordings from 10 epilepsy patients during wakeful rest (WR) and different stages of sleep: (i) Lempel-Ziv complexity, which is derived from how compressible the data are; (ii) amplitude coalition entropy, which measures the variability over time of the set of channels active above a threshold; (iii) synchrony coalition entropy, which measures the variability over time of the set of synchronous channels. When computed across sets of channels that are broadly distributed across multiple brain regions, all three measures decreased substantially in all participants during early-night non-rapid eye movement (NREM) sleep. This decrease was partially reversed during late-night NREM sleep, while the measures scored similar to WR during rapid eye movement (REM) sleep. This global pattern was in almost all cases mirrored at the local level by groups of channels located in a single region. In testing for differences between regions, we found elevated signal complexity in the frontal lobe. These differences could not be attributed solely to changes in spectral power between conditions. Our results provide further evidence that the level of consciousness correlates with neural dynamical complexity.
Collapse
Affiliation(s)
- Michael M Schartner
- Sackler Centre for Consciousness Science and School of Engineering and Informatics, University of Sussex, Brighton, UK
| | - Andrea Pigorini
- Dipartimento di Scienze Biomediche e Cliniche ‘L. Sacco’, Universitá degli Studi di Milano, Milan, Italy
| | - Steve A Gibbs
- Niguarda Hospital, C. Munari Center of Epilepsy Surgery, Milan, Italy
| | - Gabriele Arnulfo
- Deparment of Informatics and Engineering (DIBRIS), University of Genoa, Italy
| | - Simone Sarasso
- Dipartimento di Scienze Biomediche e Cliniche ‘L. Sacco’, Universitá degli Studi di Milano, Milan, Italy
| | - Lionel Barnett
- Sackler Centre for Consciousness Science and School of Engineering and Informatics, University of Sussex, Brighton, UK
| | - Lino Nobili
- Niguarda Hospital, C. Munari Center of Epilepsy Surgery, Milan, Italy
| | - Marcello Massimini
- Dipartimento di Scienze Biomediche e Cliniche ‘L. Sacco’, Universitá degli Studi di Milano, Milan, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Gnocchi Onlus, Milan, Italy
| | - Anil K Seth
- Sackler Centre for Consciousness Science and School of Engineering and Informatics, University of Sussex, Brighton, UK
| | - Adam B Barrett
- Sackler Centre for Consciousness Science and School of Engineering and Informatics, University of Sussex, Brighton, UK
- Dipartimento di Scienze Biomediche e Cliniche ‘L. Sacco’, Universitá degli Studi di Milano, Milan, Italy
| |
Collapse
|
48
|
Casarotto S, Comanducci A, Rosanova M, Sarasso S, Fecchio M, Napolitani M, Pigorini A, G Casali A, Trimarchi PD, Boly M, Gosseries O, Bodart O, Curto F, Landi C, Mariotti M, Devalle G, Laureys S, Tononi G, Massimini M. Stratification of unresponsive patients by an independently validated index of brain complexity. Ann Neurol 2016; 80:718-729. [PMID: 27717082 PMCID: PMC5132045 DOI: 10.1002/ana.24779] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [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: 04/05/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 12/19/2022]
Abstract
Objective Validating objective, brain‐based indices of consciousness in behaviorally unresponsive patients represents a challenge due to the impossibility of obtaining independent evidence through subjective reports. Here we address this problem by first validating a promising metric of consciousness—the Perturbational Complexity Index (PCI)—in a benchmark population who could confirm the presence or absence of consciousness through subjective reports, and then applying the same index to patients with disorders of consciousness (DOCs). Methods The benchmark population encompassed 150 healthy controls and communicative brain‐injured subjects in various states of conscious wakefulness, disconnected consciousness, and unconsciousness. Receiver operating characteristic curve analysis was performed to define an optimal cutoff for discriminating between the conscious and unconscious conditions. This cutoff was then applied to a cohort of noncommunicative DOC patients (38 in a minimally conscious state [MCS] and 43 in a vegetative state [VS]). Results We found an empirical cutoff that discriminated with 100% sensitivity and specificity between the conscious and the unconscious conditions in the benchmark population. This cutoff resulted in a sensitivity of 94.7% in detecting MCS and allowed the identification of a number of unresponsive VS patients (9 of 43) with high values of PCI, overlapping with the distribution of the benchmark conscious condition. Interpretation Given its high sensitivity and specificity in the benchmark and MCS population, PCI offers a reliable, independently validated stratification of unresponsive patients that has important physiopathological and therapeutic implications. In particular, the high‐PCI subgroup of VS patients may retain a capacity for consciousness that is not expressed in behavior. Ann Neurol 2016;80:718–729
Collapse
Affiliation(s)
- Silvia Casarotto
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Angela Comanducci
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.,Fondazione Europea per la Ricerca Biomedica, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Matteo Fecchio
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Martino Napolitani
- Department of Health Science, School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Andrea Pigorini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Adenauer G Casali
- Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, Brazil
| | - Pietro D Trimarchi
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Gnocchi Onlus, Milan, Italy
| | - Melanie Boly
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA.,Department of Neurology, University of Wisconsin, Madison, WI, USA
| | - Olivia Gosseries
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA.,Coma Science Group, GIGA, University of Liège, Liège, Belgium
| | - Olivier Bodart
- Coma Science Group, GIGA, University of Liège, Liège, Belgium.,Department of Neurology, University of Liège and University Hospital of Liège, Liège, Belgium
| | - Francesco Curto
- Neurocritical Care Unit, Department of Neuroscience, Azienda Socio-Sanitaria Territoriale, Grande Ospedale Metropolitano Niguarda Cà Granda, Milan, Italy
| | - Cristina Landi
- Fondazione Europea per la Ricerca Biomedica, Milan, Italy
| | - Maurizio Mariotti
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Guya Devalle
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Gnocchi Onlus, Milan, Italy
| | - Steven Laureys
- Coma Science Group, GIGA, University of Liège, Liège, Belgium
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Gnocchi Onlus, Milan, Italy
| |
Collapse
|
49
|
Gorgoni M, Lauri G, Truglia I, Cordone S, Sarasso S, Scarpelli S, Mangiaruga A, D'Atri A, Tempesta D, Ferrara M, Marra C, Rossini PM, De Gennaro L. Parietal Fast Sleep Spindle Density Decrease in Alzheimer's Disease and Amnesic Mild Cognitive Impairment. Neural Plast 2016; 2016:8376108. [PMID: 27066274 PMCID: PMC4811201 DOI: 10.1155/2016/8376108] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/02/2016] [Accepted: 02/17/2016] [Indexed: 02/05/2023] Open
Abstract
Several studies have identified two types of sleep spindles: fast (13-15 Hz) centroparietal and slow (11-13 Hz) frontal spindles. Alterations in spindle activity have been observed in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). Only few studies have separately assessed fast and slow spindles in these patients showing a reduction of fast spindle count, but the possible local specificity of this phenomenon and its relation to cognitive decline severity are not clear. Moreover, fast and slow spindle density have never been assessed in AD/MCI. We have assessed fast and slow spindles in 15 AD patients, 15 amnesic MCI patients, and 15 healthy elderly controls (HC). Participants underwent baseline polysomnographic recording (19 cortical derivations). Spindles during nonrapid eye movements sleep were automatically detected, and spindle densities of the three groups were compared in the derivations where fast and slow spindles exhibited their maximum expression (parietal and frontal, resp.). AD and MCI patients showed a significant parietal fast spindle density decrease, positively correlated with Minimental State Examination scores. Our results suggest that AD-related changes in spindle density are specific for frequency and location, are related to cognitive decline severity, and may have an early onset in the pathology development.
Collapse
Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Giulia Lauri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Ilaria Truglia
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Susanna Cordone
- Department of Physiology and Pharmacology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy
| | - Serena Scarpelli
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | | | - Aurora D'Atri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Daniela Tempesta
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 Coppito, Italy
| | - Camillo Marra
- Institute of Neurology, Catholic University of The Sacred Heart, 00168 Rome, Italy
| | - Paolo Maria Rossini
- Institute of Neurology, Catholic University of The Sacred Heart, 00168 Rome, Italy
- IRCCS San Raffaele Pisana, 00163 Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| |
Collapse
|
50
|
Gibbs SA, Proserpio P, Terzaghi M, Pigorini A, Sarasso S, Lo Russo G, Tassi L, Nobili L. Sleep-related epileptic behaviors and non-REM-related parasomnias: Insights from stereo-EEG. Sleep Med Rev 2016; 25:4-20. [DOI: 10.1016/j.smrv.2015.05.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/13/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
|