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Borzello M, Ramirez S, Treves A, Lee I, Scharfman H, Stark C, Knierim JJ, Rangel LM. Assessments of dentate gyrus function: discoveries and debates. Nat Rev Neurosci 2023; 24:502-517. [PMID: 37316588 PMCID: PMC10529488 DOI: 10.1038/s41583-023-00710-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/16/2023]
Abstract
There has been considerable speculation regarding the function of the dentate gyrus (DG) - a subregion of the mammalian hippocampus - in learning and memory. In this Perspective article, we compare leading theories of DG function. We note that these theories all critically rely on the generation of distinct patterns of activity in the region to signal differences between experiences and to reduce interference between memories. However, these theories are divided by the roles they attribute to the DG during learning and recall and by the contributions they ascribe to specific inputs or cell types within the DG. These differences influence the information that the DG is thought to impart to downstream structures. We work towards a holistic view of the role of DG in learning and memory by first developing three critical questions to foster a dialogue between the leading theories. We then evaluate the extent to which previous studies address our questions, highlight remaining areas of conflict, and suggest future experiments to bridge these theories.
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Affiliation(s)
- Mia Borzello
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Steve Ramirez
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | | | - Inah Lee
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, South Korea
| | - Helen Scharfman
- Departments of Child and Adolescent Psychiatry, Neuroscience and Physiology and Psychiatry and the Neuroscience Institute, New York University Langone Health, New York, NY, USA
- The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Craig Stark
- Department of Neurobiology and Behaviour, University of California, Irvine, Irvine, CA, USA
| | - James J Knierim
- Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD, USA
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Lara M Rangel
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA.
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Salami P, Borzello M, Kramer MA, Westover MB, Cash SS. Quantifying seizure termination patterns reveals limited pathways to seizure end. Neurobiol Dis 2022; 165:105645. [PMID: 35104646 PMCID: PMC8860887 DOI: 10.1016/j.nbd.2022.105645] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/06/2022] [Accepted: 01/26/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Despite their possible importance in the design of novel neuromodulatory approaches and in understanding status epilepticus, the dynamics and mechanisms of seizure termination are not well studied. We examined intracranial recordings from patients with epilepsy to differentiate seizure termination patterns and investigated whether these patterns are indicative of different underlying mechanisms. METHODS Seizures were classified into one of two termination patterns: (a) those that end simultaneously across the brain (synchronous), and (b) those whose termination is piecemeal across the cortex (asynchronous). Both types ended with either a burst suppression pattern, or continuous seizure activity. These patterns were quantified and compared using burst suppression ratio, absolute energy, and network connectivity. RESULTS Seizures with electrographic generalization showed burst suppression patterns in 90% of cases, compared with only 60% of seizures which remained focal. Interestingly, we found similar absolute energy and burst suppression ratios in seizures with synchronous and asynchronous termination, while seizures with continuous seizure activity were found to be different from seizures with burst suppression, showing lower energy during seizure and lower burst suppression ratio at the start and end of seizure. Finally, network density was observed to increase with seizure progression, with significantly lower densities in seizures with continuous seizure activity compared to seizures with burst suppression. SIGNIFICANCE Based on this spatiotemporal classification scheme, we suggest that there are a limited number of seizure termination patterns and dynamics. If this bears out, it would imply that the number of mechanisms underlying seizure termination is also constrained. Seizures with different termination patterns exhibit different dynamics even before their start. This may provide useful clues about how seizures may be managed, which in turn may lead to more targeted modes of therapy for seizure control.
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Affiliation(s)
- Pariya Salami
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Mia Borzello
- Department of Cognitive Science, University of California, San Diego, CA, USA; Computational Neurobiology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Mark A Kramer
- Department of Mathematics and Statistics, Boston University, Boston, MA, USA
| | - M Brandon Westover
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Beagle AJ, Zahir A, Borzello M, Kayser AS, Hsu M, Miller BL, Kramer JH, Chiong W. Amount and delay insensitivity during intertemporal choice in three neurodegenerative diseases reflects dorsomedial prefrontal atrophy. Cortex 2019; 124:54-65. [PMID: 31837518 DOI: 10.1016/j.cortex.2019.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 02/21/2019] [Revised: 07/28/2019] [Accepted: 10/17/2019] [Indexed: 12/14/2022]
Abstract
Patients with Alzheimer's disease and other dementias often make poor financial decisions, but it remains unclear whether this reflects specific failures in decision-making or more general deficits in episodic and working memory. We investigated how patients with Alzheimer's disease, behavioral variant frontotemporal dementia (bvFTD), and semantic variant primary progressive aphasia (svPPA) apply information in an intertemporal choice task between smaller intermediate and larger delayed rewards, with minimal memory demands. Multilevel modeling estimated subject-level sensitivities to three attributes of choice (the relative difference in reward magnitude, delay length, and absolute reward magnitudes) as well as baseline impulsivity. While baseline impulsivity in patients with Alzheimer's disease did not differ from controls, patients with bvFTD and svPPA were more impulsive than controls overall. Patients with Alzheimer's disease or bvFTD were less sensitive than controls to all three choice attributes, whereas patients with svPPA were less sensitive than controls to two attributes. Attenuated sensitivity to information presented during the choice was associated across all subjects with dorsomedial prefrontal atrophy for all three choice attributes. Given the minimal memory demands of our task, these findings suggest specific mechanisms underlying decision-making failures beyond episodic and working memory deficits in dementia.
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Affiliation(s)
- Alexander J Beagle
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Ali Zahir
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Mia Borzello
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Andrew S Kayser
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Division of Neurology, VA Northern California Health Care System, Martinez, CA, USA
| | - Ming Hsu
- Helen Wills Neuroscience Institute and Haas School of Business, University of California, Berkeley, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Winston Chiong
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
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McKenzie ED, Lim ASP, Leung ECW, Cole AJ, Lam AD, Eloyan A, Nirola DK, Tshering L, Thibert R, Garcia RZ, Bui E, Deki S, Lee L, Clark SJ, Cohen JM, Mantia J, Brizzi KT, Sorets TR, Wahlster S, Borzello M, Stopczynski A, Cash SS, Mateen FJ. Validation of a smartphone-based EEG among people with epilepsy: A prospective study. Sci Rep 2017; 7:45567. [PMID: 28367974 PMCID: PMC5377373 DOI: 10.1038/srep45567] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 02/27/2017] [Indexed: 12/17/2022] Open
Abstract
Our objective was to assess the ability of a smartphone-based electroencephalography (EEG) application, the Smartphone Brain Scanner-2 (SBS2), to detect epileptiform abnormalities compared to standard clinical EEG. The SBS2 system consists of an Android tablet wirelessly connected to a 14-electrode EasyCap headset (cost ~ 300 USD). SBS2 and standard EEG were performed in people with suspected epilepsy in Bhutan (2014-2015), and recordings were interpreted by neurologists. Among 205 participants (54% female, median age 24 years), epileptiform discharges were detected on 14% of SBS2 and 25% of standard EEGs. The SBS2 had 39.2% sensitivity (95% confidence interval (CI) 25.8%, 53.9%) and 94.8% specificity (95% CI 90.0%, 97.7%) for epileptiform discharges with positive and negative predictive values of 0.71 (95% CI 0.51, 0.87) and 0.82 (95% CI 0.76, 0.89) respectively. 31% of focal and 82% of generalized abnormalities were identified on SBS2 recordings. Cohen's kappa (κ) for the SBS2 EEG and standard EEG for the epileptiform versus non-epileptiform outcome was κ = 0.40 (95% CI 0.25, 0.55). No safety or tolerability concerns were reported. Despite limitations in sensitivity, the SBS2 may become a viable supportive test for the capture of epileptiform abnormalities, and extend EEG access to new, especially resource-limited, populations at a reduced cost.
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Affiliation(s)
- Erica D. McKenzie
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew S. P. Lim
- Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Edward C. W. Leung
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Andrew J. Cole
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Alice D. Lam
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Ani Eloyan
- Department of Biostatistics, School of Public Health, Brown University, Providence, RI, USA
| | - Damber K. Nirola
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Lhab Tshering
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Ronald Thibert
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Esther Bui
- Division of Neurology, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Sonam Deki
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Liesly Lee
- Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Sarah J. Clark
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Joseph M. Cohen
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Jo Mantia
- Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Kate T. Brizzi
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Tali R. Sorets
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah Wahlster
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Mia Borzello
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Arkadiusz Stopczynski
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sydney S. Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Farrah J. Mateen
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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LaPlante RA, Tang W, Peled N, Vallejo DI, Borzello M, Dougherty DD, Eskandar EN, Widge AS, Cash SS, Stufflebeam SM. The interactive electrode localization utility: software for automatic sorting and labeling of intracranial subdural electrodes. Int J Comput Assist Radiol Surg 2016; 12:1829-1837. [PMID: 27915398 DOI: 10.1007/s11548-016-1504-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 11/07/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Existing methods for sorting, labeling, registering, and across-subject localization of electrodes in intracranial encephalography (iEEG) may involve laborious work requiring manual inspection of radiological images. METHODS We describe a new open-source software package, the interactive electrode localization utility which presents a full pipeline for the registration, localization, and labeling of iEEG electrodes from CT and MR images. In addition, we describe a method to automatically sort and label electrodes from subdural grids of known geometry. RESULTS We validated our software against manual inspection methods in twelve subjects undergoing iEEG for medically intractable epilepsy. Our algorithm for sorting and labeling performed correct identification on 96% of the electrodes. CONCLUSIONS The sorting and labeling methods we describe offer nearly perfect performance and the software package we have distributed may simplify the process of registering, sorting, labeling, and localizing subdural iEEG grid electrodes by manual inspection.
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Affiliation(s)
- Roan A LaPlante
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. .,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 13th Street, Charlestown, MA, USA.
| | - Wei Tang
- Department of Neurobiology and Anatomy, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Noam Peled
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Deborah I Vallejo
- Cortical Physiology Laboratory, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Mia Borzello
- Cortical Physiology Laboratory, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Emad N Eskandar
- Department of Neurological Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Sydney S Cash
- Cortical Physiology Laboratory, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Steven M Stufflebeam
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA.,Harvard-MIT Health Sciences and Technology, Cambridge, MA, USA
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Mateen FJ, Clark SJ, Borzello M, Kabore J, Seidi O. Neurology training in sub-Saharan Africa: A survey of people in training from 19 countries. Ann Neurol 2016; 79:871-81. [PMID: 27015883 DOI: 10.1002/ana.24649] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 03/21/2016] [Accepted: 03/21/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To provide a comprehensive understanding of neurology training from the sub-Saharan African perspective. METHODS A 40-question survey was distributed to attendees of the 7th annual sub-Saharan African neurology teaching course in Khartoum, Sudan (2015). Themes included the student body, faculty, curriculum, assessment and examinations, technology, and work hours and compensation. RESULTS Of 19 responding countries, 10 had no formal neurology training programs; Burkina Faso, Cameroon, Republic of the Congo, and Mozambique had an adult neurology program; Ethiopia, Madagascar, Nigeria, Senegal, and South Africa had adult and pediatric neurology programs (training duration range = 3-6 years). There was a median of 2.5 full-time neurologists on the teaching faculty at the respondents' training institutions (neurologists on-faculty:in-country ratio = 0.48), with the lowest ratios in Sudan and Nigeria. Neurology was perceived to be a competitive specialty for entrance in 57% of countries, with 78% of respondents reporting a requisite entrance examination. Ninety-five percent had access to a personal smartphone, 62% used the Internet more than occasionally, and 60% had access to online neurology journals. The average number of weekly work hours was 51 (range = 40-75), and average monthly salary among those earning income was 1,191 USD (range = 285-3,560). Twenty percent of respondents reported paying for training. The most common barriers to neurology postgraduate education were few training programs and lack of training in neurodiagnostic tests. Among 17 reporting countries, there is an estimated average of 0.6 neurologists per million people. INTERPRETATION Neurology training programs in sub-Saharan Africa are relatively limited in number and have several unmet needs including a small cadre of faculty and an opportunity to standardize curricula and financing of programs. Ann Neurol 2016;79:871-881.
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Affiliation(s)
- Farrah J Mateen
- Department of Neurology, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Sarah J Clark
- Department of Neurology, Massachusetts General Hospital, Boston, MA
| | - Mia Borzello
- Department of Neurology, Massachusetts General Hospital, Boston, MA
| | - Jean Kabore
- University of Ouagadougou, Ouagadougou, Burkina Faso
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