Localization of beta power decrease as measure for lateralization in pre-surgical language mapping with magnetoencephalography, compared with functional magnetic resonance imaging and validated by Wada test.

Objective: Atypical patterns of language lateralization due to early reorganizational processes constitute a challenge in the pre-surgical evaluation of patients with pharmaco-resistant epilepsy. There is no consensus on an optimal analysis method used for the identification of language dominance in MEG. This study examines the concordance between MEG source localization of beta power desynchronization and fMRI with regard to lateralization and localization of expressive and receptive language areas using a visual verb generation task. Methods: Twenty-five patients with pharmaco-resistant epilepsy, including six patients with atypical language lateralization, and ten right-handed controls obtained MEG and fMRI language assessment. Fourteen patients additionally underwent the Wada test. We analyzed MEG beta power desynchronization in sensor (controls) and source space (patients and controls). Beta power decrease between 13 and 35 Hz was localized applying Dynamic Imaging of Coherent Sources Beamformer technique. Statistical inferences were grounded on cluster-based permutation testing for single subjects. Results: Event-related desynchronization of beta power in MEG was seen within the language-dominant frontal and temporal lobe and within the premotor cortex. Our analysis pipeline consistently yielded left language dominance with high laterality indices in controls. Language lateralization in MEG and Wada test agreed in all 14 patients for inferior frontal, temporal and parietal language areas (Cohen's Kappa = 1, p < 0.001). fMRI agreed with Wada test in 12 out of 14 cases (85.7%) for Broca's area (Cohen's Kappa = 0.71, p = 0.024), while the agreement for temporal and temporo-parietal language areas were non-significant. Concordance between MEG and fMRI laterality indices was highest within the inferior frontal gyrus, with an agreement in 19/24 cases (79.2%), and non-significant for Wernicke's area. Spatial agreement between fMRI and MEG varied considerably between subjects and brain regions with the lowest Euclidean distances within the inferior frontal region of interest. Conclusion: Localizing the desynchronization of MEG beta power using a verb generation task is a promising tool for the identification of language dominance in the pre-surgical evaluation of epilepsy patients. The overall agreement between MEG and fMRI was lower than expected and might be attributed to differences within the baseline condition. A larger sample size and an adjustment of the experimental designs are needed to draw further conclusions.

Neuronal Correlates of Product Feature Attractiveness.

Decision-making is the process of selecting a logical choice from among the available options and happens as a complex process in the human brain. It is based on information processing and cost-analysis; it involves psychological factors, specifically, emotions. In addition to cost factors personal preferences have significant influence on decision making. For marketing purposes, it is interesting to know how these emotions are related to product acquisition decision and how to improve these products according to the user's preferences. For our proof-of-concept study, we use magneto- and electro-encephalography (MEG, EEG) to evaluate the very early reactions in the brain related to the emotions. Recordings from these methods are comprehensive sources of information to investigate neural processes of the human brain with good spatial- and excellent temporal resolution. Those characteristics make these methods suitable to examine the neurologic process that gives origin to human behavior and specifically, decision making. Literature describes some neuronal correlates for individual preferences, like asymmetrical distribution of frequency specific activity in frontal and prefrontal areas, which are associated with emotional processing. Such correlates could be used to objectively evaluate the pleasantness of product appearance and branding (i.e., logo), thus avoiding subjective bias. This study evaluates the effects of different product features on brain activity and whether these methods could potentially be used for marketing and product design. We analyzed the influence of color and fit of sports shirts, as well as a brand logo on the brain activity, specifically in frontal asymmetric activation. Measurements were performed using MEG and EEG with 10 healthy subjects. Images of t-shirts with different characteristics were presented on a screen. We recorded the subjective evaluation by asking for a positive, negative or neutral rating. The results showed significantly different responses between positively and negatively rated shirts. While the influence of the presence of a logo was present in behavioral data, but not in the neurocognitive data, the influence of shirt fit and color could be reconstructed in both data sets. This method may enable evaluation of subjective product preference.

The intermedius nerve as a confounding variable for monitoring of the free-running electromyogram.

OBJECTIVE: A-trains, a facial nerve EMG-pattern, are correlated with postoperative functional impairment. However, an unknown confounder is suspected to cause false positive monitoring results. The intermedius nerve contains motor fibers targeting lower facial muscles; their significance for facial nerve monitoring is yet unknown. METHODS: Intraoperative videotapes and free-running 9-channel facial nerve EMG assessed from 87 patients undergoing surgery for vestibular schwannoma were evaluated, and presence/absence of an identifiable intermedius nerve was determined. The prognostic value of train time, a quantitative measure for A-train activity, was evaluated for both the groups with and without an identifiable intermedius nerve. RESULTS: Correlation between traintime and outcome (Spearman's Rho) rose to 0.73 (p<0.001) when only patients without an identified intermedius nerve were considered, and fell to 0.43 (p<0.05) with the other patient group. This difference was statistically significant (p=0.036), was more prominent in the channels monitoring perioral facial muscles, and resulted from additional A-train activity in patients with an identifiable intermedius nerve. CONCLUSIONS: A separate intermedius nerve may be more prone to manipulation, leading to A-train activity without clinical correlate, thus causing false positive monitoring results. SIGNIFICANCE: For interpretation of the free-running EMG, the intermedius nerve needs to be taken into account as a confounder.

Facial nerve palsy after vestibular schwannoma surgery: dynamic risk-stratification based on continuous EMG-monitoring.

OBJECTIVE: A-trains are a pathological pattern in intraoperative EMG-monitoring. Traintime, a parameter calculated by automated EMG-analysis, quantifies A-train activity. Its extent is associated with the degree of postoperative facial nerve palsy. However, false positive results have been observed. A systematic flaw in automated analysis was hypothesized. METHODS: Facial nerve EMG-data from 79 patients undergoing vestibular schwannoma surgery were analyzed visually. Automated traintime was compared with these results. The progressive risk for postoperative paresis was calculated with respect to traintime (visual and automated). RESULTS: Automated analysis identified a small (1.46%), but highly representative fraction of overall A-train activity: Pearson's correlation coefficient between both values was 0.944 (p<0.001). Both were correlated with clinical outcome in a highly significant way (p<0.001) with Spearman's Rho 0.592 (automated) and 0.563 (visual). Progressive risk development was visualized as an inverse sigmoid curve with traintime on a logarithmic scale. CONCLUSIONS: Automated traintime is a representative and reliable expression for overall A-train activity. As risk-development is complex, rigid thresholds are problematic. SIGNIFICANCE: Individual risk for postoperative palsy can be estimated on the basis of the calculated curve presented. This approach is of higher practical value than a rigid (and low) threshold.

Autobiographical memory in temporal lobe epilepsy: role of hippocampal and temporal lateral structures.

The present study was aimed at investigating the impact of hippocampal and temporal cortical lesions on remote autobiographical memories in temporal lobe epilepsy (TLE). Episodic specificity, episodic richness, and personal semantic memory from different life periods were assessed using a modified version of the Autobiographical Memory Interview (AMI) (M.D. Kopelman, A.E. Wilson, A. Baddeley, The autobiographical memory interview. Bury St. Edmunds: Thames Valley Test Co.; 1990) in 47 patients with unilateral mesial or lateral TLE and 38 healthy controls. Patients with TLE performed significantly more poorly than controls. Patients with left and right mTLE were equally moderately impaired, but patients with left lateral TLE had the most severe episodic memory deficits, particularly for childhood memories. With respect to personal semantic memory, patients with left TLE were significantly more impaired than those with right TLE, most pronounced for childhood memories. Both autobiographical memory aspects, episodic and personal semantic memory, were significantly intercorrelated, but both did not correlate with anterograde memory, indicating a structural dissociation between both functions.