RESUMO
Functional Magnetic Resonance Imaging (fMRI) has been so far the golden standard to study the functional aspects of the cerebellum. In this paper, a low-cost alternative imaging, i.e. functional Near-Infrared Spectroscopy (fNIRS) is demonstrated to achieve successful measurements of the cerebellar hemodynamics towards the challenging observation of motor and cognitive processes at the cerebellar level. The excitation and reception optodes need to be properly placed to circumvent a major hindering from the shielding by the neck muscles. A simple experimental protocol, i.e. finger tapping task, was implemented to observe the subject's engagement and the presence of functional asymmetries. Marked differences among subjects with different levels of lateralization were clearly noticed in terms of activation and latencies, together with peaks in the hemodynamic response following neural activation. These preliminary results suggest also differences in the hemodynamic behavior between the brain and the cerebellum and encourage future and extended analysis in this direction.Clinical Relevance-This establishes the possibility to use a novel technique (fNIRS) to study cerebellar hemodynamics instead of fMRI.
Assuntos
Mapeamento Encefálico , Espectroscopia de Luz Próxima ao Infravermelho , Encéfalo , Cerebelo , Humanos , Imageamento por Ressonância MagnéticaRESUMO
The estimation of Event-Related Potentials (ERPs) from the ambient EEG is a difficult task, usually achieved through the synchronous averaging of an extensive series of trials. However, this technique has some caveats: the ERPs have to be strictly time-locked with similar shape, i.e. emitted with the same latency and the same profile, with minor fluctuations of their amplitudes. Also, the method requires a huge number of valid trials (~100) to efficiently raise the ERPs from the EEG trials. In the case of cognitive ERPs, as with the N400, the delivered stimulus has to be different for each trial, the latencies are varying, and the number of available trials is usually low. In this paper, an alternative method, coined Integral Shape Averaging (ISA) and its derivatives are detailed. ISA is robust to varying latencies and affine transforms of shape. Furthermore, a new method coined ISAD can be derived to extract ERPs even from a single trial experiment. The aim here is to illustrate the potential of ISAD for N400 component extraction on real EEG data, with emphasis on its general applicability for ERPs computation and its major assets like reduced experimental protocol. Some insights are also given on its potential use to study ERP variability, through shape and latency.Clinical Relevance- The proposed algorithm aims to be a helpful tool in clinical practice to analyze and interpret evoked responses in real experimental settings, especially for particularities in neurology.
Assuntos
Eletroencefalografia , Potenciais Evocados , Algoritmos , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: We present the method and results of an original technique to implant electrodes in the subthalamic nucleus (STN) to treat Parkinson's disease, based on adaptations of the Fisher ZD stereotactic frame. METHODS: Targets coordinates were calculated after fusion of stereotactic CT-scan and MRI images. STN was localized by its theoretical coordinates according to AC-PC and by its direct visualization on T2 images. Electrodes were implanted after local anesthesia, using peroperative multicanal microrecordings and test stimulation. Electrodes location was checked by peroperative perpendicular radiographs. To avoid projection of the frame arm on the area of interest on anteroposterior and lateral radiographs, the arm was fixed at 45 degrees from the usual 90 degrees position. This original fixation needed a trigonometric transformation of the X and Y stereotactic coordinates. Radiopaque markers, fixed on the frame, were identified on the radiographs, allowing the calculation of the stereotactic coordinates of the electrode tip, which were then entered in the stereotactic MRI, to check its location from the defined target. RESULTS: No problem due to adaptations of the frame occurred in the 60 patients. In all cases, peroperative radiographs allowed to confirm the correct location of electrodes. Six months after surgery, UPDRS III score without medication was decreased by 52% with stimulation "on". UPDRS IV items 32, 33 and 39 scores were decreased by 75,7, 79,5 and 72%. Daily dopa-equivalent dose was decreased by 71%. One asymptomatic thalamic hematoma and two wound infections occurred. CONCLUSION: This method was efficient and safe to implant deep electrodes.