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1.
J Neurosci Methods ; 407: 110154, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38697518

ABSTRACT

BACKGROUND: Thanks to its unrivalled spatial and temporal resolutions and signal-to-noise ratio, intracranial EEG (iEEG) is becoming a valuable tool in neuroscience research. To attribute functional properties to cortical tissue, it is paramount to be able to determine precisely the localization of each electrode with respect to a patient's brain anatomy. Several software packages or pipelines offer the possibility to localize manually or semi-automatically iEEG electrodes. However, their reliability and ease of use may leave to be desired. NEW METHOD: Voxeloc (voxel electrode locator) is a Matlab-based graphical user interface to localize and visualize stereo-EEG electrodes. Voxeloc adopts a semi-automated approach to determine the coordinates of each electrode contact, the user only needing to indicate the deep-most contact of each electrode shaft and another point more proximally. RESULTS: With a deliberately streamlined functionality and intuitive graphical user interface, the main advantages of Voxeloc are ease of use and inter-user reliability. Additionally, oblique slices along the shaft of each electrode can be generated to facilitate the precise localization of each contact. Voxeloc is open-source software and is compatible with the open iEEG-BIDS (Brain Imaging Data Structure) format. COMPARISON WITH EXISTING METHODS: Localizing full patients' iEEG implants was faster using Voxeloc than two comparable software packages, and the inter-user agreement was better. CONCLUSIONS: Voxeloc offers an easy-to-use and reliable tool to localize and visualize stereo-EEG electrodes. This will contribute to democratizing neuroscience research using iEEG.


Subject(s)
Software , User-Computer Interface , Humans , Electrodes, Implanted , Electroencephalography/methods , Electroencephalography/instrumentation , Brain/physiology , Brain/diagnostic imaging , Electrocorticography/methods , Electrocorticography/instrumentation , Reproducibility of Results
2.
Nat Commun ; 15(1): 3941, 2024 May 10.
Article in English | MEDLINE | ID: mdl-38729937

ABSTRACT

A relevant question concerning inter-areal communication in the cortex is whether these interactions are synergistic. Synergy refers to the complementary effect of multiple brain signals conveying more information than the sum of each isolated signal. Redundancy, on the other hand, refers to the common information shared between brain signals. Here, we dissociated cortical interactions encoding complementary information (synergy) from those sharing common information (redundancy) during prediction error (PE) processing. We analyzed auditory and frontal electrocorticography (ECoG) signals in five common awake marmosets performing two distinct auditory oddball tasks and investigated to what extent event-related potentials (ERP) and broadband (BB) dynamics encoded synergistic and redundant information about PE processing. The information conveyed by ERPs and BB signals was synergistic even at lower stages of the hierarchy in the auditory cortex and between auditory and frontal regions. Using a brain-constrained neural network, we simulated the synergy and redundancy observed in the experimental results and demonstrated that the emergence of synergy between auditory and frontal regions requires the presence of strong, long-distance, feedback, and feedforward connections. These results indicate that distributed representations of PE signals across the cortical hierarchy can be highly synergistic.


Subject(s)
Acoustic Stimulation , Auditory Cortex , Callithrix , Electrocorticography , Animals , Auditory Cortex/physiology , Callithrix/physiology , Male , Female , Evoked Potentials/physiology , Frontal Lobe/physiology , Evoked Potentials, Auditory/physiology , Auditory Perception/physiology , Brain Mapping/methods
3.
Sci Rep ; 14(1): 11491, 2024 05 20.
Article in English | MEDLINE | ID: mdl-38769115

ABSTRACT

Several attempts for speech brain-computer interfacing (BCI) have been made to decode phonemes, sub-words, words, or sentences using invasive measurements, such as the electrocorticogram (ECoG), during auditory speech perception, overt speech, or imagined (covert) speech. Decoding sentences from covert speech is a challenging task. Sixteen epilepsy patients with intracranially implanted electrodes participated in this study, and ECoGs were recorded during overt speech and covert speech of eight Japanese sentences, each consisting of three tokens. In particular, Transformer neural network model was applied to decode text sentences from covert speech, which was trained using ECoGs obtained during overt speech. We first examined the proposed Transformer model using the same task for training and testing, and then evaluated the model's performance when trained with overt task for decoding covert speech. The Transformer model trained on covert speech achieved an average token error rate (TER) of 46.6% for decoding covert speech, whereas the model trained on overt speech achieved a TER of 46.3% ( p > 0.05 ; d = 0.07 ) . Therefore, the challenge of collecting training data for covert speech can be addressed using overt speech. The performance of covert speech can improve by employing several overt speeches.


Subject(s)
Brain-Computer Interfaces , Electrocorticography , Speech , Humans , Female , Male , Adult , Speech/physiology , Speech Perception/physiology , Young Adult , Feasibility Studies , Epilepsy/physiopathology , Neural Networks, Computer , Middle Aged , Adolescent
4.
Neurology ; 102(12): e209451, 2024 Jun 25.
Article in English | MEDLINE | ID: mdl-38820468

ABSTRACT

BACKGROUND AND OBJECTIVES: Postoperative seizure control in drug-resistant temporal lobe epilepsy (TLE) remains variable, and the causes for this variability are not well understood. One contributing factor could be the extensive spread of synchronized ictal activity across networks. Our study used novel quantifiable assessments from intracranial EEG (iEEG) to test this hypothesis and investigated how the spread of seizures is determined by underlying structural network topological properties. METHODS: We evaluated iEEG data from 157 seizures in 27 patients with TLE: 100 seizures from 17 patients with postoperative seizure control (Engel score I) vs 57 seizures from 10 patients with unfavorable surgical outcomes (Engel score II-IV). We introduced a quantifiable method to measure seizure power dynamics within anatomical regions, refining existing seizure imaging frameworks and minimizing reliance on subjective human decision-making. Time-frequency power representations were obtained in 6 frequency bands ranging from theta to gamma. Ictal power spectrums were normalized against a baseline clip taken at least 6 hours away from ictal events. Electrodes' time-frequency power spectrums were then mapped onto individual T1-weighted MRIs and grouped based on a standard brain atlas. We compared spatiotemporal dynamics for seizures between groups with favorable and unfavorable surgical outcomes. This comparison included examining the range of activated brain regions and the spreading rate of ictal activities. We then evaluated whether regional iEEG power values were a function of fractional anisotropy (FA) from diffusion tensor imaging across regions over time. RESULTS: Seizures from patients with unfavorable outcomes exhibited significantly higher maximum activation sizes in various frequency bands. Notably, we provided quantifiable evidence that in seizures associated with unfavorable surgical outcomes, the spread of beta-band power across brain regions is significantly faster, detectable as early as the first second after seizure onset. There was a significant correlation between beta power during seizures and FA in the corresponding areas, particularly in the unfavorable outcome group. Our findings further suggest that integrating structural and functional features could improve the prediction of epilepsy surgical outcomes. DISCUSSION: Our findings suggest that ictal iEEG power dynamics and the structural-functional relationship are mechanistic factors associated with surgical outcomes in TLE.


Subject(s)
Drug Resistant Epilepsy , Electroencephalography , Epilepsy, Temporal Lobe , Humans , Male , Female , Adult , Epilepsy, Temporal Lobe/surgery , Epilepsy, Temporal Lobe/physiopathology , Epilepsy, Temporal Lobe/diagnostic imaging , Treatment Outcome , Middle Aged , Drug Resistant Epilepsy/surgery , Drug Resistant Epilepsy/physiopathology , Drug Resistant Epilepsy/diagnostic imaging , Young Adult , Magnetic Resonance Imaging , Seizures/surgery , Seizures/physiopathology , Brain/physiopathology , Brain/surgery , Brain/diagnostic imaging , Electrocorticography/methods , Adolescent
5.
J Neurosci Methods ; 407: 110153, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38710234

ABSTRACT

Human brain connectivity can be mapped by single pulse electrical stimulation during intracranial EEG measurements. The raw cortico-cortical evoked potentials (CCEP) are often contaminated by noise. Common average referencing (CAR) removes common noise and preserves response shapes but can introduce bias from responsive channels. We address this issue with an adjusted, adaptive CAR algorithm termed "CAR by Least Anticorrelation (CARLA)". CARLA was tested on simulated CCEP data and real CCEP data collected from four human participants. In CARLA, the channels are ordered by increasing mean cross-trial covariance, and iteratively added to the common average until anticorrelation between any single channel and all re-referenced channels reaches a minimum, as a measure of shared noise. We simulated CCEP data with true responses in 0-45 of 50 total channels. We quantified CARLA's error and found that it erroneously included 0 (median) truly responsive channels in the common average with ≤42 responsive channels, and erroneously excluded ≤2.5 (median) unresponsive channels at all responsiveness levels. On real CCEP data, signal quality was quantified with the mean R2 between all pairs of channels, which represents inter-channel dependency and is low for well-referenced data. CARLA re-referencing produced significantly lower mean R2 than standard CAR, CAR using a fixed bottom quartile of channels by covariance, and no re-referencing. CARLA minimizes bias in re-referenced CCEP data by adaptively selecting the optimal subset of non-responsive channels. It showed high specificity and sensitivity on simulated CCEP data and lowered inter-channel dependency compared to CAR on real CCEP data.


Subject(s)
Algorithms , Cerebral Cortex , Evoked Potentials , Signal Processing, Computer-Assisted , Humans , Evoked Potentials/physiology , Cerebral Cortex/physiology , Male , Electrocorticography/methods , Electroencephalography/methods , Adult , Electric Stimulation , Computer Simulation , Female
6.
Biomed Phys Eng Express ; 10(4)2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38744259

ABSTRACT

Objective.Detection of the epileptogenic zone is critical, especially for patients with drug-resistant epilepsy. Accurately mapping cortical regions exhibiting high activity during spontaneous seizure events while detecting neural activity up to 500 Hz can assist clinicians' surgical decisions and improve patient outcomes.Approach.We designed, fabricated, and tested a novel hybrid, multi-scale micro-electrocorticography (micro-ECoG) array with a unique embedded configuration. This array was compared to a commercially available microelectrode array (Neuronexus) for recording neural activity in rodent sensory cortex elicited by somatosensory evoked potentials and pilocarpine-induced seizures.Main results.Evoked potentials and spatial maps recorded by the multi-scale array ('micros', 'mesos', and 'macros' refering to the relative electrode sizes, 40 micron, 1 mm, and 4 mm respectively) were comparable to the Neuronexus array. The SSEPs recorded with the micros had higher peak amplitudes and greater signal power than those recorded by the larger mesos and macro. Seizure onset events and high-frequency oscillations (∼450 Hz) were detected on the multi-scale, similar to the commercially available array. The micros had greater SNR than the mesos and macro over the 5-1000 Hz frequency range during seizure monitoring. During cortical stimulation experimentation, the mesos successfully elicited motor effects.Significance.Previous studies have compared macro- and microelectrodes for localizing seizure activity in adjacent regions. The multi-scale design validated here is the first to simultaneously measure macro- and microelectrode signals from the same overlapping cortical area. This enables direct comparison of microelectrode recordings to the macroelectrode recordings used in standard neurosurgical practice. Previous studies have also shown that cortical regions generating high-frequency oscillations are at an increased risk for becoming epileptogenic zones. More accurate mapping of these micro seizures may improve surgical outcomes for epilepsy patients.


Subject(s)
Electrocorticography , Evoked Potentials, Somatosensory , Microelectrodes , Seizures , Electrocorticography/instrumentation , Electrocorticography/methods , Animals , Seizures/diagnosis , Rats , Male , Electrodes, Implanted , Somatosensory Cortex , Equipment Design , Rats, Sprague-Dawley , Brain Mapping/methods , Pilocarpine , Epilepsy
7.
Commun Biol ; 7(1): 595, 2024 May 18.
Article in English | MEDLINE | ID: mdl-38762683

ABSTRACT

Dynamic mode (DM) decomposition decomposes spatiotemporal signals into basic oscillatory components (DMs). DMs can improve the accuracy of neural decoding when used with the nonlinear Grassmann kernel, compared to conventional power features. However, such kernel-based machine learning algorithms have three limitations: large computational time preventing real-time application, incompatibility with non-kernel algorithms, and low interpretability. Here, we propose a mapping function corresponding to the Grassmann kernel that explicitly transforms DMs into spatial DM (sDM) features, which can be used in any machine learning algorithm. Using electrocorticographic signals recorded during various movement and visual perception tasks, the sDM features were shown to improve the decoding accuracy and computational time compared to conventional methods. Furthermore, the components of the sDM features informative for decoding showed similar characteristics to the high-γ power of the signals, but with higher trial-to-trial reproducibility. The proposed sDM features enable fast, accurate, and interpretable neural decoding.


Subject(s)
Electrocorticography , Electrocorticography/methods , Humans , Algorithms , Signal Processing, Computer-Assisted , Male , Machine Learning , Visual Perception/physiology , Female , Reproducibility of Results , Adult , Brain-Computer Interfaces
8.
Neurology ; 102(11): e209430, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38768406

ABSTRACT

BACKGROUND AND OBJECTIVES: Tailoring epilepsy surgery using intraoperative electrocorticography (ioECoG) has been debated, and modest number of epilepsy surgery centers apply this diagnostic method. We assessed the current evidence to use ioECoG-tailored epilepsy surgery for improving postsurgical outcome. METHODS: PubMed and Embase were searched for original studies reporting on ≥10 cases who underwent ioECoG-tailored surgery for epilepsy, with a follow-up of at least 6 months. We used a random-effects model to calculate the overall rate of patients achieving favorable seizure outcome (FSO), defined as Engel class I, ILAE class 1, or seizure-free status. Meta-regression was used to investigate potential sources of heterogeneity. We calculated the odds ratio (OR) for estimating variables on FSO:ioECoG vs non-ioECoG-tailored surgery (if included studies contained patients with non-ioECoG-tailored surgery), ioECoG-tailored epilepsy surgery in children vs adults, temporal (TL) vs extratemporal lobe (eTL), MRI-positive vs MRI-negative, and complete vs incomplete resection of tissue that generated interictal epileptiform discharges (IEDs). A Bayesian network meta-analysis was conducted for underlying pathologies. We assessed the evidence certainty using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS: Eighty-three studies (82 observational studies, 1 trial) comprising 3,631 patients with ioECoG-tailored surgery were included. The overall pooled rate of patients who attained FSO after ioECoG-tailored surgery was 74% (95% CI 71-77) with significant heterogeneity, which was predominantly attributed to pathologies and seizure outcome classifications. Twenty-two studies contained non-ioECoG-tailored surgeries. IoECoG-tailored surgeries reached a higher rate of FSO than non-ioECoG-tailored surgeries (OR 2.10 [95% CI 1.37-3.24]; p < 0.01; very low certainty). Complete resection of tissue that displayed IEDs in ioECoG predicted FSO better compared with incomplete resection (OR 3.04 [1.76-5.25]; p < 0.01; low certainty). We found insignificant difference in FSO after ioECoG-tailored surgery in children vs adults, TL vs eTL, or MRI-positive vs MRI-negative. The network meta-analysis showed that the odds of FSO was lower for malformations of cortical development than for tumors (OR 0.47 95% credible interval 0.25-0.87). DISCUSSION: Although limited by low-quality evidence, our meta-analysis shows a relatively good surgical outcome (74% FSO) after epilepsy surgery with ioECoG, especially in tumors, with better outcome for ioECoG-tailored surgeries in studies describing both and better outcome after complete removal of IED areas.


Subject(s)
Electrocorticography , Epilepsy , Intraoperative Neurophysiological Monitoring , Seizures , Humans , Electrocorticography/methods , Epilepsy/surgery , Epilepsy/diagnostic imaging , Epilepsy/physiopathology , Intraoperative Neurophysiological Monitoring/methods , Seizures/surgery , Seizures/physiopathology , Treatment Outcome , Neurosurgical Procedures/methods
9.
Neurology ; 102(9): e209216, 2024 May 14.
Article in English | MEDLINE | ID: mdl-38560817

ABSTRACT

BACKGROUND AND OBJECTIVES: High-frequency oscillations (HFOs; ripples 80-250 Hz; fast ripples [FRs] 250-500 Hz) recorded with intracranial electrodes generated excitement and debate about their potential to localize epileptogenic foci. We performed a systematic review and meta-analysis on the prognostic value of complete resection of the HFOs-area (crHFOs-area) for epilepsy surgical outcome in intracranial EEG (iEEG) accessing multiple subgroups. METHODS: We searched PubMed, Embase, and Web of Science for original research from inception to October 27, 2022. We defined favorable surgical outcome (FSO) as Engel class I, International League Against Epilepsy class 1, or seizure-free status. The prognostic value of crHFOs-area for FSO was assessed by (1) the pooled FSO proportion after crHFOs-area; (2) FSO for crHFOs-area vs without crHFOs-area; and (3) the predictive performance. We defined high combined prognostic value as FSO proportion >80% + FSO crHFOs-area >without crHFOs-area + area under the curve (AUC) >0.75 and examined this for the clinical subgroups (study design, age, diagnostic type, HFOs-identification method, HFOs-rate thresholding, and iEEG state). Temporal lobe epilepsy (TLE) was compared with extra-TLE through dichotomous variable analysis. Individual patient analysis was performed for sex, affected hemisphere, MRI findings, surgery location, and pathology. RESULTS: Of 1,387 studies screened, 31 studies (703 patients) met our eligibility criteria. Twenty-seven studies (602 patients) analyzed FRs and 20 studies (424 patients) ripples. Pooled FSO proportion after crHFOs-area was 81% (95% CI 76%-86%) for FRs and 82% (73%-89%) for ripples. Patients with crHFOs-area achieved more often FSO than those without crHFOs-area (FRs odds ratio [OR] 6.38, 4.03-10.09, p < 0.001; ripples 4.04, 2.32-7.04, p < 0.001). The pooled AUCs were 0.81 (0.77-0.84) for FRs and 0.76 (0.72-0.79) for ripples. Combined prognostic value was high in 10 subgroups: retrospective, children, long-term iEEG, threshold (FRs and ripples) and automated detection and interictal (FRs). FSO after complete resection of FRs-area (crFRs-area) was achieved less often in people with TLE than extra-TLE (OR 0.37, 0.15-0.89, p = 0.006). Individual patient analyses showed that crFRs-area was seen more in patients with FSO with than without MRI lesions (p = 0.02 after multiple correction). DISCUSSION: Complete resection of the brain area with HFOs is associated with good postsurgical outcome. Its prognostic value holds, especially for FRs, for various subgroups. The use of HFOs for extra-TLE patients requires further evidence.


Subject(s)
Epilepsy, Temporal Lobe , Epilepsy , Child , Humans , Electrocorticography , Prognosis , Electroencephalography/methods , Retrospective Studies , Epilepsy/diagnosis , Epilepsy/surgery
10.
Nat Commun ; 15(1): 3255, 2024 Apr 16.
Article in English | MEDLINE | ID: mdl-38627406

ABSTRACT

Interictal Epileptiform Discharges (IED) and High Frequency Oscillations (HFO) in intraoperative electrocorticography (ECoG) may guide the surgeon by delineating the epileptogenic zone. We designed a modular spiking neural network (SNN) in a mixed-signal neuromorphic device to process the ECoG in real-time. We exploit the variability of the inhomogeneous silicon neurons to achieve efficient sparse and decorrelated temporal signal encoding. We interface the full-custom SNN device to the BCI2000 real-time framework and configure the setup to detect HFO and IED co-occurring with HFO (IED-HFO). We validate the setup on pre-recorded data and obtain HFO rates that are concordant with a previously validated offline algorithm (Spearman's ρ = 0.75, p = 1e-4), achieving the same postsurgical seizure freedom predictions for all patients. In a remote on-line analysis, intraoperative ECoG recorded in Utrecht was compressed and transferred to Zurich for SNN processing and successful IED-HFO detection in real-time. These results further demonstrate how automated remote real-time detection may enable the use of HFO in clinical practice.


Subject(s)
Electrocorticography , Neural Networks, Computer , Humans , Electrocorticography/methods , Electroencephalography/methods
11.
Commun Biol ; 7(1): 506, 2024 Apr 27.
Article in English | MEDLINE | ID: mdl-38678058

ABSTRACT

Limb movement direction can be inferred from local field potentials in motor cortex during movement execution. Yet, it remains unclear to what extent intended hand movements can be predicted from brain activity recorded during movement planning. Here, we set out to probe the directional-tuning of oscillatory features during motor planning and execution, using a machine learning framework on multi-site local field potentials (LFPs) in humans. We recorded intracranial EEG data from implanted epilepsy patients as they performed a four-direction delayed center-out motor task. Fronto-parietal LFP low-frequency power predicted hand-movement direction during planning while execution was largely mediated by higher frequency power and low-frequency phase in motor areas. By contrast, Phase-Amplitude Coupling showed uniform modulations across directions. Finally, multivariate classification led to an increase in overall decoding accuracy (>80%). The novel insights revealed here extend our understanding of the role of neural oscillations in encoding motor plans.


Subject(s)
Motor Cortex , Movement , Humans , Movement/physiology , Male , Adult , Motor Cortex/physiology , Female , Electroencephalography , Brain/physiology , Young Adult , Machine Learning , Electrocorticography , Epilepsy/physiopathology , Hand/physiology , Brain Mapping/methods
12.
Sci Rep ; 14(1): 9617, 2024 04 26.
Article in English | MEDLINE | ID: mdl-38671062

ABSTRACT

Brain-computer interfaces (BCIs) that reconstruct and synthesize speech using brain activity recorded with intracranial electrodes may pave the way toward novel communication interfaces for people who have lost their ability to speak, or who are at high risk of losing this ability, due to neurological disorders. Here, we report online synthesis of intelligible words using a chronically implanted brain-computer interface (BCI) in a man with impaired articulation due to ALS, participating in a clinical trial (ClinicalTrials.gov, NCT03567213) exploring different strategies for BCI communication. The 3-stage approach reported here relies on recurrent neural networks to identify, decode and synthesize speech from electrocorticographic (ECoG) signals acquired across motor, premotor and somatosensory cortices. We demonstrate a reliable BCI that synthesizes commands freely chosen and spoken by the participant from a vocabulary of 6 keywords previously used for decoding commands to control a communication board. Evaluation of the intelligibility of the synthesized speech indicates that 80% of the words can be correctly recognized by human listeners. Our results show that a speech-impaired individual with ALS can use a chronically implanted BCI to reliably produce synthesized words while preserving the participant's voice profile, and provide further evidence for the stability of ECoG for speech-based BCIs.


Subject(s)
Amyotrophic Lateral Sclerosis , Brain-Computer Interfaces , Speech , Humans , Amyotrophic Lateral Sclerosis/physiopathology , Amyotrophic Lateral Sclerosis/therapy , Male , Speech/physiology , Middle Aged , Electrodes, Implanted , Electrocorticography
13.
PLoS Comput Biol ; 20(4): e1011152, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38662736

ABSTRACT

Numerous physiological processes are cyclical, but sampling these processes densely enough to perform frequency decomposition and subsequent analyses can be challenging. Mathematical approaches for decomposition and reconstruction of sparsely and irregularly sampled signals are well established but have been under-utilized in physiological applications. We developed a basis pursuit denoising with polynomial detrending (BPWP) model that recovers oscillations and trends from sparse and irregularly sampled timeseries. We validated this model on a unique dataset of long-term inter-ictal epileptiform discharge (IED) rates from human hippocampus recorded with a novel investigational device with continuous local field potential sensing. IED rates have well established circadian and multiday cycles related to sleep, wakefulness, and seizure clusters. Given sparse and irregular samples of IED rates from multi-month intracranial EEG recordings from ambulatory humans, we used BPWP to compute narrowband spectral power and polynomial trend coefficients and identify IED rate cycles in three subjects. In select cases, we propose that random and irregular sampling may be leveraged for frequency decomposition of physiological signals. Trial Registration: NCT03946618.


Subject(s)
Epilepsy , Humans , Algorithms , Computational Biology/methods , Electrocorticography/methods , Electroencephalography/methods , Epilepsy/physiopathology , Epilepsy/diagnosis , Hippocampus/physiopathology , Hippocampus/physiology , Models, Neurological , Seizures/physiopathology , Seizures/diagnosis , Signal Processing, Computer-Assisted , Female
14.
Clin Neurophysiol ; 162: 151-158, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38640819

ABSTRACT

OBJECTIVE: To report clinical outcomes of patients who presented with new-onset refractory status epilepticus (NORSE), developed drug-resistant epilepsy (DRE), and were treated with responsive neurostimulation (RNS). METHODS: We performed a retrospective review of patients implanted with RNS at our institution and identified three who originally presented with NORSE. Through chart review, we retrieved objective and subjective information related to their presentation, workup, and outcomes including patient-reported seizure frequency. We reviewed electrocorticography (ECoG) data to estimate seizure burden at 3, 6, 12, and 24 months following RNS implantation. We performed a review of literature concerning neurostimulation in NORSE. RESULTS: Use of RNS to treat DRE following NORSE was associated with reduced seizure burden and informed care by differentiating epileptic from non-epileptic events. CONCLUSIONS: Our single-center experience of three cases suggests that RNS is a safe and potentially effective treatment for DRE following NORSE. SIGNIFICANCE: This article reports outcomes of the largest case series of NORSE patients treated with RNS. Since patients with NORSE are at high risk of adverse neuropsychiatric and cognitive sequelae beyond seizures, a unique strength of RNS over other surgical options is the ability to distinguish ictal or peri-ictal from non-epileptic events.


Subject(s)
Drug Resistant Epilepsy , Status Epilepticus , Humans , Status Epilepticus/therapy , Status Epilepticus/physiopathology , Status Epilepticus/diagnosis , Male , Female , Drug Resistant Epilepsy/therapy , Drug Resistant Epilepsy/physiopathology , Drug Resistant Epilepsy/diagnosis , Adult , Retrospective Studies , Middle Aged , Electric Stimulation Therapy/methods , Treatment Outcome , Electrocorticography/methods
15.
Clin Neurophysiol ; 162: 210-218, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38643614

ABSTRACT

OBJECTIVE: Focal cortical dysplasias (FCD) are characterized by distinct interictal spike patterns and high frequency oscillations (HFOs; ripples: 80-250 Hz; fast ripples: 250-500 Hz) in the intra-operative electrocorticogram (ioECoG). We studied the temporal relation between intra-operative spikes and HFOs and their relation to resected tissue in people with FCD with a favorable outcome. METHODS: We included patients who underwent ioECoG-tailored epilepsy surgery with pathology confirmed FCD and long-term Engel 1A outcome. Spikes and HFOs were automatically detected and visually checked in 1-minute pre-resection-ioECoG. Channels covering resected and non-resected tissue were compared using a logistic mixed model, assessing event numbers, co-occurrence ratios, and time-based properties. RESULTS: We found pre-resection spikes, ripples in respectively 21 and 20 out of 22 patients. Channels covering resected tissue showed high numbers of spikes and HFOs, and high ratios of co-occurring events. Spikes, especially with ripples, have a relatively sharp rising flank with a long descending flank and early ripple onset over resected tissue. CONCLUSIONS: A combined analysis of event numbers, ratios, and temporal relationships between spikes and HFOs may aid identifying epileptic tissue in epilepsy surgery. SIGNIFICANCE: This study shows a promising method for clinically relevant properties of events, closely associated with FCD.


Subject(s)
Electrocorticography , Intraoperative Neurophysiological Monitoring , Malformations of Cortical Development , Humans , Female , Male , Adult , Adolescent , Malformations of Cortical Development/physiopathology , Malformations of Cortical Development/surgery , Electrocorticography/methods , Young Adult , Intraoperative Neurophysiological Monitoring/methods , Child , Middle Aged , Epilepsy/physiopathology , Epilepsy/surgery , Epilepsy/diagnosis , Brain Waves/physiology , Child, Preschool , Action Potentials/physiology , Electroencephalography/methods , Focal Cortical Dysplasia
16.
Sci Transl Med ; 16(744): eadj7257, 2024 Apr 24.
Article in English | MEDLINE | ID: mdl-38657026

ABSTRACT

Functional mapping during brain surgery is applied to define brain areas that control critical functions and cannot be removed. Currently, these procedures rely on verbal interactions between the neurosurgeon and electrophysiologist, which can be time-consuming. In addition, the electrode grids that are used to measure brain activity and to identify the boundaries of pathological versus functional brain regions have low resolution and limited conformity to the brain surface. Here, we present the development of an intracranial electroencephalogram (iEEG)-microdisplay that consists of freestanding arrays of 2048 GaN light-emitting diodes laminated on the back of micro-electrocorticography electrode grids. With a series of proof-of-concept experiments in rats and pigs, we demonstrate that these iEEG-microdisplays allowed us to perform real-time iEEG recordings and display cortical activities by spatially corresponding light patterns on the surface of the brain in the surgical field. Furthermore, iEEG-microdisplays allowed us to identify and display cortical landmarks and pathological activities from rat and pig models. Using a dual-color iEEG-microdisplay, we demonstrated coregistration of the functional cortical boundaries with one color and displayed the evolution of electrical potentials associated with epileptiform activity with another color. The iEEG-microdisplay holds promise to facilitate monitoring of pathological brain activity in clinical settings.


Subject(s)
Brain , Electroencephalography , Animals , Brain/physiology , Electroencephalography/methods , Swine , Rats , Neurons/physiology , Brain Mapping/methods , Rats, Sprague-Dawley , Electrocorticography/methods , Male
17.
J Neural Eng ; 21(3)2024 May 20.
Article in English | MEDLINE | ID: mdl-38648781

ABSTRACT

Objective.Invasive brain-computer interfaces (BCIs) are promising communication devices for severely paralyzed patients. Recent advances in intracranial electroencephalography (iEEG) coupled with natural language processing have enhanced communication speed and accuracy. It should be noted that such a speech BCI uses signals from the motor cortex. However, BCIs based on motor cortical activities may experience signal deterioration in users with motor cortical degenerative diseases such as amyotrophic lateral sclerosis. An alternative approach to using iEEG of the motor cortex is necessary to support patients with such conditions.Approach. In this study, a multimodal embedding of text and images was used to decode visual semantic information from iEEG signals of the visual cortex to generate text and images. We used contrastive language-image pretraining (CLIP) embedding to represent images presented to 17 patients implanted with electrodes in the occipital and temporal cortices. A CLIP image vector was inferred from the high-γpower of the iEEG signals recorded while viewing the images.Main results.Text was generated by CLIPCAP from the inferred CLIP vector with better-than-chance accuracy. Then, an image was created from the generated text using StableDiffusion with significant accuracy.Significance.The text and images generated from iEEG through the CLIP embedding vector can be used for improved communication.


Subject(s)
Brain-Computer Interfaces , Electrocorticography , Humans , Male , Female , Electrocorticography/methods , Adult , Electroencephalography/methods , Middle Aged , Electrodes, Implanted , Young Adult , Photic Stimulation/methods
18.
Cereb Cortex ; 34(3)2024 03 01.
Article in English | MEDLINE | ID: mdl-38466116

ABSTRACT

Sound frequency and duration are essential auditory components. The brain perceives deviations from the preceding sound context as prediction errors, allowing efficient reactions to the environment. Additionally, prediction error response to duration change is reduced in the initial stages of psychotic disorders. To compare the spatiotemporal profiles of responses to prediction errors, we conducted a human electrocorticography study with special attention to high gamma power in 13 participants who completed both frequency and duration oddball tasks. Remarkable activation in the bilateral superior temporal gyri in both the frequency and duration oddball tasks were observed, suggesting their association with prediction errors. However, the response to deviant stimuli in duration oddball task exhibited a second peak, which resulted in a bimodal response. Furthermore, deviant stimuli in frequency oddball task elicited a significant response in the inferior frontal gyrus that was not observed in duration oddball task. These spatiotemporal differences within the Parasylvian cortical network could account for our efficient reactions to changes in sound properties. The findings of this study may contribute to unveiling auditory processing and elucidating the pathophysiology of psychiatric disorders.


Subject(s)
Brain , Electrocorticography , Humans , Prefrontal Cortex , Sound , Auditory Perception
19.
Clin Neurophysiol ; 161: 1-9, 2024 May.
Article in English | MEDLINE | ID: mdl-38430856

ABSTRACT

OBJECTIVE: Interictal biomarkers of the epileptogenic zone (EZ) and their use in machine learning models open promising avenues for improvement of epilepsy surgery evaluation. Currently, most studies restrict their analysis to short segments of intracranial EEG (iEEG). METHODS: We used 2381 hours of iEEG data from 25 patients to systematically select 5-minute segments across various interictal conditions. Then, we tested machine learning models for EZ localization using iEEG features calculated within these individual segments or across them and evaluated the performance by the area under the precision-recall curve (PRAUC). RESULTS: On average, models achieved a score of 0.421 (the result of the chance classifier was 0.062). However, the PRAUC varied significantly across the segments (0.323-0.493). Overall, NREM sleep achieved the highest scores, with the best results of 0.493 in N2. When using data from all segments, the model performed significantly better than single segments, except NREM sleep segments. CONCLUSIONS: The model based on a short segment of iEEG recording can achieve similar results as a model based on prolonged recordings. The analyzed segment should, however, be carefully and systematically selected, preferably from NREM sleep. SIGNIFICANCE: Random selection of short iEEG segments may give rise to inaccurate localization of the EZ.


Subject(s)
Electroencephalography , Epilepsy , Machine Learning , Humans , Female , Male , Adult , Epilepsy/physiopathology , Epilepsy/diagnosis , Electroencephalography/methods , Middle Aged , Time Factors , Young Adult , Electrocorticography/methods , Electrocorticography/standards , Adolescent , Brain/physiopathology , Sleep Stages/physiology
20.
Clin Neurophysiol ; 161: 80-92, 2024 May.
Article in English | MEDLINE | ID: mdl-38452427

ABSTRACT

OBJECTIVE: Ictal Single Photon Emission Computed Tomography (SPECT) and stereo-electroencephalography (SEEG) are diagnostic techniques used for the management of patients with drug-resistant focal epilepsies. While hyperperfusion patterns in ictal SPECT studies reveal seizure onset and propagation pathways, the role of ictal hypoperfusion remains poorly understood. The goal of this study was to systematically characterize the spatio-temporal information flow dynamics between differently perfused brain regions using stereo-EEG recordings. METHODS: We identified seizure-free patients after resective epilepsy surgery who had prior ictal SPECT and SEEG investigations. We estimated directional connectivity between the epileptogenic-zone (EZ), non-resected areas of hyperperfusion, hypoperfusion, and baseline perfusion during the interictal, preictal, ictal, and postictal periods. RESULTS: Compared to the background, we noted significant information flow (1) during the preictal period from the EZ to the baseline and hyperperfused regions, (2) during the ictal onset from the EZ to all three regions, and (3) during the period of seizure evolution from the area of hypoperfusion to all three regions. CONCLUSIONS: Hypoperfused brain regions were found to indirectly interact with the EZ during the ictal period. SIGNIFICANCE: Our unique study, combining intracranial electrophysiology and perfusion imaging, presents compelling evidence of dynamic changes in directional connectivity between brain regions during the transition from interictal to ictal states.


Subject(s)
Electroencephalography , Seizures , Tomography, Emission-Computed, Single-Photon , Humans , Tomography, Emission-Computed, Single-Photon/methods , Male , Female , Adult , Seizures/physiopathology , Seizures/diagnostic imaging , Electroencephalography/methods , Adolescent , Young Adult , Electrocorticography/methods , Brain/physiopathology , Brain/diagnostic imaging , Middle Aged , Child , Drug Resistant Epilepsy/physiopathology , Drug Resistant Epilepsy/diagnostic imaging , Drug Resistant Epilepsy/surgery
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