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Kaiser A, Aggensteiner PM, Blasco Fontecilla H, Ros T, Acquaviva E, Attal Y, Banaschewski T, Baumeister S, Bousquet E, Bussalb A, Delhaye M, Delorme R, Drechsler R, Goujon A, Häge A, Mayaud L, Mechler K, Menache C, Revol O, Tagwerker F, Walitza S, Werling AM, Bioulac S, Purper-Ouakil D, Brandeis D. Limited usefulness of neurocognitive functioning indices as predictive markers for treatment response to methylphenidate or neurofeedback@home in children and adolescents with ADHD. Front Psychiatry 2024; 14:1331004. [PMID: 38312916 PMCID: PMC10836215 DOI: 10.3389/fpsyt.2023.1331004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Earlier studies exploring the value of executive functioning (EF) indices for assessing treatment effectiveness and predicting treatment response in attention-deficit/hyperactivity disorder (ADHD) mainly focused on pharmacological treatment options and revealed rather heterogeneous results. Envisioning the long-term goal of personalized treatment selection and intervention planning, this study comparing methylphenidate treatment (MPH) and a home-based neurofeedback intervention (NF@Home) aimed to expand previous findings by assessing objective as well as subjectively reported EF indices and by analyzing their value as treatment and predictive markers. Methods Children and adolescents (n = 146 in the per protocol sample) aged 7-13 years with a formal diagnosis of an inattentive or combined presentation of ADHD were examined. We explored the EF performance profile using the Conners Continuous Performance Task (CPT) and the BRIEF self-report questionnaire within our prospective, multicenter, randomized, reference drug-controlled NEWROFEED study with sites in five European countries (France, Spain, Switzerland, Germany, and Belgium). As primary outcome for treatment response, the clinician-rated ADHD Rating Scale-IV was used. Patients participating in this non-inferiority trial were randomized to either NF@home (34-40 sessions of TBR or SMR NF depending on the pre-assessed individual alpha peak frequency) or MPH treatment (ratio: 3:2). Within a mixed-effects model framework, analyses of change were calculated to explore the predictive value of neurocognitive indices for ADHD symptom-related treatment response. Results For a variety of neurocognitive indices, we found a significant pre-post change during treatment, mainly in the MPH group. However, the results of the current study reveal a rather limited prognostic value of neurocognitive indices for treatment response to either NF@Home or MPH treatment. Some significant effects emerged for parent-ratings only. Discussion Current findings indicate a potential value of self-report (BRIEF global score) and some objectively measured neurocognitive indices (CPT commission errors and hit reaction time variability) as treatment markers (of change) for MPH. However, we found a rather limited prognostic value with regard to predicting treatment response not (yet) allowing recommendation for clinical use. Baseline symptom severity was revealed as the most relevant predictor, replicating robust findings from previous studies.
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Affiliation(s)
- Anna Kaiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Pascal M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Tomas Ros
- Department of Neuroscience, Campus Biotech CISA-Université de Genève, Genève, Switzerland
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department and Child Brain Institute, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris and Universite Paris Cite, Paris, France
| | | | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Elisa Bousquet
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Montpellier, France
| | | | - Marie Delhaye
- Child and Adolescent Psychiatry, Erasme Academic Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Richard Delorme
- Child and Adolescent Psychiatry Department and Child Brain Institute, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris and Universite Paris Cite, Paris, France
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Allison Goujon
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Montpellier, France
| | - Alexander Häge
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Konstantin Mechler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Olivier Revol
- Unit of Child and Adolescent Psychiatry, Hospices civils de Lyon, Hôpital Femme Mère Enfant, Bron Cedex, France
| | - Friederike Tagwerker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Stéphanie Bioulac
- SANPSY, USR 3413, CNRS, Bordeaux, France
- Clinique du Sommeil, CHU Pellegrin, Bordeaux Cedex, France
| | - Diane Purper-Ouakil
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Montpellier, France
- Development and Trajectories, INSERM CESP U 1018 Psychiatry, Montpellier, France
- CESP, INSERM U 1018, Paul Brousse Hospital, Villejuif, France
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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Grosselin F, Breton A, Yahia-Cherif L, Wang X, Spinelli G, Hugueville L, Fossati P, Attal Y, Navarro-Sune X, Chavez M, George N. Alpha activity neuromodulation induced by individual alpha-based neurofeedback learning in ecological context: a double-blind randomized study. Sci Rep 2021; 11:18489. [PMID: 34531416 PMCID: PMC8445968 DOI: 10.1038/s41598-021-96893-5] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023] Open
Abstract
The neuromodulation induced by neurofeedback training (NFT) remains a matter of debate. Investigating the modulation of brain activity specifically associated with NF requires controlling for multiple factors, such as reward, performance, congruency between task and targeted brain activity. This can be achieved using sham feedback (FB) control condition, equating all aspects of the experiment but the link between brain activity and FB. We aimed at investigating the modulation of individual alpha EEG activity induced by NFT in a double-blind, randomized, sham-controlled study. Forty-eight healthy participants were assigned to either NF (n = 25) or control (n = 23) group and performed alpha upregulation training (over 12 weeks) with a wearable EEG device. Participants of the NF group received FB based on their individual alpha activity. The control group received the auditory FB of participants of the NF group. An increase of alpha activity across training sessions was observed in the NF group only (p < 0.001). This neuromodulation was selective in that there was no evidence for similar effects in the theta (4-8 Hz) and low beta (13-18 Hz) bands. While alpha upregulation was found in the NF group only, psychological outcome variables showed overall increased feeling of control, decreased anxiety level and increased relaxation feeling, without any significant difference between the NF and the control groups. This is interpreted in terms of learning context and placebo effects. Our results pave the way to self-learnt, NF-based neuromodulation with light-weighted, wearable EEG systems.
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Affiliation(s)
- Fanny Grosselin
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Equipe Aramis, 75013, Paris, France.
- myBrain Technologies, 75010, Paris, France.
- INRIA, Aramis Project-Team, 75013, Paris, France.
| | | | - Lydia Yahia-Cherif
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Xi Wang
- myBrain Technologies, 75010, Paris, France
| | | | - Laurent Hugueville
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Philippe Fossati
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe CIA-Cognitive Control, Interoception, Attention, 75013, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Psychiatrie Adulte, 75013, Paris, France
| | | | | | | | - Nathalie George
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe Experimental Neurosurgery, 75013, Paris, France
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Guillon J, Chavez M, Battiston F, Attal Y, La Corte V, Thiebaut de Schotten M, Dubois B, Schwartz D, Colliot O, De Vico Fallani F. Disrupted core-periphery structure of multimodal brain networks in Alzheimer's disease. Netw Neurosci 2019; 3:635-652. [PMID: 31157313 PMCID: PMC6542619 DOI: 10.1162/netn_a_00087] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/02/2019] [Indexed: 11/20/2022] Open
Abstract
In Alzheimer's disease (AD), the progressive atrophy leads to aberrant network reconfigurations both at structural and functional levels. In such network reorganization, the core and peripheral nodes appear to be crucial for the prediction of clinical outcome because of their ability to influence large-scale functional integration. However, the role of the different types of brain connectivity in such prediction still remains unclear. Using a multiplex network approach we integrated information from DWI, fMRI, and MEG brain connectivity to extract an enriched description of the core-periphery structure in a group of AD patients and age-matched controls. Globally, the regional coreness-that is, the probability of a region to be in the multiplex core-significantly decreased in AD patients as result of a random disconnection process initiated by the neurodegeneration. Locally, the most impacted areas were in the core of the network-including temporal, parietal, and occipital areas-while we reported compensatory increments for the peripheral regions in the sensorimotor system. Furthermore, these network changes significantly predicted the cognitive and memory impairment of patients. Taken together these results indicate that a more accurate description of neurodegenerative diseases can be obtained from the multimodal integration of neuroimaging-derived network data.
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Affiliation(s)
- Jeremy Guillon
- Institut du Cerveau et de la Moelle Epiniere, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Universite, Paris, France
- Inria Paris, Aramis Project Team, Paris, France
| | | | - Federico Battiston
- Inria Paris, Aramis Project Team, Paris, France
- CNRS, UMR 7225, Paris, France
- Department of Network and Data Science, Central European University, Budapest, Hungary
| | | | - Valentina La Corte
- Department of Neurology, Institute of Memory and Alzheimer’s Disease, Assistance Publique - Hopitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
- Inserm, UMR 894, Center of Psychiatry and Neurosciences, Memory and Cognition Laboratory, Paris, France
- Institute of Psychology, University Paris Descartes, Sorbonne Paris Cite, France
| | - Michel Thiebaut de Schotten
- Institut du Cerveau et de la Moelle Epiniere, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Universite, Paris, France
| | - Bruno Dubois
- Institut de la Memoire et de la Maladie d’Alzheimer - IM2A, AP-HP, Sorbonne Universite, Paris, France
| | - Denis Schwartz
- Institut du Cerveau et de la Moelle Epiniere, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Universite, Ecole Normale Superieure, ENS, Centre MEG-EEG, Paris, France
| | - Olivier Colliot
- Institut du Cerveau et de la Moelle Epiniere, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Universite, Paris, France
- Inria Paris, Aramis Project Team, Paris, France
| | - Fabrizio De Vico Fallani
- Institut du Cerveau et de la Moelle Epiniere, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Universite, Paris, France
- Inria Paris, Aramis Project Team, Paris, France
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Grosselin F, Navarro-Sune X, Vozzi A, Pandremmenou K, De Vico Fallani F, Attal Y, Chavez M. Quality Assessment of Single-Channel EEG for Wearable Devices. Sensors (Basel) 2019; 19:s19030601. [PMID: 30709004 PMCID: PMC6387437 DOI: 10.3390/s19030601] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 01/28/2019] [Indexed: 11/16/2022]
Abstract
The recent embedding of electroencephalographic (EEG) electrodes in wearable devices raises the problem of the quality of the data recorded in such uncontrolled environments. These recordings are often obtained with dry single-channel EEG devices, and may be contaminated by many sources of noise which can compromise the detection and characterization of the brain state studied. In this paper, we propose a classification-based approach to effectively quantify artefact contamination in EEG segments, and discriminate muscular artefacts. The performance of our method were assessed on different databases containing either artificially contaminated or real artefacts recorded with different type of sensors, including wet and dry EEG electrodes. Furthermore, the quality of unlabelled databases was evaluated. For all the studied databases, the proposed method is able to rapidly assess the quality of the EEG signals with an accuracy higher than 90%. The obtained performance suggests that our approach provide an efficient, fast and automated quality assessment of EEG signals from low-cost wearable devices typically composed of a dry single EEG channel.
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Affiliation(s)
- Fanny Grosselin
- hlSorbonne Université, UPMC Univ. Paris 06, INSERM U-1127, CNRS UMR-7225, Institut du Cerveau et de la Moelle Épinière (ICM), Groupe Hospitalier Pitié Salpêtrière-Charles Foix, 75013 Paris, France.
- myBrainTechnologies, 75010 Paris, France.
| | | | | | | | - Fabrizio De Vico Fallani
- hlSorbonne Université, UPMC Univ. Paris 06, INSERM U-1127, CNRS UMR-7225, Institut du Cerveau et de la Moelle Épinière (ICM), Groupe Hospitalier Pitié Salpêtrière-Charles Foix, 75013 Paris, France.
- INRIA, Aramis Project-Team, F-75013 Paris, France.
| | | | - Mario Chavez
- CNRS UMR-7225, Groupe Hospitalier Pitié-Salpêtrière-Charles Foix, 75013 Paris, France.
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Breton A, Ronca V, Baudu S, Brunet E, SERVAJEAN-HILST R, Dumas T, Attal Y. Tracking the effect of a new massage system integrated in automotive seat on relaxation feeling: an electrophysiological study. Front Hum Neurosci 2018. [DOI: 10.3389/conf.fnhum.2018.227.00018] [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: 11/13/2022] Open
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Breton A, Ronca V, Mallet-Dacosta AI, Longatte F, Servajean-Hilst R, Attal Y. Identifying the neural signature of thermic comfort sensation: neuroergonomic evaluation of a new ventilating system integrated in car seat. Front Hum Neurosci 2018. [DOI: 10.3389/conf.fnhum.2018.227.00008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Guillon J, Attal Y, Colliot O, La Corte V, Dubois B, Schwartz D, Chavez M, De Vico Fallani F. Loss of brain inter-frequency hubs in Alzheimer's disease. Sci Rep 2017; 7:10879. [PMID: 28883408 PMCID: PMC5589939 DOI: 10.1038/s41598-017-07846-w] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [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: 03/28/2017] [Accepted: 06/29/2017] [Indexed: 01/05/2023] Open
Abstract
Alzheimer's disease (AD) causes alterations of brain network structure and function. The latter consists of connectivity changes between oscillatory processes at different frequency channels. We proposed a multi-layer network approach to analyze multiple-frequency brain networks inferred from magnetoencephalographic recordings during resting-states in AD subjects and age-matched controls. Main results showed that brain networks tend to facilitate information propagation across different frequencies, as measured by the multi-participation coefficient (MPC). However, regional connectivity in AD subjects was abnormally distributed across frequency bands as compared to controls, causing significant decreases of MPC. This effect was mainly localized in association areas and in the cingulate cortex, which acted, in the healthy group, as a true inter-frequency hub. MPC values significantly correlated with memory impairment of AD subjects, as measured by the total recall score. Most predictive regions belonged to components of the default-mode network that are typically affected by atrophy, metabolism disruption and amyloid-β deposition. We evaluated the diagnostic power of the MPC and we showed that it led to increased classification accuracy (78.39%) and sensitivity (91.11%). These findings shed new light on the brain functional alterations underlying AD and provide analytical tools for identifying multi-frequency neural mechanisms of brain diseases.
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Affiliation(s)
- J Guillon
- Inria Paris, Aramis project-team, 75013, Paris, France
- CNRS UMR-7225, Sorbonne Universites, UPMC Univ Paris 06, Inserm U-1127, Institut du cerveau et la moelle (ICM), Hopital Pitie-Salpetriere, 75013, Paris, France
| | - Y Attal
- MyBrain Technologies, Paris, France
| | - O Colliot
- Inria Paris, Aramis project-team, 75013, Paris, France
- CNRS UMR-7225, Sorbonne Universites, UPMC Univ Paris 06, Inserm U-1127, Institut du cerveau et la moelle (ICM), Hopital Pitie-Salpetriere, 75013, Paris, France
| | - V La Corte
- Institute of Psychology, University Paris Descartes, Sorbonne Paris Cite, France
- INSERM UMR 894, Center of Psychiatry and Neurosciences, Memory and Cognition Laboratory, Paris, France
| | - B Dubois
- Department of Neurology, Institut de la Memoire et de la Maladie dAlzheimer - IM2A, Paris, France
| | - D Schwartz
- CNRS UMR-7225, Sorbonne Universites, UPMC Univ Paris 06, Inserm U-1127, Institut du cerveau et la moelle (ICM), Hopital Pitie-Salpetriere, 75013, Paris, France
| | - M Chavez
- CNRS UMR-7225, Sorbonne Universites, UPMC Univ Paris 06, Inserm U-1127, Institut du cerveau et la moelle (ICM), Hopital Pitie-Salpetriere, 75013, Paris, France
| | - F De Vico Fallani
- Inria Paris, Aramis project-team, 75013, Paris, France.
- CNRS UMR-7225, Sorbonne Universites, UPMC Univ Paris 06, Inserm U-1127, Institut du cerveau et la moelle (ICM), Hopital Pitie-Salpetriere, 75013, Paris, France.
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Dumas T, Dubal S, Attal Y, Chupin M, Jouvent R, Morel S, George N. MEG evidence for dynamic amygdala modulations by gaze and facial emotions. PLoS One 2013; 8:e74145. [PMID: 24040190 PMCID: PMC3769395 DOI: 10.1371/journal.pone.0074145] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [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: 03/21/2013] [Accepted: 07/26/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Amygdala is a key brain region for face perception. While the role of amygdala in the perception of facial emotion and gaze has been extensively highlighted with fMRI, the unfolding in time of amydgala responses to emotional versus neutral faces with different gaze directions is scarcely known. METHODOLOGY/PRINCIPAL FINDINGS Here we addressed this question in healthy subjects using MEG combined with an original source imaging method based on individual amygdala volume segmentation and the localization of sources in the amygdala volume. We found an early peak of amygdala activity that was enhanced for fearful relative to neutral faces between 130 and 170 ms. The effect of emotion was again significant in a later time range (310-350 ms). Moreover, the amygdala response was greater for direct relative averted gaze between 190 and 350 ms, and this effect was selective of fearful faces in the right amygdala. CONCLUSION Altogether, our results show that the amygdala is involved in the processing and integration of emotion and gaze cues from faces in different time ranges, thus underlining its role in multiple stages of face perception.
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Affiliation(s)
- Thibaud Dumas
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
- CNRS, USR 3246, Centre Emotion, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphanie Dubal
- CNRS, USR 3246, Centre Emotion, Hôpital Pitié-Salpêtrière, Paris, France
| | - Yohan Attal
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
| | - Marie Chupin
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
| | - Roland Jouvent
- CNRS, USR 3246, Centre Emotion, Hôpital Pitié-Salpêtrière, Paris, France
| | - Shasha Morel
- CNRS, UMR 7295, CeRCA, Université François-Rabelais, Tours, France
| | - Nathalie George
- CNRS, UMR 7225, CRICM, Paris, France
- Inserm, U 975, Paris, France
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l′Institut du Cerveau et de la Moelle Epinière (CRICM), UMR_S 975, and Centre MEG-CENIR, Paris, France
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Fasoula A, Attal Y, Schwartz D. Comparative performance evaluation of data-driven causality measures applied to brain networks. J Neurosci Methods 2013; 215:170-89. [DOI: 10.1016/j.jneumeth.2013.02.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 02/26/2013] [Accepted: 02/28/2013] [Indexed: 11/27/2022]
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Attal Y, Schwartz D. Assessment of subcortical source localization using deep brain activity imaging model with minimum norm operators: a MEG study. PLoS One 2013; 8:e59856. [PMID: 23527277 PMCID: PMC3603889 DOI: 10.1371/journal.pone.0059856] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [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: 10/26/2012] [Accepted: 02/21/2013] [Indexed: 11/22/2022] Open
Abstract
Subcortical structures are involved in many healthy and pathological brain processes. It is crucial for many studies to use magnetoencephalography (MEG) to assess the ability to detect subcortical generators. This study aims to assess the source localization accuracy and to compare the characteristics of three inverse operators in the specific case of subcortical generators. MEG has a low sensitivity to subcortical sources mainly because of their distance from sensors and their complex cyto-architecture. However, we show that using a realistic anatomical and electrophysiological model of deep brain activity (DBA), the sources make measurable contributions to MEG sensors signals. Furthermore, we study the point-spread and cross-talk functions of the wMNE, sLORETA and dSPM inverse operators to characterize distortions in cortical and subcortical regions and to study how noise-normalization methods can improve or bias accuracy. We then run Monte Carlo simulations with neocortical and subcortical activations. In the case of single hippocampus patch activations, the results indicate that MEG can indeed localize the generators in the head and the body of the hippocampus with good accuracy. We then tackle the question of simultaneous cortical and subcortical activations. wMNE can detect hippocampal activations that are embedded in cortical activations that have less than double their amplitude, but it does not completely correct the bias to more superficial sources. dSPM and sLORETA can still detect hippocampal activity above this threshold, but such detection might include the creation of ghost deeper sources. Finally, using the DBA model, we showed that the detection of weak thalamic modulations of ongoing brain activity is possible.
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Affiliation(s)
- Yohan Attal
- CRICM UMR-S975 - Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, Université Pierre et Marie Curie-Paris 6, Paris, France.
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Rosso C, Corvol JC, Pires C, Crozier S, Attal Y, Jacqueminet S, Deltour S, Multlu G, Leger A, Meresse I, Payan C, Dormont D, Samson Y. Intensive Versus Subcutaneous Insulin in Patients With Hyperacute Stroke. Stroke 2012; 43:2343-9. [DOI: 10.1161/strokeaha.112.657122] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background and Purpose—
Intensive insulin therapy (IIT) has not yet proven its efficacy on stroke prognosis or in the reduction of MRI infarct growth. The INSULINFARCT study aims at determining in patients with hyperacute stroke whether IIT, with a better control of poststroke hyperglycemia, would reduce subsequent MRI infarct growth than usual care with subcutaneous insulin.
Methods—
One hundred eighty patients with MRI-proven ischemic stroke and with National Institutes of Health Stroke Scale from 5 to 25 at admission (<6 hours) were randomized to receive IIT or usual subcutaneous insulin for 24 hours. Admission hyperglycemia was not required for recruitment. Control MRI and 3-month follow-up (with functional outcome and serious adverse events) were planned. The primary objective was to detect a difference in the proportion of patients with mean capillary glucose test <7 mmol/L during 24 hours. The secondary objective was to investigate whether IIT would reduce infarct growth. The analysis was planned in intention-to-treat. Patients with >3 missing capillary glucose test were excluded (n=4).
Results—
The proportion of patients with mean capillary glucose test <7 mmol/L in the first 24 hours was higher in the IIT group (95.4% [83 of 87] versus 67.4% [60 of 89];
P
<0.0001). The infarct growth was lower in the subcutaneous insulin group (median, 10.8 cm
3
; 95% CI, 6.5–22.4 versus 27.9 cm
3
; 14.6–40.7; 60% of increase;
P
=0.04). The 3-month functional outcome (45.6% [41 of 90] versus 45.6% [41 of 90]), death (15.6% [14 of 90] versus 10% [9 of 90]), and serious adverse events (38.9% [35 of 90] versus 35.6% [32 of 90]) were similar in the subcutaneous insulin and IIT group.
Conclusion—
The IIT regimen improved glucose control in the first 24 hours of stroke but was associated with larger infarct growths. IIT cannot be recommended in hyperacute ischemic stroke.
Clinical Trial Registration—
URL:
http://clinicaltrials.gov
. Unique Identifier: NCT00472381.
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Affiliation(s)
- Charlotte Rosso
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Jean-Christophe Corvol
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Christine Pires
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Sophie Crozier
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Yohan Attal
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Sophie Jacqueminet
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Sandrine Deltour
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Gurkan Multlu
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Anne Leger
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Isabelle Meresse
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Christine Payan
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Didier Dormont
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
| | - Yves Samson
- From the AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France (C.R., C. Pires, S.C., S.D., G.M., A.L., I.M., Y.S.); UPMC, Univ Paris 06, Paris, France (C.R., J.-C.C., Y.A., D.D., Y.S.); COGIMAGE, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Paris, France (C.R., Y.A., D.D., Y.S.); AP-HP, Service de Neurologie Pharmacologie Clinique, Pitié-Salpêtrière Hospital, Paris, France (J.-C.C., C. Payan); Centre
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12
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Drier A, Tourdias T, Attal Y, Sibon I, Mutlu G, Lehéricy S, Samson Y, Chiras J, Dormont D, Orgogozo JM, Dousset V, Rosso C. Prediction of subacute infarct size in acute middle cerebral artery stroke: comparison of perfusion-weighted imaging and apparent diffusion coefficient maps. Radiology 2012; 265:511-7. [PMID: 22923715 DOI: 10.1148/radiol.12112430] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare perfusion-weighted (PW) imaging and apparent diffusion coefficient (ADC) maps in prediction of infarct size and growth in patients with acute middle cerebral artery infarct. MATERIALS AND METHODS This study was approved by the local institutional review board. Written informed consent was obtained from all 80 patients. Subsequent infarct volume and growth on follow-up magnetic resonance (MR) images obtained within 6 days were compared with the predictions based on PW images by using a time-to-peak threshold greater than 4 seconds and ADC maps obtained less than 12 hours after middle cerebral artery infarct. ADC- and PW imaging-predicted infarct growth areas and infarct volumes were correlated with subsequent infarct growth and follow-up diffusion-weighted (DW) imaging volumes. The impact of MR imaging time delay on the correlation coefficient between the predicted and subsequent infarct volumes and individual predictions of infarct growth by using receiver operating characteristic curves were assessed. RESULTS The infarct volume measurements were highly reproducible (concordance correlation coefficient [CCC] of 0.965 and 95% confidence interval [CI]: 0.949, 0.976 for acute DW imaging; CCC of 0.995 and 95% CI: 0.993, 0.997 for subacute DW imaging). The subsequent infarct volume correlated (P<.0001) with ADC- (ρ=0.853) and PW imaging- (ρ=0.669) predicted volumes. The correlation was higher for ADC-predicted volume than for PW imaging-predicted volume (P<.005), but not when the analysis was restricted to patients without recanalization (P=.07). The infarct growth correlated (P<.0001) with PW imaging-DW imaging mismatch (ρ=0.470) and ADC-DW imaging mismatch (ρ=0.438), without significant differences between both methods (P=.71). The correlations were similar among time delays with ADC-predicted volumes but decreased with PW imaging-based volumes beyond the therapeutic window. Accuracies of ADC- and PW imaging-based predictions of infarct growth in an individual prediction were similar (area under the receiver operating characteristic curve [AUC] of 0.698 and 95% CI: 0.585, 0.796 vs AUC of 0.749 and 95% CI: 0.640, 0.839; P=.48). CONCLUSION The ADC-based method was as accurate as the PW imaging-based method for evaluating infarct growth and size in the subacute phase.
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Affiliation(s)
- Aurélie Drier
- AP-HP Service de Neuroradiologie and AP-HP Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, France
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13
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Attal Y, Maess B, Friederici A, David O. Head models and dynamic causal modeling of subcortical activity using magnetoencephalographic/electroencephalographic data. Rev Neurosci 2012; 23:85-95. [PMID: 22718615 DOI: 10.1515/rns.2011.056] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 10/07/2011] [Indexed: 11/15/2022]
Abstract
Cognitive functions involve not only cortical but also subcortical structures. Subcortical sources, however, contribute very little to magnetoencephalographic (MEG) and electroencephalographic (EEG) signals because they are far from external sensors and their neural architectonic organization often makes them electromagnetically silent. Estimating the activity of deep sources from MEG and EEG (M/EEG) data is thus a challenging issue. Here, we review the influence of geometric parameters (location/orientation) on M/EEG signals produced by the main deep brain structures (amygdalo-hippocampal complex, thalamus and some basal ganglia). We then discuss several methods that have been utilized to solve the issues and localize or quantify the M/EEG contribution from deep neural currents. These methods rely on realistic forward models of subcortical regions or on introducing strong dynamical priors on inverse solutions that are based on biologically plausible neural models, such as those used in dynamic causal modeling (DCM) for M/EEG.
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Affiliation(s)
- Yohan Attal
- Université Pierre et Marie Curie-Paris 6, Centre de Recherche de l’institut du Cerveau et de la Moelle épinière, UMR-S975, 75651 Paris, France
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14
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Rosso C, Attal Y, Deltour S, Hevia-Montiel N, Lehéricy S, Crozier S, Dormont D, Baillet S, Samson Y. Hyperglycemia and the fate of apparent diffusion coefficient-defined ischemic penumbra. AJNR Am J Neuroradiol 2011; 32:852-6. [PMID: 21454405 DOI: 10.3174/ajnr.a2407] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Previous data have shown the feasibility of identifying ischemic penumbra in patients with acute stroke by using a semiautomated analysis of ADC maps. Here, we investigated whether the fate of ADC-defined penumbra was altered by HG. We also examined the interaction between HG and arterial recanalization on infarct growth. MATERIALS AND METHODS We examined 94 patients by using MR imaging within 6 hours of stroke onset and a follow-up MR imaging within 7 days. The ADC-defined tissue-at-risk was calculated from the early MR imaging. Patients were classified according to high (>7 mmol/L; n = 34/94, HG) or normal (n = 60/94) baseline SGL. The impact of HG status on infarct growth was assessed by using multiple regression models and analysis of the slopes of regression lines for each group. Interaction between HG status and arterial recanalization on infarct growth was investigated by using multiple regression analysis. RESULTS The slope of the predicted versus observed infarct growth regression line was steeper in HG than non-HG patients (P = .0008), suggesting that infarct growth within ADC-defined tissue-at-risk was increased in HG patients. The effect was 2.8 times more severe in nonrecanalized patients (P = .01) than in patients with recanalization (P = .001). CONCLUSIONS ADC-defined tissue-at-risk may represent ischemic penumbra because part of this area may be salvaged in normal SGL patients. The toxicity in HG patients seems to be more related to penumbra-infarction transition than reperfusion injury in humans because the effect was larger in nonrecanalized than in recanalized patients.
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Affiliation(s)
- C Rosso
- AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, France.
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15
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Dumas T, Attal Y, Dubal S, Jouvent R, George N. Detection of activity from the amygdala with magnetoencephalography. Ing Rech Biomed 2011. [DOI: 10.1016/j.irbm.2010.11.001] [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: 10/18/2022]
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16
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Attal Y, Bhattacharjee M, Yelnik J, Cottereau B, Lefèvre J, Okada Y, Bardinet E, Chupin M, Baillet S. Modeling and detecting deep brain activity with MEG & EEG. ACTA ACUST UNITED AC 2008; 2007:4937-40. [PMID: 18003114 DOI: 10.1109/iembs.2007.4353448] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We introduce an anatomical and electrophysiological model of deep brain structures dedicated to magnetoencephalography (MEG) and electroencephalography (EEG) source imaging. So far, most imaging inverse models considered that MEG/EEG surface signals were predominantly produced by cortical, hence superficial, neural currents. Here we question whether crucial deep brain structures such as the basal ganglia and the hippocampus may also contribute to distant, scalp MEG and EEG measurements. We first design a realistic anatomical and electrophysiological model of these structures and subsequently run Monte-Carlo experiments to evaluate the respective sensitivity of the MEG and EEG to signals from deeper origins. Results indicate that MEG/EEG may indeed localize these deeper generators, which is confirmed here from experimental MEG data reporting on the modulation of alpha brain waves.
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Affiliation(s)
- Yohan Attal
- Cognitive Neuroscience & Brain Imaging Laboratory, CNRS UPR640-LENA, Hôpital de la Salpêtrière, University of Paris6, France.
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17
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Fischbach M, Attal Y, Geisert J. Hemodiafiltration versus hemodialysis in children. Int J Pediatr Nephrol 1984; 5:151-4. [PMID: 6500809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A total of 6 anuric children have been suitable treated with HD for 12 months and subsequently with HDF for 12 other months. Session time, tolerance and quality of epuration are compared in HD and HDF. Hemodiafiltration combining hemodialysis and hemofiltration in the same treatment time realizes in a short time (about 50% of hemodialysis session time) an optimal epuration with a good tolerance in children.
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18
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Fischbach M, Sommermater JI, Obry F, Manière MC, Frank RM, Attal Y, Geisert J. [Dental anomalies in children with chronic renal insufficiency (II)]. Med Hyg (Geneve) 1984; 42:1346, 1349-50. [PMID: 6589461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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19
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Fischbach M, Sommermater JI, Obray F, Manière MC, Frank RM, Attal Y, Geisert J. [Dental anomalies in children with chronic renal insufficiency (I)]. Med Hyg (Geneve) 1984; 42:1259, 1261. [PMID: 6589460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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