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van den Boom MA, Gregg NM, Valencia GO, Lundstrom BN, Miller KJ, van Blooijs D, Huiskamp GJ, Leijten FS, Worrell GA, Hermes D. ER-detect: a pipeline for robust detection of early evoked responses in BIDS-iEEG electrical stimulation data. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.09.574915. [PMID: 38260687 PMCID: PMC10802406 DOI: 10.1101/2024.01.09.574915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Human brain connectivity can be measured in different ways. Intracranial EEG (iEEG) measurements during single pulse electrical stimulation provide a unique way to assess the spread of electrical information with millisecond precision. To provide a robust workflow to process these cortico-cortical evoked potential (CCEP) data and detect early evoked responses in a fully automated and reproducible fashion, we developed Early Response (ER)-detect. ER-detect is an open-source Python package and Docker application to preprocess BIDS structured iEEG data and detect early evoked CCEP responses. ER-detect can use three response detection methods, which were validated against 14-manually annotated CCEP datasets from two different sites by four independent raters. Results showed that ER-detect's automated detection performed on par with the inter-rater reliability (Cohen's Kappa of ~0.6). Moreover, ER-detect was optimized for processing large CCEP datasets, to be used in conjunction with other connectomic investigations. ER-detect provides a highly efficient standardized workflow such that iEEG-BIDS data can be processed in a consistent manner and enhance the reproducibility of CCEP based connectivity results.
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Affiliation(s)
- Max A. van den Boom
- Department of Physiology and Biomedical Engineering, Mayo Clinic; Rochester, MN, USA
- Department of Neurosurgery, Mayo Clinic; Rochester, MN, USA
| | | | | | | | - Kai J. Miller
- Department of Neurosurgery, Mayo Clinic; Rochester, MN, USA
| | - Dorien van Blooijs
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht; Utrecht, NL
- Stichting Epilepsie Instellingen Nederland (SEIN); Zwolle, The Netherlands
| | - Geertjan J.M. Huiskamp
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht; Utrecht, NL
| | - Frans S.S. Leijten
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht; Utrecht, NL
| | - Gregory A. Worrell
- Department of Physiology and Biomedical Engineering, Mayo Clinic; Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN; USA
| | - Dora Hermes
- Department of Physiology and Biomedical Engineering, Mayo Clinic; Rochester, MN, USA
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Yuan X, Zhong X, Wang C, Dai Y, Yang Y, Jiang C. Temporo-Parietal cortex activation during motor imagery in older adults: A case study of Baduanjin. Brain Cogn 2023; 173:106103. [PMID: 37922628 DOI: 10.1016/j.bandc.2023.106103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/03/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Abstract
Age-associated cognitive and motor decline is related to central nervous system injury in older adults. Motor imagery training (MIT), as an emerging rehabilitative intervention, can activate neural basis similar to that in actual exercise, so as to promote motor function in older adults. The complex motor skills rely on the functional integration of the cerebral cortex. Understanding the neural mechanisms underlying motor imagery in older adults would support its application in motor rehabilitation and slowing cognitive decline. Based on this, the present study used functional near infrared spectroscopy (fNIRS) to record the changes in oxygen saturation in older adults (20 participants; mean age, 64.8 ± 4.5 years) during Baduanjin motor execution (ME) and motor imagery (MI). ME significantly activated the left postcentral gyrus, while the oxy-hemoglobin concentration in the right middle temporal gyrus increased significantly during motor imagery. These results indicate that advanced ME activates brain regions related to sensorimotor function, and MI increases the activation of the frontal-parietal cortex related to vision. In older adults, MI overactivated the temporo-parietal region associated with vision, and tend to be activated in the right brain.
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Affiliation(s)
- Xiaoxia Yuan
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; School of Sport, Exercise and Rehabilitation Sciences, The University of Birmingham, Birmingham B25 2TT, UK.
| | - Xiaoke Zhong
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
| | - Chen Wang
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
| | - Yuanfu Dai
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
| | - Yuan Yang
- Sports Department, Beihang University, Beijing 100191, China.
| | - Changhao Jiang
- Beijing Key Laboratory of Physical Fitness Evaluation and Technical Analysis, Capital University of Physical Education and Sports, Beijing 100191, China; The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China.
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Rossel O, Schlosser-Perrin F, Duffau H, Matsumoto R, Mandonnet E, Bonnetblanc F. Short-range axono-cortical evoked-potentials in brain tumor surgery: Waveform characteristics as markers of direct connectivity. Clin Neurophysiol 2023; 153:189-201. [PMID: 37353389 DOI: 10.1016/j.clinph.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/20/2023] [Accepted: 05/24/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE Intraoperative measurement of axono-cortical evoked potentials (ACEP) has emerged as a promising tool for studying neural connectivity. However, it is often difficult to determine if the activity recorded by cortical grids is generated by stimulated tracts or by spurious phenomena. This study aimed to identify criteria that would indicate a direct neurophysiological connection between a recording contact and a stimulated pathway. METHODS Electrical stimulation was applied to white matter fascicles within the resection cavity, while the evoked response was recorded at the cortical level in seven patients. RESULTS By analyzing the ACEP recordings, we identified a main epicenter characterized by a very early positive (or negative) evoked response occurring just after the stimulation artifact (<5 ms, |Amplitude| > 100 µV) followed by an early and large negative (or positive) monophasic evoked response (<40 ms; |Amplitude| > 300 µV). The neighboring activity had a different waveform and was attenuated compared to the hot-spot activity. CONCLUSIONS It is possible to distinguish the hotspot with direct connectivity to the stimulated site from neighboring activity using the identified criteria. SIGNIFICANCE The electrogenesis of the ACEP at the hotspot and neighboring activity is discussed.
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Affiliation(s)
| | | | - Hugues Duffau
- Département de Neurochirurgie, Centre Hospitalier Universitaire de Montpellier Gui de Chauliac, Montpellier, France
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
| | - Emmanuel Mandonnet
- Département de Neurochirurgie, Centre Hospitalier Universitaire, Hôpital Lariboisière, Paris, France
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Sasagawa A, Enatsu R, Kuribara T, Arihara M, Hirano T, Ochi S, Mikuni N. Cortical regions and networks of hyperkinetic seizures: Electrocorticography and diffusion tensor imaging study. Epilepsy Behav 2021; 125:108405. [PMID: 34801803 DOI: 10.1016/j.yebeh.2021.108405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study investigated the cortical areas and networks responsible for hyperkinetic seizures by analyzing invasive recordings and diffusion tensor imaging (DTI) tractography. METHODS Seven patients with intractable focal epilepsy in whom hyperkinetic seizures were recorded during an invasive evaluation at Sapporo Medical University between January 2012 and March 2020 were enrolled in the present study. Intracranial recordings were analyzed to localize seizure-onset zones (SOZs) and symptomatogenic zones (spread areas at clinical onset). DTI was used to identify the subcortical fibers originating from SOZs. RESULTS Ten SOZs were located in four areas: (1) the inferior parietal lobule (two SOZs in two patients), (2) temporo-occipital junction (three SOZs in two patients), (3) medial temporal area (three SOZs in three patients) and (4) medial/lateral frontal lobe (two SOZs in two patients). Symptomatogenic zones appeared to be the premotor area, basal temporal area, temporo-occipital junction, and the postcentral gyrus/supramarginal gyrus. The tractographic analysis revealed that the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), middle longitudinal fasciculus (MLF), arcuate fasciculus (AF)/superior longitudinal fasciculus (SLF) II, III, and cingulum bundle may be associated with hyperkinetic seizures. CONCLUSION The present results suggest the cortical areas (the inferior parietal lobule, temporo-occipital junction, medial temporal area, and medial/lateral frontal lobe) and subcortical fibers (IFOF, ILF, MLF, AF/SLFII, III, and the cingulum bundle) responsible for generating hyperkinetic seizures.
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Affiliation(s)
- Ayaka Sasagawa
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | | | - Masayasu Arihara
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Tsukasa Hirano
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Satoko Ochi
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
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Sun K, Wang H, Bai Y, Zhou W, Wang L. MRIES: A Matlab Toolbox for Mapping the Responses to Intracranial Electrical Stimulation. Front Neurosci 2021; 15:652841. [PMID: 34194294 PMCID: PMC8236813 DOI: 10.3389/fnins.2021.652841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022] Open
Abstract
Propose Directed cortical responses to intracranial electrical stimulation are a good standard for mapping inter-regional direct connectivity. Cortico-cortical evoked potential (CCEP), elicited by single pulse electrical stimulation (SPES), has been widely used to map the normal and abnormal brain effective network. However, automated processing of CCEP datasets and visualization of connectivity results remain challenging for researchers and clinicians. In this study, we develop a Matlab toolbox named MRIES (Mapping the Responses to Intracranial Electrical Stimulation) to automatically process CCEP data and visualize the connectivity results. Method The MRIES integrates the processing pipeline of the CCEP datasets and various methods for connectivity calculation based on low- and high-frequency signals with stimulation artifacts removed. The connectivity matrices are saved in different folders for visualization. Different visualization patterns (connectivity matrix, circle map, surface map, and volume map) are also integrated to the graphical user interface (GUI), which makes it easy to intuitively display and compare different connectivity measurements. Furthermore, one sample CCEP data set collected from eight epilepsy patients is used to validate the MRIES toolbox. Result We show the GUI and visualization functions of MRIES using one example CCEP data that has been described in a complete tutorial. We applied this toolbox to the sample CCEP data set to investigate the direct connectivity between the medial temporal lobe and the insular cortex. We find bidirectional connectivity between MTL and insular that are consistent with the findings of previous studies. Conclusion MRIES has a friendly GUI and integrates the full processing pipeline of CCEP data and various visualization methods. The MRIES toolbox, tutorial, and example data can be freely downloaded. As an open-source package, MRIES is expected to improve the reproducibility of CCEP findings and facilitate clinical translation.
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Affiliation(s)
- Kaijia Sun
- School of Systems Science, Beijing Normal University, Beijing, China.,CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Haixiang Wang
- Epilepsy Center, Tsinghua University Yuquan Hospital, Beijing, China
| | - Yunxian Bai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Wenjing Zhou
- Epilepsy Center, Tsinghua University Yuquan Hospital, Beijing, China
| | - Liang Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Yamao Y, Matsumoto R, Kunieda T, Nakae T, Nishida S, Inano R, Shibata S, Kikuchi T, Arakawa Y, Yoshida K, Ikeda A, Miyamoto S. Effects of propofol on cortico-cortical evoked potentials in the dorsal language white matter pathway. Clin Neurophysiol 2021; 132:1919-1926. [PMID: 34182277 DOI: 10.1016/j.clinph.2021.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/22/2021] [Accepted: 04/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE In order to evaluate the clinical utility even under general anesthesia, the present study aimed to clarify the effect of anesthesia on the cortico-cortical evoked potentials (CCEPs). METHODS We analyzed 14 patients' data in monitoring the integrity of the dorsal language pathway by using CCEPs both under general anesthesia with propofol and remifentanil and awake condition, with the main aim of clarifying the effect of anesthesia on the distribution and waveform of CCEPs. RESULTS The distribution of larger CCEP response sites, including the locus of the maximum CCEP response site, was marginally affected by anesthesia. With regard to similarity of waveforms, the mean waveform correlation coefficient indicated a strong agreement. CCEP N1 amplitude increased by an average of 25.8% from general anesthesia to waking, except three patients. CCEP N1 latencies had no correlation in changes between the two conditions. CONCLUSIONS We demonstrated that the distribution of larger CCEP responses was marginally affected by anesthesia and that the CCEP N1 amplitude had tendency to increase from general anesthesia to the awake condition. SIGNIFICANCE The CCEP method provides the efficiency of intraoperative monitoring for dorsal language white matter pathway even under general anesthesia.
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Affiliation(s)
- Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Takeharu Kunieda
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Neurosurgery, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takuro Nakae
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sei Nishida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Rika Inano
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sumiya Shibata
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Ikeda
- Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Yamao Y, Matsumoto R, Kikuchi T, Yoshida K, Kunieda T, Miyamoto S. Intraoperative Brain Mapping by Cortico-Cortical Evoked Potential. Front Hum Neurosci 2021; 15:635453. [PMID: 33679353 PMCID: PMC7930065 DOI: 10.3389/fnhum.2021.635453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/21/2021] [Indexed: 12/04/2022] Open
Abstract
To preserve postoperative brain function, it is important for neurosurgeons to fully understand the brain's structure, vasculature, and function. Intraoperative high-frequency electrical stimulation during awake craniotomy is the gold standard for mapping the function of the cortices and white matter; however, this method can only map the "focal" functions and cannot monitor large-scale cortical networks in real-time. Recently, an in vivo electrophysiological method using cortico-cortical evoked potentials (CCEPs) induced by single-pulse electrical cortical stimulation has been developed in an extraoperative setting. By using the CCEP connectivity pattern intraoperatively, mapping and real-time monitoring of the dorsal language pathway is available. This intraoperative CCEP method also allows for mapping of the frontal aslant tract, another language pathway, and detection of connectivity between the primary and supplementary motor areas in the frontal lobe network. Intraoperative CCEP mapping has also demonstrated connectivity between the frontal and temporal lobes, likely via the ventral language pathway. Establishing intraoperative electrophysiological monitoring is clinically useful for preserving brain function, even under general anesthesia. This CCEP technique demonstrates potential clinical applications for mapping and monitoring large-scale cortical networks.
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Affiliation(s)
- Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takayuki Kikuchi
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University Graduate School of Medicine, Toon, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Skopin MD, Bayat A, Kurada L, Siddu M, Joshi S, Zelano CM, Koubeissi MZ. Epileptogenesis-induced changes of hippocampal-piriform connectivity. Seizure 2020; 81:1-7. [PMID: 32682283 DOI: 10.1016/j.seizure.2020.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 07/06/2020] [Accepted: 07/09/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Tissue remodeling has been described in brain circuits that are involved in the generation and propagation of epileptic seizures. Human and animal studies suggest that the anterior piriform cortex (aPC) is crucial for seizure expression in focal epilepsies. Here, we investigate the effect of kainic-acid (KA)-induced seizures on the effective connectivity of the aPC with bilateral hippocampal CA3 regions using cerebro-cerebral evoked potentials (CCEPs). METHODS Adult male Sprague-Dawley rats were implanted with a tripolar electrode in the left aPC for stimulation and recording, and with unipolar recording electrodes in bilateral CA3 regions. Single pulse stimulations were given to the aPC and CCEPs were averaged before KA injections and after the emergence of spontaneous recurrent seizures (SRS). Similar recordings at equivalent time intervals were obtained from animals that received saline injections instead of KA (controls). RESULTS In the experimental group, the percentage change of increased amplitude of the contralateral (but not ipsilateral) CA3 CCEPs between pre-KA injection and after the emergence of SRS was significantly greater than in controls. No significant single-pulse-induced spectral change responses were observed in either epileptic or control rats when comparing pre- and post-stimulus time intervals. Also, we found no correlation between seizure frequency and the extent of amplitude changes in the CCEPs. CONCLUSIONS In the KA model, epileptogenesis results in plastic changes that manifest as an amplification of evoked potential amplitudes recorded in the contralateral hippocampus in response to single-pulse stimulation of the aPC. These results suggest epileptogenesis-induced facilitation of interhemispheric connectivity between the aPC and the hippocampus. Since the amplitude increase of the contralateral CCEP is a possible in vivo biomarker of epilepsy, any intervention (e.g. neuromodulatory) that can reverse this phenomenon may hold a potential antiepileptic efficacy.
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Affiliation(s)
- Mark D Skopin
- Department of Neurology, George Washington University, Washington, DC, 20037, USA
| | - Arezou Bayat
- Department of Neurology, George Washington University, Washington, DC, 20037, USA
| | - Lalitha Kurada
- Department of Neurology, George Washington University, Washington, DC, 20037, USA
| | - Mithilesh Siddu
- Department of Neurology, George Washington University, Washington, DC, 20037, USA
| | - Sweta Joshi
- Department of Neurology, George Washington University, Washington, DC, 20037, USA
| | - Christina M Zelano
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mohamad Z Koubeissi
- Department of Neurology, George Washington University, Washington, DC, 20037, USA.
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Rech F, Wassermann D, Duffau H. New insights into the neural foundations mediating movement/language interactions gained from intrasurgical direct electrostimulations. Brain Cogn 2020; 142:105583. [DOI: 10.1016/j.bandc.2020.105583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
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Intraoperative Electrophysiologic Mapping of Medial Frontal Motor Areas and Functional Outcomes. World Neurosurg 2020; 138:e389-e404. [DOI: 10.1016/j.wneu.2020.02.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 11/19/2022]
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Hirano T, Enatsu R, Sasagawa A, Arihara M, Kuribara T, Yokoyama R, Suzuki H, Ochi S, Mikuni N. Anatomical and functional distribution of functional MRI language mapping. J Clin Neurosci 2020; 77:116-122. [PMID: 32439278 DOI: 10.1016/j.jocn.2020.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of the present study was to compare localization of the language cortex using electrical cortical stimulation (ECS) and functional magnetic resonance imaging (fMRI) to establish the relevance of fMRI language mapping. METHODS Language mapping with fMRI and functional ECS mapping were retrospectively compared in ten patients with refractory epilepsy who underwent fMRI language mapping and functional ECS mapping between June 2012 and April 2019. A shiritori task, a popular Japanese word chain game, was used for fMRI language mapping. RESULTS BOLD signal activation was observed in the left inferior frontal gyrus (including the pars opecularis and the pars triangularis), and superior temporal gyrus, which is a language-related area, as well as in the left superior and middle frontal gyri, the intraparietal sulcus, and fusiform gyrus. These results were compared with ECS to elucidate the functional role of the activated areas during fMRI language tasks. These activated areas included language areas, negative motor areas, supplementary motor areas (SMAs), and non-functional areas. CONCLUSION The activated areas of fMRI language mapping include language-related areas, the negative motor area, and SMAs. These findings suggest the involvement of language and higher order motor networks in verbal expression.
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Affiliation(s)
- Tsukasa Hirano
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Ayaka Sasagawa
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Masayasu Arihara
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | | | - Rintaro Yokoyama
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Hime Suzuki
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Satoko Ochi
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
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Negative motor networks: Electric cortical stimulation and diffusion tensor imaging. Rev Neurol (Paris) 2020; 176:592-600. [PMID: 32147203 DOI: 10.1016/j.neurol.2019.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/27/2019] [Accepted: 12/23/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION This study investigated the networks of Negative motor areas (NMAs) using electric cortical stimulation and diffusion tensor imaging (DTI). METHODS Twelve patients with intractable focal epilepsy, in which NMAs were identified by electrical cortical stimulation, were enrolled in this study. Electric stimulation at 50Hz was applied to the electrodes during motor tasks to identify the NMAs. DTI was used to identify the subcortical fibers originating from the NMAs found by electrical stimulation. RESULTS NMAs were found in lateral frontal areas (premotor area (PM) and precentral gyrus) in all 12 patients, in pre-supplementary motor areas (pre-SMAs) in four patients, and in posterior parietal cortices (PPCs) in four. DTI detected fibers connecting to the ipsilateral PMs, PPCs and temporal regions via U-fibers, superior longitudinal fasciculus (SLF), and arcuate fasciculus (AF) from the lateral frontal NMAs. Pre-SMA-NMAs had connections with ipsilateral PMs and contralateral pre-SMAs via the frontal aslant tract and transcallosal commissural fibers, and PPC-NMAs with ipsilateral PMs via SLF and AF. CONCLUSION This study found the characteristic cortical network of each NMA, and especially revealed new insight of pre-SMA-NMA and PPC NMA. These NMAs might be associated with different mechanism of negative motor response.
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Vincent MA, Bonnetblanc F, Mandonnet E, Boyer A, Duffau H, Guiraud D. Measuring the electrophysiological effects of direct electrical stimulation after awake brain surgery. J Neural Eng 2020; 17:016047. [DOI: 10.1088/1741-2552/ab5cdd] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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14
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Rech F, Herbet G, Gaudeau Y, Mézières S, Moureau JM, Moritz-Gasser S, Duffau H. A probabilistic map of negative motor areas of the upper limb and face: a brain stimulation study. Brain 2019; 142:952-965. [PMID: 30753319 DOI: 10.1093/brain/awz021] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 12/02/2018] [Accepted: 12/14/2018] [Indexed: 11/13/2022] Open
Abstract
Negative motor responses (NMRs) are defined as movement arrests induced by direct electrical stimulation of the brain. The NMRs manifest themselves after the disruption of a corticosubcortical network involved in motor control, referred to as the 'negative motor network'. At present, the spatial topography of the negative motor areas (NMAs) is poorly known. Hence, the objectives of the present study were to establish the first probabilistic map of the NMAs of the upper limbs and face, identify potential subareas, and investigate the NMAs' relationships with the primary motor cortex. A total of 117 patients with low grade glioma underwent awake surgery with direct electrostimulation. The Montreal Neurological Institute coordinates of sites eliciting NMRs (face and upper limbs) were registered. A probabilistic map was created, and subareas were identified in a cluster analysis. Each cluster was then plotted on the Glasser atlas and the 1200 Subjects Group Average Data from the Human Connectome Project, in order to study connectivity and compare the results with recent parcellation data. We elicited 386 NMRs (mean ± standard deviation current intensity: 2.26 ± 0.5 mA) distributed throughout the precentral gyrus in both hemispheres. In each hemisphere, we found two clusters for facial NMRs. For upper limb NMRs, we found two clusters in the right hemisphere; and three in the left. Each cluster overlapped with parcellations from the Glasser atlas. For the face, the NMAs were associated with areas 55b and 6v. For the upper limbs, the NMAs were linked to areas 6v, 6d, and 55b. Each NMA cluster showed a specific pattern of functionally connected areas, such as the inferior frontal gyrus, supplementary motor area, parietal areas, and posterior superior temporal gyrus. The white matter pathways projecting to these subareas involved the frontal aslant tract and the frontostriatal tract-both of which are well known to be associated with NMRs. This study constitutes the largest series to date of NMRs mapped to the lateral surface of both hemispheres. Rather than being randomly distributed, the NMAs appeared to be well structured and corresponded to parcellations identified by functional neuroimaging. Moreover, the white matter pathways known to drive NMRs are also connected to regions encompassing NMAs. Taken as a whole, our results suggest that NMAs belong to a large-scale modulatory motor network. Our new probabilistic map might constitute a valuable tool for use in further clinical and fundamental studies of motor control.
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Affiliation(s)
- Fabien Rech
- Department of Neurosurgery, Central Hospital, CHRU Nancy, 29 avenue du Maréchal de Lattre de Tassigny, F-54000 Nancy, France.,'Plasticity of Central Nervous System, Stem Cells and Glial Tumours' group, INSERM U1051, Institute for Neurosciences of Montpellier, F-34295 Montpellier, France
| | - Guillaume Herbet
- 'Plasticity of Central Nervous System, Stem Cells and Glial Tumours' group, INSERM U1051, Institute for Neurosciences of Montpellier, F-34295 Montpellier, France.,Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 avenue Augustin Fliche, F-34295 Montpellier, France
| | - Yann Gaudeau
- Centre de Recherche en Automatique de Nancy, UMR 7039, Faculté de médecine, Université de Lorraine, F-54000 Nancy, France.,Université de Strasbourg, 30 rue Maire Andre Traband, F-67500 Haguenau, France
| | - Sophie Mézières
- Université de Lorraine, I.E.C.L., INRIA-BIGS, CNRS UMR 7502, F-54506 Vandoeuvre-les-Nancy, France
| | - Jean-Marie Moureau
- Centre de Recherche en Automatique de Nancy, UMR 7039, Faculté de médecine, Université de Lorraine, F-54000 Nancy, France.,Centre de Recherche en Automatique de Nancy, UMR 7039, CNRS, Université de Lorraine, F-54000 Nancy, France
| | - Sylvie Moritz-Gasser
- 'Plasticity of Central Nervous System, Stem Cells and Glial Tumours' group, INSERM U1051, Institute for Neurosciences of Montpellier, F-34295 Montpellier, France.,Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 avenue Augustin Fliche, F-34295 Montpellier, France
| | - Hugues Duffau
- 'Plasticity of Central Nervous System, Stem Cells and Glial Tumours' group, INSERM U1051, Institute for Neurosciences of Montpellier, F-34295 Montpellier, France.,Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 avenue Augustin Fliche, F-34295 Montpellier, France
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15
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Neshige S, Kobayashi K, Matsuhashi M, Togo M, Sakamoto M, Shimotake A, Hitomi T, Kikuchi T, Yoshida K, Kunieda T, Matsumoto R, Maruyama H, Takahashi R, Miyamoto S, Ikeda A. A score to map the lateral nonprimary motor area: Multispectrum intrinsic brain activity versus cortical stimulation. Epilepsia 2019; 60:2294-2305. [PMID: 31612479 DOI: 10.1111/epi.16367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Multispectrum electrocorticographic components are critical for mapping the nonprimary motor area (NPMA). The objective of this study was to derive and validate a reliable scoring system for electrocorticography-based NPMA mapping (NPMA score) to replace electrical cortical stimulation (ECS) during brain surgery. METHODS We analyzed 14 consecutive epilepsy patients with subdural electrodes implanted in the frontal lobe at Kyoto University Hospital. The NPMA score was retrospectively derived from multivariate analysis in the derivation group (patients = 7, electrodes = 713, during 2010-2013) and validated in the validation group (patients = 7, electrodes = 772, during 2014-2017). We assessed the accuracy and reliability of the score relative to ECS in determining the NPMA and predicting postoperative functional outcomes. RESULTS Multivariate analysis in the derivation group led to an 8-point score for predicting ECS-based NPMA (1 point for anatomical localization of the electrode and 1 or 2 points for movement-related electrocorticographic components regardless of somatotopy in very slow cortical potential shifts [<0.5 Hz], 40-80-Hz band power increase, and 8-24-Hz band power decrease), which was validated in the validation group. The area under the receiver operating characteristic curve (AUC) was 0.89 in the derivation group. Good prediction (specificity = 94%, sensitivity = 100%) and discrimination (AUC = 0.87) were reproduced in the validation group. Overall, higher NPMA scores identified 2 patients with postoperative deficits after frontal lobe resection. SIGNIFICANCE The NPMA score is reliable for NPMA mapping, potentially replacing ECS. It is a potential prognostic marker for postoperative functional deficits.
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Affiliation(s)
- Shuichiro Neshige
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Katsuya Kobayashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masaya Togo
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mitsuhiro Sakamoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiro Shimotake
- Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takefumi Hitomi
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University Graduate School of Medicine, Toon, Japan
| | - Riki Matsumoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders, and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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16
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Viganò L, Fornia L, Rossi M, Howells H, Leonetti A, Puglisi G, Conti Nibali M, Bellacicca A, Grimaldi M, Bello L, Cerri G. Anatomo-functional characterisation of the human “hand-knob”: A direct electrophysiological study. Cortex 2019; 113:239-254. [DOI: 10.1016/j.cortex.2018.12.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/21/2018] [Accepted: 12/16/2018] [Indexed: 12/01/2022]
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17
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Suzuki Y, Enatsu R, Kanno A, Yokoyama R, Suzuki H, Tachibana S, Akiyama Y, Mikami T, Ochi S, Yamakage M, Mikuni N. The Influence of Anesthesia on Corticocortical Evoked Potential Monitoring Network Between Frontal and Temporoparietal Cortices. World Neurosurg 2019; 123:e685-e692. [DOI: 10.1016/j.wneu.2018.11.253] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 10/27/2022]
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18
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A quantitative method for evaluating cortical responses to electrical stimulation. J Neurosci Methods 2018; 311:67-75. [PMID: 30292823 DOI: 10.1016/j.jneumeth.2018.09.034] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Electrical stimulation of the cortex using subdurally implanted electrodes can causally reveal structural connectivity by eliciting cortico-cortical evoked potentials (CCEPs). While many studies have demonstrated the potential value of CCEPs, the methods to evaluate them were often relatively subjective, did not consider potential artifacts, and did not lend themselves to systematic scientific investigations. NEW METHOD We developed an automated and quantitative method called SIGNI (Stimulation-Induced Gamma-based Network Identification) to evaluate cortical population-level responses to electrical stimulation that minimizes the impact of electrical artifacts. We applied SIGNI to electrocorticographic (ECoG) data from eight human subjects who were implanted with a total of 978 subdural electrodes. Across the eight subjects, we delivered 92 trains of approximately 200 discrete electrical stimuli each (amplitude 4-15 mA) to a total of 64 electrode pairs. RESULTS We verified SIGNI's efficacy by demonstrating a relationship between the magnitude of evoked cortical activity and stimulation amplitude, as well as between the latency of evoked cortical activity and the distance from the stimulated locations. CONCLUSIONS SIGNI reveals the timing and amplitude of cortical responses to electrical stimulation as well as the structural connectivity supporting these responses. With these properties, it enables exploration of new and important questions about the neurophysiology of cortical communication and may also be useful for pre-surgical planning.
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19
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Trebaul L, Deman P, Tuyisenge V, Jedynak M, Hugues E, Rudrauf D, Bhattacharjee M, Tadel F, Chanteloup-Foret B, Saubat C, Reyes Mejia GC, Adam C, Nica A, Pail M, Dubeau F, Rheims S, Trébuchon A, Wang H, Liu S, Blauwblomme T, Garcés M, De Palma L, Valentin A, Metsähonkala EL, Petrescu AM, Landré E, Szurhaj W, Hirsch E, Valton L, Rocamora R, Schulze-Bonhage A, Mindruta I, Francione S, Maillard L, Taussig D, Kahane P, David O. Probabilistic functional tractography of the human cortex revisited. Neuroimage 2018; 181:414-429. [PMID: 30025851 PMCID: PMC6150949 DOI: 10.1016/j.neuroimage.2018.07.039] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/21/2018] [Accepted: 07/15/2018] [Indexed: 12/13/2022] Open
Abstract
In patients with pharmaco-resistant focal epilepsies investigated with intracranial electroencephalography (iEEG), direct electrical stimulations of a cortical region induce cortico-cortical evoked potentials (CCEP) in distant cerebral cortex, which properties can be used to infer large scale brain connectivity. In 2013, we proposed a new probabilistic functional tractography methodology to study human brain connectivity. We have now been revisiting this method in the F-TRACT project (f-tract.eu) by developing a large multicenter CCEP database of several thousand stimulation runs performed in several hundred patients, and associated processing tools to create a probabilistic atlas of human cortico-cortical connections. Here, we wish to present a snapshot of the methods and data of F-TRACT using a pool of 213 epilepsy patients, all studied by stereo-encephalography with intracerebral depth electrodes. The CCEPs were processed using an automated pipeline with the following consecutive steps: detection of each stimulation run from stimulation artifacts in raw intracranial EEG (iEEG) files, bad channels detection with a machine learning approach, model-based stimulation artifact correction, robust averaging over stimulation pulses. Effective connectivity between the stimulated and recording areas is then inferred from the properties of the first CCEP component, i.e. onset and peak latency, amplitude, duration and integral of the significant part. Finally, group statistics of CCEP features are implemented for each brain parcel explored by iEEG electrodes. The localization (coordinates, white/gray matter relative positioning) of electrode contacts were obtained from imaging data (anatomical MRI or CT scans before and after electrodes implantation). The iEEG contacts were repositioned in different brain parcellations from the segmentation of patients' anatomical MRI or from templates in the MNI coordinate system. The F-TRACT database using the first pool of 213 patients provided connectivity probability values for 95% of possible intrahemispheric and 56% of interhemispheric connections and CCEP features for 78% of intrahemisheric and 14% of interhemispheric connections. In this report, we show some examples of anatomo-functional connectivity matrices, and associated directional maps. We also indicate how CCEP features, especially latencies, are related to spatial distances, and allow estimating the velocity distribution of neuronal signals at a large scale. Finally, we describe the impact on the estimated connectivity of the stimulation charge and of the contact localization according to the white or gray matter. The most relevant maps for the scientific community are available for download on f-tract. eu (David et al., 2017) and will be regularly updated during the following months with the addition of more data in the F-TRACT database. This will provide an unprecedented knowledge on the dynamical properties of large fiber tracts in human.
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Affiliation(s)
- Lena Trebaul
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Pierre Deman
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Viateur Tuyisenge
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Maciej Jedynak
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Etienne Hugues
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - David Rudrauf
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Manik Bhattacharjee
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - François Tadel
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Blandine Chanteloup-Foret
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Carole Saubat
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Gina Catalina Reyes Mejia
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Claude Adam
- Epilepsy Unit, Dept of Neurology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Anca Nica
- Neurology Department, CHU, Rennes, France
| | - Martin Pail
- Brno Epilepsy Center, Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - François Dubeau
- Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France
| | - Agnès Trébuchon
- Service de Neurophysiologie Clinique, APHM, Hôpitaux de la Timone, Marseille, France
| | - Haixiang Wang
- Yuquan Hospital Epilepsy Center, Tsinghua University, Beijing, China
| | - Sinclair Liu
- Canton Sanjiu Brain Hospital Epilepsy Center, Jinan University, Guangzhou, China
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Université Paris V Descartes, Sorbonne Paris Cité, Paris, France
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Luca De Palma
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Rome, Italy
| | - Antonio Valentin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), London, UK
| | | | | | | | - William Szurhaj
- Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France
| | - Edouard Hirsch
- University Hospital, Department of Neurology, Strasbourg, France
| | - Luc Valton
- University Hospital, Department of Neurology, Toulouse, France
| | - Rodrigo Rocamora
- Epilepsy Monitoring Unit, Department of Neurology, Hospital del Mar-IMIM, Barcelona, Spain
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Ioana Mindruta
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | | | - Louis Maillard
- Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Delphine Taussig
- Service de neurochirurgie pédiatrique, Fondation Rothschild, Paris, France
| | - Philippe Kahane
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France; CHU Grenoble Alpes, Neurology Department, Grenoble, France
| | - Olivier David
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France.
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20
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Kanno A, Enatsu R, Ookawa S, Ochi S, Mikuni N. Location and Threshold of Electrical Cortical Stimulation for Functional Brain Mapping. World Neurosurg 2018; 119:e125-e130. [PMID: 30026161 DOI: 10.1016/j.wneu.2018.07.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/05/2018] [Accepted: 07/07/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Although many studies have investigated functional localization by electrical stimulation, the threshold to identify each area remains controversial. The present study aimed to elucidate the threshold of a cortical stimulation for functional mapping. METHODS We analyzed data from 17 patients with medically intractable epilepsy who underwent a 50-Hz electrical cortical stimulation for functional mapping between October 2013 and May 2017. The symptoms induced by the stimulation and the thresholds of the stimulation for these responses were evaluated. RESULTS Motor responses were observed after the stimulation of the primary motor cortex, supplementary motor area, and frontal eye field, and sensory responses after the stimulation of the primary and secondary sensory cortex. Regarding negative responses, language impairment was observed after the stimulation of the anterior, posterior, and basal temporal language areas, negative motor responses after the stimulation of the premotor cortex, posterior parietal cortex, and the pre- supplementary motor area, and an impairment in spatial recognition after the stimulation of the right posterior parietal cortex. Negative or positive auditory symptoms were observed with the stimulation of the posterior superior temporal gyrus. The thresholds for positive phenomena were significantly lower than those for negative phenomena (Mann-Whitney U test, P < 0.01), and sensory responses were induced at significantly lower intensities than motor responses (P < 0.01). CONCLUSIONS Positive and sensory effects are induced by lower intensities than negative and motor responses, respectively. The present results provide not only a practical guide for functional mapping, but also a hierarchal concept of processing in the brain.
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Affiliation(s)
- Aya Kanno
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Satoshi Ookawa
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Satoko Ochi
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
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21
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Alarcón G, Jiménez-Jiménez D, Valentín A, Martín-López D. Characterizing EEG Cortical Dynamics and Connectivity with Responses to Single Pulse Electrical Stimulation (SPES). Int J Neural Syst 2018; 28:1750057. [DOI: 10.1142/s0129065717500575] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives: To model cortical connections in order to characterize their oscillatory behavior and role in the generation of spontaneous electroencephalogram (EEG). Methods: We studied averaged responses to single pulse electrical stimulation (SPES) from the non-epileptogenic hemisphere of five patients assessed with intracranial EEG who became seizure free after contralateral temporal lobectomy. Second-order control system equations were modified to characterize the systems generating a given response. SPES responses were modeled as responses to a unit step input. EEG power spectrum was calculated on the 20[Formula: see text]s preceding SPES. Results: 121 channels showed responses to 32 stimulation sites. A single system could model the response in 41.3% and two systems were required in 58.7%. Peaks in the frequency response of the models tended to occur within the frequency range of most activity on the spontaneous EEG. Discrepancies were noted between activity predicted by models and activity recorded in the spontaneous EEG. These discrepancies could be explained by the existence of alpha rhythm or interictal epileptiform discharges. Conclusions: Cortical interactions shown by SPES can be described as control systems which can predict cortical oscillatory behavior. The method is unique as it describes connectivity as well as dynamic interactions.
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Affiliation(s)
- Gonzalo Alarcón
- Comprehensive Epilepsy Center Neuroscience Institute, Academic Health Systems, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Department of Clinical Neurophysiology, King’s College Hospital NHS FT, London, UK
- Weill Cornell Medical College, Doha, Qatar
| | - Diego Jiménez-Jiménez
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Department of Clinical Neurophysiology, King’s College Hospital NHS FT, London, UK
- Universidad San Francisco de Quito, School of Medicine, Quito, Ecuador
| | - Antonio Valentín
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Department of Clinical Neurophysiology, King’s College Hospital NHS FT, London, UK
- Weill Cornell Medical College, Doha, Qatar
| | - David Martín-López
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Weill Cornell Medical College, Doha, Qatar
- Department of Clinical Neurophysiology, Kingston Hospital NHS FT, London, UK
- Department of Clinical Neurophysiology, St George’s University Hospitals NHS FT, London, UK
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22
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Frontal Fibers Connecting the Superior Frontal Gyrus to Broca Area: A Corticocortical Evoked Potential Study. World Neurosurg 2017; 107:239-248. [DOI: 10.1016/j.wneu.2017.07.166] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 11/22/2022]
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23
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Keller CJ, Davidesco I, Megevand P, Lado FA, Malach R, Mehta AD. Tuning face perception with electrical stimulation of the fusiform gyrus. Hum Brain Mapp 2017; 38:2830-2842. [PMID: 28345189 DOI: 10.1002/hbm.23543] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 11/09/2022] Open
Abstract
The fusiform gyrus (FG) is an important node in the face processing network, but knowledge of its causal role in face perception is currently limited. Recent work demonstrated that high frequency stimulation applied to the FG distorts the perception of faces in human subjects (Parvizi et al. []: J Neurosci 32:14915-14920). However, the timing of this process in the FG relative to stimulus onset and the spatial extent of FG's role in face perception are unknown. Here, we investigate the causal role of the FG in face perception by applying precise, event-related electrical stimulation (ES) to higher order visual areas including the FG in six human subjects undergoing intracranial monitoring for epilepsy. We compared the effects of single brief (100 μs) electrical pulses to the FG and non-face-selective visual areas on the speed and accuracy of detecting distorted faces. Brief ES applied to face-selective sites did not affect accuracy but significantly increased the reaction time (RT) of detecting face distortions. Importantly, RT was altered only when ES was applied 100ms after visual onset and in face-selective but not place-selective sites. Furthermore, ES applied to face-selective areas decreased the amplitude of visual evoked potentials and high gamma power over this time window. Together, these results suggest that ES of face-selective regions within a critical time window induces a delay in face perception. These findings support a temporally and spatially specific causal role of face-selective areas and signify an important link between electrophysiology and behavior in face perception. Hum Brain Mapp 38:2830-2842, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Corey J Keller
- Department of Neurosurgery, Hofstra Northwell School of Medicine, and Feinstein Institute for Medical Research, Manhasset, New York.,Departments of Neuroscience and Neurology, Albert Einstein College of Medicine, Bronx, New York.,Departments of Psychiatry and Behavioral Sciences and Stanford Neuroscience Institute, Stanford University School of Medicine, Stanford, California
| | | | - Pierre Megevand
- Department of Neurosurgery, Hofstra Northwell School of Medicine, and Feinstein Institute for Medical Research, Manhasset, New York
| | - Fred A Lado
- Departments of Neuroscience and Neurology, Albert Einstein College of Medicine, Bronx, New York.,Department of Neurology, Montefiore Medical Center, Bronx, New York
| | | | - Ashesh D Mehta
- Department of Neurosurgery, Hofstra Northwell School of Medicine, and Feinstein Institute for Medical Research, Manhasset, New York
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Shimada S, Kunii N, Kawai K, Matsuo T, Ishishita Y, Ibayashi K, Saito N. Impact of volume-conducted potential in interpretation of cortico-cortical evoked potential: Detailed analysis of high-resolution electrocorticography using two mathematical approaches. Clin Neurophysiol 2017; 128:549-557. [PMID: 28226289 DOI: 10.1016/j.clinph.2017.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/22/2016] [Accepted: 01/15/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Cortico-cortical evoked potential (CCEP) has been utilized to evaluate connectivity between cortices. However, previous reports have rarely referred to the impact of volume-conducted potential (VCP) which must be a confounding factor of large potential around the stimulation site. To address this issue, we challenged the null hypothesis that VCP accounts for the majority of the recorded potential, particularly around the stimulation site. METHODS CCEP was recorded with high-density intracranial electrodes in 8 patients with intractable epilepsy. First, we performed regression analysis for describing the relationship between the distance and potential of each electrode. Second, we performed principal component analysis (PCA) to reveal the temporal features of recorded waveforms. RESULTS The regression curve, declining by the inverse square of the distance, fitted tightly to the plots (R2: 0.878-0.991) with outliers. PCA suggested the responses around the stimulation site had the same temporal features. We also observed the continuous declination over the anatomical gap and the phase reversal phenomena around the stimulation site. CONCLUSIONS These results were consistent with the null hypothesis. SIGNIFICANCE This study highlighted the risk of misinterpreting CCEP mapping, and proposed mathematical removal of VCP, which could lead to more reliable mapping based on CCEP.
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Affiliation(s)
- Seijiro Shimada
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Naoto Kunii
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Kensuke Kawai
- Department of Neurosurgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Takeshi Matsuo
- Department of Neurosurgery, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8625, Japan
| | - Yohei Ishishita
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kenji Ibayashi
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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25
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Yamao Y, Suzuki K, Kunieda T, Matsumoto R, Arakawa Y, Nakae T, Nishida S, Inano R, Shibata S, Shimotake A, Kikuchi T, Sawamoto N, Mikuni N, Ikeda A, Fukuyama H, Miyamoto S. Clinical impact of intraoperative CCEP monitoring in evaluating the dorsal language white matter pathway. Hum Brain Mapp 2017; 38:1977-1991. [PMID: 28112455 DOI: 10.1002/hbm.23498] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 12/07/2016] [Indexed: 11/09/2022] Open
Abstract
In order to preserve postoperative language function, we recently proposed a new intraoperative method to monitor the integrity of the dorsal language pathway (arcuate fasciculus; AF) using cortico-cortical evoked potentials (CCEPs). Based on further investigations (20 patients, 21 CCEP investigations), including patients who were not suitable for awake surgery (five CCEP investigations) or those without preoperative neuroimaging data (eight CCEP investigations including four with untraceable tractography due to brain edema), we attempted to clarify the clinical impact of this new intraoperative method. We monitored the integrity of AF by stimulating the anterior perisylvian language area (AL) by recording CCEPs from the posterior perisylvian language area (PL) consecutively during both general anesthesia and awake condition. After tumor resection, single-pulse electrical stimuli were also applied to the floor of the removal cavity to record subcortico-cortical evoked potentials (SCEPs) at AL and PL in 12 patients (12 SCEP investigations). We demonstrated that (1) intraoperative dorsal language network monitoring was feasible even when patients were not suitable for awake surgery or without preoperative neuroimaging studies, (2) CCEP is a dynamic marker of functional connectivity or integrity of AF, and CCEP N1 amplitude could even become larger after reduction of brain edema, (3) a 50% CCEP N1 amplitude decline might be a cut-off value to prevent permanent language dysfunction due to impairment of AF, (4) a correspondence (<2.0 ms difference) of N1 onset latencies between CCEP and the sum of SCEPs indicates close proximity of the subcortical stimulus site to AF (<3.0 mm). Hum Brain Mapp 38:1977-1991, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kengo Suzuki
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Neurosurgery, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Riki Matsumoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takuro Nakae
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sei Nishida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Rika Inano
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sumiya Shibata
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiro Shimotake
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobukatsu Sawamoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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26
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Matsumoto R, Kunieda T, Nair D. Single pulse electrical stimulation to probe functional and pathological connectivity in epilepsy. Seizure 2016; 44:27-36. [PMID: 27939100 DOI: 10.1016/j.seizure.2016.11.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 11/02/2016] [Indexed: 12/12/2022] Open
Abstract
In the last decade, single pulse electrical stimulation (SPES) has been used as an investigational tool in the field of epilepsy surgery. Direct cortical stimulation applied at a frequency of ∼1Hz can probe cortico-cortical connections by averaging electrocorticogram time-lock to the stimuli (2×20-30 trials). These evoked potentials that emanate from adjacent and remote cortices have been termed cortico-cortical evoked potentials (CCEPs). Although limited to patients undergoing invasive presurgical evaluations with intracranial electrodes, CCEP provides a novel way to explore inter-areal connectivity in vivo in the living human brain to probe functional brain networks such as language and cognitive motor networks. In addition to its impact on systems neuroscience, this method, in combination with 50Hz electrical cortical stimulation, could contribute clinically to map the functional brain systems by tracking the cortico-cortical connections among the functional cortical regions in each individual patient. This approach may help identify the normal cortico-cortical network within pathology as well as reveal connections that might arise from neural plasticity. Because of its high practicality, it has been recently applied for intraoperative monitoring of the functional brain networks for patients with brain tumor. With regard to epilepsy, SPES has been used for the two major purposes, one to probe cortical excitability of the focus, namely, epileptogenicity, and the other to probe seizure networks. Both early (i.e., CCEP) and delayed responses, and probably their high frequency oscillation counterparts, are regarded as a surrogate marker of epileptogenicity. With regards to its impact on the human brain connectivity map, worldwide collaboration is warranted to establish the standardized CCEP connectivity map as a solid reference for non-invasive connectome researches.
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Affiliation(s)
- Riki Matsumoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Dileep Nair
- Epilepsy Center, Cleveland Clinic Foundation, Cleveland, USA
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27
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Enatsu R, Gonzalez-Martinez J, Bulacio J, Mosher JC, Burgess RC, Najm I, Nair DR. Connectivity of the frontal and anterior insular network: a cortico-cortical evoked potential study. J Neurosurg 2016; 125:90-101. [DOI: 10.3171/2015.6.jns15622] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
The frontal and insular fiber network in humans remains largely unknown. This study investigated the connectivity of the frontal and anterior insular network in humans using cortico-cortical evoked potential (CCEP).
METHODS
This retrospective analysis included 18 patients with medically intractable focal epilepsy who underwent stereoelectroencephalography and CCEP. Alternating 1-Hz electrical stimuli were delivered to parts of the frontal lobe and anterior insula (prefrontal cortex [PFC], ventrolateral and dorsolateral premotor area [vPM and dPM, respectively], presupplementary motor area [pre-SMA], SMA, frontal operculum, and anterior insula). A total of 40–60 stimuli were averaged in each trial to obtain CCEP responses. The distribution of CCEP was evaluated by calculating the root mean square of CCEP responses.
RESULTS
Stimulation of the PFC elicited prominent CCEP responses in the medial PFC and PMs over the ipsilateral hemisphere. Stimulation of the vPM and dPM induced CCEP responses in the ipsilateral frontoparietal areas. Stimulation of the pre-SMA induced CCEP responses in the ipsilateral medial and lateral frontal areas and contralateral pre-SMA, whereas stimulation of the SMA induced CCEP responses in the bilateral frontoparietal areas. Stimulation of the frontal operculum induced CCEP responses in the ipsilateral insula and temporal operculum. CCEPs were observed in the ipsilateral medial, lateral frontal, and frontotemporal operculum in the anterior insular stimulation. Stimulation of the vPM and SMA led to the network in the dominant hemisphere being more developed.
CONCLUSIONS
Various regions within the frontal lobe and anterior insula were linked to specific ipsilateral and contralateral regions, which may reflect distinct functional roles.
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Affiliation(s)
- Rei Enatsu
- 1Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and
- 2Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | | | - Juan Bulacio
- 1Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - John C. Mosher
- 1Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Richard C. Burgess
- 1Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Imad Najm
- 1Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Dileep R. Nair
- 1Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and
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28
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Boulogne S, Andre-Obadia N, Kimiskidis VK, Ryvlin P, Rheims S. Cortico-cortical and motor evoked potentials to single and paired-pulse stimuli: An exploratory transcranial magnetic and intracranial electric brain stimulation study. Hum Brain Mapp 2016; 37:3767-3778. [PMID: 27312488 DOI: 10.1002/hbm.23274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Paired-pulse (PP) paradigms are commonly employed to assess in vivo cortical excitability using transcranial magnetic stimulation (TMS) to stimulate the primary motor cortex and modulate the induced motor evoked potential (MEP). Single-pulse cortical direct electrical stimulation (DES) during intracerebral EEG monitoring allows the investigation of brain connectivity by eliciting cortico-cortical evoked potentials (CCEPs). However, PP paradigm using intracerebral DES has rarely been reported and has never been previously compared with TMS. OBJECTIVE The work was intended (i) to verify that the well-established modulations of MEPs following PP TMS remain similar using DES in the motor cortex, and (ii) to evaluate if a similar pattern could be observed in distant cortico-cortical connections through modulations of CCEP. METHODS Three patients undergoing intracerebral EEG monitoring with electrodes implanted in the central region were studied. Single-pulse DES (1-3 mA, 1 ms, 0.2 Hz) and PP DES using six interstimulus intervals (5, 15, 30, 50, 100, and 200 ms) in the motor cortex with concomitant recording of CCEPs and MEPs in contralateral muscles were performed. Finally, a navigated PP TMS session targeted the intracranial stimulation site to record TMS-induced MEPs in two patients. RESULTS MEP modulations elicited by PP intracerebral DES proved similar among the three patients and to those obtained by PP TMS. CCEP modulations elicited by PP intracerebral DES usually showed a pattern comparable to that of MEP, although a different pattern could be observed occasionally. CONCLUSION PP intracerebral DES seems to involve excitatory and inhibitory mechanisms similar to PP TMS and allows the recording of intracortical inhibition and facilitation modulation on cortico-cortical connections. Hum Brain Mapp 37:3767-3778, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sébastien Boulogne
- Department of Functional Neurology and Epileptology, Hospices Civils De Lyon, 59 Boulevard Pinel, Bron, 69675, France. .,Lyon's Research Neuroscience Center, Institut National De La Santé Et De La Recherche Médicale U1028, Centre National De La Recherche Scientifique 5292, Lyon, France, CH Le Vinatier, Bâtiment 452, 95 Boulevard Pinel, 69675 Bron, France. .,Lyon 1 University, 43 Boulevard Du 11 Novembre 1918, Villeurbanne, 69100, France.
| | - Nathalie Andre-Obadia
- Department of Functional Neurology and Epileptology, Hospices Civils De Lyon, 59 Boulevard Pinel, Bron, 69675, France
| | - Vasilios K Kimiskidis
- Laboratory of Clinical Neurophysiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
| | - Philippe Ryvlin
- Department of Functional Neurology and Epileptology, Hospices Civils De Lyon, 59 Boulevard Pinel, Bron, 69675, France.,Lyon's Research Neuroscience Center, Institut National De La Santé Et De La Recherche Médicale U1028, Centre National De La Recherche Scientifique 5292, Lyon, France, CH Le Vinatier, Bâtiment 452, 95 Boulevard Pinel, 69675 Bron, France.,Lyon 1 University, 43 Boulevard Du 11 Novembre 1918, Villeurbanne, 69100, France.,Department of Clinical neurosciences, CHU Vaudois, 46 Rue Du Bugnon, Lausanne, 1011, Switzerland
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils De Lyon, 59 Boulevard Pinel, Bron, 69675, France.,Lyon's Research Neuroscience Center, Institut National De La Santé Et De La Recherche Médicale U1028, Centre National De La Recherche Scientifique 5292, Lyon, France, CH Le Vinatier, Bâtiment 452, 95 Boulevard Pinel, 69675 Bron, France.,Lyon 1 University, 43 Boulevard Du 11 Novembre 1918, Villeurbanne, 69100, France
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29
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Kinoshita M, Miyashita K, Tsutsui T, Furuta T, Nakada M. Critical Neural Networks in Awake Surgery for Gliomas. Neurol Med Chir (Tokyo) 2016; 56:674-686. [PMID: 27250817 PMCID: PMC5221778 DOI: 10.2176/nmc.ra.2016-0069] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
From the embarrassing character commonly infiltrating eloquent brain regions, the surgical resection of glioma remains challenging. Owing to the recent development of in vivo visualization techniques for the human brain, white matter regions can be delineated using diffusion tensor imaging (DTI) as a routine clinical practice in neurosurgery. In confirmation of the results of DTI tractography, a direct electrical stimulation (DES) substantially influences the investigation of cortico-subcortical networks, which can be identified via specific symptoms elicited in the concerned white matter tracts (eg., the arcuate fascicle, superior longitudinal fascicles, inferior fronto-occipital fascicle, inferior longitudinal fascicle, frontal aslant tract, sensori-motor tracts, optic radiation, and so forth). During awake surgery for glioma using DES, it is important to identify the anatomo-functional structure of white matter tracts to identify the surgical boundaries of brain regions not only to achieve maximal resection of the glioma but also to maximally preserve quality of life. However, the risk exists that neurosurgeons may be misled by the inability of DTI to visualize the actual anatomy of the white matter fibers, resulting in inappropriate decisions regarding surgical boundaries. This review article provides information of the critical neuronal network that is necessary to identify and understand in awake surgery for glioma, with special references to white matter tracts and the author's experiences.
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30
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Proposal of an optimized strategy for intraoperative testing of speech and language during awake mapping. Neurosurg Rev 2016; 40:29-35. [DOI: 10.1007/s10143-016-0723-x] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 11/15/2015] [Accepted: 01/25/2016] [Indexed: 01/21/2023]
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31
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A connectomics approach combining structural and effective connectivity assessed by intracranial electrical stimulation. Neuroimage 2016; 132:344-358. [DOI: 10.1016/j.neuroimage.2016.02.054] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/31/2016] [Accepted: 02/17/2016] [Indexed: 10/22/2022] Open
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32
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Trebaul L, Rudrauf D, Job AS, Mălîia MD, Popa I, Barborica A, Minotti L, Mîndruţă I, Kahane P, David O. Stimulation artifact correction method for estimation of early cortico-cortical evoked potentials. J Neurosci Methods 2016; 264:94-102. [PMID: 26952846 PMCID: PMC4840016 DOI: 10.1016/j.jneumeth.2016.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Effective connectivity can be explored using direct electrical stimulations in patients suffering from drug-resistant focal epilepsies and investigated with intracranial electrodes. Responses to brief electrical pulses mimic the physiological propagation of signals and manifest as cortico-cortical evoked potentials (CCEP). The first CCEP component is believed to reflect direct connectivity with the stimulated region but the stimulation artifact, a sharp deflection occurring during a few milliseconds, frequently contaminates it. NEW METHOD In order to recover the characteristics of early CCEP responses, we developed an artifact correction method based on electrical modeling of the electrode-tissue interface. The biophysically motivated artifact templates are then regressed out of the recorded data as in any classical template-matching removal artifact methods. RESULTS Our approach is able to make the distinction between the physiological responses time-locked to the stimulation pulses and the non-physiological component. We tested the correction on simulated CCEP data in order to quantify its efficiency for different stimulation and recording parameters. We demonstrated the efficiency of the new correction method on simulations of single trial recordings for early responses contaminated with the stimulation artifact. The results highlight the importance of sampling frequency for an accurate analysis of CCEP. We then applied the approach to experimental data. COMPARISON WITH EXISTING METHOD The model-based template removal was compared to a correction based on the subtraction of the averaged artifact. CONCLUSIONS This new correction method of stimulation artifact will enable investigators to better analyze early CCEP components and infer direct effective connectivity in future CCEP studies.
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Affiliation(s)
- Lena Trebaul
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France; Inserm, U1216, F-38000 Grenoble, France
| | - David Rudrauf
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France; Inserm, U1216, F-38000 Grenoble, France
| | - Anne-Sophie Job
- Inserm, U1216, F-38000 Grenoble, France; Laboratoire de Neurophysiopathologie de l'Epilepsie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | | | - Irina Popa
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | - Andrei Barborica
- Physics Department, University of Bucharest, Bucharest, Romania; FHC Inc, Bowdoin, ME, USA
| | - Lorella Minotti
- Inserm, U1216, F-38000 Grenoble, France; Laboratoire de Neurophysiopathologie de l'Epilepsie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Ioana Mîndruţă
- Neurology Department, University Emergency Hospital, Bucharest, Romania; Neurology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Philippe Kahane
- Inserm, U1216, F-38000 Grenoble, France; Laboratoire de Neurophysiopathologie de l'Epilepsie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Olivier David
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France; Inserm, U1216, F-38000 Grenoble, France.
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33
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Vincent M, Rossel O, Hayashibe M, Herbet G, Duffau H, Guiraud D, Bonnetblanc F. The difference between electrical microstimulation and direct electrical stimulation – towards new opportunities for innovative functional brain mapping? Rev Neurosci 2016; 27:231-58. [DOI: 10.1515/revneuro-2015-0029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/17/2015] [Indexed: 11/15/2022]
Abstract
AbstractBoth electrical microstimulation (EMS) and direct electrical stimulation (DES) of the brain are used to perform functional brain mapping. EMS is applied to animal fundamental neuroscience experiments, whereas DES is performed in the operating theatre on neurosurgery patients. The objective of the present review was to shed new light on electrical stimulation techniques in brain mapping by comparing EMS and DES. There is much controversy as to whether the use of DES during wide-awake surgery is the ‘gold standard’ for studying the brain function. As part of this debate, it is sometimes wrongly assumed that EMS and DES induce similar effects in the nervous tissues and have comparable behavioural consequences. In fact, the respective stimulation parameters in EMS and DES are clearly different. More surprisingly, there is no solid biophysical rationale for setting the stimulation parameters in EMS and DES; this may be due to historical, methodological and technical constraints that have limited the experimental protocols and prompted the use of empirical methods. In contrast, the gap between EMS and DES highlights the potential for new experimental paradigms in electrical stimulation for functional brain mapping. In view of this gap and recent technical developments in stimulator design, it may now be time to move towards alternative, innovative protocols based on the functional stimulation of peripheral nerves (for which a more solid theoretical grounding exists).
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Affiliation(s)
- Marion Vincent
- 1INRIA, Université de Montpellier, LIRMM, équipe DEMAR, F-34095 Montpellier, France
| | - Olivier Rossel
- 1INRIA, Université de Montpellier, LIRMM, équipe DEMAR, F-34095 Montpellier, France
| | - Mitsuhiro Hayashibe
- 1INRIA, Université de Montpellier, LIRMM, équipe DEMAR, F-34095 Montpellier, France
| | | | | | - David Guiraud
- 1INRIA, Université de Montpellier, LIRMM, équipe DEMAR, F-34095 Montpellier, France
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34
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Rech F, Herbet G, Moritz-Gasser S, Duffau H. Somatotopic organization of the white matter tracts underpinning motor control in humans: an electrical stimulation study. Brain Struct Funct 2015; 221:3743-53. [PMID: 26459143 DOI: 10.1007/s00429-015-1129-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 10/04/2015] [Indexed: 10/23/2022]
Abstract
The somatotopic organization of the primary motor cortex is well documented. However, a possible somatotopy of the network involved in motor control, i.e., eliciting negative motor phenomena during electrostimulation, is unknown in humans, particularly at the subcortical level. Here, we performed electrical stimulation mapping in awake patients operated for gliomas, to study the distribution of the white matter tracts subserving movement control of the lower limb, upper limb(s), and speech. Eighteen patients underwent awake surgery for frontal low-grade gliomas, by using intraoperative subcortical electrostimulation mapping to search interference with movement of the leg, arm(s), and face. We assessed the negative motor responses and their distribution throughout the tracts located under premotor areas. The corresponding stimulation sites were reported on a standard brain template for visual analysis and between-subjects comparisons. During stimulation of the white matter underneath the dorsal premotor cortex and supplementary motor area, rostral to the corticospinal tracts, all patients experienced cessation of the movement of lower and upper limbs, of bimanual coordination, and/or speech. These subcortical sites were somatotopically distributed. Indeed, stimulation of the fibers from mesial to lateral directions and from posterior to anterior directions evoked arrest of movement of the lower limb (mesially and posteriorly), upper limb(s), and face/speech (laterally and anteriorly). There were no postoperative permanent deficits. This is the first evidence of a somatotopic organization of the white matter bundles underpinning movement control in humans. A better knowledge of the distribution of this motor control network may be helpful in neurosciences and neurosurgery.
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Affiliation(s)
- Fabien Rech
- Department of Neurosurgery, CHU Nancy, Nancy, France
| | - Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Avenue Augustin Fliche, 34295, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", INSERM U1051, Institute for Neurosciences of Montpellier, Montpellier, France
| | - Sylvie Moritz-Gasser
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Avenue Augustin Fliche, 34295, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", INSERM U1051, Institute for Neurosciences of Montpellier, Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 80 Avenue Augustin Fliche, 34295, Montpellier, France. .,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", INSERM U1051, Institute for Neurosciences of Montpellier, Montpellier, France.
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35
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Yamao Y, Kunieda T, Matsumoto R. Reply to Commentary on "Neural correlates of mirth and laughter: A direct electrical cortical stimulation study". Cortex 2015; 75:244-246. [PMID: 25998750 DOI: 10.1016/j.cortex.2015.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 03/17/2015] [Accepted: 03/24/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Japan.
| | - Riki Matsumoto
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan.
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Kunieda T, Yamao Y, Kikuchi T, Matsumoto R. New Approach for Exploring Cerebral Functional Connectivity: Review of Cortico-cortical Evoked Potential. Neurol Med Chir (Tokyo) 2015; 55:374-82. [PMID: 25925755 PMCID: PMC4628165 DOI: 10.2176/nmc.ra.2014-0388] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
There has been a paradigm shift in the understanding of brain function. The intrinsic architecture of neuronal connections forms a key component of the cortical organization in our brain. Many imaging studies, such as noninvasive magnetic resonance imaging (MRI) studies, have now enabled visualization of the white matter fiber tracts interconnecting the functional cortical areas in the living brain. Although such a structural connectome is essential for understanding of cortical function, the anatomical information alone is not sufficient. Practically, few techniques allow the investigation of the excitatory and inhibitory mechanisms of the cortex in vivo in humans. Several attempts have been made to track neuronal connectivity by applying direct electrical stimuli to the brain in order to stimulate subdural and/or depth electrodes and record responses from the functionally connected cortex. In vivo single-pulse electrical stimulation (SPES) and/or cortico-cortical evoked potential (CCEP) were recently introduced to track various brain networks. This article reviews the concepts, significance, methods, mechanisms, limitations, and clinical applications of CCEP in the analysis of these dynamic connections.
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Affiliation(s)
- Takeharu Kunieda
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
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Connections of the limbic network: A corticocortical evoked potentials study. Cortex 2015; 62:20-33. [DOI: 10.1016/j.cortex.2014.06.018] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 05/07/2014] [Accepted: 06/26/2014] [Indexed: 11/22/2022]
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Saito T, Muragaki Y, Maruyama T, Tamura M, Nitta M, Okada Y. Intraoperative functional mapping and monitoring during glioma surgery. Neurol Med Chir (Tokyo) 2014; 55:1-13. [PMID: 25744346 PMCID: PMC4533401 DOI: 10.2176/nmc.ra.2014-0215] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Glioma surgery represents a significant advance with respect to improving resection rates using new surgical techniques, including intraoperative functional mapping, monitoring, and imaging. Functional mapping under awake craniotomy can be used to detect individual eloquent tissues of speech and/or motor functions in order to prevent unexpected deficits and promote extensive resection. In addition, monitoring the patient’s neurological findings during resection is also very useful for maximizing the removal rate and minimizing deficits by alarming that the touched area is close to eloquent regions and fibers. Assessing several types of evoked potentials, including motor evoked potentials (MEPs), sensory evoked potentials (SEPs) and visual evoked potentials (VEPs), is also helpful for performing surgical monitoring in patients under general anesthesia (GA). We herein review the utility of intraoperative mapping and monitoring the assessment of neurological findings, with a particular focus on speech and the motor function, in patients undergoing glioma surgery.
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Affiliation(s)
- Taiichi Saito
- Department of Neurosurgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women' Medical University; Department of Neurosurgery, Tokyo Rosai Hospital
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Maillard L, Gavaret M, Régis J, Wendling F, Bartolomei F. Fast epileptic discharges associated with ictal negative motor phenomena. Clin Neurophysiol 2014; 125:2344-8. [DOI: 10.1016/j.clinph.2014.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 02/10/2014] [Accepted: 03/25/2014] [Indexed: 11/28/2022]
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Serletis D, Bulacio J, Bingaman W, Najm I, González-Martínez J. The stereotactic approach for mapping epileptic networks: a prospective study of 200 patients. J Neurosurg 2014; 121:1239-46. [DOI: 10.3171/2014.7.jns132306] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Stereoelectroencephalography (SEEG) is a methodology that permits accurate 3D in vivo electroclinical recordings of epileptiform activity. Among other general indications for invasive intracranial electroencephalography (EEG) monitoring, its advantages include access to deep cortical structures, its ability to localize the epileptogenic zone when subdural grids have failed to do so, and its utility in the context of possible multifocal seizure onsets with the need for bihemispheric explorations. In this context, the authors present a brief historical overview of the technique and report on their experience with 2 SEEG techniques (conventional Leksell frame-based stereotaxy and frameless stereotaxy under robotic guidance) for the purpose of invasively monitoring difficult-to-localize refractory focal epilepsy.
Methods
Over a period of 4 years, the authors prospectively identified 200 patients with refractory epilepsy who collectively underwent 2663 tailored SEEG electrode implantations for invasive intracranial EEG monitoring and extraoperative mapping. The first 122 patients underwent conventional Leksell frame-based SEEG electrode placement; the remaining 78 patients underwent frameless stereotaxy under robotic guidance, following acquisition of a stereotactic ROSA robotic device at the authors' institution. Electrodes were placed according to a preimplantation hypothesis of the presumed epileptogenic zone, based on a standardized preoperative workup including video-EEG monitoring, MRI, PET, ictal SPECT, and neuropsychological assessment. Demographic features, seizure semiology, number and location of implanted SEEG electrodes, and location of the epileptogenic zone were recorded and analyzed for all patients. For patients undergoing subsequent craniotomy for resection, the type of resection and procedure-related complications were prospectively recorded. These results were analyzed and correlated with pathological diagnosis and postoperative seizure outcomes.
Results
The epileptogenic zone was confirmed by SEEG in 154 patients (77%), of which 134 (87%) underwent subsequent craniotomy for epileptogenic zone resection. Within this cohort, 90 patients had a minimum follow-up of at least 12 months; therein, 61 patients (67.8%) remained seizure free, with an average follow-up period of 2.4 years. The most common pathological diagnosis was focal cortical dysplasia Type I (55 patients, 61.1%). Per electrode, the surgical complications included wound infection (0.08%), hemorrhagic complications (0.08%), and a transient neurological deficit (0.04%) in a total of 5 patients (2.5%). One patient (0.5%) ultimately died due to intracerebral hematoma directly ensuing from SEEG electrode placement.
Conclusions
Based on these results, SEEG methodology is safe, reliable, and effective. It is associated with minimal morbidity and mortality, and serves as a practical, minimally invasive approach to extraoperative localization of the epileptogenic zone in patients with refractory epilepsy.
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Affiliation(s)
- Demitre Serletis
- 1Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and
| | - Juan Bulacio
- 2Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - William Bingaman
- 2Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Imad Najm
- 2Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
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Kinoshita M, de Champfleur NM, Deverdun J, Moritz-Gasser S, Herbet G, Duffau H. Role of fronto-striatal tract and frontal aslant tract in movement and speech: an axonal mapping study. Brain Struct Funct 2014; 220:3399-412. [DOI: 10.1007/s00429-014-0863-0] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
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Entz L, Tóth E, Keller CJ, Bickel S, Groppe DM, Fabó D, Kozák LR, Erőss L, Ulbert I, Mehta AD. Evoked effective connectivity of the human neocortex. Hum Brain Mapp 2014; 35:5736-53. [PMID: 25044884 DOI: 10.1002/hbm.22581] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 06/04/2014] [Accepted: 06/27/2014] [Indexed: 10/25/2022] Open
Abstract
The role of cortical connectivity in brain function and pathology is increasingly being recognized. While in vivo magnetic resonance imaging studies have provided important insights into anatomical and functional connectivity, these methodologies are limited in their ability to detect electrophysiological activity and the causal relationships that underlie effective connectivity. Here, we describe results of cortico-cortical evoked potential (CCEP) mapping using single pulse electrical stimulation in 25 patients undergoing seizure monitoring with subdural electrode arrays. Mapping was performed by stimulating adjacent electrode pairs and recording CCEPs from the remainder of the electrode array. CCEPs reliably revealed functional networks and showed an inverse relationship to distance between sites. Coregistration to Brodmann areas (BA) permitted group analysis. Connections were frequently directional with 43% of early responses and 50% of late responses of connections reflecting relative dominance of incoming or outgoing connections. The most consistent connections were seen as outgoing from motor cortex, BA6-BA9, somatosensory (SS) cortex, anterior cingulate cortex, and Broca's area. Network topology revealed motor, SS, and premotor cortices along with BA9 and BA10 and language areas to serve as hubs for cortical connections. BA20 and BA39 demonstrated the most consistent dominance of outdegree connections, while BA5, BA7, auditory cortex, and anterior cingulum demonstrated relatively greater indegree. This multicenter, large-scale, directional study of local and long-range cortical connectivity using direct recordings from awake, humans will aid the interpretation of noninvasive functional connectome studies.
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Affiliation(s)
- László Entz
- Department of Neurosurgery, Hofstra North Shore LIJ School of Medicine and Feinstein Institute of Medical Research, Manhasset, New York, 11030; Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, 1132, Hungary; Department of Functional Neurosurgery and Department of Epilepsy, National Institute of Clinical Neuroscience, Budapest, 1145, Hungary; Péter Pázmány Catholic University, Faculty of Information Technology and Bionics, Budapest, 1083, Hungary
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Saito T, Tamura M, Muragaki Y, Maruyama T, Kubota Y, Fukuchi S, Nitta M, Chernov M, Okamoto S, Sugiyama K, Kurisu K, Sakai KL, Okada Y, Iseki H. Intraoperative cortico-cortical evoked potentials for the evaluation of language function during brain tumor resection: initial experience with 13 cases. J Neurosurg 2014; 121:827-38. [PMID: 24878290 DOI: 10.3171/2014.4.jns131195] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objective in the present study was to evaluate the usefulness of cortico-cortical evoked potentials (CCEP) monitoring for the intraoperative assessment of speech function during resection of brain tumors. METHODS Intraoperative monitoring of CCEP was applied in 13 patients (mean age 34 ± 14 years) during the removal of neoplasms located within or close to language-related structures in the dominant cerebral hemisphere. For this purpose strip electrodes were positioned above the frontal language area (FLA) and temporal language area (TLA), which were identified with direct cortical stimulation and/or preliminary mapping with the use of implanted chronic subdural grid electrodes. The CCEP response was defined as the highest observed negative peak in either direction of stimulation. In 12 cases the tumor was resected during awake craniotomy. RESULTS An intraoperative CCEP response was not obtained in one case because of technical problems. In the other patients it was identified from the FLA during stimulation of the TLA (7 cases) and from the TLA during stimulation of the FLA (5 cases), with a mean peak latency of 83 ± 15 msec. During tumor resection the CCEP response was unchanged in 5 cases, decreased in 4, and disappeared in 3. Postoperatively, all 7 patients with a decreased or absent CCEP response after lesion removal experienced deterioration in speech function. In contrast, in 5 cases with an unchanged intraoperative CCEP response, speaking abilities after surgery were preserved at the preoperative level, except in one patient who experienced not dysphasia, but dysarthria due to pyramidal tract injury. This difference was statistically significant (p < 0.01). The time required to recover speech function was also significantly associated with the type of intraoperative change in CCEP recordings (p < 0.01) and was, on average, 1.8 ± 1.0, 5.5 ± 1.0, and 11.0 ± 3.6 months, respectively, if the response was unchanged, was decreased, or had disappeared. CONCLUSIONS Monitoring CCEP is feasible during the resection of brain tumors affecting language-related cerebral structures. In the intraoperative evaluation of speech function, it can be a helpful adjunct or can be used in its direct assessment with cortical and subcortical mapping during awake craniotomy. It can also be used to predict the prognosis of language disorders after surgery and decide on the optimal resection of a neoplasm.
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Mandonnet E, Duffau H. Understanding entangled cerebral networks: a prerequisite for restoring brain function with brain-computer interfaces. Front Syst Neurosci 2014; 8:82. [PMID: 24834030 PMCID: PMC4018536 DOI: 10.3389/fnsys.2014.00082] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 04/20/2014] [Indexed: 11/23/2022] Open
Abstract
Historically, cerebral processing has been conceptualized as a framework based on statically localized functions. However, a growing amount of evidence supports a hodotopical (delocalized) and flexible organization. A number of studies have reported absence of a permanent neurological deficit after massive surgical resections of eloquent brain tissue. These results highlight the tremendous plastic potential of the brain. Understanding anatomo-functional correlates underlying this cerebral reorganization is a prerequisite to restore brain functions through brain-computer interfaces (BCIs) in patients with cerebral diseases, or even to potentiate brain functions in healthy individuals. Here, we review current knowledge of neural networks that could be utilized in the BCIs that enable movements and language. To this end, intraoperative electrical stimulation in awake patients provides valuable information on the cerebral functional maps, their connectomics and plasticity. Overall, these studies indicate that the complex cerebral circuitry that underpins interactions between action, cognition and behavior should be throughly investigated before progress in BCI approaches can be achieved.
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Affiliation(s)
- Emmanuel Mandonnet
- Department of Neurosurgery, Hôpital Lariboisière Paris, France ; Department of Neurosurgery, Université Paris Diderot Paris, France ; IMNC, UMR 8165 Orsay, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center Montpellier, France ; Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," INSERM U1051, Institute for Neuroscience of Montpellier, Montpellier University Medical Center Montpellier, France
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Yamao Y, Matsumoto R, Kunieda T, Arakawa Y, Kobayashi K, Usami K, Shibata S, Kikuchi T, Sawamoto N, Mikuni N, Ikeda A, Fukuyama H, Miyamoto S. Intraoperative dorsal language network mapping by using single-pulse electrical stimulation. Hum Brain Mapp 2014; 35:4345-61. [PMID: 24615889 DOI: 10.1002/hbm.22479] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/27/2013] [Accepted: 01/21/2014] [Indexed: 11/09/2022] Open
Abstract
The preservation of language function during brain surgery still poses a challenge. No intraoperative methods have been established to monitor the language network reliably. We aimed to establish intraoperative language network monitoring by means of cortico-cortical evoked potentials (CCEPs). Subjects were six patients with tumors located close to the arcuate fasciculus (AF) in the language-dominant left hemisphere. Under general anesthesia, the anterior perisylvian language area (AL) was first defined by the CCEP connectivity patterns between the ventrolateral frontal and temporoparietal area, and also by presurgical neuroimaging findings. We then monitored the integrity of the language network by stimulating AL and by recording CCEPs from the posterior perisylvian language area (PL) consecutively during both general anesthesia and awake condition. High-frequency electrical stimulation (ES) performed during awake craniotomy confirmed language function at AL in all six patients. Despite an amplitude decline (≤32%) in two patients, CCEP monitoring successfully prevented persistent language impairment. After tumor removal, single-pulse ES was applied to the white matter tract beneath the floor of the removal cavity in five patients, in order to trace its connections into the language cortices. In three patients in whom high-frequency ES of the white matter produced naming impairment, this "eloquent" subcortical site directly connected AL and PL, judging from the latencies and distributions of cortico- and subcortico-cortical evoked potentials. In conclusion, this study provided the direct evidence that AL, PL, and AF constitute the dorsal language network. Intraoperative CCEP monitoring is clinically useful for evaluating the integrity of the language network.
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Affiliation(s)
- Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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