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Zilio F, Gomez-Pilar J, Chaudhary U, Fogel S, Fomina T, Synofzik M, Schöls L, Cao S, Zhang J, Huang Z, Birbaumer N, Northoff G. Altered brain dynamics index levels of arousal in complete locked-in syndrome. Commun Biol 2023; 6:757. [PMID: 37474587 PMCID: PMC10359418 DOI: 10.1038/s42003-023-05109-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 09/22/2022] [Accepted: 07/06/2023] [Indexed: 07/22/2023] Open
Abstract
Complete locked-in syndrome (CLIS) resulting from late-stage amyotrophic lateral sclerosis (ALS) is characterised by loss of motor function and eye movements. The absence of behavioural indicators of consciousness makes the search for neuronal correlates as possible biomarkers clinically and ethically urgent. EEG-based measures of brain dynamics such as power-law exponent (PLE) and Lempel-Ziv complexity (LZC) have been shown to have explanatory power for consciousness and may provide such neuronal indices for patients with CLIS. Here, we validated PLE and LZC (calculated in a dynamic way) as benchmarks of a wide range of arousal states across different reference states of consciousness (e.g., awake, sleep stages, ketamine, sevoflurane). We show a tendency toward high PLE and low LZC, with high intra-subject fluctuations and inter-subject variability in a cohort of CLIS patients with values graded along different arousal states as in our reference data sets. In conclusion, changes in brain dynamics indicate altered arousal in CLIS. Specifically, PLE and LZC are potentially relevant biomarkers to identify or diagnose the arousal level in CLIS and to determine the optimal time point for treatment, including communication attempts.
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Affiliation(s)
- Federico Zilio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padua, Italy.
| | - Javier Gomez-Pilar
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Valladolid, Spain
| | - Ujwal Chaudhary
- BrainPortal Technologies GmbH, Mannheim, Germany
- ALS Voice gGmbH, Mössingen, Germany
| | - Stuart Fogel
- School of Psychology, University of Ottawa, Ottawa, Canada
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Tatiana Fomina
- Department for Empirical Inference, Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Shumei Cao
- Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jun Zhang
- Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Zirui Huang
- Center for Consciousness Science, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
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2
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Fomina T, Kukushkina T. Flowers of C ampanula species as a source of biologically active substances. BIO Web Conf 2021. [DOI: 10.1051/bioconf/20213800033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The content of the major groups of biologically active substances in flowers of 7 Campanula species, cultivated in the forest-steppe of Western Siberia, were investigated for the first time. Freshly collected flowers were found to contain 0.06-0.15 % of catechins, 0.31-3.17 % of flavonols, 3.31-6.47 % of tannins, 3.10-15.57 % of pectic substances, and 0.66-16.4 mg% of carotenoids calculated per absolute dre weight of raw material. The amount of ascorbic acid was 36.9-114.0 mg% per wet weight. The data indicate that Campanula flowers are promising for the production of phenolic compounds, the development of food additives and fresh consumptions a seasoning.
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Zilio F, Gomez-Pilar J, Cao S, Zhang J, Zang D, Qi Z, Tan J, Hiromi T, Wu X, Fogel S, Huang Z, Hohmann MR, Fomina T, Synofzik M, Grosse-Wentrup M, Owen AM, Northoff G. Are intrinsic neural timescales related to sensory processing? Evidence from abnormal behavioral states. Neuroimage 2020; 226:117579. [PMID: 33221441 DOI: 10.1016/j.neuroimage.2020.117579] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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: 07/15/2020] [Revised: 10/15/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022] Open
Abstract
The brain exhibits a complex temporal structure which translates into a hierarchy of distinct neural timescales. An open question is how these intrinsic timescales are related to sensory or motor information processing and whether these dynamics have common patterns in different behavioral states. We address these questions by investigating the brain's intrinsic timescales in healthy controls, motor (amyotrophic lateral sclerosis, locked-in syndrome), sensory (anesthesia, unresponsive wakefulness syndrome), and progressive reduction of sensory processing (from awake states over N1, N2, N3). We employed a combination of measures from EEG resting-state data: auto-correlation window (ACW), power spectral density (PSD), and power-law exponent (PLE). Prolonged neural timescales accompanied by a shift towards slower frequencies were observed in the conditions with sensory deficits, but not in conditions with motor deficits. Our results establish that the spontaneous activity's intrinsic neural timescale is related to the neural capacity that specifically supports sensory rather than motor information processing in the healthy brain.
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Affiliation(s)
- Federico Zilio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padua, Italy.
| | - Javier Gomez-Pilar
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Valladolid, Spain
| | - Shumei Cao
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Zhang
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Di Zang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zengxin Qi
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiaxing Tan
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Tanigawa Hiromi
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Xuehai Wu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Stuart Fogel
- The Brain and Mind Institute, Department of Physiology and Pharmacology and the Department of Psychology, University of Western Ontario, Canada
| | - Zirui Huang
- Center for Consciousness Science, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Matthias R Hohmann
- Department for Empirical Inference, Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Tatiana Fomina
- Department for Empirical Inference, Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurology, Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Moritz Grosse-Wentrup
- Research Group Neuroinformatics, Faculty of Computer Science, University of Vienna, Austria
| | - Adrian M Owen
- The Brain and Mind Institute, Department of Physiology and Pharmacology and the Department of Psychology, University of Western Ontario, Canada
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
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Fomina T, Burmistrova-Savenkova A, Morosanova V. Self-Regulation and Psychological Well-Being in Early Adolescence: A Two-Wave Longitudinal Study. Behav Sci (Basel) 2020; 10:bs10030067. [PMID: 32164173 PMCID: PMC7139468 DOI: 10.3390/bs10030067] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022] Open
Abstract
This paper addresses the question of whether self-regulation capacities are a significant psychological resource of schoolchildren's psychological well-being. The study contributes to the search of significant predictors of the students' psychological well-being. Moscow secondary schools pupils (N = 239) participated in a two-wave longitudinal study, the procedure being made in the 4th grade and repeated in the 5th grade, six months after the first measurement. The results are presented describing the dynamics of manifestations of the psychological well-being and the conscious self-regulation of the schoolchildren during their transition from the primary to the middle school. Using the cross-lagged panel analysis allowed concluding that the level of conscious self-regulation of the learning activity of the 4th graders significantly predicts their psychological well-being not only in the 4th grade, but also in the 5th grade. The study revealed the specific regulatory predictors characteristic of different manifestations of the schoolchildren' psychological well-being. The obtained results highlight the significance of research on the conscious self-regulation of learning activities as a resource for pupils' psychological well-being, which is predictive for its maturation in the subsequent ages.
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Yukhno A, Hlobenko H, Fomina T, Denysova A, Rudoi K. [PROBLEMS OF ENSURING AND IMPLEMENTING THE RIGHTS OF MENTALLY DISTURBED PEOPLE WITHIN CRIMINAL PROCEEDINGS OF UKRAINE]. Georgian Med News 2019:90-96. [PMID: 30829597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The objective of this article is to determine the scope of the rights of mentally disturbed people while carrying out criminal proceedings. To achieve this objective, the authors have formulated the methodological complex, which included both general scientific methods and special methods of cognition. The scope of the rights of a mentally disturbed person in criminal proceedings has been determined with the help of the method of legal analysis. The statistical method was used to study the dynamics in the processes related to the investigation and submission to the court of criminal proceedings with a petition for the application of compulsory medical measures. The comparative and legal method made it possible to compare the norms of national legislation with the cases of the European Court of Human Rights on the possibility of appeal and cassation appeal of the application of compulsory medical measures. The conducted study led to the conclusion that mentally disturbed people are a special category of participants in criminal proceedings in Ukraine. These persons have the same rights as a suspect, accused and, in certain cases defined by the law exercise them through a legal representative, a defense attorney. Since the status of a legal representative is not legally defined in national legislation, the authors have offered to establish the rights and obligations of a legal representative as the main subject representing the rights and interests of a mentally disturbed person in the Criminal Procedural Code of Ukraine. The need to apply the practice of the European Court of Human Rights in Ukraine during criminal proceedings demonstrates the advisability of revising national legal provisions on the possibility of appealing and cassational appealing of compulsory medical measures by mentally disturbed people.
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Affiliation(s)
- A Yukhno
- Kharkiv National University of Internal Affairs; Odessa State University of Internal Affairs, Ukrane
| | - H Hlobenko
- Kharkiv National University of Internal Affairs; Odessa State University of Internal Affairs, Ukrane
| | - T Fomina
- Kharkiv National University of Internal Affairs; Odessa State University of Internal Affairs, Ukrane
| | - A Denysova
- Kharkiv National University of Internal Affairs; Odessa State University of Internal Affairs, Ukrane
| | - K Rudoi
- Kharkiv National University of Internal Affairs; Odessa State University of Internal Affairs, Ukrane
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Mortensen JHS, Øyen N, Nilsen RM, Fomina T, Tretli S, Bjørge T. Paternal characteristics associated with maternal periconceptional use of folic acid supplementation. BMC Pregnancy Childbirth 2018; 18:188. [PMID: 29843620 PMCID: PMC5975548 DOI: 10.1186/s12884-018-1830-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background Maternal predictors of folic acid (FA) supplementation use to reduce offspring risk of neural tube defects are well known, while paternal determinants for maternal FA use are less known. Such knowledge is important to increase women’s compliance to recommended periconceptional FA use. Methods In a nation-wide study of 683,785 births registered in the Medical Birth Registry of Norway during 1999–2010, the associations between paternal characteristics (age, education, occupation, country of origin) and maternal FA use were estimated by relative risks (RR) with 95% confidence intervals (CI), using log-binomial regression. Results Maternal FA use before and during pregnancy (adequate FA use) was found in 16% of the births. The association between paternal age and adequate FA use was inversely U-shaped; adjusted RRs for adequate FA use were 0.35 (95% CI 0.28–0.43) and 0.72 (95% CI 0.71–0.74) for paternal age < 20 and ≥ 40 years, respectively, comparing age 30–34 years. Compulsory education (1–9 years) among fathers was compared to tertiary education; the RR was 0.69 (95% CI 0.68–0.71) for adequate FA use. The lower risk of adequate FA use for paternal compulsory education was present in all categories of maternal education. Occupation classes other than “Higher professionals” were associated with decreased risk of adequate FA use, compared with the reference “Lower professionals”. RR for adequate FA use was 0.58 (95% CI 0.56–0.60) comparing fathers from “Low/middle-income countries” with fathers born in Norway. Conclusion Adequate FA use in the periconceptional period was lower when fathers were younger or older than 30–34 years, had shorter education, had manual or self-employed occupations, or originated from low/middle-income countries. Partners may contribute to increase women’s use of periconceptional FA supplementation.
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Affiliation(s)
- Jan Helge Seglem Mortensen
- Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018, Bergen, Norway. .,Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
| | - Nina Øyen
- Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018, Bergen, Norway.,Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Roy M Nilsen
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tatiana Fomina
- Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018, Bergen, Norway
| | | | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018, Bergen, Norway.,Cancer Registry of Norway, Oslo, Norway
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Moreno Uribe LM, Fomina T, Munger RG, Romitti PA, Jenkins MM, Gjessing HK, Gjerdevik M, Christensen K, Wilcox AJ, Murray JC, Lie RT, Wehby GL. A Population-Based Study of Effects of Genetic Loci on Orofacial Clefts. J Dent Res 2017; 96:1322-1329. [PMID: 28662356 DOI: 10.1177/0022034517716914] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Prior genome-wide association studies for oral clefts have focused on clinic-based samples with unclear generalizability. Prior samples were also small for investigating effects by cleft type and exclusively studied isolated clefts (those occurring without other birth defects). We estimated the effects of 17 top loci on cleft types in both isolated and nonisolated cases in the largest consortium to date of European-descent population-based studies. Our analytic approach focused on a mother-child dyad case-control design, but it also allowed analyzing mother-only or child-only genotypes to maximize power. Our total sample included 1,875 cases with isolated clefts, 459 cases with nonisolated clefts, and 3,749 controls. After correcting for multiple testing, we observed significant associations between fetal single-nucleotide polymorphisms (SNPs) at IRF6, PAX7, 8q21.3, 8q24, KIAA1598-VAX1, and MAFB and isolated cleft lip only (CLO) and cleft lip and palate (CLP). Significant associations were observed between isolated CLO and fetal SNPs near TPM1 and NOG1 and between CLP and fetal SNPs at ABCA4-ARHGAP29, THADA, FOXE1, and SPRY2. Overall, effects were similar for isolated CLO and CLP, except for ABCA4-ARHGAP29. A protective effect was observed for the fetal NOG1 SNP on cleft palate only, opposite in direction to the effect on CLO. For most fetal SNPs, a dose-response allelic effect was observed. No evidence of parent-of-origin or maternal genome effects was observed. Overall, effect direction and magnitude were similar between isolated and nonisolated clefts, suggesting that several loci are modifiers of cleft risk in both isolated and nonisolated forms. Our results provide reliable estimates of the effects of top loci on risks of oral clefts in a population of European descent.
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Affiliation(s)
- L M Moreno Uribe
- 1 Department of Orthodontics and Dows Institute, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - T Fomina
- 2 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - R G Munger
- 3 Department of Nutrition and Food Sciences, Utah State University, Logan, UT, USA
| | - P A Romitti
- 4 Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - M M Jenkins
- 5 National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H K Gjessing
- 2 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,6 Norwegian Institute of Public Health, Bergen and Oslo, Norway
| | - M Gjerdevik
- 2 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,6 Norwegian Institute of Public Health, Bergen and Oslo, Norway
| | - K Christensen
- 7 Department of Public Health, University of Southern Denmark; Department of Clinical Genetics and Department of Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - A J Wilcox
- 8 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA
| | - J C Murray
- 9 Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - R T Lie
- 2 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,6 Norwegian Institute of Public Health, Bergen and Oslo, Norway
| | - G L Wehby
- 10 Departments of Health Management and Policy, Economics, and Preventive and Community Dentistry, and Public Policy Center, University of Iowa, Iowa City, IA, USA
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Fomina T, Lohmann G, Erb M, Ethofer T, Schölkopf B, Grosse-Wentrup M. Self-regulation of brain rhythms in the precuneus: a novel BCI paradigm for patients with ALS. J Neural Eng 2016; 13:066021. [PMID: 27841159 DOI: 10.1088/1741-2560/13/6/066021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Electroencephalographic (EEG) brain-computer interfaces (BCIs) hold promise in restoring communication for patients with completely locked-in stage amyotrophic lateral sclerosis (ALS). However, these patients cannot use existing EEG-based BCIs, arguably because such systems rely on brain processes that are impaired in the late stages of ALS. In this work, we introduce a novel BCI designed for patients in late stages of ALS based on high-level cognitive processes that are less likely to be affected by ALS. APPROACH We trained two ALS patients via EEG-based neurofeedback to use self-regulation of theta or gamma oscillations in the precuneus for basic communication. Because there is a tight connection between the precuneus and consciousness, precuneus oscillations are arguably generated by high-level cognitive processes, which are less likely to be affected by ALS than processes linked to the peripheral nervous system. MAIN RESULTS Both patients learned to self-regulate their precuneus oscillations and achieved stable online decoding accuracy over the course of disease progression. One patient achieved a mean online decoding accuracy in a binary decision task of 70.55% across 26 training sessions, and the other patient achieved 59.44% across 16 training sessions. We provide empirical evidence that these oscillations were cortical in nature and originated from the intersection of the precuneus, cuneus, and posterior cingulate. SIGNIFICANCE Our results establish that ALS patients can employ self-regulation of precuneus oscillations for communication. Such a BCI is likely to be available to ALS patients as long as their consciousness supports communication.
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Affiliation(s)
- Tatiana Fomina
- Department Empirical Inference, Max Planck Institute for Intelligent Systems, Tübingen, Germany. IMPRS for Cognitive and Systems Neuroscience, University of Tübingen, Tübingen, Germany
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Jayaram V, Widmann N, Förster C, Fomina T, Hohmann M, Müller Vom Hagen J, Synofzik M, Schölkopf B, Schöls L, Grosse-Wentrup M. Brain-computer interfacing in amyotrophic lateral sclerosis: Implications of a resting-state EEG analysis. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:6979-82. [PMID: 26737898 DOI: 10.1109/embc.2015.7319998] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite decades of research on EEG-based brain-computer interfaces (BCIs) in patients with amyotrophic lateral sclerosis (ALS), there is still little known about how the disease affects the electromagnetic field of the brain. This may be one reason for the present failure of EEG-based BCI paradigms for completely locked-in ALS patients. In order to help understand this failure, we have recorded resting state data from six ALS patients and thirty-two healthy controls to investigate for group differences. While similar studies have been attempted in the past, none have used high-density EEG or tried to distinguish between physiological and non-physiological sources of the EEG. We find an ALS-specific global increase in gamma power (30-90 Hz) that is not specific to the motor cortex, suggesting that the mechanism behind ALS affects non-motor cortical regions even in the absence of comorbid cognitive deficits.
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Jortveit J, Leirgul E, Eskedal L, Greve G, Fomina T, Døhlen G, Tell GS, Birkeland S, Øyen N, Holmstrøm H. Mortality and complications in 3495 children with isolated ventricular septal defects. Arch Dis Child 2016; 101:808-13. [PMID: 27091847 DOI: 10.1136/archdischild-2015-310154] [Citation(s) in RCA: 24] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/28/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Ventricular septal defects (VSDs) are the most common congenital heart defects (CHDs). Previous studies indicate an increased risk of endocarditis, aortic regurgitation, left ventricular outflow tract obstructions, pulmonary hypertension, arrhythmias and sudden death in patients with isolated VSDs. The present nationwide cohort study reports mortality and cardiac complications requiring hospitalisation or intervention in children with isolated VSDs. METHODS AND RESULTS Medical information concerning all 943 871 live births in Norway in 1994-2009 was retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry of Congenital Heart Defects and the Norwegian Cause of Death Registry. Isolated VSDs were identified in 3495 children without known chromosomal aberrations or extracardiac malformations. Surgical or catheter-based treatment of VSD was performed in 181 (5.2%) cases. Twelve (0.3%) children with VSDs died before 2013. There was no operative mortality, and no excess mortality in children with isolated VSDs compared with children without VSDs (adjusted HR 0.8 (0.5 to 1.4), p=0.48). The following conditions were recorded as possible cardiac complications of the VSDs: endocarditis in 3 children (0.9‰), aortic regurgitation in 12 children (3.4‰), left ventricular outflow tract obstructions in no children (0.0‰), pulmonary hypertension in 1 child (0.3‰) and arrhythmias in 16 children (4.6‰). CONCLUSIONS The entire group of children with isolated VSDs had a favourable prognosis without excess mortality. Cardiac complications requiring hospitalisation or intervention, including endocarditis, aortic regurgitation, left ventricular outflow tract obstructions, pulmonary hypertension and arrhythmias, were infrequent during childhood. TRIAL REGISTRATION NUMBER NCT02026557.
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Affiliation(s)
- Jarle Jortveit
- Department of Cardiology, Sørlandet, Arendal, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth Leirgul
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Leif Eskedal
- Department of Research, Sørlandet Hospital, Kristiansand, Norway
| | - Gottfried Greve
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Department of Medical Science, University of Bergen, Bergen, Norway
| | - Tatiana Fomina
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gaute Døhlen
- Women's and Children's Department, Oslo University Hospital, Oslo, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Division of epidemiology, Norwegian Institute of Public Health, Bergen, Norway
| | - Sigurd Birkeland
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Nina Øyen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Henrik Holmstrøm
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway Women's and Children's Department, Oslo University Hospital, Oslo, Norway
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Jortveit J, Øyen N, Leirgul E, Fomina T, Tell GS, Vollset SE, Eskedal L, Døhlen G, Birkeland S, Holmstrøm H. Trends in Mortality of Congenital Heart Defects. CONGENIT HEART DIS 2015; 11:160-8. [DOI: 10.1111/chd.12307] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Jarle Jortveit
- Department of Cardiology; Sørlandet Hospital; Arendal Norway
- Institute of Clinical Medicine, University of Oslo; Oslo Norway
| | - Nina Øyen
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital; Bergen Norway
| | - Elisabeth Leirgul
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
| | - Tatiana Fomina
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
| | - Grethe S. Tell
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Division of Epidemiology; Norwegian Institute of Public Health; Bergen Norway
| | - Stein Emil Vollset
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Division of Epidemiology; Norwegian Institute of Public Health; Bergen Norway
| | - Leif Eskedal
- Research Department; Sørlandet Hospital; Kristiansand Norway
| | - Gaute Døhlen
- Women's and Children's Department, Oslo University Hospital; Oslo Norway
| | - Sigurd Birkeland
- Department of Cardiothoracic Surgery, Oslo University Hospital; Oslo Norway
| | - Henrik Holmstrøm
- Institute of Clinical Medicine, University of Oslo; Oslo Norway
- Women's and Children's Department, Oslo University Hospital; Oslo Norway
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Mortensen JHS, Øyen N, Fomina T, Melbye M, Tretli S, Vollset SE, Bjørge T. Supplemental folic acid in pregnancy and maternal cancer risk. Cancer Epidemiol 2015; 39:805-11. [PMID: 26569032 DOI: 10.1016/j.canep.2015.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/16/2015] [Revised: 09/10/2015] [Accepted: 10/07/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND There is evidence that increased intake of folate protects against the development of several types of cancer. Some studies have, however, raised concern about the safety of folate in relation to cancer risk. Here we examined the risk of maternal cancer after intake of supplemental folic acid in pregnancy. METHODS This is a population-based cohort study comprising 429,004 women with data from the Medical Birth Registry of Norway, the Cancer Registry of Norway, and other national registries from 1999 to 2010. Altogether 3781 cancer cases were identified during follow-up (average 7 years). Cox proportional hazards regression models were used to estimate hazard ratios of maternal cancer according to folic acid use prior to and during one or two or more pregnancies as compared to no supplement use. RESULTS Folic acid supplementation use had no overall effect on cancer risk in women using folic acid supplementation in one (HR 1.08; 95% CI 1.00-1.18) or two or more pregnancies (HR 1.06; 95% CI 0.91-1.22) (ptrend=0.12). Analyses of 13 cancer types revealed no associations between folic acid and cancer. CONCLUSION Folic acid supplementation before and during pregnancy had no overall effect on maternal cancer risk. IMPACT Folic acid substitution before and/or during pregnancy does not increase the short-term overall maternal cancer risk.
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Affiliation(s)
- Jan Helge Seglem Mortensen
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
| | - Nina Øyen
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tatiana Fomina
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Mads Melbye
- Department of Epidemiology Research, National Health Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Stein Emil Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Norwegian Institute of Public Health, Oslo, Norway
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Cancer Registry of Norway, Oslo, Norway
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Jortveit J, Eskedal L, Hirth A, Fomina T, Døhlen G, Hagemo P, Tell GS, Birkeland S, Øyen N, Holmstrøm H. Sudden unexpected death in children with congenital heart defects. Eur Heart J 2015; 37:621-6. [PMID: 26341891 DOI: 10.1093/eurheartj/ehv478] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 03/23/2015] [Accepted: 08/24/2015] [Indexed: 11/13/2022] Open
Abstract
AIMS Congenital heart defects (CHDs) are the most common birth defects and are an important cause of death in children. The fear of sudden unexpected death has led to restrictions of physical activity and competitive sports. The aim of the present study was to investigate the rate of sudden unexpected deaths unrelated to surgery in children 2-18 years old with CHDs and, secondarily, to determine whether these deaths were related to cardiac disease, comorbidity, or physical activity. METHODS AND RESULTS To identify children with CHDs and to determine the number of deaths, data concerning all 9 43 871 live births in Norway in 1994-2009 were retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry for Congenital Heart Defects and the Norwegian Cause of Death Registry. Survivors were followed through 2012, and information for the deceased children was retrieved from medical records at Norwegian hospitals. Among 11 272 children with CHDs, we identified 19 (0.2%) children 2-18 years old who experienced sudden unexpected deaths unrelated to cardiac surgery. A cardiac cause of death was identified in seven of these cases. None of the children died during physical activity, whereas two children survived cardiac arrest during sports. CONCLUSION Sudden unexpected death was infrequent among children with CHDs who survived 2 years of age. Comorbidity was common among the children who died. This study indicates that sudden unexpected death in children with CHDs rarely occurs during physical activity.
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Affiliation(s)
- Jarle Jortveit
- Department of Cardiology, Sørlandet Hospital, PO Box 783, Stoa, 4809 Arendal, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Leif Eskedal
- Research Department, Sørlandet Hospital, Kristiansand, Norway
| | - Asle Hirth
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Tatiana Fomina
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gaute Døhlen
- Women's and Children's Department, Oslo University Hospital, Oslo, Norway
| | - Petter Hagemo
- Women's and Children's Department, Oslo University Hospital, Oslo, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway
| | - Sigurd Birkeland
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Nina Øyen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Henrik Holmstrøm
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway Women's and Children's Department, Oslo University Hospital, Oslo, Norway
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Leirgul E, Gildestad T, Nilsen RM, Fomina T, Brodwall K, Greve G, Vollset SE, Holmstrøm H, Tell GS, Øyen N. Periconceptional Folic Acid Supplementation and Infant Risk of Congenital Heart Defects in Norway 1999-2009. Paediatr Perinat Epidemiol 2015. [PMID: 26212116 DOI: 10.1111/ppe.12212] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The birth prevalence of congenital heart defects (CHDs) has decreased in Canada and Europe. Recommended intake of folic acid in pregnancy is a suggestive risk-reducing factor for CHDs. We investigated the association between periconceptional intake of folic acid supplements and infant risk of CHDs. METHODS Information on maternal intake of folic acid supplements before and during pregnancy in the Medical Birth Registry of Norway 1999-2009 was updated with information on CHD diagnoses from national health registers and the Cardiovascular Diseases in Norway Project. The association between folic acid intake and infant risk of CHD was estimated as relative risk (RR) with binomial log linear regression. RESULTS Among 517 784 non-chromosomal singleton births, 6200 children were identified with CHD and 1153 with severe CHD. For all births, 18.4% of the mothers initiated folic acid supplements before pregnancy and 31.6% during pregnancy. The adjusted RR for severe CHD was 0.99 [95% confidence interval [CI] 0.86, 1.13] comparing periconceptional intake of folic acid with no intake. Specifically, RR for conotruncal defects was 0.99 [95% CI 0.80, 1.22], atrioventricular septal defects 1.19 [95% CI 0.78, 1.81], left ventricular outflow tract obstructions 1.02 [95% CI 0.78, 1.32], and right ventricular outflow tract obstructions 0.97 [95% CI 0.72, 1.29]. Birth prevalence of septal defects was higher in the group exposed to folic acid supplements with RR 1.19 [95% CI 1.10, 1.30]. CONCLUSIONS Periconceptional folic acid supplement use showed no association with severe CHDs in the newborn. An unexpected association with an increased risk of septal defects warrants further investigation.
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Affiliation(s)
- Elisabeth Leirgul
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Trude Gildestad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Roy Miodini Nilsen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Tatiana Fomina
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kristoffer Brodwall
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gottfried Greve
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Stein Emil Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Institute of Public Health, Bergen, Norway
| | - Henrik Holmstrøm
- Department of Pediatrics, Oslo University Hospital, Oslo, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Institute of Public Health, Bergen, Norway
| | - Nina Øyen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
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Fomina T, Hohmann M, Scholkopf B, Grosse-Wentrup M. Identification of the Default Mode Network with electroencephalography. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:7566-7569. [PMID: 26738043 DOI: 10.1109/embc.2015.7320143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Default Mode Network (DMN) is a brain resting-state network that is closely linked to consciousness and neuropsychiatric disorders. The DMN is routinely identified with functional magnetic resonance imaging (fMRI) or positron emission tomography (PET). However, both of these methods impose restrictions on the groups of patients that can be examined. We show that the DMN can also be identified by electroencephalography (EEG). Instructing subjects to alternate between self-referential memory recall and focusing on their breathing induces a spatial pattern of spectral band power modulation in the θ- and α-band (4-16 Hz) that is consistent with the DMN pattern observed with PET and fMRI. Since EEG is a portable, cheap, and safe technology, our work enables the characterization of DMN alterations in patient groups that are difficult to study with fMRI or PET.
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Morosanova V, Fomina T, Bogdanova O. Self-regulation, cognitive characteristics, and mathematical success. Personality and Individual Differences 2014. [DOI: 10.1016/j.paid.2013.07.180] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kozlova N, Oleynik N, Kotlyarov Y, Popov A, Belyavsky A, Gromut I, Fomina T, Klimova N. P14 First results of Breast Cancer Screening Program in Khanty-Mansiysk State region Ugra. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70246-5] [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: 11/29/2022] Open
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